CMAJ: Canadian Medical Association Journal articles from April 2008

CMAJ: Canadian Medical Association Journal archives from April 2008

Effect of regulatory warnings on antidepressant prescription rates, use of health services and outcomes among children, adolescents and young adults.(Research)(Report)(Statistical data)
April 8, 2008... Abstract Background: Regulatory bodies worldwide, including Health Canada, have issued warnings about prescribing antidepressants to children and adolescents. We sought to determine whether the Health Canada warning had the desired effects...

Examining asthma quality of care using a population-based approach.(Research)(Report)(Statistical data)
April 8, 2008... Abstract Background: Asthma accounts for considerable burden on health care, but in most cases, asthma can be controlled. Quality-of-care indicators would aid in monitoring asthma management. We describe the quality of asthma care using a...

Battling depression.(Research)(Report)
April 8, 2008... Depression is a major public health problem, which is predicted to be second only to cardiovascular disease as the leading cause of disease-related disability worldwide by 2020. (1) It is already the leading cause of disease-related disability...

Health advisories: when good intentions go bad.(Research)(Report)(Statistical data)
April 8, 2008... Health advisories for drug therapies are issued by regulatory bodies such as Health Canada with the best of intentions: to protect the public. Such advisories are backed by teams of internationally renowned experts convened by these regulatory...

Asthma in Canada: missing the treatment targets.(Research)(Survey)(Statistical data)
April 8, 2008... Twenty years ago, an article in CMAJ catalyzed a revolution in Canadian asthma management. (1) Mao and colleagues reported a rising rate of deaths caused by asthma at a time when physicians were complacent about their ability to manage this...

The Canadian Academy of Health Sciences: coming of age at the right time.(Health policy)(Organization overview)
April 8, 2008... Do vaccines cause autism? How much vitamin D should Canadians be taking? How can we reform our health care system to care for the coming avalanche of elderly citizens with comorbid chronic diseases? How much should we be spending on the last...

Obesity reduction and its possible consequences: what can we learn from Cuba's Special Period?(Public health)(Report)
April 8, 2008... In a recent issue of the American Journal of Epidemiology, (1) we described the relation between sustained population-wide weight loss and a decline in all-cause mortality and in the rates of death from diabetes mellitus and cardiovascular...

Recruiting foreign-trained professionals.(Letters)(Letter to the editor)
April 8, 2008... The editorial by Amir Attaran and Roderick Walker about Shoppers Drug Mart's practice of recruiting pharmacists from South Africa (1) raises an important moral point, but in my view the authors' argument is seriously flawed. As a family...

Involving physicians in MedsCheck.(Letters)(Letter to the editor)
April 8, 2008... I completely agree with Shawn Tracy and Ross Upshur that physicians should become more involved in MedsCheck, (1) a program in which Ontario patients with chronic diseases who take 3 or more prescription medications daily can have a free yearly...

Correction.(Letters)(Correction notice)
April 8, 2008... A News article in the Feb. 26 issue about the activities of astronaut Dr. Scott Parazynski contained an error. (1) Parazynski undertook 7 spacewalks, not 3 as stated. CMAJapologizes for this error. REFERENCE (1.) Howell E. "Honorary...

Situation A, potentiality B, lovelorn C.(Room for a view)(Viewpoint essay)
April 8, 2008... I've looked at friends who have devoted their lives to writing and felt utterly sapped. I've romanticized their lives, imagining them howling at their vicious muses at 2 am. These friends of mine are poets and novelists and all of them are fine...

Physicians as patients: a narrative patchwork.(Lifeworks)
April 8, 2008... Centering Ourselves as Patients Suzanne Watters MD and Lindsay Zier-Vogel MA The University of British Columbia Health Clinic and the Family Practice Centre British Columbia Women's Hospital Vancouver, British Columbia ...

In the line of duty.(Book review)
April 8, 2008... "Our Gallant Doctor" Enigma and Tragedy: Surgeon Lieutenant George Hendry and HMCS Ottawa, 1942 James Goodwin Toronto: Dundurn Press; 2007 280 pp $35.00 ISBN 978-1-55002-687-0 Hero is a troublesome word. Usually it is...

