CMAJ: Canadian Medical Association Journal articles from December 2008

CMAJ: Canadian Medical Association Journal archives from December 2008

Statins, indication creep and risks for children and youth/Les statines, l'etendue des indications et les risques pour les enfants et les adolescents.(Editorial)
December 2, 2008... More than half of the drugs given to children and youth in hospital are used off label. Although therapy given to adults is usually guided by evidence, the evidence for the use of these drugs in children is often scant or nonexistent....

Can studies of harm be harmful?(Commentary)
December 2, 2008... In this issue of CMAJ, Wen and colleagues report that the use of folic acid antagonists was associated with a higher risk of placenta-mediated adverse outcomes of pregnancy. (1) Had these medications appeared to be protective, we might be more...

Treatment of community-acquired pneumonia.(Commentary)
December 2, 2008... In this issue of CMAJ, Vardakas and colleagues (1) present the findings of a meta-analysis of treatment strategies for community-acquired pneumonia. Because pneumonia is a leading cause of death in the developed world, determining which...

Balancing evidence and opinion in stroke care: the 2008 best practice recommendations.(Commentary)
December 2, 2008... Research in stroke care is generating new information at a rate that challenges our ability to effect health-system change in a timely manner. For example, 10 years after publication of a meta-analysis showing that delivery of care in a...

Patient-safety reforms inhibited by systemic impediments.(News)(Conference notes)
December 2, 2008... The progress of the patient safety movement is being stymied by regulatory, structural and attitudinal problems, according to speakers at the eighth annual Canadian Healthcare Safety Symposium. "Our own safety is on the line," warned Dr....

Jordan's Principle remains in limbo.(News)
December 2, 2008... Federal and provincial governments have failed profoundly to live up to their obligations in the year since the House of Commons unanimously passed Jordan's Principle to end jurisdictional disputes over social, education and medical services...

Health advocates assail Canada's asbestos stance.(News)
December 2, 2008... The Canadian government's ongoing support of the export of chrysotile asbestos has not only sullied Canada's global reputation, say health and environment advocates from around the world, but has undermined an international convention created...

Rookie appointed federal health minister.(For the record)
December 2, 2008... It's already safe to call newly minted Member of Parliament Leona Aglukkaq (Nunavut) a historymaker. She's the first Inuk to be appointed to senior cabinet post, having been named federal Minister of Health during Prime Minister Stephen...

Universities and prosperity.(For the record)(Brief article)
December 2, 2008... Universities perform a third of the research and development conducted in Canada, thereby contributing an estimated $60 billion to the national economy, according to a report released by the Ottawa-based Association of Universities and Colleges...

Canada needs paradigm shift in public health nutrition.(News)
December 2, 2008... The refrain was common: lots of talk, little action. Whether regulating trans fats and salt, adequately labelling foods, or taxing potato chips and other calorie-rich snacks, initiatives around the world are sparse and successes sparser still,...

Raising the bar.(Briefly)
December 2, 2008... Raising the bar: Hand-hygiene compliance, and policies on dangerous abbreviations, heparin safety, narcotic safety, suicide prevention and pressure ulcer prevention have been added to Accreditation Canada's list of required organizational...

FDA inspections.(Briefly)(Brief article)
December 2, 2008... FDA inspections: The United States Food and Drug Administration's monitoring of foreign drug manufacturing plants is lax and inadequate, the highly respected US Government Accountability Office says in a report on the FDA's Foreign Drug...

China health reforms.(Briefly)(Brief article)
December 2, 2008... China health reforms: Over 2 decades after dismantling its universal health care system, the government of China has unveiled a draft health-reform plan (http://en.ndrc.gov.cn/) that proposes to reintroduce equitable, universal access to basic...

Somali symbiosis, part 2: what I did.(Dispatch from the medical front)(Personal account)
December 2, 2008... As a surgeon, I realized I needed to get past my judgments of how things could be, and my horror at situations I saw, and get down to the business of offering medical and surgical care to those in need. I was part of a Medicins Sans...

Maternal exposure to folic acid antagonists and placenta-mediated adverse pregnancy outcomes.(Research)(Clinical report)
December 2, 2008... Abstract Background: In previous studies, maternal exposure to folic acid antagonists was associated with increased risks of neural tube defects, cardiovascular defects, oral clefts and urinary tract defects. The objective of the current...

Respiratory fluoroquinolones for the treatment of community-acquired pneumonia: a meta-analysis of randomized controlled trials.(Research)(Clinical report)
December 2, 2008... Abstract Background: We investigated whether the use of respiratory fluoroquinolones was associated with better clinical outcomes compared with the use of macrolides and [beta]-lactams among adults with pneumonia. Methods: We searched...

