CMAJ: Canadian Medical Association Journal articles from April 2005

CMAJ: Canadian Medical Association Journal archives from April 2005

Epidemiology of severe trauma among status Aboriginal Canadians: a population-based study.(Research/Recherche)
April 12, 2005... Abstract Background: Aboriginal Canadians are considered to be at increased risk of major trauma. However, population-based studies characterizing the distribution, determinants and outcomes of major trauma in this group are lacking. We...

Rate of elective cholecystectomy and the incidence of severe gallstone disease.(Research/Recherche)
April 12, 2005... Abstract Background: The use of elective cholecystectomy has increased dramatically following the widespread adoption of laparoscopic cholecystectomy. We sought to determine whether this increase has resulted in a reduction in the...

Getting to the root of trauma in Canada's Aboriginal population.(Commentary/Commentaire)
April 12, 2005... Aboriginal Canadians bear a disproportionate risk of injury and illness compared with their non-Aboriginal counterparts. (1) Age-standardized, allcause mortality rates for our Aboriginal population are almost twice those of the whole population...

A call to bloggers (not a running group).(weblogs)
April 12, 2005... Last week CMAJ posted its first blog (www.cmaj.ca /misc/drblog1.shtml). James Maskalyk (a.k.a. Dr. Blog), a former editorial fellow at CMAJ, is its author and the engineer of this experiment at the journal. Working with Medecins Sans frontieres...

The 2003 Canadian recommendations for dyslipidemia management: revisions are needed.(Controversy)
April 12, 2005... The recommendations of the 2003 Canadian guidelines for the management and treatment of dyslipidemia, if applied in clinical practice, will result in more people being screened and prescribed statin therapy. (1,2) When compared with the 2000...

The analysis by Manuel and colleagues creates controversy with headlines, not data.(coronary artery disease)
April 12, 2005... The last 15 years have seen extraordinary changes in the approaches to the prevention and treatment of coronary artery disease (CAD). The high burden and cost of atherosclerotic disease renders its prevention and early detection and treatment...

Rebuttal.(coronary heart disease)
April 12, 2005... We very much agree with the guidelines' stated approach of assessing coronary artery disease (CAD) risk, as opposed to relying solely on lipid levels. However, Genest and his colleagues did not do a good job of estimating the individual and...

Intra-articular hyaluronic acid for the treatment of osteoarthritis of the knee: systematic review and meta-analysis.(Review/Synthese)
April 12, 2005... Abstract Background: Osteoarthritis of the knee affects up to 10% of the elderly population. The condition is frequently treated by intraarticular injection of hyaluronic acid. We performed a systematic review and meta-analysis of...

The human right thing to do.(Hope in Hell: Inside the world of Doctors Without Borders)(Pathologies of Power: Health, Human Rights, and the New War on the Poor)(Book Review)
April 12, 2005... Hope in hell: inside the world of Doctors Without Borders Dan Bortolotti Richmond Hill, ON: Firefly Books Ltd; 2004 304 pp $35 ISBN 1-55297-865-6 Pathologies of power: health, human rights, and the new war on the poor Paul Farmer Berkeley,...

Through the gates.(Lifeworks)(Interview)
April 12, 2005... The Gates Christo and Jeanne-Claude Feb. 12-27, 2005 The environmental artists Christo and Jeanne-Claude say there was no message, no symbolism, no purpose to The Gates, Central Park, New York City, 1979-2005, other than to be art. "We...

Deaths/Necrologie.(Obituary)
April 12, 2005... Anderson, James L., Parksville, BC; University of Saskatchewan, 1959; former staff, Nanaimo Regional General Hospital. Died Oct. 30, 2004, aged 72. Baillie, James H., Foster, Que.; University of Toronto, 1938; public health; FRCPC; former...

Query.
April 12, 2005... I can remember my time in medical school--decidedly unhalcyon days--when, at the behest of my attending, I, a lowly clerk, would call specialists in the hospital and ask them to see patients on our ward. I was quite bad at this. I took too long...

Avian influenzavirus: are we prepared?/ La grippe aviaire : sommes-nous prets?(Editorial)
April 12, 2005... So far, almost all of the 69 cases of human infection with avian influenzavirus reported since January 2004 have involved people who lived or worked with poultry, poultry meat or eggs in Southeast Asia. Why should these relatively few cases...

