CMAJ: Canadian Medical Association Journal articles from August 2007

CMAJ: Canadian Medical Association Journal archives from August 2007

Jordan's Principle, governments' paralysis/Le Principe de Jordan et la paralysie des administrations publiques.(Editorial)
August 14, 2007... Children are vulnerable members of our society. They are voiceless in decision-making, subject to the judgments and actions of others. First Nations people are also vulnerable--victims of ill-will and broken promises and suffering from the...

American Medical Association boards implantable chip wagon.(News)
August 14, 2007... The influential American Medical Association (AMA) has thrown its weight behind what might be called medical human bar-coding by adopting a policy that endorses the provisional use of implantable radio frequency identification tags, or...

A conversation with Dr. Day: the joys of notoriety.(News)(orthopedic surgeon Brian Day)(Interview)
August 14, 2007... Few will likely ever assume the Canadian Medical Association (CMA) presidency with such advance notoriety. "Dr. Profit" and "Darth Vader" are among the tags that have been attached to Vancouver-based orthopedic surgeon Dr. Brian Day for...

Ontario overhauls medical audit regime.(News)
August 14, 2007... Ontario's medical audit system will become less onerous this fall as a result of recent provincial legislation that limits the worst abuses of its widely criticized predecessor, the Ontario Medical Association (OMA) says. The new system...

C. difficile outbreaks in Gatineau, Sault Ste. Marie.(News)(Clostridium difficile)(Brief article)(Clinical report)
August 14, 2007... A virulent strain of Clostridium difficile that has killed close to 2000 people in Quebec spread to a Gatineau hospital this spring, hospital officials have confirmed. There were 15 cases of this strain of C. difficile at the Sante Service...

Organ crackdown.(News @ a glance)(organ transplant tourism)(Brief article)
August 14, 2007... Organ crackdown: The Chinese government will significantly curtail organ transplants for foreigners as part of a crackdown on transplant tourism. The new regulations severely limit the number of hospitals that are authorized to perform such...

Living wills.(News @ a glance)
August 14, 2007... Living wills: Nova Scotia's largest district health authority has implemented a policy whereby every patient who is admitted to hospital is asked if they have advanced directives and if they'd like more information. The policy, 11 years in the...

From the medical front: treadmills.(Dispatch)
August 14, 2007... I was asked to see John for intermittent chest pain. The tough Inuit hunter waited until his granddaughter returned to his bedside to translate, and I gradually learned his story. Like many patients from the high Arctic, John had undergone...

Acquired hemophilia A presenting post partum.(Teaching Case Report)(Case study)
August 14, 2007... The case: A 41-year-old woman (gravida 4, para 3) presented in labour after 39 weeks' gestation. Her medical history included myasthenia gravis and thymectomy in 1995 and immunosuppression with azathioprine, which was stopped at 12 weeks'...

Acquired hemophilia A presenting in an elderly man.(Teaching Case Report)(Case study)
August 14, 2007... The case: An 85-year-old man presented with bruising of his hands, which he first noticed after shovelling snow 3 days earlier. His past medical history included benign prostatic hypertrophy and glaucoma. He was not taking anticoagulants or...

A tourist with tungiasis.(Clinical Vistas)(Case study)
August 14, 2007... A 35-year-old man presented with a slightly painful papule with a central dark spot on his right heel (Figure 1). It had developed 2 weeks before his return to Canada after a 3-month vacation in Ecuador. The lesion was typical of tungiasis,...

Drug-drug interactions between antithrombotic medications and the risk of gastrointestinal bleeding.(Research)
August 14, 2007... Abstract Background: Anticoagulants and antiplatelet drugs (e.g., warfarin, clopidogrel and acetylsalicylic acid) are key therapeutic agents in the treatment of cardiovascular diseases. However, drug-drug interactions may lead to a greatly...

Comparison of obstetric outcomes between on-call and patients' own obstetricians.(Research)(Report)
August 14, 2007... Abstract Background: The question "will you be delivering my baby?" is one that pregnant women frequently ask their physicians. We sought to determine whether obstetric outcomes differed between women whose babies were delivered by their...

Interaction between lopinavir/ritonavir and warfarin.(Case study)
August 14, 2007... ABSTRACT Drug interactions involving protease inhibitors are common. Protease inhibitors are well known inhibitors of the 3A4 isozyme of cytochrome P450. Select protease inhibitors, including co-formulated lopinavir/ritonavir, may induce...

