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Canadian Medical Association Journal


Is bigger better?

A large Canadian study found no significant difference in postoperative mortality between high- and low-volume hospitals for complex surgical procedures. The authors suggest that volume-based regionalization may have good reasons, but the main benefit of reduced mortality rates may be overstated.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateMay 26, 2003

Concerns over peanut allergy

The Canadian Medical Association Journal published a comprehensive review of peanut allergy prevalence, highlighting its severity and early onset. Self-injectable epinephrine remains a cornerstone of peanut allergy management, while new therapies are being developed to address this condition.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateMay 12, 2003

Drugs in the news

A study by Alan Cassels and colleagues analyzed newspaper coverage of 5 different prescription drugs in 24 Canadian newspapers. The findings showed that a majority of articles failed to mention potential side effects or harms, while only a small minority provided quantitative information on benefits and harms.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateApr 28, 2003

Doctors without borders

A survey of international medical graduates who applied to the CaRMS match found that almost half (49.2%) would prefer to practice in communities with a population of less than 100,000 people. However, only 7.8% would choose rural areas with populations under 10,000.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateApr 28, 2003

SARS in Canada

The Canadian Medical Association Journal reports on the hospital's experience managing the outbreak and reorganizing care. Dr. David Patrick of the BCCDC discusses why BC's case numbers are low, despite being a hotspot for travel from Asia.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateApr 16, 2003

Into the mouths of babes

A survey of low-income single mothers in Atlantic Canada found that 78% experienced food insecurity and reported poorer nutrition than their children. The study highlights the need for policy reforms to address income inequality and ensure access to nutritious food for vulnerable populations.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateMar 17, 2003

ADHD in adults

Adults with ADHD are at higher risk of dropping out of school, losing jobs, and experiencing marital problems due to poor social skills and increased anxiety and depression. Reliable diagnosis and treatment options, such as stimulant medications and new psychotherapeutic approaches, can help manage the condition.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateMar 17, 2003

Mandatory reporting of HIV infection does not reduce testing rates

A study in Alberta found that mandatory reporting of HIV infection did not significantly impact testing rates among the general population. However, an opt-out prenatal screening policy resulted in a dramatic increase in female tests, suggesting that fear of receiving a positive test may be a more significant deterrent to testing.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateMar 17, 2003

Ramipril use in Canada

The number of ramipril prescriptions for elderly Ontario residents increased significantly after the release of HOPE's results, peaking at 304/100 000 in May 2000. This surge in prescribing was attributed to widespread media coverage of the study's success.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateMar 3, 2003

Sobering data on student DWI habits

A Canadian Medical Association Journal study found that 15% of Ontario students with driver's licenses reported driving under the influence of alcohol, and 20% admitted to driving after using cannabis. These findings are particularly concerning given the high incidence of alcohol-related motor vehicle collisions among adolescents.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateMar 3, 2003

Predicting the birth of big babies

Researchers found that plasma glucose levels were poorly correlated with birth weight, and factors like smoking, pregnancy weight, and weight gain during pregnancy were more important predictors. The authors also questioned the historic link between gestational diabetes and large-for-gestational-age (LGA) neonates.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateFeb 17, 2003

Rich, poor, the wait is the same

A study by Shortt and Shaw found no correlation between socioeconomic status and waiting times for elective surgical procedures. The authors suggest that health reforms should track trends in service delivery to vulnerable groups, highlighting the need for equity in healthcare.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateFeb 17, 2003

Leaving hospital AMA

Patients who leave hospital against medical advice (AMA) are at a higher risk of being readmitted, with 21% likelihood compared to 3% for routine discharges. Readmissions often occur within the first 15 days after discharge.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateFeb 17, 2003

Hurry up and wait

A study examining ambulance transport data in Toronto found that diversion can cause important delays for critically ill patients. The researchers used data from 3609 patients with chest pain in 1997 and 1999 to show a 28.4% increase in transport intervals during periods of high overcrowding.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateFeb 3, 2003

Supply and demand and illicit drugs

A recent Canadian Medical Association Journal investigation found that a massive heroin seizure had no impact on drug prices or overdose rates. Heroin prices actually decreased after the shipment was intercepted, raising questions about the effectiveness of supply-side interventions in controlling Canada's illicit drug epidemic.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateJan 20, 2003

Shaken baby syndrome in Canada

A study of Canadian children with shaken baby syndrome found nearly 20% died, 55% suffered lasting neurologic injuries, and 65% experienced visual impairment. The authors estimate at least 40 cases occur annually, calling for further research on prevention strategies.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateJan 20, 2003

