CMAJ: Canadian Medical Association Journal articles from February 2009

CMAJ: Canadian Medical Association Journal archives from February 2009

Get excess salt out of our diet.(EDITORIAL)
February 3, 2009... Once a commodity of exchange, salt is now a commodity of disease and death. We underestimate how much excess salt we eat and how much harm it can do. The greatest harm comes from high blood pressure and its consequences. Of the estimated 1...

Eliminer l'exces de sel de notre alimentation.(EDITORIAL)(eliminating salt in dies)(Editorial)
February 3, 2009... Le sel, jadis utilise comme monnaie d'echange, est desormais devenu une cause importante de maladies et de deces. Nous sommes portes a sous-estimer notre consommation de sel et les dommages qu'entraine une consommation excessive de ce mineral...

Multidrug-resistant Neisseria gonorrhoeae.(COMMENTARY)(Report)
February 3, 2009... Key points * Resistance of Neisseria gonorrhoeae to antibiotics, including quinolones, has increased rapidly in recent years and has reduced the options for treatment. * Studies have shown the wide and global spread of gonorrhea...

Proper studies of selective serotonin reuptake inhibitors are needed for youth with depression.(COMMENTARY)
February 3, 2009... Key points * The conclusion by Barbui and colleagues that SSRIs are protective against suicidality among young adults challenges the justification of a "black box" warning about the risk of suicide with the use of SSRIs. * Their...

Transparency in the delivery of lawful abortion services.(COMMENTARY)
February 3, 2009... Key points * Laws limiting access to abortion services do not reduce the number of abortions, only their safety. * Governments of countries are obligated to collect official statistics on the number of abortions and their health...

Rapidly rising clinical trial costs worry researchers.(News)
February 3, 2009... [ILLUSTRATION OMITTED] This is part of a series of articles on clinical trials that will run in the CMAJ News section throughout 2009. The cost of conducting a clinical trial for a drug is rising like mercury on a summer afternoon, a...

Drug development cost estimates hard to swallow.(News)
February 3, 2009... In the March 2003 edition of the Journal of Health Economics, a trio of economists from the United States wrote about a number. Soon after, that number began popping up all over the place--in newspapers and political speeches, on television and...

Public health insurance in Uganda still only a dream.(News)
February 3, 2009... Three months ago, Uganda planned to launch a compulsory public health insurance scheme, the first in the country. It didn't happen. The plan was to initially cover about 2 million employed Ugandans (6% of the population), including 300 000...

Legal consensus eludes Europe.(News)
February 3, 2009... A recent ruling by Britain's High Court on assisted suicide and a television documentary showing a man taking his own life has reopened debate on the subject in the United Kingdom and other European countries. In October 2008, Debbie...

Direct v. indirect euthanasia.(News)(Brief article)
February 3, 2009... Direct active euthanasia involves specific actions to cause a patient's death, such as administering an overdose of drugs. This practice is illegal in most countries, including Switzerland. Indirect active euthanasia involves giving the patient...

Serving up progress.(For the record)(food quality and safety standards)(Report)(Brief article)
February 3, 2009... The United States is making significant progress in its goal to better protect its food supply, according to a report from the US Food and Drug Administration (www.fda .gov/oc/initiatives/advance/food/progress report1108.html). The report,...

Healthy competition.(For the record)(public drug plans)(Report)(Brief article)
February 3, 2009... Public drug plans, businesses and individuals could enjoy annual savings of up to $800 million if there were more competition in the generic drug market, according to a federal Competition Bureau report. The bulk of potential savings--up to...

Slight decrease in HIV and AIDS rates.(For the record)(Report)(Brief article)
February 3, 2009... The number of new positive HIV test reports dropped 5% in 2007 compared to 2006, according to the Public Health Agency of Canada's year-end booklet, HIV and AIDS in Canada. The exact cause of the 5% decrease is not clear, stated agency...

Trends in the profile of the Canadian physician pool.(News)
February 3, 2009... The national physician pool is a bit older but fractionally larger than it was 5 years ago. It's also more likely that Canadians will be treated by a female physician, by someone who was educated outside of Canada or someone who has returned...

Inside Zimbabwe's cholera epidemic.(Dispatch from the medical front)
February 3, 2009... I am feeling a little uncomfortable," says the middle-aged man lying in the dirt behind the main hospital in Beitbridge, Zimbabwe. His name is Henry. He is so dehydrated his cheeks look collapsed and his eyes protrude from his closely...

