CMAJ: Canadian Medical Association Journal articles from March 2008

CMAJ: Canadian Medical Association Journal archives from March 2008

Ending the sexist blame game/Mettre fin au jeu de blame sexiste.(Editorial: English on previous page/Editorial: Francais a la page suivante)
March 11, 2008... More often than not, questions of access to health care rest on the availability of health care professionals. In recent weeks, our colleagues and medical students have expressed deep concern about media reports that suggest the physician...

Gutted programs and children's guts.(News)
March 11, 2008... In polite parlance, it could be said educational administrators have now seen the error of their ways. After gutting physical education programs in the nation's schools a decade ago, they're now madly scrambling to revitalize previously robust...

Fit patients.(News @ a glance)(Survey)(Brief article)
March 11, 2008... Fit patients: A survey of the opinions of 870 British family and hospital doctors published in The Telegraph's Doctor magazine on Jan. 28, 2008, indicated many believe patients should be denied medical treatment because of lifestyle. Some 94%...

More students.(News @ a glance)(Brief article)
March 11, 2008... More students: The Manitoba government will invest $3 million to create 10 new spots for medical students at the University of Manitoba Faculty of Medicine, thereby raising the number of available spaces to 110 from 100.--Wayne Kondro, CMAJ

A black sheep in the nuclear family.(News)
March 11, 2008... Canadian isotope distributor MDS Nordion thwarted a 1999 effort to create a global backup plan to mitigate the effects of a disruption to the world's medical isotope supply, says the head of a major European isotope supplier. The...

A knee in the neck of excited delirium.(News)
March 11, 2008... Some call it an entirely manufactured psychological condition. The police believe it is not only legitimate, but potentially fatal. The latter, though, may have a vested interest in perpetuating the notion that "excited delirium" is a valid...

US legislators drive accountability measures.(News)(docinfo.org)(Website overview)
March 11, 2008... In comparison to Canada, the level of transparency and ease of use seem nothing short of astonishing. While Canadians must often dig through a maze of confusing links to find the performance records of their doctors (CMAJ 2008;178[1]:14-6),...

More bang for the taxpayer's buck.(News)
March 11, 2008... Consider it a milestone for public access to the findings of publicly funded research. Commencing this April, researchers funded by the US National Institutes of Health will be required to send copies of their final manuscripts to the National...

Soup truck.(Dispatch from the medical front)
March 11, 2008... The pickup truck, loaded with buckets full of banku balls and groundnut soup, stops on the red earth courtyard of Tamale's residential mental health centre, where the windows are boarded up, the staff and funding long gone. For a moment,...

Life-support guidelines.(For the record)
March 11, 2008... The College of Physicians and Surgeons of Manitoba stepped boldly into the fray of withholding life-sustaining treatments by becoming the first regulatory body in Canada to issue guidelines governing when, and how doctors should decide, to...

Pack your bags and beat it.(For the record)(retirement of Arthur Carty )(Brief article)
March 11, 2008... Informed that the position of National Science Advisor will be eliminated by the federal government, Arthur Carty will retire in "dismay" that Canadians will be losing a mechanism for generating credible, independent nonpartisan scientific...

Agencies review plastic bottles.(News)(Brief article)
March 11, 2008... Health Canada is conducting a review of scientific literature to determine whether it should revise its threshold for the use of the chemical bisphenol A in food containers, particularly tin can lining and reusable water bottles. ...

Canadian cancer statistics at a glance: mesothelioma.(Facts and figures)
March 11, 2008... Key points of the article * Mesothelioma is usually associated with workplace exposure to asbestos. * Canada still produces asbestos and exports it to developing countries. * In addition to miners, construction workers continue to...

Spontaneous hemothorax caused by metastasis of a rib tumour.(Interesting images)(Brief article)
March 11, 2008... [FIGURE 1 OMITTED] A 62-year-old man with a history of hepatocellular carcinoma presented to the emergency department with sudden onset of chest pain on his right side, dyspnea and syncope. A chest computed tomography scan with contrast...

Gastric acid burns because of a disconnected nasogastric tube.(Clinical vistas)(Medical condition overview)(Case study)(Brief article)
March 11, 2008... A 48-year-old man who had a recent right-sided motor stroke was receiving food through a nasogastric tube. At the time of the incident, the patient's hands were restrained, and he had a Glasgow coma score of 10 (his eye, verbal and motor...

The effect of patients' sex on physicians' recommendations for total knee arthroplasty.(Research)(Clinical report)
March 11, 2008... ABSTRACT Background: The underuse of total joint arthroplasty in appropriate candidates is more than 3 times greater among women than among men. When surveyed, physicians report that the patient's sex has no effect on their...

