Subclinical hypothyroidism in pregnancy.
PMID: 28716849 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 17, 2017 Category: General Medicine Authors: Deshauer S, Wyne A Tags: CMAJ Source Type: research

Fluid-filled striae in a patient with hypoalbuminemia.
PMID: 28716850 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 17, 2017 Category: General Medicine Authors: Jogova M, Hwang SW Tags: CMAJ Source Type: research

Chronic obstructive pulmonary disease and Occam's razor.
PMID: 28716851 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 17, 2017 Category: General Medicine Authors: Weiner BC Tags: CMAJ Source Type: research

US Senate health care bill draws widespread criticism.
PMID: 28716852 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 17, 2017 Category: General Medicine Authors: Collier R Tags: CMAJ Source Type: research

No immediate plans to build new CMA HQ.
PMID: 28716853 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 17, 2017 Category: General Medicine Authors: Glauser W Tags: CMAJ Source Type: research

India introducing routine pneumococcal vaccine.
PMID: 28716854 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 17, 2017 Category: General Medicine Authors: Chaudhuri P Tags: CMAJ Source Type: research

Risk factors for surgical site infection following cesarean delivery: a retrospective cohort study.
Abstract BACKGROUND: The rate of cesarean delivery is increasing in North America. Surgical site infection following this operation can make it difficult to recover, care for a baby and return home. We aimed to determine the incidence of surgical site infection to 30 days following cesarean delivery, associated risk factors and whether risk factors differed for predischarge versus postdischarge infection. METHODS: We identified a retrospective cohort in Nova Scotia by linking the provincial perinatal database to hospital admissions and physician billings databases to follow women for 30 days after they had gi...
Source: cmaj - July 11, 2017 Category: General Medicine Authors: Ketcheson F, Woolcott C, Allen V, Langley JM Tags: CMAJ Open Source Type: research

Hospital admission rates and emergency department use in relation to glycated hemoglobin in people with diabetes mellitus: a linkage study using electronic medical record and administrative data in Ontario.
In this study population, higher HbA1c values were associated with increased ED visits and hospital admissions, with an increasing gradient as HbA1c increased from less than 7% to greater than 8%. PMID: 28701374 [PubMed] (Source: cmaj)
Source: cmaj - July 11, 2017 Category: General Medicine Authors: Birtwhistle R, Green ME, Frymire E, Dahrouge S, Whitehead M, Khan S, Greiver M, Glazier RH Tags: CMAJ Open Source Type: research

Delivering timely surgery in Canadian hospitals.
PMID: 28694307 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 10, 2017 Category: General Medicine Authors: Urbach DR Tags: CMAJ Source Type: research

Association of delay of urgent or emergency surgery with mortality and use of health care resources: a propensity score-matched observational cohort study.
Abstract BACKGROUND: Delay of surgery for hip fracture is associated with increased risk of morbidity and mortality, but the effects of surgical delays on mortality and resource use in the context of other emergency surgeries is poorly described. Our objective was to measure the independent association between delay of emergency surgery and in-hospital mortality, length of stay and costs. METHODS: We identified all adult patients who underwent emergency noncardiac surgery between January 2012 and October 2014 at a single tertiary care centre. Delay of surgery was defined as the time from surgical booking to o...
Source: cmaj - July 10, 2017 Category: General Medicine Authors: McIsaac DI, Abdulla K, Yang H, Sundaresan S, Doering P, Vaswani SG, Thavorn K, Forster AJ Tags: CMAJ Source Type: research

Postpartum hypertension.
PMID: 28694309 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 10, 2017 Category: General Medicine Authors: Powles K, Gandhi S Tags: CMAJ Source Type: research

Stairlike fracture of the sternum.
PMID: 28694310 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 10, 2017 Category: General Medicine Authors: Sade R, Aydin Y Tags: CMAJ Source Type: research

Spoon versus knife.
PMID: 28694311 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 10, 2017 Category: General Medicine Authors: Yan H, Ng WP Tags: CMAJ Source Type: research

Using thermography responsibly.
PMID: 28694312 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 10, 2017 Category: General Medicine Authors: Lawson JR Tags: CMAJ Source Type: research

Underlying maternal infection likely cause of study findings.
PMID: 28694313 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 10, 2017 Category: General Medicine Authors: Elwood C, Money D Tags: CMAJ Source Type: research

