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.
A study found that elevated PAPP-A levels were associated with a higher risk of cardiovascular events in people with cardiac chest pain due to heart disease. The presence of PAPP-A also predicted cardiovascular events, including heart attacks and strokes, even after controlling for other factors.
The dangers of magnet ingestion in young children are becoming increasingly apparent, with high-powered magnets causing life-threatening problems like bowel perforations. Effective recognition, prompt management, and targeted campaigns can help mitigate these risks through primary prevention and multidisciplinary collaboration.
Prisoners in Canada often experience worse health than the general population, with higher rates of communicable diseases and mental health issues. A well-organized and coordinated healthcare system is needed to address these complex needs.
Women over 40 face declining fertility and require effective contraception to prevent pregnancy. Various methods are considered safe and effective, including copper IUDs, progestin implants, and sterilization, with benefits outweighing risks for most women.
A study published in CMAJ found that people who smoke contraband cigarettes are less likely to stop smoking compared to those who smoke premium or discount cigarettes. Contraband cigarettes are widely available and significantly cheaper than legitimate options.
People of high socioeconomic status are more likely to receive appointment offers and prioritized access to primary care, even in a single-payer universal health insurance system. Researchers found that physicians' offices discriminate against those with low socioeconomic status, despite equal reimbursement for each patient.
A randomized controlled trial found that acupuncture with intense stimulation (de qi) improves facial muscle recovery, disability, and quality of life in patients with Bell palsy. The study suggests de qi is a key factor in achieving therapeutic effects in this condition.
Researchers found higher stillbirth rates among Inuit and First Nations women in Quebec, particularly at term, with rates 2 times those of non-Aboriginal populations. The study suggests that reducing smoking and managing weight may help prevent stillbirths.
A study of over 180,000 people in Scotland found that those with multiple chronic health conditions and mental illness had significantly higher rates of unplanned hospital admissions. The risk was further increased among those from lower socioeconomic backgrounds, highlighting the need for better coordinated care and prioritization of ...
A new study found that infants born by cesarean delivery and those strictly formula-fed have different gut bacteria than those delivered vaginally and breastfed. The researchers suggest that these early-life influences may impact the development of conditions like asthma, obesity, and type 1 diabetes.
A large study found that ABO blood type is a strong risk factor for venous blood clots. The research, published in the Canadian Medical Association Journal, also identified other genetic mutations associated with an increased risk of these conditions.
Climate change affects human health, prompting physicians to take action; doctors can lobby governments, reduce greenhouse gas emissions and clinical waste. Immediate wise action is necessary to mitigate disastrous consequences.
A combined strategy of door-to-door visits and education campaigns is proposed to combat TB in Nunavut. The territory's TB rate is 66 times higher than the general Canadian population, but control can be achieved through a community approach combined with clear performance targets.
Effective treatments for senior constipation include polyethylene glycol and lactulose, which increase colon water secretion and may alleviate symptoms. However, these agents can cause bloating and diarrhea, while stimulant laxatives like senna are effective but may lose effectiveness over time.
A randomized trial shows that the dual-hormone artificial pancreas system improved glucose levels and reduced hypoglycemia compared to conventional pump treatment in patients with Type 1 diabetes. The system delivered insulin and glucagon using continuous glucose sensor readings and an intelligent dosing algorithm.
A systematic review of 24 randomized clinical trials found significant observer bias in nonblinded outcome assessment, favoring a more beneficial treatment effect. The study recommends using blinded assessors to remove this bias and suggests that conscientious nonblinded assessors may overcompensate for expected biases.
A study published in the Canadian Medical Association Journal found that women with hypertensive disorders during pregnancy are at higher risk of chronic kidney disease and end-stage renal disease. The study analyzed data from over 26,000 women in Taiwan and found an increased risk of end-stage renal disease among those with preeclamps...
Serial compression ultrasonography with Doppler imaging is a reliable method for ruling out deep vein thrombosis in pregnant women, detecting 94% of cases. This approach safely allows physicians to withhold anticoagulation therapy, reducing unnecessary risks during pregnancy.
Cognitive enhancement medications, used to treat attention deficit disorder (ADD), may not be suitable for healthy individuals due to limited evidence and potential risks. Physicians in Canada are advised to prioritize their professional integrity and limit healthcare resources by refusing prescription requests.
The Canadian Medical Association Journal advocates for regulating sugary drinks to combat obesity. New York City's 16-ounce limit is seen as a successful model, and critics argue that similar measures can be taken without threatening personal choice.
