19,265 results match your criteria CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne[Journal]


The Canadian Forces Cancer and Mortality Study II: a longitudinal record-linkage study protocol.

CMAJ Open 2018 Oct-Dec;6(4):E619-E627. Epub 2018 Dec 10.

Directorate of Force Health Protection (Rolland-Harris, Weeks, Simkus) and Directorate Mental Health (Zamorski, Boulos), Department of National Defence, Ottawa, Ont.; Research Directorate (VanTil, Simkus), Veterans Affairs Canada, Charlottetown, PEI; Statistics Canada (Reicker, Masoud, Trudeau), Ottawa, Ont.

Background: Military service exposes personnel to unusual situations with unclear health-related implications, and to identify both immediate and delayed risks, part of health surveillance includes examination of mortality and cancer rates that extends beyond periods of military service. The main aim of the Canadian Forces Cancer and Mortality Study II (CFCAMS II) is to describe the mortality and cancer experience of Canadian Armed Forces personnel (serving and released; about 230 000 people), with the further aim of informing health promotion and prevention programs for serving personnel and services for veterans after they leave the military.

Methods: This protocol is for a retrospective cohort study of serving and released Canadian Armed Forces personnel who enrolled on or after Jan. Read More

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December 2018
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Prescribing and testing by primary care providers to assess adherence to the Choosing Wisely Canada recommendations: a retrospective cohort study.

CMAJ Open 2018 Oct-Dec;6(4):E603-E610. Epub 2018 Dec 10.

Departments of Family Medicine (Singer, Kosowan, Katz, Jolin-Dahel, Appel) and Community Health Sciences (Katz, Lix), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Manitoba Primary Care Research Network (Singer); Manitoba Centre for Health Policy (Katz), Winnipeg, Man.; Centre Medical Seine (Jolin-Dahel), Ste. Anne, Man.; Seven Oaks Hospital (Appel), Winnipeg, Man.

Background: Choosing Wisely Canada is an initiative to reduce overprescribing and overtesting. This study assessed adherence to 4 Choosing Wisely Canada recommendations for interventions commonly performed in primary care: (a) antibiotic prescriptions for infections that are probably viral in origin, (b) routine vitamin D tests in low-risk adults, (c) annual screening blood tests and (d) prescriptions of antipsychotic medication to treat symptoms of dementia.

Methods: We conducted a retrospective cohort study of data from the electronic medical records of patients who had an encounter between 2014 and 2016 with a participating Manitoba Primary Care Research Network primary care provider in Manitoba, Canada. Read More

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December 2018

Dose response of sodium glucose cotransporter-2 inhibitors in relation to urinary tract infections: a systematic review and network meta-analysis of randomized controlled trials.

CMAJ Open 2018 Oct-Dec;6(4):E594-E602. Epub 2018 Dec 10.

School of Pharmacy (Donnan, Grandy, Chibrikov, Marra, Johnston, Hache, Curnew, Nguyen, Gamble) and Faculty of Medicine (Aubrey-Bassler, Swab), Memorial University, St. John's, NL; School of Pharmacy (Marra), University of Otago, Dunedin, New Zealand; School of Pharmacy (Gamble), University of Waterloo, Kitchener, Ont.

Background: The sodium glucose cotransporter-2 (SGLT2) inhibitors are a novel group of drugs for treatment of type 2 diabetes mellitus. We investigated whether there is a dose-response relation between SGLT2 inhibitors and urinary tract infections (UTIs) in patients with type 2 diabetes, relative to other diabetes therapies or placebo.

Methods: We conducted a systematic review and network meta-analysis of randomized controlled trials (RCTs) of SGLT2 inhibitors in patients with type 2 diabetes. Read More

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December 2018

Dog hospital.

Authors:
Alan Blum

CMAJ 2018 Dec;190(49):E1465

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December 2018

Culture of bullying in medicine starts at the top.

Authors:
Lauren Vogel

CMAJ 2018 Dec;190(49):E1459-E1460

CMAJ.

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December 2018

Art at the McGill University Health Centre.

CMAJ 2018 Dec;190(49):E1457

RBC Art and Heritage Centre of the McGill University Health Centre, Montréal, Que.

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December 2018

Erythrodermic paraneoplastic dermatomyositis.

CMAJ 2018 Dec;190(49):E1453

Department of Medicine, University of Toronto, Toronto, Ont.