Measles mortality falling.(Briefly)(Report)(Brief article)
February 3, 2009... Measles mortality falling: In 2007, 197 000 people died from measles, down from 750 000 in 2000. The Measles Initiative (www.measles initiative.org), an organization that provides support for vaccination campaigns and disease surveillance,...

Green group.(Briefly)(medical students form a green group)(Brief article)
February 3, 2009... Green group: Medical Students for Environmental Health has been founded by University of Alberta medical student Sean Welling to combat the "gross deficiency in education and student advocacy groups regarding the medical impacts of the...

Hold the cold meds.(Briefly)(Brief article)
February 3, 2009... Hold the cold meds: Children under 6 years old should not be given cough and cold medications, according to a Health Canada decision on labelling on Dec. 18, 2008. The statement warns of potential severe side effects, based on numerous severe...

Prevalence of and risk factors for quinolone-resistant Neisseria gonorrhoeae infection in Ontario.(Research)(Disease/Disorder overview)
February 3, 2009... After declining for a number of years, Neisseria gonorrhoeae infections are once more on the rise in Canada. Between 1997 and 2007, reported incidence of the disease more than doubled, from 15 to 35 cases per 100 000. (1) To address the...

Selective serotonin reuptake inhibitors and risk of suicide: a systematic review of observational studies.(Research)(Clinical report)
February 3, 2009... There is uncertainty about the safety of selective serotonin reuptake inhibitors (SSRIs), which may cause worsening of suicidal thoughts in vulnerable people. (1,2) In 2005, a systematic review of published randomized controlled trials...

Clandestine induced abortion: prevalence, incidence and risk factors among women in a Latin American country.(Research)(Report)
February 3, 2009... In most developing countries, induced abortion is legal only if the pregnancy threatens the health or life of the mother. Many women, therefore, seek clandestine abortions, which are too often unsafe and place the woman at risk of complications...

Neurobiological mechanisms in major depressive disorder.(Disease/Disorder overview)
February 3, 2009... Key points * Major depressive disorder is caused by the cumulative impact of genetics, adverse events in childhood and ongoing or recent stress. * Gene--environment interactions seem to predict a person's risk for major depressive...

Cuba's system of maternal health and early childhood development: lessons for Canada.(Global health)(Report)
February 3, 2009... Key points * The Canadian Senate Subcommittee on Population Health is evaluating Cuba's models of community-based care. * The infant mortality rate in Cuba rivals the rate in Canada at lower costs. * Cuba's success appears to be...

Abdominal aortic pseudocoarctation.(Teaching cases)(Case study)
February 3, 2009... [FIGURE 1 OMITTED] The case: A 68-year-old woman with Waardenburg syndrome presented in 2005 with pain in her chest and back. computed tomography scan of the thoraco-abdominal cavity showed an unusual aortic configuration. Her abdominal...

Pneumococcal vaccination and myocardial infarction.(LETTERS)(Report)
February 3, 2009... Francois Lamontagne and colleagues recently reported an association between receipt of pneumococcal vaccination and a lower risk of myocardial infarction with an adjusted odds ratio of 0.53. (1) Paradoxically, they reported greater protection...

Sculpting life.(Bernini and the Birth of Baroque Portrait Sculpture)(Book review)
February 3, 2009... Bernini and the Birth of Baroque Portrait Sculpture Curators: Catherine Hess, Andrea Bacchi, Jennifer Montagu Organized by the J. Paul Getty Museum in association with the National Gallery of Canada The National...

In pursuit of equity.(Health Inequality: Morality and Measurement)(Book review)
February 3, 2009... Health Inequality: Morality and Measurement Yukiko Asada University of Toronto Press; 2007 294 pp $55.00 Many of us working in health care are concerned about health equity. However, we often lack a clear understanding of...

Four seasons in one day.(Creative works)(Diary entry)
February 3, 2009... Today I am a hero. Today I am a coward. Today I drive for the first time to a small community, one suffering from such a dearth of doctors that patients apologize when presenting for care. Doc, I'm sorry for bothering you on such...

Superior vena cava syndrome.(Clinical images)(Case study)
February 3, 2009... [ILLUSTRATIONS OMITTED] A 72-year-old man who was overweight and had a history of hypertension and heavy smoking presented with a swollen neck. He had no dysphagia. He reported that he had experienced increased snoring and daytime...

Chief thieves.(Salon)
February 3, 2009... Don't you trust me? I'm the chief thief," says the man who had been sought out by my Canadian friend in Ghana West Africa. She had lost the stereo, computer and printer from her home office. Each town has a chief thief. "Retired" from the...

