CMAJ: Canadian Medical Association Journal articles from May 2007

CMAJ: Canadian Medical Association Journal archives from May 2007

Peer review or barbecue? The choice is clear.(Government aid to research)(Editorial)
May 8, 2007... As a rule of thumb, new investments in research are usually applauded within Canadian scientific circles, particularly a sizeable amount such as the $350 million earmarked for a newly minted federal program called the Centres of Excellence for...

Examen par les pairs ou lobby politique? Le choix est clair.(EDITORIAL)(les 350 millions de dollars reserves pour un nouveau programme federal de centres d'excellence pour la commercialisation et la recherche)(Editorial)
May 8, 2007... Les milieux scientifiques du Canada se rejouissent habituellement des nouveaux investissements dans la recherche, en particulier lorsqu'il s'agit d'un montant important comme les 350 millions de dollars reserves pour un nouveau programme...

New diabetes treatment and prevention strategies needed.(NEWS)
May 8, 2007... Aggressive team-based treatment and prevention strategies are needed to reverse the upward trend in diabetes rates across Canada, the Health Council of Canada says. That will require a shift in health care attitudes from the current...

Hospitals to report C. difficile and MRSA.(NEWS)(Clostridium)(methicillin-resistant Staphylococcus aureus)
May 8, 2007... Commencing next year, acute-care hospitals, nursing homes and other institutions will be asked to report their rates of either Clostridium difficile or methicillin-resistant Staphylococcus aureus as part of the process for obtaining Canadian...

Canadian physicians help fight RVF in Kenya.(NEWS)
May 8, 2007... Canadians can stake a claim in helping contain a major outbreak of a virulent new strain of Rift Valley Fever (RVF) that recently killed 150 Kenyans and 40 Somalis. The virus is a mosquito-born pathogen that primarily affects livestock but...

Direct-to-consumer advertising debated in the United States and European Union.(NEWS)
May 8, 2007... As Canada assesses the legality of direct-to-consumer drug advertising in the courts (CMAJ 2007;176:19-20), the United States Congress is about to consider limits, and activists in the European Union are poised to oppose an anticipated move...

New Brunswick medical school expansion delayed.(NEWS)
May 8, 2007... A medical education training program scheduled to start in New Brunswick in September 2008 will be delayed by at least 1 year, according to Dalhousie University's dean of medicine. Dr. Harold Cook says the New Brunswick government still...

CMAJ's new deputy editor, news and humanities.(NEWS)
May 8, 2007... Every organization invariably has, and needs, a few of those employees who have that remarkable capacity to juggle a dozen files and duties simultaneously and somehow get the many jobs done. Good corporate etiquette, in turn, requires...

New Centres program remains in flux.(NEWS)
May 8, 2007... Oversight and management of the recently minted Centres of Excellence in Commercialization and Research program remains in flux. The federal government hasn't yet determined which agency will administer the program, although nearly a month...

A call to unite: physicians must help children in areas of conflict.(NEWS)(Conference news)
May 8, 2007... Canadian physicians should throw their considerable political weight behind international efforts to protect children's rights and help heal children who've been affected by war and conflict, former Canadian senator Langdon Pearson pleaded in a...

News @ a glance.(NEWS)
May 8, 2007... All aboard: The nation's 13 provinces and territories quickly clambered onto the Patient Wait Time Guarantee incentive train to qualify for a per capita share of a new $612 million wait time fund unveiled in Finance Minister Jim Flaherty's Mar....

Amiodaronoma: an unusual form of amiodarone-induced pulmonary toxicity.(TEACHING CASE REPORT)(Clinical report)
May 8, 2007... The Case: A 66-year-old woman was admitted to hospital because of progressive dyspnea on exertion. At the time of admission, the patient became breathless on minimal activity. A high-grade atrioventricular block and associated congestive heart...

These boots weren't made for walking: tarsal tunnel syndrome.(CLINICAL VISTAS)(Clinical report)
May 8, 2007... Ahealthy, 39-year-old man who works at construction sites arrived with a 1-year history of "electric shocks" in his right foot whenever he wore his work boots. This was initially attributed to ill-fitting footwear. In time, his symptoms...

