Diagnosis and treatment of deep-vein thrombosis
Deep-vein thrombosis (DVT) is a common and serious condition that can lead to long-term complications and death. In the last decade, new strategies for the diagnosis of suspected DVT have been introduced. Scarvelis and Wells review these changes and suggest an algorithm that combines the determination of a patient's pretest probability of DVT, D-dimer testing and compression ultrasonography. They also review treatment strategies in a variety of clinical situations.
See page 1087
Overweight and obesity in an Indo-Asian population
Worldwide, Indo-Asian people are among the populations at highest risk for cardiovascular disease. Also, associations between body mass index (BMI) and chronic disease may differ between Indo-Asian and Western populations. Analyzing data from a national health survey in Pakistan, Jafar and coauthors estimate that as many as 25% of the population 15 years and older are overweight or obese, with alarming levels of obesity among the young and women. The findings support the use of Indo-Asian-specific BMI thresholds for defining overweight in this population. In a related commentary, Anand reviews the measures needed to counteract the powerful societal forces that promote obesity (e.g., use of cars, sedentary lifestyles) that come with economic prosperity.
Angioedema without urticaria
Zingale and colleagues collected data over 11 years on 929 cases of angioedema without urticaria (hives). A variety of causes were documented, although many remained idiopathic. Here, they suggest a clinical classification and workup for patients with this unusual condition. In a related commentary, Bowen recounts the formation and describes the goals of the Canadian Network of Rare Blood Disorder Organizations.
Analysis • Practice
In a review of editorials published across Canada, Quesnel-Vallée and coauthors reveal some interesting points about public opinion in the aftermath of Chaoulli v. Quebec (page 1051).
The difficult treatment challenge of nonbacterial thrombotic endocarditis, which can accompany an underlying malignancy, is reviewed in this issue's Teaching Case Report (page 1055).
In Public Health, Copes reviews recent measures to ensure the safety of drinking water in Canadian communities. He gives practical advice to help physicians recognize water-related illness in their patients (page 1057).
In this issue's Clinical Vistas Briefs, try your hand at diagnosing a case of congestive heart failure and a harsh cranial bruit in an infant; fever, chills, a tender thumb and calcinosis in a woman with scleroderma; and recurrent, painless swelling of a knee in an adolescent when he stands (page 1059).