CMAJ: Canadian Medical Association Journal articles from October 2007

CMAJ: Canadian Medical Association Journal archives from October 2007

Getting serious about Canadian health research/La recherche en sante au Canada : un peu de serieux.(Editorial)(Canadian Institutes of Health Research)
October 9, 2007... The imminent departure of Dr. Alan Bernstein from the presidency of the Canadian Institutes of Health Research (CIHR) will doubtless be the subject of much hand-wringing over a suitable replacement, future directions, programming and other...

Troubled Afghan hospital needs Canadian SWAT team.(NEWS)(Mirwais Hospital)
October 9, 2007... Published at www.cmaj.ca on Sept. 26, 2007 Canada's doctors should "adopt" the ill-equipped Mirwais Hospital in Khandahar as a contribution to reconstruction of war-torn Afghanistan, a Paris-based international development security policy...

Vaccine-autism link discounted, but effect of "study" is unknown.(News)(Clinical report)
October 9, 2007... As the authors of a controversial study that linked the measles, mumps and rubella (MMR) vaccine and autism fend off allegations of professional misconduct, debate over the study's impact on immunization rates continues to rage in Canada. ...

US Medicare will stop paying for preventable errors.(News)
October 9, 2007... In a major policy change projected to save lives and millions of dollars, Medicare will stop paying US hospitals to correct 8 preventable medical errors caused by their own negligence, commencing in October 2008. The new payment guidelines...

Exit interview with Dr. Alan Bernstein.(Behind the News)(Canadian Institutes of Health Research)(Interview)
October 9, 2007... History will probably record the move as the crucible upon which the grand experiment called the Canadian Institutes of Health Research (CIHR) ultimately turned. In response to recommendations from a blue-ribbon International Review Panel,...

Fertility rates and gross national incomes per capita.(Pulse)(Brief article)
October 9, 2007... Recently the World Health Organization reported 2005 fertility rates per woman and gross national incomes per capita from its 193 member countries. (1) Figure 1 shows these data for the 20 countries with the highest and lowest fertility rates...

Prexige review.(News @ a glance)(Drug overview)(Brief article)
October 9, 2007... Prexige review: In the wake of a decision by Australian authorities to yank lumiracoxib (Prexige) from the market after reports of liver problems, including 2 deaths and 2 liver transplants, in 8 people who took the drug, Health Canada has...

Research access.(News @ a glance)(Canadian Institutes of Health Research)(Brief article)
October 9, 2007... Research access: The Canadian Institutes of Health Research has adopted a policy that will require all researchers to make peer reviewed research articles stemming from work funded in whole or in part by the agency (after Jan. 1, 2008) freely...

Landings.(News @ a glance)(Canadian Health Services Research Foundation)(Brief article)
October 9, 2007... Landings: The Canadian Health Services Research Foundation has appointed beleaguered former Newfoundland and Labrador Eastern Regional Health Authority president George Tilley as their interim chief executive officer. Tilley resigned from the...

Hybrids and chimeras.(News @ a glance)(licensing; embryology research)(Brief article)
October 9, 2007... Hybrids and chimeras: Britain's Human Fertilization and Embryology Authority has cleared the path for 2 research groups to obtain licences to create cytoplasmic embryos by merging animal eggs with human cells, from which they will extract...

Superbug swatter.(News @ a glance)(hospital-acquired infections)(Brief article)
October 9, 2007... Superbug swatter: The Public Health Agency of Canada will craft a national plan by January to reduce hospital-acquired infections, now estimated at 220 000 per year in Canada, at a cost of between 8000 and 12 000 lives. Agency officials say the...

Ethics refresher.(News @ a glance)(medical ethics course; World Medical Association)(Brief article)
October 9, 2007... Ethics refresher: The World Medical Association has launched a new free, Web-based medical ethics course in conjunction with the Norwegian Medical Association that covers core issues typically faced by physicians in the course of practice,...

