CMAJ: Canadian Medical Association Journal articles from June 2008

CMAJ: Canadian Medical Association Journal archives from June 2008

Canada's pathology/La pathologie au Canada.(Editorial)(Editorial)
June 3, 2008... Critical issues in Canadian anatomic pathology have surfaced like a crashing wave. Reports from the judicial inquiry into erroneous breast cancer estrogen and progesterone receptor testing, (1) the public inquiry into faulty forensic pathology,...

Finding a balance in the treatment and prevention of obstetric fistula.(News)(Case study)
June 3, 2008... With curly lashes and soft, full eyebrows, Almaz looks younger than her 20 years, even more so when she starts to cry. "I'm scared," she says in Amharic, digging her nails into the palms of her hands. "I don't want to die." She is about to...

Medical whistle-blower protection lacking.(News)
June 3, 2008... Whistle-blowing doctors who take stands on behalf of their patients typically have few protections against retaliation. But that's begun to change in some countries and states, like California, in which hospitals can be fined for reprisals....

Bringing health care to a contested corner of India.(News)
June 3, 2008... The 9-year-old girl's smile glows in the dim light of a mud-floor clinic in Tuining, a small village in the Indian state of Manipur, as she listens intently to a health counsellor. Domhring is HIV-positive; so are her mother and father. Every...

Risks unavoidable and worth taking.(Dispatch from the medical front)
June 3, 2008... At the Canadian-led Role 3 Multinational Medical Unit, we have had to take risks. When transferring Afghan patients home, to the Khandahar Regional Military Hospital or to Mirwais Regional Hospital, we often have to weigh the probability of...

Inadequate surveillance.(For the record)
June 3, 2008... The Public Health Agency of Canada's capacity to detect, monitor and control infectious disease threats remains sorely lacking even though 4 years have elapsed since it was established, says Auditor-General of Canada Sheila Fraser. Fraser...

Whatever happened to Jordan's principle?(News)
June 3, 2008... Thirty-seven special needs children living on a remote Manitoba First Nation reserve are going without a variety of medical and social services because the federal and provincial governments cannot decide who should cover the costs. ...

Ontario and Manitoba to reimburse expenses for living organ donors.(News)
June 3, 2008... Living organ donors in Ontario and Manitoba are now eligible to receive reimbursements for out-of-pocket expenses and income lost during surgery recovery. British Columbia is the only other province with such a program. In Manitoba, the...

Infection prevention measures may limit liability.(News)
June 3, 2008... Hospitals can be subject to medical liability claims if they fail to take steps to demonstrate that they are striving to minimize the risk of nosocomial infections, legal experts say. The degree of liability would likely depend on the...

DNA discrimination.(Also in the news)(Brief article)
June 3, 2008... DNA discrimination: Health insurers or employers will be prohibited, under legislation passes by the United States Senate in April 2008, from using DNA testing to deny people medical coverage or jobs because of a genetic disposition to a...

Evenings and weekends.(Also in the news)(Brief article)
June 3, 2008... Evenings and weekends: One in 4 emergency-department visits to Ontario hospitals in 2005/06 were made by children under the age of 17, according to the Canada Institute for Health Information. Over 1 million visits were made by approximately...

Itsy-bitsy spiders.(Also in the news)(Brief article)
June 3, 2008... Itsy-bitsy spiders: Australian health authorities ordered the evacuation of Baralaba Hospital in the Banana Shire region of the state of Queensland after the facility was invaded by a horde of venomous redback spiders. The spiders, 2 to 4 cm...

Pesticide ban.(Also in the news)(Brief article)
June 3, 2008... Pesticide ban: Ontario has become the second province to officially ban the so-called "cosmetic use" of pest control products on residential lawns, gardens and parks. The ban "on over 300 toxic products goes far beyond Quebec's ban and is quite...

Holistic database.(Also in the news)(Brief article)
June 3, 2008... Holistic database: The Canadian Interdisciplinary Network for Complementary and Alternative Medicine Research has established an "Outcomes Database" (www.outcomesdatabase.org) to disseminate data about complementary and alternative medicine...

An even dozen.(Also in the news)(Brief article)
June 3, 2008... An even dozen: The University of Manitoba will launch the nation's first nonmilitary physician assistant (CMAJ 2007;177[5]:177) program in September. Up to 12 candidates will be accepted for the 2-year, full-time graduate-level program, which...