The authors respond to "Underlying maternal infection likely cause of study findings".
The authors respond to "Underlying maternal infection likely cause of study findings". CMAJ. 2017 Jul 10;189(27):E919 Authors: Bérard A, Muanda FT, Sheehy O PMID: 28694314 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 10, 2017 Category: General Medicine Authors: Bérard A, Muanda FT, Sheehy O Tags: CMAJ Source Type: research

Half of Canadians can expect cancer diagnosis during lifetime.
PMID: 28694315 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 10, 2017 Category: General Medicine Authors: Collier R Tags: CMAJ Source Type: research

Canadian women opting for less effective birth control.
PMID: 28694316 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 10, 2017 Category: General Medicine Authors: Vogel L Tags: CMAJ Source Type: research

Family physicians support Open Pharma.
PMID: 28694317 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 10, 2017 Category: General Medicine Authors: Glauser W Tags: CMAJ Source Type: research

Pulling together.
PMID: 28694318 [PubMed - in process] (Source: cmaj)
Source: cmaj - July 10, 2017 Category: General Medicine Authors: Kidd M Tags: CMAJ Source Type: research

Cancer incidence attributable to lifestyle and environmental factors in Alberta in 2012: summary of results.
Abstract BACKGROUND: Estimates of the proportion of cancer cases that can be attributed to modifiable risk factors are not available for Canada and, more specifically, Alberta. The purpose of this study was to estimate the total proportion of cancer cases in Alberta in 2012 that could be attributed to a set of 24 modifiable lifestyle and environmental risk factors. METHODS: We estimated summary population attributable risk estimates for 24 risk factors (smoking [both passive and active], overweight and obesity, inadequate physical activity, diet [inadequate fruit and vegetable consumption, inadequate fibre in...
Source: cmaj - July 7, 2017 Category: General Medicine Authors: Grundy A, Poirier AE, Khandwala F, Grevers X, Friedenreich CM, Brenner DR Tags: CMAJ Open Source Type: research

Outcomes in a nurse-led peripherally inserted central catheter program: a retrospective cohort study.
We report on patient and device outcomes from a nurse-led program. METHODS: We performed a retrospective analysis of a prospective cohort of consecutive patients undergoing PICC insertion at The Ottawa Hospital between Jan. 1, 2013 and Dec. 31, 2014. Of the 8314 BioFlo PASV PICCs inserted, we randomly selected a sample of 700 and obtained a complete data set for 656. We measured the cumulative incidence of major complications (catheter-related bloodstream infections and deep vein thrombosis) and use of a thrombolytic to alleviate occlusions. RESULTS: The total number of catheter days was 58 486, and the median ...
Source: cmaj - June 30, 2017 Category: General Medicine Authors: McDiarmid S, Scrivens N, Carrier M, Sabri E, Toye B, Huebsch L, Fergusson D Tags: CMAJ Open Source Type: research

Cancer incidence attributable to air pollution in Alberta in 2012.
Abstract BACKGROUND: The International Agency for Research on Cancer has classified outdoor air pollution (fine particulate matter [PM2.5]) as a Group 1 lung carcinogen in humans. We aimed to estimate the proportion of lung cancer cases attributable to PM2.5 exposure in Alberta in 2012. METHODS: Annual average concentrations of PM2.5 in 2011 for 22 communities across Alberta were extracted from the Clean Air Strategic Alliance Data Warehouse and were population-weighted across the province. Using 7.5 µg/m3 and 3.18 µg/m3 as the annual average theoretical minimum risk concentrations of PM2.5, we es...
Source: cmaj - June 28, 2017 Category: General Medicine Authors: Poirier AE, Grundy A, Khandwala F, Friedenreich CM, Brenner DR Tags: CMAJ Open Source Type: research

Lung cancer incidence attributable to residential radon exposure in Alberta in 2012.
The objective of this study was to quantify the proportion and number of lung cancer cases in Alberta in 2012 that could be attributed to residential radon exposure. METHODS: We estimated the population attributable risk of lung cancer for residential radon using radon exposure data from the Cross-Canada Survey of Radon Concentrations in Homes from 2009-2011 and data on all-cause and lung cancer mortality from Statistics Canada from 2008-2012. We used cancer incidence data from the Alberta Cancer Registry for 2012 to estimate the total number of lung cancers attributable to residential radon exposure. Estimates were a...
Source: cmaj - June 28, 2017 Category: General Medicine Authors: Grundy A, Brand K, Khandwala F, Poirier A, Tamminen S, Friedenreich CM, Brenner DR Tags: CMAJ Open Source Type: research

