CMAJ: Canadian Medical Association Journal articles from May 2005

CMAJ: Canadian Medical Association Journal archives from May 2005

Deaths/Necrologie.
May 10, 2005... Barr, Elizabeth B.S., Collingwood, Ont.; University of Toronto, 1953. Died Dec. 5, 2004, aged 75; survived by her husband, Don, and her children Ian, Joan, Carol, Larry and Laura. Beairsto, Arthur W., York, Ont.; University of Toronto,...

Lawnmower neuritis: an unusual occupational hazard.(Letters/Correspondance)(Letter to the Editor)
May 10, 2005... Meralgia paresthetica is a purely sensory neuropathy caused by irritation or compression of the lateral femoral cutaneous nerve of the thigh, usually at the point where the nerve enters the thigh under the inguinal ligament. The condition is...

Body weight classification.(Letters/Correspondance)(Letter to the Editor)
May 10, 2005... I agree with Simone Lemieux and associates (1) that further discussion is warranted regarding the strengths and limitations of the 2003 Canadian Guidelines for Body Weight Classification in Adults. (2) However, several points in the commentary...

Correction.(Letters/Correspondance)(Correction Notice)
May 10, 2005... In a recent Public Health article, (1) the term Plasmodium falciparum mistakenly read Plasmodium falciform. Reference (1.) Weir E. Malaria update. CMAJ 2005;172(4):473. DOI:10.1503/cmaj.050434

Wait Time Alliance first to set benchmarks.(Access to Health Care)
May 10, 2005... Health Minister Ujjal Dosanjh is praising a report by 6 national specialty societies and the Canadian Medical Association that sets out clinically acceptable waiting times for patients requiring urgent and nonurgent care. The Wait Time...

Quebec medical students strike at their own pace.(Medical Education)(Brief Article)
May 10, 2005... About 2700 Quebec medical students joined a province-wide strike by 185 000 students protesting the province's decision to cut $103 million in bursaries and loans. The action ended Apr. 2 when the province agreed to dedicate $482 million...

Universite de Montreal in the dark about fraud.(Poehlman Case)
May 10, 2005... The executive director of the Canada Research Chairs program says it's understandable that neither that organization nor the Universite de Montreal were informed about a fraud investigation concerning a professor they hired to head a nutrition...

C. difficile strain 20 times more virulent.(Hospital Acquired Infection)(Clostridium difficile)
May 10, 2005... The strain of Clostridium difficile circulating in Quebec and reported in CMAJ last year [171: 19-21] was associated with a greater severity of illness than is typical of the organism. Evidence presented at the Apr. 11, 2005, meeting of the...

Canadians spending more on drugs.(Pharmaceutical Spending)(Brief Article)
May 10, 2005... Canadians spent an estimated $22 billion on prescription and non-prescription drugs in 2004--the fastest-growing segment of health care spending, according to a new report from the Canadian Institute for Health Information. Drug costs,...

Marburg strikes.(News @ a glance)(Brief Article)
May 10, 2005... Marburg strikes: Canada sent one of the world's foremost experts on hemorrhagic fevers to Angola, where Marburg virus had infected 200 people, killing 173 as of Apr. 6. Dr. Heinz Feldmann, head of special pathogens program at the National...

Public health goals.(News @ a glance)(Brief Article)
May 10, 2005... Public health goals: If you had to define the most effective public health goals, what would you choose? That's the question being put to Canadians by Federal Minister of State for Public Health, Carolyn Bennett during a Canada-wide...

Ontario MDs settle.(News @ a glance)(Brief Article)
May 10, 2005... Ontario MDs settle: Five months of negotiations between the Ontario government and 24 000 physicians ended in late March with a 4-year agreement worth $2.4 billion. The new contract increases the province's 24 000 doctors' overall pay by $1.1...

Autism treatment debate.(News @ a glance)(Brief Article)
May 10, 2005... Autism treatment debate: Ontario's autistic children won the right to public funding for a controversial therapy, only to have the provincial government appeal the ruling. The province has been paying for intensive behaviour intervention (IBI)...

Michener finalist.(News @ a glance)(Brief Article)
May 10, 2005... Michener finalist: CMAJ and Decouverte, a Radio-Canada science program, were jointly short-listed for the prestigious Michener Award for meritorious public service in journalism for coverage of the outbreak of Clostridium difficile infection in...

A national strategy for waiting-times research?(Waiting Times)
May 10, 2005... The First Ministers' Conference on Health Care in the fall of 2004 resulted in a federal government pledge of $4.5 billion over 6 years to reduce waiting times for cancer care, coronary angioplasty, bypass surgery and angiography, diagnostic...

How an imprint can lead to cancer.(Science and Medicine)
May 10, 2005... Mutations in DNA may not be the sole mechanism that leads to cancer. New research suggests that variations in the imprint left on a genome by parent can influence tumour development. The mechanism, which appears to be linked to how cells...