Urine proteomics: the present and future of measuring urinary protein components in disease.(Clinical report)
August 14, 2007... ABSTRACT For centuries, physicians have attempted to use the urine for noninvasive assessment of disease. Today, urinalysis, in particular the measurement of proteinuria, underpins the routine assessment of patients with renal disease....

Drug interactions with warfarin: what clinicians need to know.(Research)
August 14, 2007... Remaining vigilant for interactions between medications is a formidable challenge for several reasons. The science of drug interactions is dauntingly complex and constantly evolving, the patient's medication list is often a moving target with...

"You're not my obstetrician" (and it may not matter).(Research)
August 14, 2007... Transferring care or "handing off" patient care to another physician is an essential component of practising medicine. In the "24-7" system of hospital care, physicians need to be able to convey essential patient information to another...

Enhancing research integrity.(Letters)(Letter to the editor)
August 14, 2007... Wayne Kondro and Paul Hebert advocate establishing a central agency in Canada to deal with scientific misconduct. (1) We propose a set of preventive procedures to enhance research integrity. Researchers should consider the US Sarbanes-Oxley Act...

Ethical funds for physicians.(Letter to the editor)
August 14, 2007... CMA Holdings Inc. has a policy of not investing in the tobacco industry. This is admirable and to be expected from a physician-owned corporation. I also believe that, as a matter of policy, CMA Holdings and its subsidiary MD Management Ltd....

Canada's approach to conflict-of-interest oversight.(Letter to the editor)
August 14, 2007... In his CMAJ news piece on the proposed US Food and Drug Administration conflict-of-interest rules that would limit the ability of experts with financial interests in the pharmaceutical industry to sit on the agency's advisory committees, Wayne...

Is primary care a lost cause?(Letters)(Letter to the editor)
August 14, 2007... The difficulty in attracting graduating physicians to family practice that Wayne Kondro described in a recent CMAJ news piece (1) is a worldwide phenomenon. (2) In 1987, 31% of German medical students wanted to become family physicians, whereas...

Sleepy older drivers.(Letter to the editor)
August 14, 2007... Norman Wolkove and colleagues recently presented an excellent review of sleep disorders in older people. (1,2) However, they did not mention that one of the main symptoms of sleep disorders, excessive daytime sleepiness, increases the risk of...

Genetic analysis to prevent warfarin complications.(Letter to the editor)
August 14, 2007... Warfarin is the most widely used oral anticoagulant therapy for patients with thrombosis. Owing to the notoriously narrow therapeutic range of this drug, small variations in dosing may result in hemorrhagic or thrombotic complications. We read...

Correction.(Correction notice)
August 14, 2007... In a recent News article, (1) the first photograph should be attributed to Lorne Turner. Incorrect information appeared in the print version of the July 17 issue. We apologize for this error. REFERENCE (1.) Kondro W. Afghanistan:...

SiCKO strikes a chord.(Movie review)
August 14, 2007... SiCKO Written, produced and directed by Michael Moore Alliance Atlantis; 2007 116 min There's a scene in Michael Moore's latest documentary, SiCKO, in which the populist filmmaker takes 3 boatloads of ill Americans--many of whom are rescue...

Losing your mind.
August 14, 2007... Rose Adams: Mind Works Craig Gallery, Dartmouth, NS May 3-26, 2007 In Mind Works, Canadian artist Rose Adams provides a perspective on Alzheimer's disease and dementia that is often missing from reports and statistics. For example, the...

Deaths.(Obituary)
August 14, 2007... Archer, James Charles, Surrey, BC; Queen's University Belfast, Northern Ireland, 1965, internal medicine. Died Mar. 22, 2007, aged 70. Bean, John Louis McDougall, Toronto; University of Toronto, 1945, obstetrics and gynecology. Died Apr....

New thinking about postoperative delirium.(Salon)(Disease/Disorder overview)
August 14, 2007... The scenario is simple. An 87-year-old woman is electively admitted to hospital because of postmenopausal bleeding. The diagnosis is endometrial cancer, and the treatment is a transabdominal hysterectomy. I get involved on the first...

Human papillomavirus vaccine: waiting for a miracle/Vaccin contre le virus du papillome humain: en attente d'un miracle.(Editorial)(Clinical report)
August 28, 2007... CMAJ is publishing this special issue on the human papillomavirus (HPV) vaccine in part to acknowledge those researchers who developed the HPV vaccine and to acknowledge the pharmaceutical industry, which embarked on the long and difficult task...

Colleges contemplate revising post-graduate medical education.(News)
August 28, 2007... The Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada are nearing the end of a 2-year national consultation that could redefine post-graduate education for future generations of Canadian medical...

