How should we interpret noncompliance with screening mammography?

Primary care practitioners have an important role to play in recommending breast cancer screening to patients in the target age group. In this issue of CMAJ (see pages 1335 to 1343) Dr. Marie-Dominique Beaulieu and associates report the results of a program designed to maximize utilization of screening mammography. Only two thirds of eligible women for whom screening mammography was prescribed obtained a mammogram within the 2-month study period. However, when taken in context, this compliance rate is fairly encouraging. There are many possible reasons for noncompliance such as a need for more information or for repeated suggestions. Family physicians should not become disheartened in their efforts to increase the use of screening procedures and may find that collaboration with others in giving consistent messages will help to maximize screening rates within their patient population.     

Proliferation/Quiescence: When to start? Where to stop? What to stock?

ABSTRACT: The cell cycle is a tightly controlled series of events that ultimately lead to cell division. The literature deciphering the molecular processes involved in regulating the consecutive cell cycle steps is colossal. By contrast, much less is known about non-dividing cellular states, even if they concern the vast majority of cells, from prokaryotes to multi-cellular organisms. Indeed, cells decide to enter the division cycle only if conditions are favourable. Otherwise they may enter quiescence, a reversible non-dividing cellular state. Recent studies in yeast have shed new light on the transition between proliferation and quiescence, re-questioning the notion of cell cycle commitment. They also indicate a predominant role for cellular metabolic status as a major regulator of quiescence establishment and exit. Additionally, a growing body of evidence indicates that environmental conditions, and notably the availability of various nutrients, by impinging on specific metabolic routes, directly regulate specific cellular re-organization that occurs upon proliferation/quiescence transitions.     

American and European recommendations for screening mammography in younger women: a cultural divide?

The American Cancer Society advocates mammography screening for all women from age 40, whereas in Europe it is not recommended for women below the age of 50. Randomised prospective studies have failed to show a significant benefit from screening women aged under 50 and five potentially harmful effects of screening should be considered: lead time, overdiagnosis, radiation exposure, false positive results, and cost. Younger women must be properly informed about the potential for harm as well as for benefit before screening.     

Time to recognise that mitochondria are bacteria?

The scientific community is comfortable with recognising mitochondria as organelles that happen to be descendants of bacteria. Here, I playfully explore the arguments for and against a phylogenetic fundamentalism that states that mitochondria are bacteria and should be given their own taxonomic family, the Mitochondriaceae. I also explore the consequences of recognizing mitochondria as bacteria for our understanding of the systemic response to trauma and for the prospects of creating transgenic mitochondria.     

What does airport baggage screening have to do with cervical cancer screening?

The implementation of liquid based technologies for cervical cytology has delivered many of the expected benefits but is also accompanied by a raft of new challenges for the cytomorphologist. Differences in the presentation of cellular material may on occasion make it more difficult to detect subtle or scanty abnormalities and novel cellular appearances expand the existing list of differential diagnoses. This presentation will focus on these changes and will examine strategies which may assist the practitioner in the reliable reporting of cervical samples.     

What are the missing pieces needed to stop antibiotic resistance?

As recognized by several international agencies, antibiotic resistance is nowadays one of the most relevant problems for human health. While this problem was alleviated with the introduction of new antibiotics into the market in the golden age of antimicrobial discovery, nowadays few antibiotics are in the pipeline. Under these circumstances, a deep understanding on the mechanisms of emergence, evolution and transmission of antibiotic resistance, as well as on the consequences for the bacterial physiology of acquiring resistance is needed to implement novel strategies, beyond the development of new antibiotics or the restriction in the use of current ones, to more efficiently treat infections. There are still several aspects in the field of antibiotic resistance that are not fully understood. In the current article, we make a non-exhaustive critical review of some of them that we consider of special relevance, in the aim of presenting a snapshot of the studies that still need to be done to tackle antibiotic resistance.     

Did Drosera evolve long scapes to stop their pollinators from being eaten?

Background and Aims

Insectivorous plants frequently display their flowers on the ends of long racemes. Conventional wisdom is that long racemes in insectivorous plants have evolved to provide spatial separation between flowers and traps, which consequently prevents pollinators from being captured. However, it is also possible that long racemes evolved for better seed dispersal or to make flowers more visible to pollinators.

Methods

Two sympatric insectivorous plants with identical pollinators were studied: Drosera cistiflora, with an upright growth form but a short raceme; and Drosera pauciflora, with a basal rosette of traps and a very long raceme. If long racemes evolved to protect their pollinators then D. cistiflora should capture more pollinators than D. pauciflora. However, if long racemes evolved to attract pollinators then taller flowers should receive more pollination visits than shorter flowers.

Key Results

Examination of D. pauciflora and D. cistiflora traps revealed that no pollinators were captured by either species, suggesting that long racemes did not evolve to protect pollinators from being captured. Experimental manipulations of flower height in D. cistiflora showed that experimentally shortened plants received significantly fewer pollination visits than plants which were taller in stature.

Conclusions

Long scapes in Drosera and non-insectivorous plants probably evolved due to similar selective pressures such as pollinator attraction.