A potentially preventable case of serious influenza infection in a pregnant patient.(Teaching Case Report)(Case study)(Clinical report)
October 9, 2007... The case: A 16-year-old pregnant teenager (gravida 1, para 0) presented at 32 weeks' gestation to a local emergency department in late December 2006 with a 5-day history of increasing dyspnea, low-grade fever, nausea and vomiting. She had taken...

Phrynoderma: a cutaneous sign of an inadequate diet.(Clinical Vistas)(Case study)(Clinical report)
October 9, 2007... A 28-year-old man was referred to our dermatology clinic with a 6-month history of diffuse and slightly pruritic papules. These hyper-keratotic, follicular, cutaneous lesions were mainly located on the patient's trunk (Figure 1), shoulders and...

One-year follow-up of a therapeutic lifestyle intervention targeting cardiovascular disease risk.(Research)(Clinical report)
October 9, 2007... ABSTRACT Background: In this study, we tested the efficacy of a low-intensity lifestyle intervention aimed at reducing the risk of cardiovascular disease among mid-life individuals. Methods: We conducted a randomized controlled trial...

Effect of perindopril on physical function in elderly people with functional impairment: a randomized controlled trial.(Research)(Clinical report)
October 9, 2007... Abstract Background: Physical function and exercise capacity decline with age and are a major source of disability in older people. Recent evidence suggests a potential role for the rennin-angiotensin system in modulating muscle function....

Predictors of inappropriate antibiotic prescribing among primary care physicians.(Research)(Report)
October 9, 2007... Abstract Background: Inappropriate use of antibiotics promotes antibiotic resistance. Little is known about physician characteristics that may be associated with inappropriate antibiotic prescribing. Our objective was to assess whether...

Therapeutic lifestyle and disease-management interventions: pushing the scientific envelope.(Research)(Clinical report)
October 9, 2007... Key points of the article * Variation in the results of studies of therapeutic lifestyle and disease management interventions probably relate to the heterogeneity and complexity of such programs, their populations and their evaluation ...

Is there a new role for angiotensin-converting-enzyme inhibitors in elderly patients?(Research)(Drug overview)(Clinical report)
October 9, 2007... Key points of the article * Age-related declines in muscle mass and quality (sarcopenia) are associated with significant morbidity and mortality * In the randomized controlled trial by Sumukadas and colleagues, the...

Revenge of the killer microbe.(Research)(inappropriate antibiotic prescription)(Clinical report)
October 9, 2007... Key points of the article * Rates of inappropriate antibiotic prescribing (prescription of antibiotics for viral infections or of second- or third-line antibiotics as first-line treatment) have decreased since the early to mid-1990s;...

Analyzing the risks of cesarean delivery.(Letters)(Brief article)(Clinical report)
October 9, 2007... [ILLUSTRATION OMITTED] Shiliang Liu and colleagues conclude that the risks of severe maternal morbidity associated with planned cesarean delivery are higher than those associated with planned vaginal delivery. (1) However, a...

Treatment of septic arthritis.(Letters)(Letter to the editor)
October 9, 2007... Raheem Kherani and Kam Shojania recently provided a comprehensive overview of septic arthritis; however, I have some concerns about the antimicrobial therapies outlined in their article. (1) The authors recommend that gram-positive cocci...

Health Canada's new standards on conflict of interest.(Letters)(Letter to the editor)
October 9, 2007... In a CMAJ news piece, Wayne Kondro stated that "Canada has no hard rules governing exemptions or waivers. Experts with conflicts are allowed to sit on [scientific advisory] panels without a formal waiver process." (1) This is incorrect. Health...

Whose responsibility is it?(Letters)(health care decline)(Letter to the editor)
October 9, 2007... I agree with much that my old friend Michael Bliss put forward about "socialized medicine and Canada's decline," (1) but I would submit that the responsibility for our inadequate health care system rests more with our medical educators --the...

Correction.(Correction notice)
October 9, 2007... In the July 31 issue of CMAJ, a news story on national standards for forensic pathology training (1) should have identified Dr. Charles Smith as a resident in anatomical pathology within the University of Toronto residency training program in...

