CMAJ: Canadian Medical Association Journal articles from June 2005

CMAJ: Canadian Medical Association Journal archives from June 2005

Patient n plus 1.(Editorial)(Editorial)
June 7, 2005... The nth patient is the last patient to enter a randomized controlled trial, having satisfied the restrictive entry criteria--a prescribed age range (rarely old or young), sex (often male), lacking specified comorbidities, taking few or no other...

Integrating medical and engineering undergraduate training.(Letters/Correspondance)
June 7, 2005... Academic programs that allow students to study core material from multiple subject areas in an integrated fashion have existed at North American medical schools for many decades and have included MD/PhD, MD/MBA and MD/MPH options. Interest in...

Global IDEA.(Letters/Correspondance)
June 7, 2005... Recent CMAJ commentaries (1,2) have promoted the view that improved medical technologies are the most promising means of improving population health in developing countries. Although we support an increase in research into global health issues,...

The study of NOELs.(Letters/Correspondance)
June 7, 2005... As a member of the Biological Lecturers of Western Ontario (BLOW), I must respond to the study by Kenneth Rockwood and colleagues. (1) I was frankly appalled at the aspersions cast upon the venerable tweed jacket. I can state categorically...

UK decision to sell statins over the counter criticized.(Drug Access)
June 7, 2005... The UK's drug regulatory agency approved the world's first over-the-counter (OTC) statin on the basis of inconclusive evidence, according to the UK's influential Drug and Therapeutics Bulletin (DTB). The Medicines and Healthcare products...

Ads pressure Ontario to butt out in retail locations.(Tobacco Regulation)(Brief Article)
June 7, 2005... The Ontario Tobacco-Free Network (OTN) wants the province to check in-store tobacco marketing by either banning or hiding tobacco products. The OTN network, which includes the Canadian Cancer Society (Ontario division), the Heart and Stroke...

Ottawa to combine smart regulation and precaution.(Federal Regulations)
June 7, 2005... Ottawa's plan to modernize health and safety regulations has raised concerns that this may be an industry-driven step toward deregulation. The Smart Regulation initiative, which the public service will present to the federal government for...

US health spending up; medicare expanded.(US Government Policy)
June 7, 2005... With health spending in the United States projected to continue its rise, the Bush Administration is opening the federal coffers to provide more publicly funded prescription drugs. Some, however, think it may not do much good. By 2014,...

New malaria combination cheaper and easier to take.(Global Health)(Brief Article)
June 7, 2005... At least 50 million malaria patient a year could benefit from the first new drug developed by the 2-year-old Drugs for Neglected Disease initiative (DNDi). A patent-free, fixed-dose formulation of combined artesunate-amodiaq antimalarial will...

Vaccine center.(News @ a glance)(Brief Article)
June 7, 2005... Vaccine centre: The new International Vaccine Centre (InterVac) at the University of Saskatchewan will develop and test vaccines that protect Canadians from emerging diseases, including avian influenza, West Nile virus and SARS. The federal...

Polio reinfection.(News @ a glance)(Brief Article)
June 7, 2005... Polio reinfection: Indonesia is the 16th previously polio-free country to report new infections in the past 2 years, reports the World Health Organization. Global eradication efforts have reduced the number of polio cases from 350 000 annually...

Pollution kills.(News @ a glance)(Brief Article)
June 7, 2005... Pollution kills: An estimated 5900 Canadians in 8 major cities die every year because of air pollution, reports Health Canada. The figure is based on health studies and statistical models correlating air pollution and mortality data from Quebec...

Tsunami lessons.(News @ a glance)(Brief Article)
June 7, 2005... Tsunami lessons: The World Health Organization should coordinate the response to future natural disasters, concluded attendees at an international conference. Some 400 health practitioners from more than 130 countries, organizations and the...

Abortion coverage challenged.(News @ a glance)(Brief Article)
June 7, 2005... Abortion coverage challenged: Health Minister Ujjal Dosanjh has formally invoked a dispute resolution mechanism set up by federal and provincial health ministers and is taking New Brunswick to task for not funding abortion services at a private...

Google scholar: a source for clinicians?(Google Scholar)
June 7, 2005... The release of the beta version of Google Scholar (http: //scholar.google.com) in November 2004 generated much media coverage and academic commentary. (1) With this service, Google hopes to make scholarly literature more accessible by indexing...

Depression: more than just serotonin.(Science And Medicine)
June 7, 2005... Serotonin and dopamine neurotransmitter systems in the brain are generally thought to function separately. In the presence of antidepressants that inhibit the reuptake of serotonin, however, their signals may become crossed. New research...

