CMAJ: Canadian Medical Association Journal articles from August 2008

CMAJ: Canadian Medical Association Journal archives from August 2008

Doping, sport and the community/Le dopage, le sport et la communaute.(Editorial)
August 12, 2008... It is almost 20 years since the Ben Johnson scandal at the Olympics in Seoul, Korea, drew attention to the issue of doping. Have we made progress since then in addressing this important sport and public health concern? Will the Olympic ideal...

Proton pump inhibitors: balancing the benefits and potential fracture risks.(Commentary)
August 12, 2008... Proton pump inhibitors have been a cornerstone in the treatment of gastresophageal reflux disease and peptic ulcer disease since their introduction in the late 1980s. Gastresophageal reflux disease is a common disorder, and 12.4 million...

Fault/no fault: bearing the brunt of medical mishaps.(News)
August 12, 2008... "I'd rather not talk about it, even though in the end no fault was found. For 7 years it went on, months sitting in court listening to what a terrible person you are, no one recovers from that. It is on your mind every day, every minute. It...

Incoming CMA president impatient for reform.(News)(Canadian Medical Association)
August 12, 2008... It could be argued that the incoming president of the Canadian Medical Association (CMA) is a trifle impatient. After all, Dr. Robert Ouellet says that he is "allergic" to pilot projects and "a bit against consensus because I am a man of...

Suicide fad threatens neighbours, rescuers.(News)
August 12, 2008... Japanese authorities have moved to crack down on websites listing the ingredients and the process for concocting a deadly hydrogen sulfide gas that has been used in a spate of recent "detergent suicides." The gas, which can form a cloud...

Clowning around sets patients at ease.(News)
August 12, 2008... We've got to walk," says the grandmother, holding her 4year-old granddaughter's hand. Behind them, near the entrance to the cardiology ward of the Hospital for Sick Children (SickKids), trails her 7-year-old grandson. From under the girl's...

Sexually transmitted diseases on the rise.(For the record)(Report)(Brief article)
August 12, 2008... Alberta announced the launch of a $2 million campaign to combat the rise of sexually transmitted diseases on June 17, 2008, a day after releasing figures indicating skyrocketing rates of gonorrhea and chlamydia among young people in the...

G8 attention to neglected diseases research welcomed.(News)(Group of 8 leaders)
August 12, 2008... The Drugs for Neglected Diseases Initiative faces the challenge of running clinical trials on promising drugs in remote parts of the world, where health care infrastructure is minimal, access is difficult and political instability the norm. ...

New pet visit guidelines aim to control infections.(News)
August 12, 2008... No llamas, reptiles or ponies allowed. Those might seem altogether sensible, if not self-evident restrictions when talking about hospitals and long-term care facilities. Yet, there have been instances in which those or even more exotic and...

Class action approvals.(Briefly)(Class action lawsuits against Pfizer Inc. and Merck & Co.)(Brief article)
August 12, 2008... Class action approvals: The Quebec Superior Court has approved a $50 million suit against Pfizer Inc. related to its contraceptive Depo-Provera, which allegedly causes a decrease in bone density in women. Meanwhile, the Saskatchewan Court of...

2,4-D safe.(Briefly)(2,4-dichlorophenoxyacetic acid )(Brief article)
August 12, 2008... 2,4-D safe: Health Canada's Pest Management Regulatory Agency says a scientific re-evaluation of the herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) has concluded that it poses no risks to the health of children, adults, animals or the...

Antiretroviral access.(Briefly)
August 12, 2008... Antiretroviral access: About 3 million people had access to antiretroviral therapy in low- and middle-income countries in 2007, comprising roughly 31% of the 9.7 million who now need the life-saving HIV drugs, according to a new report...

Discarded needles.(Briefly)
August 12, 2008... Discarded needles: The city of Ottawa will spend $100 000 over the course of the summer of 2008 to hire summer students, who'll roam streets and parks picking up discarded drug needles, which critics say are littering the streets of the...

Darfur: truck ride.(Dispatch from the medical front)
August 12, 2008... It is market day in the rebel-held village of Feina in the mountains of South Darfur. Some women have walked; others have travelled by donkey for as long as 6 hours. For many, it is the highlight of the week. Our clinic is located on the...

Use of proton pump inhibitors and risk of osteoporosis-related fractures.(Research)(Clinical report)
August 12, 2008... Abstract Background: The use of proton pump inhibitors has been associated with an increased risk of hip fracture. We sought to further explore the relation between duration of exposure to proton pump inhibitors and osteoporosis-related...