Diagnosis and treatment of dementia: 6. Management of severe Alzheimer disease.(Clinical report)
December 2, 2008... Abstract Background: The management of severe Alzheimer disease often presents difficult choices for clinicians and families. The disease is characterized by a need for full-time care and assistance with basic activities of daily living....

Health care reform in Chile.(Global health)(Report)
December 2, 2008... Chile has maintained a dual health care system under which its citizens can voluntarily opt for coverage by either the public National Health Insurance Fund or any of the country's private health insurance companies. Currently, 68% of the...

"Doctor, will that x-ray harm my unborn child?".(Practice)(Clinical report)
December 2, 2008... Abstract: Exposure to ionizing radiation can be a source of anxiety for many pregnant women and their health care providers. An awareness of the radiation doses delivered by different techniques and the acceptable exposure thresholds can help...

What is your call? A spontaneous skin lesion.(Practice)(Clinical report)
December 2, 2008... A 34-year-old woman presented with long-standing severe asthma and chronic idiopathic angioedema. We found 2 lesions on her back (Figure 1, Figure 2). The lesions had occurred spontaneously 10 years ago and had grown slightly bigger over that...

No-fault compensation systems.(Letters)
December 2, 2008... In a series of recent articles about no-fault compensation, CMAJ raised important questions regarding the Canadian medical liability system. (1-3) However, the length of these articles did not permit a full discussion of the issues, which are...

Accuracy in images.(Letters)
December 2, 2008... I am concerned about the scary picture on the cover of the Sept. 9 issue of CMAJ, which highlights articles about the human papillomavirus (HPV) vaccine. Although the articles did a good job of accurately conveying the low risks associated with...

Corrections.(Letters)(Correction notice)
December 2, 2008... A picture in the News briefs (1) section of the October 21 issue should have been identified as the Confederation Building in St. John's, Newfoundland. REFERENCE (1.) Kondro W. Briefly. CMAJ 2008;179:890. DOI:10.1503/cmaj.081812...

The cure is a gift: 1682 in northern Italy.(Holiday Reading)(Short story)(Excerpt)
December 2, 2008... On a quiet night in the city of Cremona, Padre Fabrizio Cambiati lay in bed listening to the rain when he heard a timid knock at the door. He thought perhaps he was dreaming, but a moment later it came again. Timid, but insistent. Fabrizio...

Time to heal thyself: Christmas eve.(Holiday Reading)(Fictional work)(Brief article)
December 2, 2008... [ILLUSTRATION OMITTED] It is time. I have levied love enough I have showed it to them, wrapped in a bow. It is Christmas, and it is time for me to stop doctoring the books. I am a mere recorder, a cheerleader for time, watching men and...

Flawed physicians.(Holiday Reading)(Excerpt)
December 2, 2008... I used to be obsessed by my flaws: my inability to live up to what I believed was required of me as a doctor. I still believe that medicine is fundamentally a moral enterprise and so what is required of me, even if this sounds hopelessly vague,...

Words are not wasted when there is soup to deliver.(Holiday Reading)
December 2, 2008... Spring came reluctantly to Yellowknife in the Northwest Territories this year, but finally the ice bridge over the Mackenzie River gave way to a ferry crossing, just in time for my new grand piano to travel by road from Kelowna, British...

Final exam.(Holiday Reading)(Excerpt)
December 2, 2008... I pronounced my first patient dead today, a patient whom I had never met. I was on call for our hospitalist team and received a page telling me that she had passed away in her sleep. I vaguely remembered her story from rounds--a very elderly...

Spilling the beans on the pharmaceutical industry.(Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial )(Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into slick Marketing Machines and Hooked the Nation on Prescription Drugs)(Book review)
December 2, 2008... Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial Alison Bass Algonquin Books of Chapel Hill; 2008 260 pp $24.95 ISBN978 1-56512-553-7 Our Daily Meds: How the Pharmaceutical ...

Fracture of the maxillary bone during hyperbaric oxygen therapy.(Clinical images)(Brief article)(Clinical report)
December 2, 2008... [FIGURE 1 OMITTED] [FIGURE 2 OMITTED] A 26-year-old hyperbaric oxygen therapy technician with a history of chronic paranasal sinusitis was admitted to the emergency department because of ecchymosis and painful swelling over her lower...

A proposal for peace.(Salon)
December 2, 2008... In 1931 the League of Nations arranged for an exchange of letters between intellectuals to promote discussion of its concerns. One of the first to be approached was Albert Einstein; the person he, in turn, chose to correspond with was Sigmund...

Canadian best practice recommendations for stroke care (updated 2008).(Medical condition overview)
December 2, 2008... This document is an abbreviated version of the Canadian Best Practice Recommendations for Stroke Care, updated 2008. This supplement provides an overview of the development process and a summary of the recommendations. For the full version...