CMAJ: Canadian Medical Association Journal articles from November 2007

CMAJ: Canadian Medical Association Journal archives from November 2007

It's time to take back the health care debate/Il est temps de reprendre le controle du debat sur les soins de sante.(Editorial)
November 6, 2007... Nearly everyone would agree that Canada's health care system needs substantial improvements. However, as we listen to debates over proposed solutions, we find it frustrating to hear the issue inevitably and exclusively defined for us as a war...

Health care in France: facing hard choices.(News)
November 6, 2007... Filmmaker Michael Moore frames the for-profit insurance industry as a bankruptcy-causing cancer on the US health care system in his latest documentary, Sicko, and champions socialized medicine as the preferred cure. To bring his point...

Adverse events reported for HPV vaccine.(News)(human papillomavirus, Gardasil)
November 6, 2007... As 4 provinces began immunizing schoolgirls to prevent the human papillomavirus, a watchdog group in the United States warned of dangerous adverse events stemming from the vaccine's delivery--concern government regulators dismiss. Public...

America poised on the precipice of health reform.(News Analysis)
November 6, 2007... Americans without health insurance shouldn't sweat it, according to US President George W. Bush. "I mean, people have access to health care in America," Bush proclaimed in Cleveland, Ohio, over the summer. "After all, you just go to an...

Pharmacists to red flag risky drug interactions.(News Analysis)(Brief article)
November 6, 2007... Proponents bill it as a potential lifesaver. The more immediate goal of Ontario's "MedChecks" program, though, is patient awareness. Under the initiative, Ontarians taking 3 or more prescription medications for a chronic condition can book...

Homeless in Toronto.(News Analysis)(Brief article)
November 6, 2007... Chronic illnesses such as diabetes, angina, asthma and arthritis are more prevalent among the homeless in Toronto now than 15 years ago, according to a new research report by Street Health, a nursing care and outreach organization. The...

Generational attitudes and attributes to affect physician workforce.(News Analysis)
November 6, 2007... Generational and gender differences within the national physician pool will exacerbate Canada's shortage of doctors, an Ottawa psychiatrist says. Health Canada has estimated there'll be a shortfall of nearly 6000 physicians by 2010 but...

Statistics don't count.(Dispatch from the Medical Front)(treating patients in Swaziland)
November 6, 2007... There is a definite inadequacy in numbers, as my wife and I discovered recently during a 5-week foray to Swaziland. Jennifer is in third year medicine at the University of British Columbia and I am an ultrasound technician at Vancouver...

Brief reprieve.(News @ a glance)(for InSite, the safe injection site in Vancouver, Canada)(Brief article)
November 6, 2007... Brief reprieve: The Vancouver-based InSite safe injection site has been given another 6-month reprieve from the federal Controlled Drugs and Substances Act. Health Minister Tony Clement said in a terse news release that the extension "will...

Haloperidol warning.(News @ a glance)(Brief article)
November 6, 2007... Haloperidol warning: The US Food and Drug Administration (FDA) has warned that injectable haloperidol should not be administered intravenously. Although the antipsychotic is to be used intramuscularly, it is sometimes used off-label as an...

AMWA honour.(News @ a glance)(American Medical Writers Association President's Award )(Brief article)
November 6, 2007... [ILLUSTRATION OMITTED] AMWA honour: The American Medical Writers Association will this year confer its prestigious President's Award on Peggy Robinson, CMAJ's former manager of submissions and peer review, and former managing editor....

Heading west.(News @ a glance)(medical personnel going to Alberta, Canada)(Brief article)
November 6, 2007... Alberta has supplanted BC as the El Dorado of the health care profession as it attracted more health care providers than any other province between 1996 and 2001, according to the Canadian Institute for Health Information. Alberta's health...

Differences in healthy life expectancy among men and women.(Pulse)(Table)(Brief article)
November 6, 2007... The World Health Organization (WHO) defines healthy life expectancy as the "average number of years that a person can expect to live in 'full health' by taking into account years lived in less than full health due to disease and/or injury."...