Results of the Recent Immigrant Pregnancy and Perinatal Long-term Evaluation Study (RIPPLES).(RESEARCH)(Clinical report)
May 8, 2007... ABSTRACT Background: People who immigrate to Western nations may experience fewer chronic health problems than original residents of those countries, which raises concerns about long-term environmental or lifestyle factors in those...

Testing for HER2-positive breast cancer: a systematic review and cost-effectiveness analysis.(RESEARCH)(Epidermal growth factor receptors)(Clinical report)
May 8, 2007... ABSTRACT Background: Testing to determine HER2 status has come into focus since the approval of trastuzumab (Herceptin) for the treatment of HER2-positive breast cancer. We compared the cost-effectiveness of various strategies used to test...

Healthier on arrival? Further insight into the 'healthy immigrant effect'.(COMMENTARY)(Clinical report)
May 8, 2007... In this issue Ray and colleagues (1) explore the relation between immigration to Canada (Ontario specifically) and the risk of placental dysfunction. Quantifying a triad of obstetric complications (pre-eclampsia or eclampsia, placental...

HER2 testing: The patent 'genee' is out of the bottle.(COMMENTARY)(Epidermal growth factor receptors)
May 8, 2007... Since the first rough draft of the human genome was completed in 2000, the public has waited patiently for the benefits that were promised breathlessly by researchers. Increasingly, these benefits come at a steep price. According to Jensen...

Where are we going with preimplantation genetic diagnosis?(COMMENTARY)
May 8, 2007... In Canada, preimplantation genetic diagnosis is governed by the Assisted Human Reproduction Act, (1) which received royal assent on Mar. 29, 2004. Regulations for preimplantation genetic diagnosis in accordance with the act are currently being...

Sleep and aging: 2. Management of sleep disorders in older people.(REVIEW)
May 8, 2007... ABSTRACT The treatment of sleep-related illness in older patients must be undertaken with an appreciation of the physiologic changes associated with aging. Insomnia is common among older people. When it occurs secondary to another medical...

Emergency medicine in the Canadian military.(Letter to the editor)
May 8, 2007... I repeatedly read in CMAJ that the Canadian Forces Health Services are in "critical need" of doctors (1) and that there are severe shortages of uniformed personnel. (2) CMA Past-President Ruth Collins-Nakai has been quoted as saying that "we...

Milk intake in pregnancy.(LETTERS)
May 8, 2007... The article about milk intake during pregnancy and decreased birth weight1 has several flaws. It may also serve to perpetuate typical physician perceptions that bovine milk is necessary for human health. The study found that pregnant women...

Time to reperfusion therapy.(Letter to the editor)
May 8, 2007... In their article on delays to reperfusion therapy in the province of Quebec, Thao Huynh and associates concluded that for most patients the time to primary percutaneous coronary intervention exceeded current recommendations. (1) This conclusion...

Hockey playoff noise.(Letter to the editor)
May 8, 2007... In a recent CMAJ article, William Hodgetts and Richard Liu examined the risk of hearing loss to people who attended the 2006 Stanley Cup finals in Edmonton. (1) The average noise levels during the 3 games were between 100.7 and 104.1 dB with...

Corrections.
May 8, 2007... There was an error in a recent news article concerning access to drugs in the developing world. (1) The Grand Challenges in Global Health Program is run by the Bill and Melinda Gates Foundation, while Universities Allied for Essential Medicines...

Guiding the healing of suicide survivors.(Touched by Suicide: Hope and Healing After Loss)(Book review)
May 8, 2007... Touched by suicide: hope and healing after loss Michael F. Myers and Carla Fine Gotham Books; 2006 320 pp Can$19.50 ISBN 1-592-40228-3 Sudden death, from any cause, and sudden death from suicide are neighbours, and yet worlds...

All the ward's a stage: a surgeon's sonnet.(Poem)
May 8, 2007... Too soon the curtain of this stage will rise Well trained am I and in this role well versed In readiness again I don my guise Yet fear and trembling parch my throat with thirst My face assumes a self assured masque The company does...

