CMAJ: Canadian Medical Association Journal articles from February 2007

CMAJ: Canadian Medical Association Journal archives from February 2007

Mentally ill youth: meeting service needs.(GUEST EDITORIAL)(Disease/Disorder overview)(Editorial)
February 13, 2007... Mental disorders as a group constitute the largest burden of disease globally. For example, in the 15-44-year-old age group, 4 of the 5 most disabling illnesses are mental disorders: depression, bipolar disorder, alcohol abuse and...

Les jeunes atteints de maladie mentale: repondre au besoin de services.(EDITORIAL INVITE)(Editorial)
February 13, 2007... Les troubles mentaux constituent collectivement le fardeau de maladie le plus lourd dans le monde. Chez les 15 a 44 ans, par exemple, quatre des cinq maladies les plus invalidantes sont des troubles mentaux: depression, trouble bipolaire, abus...

Academic drug detailing: an evidence-based alternative.(NEWS)
February 13, 2007... It's a little known service to physicians offered in 5 provinces. One, though, recently axed its program, while another may soon follow suit. It could be called a distant and poor cousin of pharmaceutical detailing because it too hopes to...

"This is the kind of information we need".(NEWS)
February 13, 2007... There's no doubt in the mind of clinical pharmacist Dr. Aaron Tejani, the co-ordinator of clinical research and drug information for British Columbia's Fraser Health Authority (FHA), that academic detailing has a indispensable role to play in...

Canada's new toxic hit list called "inadequate".(NEWS)
February 13, 2007... Is it a toxic hit list or toxic miss list? That's the question many in the medical and scientific community are asking about the federal government's new Chemicals Management Plan--a multi-million dollar program that imposes strict new...

Report supports cost-effective prison tattoo program.(NEWS)
February 13, 2007... In the wake of the release of a draft evaluation report indicating that a federal prison sterile tattooing pilot project was reducing potential exposure to infectious diseases like HIV and hepatitis C (HCV), questions continue to abound about...

Post-SARS: more protection needed for health care workers.(NEWS)(Severe acute respiratory syndrome)
February 13, 2007... Four years after the trauma of the SARS outbreak that claimed 44 lives, Ontario health care workers don't feel a whole lot safer. "On the front lines, there is still not trust in the system.... No one will let their guard down," says...

New Ontario college for traditional Chinese medicine.(NEWS)
February 13, 2007... Traditional Chinese medicine (TCM) and acupuncture are now officially recognized as a health profession in Ontario under new legislation that will allow practitioners of the ancient holistic therapy operate under their own regulatory...

News @ a glance.(NEWS)(US Pharmaceutical companies are now disclosing more information about their clinical trials)(outbreaks of viral gastroenteritis in Canada)(Saint John Regional Hospital negotiates with emergency physicians)(Report)
February 13, 2007... More trial info: Pharmaceutical companies in the US are now disclosing more information about their clinical trials. The number of trials with incomplete information on the National Institutes of Health's registration Website...

The hazards of nursing.(PULSE)(Survey)
February 13, 2007... Astaggering 18% of 18 348 Canadian nurses responding to a recent survey say their patients were "occasionally" or "frequently" administered the wrong medication or dose while in their care, according the first National Survey of the Work and...

Copy-number variations add a new layer of complexity in the human genome.(ANALYSIS)(Report)
February 13, 2007... The first draft of the DNA sequence of the human genome was completed in 2001. (1, 2) This Herculean effort involved scientific teams around the world who together arranged in correct sequence 3 billion base pairs of DNA. Afterward, many...

Allergic contact dermatitis to paraphenylendiamine in hair dye after sensitization from black henna tattoos: a report of 6 cases.(TEACHING CASE REPORT)(Clinical report)
February 13, 2007... The cases: Over a 2-year period, 6 women have come to our dermatology clinic with an allergic contact dermatitis to paraphenylendiamine (PPD) from hair dye after being previously sensitized to PPD from black henna tattoos. These patients, 14-38...

Cerebral trypanosomiasis in an incarcerated man.(CLINICAL VISTAS)(Clinical report)
February 13, 2007... A 40-year-old First Nations man was transferred to hospital from a Manitoba correctional facility following a 2-week history of headache, nausea, vomiting and drowsiness. He denied any travel outside of Manitoba; family members confirmed this....

Trichinellosis from consumption of wild game meat.(PUBLIC HEALTH)(Clinical report)
February 13, 2007... Trichinellosis, or trichinosis, is acquired by eating raw or undercooked meat that contains larvae of the tissue-dwelling nematode Trichinella. Historically, pigs were considered to be the main reservoir of Trichinella, but a recent Canadian...

Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term.(RESEARCH)(Clinical report)
February 13, 2007... ABSTRACT Background: The rate of elective primary cesarean delivery continues to rise, owing in part to the widespread perception that the procedure is of little or no risk to healthy women. Methods: Using the Canadian Institute for...

Impact of influenza exposure on rates of hospital admissions and physician visits because of respiratory illness among pregnant women.(RESEARCH)(Clinical report)
February 13, 2007... ABSTRACT Background: Excess deaths have occurred among pregnant women during influenza pandemics, but the impact of influenza during nonpandemic years is unclear. We evaluated the impact of exposure during nonpandemic influenza seasons on...

Bringing children's mental health "out of the shadows".(COMMENTARY)(Report)
February 13, 2007... In May 2006, the Honourable Michael Kirby, chair, and the Honourable Wilbert Keon, deputy chair of the Standing Senate Committee on Social Affairs, Science and Technology, issued their final report on mental health: Out of the Shadows at Last:...

Is planned cesarean childbirth a safe alternative?(COMMENTARY)
February 13, 2007... Cesarean birth rates have risen dramatically during the past decade, reaching more than 50% in some regions of the world, despite a lack of evidence of any increase in obstetric emergencies. (1,2) The marked increase in primary elective...

The body, emotions and intentions: challenges of preconception arrangements for health care providers.(COMMENTARY)
February 13, 2007... Dan Reilly has written an important article in this issue of CMAJ for medical practitioners who manage the health care of pregnant women intending to surrender the child once born. (1) In addition to providing an accurate overview of the law,...

Surrogate pregnancy: a guide for Canadian prenatal health care providers.(REVIEW)
February 13, 2007... ABSTRACT Providing health care for a woman with a surrogate pregnancy involves unique challenges. Although the ethical debate surrounding surrogacy continues, Canada has banned commercial, but not altruistic, surrogacy. In the event of a...

Homeless shelters and substance misuse.(LETTERS)(Letter to the editor)(Brief article)
February 13, 2007... We read with interest Wendy Muckle and Jeffrey Turnbull's guest editorial on homelessness. (1) Although shelters are not perfect, they do protect people from some aspects of homelessness. For example, there is evidence of cognitive impairment...

Family practitioners and the Canadian Diabetes Association.(LETTERS)(Letter to the editor)
February 13, 2007... I recently attended the national Canadian Diabetes Association (CDA) conference in Toronto. The conference was attended by a host of professionals and lay people from various walks of life, but family physicians were not well represented. Where...

Cardiac risks with COX-2 inhibitors.(LETTERS)(Letter to the editor)
February 13, 2007... Linda Levesque and colleagues' findings concerning the timing of cardiovascular risks in elderly users of cyclooxygenase-2 (COX-2) inhibitors are interesting, (1) but they might reflect the superiority of rofecoxib over other agents as an...

Access to abortion.(LETTERS)(Letter to the editor)
February 13, 2007... The guest editorial in the July 4, 2006, issue (1) contains 2 factual errors. First, Sanda Rodgers and Jocelyn Downie have misrepresented the 1988 Supreme Court decision in R. v. Morgentaler by stating that as a result of this decision "a...

Disease and the dream of drugs.(Super Pills: The Prescription Drugs We Love to Take)(Book review)
February 13, 2007... Super pills: the prescription drugs we love to take Steven Manners Raincoast Books; 2006 256 pp $24.95 ISBN 978-1-55192-857-9 What is a perfect world? Is it an illusion? Or is it perfect health? Can you imagine a world without...

Influenced.(Room for a view)(influenza)
February 13, 2007... Why do we, as physicians, feel let down when we get sick? Do we expect that we are somehow immune from something as universal as illness? Striving constantly for perfection, do we feel abandoned by our bodies when we become ill? I'm not sure...

My Dear Mother.(Annotations)(the Spanish Flu)(Personal account)
February 13, 2007... The worst influenza pandemic of the last century occurred in 1918. Called "the Spanish Flu," the illness caused at least 30 000 (some estimate 50 000) deaths in Canada. The following are excerpts from unpublished letters written by Annie Laird,...

You never forget.(Notes)
February 13, 2007... You never forget the first time someone dies in your care. At least that's what they tell me tonight. I arrived in the North only days ago. My time has already been enriching as I greedily accumulate post-residency experience: my first...

Deaths.(Obituary)
February 13, 2007... NOTICE Readers are invited to submit brief remembrances of recently departed colleagues. Colourful writing is encouraged, but please limit your notice to 150 words. Send to pubs@cma.ca; fax 613 565-5471. Alport, William Edward, Regina;...

