Tales of Cochrane
That sinking feeling you get whenever you try to keep up with the latest research is fully justified. About 55 new trials are published every day, it was revealed at the International Clinical Trials Symposium, held in Sydney in October. This statistic was cited by Glasziou, whose editorial in this issue (page 532) outlines the achievements of the Cochrane Library. The good news is that not only have Cochrane reviews synthesised data from trials, but they are now also available free on the Internet to all Australians.
What (Indigenous) women want
Pap smear registries do not provide data on Indigenous status, so researchers need to use other means to determine the uptake of cervical screening in this segment of the population. It’s an important question, because Indigenous women are currently 10 times more likely than non-Indigenous women to die of cervical cancer. Coory et al (page 544) compared biennial screening rates in 13 remote Indigenous communities in Queensland with rates in the rest of Queensland. The variability between communities, say Hunt and Geia (page 533), might reflect the degree to which the resident women are having their healthcare wish lists fulfilled.
Given that blood banks spend more time pleading for donations of blood than turning them down, surveillance of how these valuable donations are used is crucial. French and colleagues (page 548) evaluated the incidence and appropriateness of red blood cell transfusion in Australian and New Zealand intensive care units, with some encouraging results.
It’s now official: Australia has the world’s third-highest rate of psychostimulant consumption, outranked only by the United States and Canada. Berbatis and colleagues (page 539) give the first standardised analysis of consumption of the drugs dexamphetamine and methylphenidate, used mainly to treat ADHD. Western Australian (WA) rates are the highest in Australia, in fact on a par with US rates. Official reports and a recent WA government crackdown on dexamphetamine misuse in schools show that the black market is alive and well in WA.
The dangers of having an undiagnosed, persistent cough, particularly when visiting a special-care nursery, are demonstrated in Lessons from Practice by Spearing et al (page 568).
Sanguine about chlamydia?
Magritte’s painting Le sang du monde (pictured) shows arteries remarkably clear of that scourge of the Western world, atheroma. While our knowledge of its pathophysiology is not quite as surreal as the painting, some controversies remain. For instance, what’s the link between vascular disease and Chlamydia pneumoniae, and should we be treating this condition with antibiotics? Larsen and colleagues review the evidence on page 558.
Fentanyl patches are gaining currency — not just to treat chronic or malignant pain, but as a means to another risky form of drug misuse. Turn to page 552 for the consequences for one such risk taker in this issue’s Notable Case by Reeves and Ginifer.
Matter over mind
We all come with a context, but in children with suspected attention deficit hyperactivity disorder (ADHD) this is sometimes overlooked, say Halasz and Vance (page 554). They discuss the tension between the “cookbook” approach of the DSM-IV criteria and the developmental approach to assessing and treating these children.
Turning down the pressure
Goldberg and colleagues (page 535) urge us to do so with early diagnosis of the commonest cause of preventable blindness in our community, glaucoma. Their editorial outlines the latest in medical, laser and surgical therapies for this condition.
Another time ... another place...
. . . “this rate [of cancer of the uterus] has remained practically constant during the past twenty-five years.” . . .
Papanicolaou G, Traut HF, The diagnostic value of vaginal smears in carcinoma of the uterus, Am J Obstet Gynecol 1941; 42: 193-206