Breast cancer is found largely in older women; women aged over 65 account for 13% of the female population but for two thirds of all deaths from breast cancer (Annals of Internal Medicine 2003;139: 835-842). Few studies have looked closely at these figures, but the available evidence shows that screening using mammography every two years would reduce the death rate at an acceptable cost.

A new use has been found for lidocaine cream (Emla). Some patterns of self injury may be reinforced by the sensory stimulation, rather than social or psychological stimuli. A report in Developmental Medicine and Child Neurology (2003;45: 769-771) describes a child with autism who slapped his cheek at a rate of 45 slaps a minute. When the cheek was numbed with Emla the rate of slapping fell to 20 a minute, blocking the sensory response.

A study in Boston of adult cyclists who needed hospital treatment for road accidents found that the numbers seen rose by 30% between 1994 and 1999 (Injury 2003;34: 825-829). Thirty five of the 222 people studied had raised blood alcohol concentrations and half those with closed head injuries had not been wearing helmets. The lessons, say …