Anaesthetists are under increasing pressure to move patients quickly through intensive care units after major surgery, which means extubating them as soon as possible. A randomised controlled trial of “fast track” anaesthesia and early extubation after coronary artery surgery showed that it is possible to halve the time to extubation without increasing postoperative complications (Chest 1998;113:481-8). Median time to extubation in the fast track group was only four hours.

Genetic testing for Alzheimer's disease is now possible, but not necessarily ethical. A working group from the Stanford programme in genomics, ethics, and society warns that there are few people who would benefit from predictive testing (Nature Medicine 1998;4:757-9). In an admirably brief report the working group counsels against any form of testing in children, embryos, or fetuses and urges governments to control the marketing of tests in the same way as they control the marketing of drugs.

Postmenopausal women who have had a non-traumatic vertebral fracture plainly need treatment for their osteoporosis, but as yet there is no consensus on what should be done. A report in Annals of the Rheumatic Diseases (1998;57:346-9) of a controlled trial in 58 women …