CMAJ: Canadian Medical Association Journal articles from June 2006

CMAJ: Canadian Medical Association Journal archives from June 2006

Capacity, population aging and professionalism/Capacite, vieillissement de la population et professionnalisme.(Column)
June 6, 2006... The role of physicians in relieving suffering and improving function is only part of the physician--patient relationship. Acting with beneficence (and doing no harm) must be done in partnership with patients. Physicians seek partnership because...

Independent federal safety board needed to prevent adverse events.(medical safety)
June 6, 2006... Published at www.cmaj.ca on May 8, 2006. Revised on May 15, 2006. With harsh statistics suggesting adverse events occur in as many as 30% of medical treatments and that as many as 24 000 Canadians die annually due to medical mishaps, a...

Federal budget focused on tax cuts, not health.(News)
June 6, 2006... Published at www.cmaj.ca on May 9, 2006. Revised on May 15, 2006. There was, to be sure, little in the way of deviation from Conservative script. But then, Prime Minister Stephen Harper made it clear from the time he began campaigning for...

Accutane registry compulsory in US, but not Canada.(isotretinoin)
June 6, 2006... Published at www.cmaj.ca on May 17, 2006. The United States has ramped up efforts to mitigate the risk of birth defects associated with isotretinoin (Accutane) by requiring physicians and patients to register before they can prescribe or...

US abortion bans.(Brief article)
June 6, 2006... US abortion bans: South Dakota banned abortion in February, and 11 other states are poised to consider similar action. "People are afraid here," Dr. Marivin Buehner told the St. Louis Post-Dispatch. Buehner's Rapid City office was picketed...

Michener finalist.(Michener Award for Meritorious Public Service in Journalism )(Brief article)
June 6, 2006... Michener finalist: CMAJ was short-listed for the Michener Award for Meritorious Public Service in Journalism for its article on barriers to accessing Plan B (CMAJ 2005;173:1435-6). The 6 finalists for the award included the Globe and Mail,...

Free Nepali MDs.(Physicians for Global Survival (Canada) urges freedom of Nepali physicians arrested)(Brief article)
June 6, 2006... Free Nepali MDs: Physicians for Global Survival (Canada) is urging physicians to sign a petition calling for the freeing of 7 Nepali physicians. The physicians, including Mahesh Masky, the vice president of International Physicians for the...

Who's doing what? Time spent on committee and administrative work.(physicians)(Brief article)
June 6, 2006... According to data from the 2004 CFPC/CMA/RCPSC National Physician Survey, physicians in the fields of community medicine, microbiology and infectious diseases, hematology, emergency medicine and medical oncology contributed the greatest number...

Pulmonary hypertension after pulmonary emboli: an underrecognized condition.
June 6, 2006... Chronic thromboembolic pulmonary hypertension (CTEPH) is the end result of persistent obstruction of the pulmonary arteries by acute or recurrent pulmonary emboli. In the era of successful surgical therapy, CTEPH, although historically...

E. coli-sporadic case or an outbreak?(Public Health)
June 6, 2006... Background and epidemiology: One of the many unfortunate consequences of the Walkerton tainted-water tragedy has been a lingering association of Escherichia coli O157:H7 with large-scale outbreaks. Lost somewhere among the lessons learned is an...

Rickets.(Brief article)
June 6, 2006... When enlargement of this boy's costochondral junctions was noted incidentally on a chest radiograph, additional skeletal images were ordered. They revealed widening, fraying, cupping and irregularity of the metaphyseal border of his distal...

Mollaret's meningitis.(Brief article)
June 6, 2006... May-Grunwald-Giemsa staining of CSF revealed large monocytes with blunt pseudopods and bean-shaped (arrow, in Fig. 1) and bilobed nuclei (arrowhead). Further examination disclosed 114 leukocytes (all mononuclear cells), 0.75 mg protein, 2.8...

Colonic intussusception.(Brief article)
June 6, 2006... Depending on its orientation relative to the image plane, this type of intestinal process appears as a sausage-like (Fig. 1) or target-like mass (Fig. 2). The lead-point lesion in this case was found at pathology to be an intraluminal lipoma....

Increased risk of atherothrombotic events associated with cytochrome P450 3A5 polymorphism in patients taking clopidogrel.
June 6, 2006... Abstract Background: Clopidogrel is a prodrug requiring metabolism by cytochrome P450 3A (CYP3A) isoenzymes, including CYP3A5, in order to be active. It is controversial whether clopidogrel interacts with CYP3A inhibitors. We investigated...

