CMAJ: Canadian Medical Association Journal articles from March 2007

CMAJ: Canadian Medical Association Journal archives from March 2007

What's killing and maiming Canada's youth?(Editorial)
March 13, 2007... Across Canada, injuries are the leading cause of death among our youth--those defined by the World Health Organization as being 12-24 years of age. The transition to adulthood, although smooth for some, can be full of danger: many take chances,...

Qu'est-ce qui tue et blesse les jeunes du Canada?(EDITORIAL)
March 13, 2007... D'un bout a l'autre du Canada, les blessures sont les principales causes de mortalite chez les jeunes--soit les 12 a 24 ans selon l'Organisation mondiale de la sante. Meme si elle se fait sans heurts pour certains, la transition vers l'age...

Call for arm's-length national research integrity agency.(NEWS)
March 13, 2007... It's the classic Canadian response to a problem like scientific misconduct, says Toronto physician--scientist Dr. Paul Pencharz. "Deny, deny, deny. Sweep it under the carpet." Inevitably, though, Pencharz forecasts Canada will have little...

$110 million vaccine research center to be built in Saskatoon.(NEWS)(International Vaccine Center, InterVac)
March 13, 2007... An advanced vaccine research station, to be constructed in Saskatoon by 2010, will put Canada at the forefront of the worldwide fight against infectious diseases such as SARS, avian influenza, hepatitis C and tuberculosis. The...

Graduated driver licensing in Canada: slowly but surely.(NEWS)
March 13, 2007... Graduated driver licensing programs vary significantly across the country but new evidence about best practices shows there is room for improvement (see editorial, pages 737 and 739). Since 1994, nearly every province has implemented some...

Mixed reviews for Canada's new food guide.(NEWS)
March 13, 2007... Federal health minister Tony Clement believes it's state-of-the-art and some praise the newly updated Canada Food Guide as sound nutritional advice, but critics aren't convinced that recent revisions to the 65-year-old document will do enough...

RateMDs.com nets ire of Canadian physicians.(NEWS)
March 13, 2007... An American Web site that lets patients post anonymous comments about their physicians online appears to have become wildly popular in Canada in recent months. But it's provoking both fear and threats of legal action from the medical community...

Politicians', bureaucrats' drug plans deemed too costly for public formularies.(NEWS)
March 13, 2007... Call a spade a spade, says Lillian Morgenthau, president of Canada's Association for the Fifty Plus (CARP). Politicians and bureaucrats whose taxpayer-funded drug plans include medications that they've deemed too expensive for the...

Montreal clinic uses public-private payment scheme.(NEWS)
March 13, 2007... Controversy has erupted over a new "semi-private" medical clinic in Montreal that many believe crosses the line to create a two-tier medical system in Quebec. The clinic, critics say, violates provisions of both the Canada Health Act and...

News @ a glance.(NEWS)(treating gambling addiction)(Brief article)
March 13, 2007... UK gamblers need treatment: The British Medical Association wants gambling to be recognized as an addiction that requires treatment under the National Health Service. In its Jan. 15 report, Gambling addition and its treatment within the NHS,...

Ten-year trend: surgeries up, hospitalizations down.(PULSE)(Statistical data)
March 13, 2007... Laparoscopic surgery and other advances in medical technology are associated with a decline in the number of patients admitted to hospital over the last decade, the Canadian Institute for Health Information (CIHI) reports. When adjusted...

Stock your emergency department with ice packs: a practical guide to therapeutic hypothermia for survivors of cardiac arrest.(PRACTICE)(Clinical report)
March 13, 2007... Prognosis after cardiac arrest is dismal, with an overall survival rate of less than 6%. Outcomes vary with cardiac arrest rhythm: less than 2% of patients with asystolic or pulseless electrical activity survive, compared with up to 33% of...

Interventional radiology in palliative care.(CLINICAL VISTAS)
March 13, 2007... A41-year-old woman presented to the emergency department with pain in the lower right quadrant that was presumed to be caused by appendicitis. During surgery, a mass was found that was confirmed by pathology to be a moderately differentiated...

