CMAJ: Canadian Medical Association Journal articles from June 2007

CMAJ: Canadian Medical Association Journal archives from June 2007

Protecting vaccine programs and the public/La protection des programmes de vaccination et du public.(Guest Editorial/Editorial invite)(Editorial)
June 5, 2007... In 1986, this journal published an article by the Canadian Pediatric Society calling for Canada to develop a no-fault compensation program for vaccination injuries. (1) More than 2 decades later there is no such national system in place,...

Pay-for-performance incentives/Les incitatifs de la remuneration au rendement.(Highlights of this Issue/Dans ce numero)(Brief article)
June 5, 2007... Do pay-for-performance incentives improve processes of care and patient outcomes? Millett and colleagues report on their study of the impact such incentives have on the documentation of smoking status and the delivery of smoking cessation...

Parental divorce and methylphenidate use in children/Le divorce des parents et l'usage de methlphenidate chez les enfants.(Highlights of this Issue/Dans ce numero)(Brief article)(Clinical report)
June 5, 2007... To determine whether parental divorce is a predictor of methylphenidate use among Canadian children, Strohschein analyzed data from the National Longitudinal Survey of Children and Youth. She included data for children who remained in the...

Encouraging medical students to do research/Encourager les etudiants en medecine a faire de la recherche.(Highlights of this Issue/Dans ce numero)
June 5, 2007... A senior clinician and a medical student team up to offer advice on helping students and trainees to participate successfully in research. See page 1719 Un clinicien principal et un resident en medecine conjuguent leurs efforts pour...

Embryo donation for stem cell research/Don d'embryons pour la recherche sur les cellules souches.(Highlights of this Issue/Dans ce numero)
June 5, 2007... In this commentary, Caulfield and colleagues consider 2 unresolved issues surrounding embryo donation for stem cell research: Who should obtain consent? and Does the donor have the right to withdraw consent? See page 1722 Dans ce...

Global health/Sante dans le monde.(Highlights of this Issue/Dans ce numero)(Brief article)
June 5, 2007... The Jean Chretien Pledge to Africa Act came into force in 2005, promising to bring cheaper drugs to poor, epidemic-cridden developing countries. Attaran lays harsh criticism on this law, noting that the only result so far has been "zero...

Practice/Dans la pratique.(Highlights of this Issue/Dans ce numero)(case report of meningovascular syphilis)(Brief article)
June 5, 2007... "The great imitator" is making a comeback in Canada. A Teaching Case Report outlines the symptoms and diagnostic clues that led to the correct diagnosis of 2 cases of meningovascular syphilis (page 1699). In Clinical Vistas,...

Sir Frederick Banting homestead sold to developer, family outraged.(News)(Ontario Heritage Society)
June 5, 2007... The incongruities seem startling, primarily because it's a tale involving the honour and memory of Canadian icon Sir Frederick Banting, who unselfishly gave diabetes sufferers the gift of insulin for the princely sum of $1. In fact, the...

Physicians challenge Canada to make children, youth a priority.(News)
June 5, 2007... Published at www.cmaj.ca on Apr. 26, 2007. Revised June 5, 2007. A coalition of 3 Canadian medical associations is challenging the country to make the health and well-being of all Canadian children and youth a priority. "Let's be among...

US children's study escapes knife.(News)
June 5, 2007... A massive study of the genetic and environmental causes of illness in American children is set to begin recruiting subjects next year after a late cash infusion from the US Congress. The National Children's Study hopes to pinpoint causes of...

Northern Ontario medical school first to require community clerkships.(News)(Northern Ontario School of Medicine)
June 5, 2007... Canada's newest medical school has become the world's first to require students to spend their third year living and working in clinical settings in smaller communities. Unlike most medical school curricula, which require students in their...

New portal.(News @ a glance)(www.who.int/trialsearch/)(Brief article)
June 5, 2007... New portal: The World Health Organization has unveiled a new Clinical Trial Search Portal designed to help physicians, researchers and consumers navigate their way through the exploding battery of clinical trial registers. The portal...

Lunchless.(News @ a glance)(launch of online directory)(http://nofreelunch.org)(Brief article)
June 5, 2007... Lunchless: The No Free Lunch Directory (US version only) has gone online to provide patients with access to a database of health care professionals--physicians, pharmacists, nurse practitioners, nurse-midwives and others--who have taken "The...

Wild Rose approval.(News @ a glance)(fiscal agreement approved)(Brief article)
June 5, 2007... Wild Rose approval: Some 91% of Alberta's doctors voted to approve a trilateral fiscal agreement between the Alberta Medical Association, the provincial government and the province's 9 health regions that increases their fee schedule by 9% over...