One thousand words.(The Left Atrium)
April 8, 2008... [ILLUSTRATION OMITTED] "A refreshing splash," was taken in the Oddar Meanchey province of Cambodia where many communities struggle with access to fresh water during the dry season. Numerous nongovernmental organizations work to provide...

Deaths.
April 8, 2008... Arhanic, Milivoj Clement, Toronto, Ontario; Sveucilista u Zagrevbu, Zagreb, Croatia, 1959, diagnostic radiology. Died Dec. 21, 2007, aged 75. Auger, Claude, Orleans, Ontario; Universite Laval, Sainte-Foy, Quebec, 1973, general surgery....

Requiem for the sounds of silence.(Salon)(Viewpoint essay)
April 8, 2008... During my annual reflection on the occasion of President John F. Kennedy's assassination, I serendipitously stumbled on the moving poetry from Paul Simon's signature song, The Sounds of Silence. It happens, ironically--and previously...

Safe water? Depends on where you live!/Votre eau potable est-elle salubre? Tout depend de l'endroit ou vous vivez!(Editorial)(Editorial)
April 8, 2008... The contaminated water tragedy in Walkerton, Ontario, in 2000, which caused the deaths of 7 people and illness in at least 2300 others, rocked Canadians' belief that our public water supply was safe. Nevertheless, after 8 years and millions of...

Growth generates health care challenges in booming India.(News)(Financial report)(Statistical data)
April 8, 2008... At first blush, the basic numbers paint a grim picture. While there's a double-digit annual increase in health outlays, as many as 3.1 million people are infected with HIV and roughly 800 000 contract an infectious form of tuberculosis each...

Despite federal promises, First Nations' water problems persist.(News)(Report)
April 8, 2008... A year after the federal Conservative government promised to draft drinking water standards for First Nations communities, there is still no bill before the House of Commons--and boil-water advisories remain in place on more than 90 Canadian...

Private health clinics remain unregulated in most of Canada.(News)(Report)
April 8, 2008... Provincial governments and governing medical colleges across Canada are scrambling to regulate and monitor private medical facilities as anxious patients languishing on waiting lists look outside the public system for health services. ...

Barbara Seaman (1935-2008): pioneer in the women's health movement.(Obituary)(Obituary)
April 8, 2008... Women's health lost a powerful champion with the death of Barbara Seaman, an author, journalist and patients' rights advocate, on Feb. 27, 2008, at her Manhattan home in New York City, New York. She had been living with lung cancer. Seaman...

President-elect.(News @ a glance)(Brief article)
April 8, 2008... President-elect: Saskatoon, Sask., family physician Dr. Anne Doig has been selected president-elect of the Canadian Medical Association for 2009/10. Doig emerged as the victor on the fourth ballot of a 7 candidate contest (CMAJ...

Tuberculosis hot spots.(News @ a glance)(Brief article)(Clinical report)
April 8, 2008... Tuberculosis hot spots: Nearly 500 000 or a staggering 5% of all 9 million new tuberculosis cases diagnosed annually worldwide are of the multidrug-resistant variety, according to the World Health Organization's first update on the disease in 4...

Marijuana tug-of-war.(News @ a glance)(Brief article)
April 8, 2008... Marijuana tug-of-war: The 124 000-strong American College of Physicians has called on the Bush administration to review marijuana's status as a Schedule 1 controlled substance so that its therapeutic use can be legitimized. Re-News...

Down to 2.(News @ a glance)
April 8, 2008... Down to 2: Over the course of leading his Progressive Conservative party to a record 11th consecutive majority, Alberta Premier Ed Stelmach vowed to phase out health care premiums over 4 years. Albertans now annually shell out $538 per...

Medical fugitives.(News @ a glance)
April 8, 2008... Medical fugitives: Nearly 9% of physicians, nurses and ancillary health care staff working in the United States have invalid licenses or questionable credentials, according to an assessment (www.medversant.com) of the professional licensing...

Failing grades.(News @ a glance)
April 8, 2008... Failing grades: Nova Scotia Auditor-General Jacques Lapointe says the province's Department of Health Protection response to its recent mumps outbreak (some 777 cases) was "less than timely." The department was ciriticized for, among other...

