- © 2008 Canadian Medical Association
Climate change and infectious diseases
In this narrative review, Greer and colleagues describe the effects that climate change is projected to have on the burden and distribution of infectious diseases in North America.
See page 715
A patient's sex and physician recommendations for total knee arthroplasty
In this prospective study by Borkhoff and colleagues, a standardized male and female patient, each trained to present an identical case history of moderate osteoarthritis, were assessed blindly by 38 family physicians and 33 orthopedic surgeons in Ontario. The authors found that total knee arthroplasty was recommended significantly more often to the male patient than to the female patient. In a related commentary, Herrera explains why it can be ethical to conduct “undercover” research on people who are unaware that they are being studied.
Joint contractures in the intensive care unit
In this retrospective study involving 155 patients admitted to a tertiary intensive care unit for 2 or more weeks, Clavet and colleagues found that one-third of them had functionally significant joint contractures, usually affecting 2 or more joints, upon leaving the unit. Most of the contractures persisted to hospital discharge. In a related commentary, Herridge calls into question the “culture of immobility” in the intensive care unit.
Predicting pregnancy complications
In this systematic review and meta-analysis, Cnossen and colleagues summarize the evidence for the diagnostic utility of uterine artery Doppler ultrasonography in predicting pre-eclampsia and intrauterine growth restriction. The authors found that abnormal Doppler waveforms were better predictors of pre-eclampsia than of intrauterine growth restriction, that testing was more accurate in the second than in the first trimester and that the most predictive Doppler index was the pulsatility index, with or without uterine artery notching. In a related commentary, McLeod discusses how this evidence will contribute to better surveillance and prevention of adverse perinatal outcomes.
Women in medicine
In a guest editorial, Herbert and colleagues refute recent media reports that have implied a causal link between the increasing proportion of women in medicine and Canada's doctor shortage.
See page 659
Practice
In this Facts and Figures column, Marrett and colleagues discuss the annual Canadian incidence of mesothelioma, a rare cancer with a high fatality rate, and describe the most common cause of this disease (page 677).
In this issue's Interesting Image, Tan and colleagues present the case of a spontaneous hemothorax in a 62-year-old man (page 679).
In this Clinical Vista, Thorat and Wang describe how a disconnected nasogastric tube can lead to first-and second-degree burns (page 680).