CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne最新文献

{"title":"Improving hypertension management in Canada.","authors":"Rhian M Touyz","doi":"10.1503/cmaj.250794","DOIUrl":"10.1503/cmaj.250794","url":null,"abstract":"","PeriodicalId":520595,"journal":{"name":"CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne","volume":"197 20","pages":"E584-E585"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pleural infection.","authors":"Maha K Alghamdi, Stéphane Beaudoin, Amr J Alwakeel","doi":"10.1503/cmaj.241633","DOIUrl":"10.1503/cmaj.241633","url":null,"abstract":"","PeriodicalId":520595,"journal":{"name":"CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne","volume":"197 20","pages":"E569"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond individual interventions: advancing systems thinking in the clinical management of obesity.","authors":"Pablo Arrona Cardoza, Laurette Dubé, Daiva E Nielsen","doi":"10.1503/cmaj.152390-l","DOIUrl":"10.1503/cmaj.152390-l","url":null,"abstract":"","PeriodicalId":520595,"journal":{"name":"CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne","volume":"197 20","pages":"E570"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertension Canada guideline for the diagnosis and treatment of hypertension in adults in primary care.","authors":"Rémi Goupil, Ross T Tsuyuki, Nancy Santesso, Kristin A Terenzi, Jeffrey Habert, Gemma Cheng, Stephanie C Gysel, Jill Bruneau, Alexander A Leung, Norman R C Campbell, Ernesto L Schiffrin, Gregory L Hundemer","doi":"10.1503/cmaj.241770","DOIUrl":"10.1503/cmaj.241770","url":null,"abstract":"<p><strong>Background: </strong>Canada has historically been among the world leaders in hypertension care, but hypertension treatment and control rates have regressed in recent years. This guideline is intended to provide pragmatic primary care-focused recommendations to improve hypertension management in adults at the population level.</p><p><strong>Methods: </strong>We employed Grading of Recommendations Assessment, Development and Evaluation and ADAPTE frameworks in accordance with Appraisal of Guidelines for Research and Evaluation (AGREE II) quality and reporting standards to develop recommendations on managing hypertension for adults aged 18 years and older. We used the HEARTS framework - a model of care developed by the World Health Organization to improve hypertension control and reduce cardiovascular burden - to integrate these recommendations into streamlined, pragmatic, and evidence-based algorithms. The guideline committee predominantly comprised primary care providers and also included patient, methodology, and hypertension specialist representatives. Our process for managing competing interests adhered to Guidelines International Network principles.</p><p><strong>Recommendations: </strong>The 9 recommendations for managing hypertension in adults are grouped under the categories of diagnosis and treatment. Diagnostic recommendations include a standardized approach to measuring blood pressure (BP) and confirming hypertension, as well as providing a uniform definition for hypertension of BP ≥ 130/80 mm Hg. Treatment recommendations include targeting a systolic BP < 130 mm Hg, implementing healthy lifestyle changes, and providing stepwise guidance on optimal medication choices for patients requiring pharmacotherapy.</p><p><strong>Interpretation: </strong>Our aim is to enhance the standard of hypertension care in the Canadian primary care setting. Accurate diagnosis and optimal treatment of hypertension can reduce adverse cardiovascular events and risk of death.</p>","PeriodicalId":520595,"journal":{"name":"CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne","volume":"197 20","pages":"E549-E564"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid-onset tardive dyskinesia-like disorder after a single dose of haloperidol.","authors":"Carolyn Michelle Tan, Barbara Liu, David Juurlink","doi":"10.1503/cmaj.241359","DOIUrl":"10.1503/cmaj.241359","url":null,"abstract":"","PeriodicalId":520595,"journal":{"name":"CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne","volume":"197 20","pages":"E565-E568"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La prise en charge non pharmacologique des symptômes comportementaux et psychologiques de la démence.","authors":"Hana Brath, Lesley Wiesenfeld, Nathan M Stall","doi":"10.1503/cmaj.241076-f","DOIUrl":"10.1503/cmaj.241076-f","url":null,"abstract":"","PeriodicalId":520595,"journal":{"name":"CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne","volume":"197 