Islam's forgotten contributions to medical science.(Past progressive)
May 8, 2007... The transmission of medical knowledge can be traced to some of the earliest writings in human history. Yet a particularly fruitful period for advancement in medical science emerged with the rise of Islam. For the most part, Western scholarship...

Bobechko.(DEATHS)(Walter Peter Bobechko)(Obituary)(Brief article)
May 8, 2007... Bobechko, Walter Peter, Dallas; University of Toronto, 1957, orthopedic surgery. Died Jan. 6, 2007, aged 74. NOTICE Readers are invited to submit brief remembrances of recently departed colleagues. Colourful writing is encouraged, but...

Duncan.(DEATHS)(Barrie Potter Duncan)(Obituary)(Brief article)
May 8, 2007... Duncan, Barrie Potter, Calgary; University of Manitoba, 1939, pediatrics. Died Jan. 23, 2007, aged 90. "After military service in World War II Dr. Duncan worked as a general practitioner in Dawson City, Yukon, 1945-51. He gained national fame...

Fahrni.(DEATHS)(Gordon Paton Fahrni)(Obituary)(Brief article)
May 8, 2007... Fahrni, Gordon Paton, Winnipeg; University of Manitoba, 1940, general surgery. Died Jan. 20, 2007, aged 90. "After graduation in 1940 Dr. Gordon joined the Royal Canadian Navy. He was deployed to England and served on the HMS Fitzroy, a...

Gagnon.(DEATHS)(Jean-Louis Gagnon)(Obituary)(Brief article)
May 8, 2007... Gagnon, Jean-Louis, Quebec; Universite Laval, 1954, gynecology. Died Jan. 22, 2007, aged 77.

Goh.(DEATHS)(Keng Eok Goh)(Obituary)(Brief article)
May 8, 2007... Goh, Keng Eok, Edmonton; University of Alberta, 1969, general surgery. Died Feb. 1, 2007, aged 65.

Gordon.(DEATHS)(Alan Gordon)(Obituary)(Brief article)
May 8, 2007... Gordon, Alan, Thunder Bay, Ont.; University of Liverpool, United Kingdom, 1957, internal medicine. Died Dec. 23, 2006, aged 71. "He came to Thunder Bay in 1966, where his colleagues at McKellar General Hospital recognized him as an astute...

Hoh.(DEATHS)(Kwok-Fai Hoh)(Obituary)(Brief article)
May 8, 2007... Hoh, Kwok-Fai, Niagara Falls, Ont.; China Medical College, Taiwan, 1974, internal medicine. Died Jan. 19, 2007, aged 58.

Janda.(DEATHS)(Jana Otylie Janda)(Brief article)
May 8, 2007... Janda, Jana Otylie, Victoria; Univerzita Karlova, Czechoslovakia, 1967, ophthalmology. Died Jan. 25, 2007, aged 64.

O'Hanley.(DEATHS)(John Hubert O'Hanley)(Obituary)(Brief article)
May 8, 2007... O'Hanley, John Hubert, Charlottetown; McGill University, 1950, pediatrics. Died Jan. 18, 2007, aged 85. "Dr. O'Hanley served overseas as a lieutenant during World War II. He served as president of the Medical Society of Prince Edward Island and...

Rueben.(DEATHS)(Erich Franz Joseph Rueben)(Obituary)(Brief article)
May 8, 2007... Rueben, Erich Franz Joseph, North Vancouver; Universitat Heidelberg, Germany, 1951, otolaryngology. Died Jan. 27, 2007, aged 83.

Stephenson.(DEATHS)(Susan Elizabeth Stephenson)(Obituary)(Brief article)
May 8, 2007... Stephenson, Susan Elizabeth, Berkeley, Ont.; University of Toronto, 1974, family medicine. Died Jan. 22, 2007, aged 57. "Dr. Stephenson recently retired after 30 years of general practice in Bowmanville and Courtice, Ont. Susan was the beloved...

