CMAJ: Canadian Medical Association Journal articles from September 2006

CMAJ: Canadian Medical Association Journal archives from September 2006

Editorial policy: the right to medical information/ Politique de la redaction: Le droit a l'information medicale.(Editorial)
September 12, 2006... In a recent editorial co-published by PLoS Medicine and the Bulletin of the World Health Organization, Barbour and colleagues, (1) employees of the Public Library of Science (PLoS), make the valid point that "print is no longer the most...

"Mixed message" about public-private interface emerges from CMA.(Canadian Medical Association)
September 12, 2006... Published at www.cmaj.ca on August 23, 2006 The Canadian Medical Association's General Council passed seemingly contradictory motions during its debate over the funding and delivery of health care, some supporting a public system, others...

New Day dawns.(Canadian Medical Association presidential electcts Brian Day)
September 12, 2006... Published at www.cmaj.ca on August 22, 2006 In a hotly contested campaign, orthopedic surgeon Dr. Brian Day, the founder of Vancouver's private, for-profit Cambie Surgery Centre, was elected Aug. 22 at the CMA General Council as CMA...

CMA wants national children's health strategy.(Canadian Medical Association)
September 12, 2006... Published at www.cmaj.ca on August 22, 2006 The "epidemic" of child obesity and poor health among Aboriginal children are among compelling reasons for the federal government to commit to national health goals and targets, as well as a...

Clement: set wait-times or the courts will.(Tony Clement )(Brief article)
September 12, 2006... Published at www.cmaj.ca on August 22, 2006 Although establishing wait-time guarantees was quietly lifted from the Conservative government's list of five priorities in recent months, federal Health Minister Tony Clement told delegates to...

Advances and retreats on AIDS front.
September 12, 2006... Published at www.cmaj.ca on August 21, 2006 Sobering reports about drastically underutilized but proven HIV/AIDS prevention tools tempered good news at the XVI International AIDS Conference about increases in the number of people accessing...

MED-1: hospital on wheels.
September 12, 2006... Earlier this year, a New Orleans blogger noted on his Web site that a mobile hospital deployed to Mississippi last September to care for victims of Hurricane Katrina was now en route to New Orleans for Mardi Gras. "Does that mean they are...

West Nile virus still a threat.
September 12, 2006... It's tempting to conclude that the worst is over, that precautionary measures and the vicissitudes of fate and nature have somehow combined to reduce the health threat posed by the West Nile virus (WNV). But experts say the lower incidence...

Alberta doctors seek relief from oil patch boom.
September 12, 2006... It's boom time in the oil patch, which has traditionally meant a run on gold faucets and bidding wars for houses. This time around, the economic explosion prompted by rising world oil prices has led to a population boom--25 900 more people in...

Clinical trial registry.(Brief article)
September 12, 2006... Clinical trial registry: The World Health Organization has launched a campaign urging research institutions and pharmaceutical companies to voluntarily register 20 core elements of all clinical trials involving human beings. The data are...

JAMA tightens disclosure.(Journal of the American Medical Association )(Brief article)
September 12, 2006... JAMA tightens disclosure: Starting in January 2007, the Journal of the American Medical Association (JAMA) will tighten its financial conflict-of-interest policy, requiring authors to list all links in the acknowledgement section of...

Infectious disease tracking.(World Organization for Animal Health)(Brief article)
September 12, 2006... Infectious disease tracking: The United Nations Food and Agricultural Organization, the World Organization for Animal Health (OIE) and the World Health Organization launched a global early warning system for zoonotic diseases in late July in...

Global skin cancer rates.(Brief article)
September 12, 2006... Global skin cancer rates: Worldwide, up to 60 000 people die annually from malignant melanomas and other forms of skin cancer, according to the World Health Organization's first attempt to quantify the global health impact of excessive exposure...

Marijuana dispensaries.(Brief article)
September 12, 2006... Marijuana dispensaries: Cannabis dispensaries, such as compassion clubs, should feel comfortable doling out marijuana if a patient has a "confirmation of diagnosis" from a medical practitioner that he or she suffers from 1 of 25 specified...