The burden and management of crystal meth use.(Public health)
June 3, 2008... Methamphetamine, a central nervous system stimulant, was first synthesized in 1919 as a synthetic substitute for ephedrine. Occult methamphetamine laboratories emerged in California in the 1960s, and its recreational use spread up and down the...

Diagnosis of scabies with dermoscopy.(Innovations in care)(Case study)
June 3, 2008... A 72-year-old woman was referred to our dermatology clinic with a 6-month history of severe diffuse pruritus. Examination with a hand-held epiluminescent stereomicroscope (dermoscope) (Figure 1) revealed scabies mites (Figure 2) within minutes,...

Tender nodules on the palms and soles after chemotherapy.(What is your call?)(Case study)
June 3, 2008... [FIGURE 1 OMITTED] [FIGURE 2 OMITTED] A 70-year-old man with a spindle-cell malignant tumour located in the left pleura received a first course of chemotherapy that consisted of 20 mg/[m.sup.2] of epirubicin and 2500 mg/[m.sup.2] of...

Postdischarge thromboprophylaxis and mortality risk after hip- or knee-replacement surgery.(Research)(Clinical report)
June 3, 2008... ABSTRACT Background: Patients undergoing hip or knee replacement are at high risk of developing a postoperative venous thromboembolism even after discharge from hospital. We sought to identify hospital and patient characteristics...

Impact of patient communication problems on the risk of preventable adverse events in acute care settings.(Research)
June 3, 2008... ABSTRACT Background: Up to 50% of adverse events that occur in hospitals are preventable. Language barriers and disabilities that affect communication have been shown to decrease quality of care. We sought to assess whether communication...

Incidence, severity and preventability of medication-related visits to the emergency department: a prospective study.(Research)(Report)
June 3, 2008... ABSTRACT Background: Medication-related visits to the emergency department are an important but poorly understood phenomenon. We sought to evaluate the frequency, severity and preventability of drug-related visits to the emergency...

Outpatient thromboprophylaxis after hip or knee surgery: discrepancies and concerns.(Research)
June 3, 2008... The high risk of venous thromboembolism among patients undergoing major lower limb surgery is well recognized. Recommendations for appropriate prophylaxis based on solid scientific evidence have been published by the American College of Chest...

Health literacy and harm: who is at risk? What is the fix?(Research)
June 3, 2008... The study by Bartlett and colleagues (1) on the risk of preventable adverse events among patients with communication problems admitted to acute care hospitals in this issue of CMAJ highlights major known flaws in how health care is delivered....

Funding for continuing medical education.(Letters)(Letter to the editor)
June 3, 2008... I am writing on behalf of the continuing medical education and continuing professional development offices at the 17 Canadian medical schools. For many years, we have had the same concerns as those expressed by Paul Hebert and the...

Looking for Mr. Gray.(Book review)
June 3, 2008... The Anatomist: A True Story of Gray's Anatomy Bill Hayes Ballantine Books; 2007 272 pp $24.95 ISBN 978-0-345-45689 Pity Bill Hayes, the author of this new biography of Henry Gray, the British surgeon who gave the world Gray's...

ABCs of medicine.(Room for a view)(Column)
June 3, 2008... Never forget that it is not a pneumonia, but a pneumonic man who is your patient. --William Withey Gull He travels down the hall on an embarrassing and uncomfortable gurney, bundled in layers of blankets, a hospital chart sitting...

Infection: 1882.(Poem)
June 3, 2008... Infection: 1882 "It is blood vessels, the system of nerves, of changes in temperature: these help the body fight off infection," the other doctors all say. But here he is, having left the University of Odessa for Messina months...

The nature of the profession.(Book review)
June 3, 2008... Catharsis: On the Art of Medicine Andrzej Szczeklik University of Chicago Press; 2005 161 pp $20.00 ISBN 0-226-78869-5 Why is a book on the essential art of medicine still getting rave reviews? Andrzej Szczeklik, a Polish...

Snapshot.(Notes)(Brief article)
June 3, 2008... Five pm... you are the last consult, the end of a busy Friday of a busy week... I review your chart... heart failure, diabetes, ACE inhibitors (if you're going to take an inhibitor, might as well be an ace!). You live in a private...

Deaths.
June 3, 2008... 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. Delaquis, Hubert, Winnipeg, Manitoba;...