Fatal agricultural injuries in preschool children: risks, injury patterns and strategies for prevention.
June 6, 2006... ABSTRACT Background: Agricultural injuries are an important health concern for pediatric populations and particularly for children of preschool age. This study was conducted to estimate rates and determine patterns of fatal agricultural...

Understanding clopidogrel efficacy in the presence of cytochrome P450 polymorphism.
June 6, 2006... In this issue, Suh and colleagues report on the risk of atherothrombotic events in people taking clopidogrel. (1) Their main objective was to link clopidogrel efficacy to the activity of a specific CYP3A isoenzyme, namely CYP3A5, in people with...

Pediatric safety on farms: redefining the unacceptable.
June 6, 2006... The universality of our desire to nurture and protect children is reflected in the many programs that address the major health and economic issues faced by children worldwide. The stereotypical view of farms as wholesome, healthy places for...

Send us your briefs!--a new CMAJ call for medical images.
June 6, 2006... Nearly 5 years ago, CMAJ launched Clinical Vistas, a case-based imaging column, (1) in order to increase the clinical and visual content of the Journal. Since that time readers have been provided glimpses of a variety of interesting and...

Re-examining the efficacy of [beta]-blockers for the treatment of hypertension: a meta-analysis.
June 6, 2006... Abstract Background: In a recently published meta-analysis, investigators asserted that [beta]-blockers should not be used to treat hypertension. Because the pathophysiology of hypertension differs in older and younger patients, we...

Risks on the roads.(Letter to the editor)
June 6, 2006... In a recent article about global trends in injury, (1) Sally Murray describes prevention efforts for traffic-related injuries, but 2 independent trends in the developed world may reverse some of the improvements that have already been made: the...

Why the surprise?(Letter to the editor)
June 6, 2006... Mark Baerlocher (1) expresses surprise that, according to results in the 2004 National Physician Survey, geriatricians constituted the second most satisfied group of doctors. Geriatricians' high level of satisfaction with their current...

The perverted irony of health Canada's special access programme.(Letter to the editor)
June 6, 2006... The Oxford English Dictionary defines the word "irony" as "a state of affairs that appears perversely contrary to what one expects." A recent description of the use of Health Canada's Special Access Programme (SAP) to obtain breast implants (1)...

Changes at CMAJ.(Letter to the editor)
June 6, 2006... I have been shocked by recent events at the CMAJ, including the firing of John Hoey and Anne Marie Todkill as editor-in-chief and senior deputy editor. In a situation like this one, what are the rights of long-time CMA members, like me, whose...

Corrections.(Letters)(Correction notice)
June 6, 2006... The DOI published in a recent News item (1) was mistakenly listed as 10.1503/cmaj.060387. It should have been 10.1503/cmaj.060386. REFERENCE (1.) Kondro W. Apples, oranges and wait times: CIHI report. CMAJ 2006;174(9):1246-7. ...

Harvey Cushing--a standard worth striving for.(Harvey Cushing: A Life in Surgery )(Book review)
June 6, 2006... Harvey Cushing: a life in surgery Michael Bliss Toronto: University of Toronto Press; 2005 593 pp $50 (cloth) ISBN 0-H020-H950-X In the first three decades of the 1900s, Harvey Cushing (1869-1939) was a cosmic force in the special field of...

Until my "time of death".(Poem)
June 6, 2006... Until my "time of death" Without breath the stillness of my body consumes me erratic uncertain my heart is coerced to contract a muscle no longer willing a ventricle hardly filling cells unable to fire...

The (un)-definitive time of death.
June 6, 2006... Many of us can intuitively feel death drawing near in a patient. Whether it is something the patient says before they fall to sleep, the colour of the skin, the shutting down of the kidneys, the cold that sheds from someone's body, or something...

Deaths.(Obituary)
June 6, 2006... Einarson, Dawson Wray, Kingston, Ont.; Queen's University, 1952, anesthesia. Died Mar. 9, 2006, aged 82. "Formerly of Perry Sound and born in Capreol, Ont., dear son of the late Einar and Olive Einarson of Rosseau and loving husband of Eleanor...

Query.(new approach medical treatment)(Column)
June 6, 2006... A few weeks ago I tried a new approach with one of my patients. He's affected with a particularly debilitating illness; I'd been treating him for what appeared to be a garden-variety depression. I started him on medication and did what mild...

Editorial policy: industry funding and editorial independence/Politique editoriale : le financement par l'industrie et l'independance de la redaction.(Editorial)
June 20, 2006... The separation of editorial decisions from financial issues is essential to ensure editorial independence. Given this, it is important to reflect upon current policy and practices with respect to advertising and supplement sponsorship....

