CMAJ: Canadian Medical Association Journal articles from February 2006

CMAJ: Canadian Medical Association Journal archives from February 2006

Are journals doing enough to prevent fraudulent publication?/Les journaux font-ils assez d'efforts pour prevenir la publication frauduleuse?(Editorial/Francais a la page suivante)
February 14, 2006... Recent warnings by editors of 3 major journals that data contained in published papers were or may have been incomplete, (1) falsified (2) or fabricated (3) has dismayed scientists and scientific editors around the world and added to the...

Breast implant advisory panel: more study on silicone leakage: early release, published at www.cmaj.ca on Jan. 13, 2006. subject to revision.(News)
February 14, 2006... Two companies that manufacture silicone-gel breast implants have not satisfied a Health Canada expert advisory panel about the potential health effects of exposure to low-molecular-weight silicones if the implants leak, or about long-term...

WTO's new rules allow poorest to import drugs.(News)(World Trade Organization)
February 14, 2006... The World Trade Organization is planning to put into law a waiver originally drafted in 2003 that allows least-developed countries to import generic drugs in public health emergencies, such as the HIV/AIDS epidemic. The waiver pertains to...

The vexations of Vioxx.(News)(Merck and Company Inc.)
February 14, 2006... The wave of litigation surrounding rofecoxib (Vioxx) has lapped ashore at the New England Journal of Medicine (NEJM), whose oftcited study of the drug published in 2000 appears to contain incomplete adverse event information. Merck & Co....

China borrows Canadian know-how for new labs.(News)(Brief Article)
February 14, 2006... Infectious disease experts from Winnipeg have signed a 3-year agreement with Guangdong Province in China to develop a network of high-security laboratories necessary to help contain outbreaks of diseases such as avian flu. The agreement,...

Challenges for a conservative minority.(News)
February 14, 2006... The new federal Conservative government's minority position means it will not be able to do anything too drastic, says a professor of political science at the University of Windsor. "To the extent that [Prime Minister-elect Stephen Harper]...

Closed book.(News @ a glance)(budget plans of Health Canada)(Brief Article)
February 14, 2006... Closed book: Health Canada plans to halve its budget at 6 Ottawa health science libraries and reduce staff from 26 to 10 over the next 3 years. At the same time the department will create an electronic library in collaboration with the National...

The lottery.(News @ a glance)(training lottery ticket vendors to prevent compulsive gambling)(Brief Article)
February 14, 2006... The Lottery: A Quebec coroner wants lottery ticket vendors to be trained to help combat compulsive gambling. The recommendations stem from an investigation into the Aug. 21, 2005, suicide of 62-year-old Andre Baril. The Carignan man killed...

Milk banks.(News @ a glance)(breast milk banks)(Brief Article)
February 14, 2006... Milk banks: The coordinator of Canada's only breast milk bank is calling for other regions to establish similar banks. "With the increased research on the benefits of human milk, there's greater demand," says Frances Jones at BC Women's...

Reddoch case.(News @ a glance)
February 14, 2006... Reddoch case: The Yukon Medical Council has apologized to CMA past president Dr. Allon Reddoch for the loss of files that were stolen while in the Council's keeping. The files pertained to Reddoch's appeal of a YMC finding of "unprofessional...

Do richer provinces have shorter waiting times to see specialists?(Pulse)(Brief Article)
February 14, 2006... According to the 2004 National Physician Survey Database, provinces with the greatest gross domestic product (GDP) per capita (Alberta, Ontario, Saskatchewan and British Columbia) had among the longest wait times for urgent referrals to a...

Breaking down the blood-brain barrier.(Bench to Bedside)(Brief Article)
February 14, 2006... Although the blood-brain barrier protects the brain from harmful substances in the blood, it also prevents potentially beneficial drugs from reaching the brain. One solution for improving drug delivery to the brain is to remove the blood-brain...

