CMAJ: Canadian Medical Association Journal articles from October 2008

CMAJ: Canadian Medical Association Journal archives from October 2008

Listeriosis is the least of it/Listeriose: la de l'iceberg<.(Editorial)(Clinical report)
October 7, 2008... In August, Canada experienced the worst epidemic of listeriosis in the world. Contaminated cold cuts from a Toronto meat processing plant have, as of Sept. 12, 2008, killed at least 16 Canadians from among 43 confirmed cases of listeriosis in...

Spectrum of Clostridium difficile infections outside health care facilities.(Commentary)(Clinical report)
October 7, 2008... Clostridium difficile is mainly known as a hospital-acquired, nosocomial infection. The hospital environment is considered an ideal place for C. difficile to persist, infect susceptible elderly patients and spread among vulnerable patients....

Acute infections, vaccination and prevention of cardiovascular disease.(Commentary)(Clinical report)
October 7, 2008... Extensive research in recent decades has established a critical role for cellular and humoral inflammation in the initiation and progression of atherosclerosis and its acute clinical presentations. (1) Although atherosclerotic disease has a...

Does analysis using "last observation carried forward" introduce bias in dementia research?(Research methods)
October 7, 2008... If there were a prize for the most inappropriate analytical technique in dementia research, "last observation carried forward" would be the runaway winner. As a society, we have spent millions of dollars on drug research in the hope of...

Shifting to food industry self-monitoring may be hazardous.(News)
October 7, 2008... Contamination in a Canadian meat processing plant may no longer automatically result in a shutdown, according to a leaked chapter of the Canadian Food Inspection Agency's proposed procedures manual for meat hygiene. Rather, companies are...

Election 2008: where the parties stand--or not.(News)
October 7, 2008... Opinion polls consistently indicate that health care remains a main concern of Canadians, while health care expenditures now amount to 10.3% of Canada's gross domestic product, "the highest level in more than 30 years," according to the...

Switching swine for simulators: at what cost?(News)
October 7, 2008... Consider the pig. In terms of respect, it is the Rodney Dangerfield of the animal kingdom--it gets none. Horses are admired for their well-defined musculature; pigs are famous for their immense bellies and fondness for mud. When you...

Close the gap in health, international report urges.(News)(World Health Organization's Commission on Social Determinants of Health report)
October 7, 2008... No biological reason exists for the dramatic differences in health and life expectancy of people around the world, says the chair of the World Health Organization's Commission on Social Determinants of Health. Instead, a toxic combination...

Emergency medical response strategy proved critical to sustaining Georgia's health infrastructure.(News)
October 7, 2008... Call it the sort of painful experience that few wish for, but once gained is invaluable. Georgia's long and troubled history at the crossroads of clashing civilizations came in handy when a humanitarian crisis emerged overnight with the start...

Prostrate screening.(Brief article)(Clinical report)
October 7, 2008... Prostrate screening: The United States Preventive Services Task Force is recommending that physicians discontinue routine prostate cancer screening of men over 75 because the harms outweigh the benefits (www.ahrq.gov). The harms of screening...

Work benefits.(active lifestyles)(Brief article)(Clinical report)
October 7, 2008... Work benefits: An Australian Bureau of Statistics study (www.abs.gov.au/ausstats) indicates that continued participation in the labour force trumps retirement as older workers have significantly lower rates of arthritis and cardiovascular...

Racial divide apology.(American Medical Association)(Brief article)
October 7, 2008... Racial divide apology: The American Medical Association has issued an apology "for its past history of racial inequality toward African-American physicians," after releasing the findings of its internal study into organized medicine's racial...

Yaounde declaration.(Briefly)(meningitis prevention)(Brief article)
October 7, 2008... Yaounde declaration: Health ministers from the 25 countries in the African Meningitis Belt have committed themselves to a new meningtis prevention and control strategy that includes the administration of a new candidate meningococcal A...

Contingency planning critical to ensuring medical isotope supply.(For the record)
October 7, 2008... Timely disclosure to the medical community about potential disruptions in isotope supply and a valid plan for alternative sources of supply are among a host of recommendations urged by an Ad Hoc Health Experts Working Group on Medical Isotopes...

Preparedness remains a distant dream.(News)
October 7, 2008... Obfuscation, rhetoric and jurisdictional wrangling continue to plague Canada's capacity to respond to natural disasters, disease outbreaks and terrorist acts, says the Senate Committee on National Security and Defence in a report, "Emergency...

