CMAJ: Canadian Medical Association Journal articles from September 2005

CMAJ: Canadian Medical Association Journal archives from September 2005

Private health insurance: in one door and out the other? / L'assurance sante privee: Entree cote cour pour sortir cote jardin?(Editorial)
September 13, 2005... The Supreme Court decision to invalidate Quebec's laws banning private health insurance for services covered under the Canada Health Act continues to stir the passions of physicians and health care providers. At their annual meeting, delegates...

Emergency contraception.(Letter to the Editor)
September 13, 2005... A recent CMAJ editorial (1) on oral emergency contraception asked, "Why... must competent women... be regarded as fair game for unwanted questioning and unsought advice--at their own expense?" This undermines the valuable counselling services...

Physicians and advocacy.(Letter to the Editor)
September 13, 2005... It is evident that providing responsible advocacy for patients, individually and collectively, is an obligation for Canadian physicians, as was discussed in a CMAJ editorial (1) earlier this year. The College of Family Physicians of Canada has...

A novel mutation in a patient with pantothenate kinase-associated neurodegeneration.(Letter to the Editor)
September 13, 2005... Pantothenate kinase-associated neurodegeneration is an autosomal recessive disorder characterized by accumulation of iron mainly in the basal ganglia. (1,2) In about half of these cases, patients have an identifiable mutation in the PANK2 gene....

Correction.(Correction Notice)
September 13, 2005... A correction (1) that appeared in a recent issue of CMAJ should have also referred to the print version of the relevant article. (2) References (1.) Correction. CMAJ 2005;173(1):18. (2.) McGinn T, Wyer PC, Newman TB, Keitz S,...

Declining CABG rate means fewer jobs for surgeons.(Technological Change)
September 13, 2005... Increased rates of percutaneous coronary intervention (PCI) in Canada and the subsequent decrease in coronary artery bypass grafts (CABG) are decreasing the need for cardiac surgeons and shortening some provincial waiting times, report some...

Canada and UK must stop taking African doctors.(Physician Supply)
September 13, 2005... Canada must become self-sufficient in physician supply by increasing residency positions, quadrupling re-entry positions and launching long-term, pan-Canadian planning, delegates to the Canadian Medical Association's General Council decided...

CMA okays private health care for waiting patients.(Private Health Care)
September 13, 2005... Citing the recent Supreme Court of Canada ruling and concerns about lengthy wait times, the Canadian Medical Association has endorsed private health insurance and private-sector health services for patients who don't get timely treatment...

Questions raised about private insurance.(Accessibility)(Brief Article)
September 13, 2005... The CMA's decision to open the door to private health insurance raises new questions about accessibility (see article above). Health insurance isn't readily available to people with pre-existing conditions, acknowledged QMA President Dr....

Hunger without borders.(Humanitarian Crisis)(food crisis in Niger)
September 13, 2005... As humanitarian and UN agencies scramble to catch up with the food crisis in Niger, neighbouring Mali, Mauritania and Burkina Faso warn that they will soon face similar crises. Drought, locusts and flooding have created a shortage of food...

HIV jump.(News @ a glance)(Brief Article)
September 13, 2005... HIV jump: More than 6 million of South Africa's 40 million citizens may be infected with HIV, up from previous estimates of 4.5 million, states the country's health department. India has the second highest overall number of people living with...

Avian flu vaccine.(News @ a glance)(Brief Article)
September 13, 2005... Avian flu vaccine: US researchers have successfully tested an avian influenza vaccine in healthy volunteers. The New York Times (Aug 7, 2005) reported high doses of the vaccine produced antibody responses to the A(H5N1) strain of avian...

e-Health Canada.(News @ a glance)(www .healthcanada.gc.ca/medeffect)(Brief Article)
September 13, 2005... e-Health Canada: Health Canada has launched MedEffect (www .healthcanada.gc.ca/medeffect) to centralize health product safety information. The site includes access to Health Canada's advisories, warnings and recalls, the Canadian Adverse...

Expanding undergraduate medical education in British Columbia: a distributed campus model.(Undergraduate Education)
September 13, 2005... As in the rest of Canada, British Columbia has a shortage of physicians in rural areas, particularly in the northern parts of the province and on the remoter parts of Vancouver Island. People living in these areas have reduced access to health...

Immunotherapy for West Nile virus infection.(Science and Medicine)
September 13, 2005... The treatment for infection by West Nile virus (WNV) is currently supportive. New research, however, suggests that a monoclonal antibody may prove an effective treatment in the future. (1) WNV is a single-stranded RNA flavivirus related to...

