CMAJ: Canadian Medical Association Journal articles from November 2004

CMAJ: Canadian Medical Association Journal archives from November 2004

Health and economic benefits of an accelerated program of research to combat global infectious diseases.(Essay)
November 9, 2004... Global IDEA Scientific Advisory Committee Reducing the burden of disease in developing countries is central to global economic development and security. (1-3) Combatting infectious disease is crucial to improving prospects for the poor and...

Incomplete patient drug information still a problem.(Letters/Correspondance)(Letter to the Editor)
November 9, 2004... In 2001, we published a letter criticizing the poor quality of drug information available to the Canadian public, (1) using as an example cisapride, a drug that had been withdrawn from the market for safety reasons in August 2000. In response,...

Catering to the customers.(Letters/Correspondance)(Letter to the Editor)
November 9, 2004... It is not surprising that 6 English-language journals published in North America and the United Kingdom would tend to include articles on topics of interest to English-speaking patients, physicians and researchers in those industrialized,...

Care at for-profit hospitals.(Letters/Correspondance)(Letter to the Editor)
November 9, 2004... I was surprised to learn that Gordon Guyatt, coauthor of an influential paper on health care delivery, (1) was also a candidate for the New Democratic Party during this year's federal election. The statement in the article claiming that there...

The gender gap in Canadian health care.(Letters/Correspondance)(Letter to the Editor)
November 9, 2004... Kirsteen Burton and Ian Wong, in their article on the physician workforce in Canada, (1) state that "Compared with men, women work fewer hours per week, see fewer patients (and provide fewer services), [and] are likely to leave the medical...

Reforms mean 25 million Russians lose free health care.(Global Health)
November 9, 2004... A sweeping package of reforms will see an estimated 25 million Russian pensioners and other government dependants exchange Soviet-era entitlements, including free health services, medicine and public transit, for larger government cheques. ...

Isolate patients, screen staff to fight MRSA.(Hospital Infections)
November 9, 2004... Strategies to contain methicillin-resistant Staphylococcus aureus will fail unless they include screening all health care workers and decolonizing carriers, say Dutch researchers. The Netherland's strict "search and destroy" tactics, which...

Mandatory error reporting in Saskatchewan.(Adverse Events)
November 9, 2004... Saskatchewan has become the first jurisdiction in Canada to require health districts to report all medical errors to the province. The Saskatchewan Department of Health will analyze the details of each reported event and issue province-wide...

Obesity epidemic migrates east.(Global Health)
November 9, 2004... A dramatic decrease in physical activity and an influx of junk food following the collapse of the Berlin Wall have triggered an epidemic of obesity among Eastern Europeans. Hungary's ministry of health, for example, reports that the level...

Obstacles to combatting cancer in the developing world.(Global Health)
November 9, 2004... Cancer patients in developing countries must overcome the obstacles of inadequate infrastructure for treatment and lack of follow-up even as they contend with the disease itself, said experts at a radiation therapy conference tackling these...

SARS silver lining: a renewal of public health.(Public Health)
November 9, 2004... Dr. David Butler-Jones measures the sea change in attitude toward public health by the number of politicians at the news conference announcing his appointment as Canada's first Chief Public Health Officer. Prime Minister Paul Martin,...

Learning to care for those who can't be cured.(Medical Education)
November 9, 2004... Canada's medical schools will soon teach the next generation of doctors how to care for those who can't be cured. "Physicians have not been taught to deal with death," says Dr. Larry Librach, director of the Temmy Latner Centre for...

Varicella vaccine cost-effective: US study.(Public Health)
November 9, 2004... A new US study concluding that chickenpox vaccination programs can save millions in direct medical costs comes at a time when more Canadian jurisdictions are adding varicella to their list of covered immunizations. The study, published in...

Master's in Global Health.(News @ a glance)
November 9, 2004... Master's in Global Health: Canada's first master's program in global health is slated to begin in the fall of 2006 at Simon Fraser University in Vancouver. The interdisciplinary, participatory program will emphasize population and public health...

Discount drugs.(News @ a glance)(Brief Article)
November 9, 2004... Discount drugs: Pharmaceutical giant Pfizer Inc. is offering discounts on prescription drugs to 43 million uninsured Americans, a move analysts said could be aimed at countering growing pressure for US cost controls. Under the "Pfizer Pfriends"...

