CMAJ: Canadian Medical Association Journal articles from November 2005

CMAJ: Canadian Medical Association Journal archives from November 2005

Moving forward with CMAJ.ca/L'evolution du JAMC.ca.(Editorial)(Editorial)
November 8, 2005... Even before Tim Berners-Lee proposed, in 1989, the global hypertext project now known as the World Wide Web, the electronic exchange of scientific information had already begun to flourish. (Some of us might recall using "gopher.") When, in...

Medical schools tackle conflict of interest.(News)
November 8, 2005... As ties between industry and the medical community become more complex, the issue of conflict of interest in research and clinical decision-making has spilled over into the realm of medical schools. All 17 Canadian medical schools have...

MPs call for removal of Health Canada's breast-implant panel members.(News)
November 8, 2005... Opposition MPs are calling on Health Canada to remove members of an expert advisory panel on breast implants, or to suspend the panel's work, because at least 3 members have ties to manufacturers of the medical devices. "Why would we say...

Dire needs post earthquake.(South Asia)
November 8, 2005... The Oct. 8 earthquake in South Asia destroyed 26 hospitals and 600 clinics, claiming the lives of 54 000 people, including health care workers. Eight days later, aid organizations were still unearthing bodies and treating victims. ...

Canada resists banning flame retardant.(brominated flame retardant)
November 8, 2005... Despite a growing number of peer-reviewed studies charting the toxicity of brominated flame retardant (BFR) in animals and possibly humans, the Canadian government remains reluctant to ban it. The European Union (EU) banned 2 of the 3...

Marijuana liability.(Canadian Medical Protective Association )(Brief Article)
November 8, 2005... Marijuana liability: The Canadian Medical Protective Association (CMPA) recommends that doctors who sign declarations giving their patients access to medicinal marijuana should ask their patients to sign a release-from-liability form at the...

Chernobyl's legacy.(nuclear radiation exposure)(Brief Article)
November 8, 2005... Chernobyl's legacy: Nearly 4000 people could eventually die from radiation exposure as a result of Chernobyl's nuclear power plant disaster in 1986. A new report from the Chernobyl Forum states that at the time of the disaster, approximately...

Car crashes and cell phone use.(News @ a glance)(Brief Article)
November 8, 2005... Car crashes and cell phone use: Drivers using mobile phones have a 4-fold increased risk of crashing and suffering injuries that require hospital attendance. A recent study (BMJ 2005; 331:428) found that the increased risk occurred whether or...

Nobel for ulcer scientists.(Barry Marshall, Robin Warren)(Brief Article)
November 8, 2005... Nobel for ulcer scientists: An Australian scientist was awarded the 2005 Nobel Prize for Medicine 23 years after infecting himself with Helicobacter pylori to prove it caused stomach ulcers. Drs. Barry Marshall and Robin Warren, the joint Nobel...

Progress in the prevention of pneumococcal infection.(Analysis)
November 8, 2005... Streptococcus pneumoniae (pneumococcus) remains an important human pathogen more than a century after its discovery, with infections occurring most commonly among young children and elderly people. It causes a wide range of invasive infections...

Applying the 2005 Canadian Hypertension Education Program recommendations: 5. Therapy for patients with hypertension and diabetes mellitus.(Practice)
November 8, 2005... The number of people with diabetes is expected to double within a decade. Most people with diabetes have or will develop hypertension, and observational and randomized trial evidence has proven a causal relation between raised blood pressure...

Chewing the fat on trans fats.(Public Health)
November 8, 2005... Background and epidemiology: Trans fatty acids, or trans fats, are unsaturated fats produced through partial hydrogenation, when vegetable oils are heated in the presence of metal catalysts and hydrogen. (1) Hydrogenation increases the shelf...

