CMAJ: Canadian Medical Association Journal articles from October 2005

CMAJ: Canadian Medical Association Journal archives from October 2005

Query.(treatment for communal hysteria )
October 11, 2005... The exodus of two physicians from our small community has had many effects. The first is communal hysteria: a host of citizens are afraid that the rest of their doctors will leave, and I'm regularly asked if I'm going to go, too. Some ask out...

Katrina, climate change and the poor/Katrina, les changements climatiques et la pauvrete.(Hurricane Katrina, 2005)(Editorial)
October 11, 2005... Although no one could argue that it was the SUVs driven by the affluent folk now returning to the Uptown district of New Orleans that drew Katrina's fury upon their city, it is becoming clearer that climate change resulting from the greenhouse...

Excluding the experts?(Letter to the Editor)
October 11, 2005... Although it is a laudatory objective to publish only articles by authors who have no financial relationship with corporations or the products and issues discussed in the articles, as outlined in a recent CMAJ editorial, (1) it may not be...

The marginalization of some medical students.(Letter to the Editor)
October 11, 2005... We very much appreciate Verna Yiu's recent article on the well-being of medical students and the enormous level of stress we face. (1) It is very important for medical schools not to overlook the psychosocial health of the future physician...

An unusual crystal.(Letter to the Editor)
October 11, 2005... We were most interested in the report by Joe Dylewski and colleagues on acute monoarticular arthritis caused by birefringent Maltese cross-like crystals composed of lipids. (1) Arthritis has been reported in patients with hyperlipidemias,...

Coxibs and cardiovascular risk.(Letter to the Editor)
October 11, 2005... Jill Cotter and Eric Wooltorton (1) highlight the importance of differences in cyclooxygenase 2 (COX-2) selectivity as a potential explanation for the prothrombotic effects of coxibs. However, they neglect important evidence that celecoxib...

The wrong stuff.(Letter to the Editor)
October 11, 2005... If Dr. Ursus gets upset and anxious, indeed paranoid, about misdiagnosing the very early manifestations of an extraordinarily rare disorder such as Guillain-Barre syndrome,1 he won't last long in this job. Ian McM. Connor Pediatrician...

Physicians want transparency as Guidant lawsuits grow.
October 11, 2005... Canadian physicians who implant cardiac defibrillators are calling on Guidant Corporation and other manufacturers to notify doctors and patients as soon as device failures occur. "All of this information has to be provided to the...

Looking at the big picture.(Editorial)
October 11, 2005... Sally Murray brings a passion for public health and a love of writing to her new role as the 8th Editorial Fellow at CMAJ. Murray, an Australian physician, has worked in international health in Kenya, Ethiopia, Eritrea and at the WHO in Geneva....

Katrina scars tens of thousands psychologically.(Hurricane Katrina, 2005)(Brief Article)
October 11, 2005... Tens of thousands of victims of Hurricane Katrina in the US Gulf Coast states are psychologically scarred from the trauma and will need help, says a Canadian emergency physician who travelled to Louisiana as part of Vancouver's Urban Search and...

Med schools need to train more doctors: Dosanjh.(Ujjal Dosanjh)
October 11, 2005... In light of the physician shortage and long wait lists, Canada's 17 medical schools must increase enrolment and provincial governments must work harder with professional bodies to license more international medical graduates, says Health...

Inconclusive evidence puts Adderall back on the market.(Shire BioChem Inc.'s central nervous stimulant )
October 11, 2005... Health Canada has reintroduced Adderall (amphetamine salts) to the Canadian market after an independent panel found it impossible to accurately ascertain whether the drug increases the risk of cardiac death. Adderall, a central nervous...

Potential cure for HIV.(Brief Article)
October 11, 2005... Potential cure for HIV: Researchers in Texas have found that valproic acid can awaken dormant HIV infection in cells, meaning HIV may become curable. Their proof-of-concept study (Lancet 2005;366:549-55) showed the number of HIV infected cells...

Tell the CMA.
October 11, 2005... Tell the CMA: The Canadian Medical Association is sending a letter to members asking for their view of the private-public health care debate. In August, CMA General Council passed several resolutions (CMAJ 2005:173:565) supporting a strong...

Sports and tobacco.(rules for smokers by Quebec. Court of Appeal)
October 11, 2005... Sports and tobacco: The Quebec Court of Appeal has struck down a long-standing law prohibiting the name of a tobacco firm from being associated with a public event. Three tobacco companies--JTI-Macdonald Corp., Rothmans, Benson & Hedges Inc.,...

