Highlights

E-cigarette use in teens

There is mounting evidence associating use of electronic cigarettes with tobacco use, especially among teens. Stanbrook argues that we cannot ignore the potential for harm creation while we debate the controversial question of whether e-cigarettes may enable harm reduction for smokers. He calls for explicitly extending advertising restrictions currently in place for tobacco products to e-cigarettes. See Editorial, page 785

In this cross-sectional study of grade 9 students in the Niagara region of Ontario, reported use of e-cigarettes was common and associated with potential risk factors, including exposure to use of tobacco by family members and friends, and personal tobacco use. Most reported trying e-cigarettes because it was cool/fun/new, rather than for smoking reduction or cessation. See Research, page 794

Utility of next-generation sequencing

This Canadian pilot study shows the potential of next-generation sequencing to deliver molecular diagnoses rapidly and with a high success rate for severely ill neonates. See Research, page E254

Accurate interpretation of genetic diagnoses made using next-generation sequencing requires a close partnership among clinicians, molecular geneticists and bioinformaticians. See Commentary, page 786

Military personnel and suicide

Canadian military personnel showed a higher use of mental health services compared with the general population in two surveys conducted 10 years apart. The authors of this observational study examined data from routine surveys of Canadian military and civilian populations conducted in 2002 and 2012/13. They found that the prevalence rates of suicidal ideation and plans were higher among military personnel than among civilians in 2012/13. Among people who reported suicidal behaviours, those in the military had a higher rate of help-seeking and number of professionals seen compared with civilians in both surveys. See Research, page E261

Pulmonary hypertension

Characterized by increased pulmonary artery pressure and complicated by right ventricular failure, pulmonary hypertension is an uncommon but serious progressive disease. Hambly and colleagues review its multiple causes, outline a comprehensive approach to diagnosis and present the latest evidence regarding optimal management of the condition. See Review, page 804

Back pain in rheumatoid arthritis

A 59-year-old woman with rheumatoid arthritis presented with back pain after an intense workout. Her examination showed tenderness to palpation on her right side at the T5/T6 level, consistent with musculoskeletal pain. But that was not the final diagnosis. The authors tell us more. See What is your call?, page 817

Acute mesenteric ischemia

Acute mesenteric ischemia is caused by arterial insufficiency or venous obstruction, most often treated with surgery. Minimally invasive treatment options are now available for this serious condition. However, mortality rates are high, even with appropriate management, say Dattani and Horvath. See Five things to know about …, page 820

Giant renal angiomyolipoma

A 64-year-old man was diagnosed with giant bilateral renal angiomyolipoma after presenting with abdominal distention. About 40%–80% of patients with tuberous sclerosis complex have documented angiomyolipoma, say Shikino and Ikusaka. See Clinical images, page 821

Humanities in this issue

A mid-19th-century artificial limb manufacturer successfully merged philanthropy and profit. See Medicine and Society, page 824

Telling stories from the practise of rural medicine has become a passion for Dr. Paul Dhillon. See Profile, page 826