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									                               CMAJ                                                                                                          Highlights
                             Deep vein thrombosis in pregnancy                                                                      this situation. Van Walraven and colleagues have developed
                                                                                                                                    a prognostic index based on commonly available information
                             In nonpregnant patients, most deep vein thromboses of the                                              for patients and clinicians to use when discussing dialysis
                             lower extremities start in the calf veins and progress proxi-                                          and transplantation options. See Research, page 666
                             mally, but is the pattern the same for pregnant women? Based
                             on their review of the literature, Chan and colleagues found
                             that proximal deep vein throm-                                                                         Underdiagnosis of COPD in primary care
                             bosis restricted to the femoral  James King-Holmes/Science Photo Library

                             or iliac veins is more common                                                                          Detection of chronic obstructive pulmonary disease at an
                             among pregnant women. They                                                                             early stage is crucial for implementing targeted interventions,
                             also found, as with previous                                                                           such as smoking cessation and increased exercise. In their
                             studies, that these thromboses                                                                         study of three primary care sites, Hill and colleagues found
                             usually develop on the left side.                                                                      that up to one in five patients with known risk factors had
                             See Research, page 657                                                                                 spirometric evidence of chronic obstructive pulmonary dis-
                                We lack good evidence-                                                                              ease. Of these patients, only one-third were aware of their
                             based studies on techniques for                                                                        diagnosis before the study. See Research, page 673
                             diagnosing deep vein throm-
                             boses in pregnant women, says
                             Kaaja. As a consequence, the natural course of proximal or                                             Preventing migraine
                             distal deep vein thrombosis in pregnancy is not clear. See
                             Commentary, page 649                                                                                   Prophylaxis of migraine should

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                                                                                                                                    be considered in patients whose
                                                                                                                                    headaches affect their quality of
                             The genetics of Crohn disease                                                                          life despite appropriate sympto-
                                                                                                                                    matic treatment and in those who
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