- © 2004 Canadian Medical Association or its licensors
Stem cell transplantation
Stem cell research has garnered much attention in the media. Currently, stem cell transplantation is commonly used to treat various malignant hematologic conditions. However, although this important treatment has such profound clinical implications, many physicians are unfamiliar with it. Léger and Nevill distill the complexities of hematopoietic stem cell transplantation to its most important concepts, allowing primary care physicians who care for transplant survivors to better understand the procedure, the potential complications and the issues surrounding long-term follow-up.
See page 1569
Drug use after a police crackdown
In 2003 the Vancouver police began a concerted effort to reduce illicit drug use in the city's Downtown Eastside. In the first several weeks of the crackdown, there were an additional 236 trafficking charges against 162 individuals. Despite this apparent success, a survey of injection drug users (IDUs) by Wood and colleagues reveals that the rates of drug use, proportion of IDUs starting methadone treatment and the price of drugs remained constant during the 3 months after the crackdown started. IDUs reported that the increased police presence caused them to change where they use drugs. The authors conclude that rates of drug use were not affected by the police effort, and drug users and sellers merely switched neighbourhoods; they underscore the potential for exposing more people to drug use when such displacement occurs.
See page 1551
Cervical cancer mortality
Cervical cancer is both detectable and treatable at an early stage, but rates of death from the disease have been known to vary by socioeconomic status. Ng and colleagues present Canadian data on cervical cancer mortality from 1971 to 1996 by neighbourhood income levels in urban areas. They found that the overall age-standardized death rate declined by 62%, from 5.0 per 100 000 women in 1971 to 1.9 per 100 000 in 1996. Furthermore, they found that the decline was greater among women in the poorest income quintile (65% decrease) than among women in the wealthiest quintile (44% decrease). The authors suggest that numerous factors may have contributed to the decline, including the implementation of universal health care coverage and effective screening programs.
See page 1545
In Synopsis
Bailey and Dresser explain why the consumption of natural products may alter the metabolism of other drugs, potentially causing important drug interactions (see page 1531). The Canadian Task Force on Preventive Health Care presents its recommendations on hormone replacement therapy for the primary prevention of chronic diseases (see page 1535). Weir and colleagues comment on the new nutrition labelling system introduced in Canada last year (see page 1538). Bhandari comments on a study of how effective perioperative oral rofecoxib therapy is in improving functional recovery after total knee replacement surgery (see page 1540). Kanani and Muise describe an unusual case of peritonitis (see page 1541).