CMAJ: Canadian Medical Association Journal articles from February 2008

CMAJ: Canadian Medical Association Journal archives from February 2008

Protecting Canadian travellers: prevention is better than cure/ La protection des voyageurs canadiens: mieux vaut prevenir que guerir.(Editorial)(Editorial)
February 12, 2008... As the winter travel season is upon us, it is worth knowing that an estimated 2 million Canadians will travel this year to developing countries; more than 20% of these travellers will be immigrants returning to their countries of origin to...

Searching for docs on foreign shores.(News)
February 12, 2008... Laureen Larson, lead headhunter for Regina Qu'Appelle Health Region, had been trying to hire a British urologist for months when she accompanied a Saskatchewan recruiting team to a job fair in London, England, last October. They were there...

Physician, count thyself.(News)
February 12, 2008... For many patients, seeing a specialist quickly is tantamount to winning the lottery. Tales of seemingly endless waits for procedures such as hip replacements and cataract surgery are endemic, and often heartbreaking. Physician shortages...

Doctors call for plan to curb physician shortage.(News)
February 12, 2008... With many doctors from the baby boom generation set to retire in the near future, leaders in the health care community are calling for the creation of a national strategy to ensure the physician workforce can sustain itself. Of the 20 000...

Cigarette ads return to Canadian magazines.(News)
February 12, 2008... If Mags and Fags doesn't carry a magazine that interests you, chances are you aren't interested in anything. With somewhere between 6500 and 7000 titles, on subjects ranging from miniature doll houses to elk hunting, the store offers the widest...

Checking up on Health Check.(News)
February 12, 2008... Published at www.cmaj.ca on Jan. 17, 2008. They seem at first a saving grace for parents of picky eaters: a source of calcium, made with whole wheat, low in saturated and trans fats; iGor muffins look and taste like chocolate Twinkies. On...

Moratorium lifted.(News @ a glance)(Brief article)
February 12, 2008... Moratorium lifted: The United States Food and Drug Administration announced last month that it endorses the marketing of milk and meats from cloned animals and their offspring, without requirements for special labelling. Although the US...

Queue-jumping.(getting quicker medical treatment)(News @ a glance)(Brief article)
February 12, 2008... Queue-jumping: In the wake of nationally publicized comments from Canadian Medical Association President Dr. Brian Day that it's common for the well-heeled and well-connected to pull strings to get quicker medical treatment, the Ottawa Hospital...

Donor prohibitions.(News @ a glance)(Brief article)
February 12, 2008... Donor prohibitions: Health Canada has issued a regulatory prohibition against organ donation by any man who has had sex with another man in the previous 5 years, injection drug users, recent recipients of tattoos or body piercings and all...

Pharmaceutical facts.(News @ a glance)(Brief article)
February 12, 2008... Pharmaceutical facts: The United States pharmaceutical industry spends nearly twice as much annually on drug promotion than it does on research and development, according to a new study by York University researchers Marc-Andre Gagnon and Joel...

Pyrrhic victories.(Dispatch from the medical front)(Essay)
February 12, 2008... I recently returned from eastern Democratic Republic of Congo, where I was working for Medecins Sans Frontieres. And everyone asks, what was it like? It's hard to describe the experience properly. I was 1 of 6 doctors (the other 5 were...

Recognizing a common genetic syndrome: 22q11.2 deletion syndrome.(Teaching case report)(Clinical report)
February 12, 2008... The case: A 24-year-old woman presented with a history of multiple medical, surgical and psychiatric issues as well as learning difficulties and mild dysmorphic facial features. During her lifetime, she had seen 12 different specialists and 7...

Pseudohorseshoe lung.(Interesting images)(Brief article)
February 12, 2008... [FIGURE 1 OMITTED] A 14-year old boy presented with a 10-year history of recurring episodes of fever and productive cough. Ten years previously he had been treated for pneumonia, and subsequently he had also received antituberculous...

