http://bmj.com/cgi/content/full/323/7320/0
BMJ 2001;323 ( 3 November )
Editor's choice
Types of resistance
and
other manufacturers offer alternative antibiotics (p 1023)Tony
Hart and Nicholas Beeching warn (p 1017)
that prolonged administration of ciprofloxacin to many individuals
may lead to the emergence of resistance. That, they conclude,
"would be an even greater triumph for the terrorists."
The pessimists' view on resistancethat
"bacteria are bound to win the war against medicine"is
quoted by Richard Wise in his commentary on a paper that seems to
show that general practices with very different rates of antibiotic
prescribing show only small differences in rates of antibacterial
resistance. Patricia Priest and her colleagues conclude from their
data that trying to reduce the overall level of antibiotic
prescribing may not be the best way of reducing resistance (p 1037).
But Wise argues that the dynamics of the relation between
prescribing and resistance are complicated (p 1041).
This week's theme is another complicated relationshipthat
of men and their health. As Siegfried Meryn and Alejandro Jadad say
in their editorial, "despite having had most of the social determinants
of health in their favour, men have . . . a life expectancy
about seven years shorter than women's" (p 1013).
This difference is even greater in eastern Europe. Martin McKee and
Vladimir Shkolnikov paint a bleak picture of the vulnerability of
poorly educated single men (p 1051)"to
be drunk anywhere can be dangerous but especially so in a society
where there are few people on whom one can depend and where many elements
of the environment present lethal hazards."
One thing this issue does is to explain the all-important difference between
sex and gender (p 1055,
1061).
Alexander Kiss and Siegfried Meryn do this by contrasting the gender
differences in two sex-related cancersbreast
and prostate (p 1055).
For example, there is little research into the effect of prostate
cancer on men's ideas of masculinity, but much on the effect of
breast cancer on femininity.
Abi Berger was heartened when her general practice became an all-female
practice and none of her male patients said that it mattered
(p 1077).
But that might have been becauseas
Ian Banks points out (p 1058)
and Gordon Graham illustrates (p 1076)men
resist consulting doctors of any sex. Meanwhile, Marcus Müllner finds
from that great barometer of 21st century life, the web, that men
seem to be "mainly concerned with hair growth, penis enlargement,
smart eating, and better weightlifting."
Footnotes
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