A drug target for focal segmental glomerulosclerosis.(Analysis)(Brief Article)
June 7, 2005... Focal segmental glomerulosclerosis (FSGS) is a syndrome for which there is no reliable treatment, in part because of a poor understanding of its pathophysiology. However, recent research has identified a potential target for therapy. FSGS...

A young man with palpitations and Ebstein's anomaly of the tricuspid valve.(Teaching Case Report)
June 7, 2005... CASE: A 28-year-old previously healthy man presented with a 6-week history of palpitations. The symptoms occurred during rest, 2-3 times per week, lasted up to 30 minutes at a time and were associated with dyspnea. Except for a grade 2/6...

Plague: a continuing threat.(Public Health)
June 7, 2005... Background and epidemiology: An outbreak of plague in a remote diamond mine in the Democratic Republic of the Congo resulted in the deployment on Feb. 19, 2005, of a multidisciplinary team of epidemiologists, physicians and logisticians from...

An elderly man with excruciating retrosternal pain and dysphagia.(Clinical Vistas)
June 7, 2005... A 78-year-old man presented to the emergency department with a 1-day history of progressive, retrosternal chest pain radiating up to his throat that began suddenly upon rising after reaching into the refrigerator. At presentation, the pain had...

Is genetic screening for the Lynch syndrome effective?(In the Literature)
June 7, 2005... Hampel H, Frankel WL, Martin E, Arnold M, Khanduja K, Kuebler P, et al. Screening for the Lynch syndrome (hereditary nonpolyposis colorectal cancer). N Engl J Med 2005;352:1851-60. Background: Probably about 3%-4% of cases of colorectal...

A clinical return-to-work rule for patients with back pain.(Research/Recherche)
June 7, 2005... Abstract Background: Tools for early identification of workers with back pain who are at high risk of adverse occupational outcome would help concentrate clinical attention on the patients who need it most, while helping reduce unnecessary...

Vitamin [B.sub.12], homocysteine and carotid plaque in the era of folic acid fortification of enriched cereal grain products.(Research/Recherche)
June 7, 2005... Abstract Background: Carotid plaque area is a strong predictor of cardiovascular events. High homocysteine levels, which are associated with plaque formation, can result from inadequate intake of folate and vitamin [B.sub.12]. Now that...

Clinical prediction rule for return to work after back pain.(Commentary/Commentaire)
June 7, 2005... Back pain is the main cause of work absence and disability in industrialized societies, and one of the most common reasons for a visit to a physician. (1) Effective treatments for workers with back pain range in complexity and cost from simple...

Borderline personality disorder.
June 7, 2005... Abstract BORDERLINE PERSONALITY DISORDER is a chronic psychiatric disorder characterized by marked impulsivity, instability of mood and interpersonal relationships, and suicidal behaviour that can complicate medical care. Identifying this...

Reality emergency.(The Left Atrium)
June 7, 2005... Situation critical Ira Levy, Ron Singer and Peter Williamson, producers Jacques Holender, Lara Fitzgerald, Liz Marshall and Dan Robinson, directors Breakthrough Films and Television, Toronto, in association with Discovery Health Channel Eleven...

After birth.(Room for a view)
June 7, 2005... November 6. My niece is nine years old today. My mind slips back to the day of her birth, the hours spent waiting restlessly with my mother at one end of our local community hospital maternity ward. I remember how it was: feeling somewhat...

Better off in a bubble.
June 7, 2005... A resident on our team has just paged me. I'm in emerg, she says. I'm already doing an admission, but there's another one here. Do you want to do it? Sure, I say. I'll be right down. Great, she says. I don't know much about it, but I...

Deaths/Necrologie.
June 7, 2005... Baxter, Stephen D., North Bay, Ont.; University of Western Ontario, 1982; psychiatry; staff, North Bay Psychiatric Hospital. Died Dec. 30, 2004, aged 46. Beer, John K., Charlottetown; Dalhousie University, 1941; general surgery; FRCSC....

Query.
June 7, 2005... Just a few days ago I blithely floated from examining room to examining room, seeing sore throats and infected big toes, listening to epic tales of insomnia and marital frustration, adding pills, subtracting pills, switching pills. I flitted...

Why should clinical trials be registered?(Editorial)(Editorial)
June 21, 2005... A friend of ours is considering entering a multicentre phase II placebo-controlled trial of a drug for the treatment of small-cell lung cancer. The patient information sheets, although detailed and clear, contain no promise that the trial...

Difficulties of peace-building in Nepal.(Correspondance)(Letter to the Editor)
June 21, 2005... Sonal Singh (1) describes how political conflict has affected people's health in Nepal, concluding that health care professionals can play an important role in peace-building efforts. However, this is not as easy as it sounds. In December...