Opioid use during pregnancy: a population-based cohort study.
We examined opioid use before and during pregnancy in a complete population-based cohort. METHODS: We examined opioid use in a cohort of all pregnant women in Manitoba, Canada, from 2001 to 2013. Opioid use was defined by prescriptions for opioids, converted to oral morphine equivalents (MEQ), during the 3 months before pregnancy and for each trimester. Given that the exposure per person may vary (because not all women complete all time periods), we determined a weighted number of pregnancies in each period. RESULTS: During the study period, 174 848 completed pregnancies were eligible for analysis (173 680 live b...
Source: cmaj - June 26, 2017 Category: General Medicine Authors: Falk J, Dahl M, Raymond CB, Chateau D, Katz A, Leong C, Bugden S Tags: CMAJ Open Source Type: research

Natural health products should be sold separately from drugs.
PMID: 28652478 [PubMed - in process] (Source: cmaj)
Source: cmaj - June 26, 2017 Category: General Medicine Authors: Stanbrook M Tags: CMAJ Source Type: research

Medical assistance in dying: time for physicians to step up to protect themselves and patients.
PMID: 28652479 [PubMed - in process] (Source: cmaj)
Source: cmaj - June 26, 2017 Category: General Medicine Authors: Downar J, Francescutti LH Tags: CMAJ Source Type: research

Influences on the start, selection and duration of treatment with antibiotics in long-term care facilities.
We examined variability in antibiotic prescribing among physicians for 3 measures: start of treatment with antibiotics, use of prolonged durations exceeding 7 days and selection of fluoroquinolones. Funnel plots with control limits were used to determine the extent of variation and characterize physicians as extreme low, low, average, high and extreme high prescribers for each tendency. Multivariable logistic regression was used to assess whether a clinician's prescribing tendency in the previous year predicted current prescribing patterns, after accounting for residents' demographics, comorbidity, functional status and in...
Source: cmaj - June 26, 2017 Category: General Medicine Authors: Daneman N, Campitelli MA, Giannakeas V, Morris AM, Bell CM, Maxwell CJ, Jeffs L, Austin PC, Bronskill SE Tags: CMAJ Source Type: research

A 44-year-old man with acute asymmetric polyarthritis and fever.
PMID: 28652481 [PubMed - in process] (Source: cmaj)
Source: cmaj - June 26, 2017 Category: General Medicine Authors: Yu J, Elsayed S, Sun D Tags: CMAJ Source Type: research

Demodex folliculitis.
PMID: 28652482 [PubMed - in process] (Source: cmaj)
Source: cmaj - June 26, 2017 Category: General Medicine Authors: Bachmeyer C, Moreno-Sabater A Tags: CMAJ Source Type: research

Serving two masters: the medical and political careers of Sir Charles Tupper.
PMID: 28652483 [PubMed - in process] (Source: cmaj)
Source: cmaj - June 26, 2017 Category: General Medicine Authors: Murray TJ Tags: CMAJ Source Type: research

Identifying those infected with hepatitis C virus.
PMID: 28652484 [PubMed - in process] (Source: cmaj)
Source: cmaj - June 26, 2017 Category: General Medicine Authors: Yoshida EM, Renner E, Wong P, Krajden M Tags: CMAJ Source Type: research

Hepatitis C testing in Canada: don't leave baby boomers behind.
PMID: 28652485 [PubMed - in process] (Source: cmaj)
Source: cmaj - June 26, 2017 Category: General Medicine Authors: Ti L, Lima V, Hull M, Nosyk B, Joy J, Montaner J, Krajden M, Harrigan R, Kerr T, Shannon K, Wood E, Shoveller J, Ramji A, Ko HH, Yoshida E, Hall D, Barrios R Tags: CMAJ Source Type: research

Harms of overoxygenation in patients with exacerbation of chronic obstructive pulmonary disease.
Authors: PMID: 28652486 [PubMed - in process] (Source: cmaj)
Source: cmaj - June 26, 2017 Category: General Medicine Tags: CMAJ Source Type: research

Manitoba's unique health care burdens stall federal deal.
PMID: 28652487 [PubMed - in process] (Source: cmaj)
Source: cmaj - June 26, 2017 Category: General Medicine Authors: Collier R Tags: CMAJ Source Type: research

