Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Physicians & Subscribers
    • Benefits for Canadian physicians
    • CPD Credits for CMA Members
    • Subscribe to CMAJ Print
    • Subscription prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Physicians & Subscribers
    • Benefits for Canadian physicians
    • CPD Credits for CMA Members
    • Subscribe to CMAJ Print
    • Subscription prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Instagram
  • Listen to CMAJ podcasts
Highlights of this issue

Highlights of this issue

CMAJ May 30, 2000 162 (11) 1549;
  • Article
  • Responses
  • Metrics
Loading

The 5 Rs of acute stroke care

Between April 1996 and January 1999, 69 patients with acute ischemic stroke received intravenously administered tissue plasminogen activator (tPA) through the Calgary Regional Stroke Program. Over 1 year, only 6% of the patients admitted with stroke were given tPA; the main reasons for not treating more patients were thought to be a delay in arrival at hospital and difficulty establishing the time of symptom onset. Michael Hill and colleagues outline the essential 5 Rs of acute stroke care — recognition, reaction, response, reveal and reperfusion — and report on the barriers, outcomes and lessons learned during the first 3 years of the program. They emphasize the need for public education about the symptoms of stroke.

See page 1589

Are adolescents competent?

Should adolescents be given the authority to make health care decisions? Christopher Doig and Ellen Burgess review the arguments, including the idea of "proportionality,” which states the more serious the health outcome, the higher the level of competency required. The authors identify a clear ethical and legal foundation for permitting competent adolescents to decide whether they will accept life-sustaining medical treatment.

See page 1585

Chest pain and cardiac markers

Eugene Dagnone and colleagues conducted a randomized controlled trial involving 296 patients with chest pain and a nondiagnostic electrocardiogram to investigate whether the addition of 2 new cardiac markers (baseline cardiac troponin I and myoglobin and 2-hour myoglobin) to the standard panel (baseline creatine kinase [CK] and CK MB fraction) would result in improved clinical decisions in the emergency department. They found no difference in the length of stay in the emergency department between patients randomly assigned to have the standard panel of cardiac markers and those assigned the enhanced panel. Fewer patients in the latter group were admitted to the cardiology service (46% v. 54%), but the difference was not significant (8.1%, 95% confidence interval ‐3.3 to 19.5). At 30 days the proportions of patients with a diagnosis of recurrent angina or an acute myocardial infarction were similar in the 2 groups. The authors conclude that the additional markers did not substantially change clinical management.

See page 1561

Folate status at first prenatal visit

It is well known that the intake of folate and multivitamins in the periconceptional period reduces the risk of several congenital anomalies. James House and colleagues measured serum and red blood cell (RBC) folate levels in 1424 women in Newfoundland at their first prenatal visit. According to the serum levels less than 4% of the women had deficient or indeterminate folate levels; however, the RBC levels, which may be more reflective of the time of neural tube closure, indicated that 24% had deficient or indeterminate levels. In an accompanying commentary Judith Hall laments the opportunity many of us miss by failing to take daily supplements of folic acid.

See pages 1557 and 1571

Ticks on the wing

The blacklegged tick Ixodes scapularis is a principal vector of Borrelia burgdorferi, the spirochete that causes Lyme disease. Satyendra Banerjee and colleagues report that, of 139 I. scapularis ticks collected from Ontario dogs between 1997 and 1998, 9 were carrying B. burgdorferi. Some of the dogs were in areas where the tick species is not endemic. In an accompanying commentary Ian Barker and Robbin Lindsay explain that these were likely ”adventitious” ticks that arrived in immature stages on birds migrating from endemic areas and that their density in the environment is quite low.

See pages 1567 and 1573

Figure

Figure.

Figure

Figure.

Figure

Figure.

PreviousNext
Back to top

In this issue

CMAJ
Vol. 162, Issue 11
30 May 2000
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Highlights of this issue
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Highlights of this issue
CMAJ May 2000, 162 (11) 1549;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Highlights of this issue
CMAJ May 2000, 162 (11) 1549;
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
    • The 5 Rs of acute stroke care
    • Are adolescents competent?
    • Chest pain and cardiac markers
    • Folate status at first prenatal visit
    • Ticks on the wing
  • Responses
  • Metrics

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Highlights
  • Highlights
  • Highlights of this issue
Show more Highlights of this Issue

Similar Articles

 

View Latest Classified Ads

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • CPD credits
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Advisory Panels
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions
CMAJ Group

Copyright 2023, CMA Impact Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: [email protected]

CMA Civility, Accessibility, Privacy

 

Powered by HighWire