Summary basis of decision in context.(Correspondance)(Letter to the Editor)
June 21, 2005... In their analysis of Health Canada's Summary Basis of Decision (SBD) initiative, Joel Lexchin and Barbara Mintzes (1) raise important issues about transparency, but they do not discuss the unique Canadian legal context within which...

Training pediatricians.(Correspondance)(Letter to the Editor)
June 21, 2005... A recent item in the CMA Bulletin (1) discussed a proposal from the Royal College of Physicians and Surgeons of Canada (RCPSC) to reduce the number of PGY-1 training programs from approximately 30 to just a few "generalist competency" training...

Tintin in CMAJ.(Correspondance)(Letter to the Editor)
June 21, 2005... The article by Antoine Cyr and associates (1) is a fascinating perspective into the enigmatic delayed development of Tintin. The researchers must be commended for such insightful extrapolation from the limited source material. One wonders about...

Corrections.(Correspondance)(Correction Notice)
June 21, 2005... The DOI attached to a letter to the editor (1) published last year should have read 10.1503/cmaj.1050132. Reference (1.) Brock G. Does testosterone affect effect? [letter]. CMAJ 2004;171(6):553. DOI:10.1503/cmaj.050645 The DOI...

Radiologists, physicians push for PET scans.(Diagnostic Imaging)
June 21, 2005... Antiquated regulations and the refusal of some provinces to fund positron emission tomography (PET) scans means patients are denied a diagnostic tool that is standard in most industrialized countries, say Canada's leading radiologists and...

Quebec doubling PET capacity.(Technological Advances)
June 21, 2005... If Quebecers didn't know what positron emission tomography (PET) was before Les Invasions Barbares became an Oscar-winning hit, they do now. In the film--which mocks the overcrowded, underfunded state of Quebec's hospitals--a man with cancer is...

Conditional okay for cannabis prescription drug.(Drug Regulation)
June 21, 2005... Health Canada has conditionally approved the first cannabisderived prescription pain killer. Cannabis sativa extract (Sativex), an under-the-tongue spray, was approved in April for use as an adjunctive treatment for the symptom relief of...

New US guidelines for research on human embryos.(Research Ethics)(Brief Article)
June 21, 2005... US embryonic stem cell researchers now have relief from the patchwork of regulations and funding restrictions they currently face. In August 2001 the US president limited federally funded researchers to the use of tissue derived from...

$10-billion increase.(News @ a glance)(Brief Article)
June 21, 2005... $10-billion increase: Total health spending by Canada's 10 provinces for the 2005-06 fiscal year reached $87.5 billion--an increase of nearly $10 billion in 2 years. Spending in 2003-04 was $77.8 billion. This figure includes federal spending,...

Rubella outbreak.(News @ a glance)(Brief Article)
June 21, 2005... Rubella outbreak: An outbreak of rubella in southwestern Ontario likely originated in the Netherlands, says Ontario's chief medical officer of health. Dr. Sheela Basrur said certain communities in the Netherlands have been experiencing an...

Taping births.(News @ a glance)(Brief Article)
June 21, 2005... Taping births: Many US doctors have stopped allowing patients to freely videotape during births because of increasing fears the tapes could be used against them in future lawsuits, says Dr. John Nelson, an obstetrician and president of the...

Agent Orange.(News @ a glance)(disability pensions for Canadian forces affected by Agent Orange)(Brief Article)
June 21, 2005... Agent Orange: Veterans or current members of the Canadian Forces who spent time at a New Brunswick base where the federal government allowed the United States to test Agent Orange may be eligible for disability pensions if their health was...

Light redefined.(News @ a glance)(cigarette labelling)(Brief Article)
June 21, 2005... Light redefined: Cigarettes labelled as light or mild should have to adhere to the same standard as food products, say the authors of a new study (Can J Public Health 2005;96[3]:167-72). Using a laboratory protocol that more closely mimics...

Emergence of lymphogranuloma venereum in Canada.(Sexually Transmitted Infections)
June 21, 2005... Lymphogranuloma venereum (LGV) is a sexually transmitted infection (STI) caused by Chlamydia trachomatis serotypes L1, L2 and L3. Unlike other serotypes (A to K), those that cause LGV are invasive and preferentially target lymph tissue. LGV can...

Can NSAIDs contribute to Alzheimer's disease?(Science and Medicine)
June 21, 2005... Several years ago it was discovered that some NSAIDs lower the levels of amyloid a peptide (Aa). This peptide is a key component of neuritic plaques, which, along with neurofibrillary tangles and cerebral atrophy, are a pathologic hallmark of...

Congenital rubella syndrome despite maternal antibodies.(Teaching Case Report)
June 21, 2005... THE CASE: In January 2004 a female infant was delivered by cesarean section at 36 weeks' gestation because of severe intrauterine growth restriction. The mother was a healthy 31-year-old gravida 4 para 2 woman who had been travelling in Sri...

