End-stage renal disease (ESRD) has increased in Canada and worldwide since 1980, with 25,000 Canadians receiving life-sustaining treatment. Despite its benefits, there is a marked regional disparity in transplant rates, highlighting the need for tailored guidelines on eligibility across various criteria.
Researchers found that patients with partial small-bowel obstruction who received oral therapy had a higher success rate of treatment without surgery (91% vs. 76%) and shorter hospital stays compared to those receiving standard care alone. The study suggests a new management strategy for similar patients, leading to reduced surgical in...
Patients taking ASA plus dipyridamole had increased rates of myocardial infarction, but the addition of dipyridamole is rarely justified for stroke prevention. ASA remains the gold standard treatment for preventing stroke in high-risk patients.
A randomized controlled trial found that ginseng reduced the frequency and severity of colds in study subjects. Ginseng was also effective in lessening symptom severity and duration. In contrast, Echinacea angustifolia was not found to be a preventive herbal product for the common cold.
A recent study by Ravi Retnakaran and colleagues found that Aboriginal youths who smoked more than six cigarettes per day had higher systolic blood pressure and plasma homocysteine levels. The study highlights the importance of addressing smoking habits among Aboriginal youth to prevent cardiovascular disease.
A study found that CT colonography can detect cancer lesions and polyps with nearly the same sensitivity as colonoscopy, avoiding fatal perforations but potentially leading to more cancer-related deaths. The method's higher cost is offset by its non-invasive nature and appeal to patients.
A Canadian study found that severe maternal morbidity rates declined between 1991 and 2001, with lower rates of postpartum hemorrhage requiring transfusion. However, a significant increase in uterine rupture cases was observed during this period, with women who experienced these complications being 158 times more likely to die.
A population-based study found that women with breast cancer are more likely to be absent from work for 4 weeks or more compared to healthy women. However, by the third year, work absence patterns become similar. The study also reveals factors that modulate work absence, such as stable relationships and self-employment.
In Canada, delisting prescription drugs from public health insurance programs transfers costs to private citizens or private health insurance plans, generating cost-savings for governments. Deregulation may also benefit pharmacists by increasing over-the-counter sales and expanding their clinical role.
Researchers found that homeless mothers are 2.9 times more likely to have a pre-term delivery, while those with substance abuse are 6.9 times more likely to give birth to an infant weighing less than 2000 grams. This highlights the urgent need for healthcare support and interventions for these vulnerable populations.
A review by Devereaux and colleagues highlights the risks of non-cardiac surgery, with 500,000 to 900,000 patients experiencing cardiac events each year. The authors discuss methods for estimating risk pre-operatively and communicating these findings to clinicians.
A Canadian Medical Association Journal study finds that children living in low-income neighborhoods are at high risk of overweight and obesity. The research suggests that school programs promoting healthy lunches and physical activity could be effective preventive measures.
A Canadian Medical Association Journal study found that salivary cotinine levels, a measure of second-hand smoke exposure, are linked to an increased likelihood of smoking in adolescence. The research suggests that early childhood exposure may be a key factor in the development of nicotine-seeking behavior.
A study found no significant association between waiting period and pre- and postoperative mortality and morbidity for patients undergoing coronary artery bypass grafting. However, the authors emphasize that the acceptable rate of adverse events for a managed waiting strategy remains undetermined.
A randomized controlled trial found that liposomal lidocaine significantly improved cannulation success rates and reduced pain and procedure time in children. The study suggests that liposomal lidocaine can be recommended for cutaneous analgesia in children, providing a promising new approach to pediatric procedural care.
A study published in the Canadian Medical Association Journal found that levels of ischemia-modified albumin provided no useful information in predicting which patients with potential acute coronary syndrome would experience serious cardiac outcomes. The analysis suggests that prognosis may precede diagnosis in these cases.
A new clinical return-to-work rule developed by Dionne et al. improves the prediction of successful outcomes for patients with back pain. However, C. Maher suggests that further research is required to determine its effectiveness in guiding treatment decisions.
Researchers found that vitamin B12 deficiency was common among patients referred to vascular disease prevention clinics. Creatinine levels were also found to be a strong predictor of homocysteine levels, similar to vitamin B12 levels.
A recent study by A.W. Howard and colleagues found that replacing hazardous playground equipment with safer versions significantly reduced injury rates. The study, which analyzed data from 86 schools, avoided 550 injuries over a 10-month period after the replacement of unsafe equipment.
A study published in the Canadian Medical Association Journal found that thrombolysis for acute ischemic stroke is a safe and effective therapy. The results indicate excellent outcomes for over one-third of patients and low rates of symptomatic intracranial hemorrhage and orolingual angiodema.
Research highlights that body mass index is just one aspect of ischemic heart disease risk, with insulin resistance syndrome playing a significant role. Metabolically healthy obese men and metabolically unhealthy lean men have been found to have different heart disease risks.
The Canadian Medical Association Journal reports that prescription drug costs have surpassed $18 billion. This significant increase underscores the importance of disseminating unbiased information to ensure patient safety and healthcare sustainability.
The study found that mortality decreased over time for both young and old patients, but the risk of postoperative stroke remained unchanged among older patients. Older patients undergoing elective procedures may experience similar outcomes to those of younger patients if there is a clinical need for CABG.
A head-to-head retrospective analysis of 18,000 elderly patients with AMI found that five commonly prescribed statins were equally effective for secondary prevention. The study highlights the need to consider costs when selecting statins.
