CMAJ: Canadian Medical Association Journal articles from January 2008

CMAJ: Canadian Medical Association Journal archives from January 2008

Is it time for another medical curriculum revolution?/Le temps est-il venu d'une autre revolution des programmes d'etudes en medecine?(Editorial)
January 1, 2008... Many physicians would agree that medical school was long and arduous, featuring some courses that ultimately proved of dubious relevance to their current practices. That might not be as true for younger physicians who trained during the time of...

Deaths.(Obituary)
January 1, 2008... Beckstead, James Lewis, Winnipeg; University of Manitoba, 1941, internal medicine. Died Sept. 8, 2007, aged 91. Campbell, Alexander Arthur, Winnipeg; University of Manitoba, 1950, family medicine. Died Sept. 29, 2007, aged 80. "Dr. Campbell...

Bioethics? A grand idea.(Salon)
January 1, 2008... When Mahatma Gandhi was asked about American democracy, he said he thought it a grand idea and hoped, someday, Americans might try it. A devastating critique, gently delivered, it is how I think of bioethics, a good idea we await rather than...

Canvassing the Canadian complaints landscape.(News)
January 1, 2008... The Finnish concept of valituskuoro has taken Europe by storm as people learn the value of hiring "complaints choirs" to publicly sing their frustrations, as opposed to continuing to relentlessly bang their heads against intractable walls of...

Sanitation habits increase global health stresses.(News)
January 1, 2008... The negative effects of pollution and sanitation on health have reached such staggering proportions that only scientists from different disciplines working together will be able to reverse the problem, says an author of the United Nations...

The new architecture of medical education.(News)(Edmonton Clinic)
January 1, 2008... It will be much more than just another glittering multi-million dollar facility in booming Wild Rose Country. In fact, proponents believe the new $900 million state-of-the-art Edmonton Clinic, scheduled to open in 2011, will embody a...

Elderly face longer bed wait times in hospitals.(News)(Brief article)
January 1, 2008... Older and sicker patients may be subject to longer wait times within hospital emergency departments before they are admitted and transferred to an acute care bed, according to a report by the Canadian Institute for Health Information. ...

Promising results for new tuberculosis therapy.(News)
January 1, 2008... Hopes of shorter duration treatment for tuberculosis (TB) are rising in the wake of preliminary findings from a clinical trial indicating that new combination therapy including the antibiotic Moxifloxacin can cut the time needed to cure...

Stop that smoking car!(News)(law against smoking in automobiles with children inside)(Brief article)
January 1, 2008... Anti-smoking activists say a new bar for protecting children from the harmful effects of tobacco was raised in Wolfville, Nova Scotia, when the municipality became the first in Canada to ban adults from smoking in automobiles when anyone under...

Too many sergeants.(News @ a glance)(military health expenditures)(Brief article)
January 1, 2008... It cost an average $8600 per year to provide health care for each of Canada's 63 500 military personnel, nearly double the $4500 per person that is spent to provide health care for other Canadians, according to Auditor-General of Canada Sheila...

TB epidemic.(News @ a glance)(tuberculosis)(Brief article)
January 1, 2008... Overcrowded and substandard housing is fuelling a tuberculosis epidemic among First Nations people, according to a report of the Canadian Tuberculosis Committee to the Public Health Agency of Canada. The incidence of TB among First Nations...

Docs demographics.(News @ a glance)(doctor)(Brief article)
January 1, 2008... There were 62 307 practising physicians in Canada in 2006, a 4.9% increase over the previous 5 years, according to the Canadian Institute for Health Information's latest report on the supply, distribution and migration of physicians. The report...

Less than a teaspoon.(News @ a glance)(sodium intake)(Brief article)
January 1, 2008... A national coalition of 17 health groups, including the Canadian Medical Association, has urged the federal government to adopt graduated targets to reduce the average intake of sodium to 1200-1500 mg by 2020 from a current national average of...

Pharmacare light.(News @ a glance)(drug plans)(Brief article)
January 1, 2008... The first proposed provincial pharmacare program was buried along with New Democrat Premier of Saskatchewan Lorne Calvert's 16-year-old government as the Saskatchewan Party swept to victory in the fall election. Calvert had proposed to...