The ethics of research involving Canada's Aboriginal populations.(Letters/Correspondance)(Letter to the Editor)
April 12, 2005... The recent publication of 2 epidemiologic studies examining Aboriginal populations (1,2) raises ethical concerns. Neither study describes any consultations with First Nations or Metis community members in the formulation of the research...

Clinical trials registry.(Letter to the Editor)
April 12, 2005... The requirement of the International Committee of Medical Journal Editors (ICMJE) that clinical trials be prospectively registered, before commencement, (1) is an important step, but of equal or greater importance would be better regulation of...

Correction.(Letters/Correspondance)(Correction Notice)
April 12, 2005... The DOI published in a recent News item1 was mistakenly listed as 10.1503/cmaj.1050134. It should have been read 10.1503/cmaj .050134. Reference (1.) Sibbald B. Feeling the pressure. CMAJ 2005;172 (6):735. DOI:10.1503/cmaj.050305

Debate over credibility of natural health product claims.(Complementary Medicine)
April 12, 2005... Clinical trials of natural health products are unnecessary because the existing licensing process adequately addresses the public's safety and efficacy concerns, says the director-general of Health Canada's Natural Health Products Directorate...

More resident positions needed say medical students.(Medical Education)
April 12, 2005... Seventy-seven anglophone medical school graduates are without a residency position following the first round of the 2005 residency match, underlining the need for more positions, says the Canadian Federation of Medical Students. Many of...

Russia underestimates HIV/AIDS incidence.(Infectious Disease)
April 12, 2005... A highly detailed statistical investigation of Russian HIV/AIDS data funded by the US Agency for International Development suggests the Russian government dramatically underestimates what may be the world's fastest-growing AIDS epidemic. ...

Pacific disease control.(Center for Disease Control)(Brief Article)
April 12, 2005... Pacific disease control: The BC Centre for Disease Control will expand to become the Pacific Centre for Disease Control, with a focus on diseases emerging in Asia. The change makes official collaborations between research and health centres in...

Antibiotic resistance.(reports)(Brief Article)
April 12, 2005... Antibiotic resistance: Canada is still a world leader in the fight against antibiotic resistance, but some rates are increasing. The National Report Card on Antibiotic Resistance shows that rates of high-level resistance have remained stable...

Privacy invasion?(Doctors Nova Scotia)(cases of freedom of information)(Brief Article)
April 12, 2005... Privacy invasion? Doctors Nova Scotia has filed an appeal in the Supreme Court against the Freedom of Information decision to release doctors' names and their billings. The physician organization claims releasing this information is an invasion...

Retraction.(research on vitamin supplements by Ranjit Kumar Chandra published)(Brief Article)
April 12, 2005... Retraction: The journal Nutrition (21[2]:286) has retracted published research by a Canadian scientists concerning the benefits of vitamin supplements for seniors. In 2001, Nutrition published an article by Dr. Ranjit Kumar Chandra, then an...

Measles deaths drop.(Brief Article)
April 12, 2005... Measles deaths drop: Globally, measles deaths have dropped by 39% from 873 000 in 1999 to an estimated 530 000 in 2003, report WHO and UNICEF. Africa saw the largest reduction with an estimated 46% decrease in measles deaths. The dramatic...

Dangerous copyright proposals hit medical community hard.(Copyright Policy)
April 12, 2005... If one were to ask the average physician to name imminent policy reforms relevant to the medical profession, copyright law is not among those topics most likely to leap to mind. This may soon change: the Canadian government is contemplating...

Straight to the heart with Viagra.(Sildenafil)
April 12, 2005... Sildenafil, a popular drug used for erectile dysfunction, aids the enlargement of one organ but may inhibit that of another. New research by Eiki Takimoto and colleagues (1) demonstrates that sildenafil suppresses myocardial hypertrophy in the...

Targeting hard-to-treat cancers.(Science and Medicine)
April 12, 2005... For most patients with chronic myelogenous leukemia (CML), chemotherapy with imatinib results in a complete hematologic and cytogenetic response. However, patients who acquire drugresistant CML have a poor prognosis. Ellen Weisberg and...