Willingness of patients to change surgeons for a shorter waiting time for joint arthroplasty.(Research)
August 12, 2008... Abstract Background: To improve access to care, many jurisdictions have proposed waiting-time benchmarks and guarantees. We assessed the willingness of patients to consider changing their surgeon to one with a shorter waiting time for...

Anemia of chronic disease: a harmful disorder or an adaptive, beneficial response?(Clinical paradigms)(Disease/Disorder overview)
August 12, 2008... Anemia of chronic disease is a hypoproliferative anemia that develops in response to systemic illness or inflammation. (1) It was first described in the 1930s and was more fully characterized by Cartwright and Wintrobe in the 1950s. (2)...

Pulmonary lymphangitic carcinomatosis as a primary manifestation of colon cancer in a young adult.(Teaching cases)(Case study)
August 12, 2008... Abstract: Pulmonary lymphangitic carcinomatosis is a metastatic lung disease characterized by diffuse spread of the tumour to the pulmonary lymphatic system. We describe the case of a 31-year-old woman who initially received a diagnosis of...

Patch test triggering recurrence of distant dermatitis: the flare-up phenomenon.(Clinical images)(Case study)
August 12, 2008... [FIGURE 1 OMITTED] A 37-year-old woman presented with a pruritic, vesiculobullous eruption on her neck in the region of an ebony pendant. Acute allergic contact dermatitis was suspected and treated with oral prednisone and hydroxyzine...

Pathology practice in Canada.(Letter to the editor)
August 12, 2008... In their recent editorial, Kathy Chorneyko and Jagdish Butany made several excellent points about the challenges pathologists face, including human-resource shortages and the need for provincial governments to support quality-assurance efforts....

Tasers.(Letter to the editor)
August 12, 2008... My interest in Matthew Stanbrook's editorial on tasers (1) was roused less by what Stanbrook had to propose than by the fact that CMAJ had finally thought fit to take up this issue. At the Toronto Police Services Board, the civilian governance...

Electronic control devices.(Letter to the editor)
August 12, 2008... We are members of the TASER International Scientific and Medical Advisory Board, and we would like to comment on the recent CMAJ editorial on tasers. (1) Essentially every implication of the editorial was either erroneous or misleading. Only 4...

Hypertension in children and adolescents.(Letter to the editor)
August 12, 2008... We read with great interest the recent article by Karen Tu and colleagues concerning the prevalence of hypertension in adults aged 20 years and older. (1) The authors' estimate for 1995-2005 in Ontario was considerably higher than the recent...

Correction.(Letters)(Correction notice)
August 12, 2008... In the print version of a recent scientific article, (1) the seventh sentence in the third paragraph of the Interpretation section on page 232 should have been supported by reference 33, as follows: "A similar phenomenon was seen in a study...

Virtual science.(Lifeworks)
August 12, 2008... Science in Art Curator: Julie Belisle www.museevirtuel.ca/Exhibitions/Science/English/index.html Sponsored by Heritage Canada and Canada's Museum Community Ongoing online exhibition Does this hurt? Would you call it a stabbing...

Performance review.(Book review)
August 12, 2008... Better: A Surgeon's Notes on Performance Atul Gawande MD Metropolitan Books/Henry Holt Company; 2007 273 pp $14 paper ISBN 13 978-0312427658 [ILLUSTRATION OMITTED] As doctors, we spend a lot of time thinking: about...

To smile and cry humbly at our world.(Book review)
August 12, 2008... The Enemy Rafael Campo Duke University Press; 2007 99 pp $17.95 ISBN 978-0-8223-3960-1 [ILLUSTRATION OMITTED] Rafael Campo, a physician who teaches and practises internal medicine at Harvard Medical School and Beth Israel...

Bevel Up for nursing and medical students.(Video recording review)
August 12, 2008... Bevel Up: Drugs, Users and Outreach Nursing Interactive DVD Director: Nettie Wild National Film Board of Canada, British Columbia Centre for Disease Control; 2008 45 min. documentary; 4 hours learning options Harm...

Hearts and minds.(Poem)
August 12, 2008... Hearts and minds Lost keys: the thousandth time. I check your pockets, the truck, wallet, walkway, yesterday's clothes. Hours of this, hours of me turning your pockets inside out, of retracing the day you can't remember, ...

