Malnutrition
Rates of malnutrition worldwide show no sign of decreasing. Pulfrey reviews the challenges of addressing this global public health problem.
See page 1837
Pulmonary hypertension following ibuprofen administration in a preterm infant
Patent ductus arteriosus (PDA) is one of the most common congenital abnormalities found in premature infants, and ibuprofen is used to induce PDA closure. Bellini and colleagues report a case of pulmonary hypertension in a preterm infant following ibuprofen therapy. In a related commentary, Lee reviews the measures needed by patients, doctors and regulatory bodies to respond to adverse reactions when new drugs are put on the market.
Self-managed oral anticoagulation therapy
Patient self-management of long-term oral anticoagulation therapy is an effective strategy in a number of clinical situations, but it is currently not a funded option in the Canadian health care system. Regier and colleagues compared the incremental cost and health benefits of self-management with those of physician management from the perspective of the Canadian health care payer over a 5-year period. Their findings suggest that self-management is a cost-effective strategy for those receiving continuing oral anticoagulation therapy.
See page 1847
CPGs — Who is right?
Clinical practice guidelines have great influence in treatment decisions, yet the various groups developing them may work under different mandates, resulting in different recommendations. Johnson and Edwards comment on recent debate on diabetes management, and call on influential groups to work within a common strategy.">Clinical practice guidelines have great influence in treatment decisions, yet the various groups developing them may work under different mandates, resulting in different recommendations. Johnson and Edwards comment on recent debate on diabetes management, and call on influential groups to work within a common strategy.
See page 1856
Reducing the risk of SIDS
Sudden infant death syndrome (SIDS) is still the leading cause of postneonatal infant death in Canada and many other countries. Hunt and Hauck review the pathophysiology and epidemiology of SIDS as well as the interactions between environmental and genetic risk factors. They also discuss recent guidelines for reducing exposure to modifiable risk factors.">Sudden infant death syndrome (SIDS) is still the leading cause of postneonatal infant death in Canada and many other countries. Hunt and Hauck review the pathophysiology and epidemiology of SIDS as well as the interactions between environmental and genetic risk factors. They also discuss recent guidelines for reducing exposure to modifiable risk factors.
See page 1861
Analysis • Practice
People with cardiac syndrome X have symptoms and signs suggestive of myocardial ischemia, but their arteries appear normal on coronary angiography. Arroyo-Espliguero and Kaski explore possible causes, including the role of inflammation (page 1833).
Buprenorphine should soon be available in Canada as an additional treatment option to methadone. Srivastava and Kahan provide a practical guide to its use (page 1835).
A case report of a 21-year-old man with myocardial infarction complicating Kawasaki disease provides background to a review of the typical clinical presentation of this childhood disease and its long-term cardiac complications (page 1839).