CMAJ: Canadian Medical Association Journal articles from May 2006

CMAJ: Canadian Medical Association Journal archives from May 2006

Query.(Column)
May 9, 2006... I got caught yesterday. Not doing or dealing drugs in the hospital, not smoking, not having sexual relationships with patients. None of that stuff. No, I got caught doing something else: gossiping. It was one of those interminable meetings...

Uncharted territory: Hippocratic ethics and health systems/En territoire inconnu : l'ethique d'Hippocrate et les systemes de sante.(Guest Editorial/Editorial invite)(Editorial)
May 9, 2006... In the wake of the Supreme Court decision on the Chaoulli case, the CMA will be advising on the relationship between the public and private sectors in the delivery and funding of health care. It is crucial that Canadian doctors recognize that...

Former director general: Health Canada needs broader drug safety powers.(News)
May 9, 2006... Health Canada needs broader powers to assess the safety of new prescription drugs, including the power to require post-market trials, says the former director general of the department's Therapeutics Products Directorate. "Drug safety has...

Alberta leads country in e-health records.(News)(Physician Office System Program )
May 9, 2006... Talking to Dr. Tim Kolotyluk about cybermedicine is like running beside a freight train. You can't keep pace with his enthusiasm. Kolotyluk, a 53-year-old family doctor in Westlock, just north of Edmonton, wired his clinic in 1998 knowing...

Dispute over Vioxx study plays out in New England journal.(News)
May 9, 2006... The New England Journal of Medicine is maintaining that Canadian-led study of the anti-arthritis drug rofecoxib (Vioxx) that it published in November 2000 contained "misleading" conclusions regarding the drug's safety. But the authors of...

Pandemic portal.(News @ a glance)(www.pandemicinfluenza.gc.ca)(Brief article)
May 9, 2006... Pandemic portal: Health Canada has launched a new Web site to serve as "one-stop source of information" about pandemic influenza. The site, www.pandemicinfluenza.gc.ca, compiles information provided by the Public Health Agency of Canada and...

Suing big tobacco.(News @ a glance)(Brief article)
May 9, 2006... Suing big tobacco: Manitoba has become the latest province to table legislation that would allow it to sue tobacco companies for the cost of treating people with smoking-related diseases. Health Minister Tim Sale estimates it costs more than...

3 by 5 falls short.(News @ a glance)(Brief article)
May 9, 2006... 3 by 5 falls short: The United Nations' campaign to treat 3 million more HIV-positive people with anti-retroviral drugs did not achieve its goal, the World Health Organization and the Joint United Nations Programme on HIV/AIDS has concluded....

Polio returns.(News @ a glance)(Brief article)
May 9, 2006... Polio returns: Bangladesh is resuming polio vaccinations after finding its first case in March after nearly 6 years. A 9-year-old girl, who became paralyzed, was the first person to get the disease since August 2000, according to the World...

Tumour bank.(News @ a glance)(Canadian Tumour Repository Network)(Brief article)
May 9, 2006... Tumour bank: Cancer researchers around the world will now be able to obtain tissue samples from the Canadian Tumour Repository Network. The Network, financed by a 5-year, $3.8-million grant from the Canadian Institutes of Health Research, has...

Marijuana use by tobacco smokers and nonsmokers: who is smoking what?(Pulse)
May 9, 2006... Marijuana is often mixed with tobacco when smoked, and there is increasing evidence that its use by non-tobacco-smoking people may be a gateway to tobacco smoking. (1) Using data from the 2004 Canadian Tobacco Use Monitoring Survey, (2) we...

The smoking regulatory index: a new way to measure public health performance.(Analysis)
May 9, 2006... Cigarette smoking and environmental tobacco smoke (ETS) exposure are recognized as leading threats to public health. The health effects of ETS have been widely documented, and include an increased risk of lung cancer, respiratory ailments such...

Strategies for preventing calcium oxalate stones.(Practice)
May 9, 2006... About 10% of people will experience nephrolithiasis in their lifetime, and about 70% of those will have recurrences. About 80% of stones are calcium based, and about 80% of those are calcium oxalate stones. We discuss here briefly the evidence...

