CMAJ: Canadian Medical Association Journal articles from May 2008

CMAJ: Canadian Medical Association Journal archives from May 2008

Bringing a research base to psychiatry/Etablir une base de recherche en psychiatrie.(Editorial)
May 6, 2008... In this era of evidence-based medicine, the scarcity of high-quality evidence for mental health care is striking. Mental health practitioners often cannot obtain useful information to guide their clinical decisions, a situation that the...

Investigative report: 1766 boil-water advisories now in place across Canada.(News)(Survey)
May 6, 2008... Published at www.cmaj.ca on Apr. 7, 2008. Print version revised. More than 1760 provincial boil-water advisories are currently in effect in communities and neighbourhoods across Canada, prompting calls from national and municipal advocacy...

Research chairs program under review.(News)
May 6, 2008... The formulas for divvying up Canada Research Chairs among the biomedical, natural and social sciences, and among the nation's universities, will be put under an international microscope in a forthcoming review of the program. No aspect of...

Inducing seizures among seniors.(News)
May 6, 2008... For some patients with major depression, psychotherapy and medications offer little respite, which prompts many psychiatrists to turn to electroconvulsive therapy, particularly to relieve psychosis or thoughts of suicide. It's been...

Notes on electroconvulsive therapy.(News)
May 6, 2008... Although electroconvulsive therapy is accepted by the Canadian and American psychiatric associations as a treatment for major depression and bipolar disorder, it has a checkered history. It once was administered without muscle relaxants or...

The strains of Ebola.(News)
May 6, 2008... Inside tiny Kikyo Health Centre nestled high in the Rwenzori Mountains of Uganda, a sheet on the office wall entitled "Weekly epidemiological cases," tracks incoming patients. The list gives testimony to the challenges faced when a 10-bed...

Conservatives unveil new product safety regime.(For the record)
May 6, 2008... Progressive licensing for pharmaceuticals and biologics, as well as mandatory reporting of adverse drug reactions by health care institutions, highlight omnibus consumer protection legislation introduced by the minority federal Conservative...

United Kingdom updates ethics guidance.(News)(Brief article)
May 6, 2008... The United Kingdom General Medical Council has issued supplementary guidelines for doctors on proper behaviour when patient care conflicts with their religious or personal beliefs. The new "Personal Beliefs and Medical Practice" guidance...

Needle therapy.(News @ a glance)(acupuncture as a supplementary benefit under its health insurance plan)(Brief article)
May 6, 2008... Needle therapy: British Columbia has become the first province to include acupuncture as a supplementary benefit under its health insurance plan. Residents earning less than $28 000 per year will be reimbursed $23 for each visit (maximum 10) to...

HIV trends.(News @ a glance)(Brief article)(Clinical report)
May 6, 2008... HIV trends: A government of Manitoba report indicates HIV infection is spreading more rapidly in heterosexual First Nations populations than other groups (www.gov.mb.ca). The update on HIV 1985-2007 indicates 24%, or 20 of 82 newly diagnosed...

CMAJ welcomes new senior editor.(News)(Dr. Rajendra Kale joined Canadian medical Association as Senior Deputy Editor )
May 6, 2008... Winter dumped a near-record amount of snow on Ottawa, Ontario, and by late February 2008 most residents would have sooner donned a Toronto Maple Leafs jersey than seen another flake. But as far as Dr. Rajendra Kale was concerned, the more snow...

From bedside to lab and back again.(News)
May 6, 2008... Canada must persuade more physicians to become more involved in research to ensure that bench science is being transferred to the bedside and that research protocols are properly informed by health needs, says the incoming President of the...

Eye contact.(Dispatch from the medical front)(Case study)
May 6, 2008... He was my first patient in East Timor: 12 years old, with a 5-day history of delirium and fever. I'd just finished my first year of medical school, but what I lacked in clinical experience, I hoped to make up for in enthusiasm,...

Diagnosis and treatment of dementia: 3. Mild cognitive impairment and cognitive impairment without dementia.
May 6, 2008... Abstract Background: Mild cognitive impairment and cognitive impairment, no dementia, are emerging terms that encompass the clinical state between normal cognition and dementia in elderly people. Controversy surrounds their...