20","pages":"E578-E579"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giardiase et spirochétose intestinale causant une perte de poids involontaire chez un homme de 40 ans.","authors":"Eshita Kapoor, Tara O'Brien, Lianne Tile, Brandon Tang","doi":"10.1503/cmaj.241507-f","DOIUrl":"10.1503/cmaj.241507-f","url":null,"abstract":"","PeriodicalId":520595,"journal":{"name":"CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne","volume":"197 20","pages":"E573-E577"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Uncovering SARS-CoV-2 vaccine uptake and COVID-19 impacts among First Nations, Inuit and Métis Peoples living in Toronto and London, Ontario\".","authors":"","doi":"10.1503/cmaj.221432","DOIUrl":"https://doi.org/10.1503/cmaj.221432","url":null,"abstract":"","PeriodicalId":520595,"journal":{"name":"CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne","volume":" ","pages":"E1383"},"PeriodicalIF":14.6,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/91/db/194e1383.PMC9616140.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33517832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home sweet homeless.","authors":"Matt Larsen","doi":"10.1503/cmaj.220535","DOIUrl":"https://doi.org/10.1503/cmaj.220535","url":null,"abstract":"","PeriodicalId":520595,"journal":{"name":"CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne","volume":" ","pages":"E1117-E1118"},"PeriodicalIF":14.6,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2f/ef/194e1117.PMC9528526.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40418104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postrenal acute kidney injury from a sliding inguinal hernia.","authors":"Rosemarie Vincent,&nbsp;Shannon A Fraser,&nbsp;Evan G Wong","doi":"10.1503/cmaj.211805","DOIUrl":"https://doi.org/10.1503/cmaj.211805","url":null,"abstract":"CMAJ | August 22, 2022 | Volume 194 | Issue 32 © 2022 CMA Impact Inc. or its licensors A 92-year-old man with chronic kidney disease (baseline creatinine 120 μmol/L) developed acute kidney injury (highest creatinine 422 μmol/L) while hospitalized following his third myocardial infarction. He had no pain or lower urinary tract symptoms, but had noticed a bulge in his left inguinal area for the previous 2 years. Physical examination showed that the patient was frail, with a large, partially reducible, left inguinal mass. His acute kidney injury did not resolve after intravenous hydration. We ordered pelvic ultrasonography, which showed moderate-to-severe bilateral hydronephrosis and a poorly visualized left testicle. We inserted a Foley catheter and consulted a urologist. We ordered computed tomography to look for intrinsic and extrinsic causes of the hydronephrosis, which showed that most of the bladder had herniated through a left inguinal hernia. It also showed bilateral hydronephrosis and hydroureter (Figure 1). We attempted a mechanical reduction of the bladder hernia, which was not successful. We offered the patient and his family surgical repair or more conservative management. Because of his high surgical risk, they chose nonoperative management. We inserted bilateral nephrostomy tubes, and the acute kidney injury improved. We subsequently removed the tubes and discharged the patient with an indwelling Foley catheter. He did not have further complications related to his hernia or his urinary system during the 6 months after discharge. Bladder hernias are uncommon, accounting for 1%–4% of inguinal hernias.1 Only 7%–10% are diagnosed preoperatively.1,2 Inguinal bladder hernias presenting as obstructive uropathy are infrequent, but should be considered in patients with an inguinal mass and concomitant acute kidney injury based on history and physical examination.2 The diagnosis can be confirmed with ultrasonography, computed tomography or cystography.1 Patients who are at low-to-moderate operative risk are usually offered surgery, but decompression with transient nephrostomy tubes and a permanent bladder catheter is an alternative for patients who have a high operative risk. References","PeriodicalId":520595,"journal":{"name":"CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne","volume":" ","pages":"E1112"},"PeriodicalIF":14.6,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b1/28/194e1112.PMC9528529.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40418107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}