CMAJ: Canadian Medical Association Journal articles from February 2005

CMAJ: Canadian Medical Association Journal archives from February 2005

Global emergencies/urgences a l'echelle mondiale.(Editorial)
February 1, 2005... When a seismic Leviathan hurled a wave of death toward 11 countries on the rim of the Indian Ocean, a second wave swept through countries geographically exempt from this catastrophe. The outpouring of private, corporate and government donations...

Complexity of risk determination.(Letters/Correspondance)(Letter to the Editor)
February 1, 2005... It has been known for some time that the risks of morbidity and mortality associated with narcotic dependence are greater than among the general population. These risks are mitigated somewhat by enrolment in treatment (mostly methadone...

Definitions of pediatric obesity.(Letters/Correspondance)(Letter to the Editor)
February 1, 2005... Neither the article by Patricia Canning and associates (1) concerning prevalence of overweight and obesity among children in Newfoundland and Labrador nor the accompanying editorial by Douglas Willms, (2) noted that prevalence estimates vary...

Stats Can under-represents rural shortage.(Letters/Correspondance)(Letter to the Editor)
February 1, 2005... I suspect that Statistics Canada's interpretation of the data presented in a recent CMAJ news article (1) under-represents the shortage of rural practitioners. Marc Hamel of Stats Can feels that the data do not indicate that people in rural...

Not a middle-of-the-road position.(Letters/Correspondance)(Letter to the Editor)
February 1, 2005... I cannot understand how Dr. Ursus (1) can claim to have a "middle-of-the-road" position on abortion when he clearly supports abortion on demand. He may deeply regret the necessity of abortions; however, by performing these procedures or...

Strains and toxins of Clostridium.(Letters/Correspondance)(Letter to the Editor)
February 1, 2005... Jacques Pepin and associates (1) have reported an epidemic of Clostridium difficile-associated diarrhea (CDAD) associated with an increased case-fatality rate. They hypothesize the presence of a more virulent strain. The genus Clostridium...

Drug approval system questioned in US and Canada.(Regulatory System)
February 1, 2005... As the FDA's drug approval process comes under increasing scrutiny in the US, Health Canada moves closer to beginning concurrent drug reviews with the American regulator. "We're looking at the potential to implement pilot activities that...

Tighten Ontario's methadone program states inquest.(Addiction Medicine)
February 1, 2005... Ontario's methadone maintenance program needs additional funding and more precise treatment guidelines for physicians, a coroner's jury has concluded after investigating 4 deaths related to the program. The Office of the Chief Coroner's...

Privacy versus public safety: reporting of gunshot wounds.(Legislation)
February 1, 2005... Alberta politicians want to amend the Health Information Act to force doctors to tell police when they are treating a gunshot victim and to disclose that patient's health status. Currently, doctors are prohibited from providing that...

Tattoo taboo.(News @ a glance)(Brief Article)
February 1, 2005... Tattoo taboo: Injecting anesthetic through a tattoo may be risky, say UBC researchers and the American Association of Nurse Anesthetists. The researchers, Drs. Joanne Douglas and Jean Swenerton, caution women to think twice before getting a...

Casino medicine.(News @ a glance)(Brief Article)
February 1, 2005... Casino medicine: What do a casino and a hospital have in common? For the Queen Elizabeth II in Halifax, it's a new shift schedule. Hoping to reduce the number of medical errors and improve the quality of patient care, the hospital is Canada's...

Home medicine.(News @ a glance)(Brief Article)
February 1, 2005... Home medicine: Philips Medical Systems hopes its HeartStart Home Defibrillator will become a must-have item, now that the US Food and Drug Administration has licensed over-the-counter sale of the automatic external defibrillators. Complete with...

Slower spending.(News @ a glance)(Brief Article)
February 1, 2005... Slower spending: Health care spending kept pace with the economy this year, according to new figures from the Canadian Institute for Health Information. The federal-provincial agency released National Health Expenditure Trends, 1975-2004, in...

Needle phobia?(News @ a glance)(Brief Article)
February 1, 2005... Needle phobia? New research shows only 37% of health care workers in the emergency departments of 4 teaching hospitals in London, Ont., were vaccinated against influenza during the 1999-2000 flu season (Can J Emerg Med 2005;7[1]:17-21)....

