Canadian Medical Association journal最新文献

{"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":"https://doi.org/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}

{"title":"Diabetic ketoacidosis induced by a sodium-glucose cotransporter-2 inhibitor in a 28-year-old man without known diabetes.","authors":"Seungjae Cho, Jessica Mak, Jacob A Udell, Wayne L Gold, Alanna Weisman","doi":"10.1503/cmaj.241400","DOIUrl":"https://doi.org/10.1503/cmaj.241400","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 17","pages":"E478-E481"},"PeriodicalIF":9.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985462","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":"Avis de décès pour avril 2025.","authors":"","doi":"10.1503/cmaj.250545-f","DOIUrl":"https://doi.org/10.1503/cmaj.250545-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 17","pages":"E493-E496"},"PeriodicalIF":9.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990011","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":"Wildfire smoke air pollution: new approaches needed to protect people affected.","authors":"Sarah B Henderson","doi":"10.1503/cmaj.250510","DOIUrl":"https://doi.org/10.1503/cmaj.250510","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 17","pages":"E483-E484"},"PeriodicalIF":9.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976730","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":"Caring for patients with intrathecal baclofen pumps.","authors":"Katherine Archibold, Alex Whelan","doi":"10.1503/cmaj.241230","DOIUrl":"https://doi.org/10.1503/cmaj.241230","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 17","pages":"E482"},"PeriodicalIF":9.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970697","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":"Vitiligo.","authors":"Shahnawaz Towheed, Ajith Cy","doi":"10.1503/cmaj.240778-f","DOIUrl":"https://doi.org/10.1503/cmaj.240778-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 17","pages":"E487-E488"},"PeriodicalIF":9.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986109","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":"Deaf, to good advice.","authors":"A Mark Clarfield","doi":"10.1503/cmaj.250189","DOIUrl":"https://doi.org/10.1503/cmaj.250189","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 17","pages":"E485-E486"},"PeriodicalIF":9.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967421","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":"Défendre la limite.","authors":"Kirsten Patrick","doi":"10.1503/cmaj.250418-f","DOIUrl":"https://doi.org/10.1503/cmaj.250418-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 17","pages":"E489-E490"},"PeriodicalIF":9.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985038","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":"L’importance de la confiance dans le long parcours d’une patiente atteinte d’une névralgie du trijumeau.","authors":"Isabella Spensieri","doi":"10.1503/cmaj.241308-f","DOIUrl":"https://doi.org/10.1503/cmaj.241308-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 16","pages":"E461-E462"},"PeriodicalIF":9.4,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977705","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":"Pediatricians' response to presenting formula and breast- or chestfeeding as equivalent options for parents with virally suppressed HIV.","authors":"Sarah Khan, Jason Brophy, Fatima Kakkar, Nancy Nashid, Laura Sauve, Rupeena Purewal, Ari Bitnun","doi":"10.1503/cmaj.152179-l","DOIUrl":"https://doi.org/10.1503/cmaj.152179-l","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 16","pages":"E457"},"PeriodicalIF":9.4,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970701","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}