Waiting for essential diagnostic tests

A study published in the Canadian Medical Association Journal found that patients waiting for cardiac catheterization experienced a significant risk of mortality and morbidity. The study documented 109 cases of major cardiac events among 8030 patients, resulting in 50 deaths during a median wait time of 27 days.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateNov 25, 2002

COX-2 inhibitors and the elderly

The study found that COX-2 inhibitors led to a substantial increase in NSAID prescriptions and expenditures among elderly patients in Ontario. The listing of these medications had an immediate impact, accounting for 48% of prescriptions and 66% of expenditures for NSAIDs.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateNov 11, 2002

What savings?

A review of medical savings accounts (MSAs) suggests they are unlikely to reduce healthcare spending while maintaining access to services for all Canadians. MSAs were assessed using data from Manitoba residents, and the results showed an increase in government spending on healthcare if the threshold was used as MSA entitlement.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateJul 22, 2002

Fatal Fridays

A study by van Walraven and Bell found that patients released on Fridays are more likely to die or be readmitted within 30 days. The authors suggest that delays in social services or incomplete discharge information may contribute to this increased risk.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateJun 24, 2002

Profit vs. non-profit health care

A systematic review of studies found private for-profit hospitals in the US had a higher risk of death compared to not-for-profit institutions. This new evidence has sparked debate about the relevance of for-profit care and the importance of a universal healthcare system with public accountability.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateMay 27, 2002

Opening up research ethics boards

Research ethics boards involved in industry-sponsored pharmaceutical trials are under investigation due to concerns of secrecy and lack of transparency. Industry sponsorship can create conflicts of interest, compromising the integrity of clinical trials and patient safety.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateMay 13, 2002

The paper chase

A study published in the Canadian Medical Association Journal suggests that journals' practices for accelerating publication may be inconsistent. General internists rated articles from The Lancet and New England Journal of Medicine, finding case articles scored higher on importance, ease of applicability, and health outcomes than contr...

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateApr 29, 2002

Is medical school only for the rich?

A study found that Canadian medical students are more likely to be from visible minorities, but underrepresented from certain minority groups like black and Aboriginal. Medical students also tend to come from higher socioeconomic backgrounds and less rural areas compared to the general Canadian population.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateApr 15, 2002

Preventing HIV infection in newborns

A retrospective review of 6 cases involving HIV-positive infants whose mothers did not know their own HIV status revealed incomplete application of guidelines. The authors recommend universal HIV testing and counselling to prevent perinatal transmission, while a commentary discusses 5 critical steps needed for prevention.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateApr 1, 2002

Marijuana’s impact on intelligence

A Canadian study found that heavy marijuana use is associated with decreased IQ scores, but light and former use are linked to modest gains. The research, which followed 70 subjects over several years, suggests that the effects of marijuana on intelligence may be more complex than previously thought.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateApr 1, 2002

HIV infection among female injection drug users

A study found that female injection drug users in Vancouver with high-risk behaviors like daily cocaine use and unsafe sex were more likely to convert to HIV. The authors emphasize the need for sex-specific prevention initiatives due to alarming rates of HIV infection among Aboriginal women, twice as high as in non-Aboriginal populations.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateApr 1, 2002

Like a deer in the headlights

A recent study published in the Canadian Medical Association Journal found a significant increase in wildlife vehicle collisions across Canada. The research highlights the growing concern of these accidents, which can result in serious injuries and fatalities.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateMar 18, 2002

Decision rules and physician judgment

The study found that physician judgment had a sensitivity of 89% and specificity of 26% for the Ottawa rules, and 80% and 59% for the Leiden rule. With structured data collection, physicians' judgment was similar to existing ankle rules in terms of sensitivity and ability to safely reduce radiographic examinations.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateMar 18, 2002

Whither the GP who can do everything?

Research reveals a decline in general practitioners' and family physicians' involvement in non-office settings, leading to a reduction in comprehensive care. Alternative models such as group practices and networks can help meet the need for primary care, but reliance on core physicians working in multiple settings remains a concern.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateFeb 18, 2002

Safety of home births

A Canadian study finds that home births attended by midwives have comparable perinatal outcomes to hospital births, including lower rates of maternal infection and neonatal complications. However, the authors recommend ongoing monitoring for rare adverse outcomes such as hemorrhage and ventilator support.

SourceCanadian Medical Association Journal·JournalCanadian Medical Association Journal·DateFeb 4, 2002