Three provinces to study 2-dose HPV vaccine.(News)(British Columbia, Quebec and Nova Scotia; human papillomavirus)
August 28, 2007... British Columbia, Quebec and Nova Scotia are poised to begin a clinical trial to study the safety and effectiveness of giving younger girls 2 doses of a new vaccine against human papillomavirus, instead of the current 3-dose regimen. "Our...

Pass me that scalpel, instrumentalist.(News)(operating room personnel)(Report)
August 28, 2007... Wait times and waiting lists are becoming so lengthy that the health care system must look to new staffing and procedural solutions so it can efficiently move more patients through operating rooms, says Dr. Gaetan Barrette, president of the...

Nova Scotia paramedics to be wired.(News)(electronic reporting system)
August 28, 2007... More accurate diagnoses are among the forecast benefits of Canada's first province-wide electronic reporting system for paramedics. Siren ePCR will be fully implemented in Nova Scotia, at a cost of $2.2 million over 3 years, by early next...

The next wave: "physician extenders"?(News)
August 28, 2007... They're potentially an old solution to a very current problem. In fact, their existence can be traced back to Canada's involvement in the 1950s Korean conflict, and they may prove to be a partial answer to systemic challenges, such as how to...

WHO regulations to prevent spread of infectious disease.(News)(World Health Organization)
August 28, 2007... Under new WHO regulations aimed at preventing the spread of infectious diseases, all 193 member states must report within 24 hours of assessment any disease or event that may constitute a public health emergency of international concern. ...

Libya negotiates deal for release of doctor, 5 nurses.(News)
August 28, 2007... After 8 years of imprisonment, torture and maltreatment in Libya for allegedly infecting more than 400 children with HIV, purportedly in collusion with the CIA and Israeli secret service, 5 Bulgarian nurses and a Palestinian-born doctor were...

Fallout on the rock.(News @ a glance)(Newfoundland and Labrador's Eastern Regional Health Authority)(Brief article)
August 28, 2007... Fallout on the rock: George Tilley, the beleaguered president and chief executive officer of Newfoundland and Labrador's Eastern Regional Health Authority, has resigned in the wake of the ongoing controversy over inaccurate hormone receptor...

Travel hazards.(News @ a glance)(thromboembolism)(Brief article)
August 28, 2007... Travel hazards: The World Health Organization has released a study indicating that plane, train, bus or automobile passengers double their risk of developing venous throm-boembolism if they remain seated and immobile on journeys of more than 4...

Jaundice screening.(News @ a glance)(Brief article)
August 28, 2007... Jaundice screening: The Canadian Paediatric Society has issued new guidelines for the detection, management and prevention of hyperbilirubinemia which urge that all newborns be screened for jaundice between 3 and 5 days after birth. Elevated...

Chagas network.(News @ a glance)(World Health Organization)
August 28, 2007... Chagas network: The World Health Organization has established a Global Network to combat Chagas disease in hopes of eliminating the tropical disease by the year 2010. The new network will develop a strategy by the end of this year on such...

Butting out.(News @ a glance)(tobacco use)(Brief article)
August 28, 2007... Butting out: The annual Canadian Tobacco Use Monitoring Survey indicates that smoking rates among youth aged 15-19 declined to 15% in 2006, as compared with 18% in 2005. Health Minister Tony Clement attributed the decline to the efficacy of...

Personal chitchat.(News @ a glance)(physicians' self disclosure)(Brief article)
August 28, 2007... Personal chitchat: Many doctors waste patients' time by talking about themselves rather than focusing the discussion on information that might aid diagnosis, reveals a new study on the value of physician self-disclosure. "We found that...

Red in the desert.(Dispatch from the medical front)(transfusion)
August 28, 2007... Inever thought that I would celebrate starting a transfusion, and certainly not in Saharan Africa. But life takes strange turns sometimes, and here I am with 3 other expatriates, opening a cheap carton of red wine sent from the Paris head...

A Canadian immigrant with coinfection of Strongyloides stercoralis and human T-lymphotropic virus 1.(Teaching Case Report)(Case study)(Clinical report)
August 28, 2007... The case: A 57-year-old man presented to hospital with malaise, abdominal pain and bilateral leg edema. He had immigrated to Canada from St. Vincent, Virgin Islands, 30 years earlier and had last visited the Caribbean 7 years before...

