December 10th 2008
This week in medicine
The following will appear in the Dec 13 issue of The Lancet:
Tired doctors In the USA, an Institute of Medicine report has recommended changes in medical training to help ensure patient safety. At present, medical residents can work up to an 80 h week, with individual shifts of 30 h. The report proposes compulsory sleep breaks and better shift structures to minimise the risk of errors caused by tiredness. However, it might be difficult for hospitals to afford the changes, which could cost up to $1·7 billion.
Teething-syrup deaths 34 infants in Nigeria have died from kidney failure after taking teething syrup tainted with diethylene glycol. The National Agency for Food, Drug Administration and Control has said that it is flying in doses of antidote from the UK. So far, more than 400 bottles of the syrup have been retrieved from the market and several arrests have been made in connection with the case.
Health-system collapse In Zimbabwe, doctors from Parirenyatwa Hospital-named after Tichafa Parirenyatwa, the first black Zimbabwean to graduate as a doctor-have presented a petition to the health minister, David Parirenyatwa, Tichafa’s son. The hospital, once one of Zimbabwe’s best, has been forced to close because of a lack of power, running water, medical supplies, and staff-most of whom have walked out because of the conditions.
Private care An Oxfam report, Blind optimism: challenging the myths about private health care in poor countries, finds that evidence in favour of private-sector solutions to health care is weak. Yet a growing number of international donors are promoting private-sector health-care delivery in the poorest countries, while neglecting expansion of government provision of free health services.
Drink measures The UK Government is clamping down on alcohol-fuelled crime and disorder by introducing a mandatory code of practice for retailers. New regulatory measures will include banning of “all you can drink” promotions in pubs, compulsory display of unit content, and an end to multipack supermarket discounts. Last year, a fifth of violent incidents in the UK took place in or around pubs and clubs, at a cost of £7·3 billion.
Ambulance joy The Somali capital, Mogadishu, is to have an emergency ambulance service for the first time in nearly 20 years. The free service, partly provided by Irish charity Lifeline Africa Foundation, has five ambulances staffed by a team of nurses. Patients in need of emergency transport can dial 777 and be rapidly taken to hospital. Previously many patients had to be transported in carts and wheelbarrows.
Hard up Harvard University’s fabled endowment, having peaked in mid- 2008 at about US$37 billion, has been hit by the global financial crisis. The private Ivy League school, based in Cambridge, MA, USA, has seen its funds decrease by about $8 billion, or 22%, so far, indicating that budget cuts will be necessary in the coming year.
Polio-free by 2011 In Bangladesh, 22 million children younger than 5 years of age-97% of this age group-were successfully immunised against polio on the country’s 17th national immunisation day. Government workers and 600 000 volunteers administered oral polio vaccines to children in 140 000 sites across the country followed by a 4-day house-to-house search.
Radical policy Swiss voters have supported a proposal to provide prescription heroin to addicts. 68% of voters backed the scheme, under which addicts can visit clinics twice a day to inject the drug under medical supervision. The plan has been described as a last resort but supporters believe it is effective, allowing addicts to be treated for other medical problems, including mental-health issues.
Milk scandal The Chinese Ministry of Health has revised estimates for the number of children affected by melamine-contaminated milk from 50 000 to 294 000. The official number of melamine-related deaths now stands at six, although some believe that figure to be incomplete. 861 babies are still in hospital with renal complications, with 184 of those said to be severe cases.
Side-effects The US FDA plans to study how side-effect statements in TV drug adverts affect understanding of risk information. 1600 people will view several commercials, including one for a fictitious blood pressure medicine, in which the placement and display time of two side-effect statements will be varied. Participants’ comprehension of risks and benefits associated with the products will then be assessed.
Stretching the imagination India’s health minister, Anbumani Ramadoss, has told a diabetes summit in southern India that he wants to make yoga mandatory for all schoolchildren in the country next year in the hope that it will reduce the prevalence of stress, hypertension, and diabetes. Fingers, arms, and legs crossed that it works.
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