Vaginal bleeding in the prepubertal child.(Teaching Case Report)
May 10, 2005... THE CASE: A 5-year-old black girl, who was originally from Sudan, was seen by her general pediatrician after her parents noted intermittent bright red blood staining her underwear. She did not report abdominal pain, constipation, dysuria,...

Preventing violence in youth.(Public Health)
May 10, 2005... After a wave of violence in Ontario involving students and schools that resulted in the death of 3 teens in 3 separate incidents, Ontario's Minister of Education, Gerard Kennedy, unveiled components of the provincial government's Safe Schools...

Does intensified cholesterol lowering provide greater protection from cardiovascular events among patients with stable coronary artery disease?(In the Literature)
May 10, 2005... LaRosa JC, Grundy SM, Waters DD, Shear C, Barter P, Fruchart JC, et al. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med2005;352(14):1425-35. Background: It is unknown whether intensive...

Intracranial hematoma in a patient with AIDS.(Clinical Vistas)
May 10, 2005... A 41-year-old man with HIV infection and chronic hepatitis C was admitted to hospital with a 4-week history of increasing cognitive decline and left hemiparesis. He was a former intravenous drug user. His HIV infection had been diagnosed and...

New restrictions on celecoxib (Celebrex) use and the withdrawal of valdecoxib (Bextra).(Health and Drug Alerts)
May 10, 2005... Published at www.cmaj.ca on Apr. 15, 2005. Revised on Apr. 19, 2005. Reason for posting: Coxibs, the class of NSAIDs that selectively inhibit cyclooxygenase 2 (COX-2), were designed to reduce joint pain and inflammation without causing the...

Insulin resistance syndrome, body mass index and the risk of ischemic heart disease.(Research/Recherche)
May 10, 2005... Abstract Background: Many people who are not obese according to standard height and weight criteria may still display features of insulin resistance syndrome and thus be at high risk of ischemic heart disease. We sought to investigate the...

Thrombolysis for acute ischemic stroke: results of the Canadian Alteplase for Stroke Effectiveness Study.(Research/Recherche)
May 10, 2005... Abstract Background: Thrombolysis for acute ischemic stroke has remained controversial. The Canadian Alteplase for Stroke Effectiveness Study, a national prospective cohort study, was conducted to assess the effectiveness of alteplase...

Heart disease risk among metabolically healthy obese men and metabolically unhealthy lean men.(Commentary/Commentaire)
May 10, 2005... In this issue of CMAJ, St-Pierre and colleagues (1) present the results of a longitudinal cohort study conducted in Quebec to determine the contribution of metabolic factors to cardiovascular disease. The authors found that among study...

Clinical practice guidelines for the care and treatment of breast cancer: follow-up after treatment for breast cancer (summary of the 2005 update).(Commentary)
May 10, 2005... This article provides a summary of the changes along with the updated recommendations (Table 1) made by Health Canada's Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer to the article "Clinical...

Canadian prescription drug costs surpass $18 billion.(Commentary)
May 10, 2005... Growth in prescription drug costs since 1996 has set a new record. Not since World War II has drug spending escalated so rapidly for such a prolonged period. The latest figures published by the Canadian Institute of Health Information (CIHI)...

Women's sexual dysfunction: revised and expanded definitions.
May 10, 2005... Abstract ACCEPTANCE OF AN EVIDENCE-BASED CONCEPTUALIZATION OF WOMEN'S SEXUAL RESPONSE combining interpersonal, contextual, personal psychological and biological factors has led to recently published recommendations for revision of...

Hospitable medicine.(The Left Atrium)(Book Review)
May 10, 2005... The renewal of generosity: illness, medicine, and how to live Arthur W. Frank Chicago and London: University of Chicago Press, 2004 166 pp $34.50 ISBN 0-226-26015-1 (cloth) Arthur Frank wastes no time in taking on the role of moral agent...

Frogs.(Room for a view)
May 10, 2005... Though no one had been in the mobile home for seven years, I wasn't prepared for the total wreck of the place. My grandmother, on the other hand, barely noticed that our weight on the linoleum threatened to push right through the bruised wood...

The doctor in the street.(Room for a view)
May 10, 2005... Several years ago, as a pediatric resident, I worked with a distinguished professor from whom I anticipated learning a great deal. I recall one busy day at the clinic, in the course of which my professor pointed out several "clinical pearls"...

A letter to cancer.(Room for a view)(Poem)
May 10, 2005... A letter to cancer I watch for you, Scoundrel. You sneak and hide. You tease and devour. How do you choose your next morsel, pick names from a cosmic spinning drum some of them more than once?...

