CMAJ: Canadian Medical Association Journal articles from September 2008

CMAJ: Canadian Medical Association Journal archives from September 2008

Human papillomavirus vaccine risk and reality/Le vaccin contre le virus du papillome humain : risques et realites.(Editorial)
September 9, 2008... Loudly voiced concerns greeted Canada's school-based human papillomavirus (HPV) vaccine programs last year. This was particularly the case in Ontario, where vaccine uptake was only about 50%, a sharp contrast to over 80% uptake in Nova Scotia...

The human papillomavirus vaccine and risk of anaphylaxis.(Commentary)
September 9, 2008... In this issue of CMAJ, Brotherton and colleagues (1) report a comprehensive investigation revealing higher than expected rates of apparent anaphylaxis following vaccination with the quadrivalent human papillomavirus (HPV) vaccine in Australian...

Perpetration of violence against intimate partners: health care implications from global data.(Commentary)
September 9, 2008... Intimate partner violence is a widespread global phenomenon engendering serious health problems for women and children. (1-3) Consequently, there have been many recommendations to identify and intervene with victims in the health care system....

Fault/no fault, part 3: vested interests and the silence of suffering patients cited as obstacles to system change.(News)
September 9, 2008... James Kreppner was a 24-year-old Toronto law student when in 1985, he was infected with HIV through blood products. Seven years later, he issued a formal notice against the provincial Crown, indicating he would be launching a lawsuit for...

Veterans' health system blazing trails.(News)
September 9, 2008... In a country where mere whispers of socialized medicine conjure images of the Red Army marching in to take over hospitals, it is ideologically inconvenient that a system run by the United States government provides the best health care. ...

CMA adopts new governance structure: the following 3 pages feature articles on an array of medical and political issues that surfaced at the Canadian Medical Association's 141st General Council and annual general meeting held in Montreal, Quebec, Aug. 17-20, 2008.(News)(Canadian Medical Association)
September 9, 2008... The size of the Canadian Medical Association Board of Directors will be pared down from 34 to 25, while its core councils and committees will feature regional, rather than provincial, representation under governance reforms approved by...

Federal Health Minister assails ethics of InSite.(For the record at CMA General Council)
September 9, 2008... Doctors and other health professionals who support the Vancouver-based InSite safe injection site are unethical, says federal Health Minister Tony Clement. There are no ethical grounds for health care professionals to support sites where...

Inaugural address.(For the record at CMA General Council)(Brief article)
September 9, 2008... Patient-based funding, a universal prescription drug program and better pay for doctors were among remedies to the ailments of Canada's health care system recommended by radiologist Dr. Robert Ouellet in his inaugural address as the CMA's new...

Gender discrimination.(For the record at CMA General Council)(Brief article)
September 9, 2008... Gender discrimination against Canadian doctors and trainees stemming from patient pressure to apply practices "dictated by their religion on culture" should be prohibited, according to a CMA General Council resolution. "A worrisome...

President-elect puts patients first.(For the record at CMA General Council)(Brief article)
September 9, 2008... Canadian doctors must be the "authoritative voice" that speaks for patients, says Saskatchewan family physician and CMA President-elect Dr. Anne Doig. "Moreover, our voices must be loudest for those who cannot speak for themselves: our...

Mental health prejudices.(For the record at CMA General Council)(Brief article)
September 9, 2008... Doctors are at least as guilty of discriminating against people with mental illnesses as the general population, according to the chair of the Mental Health Commission of Canada. "One of the first targets for our anti-stigma campaign is...

Patient-based funding model endorsed.(For the record at CMA General Council)
September 9, 2008... The Canadian Medical Association has thrown its weight behind patient-based funding of the health care system. To that end, the association will develop a "blueprint and a timeline" for the transformation of the system to include...

AIDS treatment specialists take on prevention.(For the record)(Acquired immune deficiency syndrome)(Brief article)
September 9, 2008... The provision of treatment and prevention information about HIV/AIDS is being amalgamated and centralized as a result of a Public Health Agency of Canada initiative. The Canadian AIDS Treatment Information Exchange (CATIE, www .catie.ca),...

Smog-free Beijing?(For the record)(Brief article)
September 9, 2008... Rainy day blues proved to be a misnomer for smog-wary Olympic athletes in Beijing, China. Heavy rain on Aug. 10 washed away smog-laden air. The next day, particulate matter, a prime measure of pollution, had dropped by more than half,...