Public Health.(PRACTICE)(Hygiene: What and why?)
March 13, 2007... Hygiene: What and why? Mental hygiene, industrial hygiene, oral hygiene, vocal hygiene, respiratory hygiene... There are many "hygienes," but what does the word actually mean? Its definition--the science of preventive medicine and the...

Canadian breast cancer guidelines: have they made a difference?(RESEARCH)
March 13, 2007... ABSTRACT Background: A principal objective of the Canadian Clinical Practice Guidelines for the Care and Treatment of Breast Cancer was to reduce the variation in the way that breast cancer was being treated. To evaluate whether this goal...

Inequitable access for mentally ill patients to some medically necessary procedures.(RESEARCH)(Clinical report)
March 13, 2007... ABSTRACT Background: Although universal health care aims for equity in service delivery, socioeconomic status still affects death rates from ischemic heart disease and stroke as well as access to revascularization procedures. We...

Canadian breast cancer guidelines are as effective as possible under the circumstances.(COMMENTARY)
March 13, 2007... Clinical practice guidelines systematically synthesize overwhelming and sometimes conflicting medical research into a cogent statement to guide clinical decisions: However, the million dollar question remains unanswered--are guidelines...

Mental illness and cardiovascular mortality: searching for the links.(COMMENTARY)
March 13, 2007... In the Canadian health care system, where universal access is promoted as a goal (if not a reality), we need to understand where and why such access is unequal or inequitable--the latter term implying elements of unjustness and unfairness...

Sex-specific issues related to cardiovascular disease: a synopsis of the 2007 supplement.(COMMENTARY)
March 13, 2007... Accompanying this issue of CMAJ is a special supplement entitled "A comprehensive view of sex-specific issues related to cardiovascular disease" (available online at www.cmaj.ca/cgi/content/full/176/6/S1). (1) The supplement was prepared by...

Women and cardiovascular disease.(COMMENTARY)
March 13, 2007... Cardiovascular disease is responsible for half of all deaths among women aged 50 and older in Canada and the United States. Nevertheless, women have less heart disease than men. Perhaps this is the main reason why the study of heart disease in...

Management of acute decompensated heart failure.(REVIEW)(Disease/Disorder overview)
March 13, 2007... ABSTRACT Acute decompensated heart failure represents a heterogeneous group of disorders that typically present as dyspnea, edema and fatigue. Despite the high prevalence of this condition and its associated major morbidity and mortality,...

Possible patient overlap in studies.(increased risk of Clostridium difficile-associated disease with exposure to proton pump inhibitors)(Letter to the editor)
March 13, 2007... I read with great interest the article by Sandra Dial and colleagues, in which they reported an increased risk of Clostridium difficile-associated disease with exposure to proton pump inhibitors. (1) The cases in this study were recorded in the...

Health science research in Hungary.(canadian assistance)(Letter to the editor)
March 13, 2007... We read with great interest the paper by Judith Hall and associates on interdisciplinary health research in Canada. (1) In the 1990s, Canada contributed significantly to the development of education and research in the health sciences in...

The 1% solution.(Letter to the editor)
March 13, 2007... I read with interest CMAJ's list of health-related charities to which one could make donations as an alternative to buying Christmas gifts. (1) Most physicians I know will readily give $20 for a worthwhile cause (for example, they will buy...

Please slow down the CanMEDS express.(Letter to the editor)
March 13, 2007... Louise Samson, President of the Royal College of Physicians and Surgeons of Canada, recently wrote about a planned revision of the entire medical education curriculum at the Universite de Montreal based on the CanMEDS competency categories. (1)...

Inspired by Banting and Best.(Letter to the editor)
March 13, 2007... The reprinting of the first page of the original report on the use of pancreatic extracts in the treatment of diabetes mellitus by Banting and Best, with the wonderful accompanying commentary by Cathy Younger-Lewis, (1) gave me much joy, along...

