Ambulatory gynaecology: what can we do?

The aim of ambulatory gynaecology is to admit, treat and discharge the patient on the same day in an outpatient setting. Traditional inpatient operations are being rapidly replaced by office, outpatient or day surgery procedures. In this review, a brief assessment of current ambulatory gynaecological practice is attempted, followed by a discussion of audit and quality assessment methods.

Stem cells as future therapy in cardiology.

This article focuses on the key studies relevant to the clinical application of stem-cell research in cardiovascular disease. The authors also discuss current and future directions in clinical cardiovascular stem-cell research, including the potential problems and pitfalls that must be addressed to ensure the safety, as well as the efficacy, of treatment regimens in this rapidly evolving therapeutic field.

Down-regulation of nitric oxide synthase in the diabetic rabbit kidney: potential relevance to the early pathogenesis of diabetic nephropathy.

Objectives: Nephropathy is a well-recognised complication of diabetes mellitus (DM). The aim of this study was to investigate the effect of DM on the density and distribution of nitric oxide (NO) synthase (NOS) in the rabbit kidney. Quantification of the NOS radioligand on slide-mounted sections was compared with the nitroblue tetrazolium reaction, where the intensity of the reaction varies with the nicotinamide adenine dinucleotide diaphorase (NADPH-d) activity of NOS.

The national clinical assessment authority: a healthy sign of the times.

The National Clinical Assessment Authority (NCAA) is a special health authority established on the 1 April 2001 following recommendations made in the Chief Medical Officer's reports, Supporting doctors, protecting patients (November 1999) and Assuring the quality of medical practice (January 2001). The aim of the Authority is to provide a support service to NHS primary care, hospital and community trusts, and to the Prison and Defence Medical Services when they are faced with concerns at the performance of an individual doctor or dentist. The Authority provides advice, takes referrals and carries out targeted assessments where necessary, using trained medical and lay assessors.

A systematic review of the use of opioids in the management of dyspnoea.

Background: Opioids are commonly used to treat dyspnoea in palliative medicine but there has been no formal evaluation of the evidence for their effectiveness in the treatment of dyspnoea. A systematic review was therefore carried out to examine this.

Methods: The criteria for inclusion required that studies were double blind, randomised, placebo controlled trials of opioids for the treatment of dyspnoea secondary to any cause.

Cross-reaction of human chorionic gonadotrophin in Immulite 2000 luteinizing hormone assay.

Background And Method: The cross-reactivity of human chorionic gonadotrophin (hCG) in the new DPC Immulite 2000 luteinizing hormone immunoassay was studied using sera from healthy pregnant women and pooled serum spiked with hCG standard IRP 75/537.

Results And Conclusion: Significant positive bias was seen in sera from pregnant women and in IRP 75/537 spiked serum.

The role of methicillin-resistant Staphylococcus aureus in orthopaedic implant surgery.

The problems presented by methicillin-resistant Staphylococcus aureus (MRSA) must be accommodated in both prophylactic and treatment regimens for orthopaedic implant surgery. The rationale of pre-admission nasal swabbing in directing prophylaxis for orthopaedic patients is discussed. The potential advantage of nasal mupirocin for Staphylococcus aureus and MRSA carriers is described.

Opioids for the palliation of breathlessness in terminal illness.

Background: Breathlessness is a common symptom in people with advanced disease. The most effective treatments are aimed at treating the underlying cause of the breathlessness but this may not be possible and symptomatic treatment is often necessary. Strategies for the symptomatic treatment of breathlessness have never been systematically evaluated.