Oxidative stress in ocular disease: does lutein play a protective role?
October 11, 2005... Although age-related macular degeneration and cataracts are leading causes of blindness, how they themselves are caused is unclear. These diseases are thought to result from damage caused, photochemically and nonphotochemically, to various cell...

Pathogens fight back.
October 11, 2005... Opportunistic infections are thought to be caused by pathogens that are generally weaker than other organisms (i.e., have lower virulence) but are able to invade weakened hosts. It has also been suggested that bacteria regulate the expression...

Link between porphyria and fasting uncovered.
October 11, 2005... The madness of King George III has been attributed to acute intermittent porphyria, an inherited genetic disorder of the heme biosynthesis pathway. Acute attacks of porphyria result in neuropsychiatric dysfunction and are often brought on by...

Applying the 2005 Canadian Hypertension Education Program recommendations: 4. Managing uncomplicated hypertension.
October 11, 2005... Hypertension is a major risk factor for cardiovascular-related disease and death worldwide. Although it is one of the most common reasons for physician visits, hypertension is often undertreated. To facilitate the management of hypertension,...

The changing ecology of avian flu.
October 11, 2005... Background and epidemiology: On August 5, 2005, the World Health Organization (WHO) posted its 27th update on the situation with avian influenza, (1) along with a table of the cumulative number of confirmed human infections (Table 1). (2) The...

Books received.
October 11, 2005... Bergeron B. Case studies in genes and disease: a primer for clinicians. Philadelphia: American College of Physicians; 2004. 262 pp. $42.95 ISBN 1-930513-50-X Busse R, Riesberg A. Health care systems in transition: Germany. Copenhagen; WHO,...

A newborn requiring selective bronchial intubation.
October 11, 2005... A preterm infant born at 27 weeks' gestation had stable ventilatory requirements until day 3, when a pulmonary hemorrhage developed. Positive end-expiratory pressure was increased from 5 to 7mmHg. On day 10 a left-sided pneumothorax...

Does [beta]-blocker prophylaxis improve survival after major noncardiac surgery?
October 11, 2005... Lindenauer PK, Pekow P, Wang K, Mamidi DK, Gutierrez B, Benjamin EM. Perioperative beta-blocker therapy and mortality after major noncardiac surgery. N Engl J Med2005;353:349-61. Background: The value of prophylactic [beta]-blockade in...

Cost-effectiveness of computerized tomographic colonography versus colonoscopy for colorectal cancer screening.
October 11, 2005... Abstract Background: Computerized tomographic (CT) colonography is a potential alternative to colonoscopy for colorectal cancer screening. Its main advantage, a better safety profile, may be offset by its limitations: lower sensitivity,...

Cigarette smoking and cardiovascular risk factors among Aboriginal Canadian youths.
October 11, 2005... Abstract Background: Aboriginal populations in North America are exhibiting an increased prevalence of cardiovascular disease and associated traditional and nontraditional cardiovascular risk factors, trends believed to be due to the...

Improving patient safety: moving beyond the "hype" of medical errors.
October 11, 2005... The recent Canadian Adverse Event Study found that 7.5% of hospitalizations were associated with adverse events and that 1 in 6 patients with an adverse event died. (1) These findings, which are not unique to Canada, (2) have resulted in some...

The Chaoulli decision: a debate in which physicians must be heard.
October 11, 2005... "The Canadian Medical Association supports the principle that when timely access to care cannot be provided in the public health care system, the patient should be able to utilize private health insurance to reimburse the cost of care obtained...

Public versus private: the medical resident perspective.
October 11, 2005... It is nothing short of remarkable that the complex issue of health care reform in Canada has been boiled down to a mere 2 words: "private" and "public." Why must opinion be so polarized? Why has the emphasis been drawn away from the myriad...

Should Canadian physicians support parallel private health care?
October 11, 2005... Delegates at the CMA's General Council meeting in August voted by a margin of almost 2:1 in favour of a resolution supporting access to private insurance to cover medically necessary services that the public system fails to deliver in a timely...

Diagnosis and treatment of ectopic pregnancy.
October 11, 2005... Abstract ECTOPIC PREGNANCY IS A LIFE- AND FERTILITY-threatening condition that is commonly seen in Canadian emergency departments. Increases in the availability and use of hormonal markers, coupled with advances in formal and emergency...