Raccoon roundworm.(Public Health)
May 9, 2006... Background and epidemiology: Baylisascaris procyonisis an intestinal roundworm commonly found in raccoon feces, with wide distribution across North America. The parasite can cause severe human neurological disease if ingested. Fifteen human...

Ecchymotic groin plaques in an immunocompromised man.(Clinical Vistas)
May 9, 2006... A 50-year-old man with a 4-year history of non-Hodgkin's lymphoma presented to the dermatology clinic with painful violaceous plaques in his peri-inguinal area that had slowly enlarged over 3 weeks. A year before presentation the patient had...

Effect of neighbourhood income and maternal education on birth outcomes: a population-based study.(Research)
May 9, 2006... ABSTRACT Background: Maternal socioeconomic status (SES) is an important determinant of inequity in maternal and fetal health. We sought to determine the extent to which associations between adverse birth outcomes and SES can be identified...

Efficacy and safety of unfractionated heparin versus enoxaparin: a pooled analysis of ASSENT-3 and -3 PLUS data.(Research)
May 9, 2006... ABSTRACT Background: The optimal antithrombotic therapy to accompany tenecteplase in cases of acute ST-segment elevation myocardial infarction (STEMI) remains unclear. We undertook a prespecified pooled analysis of data from the ASSENT-3...

Socioeconomic inequality in birth outcomes: what do the indicators tell us, and where do we find the data?(Commentary)
May 9, 2006... All human beings are born free and equal in dignity and rights.--Universal Declaration of Human Rights (1) We all know the first words in Article 1 in the United Nation's Declaration of Human Rights. We also know, however, that this is...

Low-molecular-weight heparins as adjunctive therapy to thrombolytics: extracting the best data.(Commentary)
May 9, 2006... In the United States, ST-segment elevation myocardial infarction (STEMI) affects about 500 000 people annually; in Canada, about 50 000. The time to restoration of normal blood flow in the occluded artery is accepted to be a key determinant of...

Current management of the complications of portal hypertension: variceal bleeding and ascites.
May 9, 2006... ABSTRACT Portal hypertension is one of the main consequences of cirrhosis. It results from a combination of increased intrahepatic vascular resistance and increased blood flow through the portal venous system. The condition leads to the...

Maternal mortality: an important priority.(Letters)(Letter to the editor)
May 9, 2006... We were pleased to read Donna Stewart's analysis of maternal mortality in Canada (1) and we fully agree that prevention of maternal mortality and morbidity requires a broad view. Dr. Stewart's concern about the limited knowledge of maternal...

Diabetes and the proactive laboratory.(Letters)(Letter to the editor)
May 9, 2006... Graham Woodward and associates (1) recently reported on poor adherence to the Canadian Diabetes Association (CDA) guidelines in the general population of eastern Ontario. A similar situation in British Columbia in 2001 (2) led the Medical...

Saving the medical marriage.(Letters)(Letter to the editor)
May 9, 2006... I am the wife of a rural physician. During the night, I often hear the buzz of my husband's pager, and I sink deeper under the warm covers as he stumbles out of bed. In the grey light of dawn, I often sense the empty space beside me in the bed...

Sex ratio for medical residencies.(Letters)(Letter to the editor)
May 9, 2006... Mark Baerlocher and Allan Detsky report that, between 1995 and 2004, men were more likely than women to be rejected from their top-ranked discipline when applying to Canadian residency programs. (1) They suggest that female residency applicants...

Yes to "febrile," no to "flu-like".(Letters)(Letter to the editor)
May 9, 2006... I would like to suggest that all physicians make an effort to stop referring to febrile illnesses as "flu-like." This habit gives the lay public an incorrect idea of the symptoms of influenza. I have read numerous articles on...

Corrections.(Correction notice)
May 9, 2006... In our recent article on hepatitis C, (1) the correct sentence is "For analgesia, small doses of ASA ( REFERENCE (1.) Wong T, Lee SS. Hepatitis C: a review for primary care physicians. CMAJ2006;174(5):649-59. DOI:10.1503/cmaj.060484...