Death: one, medicine: no score.(Room for a view)
October 9, 2007... My 86-year-old father recently died after a lengthy and agonizing decline, and subsequently I found myself participating in the ancient, week-long Jewish mourning ceremony known as shiva. And I resolved after the traditional daily religious...

Of kings and alchemy.('Europe's Physician: The Various Life of Sir Theodore de Mayerne')(Book review)
October 9, 2007... Europe's Physician: The Various Life of Sir Theodore de Mayerne Hugh Trevor-Roper Yale University Press; 2006 464 pp US$35 ISBN 0-300-11263-7 Hugh Trevor-Roper never had this biography of the 17th- century physician Theodore de Mayerne...

Deaths.(Obituary)
October 9, 2007... Brown, Berkeley Cline, Victoria, BC; University of Western Ontario, 1940, internal medicine. Died July 12, 2007, aged 92. Burrows, Derek Cecil Raymond. Died Aug. 31, 2007, aged 85. "Dr. Burrows was a radiologist, and was the first chief of...

Reefer madness.(Salon)(cannabis; schizophrenia)(Clinical report)
October 9, 2007... Studies have suggested that as many as 1 in 4 cannabis users may be genetically at risk for developing schizophrenia or a related psychotic disorder. Now, a new study reveals all users are at risk. (1) Given recent United Nations'...

Global poverty is ours to reject/La pauvrete mondiale : a nous de la faire reculer.(Editorial)(Viewpoint essay)
October 23, 2007... Canada is a wealthy country and a comfortable place to live. In contrast, much of the world is poverty stricken and is an uncomfortable place to die. This difference is the greatest single challenge, in medicine or any other discipline, of our...

The North "like Darfur".(Poverty and human development)
October 23, 2007... Most of the time, Nick Finney's job is to respond to rapid-onset humanitarian disasters--floods, earthquakes and health emergencies. But in First Nations communities in northern Canada last winter he witnessed "the slowest evolved disaster that...

The harsh numbers are unchanged.(Poverty and human development)(Report)
October 23, 2007... Tragedies among Canada's Aboriginal population are often treated as isolated events and there is an illusion that "progressive thinking and improved attitudes have brought fair treatment to Canada's native peoples." That statement is from...

Extending an invitation, and a hand.(Poverty and human development)
October 23, 2007... Consider yourself invited to Webequie, a First Nations community 540 kilometres north of Thunder Bay, Ont., with a population of about 700. Chief Scott Jacob would be pleased to show off his home to anyone who can find their way there...

Shelter from the mental storm.(Poverty and human development)
October 23, 2007... Homeless people are more likely to suffer from a mental illness than the general population, and to be admitted to hospital as a result, says a new report by the Canadian Institute for Health Information. The report, Improving the Health of...

Building health services in the world's poorest nations.(Poverty and human development)(Brief article)
October 23, 2007... A concerted effort will be made to link global health aid with efforts to redress underlying structural deficiencies in the health systems of several of the world's poorest nations under a new International Health Partnership established last...

Faster malaria testing.(Poverty and human development)(Brief article)
October 23, 2007... The first rapid malaria test approved by the US Food and Drug Administration is now on the market, intended for laboratory use. The FDA approved Binax NOW on June 13, calling it "significantly faster and easier to use" than existing methods...

US$58 million grant to fight yellow fever in Africa.(Poverty and human development)
October 23, 2007... Efforts to contain the resurgence of yellow fever in 12 West African states have been boosted by a US$58 million grant from the GAVI Alliance to support special immunization campaigns in countries at high risk of yellow fever epidemics. ...

"Homophobia is fuelling the AIDS epidemic in Africa".(Poverty and human development)(acqiured immunodeficiency syndrome)
October 23, 2007... Homosexuals are a key contributor to rising infection numbers in many African and Middle East countries, according to research findings presented at a June meeting in Rwanda of people who implement HIV prevention and care programs. Stigma...