Task Force Two calls for pan-Canadian approach to physician resources.
June 20, 2006... A comprehensive "pan-Canadian" strategy for educating, recruiting, licensing and equipping doctors should be implemented to ensure that Canada has enough physicians to meet evolving needs, states Task Force Two, a blue-ribbon panel struck to...

Chronic malnutrition grips western Nepal.
June 20, 2006... The combined effects of conflict and large-scale drought have led to a high rate of chronic malnutrition in western parts of Nepal, reports Action Contre la Faim (ACF), a France-based international, non-profit devoted to hunger relief. ...

Darfur on life-support: MSF.(Medecins Sans Frontieres )(Interview)
June 20, 2006... "My team in Muhajariya Hospital is receiving truckloads of wounded. We just received another 44 cases of violent trauma last night [May 8]--most of them civilians," reports Vanessa Van Schoor, Medecins Sans Frontieres head of mission (Dutch...

Alberta health reforms shelved, again.
June 20, 2006... Scant months after introducing their controversial plan to allow doctors to practise in the public and private system simultaneously and to allow Albertans to purchase private insurance to obtain quicker health care service, Alberta's governing...

International child growth standards.(News @ a glance)(Brief article)
June 20, 2006... International child growth standards: The WHO's new international child growth standards provide for the first time evidence and guidance about how every child in the world should grow (www.who.int). Using these standards, physicians and others...

Governance panel.(Richard Pound, Canadian Medical Association Journal Governance Review Panel)(Brief article)
June 20, 2006... Governance panel: Montreal lawyer and chartered accountant Richard Pound replaced former Supreme Court chief justice Antonio Lamer as head of the CMAJ Governance Review Panel on May 8. Lamer resigned May 3 due to illness. Pound is the chair of...

WHO Director-General dies.(Dr. Lee Jong-wook)(Obituary)(Brief article)
June 20, 2006... WHO Director-General dies: Dr. Lee Jong-wook died on May 22, 2 days after surgery for a subdural hematoma. Dr. Lee, a 61-year-old national of the Republic of Korea, worked at WHO for 23 years and began his 5-year term as Director-General of WHO...

CMAJ wins award.(Canadian Medical Association Journal )(Brief article)
June 20, 2006... CMAJ wins award: The Canadian Association of Journalists presented its award for investigative journalism in a magazine to CMAJ in Halifax, May 13. The award was for the journal's news article, "Privacy issues raised over Plan B" (CMAJ...

More MDs.(medical school enrolments )(Brief article)
June 20, 2006... More MDs: The US is increasing first-year medical school enrolment by as much as 4500 students by 2015. First year enrolment in 2002 totalled 19 567. In Canada, enrolment will rise by about 300 this September, for a total of 2500 first-year...

Hypertension chair.(Dr. Norm Campbell, Canadian Chair in Hypertension Prevention and Control)(Brief article)
June 20, 2006... Hypertension chair: The first ever Canadian Chair in Hypertension Prevention and Control will be filled by Dr. Norm Campbell from the University of Calgary. The chair has funding of $900 000 over 5 years from the Canadian Hypertension Society,...

Teamster doctors.(doctors join Teamsters Local 1149)(Brief article)
June 20, 2006... Teamster doctors: Frustrated by a 20% cut in fee schedules and restrictions on medical care by Excellus BlueCross BlueShield, nearly 300 central New York State physicians have joined the 1-million strong Teamsters Local 1149. According to...

Happy doctors? Balancing professional and personal commitments.(Brief article)
June 20, 2006... A recent Pulse article (CMAJ 2006;174[8]:1070) gave a glimpse into the degree of satisfaction specialists reported having with their current professional lives. In this issue, additional results from the 2004 CFPC/CMA/RCPSC National Physician...

Microvascular dysfunction in cardiac syndrome X: the role of inflammation.
June 20, 2006... Between 10% and 30% of patients who undergo diagnostic coronary angiography because of typical symptoms of angina pectoris are found to have "normal" or "near normal" epicardial coronary arteries. Of these patients, those who have predominantly...

Buprenorphine: a potential new treatment option for opioid dependence.
June 20, 2006... Although there are an estimated 60 000-90 000 illicit opioid abusers (1) in Canada, only about 25% are currently receiving treatment. (2) Methadone, a long-acting opioid agonist, is the treatment of choice for opioid dependence. However,...

