Highlights of this issue
CMAJ 2000;162:1
Causes of Alzheimer's disease
- Causes of Alzheimer's disease [Review]
Although age remains the major risk factor for Alzheimer's disease (AD), genetics clearly plays a role. A common polymorphism in the gene for apolipoprotein E, a lipoprotein responsible for repairing synapses, increases the risk of AD 5 to 15 times. Moreover, cerebral infarcts in the presence of AD-type lesions raise the risk of dementia 20 times. Women receiving estrogen replacement therapy and patients taking long-term NSAID therapy are less likely to have AD. While we await confirmation of the potential preventive effectiveness of estrogen, NSAIDs and antioxidants, we should strive to reduce the risk of cerebrovascular disease.
Ranking Canada's medical literature Using authors' affiliations Roy Gagnon and colleagues have identified demographic trends in the number of original articles of human studies entered in the MEDLARS databases between 1989 and 1998. Canada ranked seventh in the number of articles published during the 10 years (62 435) and ninth in the annual rate of increase in productivity (4%). About two-thirds of the Canadian articles were by authors affiliated with medical schools. The University of Toronto accounted for the greatest number (8604), whereas McGill had the highest rate of annual increase (8%).
HIV complacency
[See Letters: What exactly were you highlighting? W.S. Lofters; M.B. Abdurrahman]
- HIV infection and risk behaviours among young gay and bisexual men in Vancouver [Research]
- HIV: the millennium bug [Commentary]
The first year's follow-up results of a prospective study involving 681 young gay and bisexual men in Vancouver reveal a high incidence of HIV infection and a disturbing trend toward increasing levels of unprotected anal sex. Over a total of 638.63 person-years, 11 men became seropositive between enrolment and follow-up, for an overall HIV incidence rate of 1.7 per 100 person-years. This rate rose to 9.5 per 100 person-years among those who exchanged sex for money, good or drugs. Of the 232 men with casual partners who reported having protected anal sex in the year before enrolment, 43 (18.5%) reported at least one episode of unprotected anal sex in the subsequent year. Have advances in HIV therapy engendered complacency in this cohort? Wealthy nations must not be lulled into viewing HIV infection as a manageable chronic illness, warns editorialist Brian Willoughby, citing a worldwide prevalence of over 26 million and low compliance with complex drug regimens among poor people and injection drug users.
Multiple sclerosis and interferons
Multiple sclerosis is the most common disabling neurological disorder among young Canadian adults, with a prevalence estimated at 1 in 1000 to 1 in 500. Treatment was purely symptomatic and largely empirical until the arrival of interferons, whose effectiveness in preventing relapse has now been established. Although they have unpleasant side effects, are only partially effective and are very expensive, interferons provide a lifeboat until the true rescuer arrives.
Oxygen therapy
- Development, dissemination, implementation and evaluation of a clinical pathway for oxygen therapy [Research]
© 2000 Canadian Medical Association or its licensors