Joint contracture following prolonged stay in the intensive care unit.(Research)(Clinical report)
March 11, 2008... Abstract Background: Prolonged immobility during a critical illness may predispose patients to the development of joint contracture. We sought to document the incidence of, the risk factors for and the reversibility of joint contractures...

Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis.(Research)(Clinical report)
March 11, 2008... ABSTRACT Background: Alterations in waveforms in the uterine artery are associated with the development of pre-eclampsia and intrauterine growth restriction. We investigated the predictive accuracy of all uterine artery Doppler indices for...

Climate change and infectious diseases in North America: the road ahead.
March 11, 2008... ABSTRACT Global climate change is inevitable--the combustion of fossil fuels has resulted in a buildup of greenhouse gases within the atmosphere, causing unprecedented changes to the earth's climate. The Fourth Assessment Report of the...

In praise of undercover research.(Research)(Viewpoint essay)
March 11, 2008... Key points of the article * Undercover research can be assessed similarly to other research methods, such as those used in a clinical trial, in terms of likely risks and benefits. * The use of undercover research can clarify and...

Mobile, awake and critically ill.(consequence of immobility caused by prolonged critical illness)(Research)(Viewpoint essay)
March 11, 2008... Key points of the article * The success of intensive care medicine has lead to large numbers of patients discharged from the ICU with important physical and neuropsychological disabilities. * The most common morbidity after critical...

How useful is uterine artery Doppler ultrasonography in predicting pre-eclampsia and intrauterine growth restriction?(Research)(Clinical report)
March 11, 2008... Key points of the article * Pre-eclampsia and intrauterine growth restriction are important causes of maternal and neonatal complications and death. * Doppler ultrasonography of the uterine arteries is a promising technique for...

Information about a discontinued drug.(Letters)(Brief article)
March 11, 2008... In their research letter on the extent to which publication in the biomedical literature concerning drug-induced harm can influence the legal process, David Juurlink and colleagues mention that the manufacturer of gatifloxacin stopped marketing...

Hunger in Canada.(Letters)
March 11, 2008... Gerard Kennedy's heartfelt editorial on hunger in Canada reminded CMAJ readers during the holiday season of the social suffering of others. (1) However, Kennedy's analysis failed to accurately position hunger, particularly child hunger, within...

Krever: the recommendation not followed.(Letters)(Viewpoint essay)(Brief article)
March 11, 2008... I read with interest Kumanan Wilson's commentary on the contributions of the report of the Krever Commission to public health in Canada. (1) Of Justice Krever's 50 recommendations, it was the first (no-fault compensation for people who...

Colorectal cancer screening.(Letters)(Viewpoint essay)
March 11, 2008... In their editorial on screening for colorectal cancer, Alan Barkun and Ken Flegel exaggerated the screening rate for this disease in the United States. (1) They cited a survey in which adults over 50 years of age were asked if they had ever...

Corrections.(Letters)(Correction notice)
March 11, 2008... Box 4 in the review by Warburton and colleagues1 should have listed the formula to predict maximum heart rate in obese people as 200--(0.5 x age). REFERENCE (1.) Warburton D, Nicol C, Bredin S. Prescribing exercise as preventative...

Code 9991 STAT.(Diagnosing Genius: The Life and Death of Beethoven)(Book review)
March 11, 2008... Diagnosing Genius: The Life & Death of Beethoven Francois Martin Mai MD McGill-Queen's University Press; 2007 269 pp $34.95 ISBN 978-0-7735-3190-1 He died at age 57 with a liver that was half its normal size, bluish green in colour and...

Herpes B virus - "B" is for Brebner: Dr. William Bartlet Brebner (1903-1932).(Past progressive)
March 11, 2008... In medical virology, the letter "B" may be used to designate a separate etiology for viral hepatitis (hepatitis B virus) or the location of an unexpected reaction (parvovirus B19; panel B, sample 19). Herpes B virus, however, was named after a...

Ladan and Laleh.(Poem)
March 11, 2008... Ladan and Laleh The two of you never knew the necessary interludes, the take leave from the presence of others delectable silences, once the heart is sated. Projected from the birth canal into each other's orbit two...

A "living" will.(Notes)(Reprint)
March 11, 2008... I met Edward at the end of his life, during a palliative medicine rotation. He was barely rousable and unable to communicate; I came to know him only through the words of his hospital chart and from speaking to his sister-in-law. Edward had...

Deaths.
March 11, 2008... 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. Chambers, Margaret Cleveland,...

Fiction dereliction.(vaccines-cause-autism fallacy)(Salon)
March 11, 2008... Computer animators have long known that blurring the line between fantasy and reality can lead to problems. Moviegoers like cartoon characters with human traits--ants that talk, rats that cook, cars that fall in love. But a funny thing happens...

