Press release
HIV: Is complacency the enemy?
p. 21 HIV infection and risk behaviours among young gay and bisexual men in Vancouver – S.A. Strathdee et al [full article]
p. 52 HIV: the millennium bug – B.C. Willoughby [full article]
In their first-year follow-up of a prospective study involving 681 young gay and bisexual men in Vancouver, Steffanie Strathdee and colleagues report a high incidence of HIV infection and a disturbing trend toward increasing levels of unprotected anal sex.
Over a period 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. The authors report that this rate rose to 9.5 per 100 person-years among those who exchanged sex for money, goods 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. The authors state that the incidence of HIV infection is unacceptably high among this cohort of young gay and bisexual men.
In a related editorial, Brian Willoughby warns that advances in knowledge have produced dramatic reductions in the rates of AIDS and AIDS-related deaths, but may also lull wealthier nations into the false sense of security that HIV infection is a manageable chronic illness.
Canadian medical research output something to brag about
p. 37 A quantitative ranking of Canada's research output of original human studies for the decade 1989 to 1998 – Roy Gagnon et al [full article]
Roy Gagnon and colleagues used author affiliations listed in original articles of human studies to determine that the annual rate of increase for Canadian research output was more than 3 times higher than the worldwide rate. Canada is now ranked seventh among countries contributing human studies to the Medical Literature Analysis and Retrieval System of the National Library of Medicine.
The authors conclude that Canada's medical schools are productive, competitive in making contributions to medical science and are supporting Canadian journals.
Alzheimer's disease: a new look at the risk factors
p. 65 Causes of Alzheimer's disease – David G.Munoz; Howard Feldman [full article]
Although age remains the major risk factor for Alzheimer's disease (AD), scientists have discovered that genetics also plays a role.
David Munoz and Howard Feldman present a thorough analysis of the risk factors, dismissing some – such as high levels of aluminum–and focusing on others. For instance, cerebral strokes that occur when AD-type lesions are present raise the risk of dementia 20 times.
They also report that women receiving estrogen replacement therapy and patients taking long-term nonsteroidal anti-inflammatory drug (NSAID) therapy are less likely to have AD. While waiting confirmation of the potential preventive effectiveness of estrogen, NSAIDs and antioxidants, the authors recommend striving to reduce the risk of cerebrovascular disease as a positive step in avoiding AD.
All I need is the air that I breathe
p. 29 Development, dissemination, implementation and evaluation of a clinical pathway for oxygen therapy – C. Wong et al [full article]
Oxygen is commonly administered to patients in hospital, but there may be problems in prescribing and monitoring this therapy. The authors developed a clinical pathway for the ordering, titration and discontinuation of oxygen and found that the multidisciplinary, multimethod oxygen pathway did lead to changes in oxygen-prescribing behaviour, but also consumed more resources than standard management and was not associated with changes in patient outcome.
The authors conclude that appropriate management of oxygen prescribing and monitoring by physicians and nurses takes time and costs money.
© 2000 Canadian Medical Association or its licensors
