Canadian Medical Association journal最新文献

{"title":"Why reduce frequency of print issues if they are well read?","authors":"Nancy Craig","doi":"10.1503/cmaj.152112-l","DOIUrl":"https://doi.org/10.1503/cmaj.152112-l","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 15","pages":"E421"},"PeriodicalIF":9.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977840","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 COVID-19 pandemic on tuberculosis program performance in Alberta, Canada: a population-based evaluation.","authors":"Seun Akinfolarin, Divya Shah, Courtney Heffernan, Tamara Samardzic, Angela Lau, Robin Love, Amy Colquhoun, Ryan Cooper, Stacy Valaire, Alexander Doroshenko, Mary Lou Egedahl, Gregory Tyrrell, Richard Long","doi":"10.1503/cmaj.241411","DOIUrl":"https://doi.org/10.1503/cmaj.241411","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic caused major disruptions to essential tuberculosis (TB) services globally. We evaluated the performance of the TB program in Alberta, Canada, in 2 periods - before and during the pandemic - to estimate the impact of those disruptions.</p><p><strong>Methods: </strong>We applied 10 program performance indicators and their related targets and compared them by period. The performance indicators included a measure of decline in the age- and sex-adjusted incidence by population group, the proportion of recently arrived immigrants screened on time, and 5 case management and 3 close contact management indicators. We measured performance targets by time period and clinic type - outpatient versus virtual. We used interrupted time series analysis to estimate the impact of the COVID-19 pandemic response on timeliness of immigrant screening.</p><p><strong>Results: </strong>Since 2009, the rate of disease has declined in the Canadian-born but not the foreign-born population. However, the rate of disease by population group was not different prepandemic versus during the pandemic. Program performance was not negatively affected by the pandemic in general, but there was a large reduction in immigration and, in turn, the number of immigrants referred for screening (37.6%) and contacts identified for assessment (71.8%) during the pandemic, associated with improvements to the proportion of referrals assessed (91.7% v. 96.6%, relative risk [RR] 0.949, 95% confidence interval [CI] 0.936-0.962); contacts assessed (81.7% v. 90.0%, RR 0.908, 95% CI 0.875-0.943), and contacts completing treatment of infection (90.4% v. 97.1%, RR 0.931, 95% CI 0.886-0.979). Among patients with TB disease, monitoring of treatment response was suboptimal, whereas other targets were met or nearly met. Virtual clinic performance tended to be worse during the pandemic than the outpatient clinics.</p><p><strong>Interpretation: </strong>COVID-19-related disruptions were not as substantial in the Alberta TB program as elsewhere, likely because of its centralized operational model and protection of its staff from secondment. However, no progress has been made toward reducing TB incidence. Better resourcing of prevention activity and a more responsive information system should be considered.</p>","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 15","pages":"E403-E412"},"PeriodicalIF":9.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960162","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":"Central nervous system blastomycosis in an immunocompetent child.","authors":"Hassan Jamal, Conor Broderick, Manal Tadros, Irene Lara-Corrales, Ari Bitnun","doi":"10.1503/cmaj.241332","DOIUrl":"https://doi.org/10.1503/cmaj.241332","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 15","pages":"E413-E416"},"PeriodicalIF":9.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966587","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":"Blastomycosis in a 49-year-old man from southwestern Ontario.","authors":"Hannah Stirton, David Croitoru","doi":"10.1503/cmaj.241680","DOIUrl":"https://doi.org/10.1503/cmaj.241680","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 15","pages":"E419-E420"},"PeriodicalIF":9.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976750","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":"Diagnostic et prise en charge de la rhinosinusite chronique.","authors":"Christopher J Chin, John R Scott, John M Lee","doi":"10.1503/cmaj.241101-f","DOIUrl":"https://doi.org/10.1503/cmaj.241101-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 15","pages":"E427-E434"},"PeriodicalIF":9.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976753","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":"April 2025 obituaries.","authors":"","doi":"10.1503/cmaj.250545","DOIUrl":"https://doi.org/10.1503/cmaj.250545","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 15","pages":"E423-E426"},"PeriodicalIF":9.