Highlights of this issue
========================


**Comparison of 2 personal protective systems** 

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/175/3/229.1/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/175/3/229.1/F1)

Figure. 

The emergence of new pathogens such as SARS and avian influenza virus has focused attention on infection-control practices for health care workers. In this comparison of the efficacies of enhanced respiratory and contact precautions (E-RCP) and body suits that incorporate a powered air-purifying respirator, Zamora and colleagues found that the skin and inner clothing of participants in the latter group were less likely to be contaminated. In a related commentary, Conly reviews the experience of the SARS outbreak and the importance of infection-control techniques.

**See pages** [249](http://www.cmaj.ca/lookup/volpage/175/249) **and** [263](http://www.cmaj.ca/lookup/volpage/175/263)

**How early does nicotine dependence start?** 

The natural course of cigarette use has traditionally been thought to progress through 5 stages, ending with nicotine-dependent smoking. Gervais and colleagues describe the sequence and timing of 12 milestones (6 related to cigarette use and 6 to symptoms of nicotine dependence) among grade 7 students. They found that symptoms of nicotine dependence can manifest long before regular smoking, even after the first puff in some cases. In a related commentary, Klein discusses the challenges in helping young smokers quit and the need for stronger public health efforts to keep youth from starting.

**See pages** [255](http://www.cmaj.ca/lookup/volpage/175/255) **and** [262](http://www.cmaj.ca/lookup/volpage/175/262)

**Managing neuropathic pain in primary care** 

Neuropathic pain, caused by various nerve disorders, is difficult to control and is personally devastating to the people who have it. Gilron and colleagues review the clinical presentation, pathophysiology and current treatments available. They also provide a practical approach to the management of neuropathic pain in primary care.

**See page** [265](http://www.cmaj.ca/lookup/volpage/175/265)

**Analysis • Practice** 

Hyperthyroidism and thyroiditis can be accompanied by disorders of the extraocular muscle and orbital connective tissue, collectively referred to as **thyroid-associated ophthalmopathy** (TAO). Tani and Wall discuss current theories about why TAO is associated with thyroid autoimmunity, and suggest how eye-muscle antigens could be involved (page [239](http://www.cmaj.ca/lookup/volpage/175/239)).

Singh and colleagues describe a case of **hereditary hemorrhagic telangectasia** (page [242](http://www.cmaj.ca/lookup/volpage/175/242)).

![Figure2](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/175/3/229.1/F2.medium.gif)

[Figure2](http://www.cmaj.ca/content/175/3/229.1/F2)

Figure. 

Clinical Vistas reviews the case of a man with **severe blistering and edema**; describes how computed tomography was used to diagnose an unusual problem in a man with **fever and acute pain** in his left lower abdomen; and discusses an **anatomic phenomenon** in an apparently healthy teenager (page [244](http://www.cmaj.ca/lookup/volpage/175/244)).

![Figure3](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/175/3/229.1/F3.medium.gif)

[Figure3](http://www.cmaj.ca/content/175/3/229.1/F3)

Figure. Photo by: CDC/WHO

Leslie and colleagues describe the emergence of **visceral leishmaniasis** in Afghanistan (page [245](http://www.cmaj.ca/lookup/volpage/175/245)).