Prescription drug expenditures rising--too fast? / Les depenses en medicaments d'ordonnace: hors de controle.(Editorial)
May 10, 2005... Western societies spend a lot of money on prescription drugs. According to the Canadian Institute for Health Information (CIHI), prescription drug costs reached $18 billion in Canada last year. (Physician costs were $17 billion, and total...

Query.(depression in physicians)
May 10, 2005... It started a few months ago. I noticed Dr. Lente's rack of unfinished carts piling up, heard whispers about unchecked lab results, saw his gait begin to slow and trundle, watched him avoid eye contact with colleagues and patients. Even his...

Query.
May 24, 2005... Leo couldn't say two words without gasping; the last time he was weighed, he was 82 pounds. I came to visit him after being called by his frantic wife, who felt that Leo had given up hope and was willing himself to die. I was struck most by two...

Challenges of teaching EBM.(Letters/Correspondance)(Letter to the Editor)
May 24, 2005... As a clinician at an academic institution and possessor of a master's degree in clinical epidemiology, I support the principles of evidence-based medicine (EBM). Nevertheless, I have found it a challenge to teach EBM, primarily because it is a...

Guidelines for STEMI.(Letters/Correspondance)(Letter to the Editor)
May 24, 2005... We commend Peter Bogaty and colleagues (1) for their Canadian adaptation of the ST-elevation myocardial infarction (STEMI) guidelines. They have appropriately emphasized the importance of time to reperfusion, whether thrombolysis or primary...

Correction.(Letters/Correspondance )(Correction Notice)
May 24, 2005... In a recent article in the Practice section, (1) the chemical structures of hydroquinone and homogentisic acid should have been drawn as 6-membered rings, and not as 8-membered rings. Reference (1.) Maxwell D. Alkaptonuria and...

WHO's call for international pandemic action unheeded.(Global Health)
May 24, 2005... Despite the World Health Organization's plea that wealthy nations should help developing countries finance preparations for an impending influenza pandemic, two-thirds of the world's population will likely face the first wave of a virulent new...

In the field, Canadians diagnose Marburg.(Angola, Africa)
May 24, 2005... Using a portable lab they had packed into suitcases and hauled halfway around the world, a Winnipeg virologist and a lab technician rendered life-or-death verdicts during the recent outbreak of Marburg in Angola. Over a 3-week period in...

Health Canada to publish reasons for drug approvals.(Drug Regulation)
May 24, 2005... Health Canada will launch a new database this summer to provide health care professionals and the public with information about all drugs approved in Canada since 1994. The searchable, bilingual database will list Notices of Compliance...

International MDs.(News @ a glance)(Brief Article)
May 24, 2005... International MDs: Ottawa announced a $75-million plan on Apr. 25 to integrate international medical graduates into the Canadian workforce--provided the beleaguered Liberal government stays in power long enough to pass the budget allocating the...

Breast cancer drug.(News @ a glance)(Brief Article)
May 24, 2005... Breast cancer drug: Canadian women now have a new treatment option to reduce the threat of breast cancer beyond the 5 years of tamoxifen therapy. Health Canada recently fast-tracked approval of letrozole (Femara) for the extended adjuvant...

Public guardian awards.(News @ a glance)(Brief Article)
May 24, 2005... Public guardian awards: The inaugural Vanessa Awards were presented May 9 to 8 "public guardians who demonstrated integrity and courage in the public interest at a significant personal cost." The awards (see photo) were presented to the 4...

Oxycodone cases.(News @ a glance)(Brief Article)
May 24, 2005... Oxycodone cases: The Ohio Supreme Court has reversed a lower court decision to grant class certification to a statewide class-action suit again Purdue Pharma, the manufacturers of the controversial painkiller oxycodone (time-released...

Hepatitis C.(News @ a glance)(Brief Article)
May 24, 2005... Hepatitis C: The federal government is extending compensation to hepatitis C victims who were infected through the tainted blood system before 1986 and after 1990. Liberals joined Opposition members in voting for Conservative MP Steven...

Smoke free.(News @ a glance)(Brief Article)
May 24, 2005... Smoke free: Bhutan is the first country in the world to completely ban tobacco sales. Bhutan, the Himalayan kingdom between China and India, instituted the ban in December as part of King Jigme Singye Wangchuk's plan for "gross national...

Tsunami of aid.(Global Health)(Brief Article)
May 24, 2005... Within 10 days of the devastating tsunami in Southeast Asia, Medecins Sans Frontieres Canada had reached its capacity for donations, but was able to garner another $4.9 million or so for its global emergency fund. By Jan. 4, MSF had...

Treating HIV/AIDS and leishmaniasis coinfection in Ethiopia.(HIV/AIDS)
May 24, 2005... HIV/AIDS is currently recognized as the leading cause of adult illness and death in Ethiopia and has infected a cumulative total of 1 500 000 adults and children. Kafta Humera Woreda is an isolated area in the northwest region of the Ethiopian...