Canadian guidelines for body weight classification in adults: application in clinical practice to screen for overweight and obesity and to assess disease risk.(Overweight and Obesity)
April 12, 2005... Since 1985, the number of obese adults in Canada has doubled. (1) According to 2003 data from Statistics Canada (www.statcan.ca/english/freepub/82-221-XIE/00604/tables/html/1228_03.htm), 15% of adults are obese (body mass index [BMI] > 30...

Hand-arm vibration syndrome.(Public Health)
April 12, 2005... Background and epidemiology: Hand-arm vibration syndrome (HAVS) refers to a constellation of vascular, neurological and musculoskeletal signs and symptoms that may occur in workers who use handheld vibrating tools, in particular drills,...

Alkaptonuria and photography: a patient's urine tells the story.(Clinical Vistas)
April 12, 2005... This picture of a patient who had alkaptonuria (Fig. 1) was taken by my father, Dr. Ian Maxwell, in 1957 and was developed using the patient's own urine. [FIGURE 1 OMITTED] Alkaptonuria was the first described "inborn error of...

Is there a role for estrogen in the prevention and treatment of urinary incontinence?(In the Literature)
April 12, 2005... Hendrix SL, Cochrane BC, Nygaard IE, Handa VL, Barnabei VM, Igesia C, et al. Effects of estrogen with and without progestin on urinary incontinence. JAMA 2005;293:935-48. Background: The role of estrogen in the treatment of urinary...

The sacred and the secular: the life and death of Terri Schiavo/Le sacre et le profane: la vie et la mort de Terri Schiavo.(Editorial)
April 26, 2005... I urge all those who honor Terri Schiavo to continue to work to build a culture of life, where all Americans are welcomed and valued and protected, especially those who live at the mercy of others. The essence of civilization is that the strong...

Pediatric clinical trials registry.(Letters/Correspondance)
April 26, 2005... Although the need to register clinical trails in a publicly accessible register has been considered for years, (1,2) it has only recently become a major issue. After the much-publicized situation regarding withheld data on the use of selective...

Cardiovascular risk in patients with type 2 diabetes.(Letters/Correspondance)
April 26, 2005... There is no doubt that aggressive control of common risk factors is of paramount importance in the management of diabetic patients with atherosclerotic disease to prevent cardiovascular morbidity and mortality. In assessing management of such...

C. difficile: will lessons be learned?(Letters/Correspondance)(clostridium)
April 26, 2005... Laura Eggertson (1) reports that "there were 7004 cases of [Clostridium] difficile across Quebec from Apr. 1, 2003, to Mar. 31, 2004, and 1270 people died." Additional data in her article reveal a staggering increase in both morbidity and...

Influenza vaccine for all?(Letters/Correspondance)
April 26, 2005... I find it interesting that, a few weeks after celebrating the achievements of the Cochrane Collaboration, (1) CMAJ published a systematic review (2) and a recommendation statement from the Canadian Task Force on Preventive Health Care (3) on...

Earning our patients' trust/Gagner la confiance de nos patients.(Letters/Correspondance)
April 26, 2005... A recent editorial in the CMAJ1 used notorious British family physician and serial murderer Harold Shipman as an example of how "professional malfeasance" wrought by physicians has eroded public confidence in physicians. While I could not agree...

Corrections.(Letters/Corresponance)(Correction Notice)
April 26, 2005... In a recent News item, (1) the sentence "Studies have shown that patients initially lose between 35%-60% of baseline body weight and maintain weight reductions of approximately 16% after 8 years" should have read "Studies have shown... after...

Feds to stockpile antivirals as pandemic "speed bump".(Infectious Disease)
April 26, 2005... A longer version of this article was posted Mar. 23, 2005, at www.cmaj.ca The federal government has generated an ambitious plan to stockpile massive quantities of antiviral drugs in readiness for a potential influenza pandemic, to buy...

UK rejects compulsory mental health treatment.(Government Legislation)(Brief Article)
April 26, 2005... Attempts to overhaul mental health law in England and Wales suffered a withering blow last month when a Joint Parliamentary Committee described the draft bill as "fundamentally flawed" and sent it back to committee. The British Medical...

