Highlights of this issue

Family physician contact and colorectal cancer screening

In a study that included 12 776 people in 4 Canadian provinces, Zarychanski and colleagues found that the rate of participation in colorectal cancer screening was very low but that people with increased contact with a family physician were more likely to receive screening. In the editorial, Barkun and Flegel argue that physicians must take on a more active role in promoting colorectal cancer screening.

See pages 545 and 593

Low bone mineral density and fracture burden in postmenopausal women

From their study involving 16 505 postmenopausal women, Cranney and colleagues found that most fractures occurred in women with non-osteoporotic bone mineral density values. They emphasize that osteoporosis treatment decisions should consider overall fracture risk.

See page 575

Perinatal outcomes in a universal health care setting

Socioeconomic status influences perinatal outcomes, but whether differences in access to health care are responsible has been unclear. In a retrospective cohort study involving 76 440 women in Nova Scotia, Joseph and colleagues found that lower family income was significantly associated with increased rates of small-for-gestational-age birth, preterm birth, gestational diabetes mellitus and postneonatal death. They conclude that universal access to health care was insufficient to mitigate these effects, which instead may reflect gaps in social support and provision of health information.

See page 583

Dementia and the assessment of driving risk

In this commentary, Rapoport and colleagues discuss the conflicts that physicians encounter between the difficulty in confidently assessing whether patients with mild dementia are safe to drive and the duty (mandatory in many jurisdictions) to report unsafe drivers. They stress the importance of better screening tools for physicians and increased accessibility of on-road testing.

See page 599

Practice

In this teaching case report, Seet and Lim describe a case of intermittent ataxia associated with migraine headaches (page 565).

Alqahtani and colleagues present a case of valproate-induced hyperammonemic encephalopathy with elevated serum ammonia but normal liver biochemistry (page 568).

In Public Health, Galanis addresses the diagnosis and management of Campylobacter infection, the most common type of bacterial gastroenteritis in Canada (page 570).