Fitness to drive.(motor vehicle driving)
September 12, 2006... A popular guide for physicians on determination of medical fitness to drive is published by the Canadian Medical Association. In the updated seventh edition (available this fall), notable changes from the sixth edition (1) reflect the emergence...

Human T-cell lymphotropic virus type 1-associated adult T-cell leukemia/lymphoma in the Inuit people of Nunavut.
September 12, 2006... Case 1: A 55-year-old Inuit woman from Nunavut presented with a 2-week history of malaise, pain in the right upper abdominal quadrant and mild jaundice. She had a history of tuberculosis, Helicobacter pylori gastritis and peptic ulcer disease....

Online reporting of adverse reactions.(Health Canada online )(Brief article)
September 12, 2006... Physicians can now file adverse reaction reports with Health Canada online (at www.hc-sc.gc.ca/dhp-mps/medeff /report-declaration/index_e.html). The online system, launched in late July, makes it more convenient for health professionals and...

An unusual cause of gastrointestinal bleeding in a young girl.
September 12, 2006... A 12-year-old girl was referred to our gastroenterology unit for further examination after 2 self-limited episodes of upper gastrointestinal (GI) bleeding with hematemesis and melena. She had taken no medications at all during the month before...

Incidence and causes of severe neonatal hyperbilirubinemia in Canada.
September 12, 2006... Abstract Background: Severe hyperbilirubinemia is the most common cause of neonatal readmission to hospital in Canada even though, in the majority of cases, risk factors can be identified before discharge. Severe neonatal...

Predictors of driving cessation in mild-to-moderate dementia.
September 12, 2006... Abstract Background: Although physicians in most provinces are mandated to report patients whose driving ability is impaired by illness, little is known about dementia-related factors associated with driving cessation. The purpose of our...

Surveillance of severe neonatal hyperbilirubinemia: a view from south of the border.
September 12, 2006... In this issue of the CMAJ, Sgro and colleagues (1) report their identification, through the Canadian Paediatric Surveillance Program (CPSP), of 258 infants who had severe neonatal hyperbilirubinemia (total serum bilirubin level greater than 425...

Driving retirement: the role of the physician.(Column)
September 12, 2006... In the United States, licensed drivers over the age of 65 years today number more than 20 million--a figure that will increase substantially over the next few decades. (1) Certain age-associated conditions such as dementia will lessen the...

Understanding the health of indigenous peoples in Canada: key methodological and conceptual challenges.
September 12, 2006... Over the past year I have had the privilege of working with Metis elder and author Maria Campbell and 2 northern Saskatchewan communities on an oral history project. The project, "Kokum, what makes a baby well?" is designed to archive historic...

Health literacy: where are the Canadian doctors?(Public Health)
September 12, 2006... As a Canadian member of the US Institute of Medicine (IOM) Committee on Health Literacy, (1) I was impressed with the extent to which individual physicians and medical institutes have led the way in putting the issue of health literacy * on...

Natriuretic peptides in the diagnosis and management of heart failure.
September 12, 2006... Abstract The natriuretic peptides are a family of related hormones that play a crucial role in cardiovascular homeostasis. They have recently emerged as potentially important clinical markers in heart failure. Recent data have suggested an...

Patient safety deserves better response.(Letter to the editor)
September 12, 2006... In Wayne Kondro's article (1) about our report to Health Canada on governance for patient safety, (2) Ross Baker suggests that a national patient safety agency probably isn't feasible in Canada because jurisdiction over health care is...

End-of-life care in Canada.(Letter to the editor)
September 12, 2006... In their article about end-of-life care, Daren Heyland and associates (1) conclude that trusting, communicative relationships between physicians and seriously ill patients and family members are key to quality end-of-life care, but they offer...

Terri Schiavo: rest in peace.(Letter to the editor)
September 12, 2006... As Charles Weijer has pointed out, the case of Terri Schiavo involved a family conflict regarding end-of-life decisionmaking. (1) This irreconcilable conflict resulted in a series of judicial interventions that were a rerun, with some...

