- © 2004 Canadian Medical Association or its licensors
Aboriginal health
Some health problems, such as end-stage renal disease (ESRD) and poor birth outcome, are more frequent among Aboriginal people in Canada. Tonelli and colleagues investigated the survival and renal transplantation rates among Aboriginal patients with ESRD after initiation of dialysis. Their analysis reveals that the survival of Aboriginal and white patients with ESDR was similar, but Aboriginal people were less than half as likely to receive renal transplants.
See page 577
Wenman and colleagues report on their prospective study of the prenatal risk factors and birth outcomes among Aboriginal women in Edmonton and compare them with those among non-Aboriginal women. Smoking during pregnancy, poor nutrition, a previous premature infant and bacterial vaginosis were more frequent among Aboriginal women, but after adjusting for potential confounding factors, there was no statistically significant relation between Aboriginal status and birth outcome.
See page 585
In his commentary on health outcomes in Aboriginal populations, Cass emphasizes that low socioeconomic status, health-damaging behaviour and the presence of comorbid illnesses, which are increasingly present among Aboriginal people, seem to be risk factors for poorer health outcomes, rather than “Aboriginality” itself.
See page 597
Nasal sprays and thunderclap headache
A severe headache with sudden onset is called thunderclap headache, and Loewen and colleagues describe a patient who experienced one immediately after using a nasal spray that contains oxymetazoline. They recommend that patients presenting with thunderclap headache should be asked about their use of nasal decongestants.
See page 593
Confidence intervals: What do they tell us?
The confidence interval (CI) is the second topic in our series of tips for learners of evidence-based medicine. Montori and colleagues offer useful tips on how to make the calculation of CIs intuitive, how to interpret them and how to estimate them for extreme proportions.
See page 611
ICMJE statement on clinical trial registration
In a new policy to become effective during 2005, the member journals of the International Committee of Medical Journal Editors (ICMJE) will require registration of clinical trials in a public trials registry before considering the results of those trials for publication. The ICMJE has stated that there must be “full transparency with respect to performance and reporting of clinical trials”; requiring trial registration will advance this goal.
See page 606
In Synopsis
In the tradition of narrative medicine, Bayoumi and colleagues, in Practice, advocate presenting case reports as the story of the patient's experience of illness and the doctor's story of diagnosis and treatment (see page 569). In Clinical Vistas, Tan and colleagues describe a case of a man with fibrosing mediastinitis as a rare and late complication of Histoplasma capsulatum infection (see page 573).