Highlights of this issue

Hypertriglyceridemia: manifestations and treatment

Knowing when and how, or even if, to treat elevated plasma triglycerides is a clinical challenge. Yuan and associates review the causes, manifestations and treatment of this common biochemical finding. The many conditions associated with secondary hypertriglyceridemia are also reviewed.

See page 1113

Migration of Canadian-educated physicians

Phillips and colleagues investigate the migration patterns of Canadian-educated physicians to and from the United States in this cross-sectional study. Their findings indicate that immigration of physicians to the United States may be slowing. The authors suggest policy options to further reduce this loss.

See page 1083

Conditions often not met for testing for publication bias

Asymmetry tests are commonly used in meta-analyses to detect publication bias, the tendency of research with “negative” results to not be published. When these tests are inappropriately applied, overall research findings can be interpreted erroneously. In an evaluation of 60 meta-analyses, Ioannidis and Trikalinos find that the statistical conditions for asymmetry tests are usually absent — yet, the tests are still performed and reported.

See page 1091

Elevated serum lactate: a clue to ethylene glycol poisoning

Brindley and colleagues describe how discrepancies in point-of-care serum lactate readings can be used for the diagnosis and early treatment of ethylene glycol ingestion in uncooperative or comatose patients.

See page 1097

New obesity guidelines

The prevalence of obesity and its related health consequences is increasing at an alarming rate. In 2004, a panel of experts from across Canada was convened to develop a comprehensive set of clinical practice guidelines to address not only the management but also the prevention of obesity in both adults and children. The final set of guidelines is presented in a supplement to this issue. In a synopsis of the guidelines in this issue, Lau reviews the development, objectives and key recommendations. In a related commentary, McDonald reviews the guidelines and identifies the need for large, long-term trials to address gaps in our knowledge.

See pages 1103 and 1109

Practice

Hypothyroidism and pregnancy: In this teaching case report, Bungard and Hurlburt describe the management of a pregnant 33-year-old woman with primary hypothyroidism. They also mention precautions that should be taken to avoid exacerbation of hypothyroidism during pregnancy (page 1077).

Effort-induced deep-vein thrombosis: Har-Noy and Meltzer uncover the cause of upper-extremity deep-vein thrombosis in an elderly man after vigorous exercise (page 1078).