Superior vena cava syndrome and telangiectasia in a man with lymphoma.(Teaching Case Report)(Case study)
November 6, 2007... The case: A 30-year-old man presented with shortness of breath 5 days after returning from a Hawaiian vacation. He reported a 2-week history of progressive difficulty breathing and pain between his shoulder blades, especially when in a supine...

Widened mediastinum in a child with severe trauma.(Clinical Vistas)(Case study)
November 6, 2007... A 3-year-old girl was struck by a vehicle travelling at a high speed and was thrown approximately 6 m. Emergency medical services staff noted that the patient was seizing with left-deviated eyes. She was rushed to the closest community hospital...

Incidence of deep vein thrombosis related to peripherally inserted central catheters in children and adolescents.(Research)(Clinical report)
November 6, 2007... ABSTRACT Background: Peripherally inserted central catheters (PICC) in children and adolescents are being used with increasing frequency. We sought to determine the incidence and characterize risk factors of deep vein thrombosis associated...

Differences in admission rates and outcomes between men and women presenting to emergency departments with coronary syndromes.(Research)(Clinical report)
November 6, 2007... Abstract Background: Previous studies examining sex-related differences in the treatment of coronary artery disease have focused on patients in hospital. We sought to examine sex-related differences at an earlier point in...

Perceptions of "futile care" among caregivers in intensive care units.(Research)
November 6, 2007... Abstract Background: Many caregivers in intensive care units (ICUs) feel that they sometimes provide inappropriate or excessive care, but little is known about their definition of "futile care" or how they attempt to limit its impact. We...

Noninvasive positive-pressure ventilation in acute respiratory failure.
November 6, 2007... Abstract Noninvasive positive-pressure ventilation is a type of mechanical ventilation that does not require an artificial airway. Studies published in the 1990s that evaluated the efficacy of this technique for the treatment of diseases...

A guide to the Canadian Medical Association Handbook on Clinical Practice Guidelines. (Commentary).(Book review)
November 6, 2007... At the fourth meeting of the Guideline International Network, held in Toronto in August 2007, world experts from 31 countries met to discuss the challenges and innovations afforded by clinical practice guidelines. (1) Although each country...

Radon exposure: can we make a difference?(Public health)
November 6, 2007... From a public health perspective, radon is second only to smoking as a cause of lung cancer. It is estimated to cause about 10% of lung cancers, (1,2) or more than 2000 cases each year in Canada. Radon is recognized as a group 1 carcinogen by...

Reflections on the birth of conjoined twins.(Letters)(Letter to the editor)
November 6, 2007... [ILLUSTRATION OMITTED] How refreshing it was to read Ken Walker's article. (1) He has the courage to speak out on a subject from which most of us shy away. The major concern of physicians since the time of Hippocrates has been to help...

Disclosing medical errors.(Letters)(Letter to the editor)
November 6, 2007... The commentary on disclosing errors to patients by Wendy Levinson and Thomas Gallagher (1) perpetuates the confusion created by others. (2,3) Levinson and Gallagher suggest that errors alone lead to harm; if harm is not caused, it is "by chance...

"I dare do all ...": the saga of Dr. Tillson Lever Harrison.(Past progressive)(Biography)
November 6, 2007... A serial bigamist, front-line physician in 7 wars, and humanitarian revered in China, Canada's own Dr. Tillson Lever Harrison is a study in contradictions. Although he was the veteran of 8 armies on 5 continents, Harrison is best known in...

Militi Succurrimus.(Canadian Forces Medical Services motto)(Brief article)
November 6, 2007... As Remembrance Day approaches, readers may be interested to know the origins of the Canadian Forces Medical Services' (CFMS) motto. Dr. Michael Warrington LCol (Hon. Ret'd) recounts the following. "In 1976, while serving as medical officer...