Do ASA and NSAIDs reduce the risk of colorectal cancer?(In the Literature)(aspirin)(nonsteroidal anti-inflammatory drugs )
November 8, 2005... Chan AT, Giovannucci EL, Meyerhardt JA, et al. Long-term use of aspirin and nonsteroidal anti-inflammatory drugs and risk of colorectal cancer. JAMA 2005;294(8):914-23. Background: Regular use of ASA in patients with a history of...

Intoxication a un anticholinergique.
November 8, 2005... Suite a une deuxieme consultation a l'urgence pour des symptomes anticholinergiques (Encadre I) chez un couple, un medecin en environnement de la Direction regionale de sante publique (DSP) a effectue une enquete environnementale et une visite...

Nonsurgical management of partial adhesive small-bowel obstruction with oral therapy: a randomized controlled trial.(Research)
November 8, 2005... ABSTRACT Background: Patients with partial adhesive small-bowel obstruction are usually managed conservatively, receiving intravenous hydration and nothing by mouth. Previous studies have suggested that this approach is associated with...

Socioeconomic status and the utilization of diagnostic imaging in an urban setting.(Research)
November 8, 2005... ABSTRACT Background: In publicly funded health care systems, the utilization of health care services should be equitable, irrespective of socioeconomic status (SES). Although the association between SES and health care utilization has been...

Canadian Society of Transplantation consensus guidelines on eligibility for kidney transplantation.(Commentary)
November 8, 2005... Since 1980 the incidence and prevalence of end-stage renal disease have grown each year in Canada and throughout the world. From 1981 to 1999, the number of new patients with the disease increased at a compound annual rate of 7.3%, (1) and...

Of genomics and public health: building public "goods"?(Commentary)
November 8, 2005... "Global public goods favor the mechanism of public information resources and free and open communication therein. Global public goods once produced should benefit all. Like a clean environment, knowledge about human health has no one...

Troponin: the biomarker of choice for the detection of cardiac injury.
November 8, 2005... ABSTRACT It has been known for 50 years that transaminase activity increases in patients with acute myocardial infarction. With the development of creatine kinase (CK), biomarkers of cardiac injury began to take a major role in the...

Using antidepressants during pregnancy.
November 8, 2005... In a recent CMAJ article, Gideon Koren and associates discuss maternal use of selective serotonin reuptake inhibitors (SSRIs) in the third trimester of pregnancy. (1) Clinicians often speculate that a particular person with depressed mood has...

A positive prognosis.(malignant fibrous histiocytoma)
November 8, 2005... We read with interest the recent report by Krishna Sharma (1) of a case of malignant fibrous histiocytoma, metastatic to the lung, with spontaneous expectoration of large tumour fragments. We felt it would be illustrative to present a similar...

Predicting cardiac outcomes.(Letters)(Letter to the Editor)
November 8, 2005... Despite substantial advances in the diagnosis of suspected acute coronary syndromes, significant challenges persist. (1) Andrew Worster and colleagues recently reported in CMAJ that ischemia-modified albumin (IMA) was a poor predictor of...

Questioning the benefits of statins.
November 8, 2005... The assessment by Douglas Manuel and associates (1) of the 2003 Canadian dyslipidemia guidelines (2) is welcome, but they overlooked the all-cause mortality issue, where statins have essentially failed to deliver. (1) There are no statin trials...

Correction.(Letters)(Correction Notice)
November 8, 2005... In a recent Review article, (1) the amount for saline, as indicated in the caption for Fig. 1, should have read 0.45% (not 45%). REFERENCE (1.) Goldenberg I, Matetzky S. Nephropathy induced by contrast media: pathogenesis, risk factors...

A not-so-modest proposal.(The End of Poverty: Economic Possibilities for Our Time)(Book Review)
November 8, 2005... The end of poverty: economic possibilities for our time Jeffrey D. Sachs New York: The Penguin Press; 2005 396 pp $40 ISBN 1-59420-045-9 Must the poor always be with us? If leaders of the world's richest countries would only heed his...