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December 2018

Bone health after diagnosis of breast cancer.

CMAJ 2018 Dec;190(49):E1452

Department of Medicine (Ruzycki), University of Calgary; Department of Oncology (Nixon), Tom Baker Cancer Centre, Calgary, Alta.

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December 2018

Recommendations on screening for breast cancer in women aged 40-74 years who are not at increased risk for breast cancer.

CMAJ 2018 Dec;190(49):E1441-E1451

Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Department of Family Medicine (Lewin), University of Ottawa, Ottawa, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Thériault), McGill University, Montréal, Que.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Public Health Agency of Canada (Sims-Jones, Courage, Doull, Jaramillo Garcia), Ottawa, Ont.; Department of Psychiatry (Thombs), McGill University, Montréal, Que.

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December 2018

Occurrence of and referral to specialists for pain-related diagnoses in First Nations and non-First Nations children and youth.

CMAJ 2018 Dec;190(49):E1434-E1440

Faculty of Health (Latimer), Dalhousie University; Centre for Pediatric Pain Research (Latimer, MacLeod, Sylliboy, Filiaggi, Finley), IWK Health Centre, Halifax, NS; Department of Integrated Studies (Sylliboy), McGill University, Montréal, Que.; Eskasoni Health Centre (Rudderham), Eskasoni, NS; Departments of Surgery (Lethbridge) and Anesthesia, Pain Management and Perioperative Medicine (Finley), and School of Physiotherapy (Harman), Dalhousie University, Halifax, NS.

Background: Indigenous youth have higher rates of chronic health conditions interfering with healthy development, including high rates of ear, dental, chest and musculoskeletal pain, as well as headache, arthritis and mental health issues. This study explores differences in pain-related diagnoses in First Nations and non-First Nations children.

Methods: Data from a study population of age- and sex-matched First Nations and non-First Nations children and youth were accessed from a specific region of Atlantic Canada. Read More

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December 2018

Wise guidance and its challenges: the new Canadian recommendations on breast cancer screening.

CMAJ 2018 Dec;190(49):E1432-E1433

Memorial Sloan Kettering Cancer Center; Weill Cornell Medical College, New York, NY

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December 2018
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The authors respond to "Tread carefully with #MeToo in the medical profession".

CMAJ 2018 Dec;190(48):E1424

Clinician scientist, Department of Medicine, University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ont.

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December 2018

Tread carefully with #MeToo in the medical profession.

Authors:
Gary Satenstein

CMAJ 2018 Dec;190(48):E1423

Family physician, Wakefield, Que.

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December 2018

Pituitary apoplexy.

CMAJ 2018 Dec;190(48):E1419

The Post-graduate Education Center (Yamada); Department of General Internal Medicine (Fujikawa), Mitoyo General Hospital, Kan'onji, Kagawa, Japan

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December 2018

Acute flaccid myelitis.

CMAJ 2018 Dec;190(48):E1418

Divisions of Paediatric Medicine (Gill), infectious Diseases (Bitnun) and Neurology (Yeh), The Hospital for Sick Children; Department of Paediatrics (Gill, Bitnun, Yeh), University of Toronto; Department of Pediatrics (Gill, Bitnun, Yeh), Division of Neurosciences and Mental Health (Yeh), SickKids Research Institute, University of Toronto, Toronto, Ont.

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December 2018

Cardiac manifestations in Emery-Dreifuss muscular dystrophy.

CMAJ 2018 Dec;190(48):E1414-E1417

Department of Medicine (Faiella), Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS; Division of Cardiology (Bessoudo), New Brunswick Heart Centre, Saint John Regional Hospital, Saint John, NB.

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December 2018
2 Reads

Clinical validation of a risk scale for serious outcomes among patients with chronic obstructive pulmonary disease managed in the emergency department.

CMAJ 2018 Dec;190(48):E1406-E1413

Departments of Emergency Medicine (Stiell, Calder, Perry) and Medicine (Aaron, Forster), Clinical Epidemiology Program, Ottawa Hospital Research Institute (Stiell, Perry, Clement, Aaron, Forster, Brinkhurst), University of Ottawa Heart Institute (Wells), University of Ottawa, Ottawa, Ont.; Division of Emergency Medicine, Department of Family and Community Medicine (Borgundvaag), University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Brison), Kingston Health Sciences Centre, Kingston, Ont.; Department of Emergency Medicine (McRae), University of Calgary, Calgary, Alta.; Department of Emergency Medicine and School of Public Health, University of Alberta, and Alberta Health Services (Rowe), Edmonton, Alta.