"Lose 40 pounds in 4 weeks": regulating commercial weight-loss programs/<<Perdre 20 kilos en 4 semaines>> : la reglementation des programmes commerciaux d'amaigrissement s'impose.(Editorial)
February 17, 2009... The $50 billion North American weight-loss industry comprises a morass of fantastical claims of products and programs promising quick, easy, long-lasting results. (1) Given this wealth of magical weight-loss aids, why is obesity still a...

Insulin analogues: too much noise about small benefits.(Commentary)(Report)
February 17, 2009... The development of insulins has long been central to improvements in the management of diabetes mellitus. The first insulin preparations varied significantly in potency. Also, contamination of insulin solutions was common. Thus, considerable...

Embracing ecology to limit antimicrobial resistance.(Commentary)(Report)
February 17, 2009... Headlines declaring "the end of the antimicrobial era" and "superbugs kill patients" are becoming commonplace. Such headlines engender anxiety, anguish and questions among the public. Is there a crisis? Does "something need to be done"? What...

Clinical trials: chasing recruits.(News)
February 17, 2009... "Are you a healthy, nonsmoking MALE OR FEMALE 18-55 YEARS OF AGE. free of daily medications? If so, you may be eligible for our upcoming clinical research studies.... Compensation may range from $1000 to $1500 depending on the length of the...

Ethics guidelines strengthened but reach remains limited.(News)
February 17, 2009... Canada's granting councils have issued an updated draft of ethics guidelines governing human research, including expanded sections about aboriginal and qualitative research, as well as bolstered chapters concerning genetic and human-tissue...

Failing grade for public-private partnership hospitals.(News)
February 17, 2009... Ontario could have saved hundreds of millions of dollars if the Brampton Civic Hospital had been built and operated publicly rather than under a public-private partnership (P3), Ontario Auditor General Jim McCarter says. The government...

Antismoking drug still recommended to Canadians despite side effects and US advisory.(News)
February 17, 2009... Aspate of complaints about the smoking-cessation drug varenicline (Champix) prompted bans on its use by pilots and commercial drivers in the United States last year, but reports of adverse reactions have not resulted in such dramatic...

Apologies abound: advances in adverse-event disclosure.(News)
February 17, 2009... Canadian physicians seeking to improve communication with patients who have been harmed are getting plenty of assistance. Ontario late last year became the fourth province to unveil apology legislation, while the Canadian Patient Safety...

US biovigilance network to track donor-derived infections.(News)
February 17, 2009... The United States has begun rolling out a "national biovigilance network" to track donorderived infections transmitted during organ transplants and blood transfusions. The web-based network will collect data on deaths and complications...

Salt down under.(For the record)(Brief article)
February 17, 2009... In Canada, broadcasters would declare it a national crisis. Such is the apoplectic state that has ensued in Australia after a national preventative health task force floated the proposition that Vegemite--a paste comprised of brewer's yeast,...

Drug network.(Briefly)(Brief article)
February 17, 2009... Drug network: Federal Health Minister Leona Aglukkaq says the government will pump $31 million over 4 years into ongoing development of a national Drug Safety and Effectiveness Network that aims to link researchers into a new virtual network...

Isotope production.(Briefly)(Brief article)
February 17, 2009... Isotope production: The United States National Academy of Sciences says it is feasible to eliminate the use of highly enriched uranium in medical isotope production and shift to production methods that use low enriched uranium. But the move...

Lung transplants.(Briefly)(Brief article)
February 17, 2009... Lung transplants: The rate of lung transplants in Canada rose more than 3 times faster than that of solid organ transplants over a 10-year period ending in 2006, according to a report by the Canadian Institute of Health Information...

Fit notes.(Briefly)(Brief article)
February 17, 2009... Fit notes: The Department for Work and Pensions has announced that paper-based "sick notes" will be replaced in the United Kingdom in 2010 with electronic "fit notes" in a bid to keep people with disabilities or long-term medical conditions...

Acquittal.(Briefly)(Brief article)
February 17, 2009... Acquittal: The first person to face a jury trial in Quebec on charges of assisting suicide has been acquitted. Stephan Dufour, 30, was found not guilty of aiding or abetting his disabled uncle, Chantal Maltais, who had polio, to commit suicide....

Mednik.(Briefly)(Brief article)
February 17, 2009... MEDNIK: Scientists have discovered a rare disease characterized by mental retardation, enteropathy, deafness, peripheral neuropathy, ichthyosis and keratodermia that afflicts 4 French Canadian families in the eastern Quebec region of...

