CMAJ: Canadian Medical Association Journal articles from January 2007

CMAJ: Canadian Medical Association Journal archives from January 2007

A new year and new opportunities.(EDITORIAL)
January 2, 2007... My first memorable encounter with CMAJ was reading the 7-part series "How to read clinical journals," which began in 1981. (1) This series, one of the most frequently cited ever in CMAJ, changed medical practice worldwide and played a pivotal...

Une nouvelle annee et de nouvelles possibilites.(EDITORIAL)
January 2, 2007... La lecture de la serie en sept parties intitulee >, lancee en 1981 (1), a constitue mon premier contact memorable avec le JAMC. Cette serie, qui demeure l'une des plus citees du Journal, a change la pratique medicale dans le monde entier et a...

CanWest set to challenge ban on DTCA.(NEWS)(CanWest Global Communications)(direct-to-consumer advertising)(Health Canada)
January 2, 2007... CanWest Global Communication's bid to overturn Ottawa's ban on direct-to-consumer advertising (DTCA) of prescription drugs will face a stiff challenge after a court ruling has allowed a coalition of Canadian health and consumer groups and...

Quebec allows Vioxx class-action suit.(NEWS)(Merck Frosst Canada Ltd.)(Brief article)
January 2, 2007... The Quebec Superior Court has set a worldwide precedent in granting plaintiffs class-action status in a suit against Merck Frosst Canada Ltd., the Canadian manufacturer of rofecoxib (Vioxx). US parent Merck & Co. Inc., announced Sept. 30,...

New Liberal leader champions R & D boost.(NEWS)(Stephane Dion)
January 2, 2007... Scores of federal Liberals seemed to emerge from their leadership convention expressing a measure of incredulity about what they'd just done in selecting former cabinet minister Stephane Dion to their party helm. It took several curious...

Furor over proposed offshore teleradiology.(Canadian Association of Radiologists' Normand Laberge's case)
January 2, 2007... Normand Laberge has courted his fair share of controversy during his 7 years as CEO of the Canadian Association of Radiologists, but even he was surprised at the backlash when he argued in favour of offshore teleradiology as a solution to...

Plans afoot for national network of for-profit urgent care centres.(NEWS)(Mark Godley)
January 2, 2007... Dr. Mark Godley plans to set up private, for-profit urgent care centres across Canada, including, possibly, Ontario Aboriginal reserves. Just days after he and 3 partners opened Canada's first such centre on the bottom floor of their False...

Auditor-General slams regulatory regime.(NEWS)(Shiela Fraser)
January 2, 2007... Health Canada's management of its 3 primary regulatory programs is so haphazard that it is impossible to ascertain whether "it is fully meeting its responsibilities as the regulator of drug products, medical devices and product safety,"...

Ottawa creates clearing house for cancer information.(NEWS)(Canadian Partnership Against Cancer)
January 2, 2007... Cancer treatment inequities across the nation should eventually be mitigated by a new federal plan, funded to the tune of $260 million over 5 years, to disseminate "best practices" information about prevention, detection and treatment,...

Prominent researcher is CMAJ's new editor-in-chief.(NEWS)(Paul Hebert)
January 2, 2007... Enthusiastic. Energetic. Exuberant, but "sometimes impatient," the sort of man who just wants to get things done, immediately, if not as of yesterday. According to fellow researchers and friends, a 200-mph whirlwind has just been unleashed...

News @ a glance.(NEWS)(health care spending)(pharmacists allowed to prescribe in Alberta)(Quebec physicians get hike in salary)(Statistical data)
January 2, 2007... Open vaults: The national health care bill will top $96 billion for the first time in 2006/07, as spending rises 5.7%, or $5.1 billion, over the current year, according to the Canadian Institute for Health Information's annual projections. Per...

International aid doldrums.(PULSE)
January 2, 2007... Oflate, the promises have been plentiful but the hard numbers indicate the gap between Canadian outlays for foreign aid and the 0.7% of GNP target, first urged by ex-Prime Minister and Nobel Laureate Lester Pearson in the late 1960s, remains...