Filming at the front lines of health.(Film and other media)
November 6, 2007... It started out as a 6-week program, but turned into a life-changing experience for the handful of sometime-homeless young mothers who have learned to film, take photos, audiotape and maintain Internet blogs --among other accomplishments. ...

Filmmaker-in-residence at St. Michael's Hospital.(Film and other media)(Katerina Cizek)
November 6, 2007... A filmmaker at the front lines of inner city health? Interventionist media in a hospital setting? When St. Michael's Hospital agreed to allow the National Film Board to "embed" a filmmaker, it was a huge leap of faith. "The scary part was they...

Deaths.(Obituary)
November 6, 2007... Brandt, J. Leonard, West Hartford, Conn.; State University of New York Downstate Medical School, 1943, internal medicine. Died June 18, 2003, aged 83. "Dr. Brandt was a US Army veteran of World War II. He was senior physician and chief of...

Climate of change.(Salon)(health implications of climate change)
November 6, 2007... The year 2000 saw 150 000 people die as a result of climate change. This is a conservative World Health Organization estimate of excess mortality resulting from the relatively mild 0.8[degrees]C global warming experienced over the past century....

Whose life is it anyway? Capacity and consent in Canada / De quelle vie s'agit-il, exactement? Capacite et consentement au Canada.(Editorial)
November 20, 2007... A wise patient will have a discussion with his or her family physician about personal-care directives. Wise hospital physicians will ask their patients about such directives at the time of admission. Unfortunately, such wisdom does not usually...

Health authority bans physician shadowing.(News)
November 20, 2007... In British Columbia's biggest health authority, the days when a pharmaceutical or medical equipment sales representative could scrub in and attend a surgery in an operating theatre, wander unattended through the emergency room or even be...

China's doctors signal retreat on organ harvest.(News)
November 20, 2007... The Chinese Medical Association has signalled its formal opposition to the use of transplant organs from executed prisoners, except for their immediate family. [ILLUSTRATION OMITTED] Facing pressure from the World Medical Association...

On-the-job training.(News)
November 20, 2007... When the $21-million David Strangway Building opened at the University of British Columbia nearly 2 years ago, it was a state-of-the-art, energy-efficient edifice. But almost immediately, the 30 faculty and staff at the UBC medical school's...

Alberta to limit self-regulation.(bill to control self-regulation of physicians in Alberta)
November 20, 2007... Legislation that would curb self-regulation by 28 health care professions in Alberta will go to second reading this fall--outraging the province's doctors. The Alberta Medical Association calls the bill "draconian" and "a threat to...

Slouching toward disclosure.(disclosing medical errors)
November 20, 2007... The "culture of non-disclosure" about medical errors that has prevailed in Canada for years is finally beginning to change, says the physician in chief of a major Toronto hospital. The tendency to instantly invoke "shame and blame" where...

National guidelines in the offing.(National Guidelines for the Disclosure of Adverse Events to patients)
November 20, 2007... The move towards greater openness with patients who have suffered harm from medical treatment is gaining momentum across the country. National Guidelines for the Disclosure of Adverse Events to patients and families are promised by the...

Arsenic threat reaching global dimensions.(News)(drinking water pollution due to high arsenic content)
November 20, 2007... The scope of arsenic contamination of drinking water, and the threat it poses to global health, is much more widespread than previously believed, new research suggests. [ILLUSTRATION OMITTED] As many as 140 million people worldwide may...

Unprohibited crimes.(Dispatch from the medical front)(Personal account)
November 20, 2007... A few years ago, when I was working in one of the Middle East countries... It was a summer day, I was sitting in my office... waiting for the coming patient... somebody knocked the door.... Come in, I said. Hello, doc... He...

New specialties.(News @ a glance)(new medical specialties at the Royal College of Physicians and Surgeons of Canada )(Brief article)
November 20, 2007... The Royal College of Physicians and Surgeons of Canada is now examining 7 new specialties as potential candidates for certification. The 7 are child and adolescent psychiatry, forensic psychiatry, geriatric psychiatry, psychomatic medicine...