Medpedia.(Briefly)
September 9, 2008... Medpedia: Four of the world's most prestigious medical schools have banded together to help establish the most comprehensive online encyclopedia of medicine. To be called Medpedia and made freely available to all, the initiative proposes to be...

Island fever.(Briefly)(Brief article)
September 9, 2008... Island fever: Health officials in the South Pacific island nation of Niue have proposed banning smoking and the sale of tobacco in both public areas and private homes. They must still convince their government to enact legislation implementing...

HIV drug funding.(Briefly)(human immunodeficiency virus)(Brief article)
September 9, 2008... HIV drug funding: The international drug financing organization UNITAID is contributing $50 million to address mother-to-child transmission of HIV. It announced the funding on July 31, 2008, with its partners in the initiative: UNICEF and the...

Patient navigators.(Briefly)(Brief article)
September 9, 2008... Patient navigators: Alberta has dedicated $43 million to a "patient navigator" program to help people suffering from heart disease gain timely access to specialists. The province hired 11 patient navigators, who will help patients find...

Most Paralympians inspire, but others cheat.(News)
September 9, 2008... Paralympians are often described as inspirational, even heroic. But as the Paralympics has grown and become more competitive, some advantage-seeking athletes are following the lead of their less scrupulous able-bodied peers: that is, they...

Disabled athletes suffer unique injuries.(News)(Brief article)
September 9, 2008... Paralympians train just as hard as able-bodied athletes and get injured just as often. But the types of injuries and the rehab that these entail are different. Injuries also have a greater impact on everyday life for a Paralympian. ...

Anaphylaxis following quadrivalent human papillomavirus vaccination.(Research)(Clinical report)
September 9, 2008... Abstract Background: In 2007, Australia implemented the National human papillomavirus (HPV) Vaccination Program, which provides quadrivalent HPV vaccine free to all women aged 12-26 years. Following notification of 7 presumptive cases of...

Physical violence against intimate partners and related exposures to violence among South African men.(Research)(Survey)
September 9, 2008... ABSTRACT Background: Despite high rates of intimate partner violence in South Africa, there have been no national studies of men's perpetration of violence against female partners. Methods: We analyzed data from the South Africa Stress...

Asthma, outdoor air quality and the Olympic Games.
September 9, 2008... With the world's best athletes gathered in Beijing for the 2008 Olympic Games, the sport community is waiting to see what the impact of the environment and air quality might be on athletes' performance. Speculation by the media has painted an...

The "number needed to treat" turns 20--and continues to be used and misused.(Analysis)
September 9, 2008... In the 20 years since the initial description of the number needed to treat, (1) this method of expressing the efficacy of an intervention has become widely used. Indeed, the Consolidated Standards of Reporting Trials statement recommends that...

Chronic vulvocrural dermatitis with burning and itching.(What is your call?)(Case study)
September 9, 2008... [FIGURE 1 OMITTED] A 73-year-old woman presented with an 18-year history of an intermittent recalcitrant groin rash, vulvar burning and dyspareunia. The rash started on her right labia majora and had spread gradually over the entire vulva,...

Limiting production of crystal meth.(Letters)(Letter to the editor)
September 9, 2008... I read with interest the recent Public Health piece on methamphetamine hydrochloride (crystal meth). (1) Two subsequent articles on the same topic provided more details, but there were no comments on prevention programs or on limiting...

A question of ethics.(Letters)(Letter to the editor)
September 9, 2008... In his review of the pharmacologic mechanisms of methamphetamine hydrochloride (crystal meth), (1) Stephen Kish made no mention of the fact that the so-called research in one of the articles he cited (2) was conducted at a military hospital in...

An act of remembering.
September 9, 2008... Something Happened Drawings by Jane Martin Exhibited at The Red Head Gallery, an artist's cooperative, Toronto, Ontario June 4-28, 2008 Artist Jane Martin's husband began to have difficulty speaking and remembering around...

Sweet dreams.(Book review)
September 9, 2008... Combating Sleep Disorders Kathy Sexton-Radek and Gina Graci Praeger Publishers; 2008 152 pp $34.95 ISBN 978-0-275-98973-6 Had I been able to read Combating Sleep Disorders 25 years ago I might have enjoyed more and better...

On listening.(Essay)
September 9, 2008... I have nothing to live for." Helen spoke softly. A bright and articulate woman at 86, this was the first time in 20 years that I had heard these words from her. She suffered from chronic osteoarthritic pain in her joints, and fatigue and...