Donor hearts needed.(News @ a glance)(Author Abstract)
November 9, 2004... Donor hearts needed: A shortage of donor hearts is forcing Canadian transplant physicians to go to the United States for organs as hospitals turn to implanting ventricular assistive devices (VADs) in patients waiting for new hearts. Even though...

Battle of the bulge.(News @ a glance)(Brief Article)
November 9, 2004... Battle of the bulge: The US Institute of Medicine is calling for a national effort to combat childhood obesity, a problem for 9 million children aged 6 and over. The Childhood Obesity Prevention Study (www.iom .edu/report.asp?id=22596) says...

Vagus nerve stimulation in the treatment of epilepsy.(Neurology)
November 9, 2004... Despite the fact that 15 different antiepileptic drugs are now available for use in Canada, about one-third of patients with epilepsy continue to have inadequate seizure control. Patients with pharmacoresistant epilepsy often experience various...

Prevention of influenza in the general population: recommendation statement from the Canadian Task Force on Preventive Health Care.(Influenza)
November 9, 2004... Influenza virus causes yearly epidemics of respiratory illness of varying severity worldwide in people of all ages, and it may be the most important cause of medically attended acute respiratory illness. (1) In healthy adults illness is usually...

A 32-year-old woman with breast swelling and crepitant rales.(Clinical Vistas)
November 9, 2004... A 32-year-old previously healthy female smoker was admitted to hospital after presenting with a sudden onset of painful bilateral breast swelling and chest pain that occurred when she was resting. Her pain was nonpleuritic, with no associated...

Are there long-term benefits of donepezil in Alzheimer's disease?(In The Literature)
November 9, 2004... Courtney C, Farrell D, Gray R, Hills R, Lynch L, Sellwood E, et al; AD2000 Collaborative Group. Long-term donepezil treatment in 565 patients with Alzheimer's disease (AD2000): randomised double-blind trial. Lancet 2004;363:2105-15. ...

Optimal search strategies for detecting health services research studies in MEDLINE.(Research/Recherche)
November 9, 2004... Abstract Background: Evidence from health services research (HSR) is currently thinly spread through many journals, making it difficult for health services researchers, managers and policy-makers to find research on clinical practice...

Evidence of suboptimal management of cardiovascular risk in patients with type 2 diabetes mellitus and symptomatic atherosclerosis.(Research/Recherche)
November 9, 2004... Abstract Background: Given that most deaths among patients with diabetes mellitus are due to cardiovascular disease, we sought to determine the extent to which medications proven to reduce cardiovascular mortality are prescribed for...

Predictive value of a self-reported history of varicella infection in determining immunity in adults.(Research letter)
November 9, 2004... Abstract THE RECENT INTRODUCTION OF A VACCINE FOR VARICELLA has raised questions about whether, for adults, a patient's history of varicella infection is useful in determining if vaccination is necessary. We report findings on 184 family...

Global health indicators: an overview.(Commentary/Commentaire)
November 9, 2004... The health of people living in developing countries around the world has improved considerably over the past 2 decades. For example, the total number of deaths annually among children less than 5 years of age has been halved over the past 40...

Global failures/Constat d'echec dans le monde.(Editorial)
November 9, 2004... Overcoming human poverty will require a quantum leap in scale and ambition... The Millennium Development Goals are still technically feasible in even the poorest countries, but the window of opportunity is rapidly narrowing and the political...

Prevention of influenza in the general population.(Review/Synthese)
November 9, 2004... Abstract Background: Although all jurisdictions in Canada offer annual influenza immunization to people at high risk of complications, only Ontario has provided universal annual immunization of healthy adults and children. Use of...

The ties that bind.(The Left Atrium)
November 9, 2004... The ties that bind Les Triplettes de Belleville/The Triplets of Belleville Directed by Sylvain Chomet Columbia Tristar, 2003, 81 min Les Invasions barbares/The Barbarian Invasions Directed by Denys Arcand Alliance...

The salt of tears.(Room for a view)
November 9, 2004... Some of the best memories I never had are of visiting my Great-Uncle Donald Ross at his home in Grafton, just a short drive from Kingston. We would pull up the tree-lined drive to the family farm, Katie still young and vital at 72, and me, her...

