From the journals, April 2004

New Eng J Med Vol 350

1430 Screening mammography has led to a big rise in the detection of breast cancer, a third of which would never affect the patient during her lifetime (see BMJ 2004; 328: 921): this review of ductal carcinoma in situ of breast helps to explain why.

1495 If you really want to reduce the recurrence of acute coronary events, use atorvastatin 80 mg rather than pravastatin 40 mg.

1764 A clinical case discussion of Kaposiform haemangioendothelioma with the Kasabach–Merritt phenomenon. At last.

1819 Rather late in the day, a US randomised trial of open mesh repair for hernia versus laparoscopic mesh repair. In line with most other studies, this one comes out in favour of open.

Lancet Vol 363

1099 If we get another respiratory virus scare, will we be able to manufacture a vaccine in time to halt it? Perhaps, by a new technique known as reverse genetics.

1104 Do women with medical complications of pregnancy really need to stay in hospital? In this study, most did as well if they went home at night, even if they had premature rupture of membranes.

1184 Older people who develop new epilepsy are at markedly increased risk of stroke.

1193 People get iller at times of upheaval in the workplace, whether it's expansion or downsizing.

1264 ‘So what did you think of that ball, Sven?’ was no doubt a common question in this study of Scandinavian cryptorchism, showing that Danish boys keep theirs hidden more than Finnish.

1277 Strangely enough, this is the first study to establish a link between gout and alcohol — and then it only holds for beer and spirits.

1341 Publication bias — the tendency of journals [not this one — Ed] not to publish negative studies — may have put children's lives at risk. A painstaking study of the unpublished literature on SSRI antidepressants in children shows that there are many trials which would have given warning of adverse effects and lack of benefit.

JAMA Vol 291

1578 Is sex good for the prostate? This review of the evidence about frequency of ejaculation and prostate cancer concludes that it can't do any harm; whereas a BMJ (328: 851a) headline happily ejaculates that it is good for you.

1610 This review concludes that oestrogen is good for menopausal ‘flashes’.

1701 And — if it is conjugated oestrogen, used alone in hysterectomised women — it seems to lower the incidence of breast cancer as well as hip fracture, though at the cost of a few more strokes.

1713 Because most people shy away from the idea of real colonoscopy, virtual colonoscopy using computerised tomography has enjoyed a vogue in the US. This may come to an end with this study showing that it can miss cancers.

1864 In the US, the old people most likely to be prescribed statins are those at least risk.

1887 A review showing that just because a person has an alcohol problem, you should not be shy of treating their depression.

American Annals of the Deaf (Washington)

This is the real name of a useful scientific publication, but it might equally describe the behaviour of the Bush administration. A US embargo on scientific exchange with ‘rogue states’ like Iran and Cuba brought a letter of protest (Lancet: 1160) from the lovely Iranian city of Shiraz, which has civilised the world for more than 2000 years with her poets and her vines. But perhaps it's not so bad: JAMA (page 1950) reports that the embargo had been misinterpreteted, and materials produced by these rogues can be read by Americans provided there is no collusion with them. Book burning and the imprisonment of scientific editors will not join the repertoire just yet.

Other Journals

‘Music hath charms to soothe the savage breast’, wrote Congreve. He was right, according to J Music Ther (40: 283); it worked on aggressive teenage boys, so the savage breast cannot be a problem. Rats, however, are more difficult, according to the paper ‘Do rats show a Mozart effect?’ in Music Perception (21: 251). And I guess music has no effect on the breasts, savage or otherwise, of those who are unfortunate enough to be tone deaf. The nature of their affliction is explored in Brain (127: 801).

Plant of the Month: Iris ‘Black Swan’

This big scented iris will have people gawping over your garden wall — if you plant it where the sun can shine through the black petals, giving them a halo of lucent amber brown.