Cochrane Network launches $500 000 access petition.(For the record)
April 8, 2008... Hoping to persuade the federal government to pony up over $500 000 per year to purchase a national license to access the Cochrane Library, the Canadian Cochrane Network and Centre has launched an online petition urging Ottawa to open its vaults...

Academic athletes.(News)(Report)(Brief article)
April 8, 2008... The British Medical Association is worried that healthy people are increasingly using brain boosting prescription drugs. The Association's medical ethics committee argues that greater use of cognitive enhancements demands that society consider...

Preparing for Afghanistan's medical future.(Dispatch from the medical front)
April 8, 2008... In January 2007, the commanding officer of the Health Service Support Unit at Kandahar Air Field, Afghanistan, shared with me his vision for improving local health care capacity. He wished to partner the Canadian-led Role 3 Multinational...

The dietary supplement 5-hydroxytryptophan and urinary 5-hydroxyindole acetic acid.(Teaching case report)(Case study)
April 8, 2008... The case: A 56-year-old woman presented with diarrhea (6-8 loose stools daily with no obvious blood). The diarrhea was intermittent but had persisted for 12 weeks. The patient reported having some fecal incontinence. The patient had no...

Giant calculi in urethral diverticula.(Interesting images)(Brief article)(Clinical report)
April 8, 2008... [FIGURE 1 OMITTED] A 45-year-old woman presented with a 10-year history of recurrent urinary tract infections. On clinical examination, we found a hard periurethral mass in the anterior vaginal wall. A radiograph of her pelvis showed giant...

Chronic contained rupture of an abdominal aortic aneurysm with vertebral erosion.(Clinical vistas briefs)(Case study)
April 8, 2008... A 67-year-old man presented with a 6-month history of low-back pain despite having sought medical treatment. He had no fever, and his blood pressure was 136/64 mm Hg on admission. His abdomen was flat and soft without any palpable mass. There...

Screening and case-finding instruments for depression: a meta-analysis.(Research)(Statistical table)(Survey)
April 8, 2008... Abstract Background: Screening and case-finding has been proposed as a simple, quick and cheap method to improve the quality of care for depression. We sought to establish the effectiveness of screening in improving the recognition of...

Ending life with grace and agreement/Finir sa vie dans la grace et la concorde.(Editorial)(Editorial)
April 22, 2008... Making the decision to withdraw or withhold life-sustaining care is difficult at the best of times, but when families and caregivers disagree about the course of action, the conflict disrupts patient care and consumes enormous personal...

Diagnosing the aging physician.(News)
April 22, 2008... The cardboard boxes piled floor to ceiling in the basement of Dr. Ah-Yin Eng's office hold more than just medical records--they hold stories. Some of these stories, the remnants of 37 years of family practice, didn't end well. Standing amid the...

Gairdner winners bumped to $100 000 next year.(News)
April 22, 2008... The 2008 winners of Canada's most internationally recognized prize for biomedical research have been unveiled by the Gairdner Foundation. The recipients of this year's Gairdner International awards, who were announced Apr. 15, 2008, will each...

Global Health forum urges training programs.(News)
April 22, 2008... When it comes to staffing levels at Bundibugyo District Hospital in western Uganda, the gap between the ideal and the reality is as jarring as the rough drive through the Rwenzori Mountains to reach the isolated community. Though...

Abramson: direct-to-consumer advertising will erode health care.(News)
April 22, 2008... Canadian medical care will be corrupted and the country's political system will be polluted if a legal bid to strike down Canada's ban on direct-to-consumer advertising of prescription drugs is successful, warns prominent academic Dr. John...

Ditch that white coat.(News)
April 22, 2008... Some British physicians call it "chasing sound bites." Others say the new "bare below the elbows" policy is simply good infection control. Whatever the opinion, few issues have generated controversy quite like the one that's ensued in the wake...

Cost of acute care hospital stays.(For the record)(Report)(Brief article)
April 22, 2008... Canadian acute care hospitals spend an average $6983 to treat a patient for a night, the Canadian Institute for Health Information (CIHI) says. In its first analysis of national data on hospital spending by patient stay and medical...