Deaths.(Deaths/Necrologie)(Obituary)
November 9, 2004... Bodnar, Stephen, Montreal; University of Debrecen (Hungary) 1951; obstetrics/ gynecology; FRCSC; former staff, St. Mary's, Reddy Memorial and Queen Elizabeth hospitals; lecturer, McGill University. Died Aug. 2, 2004; survived by his wife, Medy,...

Query.
November 9, 2004... I lost my coffee cup a week ago. A big, 750 mL Thermos with a switch-top lid that I'd carted around to four provinces and dozens of hospitals. I'd fill it up in the morning, and it rarely ran dry for the rest of the day; I'd keep refilling it...

Query.
November 23, 2004... I referred a woman for an abortion yesterday. With abortion, the question of sides inevitably comes up, often fiercely: my own feelings on the issue are mixed. Although I see myself as aligned on the side of life, I also acknowledge the right...

Views on recertification.(Letters/Correspondance)(Letter to the Editor)
November 23, 2004... The CMAJ editorial on mandatory recertification (1) expresses a positive opinion on the desirability of such a move. However, nothing approaching good evidence is quoted to support this view, which raises the question of whether our licensing...

Acute coronary syndromes.(Letters/Correspondance)(Letter to the Editor)
November 23, 2004... Jim Christenson and colleagues, (1) in their article about emergency department assessment of chest discomfort, state that chest pain evaluation units "are cost-effective relative to admitting all low-risk patients to coronary care units but...

Rethinking diabetes care in Canada.(Letters/Correspondance)(Letter to the Editor)
November 23, 2004... In a study published last year in Canadian Family Physician, Harris and associates (1) found evidence that many Canadians with diabetes are not being monitored appropriately: 16% had not had their glycosylated hemoglobin (A1C) level tested in...

Final evaluation results for the Fast-Check HIV rapid test kits.(Letters/Correspondance)(Letter to the Editor)
November 23, 2004... In late April 2002, the British Columbia Centre for Disease Control (BCCDC) reported to Health Canada potential problems with the Fast-Check HIV-1/2 point-of-care whole blood (POC WB) test (BioChem ImmunoSystems). On the basis of these data,...

A question of ethics.(Letters/Correspondance)(Letter to the Editor)
November 23, 2004... A recent CMAJ editorial about the outbreak of Clostridium difficile-associated diarrhea in certain Canadian hospitals (1) describes the "stifling of concerned voices on the front lines of medicine" as the "worst news" in a bad-news story. ...

The doubts and fears of emergency physicians.(Letters/Correspondance)(Letter to the Editor)
November 23, 2004... My colleague Dr. Ursus describes the emotional turmoil of working in an emergency department. (1) As an emergency physician myself, I have faced some of the same questions and concerns, but I have also gained a few pearls of wisdom from my...

Clostridium difficile colitis: a marker for ischemic colitis?(Letters/Correspondance)(Letter to the Editor)
November 23, 2004... In an electronic letter published in Gut earlier this year, (1) I wrote, "Nine years ago I alerted the CDC [US Centers for Disease Control and Prevention] in Atlanta to the possibility that C difficile colitis might be a marker of a far more...

Corrections.(Letters/Correspondance)(Correction Notice)
November 23, 2004... The last name of the author of a recent Left Atrium article (1) was published incorrectly. The author's name is Alejandro R. Jadad. The online version was corrected. Reference (1.) Halifax ND, Gray R, Jadad AR. Self-portraits of...

C. difficile: by the numbers.(Hospital-acquired Infection)(Clostridium difficile infections)
November 23, 2004... Published at www.cmaj.ca on Nov. 2, 2004. Canada's new public health agency will track Clostridium difficile infections in 25 teaching hospitals across the country, after Quebec acknowledged an "epidemic" of infections in Montreal and...

Medical schools accept tobacco dollars.(Institution Ethics)(Brief Article)
November 23, 2004... Respondents to a survey of Canada's 16 medical schools say they have no policy about accepting funding or donations from tobacco companies (Canadian Journal of Public Health 2004;95[3]:205-7). Study author Dr. Joanna Cohen said she wasn't...

