CMAJ: Canadian Medical Association Journal articles from November 2008

CMAJ: Canadian Medical Association Journal archives from November 2008

Risk of incarceration of inguinal hernia among infants and young children awaiting elective surgery.(Research)(Clinical report)
November 4, 2008... ABSTRACT Background: We determined the rate of incarceration of inguinal hernia among infants and young children waiting for elective surgery and examined the relation to wait times. We also explored the relation between wait times and the...

Access to health care among status Aboriginal people with chronic kidney disease.(Research)
November 4, 2008... ABSTRACT Background: Ethnic disparities in access to health care and health outcomes are well documented. It is unclear whether similar differences exist between Aboriginal and non-Aboriginal people with chronic kidney disease in Canada....

Information exchange among physicians caring for the same patient in the community.(Research)(Clinical report)
November 4, 2008... ABSTRACT Background: The exchange of information is an integral component of continuity of health care and may limit or prevent costly duplication of tests and treatments. This study determined the probability that patient information from...

Diagnosis and treatment of dementia: 5. Nonpharmacologic and pharmacologic therapy for mild to moderate dementia.(Clinical report)
November 4, 2008... ABSTRACT Background: Practising physicians frequently seek advice on the most effective interventions for dementia. In this article, we provide practical guidance on nonpharmacologic and pharmacologic interventions for the management of...

Wrongful birth litigation and prenatal screening.(Analysis)(Clinical report)
November 4, 2008... Canadian clinicians must be aware of new standards of care resulting from national clinical practice guidelines, both to ensure best practice (1,2) and to avoid malpractice litigation. (3,4) Clinical practice guidelines can reduce successful...

Postpartum thunderclap headache.(What is your call?)
November 4, 2008... Two days after giving birth to a healthy baby following an uneventful term pregnancy, a healthy 31-year-old woman experienced a severe, diffuse "thunderclap" headache and generalized seizures. She had not received spinal anesthesia during...

Protecting children from lead in tap water.(Letters)(Letter to the editor)
November 4, 2008... Lead in drinking water is still an important health issue in Germany. There is concern about the association of lead exposure with neurologic and intellectual deficits as described by Mark Payne (1) and with hearing impairment in infants;...

Hospital standardized mortality ratios.(Letters)(Letter to the editor)
November 4, 2008... We do not agree with Kaveh Shojania and Alan Forster's assessment of the value of reporting hospital standardized mortality ratios. (1) Our view is that the public reporting of hospital standardized mortality ratios in Canada provides a useful...

Smoking cessation trials.(Letters)(Letter to the editor)
November 4, 2008... I submit that the meta-analysis by Mark Eisenberg and colleagues on pharmacotherapies for smoking cessation (1) is grounded in a false premise, namely that researchers were somehow able to hide the onset of nicotine withdrawal symptoms from...

Correction.(Letters)(Correction notice)
November 4, 2008... In a recent research article on stable angina, (1) a sentence in the "symptoms and prognosis" section of Results that read "Among South Asian people with atypical pain, the symptom score was associated with coronary outcomes (Figure 3,...

The Future Triumph of medical science over cancer: a mural for oncology.(Lifeworks)
November 4, 2008... The first half of the 20th-century saw the birth of the Mexican muralist movement, which, in the post-revolutionary period, was primarily concerned with exalting the great social, technical and scientific movements that were taking place in...

Age is only another number.(Old Endeavour: Scientific and Humanitarian Contributions by Physicians Over Age 65)(Book review)
November 4, 2008... Old Endeavour: Scientific and Humanitarian Contributions by Physicians over age 65 William C. Gibson International Association for Humanitarian Medicine Brock Chisholm; 2007 319 pp $30.00 ISBN 978-88-902020-1-8 When do we...

Evolution at the St. John Ambulance.(The Maple Leaf and the White Cross)(Book review)
November 4, 2008... The Maple Leaf and the White Cross Christopher McCreery Dundurn Press; 2008 332 pp $50 ISBN 978-1-55002-740-2 [ILLUSTRATION OMITTED] The St. John Ambulance has been providing Canadians with first-aid training since 1883, but...

The pediatric doctor mom blues.(Humour)(Poem)
November 4, 2008... The pediatric doctor mom blues when I woke up this mornin' I couldn't get out of bed I was twisted in the covers cat was sleepin' on my head the clock was reading 8:15 my clinic starts at 8 my husband turned...

Pneumopericardium.(Clinical Images)
November 4, 2008... [ILLUSTRATION OMITTED] A previously healthy 21-year-old man received his first cycle of standard chemotherapy for a poorly differentiated seminoma. Because of respiratory distress secondary to the large mediastinal tumour, he also received...