Leg pains, clubbing of digits and lung mass: what is your call?(Clinical quiz)
February 12, 2008... [FIGURE 1 OMITTED] [FIGURE 2 OMITTED] A 43-year-old woman presented to a rheumatology clinic with a 6-month history of progressive swelling of her lower legs and pain in her knees and ankles. She had no pre-existing medical conditions...

Canine leptospirosis in Canada: a veterinarian's perspective.(Public health)(Report)
February 12, 2008... Leptospirosis is a zoonotic bacterial disease that appears to be becoming more prevalent in Canada. The number of cases of leptospirosis in dogs in Canada and the United States has increased markedly in the last decade. (1-10) Transmission to...

Leptospirosis in the family dog: a public health perspective.(Public health)
February 12, 2008... In North America, there is a low incidence of leptospirosis that occurs as a result of direct transmission of the bacterium from dogs to its owners and their families. It is not mandatory for leptospirosis to be reported to health authorities...

Comparison of provincial prescription drug plans and the impact on patients' annual drug expenditures.(Research)(Report)
February 12, 2008... Abstract Background: Reimbursement for outpatient prescription drugs is not mandated by the Canada Health Act or any other federal legislation. Provincial governments independently establish reimbursement plans. We sought to describe...

Restrictive access to clopidogrel and mortality following coronary stent implantation.(Research)(Clinical report)
February 12, 2008... Abstract Background: In Canada, access to clopidogrel is restricted by most provincial drug insurance plans in order to contain costs. Until April 2007, the Regie de l'assurance maladie du Quebec (RAMQ) Prescription Drug Insurance Plan...

Availability of emergency contraception after its deregulation from prescription-only status: a survey of Ontario pharmacies.(Research letter)
February 12, 2008... ABSTRACT In 2005 the emergency contraception formulation of levonorgestrel (Plan B) became available in Ontario pharmacies without a prescription. We surveyed 239 pharmacies 1 month before the regulatory change and 14-17 months after the...

Mortality benefit from unrestricted access to clopidogrel: too good to be true?(Research)(Clinical report)
February 12, 2008... The use of clopidogrel, a thienopyridine antiplatelet agent, at the time of percutaneous coronary intervention has been generally shown in randomized controlled trials to reduce the risk of thrombosis and related complications. Clinicians are...

Moving from opacity to transparency in pharmaceutical policy.(Health policy)
February 12, 2008... Physicians and patients should demand, and participants in the system should provide, transparency in all of the areas of drug approval and reimbursement (Table 1). The current situation, in which the evidence used to make decisions often...

Optimizing the use of prescription drugs in Canada through the Common Drug Review.(Commentary)
February 12, 2008... Although pharmaceuticals have the ability to improve health outcomes, they are the fastest growing component of Canadian health care expenditures, with costs escalating at a rate of about 11% per year. (1) In 2002, federal, provincial and...

Funding for Canadian health care research.(Letters)(Letter to the editor)
February 12, 2008... In a recent editorial, Matthew Stanbrook and Paul Hebert discuss Canada's inadequate support for health research. (1) Their comparison of the expected per capita investments in academic health research in 2007 in Canada and the United States...

Organ procurement and futile medical care.(Letters)(Letter to the editor)
February 12, 2008... As Robert Sibbald and colleagues pointed out in their recent CMAJ study, (1) there has been no increase in the rates of documented discussions of resuscitation status or do-not-resuscitate orders for patients who want to forego resuscitation,...

MedsCheck: an opportunity missed.(Letters)(Letter to the editor)
February 12, 2008... In 2007 the Ontario Ministry of Health and Long-Term Care, in collaboration with the Ontario Pharmacy Council and the Ontario Pharmacists' Association, launched the MedsCheck program, which targets Ontario patients with chronic diseases who...

Corrections.(Letters)(Correction notice)
February 12, 2008... In the Jan. 1 issue, a news story on the physician complaints process (1) should have stated that if a complaint reaches a disciplinary hearing and the committee overseeing the process rules that the physician was at fault, his or her name is...

Musicophilia: Tales of Music and the Brain.(Book review)
February 12, 2008... Musicophilia: Tales of Music and the Brain Oliver Sacks MD Alfred A. Knopf; 2007 381 pp $34.95 ISBN 978-0-676-97978-7 Neurologist Oliver Sacks' great gift, as seen in a number of engaging volumes such as The Man Who Mistook his Wife for a...