Chaoulli Ontario.(News @ a glance)(Ontario's Health Insurance Act)(Brief article)
June 5, 2007... Chaoulli Ontario: Newmarket auto body shop owner Lindsay McCreith has launched a constitutional challenge to Ontario's Health Insurance Act and the Commitment to the Future of Medicare Act for prohibiting private health insurance for medically...

The re-emergence in Canada of meningovascular syphilis: 2 patients with headache and stroke.(Teaching Case Report)
June 5, 2007... Case 1: A previously healthy 51-year-old man came to hospital complaining of headache of 3 weeks' duration and several days of nausea, vomiting and confusion. He had some difficulty recalling the events of the preceding 3 weeks, but the results...

Bilateral trapezius hypertrophy with dystonia and atrophy.(Clinical Vistas)
June 5, 2007... A 50-year-old woman arrived with progressive neck pain and stiffness, 3 years after a whiplash injury sustained in a motor vehicle crash. Previous diagnoses included cervical spondylosis and muscle imbalance; treatment with analgesics had...

Impact of a pay-for-performance incentive on support for smoking cessation and on smoking prevalence among people with diabetes.(Research)(Survey)
June 5, 2007... ABSTRACT Background: Many people with diabetes continue to smoke despite being at high risk of cardiovascular disease. We examined the impact of a pay-for-performance incentive in the United Kingdom introduced in 2004 as part of the new...

Prevalence of methylphenidate use among Canadian children following parental divorce.(Research)(Survey)
June 5, 2007... Abstract Background: Evidence suggests that children living in single-parent or step-parent households are more likely than children in households with 2 biological parents to be prescribed methylphenidate. I conducted a study of...

Pay for performance: learning about quality.(Commentary)
June 5, 2007... Most doctors feel that they provide good to above-average patient care. However, Canadian physicians rarely receive feedback about their clinical performance or patient outcomes. Although both of us believe that we provide excellent patient...

Encouraging medical students to do research and write papers.(Commentary)
June 5, 2007... Society has a vested interest in supporting and promoting health care research. Physicians, among other clinical professionals, have an important role to play. In recent years, many have decried the lack of opportunities for physicians to...

Informed consent in embryonic stem cell research: are we following basic principles?(Commentary)
June 5, 2007... The question of whether stem cell research involving human embryos is morally acceptable has dominated much of the national and international dialogue, including parliamentary debates in Canada. (1,2) Many of the policies surrounding the ethics...

A tragically naive Canadian law for tragically neglected global health.(Global health)
June 5, 2007... In May 2004 Canada's Parliament was the first in the world to subscribe to reforms enacted by the World Trade Organization, which promised to bring cheaper medicines to poor, epidemic-ridden developing countries. Parliament passed a new law,...

The World Bank and sub-Saharan Africa's HIV/AIDS crisis.(Global health)
June 5, 2007... Between the early 1980s and 2000 the prevalence rate of HIV infection in sub-Saharan Africa increased from less than 1% to 12%, (1) as illustrated in the prevalence maps in Fig. 1. This represents an increase in the number of people living with...

Cardiovascular imaging techniques.(Letter to the editor)
June 5, 2007... I read with interest Esteban Escolar and colleagues' article on new tomographic cardiovascular imaging techniques. (1) In my opinion, the greatest diagnostic advantage of multiple-slice spiral computed tomography (CT) angiography is in...

Industrial health research in Canada.(Letter to the editor)
June 5, 2007... In his commentary on the pharmaceutical industry, Henry Mintzberg recommends several measures that are already in place in Canada. (1) He recommends firmer regulation of pricing, but Canada is unique in that it has 2 levels of price control, at...

Noncompliance in randomized controlled trials.(Letter to the editor)(Brief article)
June 5, 2007... Catherine Hewitt and colleagues (1) have given an excellent brief account of the effect of noncompliance on the analysis of randomized controlled trials. We would like to add a few more points to make the discussion more complete. ...

Novice drivers with attention-deficit hyperactivity disorder.(Letter to the editor)
June 5, 2007... The recent CMAJ lead editorial on the high rate of injuries and deaths among youthful drivers is long overdue. (1) It focuses our attention on potentially modifiable human factors in this important public health epidemic. (2) The latest edition...

