A new guideline from the Canadian Society of Nephrology recommends delaying dialysis for asymptomatic adults with chronic kidney disease, citing improved quality of life and cost savings. The 'intent-to-defer' strategy avoids the burden of early start, while still closely monitoring patients.
Researchers analyzed data on over 65,000 women and found no association between NSAID use during the first trimester and miscarriage risk. However, they discovered an increased risk of miscarriage after exposure to indomethacin due to potential 'reverse causation bias'.
A new study found that postmenopausal hormone replacement therapy (HRT) may increase the risk of acute pancreatitis. The risk was higher among women who used systemic therapy and those who had used HRT for more than 10 years.
Handwashing and zinc are likely effective in preventing colds, with some evidence suggesting they also work for adults. Antihistamines combined with decongestants and pain medications can provide relief from symptoms, while ibuprofen and acetaminophen help with pain and fever.
A new study published in CMAJ found that people who enjoy life maintain better physical function as they age, with slower declines in daily activities and walking speeds. Participants who had higher levels of well-being were less likely to develop problems in their daily physical activities.
The Canadian Medical Association Journal provides a comprehensive review of autism spectrum disorder, emphasizing the importance of early detection and referral to intervention services. The article highlights best practices for pediatricians and family doctors, including behavioral interventions and personalized medicine.
The CANHEART health index found that 9.4% of Canadian adults and 16.6% of youth were in ideal cardiovascular health, while 37.3% of adults and 49.7% of youth had poor heart health. The study suggests that addressing behaviours can reduce cardiac risk factors.
A comprehensive new checklist aims to fill the need for practical steps and resources in guideline development. The checklist, published in CMAJ, includes 18 topics and 146 items with links to resources and training materials.
A study found that First Nations adults with diabetes are more than double the risk of developing end-stage kidney disease. The high rates of kidney disease among First Nations people are attributed to younger onset of diabetes, leading to increased survival time and likelihood of progression to end-stage renal disease.
A third of older adults admitted to the ICU were classified as frail, increasing their risk of death, illness, and adverse events. Frailty is characterized by a loss of physical and mental strength, making patients more vulnerable to complications.
Family members of patients with coronary heart disease improved cholesterol levels, physical activity, and dietary habits after participating in a year-long intervention program. The program included counselling sessions, goal setting, and feedback, resulting in reduced body mass index and waist circumference.
A randomized controlled trial found that early surgery for hip fractures in older adults can significantly reduce complications and improve outcomes. The study involved 60 patients aged 45 or older who received either accelerated care or standard care, with the former resulting in shorter wait times and improved surgical results.
Analysis suggests replacing saturated fats with polyunsaturated oils like corn and safflower oil may not reduce heart disease risk, but rather increase it. Health Canada should modify health claims to exclude these oils.
A new study published in CMAJ found that the odds of patients with brain injury deteriorating to neurologic death decreased over a 10-year period, likely due to improved care and prevention measures such as road safety initiatives and enhanced clinical care.
A growing body of evidence suggests a causal link between traffic-related air pollution and the development of asthma in children and adults. The authors highlight four strategies to mitigate its effects, including reducing vehicle emissions and modifying current infrastructure.
Street-involved youth using crystal methamphetamine are at increased risk of injecting drugs, with the drug often used during initiation events. Researchers linked recent non-injection use of crystal methamphetamine to higher rates of subsequent injection among youth who did not inject initially.
An analysis of 32 studies found that anemic children who received iron supplements showed substantial improvement in IQ scores and other cognitive tests. Daily iron supplementation also decreased the prevalence of anemia by about 50% and improved growth, with no adverse effects reported.
Falls account for more than 60% of hospital stays for traumatic brain injury in seniors over age 65. Researchers found that hand impact occurred in 74% of falls, highlighting the need for exercises to strengthen upper limbs and design safer environments.
A clinical trial found that a booster dose of the new meningitis B vaccine at 40 months of age can overcome waning immunity induced by infant vaccination, showing high antibody levels in 89%–100% of children against most strains.
High drug expenses in Canada hinder treatment access and outcomes due to copayments and limited coverage. A universal drug program could address these issues with a national agency implementing a comprehensive solution.
A review of 8 trials found no long-term benefits from cognitive enhancers like donepezil and rivastigmine for patients with mild cognitive impairment. These medications were associated with increased nausea, diarrhea, vomiting, and headaches, but no cognitive improvement.
A study of 3044 civil servants found that chronic exposure to high interleukin-6 levels was associated with a lower likelihood of healthy aging, including impaired musculoskeletal functioning and diabetes. Maintaining low interleukin-6 levels may facilitate successful aging by reducing the risk of these age-related diseases.
A new study in the Canadian Medical Association Journal found that patients who leave hospital against their doctors' orders are more likely to be readmitted or die. The research, which analyzed over 1.9 million adult admissions, shows that leaving hospital against medical advice is associated with a higher risk of readmission and deat...
Patients with heart failure who see a physician within a month of hospital discharge have better survival rates compared to those without follow-up care. Continuity with a familiar physician is most beneficial, reducing risk of readmission and death by 3-8%.
A new clinical trial finds that a simple low-risk ankle rule can significantly reduce the use of radiography for children's ankle injuries, lowering exposure to radiation and healthcare costs. The Low Risk Ankle Rule has potential broad applicability to emergency departments worldwide.
A Canadian study found that women living in large urban areas have a higher risk of postpartum depression. The study analyzed data from 6421 women and found that urban residents had almost 10% reporting postpartum depression compared to 6% in rural areas.
