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Background: The growing demand for complementary and alternative medicine (CAM) is undeniable. We report a first study about the attitudes and behaviour of Australian rehabilitation physicians to CAM. Methods: A prospective cross-sectional survey was undertaken to document the prevalence of, knowledge about and referrals to CAM therapies and their perceived effectiveness, by a sample of Australian rehabilitation physicians. Results: Thirty-six out of 94 actively practising rehabilitation physicians from the Australasian Faculty of Rehabilitation Medicine, the Royal Australasian College of Physicians, replied to the survey, a response rate of 38%, and 85% reported familiarity with CAM, the most familiar therapies being acupuncture (80%), yoga (74%) and Tai-Chi (72%). CAM referral was reported in 84%, 38% personally used CAM, 94% of patients enquired about CAM therapies, 32% of respondents routinely enquired about CAM use. Age, sex and year of Fellowship were not associated with familiarity, personal use or frequency of patient enquiry about CAM. Those who reported to be very familiar with CAM were more likely to routinely enquire about CAM use ( P = 0.028) and be more confident in prescribing certain CAM therapies ( P < 0.05). Conclusion: Australian rehabilitation physicians report similar CAM referral rates to Canadian physiatrists and Australian general practitioners. The most commonly prescribed therapies were acupuncture, yoga and Tai-Chi. Almost all patients use CAM therapies, but only a minority of rehabilitation physicians enquires about CAM use on a regular basis. The latter may avoid potentially harmful drug interactions, as well as improve the quality of the physician–patient relationship. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Thromboprophylaxis Following Hip and Knee Arthroplasty" by C. Mirkazemi, L. R. Bereznicki, and G. M. Peterson in the 2013; 43 issue.

Chan DKY, O'Rourke F, Shen Q, Mak JCS, Hung WT. Meta-analysis of the cardiovascular benefits of intensive lipid lowering with statins. Acta Neurol Scand: 2011: 124: 188-195. © 2010 John Wiley & Sons A/S. Objective - To evaluate the efficacy of intensive lipid lowering with higher-dose statins. Methods - Meta-analysis of seven randomized controlled trials comprising 50,972 participants. Results - Mean follow-up was 3.1 years with mean age 63 years. Final LDL-C levels in intensive lipid-lowering group were 1.42-2.07 mmol/l compared to 2.1-3.5 mmol/l in the less intensive or control group. The intensive arm had significantly lower risks for stroke OR 0.80 (95% CI 0.71-0.89); major coronary events OR 0.74 (95% CI 0.65-0.83); cardiovascular disease (CVD) or coronary heart disease (CHD) deaths OR 0.84 (95% CI 0.74-0.95). Significantly higher liver enzyme abnormalities occurred in intensive group* (OR 3.96; 95% CI 2.08-7.53), but it was not associated with drug discontinuations (OR 1.20; 95% CI 0.88-1.64). Conclusion - In those at high risk of cardiovascular events, intensive lipid lowering with statins to LDL-C level <2.1 mmol/l significantly reduces risk of stroke, major coronary events and CVD or CHD deaths compared to LDL-C level ≥2.1 mmol/l. [*Correction added on 11 January 2011 after first online publication on 27 October 2010. The phrase, 'Significantly higher liver enzyme abnormalities occurred in less intensive group', was amended to 'Significantly higher liver enzyme abnormalities occurred in intensive group'.] [ABSTRACT FROM AUTHOR]