CMAJ: Canadian Medical Association Journal articles from October 2006

CMAJ: Canadian Medical Association Journal archives from October 2006

Deaths.(John Douglas Armstrong, Philip John Dee, Angus Campbell Derby)(Obituary)
October 10, 2006... 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@cma.ca; fax 613 565-5471. Armstrong, John Douglas (Jack),...

Query.(medication)
October 10, 2006... Medication. I hate taking it. Never mind for what; it doesn't matter. What I hate is taking it. Why? Embodied in a small, yellow capsule is the summa of my infirmity. In that capsule is the entirety of what I cannot accomplish on...

Canada gets a marginal grade on childhood injury/ Blessures chez les enfants: le Canada obtient une note mediocre.
October 10, 2006... In this issue, Birken and coauthors document a substantial decline from 1971 to 1998 in the rate of unintentional injuries among Canadian children living in urban areas (see page 867). (1) They also determine that, for these injuries, the...

International panel says CIHR needs management overhaul.(Canadian Institutes of Health Research)
October 10, 2006... Never let it be said that Canadian Institutes of Health Research (CIHR) President Dr. Alan Bernstein lacks nerve. Few, if any, heads of scientific granting councils around the world would subject their agency's structure, functions and...

Ibuprofen redux.(News)(Brief article)
October 10, 2006... The news article "Ibuprofen should go behind-the-counter says expert panel" (CMAJ 2006; 175[3]:253-4) requires further elaboration of Health Canada's position on this issue. Health Canada started its internal scientific review on the safety of...

Injection site gets 16-month extension.(permitted heroin injection)
October 10, 2006... As summer ran its course in Vancouver, a 3-year experiment to provide heroin addicts with a medically supervised injection site neared its scheduled Sept. 12 expiration. Canada's former Liberal government had granted the facility, In-Site, a...

Hepatitis E and cholera outbreak in Kathmandu.
October 10, 2006... The incidence of infective diarrhea and hepatitis E has sharply increased in Kathmandu, Nepal, said doctors at a recent press conference organized by Liver Foundation Nepal. This summer, the Epidemiology and Disease Control Division (EDCD)...

Schwarzenegger vetoes single-payer bill.(Arnold Schwarzenegger)
October 10, 2006... California Governor Arnold Schwarzenegger has promised to veto a government- financed single-payer universal health insurance bill passed by the state legislature claiming "socialized medicine is not the solution to our state's health care...

Quebec specialist taking government to court.(Deborah Robertson)
October 10, 2006... When obstetrician-gynecologist Deborah Robertson decided to pursue training in advanced surgery in Toronto, she never dreamed she might be leaving her home province of Quebec for good. "I love working in Quebec," says Robertson. "But for...

Plan B available to women 18 and older in US.(oral contraceptive)
October 10, 2006... The US Food and Drug Administration has approved over-the-counter use of levonorgestrel (Plan B), the morning-after emergency contraception pill, to women who can prove they are 18 or older. OTC sales of levonorgestrel, which has been...

Birth rates.(Statistics Canada)(Brief article)
October 10, 2006... Birth rates: Canada's crude birth rate declined to a record low in 2004, with just 10.5 live births for every 1000 people, according to Statistics Canada's annual projection. It marked the second straight decrease in the number of live births,...

Head injuries.(Canadian Institute for Health Information report)(Brief article)
October 10, 2006... Head injuries: Although seatbelts and helmets appear to have helped reduce hospital admissions due to traumatic head injury over the last decade, particularly among youths, under age 19, and people over 60, people in these age groups remain at...

Go north.(Family Physician Incentive Program for New Graduates, Yukon Territory)(Brief article)
October 10, 2006... Go North: The Yukon government is offering eligible new family physicians up to $50 000 to practise in the territory. The Family Physician Incentive Program for New Graduates, part of the territory's $12.7-million health human resources...

Youth and tobacco.(Health Canada's 2004-05 Youth Smoking Survey)(Brief article)
October 10, 2006... Youth and tobacco: The number of youths (grades 5 through 9) trying tobacco products decreased by 50% between 1994 and 2004-05. Health Canada's 2004-05 Youth Smoking Survey reports that 21% of youths have experimented with these products...

