Ask the patient

Patient-reported outcomes (PROs) are commonly used in research involving large numbers of participants, such as clinical trials, but they can be very useful at the individual level, say the authors of a commentary about including such tools in clinical practice. PROs can be used as screening questionnaires, with follow-up in the management of conditions such as depression, and in cancer management as a tool to provide feedback to the clinician about treatment and quality of life. The authors comment that, as well as being useful to facilitate communication between clinician and patient, PROs can improve patients’ recall of health-related incidents and help identify problems which they might not otherwise have raised.

Lancet 2009; 374: 369-370

Solvent exposure and lymphoma

Frequent and heavy exposure to degreasing work, which uses organic solvents, may be associated with an increased risk of non-Hodgkin lymphoma (NHL), say the authors of a US study. In a large, population-based case-control study of NHL, researchers collected information about solvent exposure and used the resulting detailed data to search for a relationship between risk of NHL and such tasks as degreasing, painting, stripping paint, gluing and staining. An apparent increased risk for NHL was observed in subjects performing a large number of degreasing jobs that placed them in the highest category of maximal degreasing frequency (more than 520 hours per year). Other solvent-related tasks did not seem to be associated with NHL. The authors acknowledge limitations of the study, including the small numbers of participants highly exposed to solvent-related tasks. Despite this, they suggest that research needs to be done to determine the effect of degreasing agents on lymphomagenesis.

Occup Environ Med 2009; 66: 557-560

Chlamydia in men — a quick test

A new, rapid urine test for chlamydia in men using first-void urine has shown promising results in a UK evaluation trial. The study, which involved over 1200 men, compared the sensitivity, specificity, positive predictive value, and negative predictive value of the Chlamydia Rapid Test with a traditional polymerase chain reaction assay. The new test performed well on all criteria, having a combined overall sensitivity and specificity of 82.6% and 98.5%, respectively. The authors comment that test results are available within 1 hour, allowing for immediate treatment and contact tracing, and that first-void urine is a preferable collection method to urethral swabbing for many men. They also point out that the test could be used as a screening tool in areas where infection with Chlamydia trachomatis is highly prevalent or access to nucleic acid amplification testing is limited.

BMJ 2009; 339: b2655

Twin towers — the health legacy

Almost 8 years after the terrorist attacks on the World Trade Center on 11 September 2001, a longitudinal cohort study has been published highlighting some of the ongoing health effects in those who were involved. The World Trade Center Health Registry includes information on over 70 000 rescue and recovery workers, residents, office workers and passers-by who were affected by the event. Two surveys, completed in 2003-2004 and 2006-2007, reported new asthma diagnoses in 10.2% of adults post-event, with asthma risk highest among rescue and recovery workers exposed to the heavy dust cloud associated with the event. Participants also completed a post-traumatic stress disorder (PTSD) checklist; of those with no PTSD history, nearly a quarter reported symptoms at either survey and nearly 10% had symptoms at both surveys. The authors recommend short-and long-term interventions for mental and physical health following future disasters.

JAMA 2009; 302: 298-305

Dr Tanya Grassi, MJA

©The Medical Journal of Australia 2009 www.mja.com.au PRINT ISSN: 0025-729X ONLINE ISSN: 1326-5377