CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Review Practice Guideline Guideline
Periodic health examination, 1994 update: 1. Obesity in childhood. Canadian Task Force on the Periodic Health Examination.
To update the 1979 Canadian Task Force on the Periodic Health Examination recommendation on screening for childhood obesity by reviewing any new evidence concerning health risks in childhood and adulthood, and effective preventive or therapeutic interventions. ⋯ These guidelines were developed and endorsed by the Canadian task force, which is funded by Health Canada.
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Review
Interactions between physicians and the pharmaceutical industry: what does the literature say?
To determine the effect of three types of interaction between physicians and the pharmaceutical industry--company-funded clinical trials, company-sponsored continuing medical education (CME) and information for physicians supplied by pharmaceutical detailers--on orientation and quality of clinical trials, content of CME courses and physicians' prescribing behaviour. ⋯ Physicians are affected by their interactions with the pharmaceutical industry. Further research needs to be done in most cases to determine whether such interactions lead to more or less appropriate prescribing practices. The CMA's guidelines on this topic should be evaluated to see whether they are effective in controlling physician-industry interactions. Further measures may be necessary if the guidelines fail to prevent negative effects on prescribing practices.
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To review the current research and formulate a rational approach to the cause, prevention and treatment of postdural puncture headache (PDPH). ⋯ The rate of PDPH after lumbar puncture can be minimized through strict attention to technique and the employment of a 25-gauge needle with the bevel parallel to the dural fibres. A reliable diagnosis and stepwise approach to treatment will minimize complications.
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Review
Computed tomography before lumbar puncture in acute meningitis: a review of the risks and benefits.
To determine the indications, if any, for routine computed tomography (CT) of the brain before lumbar puncture in the management of acute meningitis. ⋯ (a) There is no evidence to recommend CT of the brain before lumbar puncture in acute meningitis unless the patient shows atypical features, (b) for patients with papilledema the risks associated with lumbar puncture are 10 to 20 times lower than the risks associated with acute bacterial meningitis alone, (c) CT may be necessary if there is no prompt response to therapy for meningitis or if complications are suspected, (d) the inability to visualize the optic fundi because of cataracts or senile miosis is not an indication for CT and (e) there are no Canadian legal precedents suggesting liability if physicians fail to perform CT in cases of meningitis.