Highlights of this issue

Screening for diabetes in women with polycystic ovary syndrome

This study by Gagnon and Baillargeon indicates that, in women with polycystic ovary syndrome, the fasting glucose test is insufficiently sensitive to detect abnormal glucose tolerance. In an accompanying commentary, Lau details the relation of this syndrome to impaired glucose tolerance and diabetes, and the costs and other practicalities of glucose testing.

See pages 933 and 951

Ovarian cancer risk and health care use

Abenhaim and colleagues investigate the frequency of medical visits and pelvic examinations and the type of health care provider most often visited among women with and without ovarian cancer. They found that women who had no medical visits, pelvic examinations or regular health care provider were at increased risk of ovarian cancer. In a related commentary, Fung-Kee-Fung and colleagues discuss the implications of this finding for policy and practice.

See pages 941 and 949

Contraception in Canada

Fisher and Black provide information on current trends in Canadians' choices of contraception. They review the characteristics and effectiveness of contraceptive methods, with an emphasis on hormonal methods and newer options such as the levonorgestrel-releasing intrauterine device. They also discuss adherence to contraception and approaches to counselling to promote adherence and to reduce the risk of sexually transmitted infection in the context of contraception.

See page 953

Practice

Lithium intoxication: A decreased anion gap and an elevated osmolar gap give clues in a case of a patient found in a state of clouded consciousness (page 921).

Older patients commonly experience hearing loss: our Public Health article includes tips for the clinician dealing with its diagnosis and rehabilitation (page 925).

In this issue's Clinical Vistas Briefs, readers are asked to determine the cause of an ulcerated umbilical nodule and vaginal bleeding in a 62-year-old woman and to diagnose isolated purple stripes on the back of a 15-year-old boy (page 929).