Cancer stem cells: the centrality of translational research to cancer control.(ANALYSIS)
January 2, 2007... Cancer treatment has been based on the implicit assumption that human cancer populations are homogeneous. According to this model, every cell in a tumour has equal tumorigenic potential, the culmination of a Darwinian process that selects for...

The rash of secondary syphilis.(TEACHING CASE REPORT)
January 2, 2007... The Case: A 34-year-old homosexual man was referred to a dermatologist for evaluation of a nonpruritic skin rash. The rash had appeared on his abdomen 3 weeks earlier and, over 1 week, had spread to his entire body. During the first week of the...

Canada's public health system: building support for front-line physicians.(PUBLIC HEALTH)
January 2, 2007... After the holiday revelry dies down and the new year begins, clinics and doctors' offices are typically filled with coughing, sneezing and aching patients. Most may have little more than the common cold: remedied by the age-old prescription of...

Lambert-Eaton myasthenic syndrome.(CLINICAL VISTAS BRIEFS)(Disease/Disorder overview)
January 2, 2007... Repetitive electric stimulation at 50-Hz applied to the ulnar nerve at the wrist normally elicits from the abductor of the fifth finger an evoked response of [greater than or equal to] 5 mV, which may increase no more than 50%. In the case we...

Paraesophageal hernia.(CLINICAL VISTAS BRIEFS)
January 2, 2007... Paraesophageal hernia occurs when a portion of the gastric fundus herniates through the diaphragm along the distal esophagus. Why such hernias form is unclear, but they are likely congenital in origin or secondary to a weakness or defect in the...

Venlafaxine (Effexor): concerns about increased risk of fatal outcomes in overdose.(HEALTH AND DRUG ALERTS)
January 2, 2007... Reason for posting: A change in the prescribing information for venlafaxine has been issued by the US manufacturer, based on concerns that the antidepressant drug has been associated, in cases of overdose, with an increased risk of death...

Reliability of disclosure forms of authors' contributions.(RESEARCH)
January 2, 2007... ABSTRACT Background: The contribution disclosure forms used by medical journals to assess and confirm authorship are surveys of self-reported behaviour that follow the cognitive rules of psychometric instruments. We sought to analyze how...

Protective measures and human antibody response during an avian influenza H7N3 outbreak in poultry in British Columbia, Canada.(RESEARCH)(Clinical report)
January 2, 2007... ABSTRACT Background: In 2004 an outbreak of avian influenza of the H7N3 subtype occurred among poultry in British Columbia, Canada. We report compliance with recommended protective measures and associated human infections during this...

Community-associated MRSA: superbug at our doorstep.(Public Health)(methicillin-resistant Staphylococcus aureus)
January 2, 2007... While the potential for a devastating influenza pandemic has captured the imagination of the medical community and the population at large, another epidemic is currently raging in the United States and has already made inroads in Canada. (1)...

For-profit versus not-for-profit delivery of long-term care.(COMMENTARY)
January 2, 2007... Public funds can be used to pay for health care services that are delivered either by for-profit or not-for profit agencies. A systematic review of patient outcomes in US hospitals by ownership status showed that not-for-profit hospitals tended...

Lead and mercury exposures: interpretation and action.(REVIEW)
January 2, 2007... ABSTRACT Lead and mercury are naturally occurring elements in the earth's crust and are common environmental contaminants. Because people concerned about possible exposures to these elements often seek advice from their physicians,...

Les <<dysnutritions>> dans les pays en developpement.(Letter to the editor)
January 2, 2007... Le commentaire du [D.sup.r] Pulfrey (1) sur la malnutrition grave est particulierement pertinent. Rappelons aussi que si la malnutrition moderee est moins dramatique, elle n'en est pas moins un important facteur de surmortalite infantile dans...

Obesity registers.
January 2, 2007... Given the health risks associated with obesity, especially the increased potential for cardiovascular disease and type 2 diabetes, we should consider obesity to be a chronic disease and should treat it as such. Many Canadian family physicians...

Do you really know how tall you are?(Letter to the editor)
January 2, 2007... Whereas it is customary for patients seen in ambulatory care settings to have their weights measured, heights are usually taken from the patient's recollection. To see if this practice may result in incorrect estimates of body mass index for...