Background: The Ottawa chronic obstructive pulmonary disease (COPD) Risk Scale (OCRS), which consists of 10 criteria, was previously derived to identify patients in the emergency department with COPD who were at high risk for short-term serious outcomes. We sought to validate, prospectively and explicitly, the OCRS when applied by physicians in the emergency department.

Methods: We conducted this prospective cohort study involving patients in the emergency departments at 6 tertiary care hospitals and enrolled adults with acute exacerbation of COPD from May 2011 to December 2013. Read More

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December 2018
3 Reads

High-strength opioid formulations: the case for a ministerial recall.

CMAJ 2018 Dec;190(48):E1404-E1405

Health Law Institute and Department of Pharmacology, Faculty of Medicine (Herder), Dalhousie University, Halifax, NS; Division of Clinical Pharmacology and Toxicology, and Medicine, Pediatrics, and Health Policy, Management and Evaluation (Juurlink), University of Toronto; Divisions of General Internal Medicine and Clinical Pharmacology & Toxicology (Juurlink), Sunnybrook Health Sciences Centre, Toronto, Ont.

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December 2018

To keep patients with COPD out of hospital, look beyond the lungs.

CMAJ 2018 Dec;190(48):E1402-E1403

Department of Medicine (Flegel), McGill University, Montréal, Que.; Senior editor (Flegel), CMAJ; Deputy editor (Stanbrook), CMAJ; Department of Medicine (Stanbrook), University of Toronto; ICES (Stanbrook), Toronto, Ont.

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December 2018

Factors associated with attendance at primary care appointments after discharge from hospital: a retrospective cohort study.

CMAJ Open 2018 Oct-Dec;6(4):E587-E593. Epub 2018 Dec 3.

Department of Medicine (Lam, Abrams, Okrainec), University of Toronto; Division of General Internal Medicine (Abrams, Okrainec), University Health Network; Biostatistics Research Unit (Matelski), University Health Network, Toronto, Ont.

Background: Follow-up with a primary care provider within 1-2 weeks of discharge from hospital has been associated with reduced readmissions. We sought to determine appointment attendance with primary care providers postdischarge and identify factors associated with attendance.

Methods: We conducted a retrospective cohort study involving general medicine patients who had been discharged from hospital between Sept. Read More

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December 2018
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Emerging antimicrobial resistance among strains in bloodstream infections in Toronto, 2006-2016: a retrospective cohort study.

CMAJ Open 2018 Oct-Dec;6(4):E580-E586. Epub 2018 Dec 3.

Department of Microbiology (Mineau, Kozak, Kissoon, Paterson, Oppedisano, Douri, Gogan, Willey, McGeer, Poutanen), University Health Network/Sinai Health System, Toronto, Ont.; Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Mineau), Sainte-Marie, Que.; Lawrence Park Collegiate Institute (Gogan); Departments of Laboratory Medicine and Pathobiology and of Medicine (McGeer, Poutanen), University of Toronto, Toronto, Ont.

Background: Enterobacteriaceae that produce extended-spectrum β-lactamase (ESBL) have emerged as a serious threat, with variable rates depending on geographic region. We determined the prevalence of ESBL-producing , , and in bloodstream infections in Toronto from 2006 through 2016.

Methods: All patients with , , and isolated from blood in a tertiary care microbiology laboratory in Toronto between 2006 and 2016 (1 isolate per species per patient per year) were included in this retrospective cohort study. Read More

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December 2018
2 Reads

Canadian regulations and legal ramifications for hepatic encephalopathy: a descriptive analysis.

CMAJ Open 2018 Oct-Dec;6(4):E575-E579. Epub 2018 Dec 3.

University of Calgary Liver Unit, Department of Medicine (Nguyen, Swain, Congly), Division of Gastroenterology and Hepatology, Calgary, Alta.; McGill University Health Centre (Wong), Royal Victoria Hospital, Montréal, Que.

Background: Hepatic encephalopathy, a form of brain dysfunction seen in the setting of liver insufficiency, negatively affects driving performance and so is both a patient and public safety issue. We aimed to review the motor vehicle codes in each Canadian province and territory relating to the reporting of patients with hepatic encephalopathy and to search a Canadian legal database for cases of motor vehicle collisions involving patients with hepatic encephalopathy.