The Olivieri story, take three.(The Drug Trial)(Book Review)
October 11, 2005... The drug trial Miriam Shuchman Toronto: Random House; 2005 451 pp $34.95 ISBN 0-679-31084-3 The Olivieri story, take three This aptly titled account by journalist and psychiatrist Miriam Shuchman describes not only the clinical trials of...

Witness to a birth.(child birth research)
October 11, 2005... Palimar is a sleepy hamlet tucked deep in the hinterland of westcoastal India. A single mud track leads to this place; a once-a-day bus, and an occasional radio, provide the only connection with the outside world. This is where I found myself,...

Matched?(Canadian Resident Matching Service future plans for medical students)(Brief Article)
October 11, 2005... Matched? In 2005 more than 1400 graduating medical students participated in the Canadian Resident Matching Service, best known by its acronym CaRMS. CaRMS held its first residency match in 1970, when the undergraduate dean of the local medical...

Rhetoric and reform.(after war conditions)(Excerpt)
October 11, 2005... As rancorous as debates on health care reform have occasionally been of late, in some respects the rhetoric used to be more extreme. This excerpt from the September 1940 issue of CMAJ is from an essay written against the ominous background of...

4 Main.(palliative care for mediacl personnels)(Brief Article)
October 11, 2005... I think the hardest part about being the senior medical resident is covering 4 Main at night. 4 Main is our palliative care unit. It is the place where kindness is recognized as more important than advanced cardiac life support algorithms....

Deaths/Necrologie.(David J.P. Allan, Gordon R. Bell, Jack D. Blanchard)(Obituary)
October 11, 2005... Allan, David J.P., Port Sydney, Ont.; Queen's University, 1972; general surgery; FRCSC; associate staff, Huntsville District Memorial Hospital; consultant, South Muskoka Memorial Hospital. Died July 9, 2005, aged 58; survived by his wife,...

A renewed and improved CMAJ/Un JAMC nouveau et ameliore.(Editorial)(Editorial)
October 25, 2005... With this issue we launch a new look for CMAJ. After almost 10 years since its last redesign, it had became apparent that the Journal was in need of a refit to meet the changing needs of readers. Our aim was to create a design that would...

India's war on polio.(Ashok Talyan)(Interview)
October 25, 2005... A campaign to vaccinate children against polio in India, one of the few remaining countries where the disease has not been eradicated, has been bolstered by a national polio project's decision to use a monovalent vaccine against the most...

C. difficile may have killed 2000 in Quebec: study.(Clostridium difficile)
October 25, 2005... An earlier report was published at www.cmaj.ca on Sept. 22, 2005. See also pages 1037, 1049. As many as 2000 patients may have died in Quebec in 2003-2004 during an outbreak of Clostridium difficile, which the majority of those...

Dean of medicine becomes.(David Naylor, president of University of Toronto)
October 25, 2005... After 6 years as the University of Toronto's dean of medicine, David Naylor has landed one of the most prestigious academic jobs in the country, with his appointment as 15th president of the University of Toronto. Professional challenges...

Advisers to the nation.(Canadian Academy of Health Sciences)(Brief Article)
October 25, 2005... Health care leaders and researchers have united to create Canada's first national health advisory body. Modelled on the US Institute of Medicine, the Canadian Academy of Health Sciences (CAHS) will advise policy-makers, the public and public-...

Chemical exposures.(Human Exposure to Environmental Chemicals, Centers for Disease Control and Prevention report)(Brief Article)
October 25, 2005... Chemical exposures: The US Centers for Disease Control and Prevention is reporting on public exposure to 38 new chemicals in its Third National Report on Human Exposure to Environmental Chemicals. For the first time, reference ranges of...

Nursing centennial.(Canadian Nurse, periodical)(Brief Article)
October 25, 2005... Nursing centennial: Canadian Nurse celebrated its 100th anniversary in September. The first issue of Canada's oldest peer-reviewed nursing journal was sponsored by the alumnae of the Toronto General Hospital. It became a national publication in...

Infected hamster.(lymphocytic choriomeningitis virus contracted through pet)(Brief Article)
October 25, 2005... Infected hamster: The Center for Disease Control in Washington has traced the source of a viral infection that killed 3 transplant patients to a pet hamster. Four patients became infected with lymphocytic choriomeningitis virus (LCMV) from a...

Newborn screening.(News @ a glance)(Brief Article)
October 25, 2005... Newborn screening: Ontario is adding 19 tests for inherited metabolic disorders; the province now screens for only 2 diseases (CMAJ2005;173:23). California tests for 75.