Safe prescribing.(Letter to the editor)
January 2, 2007... Kaveh Shojania proposes several solutions to the pitfalls associated with illegible or hard-to-interpret prescriptions, including 2 suggestions of ways to prevent misinterpretation of written prescriptions. (1) The first and best, according to...

Prescribing powers for pharmacists.(Letter to the editor)
January 2, 2007... At a time when the impact of diagnostic error on patient safety is finally being appreciated, the news that pharmacists in Alberta will be allowed to diagnose medical conditions (1) will generate alarm and some despondency among researchers in...

Preventing adverse drug events.(Letter to the editor)
January 2, 2007... I read with interest Alan Forster's article on preventing adverse drug events after hospital discharge. (1) In the 2 cases he outlines, it is likely that the involvement of a hospital pharmacist would have helped to prevent the adverse outcomes...

Novel technique for critical care training.(Letter to the editor)
January 2, 2007... Capital Health provides care for 2 million Albertans across 9800 [km.sup.2]. Many critically ill patients require transfer to Edmonton. Long distances, climatic factors and resource pressures complicate how we stabilize and transport patients...

Training Canada's future clinician-teachers and researchers.(Letter to the editor)
January 2, 2007... Although Mark Baerlocher's review of data from the 2004 CFPC/CMA/RCPSC National Physician Survey (1) suggests that medical students have a greater desire to engage in teaching or research than physicians currently in practice, it fails to...

Free access to medical information: a moral right?(Letter to the editor)
January 2, 2007... In a recent CMAJ editorial, (1) Bruce Squires echoes a sentiment expressed by Virginia Barbour and colleagues (2) that society has a moral right to medical information. They tell a chilling tale of what they describe as the "deadly"...

Canadian mnemonics for heart sounds.(Letter to the editor)
January 2, 2007... A critical part of the physical examination is auscultation of the heart. Auscultation is fun, but the heart sounds are hard to learn, hard to teach and hard to remember without constant practice. As a teacher, I have struggled to make them...

Registration requirements.(Letter to the editor)
January 2, 2007... Why does each province and territory have different registration requirements? The expectation that a physician has to go through a registration process with each province or territory in which he or she may wish to work is undoubtedly...

Clarification.(Correction notice)
January 2, 2007... In a recent News article (1) concerning the growing number of satellite campuses, Dr. Joanna Bates' title was incorrect. Dr. Bates is the Senior Associate Dean, Education, University of British Columbia Faculty of Medicine. REFERENCE ...

Corrections.(Correction notice)
January 2, 2007... The DOI published with a recent News article (1) was mistakenly listed as 10.1503/cmaj.061349. It should have read 10.1503/cmaj.061351. REFERENCE 1. Silversides A. Complex and unique HIV/AIDS epidemic among Aboriginal Canadians. CMAJ...

Toward an understanding of global health inequality.(Awakening Hippocrates: A Primer on Health, Poverty, and Global Service)(Book review)
January 2, 2007... Awakening Hippocrates: a primer on health, poverty, and global service Edward O'Neil, Jr. American Medical Association; 2006 507 pp US$34.95 ISBN: 1-57947-772-0 As a preceptor to medical students and residents, I am often...

The mother.(Poem)
January 2, 2007... She huddles by the roadside Scared of the sleek, passing limousines Her clothes have seen better days The child on her hips, clothed in rags The child howls, her brow clouded with sweat The mother tries to comfort, offers a chunk...

Medically speaking.(Room for a view)
January 2, 2007... "It is generally assumed that doctors take a professional view of suffering and that the process of professional insulation begins in their second year as medical students when they first start dissecting the human body.... Later, other factors...

One thousand words.(THE LEFT ATRIUM)
January 2, 2007... This photograph is one of the winning entries in a contest held during the 2006 International Women and Children's Health Conference, which took place at McMaster University, Hamilton, Ont. Students in Health Sciences programs submitted...

Deaths.
January 2, 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. Bonnell, Mark Lorne, Murray...

Query.(managing self-development)(Viewpoint essay)
January 2, 2007... In my 30-plus years, I've never made a New Year's resolution. But I've watched other people make them. The three perennial resolutions also happen to be the ones most often consigned to the dustbin: dieting, exercising and losing weight....

