New fines pose financial catch-22 for Ontario long-term care.
PMID: 29789292 [PubMed - in process] (Source: cmaj)
Source: cmaj - May 22, 2018 Category: General Medicine Authors: Vogel L Tags: CMAJ Source Type: research

Major gaps in supports for medical trainees with disabilities.
PMID: 29789293 [PubMed - in process] (Source: cmaj)
Source: cmaj - May 22, 2018 Category: General Medicine Authors: Vogel L Tags: CMAJ Source Type: research

Public health in the 21st century: Governance for a healthy, just and sustainable future.
PMID: 29789294 [PubMed - in process] (Source: cmaj)
Source: cmaj - May 22, 2018 Category: General Medicine Authors: Hancock T Tags: CMAJ Source Type: research

Factors associated with delay in carotid endarterectomy for patients with symptomatic severe internal carotid artery stenosis: a case-control study.
Abstract BACKGROUND: The Canadian Best Practice Recommendations for Stroke Care (2008 update) recommend that patients with neurologic symptoms secondary to severe internal carotid artery stenosis undergo carotid endarterectomy within 14 days of symptom onset to prevent stroke. The purpose of this study was to identify patient and system factors associated with meeting, or failing to meet, the guideline. METHODS: In this case-control study, potential study participants were identified through an electronic search of the Discharge Abstract Database. We reviewed the charts of patients who presented to our centre...
Source: cmaj - May 15, 2018 Category: General Medicine Authors: Meyer D, Karreman E, Kopriva D Tags: CMAJ Open Source Type: research

Missed opportunities for prevention of vertical HIV transmission in Canada, 1997-2016: a surveillance study.
ogram Abstract BACKGROUND: Vertical HIV transmission has declined in Canada, but missed opportunities for prevention continue to occur. We sought to determine the adequacy, and changes over time in adequacy, of uptake of maternal and neonatal antiretroviral therapy for the prevention of vertical HIV transmission, and to determine the vertical transmission rate over time and according to adequacy of antenatal antiretroviral therapy during the combination antiretroviral therapy era in Canada. METHODS: The Canadian Perinatal HIV Surveillance Program collects data annually through retrospective chart review conce...
Source: cmaj - May 10, 2018 Category: General Medicine Authors: Bitnun A, Lee T, Brophy J, Samson LM, Kakkar F, Vaudry W, Tan B, Money DM, Singer J, Sauvé LJ, Alimenti A, Canadian Perinatal HIV Surveillance Program Tags: CMAJ Open Source Type: research

Call for a pan-Canadian approach to ethics review in Canada.
PMID: 29735532 [PubMed - in process] (Source: cmaj)
Source: cmaj - May 7, 2018 Category: General Medicine Authors: Nicholls SG, Morin K, Evans L, Longstaff H Tags: CMAJ Source Type: research

Mode of delivery after a previous cesarean birth, and associated maternal and neonatal morbidity.
Abstract BACKGROUND: The mode of delivery for women with a previous cesarean delivery remains contentious. We conducted a study comparing maternal and infant outcomes after attempted vaginal birth after cesarean delivery versus elective repeat cesarean delivery. METHODS: We used data from the Discharge Abstract Database that includes all hospital deliveries in Canada (excluding Quebec). In our analysis, we included singleton deliveries to women between 37 and 43 weeks gestation who had a single prior cesarean delivery between April 2003 and March 2015. The primary outcomes were severe maternal morbidity and m...
Source: cmaj - May 7, 2018 Category: General Medicine Authors: Young CB, Liu S, Muraca GM, Sabr Y, Pressey T, Liston RM, Joseph KS, Canadian Perinatal Surveillance System Tags: CMAJ Source Type: research

Rickets presenting as gross motor delay in twin girls.
PMID: 29735534 [PubMed - in process] (Source: cmaj)
Source: cmaj - May 7, 2018 Category: General Medicine Authors: Prasad C, Cummings E Tags: CMAJ Source Type: research

Point-of-care testing for HIV.
PMID: 29735535 [PubMed - in process] (Source: cmaj)
Source: cmaj - May 7, 2018 Category: General Medicine Authors: Dalcin D, Bogoch II Tags: CMAJ Source Type: research

Medical marijuana in treating obstructive sleep apnea.
PMID: 29735536 [PubMed - in process] (Source: cmaj)
Source: cmaj - May 7, 2018 Category: General Medicine Authors: Pupko HA Tags: CMAJ Source Type: research

Addressing challenges with current therapies for obstructive sleep apnea.
PMID: 29735537 [PubMed - in process] (Source: cmaj)
Source: cmaj - May 7, 2018 Category: General Medicine Authors: Laratta CR, Ayas NT, Povitz M, Pendharkar SR Tags: CMAJ Source Type: research