Spinal dural arteriovenous fistula: a treatable cause of myelopathy.(Teaching case report)(Case study)
May 6, 2008... The case: A previously healthy 46-year-old man, who works as a standing forklift operator, presented to an emergency department with a 1-day history of bilateral leg "soreness" and numbness in his right leg ascending to his groin. Seven-months...

Malaise, weight loss, pleuritic chest pain and productive cough: what is your call?(Clinical quiz)(Disease/Disorder overview)
May 6, 2008... [FIGURE 1 OMITTED] A 53-year-old man from Texas presented with a 2-month history of malaise, anorexia and 14-kg weight loss, and a 2-week history of chest pain and a productive cough of yellow-brown sputum. He was a smoker (40 pack-year),...

Selective serotonin reuptake inhibitors for unipolar depression: a systematic review of classic long-term randomized controlled trials.(Research)
May 6, 2008... Abstract Background: Selective serotonin reuptake inhibitors are increasingly used in the long-term treatment of depression. Much of the supporting evidence about the effects of these drugs comes from discontinuation trials, a variant of...

Effect of different angiotensin-converting-enzyme inhibitors on mortality among elderly patients with congestive heart failure.(Research)
May 6, 2008... Abstract Background: Existing clinical trial data do not address whether all angiotensin-converting-enzyme (ACE) inhibitors are similarly beneficial in improving survival and reducing the rate of readmission among patients with congestive...

Developing the evidence for evidence-based practice.(Research)
May 6, 2008... In this issue of CMAJ, Deshauer and colleagues (1) note that most (93%) trials of drugs for the treatment of depression last less than 6 months (typically 6-8 weeks); indeed, most are conducted for registration purposes by industry. Despite the...

Comparative effectiveness of angiotensin-converting-enzyme inhibitors: is an ACE always an ace?(Research)
May 6, 2008... Although large randomized clinical trials remain the foundation for informing evidence-based prescribing, vast data sources can provide insight into complex questions that arise in clinical decision-making. Using tens of thousands to millions...

Mental health in Canada: out of the shadows forever.(Public health)
May 6, 2008... Canada is the only G8 country that does not have a national mental health strategy. This startling fact was one of the findings of the investigation of mental health in Canada by the Standing Senate Committee on Social Affairs, Science and...

Electronic medical records.(Letters)(Letter to the editor)
May 6, 2008... A recent editorial by Ken Flegel repeats the purported advantages of keeping electronic medical records. (1) The results of the electronic conversion of paper records in other industries suggest that such a conversion in medicine will be a boon...

The language of living wills.(Letters)(Letter to the editor)
May 6, 2008... In a recent article in The Left Atrium, Mark Belletrutti and Ingrid DeKock present and highly recommend a living will from "Edward," one of their patients. (1) They write that "unlike many of today's legally prepared documents, Edward's...

Corrections.(Letters)(Correction notice)
May 6, 2008... A News article in the Feb. 12 issue about shortages of medical specialists contained an error. The Canadian Association of Emergency Physicians did participate in CMAJ's canvass of specialty associations by providing a report on the issue. (1)...

Ghost-busting addictions.(Book review)
May 6, 2008... In the Realm of Hungry Ghosts: Close Encounters with Addiction Gabor Mate MD Knopf Canada; 2008 480 pp $34.95 ISBN 978-0-676-97740-0 If stigma still shapes the ways we understand and respond to addictions in contemporary...

Too much medicine.(Book review)
May 6, 2008... Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer Shannon Brownlee, Bloomsbury USA; 2007 343 pp $28.95 ISBN 978-1-58234-580-2 Six billion people on this planet inhabit a world of unimaginable health extremes. At one...

Letter to Leo.(Poem)
May 6, 2008... Letter to Leo How many restaurants, how many times? Always the language of Sisyphus: grunt and groan. I asked you of the cancer that claimed you, that you couldn't pronounce: irony, the big, crushing stone. And...