Trends in rates of death from unintentional injury among Canadian children in urban areas: influence of socioeconomic status.
October 10, 2006... Injury is the leading cause of death and a major cause of morbidity among children aged 14 years and less in Canada. In 1997, 1 of every 2 deaths and 1 of every 8 hospital admissions in this age group were caused by injuries. (1) Socioeconomic...

Uncontrollable movements in patient with diabetes mellitus.
October 10, 2006... The Case: A 63-year-old woman presented to the emergency department after experiencing uncontrollable, irregular jerking movements of her right arm for 1 week. The movements were increasingly painful and were making it difficult for her to...

Triptan migraine treatments and antidepressants: risk of serotonin syndrome.(Health and Drug Alerts)
October 10, 2006... Reason for posting: Serotonin syndrome is a rare but serious and sometimes fatal toxidrome characterized by mental, autonomic and neurologic symptoms. Serotonergic psychotropic medications, including many antidepressants, have long been...

Patient sheet: tips for avoiding problems with polypharmacy.(Public Health)
October 10, 2006... Polypharmacy is a major problem among elderly patients. In the spirit of helping patients and their families to better understand the problem and how to deal with it, we offer this special Public Health column, directed to a lay audience. We...

An infant with the "setting-sun" eye phenomenon.
October 10, 2006... A 2-month-old boy was transferred from a community hospital to a tertiary care pediatric centre for work-up of recurrent Escherichia coli meningitis. The patient was born at 34 weeks because of premature rupture of membranes; his mother had a...

Home safety measures and the risk of unintentional injury among young children: a multicentre case-control study.
October 10, 2006... Abstract Background: Young children may sustain injuries when exposed to certain hazards in the home. To better understand the relation between several childproofing strategies and the risk of injuries to children in the home, we undertook...

Accountability sought by patients following adverse events from medical care: the New Zealand experience.
October 10, 2006... Abstract Background: Unlike Canada's medical malpractice system, patients in New Zealand who are dissatisfied with the quality of their care may choose between 2 well-established medicolegal paths: one leads to monetary compensation and...

Injury in childhood: a vexingly simple problem.
October 10, 2006... It is widely stated that 90% of childhood injuries are preventable. Why, then, are 1 in 8 hospital admissions of children the result of injury, and why are injuries still the leading cause of death among Canada's children? Two articles in...

Monetary and nonmonetary accountability following adverse medical events: options for Canadian patients.(Column)
October 10, 2006... The analysis of the New Zealand data by Bismark and colleagues (see page 889) (1) reinforces the Canadian Medical Protective Association's long-held view that patients harmed in the course of receiving medical care seek redress based on a range...

Is the Canadian health care system ready for donation after cardiac death? A note of caution.(Column)
October 10, 2006... "It seems inevitable that the fact that someone else is waiting for this patient's kidney must to some extent influence the decision, since the longer the injured patient is connected to the machines the more his kidneys and other vital organs...

Clinical applications of cardiovascular magnetic resonance imaging.
October 10, 2006... Abstract Cardiovascular magnetic resonance imaging (MRI) has evolved from an effective research tool into a clinically proven, safe and comprehensive imaging modality. It provides anatomic and functional information in acquired and...

Clinical utility of the Coombs test.(Letter to the editor)
October 10, 2006... The article by J. Manuel Zarandona and Mark Yazer on the clinical utility of the Coombs test (1) prompts consideration of the pitfalls of a negative test result. Specifically, further evaluation will be required if a patient with clinically...

Promotion of traditional lifestyles.(Letter to the editor)
October 10, 2006... Jeff Reading discusses some of the work being done to understand and alleviate the problem of diabetes among Aboriginal people in Canada. (1) Although the risk factors associated with diabetes and hypertension within Aboriginal communities are...

Changing ethics: where to start?(Letter to the editor)
October 10, 2006... Nuala Kenny's editorial reminding us of Hippocratic ethics is thought-provoking. (1) Hippocrates was probably unburdened by the need for a hefty loan or mortgage to complete his medical studies. Persuasive efforts by the pharmaceutical...

Lifelines.(Tales from the Doctor's House)(Excerpt)
October 10, 2006... It is 1927. The author, John Patrick Dunn, is 7 years old, and his brother Billy is five. Their father, Dr. John Francis Dunn, is a general practitioner whose office is in his home. Known as "the doctor's boys," John and Billy often accompany...