Lilly to register.(News @ a glance)(Eli Lilly and Company)(Brief Article)
February 1, 2005... Lilly to register: Eli Lilly and Company has created a clinical trial register (www.lillytrials com) that will post results from all clinical trials ("regardless of outcome") of marketed products. The company will also post information on the...

Percutaneous coronary intervention and drug-eluting stents.(Cardiology)
February 1, 2005... Interventional cardiology made its debut 27 years ago, when Andreas Gruntzig performed the first percutaneous transluminal coronary angioplasty in a human. Since then, rapid expansion of our knowledge of vascular pathology and its response to...

Do stem cells cause gastric cancer?(Science and Medicine)
February 1, 2005... Although the link between Helicobacter pylori infection and gastric cancer is well established, new research suggests that stem cells play an important role in the development of this malignant disease. JeanMarie Houghton and colleagues...

Diabetic ketoacidosis and pediatric stroke.(Teaching Case Report)
February 1, 2005... THE CASE: A 6-year-old previously healthy right-handed girl presented with a 3-day history of progressive epigastric abdominal pain, polydipsia and secondary nocturnal enuresis and a 2-week history of weight loss of 5 kg. Her initial assessment...

Sushi, nemotodes and allergies.(Public Health)(food safety laws)
February 1, 2005... Background amd epidemiology: New food safety regulations for commercial establishments in Ontario require fish that is intended to be consumed raw to be frozen before preparation and serving to a temperature of -20[degrees]C or below for 7 days...

Coxib medications to be handled with care.(Health and Drug Alerts)
February 1, 2005... Published at www.cmaj.ca on Dec. 22, 2004. Reasons for posting: On December 17, 2004, Pfizer and the US National Cancer Institute announced that they have stopped administering Celebrex celecoxib), a cyclooxygenase-2 COX-2) inhibitor, in an...

Does gastric acid suppression increase the risk of community-acquired pneumonia?(In the Literature)
February 1, 2005... Laheij RJ, Sturkenboom MC, Hassing RJ, Dieleman J, Stricker BH, Jansen JB. Risk of community-acquired pneumonia and use of gastric acid-suppressive drugs. JAMA2004;292(16):1955-60 Background: Dyspepsia is responsible for 7% of visits to...

A 4-year-old child with leukemia and an enlarging arm lesion.(Clinical Vistas)
February 1, 2005... A 4-year-old boy was admitted to hospital with a diagnosis of pre-B-cell acute lymphoblastic leukemia. Ten days later, he experienced fever, neutropenia and a lesion on the lateral aspect of his left arm just above the elbow. The purplish...

A randomized, double-blind, placebo-controlled noninferiority trial of amoxicillin for clinically diagnosed acute otitis media in children 6 months to 5 years of age.(Research/Recherche)
February 1, 2005... Abstract Objectives: Debate continues with respect to a "watch and wait" approach versus immediate antibiotic treatment for the initial treatment of acute otitis media. In this double-blind noninferiority trial, we compared clinical...

Economic evaluation of sirolimus-eluting stents.(Research/Recherche)
February 1, 2005... Abstract Background: Sirolimus-eluting stents have recently been shown to reduce the risk of restenosis among patients who undergo percutaneous coronary intervention (PCI). Given that sirolimus-eluting stents cost about 4 times as much as...

Glycogen storage disease type III in Inuit children.(Case report)
February 1, 2005... Abstract GLYCOGEN STORAGE DISEASE TYPE III (GSD III) was diagnosed in 4 Inuit children (3 confirmed, 1 suspected case) at our institution over the last decade. This rare autosomal recessive disease, which results from a deficiency of the...

The dollars and sense of drug-eluting stents.(Commentary/Commentaire)
February 1, 2005... Percutaneous transluminal coronary angioplasty, now known as percutaneous coronary intervention (PCI), was described for the first time 26 years ago (1) and has undergone many technological advances, most notably the introduction of...

The Canadian Stroke Quality of Care Study: establishing indicators for optimal acute stroke care.(Commentary)
February 1, 2005... Every 10 minutes someone in Canada suffers a "brain attack," making stroke the most common serious neurological condition requiring hospital admission. Each year, about 50 000 Canadians are admitted to hospital because of stroke, with an...