Self-managed oral anticoagulation therapy.(Letter to the editor)
March 13, 2007... Dean Regier and colleagues successfully demonstrated that there are fewer thrombotic events, fewer major hemorrhagic events, fewer deaths and substantial cost savings for oral anticoagulation therapy self-managed by the patient compared with...

Avascular necrosis after a steroid injection.(LETTERS)(Letter to the editor)
March 13, 2007... I read with interest the Clinical Vista Brief about bilateral hip avascular necrosis. (1) I note that the corticosteroid injection was given 8 months before the condition was diagnosed, but the patient had complained of hip pain for 13 months....

The last day.(Room for a view)(pediatric intensive care)
March 13, 2007... In the pediatric intensive care unit, the difficult decision to forgo life-sustaining treatment must sometimes be made. The ICU doctors, the social worker, pastoral care, RTs... they all come and go into the room. However, one staff person--a...

The limits of hope.(The Road)(Book review)
March 13, 2007... The road Cormac McCarthy Random House; 2006 256 pp $30.00 ISBN 0-30726-543-9 We all, someday, are going to die. About this fact "there is no manner of doubt, no possible probable shadow of doubt, no possible doubt whatever" (W.S....

Grace in extremis.(Annotations)(life of Charles Lennox)(Biography)
March 13, 2007... His Grace, Charles Lennox, loved animals. [ILLUSTRATION OMITTED] He was born in the 18th century, into the English aristocracy, a world of privilege, duty and honour. At age 25 he was involved in a duel, triggered by a comment about...

Rabies in 19th century Great Britain.
March 13, 2007... Rabies was a well known clinical condition in Great Britain in the early part of the 19th century. The 7th edition of Thomas' practice published in 1821 (1) has a 15-page section on hydrophobia, rabies or canine madness. The text correctly...

Deaths.(Obituary)
March 13, 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. Davis, Murray McCulloch,...

Query.(when patients ditch the doctor)
March 13, 2007... It shouldn't matter. I should be used to it by now. But whenever it happens, I always think: what did I do? What didn't I do? Yesterday, via letter, a patient of mine requested that his records be transferred to another doctor. Normally,...

A comprehensive view of sex-specific issues related to cardiovascular disease.(Disease/Disorder overview)
March 13, 2007... ABSTRACT Cardiovascular disease (CVD) is the leading cause of mortality in women. In fact, CVD is responsible for a third of all deaths of women worldwide and half of all deaths of women over 50 years of age in developing countries. The...

Research misconduct? What misconduct?(control of misconduct among researchers through strict legislation)(Editorial)
March 27, 2007... Why has Canada lagged so far behind its Western counterparts in establishing comprehensive mechanisms and processes to deal with scientific misconduct? Is it inertia? Juris dictional wrangling? A naive belief that all Canadian researchers are...

Inconduite scientifique? Quelle inconduite?(EDITORIAL)(Editorial)
March 27, 2007... Pourquoi le Canada a-t-il tant de retard sur ses homologues occidentaux dans l'etablissement de mecanismes et processus integres pour faire face a l'inconduite scientifique? Est-ce un probleme d'inertie? De conflits entre niveaux de competence?...

Debate begins over public funding for HPV vaccine.(NEWS)(Human papillomavirus)
March 27, 2007... Should the vaccine against human papillomavirus be made available to young women and girls at public expense? Health Canada's National Advisory Committee on Immunization (NACI) and the Society of Obstetricians and Gynaecologists of Canada...

Students, scientists push for access to drugs in developing world.(NEWS)
March 27, 2007... High profile Canadian doctors and scientists have joined student activists in a campaign to push universities to reform their policies so that research and lifesaving medicines are more accessible in developing countries. Universities...

C. difficile inquest too narrow as "Quebec strain" goes international.(NEWS)
March 27, 2007... You know, you don't go to the hospital to get more sick," says Danielle Raymond, recounting how her father, 71-year-old Laurier Raymond, was sent home suffering from severe diarrhea last autumn, several weeks after his admission to...