National consumer drug safety network launched.(Drug Safety)
April 26, 2005... Citing the recent withdrawal of refecoxib (Vioxx), members of a new national consumer network say Health Canada and Canadian doctors are failing in their duty to protect the public from harmful drugs. "The evidence is clear, something is...

Patent-drug price board to review guidelines.(Access to Drugs)
April 26, 2005... The tribunal in charge of regulating drug prices is reviewing its guidelines in light of an increase in the price of 35% of all patented drugs last year. In a Mar. 9 discussion paper, the Patented Medicine Prices Review Board (PMPRB)...

Schiavo ruling.(News @ a glance)(Terri Schiavo)(Brief Article)
April 26, 2005... Schiavo ruling: An extraordinary intervention in a family fight over whether to remove a comatose woman's feeding tube saw the US Congress pass a law requiring a Federal Court judge to hear the case. Despite rulings by 19 Florida judges in...

Sunbed risks.(News @ a glance)(Brief Article)
April 26, 2005... Sunbed risks: Sunbed use increases the risk of skin cancer, particularly among people under 18, warns the WHO. Studies have shown that young people who get sunburns have an increased risk of developing melanoma later in life. More recently, a...

Applying pressure.(News @ a glance)(ome blood pressure monitoring devices)(Brief Article)
April 26, 2005... Applying pressure: Millions of Canadians who use home blood pressure monitoring devices may be endangering their health if they are not properly instructed in how to read the machines. Dr. Thomas Wilson, a researcher with the Canadian Heart and...

Breast best.(News @ a glance)(breast milk )(Brief Article)
April 26, 2005... Breast best: Healthy, full-term babies should receive only breast milk for the first 6 months, advises the Canadian Paediatric Society. Previously, the CPS had endorsed a range of 4 to 6 months. "There is evidence that the benefits increase...

Alternative choice.(News @ a glance)(Alternative medicine)
April 26, 2005... Alternative choice: Alternative medicines are increasing in popularity among Canadians, indicate new data from Statistics Canada. The latest figures from the Canadian Community Health Survey show that 20% of Canadians over age 12--some 5.4...

New litigation limit leads to storage woes.(Medicolegal)
April 26, 2005... As provincial governments across Canada tweak their regulation of malpractice lawsuits, physicians aren't worried about heading to the courtroom, they're angry about spending extra time and money storing patient records. "I haven't seen...

Discontinuing life support in comatose patients: an example from Canadian case law.(Life Decisions)
April 26, 2005... The type and extent of medical intervention that is appropriate for patients in a persistent vegetative state is a matter of painful moral and legal debate, as the Terri Schiavo case in the United States has recently shown. Every day, in...

Light as a defence against fungal infection.(Science and Medicine)
April 26, 2005... Fungi love the dark, and one day we may be able to turn this fact against them to fight fungal infections. New research suggests that the way in which the fungus Cryptococcus neoformans detects light plays a role in its virulence. Two genes...

When should surgery be considered for the treatment of epilepsy?(Teaching Case Report)
April 26, 2005... THE CASE: A 45-year-old right-handed man was admitted to hospital for evaluation of seizures that had begun when he was 10 years old but were not responding to treatment. The events were characterized by an initial butterfly sensation in his...

Protecting against Clostridium difficile illness.(Public Health)
April 26, 2005... Background and epidemiology: A gram-positive, anaerobic bacterium that is common in the environment, Clostridium difficile is transmitted by the fecal-oral route. Its resistant spores are ingested, survive passage through the stomach and...

Eczema drugs tacrolimus (Protopic) and pimecrolimus (Elidel): cancer concerns.(Health and Drug Alerts)
April 26, 2005... Published at www.cmaj.ca on Apr. 7, 2005. Reason for posting: Many patients with eczema, or atopic dermatitis, are prescribed the topical immunomodulators tacrolimus and pimecrolimus. The drugs are often given to people for whom the...

Does coronary revascularization before major vascular surgery decrease mortality?(In the Literature)
April 26, 2005... McFalls EO, Ward HB, Moritz TE, Goldman S, Krupski WC, Littooy F, et al. Coronary-artery revascularization before elective major vascular surgery. N Engl J Med 2004;351(27):2795-804. Background: Evidence gathered over the last 30 years has...