Adverse events disclosure.(For the record)(Brief article)
April 22, 2008... The Canadian Patient Safety Institute has unveiled non-binding disclosure guidelines for adverse events. Predicated on the proposition that "all harm must be communicated to patients, irrespective of the reason for the harm," the...

Beaudet named CIHR president.(News)(Canadian Institutes of Health Research has appointed Dr. Alain Beaudet )(Brief article)
April 22, 2008... There'll be no lack of managerial experience in the next president of the Canadian Institutes of Health Research. Federal Health Minister Tony Clement reached into the provincial bureaucratic ranks to find a new head for the granting...

Proposed cuts to sport and recreation could hinder health of northern communities.(News)
April 22, 2008... Efforts to combat the northern battle of the bulge have been imperilled by a recently proposed 40% cut in sport and recreation programming aimed at promoting more physical activity at the community level, sport organizations say. The...

Dr. Donald Graham, 1914-2008.(News)(Biography)
April 22, 2008... Dr. Donald Carter Graham had no idea nuns were so scary. One day in the 1950s, while practising at St. Michael's Hospital in Toronto, Ontario, Graham brought his oldest son, also named Donald, to work. The hospital's nurses were also nuns and...

Colorectal screening.(News @ a glance)(Brief article)
April 22, 2008... Colorectal screening: Ontario Health Minister George Smitherman has launched a public education campaign to promote screening for colorectal cancer for all "average risk" residents of the province 50 years and older, using a fecal occult blood...

Mental health parity.(News @ a glance)(Brief article)
April 22, 2008... Mental health parity: The United States appears poised to adopt mental health parity legislation that will require group health insurance plans to provide equal levels of coverage for physical and mental illnesses, while prohibiting larger...

Complaints department.(News @ a glance)
April 22, 2008... Complaints department: Health Canada has established a Food and Drugs Act Liaison Office to provide "in dependent and confidential" advice to consumers with complaints about federal regulations or processes governing food and drug approval or...

Squires award.(News @ a glance)(Brief article)
April 22, 2008... Squires award: University of Dundee, United Kingdom, researchers Dr. Deepa Sumukadas, Miles D. Witham, Dr. Allan D. Struthers and Dr. Marion E.T. McMurdo will receive the 2007 Bruce Squires Award from CMAJ. Their study, entitled Effect of...

Emergency battlefield cricothyrotomy.(Teaching case report)(Case study)
April 22, 2008... The case: A 19-year-old Afghan man was critically injured after a blast from an improvised explosive device. A Canadian Forces medic treated him within minutes of the injury. On initial assessment in the field, the man was conscious and...

Angioedema of the tongue.(Interesting images)(Case study)(Brief article)
April 22, 2008... [FIGURE 1 OMITTED] An 86-year-old woman presented with acute, painless, nonpruritic tongue swelling (Figure 1) that had developed 6 hours earlier. She had no symptoms of upper airway obstruction or dyspnea, but her speech was dysarthric....

Black hairy tongue: What is your call?(Clinical quiz)
April 22, 2008... [FIGURE 1 OMITTED] A 73-year-old male smoker attended a follow-up outpatient clinic 18 months after starting antibiotic therapy (rifampicin, isoniazid and clarithromycin) for a nontuberculous mycobacterial lung infection. His infection was...

The OPALS Major Trauma Study: impact of advanced.(Research)(Ontario Prehospital Advanced Life Support)(Report)
April 22, 2008... ABSTRACT Background: To date, the benefit of prehospital advanced life-support programs on trauma-related mortality and morbidity has not been established Methods: The Ontario Prehospital Advanced Life Support (OPALS) Major Trauma...

Effect of mechanical ventilation in the prone position on clinical outcomes in patients with acute hypoxemic respiratory failure: a systematic review and meta-analysis.(Research)(Clinical report)
April 22, 2008... ABSTRACT Background: Mechanical ventilation in the prone position is used to improve oxygenation in patients with acute hypoxemic respiratory failure. We sought to determine the effect of mechanical ventilation in the prone position on...