US grapples with covering the uninsured.(NEWS)
March 27, 2007... With the 2008 presidential election in full flight, universal health care coverage has surged to the top of the political agenda in the United States, second only to the Iraq war. Propelled by rising premiums and shrinking access to private...

Quebec extends free drug coverage to 300 000.(NEWS)
March 27, 2007... Anti-poverty groups in Quebec are welcoming a government initiative to extend free prescription medication benefits to nearly 300 000 additional people--those on welfare and senior citizens on limited incomes. Quebec Health Minister...

Cochrane Library to be available to all Canadians.(NEWS)
March 27, 2007... Free access to the vast online databases of the Cochrane Collaboration, including 4655 Cochrane systematic reviews, 5900 non-Cochrane reviews and 5 other databases of research evidence, could soon be a reality for all Canadians. Free,...

Long road home: 15 Calgary physicians return to Sudan.(NEWS)
March 27, 2007... After more than 20 years, 3 countries and thousands of kilometres, Daniel Madit Thon Duop is on the verge of realizing his dream of returning to southern Sudan to practise medicine thanks to the intervention of a Canadian relief agency and...

News @ a glance.(NEWS)(Canadian Physicians for Aid and Relief's second annual World Health Day Challenge)(clinical trials of a topical microbicide to prevent HIV infection is halted)(prototype pandemic influenza vaccines shows promise against H5N1 virus)
March 27, 2007... Donating days: Roughly 60 physicians and health practitioners were up to the challenge last year. Will more meet the test this April 7th? That's certainly the hope of organizers of the Canadian Physicians for Aid and Relief's second annual...

Negative anion gap and elevated osmolar gap due to lithium overdose.(TEACHING CASE REPORT)(Clinical report)
March 27, 2007... The case: A 65-year-old man was found in a state of clouded consciousness of unknown duration. At hospital his Glasgow Coma Scale score was 9. Naloxone and thiamine were administered. A CT head scan showed no acute injury. The serum anion gap...

Hearing and aging.(PUBLIC HEALTH)(Clinical report)
March 27, 2007... Clinically significant hearing loss is the third most common condition among older adults. It is present in about 25%-40% of people over 65 years of age, 50% of those over 75, and 80% of those over 85 years (1)--becoming, with aging, the rule...

What's your call?(CLINICAL VISTAS BRIEFS)
March 27, 2007... A 62-year-old women presented with an ulcerated umbilical nodule and vaginal bleeding. [ILLUSTRATION OMITTED] A 15-year-old boy presented with a 4-month history of purple horizontal stripes on his lower back. [ILLUSTRATION...

Sister Mary Joseph's nodule.(CLINICAL VISTAS BRIEFS)(Clinical report)
March 27, 2007... This patient presented with an ulcerated umbilical nodule, profuse vaginal bleeding and a hemoglobin level of 45 g/L. Tumour was visualized at the apex of the vagina; however, biopsy was contraindicated because of bleeding. Biopsy of the...

Idiopathic striae atrophicae of puberty.(CLINICAL VISTAS BRIEFS)(Clinical report)
March 27, 2007... A 15-year-old boy presented with isolated horizontal stripes on his back that initially were purple but gradually faded. In the 6 months before presentation, he had gained 11 kg, to a weight of 61.1 kg (50th percentile) and had grown 10 cm, to...

Suitability of recommended limits for fasting glucose tests in women with polycystic ovary syndrome.(RESEARCH)(Clinical report)
March 27, 2007... Abstract Background: The Canadian and American Diabetes Associations recommend the use of an oral glucose tolerance test to screen for abnormal glucose tolerance among women with polycystic ovary syndrome when their fasting plasma glucose...

Ovarian cancer risk in relation to medical visits, pelvic examinations and type of health care provider.(RESEARCH)(Clinical report)
March 27, 2007... ABSTRACT Background: Whether the current recommendations for ovarian cancer prevention and screening (annual history and physical examination) are effective has not been evaluated. We examined the relation between health care use and the...

