Highlights of this issue

Diagnosis of dementia

In the second article in CMAJ's series on dementia, Feldman and colleagues provide physicians with practical guidance on the diagnosis of dementia based on recommendations from the Third Canadian Consensus Conference on the Diagnosis and Treatment of Dementia.

See page 825

Fluoroquinolones and acute bacterial sinusitis

In this meta-analysis of 11 randomized controlled trials involving 5779 patients with acute bacterial sinusitis, Karageorgopoulos and colleagues found that fluoroquinolones, including the newer “respiratory” fluoroquinolones, conferred no benefit over β-lactam antibiotics in terms of the primary effectiveness and safety outcomes studied. They conclude that fluoroquinolones should not be chosen over β-lactam antibiotics for the treatment of acute bacterial sinusitis. In a related commentary, Le Saux argues that the use of fluoroquinolones as first-line therapy should be discouraged because of its greater potential for generating resistance.

See pages 845 and 865

Diagnostic tests for lymph node status in cervical cancer

In this systematic review of 72 studies involving 5042 women, Selman and colleagues compared sentinel node biopsy, positron emission tomography, magnetic resonance imaging and computed tomography for determining pelvic and para-aortic lymph node status in cervical cancer. Sentinel node biopsy was the most accurate test, while positron emission tomography was substantially more accurate than the other imaging modalities. In a related commentary, Bernardini and Covens affirm the value of these results but discuss contextual factors that may mitigate the findings.

See pages 855 and 867

Privacy legislation and observational research

In this commentary, Gershon and Tu discuss the real and potential detrimental consequences of privacy legislation for those conducting observational research.

See page 871

Physicians and continuing education

This issue's editorial argues that the current system of continuing education, which is dominated by pharmaceutical industry funding, needs a major overhaul. The editorial proposes a new arm's-length national institute to oversee and administer funding for continuing health professional education.

See page 805

In Practice

In Clinical Vistas Briefs, readers are asked to determine the cause of hyperthermia, abdominal pain and confusion in a 77-year-old woman (page 836).

In the Clinical Quiz, readers are asked to determine the cause of vomiting, diarrhea and stiff neck in a 10-year-old girl (page 837).

In this issue's Clinical Vista, Daneman and Slinger present a case of African tick-bite fever in a 47-year-old man and stress the importance of obtaining a travel history of febrile patients (page 841).