A refresher on rubella.(Public Health)
June 21, 2005... Background and epidemiology: In March 2005 the US Centers for Disease Control and Prevention posted an early-release article online that announced the elimination of endemic rubella and congenital rubella syndrome (CRS) in the United States....

In patients with early prostate cancer, is surgery better than watchful waiting?(In the Literature)
June 21, 2005... Bill-Axelson A, Holmberg L, Ruutu M, Haggman M, Andersson SO, Bratell S, et al; Scandinavian Prostate Cancer Group Study No. 4. Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med 2005;352(19):1977-84. ...

A 37-year-old woman with fever and abdominal pain.(Clinical Vistas)
June 21, 2005... A 37-year-old woman presented to the emergency department with a 5-day history of increasing right upper quadrant pain, mild fever, chills and night sweats. She had had a hepatic hydatid cyst treated with "deworming drugs" in India 9 years...

Patients receiving intravenous bisphosphonates should avoid invasive dental procedures.(Health and Drug Alerts)
June 21, 2005... Published at www.cmaj.ca on June 1, 2005. Reason for posting: The intravenous bisphosphonates pamidronate (Aredia) and zoledronic acid (Zometa) are often used to treat cancer-related hypercalcemia, Paget's disease and symptoms from...

Capability of ischemia-modified albumin to predict serious cardiac outcomes in the short term among patients with potential acute coronary syndrome.(Research)
June 21, 2005... Abstract Background: Ischemia-modified albumin (IMA) has been suggested as a marker of cardiac ischemia. Little, however, is known about its capacity to predict short-term serious cardiac outcomes (death, myocardial infarction, congestive...

Liposomal lidocaine to improve procedural success rates and reduce procedural pain among children: a randomized controlled trial.(Research)
June 21, 2005... Abstract Background: Historically, children have been undertreated for their pain, and they continue to undergo painful cutaneous procedures without analgesics. A new topical anesthetic, liposomal lidocaine 4% cream (Maxilene, RGR Pharma,...

When prognosis precedes diagnosis: putting the cart before the horse.(Commentary)
June 21, 2005... Each year in the United States, some 6 million people present to emergency departments with chest pain. (1) Although only 15%-20% of these patients are ultimately diagnosed with an acute coronary syndrome (ACS), (2) about half are admitted for...

Do no harm--but first, do not hurt.(Commentary)
June 21, 2005... As recently as 20 years ago, many health care professionals believed that young children did not experience pain and that the use of opiates for pain control was contraindicated because of a substantial risk of addiction. (1) A related...

Is this clinical trial fully registered? A statement from the International Committee of Medical Journal Editors.(Commentary)
June 21, 2005... In September 2004, the members of the International Committee of Medical Journal Editors (ICMJE) published a joint editorial aimed at promoting registration of all clinical trials. (1) We stated that we will consider a trial for publication...

Modern antipsychotic drugs: a critical overview.(Synthese)
June 21, 2005... Abstract CONVENTIONAL ANTIPSYCHOTIC DRUGS, used for a half century to treat a range of major psychiatric disorders, are being replaced in clinical practice by modern "atypical" antipsychotics, including aripiprazole, clozapine, olanzapine,...

A surgical history: The knife man.(Book Review)
June 21, 2005... A surgical history The knife man Wendy Moore London (UK): Transworld Publishers; 2005 482 pp $40.50 (cloth) ISBN 0593-052099 On Dec. 12, 1785, in St. George's Hospital, London, an unnamed hackney cab driver with a popliteal artery aneurysm...

Baptism.(Poem)
June 21, 2005... Baptism I enter the rooms where the anxious patients wait to learn what changelings have been left in their lives, in their guts. I bring names for these new entities: it is time to bring them into the light, and christen...

Hurry up and wait.(Room for a view)
June 21, 2005... Martin is in his late eighties. He was admitted to hospital for an acute illness--partly, as it turns out, caused iatrogenically, a change in drug dosage. He and his wife had been living on their own, getting by well enough, until he was rushed...

Deaths.(Obituary)
June 21, 2005... CMAJ welcomes obituaries submitted within 60 days of a death. Send to Kyle Rooks, kyle.rooks@cma.ca; fax 613 565-5471. Bendl, Bernard J.J., Richmond, BC; University of Toronto, 1962; dermatology; FRCPC; active staff, Vancouver Hospital &...

Query.
June 21, 2005... I wrote my will yesterday. It was something my financial adviser recommended I do the past three visits; instead of facing his chiding another time, I decided to finally hire a lawyer and perform the deed. I think I was putting it off for a...