The Avoid Stroke as Soon as Possible (ASAP) audit by Sturm and colleagues of over 16 000 patients in general practice (page 312) revealed that nearly three-quarters had at least one risk factor for having a stroke. Given that these are modifiable risk factors, what are the ingredients for success in preventing stroke? The editorial by Levi et al (page 303) suggests how GPs could be assisted in assessing risk of stroke.
Is Sydney an area of iodine deficiency? Are Sydney’s infants at risk of impaired brain development? To answer these questions, McElduff and colleagues (page 317) measured thyroid-stimulating hormone levels in neonates and compared the results of some with the urine iodine concentrations of their mothers.
An editorial by Laurberg and Nøhr (page 306) explains the difficulties inherent in evaluating iodine intake and the risk of thyroid disease in mothers and infants, supporting the call for a formal study of the iodine status of Australian communities.
Raising the subject of adequate remuneration is guaranteed to get many GPs hot under the collar. The MJA is tackling the debate with a series on fundholding in primary care. In the first article of this series, Beilby and Pekarsky (page 321) explain the concept and report on the outcomes of the fundholding “experiments” so far undertaken in Australia.
Anyone who imagines that guidelines are formulated in an atmosphere of evidence-based calm will find out how wrong they are on this issue. A Working Group (of clinicians, academics and industry representatives) met to generate guidelines for safe prescribing of COX-2 inhibitors (page 328). However, Edmonds and colleagues (page 332) give an eye-opening account of the dissent behind the scenes which led to several members withdrawing from the Group.
So, how far can we trust guidelines if they mask such diversity of opinion? Van Der Weyden’s editorial (page 304) takes the debate forward: it’s not how but who that matters . . .
Beware the boogie board
A crystal ball can be useful when you’re wondering which patients with pneumonia need hospital admission. However, in the absence of this definitive decision-support tool, Johnson et al (page 341) delineate how to tell which patients will do poorly at home. This instalment of the MJA Practice Essentials – Infectious Diseases series provides the latest on diagnosis and therapy of community-acquired pneumonia.
|MJA exclusive: landmark Australian genome research!
Sydney researchers Fitzgerald and Isaacs have won the race to report definitive data linking genotype–phenotype correlations with personality traits. Turn to page 339 for their innovative findings on a sample of healthcare professionals.
|I’ll be watching you . . .
What do Madonna, John Lennon and Monica Seles have in common with some doctors? They’ve been the objects of the unwanted attentions of stalkers. Doctors are at greater risk of being stalked, mainly because of our regular contact with lonely and “disordered” patients. Pathé and colleagues (page 335) describe why some patients stalk doctors, and how to handle such patients and prevent stalking incidents.
|Shaken baby syndrome
Moran’s report (page 310) of a National Australian Conference on this syndrome, a form of child abuse, draws our attention to its clinical features (which differ from those of accidental injury) and whom to target with preventive strategies.
|Last but not least
Letters to the Editor brought to our attention omissions in our Updates in Medicine issue (MJA 7 Jan 2002), visual loss due to warfarin, various aspects of diabetes care, good news on prostate cancer mortality, and finally, the dangers of making popcorn.
time ... another place...
The Federal Minister for Health and Family Services, Dr Michael Wooldridge, in opening the RACP’s Annual Scientific Meeting in Canberra in May 1996, indicated his keen interest in evidence-based medicine and his support for guideline development.
MJA 1997; 166: 592-595
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