A new study published in CMAJ found that depressed elderly men have a twofold risk of hospital admission and experience longer hospital stays. The study, which analyzed data from 5411 men aged 69 years and older, suggests that depression exacerbates chronic diseases and impairs communication with healthcare providers.
A study published in CMAJ found that women with PCOS taking combined oral contraceptives have a 2-fold increased risk of venous thromboembolism compared to matched controls. The risk is similar when expanding the definition of PCOS by including its symptoms and treatment.
A new study published in CMAJ found that rules limiting aggression in ice hockey, such as bodychecking, can significantly reduce injuries among young players, including serious brain and spine injuries. The study suggests that interventions based on rule changes showed the greatest likelihood of making ice hockey safer for youth.
Routine HIV testing can significantly reduce AIDS-related morbidity and death, as well as HIV transmission. Implementing this strategy would provide a roadmap for an AIDS-free generation.
The number of prescription drugs that interact with grapefruit is significantly increasing, putting patients at risk of serious adverse effects. Older adults are especially vulnerable due to decreased tolerance and age-related changes in drug metabolism.
Rates of hemorrhage for older warfarin patients are significantly higher than reported in clinical trials. Hemorrhage rates were found to be 11.8% in the first 30 days and 3.8% over a 13-year period.
A new study published in Canadian Medical Association Journal found no elevated 10-year risk of heart disease for people who became ill during the Walkerton E. coli O157:H7 outbreak. The study involved 898 adults who consumed polluted drinking water and monitored their cardiovascular health over time.
The Canadian premiers' commitment to reduce generic drug prices is a significant change. The government should learn from past attempts and aim for universal public coverage for medications.
Patients with mental illness experience shorter waits for assessment and admission during crowded periods, but still face delays compared to other patients. The presence of psychiatric teams may help identify higher priority cases.
In an editorial published in CMAJ, Dr. Ken Flegel argues that a mandatory flu vaccine for healthcare workers is necessary due to the high risk of transmission and severe illness. With 55% of physicians not getting vaccinated, hospitals are at risk of outbreaks, emphasizing the need for compulsory vaccination rates above 90%.
A study found that mothers and newborns admitted to ICU together have a higher risk of death compared to those not needing ICU admission. This can lead to maternal-infant separation, negatively impacting bonding., The study suggests coordination of care plans and transfer to the same hospital may help lessen this burden.
A recent study published in CMAJ found that engaging in four healthy behaviors during midlife significantly increases the chances of successful aging. These behaviors include not smoking, moderate alcohol consumption, exercise, and eating fruits and vegetables daily.
The new guidelines suggest using a risk calculator to determine the risk level for general population, and recommend no routine screening with blood tests for adults at low or moderate risk of diabetes. For high-risk adults, screening is recommended every 3-5 years using A1C blood test.
A systematic review of 8 case studies found the 'mother's kiss' technique to be an effective and safe method for removing foreign objects from young children's nasal passages. The technique involves a parent covering the child's mouth and blowing gently, which can dislodge the object without the need for invasive measures.
A recent study published in the Canadian Medical Association Journal found that cyclists who died from head injuries were three times more likely not to be wearing a helmet compared to those who died from other causes. The study analyzed data from 129 accidental cycling deaths in Ontario and concluded that wearing helmets can save lives.
A study published in Canadian Medical Association Journal found that the Canadian C-spine rule is more accurate than NEXUS in diagnosing important cervical spine injuries. The rule's better diagnostic accuracy and lower rate of false negatives make it a preferable choice for assessing cervical spine imaging needs.
A new study in Canadian Medical Association Journal reveals that hospital-specific readmission rates vary significantly depending on the calculation method used. The study highlights the need for caution when comparing hospital performance based on these rates.
A large study found that moderate alcohol consumption increases the risk of atrial fibrillation in older people with heart disease or advanced diabetes. The study involved over 30,000 individuals from 40 countries and found a significant increase in atrial fibrillation cases linked to higher alcohol consumption.
Research found a significant association between sleep disturbance and cardiovascular risk factors in adolescents, including high cholesterol levels, BMI, and hypertension. Poor sleep habits were also linked to unhealthy lifestyle choices, such as consuming more fried foods and exercising less.
Women born preterm are at higher risk of pregnancy complications, including gestational diabetes and hypertension. The risk almost doubles for mothers born before 32 weeks' gestation, according to a study published in the Canadian Medical Association Journal.
Female family physicians in Canada are practising differently, working fewer hours and seeing more patients with longer visits, but younger male physicians also work less than older counterparts