Highlights of this issue

How safe are medical cannabinoids?

Studies of adverse events associated with the medical use of cannabinoids are systematically reviewed by Wang and colleagues. The authors also evaluate the quality of the studies to guide future research on the safety of the medical use of cannabinoids.

In a related commentary, Degenhardt states that, although the side effects of oral cannabis therapy appear to be minor in the short term, their longer term effects, particularly in the setting of chronic illness, have yet to be studied.

See pages 1669 and 1685

Aging and bone mineral density

Older women and men experience increasing rates of hip fracture because of the age-related acceleration in bone loss. Berger and colleagues studied a large cohort of Canadians and found that antiresorptive medication attenuates this loss. Once the effect is established, we could possibly extend the interval for repeat testing of bone mineral density to every 5 years.

In a related commentary, Cooper highlights the 2-phased nature of bone loss, first around menopause and then after the age of 70. He also stresses that the change in bones over time is complex and that measuring just the bone density does not capture it. We need to consider other risks for fracture such as age, gender and risk for falls.

See pages 1660 and 1683

Pharmacology of crystal meth

When smoked, crystal meth rapidly achieves high concentrations in the brain without the burdens of the intravenous route. Kish reviews the actions of methamphetamine and explains the potential role of dopamine in methamphetamine craving.

See page 1679

Combating methamphetamine

Prevention, treatment, enforcement and harm reduction form the 4 pillars of the York Region's strategy to combat methamphetamine. In their article, Cronkwright Kirkos and colleagues recognize that criminal behavior is only one element in the production and use of methamphetamine, and they identify elected officials, school boards, the courts, at-risk communities and private industry as key stakeholders in the strategy.

See page 1655

Practice

A 1-week-old infant developed subcutaneous nodules with redness of the overlying skin. Her total serum calcium level was elevated. The infant appeared otherwise well. What is your diagnosis (page 1653)?

An 85-year-old man with a history of tongue cancer reported having 2 days of abdominal pain and constipation. A plain radiograph showed an air-filled mass that looked like an inverted coffee-bean. What is it (page 1657)?

News

Hospital lotteries blur the line between philanthropy and gambling. While hospitals become more dependent on lottery revenues, experts say that reliance on gambling revenues is not without cost, or consequence (page 1643).