Self-sacrifice.(News @ a glance)(body part donation acclaimed by church)(Brief article)
November 20, 2007... The Church of England has declared that donating body parts for transplantation is an act of mercy and "part of the self-sacrifice that God requires for us.... Giving oneself and one's possessions voluntarily for the well being of others and...

Acupuncture coverage.(News @ a glance)(accupunture treatment under medical services plan)(Brief article)
November 20, 2007... [ILLUSTRATION OMITTED] British Columbia has become the first Canadian province to include acupuncture treatments as a supplementary health benefit of its medical services plan, announcing that residents with a combined family income under...

New York bound.(News @ a glance)(Global HIV Vaccine Enterprise)(Brief article)
November 20, 2007... The hunt for an HIV vaccine got a shot in the arm last month when former Canadian Institutes of Health Research president Alan Bernstein was named the first executive director of the Global HIV Vaccine Enterprise, an alliance of independent...

Maternal mortality.(News @ a glance)(low chance of decline in maternaal mortality, Millennium Development Goal 5)(Brief article)
November 20, 2007... There's little chance that Millennium Development Goal 5--to reduce the number of women who die in pregnancy and children by three-quarters by 2015--can be achieved as the world's maternal mortality ratio isn't declining by the requisite pace,...

First aid.(News @ a glance)(mental health diagnosis training for teachers)(Brief article)
November 20, 2007... Alberta will commence mental health first aid training for at least 1 teacher or staff person in each of the province's roughly 2000 schools next year so that they can recognize symptoms of mental health problems such as depression within the...

Royal College of Physicians and Surgeons of Canada.(Appointments)(Brief article)
November 20, 2007... Newfoundland general surgeon Dr. William Fitzgerald has been elected the 40th president of the Royal College of Physicians and Surgeons of Canada. Fitzgerald assumed the 2-year post in September, saying his priority will be to press for a...

Texas 2-step.(News @ a glance)(Brief article)
November 20, 2007... Applications for licences to practise are flooding into the Texas Medical Board 4 years after the state approved a constitutional amendment limiting the size of damages in medical malpractice suits. The board has licensed 10 878 new physicians...

House of bliss.(News @ a glance)(new research laboratory in London)(Brief article)
November 20, 2007... The UK Medical Research Council, Wellcome Trust, Cancer Research UK and University College, London are proposing to construct a massive new laboratory complex in central London that is capable of accommodating 1500 researchers. Billed as the...

Palliative care planning.(News @ a glance)(Brief article)
November 20, 2007... The World Health Organization has issued a guide for developing palliative care services for terminally ill cancer patients. Aimed at health care planners, the guide contains formulas for mapping need against services, while outlining typical...

Adult literacy rates in African and Eastern Mediterranean countries.(Pulse)(correlation between adult literacy and national income)(Statistical table)
November 20, 2007... According to the most recent data available from the World Health Organization, 15 (43%) of 35 African countries and 4 (25%) of 16 Eastern Mediterranean countries had an adult literacy rate of less than 60% (Table 1). Countries with a low gross...

Penetrating pharyngeal injury in an infant.(Clinical Vistas)(Case study)
November 20, 2007... A 1-year-old boy was brought to the emergency department because his parents were concerned that he might have ingested a pencil-tip eraser. His parents did not witness the event, but they reported that they had heard choking sounds for a few...

Autoimmune diseases after adolescent or adult immunization: what should we expect?(Public health)
November 20, 2007... In October 2006, the Israeli minister of health temporarily suspended the national influenza immunization program after 4 elderly patients with underlying cardiovascular disease suddenly died only days after receiving the influenza vaccine....

Increased incidence of differentiated thyroid carcinoma and detection of subclinical disease.(Research)(Clinical report)
November 20, 2007... Abstract Background: Recent reports from North America and Europe have documented an annual increase in the incidence of differentiated thyroid carcinoma. We sought to investigate the relation between rates of detection, tumour size, age...

