The life, achievements and legacy of a great Canadian investigator: Professor Boris Petrovich Babkin (1877-1950).

The present paper reviews the life and achievements of Professor Boris Petrovich Babkin (MD DSc LLD). History is only worth writing about if it teaches us about the future; therefore, this historical review concludes by describing what today's and future gastrointestinal physiologists could learn from Dr Babkin's life. Dr Babkin was born in Russia in 1877. He graduated with an MD degree from the Military Medical Academy in St Petersburg, Russia, in 1904. Not being attracted to clinical practice, and after some hesitation concerning whether he would continue in history or basic science of medicine, he entered the laboratory of Professor Ivan Petrovich Pavlov. Although he maintained an interest in history, in Pavlov's exciting environment he became fully committed to physiology of the gastrointestinal system. He advanced quickly in Russia and was Professor of Physiology at the University of Odessa. In 1922, he was critical of the Bolshevik revolution, and after a short imprisonment, he was ordered to leave Russia. He was invited with his family by Professor EH Starling (the discoverer of secretin) to his department at University College, London, England. Two years later, he was offered a professorship in Canada at Dalhousie University, Halifax, Nova Scotia. After contributing there for four years, he joined McGill University, Montreal, Quebec, in 1928 as Research Professor. He remained there for the rest of his career. Between 1940 and 1941, he chaired the Department, and following retirement, he remained as Research Professor. At the invitation of the world-famous neurosurgeon, Wilder Penfield, Dr Babkin continued as Research Fellow in the Department of Neurosurgery until his death in 1950 at age 73. His major achievements were related to establishing the concept of brain-gut-brain interaction and the influence of this on motility, as well as on interface of multiple different cells, nerves and hormones on secretory function. He had a major role in the rediscovery of gastrin. He established a famous school of gastrointestinal physiologists at McGill University. He supported his trainees and helped them establish their careers. He received many honors: a DSc in London, England, and an LLD from Dalhousie University. Most importantly, he was the recipient of the Friedenwald Medal of the American Gastroenterological Association for lifelong contributions to the field. Dr Babkin taught us his philosophical aspect of approaching physiology, his devotion to his disciples and his overall kindness. Most importantly, he has proven that one can achieve international recognition by publishing mainly in Canadian journals. He is an example to follow.

Canadian Helicobacter Study Group Consensus Conference: Update on the approach to Helicobacter pylori infection in children and adolescents--an evidence-based evaluation.

As an update to previously published recommendations for the management of Helicobacter pylori infection, an evidence-based appraisal of 14 topics was undertaken in a consensus conference sponsored by the Canadian Helicobacter Study Group. The goal was to update guidelines based on the best available evidence using an established and uniform methodology to address and formulate recommendations for each topic. The degree of consensus for each recommendation is also presented. The clinical issues addressed and recommendations made were: population-based screening for H. pylori in asymptomatic children to prevent gastric cancer is not warranted; testing for H. pylori in children should be considered if there is a family history of gastric cancer; the goal of diagnostic interventions should be to determine the cause of presenting gastrointestinal symptoms and not the presence of H. pylori infection; recurrent abdominal pain of childhood is not an indication to test for H. pylori infection; H. pylori testing is not required in patients with newly diagnosed gastroesophageal reflux disease; H. pylori testing may be considered before the use of long-term proton pump inhibitor therapy; testing for H. pylori infection should be considered in children with refractory iron deficiency anemia when no other cause has been found; when investigation of pediatric patients with persistent or severe upper abdominal symptoms is indicated, upper endoscopy with biopsy is the investigation of choice; the 13C-urea breath test is currently the best noninvasive diagnostic test for H. pylori infection in children; there is currently insufficient evidence to recommend stool antigen tests as acceptable diagnostic tools for H. pylori infection; serological antibody tests are not recommended as diagnostic tools for H. pylori infection in children; first-line therapy for H. pylori infection in children is a twice-daily, triple-drug regimen comprised of a proton pump inhibitor plus two antibiotics (clarithromycin plus amoxicillin or metronidazole); the optimal treatment period for H. pylori infection in children is 14 days; and H. pylori culture and antibiotic sensitivity testing should be made available to monitor population antibiotic resistance and manage treatment failures.

Birth of the Canadian Digestive Health Foundation.

The Canadian Digestive Disease Foundation, renamed the Canadian Digestive Health Foundation--Fondation canadienne pour la promotion de la santé digestive--in December 2001, is the culmination of ongoing efforts by the Canadian Association of Gastroenterology to establish an independent charitable organization. In February 2001, it was officially endorsed as the Foundation for the Canadian Association of Gastroenterology. The initial efforts to establish this Foundation, led by Dr Richard McKenna in 1963, were unsuccessful. In 1991, Glaxo Canada (now GlaxoSmithKline) became a founding donor, and with the four founding physicians--Drs Ivan T Beck, Richard H Hunt, Suzanne E Lemire and Alan BR Thomson--the expenses to establish the Foundation were met. A charitable number was obtained in 1995 (0997427-11). The second founding donor was Janssen Canada (now Janssen-Ortho), and public education support came from Astra Canada (now AstraZeneca Canada). The Foundation initially relied on corporate donors, but now approaches physicians, patients and the general public. The objectives of the Foundation are to advance the science of gastroenterology and to provide knowledge of digestive diseases and nutrition to the general public, to enhance the quality of life of persons who are afflicted with these disorders. The major achievements of the Foundation are the provision of one-year operating grants to new investigators, which have allowed them to accumulate early data and subsequently obtain support from other major granting organizations. It also provides Fellowships and studentship support grants, in conjunction with the Canadian Institutes of Health Research and the pharmaceutical industry. The education committee found that there was little research support in this field, considering the large economic burden of digestive disease and the amount of outstanding work done by Canadian researchers. A bilingual Web site, a web-based specialist's discussion program and bilingual pamphlets facilitate public awareness and allow patients to voice concerns.

The health care philosophy that nearly destroyed Medicare in Canada in a single decade.

BACKGROUND: In 1989, governments in Canada perceived an economic crisis in health care funding and commissioned two economists, Drs. Barer and Stoddart, to review policies. They indicated that major costs were caused by physicians and recommended cutting physician training and hospital facilities. In 1991 governments selectively implemented their recommendations. The Federally established Romanow Commission 're-reviewed' the problem and reported in 2002. OBJECTIVES: To examine whether there was an economic crisis and to assess the effects of reductions in funding on the provision of health care in Canada. METHOD: We analyzed data from Statistics Canada, the Association of Canadian Medical Colleges, and the Canadian Institute of Health Information, the Canadian Nurses Association, and Health Canada. We focus exclusively on public health care spending. RESULTS: Publicly financed health care spending remained stable as percentage of Gross Domestic Product in the five years leading up to the commissioning of the Barer-Stoddart report (1986-1990). An increase in the elderly population partly explained rising costs. By 2000, people over 65 accounted for 48% of overall health costs. Emerging from the report's recommendations, between 1990 and 2000 medical students and residents as a proportion of the population were cut by 17% and 12% respectively and hospital beds by a third. Nurses per 100,000 fell 12%. Home care remained under-funded, less than 4% of the total health budget. CONCLUSION: There was no economic health care crisis in the early 1990s. Growing costs were principally due to increased patient need. Funding reductions resulted in inadequate care, including the creation of prolonged wait lists that have resulted in legalizing private care, thereby threatening the universal equal care principle.