Highlights of this issue

Granulocyte colony-stimulating factor for stroke

Granulocyte colony-stimulating factor (G-CSF) is anti-inflammatory and neuroprotective and is known to mobilize stem cells: can it be used as therapy for acute ischemic stroke? In a pilot study, Shyu and colleagues compared the recovery of stroke patients randomly assigned to receive G-CSF injections for 5 days or usual care. They found that, after 12 months, patients given G-CSF had significantly better neurologic functioning than control patients and had experienced no adverse effects. In a related commentary, Borlongan and Hess discuss the growing optimism for mobilizing endogenous stem cells as therapy for stroke.

See pages 927 and 954

High-dose vitamin C as cancer therapy

Despite evidence for and against its benefit, vitamin C is used as an alternative cancer therapy. Padayatty and colleagues report on 3 cases of cancer patients who responded favourably to high doses of vitamin C administered intravenously and on new evidence for the biological plausibility of high doses of the vitamin as cancer therapy. In a related commentary, Assouline and Miller discuss the need for clinical trials of complementary and alternative therapies.

See pages 937 and 956

Prescribing exercise for health

In the previous issue, Warburton and colleagues reviewed the evidence supporting the role physical activity plays in preventing chronic illness and premature death. In this issue, they outline how to evaluate patients' cardiovascular and musculo-skeletal fitness and their physical activity levels. They also describe the current recommendations for exercise and the resources available for patients and physicians.

See page 961

Analysis • Practice

Patel and Pittas assess the role of insulin therapy in critically ill patients in hospital (page 917). Forster describes factors contributing to drug-related adverse events that develop after hospital discharge and how to avoid them (page 921). Murray looks at the link between poverty and health worldwide (page 923). Atkinson and colleagues describe an unusual presentation of Crohn's disease in a child with fever, hip pain and limp (page 924).