Applying the 2005 Canadian Hypertension Education Program recommendations: 2. Assessing and reducing global atherosclerotic risk among hypertensive patients.(CHEP Recommendations)
September 13, 2005... Evidence from large population-based studies has confirmed that hypertension increases a patient's risk of cardiovascular disease about 2- to 3-fold. Even after adjusting for other risk factors, the presence of borderline systolic hypertension...

Hurricanes: lessons from Charley and the gang.(Public Health)
September 13, 2005... Background and epidemiology: Immediately after Florida experienced 4 major hurricanes (Charley, Frances, Ivan and Jeanne) in quick succession during August and September of 2004, the Florida Department of Health deployed the Behavioral Risk...

Do medical emergency teams improve the outcomes of in-hospital patients?(In the Literature)
September 13, 2005... Hillman K, Chen J, Cretikos M, Bellomo R, Brown D, Doig G, et al.; MERIT study investigators. Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial. Lancet 2005;365(9477):2091-7. Background: The...

Stridor in a newborn.(Clinical Vistas)
September 13, 2005... A baby girl was noted to have stridor on day 1 of life. Her examination was otherwise normal, and a provisional diagnosis of laryngomalacia was made. However, she continued to have intermittent tachypnea, vomiting and diaphoresis with feeds. An...

Prevalence of and risk factors for childhood overweight and obesity.(Research/Recherche)
September 13, 2005... Abstract Background: Increases in childhood overweight and obesity have become an important public health problem in industrialized nations. Preventive public health action is required, but more research of risk factors is required before...

Adverse perinatal outcomes associated with homelessness and substance use in pregnancy.(Research/Recherche)
September 13, 2005... Abstract Background: Women who are homeless during pregnancy may be exposed to poor nutrition, violence and substance use, yet the health status of their newborn infants has not been systematically evaluated. We undertook a study to...

The CMA Code of Ethics and the donation of fresh embryos for stem cell research.(Commentary/Commentaire)
September 13, 2005... The promises of human embryonic stem cell (hESC) research and the needs of Canadian scientists to acquire fresh human embryos with which to participate in this important field of inquiry may result in the unintended compromise of the...

Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk.
September 13, 2005... Abstract THIS IS THE FIRST OF 2 ARTICLES EVALUATING cardiac events in patients undergoing noncardiac surgery. In this article, we review the magnitude of the problem, the pathophysiology of these events, approaches to risk assessment and...

Considering the state of the world.(The Left Atrium)(Global Crises, Global Solutions)(Book Review)
September 13, 2005... Global crises, global solutions Edited by Bjorn Lomborg Cambridge: Cambridge University Press; 2004 700 pp $39.95 ISBN 0-521-60614-4 Considering the state of the world Having trouble thinking clearly about the state of the world? Global...

Dyspnea.(care and treatment)
September 13, 2005... It's very late in the NICU. I push on the resuscitation room door, so weary I can barely open it. I look inside the room, and then I gasp. My fatigue is gone, replaced by anxiety and euphoria. There she is. I'm in love with a respiratory...

"A fistful of dollars".(Room for a view)(laryngeal cancer)
September 13, 2005... Mr. Johnson was a 53-year-old patient with laryngeal cancer admitted for pain control who loved to watch Westerns. He had mentioned this fact while I percussed his belly. He had elaborated on it while I examined his motor strength. At the...

Deaths/Necrologie.(William E. Cooper, Raymond G. Gagner, Russell A. Gill)( )(Obituary)
September 13, 2005... Cooper, William E., Niagara Falls, Ont.; University of London (England), 1948; internal medicine and cardiology; FRCPC; former staff, Greater Niagara General Hospital. Died Apr. 12, 2005, aged 81; survived by his wife, Moira, his children, Dr....

Query.
September 13, 2005... I saw a woman in my office the other morning, and no matter how hard I tried I couldn't convince her that she wasn't a bad person. She was four weeks post-abortion--a therapeutic abortion at a private clinic--and was seeing me for scheduled...

Have paper records passed their expiry date?/Les dossiers papiers sont-ils perimes?(Editorial)
September 27, 2005... The manager of your local grocery store can instantly determine how many kilos of Ida Red apples are still on the shelves, the use-before dates of every carton of soy milk, the total cash in the cash registers and the dollar value of unsold...

Modelling continuous data.(Letter to the Editor)
September 27, 2005... Gilbert Welch and colleagues have written an interesting essay contrasting continuous and categorical approaches to modelling the relation between exposure and health effects. (1) They suggest that assuming a continuous relation between...

