CMAJ: Canadian Medical Association Journal articles from March 2006

CMAJ: Canadian Medical Association Journal archives from March 2006

Is medicine still a profession?/La medecine est-elle encore une profession?(Editorial)
March 14, 2006... There must be something to this question, given the increasing number of medical associations that are issuing proclamations to promote professionalism. Among these is a report published in the UK late last year by the Royal College of...

Copeman clinics come under scrutiny.(News)
March 14, 2006... The high-end for-profit medical clinics that Vancouver-based Don Copeman hopes to establish across the country are still waiting for the green light after the governments of Ontario and British Columbia questioned the legality of enrolment...

Tony Clement appointed as Canada's new health minister.(News)
March 14, 2006... Former Ontario health minister Tony Clement, once dubbed "two-tier Tony" for his oft-stated belief there must be "more choice in health care," was appointed federal Minister of Health in the new Conservative government on Feb. 6. Clement's...

SSRI ads questioned.(selective serotonin reuptake inhibitor)
March 14, 2006... Claims in drug monographs and advertising that selective serotonin reuptake inhibitor (SSRI) antidepressants work by normalizing serotonin levels are not based on scientific evidence and should be prohibited, says a leading US psychiatrist. ...

Accelerate health system renewal, says Health Council.(News)
March 14, 2006... It's time to accelerate the renewal of Canada's "patchwork" approach to healthcare with an emphasis not only on access, but also on quality, says a new report from the Health Council of Canada. "Access is important, but it's time to...

Assisted suicide debated in the United States.(News)
March 14, 2006... When the US Supreme Court upheld Oregon's controversial assisted suicide law in January, it rekindled other states' efforts to pass similar legislation. With a 6-3 decision, the court ruled that the US attorney general can't punish doctors...

Yukon physician shortage taxes family doctors.(News)(Brief article)
March 14, 2006... About 5000 patients in the Yukon Territory lack a family physician, and the shortage of specialists is putting increasing strain on existing doctors, says the president of the Yukon Medical Association. "A lot of our time is spent working...

Funds to fight TB.(News @ a glance)(Brief Article)
March 14, 2006... Funds to fight TB: The Global Plan to Stop Tuberculosis (2006-2015), a partnership led by WHO, was launched with a UK commitment of US$74 million and tripling of funding from the Bill and Melinda Gates Foundation to more than US$900 million....

Sobering thought.(News @ a glance)(Brief Article)
March 14, 2006... Sobering thought: Almost 50% of seriously injured snowmobile drivers had been drinking alcohol--double the number from 5 years ago. New data from the Canadian Institute for Health Information confirm that snowmobile incidents are still the...

Toxic tobacco smoke.(News @ a glance)(Brief Article)
March 14, 2006... Toxic tobacco smoke: California is the first US state to place secondhand tobacco smoke alongside tailpipe and smokestack exhausts as a toxic air pollutant and candidate for regulation. It is expected to revive legislative efforts to ban...

Tube feeding.(News @ a glance)(www.stopdrugads.org)(Brief Article)
March 14, 2006... Tube feeding: Commercial Alert, a consumer advocacy group, has launched a Web site devoted to ending direct-to-consumer prescription drug advertising (www.stopdrugads.org). More than 200 American medical school professors signed a statement...

Junk TV.(News @ a glance)(Brief Article)
March 14, 2006... Junk TV: American advocacy groups and parents in Massachusetts are suing the Nickelodeon TV network and Kellogg Co. in a bid to stop junk food marketing to children. The plaintiffs are the Center for Science in the Public Interest, a non-profit...

How do we choose our specialty?(Pulse)
March 14, 2006... Results from the 2004 National Physician Survey illustrate interesting differences in how physicians choose their specialty (Fig. 1). [FIGURE 1 OMITTED] Among second-year residents who completed the survey, those who chose family...

Increasing interest in family medicine.(Analysis)
March 14, 2006... The Canadian Federation of Medical Students (CFMS) believes that high-quality and sustainable health care depends on an adequate supply of family physicians and that more must be done to address the current (and future) shortfall of practising...

Fatigue: a practical approach to diagnosis in primary care.(Teaching Case Report)
March 14, 2006... The case: A previously well 36-year old woman taking no medications presented to her primary care physician's office with a complaint of unusual generalized fatigue. It had progressed over 8 months, was exacerbated by physical and mental...

WinRho and disseminated intravascular coagulopathy.(Health and Drug Alert)
March 14, 2006... Reason for posting: WinRho is a human blood product, [Rh.sub.o](D) immune globulin, widely used to treat immune thrombocytopenic purpura (ITP) and to prevent Rh alloimmunization in pregnant women who are Rh-negative. Recently, however, a case...

