Before 'fore'

When it comes to sports-related ocular injuries in North America, golfing injuries of the eye rank third, behind ice hockey and air gun injuries. New Zealand authors have reported a series of 11 serious cases of golf-related ocular trauma seen at two tertiary hospitals. Four of the injuries were caused by golf clubs and occurred only in children who were playing with other children. Of the seven injuries due to golf balls, three occurred in spectators.

The authors recommended supervision for children and, for adults, the wearing of protective polycarbonate lenses, which can be incorporated into sunglasses or prescription lenses.

Clin Exp Ophthalmology 2003; 31: 110-113

Stonehenge and the vulva

Canadian theorists have likened the layout of the ancient and mysterious Stonehenge to the anatomy of the human vulva. The outer stone circle would correspond with the labia majora as the altar stone would to the clitoris. By extending the analogy, they say the henge could represent, symbolically, the opening by which Earth Mother gave birth to the plants and animals on which the peoples of the time so depended – ie, via its empty geometric centre (the birth canal).

J R Soc Med 2003; 96: 94-98

Prevent cancer, lose weight

A prospective study of a cohort of 900 000 adults in the US has found that increased body weight is associated with increased death rates for all cancers combined and for cancer at many specific sites. Study subjects were cancer-free at enrolment. By the end of follow-up 16 years later, 57 145 deaths from cancer had occurred. Compared with men and women of normal weight, the risk of dying from cancer in those with a body mass index of at least 40 was 52% higher for men and 62% higher for women. In both men and women, a higher body mass index was also linked to increasingly higher rates of death due to non-Hodgkin's lymphoma, multiple myeloma and to cancer of the oesophagus, colon, rectum, liver, gallbladder, pancreas and kidney.

N Engl J Med 2003; 348: 1625-1638

Hip protection . . . or not?

The Amsterdam Hip Protector Study   a randomised controlled (but not blinded) trial of 561 institutionalised elderly people at high risk of hip fracture   has found that the hip protector studied was not effective in preventing hip fractures. Also, four of the 18 people in the intervention group who went on to fracture a hip did so while wearing protectors.

The study researchers pointed out that theirs is the fourth of 11 published randomised controlled trials to report a negative finding; further, none of the four were considered in a Cochrane review of the matter.

JAMA 2003; 289: 1957-1962

How SARS was contained

A mass voluntary quarantine of over 5000 people was one of many steps undertaken by a 419-bed community hospital in Toronto that helped in the successful containment of an outbreak of severe acute respiratory syndrome (SARS) in that institution.

The index case had been transferred from another hospital for urgent haemodialysis on 16 March 2003; a diagnosis of probable SARS was reached on 28 March 2003, after the patient had spent 13 days in the intensive care unit. In the interim, no specific respiratory isolation precautions were used and potential unprotected exposure of other patients and staff occurred.

Because of uncertainty about SARS infectivity at the time, the public health measures taken included the quarantine of 1800 hospital staff, 225 physicians, as well as volunteers, patients and all visitors to the hospital in the period between admission and diagnosis of the index case; a screening questionnaire for all those entering the hospital; wearing of gowns, gloves and N95 masks by all staff and visitors to the hospital; cessation of many of the hospital's clinical services; and the development of a self-contained SARS Assessment and Treatment Unit. The outbreak was limited to 15 others: the patient's wife, three other patients, a hospital visitor and 10 staff, mainly nurses.

CMAJ 2003; 168(11): Online-1-6