Racial influence in renal stone disease: a Saskatchewan story.

Data was obtained from two separate governement sources in an effort to review the prevalence of kidney stone disease in the province of Saskatchewan for the years 1983-1988 inclusive. The data revealed a statistally significant difference in prevalence rate among different ethnic groups within the population. Aboriginal people were found to have a prevalence rate approximately one-third that of the nonaboriginal (non-native) population. A renal stone episode prevalence of 0.858 per 1000 population compared to 0.222 per 1000 population in aboriginal people (p.<.001). The reasons for this difference could not be retrospectively associated with geographical variation. A discussion of other possible causes in association is offered, but it is felt that, in the end, more research into this area is required.

Kidney stones and lithotripters: critical analysis of the introduction of extracorporeal shock wave lithotripsy into Canada.

It is possible for a nonpharmaceutical medical innovation to enter the mainstream of the health care system without its efficacy and effectiveness having first been established by means of a randomized controlled trial (RCT). The result of this omission may be the discreditation and abandonment of the technology or procedure but not before precious resources that could have been better used elsewhere in the health care system are absorbed. A possible example of such a misallocation of resources is the introduction into Canada of extracorporeal shock wave lithotripsy (ESWL) for the treatment of urolithiasis. We review the development and diffusion of ESWL and recommend ways in which the deficiencies in regulating the introduction of new medical technologies can be corrected.

The role of the urban community hospital in gonorrhoea surveillance.

In a progressive surveillance programme designed to detect gonococcal infection in females, 113,063 women were screened for gonorrhoea in Memphis-Shelby County, Tennessee, during a 2-year period. The importance of including the urban community hospital in the surveillance programme is emphasized by the contribution of the City of Memphis Hospital where 53-3 per cent. of all positive cases of gonorrhoea were detected in only 34-2 per cent. of all tests done. The City of Memphis Hospital emergency room was an especially productive surveillance area, giving 29-0 per cent. of all positives with only 6-1 per cent. of all tests performed. The importance of taking routine cultures for gonococci from women presenting for prenatal care, delivery, or for genitourinary complaints in an urban hospital is stressed.