Quallunaat.(Dispatches from the medical front)(Viewpoint essay)
October 23, 2007... Our research team landed in Igloolik, Nunavut, to find the village in shock. A young high-school student had just committed suicide in the girls' washroom. I too was stunned by the unexpected violence, and sheer desperation of her act. It...

Mzungu.(Dispatches from the medical front)(Case study)
October 23, 2007... Susanna peers out at us disdainfully from behind the edematous folds of her face. She is 2 years old and suffering from severe Kwashiorkor malnutrition. "The signs of Kwashiorkor," explains the clinical officer who has become my mentor...

Measles.(Dispatches from the medical front)
October 23, 2007... I had never seen a case of measles before arriving in Democratic Republic of Congo. But I rapidly learned how to diagnose it. It's easy if spots are already visible (check behind the ears). The prodrome, however, is tricky but crucial...

Getting involved: donating time, money and expertise to global health.(Dispatches from the medical front)(Report)
October 23, 2007... It's the smiles that Dr. David Ponka remembers most. In the midst of poverty, disease and civil strife, the Ottawa-based family physician can't get over the resilience of the people he saw last year in Chad while on a 4-month stint providing...

Odd numbers: food banks and liposuction.(News)(Statistical data)
October 23, 2007... Indicators of either impoverished or lavish lifestyles invariably come under immediate assault as being entirely invalid or little more than sheer mathematical trickery. In the interest of avoiding such a tedious debate, what follows (Box 1)...

Release of the statement on influenza for the 2007-2008 season from the National Advisory Committee on Immunization.(Public Health)
October 23, 2007... As the influenza season winds to a close in the southern hemisphere, public health programs in Canada are preparing to launch vaccination campaigns to protect against an infection that accounts for about 4000 excess deaths each winter. (1) The...

What's your call?(Clinical Vistas Briefs)(Brief article)
October 23, 2007... [ILLUSTRATION OMITTED] Three-dimensional reconstruction of a chest computed tomography scan of a 60-year-old woman with acute and chronic chest pain localized to the region of a 10-year-old thoracotomy scar. [ILLUSTRATION OMITTED] ...

Influenza and the influenza vaccine.(CMAJ Public Health Fact Sheet)
October 23, 2007... What is influenza and what are the symptoms? Influenza, or the "flu," is an infection caused by the influenza virus. The virus infects the nose and throat, and it can sometimes spread to the lungs. Influenza commonly causes acute fever,...

Chronic post-thoracotomy pain syndrome.(Clinical Vistas Briefs)(Author abstract)
October 23, 2007... The 3-dimensional reconstruction of the computed tomography scan was obtained at the time of admission to exclude pulmonary embolus and aortic dissection. It confirmed a narrowing of the fifth intercostal space (Figure 1) where the thoracotomy...

Xanthogranulomatous pyelonephritis.(Clinical Vistas Briefs)(Brief article)
October 23, 2007... This patient had a history of renal colic and recurrent urinary tract infections. On physical examination she had tenderness at her left costophrenic angle. She had pyuria on a routine urinalysis, leukocytosis (leukocyte count 15.6 ? 10 (9) /L,...

Retroperitoneal fibrosis.(Clinical Vistas Briefs)
October 23, 2007... Based on the patient's computed tomography scans, a diagnosis of retroperitoneal fibrosis was confirmed (Figure 1 and Figure 2). Retroperitoneal Retroperitoneal fibrosis fibrosis, or Ormond's disease, is a rare, fibro-inflammatory disease with...

Changes in survival among elderly patients initiating dialysis from 1990 to 1999.(Research)(Report)
October 23, 2007... ABSTRACT Background: Over the past decade, there has been a steep rise in the number of people with complex medical problems who require dialysis. We sought to determine the life expectancy of elderly patients after starting dialysis and...

