Highlights

Children with minor head injuries

A new decision rule has the potential to standardize the use of computerized tomography in children with minor head injury. Four of the seven elements of the rule were based on high-risk and three on medium-risk factors. This decision rule was developed by Osmond and colleagues from a prospective multicentre cohort study that enrolled 3866 patients. See Research, page 341

Skiers, snowboarders and helmets

Helmets reduce the risk of head injury among skiers and snowboarders and do not increase the risk of neck injury. Russell and colleagues came to this conclusion from their meta-analysis of 12 studies, which showed a pooled odds ratio of 0.65 (95% confidence interval 0.55–0.79) in favour of the use of helmets. Their pooled analysis of the six studies that examined the risk of neck injury showed no increase in risk. Based on their study, the authors encourage the use of helmets by skiers and snowboarders. See Research, page 333

Severe outcomes in pandemic (H1N1) influenza

The presence of one or more underlying medical conditions, age of 20 years or more and a delay in hospital admission were associated with a severe outcome among patients admitted to hospital with pandemic (H1N1) influenza. This finding by Campbell and colleages was based on data from nearly 1500 patients with laboratory-confirmed pandemic (H1N1) reported to the Public Health Agency of Canada. See Research, page 349

Enteric absorption of oseltamivir

Oseltamivir is well absorbed enterically in critically ill patients. Ariano and colleagues came to this conclusion from their study involving 41 critically ill patients admitted to intensive care units with suspected or confirmed pandemic (H1N1) influenza. The powder from the capsule was dissolved in water and injected down the nasogastric or nasojejunal tube. The plasma levels achieved in these patients were comparable to those obtained in ambulatory patients. See Research, page 357

Addicted to eating

Some individuals with weight problems fulfill the diagnostic requirements for substance abuse and may benefit from treatments used to treat addictions. This controversial argument is proposed by Taylor and colleagues. See Commentary, page 327

Controlling asthma in preschoolers

Inhaled steroids, the controller medication of choice for children with asthma, must be given regularly for at least one season at a time and not just during attacks of asthma. This is one of the key messages from the final article in our seven-part series on asthma. See Reviews, page E172

Paying for drugs not available in public hospitals

Uninsured drugs should not be sold in public hospitals because of the possible negative effects on the public health care system, argue Flood and Hardcastle. See Analysis, page 374

Erectile dysfunction

A 54-year-old man has difficulty achieving an erection. After ruling out key causes, such as cardiovascular disease and depression, should you prescribe a phosphodiesterase type 5 inhibitor? See Practice, page 381

Is regionalization working?

For more than a decade, regionalization has been the dominant model of health care in Canada and, as a result, the scope of medical services varies substantially. Alberta, however, is bucking the trend, with a shift to centralized health care in 2008. Health care experts, still not sure if the move toward delivering medical services at the regional level has been successful, are watching the Alberta move closely. A three-part series. See News, page 329