Malnutrition: a silent emergency.
June 20, 2006... "No democracy has ever starved."--Amartya Sen, Nobel laureate economist. As rates of obesity continue to increase in the world's more affluent nations, it is difficult to comprehend that malnutrition affects over 800 million people...

A case of myocardial infarction complicating Kawasaki disease.(Brief article)
June 20, 2006... A 21-year-old man with a history of Kawasaki disease at the age of 5 years came to hospital with acute-onset chest pain. He denied any illicit drug use and reported that he had not taken ASA for about 2 years. His initial ECG documented...

Pulmonary hypertension following L-lysine ibuprofen therapy in a preterm infant with patent ductus arteriosus.
June 20, 2006... ABSTRACT Patent ductus arteriosus is one of the most common congenital abnormalities found in premature infants. Ibuprofen, a nonsteroidal drug that is commonly used as an antipyretic, analgesic and anti-inflammatory agent, is also used to...

Cost-effectiveness of self-managed versus physician-managed oral anticoagulation therapy.
June 20, 2006... ABSTRACT Background: Patient self-management of long-term oral anticoagulation therapy is an effective strategy in a number of clinical situations, but it is currently not a funded option in the Canadian health care system. We sought to...

Re-examining our approach to the approval and use of new drugs.(Column)
June 20, 2006... In this issue, Bellini and colleagues report on a preterm infant who experienced pulmonary hypertension after receiving L-lysine ibuprofen therapy for patent ductus arteriosus. (1) Their case report is yet another reminder that therapies can...

Evidence and advocacy: are all things considered?(Column)
June 20, 2006... The recent exchange on the discord between influential recommendations is highly relevant to our health care systems. (1-3) The Canadian Diabetes Association (CDA)'s national clinical practice guidelines (CPGs), past (4) and present, (5) are...

Sudden infant death syndrome.
June 20, 2006... ABSTRACT Sudden infant death syndrome (SIDS) continues to be the most common cause of postneonatal infant death. SIDS is a complex, multifactorial disorder, the cause of which is still not fully understood. However, much is known now about...

Wait times in the real world.(Letter to the editor)
June 20, 2006... Wayne Kondro (1) quotes Glenda Yeates, of the Canadian Institute for Health Information, as saying "There is no average person or average wait." I would like to add to this by quoting Donald Berwick of the Institute for Healthcare Improvement...

ALPHA form: additional resources.(Letter to the editor)
June 20, 2006... Further to our article describing use of the Antenatal Psychosocial Health Assessment (ALPHA) form, (1) we wish to inform CMAJ readers about a Web site (http://dfcm19.med.utoronto.ca/research/alpha/default.htm) that presents several related...

Views of medicine as a profession.(Letter to the editor)
June 20, 2006... The editorial on whether medicine is still a profession appears to emphasize that the work ethic of our profession, which traditionally was maintained primarily by the "guardian moral syndrome" is now being breached on two fronts: "better...

Patient characteristics not described.(Letter to the editor)
June 20, 2006... Research based on administrative databases, such as that reported by Scot Simpson and associates, (1) who investigated the dose-response relation between sulfonylurea drugs and death in a patient with type 2 diabetes mellitus, can demonstrate...

Corrections.(Letters)
June 20, 2006... Correction notice A sentence in the Results section of the abstract on page 1421 (1) accidentally reversed the intended meaning of the data comparison for the primary end points of the study. It should read, "Results: The efficacy end...

Whither medical botany?(Room for a view)(Column)
June 20, 2006... "I wish you had been with us last Tuesday down at the Peat Swamp, there are such splendid flowers down there.... We got the smallest and rarest variety of Ladies Slipper or Indian Moccasin plant... the most beautiful of all Canadian wild...

Benediction.(Poem)
June 20, 2006... Benediction In this place the small hospital shimmers against the Sierra Madres. In this place the people have skin the colour of the earth, Nightsky hair. In the cool hallway, a mother carries her child. ...

Deaths.(Obituary)
June 20, 2006... Forcier, Pierre, Saint-Jean-Chrysostome, Que.; Universite Laval, 1962, neurosurgery. Died Apr. 5, 2006, aged 69. Fullerton, Samuel George Burke, Riverport, NS; Dalhousie University, 1952. Died Apr. 10, 2006, aged 86. "He was a veteran of...

Query.(physician's quest)(Column)
June 20, 2006... I'm tired. Not of the usual things, mind. Not of demanding patients, of dumps from other physicians, of a desolate home life, of debt, of soccer practices and swimming classes and dance classes, of call, of office staff sick time, of an...