Health care use and risk of ovarian cancer: is there a link?(COMMENTARY)
March 27, 2007... The article by Abenhaim and colleagues in this issue presents an interesting case-control study that attempts to determine the risk of ovarian cancer associated with health care use by comparing the medical history of women with and without...

Screening for diabetes in women with polycystic ovary syndrome.(COMMENTARY)(Clinical report)
March 27, 2007... Polycystic ovary syndrome is a common hormonal disorder that affects an estimated 5%-10% of women of reproductive age. (1) This condition usually begins in the early teens and is characterized by chronic anovulation and hyperandrogenism;...

Contraception in Canada: a review of method choices, characteristics, adherence and approaches to counselling.(REVIEW)(Clinical report)
March 27, 2007... ABSTRACT Contraception is a significant concern for Canadian women of child-bearing age, their partners and their health care providers. In this narrative review we provide information on current trends and recent changes in Canadians'...

[beta]-blockers for hypertension.(Letter to the editor)
March 27, 2007... Nadia Khan and Finlay McAlister (1) conclude that [beta]-blockers are efficacious for hypertension in younger but not in older patients, but their conclusions are based on questionable statistical methods. In their Methods section, Khan and...

Coombs' testing and neonatal hyperbilirubinemia.(Letter to the editor)
March 27, 2007... Although we fully agree with Michael Sgro and colleagues regarding the need for early identification and effective management of neonatal hyperbilirubinemia, we were surprised to see their recommendation that the Coombs' test be used to screen...

Corrections.
March 27, 2007... In the meta-analysis of [beta]-blockers for the treatment of hypertension by Nadia Khan and Finlay McAlister, (1) there were typographic errors in the numbers reported on the right-hand side of Figs. 2A and 2B. None of the typographic errors...

Letters submission process.(LETTERS)
March 27, 2007... CMAJ 's enhanced letters feature is now the portal for all submissions to our letters column. To prepare a letter, visit www.cmaj.ca and click "Submit a response to this article" in the box near the top right-hand corner of any CMAJ article....

The newspaper people.(Room for a view)(Viewpoint essay)
March 27, 2007... They are the newspaper people. I meet them every morning at breakfast. They are terrorists. They are freedom fighters. They are soldiers. They are politicians. Some days it's hard to tell the difference. They are starving and oppressed by...

Ethics in conflict.(Bioethics and Armed Conflict: Moral Dilemmas of Medicine and War)(Book review)
March 27, 2007... Bioethics and armed conflict: Moral dilemmas of medicine and war Michael L. Gross The MIT Press; 2006 384 pp US$26.00 ISBN 0-262-57226-5 Medical ethics or bioethics is a core component of contemporary Western medical education...

Exploring beyond our limits.
March 27, 2007... Robert Davidson: The abstract edge Curator: Karen Duffek Organized by Museum of Anthropology at the University of British Columbia Circulated by the National Gallery of Canada National Gallery of Canada Feb. 2-May 6, 2007 ...

Donald William Alfred J., Calgary.(DEATHS)
March 27, 2007... Donald, William Alfred J., Calgary; University of Glasgow, Scotland, 1941, general surgery. Died Dec. 14, 2006, aged 90. NOTICE Readers are invited to submit brief remembrances of recently departed colleagues. Colourful writing is...

Kelen Andrew, Rockcliffe, Ont.(DEATHS)
March 27, 2007... Kelen, Andrew, Rockcliffe, Ont.; McGill University, 1943, internal medicine. Died Dec. 16, 2006, aged 88.

Kraft Barbara Netta Pead, Delta, BC.(DEATHS)(Obituary)(Brief article)
March 27, 2007... Kraft, Barbara Netta Pead, Delta, BC; McGill University, 1947, anesthesia. Died Dec. 22, 2006, aged 85. "She was a proud mother, successful physician, the loving wife of Robert William Kraft (d. 1999) and the loved friend of many. She is...