A modest request.(physician mental readiness)(Wit and whimsy)(Survey)
February 12, 2008... From: The Ministry of Health Dear Doctor: A few months ago a survey by the Centre for Perpetual Surveys reported that physicians identify job stress as the primary obstacle they now face in the provision of quality health care for...

Taking the waters in Banff, Alberta.(Past progressive)
February 12, 2008... In January 1884, William and Tom McCardell were working on the Canadian Pacific Railway on the site of present-day Banff, Alberta. Being observant types, they noticed a wisp of mist rising from the mountainside. Curious, they clambered further...

Deaths.
February 12, 2008... 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. Abraham, John Anthony,...

Supporters of the disabled should demand Latimer's release.(Salon)
February 12, 2008... Why do advocates for the disabled continue to harass Robert Latimer for ending the suffering of his 12-year-old daughter, Tracy? Rather than fighting for Latimer's continued confinement these organizations and individuals should be shouting to...

Getting to the electronic medical record/Passer au dossier medical electronique.(Editorial)
February 26, 2008... By custom, the medical record has been stored as a paper file in the physician's office. The keeper of the record has been the physician--a banality in which lie 2 deeper concepts: one of ownership and one of access. Lately, it has come to be...

Canada's nuclear fallout.(News)(Chalk River nuclear reactor damages the environment )(nuclear medicnes harms health)
February 26, 2008... This may come as a surprise, but the Ontario town of Chalk River was once mentioned in sentences that didn't contain the word "fiasco." Anyone who's glanced at a newspaper in the past 3 months knows those days are over. The ongoing...

Double curses and lost revenues.(For the record)(Canadian Medical Association launched a national "More Doctors, More Care" campaign)
February 26, 2008... Armed a with new study indicating that wait times for 4 medical treatments drained the economy of $14.8 billion in productivity and government coffers of $4.4 billion in 2007, the Canadian Medical Association last month launched a national...

US follows Canadian lead.(For the record)(Canada. Health Canada manages to maintian public health)(Brief article)
February 26, 2008... Rarely has Health Canada been ahead of United States Food and Drug Administration on consumer health advisories. Children's cold medications, though, proved the exception as Canada issued an Oct. 11, 2007, advisory and it took the FDA more than...

Panel urges "signature" project in Afghanistan.(News)
February 26, 2008... Erstwhile hopes that Canada might adopt the troubled Mir-wais Hospital in Khandahar (CMAJ2007;177[8]:837-9) received a small boost from the report of the 5-member, blue-ribbon panel, led by former Liberal cabinet minister John Manley, which had...

Crossing paradigms.(News)(Reprint)(Brief article)
February 26, 2008... It was a journey, says Dr. David Ponka, that revealed the "dissonance" between the privilege of the West and the angst of the developing world. It also managed to generate an array of arresting photos that reveal that dissonance with remarkable...

"Honorary Canadian" heals a broken space station.(News)
February 26, 2008... The old adage "if it ain't broke, don't fix it" has long been a guiding principle for doctors. But it seems it is just as apropos for repair jobs--in space. Astronaut Dr. Scott Parazynski says the medical mantra was foremost in his mind...

Therapeutic help from man's best friend.(News)(conference on using pet therapy)
February 26, 2008... It's tempting to say that organizers are hoping to orchestrate a nationwide, exuberant woof. Or at least give a voice to a growing health care sector known as animal-assisted support services. It's the ambitious goal of a 3-day...

Economist challenges recruiting hyperbole.(News)
February 26, 2008... The concept of "ethical recruitment," or headhunting foreign health professionals only in First World countries that can afford to lose them, has won widespread, international support. Yet criticisms are emerging just as the incipient...

Candidates seven.(News @ a glance)(Brief article)
February 26, 2008... Candidates seven: A record 7 candidates, including 4 ex-presidents and 1 former provincial legislator are in the hunt to become the Saskatchewan Medical Association's next president and automatic nominee as president-elect of the Canadian...