Patterns of antibiotic use and risk of hospital admission because of Clostridium difficile infection.(Research)(Clinical report)
October 7, 2008... Abstract Background: Previous observations have indicated that infection with Clostridium difficile occurs almost exclusively after exposure to antibiotics, but more recent observations have suggested that prior antibiotic exposure may be...

Pneumococcal vaccination and risk of myocardial infarction.(Research)(Clinical report)
October 7, 2008... Abstract Background: Based on promising results from laboratory studies, we hypothesized that pneumococcal vaccination would protect patients from myocardial infarction. Methods: We conducted a hospital-based case--control study that...

The effect of traumatic brain injury on the health of homeless people.(Research)(Survey)
October 7, 2008... Abstract Background: We sought to determine the lifetime prevalence of traumatic brain injury and its association with current health conditions in a representative sample of homeless people in Toronto, Ontario. Methods: We surveyed...

Diagnosis and treatment of dementia: 4. approach to management of mild to moderate dementia.(Clinical report)
October 7, 2008... Abstract Background: The management of mild to moderate dementia presents complex and evolving challenges. Practising physicians are often uncertain about the appropriate approaches to issues such as the disclosure of the diagnosis,...

Listeriosis: a primer.(Public health)(Clinical report)
October 7, 2008... Serious outbreaks of food-borne illness, whether regional or national, dramatically raise community anxiety about personal health and increase the workloads of front-line physicians. The drama further increases when the offending microbe is not...

Multiple papillae on labia minora.(What is your call?)(Clinical report)
October 7, 2008... A 24-year-old woman was referred to our dermatology clinic for assessment of vulvar papules. They had been present for at least 2 years, during which time she had tried a course of imiquimod 5% cream, a wart treatment. The lesions, aside from...

Ensuring quality in medical laboratories.(Letters)(Letter to the editor)(Clinical report)
October 7, 2008... The problems in Canada with laboratory medicine were recently discussed in CMAJ. (1,2) The Canadian Association of Pathologists released a 5-point action plan following its 2008 annual meeting. We fully endorse the call for mandatory external...

Attracting medical students to rural areas.(Letters)(Letter to the editor)(Report)
October 7, 2008... Declining recruitment to family medicine is a pressing concern in many countries. (1-3) In rural areas of Saxony, Germany, there is a severe shortage of family physicians (4) even though 27% of the medical undergraduates currently enrolled at...

Improving the reporting of surveys of clinicians.(Letters)(Letter to the editor)(Report)
October 7, 2008... We congratulate Karen Burns and colleagues for their article on how to design and conduct self-administered surveys of clinicians. (1) We agree that there is a need to advance the idea of standardizing the reporting and the quality assessment...

Correction.(Letters)(Correction notice)
October 7, 2008... Figure 7 of a recent meta-analysis examining smoking cessation therapies (1) contains 2 errors. First, the second and third columns should have been labelled "Bupropion" and "Varenicline," respectively. Second, varenicline was inadvertently...

Make hay while the sun shines.(Room for a view)(Clinical report)
October 7, 2008... [ILLUSTRATION OMITTED] She and I had endured what seemed like an excruciating, unnecessarily long period of diagnostic frustration, awaiting some answers--any answers--to what was plaguing her. Brief lapses in recent memory. Losing her...

The glorification of gout in 16th- to 18th-century literature.(Past progressive)(Clinical report)
October 7, 2008... Literary references to gout are a prime example of the insight into popular perceptions of disease that historical writings offer. While praise of podagra is currently in short supply, the merits of gout have been extolled over the centuries by...

Someone glimmering.(Poem)(Poem)
October 7, 2008... [ILLUSTRATION OMITTED] Someone glimmering These mallards quack from their greasy fake pond As a woman goes soaring off the top floor of the hospital parking lot. Over the white chapel with the...

Gallstone ileus.(Clinical images)(Disease/Disorder overview)(Clinical report)
October 7, 2008... [FIGURE 1 OMITTED] [FIGURE 2 OMITTED] An elderly woman in her 90s was admitted with signs and symptoms suggestive of obstructive ileus: crampy abdominal pain, repeated episodes of vomiting and increased bowel sounds with tympanic sound...

Who are the leaders?(Salon)(condition of health care in developing countries)
October 7, 2008... Why are you going to Papua New Guinea? Don't you know that after Baghdad, Port Moresby is the second most dangerous city in the world?" When a concerned friend from the World Bank asked me this, I realized my briefing papers had left out these...

Asbestos mortality: a Canadian export / La mortalite liee a l'amiante : une exportation canadienne.(Editorial)
October 21, 2008... Next week, a handful of Canadian bureaucrats will fly to Rome for the 4th Conference of the Parties to the Rotterdam Convention, a treaty governing trade in substances that harm human health and the environment. Their mission? If past...

