Canadian Medical Association journal最新文献

{"title":"A young woman with fever, rash, and systemic symptoms after returning from Argentina.","authors":"Zain S Ali, Amin Meghdadi, Santiago Perez Patrigeon, Adrian Baranchuk","doi":"10.1503/cmaj.241921","DOIUrl":"10.1503/cmaj.241921","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 18","pages":"E506-E508"},"PeriodicalIF":9.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syndrome de l’artère poplitée piégée chez un homme de 20 ans.","authors":"Daniel Czikk, George Elzawy, Prasad Jetty, Jennifer Leppard","doi":"10.1503/cmaj.241083-f","DOIUrl":"10.1503/cmaj.241083-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 18","pages":"E514-E518"},"PeriodicalIF":9.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virus Oropouche.","authors":"Tri Dinh, Jamil Kanji, Stephen Vaughan","doi":"10.1503/cmaj.241440-f","DOIUrl":"10.1503/cmaj.241440-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 18","pages":"E519-E520"},"PeriodicalIF":9.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dengue.","authors":"Maxime J Billick, Isaac I Bogoch","doi":"10.1503/cmaj.250114","DOIUrl":"10.1503/cmaj.250114","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 18","pages":"E509"},"PeriodicalIF":9.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lupus vulgaire chez un homme de 58 ans.","authors":"Chen Wang, Jianjun Qiao","doi":"10.1503/cmaj.241343-f","DOIUrl":"10.1503/cmaj.241343-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 18","pages":"E521"},"PeriodicalIF":9.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of a provincial opioid prescribing standard on prescribing for pain in adults: an interrupted time-series analysis.","authors":"Dimitra Panagiotoglou, Sandra Peterson, M Ruth Lavergne, Tara Gomes, Rashmi Chadha, Philippa Hawley, Rita McCracken","doi":"10.1503/cmaj.250167","DOIUrl":"10.1503/cmaj.250167","url":null,"abstract":"<p><strong>Background: </strong>In 2016, the College of Physicians and Surgeons of British Columbia released a legally enforceable opioid prescribing practice standard for the treatment of chronic noncancer pain (CNCP); it was revised in 2018 in response to concerns that it was misinterpreted. We aimed to test the effects of the practice standard on access to opioids for people treated for CNCP, living with cancer, or receiving palliative care.</p><p><strong>Methods: </strong>We used comprehensive administrative health data from Oct. 1, 2012, to Mar. 31, 2020, and multiple baseline interrupted time-series analysis to evaluate the effects of the 2016 practice standard and 2018 revision in cohorts of people treated for CNCP, living with cancer, or receiving palliative care.</p><p><strong>Results: </strong>The 2016 practice standard accelerated pre-existing monthly trends in morphine milligram equivalents (MME) dispensed per person treated for CNCP (-0.1%, 95% confidence interval [CI] -0.2% to 0.0%), but also for people living with cancer (-0.7%, 95% CI -1.0% to -0.5%) and those receiving palliative care (-0.3%, 95% CI -0.5% to 0.0%). The proportion of people with CNCP prescribed a daily dose greater than 90 MME (-0.3%, 95% CI -0.4% to -0.2%), coprescribed a benzodiazepine or other hypnotic (-0.6%, 95% CI -0.7% to -0.5%), and aggressively tapered (-0.1%, 95% CI -0.2% to 0.0%) also decreased more quickly after the practice standard. Although we observed null or decreases in level effects overall, the proportion of people aggressively tapered increased 2.0% (95% CI 0.4% to 3.3%) immediately after implementation of the practice standard. Trends slowed or reversed after the 2018 revision.</p><p><strong>Interpretation: </strong>The 2016 practice standard was associated with an immediate and long-lasting effect on physicians' opioid prescribing behaviours, including inadvertently increasing aggressive tapering (observed level effect) and reducing access to opioids for people living with cancer or receiving palliative care.</p>","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 18","pages":"E497-E505"},"PeriodicalIF":9.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating chronic pain management into care for patients with opioid use disorder.","authors":"Kiran Grant, Michael Butterfield, Paxton Bach","doi":"10.1503/cmaj.241320","DOIUrl":"10.1503/cmaj.241320","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 18","pages":"E512-E513"},"PeriodicalIF":9.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pott puffy tumour in a 61-year-old man.","authors":"Kuan-Ying Chen, Yi-Hsun Huang","doi":"10.1503/cmaj.241413","DOIUrl":"10.1503/cmaj.241413","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 18","pages":"E510-E511"},"PeriodicalIF":9.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La recherche et son (véritable) coût.","authors":"William A Ghali","doi":"10.1503/cmaj.250406-f","DOIUrl":"https://doi.org/10.1503/cmaj.250406-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 17","pages":"E491-E492"},"PeriodicalIF":9.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the 2023 wildfire smoke episodes in Ontario, Canada, on asthma and other health outcomes: an interrupted time-series analysis.","authors":"Hong Chen, Jay S Kaufman, Chen Chen, Jun Wang, Allison Maier, Adam van Dijk, Nancy Slipp, Juwel Rana, Elaina MacIntyre, Yushan Su, JinHee Kim, Tarik Benmarhnia","doi":"10.1503/cmaj.241506","DOIUrl":"10.1503/cmaj.241506","url":null,"abstract":"<p><strong>Background: </strong>During the 2023 wildfire season, Ontario, Canada, had unprecedented wildfire smoke, but the health impact on the population is unknown. We aimed to quantify the acute impact of the wildfire smoke on respiratory and cardiovascular outcomes across Ontario.</p><p><strong>Methods: </strong>We conducted a quasi-experimental study by leveraging the timing of 2 consecutive wildfire smoke episodes in June 2023. Heavy wildfire smoke blanketed much of Ontario on 2 occasions, in early June and again in late June, causing severely degraded daily air quality. Following the epidemiologic triangulation framework, we collected health data on emergency department visits for 4 outcomes (asthma-related causes, other respiratory causes, ischemic heart disease, and non-cardiorespiratory causes) from Ontario's real-time syndromic surveillance system and the National Ambulatory Care Reporting System. We also employed different epidemiologic methodologies, including interrupted time-series and case-crossover analyses.</p><p><strong>Results: </strong>After the initial heavy wildfire smoke in early June 2023, daily asthma-related visits increased substantially across Ontario, peaking at a 23.6% increase (95% confidence interval 13.2%-34.9%) at a 1-day lag and lasting up to a lag of 5 days after the start of the smoke episode. The later episode of heavy smoke, despite causing higher exposures, had a reduced effect on asthma-related visits. We did not detect any effect on other outcomes in either episode. These findings were consistent across different methodologies and data sources. Post hoc analysis revealed that asthma-related visits were briefly elevated after the wildfire smoke among children (40% higher), but we observed a more sustained effect among adults (48% higher, lasting 1 week).</p><p><strong>Interpretation: </strong>The 2023 wildfires substantially increased asthma-related emergency department visits in Ontario, with age and timing of exposure being important factors influencing the impact. As wildfires emerge as one of the fastest-growing environmental risk factors globally, future research should identify and evaluate measures to effectively mitigate the acute health impacts of wildfire smoke.</p>","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 17","pages":"E465-E477"},"PeriodicalIF":9.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}