Let's put the mouth back in the body.(GUEST EDITORIAL)(Editorial)
January 16, 2007... Oral care is a significant economic activity in Canada, accounting for 7% of all health care expenditures. The cost of care provided by dentists and other members of oral health teams amounted to about $9.7 billion in 2005. (1) This should not...

Redonnons leur importance aux soins bucco-dentaires.(EDITORIAL INVITE)
January 16, 2007... Les soins bucco-dentaires constituent une activite economique importante au Canada et representent 7 % du total des depenses consacrees aux soins de sante. Le cout des soins dispenses par les dentistes et autres membres des equipes de sante...

Thinking of med school? Where do you live?(NEWS)(medical school enrolment statistics)
January 16, 2007... Call it the luck of the Canadian geographical draw. The odds against becoming a physician, and the cost of doing so, are significantly higher in some parts of Canada than others, according to Association of Faculties of Medicine of Canada's...

Macrolides resistance rising.(NEWS)
January 16, 2007... The class of antibiotics recommended as first-line therapy in the Canadian Guidelines for the Initial Management of Community Acquired Pneumonia (CAP) has been linked to treatment failures due to resistance, a new study shows. Dr. Donald...

New mental health services for deaf patients.(NEWS)(Health Services for the Deaf)
January 16, 2007... Anew service promises to break down some of the barriers to mental health care faced by people with hearing losses. At Canada's first tertiary care Mental Health Services for the Deaf (MHSD) at Regional Mental Health Care (RMHC) in London,...

Decline in breast cancer since HRT study.(NEWS)(hormone replacement therapy)
January 16, 2007... Although the causal link hasn't been conclusively established, US researchers say there's been a remarkable decline in breast cancer rates since fewer women began taking hormone replacement therapy (HRT) to alleviate the symptoms of menopause....

Wasting emergency aid in Africa.(NEWS)(CARE International)
January 16, 2007... Aid organization CARE International says with 120 million Africans living "on the edge of emergency" due to hunger, donor agencies need to review their response to these emergencies, or billions of dollars of aid monies will continue being...

News @ a glance.(drug-eluting stents,University of Manitoba, Dr. Gabrielle Horne sues Capital Health)
January 16, 2007... Stent update: Patients with drug-eluting stents (DES) may lower their risks of MI or death by taking clopidogrel, an anti-platelet medication, longer than the currently recommended 3-6 months (JAMA 2006:297; early release Dec. 5, 2006). Among...

The medical view from 34 000 feet.(PULSE)(health care reform)
January 16, 2007... In the eyes of Canadian physicians, the health care system needs a few reforms, but is essentially functional. Only 3% believe it should be scrapped or completely overhauled. By contrast, 42% of German physicians and 16% of US physicians...

Those "in the know" should lay the parameters for human resource planning.(ANALYSIS)
January 16, 2007... Whether we consider the highly centralized National Health Service in the UK, the largely market-driven nonsystem of health care in the United States, or the predominantly publicly funded "universal coverage" model in Canada, a single theme...

A woman with recurrent cardiac ischemia without coronary artery disease.(TEACHING CASE REPORT)
January 16, 2007... The Case: A 62-year-old woman had been admitted to hospital in July 1992 with flu-like symptoms and malaise. At that time, she had a 5-year history of hypertension and newly diagnosed diabetes mellitus. She denied having chest pain and had no...

A woman with orbital myositis.(CLINICAL VISTAS)
January 16, 2007... A31-year-old woman presented with a 1-day history of a severe left-sided headache and left-eye pain of acuteonset. There was no history of trauma, and she was afebrile. The patient's symptoms were aggravated by movement of the eyes. She also...

Canadian Guidelines on Sexually Transmitted Infections, 2006.(PUBLIC HEALTH)(Canadian Public Health Association)
January 16, 2007... The 2006 edition of the Canadian Guidelines on Sexually Transmitted Infections (STIs) is available online (at www.phac-aspc.gc.ca/std-mts/sti_2006/sti_intro2006_e.html) and in hard copy from the Canadian Public Health Association. For this...