Methods: In this descriptive analysis, the transportation agencies of each Canadian province and territory were contacted via telephone and/or email between April and August 2017. Read More

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December 2018
6 Reads

Readmission following hypoxic ischemic brain injury: a population-based cohort study.

CMAJ Open 2018 Oct-Dec;6(4):E568-E574. Epub 2018 Nov 27.

Toronto Rehabilitation Institute (Chan, Stock, Jacob, Cullen, Colantonio), University Health Network, Toronto, Ont.; Department of Clinical Health and Epidemiology (Stock), Dalhousie University, Halifax, NS; West Park Healthcare Centre (Cullen); Rehabilitation Sciences Institute (Cullen, Colantonio), University of Toronto; Institute for Clinical Evaluative Sciences (Colantonio), Toronto, Ont.

Background: Readmission to acute care is common and is associated with indicators of suboptimal care and health system inefficiencies. The objective of this study was to identify independent determinants of readmission following survival of hypoxic ischemic brain injury.

Methods: We conducted a population-based retrospective cohort study using Ontario's administrative health data. Read More

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November 2018

Public prescription drug plan coverage for antiretrovirals and the potential cost to people living with HIV in Canada: a descriptive study.

CMAJ Open 2018 Oct-Dec;6(4):E551-E560. Epub 2018 Nov 27.

Department of Pharmacy (Yoong), St. Michael's Hospital, Toronto, Ont.; Centre for Urban Health Solutions (Bayoumi), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Bayoumi), University of Toronto, Toronto, Ont.; Department of Pharmacy (Robinson), Windsor Regional Hospital, Windsor, Ont.; Ontario HIV Treatment Network (Rachlis), Toronto, Ont.; Department of Family and Community Medicine (Antoniou), St. Michael's Hospital and University of Toronto, Toronto, Ont.; Li Ka Shing Knowledge Institute (Antoniou), St. Michael's Hospital, Toronto, Ont.

Background: Antiretrovirals are expensive and people living with HIV may experience a range of financial burdens when accessing these medications. Our aim was to describe the policy of all Canadian public drug insurance programs for antiretroviral drugs and illustrated how these policies might affect patients' annual out-of-pocket expenditures.

Methods: In December 2017, we reviewed public drug programs offering antiretroviral coverage in Canada using government websites to summarize eligibility criteria. Read More

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November 2018

Tightening sanctions for physician sexual misconduct.

Authors:
Brian Owens

CMAJ 2018 Nov;190(47):E1398-E1399

St. Stephen, NB.

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November 2018

Considering context within #MeToo and the medical profession.

CMAJ 2018 Nov;190(47):E1395

Former dean, Schulich School of Medicine & Dentistry, Western University, London, Ont.

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November 2018

Shining the light on #MeTooMedicine.

Authors:
Bev Johnson

CMAJ 2018 Nov;190(47):E1394

Family physician; president, Federation of Medical Women of Canada (2017-2018), Ottawa, Ont.

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November 2018
3 Reads

Acanthosis nigricans at sites of insulin injection in a man with diabetes.

CMAJ 2018 Nov;190(47):E1390

Division of Dermatology (Huang), Department of Medicine, University of Toronto, Toronto, Ont.; Scarborough General Hospital (Hessami-Booshehri), Scarborough, Ont.

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November 2018

Buprenorphine-naloxone.

CMAJ 2018 Nov;190(47):E1389

Department of Family and Community Medicine (Hu, Nijmeh, Pyle), University of Toronto, Toronto, Ont.; Department of Emergency Medicine and Critical Care (Nijmeh, Pyle), Lakeridge Health, Oshawa, Ont.; Department of Family Medicine (Nijmeh, Pyle), Queen's University, Kingston, Ont.

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November 2018

How to pay for national pharmacare.

CMAJ 2018 Nov;190(47):E1384-E1388

Faculties of Medicine and Law (Wolfson), University of Ottawa, Ottawa, Ont.; School of Population and Public Health (Morgan), University of British Columbia, Vancouver, BC.

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November 2018

Comparative risk of harm associated with trazodone or atypical antipsychotic use in older adults with dementia: a retrospective cohort study.