New year, new advice.(News @ a glance)(federal government advisory board)(Brief article)
January 1, 2008... Federal Industry Minister Jim Prentice has announced that 7 captains of industry, 4 university or college presidents, 3 federal deputy ministers and 3 academic chair holders will join chairman, chemist and former Royal Society of Canada...

Per capita saloon ratios.(News @ a glance)(best research institutions)(Brief article)
January 1, 2008... Dalhousie University tops the list of the 10 best international institutions at which to work within academia, according to The Scientist's 2007 ratings. The University of Alberta also made the list, at fifth. But after 3 years atop the...

Physicians for Global Survival launched the Canadian component of their new International Campaign to Abolish Nuclear Weapons at a reception on Parliament Hill.(News @ a glance)(Brief article)
January 1, 2008... Physicians for Global Survival launched the Canadian component of their new International Campaign to Abolish Nuclear Weapons at a reception on Parliament Hill. Addressing the launch was Mrs. Setsuko Thurlow, Hiroshima survivor and recent...

Athletic protection.(News @ a glance)(medical coverage for professional athletes)(Brief article)
January 1, 2008... Urgent or emergent medical care provided to athletes at major professional sporting events in Canada will qualify for Canadian Medical Protective Association coverage as a result of revisions announced last fall. But coverage will not be...

Elected.(News @ a glance)(Ruth Wilson of the College of Family Physicians of Canada)(Brief article)
January 1, 2008... Queen's University Professor of Family Medicine Dr. Ruth Wilson has been appointed the new President of the College of Family Physicians of Canada. A long-time advocate of primary care reform, Wilson was chair of the Ontario Family Health...

No fixed address.(Dispatch from the Medical Front)(Brief article)
January 1, 2008... We turned the furnace on last week. Still, as I wake up, I feel winter creeping in. I button up my wool coat before settling into the streetcar with my newspaper and coffee. At the Addiction Medicine Clinic, I find myself in a small room...

Onward and upward.(Pulse)(health care spending)
January 1, 2008... Canadian doctors gobbled up a larger chunk of the health care dollar in 2007 as spending on physician services rose 8.5%, according to the Canadian Institute for Health Information. The growth rate outstripped that of the 2 largest...

Cellphone contact dermatitis with nickel allergy.(Teaching Case Report)(Case study)
January 1, 2008... The case: An 18-year-old male presented with pruritic lichenified dermatitis on his lower abdomen and eczematous dermatitis on his extremities, flanks and face that had lasted several weeks. We suspected his belt buckle had led to allergic...

Wegener's granulomatosis.(Clinical Vistas Briefs)(Disease/Disorder overview)
January 1, 2008... [ILLUSTRATIONS OMITTED] This patient had a history of fleeting arthralgia, and he had an elevated erythrocyte sedimentation rate (83 [normal 1-13] mm/hr). A computed tomography scan of the paranasal sinuses (Figure 1) showed patchy...

Giant pyogenic granuloma.(Clinical Vistas Briefs)(Disease/Disorder overview)(Brief article)
January 1, 2008... This rapidly growing lesion was surgically excised, and histopathologic analysis confirmed the diagnosis of a giant pyogenic granuloma. Pyogenic granulomas are benign, exophytic, vascular tumours first described by Poncet and Dor in 1897....

Hospital volume and patient outcomes in pulmonary embolism.(Research)(Report)
January 1, 2008... ABSTRACT Background: In numerous high-risk medical and surgical conditions, a greater volume of patients undergoing treatment in a given setting or facility is associated with better survival. For patients with pulmonary embolism, the...

The effects of problem-based learning during medical school on physician competency: a systematic review.(Research)(Report)
January 1, 2008... ABSTRACT Background: Systematic reviews on the effects of problem-based learning have been limited to knowledge competency either during medical school or postgraduate training. We conducted a systematic review of evidence of the effects...

Systematic evaluation of errors occurring during the preparation of intravenous medication.(Research)(Report)
January 1, 2008... ABSTRACT Introduction: Errors in the concentration of intravenous medications are not uncommon. We evaluated steps in the infusion-preparation process to identify factors associated with preventable medication errors. Methods: We...

Blood conservation strategies to reduce the need for red blood cell transfusion in critically ill patients.(Report)
January 1, 2008... Abstract Anemia commonly affects critically ill patients. The causes are multifactorial and include acute blood loss, blood loss from diagnostic testing and blunted red blood cell production. Blood transfusions are frequently given to...