Take down syndrome out of the abortion debate.(Salon)
November 4, 2008... Trig Palin, the 5-month-old son of vice presidential candidate Sarah Palin, has drawn enormous public notice to Down syndrome. For that, many in the US and Canadian Down syndrome communities are grateful. But as the mother of 2 children...

Revalidation of physicians in Canada: Are we passing the test?/La revalidation des medecins au Canada : Passons-nous le test?(Editorial)
November 4, 2008... Physicians are ethically bound to maintain competence in their field as part of their professional accountability to the public. The Canadian Medical Association's Code of Ethics says it is the responsibility of physicians "to engage in...

Children are waiting for care and answers.(Commentary)
November 4, 2008... Children have been implicitly ignored in the recent national 10-year action plan to establish benchmarks for wait times for health care, as noted by Dr. Brian Postl, former federal advisor on wait times. (1) In this issue of CMAJ Zamakhshary...

Addressing inequities in access to quality health care for indigenous people.(Commentary)
November 4, 2008... Many issues influence access to quality health care for indigenous people. In this issue of CMAJ, Gao and colleagues (1) describe inequities in access to health care and service utilization among Canadian Aboriginal people with chronic kidney...

Strengthening primary care with better transfer of information.(Commentary)
November 4, 2008... The reality of modern health care is that patients commonly receive care from multiple providers, both physicians and nonphysicians, who often work in disconnected offices and facilities. This makes it a tremendous challenge to connect and...

Public-private partnerships, part 2: calculations of risk.(News)
November 4, 2008... Canada's 3 most populous provinces--Ontario, Quebec and British Columbia --have been shifting from traditional public sector procurement methods to public-private partnerships to design, build, finance, maintain and, sometimes, operate...

CMA Secretary General resigns.(News)(Canadian Medical Association, William Tholl)
November 4, 2008... The Canadian Medical Association's Secretary General and Chief Executive Officer, William Tholl, has resigned after more than 7 years in the job. Tholl resigned following discussions with the CMA's Board of Directors, he said in an...

Goudge: "systemic failings" in Ontario coroner's office: judge urges better training and standards for pathologists.(News)(Stephen Goudge )
November 4, 2008... Systemic flaws and inattentive bosses made it possible for an unqualified pathologist to make critical errors that led to wrongful convictions and "devastating consequences" for parents of dead children, the judge heading an inquiry into...

Morals, medicine and geography.(News)
November 4, 2008... The US government recently proposed a rule that will force hundreds of thousands of health agencies to prove that they are not compelling doctors to perform or make referrals for--or even provide clinical information about--controversial...

Court turfs product liability suits against government.(For the record)
November 4, 2008... The federal government owes no "duty of care" to individual Canadians in its regulation of medical devices and thus can't be held liable for harm resulting from their use, the Ontario Court of Appeal has ruled in rejecting a class-action...

Ontario medical watchdog censures family physician.(For the record)(Brief article)
November 4, 2008... In the first test of its regulatory crackdown on untrained family physicians who perform cosmetic surgery, the College of Physicians and Surgeons of Ontario has slapped the wrists of a Toronto-area doctor for professional misconduct while...

Electronic cigarettes.(Briefly)(Brief article)
November 4, 2008... Electronic cigarettes: The World Health Organization says there is no evidentiary basis for concluding that so-called electronic cigarettes--stainless steel devices that dispense a heated liquid nicotine mist which is absorbed by the lungs--are...

Pointless.(Briefly)(Brief article)
November 4, 2008... Pointless: A survey of British patients about the efficacy of the United Kingdom's National Health Services complaints process (CMAJ 2008;178[11]: 1409-11) found that 29% found the process "totally pointless," while 20.5% found it pointless and...

DDT stalemate stymies malaria control initiative.(News)(dichlorodiphenyltrichlorethane)(Clinical report)
November 4, 2008... Lucky Mirembe recalls that it was getting dark as the cluster of men arrived at her home. They made her wait outside as a man--wearing thick, black rubber gloves up to his elbows and a blue helmet with a face screen-- meticulously began to...

Hard work, harder numbers.(Dispatch from the medical front)(Prevention of Mother to Child Transmission Program, human immunodeficiency virus )
November 4, 2008... Birth is hard work, no matter what part of the planet you call home. But I learnt that women giving birth in rural South Africa suffer more than others because of one simple fact: numbers (read $). That's right: debt. The...

The error of not measuring asthma/Ne pas evaluer l'asthme : une erreur.(Editorial)(Clinical report)
November 18, 2008... According to national and global health statistics, we are facing an asthma epidemic. The most recent epidemiologic data suggest that 300 million people worldwide have asthma, and the global burden is projected to increase by another 100...

Evaluating Vancouver's supervised injection facility: data and dollars, symbols and ethics.(Commentary)(Clinical report)
November 18, 2008... Insite, Vancouver's supervised injection facility for injection drug users, opened in 2003 under an exemption from Canadian federal drug laws. A substantial amount of research has since been conducted on the facility (www.vch.ca/sis/). Although...