Organ donation after cardiocirculatory death.(Letter to the editor)
June 5, 2007... The Canadian recommendations for organ donation after cardiocirculatory death advocate confirming the irreversibility of cardiocirculatory arrest by the absence of palpable pulses, blood pressure and respiration during a 5-minute period of...

Breaking bad news.(physician role)(Letter to the editor)
June 5, 2007... I thank medical student Nir Lipsman for his insightful and touching article on the hospital's Family Room. (1) This room is usually spoken of, if at all, in hushed and sometimes reverent tones, and when one meets with family members and loved...

Staffing levels in long-term care facilities.(Letter to the editor)
June 5, 2007... In their recent CMAJ commentary, (1) Kimberlyn McGrail and associates correctly noted that in British Columbia private and not-for-profit providers of long-term care have different staffing levels at their sites. However, these differences are...

Thyroid hormone therapy in organ donors.(Letters)
June 5, 2007... Sam Shemie and associates recommend that consideration be given to using thyroid hormone therapy in all organ donors. (1) We have experimental data suggesting that administering thyroid hormones to hemodynamically stable organ donors could...

Respect for the dead.(Human Remains: Dissection and Its Histories)(Book review)
June 5, 2007... Human remains: dissection and its histories Helen MacDonald Yale University Press; 2006 (Melbourne University Press; 2005) 224 pp US$35.00 ISBN 0-300-11699-3 At first glance, a history of dissection may appear morbid with little relevance...

Bodysnatching in 19th century Canada.(The Left Atrium)
June 5, 2007... Although the context in Canada in the 19th century was quite different from the penal colony off the southern coast of Australia that is the focus of Helen MacDonald's book, there were nonetheless concerns here with regard to the procurement...

Giving back the helm.(Room for a view)(treatment refusal)
June 5, 2007... I I am what we call around here a "medical student": I ask a lot of questions, I am thrilled by obscure diagnosis and I never, ever, complain. October 23rd. My first day on the 12th floor started with a challenge: Laura. She was...

Up from the minors.(Notes)
June 5, 2007... Powder flew into the air as the size 7-and-a-half latex glove snapped snuggly onto my right hand. I jockeyed sideways, turned and then sunk my left hand into its awaiting outstretched glove. The scrub nurse's blue eyes floated about her...

Deaths.(Obituary)
June 5, 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. Baird, James Tertius, Long...

Query.(personal experience in writing)
June 5, 2007... Did you always want to be a doctor? I didn't. I always wanted to be a novelist. I wanted to write tortured stories of impassive, inarticulate men and outwardly cool, inwardly devastated women. If this sounds Harlequin, that's because it is. I...

Progressive licensing needs progressive open debate/L'homologation progressive : un debat ouvert progressif s'impose.(Editorial)
June 19, 2007... The worldwide withdrawal of rofecoxib (Vioxx) marked the end of an era of relative consumer innocence. It demonstrated unequivocally that, unlike other consumer "goods," pharmaceutical products cannot be driven by profit. Rather, the driver...

Progress report on the National Immunization Strategy.(News)(Report)
June 19, 2007... Stakeholders cast it as a glittering model for future intergovernmental oversight of public health initiatives. Skeptics, though, describe it as altogether light on concrete accomplishments. One calls it an "enduring Canadian mystery,"...

Clement seeks safe injection site study.(News)(InSite)
June 19, 2007... In response to Federal Health Minister Tony Clement's demand for proof of the efficacy of safe injection sites, Health Canada has issued a call for research proposals to determine whether there is any validity to the proposition that such sites...

Tuberculosis rates skyrocketing in India.(News)
June 19, 2007... The statistics continue to be nothing short of brutal. Despite the government of India's efforts to control tuberculosis, the disease continues to kill 2 people every 3 minutes or nearly 1000 daily, according to Tuberculosis Control-India (www...

Ontario noncommittal on student loan deferrals.(News)
June 19, 2007... Philip Brost has just graduated after 4 years at the University of Saskatchewan with a medical degree and a debt load of $160 000. He's also president of the Canadian Federation of Medical Students and strongly backs what some provinces are...

Patient safety.(News @ a glance)(Brief article)
June 19, 2007... Patient safety: Ontario Health and Long-Term Care Minister George Smitherman has introduced amendments to the province's Health System Improvements Act that will require all regulated health professionals to publicly report whether they have...

Yellow fever.(News @ a glance)(vacccination drive in West Africa)(Brief article)
June 19, 2007... Yellow fever: Immunization campaigns will be re-launched in 12 West African nations (Benin, Burkina Faso, Cameroon, Cote d'Ivoire, Ghana, Guinea, Liberia, Mali, Nigeria, Senegal, Sierra Leone and Togo) that are now at high risk of epidemic...