Continuity of primary care and emergency department utilization among elderly people.(Research)(Report)
November 20, 2007... Abstract Background: People aged 65 years or more represent a growing group of emergency department users. We investigated whether characteristics of primary care (accessibility and continuity) are associated with emergency department use...

The effect of publication on Internet-based solicitation of personal-injury litigants.(Research letter)
November 20, 2007... Abstract Serious adverse drug events can prompt personal-injury lawsuits. However, the extent to which biomedical publication regarding drug-induced harm can influence the legal process has not been well characterized. Using an advanced...

Treatment of tobacco dependence: integrating recent progress into practice.(Clinical report)
November 20, 2007... ABSTRACT Tobacco use is one of the leading preventable causes of death in developed countries. Adoption of approaches that have demonstrated efficacy to improve the treatment of tobacco dependence are critical to reduce the health...

Explaining the increasing incidence of differentiated thyroid cancer.(Research)
November 20, 2007... The thyroid is the largest of the endocrine glands and by far the most common site of all primary endocrine cancers. However, thyroid cancer is relatively rare, accounting for only 1% of all cancers. The number of new cases diagnosed each year...

Promoting continuity of care should be integral to any health care system.(Research)
November 20, 2007... Many physicians and patients believe that a long-term doctor-patient relationship built on trust and mutual respect is a central tenet of effective and efficient health care. (1) However, are such pronouncements, frequently made by colleges...

The Krever Commission--10 years later.(Public health)
November 20, 2007... Key points of the article * The tainted blood tragedy was arguably the worst public health catastrophe in Canada's history. * Guided by the Krever Commission findings, Canada's reformed blood system has restored public confidence in...

Personal trainers for obese patients.(Letters)(Canadian Society for Exercise Physiology (CSEP))(Letter to the editor)
November 20, 2007... [ILLUSTRATION OMITTED] We welcome the progressive recommendations of the Obesity Canada Clinical Practice Guidelines Expert Panel in their 2006 clinical practice guidelines (particularly those of Robert Dent and colleagues in Chapter 9)...

Diabetes and osteoporotic fractures.(Letters)(Letter to the editor)
November 20, 2007... In a recent study of bone mineral density and fracture burden in postmenopausal women, Ann Cranney and colleagues reported that most of the fractures in their study population occurred in women with normal or osteopenic bone mineral density....

The safety of older drivers.(Letters)(Letter to the editor)
November 20, 2007... We read with interest the commentary by Mark Rapoport and colleagues on the physician's role in assessing the safety risk posed by drivers with dementia. (1) In the coming decades, there will be a significant increase in both the number and...

Corrections.(Letters)(Correction notice)
November 20, 2007... The following error appeared in a Review paper (1) that was published in our Oct. 24, 2006, issue: in the paragraph under the heading "Algorithm approach to DVT diagnosis," the phrase "a score of less than 1 (unlikely DVT)" should have read "a...

Beyond basic anatomy.(artistic anatomy exhibited in ANATOMIA )
November 20, 2007... ANATOMIA Cindy Stelmackowich Patrick Mikhail Gallery Ottawa, Ont. Oct. 3-28, 2007 The human body has been arguably the defining subject for artists over the millennia; beautiful, infinitely variable and evocative, the body never fails to...

Borodin.(Short story)
November 20, 2007... Borodin Borodin's alarm went off at its long-set 5:20 am time. The renowned vascular surgeon bolted upright in his single bed and was overcome with a sense of acute, profound dread. Should he get out on the right side or the left side? And...

Deaths.(Obituary)
November 20, 2007... NOTICE Readers are invited to submit brief remembrances of recently departed colleagues. Colourful writing is encouraged, but please limit your notice to 150 words. Send to pubs@acma.ca; fax 613 565-5471 Bourgeois, Steve David, Ottawa;...

In search of trust.(Salon)
November 20, 2007... You probably don't think of trust as a matter of public health. But for political philosopher Francis Fukuyama, "a nation's well-being, as well as its ability to compete, is conditioned by a single, pervasive characteristic: the level of trust...