Lancet 9 Jun 2007 Vol 369

“Read, mark, learn and inwardly digest” is a phrase the teachers of my youth liked to use (it comes from Cranmer’s Collect for Bible Sunday, in the Book of Common Prayer). That’s what we need to do with articles about diseases we don’t come across often but shouldn’t miss – like syphilis in adults. Mark and inwardly digest the illustration of secondary syphilis, with what looks like a fungal infection or psoriasis of the sole, lest you miss the diagnosis and fall into perdition.

Yet another trial of chemotherapy for small-cell lung cancer – this time given pre-operatively, with a high continuation rate – proves useless.

This United Nations sponsored trial of different misoprostol regimes for early termination of pregnancy must have been designed by someone who liked to travel – to Cuba, Georgia, India, Mongolia, Vietnam and then back to Switzerland. Two-step vaginal administration with a time interval of anything between 3 and 12 hours seems the best bet: oral administration has to be more frequent and has more side-effects.

Better spitting improves TB diagnosis
. It’s so simple that nobody thought of it before: the reason that sputum cultures for tuberculosis from Pakistani women are less reliable than from men is because their spitting is too lady-like. Instruct them to do big, disgusting, manly hawking and out pops the tubercle.

Here again is a clinical review of a common primary care condition written by a professor of infectious diseases – but this time the result is a useful and readable account of vulvovaginal candidosis. Asymptomatic carriage is common, and these are the women who may get symptomatic infection following antibiotics. Unlike oral thrush, vaginal thrush is rarely resistant to azole drugs.