CMAJ 2018 Nov;190(47):E1376-E1383

Division of Geriatric Medicine (Watt, Straus), University of Toronto; Li Ka Shing Knowledge Institute (Watt, Gomes, Straus), St. Michael's Hospital; Leslie Dan Faculty of Pharmacy (Gomes), University of Toronto; ICES Central (Bronskill, Huang, Austin); Institute of Health Policy, Management, and Evaluation (Bronskill, Austin), University of Toronto, Toronto Ont.; ICES McMaster (Ho); Department of Medicine (Ho), McMaster University, Hamilton, Ont.

Background: Trazodone is increasingly prescribed for behavioural and psychological symptoms of dementia, but little is known about its risk of harm. Our objective was to describe the comparative risk of falls and fractures among older adults with dementia dispensed trazodone or atypical antipsychotics.

Methods: The study cohort included adults with dementia (excluding patients with chronic psychotic illnesses) living in long-term care and aged 66 years and older. Read More

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November 2018
3 Reads

Psychotropic drugs for the behavioural and psychological symptoms of dementia: no free ride.

CMAJ 2018 Nov;190(47):E1374-E1375

Department of Psychiatry (Abi-Jaoude), The Hospital for Sick Children; Department of Psychiatry (Abi-Jaoude), Toronto Western Hospital, University Health Network; Division of Geriatric Medicine (Stall, Rochon), Department of Medicine, and Institute of Health Policy, Management and Evaluation (Stall, Rochon), University of Toronto; Women's College Research Institute (Stall, Rochon), Women's College Hospital, Toronto, Ont.

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November 2018

Improved hospital safety performance and reduced medicolegal risk: an ecological study using 2 Canadian databases.

CMAJ Open 2018 Oct-Dec;6(4):E561-E566. Epub 2018 Nov 19.

Canadian Medical Protective Association (Yang, Zhang, Hines, Calder); Ottawa Hospital Research Institute (Calder); Department of Emergency Medicine (Calder), University of Ottawa, Ottawa, Ont.

Background: Few empirical studies have validated the relation between medicolegal risk and hospital patient safety performance. We sought to determine whether there was a relation between in-hospital patient safety events and medicolegal cases involving Canadian physicians.

Methods: In this ecological study, we used Poisson regression to compare data from the Canadian Institute for Health Information's Discharge Abstract Database and the database of the Canadian Medical Protective Association (CMPA) of medicolegal cases over 10 years (2005/06 to 2014/15). Read More

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November 2018
1 Read

Patterns of borrowing to finance out-of-pocket prescription drug costs in Canada: a descriptive analysis.

CMAJ Open 2018 Oct-Dec;6(4):E544-E550. Epub 2018 Nov 19.

Centre for Health Services and Policy Research (Kolhatkar, Cheng, Law), School of Population and Public Health; School of Population and Public Health (Morgan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Goldsmith), Simon Fraser University, Burnaby, BC; Health Quality Ontario (Dhalla); Li Ka Shing Knowledge Institute (Dhalla), St. Michael's Hospital; Institute for Clinical Evaluative Sciences (Dhalla), Toronto, Ont.; Division of Clinical Pharmacology and Toxicology (Holbrook), Department of Medicine, McMaster University, Hamilton, Ont.

Background: Out-of-pocket drug costs lead many Canadians to engage in cost-related nonadherence to prescription medications, but our understanding of other consequences such as borrowing money remains incomplete. In this descriptive study, we sought to quantify the frequency of borrowing to pay for prescription drugs in Canada and characteristics of Canadians who borrowed money for this purpose.

Methods: In partnership with Statistics Canada, we designed and administered a cross-sectional rapid-response module in the Canadian Community Health Survey administered by telephone to Canadians aged 12 years or more between January and June 2016. Read More

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November 2018
1 Read

Physicians not immune to intimate partner violence.

Authors:
Carolyn Brown

CMAJ 2018 Nov;190(46):E1372-E1373

Ottawa, Ont.

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November 2018

Was euthanasia dispute behind CMA-WMA split?

Authors:
Brian Owens

CMAJ 2018 Nov;190(46):E1369-E1370

St. Stephen, NB.

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November 2018

Propofol sedation and colonoscopy: a perspective from endoscopists.

CMAJ 2018 Nov;190(46):E1368

Gastroenterologist, Memorial University of Newfoundland, St. John's, NL.

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November 2018
1 Read