Williams.(DEATHS)(Ralph Carl Williams)(Obituary)(Brief article)
May 8, 2007... Williams, Ralph Carl, London, Ont.; University of Western Ontario, 1961. Died Jan. 18, 2007, aged 82. "Dr. Williams served with the Canadian Navy during World War II as a chief radar operator on corvettes and destroyers. After his discharge, he...

Query.
May 8, 2007... I'm perverse. A few years ago I fell ill, of the mental sort. Marital breakdown and professional stress were interrelated triggers, but it was felt that I was suffering from an actual disease, and I was treated accordingly, being referred...

They deserved better.(organ transplantation standards )(Editorial)
May 22, 2007... The irony is almost palpable. At a time when the World Health Organization is seeking to develop a measure of international standardization of principles and standards for organ transplantation, our organ donation policies and programs are...

Contraband cigarettes becoming a national norm.(News)
May 22, 2007... No question, I was slightly nervous. After all, I was about to commit a criminal act. "Got any cheap smokes?" I asked a scruffy guy sitting in a grungy coffee shop on Toronto's Queen Street. I approached him after watching him brazenly counting...

Coalition urges crackdown on contraband cigarettes.(News)(Canadian Coalition for Action on Tobacco)
May 22, 2007... Arguing that cheap, contraband cigarettes are seriously undermining public health initiatives to constrain smoking, the 70-member Canadian Coalition for Action on Tobacco has launched a national campaign to persuade governments to crack down on...

HIV microbicide trials halted.(News)
May 22, 2007... South Africa has launched an inquiry into ethical breaches that may have occured during a Phase III clinical trial of Canadian-made "Anti-AIDS" gel that was halted last January after preliminary results indicated use of cellulose sulfate could...

Imaging possibilities.(News)
May 22, 2007... Imagine the capacity to simultaneously identify the location of a tumour and obtain information about its biochemical and molecular nature. That's the goal of an ambitious $26.9 million research project that hopes to combine diverse...

Family practice a tough sell.(News)(family medicine residencies)
May 22, 2007... Family medicine residencies remained the toughest fill during the 2007 residency match, as some 108 of 987 available slots were left vacant at the conclusion of both iterations of the process. By contrast, only 36 medical specialty slots...

US proposes more stringent conflict-of-interest rules.(News)(science advisory committees)
May 22, 2007... The US Food and Drug Administration (FDA) has moved to stave-off a political firestorm by proposing new conflict of interest rules that would limit the ability of medical experts with financial interests in pharmaceutical companies to sit on...

Transplant tourism.(News@ a glance)(Brief article)
May 22, 2007... Transplant tourism: In a bid to curb the growing incidence of organ trafficking, now estimated at 10% of global transplantation practices, the World Health Organization has unveiled a blueprint of acceptable principles and standards for cell,...

Progress report.(News@ a glance)
May 22, 2007... Progress report: The Wait Time Alliance of the Canadian Medical Association issued its spring report card on provincial efforts to meet wait-time benchmarks established for 5 priority areas designated in the 2004 federal--provincial health care...

Prescribing powers.(News@ a glance)(Alberta pharmacists)(Brief article)
May 22, 2007... Prescribing powers: Alberta pharmacists have officially been given the legislative authority to initiate new prescriptions under certain circumstances (CMAJ2006;175:463-4). The regulations allow pharmacists to alter the dose, formulation and...

Alternative remuneration.(Pulse)(physicians' fee-for-service)
May 22, 2007... The nation's 59 655 physicians are ever earning more of their daily bread through alternative forms of payment to fee-for-service, according to a new Canadian Institute for Health Information (CIHI) report. Some 20.5% of the value of...

Abdominal crunches as an unusual cause of empyema.(Teaching Case Report)(Case study)
May 22, 2007... The case: A 28-year-old woman, previously healthy, came to our emergency department after 2 days of progressive left-sided chest pain. The onset had been sudden, in the midst of her doing a few abdominal crunches. She described the pain as...