Green light.(News @ a glance)(research licenses)(Brief article)
February 26, 2008... Green light: One-year research licenses have issued to King's College London and Newcastle University by Britain's Human Fertilization and Embryology Authority to create cytoplasmic embryos by merging animal eggs with human cells (CMAJ...

Bluenose overhaul.(News @ a glance)(sustaining health care system)(Brief article)
February 26, 2008... Bluenose overhaul: In the wake of a commissioned study that indicated Nova Scotia's health care system was unsustainable as configured, Premier Rodney MacDonald says his government will implement all 103 recommendations of the report, crafted...

Charges dropped.(News @ a glance)(cases of common nuisance)(Brief article)
February 26, 2008... Charges dropped: Six nuisance charges against the former national medical director of the Canadian Red Cross Society's blood transfusion services stemming from the mid-1980s tainted blood scandal have been withdrawn. The withdrawal follows the...

Suicide assessments.(News @ a glance)(Brief article)
February 26, 2008... Suicide assessments: The US Food and Drug Administration has quietly changed its clinical trial policies to require that drug companies monitor patients in clinical trails for indications of suicidal thoughts or behaviours, the New York ...

Wired world.(News @ a glance)(Brief article)
February 26, 2008... Wired world: North American and European spending on electronic health records will reach nearly US$13 billion by 2012 from a current level of about $4.4 billion, according to the independent market analysis firm Datamonitor. ...

Always accessorize.(Dispatch form the medical front)(bracelets to promote condom use)
February 26, 2008... It is a perpetual struggle, to be sure, to persuade young people to use condoms while engaging in practices that, of course, predecessor generations never contemplated. Safe sex does not always trump the proverbial heat of the moment and...

Diagnosis and treatment of dementia: 1. Risk assessment and primary prevention of Alzheimer disease.
February 26, 2008... Abstract Background: In addition to nonmodifiable genetic risk factors, potentially modifiable factors such as hypertension, hyperlipidemia and environmental exposures have been identified as risk factors for Alzheimer disease. In this...

Human rabies encephalitis following bat exposure: failure of therapeutic coma.(Teaching case report)
February 26, 2008... The case: A healthy 73-year-old man had pain in his left shoulder. He presented to a regional hospital 1 week later with fever, dysphagia, muscle spasms and progressive generalized weakness. His neurologic status deteriorated, which prompted...

Rabies: old disease, new challenges.(Public health)(Disease/Disorder overview)
February 26, 2008... Rabies is a disease entrenched in history, dating back to ancient Egypt. Caused by an RNA virus belonging to the Lyssavirus genus, rabies is capable of infecting all mammals. The World Health Organization marked Sept. 8, 2007, as World...

Rabies in India.(Public health)
February 26, 2008... Rabies is one of the oldest recognized diseases affecting humans and one of the most important zoonotic diseases in India. It has been recognized in India since the Vedic period (1500-500 BC) and is described in the ancient Indian scripture...

Rabies risk among travellers.(CMAJ fact sheet)
February 26, 2008... How do you get rabies? Rabies is a preventable, deadly disease transmitted through contact with an infected warm-blooded animal. Most often people are bitten, but in some cases they may have a non-bite exposure to the saliva of a rabid...

A painful and knotted nasogastric tube.(Interesting images)(Brief article)
February 26, 2008... [ILLUSTRATION OMITTED] Anasogastric tube was inserted in a 35-year-old man before a surgical procedure. After the operation when the tube was being removed, the patient experienced an excruciating pain in his nasopharynx. The tube could...

Multifaceted intervention to improve diagnosis and treatment of osteoporosis in patients with recent wrist fracture: a randomized controlled trial.(Clinical report)
February 26, 2008... Abstract Background: Older patients who experience a fragility fracture are at high risk of future fractures but are rarely tested or treated for osteoporosis. We developed a multifaceted intervention directed at older patients with wrist...