A week of rain, a gust of wind: narrative ethics and the teachable moment.(Room for a view)
May 9, 2006... "Everyone has a story to tell. Along with scientific ability, physicians need the ability to listen to the narratives of the patient, grasp and honour their meaning, and be moved to act on the patient's behalf." (1) Teachable moments often...

Deaths.
May 9, 2006... Babu, Tumkur Gangappa Lokesh, Edmonton; educated in India, 1989. Died Feb. 24, 2006, aged 40. Callaghan, John Henry, Charlottetown; Dalhousie University, 1968. Died Mar. 11, 2006, aged 64. "Over his 37-year medical career, he built one of...

Reflecting on governance for CMAJ/Reflechir sur la gouvernance du JAMC.(Editorial)
May 23, 2006... Editorial independence in scientific journals has again emerged as a fundamental issue for discussion as a result of recent events at CMAJ. (1-3) Editorial independence is not a simple concept. How does it relate to the journal's mission? Who...

Eliminating barriers to DTC advertising for OTCs and natural health products.(News)(direct-to-consumer)(over-the-counter drugs)
May 23, 2006... Health Canada has proposed eliminating statutory barriers against direct-to-consumer (DTC) advertising of the purported health benefits from using natural health products (NHPs) and non-prescription drugs to treat serious diseases like cancer....

Monitoring the price of new drugs.(News)
May 23, 2006... The tribunal in charge of regulating drug prices in Canada should more closely scrutinize the price of new drugs, rather than the annual price increases posted by manufacturers on already-marketed drugs. That message was delivered to the...

Canada's future physicians: clinicians, researchers or teachers?(Pulse)
May 23, 2006... Almost two-thirds of medical students who responded to the 2004 CFPC/CMA/RCPSC National Physician Survey said they hoped to include teaching in their future careers, and nearly one-third hoped to include research (Fig. 1). The proportion of...

Are there better ways to determine wait times?(Analysis)
May 23, 2006... Recently, the Western Canada Waiting List Project (WCWLP) and the Wait Time Alliance (WTA) independently released benchmark wait times for various medical procedures. Both groups used a panel of experts who reviewed survey data from clinicians,...

Persistent pulmonary hypertension of the newborn and maternal use of SSRIs.(Health and Drug Alerts)(Disease/Disorder overview)
May 23, 2006... Reason for posting: Major depressive disorders affect one in 10 women of reproductive age, and selective serotonin reuptake inhibitors (SSRIs), with their generally favourable efficacy and safety profiles, are the most common medications used...

The lesser evils of battling round goby infiltration.(Public Health)
May 23, 2006... The round goby (Neogobius melanostomus) is a freshwater fish native to the Black and Caspian Sea regions of Eurasia. In Canada it was first discovered in 1990 in Lake St. Clair, a relatively small lake nestled between Lakes Huron and Erie in...

An underrecognized cause of respiratory distress in a neonate.(Clinical Vistas)(Disease/Disorder overview)
May 23, 2006... A baby girl was born at 31 weeks' gestation after an uneventful pregnancy. She weighed 1480 g, and her Apgar score was 2 at 1 minute and 6 at 5 minutes. Within minutes of being born, her respiratory rate was 61 (normal 20-40) breaths/min, with...

Time variations in the risk of myocardial infarction among elderly users of COX-2 inhibitors.(Research)
May 23, 2006... ABSTRACT Background: The timing of cardiovascular risks associated with the use of cyclooxygenase-2 (COX-2) inhibitors is unclear. Using data collected in a previous population-based cohort study of elderly people starting nonsteroidal...

Getting physicians to accept new information technology: insights from case studies.(Research)
May 23, 2006... ABSTRACT Background: The success or failure of a computer information system (CIS) depends on whether physicians accept or resist its implementation. Using case studies, we analyzed the implementation of such systems in 3 hospitals to...