The queering of medicine.(Salon)
June 3, 2008... I was 14 when my parents split up. It got so crazy that my brother and I needed our own lawyer. I suddenly had to become an adult in order to make sense out of chaos. As part of that process, I told my Dad that I was gay. He kicked me out and...

Integrity at the Croatian Medical Journal/L'integrite au Croatian Medical Journal.(Editorial)
June 17, 2008... Editorial independence has surfaced as an issue at the Croatian Medical Journal in the wake of a confrontation between the journal and the most powerful of its 4 owners, the Zagreb University School of Medicine. Most recently, the school has...

Hospital lotteries not always the best bet.(News)(Survey)
June 17, 2008... To call the home large would be like calling the sun warm. The 6815-square-foot behemoth, valued at some $2.5 million, has a wine room (with 2 fridges), a fitness room (fully equipped) and a "lavish" master bath (with his-and-her bathtubs). And...

Plan B comes out from behind the counter.(News)
June 17, 2008... Canada has become the fifth country in the world to approve the off-the-shelf sale of levonorgestrel (Plan B), the emergency contraception drug, after the National Association of Pharmacy Regulatory Authorities recommended it come out from...

Canadian Nurses Association celebrates centennial.(News)
June 17, 2008... When a devastating earthquake heaved the Indian Ocean into a tsunami that killed or injured up to 500 000 people on Dec. 26, 2004, Indonesia was hit harder than any other country. The island nation, home to more than 230 million residents, lost...

Fallen MAPLEs.(For the record)(Multipurpose Applied Physics Lattice Experiment)
June 17, 2008... Persistent technical problems and "economic impediments" have sunk the over budget, overdue and overdesigned Multipurpose Applied Physics Lattice Experiment (MAPLE) reactors, long touted as the future jewel of Canadian medical isotope supply....

Nursing "misadventures".(For the record)(Survey)(Brief article)
June 17, 2008... There's a 1 in 5 chance that a hospital patient will be administered the wrong dose of a drug, according to a Statistics Canada survey of the nation's nurses. Medication errors are most commonly made by nurses working overtime, with 22%...

Onward and upward.(For the record)(Brief article)
June 17, 2008... Drug spending in Canada is rising faster than overall health spending and easily outstripping the rate of inflation, according to the Canadian Institute of Health Information's annual drug spending report. Canadian outlays for drugs topped...

Ontario's hospitals surpass those of Quebec in C. difficile rates.(News)
June 17, 2008... At too many hospitals, infection control is given about as much attention as "a lump of sod on the front lawn," complains a frustrated infection control specialist. Dr. Michael Gardam has investigated Clostridium difficile outbreaks that...

Aboriginal curriculum framework developed.(News)
June 17, 2008... In Calgary, Alberta, Dr. Linden Crowshoe challenges medical students to confront their stereotypes about the indigenous peoples of Canada through the use of interactive political theatre. At the Northern Ontario School of Medicine, first-year...

Industry handouts: enough is enough.(News)
June 17, 2008... An erstwhile government campaign once urged youngsters to "just say no" to street drugs. In an effort to combat the perception that medical education has become largely tainted by the influence of the pharmaceutical and medical devices...

In-vitro fertilization cost barriers.(Also in the news)(Brief article)
June 17, 2008... In-vitro fertilization cost barriers: Canadians have limited access to publicly-funded in-vitro fertilization and as a result, the country has fallen behind many developed countries in the provision of appropriate medical care for women who...

Fitness tax credit.(Also in the news)(Brief article)
June 17, 2008... Fitness tax credit: A mountaineering member of Alberta's legislature is proposing a $1500 fitness tax credit for all Albertans. Dave Rodney, a Tory who has twice climbed to the top of Mount Everest, has introduced a private member's bill to...

Killer diseases.(Also in the news)(Report)(Brief article)
June 17, 2008... Killer diseases: Noncommunicable diseases such as heart disease and stroke have replaced infectious diseases as the primary causes of deaths in the world, according to a World Health Organization report published May 19, 2008. Over the next 2...

A 1-week-old newborn with hypercalcemia and palpable nodules: subcutaneous fat necrosis.(Teaching cases)(Case study)
June 17, 2008... Abstract: We present a 1-week-old newborn with subcutaneous fat necrosis complicated by hypercalcemia. She received conservative treatment of adequate hydration and restricted supplementary vitamin D. ********** The case: A 1-week-old...