Deaths.
May 6, 2008... Blackwood, Harold John, St. John's, Newfoundland and Labrador; Dalhousie University, Halifax, Nova Scotia, 1951, general surgery. Died Jan. 10, 2008, aged 82. Borensztajn, Zelman David, North York, Ontario; Universite de Bordeaux II,...

Talking over patients: sTOP.(Salon)
May 6, 2008... [ILLUSTRATION OMITTED] An old woman lies quietly on a scanning table; the detector buzzes back and forth looking for metastases. Two technicians stand where the woman cannot see them; they are audibly discussing the "big date" from last...

Tasers in medicine: an irreverent call for proposals/Les tasers en medecine : une demande de propositions irreverencieuse.(Editorial)
May 20, 2008... Published at www.cmaj.ca on May 1, 2008. In this issue, we call your attention to an emerging and increasingly popular medical device: the taser. It may strike you as odd to hear tasers described as medical devices. Tasers are probably more...

Activity-based hospital funding: boon or boondoggle?(News)
May 20, 2008... It is a health care funding model with more names than a mobster on the run. In the United Kingdom it's known as activity-based funding or payment by results. Americans call it pay for performance, P4P for short. The moniker most often attached...

European complaint mechanisms vary widely.(News)
May 20, 2008... At times, the impulses are at odds. Treating patients' complaints seriously while not losing sight of the rights of doctors and other medical personnel can be tricky, but the course taken speaks volumes about commitment to accountability and...

Foreign-trained doctors dominate pilot project.(News)
May 20, 2008... Skeptics call it a tremendous waste of medical talent, while proponents argue it could become a viable career path for international medical graduates who are unable to obtain residencies. Neither conclusion is exactly what might have been...

Policing cosmetic surgery.(For the record)(Brief article)
May 20, 2008... General practitioners in Ontario will be prohibited from declaring that they are "cosmetic surgeons" or advertising that they have such capabilities, under new regulations adopted by the College of Physicians and Surgeons of Ontario. In...

Supervised injection site gets lukewarm review.(For the record)(Clinical report)
May 20, 2008... With the June 30th deadline looming on the Vancouver-based InSite safe injection site's exemption from the federal Controlled Drugs and Substances Act, Health Minister Tony Clement has released the final report of a government commissioned...

Preventing another forensic debacle.(For the record)
May 20, 2008... A structural overhaul of the Office of the Chief Coroner of Ontario and the creation of a Centre for Forensic Medicine and Science to improve training and research in forensic pathology lie at the core of systemic changes the office says are...

School plans.(Also in the news)(New York University has hired Dr. Peter Walker)(Brief article)
May 20, 2008... School plans: York University has hired former University of Ottawa dean of medicine Dr. Peter Walker to craft a comprehensive strategy and business plan to establish a new medical school on its campus. York hopes to establish a 100-space...

Declared dangerous.(Also in the news)(Brief article)
May 20, 2008... Declared dangerous: Health Canada has proposed to ban the importation, sale and advertising of polycarbonate baby bottles which contain bisphenol A. Health Minister Tony Clement also proposes to introduce "stringent" migration targets for...

MRSA rates.(Also in the news)(methicillin-resistant Staphylococcus aureus )(Brief article)
May 20, 2008... MRSA rates: An estimated 2300 Canadians lost their lives in 2006 because they were infected with the superbug methicillin-resistant Staphylococcus aureus in hospitals, while a projected 11 700 Canadians were newly infected by the bacteria after...

Changing attitudes.(Also in the news)(Survey)(Brief article)
May 20, 2008... Changing attitudes: Some 59% of 2000 surveyed American doctors say they support a national health insurance plan, an increase of 10% from an identical survey conducted in 2002. The percentage of physicians who opposed such a plan declined to...

Evidence lacking.(Also in the news)
May 20, 2008... Evidence lacking: The long-held notion that people should drink 8 glasses of 8 ounces of water per day lacks justification, according to a review of published clinical studies undertaken by University of Pennsylvania physicians Dr. Dan Negoianu...