A marvellous invention.(Gulliver's Travels)(Excerpt)
November 8, 2005... On the second of his improbable travels, Lemuel Gulliver is blown off course to Brobdingnag, where he finds himself much diminished. By Gulliver's scale the people are gargantuan, but their understanding is small. Their education consists of...

Canada remembers.
November 8, 2005... Permanent Exhibitions Canadian War Museum / Musee canadien de la guerre 1 Vimy Place Ottawa, Ont. www.warmuseum.ca Canada, it seems, is getting better at remembering its wars and its warriors. Remote memory grows in brilliance even as...

Deaths.(Obituary)
November 8, 2005... Notice CMAJ welcomes obituaries submitted within 60 days of a death. Send to pubs@cma.ca; fax 613 565-5471. Amerongen, Leo Joseph, Edmonton; University of Alberta, 1956. Died May 25, 2005, aged 78. Auty, Anthony, Abu Dhabi, United...

Query.(Brief Article)
November 8, 2005... Yesterday I realized I'm an arrogant bastard. The realization came to me after one of our biweekly medical staff meetings. There one can find the usual assortment of perennial attendees, stragglers and occasionals. As a perennial, I value other...

Clinical practice guidelines and conflict of interest./Les guides de pratique et les conflits d'interets.(Editorial)
November 22, 2005... In 2003, an expert committee responsible for clinical practice guidelines of the Canadian Diabetes Association (CDA) recommended that the new long-acting agent, insulin glargine, be used as an alternative for generic long-acting insulin for the...

All provinces likely to join tobacco litigation.
November 22, 2005... Seven provinces are preparing to jump on the litigation bandwagon following a Supreme Court of Canada decision that allows British Columbia to sue tobacco companies to recover billions in tobacco-related health care costs. In a 9-0...

Quebec's official numbers: 409 C. difficile deaths.
November 22, 2005... In the year since Quebec has been tracking cases of Clostridium difficile, about 8% of those infected, or 409 people, died. Quebec Health Minister Philippe Couillard and Dr. Alain Poirier, the province's director of public health, released...

National wait time standards remain elusive.
November 22, 2005... National standards for acceptable wait times in 5 priority categories of medical treatment dominated discussions when provincial and territorial health ministers met Health Minister Ujjal Dosanjh in Toronto in late October. But after 2 days of...

Pandemic preparedness.
November 22, 2005... Farm surveillance, along with fair compensation for producers who have to kill infected fowl, is the essential frontline of defence against an avian influenza pandemic, agreed health ministers from 30 countries and heads of 8 international...

HPV vaccine.(News @ a glance)(Brief Article)
November 22, 2005... HPV vaccine: An experimental vaccine has proved highly effective at preventing cervical cancer caused by the human papillomavirus (HPV) strains 16 and 18. These strains account for 70% of all cervical cancer. The phase 3, 2-year study involved...

Health research funding.(Canadian Institutes of Health Research grants)(Brief Article)
November 22, 2005... Health research funding: The Canadian Institutes of Health Research has awarded 1600 research grants worth over $354 million--the largest amount in its 5-year history. Ontario researchers got 40% of the funding ($138.5 million) and Quebec...

ED wait info.(News @ a glance)(Brief Article)
November 22, 2005... ED wait info: Fifty-seven percent of patient visits to selected emergency departments in 2003-04 were for less-urgent or non-urgent conditions such as sore throats and sprained ankles, reports the Canadian Institute for Health Information. Only...

NYC v. trans fats.(Brief Article)
November 22, 2005... NYC v. trans fats: Heart disease is New York's biggest killer, and the city is blaming trans fats. The NYC Department of Health and Mental Hygiene has asked city restaurants and other food services to avoid serving and cooking with foods that...

Hospital admissions for mental illness.(Brief Article)
November 22, 2005... Hospital admissions for mental illness: Patients with a primary diagnosis of mental illness accounted for 6% of the 2.8 million hospital stays in 2002-03, reports the Canadian Institute for Health Information. Another 9% of stays involved...