Seasonal variation in birth weight.(Letters/Correspondance)(Letter to the Editor)
September 27, 2005... Hope Weiler and colleagues noted that it was difficult to explain their observation that newborns with vitamin D deficiency were heavier and longer and had greater head circumferences than newborns with adequate vitamin. (1) However, their...

Nonalcoholic fatty liver disease.(Letters/Correspondance)(Letter to the Editor)
September 27, 2005... Leon Adams and associates (1) rightly state that obesity is associated with nonalcoholic fatty liver disease (NAFLD). In particular, visceral adiposity is highly correlated with NAFLD, whereas the correlation with subcutaneous obesity is...

Corrections.(Letters/Correspondance)(Correction Notice)
September 27, 2005... An error in the recent obituary of Dr. William Tatlow (1) was pointed out to us, as follows, by Dr. Joseph Stratford, a long-time friend and colleague of the late Dr. Tatlow. "[A]ll is fine until you come to the point where it says 'out for his...

Vaccine network surprised by funding cut.
September 27, 2005... A federal decision not to renew a $34-million grant to the Canadian Network for Vaccines and Immunotherapeutics (CANVAC) had nothing to do with the quality of its research, says the executive vice-president of the Natural Sciences and...

Benchmarks for "scheduled" cases unwise, experts say.
September 27, 2005... Setting wait-time benchmarks for "scheduled" cases may mean those most in need don't get priority treatment, say experts about a recent report from the Wait Time Alliance. The Health Canada-funded alliance, comprised of 6 medical specialty...

Canadians respond to Katrina's devastation.(Hurricane Katrina, 2005)(Brief Article)
September 27, 2005... An earlier report was published at www.cmaj.ca on Sept. 1, 2005. Canada dispatched ships loaded with medical and relief supplies, Red Cross volunteers, and a search-and-rescue team including emergency physicians to help Americans on the...

"Unrealistic" to share North American antiviral supply.(Flu Pandemic)
September 27, 2005... As the WHO was orchestrating a massive international effort to share influenza antiviral treatment in the developing world, Canada and the US decided not to create a common North American stockpile. Oseltamivir (Tamiflu) could help to...

Vioxx award good news for Canadian lawsuits.(Medicolegal)(Brief Article)
September 27, 2005... A Texas jury's decision to award US$253 million to a widow who sued pharmaceutical giant Merck & Co. should help Canadians pursue their own lawsuits against the maker of rofecoxib (Vioxx), says a Canadian lawyer. On Aug. 19, the jury found...

SARS suit.(Ontario Superior Court rules)
September 27, 2005... SARS suit: An Ontario Superior Court judge has ruled that 2 lawsuits concerning Ontario's handling of the 2003 SARS outbreak can proceed. The lawsuits include a $600-million class action by nurse Andrea Williams, who became infected while...

No free travel.(News @ a glance)(Brief Article)
September 27, 2005... No free travel: Beginning in January, Canada's 50 research-based pharmaceutical companies (Rx&D) will no longer pay physicians to attend Canadian conferences or educational sessions. Rx&D is considering extending the ban to international events...

Fewer smokers.(decline of smoking level among the Canadians)(Brief Article)
September 27, 2005... Fewer smokers: The number of Canadians who smoke declined by 200 000 between 2003 and 2004, according to Statistics Canada's Canadian Tobacco Use Monitoring Survey. An estimated 5.1 million Canadians, or 20% of the population aged 15 and older,...

Physician supply.(News @ a glance)(Brief Article)
September 27, 2005... Physician supply: Canada's total number of doctors has kept pace with population growth since the late 1990s, reports the Canadian Institute for Health Information. New data show a 5% increase in the number of physicians between 2000 and 2004....

Living in the parallel universe in Australia: public Medicare and private hospitals.
September 27, 2005... The decision in the recent Chaoulli court case may presage the development of a nontrivial private sector in the Canadian health care system. Australia models many aspects of its Medicare system on Canada's plan: Australia has a national,...

Growing autologous bone.(research of orthopedic surgery)
September 27, 2005... Tissue engineering has yet to yield a good source of bone for orthopedic surgery. So far, attempts to grow bone tissue in vitro have not been successful. (1) However, new research by Molly Stevens and colleagues suggests that new bone can be...

Applying the 2005 Canadian hypertension education program recommendations: 3. Lifestyle modifications to prevent and treat hypertension.
September 27, 2005... Lifestyle modification, although often neglected, is an important strategy to prevent and treat hypertension and reduce antihypertensive drug burden. (1,2) On a population-wide basis, even a modest reduction in blood pressure of 3 mm Hg may...

