What's in the news: Jan 23 -- Listeriosis inquiry tainted?

The federal government's promised inquiry into last year's deadly outbreak of listeriosis, which had been stalled because no one was appointed to lead it for months after it was announced, is finally getting underway. Former Edmonton health authority president Sheila Weatherill (right) has been selected to take charge of the inquiry. Her report is due July 20. [Canwest News Service] Concerns, however, have been raised about a potential conflict of interest for Ms Weatherill, who also serves as an adviser to the Prime Minister on how to improve the nation's public service. "I think it's pretty clear: Ms. Weatherill can be a cheerleader for the public service, or she can be an independent investigator of the public service,” the University of Ottawa's Amir Attaran told the Canadian Press. “But she can't be both at the same time." [Canadian Press] Liberal Party Health Critic Dr Carolyn Bennett also criticized the inquiry, saying the mandate is not broad enough. "It is only through a full judicial inquiry that all of the facts will be known – and only then can the families of the victims move forward and Canadians can be assured it won’t happen again." [Liberal Party news release]

HRT fears hurt women, says review
Hormone replacement therapy is safe for short-term use by younger menopausal women, a new Society of Obstetricians and Gynecologists of Canada review concluded. The SOGC review contradicts several major findings of the seminal 2002 Women's Health Initiative study that first raised alarms about the widespread use of HRT, including the purported links between HRT and breast cancer, and HRT and heart attacks. [SOGC Menopause and Osteoporosis Update 2009 (PDF)] "Not all women need HT, but many with troublesome symptoms were needlessly scared away from that option due to misunderstandings about the actual risks associated with it,” Queen's University reproductive endocrinology professor Dr Robert Reid, who led the review, said in a release. Of concern to the SOGC was the prospect that many postmenopausal women weren't receiving HRT for the prevention of osteoporosis-related bone loss and fracture. [SOGC news release] [Toronto Star] [CBC News] [Canadian Press] [Canwest News Service]

Grit shuffle leaves health be
Liberal Party leader Michael Ignatieff revised the party's shadow cabinet positions today. Dr Bennett remained health critic. [Liberal Party news release]

'What nursing shortage?' Quebec study asks
Montreal researchers said that Quebec's frequently cited nursing shortage has been vastly overstated. Adding 1,807 nurses, as has been suggested, wouldn't reduce wait times or improve patient care, the Center for Interuniversity Research and Analysis on Organizations report said. One of the reasons for the incorrect estimates in the past is the "lower work intensity" of Quebec nurses, who work an average of 10% less per week than do nurses in the rest of Canada and are more likely to be part-time employees. [CIRANO news release] [CIRANO report (PDF, French only)] The president of the provincial nurses' union said the report was just a guise to promote more private-sector involvement in the healthcare system. "Quebec nurses work just as hard as their colleagues in the rest of Canada and we want to continue working in a public milieu," said Line Bonamie. [Montreal Gazette] [Sherbrooke Record]

In the literature...
Four Canadian researchers, including BC provincial health officer Dr Perry Kendall, have been "thinking the unthinkable." In an essay published in the journal Public Health they suggested that the rising popularity of prescription opioid abuse might actually be a good thing because the prescription drugs aren't injected, are of high-grade medical quality, and because prescription drug abusers are less likely to commit dangerous crimes than heroin users. Admitting their idea is "speculative" and has no data to back it up, they make the phenomenally controversial statement that "An unorthodox way of thinking about the increasing prevalence of PO use among street drug users might be as an unsanctioned or indirect form of 'medical opioid substitution.'" [Public Health (no abstract available)]

A British Columbia experiment in which the government pushed patients to use a cheaper proton pump inhibitor ended up costing the province more money and was, on the whole, detrimental to patients' health, a study published online last week in the journal Alimentary Pharmacology & Therapeutics said. [Alimentary Pharmacology & Therapeutics abstract] The plan was intended to save the healthcare system $42 million. It ended it costing over $43 million more than would have been spent if the drug change hadn't taken place. [CBC News]

Cocaine users who develop agranulocytosis might have snorted a line from a batch spiked with the veterinary antiparisitic drug levamisole, suggested three researchers from the University of Alberta. [Annals of Internal Medicine]

A big, preemptive dose of fluticasone at the beginning of a child's respiratory infection cuts in half the likelihood that the infection will progress to the point that it needs to be treated with steroids, reported physicians from Quebec and UBC in a new article in the New England Journal of Medicine. However, they wrote, "Given the potential for overuse, this preventive approach should not be adopted in clinical practice until long-term adverse effects are clarified." [NEJM abstract] [University of Montreal news release]

Fear of experiencing anxiety makes patients with generalized anxiety disorder worry more, which in turn contributes to their anxiety, reported a pair of Concordia University psychology researchers in an article published online ahead of print last month in Behaviour Research and Therapy. [Behaviour Research and Therapy abstract] In other words: anxiety breeds anxiety. If that isn't enough to make you worry, I don't know what is.

72% of patients admitted to the emergency department with minor head injuries have full-blown concussions, and almost 90% of them still suffer from post-concussion sympotoms one month later, said Queen's University researchers in a study in the Journal of Emergency Medicine. [Journal of Emergency Medicine abstract]

A protein called FimH might improve people's immune reactions and "can potentially be used as an innate microbicide against mucosal pathogens" or even cancer, wrote a team of researchers from McMaster and Guelph in PLoS Pathogens. [PLoS Pathogens] "Another way to fight these diseases is to empower our own defense system to deal with the infections, or cancer," said McMaster pathology and molecular medicine professor Ali Ashkar. "This is the basis for emerging interest in factors/molecules which can boost our very own innate defense system." [McMaster news release]

Here's some disturbing news about the Canadian donated blood supply. Until guidelines were introduced last year, there was a great deal of mostly incoherent variation from hospital to hospital on the question of what would trigger an investigation into the cause of an infection after a blood transfusion. (This can be of immense importance because if one bag of blood has been contaminated with harmful bacteria, other bags may need to be tested.) [Vox Sanguinis abstract] [Public Health Agency of Canada guidelines, 2008 (PDF)]

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