Highlights of this issue

How effectively can influenza be prevented?

Figure. Photo by: Eric Field

Influenza virus causes yearly epidemics of respiratory illness. Elderly people and people with chronic medical conditions are at greater risk for complications from the infection. All jurisdictions in Canada offer annual influenza vaccination to these high-risk groups; however, the Canadian Task Force on Preventive Health Care now recommends vaccination in healthy adults and children as well. Their statement includes the potential benefits and harms of vaccination. When Langley and Faughnan conducted a systematic review of the evidence for the prevention of influenza infection in the general population, they found numerous randomized controlled trials of good quality that have consistently shown that influenza vaccination is moderately effective in preventing influenza in the general population, including healthy adults and children over 6 months of age. They also found good evidence of the effectiveness of neuraminidase inhibitor prophylaxis in caregivers and household contacts when given within 36–48 hours of symptom onset in the index case.

See pages 1169 and 1213

Cardiovascular risk control among patients with diabetes mellitus

People with type 2 diabetes mellitus have a greater risk of cardiovascular events. But how many are being prescribed medications that reduce that risk, such as ACE inhibitors, statins and antiplatelet agents? Brown and colleagues found that in a cohort of 12 106 patients with type 2 diabetes, all 3 medications were underused, even among those with established atherosclerotic disease. The authors emphasize that, to bridge this gap in health care, patients with diabetes should be screened for symptoms related to cerebrovascular, coronary or peripheral arterial disease and, in the absence of specific contraindications, prescribed all 3 medications.

See page 1189

Searching MEDLINE for health services research studies

Where and how to find the right information in a reasonable time is a problem faced by those who use large bibliographic databases. The search for information becomes even more complicated in multidisciplinary fields of research, such as health services research (HSR), because information is scattered across a large number of different scientific journals. Wilczynski and colleagues tested the retrieval performance of 7445 search terms in MEDLINE against a hand search and determined the specificity, sensitivity and precision of various combinations. Their search strategies have been made available by the US National Library of Medicine at www.nlm.nih.gov/nichsr/hedges/search.html.

See page 1179

In Synopsis

Figure.

In Clinical Vistas, Mannarino and colleagues present an unusual case of mammary emphysema in a young woman (page 1172). Around 400 patients with epilepsy in Canada have an implanted electrical device for vagus nerve stimulation (VNS), which reduces the number of seizures by half in over a third of patients. In Analysis, Guberman describes VNS, its function, efficacy and side effects and assesses its place in the treatment of patients with epilepsy (page 1165). Sandra E. Black and the late John P. Szalai scrutinize a randomized double-blind trial on the benefits of long-term donepezil therapy for patients with Alzheimer's disease (page 1174).