Doubling the burden: chronic disease.(Public Health)
March 14, 2006... Chronic diseases such as cardiovascular disease (CVD), diabetes, obesity, cancer and respiratory diseases cause more than half of the 58 million deaths that occur each year, worldwide. (1) Contrary to popular belief, these chronic diseases...

Does sex affect how patients respond to ASA?(acetylsalicyclic acid )
March 14, 2006... Berger JS, Roncaglioni MC, Avanzini F, et al. Aspirin for the primary prevention of cardiovascular events in women and men: a sex-specific meta-analysis of randomized controlled trials. JAMA 2006;295:306-13. Background: The role of ASA in...

A non-healing nodule in a returned traveler.(Clinical Vistas)
March 14, 2006... A previously healthy 26-year-old man presented for evaluation of a non-healing nodule on the medial aspect of his right heel. The lesion began while he was on holiday in Peru 4 weeks previously. He did not recall any bite or trauma. He had worn...

Books received.(Practice)
March 14, 2006... Cook RJ, Dickens BM, Fathalla MF. Sante de la reproduction et droits humains: integrer la medecine, l'ethique et le droit. Paris: Masson; 2005. 544 pp. $35 ISBN 2-294-02164-9 Cullen R. Health information on the internet: a study of...

Head and neck cancer in primary care: presenting symptoms and the effect of delayed diagnosis of cancer cases.
March 14, 2006... ABSTRACT Background: Little is known about the diagnosis of head and neck carcinoma in primary care. We sought to estimate the general prevalence of symptoms reported by patients with head and neck carcinomas and to determine the...

Variation in health services utilization among ethnic populations.(Research)
March 14, 2006... ABSTRACT Background: Although racial and ethnic disparities in health services utilization and outcomes have been extensively studied in several countries, this issue has received little attention in Canada. We therefore analyzed data from...

Can we develop wait lists for public health issues?
March 14, 2006... Wait lists have gained sharp prominence within the landscape of health care issues. Stories and statistics of how the common citizen has suffered and sometimes died while waiting for surgical and other medical procedures are legion, and they...

Living organ donors face financial barriers: a national reimbursement policy is needed.(Column)
March 14, 2006... Kidney transplantation from living donors is an established treatment for end-stage renal disease: it increases life expectancy, improves quality of life and is less costly than dialysis. In Canada, the growth of solid-organ transplantation...

Health benefits of physical activity: the evidence.
March 14, 2006... ABSTRACT The primary purpose of this narrative review was to evaluate the current literature and to provide further insight into the role physical inactivity plays in the development of chronic disease and premature death. We confirm that...

Managing low-grade cervical lesions.(Letters)(Letter to the editor)
March 14, 2006... The optimal management of patients with low-grade squamous intraepithelial lesions (LSIL), many of whom have transient human papillomavirus (HPV) infections, is controversial. We applaud Susie Lau and Eduardo Franco for tackling this difficult...

Not all guidelines are created equal.(Letter to the editor)
March 14, 2006... I have read with interest the recent editorial criticizing the Canadian Diabetes Association (CDA) Clinical Practice Guidelines (CPGs). (1) I am one of the few physicians who have served on both clinical practice guideline groups and drug...

Corrections.(Letters)(Correction Notice)
March 14, 2006... Reference 10 in a recent commentary (1) was incorrect. The reference should have read as follows: Shah T, Casas J, Cooper J, et al. Insight into the nature of the CRP-coronary event association using Mendelian randomisation [abstract]....

Brand-name disease.(Selling Sickness: How the World's Biggest Pharmaceutical Companies are Turning Us All into Patients )(Book review)
March 14, 2006... Selling sickness: How the world's biggest pharmaceutical companies are turning us all into patients Ray Moynihan and Alan Cassels Vancouver/Toronto: Greystone Books, 2006 254 pp $32.95 (cloth) ISBN 1-55365-131-6 In 1999 shyness became a...

Come, let's to bed.(great people with less physical activity)
March 14, 2006... Come, let's to bed, Says Sleepy-head; Tarry a while, says Slow: Put on the pan, Says Greedy Nan, Let's sup before we go. --Traditional nursery rhyme I was brought up in an English boarding school whose...

Deaths.
March 14, 2006... 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. Arronet, George Heinrich,...

Query.
March 14, 2006... I've agreed to cover a colleague's practice for a week. I said yes, thinking that we shared a similar outlook on life, had similar gripes about the ministry of health and the local hospital, similar frustrations with overbearing and demanding...

Deaths.(Obituary)
March 28, 2006... Aitken, Donald Melvin, Toronto; Dalhousie University, 1961. Died Jan. 20, 2006, aged 72. Allison, Gerda Elisabeth, Etobicoke, Ont.; University of Manitoba, 1937, psychiatry. Died Jan. 29, 2006, aged 92. Ayres, Peter Graham, North York,...