Spontaneous expectoration of lung tumour mass.(Clinical Vistas)
April 26, 2005... A 57-year-old man noticed a painless bluish mass enlarging on top of his right foot. Fine-needle aspiration and excisional biopsy showed a high-grade giant-cell variant of malignant fibrous histiocytoma. Because he had recurrence of the tumour...

Outcomes in octogenarians undergoing coronary artery bypass grafting.(Research/Recherche)
April 26, 2005... Abstract Background: Although octogenarians are being referred for coronary artery bypass grafting (CABG) with increasing frequency, contemporary outcomes have not been well described. We examined data from 4 Canadian centres to determine...

Effectiveness of statins for secondary prevention in elderly patients after acute myocardial infarction: an evaluation of class effect.(Research/Recherche)
April 26, 2005... Abstract Background: Clinical trials have shown the benefits of statins after acute myocardial infarction (AMI). However, it is unclear whether different statins exert a similar effect in reducing the incidence of recurrent AMI and death...

Are the benefits of statins a class effect?(Commentary/Commentaire)
April 26, 2005... In general we have to be cautious about basing prescribing decisions on the results of cohort studies. When physicians prescribed hormone replacement therapy to postmenopausal women in the 1990s for the prevention of coronary artery disease,...

A death in the family: reflections on the Terri Schiavo case.(Commentary)
April 26, 2005... Published at www.cmaj.ca on Apr. 1, 2005. Revised on Apr. 6, 2005. Terri Schiavo, a 41-year-old Florida woman who was in a persistent vegetative state for the 15 years before her death on Mar. 31, 2005, was at the centre of a political,...

Behavioural treatments for chronic systemic inflammation: effects of dietary weight loss and exercise training.
April 26, 2005... Abstract PERSISTENT LOW-GRADE INFLAMMATION, as indicated by higher circulating levels of inflammatory mediators such as C-reactive protein, interleukin-6 and tumour necrosis factor-[alpha], is a strong risk factor for several chronic...

Playing Noah.(Theater Review)
April 26, 2005... Mourning dove A play by Emil Sher Directed by Lorne Pardy Great Canadian Theatre Company, Ottawa Feb. 16-Mar. 6, 2005 Emil Sher's The Mourning Dove, which premiered at Ottawa's Great Canadian Theatre Company this winter, begins with sound:...

Fragments.(Room for a view)
April 26, 2005... So thoughtful of the geriatricians to invite the psychiatrists to dinner, even if I was the only one who could come out tonight. The restaurant is very nice, and the food is good. At my table are two geriatricians, a family physician with an...

Lessons from history.(Room for a view)(pandemics)
April 26, 2005... Dear Colleagues, I found the clue whilst traversing a recent Journal and brought it to the attention of an estimable Librarian. Employing his considerable powers of detection, he promptly unearthed the treasure itself: an operating Time...

Quarantine.(Room for a view)(Brief Article)
April 26, 2005... With respect to the closing of schools, churches, theatres and other public assemblages, each Medical Officer of Health or Local Board of Health has power to close such places if it seems desirable. The matter of placarding, and quarantining...

The Spanish influenza in Montreal.(Past progressive)(Brief Article)
April 26, 2005... From an article by S. Boucher, director of the city's Department of Health, in the December 1918 issue of CMAJ. The graph shows the peak in the number of deaths from influenza reported daily in Montreal during October and the first week of...

Deaths/Necrologie.
April 26, 2005... Ahsan-Uddin, Syed, Edmonton; University of Punjab (Pakistan), 1979; general surgery; FRCS(Glas.), LRCP, MRCS(Eng.), FRCSC; staff, Sturgeon Community Hospital & Health Centre. Died Nov. 21, 2004, aged 49. Alway, Alan E., London, Ont.;...

Query.(computers in medical practice)
April 26, 2005... I once lived the life of a paper-based creature. I wrote notes on multicoloured things called Stickies. I had a notepad to remind me about important events and items to follow up. I carried a pen. I wrote in things called charts whenever a...