Donation after cardiocirculatory death in Canada/Le don apres un deces d'origine cardiocirculatoire au Canada.
October 10, 2006... ABSTRACT These recommendations are the result of a national, multidisciplinary, year-long process to discuss whether and how to proceed with organ donation after cardiocirculatory death (DCD) in Canada. A national forum was held in...

Sources of bias for authors of clinical practice guidelines/Sources de partialite chez les auteurs de guides de pratique clinique.(Column)
October 24, 2006... Clinicians base their decisions on input from multiple sources: comfort levels with past decisions; advice from influential people such as teachers, residency supervisors and other respected clinicians; and published information such as primary...

Fragmented organ donation programs hinder progress.(Canadian Society for Transplantation)
October 24, 2006... Comparisons of international organ donation rates, systems, policies and practices often suggest most developed nations are playing chess, while Canadians are playing checkers. So varied are the nation's transplant programs that it's...

Cardiologist's privileges restored after 4 years.(Nova Scotia)
October 24, 2006... A Nova Scotia bylaw ensures that when a physician's privileges are suddenly varied the review process takes no more than 30 days. For Halifax cardiologist Dr. Gabrielle Horne that process has taken 4 long years. On Oct. 8, 2006, the...

Health research gets middling grades.(The State of Science and Technology in Canada)
October 24, 2006... What are the consequences of having your discipline deemed a mediocre research performer? Will it be used by the Conservative government to justify funnelling money into "areas of strength," while lopping off resources to those pegged as weak...

US pharma company fined $435 million.(Schering-Plough Corp.)
October 24, 2006... Schering-Plough Corp., the US pharmaceutical manufacturer perhaps best known for its anti-allergy medication Claritin, has agreed to pay US$435 million in fines to settle criminal and civil charges that it illegally promoted several drugs. The...

Aboriginal health.(First Nations of Quebec and Labrador Health and Social Services Committee report)(Brief article)
October 24, 2006... Aboriginal health: A study of 4000 Quebec Aboriginal people in 23 native communities and 3 cities reveals that the majority smoke tobacco and are overweight or obese. The interview-based study, carried out in 2002 by the First Nations of Quebec...

Legionnaires.(Queen Elizabeth II Health Sciences Centre, water contamination)(Brief article)
October 24, 2006... Legionnaires: Contaminated water in a 250-bed unit at the Queen Elizabeth II Health Sciences Centre in Halifax has been confirmed as the cause of Legionnaires disease in 2 patients in 2005. Both patients died. According to Capital Health, an...

Breast cancer diagnosis falls.(National Cancer Institute )(Brief article)
October 24, 2006... Breast cancer diagnosis falls: After steadily climbing since the 1980s, the breast cancer diagnosis rate started to fall in 2003 in the US. New data from the National Cancer Institute indicate the rate of breast cancer diagnosis fell from 137.3...

CMA's direction on the public-private interface.(Canadian Medical Association)
October 24, 2006... "Mixed messages." That was the media's mantra in its coverage of the CMA General Council debate in August. During the sessions on "It's about Access: the Funding & Delivery of Health Care" seemingly contradictory resolutions were approved by...

In the aftermath of Chaoulli v. Quebec: whose opinion prevailed?
October 24, 2006... The June 2005 Supreme Court ruling on Chaoulli v. Quebec (Attorney General) (1) has generated considerable public discussion across Canada, much of it sharpening the ideological divide over the future of our health care system. We present here...

Recurrent strokes in a 46-year-old woman: rapidly progressive nonbacterial thrombotic endocarditis.(Teaching Case Report)
October 24, 2006... The Case: A 46-year-old nurse was admitted to the Neurology Department after 6 weeks of recurrent and transient neurologic episodes. She described several episodes of disorientation, language abnormalities and motor weakness, all resolving...

What physicians can do to prevent illnesses related to drinking water.(Public Health)
October 24, 2006... Outbreaks of waterborne illness from Escherichia coli in Walkerton and Cryptosporidium in North Battleford led to recommendations and actions to prevent additional outbreaks. A panel is currently reviewing the state of drinking water in First...

Intramuscular cavernous hemangioma with juxta-articular swelling.(Clinical Vistas Briefs)
October 24, 2006... The patient reported experiencing recurrent, painless swelling of his left knee since he was 8 years old (Fig. 1). There was no preceding trauma. He had pain and swelling once or twice a year that lasted about a month. None of his symptoms...