A 71-year-old woman with abdominal pain and acute renal failure.(Clinical Vistas)(Case study)(Clinical report)
August 28, 2007... A71-year-old woman presented to the emergency department with a 6-week history of recurrent diffuse abdominal pain and nausea without vomiting that was unrelated to food consumption and was unaccompanied by fever or weight loss. The patient had...

Human papillomavirus vaccines launch a new era in cervical cancer prevention.(Public Health--Perspectives on HPV)
August 28, 2007... In 2006, the first vaccine against human papillomavirus (HPV) infection, Gardasil (Merck Frosst), was approved for use in Canada. A second vaccine, Cervarix (GlaxoSmith Kline), is currently undergoing regulatory review by Health Canada. Both...

Patient information about HPV and the HPV vaccine.(Public Health Fact sheet)(human papillomavirus)(Clinical report)
August 28, 2007... What is HPV? HPV (human papillomavirus) is a highly contagious virus that is spread by skin-to-skin contact. It can infect the skin, the mouth, the rectum and the anus. It can also infect both male and female genital areas, including the...

Estimating the number needed to vaccinate to prevent diseases and death related to human papillomavirus infection.(Research)(Clinical report)
August 28, 2007... [infinity] See related articles pages 456, 462, 469, 480 and 484 ABSTRACT Background: A vaccine against human papillomavirus (HPV) types 6, 11, 16 and 18 is now licensed for use in Canada and many other countries. We sought to estimate...

Prophylactic vaccination against human papillomavirus infection and disease in women: a systematic review of randomized controlled trials.(Research)(Clinical report)
August 28, 2007... [infinity] See related articles pages 456, 462, 464, 480 and 484 ABSTRACT Background: Human papillomavirus (HPV) is now known to be a necessary cause of cervical cancer, and prophylactic HPV vaccines aimed at preventing genital warts,...

Feasibility of self-collection of specimens for human papillomavirus testing in hard-to-reach women.(Research letter)(Clinical report)
August 28, 2007... [infinity] See related articles pages 456, 462, 464, 469 and 484 ABSTRACT To study the feasibility of self-collected specimens for testing human papillomavirus (HPV) status among hard-to-reach women, outreach nurses recruited women in...

Human papillomavirus, vaccines and women's health: questions and cautions.(Research)(Clinical report)
August 28, 2007... [infinity] See related articles pages 456, 462, 464, 469 and 480 The federal government's recently announced $300 million investment toward a program for vaccinating girls and women with the currently available human papillomavirus (HPV)...

Lactate and the osmolar gap.(Letters)(Letter to the editor)
August 28, 2007... Although the teaching case report in the March 27 issue on a negative anion gap and elevated osmolar gap resulting from lithium overdose (1) is interesting, I identified the following concern. In the third paragraph from the end of the...

Corrections.(Letters)(Correction notice)
August 28, 2007... In the July 17 issue of CMAJ, a map accompanying a news story should have identified Afghanistan's eastern and southern neighbour as Pakistan. REFERENCE 1. Kondro W. Afghanistan: Outside the comfort zone in a war zone....

Slippery slopes in genetics.('The Case Against Perfection: Ethics in the Age of Genetic Engineering')(Book review)
August 28, 2007... The case against perfection: ethics in the age of genetic engineering Michael J. Sandel Harvard University Press; 2007 176 pp US$18.95 ISBN: 0-67-401927-X Recent developments in genetic engineering and other technologies are expected to...

Humanity online.(www.portraitsofthehumanspirit.com)(Website overview)
August 28, 2007... Portraits of the human spirit: lessons in living Joel Walker MD www.portraitsofthehumanspirit.com For almost 3 decades Joel Walker has worked both as psychiatrist and photographer. He uses photographs as "photo therapy" in some of his work...

Hearing death pronounced.(Room for a view)
August 28, 2007... Early: Somehow his casual hands seem like words and his thick chest like punctuation. Simply, "I'll just be gone a moment," they seem to say. But as you sit nearby, writing notes, an absence lingers. Then you realize the dead man is saying...

Deaths.(Obituary)
August 28, 2007... Bell, James Douglas, Dundas, Ont.; Queen's University, 1957, family medicine. Died June 16, 2007, aged 75. Cabilete, Zenaide M.E., Saint John; Far Eastern University, Philippines, 1971, family medicine and psychiatry. Died June 26, 2007,...

"Emotional incontinence".(Salon)(Lady Diana's death; Royal family)
August 28, 2007... In the movie The Queen, the Tony Blair character berates his staff for their disdain of Her Royal Majesty, Elizabeth II, in the days following the death of Lady Diana . "That woman has given her whole life in service to her people," says the...