A PET mini-chip.(Bench to Bedside)(Positron electron tomography )(Brief Article)
February 14, 2006... Microfluidics, a field that deals in part with creating miniature systems for mixing liquids and gases, is likely unfamiliar to most physicians. Nevertheless, microfluidic technology may revolutionize the field of medical imaging. Positron...

Changing epidemiology and emerging risk groups for pertussis.(Analysis)
February 14, 2006... Pertussis remains one of the least well-controlled vaccine-preventable diseases for which routine vaccination exists. Although most often a persistent but relatively benign respiratory illness, pertussis can result in serious consequences, such...

Bone infarcts in a woman with systemic lupus erythematosus and antiphospholipid antibody syndrome.(Teaching Case Report)
February 14, 2006... The Case: A 48-year-old woman with systemic lupus erythematosus (SLE) diagnosed more than 20 years ago presented to our clinic with a history of generalized pain, profound fatigue, oral ulcers, dry eyes and mouth, and hair loss. She complained...

She's dying for help: global HIV.(Public Health)
February 14, 2006... "AIDS has a woman's face."--Kofi Annan With 5 million new human immunodeficiency virus (HIV) infections in 2005 and an estimated 40 million cases worldwide, the HIV epidemic shows no sign of abating (Box 1). Growing epidemics as a result of...

Inflammation at a previous inoculation site: an unusual presentation of Kawasaki disease.(Clinical Vistas)
February 14, 2006... A previously healthy 22-month-old girl of Asian heritage presented with a 10-day history of high fever and a 3-day history of nonpurulent conjunctivitis, erythema and swelling of her left upper arm and right side of her neck, and reddened,...

Relative value of multiple plasma biomarkers as risk factors for coronary artery disease and death in an angiography cohort.(Research)
February 14, 2006... Abstract Background: Although elevated levels of C-reactive protein (CRP), interleukin (IL)-6, serum amyloid A protein (SAA) and total homocysteine (tHcy) have been associated with the increased likelihood of cardiovascular events, the...

Evidence of bias and variation in diagnostic accuracy studies.(Research)
February 14, 2006... Abstract Background: Studies with methodologic shortcomings can overestimate the accuracy of a medical test. We sought to determine and compare the direction and magnitude of the effects of a number of potential sources of bias and...

The association between elevated levels of inflammation biomarkers and coronary artery disease and death.(Commentary)
February 14, 2006... In this issue of the Journal, Lee and colleagues report on the associations between 3 plasma markers of low-grade inflammation--C-reactive protein (CRP), interleukin (IL)-6 and serum amyloid A protein--and total homocysteine with coronary...

Sources of bias in diagnostic accuracy studies and the diagnostic process.(Commentary)
February 14, 2006... Making accurate diagnoses requires knowing the performance characteristics of the tests we use. How can we know whether to trust studies that purport to establish those performance characteristics? The fundamental design of studies...

Nonpatentable drugs and the cost of our ignorance.(Commentary)
February 14, 2006... The pharmaceutical industry spends over US$10 billion to fund some 90% of the 40 000-80 000 randomized controlled clinical trials (RCTs) being conducted across the world at any given time. (1-3) By its own estimation, the pharmaceutical...

New imaging techniques for diagnosing coronary artery disease.
February 14, 2006... Abstract New tomographic cardiovascular imaging tests, such as intravascular ultrasonography (IVUS), coronary computed tomography (CT) angiography and magnetic resonance imaging (MRI), can be used to assess atherosclerotic plaques for the...

Reflections from young physicians.(Letters)(Letter to the Editor)
February 14, 2006... I had a feeling of great comfort and pride when I read the commentaries by Ben Hoyt(1) and by Sacha Bahtia and Adam Natsheh:(2) if the opinions expressed by these authors reflect the attitudes of young physicians to health care in Canada for...

Training more doctors.(Letters)(Letter to the Editor)
February 14, 2006... Every time I tell someone that I am doing my residency training in the United States, I get the same reaction: "Why are you in the United States? Are you going to come back to Canada? We need more doctors." Moving to the United States was a...