Books received.
September 27, 2005... Baranek PM, Deber RB, Williams AP. Almost home: reforming home and community care in Ontario. Toronto: University of Toronto Press; 2004. 340 pp. $29.95 ISBN 0-8020-8639-X Bordowitz G. The AIDS crisis is ridiculous and other writings,...

HIV screening.(prevention of HIV infections)
September 27, 2005... Background and epidemiology: At the end of 2002 an estimated 56 000 people in Canada had HIV infection or AIDS. (1) Some 2800-5150 of these people were infected during 2002. The new infections resulted predominantly from men having sex with men...

Do statins decrease the risk of colorectal cancer?
September 27, 2005... Background: Colorectal cancer is the second leading cause of death from malignant disease in Canada. Laboratory research suggests that statins may prevent the growth of colorectal cancer cell lines. (1) Design: This population-based...

A 61-year-old man with continuous clonic jerks of his right leg.
September 27, 2005... A 61-year-old man with type 2 diabetes mellitus presented with a 3-day history of partial status epilepticus exhibited as continuous rhythmic clonic jerks of his right leg. Head CT scans appeared normal, and an MRI scan with diffusion-weighted...

Alcohol-associated rapid release of a long-acting opioid.(Palladone XL)
September 27, 2005... Reason for posting: Palladone XL (hydromorphone hydrochloride) is a long-acting opioid for chronic pain relief in patients with persistent, moderate-to-severe pain. A recent pharmacokinetic study showed that co-ingestion of the drug with...

Severe maternal morbidity in Canada, 1991-2001.
September 27, 2005... An abridged version of this article appeared in the Sept. 27, 2005, issue of CMAJ. Abstract Background: Although death rates are often used to monitor the quality of health care, in industrialized countries maternal deaths have become...

Work absence after breast cancer diagnosis: a population-based study.
September 27, 2005... An abridged version of this article appeared in the Sept. 27, 2005, issue of CMAJ. Abstract Background: Absence from work after breast cancer diagnosis may be part of the burden of disease for women with cancer, but little research...

Management of low-grade cervical lesions in young women.
September 27, 2005... Cervical infection with high-risk (oncogenic) genotypes of human papillomavirus (HPV) is a necessary early event in cervical carcinogenesis; however, cervical cancer will not inevitably develop in women with such an infection. Therefore,...

Prescription to over-the-counter deregulation in Canada: Are we ready for it, or do we need to be?
September 27, 2005... Published at www.cmaj.ca on Sept. 13, 2005. Emergency contraception (1) is just the latest example in a long list of medications that are being shifted from prescription only to over-the-counter (OTC) status. More experience with other...

Surveillance and prevention of major perioperative ischemic cardiac events in patients undergoing noncardiac surgery: a review.
September 27, 2005... Abstract THIS IS THE SECOND OF 2 ARTICLES EVALUATING cardiac events in patients undergoing noncardiac surgery. Unrecognized myocardial infarctions (MIs) are common, and up to 50% of perioperative MIs may go unrecognized if physicians rely...

A message in search of a method: A different kind of care: the social pediatrics approach.(Book Review)
September 27, 2005... A message in search of a method A different kind of care: the social pediatrics approach Gilles Julien Montreal: McGill-Queen's University Press; 2005 $24.95 208 pp ISBN 0-7735-2801-6 There's this spiky-haired kid wearing a camouflage...

Disease as idea: Lovers and livers: disease concepts in history.(Book Review)
September 27, 2005... Disease as idea Lovers and livers: disease concepts in history Jacalyn Duffin Toronto: University of Toronto Press; 2005 299 pp $27.50 ISBN 0-8020-3805-0 Lovers and Livers is a compilation of lectures delivered in 2002 by Jacalyn Duffin, a...

Elizabethan talk therapy.(Brief Article)(Excerpt)
September 27, 2005... Rosalind, disguised as a man, offers to cure the lovesick Orlando, who does not realize he is speaking to the object of his affection. ROSALIND: No: I will not cast away my physic but on those that are sick. There is a man haunts the...

Burning questions.(Room for a view)(Column)
September 27, 2005... As a budding health writer I was very excited to be attending my first press conference, convened to address avian influenza--such a sizzling topic that the briefing was held at the US embassy in Ottawa. I had, in a very professional...

Deaths/Necrologie.(Gardner E. Cooper, Arthur V. Follett, Jan H. Jansen)(Obituary)
September 27, 2005... Cooper, Gardner E., Hamilton, Ont.; University of Toronto, 1940; general and orthopedic surgery; Captain, Royal Canadian Army Medical Corps; chief of surgery, Hamilton Civic Hospitals (1959-81). Died Aug. 1, 2005, aged 90; survived by his...