From cmaj.ca
Pharmacare Act does not prescribe universal, public pharmacare
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KEY POINTS The Pharmacare Act , Bill C-64, was passed by Canada’s House of Commons on June 3, 2024, and currently awaits final approval by the Senate.[1][1] The legislation promises to provide immediate coverage of contraceptives and diabetes medications, but it does not ensure universal, public
on Aug 12
From cmaj.ca
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Background: Hypertensive disorders of pregnancy (HDP) are a leading cause of severe maternal morbidity (SMM). We sought to explore trends in HDP and related morbidity outcomes in Canada. Methods: In this retrospective population-based study, we used hospital discharge data from Canada,...
on Jul 29
From cmaj.ca
Highly pathogenic avian influenza A (H5N1) virus
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The circulating H5N1 clade (2.3.4.4b) has caused outbreaks on poultry farms and among backyard flocks, and die-offs among wild birds. Infections in mammals, including cattle and humans, triggered by viral spillover from birds highlights the potential for a pandemic, but the mechanisms of
on Jul 16
From cmaj.ca
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Background: Transgender and nonbinary (TNB) people experience obstacles that create barriers to accessing health care, including stigmatization and health inequities. Our intention was to describe the lived experiences of TNB patients and identify potential gaps in the education of health care...
on Jul 2
From cmaj.ca
Gender self-determination as a medical right
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[See related editorial at www.cmaj.ca/lookup/doi/10.1503/cmaj.240878][1] Transgender people face many formal barriers to gender-affirming care, sometimes known as “gatekeeping.” Gender-affirming care refers to a wide range of medical interventions that patients pursue to affirm, actualize, or
on Jul 2
From cmaj.ca
Auto-brewery syndrome in a 50-year-old woman
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KEY POINTS A 50-year-old woman was referred to a gastroenterology clinic after 7 presentations over the previous 2 years to emergency departments (EDs) with alcohol intoxication despite her report of no alcohol consumption. Over the preceding 5 years, she had had recurrent urinary tract infections (
on Jun 3
From cmaj.ca
Tackling late-life homelessness in Canada
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[See related editorial at www.cmaj.ca/lookup/doi/10.1503/cmaj.240649][1] KEY POINTS Many older adults experience homelessness in Canada, yet current shelters and temporary housing are not designed or resourced for them. We outline the magnitude of this large and growing public health and social
on May 22
From cmaj.ca
Excess mortality, COVID-19 and health care systems in Canada
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KEY POINTS During the first year of the COVID-19 pandemic through early 2021, international comparisons showed a wide variation in patterns of mortality across countries.[1][1] Although some countries saw no change in mortality or even fewer deaths than expected, others saw marked increases, such as
on May 20
From cmaj.ca
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BACKGROUND: Physical-distancing interventions are being used in Canada to slow the spread of severe acute respiratory syndrome coronavirus 2, but it is not clear how effective they will be. We evaluated how different nonpharmaceutical interventions could be used to control the coronavirus...
on May 3
From cmaj.ca
Severe leptospirosis after a rat bite in an urban setting
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KEY POINTS A 76-year-old man presented to the emergency department during the winter in Montréal, Quebec, with a 3-day history of fever, headache and abdominal pain. His abdomen was soft, mental status was preserved, he had no neck stiffness and his skin was normal. No jaundice was observed and his
on Apr 7
From cmaj.ca
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Background: Cognitive behavioural therapy (CBT) has been shown to be effective for several psychiatric and somatic conditions; however, most randomized controlled trials (RCTs) have administered treatment in person and whether remote delivery is similarly effective remains uncertain. We sought...
on Apr 6
From cmaj.ca
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Background: The speed of vaccine development has been a singular achievement during the COVID-19 pandemic, although uptake has not been universal. Vaccine opponents often frame their opposition in terms of the rights of the unvaccinated. We sought to explore the impact of mixing of vaccinated...
