Researchers developed a high-sensitivity cardiac troponin T algorithm to rule out and rule-in heart attacks in emergency departments. The study found that the new strategy accelerated management of patients with suspected acute MI by allowing safe rule-out and accurate rule-in in 3 out of 4 patients.
Family physicians play a crucial role in advising young women about egg freezing, providing accurate information on its benefits and risks. The procedure can help preserve fertility, but costs are high, and evidence on success rates is limited.
Elder abuse affects 5-10% of seniors and is associated with hospital admissions, reduced quality of life, and death. Physicians can help prevent it by being aware of risk factors and using validated screening tools like the Elder Abuse Suspicion Index.
A rare case study published in CMAJ found that blood transfusions can transmit food allergies to children, causing severe symptoms. The condition typically resolves within a few months with careful reintroduction of the allergenic foods into their diet.
The new guidelines emphasize regular growth monitoring, structured behavioural programs, and parent involvement in addressing childhood obesity. These measures aim to promote healthy growth patterns and lifestyle changes among children and youth.
A new study found that children who received the 4CMenB vaccine in infancy showed waning immunity to serogroup B meningococcal disease by age 5, despite receiving a booster dose at 3.5 years old. The researchers also reported lower rates of fever compared to younger children.
A new study published in Canadian Medical Association Journal suggests that implementing a universal public drug plan could reduce Canada's spending on prescription drugs by $7.3 billion per year, while employers and unions could save an additional $8.2 billion. This cost savings is attributed to economies of scale in price negotiation...
A survey of 1200 Canadians found that most valued news of incidental findings, but personal utility depended on the type of findings. Individuals preferred hearing about diseases with lifestyle modifications or treatment available, while those without treatment options saw less value in receiving such information.
Physicians can identify individuals with harmful drinking habits and offer evidence-based interventions, such as the FRAMES approach. The Canadian guidelines recommend low-risk drinking limits, and policy changes are needed to improve access to alcohol screening and treatment.
A study published in CMAJ found that nearly a quarter of patients with chest pain who visited an emergency department did not receive follow-up care. Patients with multiple health issues and rural residency were less likely to see a physician after discharge.
A recent analysis published in CMAJ argues that Canada must ensure fair pricing of all orphan drugs to allow patient access. The study examines the case of trientine, a life-saving therapy for Wilson disease, which saw its price increase 13-fold before being rescinded.
A new study published in CMAJ reports that the Rowland Universal Dementia Assessment Scale (RUDAS) is effective in assessing cognitive impairment in multicultural populations where English may not be the primary language. The tool has been shown to identify cognitive impairment and rule it out with strong psychometric properties, makin...
A randomized trial assessing resident duty hour schedules in the ICU found that shorter hours may be less safe for patients and not associated with reduced fatigue. Longer shifts were linked to more severe symptoms of fatigue among residents. The study suggests trade-offs between residents' well-being and patient safety.
A large Canadian Medical Association Journal study found that combining trimethoprim-sulfamethoxazole with spironolactone more than doubles the risk of sudden death in older patients. The study suggests that physicians should consider alternative antibiotics for patients on spironolactone to reduce this risk.
A new Canadian guideline recommends measuring body mass index at primary health care visits to prevent and manage obesity. Structured behavioral interventions, including counseling, education, and environmental modifications, can help individuals lose weight, particularly those at high risk of diabetes.
Researchers found that prescriptions for quinine and Google searches for leg cramps peak during the summer months. This seasonality could lead to a 'quinine holiday' during colder months for patients taking the medication.
A Canadian-Japanese research team has identified a shared genetic mutation responsible for an inherited metabolic disorder, glycogen storage disease type IIIa, in Inuit populations in northern Quebec. The mutation affects approximately 1 in 2500 people in Nunavik and can cause enlarged livers, hypoglycemia, and muscle weakness.
Researchers found that combining clarithromycin with certain statins increases the risk of acute kidney injury or high potassium levels, potentially leading to hospital admission. The study suggests that alternative antibiotics like azithromycin may help prevent these adverse events.
A genetic mutation has been identified as the cause of congenital sucrose-isomaltase deficiency (CSID), a disorder that prevents the absorption of sucrose in Inuit people. The study found that CSID is more common in Inuit individuals living in northern Canada and Greenland.
A systematic review of controlled trials involving adults and children found that diarrhea was over three times as likely in people taking amoxicillin-clavulanic acid, while candidiasis was also associated with the use of this antibiotic combination. The study highlights under-reporting of harms in clinical trials.
A large study found that using world region-specific birth-weight curves for immigrant mothers and their babies can predict adverse outcomes more accurately than Canadian curves. This method may help avoid unnecessary interventions and reduce parental stress.
A study published in CMAJ identified key elements of end-of-life care that patients and families want to discuss, including patient values, prognosis, and fears. Discussions on these topics lead to higher patient satisfaction with care received.
A large Canadian study published in CMAJ found that symptoms of mental illness in children and adolescents are not increasing, contrary to popular media perceptions. The study suggests a decline in depression and anxiety, as well as suicidal behavior among youth, while hyperactivity increased in younger age groups.
The Canadian Task Force on Preventive Health Care recommends against using the PSA test to screen for prostate cancer in most men, citing an increased risk of false positives and overdiagnosis. The guideline aims to balance potential benefits with substantial harms.
A randomized trial found ibuprofen to be a safer and more effective option for managing fracture pain in children, with fewer adverse events compared to oral morphine. The study involved 134 children aged 5-17 and concluded that ibuprofen remains a viable therapy for outpatient management of children's fracture pain.