Corrections.(Correction notice)
September 12, 2006... In a news brief (1) about the new Canadian Cardiovascular Atlas, the online link is incorrectly stated. It should be www.ccort.ca. We apologize for any inconvenience this may have caused. REFERENCE (1.) Sibbald B. News @ a glance. CMAJ...

Microbes of the soul.(Hermann Hesse's The Glass Bead Game)(Critical essay)
September 12, 2006... "Hermann Hesse has carried on his battle against these microbes of the soul in the field of literature.... He shouts to all of us the motto of young Joseph Knecht in Das Glasperlenspiel[ The Glass Bead Game]: '... Advance, mount higher, conquer...

A heartbeat shared.
September 12, 2006... The professor guides my right hand onto the full-term abdomen, placing the obstetrical stethoscope diaphragm right over where he wants it. The earpieces press hard against the insides of my ears, hurting: I'm not yet used to wearing this...

Deaths.(Abdul Waheed Alvi, Salim Mansour Braick, Giovanni John Cardarelli)(Obituary)
September 12, 2006... Alvi, Abdul Waheed, Winnipeg; King Edward Medical College, University of Punjab, Pakistan, 1953, internal medicine. Died July 17, 2006, aged 76. "Abdul will be lovingly remembered by his beloved wife, Josephine, their 3 sons, John Amir (Anne)...

Query.(doctor's vacation)(Column)
September 12, 2006... My vacation starts in a day. One day. My vacation. It's only a week, but it's mine, all mine, and I'm taking it, and I'm not looking back. Plans? Just fishing with my daughter on the Saint John River. And swimming at the pool. And...

Finding the way--meeting the needs of adults with childhood-acquired illnesses/Trouver la voie--repondre aux besoins des adultes atteints de maladies d'origine infantile.(Editorial)
September 26, 2006... One of the great medical success stories of the last 25 years is the taming of many serious childhood diseases that previously killed children only a generation ago. Adults with cystic fibrosis (CF) were rare in the 1980s--yet now the median...

HIV/TB co-infections rising.(News)(Disease/Disorder overview)
September 26, 2006... You've got 100-year-old TB married to 25-year-old HIV and the honeymoon is causing havoc." That's how Kenyan activist Lucy Chesire described the impact when people are infected with both mycobacterium tuberculosis and the human...

Microbicide update.(News)(Bill and Melinda Gates Foundation funding for research)(Brief article)
September 26, 2006... The US$62-billion Bill and Melinda Gates Foundation has poured money into microbicide research, because a woman "should never need her partner's permission to save her own life," Bill Gates told the opening session of the XVIth International...

Canada falters on promise of AIDS drugs for Africa.(News)
September 26, 2006... Canada will immediately review the federal legislation intended to facilitate the timely production and export of affordable, life-saving drugs to the developing world, pledged federal Health Minister Tony Clement at the XVIth International...

"Damage control" surgery techniques used on soldiers.(News)
September 26, 2006... Surgical "damage control" techniques developed at US urban trauma centres to keep victims of multiple gunshot wounds alive are now being used to save the lives of soldiers injured in Iraq and Afghanistan. The military use of techniques...

UK needs 10 000 more therapists.(News)(treating mental illness)
September 26, 2006... One in 6 adults in the UK suffers from depression or chronic anxiety disorder, making mental illness the country's biggest social problem, reports the Centre for Economic Performance in London. "We are not talking about the 'worried well',"...

Changing family practice.(News)(Report)(Brief article)
September 26, 2006... Family physicians are providing less obstetrical care and inpatient care concludes a new study from the Canadian Institute for Health Information (CIHI). The Evolving Role of Canada's Fee-for-Service Family Physicians, 1994 to 2003 updates a...

Flu vaccine delays.(News @ a glance)(Brief article)
September 26, 2006... Flu vaccine delays: Production problems will delay delivery of the annual flu vaccine to provinces and territories by at least 1 month. The Public Health Agency of Canada is hopeful the vaccine will be available before the peak flu season,...