New direction.(Also in the news)(AIDS vaccines proving entirely ineffective )(Brief article)
May 20, 2008... New direction: With the current crop of AIDS vaccines proving entirely ineffective in clinical trials, if not likely to increase the risk of becoming infected with HIV, the head of the US National Institutes of Health's National Institute of...

Fee-for-service.(Also in the news)
May 20, 2008... Fee-for-service: Payments to physicians for clinical services rose 39.4% over 5 years to $14 billion in 2005/06, according to the Canadian Institute of Health Information's new fee-for-service utilization report. Fee-for-service payments rose...

Fatality rates.(Also in the news)
May 20, 2008... Fatality rates: The 50-member Australian Health Care Reform Alliance, which includes 7 doctors' organizations, has proposed that the patient mortality rates for individual doctors, surgeons and other health workers be made publicly available as...

Joint relapse.(Also in the news)
May 20, 2008... Joint relapse: One of every 7 patients who receives a knee or elective hip replacement in Canada is back in hospital within a year because of complications associated with the surgery, most typically loosening of the prosthesis, dislocation or...

Fine dining.(Also in the news)
May 20, 2008... Fine dining: Upscale restaurants in San Francisco have taken to introducing a 3.5% service charge on all cheques to help cover their obligations under the city's new universal healthcare legislation, which requires that all medium-sized and...

Private bills.(Also in the news)
May 20, 2008... Private bills: Although rarely enacted, private members' bills can be a harbinger of government bills to come if a backbencher quietly builds political support for a pet belief. Among those working the rounds of the 39th session of Parliament...

Double-doctoring.(Also in the news)(Brief article)
May 20, 2008... Double-doctoring: New Brunswick Health Minister Mike Murphy has awarded $1.3 million to private insurance and health products firm Medaview Blue Cross to develop a prescription drug monitoring program that would prevent patients from readily...

Basic plumbing.(Also in the news)
May 20, 2008... Basic plumbing: The World Health Organization/UNICEF Joint Monitoring Programme for Water Supply and Sanitation has issued a preliminary report indicating that 2.6 billion people worldwide, including 62% of Africans and an estimated 980 million...

Buying time.(Also in the news)(Brief article)
May 20, 2008... Buying time: In a bid to attract more physicians to the territory, Yukon Community Services Minister Glenn Hart has proposed extending the period of time in which international medical graduates can receive temporary licenses to practise from 1...

Bird flu spreading in Asia.(News)
May 20, 2008... Bird flu continues to hover as a spectre over much of Asia as more nations report that the H5N1 virus has been found within their fowl and fears rise that it could mutate into a form that leads to human-to-human transmission and kills far more...

Annual residency scramble near completion.(News)(Report)
May 20, 2008... Although a record 353 international medical school graduates found positions in the 2008 residency match as provinces slowly moved to fulfill commitments to expand slots for those educated or trained abroad, some 946 international graduates and...

More casualties in Vietnam.(Dispatch from the medical front)
May 20, 2008... Forty-two years after United States marines first landed on its beaches, there are signs of increasing economic prosperity in Da Nang, Vietnam. Behind the rows of brightly coloured fishing boats stand advertisements for banks and electronics...

Toward a more effective approach to stroke: Canadian Best Practice Recommendations for Stroke Care.(Clinical report)
May 20, 2008... ABSTRACT Each year more than 50 000 Canadians experience a stroke and more than 300 000 currently live with its effects. Despite the evidence supporting best practices in stroke care, significant gaps in translating this knowledge into...

Fever and skin redness in a 10-year-old boy: what is your call.(Practice)(Case study)
May 20, 2008... [FIGURE 1 OMITTED] [FIGURE 2 OMITTED] [FIGURE 3 OMITTED] A10-year-old boy presented with a 2-day history of nausea, vomiting, malaise and fatigue as well as increasing pain, redness and swelling of his right foot and leg, right...

Prevalence and incidence of hypertension from 1995 to 2005: a population-based study.(Research)(Survey)(Statistical data)
May 20, 2008... Abstract Background: Researchers have predicted that there will be a relative increase of 24% in the prevalence of hypertension in developed countries from 2000 to 2025. Hypertension is a leading risk factor for death, stroke,...

