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CMAJ. 2016 April 19; 188(7): 479.
PMCID: PMC4835270

Highlights

Naming and classifying ECG phenomena

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Baranchuk and Bayés-Genis suggest that a more systematic approach to the development of new electrocardiographic terminology and eponyms would optimize learning and teaching strategies and facilitate consistency in the literature. See Commentary, page 485

Risk of suicide after concussion

The long-term risk of suicide after a concussion in adults is three times that among those who have not sustained a head injury, according to the findings of a large population-based study from Ontario. The risk of subsequent suicide is somewhat more elevated if the patient presents to health care services with concussion on a weekend compared with a weekday. See Research, page 497

Macrolides likely safe in older adults

The use of macrolide antibiotics was not associated with the risk of ventricular arrhythmia in older adults but was associated with reduced mortality. Using routine data to compare more than 1.2 million people receiving macrolides or another drug, the authors suggest that current warnings from the US Food and Drug Administration may be overstated. See Research, page E120

Prescribing exercise

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Exercise interventions can offer benefits that are comparable to pharmacologic treatments for many chronic conditions, yet exercise is underprescribed. Like medication and surgery, “exercise” is not a single entity and must be appropriately implemented to achieve condition-specific outcomes. Hoffman and colleagues unpick the evidence showing the benefits of exercise as treatment for several common conditions. See Review, page 510

Recurrent urinary tract infection

A 35-year-old healthy premenopausal woman has had three documented urinary tract infections in the past eight months. Does she require investigations or referral? Should she start drinking cranberry juice? What about low-dose antibiotic prophylaxis? Welk and Hickling answer these and other questions on the management of recurrent urinary tract infection. See Decisions, page 522

Biliary obstruction from a liver fluke

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A 20-year-old man presented with right upper abdominal pain, elevated liver enzyme levels and a dilated biliary tree, typical of a common bile duct stone. Yet, a surprising diagnosis was made on endoscopic retrograde cholangiopancreatography: a liver fluke was found to be obstructing the common bile duct. Ishikawa and colleagues tell us more. See Cases, page 524

Buckle fractures of the radius

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Buckle fractures of the distal radius are common in children. Use of a removable splint is just as effective as casting for these fractures, say the authors. If the child’s condition is improving, routine follow-up with an orthopedic surgeon is not necessary. See Five things to know about …, page 527

de Winter syndrome

A 62-year-old man with chest pain was diagnosed with de Winter syndrome, a condition associated with acute occlusion of the left anterior descending coronary artery and no ST-segment elevation on electrocardiography (ECG). Health care personnel involved in the triage of patients with chest pain should be able to rapidly recognize this characteristic ECG pattern and associated syndrome to ensure appropriate, urgent reperfusion treatment. See Clinical images, page 528

Wellens syndrome

In Wellens syndrome, characteristic findings on electrocardiography are predictive of substantial stenosis of the left anterior descending coronary artery. Recognition of this ominous pattern is crucial for early diagnosis and intervention. See Clinical images, page 529


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