Myocardial infarction and quality of care.(Commentary)
October 21, 2008... A critical feature of high-quality medicine is that patients receive, or at least to be considered for, all treatments where the benefits outweigh the risks and costs. This is especially true for those with acute myocardial infarction, where a...

Learning from Listeria: the autonomy of the public health agency of Canada.(Public health)
October 21, 2008... Five years after the SARS outbreak Canada's public health system is being tested again, this time by food-borne listeriosis. The 16 deaths as of Sept. 15 that have been attributed to Listeria-contaminated food have already surpassed one-third...

Is tobacco use a disease?(Medicine and society)
October 21, 2008... Should tobacco use be framed as a disease or a population-based health concern? (1) At present, there are 2 potentially competing approaches to reducing smoking rates. The first, the disease-centred approach, identifies smoking as an...

Public-private partnerships, part 1: the next hospital wave.(News)
October 21, 2008... Anyone who works in a hospital knows how incredibly complex the institutions are--and how important they are to Canadians when serious health problems plague them or their loved ones. So it is surprising that a sea change in the way that...

Asbestos panelists accuse government of misusing science.(News)
October 21, 2008... Economic and political interests are trumping science by threatening the federal government's release of a study of the health hazards of chrysotile asbestos, says the British chair of an expert panel appointed by Health Canada. The delay...

Aggressive billing techniques confusing Canadians.(News)
October 21, 2008... Medicare advocacy groups have in recent months noticed a sharp uptick in telephone calls from Canadians wondering why they are receiving so many bills from their family doctors. Letters inquiring if patients want to pay annual block fees for...

Health infrastructure a casualty of war on terror within Pakistan.(News)
October 21, 2008... Arguing that the health infrastructure in the Federally Administered Tribal Area of Pakistan has been one of the biggest casualties of the "war on terror," the nation's medical association is asking the international medical community to join...

Conflicts database.(Briefly)(Institute on Medicine as a Profession)(www.imapny.org
October 21, 2008... Conflicts database: The New York City-based Institute on Medicine as a Profession has launched a publicly accessible database (www.imapny.org /coi_database/) identifying the conflict of interest policies of the United States' 125 academic...

Code down under.(Briefly)(Australia Medical Council)(Brief article)
October 21, 2008... Code down under: The Australia Medical Council has proposed that the nation's physicians adopt a new draft code of conduct (goodmedicalpractice.org.au/) that requires doctors to disclose whether they've been convicted of a crime or found...

Citus, Altius, Fortius.(Briefly)(Brief article)
October 21, 2008... Citus, Altius, Fortius: A scant 6 athletes tested positive for performance-enhancing drugs at the 2008 Beijing Summer Games, well under the 27 miscreants who were nabbed at the 2004 Games in Athens, Greece (CMAJ 2008;179[3]:219-22), or the...

Investigation list.(Briefly)(www.fda.gov/Cder/aers/potential_signals/potential_signals_2008Q1.htm))(Brief article)
October 21, 2008... Investigation list: The United States Food and Drug Administration has moved to meet a legislative obligation to post a list of drugs whose safety is under investigation. The list,...

Pay hike.(Briefly)(Brief article)
October 21, 2008... Pay hike: The province of Ontario has reached a tentative 4-year agreement (www.oma.org) with its physicians that will see doctors earn a 12.25% increase in fees, including 3%, 2%, 3% and 4.25% hikes in each of the next 4 fiscal years. By the...

Opponents stymie fight against polio in Nigeria.(News)
October 21, 2008... There is little question that Africa's most populous nation, Nigeria, will stand out on World Polio Day. But perhaps for the wrong reasons. When the world marks progress toward eradicating the disease on Oct. 24, 2008, Nigeria, like...

Canadian disparities in access to health care.(For the record)
October 21, 2008... The health care systems of British Columbia and Nova Scotia rate highest in a comparison of medical outcomes, while Newfoundland trailed the provincial pack, according to a study by Winnipeg-based Frontier Centre for Public Policy and Europe's...

Young children remain primary victims of malaria..(For the record)(Brief article)
October 21, 2008... While worldwide access to malaria control interventions improved through 2006, there were still a staggering 247 million people estimated to have become infected with the parasite, which continues to kill about 900 000 annually, primarily...