Should we regionalize the management of pulmonary embolism?(Research)
January 1, 2008... Venous thromboembolism, which manifests as either deep vein thrombosis or pulmonary embolism, is one of the most common cardiovascular disorders in industrialized countries, affecting about 5% of people in their lifetime. (1) Pulmonary...

Problem-based learning makes a difference. But why?(Research)
January 1, 2008... A serious look at how educational innovations are disseminated may give the thoughtful observer cause to question the pervasiveness of the "scientific method." Sometimes it seems that education moves from one fad to the next. In my now longish...

Medication errors: the human factor.(Research)
January 1, 2008... In this issue, Parshuram and colleagues describe a study that included 118 health care professionals who prepared 464 morphine infusions under simulated conditions with direct observation. (1) The morphine concentration in each prepared...

Antiepileptic drugs and warfarin.(Letters)(Letter to the editor)
January 1, 2008... In a recent CMAJ commentary on drug interactions with warfarin, (1) David Juurlink overlooked a very important category of drugs that interact with warfarin: antiepileptic drugs. Phenytoin, carbamazepine and phenobarbital are potent inducers of...

Pharmacist prescribing.(Letters)(Letter to the editor)
January 1, 2008... I was interested in the discussion about pharmacist prescribing at the Canadian Medical Association's most recent annual meeting. (1) Every day, pharmacists help patients deal with drug-related problems, such as drug prescriptions with no clear...

Corticosteroids and erythropoeitin-receptor agonists.(Letters)(Letter to the editor)
January 1, 2008... The excellent meta-analysis by Ryan Zarychanski and associates demonstrated that the use of erythropoietin-receptor agonists in critically ill patients does not improve clinically important outcomes. (1) Interestingly, the potential drug...

Corrections.(Letters)(Correction notice)
January 1, 2008... The News article "New dosage limits for medical marijuana: But where's the science?" (1) contained an error in a cited study (IDrugs 2004;7:464-70). The study authors recommend a dose range of 0.05-7.40 g per day, depending on the level of...

The doctor in this House: lessons from TV's Gregory House, M.D.(Media)(television)
January 1, 2008... Nobody likes Greg House, the title character of Fox's extraordinarily successful television show House, M.D. Played by British actor Hugh Laurie, the Vicodin-popping House insults his colleagues, demeans the medical fellows who work for him,...

The script.(Poem)(Poem)(Brief article)
January 1, 2008... The Script I watch you watch me, As I open the door slowly, Carefully, As if drawing open the curtain On the first act Of this new chapter of your life. Your eyes drift from my face To the bright red...

The drowned woman.(Room for a view)
January 1, 2008... There is a helicopter suspended over the waters of Peters Lake. I see it hanging there in the white sky, a dark insect, hunting. I watch it as I drive along the highway. When I turn off the road into the parking lot, the forest interposes...

Decision-making capacity in an age of control/L'aptitude a decider en une ere de controle.(Editorial)(Editorial)(Report)
January 15, 2008... "... when you grow old, you will stretch out your hands, and someone else will gird you, and bring you where you do not wish to go." John 21:18. Clinicians know that elderly people do not fear death so much as the process of dying. Because...

Camps, cholera and cattle raids.(NEWS)(Report)
January 15, 2008... In amongst crops of corn, Erute Internally Displaced Persons Camp sits nearly empty save for a few women sorting beans on a mat and a young boy dancing barefoot across the red clay to the tinny music of a battery-powered radio. This site...

Delivering health care on US$19 per capita.(News)(Report)
January 15, 2008... Walking through the corridors of Uganda's largest hospital, Mulago, in Kampala, it is clear that standard yardsticks used to measure a country's health care system do not tell the full story. Spending figures and patient wait times do not...

Mapping infectious diseases in Africa.(News)(Report)
January 15, 2008... Mathematical modeling, by predicting the trajectory of infection, can become the next tool experts use to tackle infectious diseases that persist despite decades of effort to contain them, according to Canadian and African researchers attending...

Ethics guidelines for clinical trials to be revised.(News)(Standards)
January 15, 2008... In the wake of ongoing international furor over drug trial horror stories and in hopes of restoring its own fading influence on the global stage, the World Medical Association is proposing to again update its cornerstone statement of ethical...