Mortality among patients with hypertension from 1995 to 2005: a population-based study.(Research)(Statistical data)
May 20, 2008... Abstract Background: We have reported that the prevalence of diagnosed hypertension increased by 60% from 1995 to 2005 in Ontario. In the present study, we asked whether this increase is explained by a decrease in the mortality rate. ...

Results of the Ontario survey on the prevalence and control of hypertension.(Research)(Statistical table)(Survey)
May 20, 2008... ABSTRACT Background: Available information on the prevalence and management of hypertension in the Canadian population dates back to 1986-1992 and probably does not reflect the current status of this major risk factor for cardiovascular...

Cardiac stimulation with high voltage discharge from stun guns.(Mechanisms and innovations)
May 20, 2008... ABSTRACT The ability of an electrical discharge to stimulate the heart depends on the duration of the pulse, the voltage and the current density that reaches the heart. Stun guns deliver very short electrical pulses with minimal amount of...

Hypertension management in Canada: good news, but important challenges remain.(Research)(Clinical report)
May 20, 2008... Three research articles in this issue of CMAJ bring evidence of marked improvements in the diagnosis and treatment of hypertension in Ontario, Canada's most populous province. (1-3) The findings will have a major impact on health care...

The medical student elective in Africa: advice from the field.(Medicine and society)
May 20, 2008... For European or North American medical students, the decision to pursue an elective in Africa will not be taken lightly. Travel is expensive; finding an appropriate hospital may be difficult; health and security risks must be considered,...

Rates of colorectal cancer screening.(Letters)(Letter to the editor)
May 20, 2008... We recently reported that 23.5% of Canadians aged 50 years or older who were at average risk for colorectal cancer had ever received screening for colorectal cancer; this value fell to 17.6% when only up-to-date screening was considered. (1) In...

The need for more children's mental health services.(Letters)(Letter to the editor)
May 20, 2008... Recent articles in CMAJ and elsewhere have illuminated the ongoing concerns about the capacity of children's mental health services. (1-3) These articles have correctly attempted to focus the attention of health policy-makers on the importance...

Error in the Compendium of Pharmaceuticals and Specialties, 2008 edition.(Letters)(Letter to the editor)
May 20, 2008... A potentially serious error has been identified in the Compendium of Pharmaceuticals and Specialties (CPS),2008 edition, in the Clin-Info section, Calculations and Dosing Tools, p. L3. (1) The square brackets in the first equation for body...

Correction.(Letters)(Correction notice)
May 20, 2008... The lead author of a research paper (1) in the April 8 issue has provided the following clarification. The initial Health Canada warnings about the use of antidepressants were directed toward people aged 18 years and younger; however, in June...

The private and public nature of disease: art as a transformative medium.(Lifeworks)
May 20, 2008... In Western society, with its emphasis on physical perfection, those who are ill or have "wounded" bodies become "the Other"--separated from society both physically, in institutions, and socially. This may well be more for society's comfort than...

The cost of war.(Book review)
May 20, 2008... Medicine and Duty: The World War I Memoir of Captain Harold W. McGill, Medical Officer, 31st Battalion CEF Harold W. McGill MD Editor, Marjorie Barron Norris University of Calgary Press; 2007 379 pp $39.95 ISBN 978-1-55238-193-9...

Deaths.
May 20, 2008... Andrews, Leslie Gerald, Vancouver, British Columbia; University of London, London, England, 1952, pediatrics. Died Feb. 5, 2008, aged 78. Antuna, Faustino, Tracadie-Sheila, New Brunswick; Universidad de Salamanca, Salamanca, Spain, 1964....

Picture this: a new way of seeing risk.(Salon)
May 20, 2008... Conveying the statistics of risk is often a classic head butt between patient and doctor. You say: Smokers have a 50% greater chance of dying younger than non-smokers. The patient responds: Yes, but my uncle lived until he was 95 and he smoked...