[Is the system of assigned general practitioners more demanding for female than male physicians?]. / Er fastlegesystemet mer krevende for kvinnelige enn for mannlige leger?

The Ministry of Health has tried out and evaluated the personal doctor system in four municipalities in Norway (1993-96). We have explored the reported workload, and whether there were any reporting differences between female and male doctors. We also explored some of the possible factors explaining the reported increased workload. The doctors reported their workload by a postal questionnaire survey. The information from the questionnaires was linked to the doctors' lists received from the National Insurance Administration and were analysed separately for male and female doctors. Female doctors had more women and children on their patient lists, male doctors more men and elderly people. 50% of all the doctors reported that their workload was too heavy. There were no significant differences between male and female doctors in reporting too heavy total workload. 52% of male doctors and 82% of female doctors reported an increase in workload after the introduction of personal doctor system (p < 0.05). Of the explaining factors analysed, only women-dominated lists were associated with reported heavy workload among female doctors (p < 0.05). If the personal doctor system is to be introduced as a national system, it would seem important to have some control over the generation of lists to avoid too heavy workloads.

Antibodies to dsDNA are produced during primary BK virus infection in man, indicating that anti-dsDNA antibodies may be related to virus replication in vivo.

Experimental immunizations with both the Polyomavirus BK and with the isolated viral genomic dsDNA regularly induce antibodies with a relative affinity for BK virus dsDNA. In the present study we demonstrate that the anti-dsDNA responses to BK virus in experimental animals also appear during natural BK virus infection in man. Fifty-nine children were examined over time for serological signs of primary BK virus infection. Of eight children found to undergo primary infection with BK virus, anti-BK dsDNA antibodies appeared in all. In 4 of the 8 patients the antibodies cross-reacted significantly with mammalian dsDNA, and weak cross-reactions were also noted in at least three other patients. The antibodies resembled those induced in the experimental model with regard to their relative affinity for BK dsDNA. In contrast, most, but not all, anti-dsDNA antibodies from 10 SLE patients cross-reacted extensively with dsDNA from viral and mammalian origin. Thus, a dsDNA virus like BK virus may provoke immunological intolerance to dsDNA, but, with qualities different from those produced during SLE. The present observations demonstrate that induction of anti-dsDNA antibodies is not restricted to experimental immunization of animals, but does also take place in humans during naturally acquired BK virus infection. The relevance of this model for the spontaneous production of anti-dsDNA antibodies is discussed.