Single-entry models and team-based care can reduce wait times for surgeries while providing equitable access for patients. The authors acknowledge concerns around professional autonomy and financial security, but suggest that SEMs are fair, efficient, and patient-centered.
A new online calculator predicts the risk of death and long-term care admission for patients with dementia based on simple questions at diagnosis. The study found that older age, male sex, and organ failure are key predictors of mortality and institutionalization.
Chloroquine, hydroxychloroquine, and azithromycin can lead to rare but potentially life-threatening adverse events, including cardiac arrhythmias, hypoglycemia, and neuropsychiatric effects. Patients should be aware of the risks before treatment.
A national modelling paper suggests that Canada's ICU beds may not be enough to handle the demand during a COVID-19 outbreak, highlighting the need for higher rates of self-isolation. The study projects that at the outbreak's peak, the need for ICU beds per 10,000 population could be 2.6 times higher than the number of available beds.
A new modelling paper from Ontario indicates that dynamic physical distancing measures can reduce COVID-19 transmission while providing periodic psychological and economic relief. The study shows that modulating response measures can prevent ICU overloads without overwhelming the healthcare system.
A COVID-19 palliative care plan has been developed as an essential tool to provide care during the pandemic. The plan focuses on 8 critical elements: stockpiling medications and supplies, training staff, optimizing space, refining systems, alleviating separation effects, promoting critical conversations, focusing on marginalized popula...
A study published in CMAJ found that self-reported mental health issues and service use in Ontario increased between 2002 and 2014, with a significant rise in the number of people reporting fair or poor mental health status. The increase in help-seeking behavior suggests improved awareness and reduced stigma around mental health issues.
A new study found that cumulative doses of oral steroids are associated with increased hypertension, affecting over 24,000 adults with chronic inflammatory diseases. The researchers recommend closer monitoring of blood pressure in these patients.
A new clinical guideline aims to inform clinicians about evidence-based interventions to treat homeless and precariously housed people. The guideline recommends integrating housing support, income assistance, case management, opioid agonist therapy, and harm-reduction services to address the complex needs of vulnerable populations.
A new guideline aims to address Indigenous homelessness through four broad protocols: situating oneself, visiting, hospitality, and treating others with respect. The guidelines emphasize the importance of inter-relationality and community-based approaches to support Indigenous peoples experiencing homelessness.
Innovative, Indigenous-led health care partnerships are showing improved health outcomes and access to care for Indigenous patients. These partnerships incorporate traditional Indigenous knowledge and cultural healing practices, addressing the holistic needs of patients.
A study predicts a rise in cancer cases in Canada in 2020, with nearly 1 in 2 Canadians expected to receive a diagnosis. Lung cancer will be the leading cause of death, responsible for about 1 in 4 deaths from cancer.
Cannabinoids can interact with various drugs, increasing the risk of adverse effects. Regular marijuana use may also affect the clearance of other medications. Understanding these interactions is crucial for patients and physicians.
Research found early exposure to household cleaning products increases risk of childhood asthma and wheeze by age 3, with scented products posing the highest risk. The study suggests avoiding or reducing use of sprays and fragrance-based cleaners to minimize a child's exposure and reduce the risk of respiratory issues.
A new study in Canadian Medical Association Journal found that individuals who requested medical assistance in dying (MAiD) were younger, wealthier, and more likely to be married than the general population. MAiD requests were not associated with socioeconomic vulnerabilities or access to palliative care.
A new review in the Canadian Medical Association Journal suggests an association between excessive smartphone and social media use and mental distress among adolescents. The authors provide guidance for physicians, parents, and teachers on how to help teens achieve a healthy balance between device use and other aspects of their lives.
Elective egg freezing is a common method to increase pregnancy chances at a later age. Patients under 35 with normal ovarian reserve have the best chance of success, but future live births are not guaranteed. The treatment process takes 10-14 days and fees are not covered by Canadian government health insurance.
A recent study found that diabetes prevalence is higher among First Nations people and women, particularly those of reproductive age. The gap has narrowed over time, but the risk factors persist. Understanding these determinants is crucial for effective prevention and management strategies.
A recent CMAJ editorial emphasizes the importance of investing in social equity to address health disparities among low-income individuals. The authors highlight the persistent gaps in healthcare access and outcomes according to income, which result from poverty's association with various social determinants of health.
A new score, the Cambridge Multimorbidity Score, outperforms the Charlson Comorbidity Index in predicting healthcare outcomes for patients with multiple chronic illnesses. The score can help clinicians prioritize care and optimize health delivery to an aging population.
A national quality-improvement program in Canada's NICUs increased survival rates for very preterm babies by 25%. The EPIQ program also reduced chronic health issues and adverse outcomes, such as bronchopulmonary dysplasia and sepsis.
Adults with food insecurity are 10-37% more likely to die prematurely, on average 9 years earlier than their food-secure counterparts. Policies addressing food insecurity could reduce premature deaths.
A Danish study found that low lymphocyte counts are associated with a 60% increase in death from any cause. Participants with lymphopenia were at high risk of dying from all-cause mortality, including age-related risks.
A new frailty index shows promise in determining how acute illness affects functional ability in older patients admitted to hospital. A higher score on the FI-Laboratory was associated with increased likelihood of readmission and death when accounting for other health factors.
Cannabis edibles take on average four hours longer to produce noticeable effects than inhaled cannabis, increasing the risk of overconsumption. Vulnerable groups, such as children, pets, older people, and youth, are at particular risk due to delayed effects and potential for accidental overconsumption.