National wait times database needed.(NEWS)(Report)
January 15, 2008... As any CSI: Crime Scene Investigation enthusiast knows, hard data coupled with brilliant deduction is essential to tracking down the solution to a complex criminal case. Lead investigator Gil Grissom continually exhorts his team to "follow...

Ask and ye shall be included.(News)(new areas included in reducing waiting times list)(Brief article)
January 15, 2008... Chance appears to have played as much a role as need in the designation of 5 new priority areas as primary targets in the national effort to reduce lengthy wait times. The Wait Time Alliance, a coalition of medical specialists operating...

Confusion surrounds MedicAlert services.(News)(Report)(Brief article)
January 15, 2008... Lifetime MedicAlert members who were recently invoiced for annual membership fees will continue to have access to the organization's 24-hour protection and emergency information service even if they don't cough-up the requested monies, the...

No blame--no gain.(News)(insurance plans for vaccine-injured victims)
January 15, 2008... The Supreme Court of Canada has urged its implementation, calling it an "excellent thing" to do. Ontario Superior Court Justice Mary Anne Sanderson went even further, arguing that "the road to public health should not be paved with individual...

Obstructed labours.(Dispatch from the Medical Front)
January 15, 2008... Somalia is a beautiful country at the horn of Africa. Ravaged by war and without a functional government for 15 years, it lacks basic health infrastructure and rates as 1 of the world's worst health performers. As field nurses at the Medecins...

Med school review.(News @ a glance)(Association of Faculties of Medicine of Canada)(Brief article)
January 15, 2008... Med school review: The Association of Faculties of Medicine of Canada has launched a 2-year exercise to review all facets of medical education, including whether laxer entry requirements, shortened training periods and lower tuition fees would...

Rx for change.(News @ a glance)(www.cadth.ca)(electronic database launched by Canadian Agency for Drugs and Technologies in Health and Cochrane Effective Practice and Organisation of Care group)(Brief article)
January 15, 2008... Rx for change: The Canadian Agency for Drugs and Technologies in Health and the Cochrane Effective Practice and Organisation of Care group have launched a publicly accessible electronic database on the relative merits of evidence-based...

Child-size.(News @ a glance)(medicines for children)
January 15, 2008... Child-size: The World Health Organization has unveiled a "make medicines child size" campaign aimed at the development of antibiotics, pain medications and other drugs in dosage forms that are tailored to children's bodies and metabolic needs....

Triple B.(News @ a glance)(report on strategic framework for health research)
January 15, 2008... Triple B: The development of a strategic framework for health research is among 10 "calls to action" identified as national priorities in a report from the Association of Canadian Academic Healthcare Organizations entitled From Bench to Bedside...

Bite-size.(News @ a glance)(starbucks for hand hygiene)(Brief article)
January 15, 2008... Bite-size: It's $10 in Los Angeles and $2 in Toronto. That's Starbucks or Tim Horton's. Taking a lead from a California medical centre that offers doctors $10 Starbucks certificates if they wash their hands, Toronto's University Health Network...

Laurels.(News @ a glance)(Peter Singer awarded the Michael Smith Prize)(Brief article)
January 15, 2008... Laurels: University of Toronto and McLaughlin-Rotman Centre for Global Health senior scientist and bioethicist Peter Singer has been awarded the Michael Smith Prize from the Canadian Institutes of Health Research. The prize, complete with $500...

Hiring spree.(News @ a glance)(new faculty to be hired in universities and colleges)(Brief article)
January 15, 2008... Hiring spree: Canada's 92 universities and university colleges will have to hire as many as 35 600 new faculty by 2016 to address retirements and enrolment growth, which is projected to rise nationally by between 70 000 and 150 000 full-time...

Give a day.(News @ a glance)(donation on World AIDS campaign)(Brief article)
January 15, 2008... Give a day: Upwards of $400 000 "and counting" was donated during the 2007 Give a Day to World AIDS campaign, which challenged doctors, other professionals and all Canadians to contribute income earned on World AIDS Day (Dec. 1) to...