Query.(physicians family relations)
February 13, 2007... We all know that family members are prone to making demands on relatives who happen to be physicians. I've had an aunt ask me if I could get her a faster MRI. My father asked if I'd sign a form warranting special authorization for a pricey...

A plea for transparency in Canada's "new government".(Assisted Human Reproduction Canada)(Editorial)
February 27, 2007... On Dec. 21, 2006, Health Minister Tony Clement announced the appointments of a chair, a president and 8 board members for Assisted Human Reproduction Canada. (1) This new federal agency is charged with regulating fertility clinics, making...

Le << nouveau gouvernement >> du Canada -- plaidoyer en faveur de la transparence.(EDITORIAL)(la selection des dirigeants et des membres du conseil d'administration de l'Agence canadienne de controle de la procreation assistee)(Editorial)
February 27, 2007... Le 21 decembre 2006, le ministre de la Sante Tony Clement a annonce la nomination du president du conseil d'administration, de la presidente et de huit membres du conseil de l'Agence canadienne de controle de la procreation assistee (1). Cette...

New reproductive technology board belies expert selection process.(NEWS)
February 27, 2007... The federal government reopened an expert selection process and then hand-picked members to the board of a new reproductive health agency--a move some scientists fear is intended to circumvent the legislation the agency will enforce. On...

Human cloning a decade after Dolly.(NEWS)
February 27, 2007... Ten years ago this month, Ian Wilmut and colleagues from the Roslin Institute in Scotland published an article in Nature unceremoniously entitled: "Viable offspring derived from fetal and adult mammalian cells." This was, of course, the...

Revised Quarantine Act has serious limitations.(NEWS)
February 27, 2007... The federal government has taken a tentative step toward bolstering national capacity to handle global health threats by enhancing its authority to deal with suspected cases of communicable diseases at international entry points like airports....

Connection and communication vital to handling a pandemic in Ontario.(NEWS)
February 27, 2007... If Ontario had regionalized its health care delivery system like many other provinces, would Toronto's 2003 severe acute respiratory syndrome (SARS) outbreak have been handled better? Would a decentralized and regionalized system mean better...

Cisapride class-action suit approved.(NEWS)(Johnson & Johnson drug Cisapride adverse drug reaction )
February 27, 2007... An Ontario Superior Court Justice has certified a class-action lawsuit against Johnson & Johnson, its Canadian subsidiary, Janssen-Ortho Inc. and the Attorney General of Canada, on behalf of Canadians who took the antireflux drug cis-apride...

Canada's slow adoption of new technologies adds burden to health care system.(PULSE)
February 27, 2007... It is interesting to compare how developed countries adopt new technologies. In terms of novel minimally invasive treatments, these are often within the domain of interventional radiology. The Canadian Association of Radiologists (CAR) and...

Through the looking glass: persistent mirror movements.(TEACHING CASE REPORT)
February 27, 2007... The Case: A 21-year-old man presented to our neurology clinic with persistent mirror movements of his hands. He was a soldier, but he had been banned from handling firearms by his superior officers, who were fearful that the man would cause an...

What's your call?(CLINICAL VISTAS BRIEFS)
February 27, 2007... Head CT scans of an unconscious 42-year-old man, taken 48 hours after admission to hospital after an attempted suicide. [ILLUSTRATION OMITTED] Bilateral breast tenderness and enlargement in a 76-year-old man with congestive heart...

Alcohol use and misuse.(PUBLIC HEALTH)(Report)
February 27, 2007... Alcohol use and misuse in Canada continues to be substantial. According to the latest data from the 2005 Canadian Addiction Survey, (1) 79.3% of Canadians 15 years and older consume alcohol. Although not directly comparable to the Canadian...

CT findings in methanol intoxication.(CLINICAL VISTAS BRIEFS)(cat scan)
February 27, 2007... The patient had attempted suicide by consuming methanol. On admission, his methanol level was 46 (normal Mechanical ventilation, hemodialysis and intravenous ethanol thera

Spironolactone-induced gynecomastia.(CLINICAL VISTAS BRIEFS)
February 27, 2007... This patient reported bilateral increasing breast size and tenderness. Examination of his breasts revealed gynecomastia (Tanner stage III). The patient had an implantable cardioverter defibrillator for sustained ventricular tachycardias and a...

Adult epiglottitis.(CLINICAL VISTAS BRIEFS)(Disease/Disorder overview)
February 27, 2007... The radiograph showed the classic "thumbprint sign" (Fig. 1, arrows) characteristic of epiglottitis. The patient had progressive respiratory distress and required emergent endotracheal intubation. A swollen epiglottis was seen under direct...