Liver enzyme alteration: a guide for clinicians.(Review/Synthese)
February 1, 2005... Abstract ISOLATED ALTERATIONS OF BIOCHEMICAL MARKERS OF LIVER DAMAGE in seemingly healthy patient can present a challenge for the clinician. In this review we provide a guide to interpreting alterations to liver enzyme levels. The...

Writing au volant.(The Left Atrium)(Book Review)
February 1, 2005... Writing au volant A short journey by car Liam Durcan Montreal: Esplanade Books; 2004 200 pp $16.95 ISBN 9-781550-651898 Excluding Oliver Sacks, how many neurologists do you know who also write narratives? If I had been asked that...

My first Tensilon test.(placebo effect)
February 1, 2005... He came in with a few pages printed out from the Internet and started talking even before he had sat down. "I feel tired all the time, but especially in the evenings. And my face has gone droopy. I looked it up on the Internet--I think it...

Alone in the universe: the landscapes of Jean Paul Lemieux.(Lifeworks)
February 1, 2005... Homage to Jean Paul Lemieux National Gallery of Canada Oct. 22, 2004-Jan. 2, 2005 Curated by the National Gallery of Canada It is fitting that the National Gallery of Canada's centenary tribute to Jean Paul Lemieux (1904-1990) took place...

Deaths/necrologie.
February 1, 2005... Bach, Joan M., Sherwood Park, Alta.; University of Alberta, 1977; former staff, Grey Nuns Community Hospital and Health Centre; clinical instructor, University of Alberta. Died July 2, aged 51. Bouchard, Jean-Paul, Gatineau (Que.);...

Query.(Physician experiences)
February 1, 2005... In Hollywood Westerns--Clint Eastwood's Unforgiven comes to mind--it is often said that "It's a helluva thing to kill a man." This colloquial point is made flesh when some young initiate, game for gunslinging, assassinates his first quarry. We...

The Kyoto Protocol: in force?/Le Protocole de Kyoto: en vigueur?(Editorial)
February 15, 2005... Feb. 16, 2005,marks the entry into force of the Kyoto Protocol and its country-specific targets to reduce emissions of the "greenhouse gases "responsible for global warming. Most scientists agree that the earth's surface air temperature is...

Ovarian cancer screening.(Letters/Correspondance)(Letter to the Editor)
February 15, 2005... Usha Menon's review of ovarian cancer screening (1) appears to misquote the result of the randomized controlled trial of multimodal screening (with the tumour marker CA125 and ultrasonography) by Jacobs and associates. (2) In that study...

Treating C. difficile.(Letters/Correspondance)(Letter to the Editor)
February 15, 2005... In their review of Clostridium difficile-associated diarrhea, (1) Susan Poutanen and Andrew Simor note that concurrent administration of probiotic agents (e.g., Saccharomyces boulardii and Lactobacillus GG) and antibiotics to prevent recurrence...

Cobalamin deficiency in elderly patients.(Letters/Correspondance)(Letter to the Editor)
February 15, 2005... Emmanuel Andres and colleagues, (1) in their comprehensive review of diagnosis and treatment of vitamin [B.sub.12] (cobalamin) deficiency, fail to consider 2 elements relevant to the Canadian experience. First, because Canada's flour supply...

Short ACTH stimulation test for adrenal reserves of cortisol, not adrenal function.(Letters/Correspondance)(Letter to the Editor)
February 15, 2005... The classical description of Addison's disease in a 15-year-old girl (1) is a timely reminder of this well-known but uncommon disorder. In their description of the investigative work-up and discussion, Chantelle Barnard and associates (1) imply...

Russia and social "reform".(Letters/Correspondance)(Letter to the Editor)
February 15, 2005... Paul Webster,in his description of the Russian government's plans "to 'monetize' its social commitments" (1) through reform of a variety of Sovietera entitlements, fails to cover some important details. It is true, as stated by a health...

An Afghan doctor's prescription for peace.(Human Rights)
February 15, 2005... Human rights officials in Afghanistan have documented thousands of violations in the last 18 months, including illegal detentions, forced evictions, street kidnappings with rape, trafficking, attacks on women not wearing burqas and assaults...

