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CMAJ. 2010 August 10; 182(11): 1147.
PMCID: PMC2917922

Highlights

The Canadian C-Spine Rule

Trained nurses in the emergency department were able to detect important injuries to the cervical spine reliably and accurately. This is the finding of a prospective study of 3633 patients that evaluated the accuracy, reliability and acceptability of the Canadian Cervical Spine Rule when used by nurses. Implementation of the rule by nurses could reduce the time for which many of these patients are immobilized in emergency departments and improve the flow of patients, say the authors. See Research, page 1173

Children with coordination problems at risk of weight gain

Children with coordination problems were at greater risk of overweight and obesity than their classmates, and their risk did not diminish over time. These are the findings of Cairney and colleagues, who assessed 2082 children in the fourth grade (ages 9 and 10) for possible developmental coordination disorder and followed them up over two years to record height, weight and waist measurements. The authors call for more attention to be paid to reducing cardiovascular risk and other diseases associated with obesity in children with developmental coordination disorder. See Research, page 1167

Children with coordination problems are more likely to have excess weight gain than children with better coordination says Montgomery. Although poor coordination itself may increase the risk of unhealthy weight gain, a variety of other mechanisms may be involved. See Commentary, page 1157

Multiple organ dysfunction syndrome in critically ill children

The Pediatric Logistic Organ Dysfunction (PELOD) score can be used to identify children at high risk of death during their stay in intensive care. In a prospective study, Leteurtre and colleagues tracked the daily PELOD scores of 1806 children in pediatric intensive care units. They identified the optimum days for measuring the scores as well as the patterns of change in the scores that indicated a high risk of death. The prognostic information provided by the scores may be helpful at the bedside and could be used in epidemiologic studies. See Research, page 1181

Mortality and organ dysfunction may not be the most suitable outcomes to predict prognosis in critically ill children, argues Kneyber. He suggests that the child’s functional status be used as an outcome instead. See Commentary, page 1155

Building a research platform for disease prevention

The Canadian Partnership for Tomorrow Project will collect data from 300 000 Canadians on a long-term basis to learn more about the causes of cancer and other chronic diseases. The goal is to understand how environment, lifestyle and genetics contribute to diseases and to use this understanding to inform prevention strategies. See Analysis, page 1197

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Simulation in surgical education

Technical skills learned both on low-fidelity benchtop simulators and on high-fidelity virtual-reality systems have been shown to transfer to the operating room. Assessing which simulator is more useful in which type of training situation, however, is more difficult to determine. Furthermore, simulators are only part of the solution to training students and residents outside of the operating room. See Review, page 1191

Headache, red eyes, blurred vision and hearing loss

A 48-year-old woman presented with a week’s history of redness and discomfort in both eyes, blurred vision, headache, tinnitus and hearing loss. She had low-grade fever and neck stiffness. Examination of the ocular fundus and cerebrospinal fluid helped to make the diagnosis. Which syndrome does she have? See Practice, page 1205

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Articles from CMAJ : Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association