Emergency contraception in India.(contraception pills given without prescription)(Brief Article)
November 22, 2005... Emergency contraception in India: Emergency contraception pills are now available over the counter at pharmacies without a doctor's prescription in India. More than 200 countries, including Canada (CMAJ2005;172:861-2) but not the US, have made...

Deadly 1918 flu remade.
November 22, 2005... The 1918 influenza pandemic was unusually devastating, killing an estimated 20-50 million people worldwide. In the years since, no influenza A virus has struck healthy young adults in the same way, leaving the virulence of the 1918 flu as a...

Avian flu shows resistance.(avian influenza drug resistance)(Brief Article)
November 22, 2005... The threat of a global flu pandemic caused by the H5N1 avian influenza virus has many countries racing to stockpile the antiviral drug oseltamivir, which targets the viral enzyme neuraminidase and inhibits the release of viral progeny from a...

Medicine by media: did a critical television documentary affect the prescribing of cyproterone-estradiol (Diane-35)?
November 22, 2005... Many factors influence prescribing behaviours, including scientific evidence, commercial information, physician education and patient preferences. We present an instance where prescribing was likely affected by a media report on Diane-35, a...

The use of provisionally licensed international medical graduates in Canada.
November 22, 2005... Many communities in Canada, particularly those in rural areas, suffer from a shortage of physicians because the distribution of family physicians is inadequate and inequitable. For example, in 2000 there was an average of 94 family physicians...

Dermatologic emergencies.(Practice)
November 22, 2005... Dermatologic problems represent about 15%-20% of visits to family physicians and emergency departments. It is often a challenge for a primary care provider to differentiate mundane skin ailments from more serious, lifethreatening conditions...

Paroxetine (Paxil) and congenital malformations.
November 22, 2005... Reason for posting: Selective serotonin reuptake inhibitors (SSRIs) have not previously been demonstrated, as a group, to be teratogenic. (1) However, the results of an unpublished study (2) by GlaxoSmithKline (GSK) has led the US Food and Drug...

Books received.
November 22, 2005... Ahronheim JC, Huang Z-B, Yen V, Davitt CM, Barile D. Case studies in geriatric medicine. New York: Cambridge University Press; 2005. 298 pp. $55 ISBN 0-521-53175-6 Bhidayasiri R, Waters MF, Giza CC. Neurological differential diagnosis: a...

Legionella infection.(Public Health)
November 22, 2005... Background and epidemiology: The Legionella bacterium was first identified in 1976 when 34 members of the American Legion died at a conference in Philadelphia. It is a ubiquitous aerobic gram-negative organism that lives in soil and water....

Renal failure and ascites after remote laparoscopy.(Clinical Vistas)
November 22, 2005... A previously healthy 38-year-old woman had undergone laparoscopic left ovarian cystectomy because of endometriosis. She had previously undergone 2 cesarean sections. Two months after the cystectomy, she had sudden onset of diffuse abdominal...

Is the timing of infant cereal introduction a risk factor for celiac disease autoimmunity?(In the Literature)
November 22, 2005... Norris JM, Barriga K, Hoffenberg EJ, et al. Risk of celiac disease autoimmunity and timing of gluten introduction in the diet of infants at increased risk of disease. JAMA2005:293:2343-51. Background: Celiac disease, or gluten-sensitive...

Measuring the severity of depression and remission in primary care: validation of the HAMD-7 scale.(Research)
November 22, 2005... ABSTRACT Background: Symptomatic remission is the optimal outcome in depression. A brief, validated tool for symptom measurement that can indicate when remission has occurred in mental health and primary care settings is unavailable. We...

When patients have to pay a share of drug costs: effects on frequency of physician visits, hospital admissions and filling of prescriptions.(Research)
November 22, 2005... ABSTRACT Background: Previous research has shown that patient cost-sharing leads to a reduction in overall health resource utilization. However, in Canada, where health care is provided free of charge except for prescription drugs, the...