The joys of quality indicators.(Pulse)(hospital mortality indicators)
January 15, 2008... As a general rule of thumb, if you'd like better odds of surviving a visit to a Canadian hospital, hope that you are hospitalized in New Brunswick, Saskatchewan, Alberta or British Columbia. Hope also that it's the Moncton, Calgary...

Youth substance use and abuse: challenges and strategies for identification and intervention.(Public Health)(Disease/Disorder overview)
January 15, 2008... Jeremy is 17 and has lived on the street for 3 years. He visits the emergency department for the fifth time in the past month reporting chest pain: "My heart's jumping out of my chest. Think I'm having a heart attack or something." He further...

Alcohol and drug use among teenagers.(CMAJ fact sheet)(Survey)
January 15, 2008... How common is drug use among teenagers in Canada? According to the Ontario Student Drug Use Survey (1997-2007), the most commonly used substance among teenagers is alcohol: about two-thirds of teenagers reported drinking alcohol in the year...

Fish oil and omega-3 fatty acids.(CMAJ Fact Sheet)
January 15, 2008... What are omega-3 fatty acids? Omega-3 fatty acids are polyunsaturated fatty acids found in certain foods. The term "omega-3" refers to their chemical structure. Omega-3 fatty acids cannot be made in the body and must be obtained from food;...

Cough, fever, joint pain and tender nodules: what is your call?(Clinical Quiz)(Disease/Disorder overview)(Case study)
January 15, 2008... [FIGURE 1 OMITTED] [FIGURE 2 OMITTED] A generally healthy 59-year-old woman presented with a 2- to 3-month history of dry cough and a 1-month history of low-grade fever, arthralgia and pretibial nodules that were red and painful....

A case of skeletal sarcoidosis imitating skeletal metastases on bone scintigraphy.(Clinical vistas)(Disease/Disorder overview)
January 15, 2008... A 70-year-old woman receiving long-term corticosteroid therapy for sarcoidosis presented with hip pain. She underwent whole-body technetium 99m methylene diphosphonate bone scintigraphy to exclude avascular necrosis of the femoral head....

Fish-oil supplementation in patients with implantable cardioverter defibrillators: a meta-analysis.(Research)(Report)
January 15, 2008... ABSTRACT Background: A recent Cochrane meta-analysis did not confirm the benefits of fish and fish oil in the secondary prevention of cardiac death and myocardial infarction. We performed a meta-analysis of randomized controlled trials...

Maternal age and risk of stillbirth: a systematic review.(Research)(Clinical report)
January 15, 2008... ABSTRACT Background: The number of women who delay childbirth to their late 30s and beyond has increased significantly over the past several decades. Studies regarding the relation between older maternal age and the risk of stillbirth have...

Excessive fluid intake as a novel cause of proteinuria.(Research letter)(Report)
January 15, 2008... ABSTRACT As part of a community screening study to assess the long-term health outcomes among residents of Walkerton, Ontario, after contamination of its municipal water supply Escherichia coli O157:H7 and Campylobacter in 2000, we...

The science behind dietary omega-3 fatty acids.(Mechanisms and innovations)(Report)
January 15, 2008... Omega-3 fatty acids are being increasingly promoted as important dietary components for health and disease prevention. (1,2) These fatty acids are naturally enriched in fatty fish like salmon and tuna and in fish-oil supplements. An increasing...

Should patients with cardiovascular disease take fish oil?(Research)(Clinical report)
January 15, 2008... The scientific community and the public have been fascinated by epidemiologic data showing the beneficial effects that a diet rich in fish oils can have on cardiovascular disease. As a result, several clinical trials have been performed that...

Advanced maternal age: are decisions about the timing of child-bearing a failure to understand the risks?(Research)(Clinical report)
January 15, 2008... In the developed world, an increasing proportion of births are attributable to women of advanced maternal age ([greater than or equal to] 35 years). (1,2) Between 1995 and 2003, the mean age of first-time mothers in Canada increased from 28.8...

Awareness during anesthesia.(Anesthesiology)(Clinical report)
January 15, 2008... More than 40 million patients receive anesthesia each year in North America. The risks associated with anesthesia have progressively decreased, but the mechanisms of action of anesthetic drugs remain poorly understood. This lack of knowledge...

