- © 2008 Canadian Medical Association
Treatment of community-acquired pneumonia
Fluoroquinolones, β-lactams and macrolides are all highly effective for the treatment of pneumonia in adults, according to a meta-analysis based on 23 randomized controlled trials. Vardakas and colleagues report that fluoroquinolones, compared with β-lactams and macrolides, were associated with higher success for treatment of severe pneumonia in open-label trials. See Research, page 1269
Community-acquired pneumonia should be treated with a fluoroquinolone or a combination of a macrolide and a β- lactam antibiotic, says Low. See Commentary, page 1245
Folic acid antagonists
Maternal exposure to folic acid antagonists may increase the risk of adverse outcomes of pregnancy that are mediated through the placenta. Wen and colleagues report this finding from their retrospective cohort study that included nearly 15 000 women who were exposed to folic acid antagonists and nearly 60 000 women who were not. See Research, page 1263
Ray argues that observational studies that document harm should capture both the exposure and the outcome of interest, identify a temporal relation and account for major confounding variables. See Commentary, page 1243
Diagnosis and treatment of dementia
Our concluding article in this series looks at the management of severe Alzheimer disease. See Review, page 1279
Should children be prescribed statins?
MacDonald, Stanbrook and Rieder question the wisdom of prescribing statins to children based on limited evidence. See Editorial, page 1239
Canadian stroke guidelines, 2008
A supplement to this issue documents the “best practice” recommendations from the Canadian Stroke Network for the care of patients with stroke. The full version of the guidelines is available at www.cmaj.ca/content/vol179/issue12/#supplement. In this issue, Bayley and colleagues highlight new evidence in stroke care that was incorporated into their recommendations. See Commentary, page 1247
Health care reform in Chile
A new plan establishes a list of 56 health conditions for which coverage and treatment are guaranteed by law. See Analysis, page 1289
A spontaneous skin lesion
A 34-year-old woman has 2 tender, itchy skin lesions on her back that developed spontaneously 10 years ago. What is your call? See Practice, page 1297
Maxillary bone fracture during hyperbaric oxygen therapy
A 26-year-old hyperbaric oxygen therapy technician has a common cold. When she accompanies a patient into the treatment chamber, her maxillary bone fractures. See Clinical images, page 1351