Use of evidence-based therapies after discharge among elderly patients with acute myocardial infarction.(Research)(Clinical report)
October 21, 2008... ABSTRACT Background: Postdischarge use of evidence-based drug therapies has been proposed as a measure of quality of care for myocardial infarction patients. We examined trends in the use of evidence-based drug therapies after discharge...

Factors associated with the use of evidence-based therapies after discharge among elderly patients with myocardial infarction.(Research)(Clinical report)
October 21, 2008... ABSTRACT Background: In an accompanying article, we report moderate between-hospital variation in the postdischarge use of [beta]-blockers, angiotensin-modifying drugs and statins by elderly patients who had been admitted to hospital with...

Indicators of quality of care for patients with acute myocardial infarction.
October 21, 2008... ABSTRACT Background: There is a wide practice gap between optimal and actual care for patients with acute myocardial infarction in hospitals around the world. We undertook this initiative to develop an updated set of evidence-based...

Privatizing health care is not the answer: lessons from the United States.(Analysis)
October 21, 2008... There are strong moves within Canada to make the Canadian health care system more like the US system by partially privatizing it. Those who favour this approach claim that the US system offers more choice and better quality of care and spares...

Management of cardiovascular disease in patients with diabetes: the 2008 Canadian Diabetes Association guidelines.
October 21, 2008... Diabetes mellitus is a chronic condition that requires complex management; however, the time of health care providers is limited and patient motivation varies. How can health care providers design realistic treatment plans and establish...

Bowel loops and eyelid droops.(Teaching cases)(case study of a small-bowel obstruction associated with signs and symptoms of botulism)(Case study)
October 21, 2008... Abstract: A patient presented with a small-bowel obstruction associated with signs and symptoms of botulism. Fecal cultures were positive for viable Clostridium botulinum. This case emphasizes the importance of a broad differential diagnosis...

Increase in poliomyelitis cases in Nigeria.(Public health alert)
October 21, 2008... Poliomyelitis has been eliminated from 3 of the 6 World Health Organization regions, including the Americas. The recently reported increase in the number of cases in northern Nigeria is a cause of concern given the spread of polio from Nigeria...

Vetting journal advertisements.(Letters)(Letter to the editor)
October 21, 2008... On page 1632 of the June 17, 2008, issue of CMAJ there is a full-page Coca-Cola advertisement. The copy reads, "Can't remember the last Coca-Cola ad targeted at children? There's a reason." It goes on to state that "... for over 50 years,...

Microresearch: great idea but tough to execute.(Letters)(Letter to the editor)
October 21, 2008... I read with pleasure and excitement MacDonald and Kabakyenga's editorial proposing a "microresearch" model to foster local, outcomes-based clinical research in developing countries. (1) This model has the potential to produce a real impact in...

Corrections.(Letters)(Correction notice)
October 21, 2008... An article in the Sept. 9, 2008, issue about the prospects for no-fault insurance for Canadian patients (1) contained incorrect numbers for the Canadian Medical Protective Association's annual settlements in medical liability cases. From 2002...

Putting faces to global pandemics.(New media)
October 21, 2008... Pandemic Influenza Storybook: Personal recollections from survivors, families and friends Sharon K.D. Hoskins, Coordinator/editor United States Centers for Disease Control and Prevention; 2008 ...

Games.(Room for a view)
October 21, 2008... We're going to play a tapping game now, Mrs. MacDonald," I say, but it's not true, not exactly. The kitchen where we play this game is, according to her, not her kitchen. It is another kitchen, situated in a strange house that has replaced...

To boldly lead.(Leadership in Health Care)(Book review)
October 21, 2008... Leadership in Health Care Jill Barr and Lesley Dowding SAGE Publications Ltd; 2008 260 pp $44.95 ISBN 978-1412920681 [ILLUSTRATION OMITTED] The role of health care practitioners is to provide patients with advice and...

To his violin.(Poem)
October 21, 2008... To his violin I found you, abandoned in the attic of my boyhood home, your broken bridge, rusting strings a testimony to disregard. When had you last sung? In what year did he last hold you in his...

Sweet syndrome during pregnancy.(Clinical images)(Case study)
October 21, 2008... [FIGURE 1 OMITTED] [FIGURE 2 OMITTED] A 29-year-old woman in the 20th week of her second pregnancy presented with a fever and a 2-week history of painful, pruitic skin lesions that had appeared suddenly on her neck and face and had...

Battling Parkinson's Law.(Salon)(Viewpoint essay)
October 21, 2008... It's hard to imagine that Sonny Curtis knew about Parkinson's Law when he wrote the song "I Fought the Law." The song has achieved a place in rock history at the hands of The Clash, but the law has received comparatively less play in our...