Risk of death associated with the use of conventional versus atypical antipsychotic drugs among elderly patients.(RESEARCH)(Clinical report)
February 27, 2007... ABSTRACT Background: Public health advisories have warned that the use of atypical antipsychotic medications increases the risk of death among elderly patients. We assessed the short-term mortality in a population-based cohort of elderly...

Alcohol consumption and the use of antidepressants.(RESEARCH)(Clinical report)
February 27, 2007... ABSTRACT Background: The purpose of the present study is to explore the relation between use of antidepressants and level of alcohol consumption among depressed and nondepressed men and women. Methods: Random-digit dialling and...

The underuse of digoxin in heart failure, and approaches to appropriate use.(Viewpoint)
February 27, 2007... Most of the estimated 400 000 Canadians who experience heart failure are 6.5 years of age or older. Heart failure is the most frequent reason for hospital admission for older adults. Admission for heart failure is a marker of disease...

Necessary cautions when considering digoxin in heart failure.(Viewpoint)(Clinical report)
February 27, 2007... Digitalis is an old remedy. The first systematic study showing the benefits of digitalis in cases of dropsy was reported by the English physician and botanist William Withering in 1785. (1) Subsequent widespread use of digitalis led to a...

Pravastatin and cancer: an unproven association.(COMMENTARY)(Clinical report)
February 27, 2007... Statins produce large cardiovascular benefits, particularly in the secondary prevention of cardiovascular disease. In a meta-analysis of 14 randomized trials, participants with a history of heart disease who were taking statins for 5 years had...

Does pravastatin promote cancer in elderly patients? A meta-analysis.(REVIEW)(Clinical report)
February 27, 2007... ABSTRACT Background: An increase in the incidence of cancer among elderly people assigned to pravastatin therapy has been reported in a randomized controlled trial; however, this finding has been attributed to chance. Our aim was to assess...

Adolescent smoking.(Letter to the editor)
February 27, 2007... It is disappointing to see articles such as the one by Andre Gervais and colleagues (1) that are based on the old mantra that nicotine is very addictive and that it makes its victims "feel nauseated or ill" (as stated in the article), not to...

Controlling cervical cancer.(LETTERS)
February 27, 2007... There has been striking progress in research into cervical cancer prevention. According to a CMAJ news article by Alicia Priest, a vaccine against human papillomavirus types 6 and 18 is about to be introduced in Canada. (1) As Priest notes in...

Physician resistance to new information technology.(LETTERS)
February 27, 2007... The account by Liette Lapointe and Suzanne Rivard of the challenges of implementing electronic clinical information systems in hospitals (1) vividly reminded me of my own experience with such an undertaking 20 years ago. (2) Their report...

Natriuretic peptides and heart failure.(LETTERS)
February 27, 2007... We read with interest the recent review by Michael Felker and colleagues, (1) in which they suggest that it may be problematic to attempt to use a common plasma reference level for B-type natriuretic peptide as an indicator of the level of...

Correction.(Correction notice)
February 27, 2007... The DOI published with a recent News article (1) was mistakenly listed as 10.1503/cmaj.161715. It should have read 10.1503/cmaj.061715. REFERENCE 1. Lett D. Manitoba physicians consider DNR guidelines. CMAJ 2007;176(3):310-1. ...

From the heart.(Room for a view)(treating congestive heart failure)(Excerpt)
February 27, 2007... On May 20, 2006, I was rushed to hospital in acute congestive heart failure. I had ruptured a chord of my mitral valve. Without open-heart surgery, I would probably die in less than 10 years. I was a nurse working at a children's hospital. ...

[H.sub.2]O: water and light speak to us.(Lifeworks)(art and life)
February 27, 2007... Juan Geuer's goal is to find ways to integrate the seemingly inanimate into our visceral experience--to give us access to what we really are at the most fundamental level. His installation piece [H.sub.2]O was recently acquired by the...

A lifeline of blood.(Annotations)(National Blood Transfusion Service)(Brief article)
February 27, 2007... The first provincial unit of the fledgling National Blood Transfusion Service officially opened 60 years ago, in Vancouver, BC, on Feb. 3, 1947. Thus began Canada's national program based upon the free distribution to hospital patients of blood...

Deaths.(Obituary)
February 27, 2007... Bates, David Vincent, Vancouver; Cambridge University Medical School, UK, 1945. Died Nov. 21, 2006, aged 84. "Noted researcher and teacher, UBC Dean of Medicine from 1972 to 1977, inducted into the Order of Canada in 2003, poet, voracious...

Query.(dental practice and sedatives)
February 27, 2007... I went to work impaired yesterday. [ILLUSTRATION OMITTED] I still can't believe it. It started innocuously enough: I'm a dental coward. I still feel the drill no matter how much anesthetic is given, and so I asked my family doctor...