In This Issue

Syndrome incarnate

Did you know that the metabolic syndrome (otherwise known as “syndrome X” or “insulin resistance syndrome”) was recognised as early as the 1920s? Zimmet and colleagues describe its latest incarnation, following the global definition recently adopted by the International Diabetes Federation (→ Mainstreaming the metabolic syndrome: a definitive definition).

Opening a window

Much has been made in political circles of the need to nurture families and children. This political will should provide a perfect opportunity to develop sound policies in child health. But how will we know what’s needed? According to Goldfeld and Oberklaid collecting and collating sound data is the first important step (→ Maintaining an agenda for children: the role of data in linking policy, politics and outcomes).

Breathing asbestos

What effect does asbestos have on lung diffusion? Alfonso and colleagues assess this and its relationship with smoking in a cohort study of over 900 former mine workers and town residents at Wittenoom, Western Australia, where crocidolite asbestos was mined from 1943 to 1966 (→ Effects of asbestos and smoking on gas diffusion in people exposed to crocidolite).

Phaeochromocytomas now

Preclinical diagnoses of these tumours are becoming more common with testing for the newly discovered genetic mutations and the finding of “incidentalomas” on abdominal imaging. The Clinical Update by Alderazi and colleagues keeps us abreast of new developments in diagnosis and management of this tumour (→ Phaeochromocytoma: current concepts).

Fits and turns

Two cases in this issue offer salutary lessons in diagnosis. Seymour and Glendenning remind us that anticonvulsants can increase fracture risk in their Lessons from Practice (→ Fit for a fracture), while Yeow et al describe an unusual cause of acute abdominal pain (→ Acute abdomen due to omental torsion).

Syphilis makes a comeback

As this phenomenon emerges in gay communities worldwide, we find Australia is no exception — notification rates for syphilis in NSW and Victoria are on the rise (→ Epidemic syphilis among homosexually active men in Sydney) (→ Sustained increase in infectious syphilis notifications in Victoria). The case series and prospective cohort study by Jin and colleagues also reveal the risk factors associated with developing syphilis.

There are many reasons to be concerned about this, not least because syphilis promotes HIV transmission. An editorial by Fairley and colleagues offers solutions to combat this epidemic, arguing that it’s not unstoppable, given our effective early response to the HIV epidemic in the 1980s (→ Syphilis: back on the rise, but not unstoppable).

Biological weapons

New biological agents have been hailed as safer, more effective alternatives to standard agents in the treatment of many autoimmune diseases. How close is this to the truth? In this issue’s New Drugs, Old Drugs, Nash and Florin discuss the efficacy and toxicity of tumour necrosis factor inhibitors, used in conditions including rheumatoid and psoriatic arthritis and Crohn’s disease (→ Tumour necrosis factor inhibitors).

MJA/Wyeth prize turns 10

Awarded for the best clinical research published in the Journal each year, this prize reached its landmark 10th anniversary this year. Read “MJA/Wyeth Prize — 10th Anniversary” for winners past and present, and research topics that run the gamut from sheepskins to suppuration.

Reporting on the reporters

Journalists lurk low down on most lists of trusted professionals, but, paradoxically, most people read, watch or listen to the news. Doctors and researchers (who incidentally tend to cluster at the top of the “trust” lists) are no exception. Several articles in this issue examine medical issues in our media-immersed society.

Newnham et al asked Victorian oncology health professionals whether they follow medical news stories in the media and how patients’ access to these affects the doctor-patient interaction (→ Attitudes of oncology health professionals to information from the Internet and other media).

Meanwhile, a new medical media watchdog has been let off the virtual chain in Newcastle, NSW. Early last year, Smith and colleagues started the media doctor website, which critiques news items about medical treatments. A report of the site’s first 7 months of operation is found in “Monitoring the quality of medical news reporting: early experience with media doctor”. Media luminaries Herman and Morgan (→ Medical news reporting: establishing goodwill and cooperation), Sweet (→ New website is no miracle cure) and Swan (→ Evidence-based journalism: a forlorn hope?), unconvinced that the site will hit its mark, call for greater cooperation between medicos and mediacos, while Van Der Weyden and Armstrong offer guidance to both professions (→ Australia’s media reporting of health and medical matters: a question of quality).

“I have an allergy . . . ”

When uttered by patients after a barrage of tests by their alternative health practitioner with advice to start a restrictive diet, this phrase can strike dread in many doctors. How do you work out if it’s a “true” allergy, how well proven are non-conventional diagnostic tests, and above all, how do we advise patients and their families? Mullins and colleagues give us some tips in “Non-conventional approaches to allergy testing: reconciling patient autonomy with medical practitioners’ concerns”.

Believe nothing that you see in the newspapers . . . if you see anything in them that you know is true, begin to doubt it at once.