What's in the news: Dec. 23 -- The world's most unhealthy burger

An outraged Dr Yoni Freedhoff, the Ottawa obesity specialist who blogs at Weighty Matters, describes Disney's latest accomplishment: the creation of the "world's vilest burger," a cheeseburger squished between two miniature pizzas instead of a bun. [Weighty Matters] I respectfully dissent, and would like to submit for Dr Freedhoff's consideration the Luther Burger (named after the musician Luther Vandross), which features a bacon cheeseburger on a grilled, sliced glazed donut. [Wikipedia] [Photo from Grocery Eats] Another good candidate for the title of world's most unhealthy burger is the deep-fried cheeseburger. [Cheese-burger.net]

Family physicians' "lifestyle interventions" -- which translates to telling patients to get some exercise, don't eat too much junk food, etc. -- don't appear to do much good for patients at low risk of cardiovascular problems. "In general, while it is difficult to suggest that primary care providers not counsel all their patients on healthy lifestyles, their time might be better spent focusing on those at higher risk," found a pair Newfoundland researchers, in their systematic review published this month. [Canadian Family Physician]

A former president of the College of Physicians and Surgeons of Alberta was killed over the weekend when her husband's plane crashed in Colorado. Family physician Sheila Malm, whose husband, oil company consultant Gerrit Maureau, was flying, was 65. "There are some people who wake up in the morning and just give all day," Dr Juliet Guichon, a senior associate in the University of Calgary's bioethics office, where Dr Malm used to work as well, told the Calgary Herald. "When she saw a patient, she worked hard to see the patient in a complex web of relationships, rather than seeing the patient as an isolated human. That's how you give better care." [Calgary Herald]

Health Canada has issued a safety warning about the increasingly common off-label use of the cancer drug bevacizumab (Avastin) to treat age-related macular degeneration by injecting it directly into patients' eyes. The warning, which reminds doctors that the drug was never evaluated for use in the eyes, said, "As of November 26, 2008, Roche has been made aware of 25 spontaneously reported Canadian cases of eye inflammation, endophthalmitis, blurred vision, and floaters, some of which have been described as Toxic Anterior Segment Syndrome (TASS), in patients who were administered aliquots of AVASTIN Lot B3002B028 intravitreally." [Health Canada MedEffect]

A recent labour-mobility agreement between the medical regulatory bodies in Quebec and Ontario has some authorities on the Quebec side of the border concerned that doctors are going to see greener grass in Ontario. Some specialists could earn up to 30% more in Ontario than they do in Quebec. [CBC News]

In the wake of the death by freezing of André Gagnon, a homeless man, in Montreal, Quebec Health Minister Dr Yves Bolduc has been put on the defensive on the question of the amount of funding the provincial government contributes to homeless shelters. [La Presse] Montreal shelters receive $12 per bed per night from Quebec, whereas Toronto shelters receive $61 from Ontario, according to the head of Montreal's Old Brewery Mission shelter, where Mr Gagnon was last seen before he died. [Montreal Gazette] "We invest four times more than was invested in 2003 for shelters," Dr Bolduc told La Presse. "The condition of the homeless is something that we have been concerned with but we are waiting for the results of a parliamentary commission to decide on our action plan." Dr Bolduc also disagreed with the comparison with Toronto. Meanwhile, $24 million in new funding was announced Tuesday to combat poverty in Montreal, but some people were disappointed that none of the money was dedicated to homeless shelters. [Montreal Gazette]

Too many young Quebec GPs are starting their careers working in hospitals and emergency departments instead of walk-in clinics, to the detriment of the healthcare system, according to a new report from the Quebec Federation of General Practitioners. [Montreal Gazette] "That newly graduated physicians would want to work in emergency, that is not surprising," said report co-author Isabelle Paré. "They're young and emergency gives them an adrenaline rush. What's more disturbing is that after three years [of practice], more of them are in second-line care, in the hospital. If that trend continues, we'll have a shortage in first-line care." [Le Soleil]

The hypothesis: "The discordance between fertility intentions and outcomes may be associated with mental health in the general population." In other words, unintended pregnancies and childlessness are both real bummers. But when two McGill researchers examined the data, it turned out that neither of those outcomes caused women psychological distress, and only the former caused distress in men. [Social Science & Medicine abstract]

Saskatchewan researchers have produced the first diffraction-enhanced imaging (DEI) soft-tissue X-rays ever in North America. [University of Saskatchewan news release]

Someone was bound to do it eventually. A Californian researcher replicated the infamous Stanley Milgram obedience experiment in which subjects were instructed to administer higher and higher voltage shocks, which they believed falsely to be real, to other subjects, in order to test their willingness to obey the instructions of the fake study's investigators. The man who has reproduced it, Jerry Burger, however, did not take it as far as Dr Milgram did. Dr Burger did not allow his subjects to administer a fake shock after it became clear the fake patient would suffer. "It was a very, very, very stressful experience for many of the participants," he said of the original study. "That is the reason no one can ethically replicate the experiment today." Dr Burger found that 70% of participants were willing to increase the voltage of a shock to the patient when asked to do so, even after seeing the patient (an actor) scream in pain. "That was surprising and disappointing," he said. [Reuters] Read more about Dr Milgram's obedience experiment. [Psychology Today]

In a new video, Dr Jock Murray, the former Dalhousie University dean of medicine, gave his take on the good and bad aspects of the Canadian and American healthcare models. "Canada gives everything to everyone, but in some instances, not right now. The USA gives everything right now, but not to everyone." [Medscape]

The holiday edition of Grand Rounds was published Tuesday. [Highlight Health]

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