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A letter to the editor is presented in response to the article "Effect of aprotinin on renal dysfunction in patients undergoing on-pump and off-pump cardiac surgery: a retrospective observational study" by R. Mouton, D. Finch, I. Davies, A. Binks and K. Zacharowski in the February 9, 2008 issue.

The article focuses on the condition of public health in various countries. In the United States there is now 99% survival of infants, with life expectancy of 70-00 years and more, a far cry from the figure of 50 years in 1900. Funds for health have reached a high of 16% in the United States. The chief "killers", coronary heart disease (CHD) and stroke, have had their mortality rates almost halved, yet CHD incidence rate has not changed. Total mortality rate from cancer is stationary, or falling only slightly. The prevalence of obesity in women, and of hypertension and diabetes, already exceeds that in the white population. In most countries there is a tremendous health burden from infections, not only from malaria, but also from tuberculosis, and, more recently, from HIV infection. Rates of HIV infection in South Africa are the highest in the world; in parts, nearly 50% of antenatal African women are infected. In Spain, although mean serum cholesterol is rising, CHD mortality is falling. In Japan, although some risk factors are rising, inexplicably, mortality rates for breast and colon cancers are falling.

Opinion. Discusses the study by Pahor and colleagues, relating to observational studies of the safety of calcium-channel blockers. Their argument that these blockers might increase the incidence of cancer, by inhibition of apoptosis.

Mentions a synthesis meeting on osteoporosis to be held in Milan, Italy in October 2000. How women are affected by osteoporosis; Clinical synthesis meetings being different from consensus meetings; Publication of papers from a joint clinical synthesis meeting on hormone replacement therapy in the `Journal of Epidemiology and Biostatistics.'

Announces a conference being developed on women's health by `The Lancet,' the European Institute of Oncology, and the Harvard School of Public Health with assistance from the United Kingdom Medical Research Council and the Italian Istituto Superiore di Sanita. Subject being hormone-replacement therapy; The meeting to focus on issues, such as menopausal symptoms and cardiovascular disease in women.