The York Region Methamphetamine Strategy.(Public health)
June 17, 2008... Since early 2000, the use of methamphetamine has spread from Western to Eastern Canada. The use of methamphetamine is low in the general Canadian population; however, higher rates can be seen within certain groups (see Box 1 for sources of...

Coffee-bean sign.(Clinical vistas)(Case study)(Brief article)
June 17, 2008... An 85-year-old man with a history of tongue cancer presented to the emergency department with a 2-day history of abdominal distension, pain and constipation. He had no fever or vomiting. A physical examination revealed a distended abdomen with...

Change in bone mineral density as a function of age in women and men and association with the use of antiresorptive agents.(Research)(Survey)
June 17, 2008... ABSTRACT Background: Measurement of bone mineral density is the most common method of diagnosing and assessing osteoporosis. We sought to estimate the average rate of change in bone mineral density as a function of age among Canadians aged...

Adverse effects of medical cannabinoids: a systematic review.(Research)
June 17, 2008... ABSTRACT Background: The therapeutic use of cannabis and cannabis-based medicines raises safety concerns for patients, clinicians, policy-makers, insurers, researchers and regulators. Although the efficacy of cannabinoids is being...

Pharmacologic mechanisms of crystal meth.(Mechanisms and innovations)
June 17, 2008... Abstract Crystal meth is a form of the stimulant drug methamphetamine that, when smoked, can rapidly achieve high concentrations in the brain. Methamphetamine causes the release of the neurotransmitters dopamine, norepinephrine and...

Our approach to osteoporosis screening and treatment needs to change.(Research)
June 17, 2008... Our understanding of and approach to osteoporosis is in the middle of a revolution. The prevailing view has been that the loss of ovarian estrogen production at menopause ushers in a period of bone loss. The loss is rapid for a few years and is...

The adverse effects of cannabinoids: implications for use of medical marijuana.(Research)
June 17, 2008... Cannabis preparations have been used to relieve nausea, improve appetite and reduce pain for thousands of years. (1) The development of synthetic drugs in the 20th century supplanted these and other herbal remedies, but in the past several...

Hypoxia and Alzheimer disease.(Letters)(Letter to the editor)
June 17, 2008... Christopher Patterson and colleagues reviewed the modifiable risk factors for Alzheimer disease but did not mention that hypoxia may stimulate the development of this illness. (1) Cigarette smoking, severe head injury with loss of consciousness...

Splinting in the intensive care unit.(Letters)(Letter to the editor)
June 17, 2008... Heidi Clavet and colleagues recently reported the results of a study in a much-needed area of research that receives little attention. (1,2) Conservative treatment of contractures is time consuming and often results in few gains in cases of...

Correction.(Letters)(Correction notice)
June 17, 2008... In the full-text version of the Health and Drug Alert "The Evra (ethinyl estradiol/norelgestromin) contraceptive patch: estrogen exposure concerns," (1) the doses of ethinyl estradiol, norelgestromin and norgestimate were mistakenly listed in...

Kiviuq: the power to heal.(Movie review)
June 17, 2008... Kiviuq A film by John Houston Triad Films and drumsong production; 2007 72 min. English The film Kiviuq, the Inuit creation myth, begins with this plea from a young Inuit woman: "Many young Inuit have a hole in their spirit...

Remembering Dr. John Snow on the sesquicentennial of his death.(Past progressive)(In memoriam)
June 17, 2008... On June 16, 1858, the world lost a legendary medical pioneer. John Snow MD, suffered a fatal stroke while nearing completion of his book Chloroform and Other Anesthetics, which was edited and published later that year by his friend and...

Where art and genetics meet.(Lifeworks)
June 17, 2008... From a leaping frog to a kaleidoscope swirl, the images submitted to a first annual digital art contest and e-exhibit were hugely varied, offering intriguing interpretations of the place where visual art and genetics meet...

Deaths.(Obituary)
June 17, 2008... Basmajian, John Varoujan, Ancaster, Ontario; University of Toronto, Toronto, Ontario, 1945, physical medicine and rehabilitation. Died Mar. 18, 2008, aged 86. The citation appointing Dr. Basmajian as an Officer of the Order of Canada (1995)...

John Snow, hero of cholera: RIP.(Salon)
June 17, 2008... Dr. John Snow is not the first man to be honoured for valorous acts he never accomplished, nor is he the first to have honest, partially successful work transformed into a miraculous success. On the 200th anniversary of Snow's death it is time...