The home care conversation we're not having.
PMID: 28652488 [PubMed - in process] (Source: cmaj)
Source: cmaj - June 26, 2017 Category: General Medicine Authors: Vogel L Tags: CMAJ Source Type: research

Nigeria's polio endgame impeded by Boko Haram.
PMID: 28652489 [PubMed - in process] (Source: cmaj)
Source: cmaj - June 26, 2017 Category: General Medicine Authors: Webster P Tags: CMAJ Source Type: research

Estimated reductions in provider-initiated preterm births and hospital length of stay under a universal acetylsalicylic acid prophylaxis strategy: a retrospective cohort study.
Abstract BACKGROUND: Hypertensive disorders, especially preeclampsia, are the leading reason for provider-initiated preterm birth. We estimated how universal acetylsalicylic acid (ASA) prophylaxis might reduce rates of provider-initiated preterm birth associated with preeclampsia and intrauterine growth restriction, which are related conditions. METHODS: We performed a cohort study of singleton hospital births in 2013 in Canada, excluding Quebec. We estimated the proportion of term births and provider-initiated preterm births affected by preeclampsia and/or intrauterine growth restriction, and the correspondi...
Source: cmaj - June 23, 2017 Category: General Medicine Authors: Ray JG, Bartsch E, Park AL, Shah PS, Dzakpasu S Tags: CMAJ Open Source Type: research

Military-related sexual assault in Canada: a cross-sectional survey.
Abstract BACKGROUND: Most research on military-related sexual assault is based on the United States military and has important limitations, such as low response rates. We sought to estimate the lifetime prevalence of sexual assault, assess its relation to military service and identify the circumstances, correlates and associations with mental disorders of military-related sexual assault among Canadian military personnel. METHODS: We used the 2013 Canadian Forces Mental Health Survey, a cross-sectional representative survey of Canadian Regular Force personnel (n = 6696). The sample was weighted to be represent...
Source: cmaj - June 22, 2017 Category: General Medicine Authors: Watkins K, Bennett R, Zamorski MA, Richer I Tags: CMAJ Open Source Type: research

An environmental scan of quality indicators in critical care.
rt PC Abstract BACKGROUND: We performed a directed environmental scan to identify and categorize quality indicators unique to critical care that are reported by key stakeholder organizations. METHODS: We convened a panel of experts (n = 9) to identify key organizations that are focused on quality improvement or critical care, and reviewed their online publications and website content for quality indicators. We identified quality indicators specific to the care of critically ill adult patients and then categorized them according to the Donabedian and the Institute of Medicine frameworks. We also noted the orga...
Source: cmaj - June 21, 2017 Category: General Medicine Authors: Valiani S, Rigal R, Stelfox HT, Muscedere J, Martin CM, Dodek P, Lamontagne F, Fowler R, Gheshmy A, Cook DJ, Forster AJ, Hébert PC Tags: CMAJ Open Source Type: research

A case series of surgically diagnosed idiopathic aortitis in a Canadian centre: a retrospective study.
Abstract BACKGROUND: Idiopathic aortitis became recognized relatively recently, and the body of knowledge concerning this condition is scarce. We aimed to determine the frequency of idiopathic aortitis in aortic specimens, the clinical, laboratory and radiologic characteristics at diagnosis and during follow-up, and the approach to investigation, treatment and monitoring taken by the treating physicians. METHODS: We identified cases of aortitis diagnosed on pathological specimens of the aorta between Jan. 1, 2003, and July 31, 2013, at The Ottawa Hospital by reviewing the hospital's pathology database. Charts...
Source: cmaj - June 19, 2017 Category: General Medicine Authors: Murzin DL, Belanger EC, Veinot JP, Milman N, Canadian Vasculitis Network (CanVasc) Tags: CMAJ Open Source Type: research

Prevalence and correlates of electronic cigarette use among Canadian students: cross-sectional findings from the 2014/15 Canadian Student Tobacco, Alcohol and Drugs Survey.
Abstract BACKGROUND: Over the past decade, youth tobacco use has declined, and electronic cigarettes (e-cigarettes) have entered the market. The aims of this study were to describe the prevalence of e-cigarette use among youth in Canada, by province, across sociodemographic variables and smoking-related correlates; and to examine associations among e-cigarette use, sociodemographic variables and smoking-related correlates, with adjustment for other factors. METHODS: The 2014/15 Canadian Student Tobacco, Alcohol and Drugs Survey, a biennial, school-based survey, was administered to students in grades 6-12 in a...
Source: cmaj - June 14, 2017 Category: General Medicine Authors: Montreuil A, MacDonald M, Asbridge M, Wild TC, Hammond D, Manske S, Rutherford E Tags: CMAJ Open Source Type: research