A randomized controlled trial found that over 50% of children who received a topical analgesic experienced no pain during wound repair with tissue adhesive. The study suggested early application of the analgesic to all minor cuts may decrease children's pain during these procedures.
Concussions can have serious long-term health effects; therefore, it's essential to recognize and manage these injuries accurately. The article provides a 6-point protocol to help people resume activity after a concussion, emphasizing complete rest and gradual progression.
A new 'conversation guide' aims to increase physicians' confidence in engaging patients in meaningful end-of-life discussions. The framework provides structured guidance on identifying high-risk patients, communicating prognosis, and involving substitute decision-makers.
A randomized trial found that a 1:1:1 blood transfusion protocol is feasible but associated with higher waste of plasma. The study suggests that widespread adoption may lead to significant resource and safety implications due to the scarcity of plasma.
Two angiotensin-receptor blockers, telmisartan and valsartan, have been shown to reduce hospitalization for heart attack, stroke, or heart failure in people with type 2 diabetes. Researchers found a lower risk of cardiovascular illnesses associated with these drugs compared to other treatments.
A study published in CMAJ found that 13.5% of Canadian Forces personnel who served in support of the Afghanistan mission between 2001-08 had a mental health disorder related to their deployment. The most common disorders were posttraumatic stress disorder (PTSD) and depression, with PTSD being found in 8% of personnel.
A study of 1076 preschool children aged 3-5 years found associations between unhealthy eating behaviors and serum non-HDL cholesterol levels, indicating a potential early link to cardiovascular disease. The research suggests that promoting responsive feeding and healthy eating habits may help reduce the risk.
The development of mobile-presence medical devices can help fill the void of limited healthcare infrastructure and access to medical professionals in remote locations. Pilot tests have successfully connected obstetricians with pregnant women in Bolivia, enabling real-time monitoring and diagnostic imaging.
A recent study published in the Canadian Medical Association Journal found that current use of fluoroquinolone antibiotics increases the risk of acute kidney injury by two-fold. The risk was highest with ciprofloxacin and moxifloxacin, and concurrent use with renin-angiotensin-system blockers further increased the risk.
A regional system of organized stroke care delivery has improved outcomes for patients with stroke in Ontario, Canada. The study found a decrease in hospital admissions to long-term care facilities and death rates after stroke.
A Canadian study found that teens exposed to a schoolmate's death by suicide are significantly more likely to consider or attempt suicide, with the risk especially strong among 12-13 year olds. The study's findings support strategies targeting all students rather than just close friends in postvention efforts.
A recent study published in the Canadian Medical Association Journal found that people with job stress and an unhealthy lifestyle are at a higher risk of coronary artery disease. The study analyzed data from 7 cohort studies involving 102,128 participants and found that those with job strain had a 10-year incidence rate of 18.4 per 100...
New guidelines from the Canadian Task Force on Preventive Health Care recommend against routine screening for depression in adults without apparent symptoms. The recommendations are based on a lack of high-quality evidence on the benefits and harms of screening. Clinicians should be alert to the possibility of depression in patients wi...
A national study estimates 2.9 million Canadian adults have chronic kidney disease, a risk factor for death and significant healthcare burden. High blood pressure and diabetes are more common among those with chronic kidney disease.
Fibromyalgia can be diagnosed by relying on the art of medicine, as physical findings or laboratory tests are often absent. Primary care physicians are best positioned to manage this condition due to its prevalence rate, with a combination of nonpharmacologic and pharmacologic therapies being the most appropriate management strategy.
A randomized controlled trial found that naturopathic lifestyle counselling and enhanced usual care reduced the prevalence of metabolic syndrome and cardiovascular risk score by 17% and 3 percentage points respectively over a year. Naturopathic doctors provided diet and lifestyle advice to patients who lost weight through caloric restr...
The article provides an evidence-based overview of pancreatic cancer diagnosis and treatment, emphasizing the importance of surgery as a curative option. Key findings also highlight the benefits of accelerated progress in understanding the disease through partnerships between clinicians and basic scientists.
A large study found that high serum C-peptide levels are linked to an increased risk of death from all causes and cardiovascular disease. People with high C-peptide levels had a 1.8- to 3.2-fold increased risk compared to those with low levels.
A review of 32 randomized controlled trials suggests that mental exercise, such as computerized training programs or intensive one-on-one personal cognitive training, may benefit older adults in preventing cognitive decline. The annual rate of dementia-related cognitive decline is estimated to double to over 1 million Canadians by 2047.
A study published in Canadian Medical Association Journal found that physicians who followed recommended screening and vaccination practices had more likely patients to also follow these practices. The research involved 1488 physicians and their adult patients in Israel's largest health maintenance organization, Clalit Health Services.
Despite a decline in spontaneous stillbirths, stillbirth rates in British Columbia, Canada, have increased by 31% over the past decade, according to a study published in CMAJ. The increase was mainly due to prenatal diagnosis and pregnancy terminations of fetuses with congenital anomalies.
A study found a significant shortfall in organ donations at large general hospitals in Ontario compared to those treating transplant recipients. The rate was 1.4 per 100 deaths, significantly lower than the 5.0 per 100 deaths at transplant hospitals.
A randomized trial found that tonsillectomy significantly reduced episodes of severe pharyngitis in adult patients. The procedure improved quality of life and reduced lost work or school days compared to non-surgical treatment.
A large-scale study found that oral estrogen therapy increases the risk of gallbladder surgery in postmenopausal women. Women using transdermal therapies like patches or gels were not at increased risk.