Highlights of this issue

Delays in reperfusion therapy for myocardial infarction

Huynh and coauthors report the findings of the AMI-QUEBEC study, which looked at delays in providing reperfusion therapy for ST-segment elevation acute myocardial infarction (STEMI) to patients admitted to 17 hospitals in Québec in 2003. They also identify factors associated with the failure to deliver reperfusion therapy within current recommended times.

See page 1527

Do restrictive drug policies and COX-2 inhibitors make a good mix?

Rates of upper gastrointestinal (GI) bleeding have reportedly increased after the introduction and rapid uptake of selective cyclooxygenase-2 (COX-2) inhibitors. Mamdani and coauthors compared changes in COX-2 inhibitor use and upper GI bleeding rates in British Columbia, which restricts the use of these drugs, and Ontario, which has a less restrictive drug coverage policy. Their findings suggest that a more restrictive drug coverage policy, although limiting access to drugs and their potential benefits, may protect the population from adverse drug effects.

See page 1535

Can the Stanley Cup playoffs harm your hearing?

Hodgetts and Liu report how “leisure noise” over a period of just a few hours may be harmful to hearing unless precautions are taken. Data from a Stanley Cup playoff game are used as an example.

See page 1541

Neuropsychiatric complications in Parkinson's disease

About 100 000 Canadians have Parkinson's disease, and at some point in the course of their illness more than 60% of them will experience one or more psychiatric complications, including mood and anxiety disorders, psychosis, cognitive impairment and dementia, and sleep disorders. Ferreri and coauthors review the primary care approach to the recognition, management and prevention of neuropsychiatric disorders in patients with Parkinson's disease.

See page 1545

Analysis • Practice

The US Institute of Medicine's recent report on drug safety recommends tougher legislation to mitigate the estimated 1.5 million preventable adverse drug events each year in that country, and may influence Canada's efforts to improve drug safety (page 1515).

Torrecillas and coauthors summarize useful approaches to the introduction of digital photography into the family physician's office (page 1519).

In Public Health, Courtemanche and Peterson give advice on treating patients who have unintentionally ingested common Christmas plants (page 1523).

Holiday Review

Authors take Auscultations (page 1557) of the ethics of applying muggle medicine to wizard patients from the Harry Potter chronicles, while another pondering pundit explores whether wealth and health are affected if one is early to bed and early to rise (page 1560). Holiday Waistline (page 1563) looks at weighty issues such as Santa's jolly quotient in the face of obesity, the presence of a dessert pouch and the effect of the stomach on decision-making during conferences. In other words (page 1572) there is lots to feast on here, including a look at the propensity for creating acronyms, the allure of married men and a poetic missive on pharmaceuticals. And for those last-minute gifts, thumb though the annual MDs ‚R' Us catalogue (page 1576). Finally, a partial accounting of news by the numbers appears in the Last Gasp (page 1648). Happy holiday reading!