Blood needed.(Canadian Blood Services)(Brief Article)
October 25, 2005... Blood needed: Canada needs an estimated 80 000 new blood donors this year to build a "long-lasting and sufficient donor base," says the Canadian Blood Services. According to an Ipsos Reid survey, 52% of Canadians or one of their family members...

I love olive.(acts like ibuprofen)(Brief Article)
October 25, 2005... I love olive: Researchers in Australia believe extra-virgin olive oil may produce ibuprofen-like anti-inflammatory activity. Despite structural differences from ibuprofen, biologist Gary Beauchamp and colleagues reported in the September 1...

Do environmental toxins cause Parkinson's disease?(Bench to Bedside)(Brief Article)
October 25, 2005... It has been hypothesized that exposure to environmental toxins plays an important role in the etiology of Parkinson's disease (Cell Tissue Res 2004; 318:225-41). In support of this association, fruit flies that lack a gene linked to the disease...

Why is melanoma so malignant?(Brief Article)
October 25, 2005... Melanoma is a particularly aggressive form of malignant disease that routinely metastasizes unless detected early. The reasons why melanoma is so adept at metastasizing, when other forms of malignant disease are not, are now beginning to be...

What is the role of dipyridamole in long-term secondary prevention after an ischemic stroke or transient ischemic attack?(Analysis)
October 25, 2005... For over a decade there has been clear evidence for the benefits of antiplatelet treatment in the prevention of stroke, myocardial infarction and death in patients at high risk of serious vascular events, including people with a history of...

Spontaneous aortic thrombosis and embolization: antithrombin deficiency and the work-up of hypercoagulable states.(Teaching Case Report)
October 25, 2005... The Case: A previously healthy 24-year-old man presented to the emergency department with sudden onset of severe periumbilical and right costovertebral pain accompanied by nausea and vomiting. His vital signs, including oxygen saturation, were...

Long-acting [[beta].sub.2]-agonists in asthma: safety concerns.(Health and Drug Alerts)
October 25, 2005... Reason for posting: Long-acting [[beta].sub.2]-agonist (LABA) medications are bronchodilators used in the treatment of asthma and chronic obstructive pulmonary disease. More than a decade ago questions were raised about an excess of...

Recurrent left-leg venous thrombosis in a woman despite a therapeutic international normalized ratio.(Clinical Vistas)
October 25, 2005... A 43-year-old woman presented to the emergency department after 2 days of pain and swelling in her left thigh. She had no recent immobilization, trauma or surgery, nor a previous or family history of blood clots. She had been taking oral...

Lymphocytic choriomeningitis virus.(Public Health)
October 25, 2005... Background and epidemiology: In May 2005, the US Centers for Disease Control and Prevention (CDC) reported cases of lymphocytic choriomeningitis virus (LCMV) infection in 4 people who had received transplants of the liver, lungs or a kidney...

Can coronary calcification measured by CT predict future coronary events?(In the Literature)
October 25, 2005... Arad Y, Goodman KJ, Roth M, Newstein D, Guerci AD. Coronary calcification, coronary disease risk factors, C-reactive protein, and atherosclerotic cardiovascular disease events: the St. Francis Heart Study. J Am Coll Cardiol2005;46:158-65. ...

Mortality attributable to nosocomial Clostridium difficile-associated disease during an epidemic caused by a hypervirulent strain in Quebec.(Research)
October 25, 2005... ABSTRACT: Background: Since 2002 an epidemic of Clostridium difficile-associated disease (CDAD) caused by a hypervirulent toxinotype III ribotype 027 strain has spread to many hospitals in Quebec. The strain has also been found in the...

Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial.(Research)
October 25, 2005... [infinity] See related article page 1051 ABSTRACT Background: Upper respiratory tract infections are a major source of morbidity throughout the world. Extracts of the root of North American ginseng (Panax quinquefolium) have been found...

How should we respond to the highly toxogenic NAP1/ribotype 027 strain of Clostridium difficile?(Commentary)
October 25, 2005... It is common knowledge across Canada and elsewhere that multiple hospitals in Quebec have experienced a disastrous and highly lethal outbreak of nosocomial Clostridium difficile-associated disease (CDAD) in the past 2 years. Unaffected regions...

Studies of "natural" remedies for the common cold: pitfalls and pratfalls.(Commentary)
October 25, 2005... Current treatments for the common cold are limited to symptomatic therapies. First-generation antihistamines and adrenergic agents are modestly effective for rhinorrhea and nasal obstruction respectively, but their usefulness is diminished by...

