Highlights of this issue

Drug-eluting stents for percutaneous coronary interventions

Drug-eluting stents are seen as an attractive alternative to bare-metal stents for percutaneous coronary interventions, but their impact on cardiac care is still uncertain. Grilli and colleagues examined the influence of financial and organizational factors such as hospital ownership status (private v. public) on the use of these stents in Italy. They found that drug-eluting stents were used more often in private hospitals and more selectively in public hospitals.

In a systematic review, Ligthart and coauthors examined all published cost-effectiveness analyses comparing drug-eluting and bare-metal stents to identify factors that might explain their different conclusions. They found that conclusions were associated with a study's quality, funding source and country of origin.

In a related commentary, Knudtson examines the ongoing debates that surround the cost-effectiveness and clinical indications for drug-eluting stents.

See pages 185, 195 and 199

Auricular acupuncture reduces pain after surgery

In this randomized clinical trial, auricular acupuncture was associated with a lower requirement for ibuprofen than invasive needle control after ambulatory arthroscopic knee surgery. In a related commentary, Buckley notes that acupuncture is “entering the legislative mainstream of Canadian health care” and calls for more guidance on its use by physicians.

See pages 179 and 193

Analysis • Practice

The seventh Trilateral Conference, a meeting of opinion leaders in health care from Canada, the United Kingdom and the United States, focused this year on health human resource planning. Hawkins provides an analysis of that meeting (page 167).

Ma and coauthors describe the case of a patient with recurrent episodes of chest pain and vomiting, as well as ECG changes suggestive of cardiac ischemia. A rocky clinical course over the next several years finally leads to the correct diagnosis (page 171).

In this issue's Clinical Vistas column, Shenoy and Sattur describe an uncommon presenting symptom of orbital myositis (page 174).

In Public Health, MacDonald and Wong summarize highlights from the Canadian Guidelines on Sexually Transmitted Infections, 2006 edition (page 175).