Editors’ Blog

The March 3rd issue summary podcast is presented by Dr. Kirsten Patrick, deputy editor, and Dr. Domhnall MacAuley, associate editor.

Dr. Patrick and Dr. MacAuley discuss the following:

  • Seasonal variation of nocturnal leg cramps
  • Concerns over the use of quinine to treat leg cramps
  • Quality indicators of pharmacotherapy
  • Dangers of trimethoprim-sulfamethoxazole co-prescribed with spironolactone
  • IV immunoglobulin as therapy
  • Human myiasis in Canada
  • Use of primary care EMR data for research
  • What's happening on CMAJ Blogs

And more...

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Interview with , addiction medicine specialist and family physician at Women's College Hospital in Toronto who co-authored a commentary published in CMAJ. Spithoff and Dr. Suzanne Turner say the Canadian health care system provides inadequate access to effective treatment for at-risk drinking and alcohol use disorders. However, improved physician training, combined with strategies to ensure better access to appropriate treatment, would improve health outcomes and generate cost savings for the health system.

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is Deputy Editor at CMAJ

 

Today, February 27th 2015, marks the tenth anniversary of the coming into force of the (). To mark the historic treaty's first decade the WHO's Director-General, , gave in which she called the FCTC the 'single most powerful preventive instrument available to public health'. She wasn't exaggerating. I'll tell you why.

The FCTC was the first, and remains the only, legally binding multilateral agreement ratified by WHO member states. Most of WHO's directives are delivered with the all the authority of a global governance institution but with none of the legal teeth that multilateral trade agreements, for example, enjoy. ...continue reading

This week:

Interview with , interventional cardiologist at Sunnybrook Health Sciences Centre in Toronto and senior scientist with the Institute of Clinical Evaluative Sciences. Dr. Ko and colleagues found that patients discharged after an emergency department visit for chest pain were less likely to be seen within 30 days by a primary care physician or cardiologist if they had known cardiac or cerebrovascular conditions, as well as other comorbidities. The paradoxical finding that patients at higher risk for adverse events were less likely to receive follow-up suggests the need for a better strategy to improve transition of care in this context.

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The February 17th issue summary podcast is presented by Dr. Kirsten Patrick, deputy editor, and Dr. Matthew Stanbrook, deputy editor.

Dr. Patrick and Dr. Stanbrook discuss the following:

  • Adverse outcomes among patients co-prescribed clarithromycin and statins
  • Cost-effectiveness of screening for hepatitis C
  • Sofosbuvir to treat hepatitis C
  • Unsanctioned travel restrictions related to Ebola
  • Caring for Aboriginal patients
  • Lung-protective ventilation
  • Alicia Priest (1953-2015) on living with ALS

And more...

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This week:

Interview with Dr. Raza Naqvi, assistant professor of geriatrics at Western University. In their systematic review and meta-analysis published in CMAJ, Dr. Naqvi and colleagues found that the RUDAS, a brief and freely available tool, compares well with standard tools assessing cognitive deficits. It was developed for particular use among patients whose first language is not English, which makes it useful in settings where patient groups are diverse.

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is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK, recently returned from attending in Ottawa.

 

Myth busters could be a regular session at any medical conference. But sports medicine seems particularly susceptible to suggestion, quackery or placebo as everyone looks for an easy answer. took us on an entertaining trip around the dubious evidence base surrounding interventions such as functional movement prediction of injury; managing muscle soreness; glucosamine and chondroitin; ice baths in recovery and many others. I was delighted to hear praise for my colleague ’s work. And, indeed, mention of the .

Should my child play contact sports? It is a question asked by many parents following the discussions about trauma in professional sport. outlined many of the arguments, focusing on the short and long term risks associated with concussion. My view of Delaney's talk is that the evidence is unclear- and it can be difficult, even for you as the doctor, to be objective. ...continue reading

is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. This week he is attending the in Ottawa.

 

Edu-tainment is how we need engage audiences, according to , chair of the opening session of the CASEM-OMA 2015 meeting in Ottawa. And what a superb opening session. and introduced their five key sports medicine papers and debates of the last year. From a CMAJ perspective, it was great to hear Ian cite on arthroscopic surgery for degenerative tears of the meniscus as a key paper. He made a very important point that the outcome was the minimally important difference to patients. The authors had used the average but, looking at the minimally important difference distribution, this may not be entirely reflective, and some people may have had a benefit in the short term although, in the long term, there was no effect.

Concussion is a major issue and Pierre reminded us of a paper emphasising that concussion should include cervicovestibular evaluation ...continue reading

is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

Concussion is in the news again. In the first of the Six Nations Championship matches, George North of Wales suffered two blows to the head during the game against England. Peter Robinson, whose son Ben died in 2011 at age 14 after a schools match in Northern Ireland, was quoted in the “We are using these players as guinea pigs. I thought Ben’s death was the tipping point when they realised they had to do something, but I don’t think anything drastic will happen until there is a tragedy involving a famous star live on TV. We need a culture change.” Since the weekend, the medics, the coaching team, the concussion protocols and the rugby hierarchy have all been criticized. ...continue reading

This week's author interviews:

Interview with Dr. Christopher Parshuram, critical care specialist with the Hospital for Sick Children in Toronto. He is the lead author of a randomized trial published in CMAJ looking at patient safety, resident well-being and continuity of care for three resident duty schedules in the ICU. Work schedules incorporating shorter periods of continuous duty affected neither doctors' daytime sleepiness nor adverse outcomes in patients.

Interview with Dr. Thomas Maniatis, internal medicine training program director and clinical ethicist at McGill. Dr. Maniatis is the author of a commentary published in CMAJ. He argues that resident duty-hour reform must be further evaluated in order to design systems that provide maximal benefit and minimal harms for all involved.

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