Judicial prejudgment.(Briefly)(Brief article)
February 17, 2009... Judicial prejudgment: A Barrie, Ontario, judge who demanded that an HIV-positive witness don a mask before testifying because "the HIV virus will live in a dried state for year after year after year and only needs moisture to reactivate...

Drifting sand, hiking tours and nice tans.(Dispatch from the medical front)
February 17, 2009... On a rainy September afternoon in Vancouver, under the cold fluorescent lights of a lecture theatre, a summer trip to Honduras was an easy commitment to make. We'd just been given a slide show about building a partnership between our...

Efficacy and safety of insulin analogues for the management of diabetes mellitus: a meta-analysis.(Research)(Report)
February 17, 2009... Diabetes mellitus is associated with serious long-term complications and premature death. (1) Data from the Health Canada National Diabetes Surveillance System indicate that, in 2004/05, diabetes was diagnosed in about 5.5% (1.8 million) of...

Cost-effectiveness of insulin analogues for diabetes mellitus.(Research)
February 17, 2009... Insulin agents available for the treatment of diabetes mellitus include conventional insulins and insulin analogues. Insulin analogues were developed to mimic more closely the separate bolus and basal components of insulin secretion. (1)...

Antimicrobial resistance in hospitals: how concerned should we be?
February 17, 2009... The emergence of antibiotic-resistant organisms is a major public health concern, particularly in hospitals and other health care settings. (1,2) Antibiotic-resistant organisms appear to be biologically fit and are capable of causing serious,...

Antibiotic use and population ecology: how you can reduce your "resistance footprint".(Analysis)(Case study)
February 17, 2009... An 8-year-old child presents with a 4-day history of a nonproductive cough and a temperature of 38[degrees]C. Her chest is clear, except for some wheezing. She has no tachypnea or tachycardia. The child's father is deeply concerned. What would...

Canadian cancer statistics at a glance: cancer in children.
February 17, 2009... Every year in Canada, cancer is diagnosed in about 850 children (143 per million in 2004) between birth and 14 years of age. (1) The incidence is generally highest during the first 5 years of life and decreases with age. The incidence rates of...

Headache and seizure on postpartum day 5: late postpartum eclampsia.(Cases)(Case study)
February 17, 2009... The case: A previously healthy 37-year-old woman (gravida 3, para 1 with 2 first-trimester miscarriages) had an unremarkable pregnancy until the 35th week. Her blood pressure readings during pregnancy were between 100/70 mm Hg and 110/80 mm Hg....

Privatization of health care.(Letters)
February 17, 2009... Marcia Angell has made a very timely and important statement on the privatization of health care. (1) There are only 2 objections that need to be addressed before they are raised by the proponents of private health care. First, there is a...

Spirometry in primary care practices.(Letters)
February 17, 2009... Matthew Stanbrook and Alan Kaplan recently discussed the merits and challenges of using office spirometry in primary care practices. (1) Their theme was driven to a large extent by a CMAJ research paper by Aaron and colleagues, (2) which...

Anatomists' work song.(Creative works)(Poem)
February 17, 2009... Anatomists' work song If not in death where would we live? Wrap the night slowly draw the borders tighter round our cadaverous caverns. Woe to the scholar with insufficient vanity. and so to work ...

From plunger to Punkt-roller: a century of weight-loss quackery.(Essay)
February 17, 2009... "People trust the quack with their lives who would not trust him with the loan of a sixpence. They seem to believe advertised testimonials as if they were guaranteed by a prominent physician, forgetting that many obscure prints can be got to...

Evolutionary jerry-rigging.(Your Inner Fish: A Journey into the 3.5-Billion-Year History of the Human Body)(Book review)
February 17, 2009... Your Inner Fish: A Journey into the 3.5-Billion-Year History of the Human Body Neil Shubin Pantheon Books; 2008. 218 pp $28.00 [ILLUSTRATION OMITTED] For Neil Shubin, the human body is anything but perfect. In Your Inner...

Gum hypertrophy.(Clinical images)(Case study)(Brief article)
February 17, 2009... [FIGURE 1 OMITTED] [FIGURE 2 OMITTED] A 38-year-old man presented with fatigue, dyspnea on exertion and minor bleeding of the gums. Physical examination revealed gum hypertrophy and an extensive petechial rash (Figure 1). His...

Shades of grey: patient versus client.(Salon)(Viewpoint essay)
February 17, 2009... I came here for the cut on the head and see no reason to do what you say. You are here to serve me. My taxes pay your salary." This angry outburst came from a parent when one of our emergency nurses asked her to remove her baby's clothes so she...