Query.(obesity in doctors)
March 28, 2006... A particular Herman cartoon I saw years ago has been bothering me: one where a big blimp of a doctor, a gross, morbidly obese specimen, advises a credulous patient that he should take up exercise to lose weight. I think I've grown into...

A catalyst for change/Un catalyseur de changement.(Editorial)
March 28, 2006... Early release. Published at www.cmaj.ca on Feb. 24, 2006. The Journal's Editor in Chief, John Hoey, and Senior Deputy Editor, Anne Marie Todkill, were dismissed on Feb. 20, 2006. Their departure is a blow to the CMAJ, Canadian physicians...

Nurse practitioners now able to work across Canada.(News)
March 28, 2006... With the passage of new regulations in Prince Edward Island, legislation now exists across Canada allowing nurse practitioners (NPs) to work. All the provinces and 2 territories have passed new legislation. In the Yukon, where nurses have...

For-profit clinic founder is CMA's new president-elect.(Canadian Medical Association)
March 28, 2006... BC physicians have elected the medical director of a private, for-profit clinic as the president-elect of the CMA. Pending ratification at the CMA General Council in August, Dr. Brian Day, founder of the Cambie Surgery Centre in Vancouver,...

STIs a "hidden epidemic": SOGC.(sexually transmitted infections, Society of Obstetricians and Gynaecologists of Canada )(Brief article)
March 28, 2006... The Society of Obstetricians and Gynaecologists of Canada (SOGC) is calling for a national strategy to combat rising rates of sexually transmitted infections (STIs), which they say have risen so much they constitute a "hidden epidemic." ...

Canadian helps WHO with pandemic.(World Health Organization, Paul Gully )(Brief article)
March 28, 2006... Canada's deputy chief public health officer is heading to Geneva on a 2-year secondment to help the WHO prepare for a possible influenza pandemic. In April, Dr. Paul Gully will begin working with Dr. Margaret Chan, WHO's pandemic point...

Acting CMAJ editor appointed.(Canadian Medical Association Journal)
March 28, 2006... Dr. Noni MacDonald was appointed acting editor-in-chief Mar. 7 by the journal's owners, Canadian Medical Association Holdings (CMAH) and the CMA. Her appointment comes two weeks after CMAJ's editor-in-chief and senior deputy editor were asked...

First president.(Peter Nicholson, Canadian Academies of Science)(Brief article)
March 28, 2006... First president: Peter Nicholson, who holds a doctorate in physics, is the inaugural president of the Canadian Academies of Science. Nicholson has extensive experience in both science and government, most recently as deputy chief of staff for...

BC goes hip.(British Columbia)(Brief article)
March 28, 2006... BC goes hip: The BC government is investing $60.5 million to ramp up its wait time management, with a focus on joint and hip patients. Included in the package of reforms is $25 million for 2 new operating rooms dedicated to hip and knee...

Physician supply.(Brief article)
March 28, 2006... Physician supply: Canada needs a national body to coordinate physician human resource planning, delegates to a national conference agreed. In late January, 130 delegates from government and professional organizations attended the National...

Donate a day.(Canadian Physicians for Aid and Relief )(Brief article)
March 28, 2006... Donate a day: Canadian Physicians for Aid and Relief is challenging Canadian health practitioners to donate all or part of the day's income on World Health Day (Apr. 7) toward building healthy communities in Africa. CPAR (www.cpar.ca) works...

Pink eye and fusidic acid.(Brief article)
March 28, 2006... Is fusidic acid better than placebo for treating acute infectious conjunctivitis? In a randomized controlled trial, 181 adult patients in primary care with (muco)purulent discharge or sticking eyelids were given fusidic gel 1% or placebo 4...

Fruit, veg and stroke.(5 servings of fruit and vegetables per day have 26% less risk of stroke )(Brief article)
March 28, 2006... People who eat more than 5 servings of fruit and vegetables per day have 26% less risk of stroke than those who eat fewer than 3 servings per day (pooled relative risk [RR] 0.76, 95% CI 0.69-0.79), and eating 3-5 servings per day reduces the...

Sibling risk of CVD.(cardiovascular disease)(Brief article)
March 28, 2006... In the Framingham Offspring Study (a cohort of the Framingham Heart Study) people without cardiovascular disease (CVD) were followed for 8 years. CVD in a sibling (occurring before 55 years of age in men and 65 years in women) was found to...

Intensive diabetes therapy and CVD.(cardiovascular diseases)(Brief article)
March 28, 2006... For patients with type 1 diabetes, intensive therapy reduces the risk of microvascular and neurologic complications. Its long-term impact on CVD, however, has been unclear. In the Diabetes Control and Complications Trial, patients were randomly...

