Cervical cytology is a topic I find almost unendurably boring, and how some people can spend their lives looking at cervical smears passes all understanding. There is now a machine for doing the initial scanning of the slides, called the ThinPrep Imager, which depends on liquid based cytology slides. This first trial from Italy compares the characteristics of liquid based versus conventional cytology. It produces far fewer unsatisfactory slides but is otherwise much the same. The second trial puts the ThinPrep imager through its paces and finds a useful difference in the number of readable slides and a slightly better pick-up rate for significant lesions.
One of the biggest favours we can do our patients is to help them stop smoking. Compared with a lifetime of antihypertensive treatment or statins, smoking cessation interventions are stupendously cost-effective, and if I discover that a patient is still smoking I can hardly wait to hand them out. This Clinical Review confirms that the most cost-effective is nortriptyline, with better results than bupropion at a fraction of the cost. But in terms of results, the winner is the newcomer varenicline. Most of the trials also involved behavioural support, but hey, this is the real world. Give it your best shot and see me in two weeks.