- © 2007 Canadian Medical Association or its licensors
Osteoporosis in men: an update on diagnosis and treatment
In 2002, Osteoporosis Canada published clinical practice guidelines for the diagnosis and management of osteoporosis. Khan's group supplements those guidelines with a review of additional information on osteoporosis in men. A case report is used to illustrate diagnosis and treatment.
See page 345
Changes in waiting times for breast cancer care
Waiting times for cancer care continue to be an important issue for Canadians. However, most analyses lack data clearly documenting time intervals. Rayson and coauthors evaluated 2 cohorts of women with surgically treated breast cancer — those referred for adjuvant therapy in 1999/2000 and those referred in 2003/04 — to compare changes in waiting times over a continuum of care. They suggest that examining timelines over the entire continuum of care may provide a more realistic picture of the burden of waiting times and improve our understanding of the interdependence of care segments on access and outcomes.
See page 327
Sex differences in effectiveness of statins after acute myocardial infarction
By linking hospital discharge and drug claims databases in Quebec, Karp and colleagues investigated sex differences in the effectiveness of statin therapy after an acute myocardial infarction. The large number of men and women involved in their retrospective cohort study provided sufficient statistical power to detect sex–treatment interactions in these drugs.
See page 333
Necrotizing pancreatitis following vaccination
Shlomovitz and colleagues describe a case of severe necrotizing pancreatitis, which is suspected to have been caused by combined hepatitis A and B vaccination. The authors suggest that vaccine-induced pancreatitis is an underdiagnosed condition and discuss the possible mechanisms underlying this condition.
See page 339
Underreporting work-related injuries
Up to 50% of work-related injuries in Canada are not reported to workers' compensation boards, which results in inappropriate claims to the public health care system. If these injuries and illnesses are not reported, preventive health and safety measures in the workplace may become inadequate. Thompson emphasizes the role that physicians can play to ensure that appropriate claims are made to workers' compensation boards.
See page 343
Analysis • Practice
New research discoveries in genetics are increasing patient demand for the services of health care professionals with specialty training in clinical genetics. Silversides reviews this accelerating shortfall (page 315).
Sudden-onset dyspnea and respiratory failure in a previously healthy, pregnant patient: the first thought is a pulmonary embolus, but the results of investigations are negative. In this Teaching Case Report, the clue to the cause is in the patient's history (page 319).
In this issue's Clinical Vistas Briefs, readers are asked to diagnose blue skin discoloration on the legs, feet and gingival margin of a patient with diffuse scleroderma; to determine the cause of acute abdominal pain and hypotension in a patient with Crohn's disease; and to examine a CT scan obtained after a patient with long-standing epilepsy injured her head during a seizure (page 321).