Lockington William Alexander, Burlington, Ont.(DEATHS)
March 27, 2007... Lockington, William Alexander, Burlington, Ont.; University of Western Ontario, 1943, psychiatry. Died Dec. 9, 2006, aged 89.

McCormick Andrew Quinn, Vancouver.(DEATHS)
March 27, 2007... McCormick, Andrew Quinn, Vancouver; McGill University, 1960, ophthalmology. Died Dec. 30, 2006, aged 77.

MacIntosh Alistair Eoin, Georgetown, Ont.(DEATHS)(Brief article)
March 27, 2007... MacIntosh, Alistair Eoin, Georgetown, Ont.; University of Aberdeen, Scotland, 1943, internal medicine. Died Dec. 15, 2006, aged 85.

MacWilliam John Carlyle, Kingston, Ont.(DEATHS)(Obituary)(Brief article)
March 27, 2007... MacWilliam, John Carlyle, Kingston, Ont.; University of Western Ontario, 1939. Died Dec. 9, 2006, aged 92. "He completed his junior internship at St. Joseph's Hospital in London and his surgical residency at the Toronto General Hospital....

Marlow John Nelson, Dundas, Ont.(DEATHS)(Obituary)(Brief article)
March 27, 2007... Marlow, John Nelson, Dundas, Ont.; University of Toronto, 1952, family medicine. Died Dec. 27, 2006, aged 78. "Beloved husband of Marion Thompson for 55 years, father of John (Janice), Jane (Tim) Armstrong and Tricia."

Masson Pierre, Longueuil, Que.(DEATHS)(Universite Laval)(Brief article)
March 27, 2007... Masson, Pierre, Longueuil, Que.; Universite Laval, 1958, pediatrics. Died Dec. 20, 2006, aged 74.

Pastierovic Tibor, Victoria.(DEATHS)(Obituary)(Brief article)
March 27, 2007... Pastierovic, Tibor, Victoria; Komensky University, Slovakia, 1953. Died Dec. 11, 2006, aged 80. "He was born in Czechoslovakia and survived World War 2 under extremely harsh circumstances. After graduating from the Komensky University, he...

Pick Charles-Anson, Westmount, Que.(DEATHS)(Brief article)
March 27, 2007... Pick, Charles-Anson, Westmount, Que.; McGill University, 1942, medical oncology. Died Dec. 24, 2006, aged 88.

Purdy John Winston, Island View, NB.(DEATHS)(Brief article)
March 27, 2007... Purdy, John Winston, Island View, NB; Dalhousie University, 1977, ophthalmology. Died Dec. 28, 2006, aged 66.

Rogers Daniel, Oshawa, Ont.(DEATHS)(Obituary)
March 27, 2007... Rogers, Daniel, Oshawa, Ont.; University of Toronto, 1953. Died Dec. 11, 2006, aged 83. "Prior to entering medical school, Daniel served in the Royal Canadian Air Force and was based in Saskatoon, Sask. Following graduation from the University...

Seager David Julian, North York, Ont.(DEATHS)(Obituary)
March 27, 2007... Seager, David Julian, North York, Ont.; University of London, UK, 1967. Died Dec. 7, 2006, aged 61. "Beloved husband of Isabella and loving father of Jeremy (Elizabeth), Sara (Mike) and Julia (Greg)."

Smallman Lois A., Toronto.(DEATHS)
March 27, 2007... Smallman, Lois A., Toronto; University of Toronto, 1949, ophthalmology. Died Dec. 28, 2006, aged 82.

Vallee Jean-Guy, Outremont, Que.(DEATHS)
March 27, 2007... Vallee, Jean-Guy, Outremont, Que.; Universite Laval, 1955, general surgery. Died Dec. 21, 2006, aged 78.

Query.
March 27, 2007... After 5 years spent taking care of our little girl, my wife wants to go back to school. Her education thus far is a BSc and an MSc; she put her academic career on hold to raise our daughter, and because our daughter is going to school now, the...