Highlights of this issue

Unique challenges of surrogate pregnancy

Providing health care for a woman with a surrogate pregnancy involves unique challenges. Reilly discusses the various issues surrounding this situation, including the ethical concerns, the laws concerning surrogacy and the relationship required between health care provider and surrogate mother. In a related commentary, Guichon gives advice for health care providers on how to handle the challenges that may arise during a commissioned pregnancy.

See pages 479 and 483

What are the risks involved in a planned cesarean delivery?

Liu and colleagues report on a large population-based cohort study of all the healthy women who delivered between 1991 and 2005 in Canada (excluding Quebec and Manitoba). The results indicate a statistically significant increase in rates of severe maternal morbidity in the planned cesarean delivery group, compared with the planned vaginal delivery group. In a related commentary, Armson discusses current uncertainties about the optimal mode of delivery, with regard to infant as well as maternal outcomes.

See pages 455 and 475

Pregnancy and influenza

Should pregnant women receive the flu shot? Dodds and coauthors conducted a 13-year population-based cohort study involving pregnant women with and without comorbidities to compare their rates of hospital admissions and physician office visits because of respiratory illness during influenza, peri-influenza and non-influenza seasons. They also compared these rates with those in the year before pregnancy. Their data show that all pregnant women are at increased risk of influenza-associated respiratory illness and are likely to benefit from vaccination.

See page 463

Children's mental health needs public health strategy

In this commentary, McEwan and associates criticize the inherent emphasis on adults that is found in the 2006 Kirby–Keon report on mental health by the Standing Senate Committee on Social Affairs, Science and Technology. They call for a public health strategy that not only provides effective treatment for children with established disorders, but also promotes social and emotional well-being for all children, which will help prevent long-term mental disorders from taking root in childhood. In a guest editorial, Kutcher and Davidson observe how current mental health services, which tend to focus on either adult or pediatric care, tend to fail those in the youth population who experience mental illness.

See pages 417 and 471

Analysis • Practice

Just when we thought the DNA sequence of the human genome had been spelled out, along come CNVs — copy-number variations — which have revealed the genome to be far more complex than ever imagined (page 441).

Black henna tattoos, although temporary, can result in long-term sensitization to paraphenylendiamine (PPD) and cause subsequent contact dermatitis upon exposure to common products that contain para-dyes, such as hair dyes (page 445).

A patient with neurological symptoms but no travel history is found to have American trypanosomiasis (Chagas disease), a parasitosis endemic to South America. Nijjar and Del Bigio show us the images that helped lead to the diagnosis and comment on how the case may have occurred (page 448).

In Public Health, McIntyre and colleagues describe a recent outbreak of trichinellosis in Canada that was linked to the consumption of bear meat (page 449).