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


*   © 2007 Canadian Medical Association

**Perceptions of medically futile care in the intensive care unit** 

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/177/10/1161.1/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/177/10/1161.1/F1)

Photo by: Mediscan/Corbis

Based on comments from semi-structured interviews with 44 senior health care providers in 16 intensive care units across Ontario, Sibbald and colleagues have formed a working definition of medically futile care, discerned reasons why such care is provided and described current strategies used to limit futile care.

**See page** [1201](http://www.cmaj.ca/lookup/volpage/177/1201?iss=10)

**Deep vein thrombosis and peripherally inserted central catheters** 

In this prospective study of 214 children and adolescents receiving a peripherally inserted central catheter, Dubois and colleagues found the incidence of catheter-associated deep vein thrombosis to be 9.3%, which is lower than the incidence described with centrally inserted venous catheters in pediatric populations.

**See page [1185](http://www.cmaj.ca/lookup/volpage/177/1185?iss=10)** 

**Differences in outcomes of emergency department care between men and women with coronary syndromes** 

In this retrospective cohort study involving 54 134 patients presenting to an emergency department with coronary syndromes, Kaul and colleagues found that women were less likely than men to be admitted to hospital and to receive coronary revascularization procedures within 1 year. However, women did not have worse outcomes in terms of 1-year mortality.

**See page** [1193](http://www.cmaj.ca/lookup/volpage/177/1193?iss=10)

**Noninvasive positive-pressure ventilation** 

In this narrative review, Peñuelas and colleagues describe the techniques and interfaces used for noninvasive positive-pressure ventilation. The indications, outcomes and contraindications for this technique are also discussed.

**See page** [1211](http://www.cmaj.ca/lookup/volpage/177/1211?iss=10)

**A guide to the** ***CMA Handbook on Clinical Practice Guidelines***

In a commentary, Palda and colleagues describe the Canadian Medical Association's recently published handbook on the effective use of guidelines for improving patient care. Topics covered in the handbook include methods for addressing bias, grading systems for rating evidence and strategies for implementation.

**See page** [1221](http://www.cmaj.ca/lookup/volpage/177/1221?iss=10)

**A new Canadian guideline for radon exposure** 

Radon is the second leading cause of lung cancer. In this Public Health commentary, Copes and Scott describe Health Canada's new lower guideline for acceptable indoor radon levels and recommend measures to ensure that the new guideline results in action.

**See page** [1229](http://www.cmaj.ca/lookup/volpage/177/1229?iss=10)

**Practice** 

![Figure2](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/177/10/1161.1/F2.medium.gif)

[Figure2](http://www.cmaj.ca/content/177/10/1161.1/F2)

In this teaching case report, Bruno and Donoff describe a case of **superior vena cava syndrome and telangiectasia** in a man with lymphoma (page [1177](http://www.cmaj.ca/lookup/volpage/177/1177?iss=10)).

In Clinical Vistas, Buffo-Sequeira and Fraser describe a case of **widened mediastinum** in a young child after severe trauma and discuss the challenges of excluding aortic injury in young trauma patients (page [1181](http://www.cmaj.ca/lookup/volpage/177/1181?iss=10)).