Unnecessary exposure?(Letters)(Letter to the Editor)
February 14, 2006... In the informative article by Mithu Sen and colleagues (1) concerning neonatal exposure to active pulmonary tuberculosis, some very revealing, and I think irrelevant, details were provided about the index case. The reader learns not only this...

Reporting communicable diseases.(Letters)
February 14, 2006... Although the article on dermatologic emergencies (1) was directed primarily at the clinical management of the presenting patient, I noted that there was no mention of the fact that cases of staphylococcal toxic shock syndrome, necrotizing...

A painful elbow?(Letter to the Editor)
February 14, 2006... May I suggest the patient consult a real doctor, since the condition appears to be bilateral (text v. picture). (1) James Battershill Retired Physician Vancouver, BC REFERENCE (1.) Shu DH, Shu AC, Yuen M, et al. A case of...

Measuring the presence of chronic diseases.(Letters)(Letter to the Editor)
February 14, 2006... It is interesting that the time when patients were evaluated using the Charlson Comorbidity Index was not mentioned in the study by Pepin and colleagues. (1) It is possible that Clostridium difficile infections occurred in patients who were in...

Canadian healing oil.(Letters)(Letter to the Editor)
February 14, 2006... I was interested in the photo of Canadian Healing Oil and the accompanying caption in a recent edition of The Left Atrium. (1) I grew up in the Caribbean and can attest to the fact that Canadian Healing Oil was an essential component of the...

Is this clinical trial fully registered?(Letters)(Letter to the Editor)
February 14, 2006... In September 2004, the International Committee of Medical Journal Editors (ICMJE) proposed a specific registration for clinical trials whose authors expect consideration for publication. (1) Registration of clinical trials is an important...

An evaluation of class effect.(Letters)(Letter to the Editor)
February 14, 2006... The results of Zhou's retrospective observational study1 conflict with the evidence obtained from well-designed clinical trials. Retrospective analyses of administrative databases may indicate an association between 2 variables, but one must...

Standards of training.(Letter to the Editor)
February 14, 2006... In a recent CMAJ news article about the challenges currently faced by cardiac surgeons in Canada,1 Stephen Fremes, head of cardiac surgery at Sunnybrook and Women's College Health Sciences Centre in Toronto, is quoted as saying that training...

Corrections.(Letters)(Correction Notice)
February 14, 2006... In a Left Atrium article about the new Canadian War Museum, (1) it was implied that Siegried Sassoon died shortly after World War 1. In fact, Sassoon did not die immediately after the war, but became a celebrated war poet and lived until 1967....

A sexual evolution.(Book Review)
February 14, 2006... Written in the flesh: a history of desire Edward Shorter Toronto: University of Toronto Press; 2005 298 pp $29.95 (cloth) ISBN 0-8020-3843-3 Having written two books on the history of erotic language myself, I very much looked forward to...

The florist.(Room for a view)
February 14, 2006... Orange daylight lit the sliding glass panes of the hospital exit. I emerged into a cold Saturday in November, the morning after the season's first snowfall. It had been a particularly rough night, and I was grateful for the crisp air on my walk...

Raising Lazarus.(medical intern treat the don)
February 14, 2006... Grand rounds in medicine are, well, grand affairs. In my student days the senior don, a super-cat physician, would lead us, a motley flock of interns, final-year medicos and postgraduate students as he tapped a chest here and palpated a liver...

Deaths.
February 14, 2006... NOTICE CMAJ welcomes obituaries submitted within 60 days of a death. Send to pubs@cma.ca; fax 613 565-5471. Notice Allanach, William Gerald, Riverview, NB; University of Toronto, 1943. Died Nov. 30, 2005, aged 89. Allison, Nigel...

Query.
February 14, 2006... A rare day off, and I have one objective: not to scour OVID for answers to patients' questions, not to complete the onerous onslaught of insurance-company forms, not to dictate the waiting backlog of discharge summaries. I've worked for two...