Periorbital and facial swelling due to dermatomyositis.(Clinical Vistas)(Case study)
May 22, 2007... A 55-year-old woman presented with a 10-day history of malaise, lethargy and an elevated temperature (up to 39.5[degrees]C) accompanied by rigor. She also reported diffuse myalgia, arthralgia and bilateral facial edema. The patient's medical...

Influence of decision aids on patient preferences for anticoagulant therapy: a randomized trial.(Research)(Clinical report)
May 22, 2007... Abstract Background: Decision aids have been shown to be useful in selected situations to assist patients in making treatment decisions. Important features such as the format of decision aids and their graphic presentation of data on...

Frequency of adverse events in patients with poor anticoagulation: a meta-analysis.(Research)(Clinical report)
May 22, 2007... Abstract Background: Patients taking anticoagulants orally over the long term have international normalized ratios (INRs) outside the individual therapeutic range more than one-third of the time. Improved anticoagulation control will...

Using decision aids to help patients navigate the "grey zone" of medical decision-making.(Commentary)
May 22, 2007... Key points about patient decision aids * Patient decision aids prepare patients to discuss "grey zone" treatment options and to clarify which benefits and harms matter most to them * They differ from educational aids by not only...

Teenage pregnancy: trends, contributing factors and the physician's role.(Public Health)
May 22, 2007... Teenage pregnancy is an important public health issue: it is common, largely preventable and associated with negative sequelae, both for the teenagers who become pregnant and for their children. Compared with babies of older mothers, those born...

Septic arthritis in patients with pre-existing inflammatory arthritis.(Case study)
May 22, 2007... The case: A 56-year-old woman presents to her family physician with a 7-day history of tenderness, swelling and redness of 2 metacarpophalangeal joints and 1 proximal interphalangeal joint in her right hand. She also reports pain and redness of...

Drug-eluting stents.(Letters)(Letter to the editor)
May 22, 2007... In their recent systematic review, Suzanne Ligthart and associates compared analyses of the cost-effectiveness of drug-eluting stents. (1) They found that in most studies in which an incremental cost-effectiveness ratio greater than $50 000 per...

Correction.(Letters)(Correction notice)
May 22, 2007... The authors of a recent CMAJ article (1) have let us know that there was a minor error in their article. The odds ratios that were reported as measures for imbalance of patient characteristics in Table 1 were miscalculated. All counts,...

Defining moments: end-of-life care in the back of a truck.(Room for a view)(Brief article)
May 22, 2007... Professor of medicine, head of respirology, end-of-life researcher--that's my life as a physician. My last official home visit was nearly 30 years ago. Recently though, I spent a few days as "visiting professor" in a remote rural area, seeing...

Healthy eating: lessons from history.(Nutrition Policy in Canada, 1870-1939)(Book review)
May 22, 2007... Nutrition Policy in Canada, 1870-1939 Aleck Samuel Ostry UBC Press; 2006 (cloth)/2007 (paper) 160 pp $34.95 (paper) ISBN 978-0-7748-1328-0 It has only been a few months since Eating Well with Canada's Food Guide (1) was released as Canada's...

Waiting.(Notes)
May 22, 2007... I would like to tell you about Mrs. M. But understand, she is by no means a "fascinoma." Rather, looking at her list of diagnoses, Mrs. M. could be almost any patient on our medical ward. However, despite her end-stage renal disease,...

The elderly patient: in situ.(Lifeworks)(photography by physician)(Brief article)
May 22, 2007... Dr. Mark Nowaczynski began to take photographs of his elderly patients in their homes in 1998 with the aim of documenting their vulnerability as they lived isolated and alone, attempting to maintain their independence. An Assistant Professor in...

Deaths.(Obituary)
May 22, 2007... Barber, Hugh Otter, Thornhill, Ont.; University of Toronto, 1945, otolaryngology. Died Dec. 14, 2006, aged 83. "Dr. Barber enjoyed guiding and teaching young doctors at Sunnybrook Health Sciences Centre and the University of Toronto. He was...

Query.
May 22, 2007... I was dressed down yesterday. I saw a patient with hypertension. He was my colleague's patient. He came in asking only for a renewal of his medication. I asked him what the medications were; he said he didn't know, that they were "in the...