Balancing the cyclooxygenase portfolio.(Commentary)
May 23, 2006... "Medicine used to be simple, ineffective and relatively safe... Now it is complex, effective and potentially dangerous"--C. Chantler Few issues associated with new drug development have generated as much attention and controversy as the...

Physicians will happily adopt information technology.(Commentary)
May 23, 2006... In this issue, Lapointe and Rivard (1) report on their analysis of computer information system (CIS) implementations at 3 hospitals to understand better the dynamics of physicians' resistance to such implementations. The level of resistance...

Disabled medicine.(Commentary)
May 23, 2006... The disability experience is unique. Because the number of medical students with physical disabilities is so small, each school's experience in dealing with the unique needs of such students is limited. I disclosed my own disability before...

Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects.(Review)(Drug overview)
May 23, 2006... ABSTRACT Background: Chronic noncancer pain (CNCP) is a major health problem, for which opioids provide one treatment option. However, evidence is needed about side effects, efficacy, and risk of misuse or addiction. Methods: This...

Selling sickness.(Letters)(Letter to the editor)
May 23, 2006... In her review of Selling Sickness: How the World's Biggest Pharmaceutical Companies are Turning Us All into Patients, Miriam Shuchman1 ignores one of the central premises of the book. The authors, Ray Moynihan and Alan Cassels, argue that...

Another proposal for primary care.(Letter to the editor)
May 23, 2006... I find the rhetoric around private clinics, enrolment fees and annual dues for "gold-plated" medical services pretty amusing. As described in a recent article by Wayne Kondro, (1) clients at the Copeman clinics would get 24-hour access to...

Inconsistent position on SSRI ads.(Letter to the editor)
May 23, 2006... Dr. Wayne Goodman, Chair of the Psychopharmacologic Drugs Advisory Committee of the US Food and Drug Administration (FDA), is quoted at the beginning of Colin Meek's article (1) as saying that he thinks ads about SSRIs stating that the drugs...

Diabetes susceptibility.(Letter to the editor)
May 23, 2006... The hypothesis advanced by Hertzel Gerstein and Laura Waltman, (1) explaining why the age-adjusted prevalence of diabetes ranges from about 5% among people of European ancestry to 40% or higher in newly westernized Aboriginal populations,...

Medical wait lists.(Letters)
May 23, 2006... A recent CMAJ editorial argued that the development of wait-time benchmarks by the Canadian Wait Time Alliance might have been less useful than it seems. (1) Although it would be foolhardy to argue with the assertion that there is a lot more to...

Corrections.(Letters)(Correction notice)
May 23, 2006... There was an error in the obituary notice for Dr. Adrian Ten Cate. (1) He died on Jan. 30, 2006, not Jan. 10 as indicated. The correct notice appears in the Apr. 25, 2006, issue of CMAJ. (2) REFERENCES (1.) Deaths....

Sergey Tolstoy and The Doukhobors: the Halifax quarantine.(Annotations)
May 23, 2006... I went deep into the woods on the island along a frozen path, among the fir trees. The firs are not the same here as in Russia. The ground was covered with light snow, it was quiet, there was no one to be seen or heard, the night sky was clear....

On subjects, objects and patients.(Room for a view)
May 23, 2006... A few weeks ago we buried a close friend. He was a well recognized researcher; acknowledged by innumerable book authorships, awards and honorary doctorates. He was a physician by commitment and a researcher out of passion. His clinical...

Deaths.(Robert Alan Armstrong, Gerard Beaudoin, John Walter Bradley)(Obituary)
May 23, 2006... Armstrong, Robert Alan, Ottawa; University of Toronto, 1949. Died Feb. 25, 2006, age 79. "Dr. Armstrong left private practice to join the federal government in 1956. He was appointed the first Director of Medical Care at Health Canada in 1967,...

Query.(family medicine)
May 23, 2006... Something strange has been happening to me lately. Indecision. It started when one of my practising friends from medical school called one evening. He asked my advice on an offer he'd recently received from the medical school. Mark's story was...