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954747","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":"Menstrual equity in Canada.","authors":"Ann C Lee, Serena M Topshee, Megan E Harrison","doi":"10.1503/cmaj.241513","DOIUrl":"https://doi.org/10.1503/cmaj.241513","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 14","pages":"E393"},"PeriodicalIF":9.4,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986137","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":"Exploring the evidence for hyperbaric oxygen therapy for sudden sensorineural hearing loss.","authors":"Peng You, Daniel Newsted, Munir Demir Bajin","doi":"10.1503/cmaj.242141-l","DOIUrl":"https://doi.org/10.1503/cmaj.242141-l","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 14","pages":"E395"},"PeriodicalIF":9.4,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980892","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":"Managing obesity in children: a clinical practice guideline.","authors":"Geoff D C Ball, Roah Merdad, Catherine S Birken, Tamara R Cohen, Brenndon Goodman, Stasia Hadjiyannakis, Jill Hamilton, Mélanie Henderson, John Lammey, Katherine M Morrison, Sarah A Moore, Aislin R Mushquash, Ian Patton, Nicole Pearce, Joshua K Ramjist, Tracy Rhyason Lebel, Brian W Timmons, Annick Buchholz, Jennifer Cantwell, Jennifer Cooper, Julius Erdstein, Donna Fitzpatrick-Lewis, Dawn Hatanaka, Patrice Lindsay, Tasneem Sajwani, Meghan Sebastianski, Diana Sherifali, Julie St Pierre, Muhammad Usman Ali, Jessica Wijesundera, Angela S Alberga, Christine Ausman, Trisha C Baluyot, Emily Burke, Kara Dadgostar, Bronwyn Delacruz, Elizabeth Dettmer, Maegan Dymarski, Zahra Esmaeilinezhad, Ilona Hale, Soren Harnois-Leblanc, Josephine Ho, Nicole D Gehring, Marsha Kucera, Jacob C Langer, Amy C McPherson, Leen Naji, Krista Oei, Grace O'Malley, Angelica M Rigsby, Gita Wahi, Ian S Zenlea, Bradley C Johnston","doi":"10.1503/cmaj.241456","DOIUrl":"https://doi.org/10.1503/cmaj.241456","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a complex, chronic, stigmatized disease whereby abnormal or excess body fat may impair health or increase the risk of medical complications, and can reduce quality of life and shorten lifespan in children and families. We developed this guideline to provide evidence-based recommendations on options for managing pediatric obesity that support shared decision-making among children living with obesity, their families, and their health care providers.</p><p><strong>Methods: </strong>We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. We used the Guidelines International Network principles to manage competing interests. Caregivers, health care providers, and people living with obesity participated throughout the guideline development process, which optimized relevance. We surveyed end users (caregivers, health care providers) to prioritize health outcomes, completed 3 scoping reviews (2 on minimal important difference estimates; 1 on clinical assessment), performed 1 systematic review to characterize families' values and preferences, and conducted 3 systematic reviews and meta-analyses to examine the benefits and harms of behavioural and psychological, pharmacologic, and surgical interventions for managing obesity in children. Guideline panellists developed recommendations focused on an individualized approach to care by using the GRADE evidence-to-decision framework, incorporating values and preferences of children living with obesity and their caregivers.</p><p><strong>Recommendations: </strong>Our guideline includes 10 recommendations and 9 good practice statements for managing obesity in children. Managing pediatric obesity should be guided by a comprehensive child and family assessment based on our good practice statements. Behavioural and psychological interventions, particularly multicomponent interventions (strong recommendation, very low to moderate certainty), should form the foundation of care, with tailored therapy and support using shared decision-making based on the potential benefits, harms, certainty of evidence, and values and preferences of children and families. Pharmacologic and surgical interventions should be considered (conditional recommendation, low to moderate certainty) as therapeutic options based on availability, feasibility, and acceptability, and guided by shared decision-making between health care providers and families.</p><p><strong>Interpretation: </strong>This guideline will support children, families, and health care providers to have informed discussions about the balance of benefits and harms for available obesity management interventions to support value- and preference-sensitive decision-making.</p>","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 14","pages":"E372-E389"},"PeriodicalIF":9.4,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977756","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":"Prévention des méfaits dès la première prescription d’opioïdes.","authors":"Donna L Reynolds, Raoul Daoust, Melissa Subnath, Heather Limburg","doi":"10.1503/cmaj.250094-f","DOIUrl":"https://doi.org/10.1503/cmaj.250094-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 14","pages":"E400-E402"},"PeriodicalIF":9.4,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977473","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}