Highlights

Research ethics review

We need to overhaul the ethics review system and change it from an autonomous local process to a collaboration of local committees working within a national strategy, say Hébert and Saginur. See Editorial, page 597

Implantable cardioverter defibrillators

Setoguchi and colleagues report that older people with comorbidities and those with multiple hospital admissions related to heart failure are unlikely to have a meaningful survival benefit from implantable defibrillators. They used a cohort of over 14 000 patients with heart failure assembled from an administrative database for their study. See Research, page 611

The “one size fits all” approach to implanting defibrillators may not represent the most effective use of resources or the best balance between risk and benefit, says Dorian. See Commentary, page 599

Metabolic syndrome

In an Aboriginal Canadian population, metabolic syndrome — irrespective of the definition used — can identify individuals at risk of type 2 diabetes. Ley and colleagues came to this conclusion from their 10-year cohort study involving 492 residents in an Aboriginal community. See Research, page 617

These results may not be true of all population groups, says Reaven. He also suggests that Ley and colleagues could have concentrated more on the diagnostic utility of the individual components of metabolic syndrome than on the entire syndrome. See Commentary, page 601

Seizure following a taser shot to the head

A previously well police officer, mistakenly hit by a taser shot meant for a suspect, experienced a seizure and collapsed during a chase. See Research, page 625

Infection control in hospitals

Hand-washing, a clean environment, appropriate barriers and early identification of patients at high risk of infection remain the essential measures to prevent and control infection. See Review, page 627

Can we eat more fish?

We are told to eat more fish for its omega-3 fatty acid content. But is that recommendation sustainable? Jenkins and colleagues discuss the evidence supporting this dietary advice. See Analysis, page 633

Neurocysticercosis

A seizure experienced by a 51-year-old man in Canada led to a diagnosis of neurocysticercosis. See Practice, page 639

Half-and-half nail

Half-and-half nail is shown in this image of the hand of a 61-year-old man with chronic renal failure and diabetes mellitus. See Clinical images, page 687

HIV scandal in Chile

Chile's health minister has resigned and the country's HIV/AIDS programs are being overhauled after 512 people who tested positive for HIV were not informed of the results. See News, page 607