The efficacy and safety of intensive statin therapy: a meta-analysis of randomized trials.(Research)(Clinical report)
February 26, 2008... ABSTRACT Background: Recent lipid guidelines recommend aggressive low-density lipoprotein (LDL) cholesterol lowering in patients with coronary artery disease. To clarify the evidence for this recommendation, we conducted a meta-analysis of...

A comparison of blood pressure measurement over a sleeved arm versus a bare arm.(Research)(Clinical report)
February 26, 2008... ABSTRACT Background: The measurement of blood pressure is a common clinical exam with important health consequences. We sought to determine whether the measurement of blood pressure over a sleeved arm varies from that taken on a bare arm....

Measuring blood pressure: a call to bare arms?(Research)
February 26, 2008... For over 100 years, the dominant method of blood pressure measurement in the clinic was the use of a stethoscope and sphygmomanometer. The "gold standard" mercury-filled sphygmomanometer was so ingrained in medical practice that its unit of...

Should physicians warn patients' relatives of genetic risks?(Commentary)
February 26, 2008... When a patient refuses to disclose genetic risk information to relatives, whether the patient's physician should or may disclose such information without the patient's consent will depend on the seriousness, the imminence and the preventability...

France's health care system.(Letters)
February 26, 2008... Articles about health care in other countries are uncommon in CMAJ, so I was pleased to read the interesting News article about the French system. (1) Alas, Christina Lopes presents misleading conclusions from the World Health Organization's...

Finasteride therapy for benign prostatic hyperplasia.(Letters)(Brief article)
February 26, 2008... In their otherwise informative commentary on therapeutic advances in the treatment of benign prostatic hyperplasia, Michael Jewett and Laurence Klotz conclude that finasteride should be used routinely in men with lower urinary tract symptoms,...

Ideology and the Canadian health care system.(Letters)
February 26, 2008... I disagree with Matthew Stanbrook and colleagues when they discount ideology as a driving force in the Canadian health care system. (1) If one frames the health care debate in terms of equitable access and human rights rather than in terms of...

Noninvasive positive-pressure ventilation.(Letters)
February 26, 2008... In their in-depth review of noninvasive positive-pressure ventilation in acute respiratory failure, (1) Oscar Penuelas and colleagues did not discuss the use of this treatment in patients with infections that are transmitted through aerosols....

Abolishing the law of gravity.(Letters)(Letter to the editor)
February 26, 2008... I read with interest the cost-utility analysis of abolishing the law of gravity by Claude Cyr and Luc Lanthier. (1) Their conclusion that microgravity might be the solution to the health care crisis in Canada is intriguing. As the...

Correction.(Letters)(Correction notice)
February 26, 2008... The phrase "which began to study risk factors for breast cancer among women in 1989" should have been omitted from the abstract of a Research article in the Jan. 29 issue. (1) REFERENCE 1. Ray J, Mohllajee AP, van Dam RM, et al. Breast...

The left atrium.(Two Hemispheres)(Excerpt)
February 26, 2008... Lifework A perfect and faithful record Two Hemispheres Nadine McInnis Brick Books; 2007 93 pp $18 ISBN 978-1-894078-59-7 The following essay and poems are excerpted, with the author's permission, from Two Hemispheres. I first...

Medicos viajeros Boliviaros.(Bolivian travelling doctors)(Medical anthropology)
February 26, 2008... Deep in Andean valleys on the Bolivian side of Lake Titicaca live groups of indigenous healers, the Callahuaya. Herbalists, naturalists and magical healers, they travel by foot throughout Bolivia, Peru, Northern Chile and Argentina, where they...

Deaths.
February 26, 2008... Abraham, John Anthony, Oakville, Ontario; University of London, London, England, 1956. Died Oct. 10, 2007, aged 82. Appleby, Lyon Henry Thomas, Quesnel, British Columbia; Queen's University, Kingston, Ontario, 1950. Died Sept. 27, 2007,...

Medical humanities for what ails us.(Salon)
February 26, 2008... A young internist asks her residents if they would like to read and discuss a poem together instead of pursuing the scheduled talk on renal failure. They choose the poem. An experienced surgeon listens to the Mahler Secondafter a...