Highlights

Proton pump inhibitors and myocardial infarction

The beneficial effect of clopidogrel after myocardial infarction may be reduced by many proton pump inhibitors, with the exception of pantoprazole. Juurlink and colleagues linked data from several health record systems for the care of older people to discover this association. See Research, page 713

Inhibition of cytochrome isoenzymes may be the mechanism of the reported drug interaction, say Lau and Grubel. See Commentary, page 699

Physical activity in schools

School-based physical-activity interventions have little if any effect on body mass index. In their systematic review of 18 trials, Harris and colleagues found that, compared with the usual programs in schools, changing the duration, intensity or structure of the activity made little difference to body composition. See Research, page 719

Physical-activity programs in schools have other benefits, and multilevel society-wide approaches are needed to tackle obesity, says Baur. See Commentary, page 701

Preventing shaken baby syndrome

Educational material from the Period of PURPLE Crying program led to improvements in mothers' knowledge about crying infants and in some behaviours related to preventing shaking of infants in this randomized controlled trial involving 1279 mothers. See Research, page 727

Shaken baby syndrome is devastating, but rare, and educational interventions are probably effective at reducing its frequency, says Jenny. See Commentary, page 703

A blue child

A 2-year-old boy had persistent cyanosis and low oxygen saturation. Cyanotic congenital heart disease had been ruled out at birth, but this case, presented by Porepa and colleagues, illustrates that there are other treatable causes of this condition. See Practice, page 734

Prenatal DNA testing

New prenatal genetic diagnostic tests are safer, faster and more accurate but raise problematic issues for health care, as well as the spectre of eugenics. See News, page 705

Family tree

The US surgeon general has unveiled an electronic, standards-based program for tracking family health histories. See News, page 707

Electronic registry

Alberta has created a province-wide electronic directory for advanced directives and living wills in a bid to ensure that patients' wishes are respected. See News, page 708