CMA position against separate regulations for medical cannabis draws ire and insults.
PMID: 29735538 [PubMed - in process] (Source: cmaj)
Source: cmaj - May 7, 2018 Category: General Medicine Authors: Owens B Tags: CMAJ Source Type: research

Low awareness about CADTH among practising doctors in Canada.
PMID: 29735539 [PubMed - in process] (Source: cmaj)
Source: cmaj - May 7, 2018 Category: General Medicine Authors: Rich P Tags: CMAJ Source Type: research

Opioids and pharmacare top of mind at annual CADTH meeting.
PMID: 29735540 [PubMed - in process] (Source: cmaj)
Source: cmaj - May 7, 2018 Category: General Medicine Authors: Rich P Tags: CMAJ Source Type: research

Reducing overtreatment of prostate cancer by radical prostatectomy in Eastern Ontario: a population-based cohort study.
We examined trends in biopsy findings, clinical stage, prostate-specific antigen level and Gleason score. We then determined whether the proportion of patients with clinically significant cancer (Gleason score ≥ 7 or stage pT3) increased over time. RESULTS: During the study period, 1897 patients underwent prostatectomy in Eastern Ontario (mean 271 surgeries/yr). The proportion of patients who were determined to have National Comprehensive Cancer Network intermediate or high-risk disease increased from 46.7% in 2009 to 90.2% in 2015. The proportion of men with clinically significant cancer on prostatectomy increased...
Source: cmaj - April 30, 2018 Category: General Medicine Authors: Witherspoon L, Lau JL, Breau RH, Knee C, Fung MFK, Morash R, Mallick R, Cagiannos I, Morash C, Lavallée LT Tags: CMAJ Open Source Type: research

The lesser of two evils: a qualitative study of quetiapine prescribing by family physicians.
Abstract BACKGROUND: Quetiapine is an antipsychotic that is widely prescribed off-label by family physicians despite evidence that safer alternatives exist. The aim of this research was to explore, in-depth, family physicians' reasons for this behaviour. METHODS: We conducted qualitative interviews with 15 urban family physicians in Alberta between October 2015 and April 2016. Participants were purposively selected based on sex, years of experience and practice type. Interviews explored participants' experiences prescribing quetiapine. Interviews were recorded, transcribed verbatim and coded with the use of t...
Source: cmaj - April 30, 2018 Category: General Medicine Authors: Kelly M, Dornan T, Pringsheim T Tags: CMAJ Open Source Type: research

Failure to cope.
PMID: 29712670 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 30, 2018 Category: General Medicine Authors: Luther RA, Richardson L, Detsky AS Tags: CMAJ Source Type: research

The association between home care visits and same-day emergency department use: a case-crossover study.
We examined the association between home care visits and same-day emergency department use among patients receiving publicly funded home care. METHODS: We conducted a population-based case-crossover study among patients receiving publicly funded home care in the Hamilton-Niagara-Haldimand-Brant region of Ontario between January and December 2015. Within individuals, all days with emergency department visits after 5 pm were selected as cases and matched with control days from the previous week. The cohort was stratified according to whether patients had ongoing home care needs ("long stay") or short-term home...
Source: cmaj - April 30, 2018 Category: General Medicine Authors: Jones A, Schumacher C, Bronskill SE, Campitelli MA, Poss JW, Seow H, Costa AP Tags: CMAJ Source Type: research

Diagnosing and managing drug allergy.
PMID: 29712672 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 30, 2018 Category: General Medicine Authors: Abrams EM, Khan DA Tags: CMAJ Source Type: research

A 52-year-old man with fentanyl-induced muscle rigidity.
PMID: 29712673 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 30, 2018 Category: General Medicine Authors: Buxton JA, Gauthier T, Kinshella MW, Godwin J Tags: CMAJ Source Type: research

Eosinophilic esophagitis.
PMID: 29712674 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 30, 2018 Category: General Medicine Authors: Jeyalingam T, Grover SC Tags: CMAJ Source Type: research

Treatment of subclinical hypothyroidism in pregnant women.
PMID: 29712675 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 30, 2018 Category: General Medicine Authors: Romney JS Tags: CMAJ Source Type: research

The authors respond to "Treatment of subclinical hypothyroidism in pregnant women".
The authors respond to "Treatment of subclinical hypothyroidism in pregnant women". CMAJ. 2018 Apr 30;190(17):E546 Authors: Deshauer S, Wyne A PMID: 29712676 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 30, 2018 Category: General Medicine Authors: Deshauer S, Wyne A Tags: CMAJ Source Type: research