Nutrition guides.(News @ a glance)
June 19, 2007... Nutrition guides: The Physicians' Committee for Responsible Medicine says it will distribute, free of charge, a 900-page Nutrition Guide for Clinicians to all interested medical students in Canada and the US in a bid to elevate their awareness...

Home care spending.(News @ a glance)(Brief article)
June 19, 2007... Home care spending: In its first attempt to quantify government spending on home care, the Canadian Institute for Health Information reports that outlays grew to $3.4 billion in 2003/04 from $1.6 billion in 1994/95, an average annual growth...

Pedestrian injuries.(News @ a glance)(Brief article)
June 19, 2007... Pedestrian injuries: Hospital admissions for pedestrian injuries decreased 31% between 1994 and 2005, from 4516 to 3117, according to the Canadian Institute for Health Information 2006 National Trauma Registry Injury Hospitalizations Highlights...

Moving on.(News @ a glance)(Dr. Edward Hill, elected Chair of the World Medical Association)(Brief article)
June 19, 2007... Moving on: Former American Medical Association President and family physician Dr. Edward Hill has been elected Chair of the World Medical Association. During the annual council meeting when Hill was elected, members also voted in favour of...

Screening successes.(News @ a glance)(breast cancer screening)(Brief article)
June 19, 2007... Screening successes: A Canadian Cancer Society special report in Canadian Cancer Statistics 2007 indicates that the death rate for breast cancer for Canadian women has dropped 25% since 1986. Increased participation in organized breast...

Country food.(News @ a glance)(Brief article)
June 19, 2007... Country food: The federal government has unveiled its first-ever national food guide for First Nations, Inuit and Metis (www.hc-sc.gc.ca/fn-an/pubs /fnim-pnim/index_e.html). Inuit Tapiriit Kantami President, Mary Simon, was delighted "to see...

Drug spending tops $25 billion.(Pulse)
June 19, 2007... Although the explosive growth rate of spending on drugs in Canada abated slightly in 2006, it continued to outstrip overall growth in health spending. Canadians are projected to have shelled out $25.2 billion for drugs, including $21.1 billion...

Arrhythmogenic right ventricular cardiomyopathy with evidence of biventricular involvement.(Teaching Case Report)(Clinical report)
June 19, 2007... The case: A 37-year-old man was admitted to our hospital with recurrent palpitations. Arrhythmogenic right ventricular cardiomyopathy had been diagnosed 10 years before admission and had been treated with sotalol. Physical examination revealed...

Idiopathic granulomatous mastitis lesion mimicking inflammatory breast cancer.(Clinical Vistas)(Clinical report)
June 19, 2007... A 30-year-old schoolteacher, primiparous, came to our clinic at 4 months postpartum with a month history of a painful swelling her left breast. It had already been drained on several occasions. She had no history of fever, trauma or use of oral...

Effect of widespread restrictions on the use of hospital services during an outbreak of severe acute respiratory syndrome.(Research)
June 19, 2007... ABSTRACT Background: Restrictions on the nonurgent use of hospital services were imposed in March 2003 to control an outbreak of severe acute respiratory syndrome (SARS) in Toronto, Ont. We describe the impact of these restrictions on...

Expedited transfer for primary percutaneous coronary intervention: a program evaluation.(Research)(Clinical report)
June 19, 2007... ABSTRACT Background: A shorter time from symptom onset to reperfusion is associated with improved outcomes for patients with ST-segment elevation myocardial infarction (MI). Primary percutaneous coronary intervention is a favourable method...

Is the Quarantine Act relevant?(Public Health)
June 19, 2007... In December 2006 the Government of Canada announced the coming into force of the new Quarantine Act. (1) This new act modernizes legislation dating back to 1872. According to Dr. David Butler-Jones, Canada's Chief Public Health Officer, "the...

Achieving optimal care for ST-segment elevation myocardial infarction in Canada.(Commentary)
June 19, 2007... For patients in Canada, 2 strategies may be initiated in the emergent treatment of ST-segment elevation myocardial infarction (MI)--primary percutaneous coronary intervention or fibrinolytic drug therapy. Regardless of which strategy is chosen,...

Health Canada's progressive licensing framework.(Commentary)
June 19, 2007... Health Canada is modernizing the regulatory process for pharmaceutical and biologic products through a project called the Progressive Licensing Framework. (1) Through this initiative, Health Canada is developing a new framework consisting of...