For-profit clinics are legal but "no solution".(Privatization)
November 23, 2004... Dr. Christian Hobden is accustomed to fixing what's broken. As chief of emergency medicine at Cite de la Sante in Laval, he oversaw the task of turning around Quebec's most overcrowded emergency department. He was then invited to serve on an...

CMAJ enters for-profit market.(Canadian Medical Association Journal, CMA Holdings)
November 23, 2004... The CMAJ is poised to enter the world of profit-driven companies on Jan. 1 when CMA Publications will be sold for $4.2 million to the CMA's financial investment arm, CMA Holdings. It's hoped the move will ultimately generate adequate...

BC and Alberta crack down on cosmetic surgery prizes.(Medical Ethics)(Brief Article)
November 23, 2004... Physician regulatory bodies in BC and Alberta are cracking down on plastic surgeons who promote their services in "extreme makeover" and other contests. Last summer's Vancouver Extraordinary Makeover Experience, where 2 participants won...

Physicians sue pharmacy chain for unfair competition.(Medicolegal)(Brief Article)
November 23, 2004... Two Montreal-area doctors are suing a prominent pharmacy chain for allegedly creating unfair competition by attempting to attract doctors to locate their clinics near its stores. The physicians also accuse the Quebec College of Physicians,...

Lawsuits mount in wake of rofecoxib (Vioxx) withdrawal.(Pharmaceutical Industry)
November 23, 2004... Within 2 weeks of Merck & Co.'s decision to withdraw the anti-arthritis drug rofecoxib (Vioxx) because of its cardiovascular risks, lawyers filed 10 class-action lawsuits collectively representing several thousand plaintiffs in Canada against...

My choice.(Tobacco industry)(Brief Article)
November 23, 2004... My choice: The Canadian Tobacco Manufacturer's Council is paying $2.5 million to fund a new online association for adult Canadian smokers. Launched in late September, mychoice.ca is designed to give Canada's 5 million smokers a voice equal to...

Heroin trial.(North American Opiate Injection Trial)(Brief Article)
November 23, 2004... Heroin trial: North America's first clinical trial to determine whether prescribed heroin stabilizes the amount addicts take will begin in Vancouver's Downtown Eastside in December, followed by Montreal this winter and Toronto later in 2005....

Exam stolen.(Medical Council of Canada, security breach and probable theft of examination questions)(Brief Article)
November 23, 2004... Exam stolen: The first of 2 qualifying examinations offered by the Medical Council of Canada (MCC) is being revised after a computer audit revealed a security breach and probable theft of examination questions in mid-October. MCC Executive...

Alberta infant mortality high.(News @ a glance)(Brief Article)
November 23, 2004... Alberta infant mortality high: Albertans suffer the highest infant mortality rate in the country, according to Statistics Canada. Alberta had 7.3 deaths per 1000 live births in 2002, compared with the national average of 5.4. Dr. John Van...

Body counts.(News @ a glance)(Center for International Emergency Disaster and Refugee Studies)(Brief Article)
November 23, 2004... Body counts: In the 17.8 months after the US-led invasion of Iraq, 100 000 Iraqis died, according to a survey of Iraqi households. The survey, published online by The Lancet on Oct. 29, was led by epidemiologist Les Roberts of Johns Hopkins'...

India's HIV-1 epidemic.(Human Immunodeficiency Virus )
November 23, 2004... Africa's HIV-1 epidemic has, appropriately, received global attention. However, India stands to experience the greatest increase in absolute number of HIV-1 cases in the coming decades. As of 2004, at least 5 million people in India have been...

Sports dermatology part 2: swimming and other aquatic sports.(Dermatology)
November 23, 2004... Part 1 of this series appeared in the October 12, 2004 issue of CMAJ. Participation in athletic activities is associated with a variety of skin problems. Proper diagnosis of specific sports dermatoses requires familiarity with their...

SARS outbreak in the Greater Toronto Area: the emergency department experience.(Severe acute respiratory syndrome)
November 23, 2004... Between February and September 2003 Health Canada reported 438 probable or suspect cases of severe acute respiratory syndrome (SARS) resulting in 43 deaths (1) primarily in the Greater Toronto Area GTA). The basic reproductive number of 2-4...