on Mar 27
From cmaj.ca
Long-term trends in the work hours of physicians in Canada
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Background: Physician work hours directly influence patient access to health care services and play a vital role in physician human resource planning. We sought to evaluate long-term trends in hours worked by physicians in Canada, overall and by subgroup. Methods: We used Statistics Canada’s...
on Mar 25
From cmaj.ca
Postinfectious cough in adults
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Postinfectious cough is defined as a subacute cough, with symptoms lasting between 3 and 8 weeks.[1][1] The preceding infection triggers an inflammatory cascade, increasing bronchial sensitivity and mucus production, while reducing mucus clearance.[1][1] This clinical diagnosis requires a preceding
on Mar 1
From cmaj.ca
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Background: Conflicting recommendations exist related to which facial protection should be used by health care workers to prevent transmission of acute respiratory infections, including pandemic influenza. We performed a systematic review of both clinical and surrogate exposure data comparing...
on Jan 3
From cmaj.ca
Harry Benjamin and the birth of transgender medicine
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Harry Benjamin (1885–1986) is now best known as the author of the groundbreaking 1966 book The Transsexual Phenomenon and as a pivotal figure in the early history of transgender medicine. [1][1] The German-American physician provided the first detailed clinical discussion of the condition then
on Dec 11
From cmaj.ca
Primary care for all: lessons for Canada from peer countries with high primary care attachment
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KEY POINTS Health systems with strong primary care have better outcomes, lower costs and better equity.[1][1] Yet, even at the outset of the COVID-19 pandemic, about 17% of people in Canada reported not having a regular primary care clinician.[2][2] At the same time, Canada is seeing declining
on Dec 4
From cmaj.ca
Time to improve transparency at Health Canada’s Pest Management Regulatory Agency
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KEY POINTS In 2021, Health Canada’s Pest Management Regulatory Agency (PMRA) proposed doubling the maximum residue limits for glyphosate in some food products, such as oats and beans.[1][1] This proposal, made at Bayer-Monsanto’s request,[2][2] raised serious concerns about the health impact of
on Nov 27
From cmaj.ca
Diabetes during pregnancy among Métis people in Alberta: a retrospective cohort study
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Background: Diabetes in pregnancy is an important public health concern for Indigenous populations. We sought to evaluate the prevalence and outcomes of pre-existing and gestational diabetes among Métis pregnancies compared with other pregnancies in Alberta, Canada. Methods: We conducted a...
on Nov 21
From cmaj.ca
Cost-effectiveness of pharmacogenomic-guided treatment for major depression
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Background: Pharmacogenomic testing to identify variations in genes that influence metabolism of antidepressant medications can enhance efficacy and reduce adverse effects of pharmacotherapy for major depressive disorder. We sought to establish the cost-effectiveness of implementing...
on Nov 14
From cmaj.ca
Critical evaluation of novel health system interventions is essential
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[See related research at www.cmaj.ca/lookup/doi/10.1503/cmaj.230492][1] In this issue of CMAJ , McLeod and colleagues describe the results of an evaluation of virtual urgent care services in Ontario, a service intended to divert patients with low-acuity complaints away from emergency departments
on Nov 6
From cmaj.ca
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Background: Virtual urgent care (VUC) is intended to support diversion of patients with low-acuity complaints and reduce the need for in-person emergency department visits. We aimed to describe subsequent health care utilization and outcomes of patients who used VUC compared with similar...
on Nov 6
From cmaj.ca
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Background: Population-based cross-sectional serosurveys within the Lower Mainland, British Columbia, Canada, showed about 10%, 40% and 60% of residents were infected with SARS-CoV-2 by the sixth (September 2021), seventh (March 2022) and eighth (July 2022) serosurveys. We conducted the ninth...
on Oct 30
From cmaj.ca
Canada’s crisis of primary care access: Is expanding residency training to 3 years a solution?
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KEY POINTS In 2022, The College of Family Physicians of Canada (CFPC) published its final report of the Outcomes of Training Project, including the recommendation to extend family medicine residency training from 2 to 3 years.[1][1] Through an expanded training program, the CFPC’s goal is to
on Oct 23