Highlights of this issue

Have the Canadian breast cancer guidelines made a difference?

Latosinsky and colleagues examined the rates of surgical care for breast cancer and variations in care among surgeons before and after the introduction of the guidelines in 1998. Interestingly, they found no significant differences between the 2 periods. In a related commentary, Grunfeld discusses factors that may have affected uptake of the guidelines.

See pages 771 and 785

Mental illness: A barrier to medical care access?

Does inequitable access to cardiological or neurological procedures contribute to preventable deaths among people with mental illness? Kisely and colleagues report on their study of this possible association. In a related commentary, Goldbloom and Kurdyak note that this study documents receipt of specialized procedures; there remain many other factors contributing to inequitable access to them that require examination.

See pages 779 and 787

Managing decompensated heart failure

Despite the high prevalence of acute decompensated heart failure, diagnosis can be difficult, and treatment options remain limited. Allen and O'Connor review the currently available treatments and their efficacy, with the goal of informing clinicians how to optimize their management of patients with acute decompensated heart failure.

See page 797

Women and cardiovascular disease

Cardiovascular disease is the leading cause of death among women. Analyses suggest clinically relevant differences between women and men in terms of prevalence, presentation, management and outcomes of the disease, but little is known about why these differences exist. In a supplement to this issue (available online at www.cmaj.ca/cgi/content/full/176/6/S1), Pilote and coauthors offer a comprehensive review of sex-specific issues related to cardiovascular disease. Their summary of the supplement appears in this issue, along with a commentary by Barrett-Connor, who critiques the strengths and weaknesses of their review and highlights the many information gaps on this topic in the literature.

See pages 789 and 791

Practice

Therapeutic hypothermia in survivors of cardiac arrest: A review of evidence, as well as practical advice (page 759).

Interventional radiology and palliative care: Baerlocher and Asch present a case in which multiple interventional radiology procedures were performed to assist in the delivery of palliative care (page 762).

Hygiene: In this issue's Public Health column, Nicolle reviews recommended personal hygiene practices in the home and community and discusses their effectiveness (page 767).