- © 2007 Canadian Medical Association or its licensors
Common sleep disorders and aging
Treatment of sleep disorders in elderly patients requires special consideration. In part 2 of this short series on sleep and aging, Wolkove and colleagues review the management of various sleep disorders common among older people.
See page 1449
The healthy immigrant effect and pregnancy outcomes
New immigrants to Western nations are believed to experience fewer chronic health problems (e.g., diabetes, hypertension and heart disease) than original residents of those countries. Ray and coauthors tested whether this “healthy immigrant effect” extended to placental dysfunction during pregnancy. They found that the risk of pre-eclampsia, placental abruption or placental infarction was lowest among the most recent immigrants to Ontario and highest among those who had been living in the province for 5 or more years before delivery. In a related commentary, Gushulak discusses issues related to health and immigration and the implications for public health and immigration policies and practice.
Testing for HER2-positive breast cancer
Accurate diagnosis of HER2 status is a crucial step in determining breast cancer therapy. Two tests are used to determine HER2 status: immunohistochemistry and fluorescence in situ hybridization. In a systematic review and cost-effectiveness analysis, Dendukuri and colleagues compare various strategies involving these tests to determine which is the most cost-effective. In a related commentary, Goldman examines the promise and increasing perils that gene patenting brings to treatment.
Preimplantation genetic diagnosis
Recent decisions in the United Kingdom raise new warning flags in Canada concerning regulation of preimplantation genetic diagnosis.
See page 1445
Practice
Amiodaronoma: Jarand and colleagues describe the case of a pulmonary mass in a 66-year-old woman who had been taking amiodarone therapy for 4 years (page 1411).
A painful foot sets the scene for a review of the clinical clues to tarsal tunnel syndrome, an uncommon (but often treatable) cause of foot pain (page 1415).