Exercise-induced vasculitis.
Authors: PMID: 29712677 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 30, 2018 Category: General Medicine Tags: CMAJ Source Type: research

That's "not medicine" - when doctors advocate for safer roads, gun bans or reducing poverty.
That's "not medicine" - when doctors advocate for safer roads, gun bans or reducing poverty. CMAJ. 2018 Apr 30;190(17):E548-E849 Authors: Motluk A PMID: 29712678 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 30, 2018 Category: General Medicine Authors: Motluk A Tags: CMAJ Source Type: research

Recognition of family physicians as experts rather than gatekeepers requires "cultural shift".
Recognition of family physicians as experts rather than gatekeepers requires "cultural shift". CMAJ. 2018 Apr 30;190(17):E550-E551 Authors: Brown C PMID: 29712679 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 30, 2018 Category: General Medicine Authors: Brown C Tags: CMAJ Source Type: research

Waits increasing for some priority surgeries.
PMID: 29712680 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 30, 2018 Category: General Medicine Authors: Vogel L Tags: CMAJ Source Type: research

Warning of an increased risk of vertebral fracture after stopping denosumab.
PMID: 29685907 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 23, 2018 Category: General Medicine Authors: Symonds C, Kline G Tags: CMAJ Source Type: research

The foundation and consequences of gender bias in grant peer review processes.
PMID: 29685908 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 23, 2018 Category: General Medicine Authors: Morgan R, Hawkins K, Lundine J Tags: CMAJ Source Type: research

Assessment of potential bias in research grant peer review in Canada.
Abstract BACKGROUND: Peer review is used to determine what research is funded and published, yet little is known about its effectiveness, and it is suspected that there may be biases. We investigated the variability of peer review and factors influencing ratings of grant applications. METHODS: We evaluated all grant applications submitted to the Canadian Institutes of Health Research between 2012 and 2014. The contribution of application, principal applicant and reviewer characteristics to overall application score was assessed after adjusting for the applicant's scientific productivity. RESULTS: Among 1...
Source: cmaj - April 23, 2018 Category: General Medicine Authors: Tamblyn R, Girard N, Qian CJ, Hanley J Tags: CMAJ Source Type: research

Recent opioid use and fall-related injury among older patients with trauma.
, Chauny JM Abstract BACKGROUND: Evidence for an association between opioid use and risk of falls or fractures in older adults is inconsistent. We examine the association between recent opioid use and the risk, as well as the clinical outcomes, of fall-related injuries in a large trauma population of older adults. METHODS: In a retrospective, observational, multicentre cohort study conducted on registry data, we included all patients aged 65 years and older who were admitted (hospital stay> 2 d) for injury in 57 trauma centres in the province of Quebec, Canada, between 2004 and 2014. We looked at opioid pr...
Source: cmaj - April 23, 2018 Category: General Medicine Authors: Daoust R, Paquet J, Moore L, Émond M, Gosselin S, Lavigne G, Choinière M, Boulanger A, Mac-Thiong JM, Chauny JM Tags: CMAJ Source Type: research

Swallowing-induced atrial tachycardia.
PMID: 29685911 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 23, 2018 Category: General Medicine Authors: Mathew R, Green MS, Nery PB Tags: CMAJ Source Type: research

Eight-and-a-half syndrome: one-and-a-half syndrome with peripheral facial nerve palsy.
PMID: 29685912 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 23, 2018 Category: General Medicine Authors: Almutlaq A, Richard A Tags: CMAJ Source Type: research

Whole genome sequencing unlikely to be funded by government health plans.
PMID: 29685913 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 23, 2018 Category: General Medicine Authors: Morris T Tags: CMAJ Source Type: research

The hundred-dollar genome: a health care cart before the genomic horse.
PMID: 29685914 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 23, 2018 Category: General Medicine Authors: Singh S Tags: CMAJ Source Type: research

Mycobacterium avium complex infection presenting as persistent ascites.
Authors: PMID: 29685915 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 23, 2018 Category: General Medicine Tags: CMAJ Source Type: research

Obtaining funding an age-old problem for young researchers with novel ideas.
PMID: 29685916 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 23, 2018 Category: General Medicine Authors: Shuchman M Tags: CMAJ Source Type: research

Should medical errors ever be considered criminal offences?
PMID: 29685917 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 23, 2018 Category: General Medicine Authors: Glauser W Tags: CMAJ Source Type: research

Should doctors talk politics with patients?
PMID: 29685918 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 23, 2018 Category: General Medicine Authors: Vogel L Tags: CMAJ Source Type: research

Mental health promotion must be a priority.
PMID: 29685919 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 23, 2018 Category: General Medicine Authors: Hancock T Tags: CMAJ Source Type: research

