Highlights

Graduated drivers’ licences for seniors

A full driver’s licence should default automatically to a restricted licence that allows seniors to drive only under favourable road conditions, argue Redelmeier and Stanbrook. However, graduated licensing must allow exemptions for healthy seniors. See Editorial, page 1123

Q waves are important in prognosis

Patients with myocardial infarction who had Q waves at baseline fared worse than those without Q waves even after adjustment for time from onset of symptoms and other prognostic features. This finding is based on an analysis of data from 4341 patients in the PLATO trial. This metric should prove useful in clinical decisions about patients with chest pain and ST-segment elevation, especially when time from symptom onset is unclear, say the authors. See Research, page 1135

We must ensure that Q waves are used in conjunction with, rather than as a replacement for, time to treatment for patients with ST-segment elevation myocardial infarction, say Mercuri and colleagues. See Commentary, page 1125

Dysphagia after stroke

Dysphagia after stroke is common, presenting in 55% of all patients admitted to hospital with acute disease, yet it is often underdiagnosed. Early detection of dysphagia with screening reduces comorbidity, such as pneumonia. See Commentary, page 1127

Smoked cannabis of some benefit in MS

People with multiple sclerosis who smoked cannabis had less pain and spasticity than patients smoking placebo. Thirty-seven people were included in this randomized crossover trial that also showed some impact on cognitive abilities. Larger studies are needed to determine optimum doses, say the authors. See Research, page 1143

Impact of changing growth curves

Several organizations have recommended that physicians switch from using the Centers for Disease Control and Prevention (CDC) growth curves to the World Health Organization (WHO) growth curves to monitor growth for Canadian children aged 5–19 years. In their study, Kakinami and colleagues found that the WHO growth curves did not offer any discriminatory advantage over the CDC standards currently in practice for the detection of cardiometabolic abnormalities in children aged 9–16 years. See Research, page E539

Is zinc useful for the common cold?

Oral zinc treatment reduced the duration of cold symptoms in adults by 2.63 days. This systematic review of 17 trials involving 2121 people displayed considerable heterogeneity between trials, showed appreciable adverse events and did not detect an effect in children. There is only a weak rationale for physicians to recommend zinc for the treatment of the common cold, say the authors. See Research, page E551

Consent requirements for pelvic examinations performed for training purposes

According to Gibson and Downie, pelvic examinations performed for training purposes presumably constitute a battery in law, subject to defence of consent. They argue that the 2010 statement either needs to be revised to include residents or a new statement specfic to residents needs to be drafted. See Analysis, page 1159

Bee pollen supplements

Bee pollen supplements consist of pollen granules collected by bees. Patients with pollen allergies may have allergic reactions, including anaphylaxis, from ingesting bee pollen, warn Jagdis and Sussman. See Practice, page 1167

Diffuse panbronchiolitis

Seen primarily in Asian populations, patients with diffuse panbronchiolitis may present with productive cough, shortness of breath and a history of sinusitis. Early recognition of this chronic sinobronchial inflammatory condition is important, as treatment with long-term and low-dose erythromycin improves prognosis. See Practice, page 1171