Cut the TTC... and introduce fighting the schools?

The Ford administration in Toronto has done it again. Beyond the absurdity of cutting service to the TTC when ridership is at all-time highs, Doug Ford now wants to bring UFC to Toronto schools.

I can't wait until 2014.

Shame on you Rob Ford

TTC is forced to cut back service on 62 busy bus and streetcar routes because of Rob Ford's budget knife.

Man in testicle

The Globe and Mail has published an amusing picture of a scrotal ultrasound, originally published in journal Urology.

Pusateri's is shut down!

For all those who like gourmet food, beware: Pusateri's Avenue Road location is shut down by health inspectors because of rat and cockroach infestation.

I like my No Frills!

Nutrient supplementation and mortality

A large cohort study from Iowa found an association between use of certain nutrient supplements (multivitamins and iron in particular) and overall mortality. Calcium had a protective effect, though there was no dose-response relationship. The authors adjusted for a number of other variables, including age, education, geography, medical comorbidities, and other factors.

Considering that millions of people take vitamin and mineral supplements with the intention of reaping health benefits that may not actually be present, this study provides some food for thought.

Link: Arch Intern Med 2011;171(18):1625

Embedded acupuncture needles on plain x-ray

CMAJ has a brief, interesting article showing a plain chest radiograph of a patient who has innumerable fine acupuncture needles embedded in her skin. You definitely don't see this every day...

CMAJ 2011. doi:10.1503/cmaj.110128

Margaret Atwood on democracy

In response to Margaret Atwood's criticism against Rob and Doug Ford's ignorant and shortsighted plans to close Toronto libraries, they suggested she run for mayor.

“I am not running for mayor yet. But if it comes to be true that people cannot voice an opinion unless they have been elected, then we are no longer in a democracy,” - Margaret Atwood

It's about time for someone to speak out against the Ford oligarchy!

The emotional toll of cancer

The Globe and Mail has a good Facts and Arguments article written by a young patient about the social and emotional consequences of developing and surviving cancer.

Quincke's Pulse

Here is a video of Quincke's Pulse, a eponymous term used to describe pulsating and alternating colour and pallor in distal capillary beds found in patients with aortic regurgitation.

High demand, no jobs

The irony of the Canadian health care system is that patients can wait years for a consultation with a foot surgeon, and yet there be a job shortage for orthopedic foot surgeons. The reason? Hospitals have a disincentive to hire more surgeons because each operation increases the hospital's operating expenditure. This is in contrast to, say, joint arthroplasties, which governments have made a priority by providing bonuses to hospitals for performing. Is this fair?

The job shortage extends to nephrologists and community medicine physicians. For more, see tomorrow's Globe article.

A not-so-simple love story

Just ahead of Valentine's Day, The Globe and Mail publishes a moving story that is just different from the typical February 14th fare.

Confidentiality and public figures

Are there guidelines regarding medical confidentiality and public figures? Although it is remarkable to see and hear how Congresswoman Gabrielle Giffords' improvement in medical condition, I am surprised to see so many details and play-by-play developments reported in the news media regarding her changing health. Did her husband authorize the release of health information? If so, this important fact should be made clear in the news media.

Jack McIntyre ("Rose Man") passes away

Jack McIntyre, the man who came up with Pierre Trudeau's signature lapel rose, has died.

I had the pleasure of meeting Jack McIntyre and his wife as part of his volunteer efforts with Queen's University's Clinical Skills program. In the brief hour in which several members of our medical class visited him in Kingston, he told us about himself, his history, how he courted his wife by sending her a rose every week, and the story behind Trudeau's rose. His apartment was decorated with commendations and letters of congratulations from various dignitaries and politicians from across time. In his later years, he dedicated his efforts towards raising money for charitable causes, including cancer research.

He will be missed by all.

Santa is Canadian!

The National Post has written an article with some little-known facts about Santa Claus and his role with respect to the Canadian government:
- Santa is a Canadian citizen, according to Citizenship and Immigration Minister Jason Kenney.
- Santa's workshop is GST exempt.
- Because the North Pole is part of Canadian territory, Santa doesn't need to go through border clearance when he travels to deliver gifts.

No comment on whether Santa has to pay landing fees - or in BC, whether he needs to pay the carbon tax.

Ontario Health Study

I learned of something called the Ontario Health Study, a recently-launched longitudinal research project that aims to collect health data from millions of Ontarians over the next several decades. They currently have a large presence on the TTC - to learn more, visit the study website or this Globe and Mail article.

Wool Lovers in Kingston

To the Wool Lovers in Kingston:

Thanks for putting woollen covers on downtown Kingston's bike stands. They're really pretty and help liven up the urban landscape. I don't remember the e-mail address you tagged your creations with, but consider this a fan letter!

Derek

Local if necessary, but not necessarily local

A Globe and Mail article discusses the environmental impact of salmon that is produced locally versus being shipped from an international location. The answers may are surprising!

Antiseptics: Pink is better

In preparing patients for invasive procedures (e.g biopsies, bone marrow aspiration, major surgery), I have always wondered the difference between the various antiseptics used. In the past, I tended to use whatever was handed to me by the nurse or resident.

A recent study published in NEJM earlier this year shows that chlorhexidine-alcohol (pink solution) is superior to povidone-iodine (brown solution) in reducing rates of surgical site infection. This randomized controlled trial found a relative risk of 0.59. Although this is only one study, it strongly supports use of chlorhexidine-based solutions over iodine.

Why do cyclists take up a whole lane?

Cyclists taking the lane in Vegas,
originally uploaded by richardmasoner.

When I'm a driver on the road, sometimes I get annoyed at cyclists who take up more than their proportionate space in a road lane. However, as a road cyclist myself, I know there are many very good reasons cyclists do this. Here are some of them:

- the edge of the lane was repaved, making it bumpy and very uncomfortable to ride on
- there is gravel or dirt near the curb, reducing traction
- the edge of the lane has potholes, sewer drains, road signs or other hazardous obstacles
- it recently rained, making the side of the road wet
- there are parked cars with passengers who may open the door and give the door prize
- the cyclist is allowing the car behind it to turn right
- there is a runner or a slower cyclist on the road
- the cyclist feels the lane is too narrow, so takes up the lane to prevent drivers from passing

Some behaviours of cyclists (running red lights and stop signs) are inexcusable, but riding in the middle of the lane does have its legitimate reasons.

Welcome to a Rob Ford city

Rob Ford suggests runners should compete in parks, rather than on roads, to avoid street closures.

He also says "roads are built for buses, cars, and trucks, not for people on bikes".

Well, I suggest the following, too:
- kids should play NHL 2011 on their PlayStation 3, not on the roadway.
- roads are not for parked cars. We should ban all street parking.
- sidewalks, like bike lanes, take up precious space on roadway easements. They should be demolished and replaced with extra car lanes.
- trucks are slow. We should ban trucks, because freight should be moved over rail lines instead.