CMAJ's new editor-in-chief, Andreas Laupacis, outlines three priorities for the journal: publishing research relevant to Canadian physicians, expanding nonresearch sections, and increasing patient involvement. He plans to visit universities and healthcare professionals across Canada to gather ideas on improving healthcare.
A study published in CMAJ found that prescribing anticoagulants in the emergency department for patients with atrial fibrillation increases their likelihood of long-term medication adherence. This practice is associated with improved stroke prevention outcomes, particularly among older adults.
A recent court ruling in Ontario allows physicians to withhold CPR from patients they believe will not benefit from it, but emphasizes the importance of communicating concerns with families. The College of Physicians and Surgeons of Ontario has updated its end-of-life policy to reflect this change.
Rates of cardiac events such as heart failure and myocardial infarction decreased up to 60% among First Nations people with diabetes in Ontario. However, hospitalizations and deaths remained more frequent compared to non-First Nations individuals.
A previously healthy 17-year-old male was hospitalized with life-threatening bronchiolitis after a week of persistent cough. The case suggests a new form of damage from vaping products, similar to popcorn lung, and highlights the need for further research and regulation.
A study on cancer trends in Canada from 1971 to 2015 found an increase in breast and colorectal cancers among younger adults, particularly women aged 30-39. In contrast, cancer incidence has decreased in older age groups, with declines seen in cervical, lung, bladder, and prostate cancers across most age categories.
A new guideline from the Canadian Task Force on Preventive Health Care recommends against routine screening for thyroid dysfunction in nonpregnant adults without symptoms or risk factors. The evidence suggests that this type of screening has no health benefits and may lead to unnecessary testing, medication, and follow-up appointments.
A CMAJ editorial argues that Canada's government should adopt a holistic approach to address climate change, health, and taxes. The author suggests that framing these issues together can help people understand and support practical policies aimed at stalling climate change.
Research found brand pharmaceutical company discount cards for brand-name drugs increased private insurer costs by 46%. The study analyzed data from 2.8 million prescriptions, showing that patients using these cards often paid more due to higher insurance premiums.
A recent study found that teens who visit emergency departments for self-harm are five times more likely to have repeat visits and three times more likely to die from any cause compared to non-self-harming youth. The study also reveals that these adolescents incur significantly higher health costs over the following five years.
A new study finds community-based health programs improved healthcare for mothers and newborns in rural Nigeria, Ethiopia and India but inequities persist. Despite progress, many newborns still lack early postnatal care.
A large Canadian study found episiotomy can reduce the risk of severe perineal tears in instrument-assisted vaginal deliveries, particularly among first-time mothers. The rate of severe perineal tears has increased in Canada due to improved detection and reporting, affecting up to 15% of births.
A recent poll shows that almost 9 in 10 Canadians support a national pharmacare plan providing equal access to medications. Most federal parties are offering major policy proposals to introduce national pharmacare, but long-term thinking is crucial to its success.
Polyamorous families experience marginalization in healthcare, with participants suggesting providers acknowledge partners' presence and roles, be open and nonjudgmental, and adapt administrative forms. The study's findings align with recent reports on stigma faced by individuals engaging in consensual nonmonogamy.
E-cigarette use among Canadian youth has increased significantly, with a threefold risk of starting cigarettes among nonsmokers aged 14-30 who try e-cigarettes. E-cigarettes are unregulated devices with unknown long-term health risks and potentially serious pulmonary effects.
A national essential medicines list in Canada could reduce inequitable access to medication, improve health outcomes, and optimize spending on medicines. The study highlights the importance of an independent decision-making body, selection criteria based on clinical and cost-effectiveness, and clear communication with stakeholders.
A study published in CMAJ found that heart disease increases the risk of hospitalization for allopurinol-related severe skin reactions. People with specific genetic markers, such as HLA-B*5801, are at higher risk. The risk is further increased when combined with kidney disease.
A new study found that fat mass index is associated with a higher risk of cardiovascular events in people with type 2 diabetes. Researchers analyzed data from the ACCORD study and found that participants with higher fat mass were at increased risk, while lean body mass did not provide protection.
Guidelines recommend universal screening for opioid use and offering opioid agonist therapy, counselling, and mental health supports. Ongoing support in the postpartum period is crucial for women with opioid use disorders at increased risk of fatal overdose.
The new national guideline provides evidence-based treatment options for people with severe opioid use disorder, including injectable opioid agonist treatment with prescription heroin and hydromorphone. The guideline aims to reduce overdose deaths by supporting health care providers in delivering life-saving treatments.
A commonly used Alzheimer's treatment, donepezil, significantly increases the risk of hospitalization for rhabdomyolysis, a serious condition that can cause kidney damage. The study found a two-fold higher risk of hospitalization with donepezil compared to other cholinesterase inhibitors.
Dr. Andreas Laupacis, a renowned medical leader and researcher, has been appointed as the new editor-in-chief of CMAJ. He aims to increase research impact, enhance health policy voice, and promote medical knowledge.
The new guideline offers evidence-based recommendations to improve the standard of care for individuals with Parkinson's disease in Canada. It includes a new section on palliative care, highlighting the need to consider patients' quality of life throughout all phases of the disease.
Infections acquired by patients in Canadian hospitals are declining, with a 30% reduction between 2009 and 2017, reveals new research published in CMAJ. Urinary tract infections were the most common type of infection, followed by pneumonia and surgical site infections.
A Canadian study suggests that vaccinating older adults against shingles is cost-effective, with the Shingrix vaccine providing better protection than Zostavax. The study found that fewer people need to be vaccinated to prevent one case of shingles for the newer vaccine.