Highlights of this issue
Disease of young men on the rise
Study shows increases in testicular germ cell cancer
See also:
- Evidence: Trends in the incidence of testicular germ cell cancer in Ontario by histologic subgroup, 1965–1996
- Editorial: Why is the rate of testicular cancer increasing?
Using data from the Ontario Cancer Registry, Weir and colleagues discovered that the incidence of testicular germ cell cancer had increased by 59% between 1964 and 1996. The rise in Ontario replicates similar increases in developed countries worldwide. Because the increase was greatest for men in the youngest group (1529 years), the authors postulate a birth cohort effect, and editorialist Klotz suggests that environmental hormone disrupters may be among the causes.
The return of swamp fever
Travellers fail to take malaria prophylaxis, and those who do may receive the wrong advice
See also:
- Evidence: Survey of use of malaria prevention measures by Canadians visiting India
- Editorial: The return of swamp fever: malaria in Canadians
Interviews with people travelling to India just before their departure from Canada revealed that only 31% planned to take malaria chemoprophylaxis and only 7% had been prescribed a recommended drug regimen, even though over half had sought pretravel medical advice. There were over 1000 cases of malaria in Canada in 1997, all in returning travellers. Misconceptions about malaria risk and appropriate prevention measures seem to be the main barriers.
Cervical cancer in women living with HIV
Human papillomavirus plays a key role
See also:
- Evidence: Prevalence of risk factors associated with human papillomavirus infection in women living with HIV
As part of the Canadian Women's HIV Study, 375 women with HIV infection underwent cervical cytological testing. Overall, 67.2% of the women tested positive for human papillomavirus, as did 90.6% of those with cervical squamous cell dysplasia. One of the important risk factors for infection was a CD4 count of less than 0.20 × 109/L. Women living with HIV need annual cervical cytological screening, and if their CD4 count is low, the time between screenings should be shortened to 6 months.
Antileukotrienes: A new asthma cure-all?
New agents show promise, but indications for their use remain tentative
See also:
- Editorial: Antileukotrienes, asthma pathogenesis and the pharmaceutical industry
- Education: Antileukotriene agents in asthma: The dart that kills the elephant?
In his review of antileukotrienes in asthma, Renzi elucidates the biochemical and physiological basis for their use, recommending them largely as adjunctive therapy, as first-line treatment only when corticosteroids cannot be used and for prevention of certain types of asthma. In an accompanying editorial, O'Byrne describes the exciting history of the antileukotrienes but warns that our understanding of these agents is far from complete.
In the aftermath of the Swissair crash
Armed with science and compassion, medical detectives searched for answers
See also:
Combining compassion for victims' loved ones with the largest DNA study in Canadian history, Dr. John Butt, Nova Scotia's chief medical examiner, and his colleagues in forensic medicine and dentistry spent the last 4 months of 1998 trying to solve a grisly puzzle: identification of the 229 people who died in the violent crash of Swissair flight 111 last Sept. 2.