Limit pharmacist prescribing.(News @ a glance)(Brief article)
September 26, 2006... Limit pharmacist prescribing: Alberta's move to allow pharmacists limited prescribing authority (CMAJ 2006;175[5]:463-4) provoked a strong reaction from delegates to the CMA Annual Meeting, Aug. 23 in PEI. They overwhelmingly approved (93%:7%)...

No quick fix.(Association of Canadian Academic Healthcare Organizations)(Brief article)
September 26, 2006... No quick fix: The 2004 First Ministers Accord did not provide a "fix for a generation," report 67% of respondents to a survey of members in the Association of Canadian Academic Healthcare Organizations. The association of 40 teaching hospitals,...

Northern exposure.(survey of Northwestern Ontario physicians on their practice plans)(Survey)(Brief article)
September 26, 2006... Northern exposure: An Ontario Medical Association survey of Northwestern Ontario physicians and their spouses/partners indicates that nearly one-third of them plan to leave for less remote practices over the next 5 years. Some 18% of doctors...

Government health care outlays fall below OECD average.(Organisation for Economic Co-operation and Development nations)(Report)
September 26, 2006... Canadians have been asked to dig deeper into their own pockets to pay for private health insurance than their typical counterparts among other Organisation for Economic Co-operation and Development nations, according to the OECD's annual health...

How should developing countries manage diabetes?(Analysis)
September 26, 2006... In 2003, 194 million people 20 to 79 years of age had diabetes mellitus, almost three-quarters of them living in the developing world. By 2025 this number will have increased by 72%: 333 million cases are predicted, with a doubling of the...

Recurrent meningitis in a child due to an occult spinal lesion.(Teaching Case Report)(Case study)
September 26, 2006... The case: A 1-year-old girl presented to hospital with fever, lethargy and vomiting. She had had an episode of Escherichia coli meningitis at 2 months of age, which had been treated with antibiotics. No further investigation was conducted at...

Bowen disease.(Clinical Vistas Briefs)(Disease/Disorder overview)(Brief article)
September 26, 2006... Bowen disease is most commonly found in white patients over 60 years old. Other risk factors include chronic sun exposure, immunosuppression, arsenic exposure and cutaneous human papillomavirus (HPV) infection. HPV types 16, 18, 34 and 48 cause...

Gastroenteric duplication cyst.(Clinical Vistas Briefs)(Disease/Disorder overview)
September 26, 2006... The child was born in a rural hospital in Nigeria. His mother had an unremarkable pregnancy and normal vaginal delivery. She was well and reported taking only routine prenatal vitamins with folic acid and supplements of iron and vitamin B...

Atraumatic fracture of proximal first phalanx.(Clinical Vistas Briefs)(Disease/Disorder overview)(Brief article)
September 26, 2006... The patient was found to have a normal uric acid level but an elevated random glucose level (17 mmol/L, normal 3.9-6.1 mmol/L). Type 2 diabetes was diagnosed. The patient then admitted to a 7-year history of diabetes, with little treatment, and...

Highlights of the National Advisory Committee on immunization statement on influenza for the 2006-2007 season.(Public Health)
September 26, 2006... Although international avian influenza may be occupying media headlines and the minds of many Canadians, behind-the-scenes planning by the public health community and health care providers is underway for this year's seasonal visit of...

Proton pump inhibitor use and risk of community-acquired Clostridium difficile-associated disease defined by prescription for oral vancomycin therapy.(Research)(Clinical report)
September 26, 2006... Abstract Background: The association between the use of proton pump inhibitors and the risk of Clostridium difficile-associated disease (CDAD) is controversial. In this study we re-examined a previously reported association between the use...

The impact of physician training and experience on the survival of patients with active tuberculosis.(Research)
September 26, 2006... ABSTRACT Background: Physician training and experience may be important factors influencing treatment outcomes of patients with tuberculosis. We conducted an analysis to evaluate physician and patient characteristics and their association...

Proton pump inhibitors and the risk of Clostridium difficile-associated disease: further evidence from the community.(Commentary)
September 26, 2006... Clostridium difficile-associated disease (CDAD) is recognized as a major avoidable cause of morbidity and mortality among patients in hospital. Demographic changes and transfer of medical and surgical care into the community mean that the...