Progressive drug licensing: an opportunity to achieve transparency and accountability?(Commentary)
June 19, 2007... Health Canada's Progressive Licensing Framework, (1) as described in this issue by Neil Yeates, (2) suggests that the present drug regulation system needs improvement. The most substantive change in the new framework is that Health Canada will...

Advances in the medical management of benign prostatic hyperplasia.(Commentary)(Disease/Disorder overview)
June 19, 2007... Prostatic disease eventually affects almost all men; benign prostatic hypertrophy or hyperplasia (BPH) is an inevitable part of aging. It has several effects, including progressive bothersome voiding symptoms (now termed lower urinary tract...

Prostate-specific antigen in the early detection of prostate cancer.(Prostate Cancer Prevention Trial)(Clinical report)
June 19, 2007... ABSTRACT Throughout Canada, the United States and much of Europe, prostate-specific antigen (PSA) screening for prostate cancer has proliferated over the past 2 decades, leading to dramatic increases in detection rates of prostate cancer....

Vascular inflammation.(endothelial dysfunction)(Letter to the editor)
June 19, 2007... I read with interest the recent article by Ramon Arroyo-Espliguero and Juan Kaski on the role of vascular inflammation as a possible mechanism underlying cardiac syndrome X. (1) The hypothesis that systemic or vascular inflammation is involved...

Nitrofurantoin and pregnancy.(Letter to the editor)
June 19, 2007... The recent CMAJ teaching case report by Aneez Mohamed and colleagues elegantly details an important complication of treatment with nitrofurantoin, (1) which might have occurred even if the patient had not been pregnant. However, the...

Physicians' participation in research.(Letters)(Letter to the editor)
June 19, 2007... I (the first author) am currently working with the Motherisk program at the Hospital for Sick Children, where I am helping with a research project that involves contacting family physicians' offices, describing a survey to the nurse or office...

Maintaining ethical standards in chart audits.(Letters)(Letter to the editor)
June 19, 2007... My physician recently told me that he had audited the charts of his patients with diabetes. I casually asked who had done the audit for him. He replied, "My daughter." My heart dropped; his daughter is a student nurse in the program in which I...

Treatment of mental illness in India.(Letter to the editor)
June 19, 2007... I read with interest the article by Stephen Kisely and colleagues on inequitable access for mentally ill patients to some medically necessary procedures. (1) In India, the prevalence of major mental and behavioural disorders is estimated to be...

Correction.(Correction notice)
June 19, 2007... In a recent article, (1) the text referred to a lesion on the patient's right foot, whereas the images showed the patient's left foot. The lesion was indeed located on the patient's left foot, and we apologize for this error. REFERENCE ...

Reflections on SARS.(severe acute respiratory syndrome)(SARS in context: memory, history, policy)(Book review)
June 19, 2007... SARS in context: memory, history, policy Edited by Jacalyn Duffin and Arthur Sweetman McGill-Queen's University Press; 2006 210 pp Can$29.95 ISBN 978-0-77353-194-9 Lessons continue to be recounted and learned in the long wake after severe...

Creative convalescence.
June 19, 2007... I enjoy convalescence. It is the part that makes the illness worth while. --George Bernard Shaw Ignatius of Loyola, founder of the Jesuits, was converted to the religious life while recovering from a battle wound. Convalescence has been...

That growing uneasiness buried within.(Room for a view)(views on aging )
June 19, 2007... Time They call it a Home for the Aged, whenever it's mentioned (and mentally file it away under D... for Decrepit. And Dreary. And Death.) while they fight off their hidden reluctance to stay for that duty-bound...

Doctor, what would you do if you were me?(One thousand words)(art portrays insight)(Brief article)
June 19, 2007... A double-faced mirror, with a central band and cutouts for the eyes. Look closely into the mirror. You see your face reflected back at you, as you expect. But the eyes--the eyes are not yours! They are those of the person looking through from...

Deaths.(Obituary)
June 19, 2007... Anderson, Joseph Cockburn, Richmond, BC; University of Glasgow, Scotland, 1944. Died Feb. 5, 2007, aged 85. Cambon, Kenneth George, Vancouver; McGill University, 1951, otolaryngology. Died Feb. 25, 2007, aged 83. Cameron, Michael Paul,...

Query.(therapy of listening to music in the car)(Column)
June 19, 2007... Maybe I'm getting spiritual in my old age, flaky. Maybe it's all the therapy. But lately, when I'm driving in my car, I find I can utterly ground myself by listening to the stereo. A good song comes on and it makes the drive worthwhile: I zoom,...