Medicare: ready for a perfect storm of reform?/L'assurance-maladie, prete pour une tempete parfaite de reforme?(Editorial)
February 28, 2006... As Canada's new Conservative government settles into the more comfortable seats on the other side of the House, it will begin to adjust the levers of political and policy change. There will be necessary changes of personnel at senior...

Proposed Canada food guide called "obesogenic".(News)
February 28, 2006... The proposed revised Canada Food Guide is a recipe for dramatic increases in premature death resulting from chronic diet-related disease, some critics say. Bill Jeffery, the Canadian coordinator for the US-based Centre for Science in the...

Australian diet plan slammed.(News)(Brief Article)
February 28, 2006... Australia's most popular diet plan--and the government science institute that backs it--is under fire for recommending excessive meat consumption and for its links with the meat and livestock industry. The Commonwealth Scientific and...

New Brunswick to get medical school.(News)
February 28, 2006... Anew medical school in New Brunswick is raising hopes that the Maritime province will be able to more effectively recruit and retain physicians from within its own population. The New Brunswick Medical Training Centre--the first of its kind...

Phase 2: benchmarks to accountability.(News)
February 28, 2006... Setting wait times is not an end in itself, but a step toward a sustainable health care system, says the federal Wait Times Advisor. Dr. Brian Postl said that instead of setting "hundreds and hundreds of benchmarks" we need to look at ways...

Quebec strain of C. difficile in 7 provinces.(News)(clostridium difficile)
February 28, 2006... The same strain of Clostridium difficile that has caused close to 1400 deaths in Quebec since 2003 is present in 7 provinces, the Public Health Agency of Canada is reporting. The NAP 1 strain of C. difficile was found in hospitals in...

TB test.(News @ a glance)(tuberculosis )(Brief Article)
February 28, 2006... TB test: A new blood test for tuberculosis has been approved for use by the US Centers for Disease Control and Prevention. The QuantiFERON-TB Gold test is made by an Australian company and will be used instead of the 100-year-old tuberculin...

No Bextra.(News @ a glance)(COX-2 inhibitors)(Brief Article)
February 28, 2006... No Bextra: Following a review of safety information, Health Canada has decided that valdecoxib (Bextra), a COX-2 selective inhibitor used to treat arthritis and pain, will not return to the market. Pfizer pulled the drug in April 2005 CMAJ...

Luck of the draw.(Yarmouth physician shortage)(Brief article)
February 28, 2006... Luck of the draw: The 8000 residents of Yarmouth, NS, who don't currently have a family physician are eligible to enter a draw that may gain them admittance to a new clinic. When it opens this spring, the Ocean View Family Practice, consisting...

Malaria therapy problem.(News @ a glance)(Brief Article)
February 28, 2006... Malaria therapy problem: WHO asked 17 drug companies in January to stop selling artemisinin as a stand-alone therapy for malaria because of the potentially huge increase in drug-resistant strains. The use of artemisinin as a monotherapy weakens...

Antipsychotic drugs and mortality among elderly patients.(What's Up, Doc?)(Brief Article)
February 28, 2006... Atypical antipsychotic drugs have been linked to increased mortality among elderly patients. Researchers examined data from almost 23 000 patients over 65 years of age to see whether a similar risk existed for conventional antipsychotic drugs...

The end of [beta]-blockers?(What's Up, Doc?)(hypertension therapy)(Brief Article)
February 28, 2006... A meta-analysis examining the use of [beta]-blockers as first-line therapy for hypertension found that the relative risk of stroke was 16% higher for [beta]-blockers (RR 1.16, 95% CI 1.04-1.30) than for other antihypertensive drugs. The risk of...

Counselling versus drugs for weight loss.(What's Up, Doc?)(Brief Article)
February 28, 2006... In this study, 224 obese adults, of whom 80% were women, received sibutramine (an appetite suppressant), lifestyle-modification group counselling (30 sessions), sibutramine and group counselling, or sibutramine with brief counselling given by a...