Progress and promise in the management of chronic kidney disease.(Commentary)(Clinical report)
November 18, 2008... The recommendations made in this issue of CMAJ by Levin and colleagues (1) for the management of chronic kidney disease provide clear guidance for the cooperative care of patients with chronic kidney disease by all health care providers...

British Columbia experiments with checkups by the dozen.(News)
November 18, 2008... Almost every Wednesday morning at 9:30, Geoff Bedford drops into his doctor's office in Fraser Lake, British Columbia--along with a dozen other patients--for a group checkup. Everyone watches as Bedford's scores go up on a whiteboard:...

Canada Health Act breaches are being ignored, pro-medicare groups charge.(News)
November 18, 2008... Private for-profit medical clinics are proliferating across the country, according to a detailed report by pro-medicare groups. The number of such clinics has increased significantly over the past 5 years and there's evidence "to suspect...

American entrepreneur files free trade challenge on medicare.(News)(Centurion Health Corporation's Melvin J. Howard)
November 18, 2008... An Arizona health care entrepreneur who believes anti-American sentiment thwarted his plans to build a private surgical centre in British Columbia is seeking $155 million in redress from the Canadian government, but a North American Free Trade...

Federal election wrap: medical profession to be sparsely represented in House of Commons.(News)
November 18, 2008... If economics truly is "the dismal science," then voters might well be tempted to conclude that politics is the dismal art. As Canadians trekked to the polls on Oct. 14 to make their choices in the 40th general election, pollsters warned...

Apology measures proliferate.(For the record)(medical communication)
November 18, 2008... Canadian physicians seeking to improve the way they communicate with patients who've been harmed are getting plenty of assistance this year as provincial governments and national organizations unveil measures to promote accountability and...

WHO report.(For the record)(World Health Organization)(Brief article)
November 18, 2008... Countries must focus on primary care to address the growing gap between the world's rich and poor in health care access, costs and outcomes, the World Health Organization (WHO) says in its annual report on world health. "The world health...

National health human resources plan "a hard sell".(News)
November 18, 2008... Ramping up the number of medical school spots without developing a national health human resources plan could perpetuate the boom-and-bust cycle of the past few decades, says the president of the Association of Faculties of Medicine of Canada....

Private facilities must make educational contribution.(News)
November 18, 2008... The scope and quality of residency training in Canada may ultimately be compromised unless privately operated medical facilities become integral players in the education of future physicians, says the Royal College of Physicians and Surgeons of...

Pharma giants to create databases on gifts to physicians.(News)
November 18, 2008... Facing a national hubbub about the effects of industry money on physician practice and proposed federal legislation mandating that manufacturers of pharmaceutical drugs, devices and biologics disclose financial payments made to physicians to...

President-elect.(World Medical Association's Dr. Dana Hanson )(Brief article)
November 18, 2008... Dermatologist and former Canadian Medical Association president Dr. Dana Hanson will lead the World Medical Association in 2009/10. Hanson, who was head of CMA in 2002, was elected unopposed at the organization's annual general assembly in...

Banned.(importation, sale and advertising of bisphenol A-containing polycarbonate baby bottles)(Brief article)
November 18, 2008... Six months after proposing to ban the importation, sale and advertising of polycarbonate baby bottles which contain bisphenol A, Health Canada has announced it will draft regulations to that effect. The move does not prevent the use of...

Spiralling fees.(medical education)(Brief article)
November 18, 2008... Tuition at Canada's medical schools rose an average 4.6% for undergraduate medical students in the 2008/09 academic year, Statistics Canada reports. The average fee was $10 392, trailing only dentistry at $12 906. Graduate level medical school...

Died.(Bernard E. Freamon)(Obituary)
November 18, 2008... Bernard E. (Woody) Freamo, the first non-physician to serve as secretary general of the Canadian Medical Association, 1992 recipient of CMA's Medal of Honour, and the oft-described "father of MD Management," died Oct. 18 at the age of 85....

Ugandan effort to constrain HIV spread hampered by systemic and cultural obstacles to male circumcision.(News)
November 18, 2008... The president of the country once scoffed at the notion. Some scientists fear it may ultimately prove counterproductive because it may persuade some men to take fewer precautions during sex. Others say the country's primitive health care...

Somali symbiosis, part 1: what I saw.(Dispatch from the medical front)
November 18, 2008... You see first through the filter of your own judgments, so I saw disarray. I saw a place without a functioning state government, in a steady state of chaos, with little in the way of a health care system, heavily reliant on the 15 projects...

Overdiagnosis of asthma in obese and nonobese adults.(Research)
November 18, 2008... Abstract Background: It is unclear whether asthma is over-diagnosed in developed countries, particularly among obese individuals, who may be more likely than nonobese people to experience dyspnea. Methods: We conducted a longitudinal...