Auricular acupuncture for pain relief after ambulatory knee surgery: a randomized trial.
January 16, 2007... ABSTRACT Background: Auricular acupuncture is a promising method for postoperative pain relief. However, there is no evidence for its use after ambulatory surgery. Our aim was to test whether auricular acupuncture is better than invasive...

Effect of hospital ownership status and payment structure on the adoption and use of drug-eluting stents for percutaneous coronary interventions.(RESEARCH)
January 16, 2007... ABSTRACT Background: The impact of the use of drug-eluting stents in percutaneous coronary intervention (PCI) on cardiac care is still uncertain. We examined the influence of systemic factors, such as hospital ownership status,...

Auricular acupuncture for analgesia after arthroscopy.(COMMENTARY)
January 16, 2007... Acupuncture is entering the legislative mainstream of Canadian health care. The province of Ontario is about to legislate acupuncture as a therapeutic act under the jurisdiction of the Colleges responsible for the practitioner administering...

Drug-eluting coronary stents: faith and hope, but no charity.(COMMENTARY)
January 16, 2007... Judging from the large number of publications on the cost-effectiveness of drug-eluting coronary stents, there is an emerging international consensus that the price tag for the 2 commercially available drug-eluting stents is excessive...

The cost-effectiveness of drug-eluting stents: a systematic review.(REVIEW)
January 16, 2007... ABSTRACT Background: Drug-eluting stents have been seen as an attractive alternative to bare-metal stents for percutaneous coronary interventions (PCIs) because of the decreased need for revascularization. However, comparative clinical...

Accessible health care.(Letter to the editor)
January 16, 2007... I commend Meridith Marks and Robert Teasell for drawing attention to the problems faced by Canadians with disabilities in accessing the health care system. (1) However, I believe the most fundamental threat to the well-being of these patients...

Local thoughts on global actions.(Letter to the editor)
January 16, 2007... Unfortunately, William Cameron is correct to claim that the next milestone to be attained in HIV management is unlikely to be the delivery of medical care to the poorest people. (1) I recently saw 2 patients in Ottawa who had been exposed to...

Diabetes care in developing countries.
January 16, 2007... In a recent Analysis piece in CMAJ, (1) Venkat Narayan and colleagues noted that accurate data on the costs of treating diabetes are not available for most developing countries but that extrapolation from information gathered in developed...

Caring for young adults with diabetes.(Letter to the editor)
January 16, 2007... The recent CMAJ lead editorial on the challenges of caring for young adults with chronic diseases in the adult health care system is timely. (1) Young adults aged 20-29 years with type 1 diabetes are 4 times more likely to die than their peers...

Quality of care evaluation in France.(Letter to the editor)
January 16, 2007... Monitoring and enhancing physician performance is a major challenge. Several countries have developed programs for maintenance of certification, which may include written tests of medical knowledge, tests of clinical skills, and ratings by...

Correction.(Correction notice)
January 16, 2007... A News item concerning Health Canada's approval of the cervical cancer vaccine incorrectly stated the price of the vaccine. (1) Gardasil costs $134.95 for each of the 3 required doses. The total cost is thus $404.85 per client. CMAJ apologizes...

Profiling psychiatric research in Canada.(Psyche in the Lab: Celebrating Brain Science in Canada)(Book review)
January 16, 2007... Psyche in the lab: celebrating brain science in Canada Mary V. Seeman, Neil Seeman Hogrefe & Huber; 2006 258 pp $37-45 ISBN 0-88937-304-3 Everywhere you look in medicine these days, there are stories. Proponents of narrative medicine...

Doctors know.(Poem)
January 16, 2007... some days are good some days are bad I have come to know the bad days remembrances hung dry on the crying eyes daddy's dead memories of the little girl lost in the big strong arms of her hero her Atlas who held...

I see faces.(Room for a view)(Personal account)
January 16, 2007... It has been 30 years since I graduated from medical school, and I have noticed that familiar faces are reappearing. I see the face of the first patient that was assigned to me as a medical student. She was a 70-year-old Scottish grandmother who...

