Highlights of this issue

Retention of medical graduates

Figure. Photo by: www.comstock.com

What influences medical graduates to stay and practise in Canada and in the province where they studied? Mathews and associates looked at data for former medical graduates of the Memorial University of Newfoundland (MUN) to identify the characteristics and predictors of their working in Canada and in Newfoundland and Labrador in 2004. In a related commentary, Wootton questions the degree to which their findings may be unique to the population of Newfoundland and MUN.

See pages 357 and 371

Revascularization in patients with heart failure

The prevalence of heart failure is increasing in Western society and is an important public health problem. Using data from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH), Tsuyuki and colleagues examine how coronary revascularization relates to survival among patients with heart failure, and its association with the strategy applied (CABG v. percutaneous coronary intervention). In a related commentary, Senior notes the limitations of retrospective, observational studies and the ongoing uncertainty about the safety and benefits of revascularization of patients with heart failure and coronary artery disease.

See pages 361 and 372

Autoimmune pancreatitis mimicking metastatic tumours

Autoimmune pancreatitis is often misdiagnosed as pancreatic cancer. Rudmik and colleagues report the clinical features in a novel presentation of this condition that may help to raise the suspicion of this rare disorder and prevent unnecessary surgical intervention.

See page 367

An industry out of social control?

In this commentary, Mintzberg questions the evidence for arguments used by patent-dependent pharmaceutical companies to justify the pricing of drugs.

See page 374

Probiotics in the prevention of antibiotic-associated diarrhea in children

Antibiotic-associated diarrhea (AAD) is a common problem, and of special concern in children. Probiotic agents (e.g., Lactobacillus) are commonly used in prevention of AAD, although little is known about which probiotic strains and doses might yield the most benefit in the pediatric population. In this meta-analysis, Johnston and colleagues assess the efficacy and adverse effects of probiotics when coadministered with antibiotics to pediatric patients.

See page 377

Analysis • Practice

Is there another way to account for noncompliance in the analysis of findings from randomized controlled studies? In this analysis piece, Hewitt and coauthors present a case for the use of complier average causal effect (CACE) (page 347).

Figure.

Khandwala and Lee investigate the cause of an unusual combination of elevated levels of thyroid-stimulating hormone and thyroid hormones in the same patient (page 351).