Prevalence of asthma among Chinese adolescents living in Canada and in China.(Clinical report)
November 18, 2008... Abstract Background: Studies of the prevalence of asthma among migrating populations may help in identifying environmental risk factors. Methods: We analyzed data from Vancouver, Canada, and from Guangzhou, Beijing and Hong Kong,...

The cost-effectiveness of Vancouver's supervised injection facility.(Research)(Clinical report)
November 18, 2008... Abstract Background: The cost-effectiveness of Canada's only supervised injection facility has not been rigorously evaluated. We estimated the impact of the facility on survival, rates of HIV and hepatitis C virus infection, referral to...

Guidelines for the management of chronic kidney disease.(Clinical guidelines)
November 18, 2008... New guidelines for the management of chronic kidney disease have been developed by the Canadian Society of Nephrology (Appendix 1 contains the fulltext guidelines; available at www.cmaj.ca/cgi/content/full/179/11/1154/DC1). These guidelines...

Cancer in Canada in 2008.(Analysis)(Statistical data)(Clinical report)
November 18, 2008... In this article, we describe the changing size and nature of the cancer burden in Canada by reviewing the major findings from the 2008 edition of Canadian Cancer Statistics, which has been published annually since 1987. We also examine Canadian...

What is your call? Painless pink papules with central porcelain-white scars.(Practice)(Case study)(Clinical report)
November 18, 2008... A 61-year-old woman presented with a 2-year history of asymptomatic, erythematous to pink papules with central porcelain-white atrophic scars and a telangiectactic rim (Figure 1). A progressive number of lesions had developed on her abdomen,...

Number needed to treat and baseline risks.(Letters)(Letter to the editor)(Report)
November 18, 2008... I agree with Finlay McAlister's analysis of the number needed to treat. (1) However, I believe there is a missing issue associated with the use of the evidence-based terms we are so accustomed to using. Consider the following 2 scenarios. ...

Fostering public engagement.(Letters)(Letter to the editor)(Report)
November 18, 2008... I read with interest the article on public engagement in setting health care priorities. (1) As the chief executive officer of Canadian Blood Services, an organization that emerged from the tainted blood tragedy of the 1980s, I can attest to...

Testimonials for vaccine-preventable illnesses.(Letters)(Letter to the editor)(Report)(Brief article)
November 18, 2008... Rolando Ulloa-Gutierrez recently highlighted the serious issue of public misperceptions about pertussis, as well as its prevalence and effects. (1) Over 20 years of practising rural family medicine in southern Manitoba, I have sensed that my...

Not the view of Canadian Medical Association.(Letters)(Letter to the editor)
November 18, 2008... At the bottom of every CMAJ editorial there is a line that says, "All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association." Let me state quite clearly that the opinions...

On becoming.(Room for a view)(medical practice management)
November 18, 2008... I've been thinking about Rainer Maria Rilke lately and what it means to be a doctor. In "Archaic Torso of Apollo" Rilke advised that in order to become something, one must change one's life. This slogan should have been emblazoned on all of my...

The impetus to cure.(Tracy Kidder's 'Mountains Beyond Mountains')(Book review)
November 18, 2008... Tracy Kidder Random House; 2003 317 pp $37.95 ISBN 0-375-50616-0 [ILLUSTRATION OMITTED] Pultizer Prize winner, Tracy Kidder, the highly regarded American author of The Soul of the New Machine, House and many other celebrated...

Rethinking randomized controlled trials.(Randomized Controlled Trials: Questions, Answers and Musings, second edition)(Book review)
November 18, 2008... Randomized Controlled Trials: Questions, Answers and Musings, second edition Alejandro R. Jadad, Murray W. Enkin BMJ Books/Blackwell Publishing; 2007 160 pp $35.95 ISBN 978-1-4051-3266-4 [ILLUSTRATION OMITTED] When...

Chronicles of a cardiologist in Canada's North.(Book review)
November 18, 2008... Doctor to the North: Thirty Years Treating Heart Disease among the Inuit John H. Burgess MD McGill-Queen's University Press, 2008 168 pp $34.95 ISBN 978-0-7735-3431-5 During medical training, aspiring physicians at some point...

Pain in both knees.(Clinical images)(Case study)(Clinical report)
November 18, 2008... [FIGURE 1 OMITTED] A 40-year-old woman presented with bilateral knee pain following a motorcycle collision. She had no prior history of pain in her knees. Physical examination revealed abrasions, swelling, ecchymosis and tenderness of both...

The high cost of being an (aspiring) medical student.(Salon)(Report)
November 18, 2008... The $113 000 I will owe the National Bank after 4 years of medical school doesn't phase me one iota. Partly because this amount is actually below the average, (1) but more importantly because I know I'm making a secure investment--and I had...