- © 2008 Canadian Medical Association
Fish oil in patients with implantable cardioverter defibrillators
In this systematic review, Jenkins and colleagues pooled the evidence from 3 randomized controlled trials of fish oil in patients with implantable cardioverter defibrillators. They observed significant heterogeneity among the trials, suggesting that fish oil may help some patients and harm others. In a related commentary, Nair and Connolly advise clinicians to be cautious in recommending fish oil to patients. In a related review article, Surette describes the mechanisms and cellular effects of omega-3 fatty acids.
Maternal age and risk of stillbirth
Huang and colleagues synthesized the evidence from 37 observational studies in a systematic review and found that most studies supported an increased risk of stillbirth among women over 35. In a related commentary, Benzies calls for additional research into risk factors and greater attention to prepregnancy counselling and testing.
Excess water ingestion as a cause of proteinuria
In this research letter, Clark and colleagues describe the unexpected findings of proteinuria and polyuria among patients with normal renal function who consumed large amounts of fluid. After fluid restriction, the patients' urine protein and volume normalized. These observations suggest that consuming large volumes of fluid may have adverse effects.
See page 173
Dementia, aging and deciding
This issue's editorial criticizes the crude evaluation of elderly patients' decision-making capacity that occurs in practice. Flegel and colleagues question why the approach used to recognize limited degrees of capacity in children is not also used in adults.
See page 127
Awareness during anesthesia
In a stand-alone commentary, Orser and colleagues discuss the prevalence and mechanisms of intraoperative awareness, a phenomenon depicted in the recent motion picture Awake.
See page 185
Practice
In this issue's Public Health column and related fact sheet, Leslie discusses youth substance use and abuse and the potential challenges and strategies for identification and intervention (pages 145 and 149).
In this issue's Clinical Quiz, readers are asked to identify the cause of cough, fever, joint pain and tender nodules (page 151).
In Clinical Vistas, Nijjar and Leslie describe a case of skeletal sarcoidosis imitating skeletal metastases on bone scintigraphy (page 153).