A Mediterranean diet supplemented with extra-virgin olive oil or nuts helps reduce central obesity and blood glucose levels, reversing metabolic syndrome in 28.2% of participants. The study found no significant difference in new cases of metabolic syndrome between the two diet groups.
The Canadian Medical Association Journal refutes criticisms of the BART trial that showed a substantially increased risk of death associated with aprotinin. The authors argue that regulatory bodies should have mandated a second large trial to confirm or refute the results.
A study published in CMAJ found that metformin increases the risk of low thyroid-stimulating hormone levels in patients with hypothyroidism. Metformin monotherapy was associated with a 55% increased risk of low TSH levels compared to sulfonylurea therapy.
A study published in Canadian Medical Association Journal found that care coordination strategies can significantly decrease hospital admissions and emergency department visits among older patients with chronic conditions. However, these approaches were less effective in reducing healthcare usage among individuals with mental illness.
A randomized controlled trial found that melatonin supplementation had no effect on reducing delirium in elderly patients undergoing hip fracture surgery. The study suggests that melatonin may not be effective in preventing postoperative delirium, and further research is needed to compare its effects with antipsychotics.
A new study published in CMAJ found that arthroscopic knee surgery does not provide relief for middle-aged patients with mild osteoarthritis. The research analyzed seven randomized controlled trials and concluded that the procedure may have little to no effect on short-term and long-term outcomes.
A new study published in CMAJ found that people with cognitive impairment have a significantly increased risk of stroke, with a 39% higher risk than those with normal cognitive function. The study analyzed data from 18 studies and observed a higher rate of stroke in individuals with cognitive impairment.
Resistant hypertension is a condition affecting 20% of Canadian adults with high blood pressure, characterized by elevated blood pressure despite treatment. Structured approaches, including medication optimization and lifestyle modifications, are recommended for effective management.
A large cohort study of 10,149 patients found no apparent causal link between obstructive sleep apnea and cancer development. However, researchers discovered that low oxygen levels were linked to an increased risk of smoking-related cancers.
A new study found that seniors who have had strokes or vascular disease are at risk of stroke after heart surgery. The study identified several risk factors for long-term stroke, including previous stroke, peripheral vascular disease, valve surgery, and age 65 years or older.
Patients with advanced cancer can experience improvement in fatigue, physical endurance, and mood through rehabilitation programs combining exercise and nutritional counselling. Palliative care services should incorporate these elements to enhance patient outcomes.
Research finds that excess belly fat, low physical activity, and underweight status increase COPD risk. People with larger waist circumference have a 72% higher chance of developing COPD.
A new study suggests that individuals who are overweight, obese, or former smokers are more likely to follow recommended statin therapy for high cholesterol. Nonadherence to prescribed medication can lead to a significant risk of cardiovascular events, with studies indicating that nonadherence rates as high as 46% have been observed.
The first Canadian guideline for managing and treating Bell palsy has been published, emphasizing the use of corticosteroids to reduce involuntary facial spasms. The guideline also recommends a combined approach with antivirals for patients with severe paralysis, while cautioning against unnecessary antiviral treatment alone.
The combined MMRV vaccine has been associated with slightly higher rates of febrile seizures in young children, but these seizures are typically self-limiting and rarely have long-term effects. Researchers found a slight increase in the relative risk of febrile seizure with the MMRV vaccine compared to the separate MMR+V vaccine.
Researchers enrolled 120 MS patients and 60 healthy controls, finding no significant difference in diagnosed chronic cerebrospinal venous insufficiency between groups. The study's findings dispute the theory linking CSVI to MS due to methodological concerns and questionable diagnosis criteria.
Vaccination rates among healthcare workers are less than 50%, highlighting the need for policies that balance individual rights with public health. Mandatory flu vaccinations can benefit patient health, but must comply with employment law, provincial human rights codes, and the Canadian Charter of Rights and Freedoms.
Experts caution that reducing medical resident duty hours could compromise patient safety and resident education. Research suggests that sleep-deprived residents can still provide high-quality care despite reduced hours.
A new study published in the Canadian Medical Association Journal found that First Nations people are less likely to receive guideline-recommended coronary angiography after a heart attack. This disparity results in poorer long-term survival rates for this population, highlighting the need for improved access to cardiovascular care.
New prescription drugs are delayed in Canada due to pharmaceutical company submissions to Health Canada. The mean delay was 540 days for approved drugs submitted to the US and EU first.
A study published in CMAJ found that pregnant women are at a higher risk of serious traffic crashes during the second trimester, with a 42% increase in crashes compared to baseline. The researchers emphasize the importance of safe driving practices, such as avoiding excessive speed and minimizing distractions, to prevent accidents.
A systematic review of 31,085 deliveries found that induced labor is associated with a lower risk of cesarean delivery. Prostaglandin E2 is linked to significant reductions in cesarean risks.
The article provides evidence-based information on the latest treatments for multiple sclerosis, highlighting the benefits and risks of various therapies. Steroids are found to be the most effective way to treat relapses, while immunosuppressants like natalizumab and fingolimod have varying degrees of success.
A recent study found that 32% of adult Canadians have experienced child abuse, with physical abuse being the most common. The study highlights a strong association between child abuse and mental health issues, including suicidal ideation and attempts.
A randomized controlled trial found that pharmacists significantly improved blood pressure and cholesterol levels in stroke patients, with a 43% absolute improvement compared to the control group. Pharmacists' active medication adjustment contributed to this effect, despite already taking antihypertensive or lipid-lowering medications.