One thousand words.(THE LEFT ATRIUM)(Brief article)
January 16, 2007... Ice Sculpture. Canadian photographer Michael Moon, diagnosed with autism, feels that his autism enhances his sensory experiences. He notes that his photographs show society there are "other ways of being in and seeing the world" and that his...

Deaths.
January 16, 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. Bedard, Yvan Claude, Etobicoke,...

Query.(a medical teacher's views on the current state of medical education)(Personal account)
January 16, 2007... Am I old? I think so. I have a medical student following me around. The good part of this process is that students are keen, much keener than I remember myself being. After every patient they research the case, looking up the diagnosis on...

Our moral obligations in caring for patients with orphan cancers.
January 30, 2007... Consider a 6-year-old boy with metastatic neuroblastoma seeking experimental phase I chemotherapy, a 23-year-old woman with undifferentiated sarcoma that took 6 months of multiple physician visits to diagnose, or a 45-year-old man with breast...

Les cancers orphelins et nos obligations morales.
January 30, 2007... Prenons un garcon de 6 ans atteint d'un neuroblastome avec metastases et qui a besoin d'une chimiotherapie experimentale de phase I, une femme de 23 ans chez qui il a fallu 6 mois pour diagnostiquer un sarcome non differencie a la suite de...

Prison tattoo program wasn't given enough time.
January 30, 2007... A federal pilot project aimed at controlling the spread of infectious diseases within prisons by offering inmates sanitary tattooing wasn't given enough time to demonstrate its worth, Chief Public Health Officer of Canada Dr. David Butler-Jones...

Conservative government scuttles needle exchange.
January 30, 2007... Rejecting the findings of a Public Health Agency of Canada (PHAC) review that indicated needle-exchange programs for injection drug users in prisons reduce the need for health care interventions, the Conservative government says sterile...

NS South Shore Health authority slashes incidence of MRSA.(methicillin-resistant staphylococcus aureus )
January 30, 2007... South Shore Health, one of Nova Scotia's 9 district health authorities, has slashed its incidence of methicillin-resistant Staphylococcus aureus (MRSA) by more than half. That success was due directly to taking a firm hand--and promoting a...

Gender-specific knees.(knee prostheses to be approved for use in Canada)
January 30, 2007... The first artificial knee designed specifically for women is expected to be approved for use in Canada early in 2007. Zimmer's Gender Solutions knee, approved by the US Food and Drug Administration in May 2006, is the first knee prosthesis...

Geriatrics: the "sexy" specialty.
January 30, 2007... There are fewer than 200 geriatricians in Canada, but the estimated need is over 600, a number that is expected to skyrocket as the number of people over age 65 doubles in the next 25 years. Elderly baby boomers "will just expect" complex...

Manitoba physicians consider DNR guidelines.(College of Physicians and Surgeons of Manitoba)
January 30, 2007... The College of Physicians and Surgeons of Manitoba is circulating draft guidelines for withdrawing medical treatment in cases where doctors and families clash over whether to continue life support. The guidelines, believed to be the first...

Polio eradication setback in India.
January 30, 2007... Despite a nearly 10-fold surge in the incidence of polio in India over the past 2 years, researchers are optimistic it can be eliminated in that country by 2008. In 2006, India had 597 reported polio cases (as of Dec. 18), up from 66 the...

Global Fund pulls grants from mismanaging countries.
January 30, 2007... Due to the mismanagement and theft of earlier grants, the Global Fund to Fight Malaria, Tuberculosis and HIV/AIDS (GF) has rejected grant applications from a number of African countries, including some that are among the worst hit by HIV/AIDS....

News @ a glance.(hepatitis C settlement)(research on type 1 diabetes)(American Medical Writers Association awards fellowship to Peggy Robinson )
January 30, 2007... Hep-C settlement: The roughly 5000 so-called forgotten victims of Canada's tainted blood scandal, who were infected with hepatitis C from the blood system before Jan. 1, 1986, or after July 1, 1990, are poised to receive $962 million in...

The wide gap between genetic research and clinical needs.
January 30, 2007... Canada has invested heavily in genetic research, reaping notable payoffs in important scientific discoveries that, in turn, are increasing demand for patient services. But resources to address this growing need are not being similarly invested,...