Imperfect knowledge.(Poem)
September 9, 2008... Imperfect knowledge My toes wriggled, skeletal within new shoes-- big toe, little ones-- as x-rays passed through me, no worry of roentgens or rads. I stepped off the pedestal, laughed, and the shoe salesman...

The thinker's sign.(Clinical Images)
September 9, 2008... [FIGURE 1 OMITTED] This patient presented with tachypnea and use of the inspiratory accessory muscles. Chest auscultation revealed diffusely decreased air entry bilaterally and early inspiratory rales. A chest radiograph showed...

Grandma-forgets-to-take-her-meds disease.(Salon)
September 9, 2008... It's hard to develop a good conspiracy theory these days--that is, one that isn't too wacko. But here's one to test drive, one involving drug companies, retail drug stores and the investors, builders and operators of long-term care housing for...

Understanding and improving on 1 problem per visit/Comprendre et ameliorer la politique d'<<un seul probleme par consultation>>.(Editorial)(Report)
September 23, 2008... The sign in the family doctor's office reads: "One problem per visit please." Although such notices are not pervasive, they illustrate the need for balance in Canada's primary health care system between productivity, funding capacity and, last...

Statins and postoperative delirium.(Commentary)(Clinical report)
September 23, 2008... Delirium (acute confusional state) may be the most common postoperative complication in elderly people. It is associated with substantial morbidity, mortality and cost. (1) Two decades ago, the prevalent belief was that it was normal for older...

Unravelling the contributions of social, environmental and genetic factors to health differences.(Commentary)(Report)
September 23, 2008... Today researchers seek to unravel the factors leading to the differences in health seen between people of different racial and ethnic backgrounds. But how do we explore all of the factors that may be involved without overstating any single one?...

Disparities in the care of chest pain.(Commentary)(Clinical report)
September 23, 2008... Improving medical care for patients with chest pain is an intimidating task because of the complexity of the systems used to deliver care. Each step in the delivery of care can be seen as a potential mishap. To improve quality of care, each...

Clinical trials regulation--how Canada compares.(News)
September 23, 2008... When a 48-year-old man with no history of cardiac problems suffers 2 heart attacks and dies during a testing of a new drug, it is axiomatic that concerns will resurface about the safety of clinical trials. To clear his debts, Peter Munro, a...

Moratorium urged for foreign visa trainees.(News)
September 23, 2008... At a time when Canada has a shortage of doctors, and qualified Canadian and international medical graduates are waiting in the wings to be certified, concerns are being raised about the number of foreign visa trainees in Canadian residency...

National organ allocation mechanism to be sought.(For the record)
September 23, 2008... It is, to be sure, a bold claim. But the head of the nation's blood program says the days of incoherence in Canada's myriad organ donation programs are entirely numbered. Canadian Blood Services Chief Executive Officer Dr. Graham Sher says...

Air pollution death toll to soar.(News)(Brief article)
September 23, 2008... Canadians might want to consider wearing masks as they move about their daily chores after a Canadian Medical Association study indicated that 21 000 citizens will die this year as a result of the effects of air pollution. That will rise...

Diagnostic imaging.(Briefly)(demand for medical imaging professionals )(Brief article)
September 23, 2008... Diagnostic imaging: There's been significant growth in the number of magnetic resonance imaging (MRI) and computed tomography (CT) scanners in Canada over the past 4 years but the number of medical imaging professionals has remained relatively...

Revalidation.(Briefly)(physician competence)(Brief article)
September 23, 2008... Revalidation: In a bid to raise the practice bar, the Chief Medical Officer for England Sir Liam Donaldson has unveiled a new regulatory system (www.dh.gov/uk) that will obligate the United Kingdom's 150 000 doctors to face mandatory annual...

Shorter stays.(Briefly)(hospital confinement for mentally ill)(Brief article)
September 23, 2008... Shorter stays: Patients with mental illnesses admitted to a general hospital typically spent just 16.4 days in the facility in fiscal year 2005/06 before being discharged, as compared to 36.2 days in fiscal year 2000/01, according to the...

Europeans claim industry handouts are not a problem.(News)
September 23, 2008... Although warm-climate holiday junkets thinly disguised as medical conferences are not uncommon for doctors in Europe, the pharmaceutical industry is nowhere near as aggressive overseas in seeking to influence the therapeutic decisions of...