Too much iron?(What's Up, Doc?)(Brief Article)
February 28, 2006... Iron tablets have well-known side-effects. It is thus of interest to know whether low doses are as effective as high doses in treating iron-deficiency anemia in elderly patients (> 80 years). Ninety patients with iron-deficiency anemia received...

Polymer hints at new clotting agent.(polyphosphate)(Brief article)
February 28, 2006... A molecule once studied exclusively in simple cellular organisms has been recently shown to play an important role in the ability of human platelets to clot. Polyphosphate, a polymer of inorganic phosphate, is widely found in nature and was...

Imaging transplanted islet cells.(Bench To Bedside)(Brief Article)
February 28, 2006... Islet cell transplantation, a promising new way to treat type 1 diabetes, may someday obviate the need for exogenous insulin therapy. The ability to image transplanted cells would facilitate ongoing monitoring of both the cells and the patients...

Critical care outreach comes to Canada.(Analysis)
February 28, 2006... Not all patients who need care in a high-dependency unit (HDU) are transferred in a timely manner. Such delays may cause the patient to undergo physiological deterioration, prolongation of stay or a less favourable outcome. To avoid such...

Sleep disorders presenting as common pediatric problems. (Teaching Case Report).
February 28, 2006... Case 1: Eleven-year-old Alan has had problems at school for the last 18 months. He has severe problems with inattention and an inability to concentrate, and he cannot sit still for any length of time. Attention deficit hyperactivity disorder...

Public health.(injury)
February 28, 2006... Injury is the ninth most common cause of premature death worldwide and the third most common cause of years lived with disability. (1) Many early deaths are related to traffic accidents: each year, crashes of road vehicles kill 1.2 million...

Does a short course of clarithromycin affect mortality in patients with stable coronary artery disease?(In the Literature)
February 28, 2006... Jespersen CM, Als-Nielsen B, Damgaard M, et al. Randomised placebo controlled multicentre trial to assess short term clarithromycin for patients with stable coronary artery disease: CLARICOR trial. BMJ2006;332:22-7. Background: Chlamydia...

Rosiglitazone (Avandia) and macular edema.(Health and Drug Alerts)
February 28, 2006... Reason for posting: Thiazolidinediones such as rosiglitazone are insulin sensitizers used in the treatment of type 2 diabetes and polycystic ovarian disease. Some patients taking these drugs experience peripheral edema. (1) Recent advisories...

A teenager with abdominal pain and soft-tissue emphysema.(Clinical Vistas)
February 28, 2006... A 15-year-old girl presented with a sudden onset of abdominal and chest pain, nausea and postprandial gastric fullness. She had a history of an eating disorder with low weight and amenorrhea of 6 months' duration. On physical examination, her...

What matters most in end-of-life care: perceptions of seriously ill patients and their family members.
February 28, 2006... ABSTRACT Background: Initiatives to improve end-of-life care are hampered by our nascent understanding of what quality care means to patients and their families. The primary purpose of this study was to describe what seriously ill patients...

Comparison of evidence on harms of medical interventions in randomized and nonrandomized studies.
February 28, 2006... [infinity] See related article page 645 Abstract Background: Information on major harms of medical interventions comes primarily from epidemiologic studies performed after licensing and marketing. Comparison with data from large-scale...

"You can't always get what you want"--or can you?(terminal care)(Column)
February 28, 2006... [infinity] See related article page 627 You can't always get what you want But if you try sometimes You just might find You just might find You get what you need --Mick Jagger / Keith Richards, Let it Bleed, 1969 In the dawn of...

What is the best evidence for determining harms of medical treatment?
February 28, 2006... [infinity] See related article page 635 A proper balance of benefits and harms is necessary to assess the overall effect of medical interventions. (1) Most evidence on harms from medical treatments is obtained from observational research....