Association between proximity to the attending nephrologist and mortality among patients receiving hemodialysis.(Research)(Report)
October 23, 2007... ABSTRACT Background: Many Canadian patients who receive hemodialysis live far from their attending nephrologist, which may affect clinical outcomes. We investigated whether patients receiving hemodialysis who live farther from their...

Members' of Parliament knowledge of and attitudes toward health research and funding.(Health research funding)
October 23, 2007... ABSTRACT Background: Establishment of the Canadian Institutes of Health Research (CIHR) in 2000 resulted in increased funding for health research in Canada. Since 2001, the number of proposals submitted to CIHR that, following peer review,...

Mortality trends among Canadian patients receiving dialysis.(Research)
October 23, 2007... In this issue, 2 groups report on the outcomes of patients receiving dialysis in Canada. Given the intricacies of providing dialysis care, one would not expect easy answers from any evaluation. Using the Canadian Organ Replacement Register,...

The future of health research is hanging in the balance.(Special report)
October 23, 2007... The special report by Clark and colleagues in this issue of CMAJ concludes that Canada's Members of Parliament, who set government funding priorities and vote annually to determine the budget of the Canadian Institutes of Health Research (CIHR)...

Poverty and chronic diseases in Asia: challenges and opportunities.(Poverty and human development)
October 23, 2007... The economic rise of China and India is likely nothing less than a fundamental realignment of the global order. (1) Current income growth in these countries is paired with a rapid demographic and epidemiologic transition. The aging population...

The health of the public is the foundation of prosperity: the work of the Public Health Agency of Canada at home and around the world.(Poverty and human development)
October 23, 2007... Increasingly, it is recognized that the many factors and determinants underlying healthy, successful societies require the involvement of a variety of sectors from within those societies. As one of these sectors, public health is inextricably...

Homelessness and health.(Poverty and human development)
October 23, 2007... Homelessness is evolving into a national and international crisis. Within developed countries, homeless rates are now believed to approximate 1% of most urban populations. (1) In the 2001 Canadian census, 14 145 people were counted as living in...

Screening men for osteoporosis.(Letters)
October 23, 2007... [ILLUSTRATION OMITTED] I have many middle-aged and elderly men in my family practice, including some who are being treated for osteoporosis, and thus I read with interest the CMAJ article on managing osteoporosis in men by Aliya Khan and...

Accuracy of point-of-care measurements.(Letters)(Letter to the editor)
October 23, 2007... In a helpful case report in CMAJ, Peter Brindley and colleagues reported falsely elevated lactate levels obtained with a point-of-care analyzer and low plasma lactate levels obtained with laboratory testing in a patient who had ingested...

Rich man, poor woman; rich woman, poor man.(Room for a view)
October 23, 2007... He's a white South African--balding, grey-haired, with a considerable paunch--wearing sandals, a safari shirt and shorts. Maybe 55? She is looking a little bored, has a very bright, shiny, low-cut lilac blouse, skin-tight jeans, blue platform...

Bridging the political divide.(Room for a view)(Viewpoint essay)
October 23, 2007... Insofar as possible, I try to keep my medical practice and politics separate. After all, they do involve 2 very different disciplines. And as is the case in other professions such as piloting or plumbing, we doctors have no particular expertise...

Guidance for the globally minded physician.(Viewpoint essay)
October 23, 2007... Improving health for the world's poor: what can health professionals do? Mike Rowson, David McCoy and Martin Carroll, eds. British Medical Association, International Department; 2007 70 pp. Free online at www.bma.org.uk...

Deaths.(List)
October 23, 2007... Cumming, Harold Wallace (Hal), Kingston, Ont.; Queen's University, 1951, family medicine. Died Aug. 25, 2007, aged 87. "Dr. Cumming was a founding member of The College of Family Physicians of Canada. His greatest passion was his family:...

Reconsidering survival.(Salon)(Viewpoint essay)
October 23, 2007... There are no greater threats to the health of humanity than nuclear weapons and climate change, threats that paradoxically have arisen from human behaviour. Nuclear weapons arise out of the human proclivity for war and climate change from our...