Industry handouts to be re-examined.(News)
September 23, 2008... Canadian medical school administrators may be inching toward the development of some form of guidelines governing pharmaceutical and medical devices industry handouts for undergraduate, postgraduate and continuing medical education. The...

Complaints rise but legal actions decline.(News)
September 23, 2008... Canadian doctors are now far less likely to be named in legal actions, but more likely to face complaints lodged with their provincial regulatory colleges, compared to 10 years ago, according to the Canadian Medical Protective Association. ...

Medicine and sorcery in the Republic of Congo.(Dispatch from the medical front)
September 23, 2008... It began with frantic cries from several of the staff. A pickup truck entered the gates of Kindamba Hospital and dropped off a patient. Staff presumed it was the first victim of a rumoured internecine war among the district's Ninja rebels. ...

Delirium after elective surgery among elderly patients taking statins.(Research)
September 23, 2008... Abstract Background: Postoperative delirium after elective surgery is frequent and potentially serious. We sought to determine whether the use of statin medications was associated with a higher risk of postoperative delirium than other...

A population-based analysis of the health experience of African Nova Scotians.(Research)
September 23, 2008... Abstract Background: People of African descent living in Britain and the United States have higher rates of morbidity from chronic disease than among the general population. We investigated whether the same applied to people of African...

Presentation of stable angina pectoris among women and South Asian people.(Research)
September 23, 2008... Abstract Background: There is speculation that women and South Asian people are more likely than men and white people to report atypical angina and that they are less likely to undergo invasive management of angina. We sought to determine...

Exaggeration of treatment benefits using the "event-based" number needed to treat.(Analysis)
September 23, 2008... Recently, several articles have been published that advocate an alternative method for calculating the number needed to treat to assess the effects of medications in clinical trials. (1,2) This new method, which gives an "event-based" number...

Cobblestone-like skin.(WHAT IS YOUR CALL?)(Case study)
September 23, 2008... A 70-year-old man with obesity, hypertension and congestive heart failure presented with a fever of 4-days' duration and pain in both his anterior shins. He had progressive chronic lymphedema of the lower extremities for the last 5 years. The...

Methamphetamine strategy requires evaluation.(Letters)
September 23, 2008... We read with interest about the strategy recently developed in the York Region of Toronto to curb methamphetamine use, which is based on Vancouver's 4-pillar drug strategy. (1) We recently reported that more than 70% of Vancouver's...

TASER safety.(Letters)
September 23, 2008... We are members of the TASER International Scientific and Medical Advisory Board and would like to comment on the review by Nanthakumar and colleagues. (1) This review focused on porcine studies; it ignored the 30 papers and abstracts that have...

Corrections.(Letters)(Correction notice)
September 23, 2008... A news item about neglected diseases research in the Aug. 12, 2008, issue should have stated that the Drugs for Neglected Diseases Initiative has raised US$118 million for its research program. (1) REFERENCE (1.) Silversides, A. For...

Muhibullah.(Room for a view)
September 23, 2008... Few things on earth move faster than 4 stretcher bearers with a badly injured patient. First you hear the helicopter approaching, and then you feel the whirling and thumping in your chest. The Blackhawks whump down nimbly 180 metres from the...

Of buffoons and scamps: the struggle for medical licensure.(Book review)
September 23, 2008... Licentiate to Heal: A History of the Medical Council of Canada Christy Vodden The Medical Council of Canada; 2008 94 pp $5.00 ISBN 978-0-9690161-8-2 [ILLUSTRATION OMITTED] The Medical Council of Canada has maintained a...

Who killed the Queen? A public health murder mystery.(Book review)
September 23, 2008... Who Killed the Queen? The Story of Community Hospital and How to Fix Public Health Care Holly Dressel McGill-Queen's University Press; 2008 502 pp $39.95 ISBN 978 077 353 34 00 [ILLUSTRATION OMITTED] It is always a...

Granulocytic sarcoma of the skin.(Clinical images)(Brief article)
September 23, 2008... [FIGURE 1 OMITTED] An 89-year-old woman with refractory anemia presented with a painful neck mass that measured 5 cm x 3 cm (Figure 1A). Her peripheral leukocyte count was (118 x [10.sup.9]/L), with 98% immature blood cells. A biopsy of...

Physician advocacy essential for Canada's First Nations.(Salon)
September 23, 2008... The Government of Canada recently apologized to our First Nations' people for its residential school policy, which effectively suppressed the linguistic, cultural and spiritual practices of their pupils, with the ultimate aim of assimilation....