The need for an Institute of Continuing Health Education/Le besoin d'un Institut de l'education continue en sante.(Editorial)
March 25, 2008... At a recent conference on continuing education involving many major US stakeholders and the CMAJ, participants agreed that our current system of continuing professional development is in dire need of a major overhaul. Currently, continuing...

Over budget, overdue and, perhaps, overdesigned.(News)
March 25, 2008... They have become an enduring Canadian mystery. They were originally scheduled to become operational in November 2000, providing Canada with a long-term secure supply of medical isotopes. Yet, years later, the once highly lauded Multipurpose...

Canadian hospitals rise to the occasion during isotope shortage.(News)
March 25, 2008... The initial notice came late and the news quickly got grimmer, according to radiologists like Dr. Andrew Ross of the Halifax, Nova Scotia-based Queen Elizabeth II Health Sciences Centre. Ross had entered his hospital's nuclear medicine...

Flaherty unveils "prudent" budget.(News)
March 25, 2008... Five pilot projects to study mental health and homelessness; more monies to make drinking water safe in Aboriginal communities; a cash injection to help Atomic Energy of Canada Ltd. (AECL) develop its capacity to produce medical isotopes; and a...

Focusing the wealth on a few.(News)
March 25, 2008... The federal government's breathtaking plan to provide 20 scientific superstars with a level of funding worthy of their glitter is the centerpiece of a series of research measures unveiled in federal Finance minister Jim Flaherty's new budget....

Viewing patients as "sources of revenue".(For the record)
March 25, 2008... Dubbing the Canada Health Act "a dysfunctional statute," Quebec's ballyhooed Task Force on the Funding of the Health Care System, headed by former Liberal health minister Claude Castonguay, urged a raft of reforms in its Feb. 19, 2008, report,...

Health care a casualty in Kenyan crisis.(News)
March 25, 2008... Kenya's slide into ethnic tension, anarchy and political violence has thrown the country's health sector into crisis. Drugs and other medical supplies are in short supply. Health facilities are overwhelmed by the injured and untreated. Camps...

Coming soon: Med High.(News)
March 25, 2008... Alberta students could be soon be studying anatomy along with their arithmetic under a government proposal to create healthcare centred high schools. Part of a plan to swell the ranks of healthcare workers, the scheme would see a "medical"...

Imagined illnesses can cause real problems for medical students.(News)
March 25, 2008... The first symptom Jessica McPherson noticed was a weakness in her arms. Then her muscles began to twitch. She feared the worst, suspecting it might be amyotrophic lateral sclerosis, a fatal neurological disorder also known as Lou Gehrig...

New process created to choose centres.(News)
March 25, 2008... The first 7 were chosen by apparent whim. The new 11 have been selected by a hybrid new process, in which a measure of academic peer review was utilized to identify strengths and weaknesses of proposals but a committee of industrialists weighed...

Task shifting.(News @ a glance)(Brief article)
March 25, 2008... Task shifting: The World Health Organization has released global guidelines for "task shifting," or delegating tasks to less specialized health workers to free up the time of doctors and nurses. The guidelines, released Jan. 10, 2008, in Addis...

The Botox blues.(News @ a glance)(Brief article)
March 25, 2008... The Botox blues: The US Food and Drug Administration has issued a warning that botulinum toxin, which is sold as popular antiwrinkle drugs under the brand names Botox, Botox Cosmetic and Myobloc, has been linked to botulism symptoms in some...

Dial 911.(News @ a glance)(Brief article)
March 25, 2008... Dial 911: Shortcomings appear the norm in weighing the capacity of most physician-owned specialty hospitals in America to handle emergency care, according a report by US Department of Health and Human Resources Inspector General Daniel Levinson...

Virtual exams.(News @ a glance)(Brief article)
March 25, 2008... Virtual exams: The Quebec City, Quebec -based firm Myca will launch a new "doctor Web" service in June that will allow patients to chat with physicians about medical woes, for a fee. Patients will have to cough up $10 monthly and $50 per...

Rural obesity.(News @ a glance)
March 25, 2008... Rural obesity: Neighbourhoods can affect children's weight, says a new study released in BMC (BioMed Central) Public Health. Children living in poor or rural neighbourhoods gained more weight than those living in middle-income areas. "Less...

cmaj.ca Afghanistan blog.(News)
March 25, 2008... Get a glimpse of life at the Kandahar, Afghanistan, Multinational Medical Unit at a new cmaj.ca blog. Beginning March 20, 2008, Dr. Peter Sherk, a critical care physician from Victoria, British Columbia, will be posting his observations while...

Weak and waning in the wards.(Dispatch from the medical front)(Viewpoint essay)
March 25, 2008... A dizzying number of women lie weakly in the hospital wards with incomplete abortions. As abortion is illegal in Kenya, many women seek out dubiously trained sources for the procedure. A Kenyan doctor tells me razors and blades are commonly...