Physician experience, public health and the management of tuberculosis.(Critical essay)
September 26, 2006... In this issue Khan and colleagues provide evidence for the positive influence of physician experience (a medical proxy) and directly observed treatment (a public health proxy) on the survival of patients with active tuberculosis in Toronto. (1)...

Advancing interdisciplinary health research: a synergism not to be denied.
September 26, 2006... The test of a first-rate intelligence is the ability to hold two opposed ideas in mind at the same time and still retain the ability to function.--F. Scott Fitzgerald In this issue of CMAJ, a distinguished group of interdisciplinary health...

A meeting of minds: interdisciplinary research in the health sciences in Canada.
September 26, 2006... Absract Brought together by the newly formed Canadian Academy of Health Sciences (CAHS), recognized national leaders in the 6 health sciences disciplines consider the environment for conducting interdisciplinary health research (IDHR) in...

REAP: an extended agenda for the clinical interview.(Letter to the editor)
September 26, 2006... The value of skillful communication in reaching the correct diagnosis, providing high-quality medical care and nurturing the patient-physician relationship cannot be overestimated. (1) Communication starts with the medical interview. Physicians...

An economical cure.(Letter to the editor)
September 26, 2006... I am a retired physician whose left big toenail became heavily colonized by an unidentified fungus with resultant thickening, opacity and deformation. A respected dermatologist confirmed my diagnosis, but we decided not to initiate any...

Health benefits of physical activity.(Letter to the editor)
September 26, 2006... Darren Warburton and colleagues (1) have done a thorough job of presenting the evidence for the health benefits of physical exercise, but a cautionary note may be in order. Every book on exercise that I have seen carries the caveat that the...

Corrections.(Letters)(Correction notice)
September 26, 2006... In a recent review article, (1) a study was mistakenly listed in Appendix 1 as having been excluded from the authors' meta-analysis because of "acute diarrhea not associated with use of antibiotic therapy," when the true reason for exclusion...

Caution: elopement risk.(Room for a view)(personal freedom)(Viewpoint essay)
September 26, 2006... Our cat disappeared. He was an "indoor cat," morbidly obese, with clipped claws and, apparently, no sense of direction. He got out of the house when we weren't looking. When we chose our cat at the shelter, they told us that cats that...

Medicine and writing go well together, they shed light on each other and both do better going in hand in hand.(The Left Atrium)(Brief article)
September 26, 2006... Medicine and writing go well together, they shed light on each other and both do better going hand in hand. A doctor possessed of the writer's art will be the better consoler to anyone rolling in agony; conversely, a writer who understands the...

The stethoscope.(The Left Atrium)(Poem)
September 26, 2006... The stethoscope I walk into the room, The last in a long line of observers, Not knowing what I am to see. I hear him first. His breathing is heavy, laboured, So loud it almost drowns out The droning of the...

Desktop photos.(Notes)
September 26, 2006... The small photograph that sits alone on the office desk of a surgical colleague tells a life-saving story. Indicative of its importance to him, the photo has rested on his desk since the day he first occupied the office nearly a decade ago....

Rosie's dementia.(The Left Atrium)(Poem)
September 26, 2006... Rosie's dementia Damn you! Bring me some water. Leave me alone. I don't want you here. Heyyy--come here! Are you Sally? Where am I? Get out of here! Bring me some food. Who are you? ...

Deaths.(Robert Graydon Weir Goodall, William Raymond Keeler, Johan Kempff, )(Obituary)
September 26, 2006... Goodall, Robert Graydon Weir ("Gay"), Kingston, Ont.; McGill University, 1953. Died May 27, 2006, aged 81. "Survived by Helen, his wife of 53 years, children, Wendy Creech, Jamie and Rob and 7 grandchildren. Gay practiced general surgery at the...

Query.(physicians record keeping)(Column)
September 26, 2006... Once every two months it happens, and now it's my turn: I get to review the charts of one of my colleagues. Of course I think selfishly, not of the reviewee who has to submit to scrutiny. No, I think of myself, of how uncomfortable it is to...