Does glycemic control with insulin therapy play a role for critically ill patients in hospital?
March 28, 2006... Hyperglycemia commonly occurs in critically ill patients. Indeed, a link between critical illness and hyperglycemia was recognized as early as the late 19th century, with the coining of the term "stress hyperglycemia." In-hospital stress...

Can you prevent adverse drug events after hospital discharge?(Teaching Case Report)
March 28, 2006... Case 1: An 80-year-old woman was admitted to the clinical teaching unit of the local university hospital because of congestive heart failure, which had been precipitated by new-onset rapid atrial fibrillation. She was prescribed warfarin for...

Poverty and health.(Public Health)
March 28, 2006... Health and poverty are inextricably intertwined. Being able to breast-feed, attend school, work to grow food, earn a living or feed a family all depend on a baseline level of good health. Yet, when more than a billion people live on less than...

A child with fever, hip pain and limp.(Clinical Vistas)
March 28, 2006... A previously well 12-year-old boy presented after 1 month of increasing right-sided hip pain with a limp, decreased energy and a 2-kg weight loss. He had no history of trauma, other joint problems, recent travel or contact with ill people. He...

Granulocyte colony-stimulating factor for acute ischemic stroke: a randomized controlled trial.
March 28, 2006... Abstract Background: Because granulocyte colony-stimulating factor (G-CSF) has anti-inflammatory and neuroprotective properties and is known to mobilize stem cells, it may be useful in the treatment of acute ischemic stroke. We sought to...

Intravenously administered vitamin C as cancer therapy: three cases.
March 28, 2006... Abstract Early clinical studies showed that high-dose vitamin C, given by intravenous and oral routes, may improve symptoms and prolong life in patients with terminal cancer. Double-blind placebo-controlled studies of oral vitamin C...

Editorial autonomy of CMAJ.(Canadian Medical Association Journal )
March 28, 2006... An Ad-hoc Committee * of the Editorial Board was asked by Dr. John Hoey, the former editor in chief of CMAJ to review a series of recent events that he asserted compromised the editorial independence of CMAJ. We have reviewed the events,...

Editorial governance plan for CMAJ.(Canadian Medical Association Journal )
March 28, 2006... The Canadian Medical Association Journal (CMAJ) was founded in 1911 and after almost a century of operation it has grown to become Canada's pre-eminent peer-reviewed medical journal and one of the most respected general medical journals in the...

New hope for stroke patients: mobilization of endogenous stem cells.
March 28, 2006... Until recently, the inability of adult brain cells to regenerate iafter sustaining damage was an accepted scientific dogma. However, evidence has accumulated over the last decade that neurons and astrocytes can be generated from isolated cells...

High-dose vitamin C therapy: renewed hope or false promise?(Column)
March 28, 2006... Complementary and alternative medicine is commonly used by patients with cancer. Anywhere from 22% to 69% of cancer patients may take herbal medicine, medicinal teas, vitamins and minerals, and use visualization techniques. (1) There is often...

Prescribing exercise as preventive therapy.
March 28, 2006... Abstract Energy expenditure of about 1000 kcal (4200 kJ) per week (equivalent to walking 1 hour 5 days a week) is associated with significant health benefits. Health benefits can be achieved through structured or nonstructured physical...

Colon cancer screening.(Letter to the editor)
March 28, 2006... I am a bit perplexed about the cost-effectiveness analysis of CRC screening by Steven Heitman and associates. (1) First, it does not compare CT colonography with a "do nothing" approach nor does it take into consideration the recommendations of...

Conjugate vaccines and polysaccharide response.(Letter to the editor)
March 28, 2006... Purified polysaccharide vaccines work by activation of B cells in a T-independent manner, producing predominantly IgM and little memory B cells. (1) Proteinpolysaccharide conjugate vaccines (such as Prevnar/PCV7 which uses 7 prevalent...

Unnecessary distraction for specialist physicians.(Letter to the editor)
March 28, 2006... I read with interest the analysis and discussion of Audas and colleagues. (1) I am at a loss to understand the role of the basic medical examinations for specialist and family physicians when they are allowed to practise in their specialist...

Artist as visionary.(Norval Morrisseau: Shaman Artist, exhibition)
March 28, 2006... Norval Morrisseau: Shaman Artist Curator Greg Hill National Gallery of Canada Until Apr. 30, 2006 Northrop Frye, the venerable commentator on Canadian culture, postulated that the dominant Canadian concern is not "Who am I?" but rather...

Death of the doctor.(Poem)
March 28, 2006... Death of a doctor Be the shade from sun on the snow covered road a white scar left where the basal cell was removed deep and rooted Be the cut of the surgeon's knife the harbinger of news from tall places ...