A classic sign of hypothyroidism: a video demonstration.(Clinical images)(Case study)
August 12, 2008... [FIGURE 1 OMITTED] A 55-year-old woman presented to hospital with a 2-month history of facial puffiness, constipation, hoarse voice, fatigue and cold intolerance. She had no history of illness, and she was not taking any medication. On...

"When I'm 64".(Salon)(aging)
August 12, 2008... Why has longevity become a source of dismay rather than a cause for celebration? How did we turn the greatest triumph of 20th century public health and medicine into a problem for the 21st century? The nation's health bureaucrats and...

Microresearch: borrowing from the microfinance experience/La microrecherche: lecons a tirer de l'experience du microfinancement.(Editorial)
August 26, 2008... Who is at risk of severe head injuries in the hospital in Mbarara, and what are the outcomes? Why do some mothers in rural western Uganda seek care early for babies with severe diarrhea while others delay until the babies are in shock? These...

Stopping anticoagulant therapy after an unprovoked venous thromboembolism.(Commentary)(Clinical report)
August 26, 2008... Three or 6 months of anticoagulant therapy used to be the standard duration of treatment for almost all patients after a first episode of deep vein thrombosis or pulmonary embolism (collectively referred to as venous thromboembolism). Recently,...

Cancer and cholesterol: understanding the V-shaped association in patients with diabetes.(Commentary)
August 26, 2008... Elevated serum glucose and cholesterol levels have been widely shown to be linked to increased cardiovascular mortality and all-cause mortality. Hypercholesterolemia is also a well-established risk factor for cardiovascular disease among...

Concerns about health care warnings and their impact on prescribing behaviour.(Commentary)
August 26, 2008... In this issue of CMAJ Valiyeva and colleagues (1) report on the impact of 3 regulatory warnings on prescription rates of antipsychotic drugs among elderly adults with dementia. Their finding--that the warnings did not achieve the desired...

Fault/no fault part 2: uneasy bedfellows: is the patient safety movement on a "collision course" with the medical malpractice system?(News)
August 26, 2008... Vance Davis was just 19 when he died in a Saskatchewan hospital 6 years ago. He had been admitted for a head injury. Vance had a high level of consciousness in the intensive care unit, but that level dropped dramatically in the few minutes it...

Virtually better.(News)
August 26, 2008... At $6 million, Stephane Bouchard's 2-bedroom apartment is a little on the pricey side, especially considering the place is overrun with giant spiders. However, it does have hardwood floors. Even better, it can cure your fear of flying. ...

Big pharma and good corporate citizenship.(News)
August 26, 2008... The World Health Organization says that improving access to important and lifesaving medicines could save as many as 10 million lives a year. Yet in a world where a billion people live on less than $1 a day, and important medicines consume a...

Health Canada's investment in new post-market drug surveillance network a "pittance".(News)
August 26, 2008... Published at www.cmaj.ca on July 16, 2008. Print version revised. In the wake of mounting public concern about prescription drug safety and high-profile drug withdrawals, Health Canada has announced a $1 million investment in an independent...

Pharma gifts.(Briefly)(Brief article)
August 26, 2008... Pharma gifts: The Pharmaceutical Research and Manufacturers of America have crafted a new voluntary guideline that asks member companies to stop giving doctors pens, pads, mugs and other trinkets. Restaurant meals on the sales representative's...

Lab standards.(Briefly)(Brief article)
August 26, 2008... Lab standards: The Canadian Association of Pathologists wrapped up its annual meeting in July 2008 by calling on the federal government to establish national standards and protocols for pathologists, as urged by experts in CMAJ (CMAJ...

Maples fallout.(Briefly)(Brief article)
August 26, 2008... MAPLES fallout: MDS Inc. has served Atomic Energy of Canada Ltd. with notice that is seeking arbitration--and simultaneously filing a $1.6 billion lawsuit alleging negligence--for breaching its contractual obligations by pulling the plug on the...

Novel changes proposed to United Kingdom's National Health Service.(News)
August 26, 2008... Amid recent celebrations for the 60th anniversary of the United Kingdom's National Health Service came the release of a long-awaited report proposing radical changes to Britain's much-loved "free at the point of delivery" health care system....

Four years later, roadblocks to AIDS drugs overcome.(For The Record)
August 26, 2008... In the end, the Commissioner for Patents had to issue a compulsory licence, but at long last, low-cost life-saving AIDS drugs are scheduled to be shipped to Rwanda this fall under legislation Canada passed more than 4 years ago. Canada...