Climate change wars stall government plan.(Environmental Protection)
February 15, 2005... The Kyoto Protocol to combat climate change enters into force Feb.16, leaving Canada with the mammoth challenge of cutting its greenhouse gas emissions by 20%-25% over the next 5 years. Canada has committed to reducing greenhouse gas...

Media Doctor prognosis for health journalism.(Ethics)(Brief Article)
February 15, 2005... A group of Australian academics and clinicians have put medical reporting of new treatments under the microscope with Media Doctor (www .mediadoctor.org.au). Funded by the Newcastle Institute of Public Health, Media Doctor reviews a...

Landmark global tobacco treaty coming into effect.(International Health)
February 15, 2005... The Canada-inspired global treaty to reduce tobacco sales and use comes into effect Feb. 28. Canada sponsored the original resolution in 1995 that led to the development of the WHO Framework Convention on Tobacco Control, the world's first...

Private-public partnerships planned for BioMed City.(New Technology)(Brief Article)
February 15, 2005... Leading medical microbiologists and biomedical entrepreneurs are teaming up in Winnipeg to create "BioMed City," dedicated to studying and fighting infectious diseases. The catalyst for BioMed City is the International Centre for...

HIV rising.(News @ a glance)(Human immunodeficiency virus)(Brief Article)
February 15, 2005... HIV rising: The number of women living with HIV has increased in every region of the world over the past 2 years, states a joint UNAIDS and WHO report. The steepest increases are in East Asia (56% increase), followed by Eastern Europe and...

30 minutes.(News @ a glance)(emergency rooms renovation)(Brief Article)
February 15, 2005... 30 minutes: Several US emergency rooms are being held up to the standards set by pizza delivery businesses. At St. Anne and St. Charles Mercy Hospitals in Toledo, Ohio, for example, anyone who waits longer than 30 minutes receives a gift...

Tuition woes.(News @ a glance)(tuition fees)(Brief Article)
February 15, 2005... Tuition woes: The average tuition fees for first year medical students will exceed $10 000 for the first time next September, according to data from the CMA Re search Directorate. This academic year, the national average fee is $9814. When...

Tsunami warning.(News @ a glance)(Brief Article)
February 15, 2005... Tsunami warning: India plans to install a deep-sea warning system to provide alerts of possible tsunamis, following the Dec.26 natural disaster. The country now has 20 deep-sea buoys with sensors. It will add another 20 and deploy 6 to 12 Deep...

1:3 nurses retire.(News @ a glance)(Brief Article)
February 15, 2005... 1:3 nurses retire: A slight increase in the overall number of nurses in Canada may foster the impression that the shortage is ending. In fact, within a decade or so, a third of Canadian nurses will be getting ready to retire and given that only...

Intravaginal and intrarectal microbicides to prevent HIV infection.(HIV/AIDS)
February 15, 2005... About 40 million people worldwide have HIV infection (UNAIDS 2004 report [www.unaids.org/bangkok2004/ report.html]). In 2003 alone, almost 5 million new infections occurred, more than 90% of which were sexually acquired. Nearly 50% of the...

Antibiotics that protect the brain.(Science and Medicine)
February 15, 2005... Common antibiotics might do more than just kill bacteria. New research suggests that some antibiotics can protect against the nerve damage associated with diseases such as amyotrophic lateral sclerosis (ALS), dementia, stroke and epilepsy. The...

Acute generalized weakness due to thyrotoxic periodic paralysis.(Teaching Case Report)
February 15, 2005... THE CASE: A 28-year-old First Nations man was transferred from a northern nursing station to the Health Sciences Centre in Winnipeg for investigation of a 1-day history of generalized weakness that began when he woke in the early morning. He...

Malaria update.(Public Health)
February 15, 2005... Background and epidemiology: In November 2004 the Public Health Agency of Canada released a travel health advisory warning of the risk of malaria in the Dominican Republic after receiving notice of 3 laboratory-confirmed cases of Plasmodium...

Does reducing interns' work hours reduce the rate of medical errors?(In the Literature)(Book Review)
February 15, 2005... Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick E, Katz JT, et al. Effect of reducing interns' work hours on serious medical errors in intensive care units. N Engl J Med 2004;351: 1838-48. Background: Although multiple studies...