Vein of Galen malformation.(Clinical Vistas Briefs)(Brief article)
October 24, 2006... A large aneurysmal dilatation of the vein of Markowski and vein of Galen was noted on the cranial MRI. It was seen left of the midline, with marked mass effect, multiple fistulae and enlargement of the left middle-, left anterior-and...

Soft-tissue infection and underlying calcinosis of CREST syndrome.(Clinical Vistas Briefs)(Brief article)
October 24, 2006... A 55-year-old woman with a history of scleroderma presented after 5 days of experiencing fever, chills and progressive swelling of her right thumb (Fig. 1). The thumb was exquisitely tender to touch. Wound cultures were obtained, and the...

Angioedema without urticaria: a large clinical survey.(Research)(Disease/Disorder overview)
October 24, 2006... Abstract Background: Angioedema without major urticarial flares (hives) is poorly understood. Its causes are diverse, and little is known about its pathogenic mechanisms. We report on our 11 years of experience with this condition and...

Prevalence of overweight and obesity and their association with hypertension and diabetes mellitus in an Indo-Asian population.(Research)
October 24, 2006... Abstract Background: The associations of body mass index (BMI) and chronic disease may differ between Indo-Asian and Western populations. We used Indo-Asian-specific definitions of overweight and obesity to determine the prevalence of...

Obesity: the emerging cost of economic prosperity.(Commentary)
October 24, 2006... Western countries are experiencing an epidemic of obesity and face increasing rates of related complications, including diabetes mellitus, elevated lipid levels and hypertension. Recently a World Health Organization Expert Consultation...

Angioedema and the Canadian network of rare blood disorder organizations: extending the Canadian hemophilia care model.(Commentary)
October 24, 2006... In response to a push by Canadian patients with hereditary angioedema (HAE) who have recognized that the diagnosis and management of HAE was lagging behind that of many European countries (such as Italy, Hungary and Germany), (1,2) Jeanne...

Diagnosis and treatment of deep-vein thrombosis.(Disease/Disorder overview)
October 24, 2006... Abstract Deep-vein thrombosis (DVT) is a common condition that can lead to complications such as postphlebitic syndrome, pulmonary embolism and death. The approach to the diagnosis of DVT has evolved over the years. Currently an algorithm...

Granulocyte colony-stimulating factor.(Letters)
October 24, 2006... In the background section of their abstract, Woei-Cherng Shyu and associates (1) state that because granulocyte colony-stimulating factor (G-CSF) has anti-inflammatory and neuroprotective properties and the capacity to mobilize stem cells, it...

A mirror of the times.(Beyond the Hippocratic Oath: A Memoir on the Rise of Modern Medical Ethics)(Book review)
October 24, 2006... Beyond the Hippocratic Oath: A memoir on the rise of modern medical ethics John Dossetor University of Alberta Press; 2005 268 pp $39.95 ISBN 0-88864-453-1 Sitting beside fellow writer John Gregory Dunne at the funeral of a common friend,...

It's not all about the brain.(Room for a view)(Lowell's Command on Robert Lowell )(Critical essay)
October 24, 2006... Some time ago I read "Lowell's Command," an essay on Robert Lowell by Seamus Heaney. (1) In it, Heaney wrote: "In spite of the cruel cycles of mania, maybe even because of them, Lowell wrote extraordinarily and achieved eminence." This seemed...

Interior spaces, northern places: Nunavut artist Annie Pootoogook's artwork is observational and narrative.(Annotations)(Brief article)(Biography)
October 24, 2006... Unflinching, she depicts modern Inuit life as she sees it, rather than producing the traditional scenes that people in southern Canada have come to expect. There is tradition in Pootoogook's work, however. It is the Inuit concept of sulijuk,...

Deaths.
October 24, 2006... Ahmad, Mohammad Mukhtar, Didsbury, Alta.; University of Peshawar, Pakistan, 1964. Died July 30, 2006, aged 67. Cruickshank, Lionel Francis Gilbert, Ottawa; University of Edinburgh, UK, 1945, anesthesia. Died Sept. 8, 2006, aged 83. ...

Query.
October 24, 2006... Well, it's all over. Golf season, I mean. And now that it is over, I'm left with mixed feelings. Was it all worth it? The embarrassment, the soreness? Triple bogeys on Par-fours do not make for much satisfaction. People "playing through" three...