Food allergen labelling.(News)(Brief article)
August 26, 2008... In a bid to increase protection for food allergy sufferers, Health Canada has announced new labelling requirements for food allergens, gluten sources and added sulphites contained in prepackaged foods. The new requirements will oblige...

Safer water saves lives.(News)(Report)(Brief article)
August 26, 2008... Water-related deaths are rare in Canada, but a new World Health Organization (WHO) report indicates a large percentage of deaths in other countries could be prevented by increasing access to safe drinking water, improving sanitation and...

The intersection of faith, family and survival.(Dispatch from the medical front)
August 26, 2008... Bill's daughter Mary is worried about him again. He is elderly and she fears he is over-committed in the community, considering his multiple medical problems. She hasn't approached me this time with her concerns, but it seems I cannot escape...

Identifying unprovoked thromboembolism patients at low risk for recurrence who can discontinue anticoagulant therapy.(Research)
August 26, 2008... Abstract Background: Whether to continue oral anticoagulant therapy beyond 6 months after an "unprovoked" venous thromboembolism is controversial. We sought to determine clinical predictors to identify patients who are at low risk of...

Independent associations between low-density lipoprotein cholesterol and cancer among patients with type 2 diabetes mellitus.(Research)(Clinical report)
August 26, 2008... Abstract Background: The risk association between low-density lipoprotein (LDL) cholesterol and cancer remains controversial and largely unexplored for people not receiving statin therapy. Methods: We examined the risk association...

Effect of regulatory warnings on antipsychotic prescription rates among elderly patients with dementia: a population-based time-series analysis.(Research)
August 26, 2008... Abstract Background: Three warnings of serious adverse events associated with the use of atypical antipsychotic drugs among elderly patients with dementia were sent to health care professionals in Canada. We assessed the impact of these...

Heterochromia.(Teaching cases)(Case study)
August 26, 2008... Abstract: A patient was noted to have 2 different eye colours and miosis in her left eye. She ultimately received a diagnosis of congenital Horner syndrome. Determinants of eye colour and possible clinical significance are discussed. ...

The departure of death notices.(Letters)(Letter to the editor)
August 26, 2008... I thought I would share my displeasure upon learning that death notices will no longer be published in CMAJ. (1) They are, perhaps oddly, my favourite part of the Journal, and I have been reading them since I started medical school. I find...

Testimonials versus evidence.(Letters)(Letter to the editor)
August 26, 2008... I was interested in Dan Gardner's musings about why the media may prefer bad news to good news, and why stories matter more than statistics. 1 I believe that something similar operates in the minds of many patients, for whom anecdotes matter...

Corrections.(Letters)(Correction notice)
August 26, 2008... In a recent Analysis article, (1) the second affiliation listed for Ryan Zarychanski should have been the Ottawa Health Research Institute. REFERENCE (1.) Zarychanski R, Houston DS. Anemia of chronic disease: A harmful disorder or an...

Dancing with research.(Lifeworks)
August 26, 2008... At first glance, the art of dance has found an unlikely partner in health research. But upon reflection, one can see at least 2 points of commonality: both involve interpretation--of emotion and illness, respectively--through the physical body...

The anchor.(Room for a view)(Column)
August 26, 2008... How do I find the words to tell you that he's dying? This man whom I met only 24 hours ago, whom you have loved, leaned on and supported for these past 50 years? We met in the intensive care unit. He looked so weak, so pale, lying there...

Understanding through therapeutic writing.(Book review)
August 26, 2008... Still Here: A Post-Cocktail AIDS Anthology Collected and edited by Allan Peterkin and Julie Hann Life Rattle Press; 2008 327 pp $25.00 ISBN 978-1-897161-55-5 "Psychologically, I see my personal facts the way they are, not as...

Purple urine bag syndrome.(Clinical images)(Case study)
August 26, 2008... [FIGURE 1 OMITTED] A 58-year-old man with an indwelling urinary catheter began producing urine with a deep purple colour (Figure 1). The urine was alkaline (pH 7.8), and Proteus mirabilis urinary tract infection was diagnosed. This...

Pertussis mortality and public misperceptions.(Salon)
August 26, 2008... Recently, after attending a pertussis meeting in Halifax, Nova Scotia, I left Canada via the United States where I passed through immigration. "Sir, what was the purpose of your trip to Halifax?" the agent asked me. "I came to attend...