An 87-year-old man with a tympanic abdominal mass.(Clinical Vistas)
February 15, 2005... An 87-year-old man presented with a 3-day history of progressive, diffuse abdominal pain. He denied nausea, vomiting, fever or chills. He had no history of rectal bleeding, diarrhea or constipation, but he had noticed increased flatulence,...

Sexual risk behaviour of Canadian participants in the first efficacy trial of a preventive HIV-1 vaccine.(Research/Recherche)
February 15, 2005... Abstract Background: Phase I and phase II HIV-1 vaccine trials have revealed increases in risky sexual activity among study subjects during the trials, perhaps because the subjects believe that the vaccine being tested is efficacious;...

The availability of references and the sponsorship of original research cited in pharmaceutical advertisements.(Research/Recherche)
February 15, 2005... Abstract Background: The primary goal of pharmaceutical advertisements is to convince physicians to prescribe the manufacturer's product. We sought to determine what materials are cited in support of claims in pharmaceutical ads and...

Cerebral cholesterol granuloma in homozygous familial hypercholesterolemia.(Case report)
February 15, 2005... Abstract Familial hypercholesterolemia (FH) is characterized by the accumulation of excess cholesterol in tissues including the artery wall and tendons. We describe a patient with homozygous FH who presented with asymptomatic cholesterol...

Global climate change and health: recent findings and future steps.(Commentary/Commentaire)
February 15, 2005... More than 7 years after the Kyoto Protocol was adopted at a United Nations conference on climate change, this international and legally binding agreement to reduce greenhouse gas emissions worldwide comes into force on Feb. 16, having finally...

Enhanced weekend service: an affordable means to increased hospital procedure volume.(Commentary)
February 15, 2005... Decreasing waiting times for medical procedures and diagnostic tests has become a major focus for health policy in Canada. Although some commentators have called for increased infrastructure to handle the demand, building and equipping new...

Diagnosis and management of pertussis.(Review/Synthese)
February 15, 2005... Abstract PERTUSSIS IS INCREASING IN FREQUENCY among children too young to be vaccinated and among adolescents and adults. This increase is due mainly to waning immunity among vaccinated individuals, who become susceptible during...

Migraine chronicle.(Claire's Head)(Book Review)
February 15, 2005... Migraine chronicle Claire's head Catherine Bush Toronto: McClelland & Stewart; 2004 336 pp $32.99 (cloth) 0-7710-1752-9 Catherine Bush is a young writer of some prominence, her two earlier novels having gained an...

Aspirin take two.(Aspirin: The Story of a Wonder Drug)(Book Review)
February 15, 2005... Aspirin take two Aspirin: the story of a wonder drug Diarmuid Jeffreys London: Bloomsbury Publishing; 2004 335 pp. $27.95 (paper) ISBN 0 7475 7443 I once met a man whose child had inadvertently entertained the parish...

Of scrubs and rats.(Room for a view)(Medical student experiences)
February 15, 2005... The nurses had warned me before I went to see her. "Mme St-Laurent? Oh, such a tough patient for such a nice-looking young doctor." "Mme St-Laurent? Be careful--she'll steal things from your pocket if you're not looking." "Mme...

The stone circle.(Room for a view)(health care costs)
February 15, 2005... The Tao is a whole.--Fritjof Capra I was enjoying a beautiful sunset at my home in the Himalayas when my local caretaker broke the silence. He wanted me to take a look at his ailing father. I fetched my stethoscope and we set off down...

Deaf patient.(poem by Martina Scholtens )(Poem)
February 15, 2005... Deaf patient You can't make small talk with a pen. A physician who talks too much, a twentysomething patient with slender hands and a diagnostic clipboard. In an overflowing morning we alternate scratching...

Deaths/Necrologie.
February 15, 2005... Notice--CMAJ welcomes obituaries submitted within 60 days of a death. These should be no longer than 200 words, and colourful writing is encouraged. Send to Kyle Rooks, kyle.rooks@cma.ca; fax 613 565-5471. Dr. Marc Baltzan, a pioneer in...

Query.
February 15, 2005... Think of the following cast of characters as superantiheroes. Dr. Plustar is neurotic about paperwork: he can't get any of it done. His desk is a swamp of tardiness. Complaints have been lodged with the College regarding late workers'...