Association between person-centredness and financially driven postponement of care in European primary care: a cross-sectional multicountry study.
Abstract BACKGROUND: Previous research has shown that person-centred care has beneficial effects on several health-related outcomes. We investigated the association between a general practitioner's person-centred attitude and financially driven postponement of care in European countries. METHODS: In this cross-sectional study, data were collected within the Quality and Costs of Primary Care in Europe study, which included 69 201 patients and 7183 general practitioners from 31 European countries (all 27 European Union member states, 2 candidate states [former Yugoslav Republic of Macedonia and Turkey], Norwa...
Source: cmaj - April 18, 2018 Category: General Medicine Authors: Detollenaere J, Boeckxstaens P, Willems S Tags: CMAJ Open Source Type: research

Regional variability in fecal microbiota transplantation practices: a survey of the Southern Ontario Fecal Microbiota Transplantation Movement.
The objective of this study is to describe the program characteristics and protocols of 9 planned or operating FMT programs in the Southern Ontario Fecal Microbiota Transplantation (SOFT) Movement, to help guide future FMT program implementation. METHODS: A 59-item survey was administered electronically to clinical leads of the SOFT Movement on June 2, 2016. The survey evaluated 7 domains: FMT program characteristics, FMT recipients, donor screening/selection, transplant manufacturing, FMT administration, good manufacturing procedures/biosafety procedures and infection-control procedures. We used descriptive statistic...
Source: cmaj - April 18, 2018 Category: General Medicine Authors: Hota SS, Surangiwala S, Paterson AS, Coburn B, Poutanen SM, Southern Ontario Fecal Microbiota Transplantation (SOFT) Movement* Tags: CMAJ Open Source Type: research

Resisting influence from agri-food industries on Canada's new food guide.
PMID: 29661812 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 16, 2018 Category: General Medicine Authors: Grant JD, Jenkins DJA Tags: CMAJ Source Type: research

Quality primary health care will drive the realization of universal health coverage.
PMID: 29661813 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 16, 2018 Category: General Medicine Authors: Dugani S, Veillard J, Evans TG Tags: CMAJ Source Type: research

Psychometric findings and normative values for the CLEFT-Q based on 2434 children and young adult patients with cleft lip and/or palate from 12 countries.
pady SS, Vargas F, Forrest CR Abstract BACKGROUND: Patients with cleft lip and/or palate can undergo numerous procedures to improve appearance, speech, dentition and hearing. We developed a cleft-specific patient-reported outcome instrument to facilitate rigorous international measurement and benchmarking. METHODS: Data were collected from patients aged 8-29 years with cleft lip and/or palate at 30 hospitals in 12 countries between October 2014 and November 2016. Rasch measurement theory analysis was used to refine the scales and to examine reliability and validity. Normative CLEFT-Q values were computed for ...
Source: cmaj - April 16, 2018 Category: General Medicine Authors: Klassen AF, Riff KWW, Longmire NM, Albert A, Allen GC, Aydin MA, Baker SB, Cano SJ, Chan AJ, Courtemanche DJ, Dreise MM, Goldstein JA, Goodacre TEE, Harman KE, Munill M, Mahony AO, Aguilera MP, Peterson P, Pusic AL, Slator R, Stiernman M, Tsangaris E, Tho Tags: CMAJ Source Type: research

Why strengthening primary health care is essential to achieving universal health coverage.
PMID: 29661815 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 16, 2018 Category: General Medicine Authors: van Weel C, Kidd MR Tags: CMAJ Source Type: research

Mycotic aneurysm formation after bacillus Calmette-Gu érin instillation for recurrent bladder cancer.
Mycotic aneurysm formation after bacillus Calmette-Guérin instillation for recurrent bladder cancer. CMAJ. 2018 Apr 16;190(15):E467-E471 Authors: Rohailla S, Kitchlu A, Wheatcroft M, Razak F PMID: 29661816 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 16, 2018 Category: General Medicine Authors: Rohailla S, Kitchlu A, Wheatcroft M, Razak F Tags: CMAJ Source Type: research

Powassan virus - an emerging public health concern.
PMID: 29661817 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 16, 2018 Category: General Medicine Authors: Bogaty C, Drebot M Tags: CMAJ Source Type: research

Canada's future health care system.
PMID: 29661818 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 16, 2018 Category: General Medicine Authors: Willison DJ, O'Neill BG, Greiver M, Sullivan F Tags: CMAJ Source Type: research

Whole-family treatment of neonatal abstinence syndrome.
PMID: 29661819 [PubMed - in process] (Source: cmaj)
Source: cmaj - April 16, 2018 Category: General Medicine Authors: Byrne PJ, Foss K, Clarke D, Wismark J, Cardinal K Tags: CMAJ Source Type: research