Prescription drug coverage: an essential service or a fringe benefit?
November 22, 2005... The study in this issue by Anis and colleagues on user fees for prescription drugs (1) highlights one of the most salient contradictions in the Canadian health care system. Equal access to medically necessary services is a cherished and...

Preventive care: so many recommendations, so little time.(Commentary)
November 22, 2005... There are strong pressures to provide preventive care in the family physician's office, and the recent recommendation statement from the Canadian Task Force on Preventive Health Care on screening for depression in primary care provides yet...

Short QT syndrome.
November 22, 2005... Abstract The QT interval on an electrocardiogram signifies the time required for the heart to repolarize after depolarization. It has long been appreciated that a long QT interval predisposes patients to life-threatening ventricular...

Doctors and patients in the health care debate.(Letter to the Editor)
November 22, 2005... I appreciate Albert Schumacher's eloquent appraisal of Canadian physicians' attitude to their work, which is overwhelmingly to put patients first. (1) Schumacher, President of the CMA in 2004/05, writes that Steven Lewis' commentary in the same...

A hypertensive snow bird.(Letters)(Letter to the Editor)
November 22, 2005... A copy of mdBriefCase entitled "A hypertensive snow bird" was distributed with an issue of CMAJ this spring. This issue of mdBriefCase is biased in favour of products from the company sponsoring it, Boehringer Ingelheim. The print version...

Conforming to ICMJE principles.(Letters)(Letter to the Editor)
November 22, 2005... There is increasing concern about interactions between academic investigators and the pharmaceutical industry, particularly relating to financial and other conflicts of interest, access by investigators to all research data and the ability of...

Refresher on rubella.(Letters)(Letter to the Editor)
November 22, 2005... The authors of a recent public health column in CMAJ state that "women of childbearing age should be given rubella vaccine unless they have proof of immunity, and they should be advised to avoid pregnancy for 3 months after vaccination." (1)...

Vitamin [B.sub.12] and homocysteine.(Letter to the Editor)
November 22, 2005... In their analysis of the relationship between carotid plaque area and vitamin B12 status, (1) Julie Robertson and colleagues define vitamin [B.sub.12] deficiency as a serum concentration of less than 258 pmol/L, with a plasma homocysteine...

Correction.(Correction Notice)
November 22, 2005... A news article (1) concerning the federal government's decision not to renew funding to the Canadian Network for Vaccines and Immunotherapeutics stated that the network's early success included the "beginning of the first Canadian clinical...

Slow-change artists.(Art nature dialogues: interviews with environmental artists )(Book Review)
November 22, 2005... Art nature dialogues: interviews with environmental artists John K. Grande Foreword by Edward Lucie-Smith Albany, NY: SUNY Press; 2004 251 pp. 80 b/w photographs US $75.50 (cloth) ISBN 0-7914-6193-9 US $24.95...

Pnina Granirer: a dancing line.(painting exhibitions)
November 22, 2005... The soft body versus the hard world: perhaps this is the human predicament. Vancouver-based artist Pnina Granirer has been exploring this dichotomy for the past six years. The works included in her exhibit, Synchronicity, mounted earlier this...

New technologies and information overload.(patient care with technology updates)
November 22, 2005... The Machine is much, but it is not everything.--E.M. Forster, "The Machine Stops," 1909 Access to medical information is apparently unprecedented. Yet for older doctors like myself this information is made inaccessible through an...

Deaths.
November 22, 2005... Notice CMAJ welcomes obituaries submitted within 60 days of a death. Send to pubs@cma.ca; fax 613 565-5471. Notice Banik, Satya Ranjan, Saskatoon; University of Calcutta, 1956, psychiatry. Died June 25, 2005, aged 74. Survived by his...

Query.
November 22, 2005... The unpleasant doctor arrived from another town, and it wasn't long before the hospital was condemned as "archaic," certain physicians characterized as "bumblers," the ORs condemned as "torture chambers" and CME rechristened as CMRE, "Constant...