Informal regionalization of pediatric fracture care in the Greater Toronto Area: a retrospective cross-sectional study.
Abstract BACKGROUND: Operative management of pediatric fractures is an expected competency in the specialty of Orthopedic Surgery. However, specialized pediatric centres may be providing care for increasing numbers of patients with fractures previously treated at community hospitals. The primary objective of this study was to examine trends in presentation of children with fractures to a specialized pediatric centre. METHODS: We performed a detailed chart review to examine trends in presentation of children aged 14 years or less with supracondylar humerus or femur fractures to a specialized pediatric centre (...
Source: cmaj - June 14, 2017 Category: General Medicine Authors: Pincus D, Morrison S, Gargan MF, Camp MW Tags: CMAJ Open Source Type: research

Access to hyperacute stroke services across Canadian provinces: a geospatial analysis.
Abstract BACKGROUND: Canada's vast geography creates challenges for ensuring prompt transport to hospital of patients who have had a stroke. We sought to determine the proportion of people across various Canadian provinces for whom hyperacute stroke services are accessible within evidence-based time targets. METHODS: We calculated, for the 8 provinces with available data, drive-time polygons on a map of Canada that delineated the area around stroke centres and emergency medical services (EMS) base centres to which one can drive in 3.5-6 hours. We calculated the proportional area of each forward sortation area...
Source: cmaj - June 14, 2017 Category: General Medicine Authors: Eswaradass PV, Swartz RH, Rosen J, Hill MD, Lindsay MP Tags: CMAJ Open Source Type: research

Clinical prediction rule for delayed hemothorax after minor thoracic injury: a multicentre derivation and validation study.
ute; N, Le Sage N Abstract BACKGROUND: About 75% of patients with minor thoracic injury are discharged after an emergency department visit. However, complications such as delayed hemothorax can occur. We sought to derive and validate a clinical decision rule to predict hemothorax in patients discharged from the emergency department. METHODS: We conducted a 6-year prospective cohort study in 4 university-affiliated emergency departments. Patients aged 16 years or older presenting with a minor thoracic injury were assessed at 5 time points (initial visit and 7, 14, 30 and 90 d after the injury). Radiologists' r...
Source: cmaj - June 12, 2017 Category: General Medicine Authors: Émond M, Guimont C, Chauny JM, Daoust R, Bergeron É, Vanier L, Moore L, Plourde M, Kuimi B, Boucher V, Allain-Boulé N, Le Sage N Tags: CMAJ Open Source Type: research

Drug prices: How do we get to a better place?
PMID: 28606974 [PubMed - in process] (Source: cmaj)
Source: cmaj - June 12, 2017 Category: General Medicine Authors: Lexchin J Tags: CMAJ Source Type: research

Drivers of expenditure on primary care prescription drugs in 10 high-income countries with universal health coverage.
Abstract BACKGROUND: Managing expenditures on pharmaceuticals is important for health systems to sustain universal access to necessary medicines. We sought to estimate the size and sources of differences in expenditures on primary care medications among high-income countries with universal health care systems. METHODS: We compared data on the 2015 volume and cost per day of primary care prescription drug therapies purchased in 10 high-income countries with various systems of universal health care coverage (7 from Europe, in addition to Australia, Canada and New Zealand). We measured total per capita expenditu...
Source: cmaj - June 12, 2017 Category: General Medicine Authors: Morgan SG, Leopold C, Wagner AK Tags: CMAJ Source Type: research

A fatal case of pneumococcal sepsis years after splenectomy.
PMID: 28606976 [PubMed - in process] (Source: cmaj)
Source: cmaj - June 12, 2017 Category: General Medicine Authors: Solverson KJ, Doig CJ Tags: CMAJ Source Type: research

Loperamide abuse.
PMID: 28606977 [PubMed - in process] (Source: cmaj)
Source: cmaj - June 12, 2017 Category: General Medicine Authors: Antoniou T, Juurlink DN Tags: CMAJ Source Type: research

Ocular ischemic syndrome.
PMID: 28606978 [PubMed - in process] (Source: cmaj)
Source: cmaj - June 12, 2017 Category: General Medicine Authors: Hung JH, Chang YS Tags: CMAJ Source Type: research