Colorectal cancer screening.(Letters)(Letter to the editor)
January 15, 2008... I commend Ryan Zarychanski and colleagues for highlighting the importance of colorectal cancer screening in their recent article. (1) I have a concern about their use of data from the 2003 Canadian Community Health Survey. Respondents to this...

Staining method for kidney biopsy image.(Letters)(Letter to the editor)
January 15, 2008... Ami Schattner and colleagues' description of a case of acute phosphate nephropathy (1) is of great interest and offers important information about the safest choice of bowel-cleansing preparations. I have a question about Figure 1: Was it not...

Interprofessional collaboration.(Letters)(Letter to the editor)
January 15, 2008... In a recent CMAJ news article, Wayne Kondro referred to a patient-centred collaborative care model adopted by delegates to the Canadian Medical Association's 140th General Council. (1) The model's focus on the physician as clinical leader does...

Correction.(Letters)(Correction notice)
January 15, 2008... A News brief in the November 20 issue about the election of Dr. William Fitzgerald as the 40th president of the Royal College of Physicians and Surgeons should have identified Dr. Fitzgerald as president-elect as of September 2007 and president...

The body in the world.(Lifeworks)(Clinical report)
January 15, 2008... Autopsy is a curious practice, at once resolutely anonymous and irrepressibly intimate. The person who was, is no more, his or her personality swiped away by death. And yet, as the physical parts are separated and studied in dissection, a...

Historic operating room a monument to the advent of antisepsis.(Past progressive)
January 15, 2008... Buried deep within the heart of Royal Jubilee Hospital in Victoria, British Columbia, a small, unassuming brick building stands empty and alone. But this century-old operating room marks a milestone in medical history, as the sole surviving...

Deaths.
January 15, 2008... Cote, Paul Emile, Quebec; Universite Laval, 1941, radiation oncology. Died Sept. 23, 2007, aged 92. "Dr. Cote was an Honorary CMA Member." Dumaine, Leon Daniel, Edmonton; Universite de Geneve, Switzerland, 1957, general surgery. Died Sept....

Move over war on transfats; make way for the war on salt.(Salon)(Clinical report)
January 15, 2008... The place of nasty transfats, formerly the most evil food additive on the planet, has been usurped by a spice that just happens to be the mainstay of the modern Canadian diet: salt. Citing statistics claiming up to 15 000 Canadians are dying...

Shoppers drug mart or poachers drug mart?/Pharmaprix ou pharmabraconnage?(Editorial)(poor medical care in South Africa due to lack of pharmacists)(Editorial)
January 29, 2008... Published at www.cmaj.ca on Nov. 26, 2007. Revised on Jan. 4, 2008. Shoppers Drug Mart (Pharmaprix in Quebec) is a familiar Canadian institution. Its 1000 stores dot the landscape; no pharmacy chain is larger. In many Canadian communities,...

Restrictions on health worker migration proving problematic.(News)
January 29, 2008... Everybody's working on it, but it's a complex problem and much more needs to be done. That's the answer you'll get from pretty much anyone you speak to in the international health care community about the issue of health care worker...

Canada increasingly reliant on foreign-trained health professionals.(News)
January 29, 2008... For several years, Canada has been trying to cope with a chronic shortage of health professionals. Like many other developed nations with similar deficits in domestic health workers, poor human resources planning, an underinvestment in...

US considers establishing behind-the-counter drugs.(News)
January 29, 2008... In November, Health Canada received a last-minute invitation to a hearing on whether the United States should approve a new class of drugs for behind-the-counter sales. United States Food and Drug Administration (FDA) spokesperson Chris...

Testing the functionality of new medical devices.(News)
January 29, 2008... It's a scenario likely repeated daily across the country. A hospital needs new pieces of equipment that will cost millions of dollars and have to remain in use for a decade or more. Competing vendors each proclaim their products is not only...

The search for integrity in the cosmetic surgery market.(News)
January 29, 2008... The death of a Toronto woman from complications following liposuction has prompted Ontario to undertake a wholesale review of the regulation of cosmetic and aesthetic surgery, and sparked a national debate over which physicians should be...

Cosmetic surgery becoming the cash cow of medicine.(News)
January 29, 2008... Unregulated cosmetic and aesthetic surgery is a worldwide concern as both the number of doctors entering the lucrative field and the number of patients demanding cosmetic procedures has grown exponentially. At the same time, however, the...