Hepatitis C: a review for primary care physicians.
February 28, 2006... Abstract Primary care physicians see many of the estimated 250 000 Canadians chronically infected with the hepatitis C virus (HCV). Of this number, about one-third are unaware they are infected, which constitutes a large hidden epidemic....

A response from Dr. Nancy Olivieri.(LETTERS)(Letter to the Editor)
February 28, 2006... I write to correct the errors and misrepresentations in the review by Hoey and Todkill (1) ("The Olivieri story, take three"; Oct. 11, 2005) of Miriam Shuchman's book. (2) Many physicians may wish to appreciate more completely the significance...

What about hunter-gatherers?(Letter to the editor)
February 28, 2006... Did the authors of a recent report on "refrigerator blindness" (1) consider that men, as hunters, are programmed to spot moving game, whereas women, as gatherers, are programed to spot stationary edible plants and fruit? Just a thought. ...

Doubts about lutein.(Letter to the editor)
February 28, 2006... I found it amusing that in the same issue in which one of CMAJ's editors educated Steve Arshinoff about the journal's new conflict of interest policy, (1,2) there is a rambling opinion piece by Sylvia Santosa and Peter Jones on the possible...

News and independence.(Letter to the editor)
February 28, 2006... In their latest protest about editorial Autonomy (1) the editors note that the CMA declined their invitation to present the association's views. Perhaps as a long-time member I might be allowed to compensate for this reticence. The...

A lingering mistake.(Letter to the editor)
February 28, 2006... I would like to draw attention to a bizarre reference that occurs in a commentary by Robert Rangno in a 1997 issue of CMAJ. The author puts dimenhydrinate on the same plane as astemizole and gives the unassailable R.L. Woosley as a reference. I...

Who is that bear?(Letter to the Editor)
February 28, 2006... Dr. Ursus won't last long allowing his practice to run him. (1) There must be an appropriate balance of work and relaxtation. A doctor who wants to go the distance must prepare himself or herself in the same way that athletes train for optimal...

A prejudicial term.(Letter to the editor)
February 28, 2006... We take exception to the use of the word "pariah" in a recent commentary by Richard Smith. (1) No aspect of Indian history has provoked more controversy than the chronicles of caste divisions and untouchability. However, caste-like divisions...

A medical education.(Bloodletting and Miraculous Cures)(Book Review)
February 28, 2006... Bloodletting & miraculous cures Vincent Lam Toronto: Doubleday Canada; 2006 350 pp $29.95 (cloth) ISBN 0-385-66143-6 This collection of interconnected stories is very much a first book, but an excellent first book nonetheless....

Lives lived.(The boys: Or, Waiting for the Electrician's Daughter )(Book review)
February 28, 2006... The boys, or, Waiting for the electrician's daughter John Terpstra Kentville, NS: Gaspereau Press; 2005 Unpaginated. $25.95. ISBN 1-55447-011-0 Smyth-sewn paperback, card binding, letterpress-printed jacket. Every family has a "geography,"...

The home visit.(Room for a view)(Short story)
February 28, 2006... Lena Ivanovic lived with her widowed mother in a semidetached home on Euclid Avenue. Thursday midnight, the mother phoned Dr. Rubens, frantic. "Lena spits out food. Your pills poison her. Why did you stop seeing her?" "Mrs. Ivanovic, I...

Those eyes.(Lifeworks)(German expressionist painter, Otto Dix (1891-1969))(Brief Article)
February 28, 2006... The morbidly inclined Otto Dix (1891-1969), when preparing to create a series of etchings depicting the horrors on the German front during World War I, "spent hours in the pathological department of a local hospital, pouring over and drawing...

Query.(electronic medical record)
February 28, 2006... Our Electronic Medical Record is a comedy of errors. Ha, ha, ha. I've ranted about this before, but the frustration our system causes is so severe that I need to vent again. I'm not getting all of my lab results. Here's what should...