Constitutional Questions about Canada\u27s New Political Finance Regime

The Supreme Court of Canada has considered the constitutionality of some aspects of the political finance regime that has been in place since 1974. Recent political finance reforms raise new and challenging constitutional questions. This article examines whether the political finance reforms introduced in the 2003 Elections Act and 2006 Accountability Act-limits on political contributions by individuals and an outright prohibition on union and corporate political contributions-are contrary to Charter guarantees of freedom of expression and freedom of association. Parliament\u27s conflict of interest in regulating the democratic process and the implications that this conflict has for Charter analysis of the recent political finance reforms is highlighted

Constitutional Questions about Canada\u27s New Political Finance Regime

The Supreme Court of Canada has considered the constitutionality of some aspects of the political finance regime that has been in place since 1974. Recent political finance reforms raise new and challenging constitutional questions. This article examines whether the political finance reforms introduced in the 2003 Elections Act and 2006 Accountability Act-limits on political contributions by individuals and an outright prohibition on union and corporate political contributions-are contrary to Charter guarantees of freedom of expression and freedom of association. Parliament\u27s conflict of interest in regulating the democratic process and the implications that this conflict has for Charter analysis of the recent political finance reforms is highlighted

Freedom of Expression and the Law of the Democratic Process

The author considers the Harper v. Canada case concerning spending limits on individuals and groups other than candidates and political parties in the context of the larger landscape of Canadian campaign finance jurisprudence. The paper begins by reviewing the vibrant academic debate over law of the democratic process issues and noting the Canadian legal academy\u27s surprising lack of attention to this subject area. The egalitarian the ory of election regulation that figures prominently in Harper is reviewed and it is suggested that the the ory led the Court to be insufficiently rigorous in its review of the spending limits in Harper. The author uses U.S. legal the ory, particularly process the ory, to articulate a new approach to judicial review in law of the democratic process cases that reconciles the Court\u27s egalitarian the ory and the need to check the self-interest of Parliament

Plasma exchange in chronic inflammatory demyelinating polyradiculoneuropathy

Eleven consecutive patients with progressive chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) underwent plasma exchange. Eight patients were previously unresponsive to prednisone, two were started on prednisone with plasma exchange, and one did not receive corticosteroids. Electrodiagnostic studies revealed evidence of an acquired demyelinating polyradiculoneuropathy with varying degrees of axonal degeneration. Neurologic impairment was monitored using conventional functional status index. Five patients demonstrated substantial clinical improvement, beginning 2 days to 3 weeks after initiating plasma exchange. Two additional patients improved following a second course of plasma exchange, and four patients demonstrated minimal or no change. Comparison of responding and onresponding patients showed no differences related to the presence or absence of antecedent illness, duration of disease, duration of maximum weakness, or severity of impairment prior to plasma exchange. Responders had significantly prolonged F-response and motor distal latencies compared to nonresponders. Results in this unselected, consecutive patient trial suggest a temporal relationship between plasma exchange and clinical improvement in some patients with progressive CIDP.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/50135/1/880080409_ftp.pd

Carotid endarterectomy - An evidence-based review: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology

Objective: To assess the efficacy of carotid endarterectomy for stroke prevention in asymptomatic and symptomatic patients with internal carotid artery stenosis. Additional clinical scenarios, such as use of endarterectomy combined with cardiac surgery, are also reviewed. Methods: The authors selected nine important clinical questions. A systematic search was performed for articles from 1990 (the year of the last statement) until 2001. Additional articles from 2002 through 2004 were included using prespecified criteria. Two reviewers also screened for other relevant articles from 2002 to 2004. Case reports, review articles, technical studies, and single surgeon case series were excluded. Results: For several questions, high quality randomized clinical trials had been completed. Carotid endarterectomy reduces the stroke risk compared to medical therapy alone for patients with 70 to 99% symptomatic stenosis (16% absolute risk reduction at 5 years). There is a smaller benefit for patients with 50 to 69% symptomatic stenosis (absolute risk reduction 4.6% at 5 years). There is a small benefit for asymptomatic patients with 60 to 99% stenosis if the perioperative complication rate is low. Aspirin in a dose of 81 to 325 mg per day is preferred vs higher doses (650 to 1,300 mg per day) in patients undergoing endarterectomy. Conclusions: Evidence supports carotid endarterectomy for severe (70 to 99%) symptomatic stenosis (Level A). Endarterectomy is moderately useful for symptomatic patients with 50 to 69% stenosis (Level B) and not indicated for symptomatic patients with \u3c50% stenosis (Level A). For asymptomatic patients with 60 to 99% stenosis, the benefit/risk ratio is smaller compared to symptomatic patients and individual decisions must be made. Endarterectomy can reduce the future stroke rate if the perioperative stroke/death rate is kept low (\u3c3%) (Level A). Low dose aspirin (81 to 325 mg) is preferred for patients before and after carotid endarterectomy to reduce the rate of stroke, myocardial infarction, and death (Level A). Copyright © 2005 by AAN Enterprises, Inc

Guillain-Barré syndrome: a century of progress

In 1916, Guillain, Barré and Strohl reported on two cases of acute flaccid paralysis with high cerebrospinal fluid protein levels and normal cell counts — novel findings that identified the disease we now know as Guillain–Barré syndrome (GBS). 100 years on, we have made great progress with the clinical and pathological characterization of GBS. Early clinicopathological and animal studies indicated that GBS was an immune-mediated demyelinating disorder, and that severe GBS could result in secondary axonal injury; the current treatments of plasma exchange and intravenous immunoglobulin, which were developed in the 1980s, are based on this premise. Subsequent work has, however, shown that primary axonal injury can be the underlying disease. The association of Campylobacter jejuni strains has led to confirmation that anti-ganglioside antibodies are pathogenic and that axonal GBS involves an antibody and complement-mediated disruption of nodes of Ranvier, neuromuscular junctions and other neuronal and glial membranes. Now, ongoing clinical trials of the complement inhibitor eculizumab are the first targeted immunotherapy in GBS

International Guillain-Barré Syndrome Outcome Study (IGOS): protocol of a prospective observational cohort study on clinical and biological predictors of disease course and outcome in Guillain-Barré syndrome

Guillain-Barré syndrome (GBS) is an acute polyradiculoneuropathy with a highly variable clinical presentation, course, and outcome. The factors that determine the clinical variation of GBS are poorly understood which complicates the care and treatment of individual patients. The protocol of the ongoing International GBS Outcome Study (IGOS), a prospective, observational, multi-centre cohort study that aims to identify the clinical and biological determinants and predictors of disease onset, subtype, course and outcome of GBS is presented here. Patients fulfilling the diagnostic criteria for GBS, regardless of age, disease severity, variant forms, or treatment, can participate if included within two weeks after onset of weakness. Information about demography, preceding infections, clinical features, diagnostic findings, treatment, course and outcome is collected. In addition, cerebrospinal fluid and serial blood samples for serum and DNA is collected at standard time points. The original aim was to include at least 1000 patients with a follow-up of 1-3 years. Data are collected via a web-based data entry system and stored anonymously. IGOS started in May 2012 and by January 2017 included more than 1400 participants from 143 active centres in 19 countries across 5 continents. The IGOS data/biobank is available for research projects conducted by expertise groups focusing on specific topics including epidemiology, diagnostic criteria, clinimetrics, electrophysiology, antecedent events, antibodies, genetics, prognostic modelling, treatment effects and long-term outcome of GBS. The IGOS will help to standardize the international collection of data and biosamples for future research of GBS. ClinicalTrials.gov Identifier: NCT01582763