The Declaration of Helsinki: an update on paragraph 30.
October 25, 2005... Research on human subjects is governed by a large number and wide variety of codes and policies worldwide. In Canada, the Tri-Council Policy Statement (1) must be adhered to by individuals and institutions who receive public funding for...

Early and innovative interventions for severe sepsis and septic shock: taking advantage of a window of opportunity.
October 25, 2005... ABSTRACT The pathogenic, diagnostic and therapeutic landscape of sepsis is no longer confined to the intensive care unit: many patients from other portals of entry to care, both outside and within the hospital, progress to severe disease....

Other advantages to aerobic exercise.(Letters)(Letter to the Editor)
October 25, 2005... Persistent inflammation, as revealed by increased levels of inflammatory biomarkers, is associated with several chronic disorders, as highlighted by Barbara Nicklas and colleagues. (1) Accordingly, current guidelines recommend 30 minutes or...

Pharmaceutical advertising.(Letters)(Letter to the Editor)
October 25, 2005... I found it extremely disturbing that the May 24 issue of CMAJcame bundled with a 4-page advertisement from Berlex for their newly launched oral contraceptive pill. The advert was thinly veiled as an educational document, complete with a...

Well-water maintenance.(Letter to the Editor)
October 25, 2005... We congratulate Erica Weir for having recently drawn attention to well-water maintenance. (1) We have some additional information to help physicians interpret the results of reports on well-water quality. Although we agree with the list of...

HIV/AIDS and leishmaniasis coinfection in Ethiopia.(Letter to the Editor)
October 25, 2005... Aranka Anema and Koert Ritimeijer (1) describe their practical and effective strategy for treating visceral leishmaniasis (VL) in patients coinfected with HIV/AIDS in Ethiopia. Relying on low serologic titres of [less than or equal to] 1:400 to...

Are FASD guidelines practical and sustainable?(Letter to the Editor)
October 25, 2005... Christine Loock and associates1 recommend that children with suspected fetal alcohol spectrum disorder (FASD) undergo a "comprehensive, multidisciplinary assessment." The assessment outlined in recommendation 3.1 of the supplement presenting...

Correction.(Letters)(Correction Notice)
October 25, 2005... The DOI attached to recent English1 and French2 editorials should have read 10.1503/cmaj.051229 and 10.1503/cmaj .051230, respectively. REFERENCES (1.) Have paper records passed their expiry date? [editorial]. 2005;173(7):725. ...

A better reading.(What is Medical History?)(Book Review)
October 25, 2005... What is medical history? John C. Burnham Cambridge, UK: Polity Press 2005 163 pp $26.95 (paper) ISBN 0-7456-3225-4 In our ordinary experience of time we have to grapple with three dimensions, all of them unreal: a past that is no longer, a...

Canadian Healing Oil.(One thousand words)(Brief Article)(Product/Service Evaluation)
October 25, 2005... Canadian Healing Oil. I found this bottle in a little tienda (general store) on the main street of San Ignacio, Belize. The shop owner told me it was a good liniment for strains and sprains. He also made the claim that half a teaspoon taken...

Book learning.(Illness and metaphor)(Brief Article)(Excerpt)
October 25, 2005... Turned out to pattern by his medical school, Manson had faced the future with a well-bound textbook confidence. He had acquired a smattering of physics, chemistry, and biology--at least he had slit up and studied the earthworm. Thereafter he...

Why we wash our hands.(Room for a view)(Short Story)
October 25, 2005... Five am Sunday in Toronto, Francoise Pilon was almost fully dilated in the case-room when she screamed, " Je vais mourir!" Her French-speaking nurse, from northern Ontario, checked the patient's vitals, the monitor, and reviewed her history....

The surgeon and the nurse.(Annotation)
October 25, 2005... One of the most unflattering portrayals of a surgeon ever to appear in English literature is surely this introductory stanza from Alfred, Lord Tennyson's narrative poem, "In the Children's Hospital" (1880). Our doctor had call'd in...

Deaths.(Obituary)
October 25, 2005... Notice CMAJ welcomes obituaries submitted within 60 days of a death. Send to pubs@cma.ca; fax 613 565-5471. Allen, Cameron Smith, Vancouver, BC; University of Manitoba, 1939; orthopedic surgery. Died Apr. 21, 2005, aged 88. ...

Query.
October 25, 2005... My wife and I talked of separation last week. After an incendiary argument, one in a string of many days and nights that have long indicated a deep marital malaise, she finally said, in response to my last vicious dig, and with an ominously...