A population-based study found that Aboriginal Canadians are nearly four times as likely to sustain severe trauma as the reference population. Motor vehicle crashes were identified as a primary cause of traumatic injuries and death among this group.
The current dyslipidemia guidelines have raised controversy due to concerns that they may lead to more people being screened and prescribed statin therapy. The debate centers around the data used in the guidelines and its implications for patient care.
A recent study found that gay men did not engage in increased sexual risk-taking during an HIV vaccine trial. The study, led by Dr. Tom Lampinen, revealed that the biggest risk for new infection was among minority gay men who had unsafe sex with partners whose HIV status they didn't know.
A recent study found that nearly a third of pharmaceutical ads in American medical journals offered no supporting references. Meanwhile, the majority of data-on-file documents cited in these ads were inaccessible to physicians due to company policies. In contrast, journal articles and books were more readily available for review.
A Canadian Medical Association Journal article evaluates the economic impact of sirolimus-eluting stents, finding they are cost-effective in high-risk patients. However, their use is associated with a similar or higher cost per quality-adjusted life-year compared to other medical treatments.
A randomized controlled trial found that amoxicillin was more effective than placebo in treating middle ear infections in children, but showed no significant difference in adverse events or recurrence rates. The study suggests that antibiotics may be a useful treatment option for this common childhood illness.
A randomized trial found that physicians who received periodic letters recommending evidence-based drug therapy were more likely to prescribe those drugs. The study, which involved 499 physicians in British Columbia, showed a 30% increase in prescribing of recommended drugs over the preceding 3 months.
A prospective follow-up study found that implantable cardioverter defibrillators can significantly reduce the risk of recurring cardiac arrests after out-of-hospital incidents. Increasing access to these devices could have a substantial impact on reducing Canada's high mortality rate from sudden cardiac arrest.
A Vancouver study found significant reductions in public injection drug use and litter after the opening of a medically supervised safer injecting facility. The clinic saw an increase of 500 daily users, consistent with previous feasibility studies.
Research by P.J. Devereaux et al found higher mortality rates and higher costs associated with private for-profit hospitals compared to not-for-profit hospitals. This supports a policy shift towards not-for-profit healthcare delivery, as suggested by S. Woolhandler and D.U. Himmelstein.
A prospective study of 89 caregivers found that as breast cancer patients progressed to the last stages of their illness, caregivers experienced increased depression and burden. The authors emphasize the need to address family caregiver needs during patient care, given hospital bed shortages for palliative and hospice care.
A recent study by Rochon and colleagues found that many conditions or diseases common internationally are underrepresented in randomized controlled trials published in leading medical journals. In a related commentary, Jha and Lavery highlight the importance of delivering treatments already available to improve population health in dev...
The study found that 7.5% of hospital patients experienced adverse events, with 37% being preventable. Implementing gains in patient safety can be achieved through encouraging reporting, new technologies, and improved communication among caregivers.
A study comparing newspaper stories to peer-reviewed research papers found that genetic research is often sensationalized, leading to inaccurate public perception. The authors suggest that academic promotion, grant funding, and financial gain may drive the hype surrounding genetic research.
Researchers studied 502 hospital patients and found that nearly two-thirds experienced an adverse event before admission, with many being preventable. The study emphasizes the need for improved patient safety through ambulatory care and hospital-based interventions.
A commentary by Pauls and Downie argues that mandatory reporting could erode trust between patients and physicians. Ovens, writing on behalf of the OMA's Section on Emergency Medicine, counters that exceptions exist to protect patient confidentiality while maintaining public safety.
Mortality rates among homeless women aged 18-44 are significantly higher than the general population, with a 10-fold increased risk of death. The authors suggest addressing addictions, HIV infection, and mental health issues through targeted programs to save lives.
A prospective observational study found that physician residents worked an average of 69 hours a week, receiving 41 pages of seeking services. Ketonuria was observed in 21% of shifts, highlighting the need for stricter work hour limitations to ensure patient and physician safety.
Patients with stage I disease experienced longer intervals than those with more advanced disease. A multidisciplinary approach could help reduce anxiety and mistrust by allowing sufficient time for information digestion and procedure recovery.
The study highlights the need for greater support and educational intervention during infectious disease outbreaks. Front-line health care workers are at real danger of becoming infected, as seen in SARS cases where 20% of infected individuals were healthcare workers.
The Canadian Medical Association recommends a national review of pharmacy prescription records confidentiality, calling for Health Canada to establish standards. The pharmaceutical industry should not be responsible for managing the issue.
The Canadian Medical Association Journal explores the trend of elective cesarean sections, highlighting concerns about comparing vaginal birth to planned cesarean delivery. Hannah argues that only a comparison of planned vaginal and planned cesarean births can determine which carries greater risk to mother and baby.
Negative clinical trial results from SSRIs go unpublished, while flimsy data support their use. Flawed trial design, secrecy in approvals process, and inadequate adverse drug reporting systems contribute to ineffective and unsafe drugs entering the market.
A study of 332 randomized trials found industry-funded trials more likely to yield statistically significant pro-industry findings. Pharmaceutical companies prioritize trials with higher potential for positive results. This bias affects not only medical treatments but also new surgical interventions.
A recent study found that 72% of adverse events (AEs) among patients after discharge are related to medications. Female sex, type 2 diabetes mellitus, and pneumonia were identified as independent predictors for AEs.
A new study published in the Canadian Medical Association Journal found that infants born over the weekend had a slightly elevated risk of stillbirth and neonatal death compared to those born on weekdays. The researchers suggested that selective timing of low-risk elective deliveries may explain this difference.