Diagnosis and treatment of dementia: 2. Diagnosis.(Disease/Disorder overview)
March 25, 2008... ABSTRACT Background: Dementia can now be accurately diagnosed through clinical evaluation, cognitive screening, basic laboratory evaluation and structural imaging. A large number of ancillary techniques are also available to aid in...

Vomiting, diarrhea and stiff neck: what is your call?(Clinical quiz)(Disease/Disorder overview)(Case study)
March 25, 2008... [FIGURE 1 OMITTED] [FIGURE 2 OMITTED] A 10-year-old girl presented with a 3-day history of vomiting, diarrhea and sore throat. She had no history of fever, chest pain, respiratory distress, weight loss or travel. On examination, she...

Emphysematous cystitis.(Clinical vistas briefs)(Disease/Disorder overview)(Case study)
March 25, 2008... A 77-year-old woman without diabetes was admitted to hospital because of confusion, hyperthermia and abdominal pain, which rapidly progressed to septic shock. A computed tomography scan of her abdomen demonstrated a thickened, trabeculated...

Tache noire.(Clinical Vistas)(Disease/Disorder overview)(Case study)
March 25, 2008... A 47-year-old man presented to the emergency department with fever, chills, drenching sweats and erythema over his left buttock and groin. He was taking cephalexin, which had been prescribed 3 days earlier for presumed cellulitis, with no...

Fluoroquinolones compared with [beta]-lactam antibiotics for the treatment of acute bacterial sinusitis: a meta-analysis of randomized controlled trials.(Research)(Report)
March 25, 2008... ABSTRACT Background: The presumed superiority of newer fluoroquinolones for the treatment of acute bacterial sinusitis is based on laboratory data but has not yet been established on clinical grounds. Methods: We performed a...

Diagnostic accuracy of tests for lymph node status in primary cervical cancer: a systematic review and meta-analysis.(Research)(Report)
March 25, 2008... ABSTRACT Background: Lymph node status is the key to determining the prognosis and treatment of cervical cancer. However, it cannot be assessed clinically, and testing for nodal metastasis is controversial. We sought to systematically...

The treatment of acute bacterial sinusitis: no change is good medicine.(Research)(Viewpoint essay)
March 25, 2008... Key points of the article * Most episodes of acute sinusitis resolve without antibiotic therapy. * Ampicillin or cephalosporins are just as effective as levofloxacin or moxifloxacin in the treatment of acute bacterial sinusitis. ...

Imaging of lymph node metastases in cervical cancer.(Research)(Viewpoint essay)
March 25, 2008... Key points of the article * The literature addressing imaging of lymph node metastases in patients with cervical cancer tends to encompass all stages of the disease. * The applicability of any imaging method will require very high...

The effect of privacy legislation on observational research.(Medicine and society)
March 25, 2008... Key points of the article * Privacy legislation has been passed in many countries to protect the privacy and confidentiality of patient information in medical research. * Conservative interpretation of such legislation may serve as a...

Shortening the medical curriculum.(Letters)(Viewpoint essay)
March 25, 2008... The headline of the first CMAJ editorial of 2008 was promising: Is it time for another medical curriculum revolution? 1 The editors ask an interesting and timely question: Ought the time it takes to earn a medical degree be shortened from 4 to...

Denial, acceptance and the dreaded "D" word.(Room for a view)
March 25, 2008... I would like to go home." These were the words I was not prepared to hear. After all, everything was in place for tomorrow's surgery. The consent form had been signed, the procedure explained. The operating room was booked and all the imaging...

Mother nature and second nature: bridging the divide.(Second Nature: Brain Science and Human Knowledge)(Book review)
March 25, 2008... Second Nature: Brain Science and Human Knowledge Gerald M. Edelman MD PhD Yale University Press;2006 157 pp $24.00 ISBN 13: 978-0-300-12039-4 [ILLUSTRATION OMITTED] Second Nature is a 157-page discourse focusing on the interface...

Jocelyn's choice.(Poem)(Poem)
March 25, 2008... Jocelyn's choice Jocelyn, do you know of the mark you made like indelible ink on the hearts and minds of those who cared for you? Only 38 years to ride backhoes, climb trees... no husband, no children ...

Deaths.
March 25, 2008... Burditt, Anna Mary, Riverview, New Brunswick; Queen's University, Kingston, Ontario, 1961, family medicine. Died Dec. 15, 2007, aged 78. As president of the New Brunswick chapter of the College of Family Physicians of Canada (1969-71), Dr....

Misrepresentation of science undermines HIV prevention.(human immunodeficiency virus)(Salon)
March 25, 2008... The injection of illegal drugs remains a driving factor in the HIV/AIDS pandemic. Although a large body of scientific evidence supports the application of prevention initiative, such as needle exchanges and methadone maintenance, these programs...