Traumatic brain injury: can the consequences be stopped?(Mechanisms and innovations)(Report)
April 22, 2008... ABSTRACT Traumatic brain injury is a leading cause of morbidity and death in both industrialized and developing countries. To date, there is no targeted pharmacological treatment that effectively limits the progression of secondary injury....

Should invasive airway management be done in the field?(Research)(Report)
April 22, 2008... Traumatic injuries result in more years of productive life lost than any other disease and represent the main cause of death among young people. Despite the public health importance of trauma, there have been few advances in early resuscitative...

Ventilation in the prone position: for some but not for all?(Research)
April 22, 2008... Shortly after acute respiratory distress syndrome was first described, it was soon realized that mechanical ventilation, aside from being essential for the treatment of the disease, can also harm the lungs by increasing the stress and strain...

Health geography: supporting public health policy and planning.(Public health)(Report)
April 22, 2008... Geography and health are intrinsically linked. Where we are born, live, study and work directly influences our health experiences: the air we breathe, the food we eat, the viruses we are exposed to and the health services we can access. The...

Serious adverse events in academic critical care research.(Research)(Report)
April 22, 2008... Although it might be ideal to have a single system for defining and reporting serious adverse events that would be applicable to both academic trials investigating established drugs and industry-sponsored trials of novel pharmaceutical agents,...

Effectiveness of selective serotonin reuptake inhibitors.(Letters)(Letter to the editor)
April 22, 2008... As a family physician I see many patients with mood disorders and selective serotonin reuptake inhibitors are an important therapeutic option for them. I have the clinical impression that drugs in this class can be very effective, and I...

A "take with a grain of salt" label for Holiday Review articles.(Letters)(Letter to the editor)
April 22, 2008... For the past decade CMAJ has published a series of articles inspired by the holiday season in a section called the Holiday Review. Some of these articles consist of quirky questions addressed with real data whereas others are, in the words of...

Health check program.(Letters)(Letter to the editor)
April 22, 2008... One of the major tools to reduce the prevalence of hypertension and improve hypertension control is to reduce the amount of sodium added to our foods during processing. Recently we estimated that hypertension could be prevented in 1 million...

Corrections.(Letters)(Correction notice)
April 22, 2008... An article in The Left Atrium in the Feb. 26 issue about Bolivian travelling doctors contained an error and an omission. (1) The correct spelling of the term for these individuals is medicos viajeros Bolivianos. In addition, the coauthor of...

The possibility of change.(James Orbinski)(Interview)
April 22, 2008... Dr. James Orbinski's humanitarian drive has taken him from the board rooms of the World Health Organization to the Rwandan genocide, from co-founding Medecins Sans Frontieres Canada (1991) to accepting the Nobel Peace Prize as Medecins Sans...

Human being.(Media)(Triage: Dr. James Orbinski's Humanitarian Dilemma)(Movie review)
April 22, 2008... Triage: Dr. James Orbinski's Humanitarian Dilemma A documentary directed by Patrick Reed White Pine Pictures, National Film Board of Canada: 2007 88 min. English Dr. James Orbinski is one physician who doesn't mind raising your blood...

This book bears grim testimony.(An Imperfect Offering: Humanitarian Action in the 21st Century)(Book review)
April 22, 2008... An Imperfect Offering: Humanitarian Action in the 21st Century Dr. James Orbinski, Doubleday Canada; 2008 448 p $35.00 ISBN 978038566093 The rich beauty of Dr. James Orbinski's writing contrasts with the stark poverty and suffering...

Deaths.(physicians)(Obituary)
April 22, 2008... Asselin, Marc-Andre, Brossard, Quebec; Universite Laval, Sainte-Foy, Quebec, 1964, diagnostic radiology. Died Jan. 5, 2008, aged 68. Barnett, George Dudley, Kelowna, British Columbia; University of Manitoba, Winnipeg, Manitoba, 1944. Died...

Were polio to return, today ...(Salon)
April 22, 2008... What would we do, today, were polio to return? For those too young to remember or old enough to have forgotten, in the early 1950s the last polio pandemic swept the world. From Copenhagen, Denmark, to Vancouver, Canada, to Hong Kong, local...