Gonorrhea treatment guidelines in Canada: 2004 update.(Public Health)
November 23, 2004... Readers of CMAJ were first alerted to the rising incidence of ciprofloxacin-resistant Neisseria gonorrhoeae infection in Canada last year. (1) On the basis of this trend, the recommended treatment for gonorrhea in some areas of Canada and for...

A man with an enlarging foot mass.(Clinical Vistas)
November 23, 2004... A 32-year-old man was referred to our orthopedic service for evaluation of a left plantarmedial forefoot mass that had been present for at least 2 years. He had had intermittent foot pain in the past but currently denied any pain or difficulty...

Medical gels and the risk of serious infection.(Health and Drug Alerts)
November 23, 2004... Reason for posting: Gels are routinely used in a variety of physical examination and diagnostic medical procedures including ultrasonography and endoscopy. Health Canada, however, has recently warned that several common practices involving the...

Initial viral load and the outcomes of SARS.(Research/Recherche)
November 23, 2004... See related articles pages 1342, 1353 Abstract Background: Severe acute respiratory syndrome (SARS) is caused by a novel coronavirus. It may progress to respiratory failure, and a significant proportion of patients die. Preliminary...

The impact of SARS on a tertiary care pediatric emergency department.(Research/Recherche)(severe acute respiratory syndrome)
November 23, 2004... Abstract Background: The Greater Toronto Area (GTA) was considered a "hot zone" for severe acute respiratory syndrome (SARS) in 2003. In accordance with mandated city-wide infection control measures, the Hospital for Sick Children (HSC)...

Health Canada's new guidelines for body weight classification in adults: challenges and concerns.(Commentary/Commentaire)
November 23, 2004... In 2003 Health Canada released its new Canadian Guidelines for Body Weight Classification in Adults, (1) an update of the weight classification system that had been in use in this country since 1988. (2) The guidelines were updated in response...

Transparency in drug regulation: mirage or oasis?(Commentary/Commentaire)
November 23, 2004... In Canada, the information used to approve new drugs is deemed commercially sensitive and hence confidential under the Access to Information Act, (1) and the Therapeutic Products Directorate (TPD) will not release such information without the...

Responding to the needs of children with chronic health conditions in an era of health services reform.(Commentary/Commentaire)
November 23, 2004... Between 15% and 20% of children and adolescents live with a chronic physical, developmental, behavioural or emotional condition. (1) Although diverse in terms of clinical characteristics, causes and treatments, chronic health conditions have a...

Tips for learners of evidence-based medicine: 3. Measures of observer variability (kappa statistic).
November 23, 2004... Imagine that you're a busy family physician and that you've found a rare free moment to scan the recent literature. Reviewing your preferred digest of abstracts, you notice a study comparing emergency physicians' interpretation of chest...

Bitter pills.(Book Review)
November 23, 2004... Bitter Pills Medicines out of control? Antidepressants and the conspiracy of goodwill Charles Medawar, Anita Hardon Amsterdam: Aksant; 2004 260 pp US$34.50 ISBN 90 5260 134 8 From its provocative title, this "narrative...

The mournful wood.(Room for a view)(Biography)
November 23, 2004... When Vincenzo Suberati was a little boy, his widowed father would bring him into the wooded mountains around the Calabrian town of Nocera Terinese in search of mushrooms. The best time to go, Vincenzo learned, was after a thunderstorm,...

Deaths/Necrologie.(Obituary)
November 23, 2004... Dr. Harry Duncan Roberts, the first Newfoundlander to serve as president of the CMA, died at St. John's, Nfld., June 5, 2004. He was 95. Dr. Roberts was the president of the Newfoundland Medical Association (1950) before assuming the CMA's...

Clarification.(Correction Notice)
November 23, 2004... The obituary concerning Dr. Moses Saiphoo (CMAJ 2003; 168[2]:244) should have stated that he is survived by his wife Gloria Muller and 3 children from a previous marriage.

Conflicts of interests and investments/Conflits d'interets et placements.(Editorial)
November 23, 2004... The principles and statements of the International Committee of Medical Journal Editors (ICMJE), of which CMAJ was a founding member over 25 years ago, guide the editorial policy of this Journal. The ICMJE statement on conflict of interest...