A gene for susceptibility to tuberculosis.(Science and Medicine)
May 24, 2005... The complex genetic nature of what makes some people more susceptible than others to tuberculosis (TB) may finally be revealing itself. The answer may lie in the genes that control cell-mediated immunity, specifically a newly discovered gene...

When should I stop anticoagulation for atrial fibrillation?(Clinical Conundrum)
May 24, 2005... I am a practising community family physician with 199 patients over the age of 64 years. Eleven (5.5%) of them are taking warfarin for atrial fibrillation. Anticoagulation reduces the relative risk of stroke by about 70% over 5 years; (1)...

Earlier clinical conundrum resolved: a diagnosis with teeth.(Clinical Conundrum)(Brief Article)
May 24, 2005... We received a number of eletters (available with the original article (1) at www.cmaj.ca) suggesting possible diagnoses in the case of a man who was noted at autopsy to have several unusual structures near his pancreas. Many different...

Well-water maintenance.(Public Health)
May 24, 2005... Whenever a patient mentions that household members are experiencing a bout of "stomach flu," the physician, in addition to considering testing stool samples, should enquire about the source of household drinking water. (1) About one-third of...

Is daily inhaled steroid use necessary in the treatment of mild persistent asthma?(In the Literature)
May 24, 2005... Boushey HA, Sorkness CA, King TS, Sullivan SD, Fahy JV, Lazarus SC, et al. Daily versus as-needed corticosteroids for mild persistent asthma. N Engl J Med 2005;352:1519-28. Background: For years, daily anti-inflammatory therapy has been...

The rash of West Nile virus infection.(Clinical Vistas)
May 24, 2005... A previously healthy 44-year-old man presented to the emergency department of a rural Alberta hospital in August for assessment of a rash. He described 7-day history of sudden onset of headache accompanied by sore throat, stiff neck and joints,...

The effect of safer play equipment on playground injury rates among school children.(Research/Recherche)
May 24, 2005... Abstract Background: Changes to Canadian Standards Association (CSA) standards for playground equipment prompted the removal of hazardous equipment from 136 elementary schools in Toronto. We conducted a study to determine whether applying...

Leg-ulcer care in the community, before and after implementation of an evidence-based service.(Research/Recherche)
May 24, 2005... Abstract Background: Leg ulcers usually occur in older patients, a growing population for which increasing health care resources are required. Treatment is mainly provided in patients' homes; however, patients often receive poorly...

Neonatal exposure to active pulmonary tuberculosis in a health care professional.(Research letter)
May 24, 2005... Abstract NOSOCOMIAL TRANSMISSION OF TUBERCULOSIS (TB) is a recognized risk. Although many outbreaks of TB in health care settings have been reported, there are few cases of nosocomial transmission to neonates. We report our experience in...

Is maternal use of selective serotonin reuptake inhibitors in the third trimester of pregnancy harmful to neonates?(Commentary/Commentaire)
May 24, 2005... Last summer, the US Food and Drug Administration instructed manufacturers of antidepressants to issue warnings about perinatal complications associated with their products. (1) Physicians were advised to taper the dosage of antidepressants in...

Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies.
May 24, 2005... Abstract WITH THE INCREASING USE OF CONTRAST MEDIA in diagnostic and interventional procedures, nephropathy induced by contrast media has become the third leading cause of hospital-acquired acute renal failure. It is also associated with a...

Covenants and compromises.(Book Review)
May 24, 2005... On the take: how medicine's complicity with big business can endanger your health Jerome P. Kassirer New York: Oxford University Press; 2004 272 pp $44.95 (cloth) ISBN 0-1951-7684-7 The last well person: how to stay well despite the...

Romeo's eyes.(Poem)
May 24, 2005... Romeo's eyes Your eyes looked until you could bear see no more how rotting corpses piled high on a church doorstep the ash-faced priest for dearest butchered orphans he weeps; your help he pleads but Blue...

Une heureuse union.
May 24, 2005... I went into her room and was asked, "What's the French for 'gallbladder'?" The nice francophone lady with the positive Murphy sign had been trying to explain her problem to her husband. He'd been at her bedside since she was admitted, wearing a...

Deaths/Necrologie.
May 24, 2005... Benson, John B., Port Hope, Ont.; University of Toronto, 1943; former staff, Port Hope & District Hospital. Died Dec. 9, 2004, aged 84; survived by his brother Philip. Betkowski, Jerzy P., Valemount, BC; Polish School of Medicine...

Physicians and advocacy / les medecins et al representation.(Editorial)
May 24, 2005... "We are presently in the situation where [we] are meeting with [senior government officials] to garner support for [Providence Health Care's expansion project] and we can now anticipate an irritated reception from them due to bad press...