Nicole Zaki, Nicholas J. Miller, Patrick Frosk, Aditya Sharma
{"title":"Amyloïdose héréditaire à transthyrétine accompagnée d’un syndrome du canal carpien","authors":"Nicole Zaki, Nicholas J. Miller, Patrick Frosk, Aditya Sharma","doi":"10.1503/cmaj.230671-f","DOIUrl":"https://doi.org/10.1503/cmaj.230671-f","url":null,"abstract":"","PeriodicalId":10359,"journal":{"name":"CMAJ : Canadian Medical Association Journal","volume":"88 1","pages":"E501 - E505"},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140705866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shaleesa Ledlie, David Juurlink, Mina Tadrous, M. Mamdani, J. M. Paterson, Tara Gomes
Background: The drug toxicity crisis continues to accelerate across Canada, with rapid increases in opioid-related harms following the onset of the COVID-19 pandemic. We sought to describe trends in the burden of opioid-related deaths across Canada throughout the pandemic, comparing these trends by province or territory, age, and sex. Methods: We conducted a repeated cross-sectional analysis of accidental opioid-related deaths between Jan. 1, 2019, and Dec. 31, 2021, across 9 Canadian provinces and territories using aggregated national data. Our primary measure was the burden of premature opioid-related death, measured by potential years of life lost. Our secondary measure was the proportion of all deaths attributable to opioids; we used the Cochrane–Armitage test for trend to compare proportions. Results: Between 2019 and 2021, the annual number of opioid-related deaths increased from 3007 to 6222 and years of life lost increased from 126 115 to 256 336 (from 3.5 to 7.0 yr of life lost per 1000 population). In 2021, the highest number of years of life lost was among males (181 525 yr) and people aged 30–39 years (87 045 yr). In 2019, we found that 1.7% of all deaths among those younger than 85 years were related to opioids, rising to 3.2% in 2021. Significant increases in the proportion of deaths related to opioids were observed across all age groups (p < 0.001), representing 29.3% and 29.0% of deaths among people aged 20–29 and 30–39 years in 2021, respectively. Interpretation: Across Canada, the burden of premature opioid-related deaths doubled between 2019 and 2021, representing more than one-quarter of deaths among younger adults. The disproportionate loss of life in this demographic group highlights the critical need for targeted prevention efforts.
{"title":"Opioid-related deaths between 2019 and 2021 across 9 Canadian provinces and territories","authors":"Shaleesa Ledlie, David Juurlink, Mina Tadrous, M. Mamdani, J. M. Paterson, Tara Gomes","doi":"10.1503/cmaj.231339","DOIUrl":"https://doi.org/10.1503/cmaj.231339","url":null,"abstract":"Background: The drug toxicity crisis continues to accelerate across Canada, with rapid increases in opioid-related harms following the onset of the COVID-19 pandemic. We sought to describe trends in the burden of opioid-related deaths across Canada throughout the pandemic, comparing these trends by province or territory, age, and sex. Methods: We conducted a repeated cross-sectional analysis of accidental opioid-related deaths between Jan. 1, 2019, and Dec. 31, 2021, across 9 Canadian provinces and territories using aggregated national data. Our primary measure was the burden of premature opioid-related death, measured by potential years of life lost. Our secondary measure was the proportion of all deaths attributable to opioids; we used the Cochrane–Armitage test for trend to compare proportions. Results: Between 2019 and 2021, the annual number of opioid-related deaths increased from 3007 to 6222 and years of life lost increased from 126 115 to 256 336 (from 3.5 to 7.0 yr of life lost per 1000 population). In 2021, the highest number of years of life lost was among males (181 525 yr) and people aged 30–39 years (87 045 yr). In 2019, we found that 1.7% of all deaths among those younger than 85 years were related to opioids, rising to 3.2% in 2021. Significant increases in the proportion of deaths related to opioids were observed across all age groups (p < 0.001), representing 29.3% and 29.0% of deaths among people aged 20–29 and 30–39 years in 2021, respectively. Interpretation: Across Canada, the burden of premature opioid-related deaths doubled between 2019 and 2021, representing more than one-quarter of deaths among younger adults. The disproportionate loss of life in this demographic group highlights the critical need for targeted prevention efforts.","PeriodicalId":10359,"journal":{"name":"CMAJ : Canadian Medical Association Journal","volume":"36 4","pages":"E469 - E476"},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140705949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Weakness is often asymmetrical in contrast to polymyositis. Fatigue and exercise intolerance are common but not with shortness of breath and the respiratory muscles are usually spared. Dysphagia is problematic in 40-50% of patients. Limb weakness is not inevitable and weakness of erector spinae and 'droopy neck' can be the presentation. Muscle pain and cramps are uncommon but may occur. Sensory or autonomic changes only tend to occur if there is also a concurrent polyneuropathy, such as may occur with diabetes.
{"title":"Inclusion body myositis","authors":"J. Warman-Chardon, Ari Breiner, P. Bourque","doi":"10.1503/cmaj.231815","DOIUrl":"https://doi.org/10.1503/cmaj.231815","url":null,"abstract":"Weakness is often asymmetrical in contrast to polymyositis. Fatigue and exercise intolerance are common but not with shortness of breath and the respiratory muscles are usually spared. Dysphagia is problematic in 40-50% of patients. Limb weakness is not inevitable and weakness of erector spinae and 'droopy neck' can be the presentation. Muscle pain and cramps are uncommon but may occur. Sensory or autonomic changes only tend to occur if there is also a concurrent polyneuropathy, such as may occur with diabetes.","PeriodicalId":10359,"journal":{"name":"CMAJ : Canadian Medical Association Journal","volume":"226 18","pages":"E486 - E486"},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140704125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Jansen, Victoria Shaw, I. Grooten, M. H. Koot, Caitlin R Dean, Rebecca C Painter
{"title":"Diagnosis and treatment of hyperemesis gravidarum","authors":"L. Jansen, Victoria Shaw, I. Grooten, M. H. Koot, Caitlin R Dean, Rebecca C Painter","doi":"10.1503/cmaj.221502","DOIUrl":"https://doi.org/10.1503/cmaj.221502","url":null,"abstract":"","PeriodicalId":10359,"journal":{"name":"CMAJ : Canadian Medical Association Journal","volume":"58 2‐3","pages":"E477 - E485"},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140704914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Schizophrenic poetry, queerness, and the limits of self-expression","authors":"Nam S Hoang","doi":"10.1503/cmaj.231440","DOIUrl":"https://doi.org/10.1503/cmaj.231440","url":null,"abstract":"","PeriodicalId":10359,"journal":{"name":"CMAJ : Canadian Medical Association Journal","volume":"168 1‐2","pages":"E489 - E490"},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140704280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pantoufles usées","authors":"Amanda Pendergast","doi":"10.1503/cmaj.230747-f","DOIUrl":"https://doi.org/10.1503/cmaj.230747-f","url":null,"abstract":"","PeriodicalId":10359,"journal":{"name":"CMAJ : Canadian Medical Association Journal","volume":"62 11","pages":"E508 - E509"},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140704864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Burton line and basophilic stippling in lead poisoning","authors":"Takahide Morita, Toshinori Nishizawa, Toru Morikawa","doi":"10.1503/cmaj.231405","DOIUrl":"https://doi.org/10.1503/cmaj.231405","url":null,"abstract":"","PeriodicalId":10359,"journal":{"name":"CMAJ : Canadian Medical Association Journal","volume":"184 3","pages":"E487 - E487"},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140704541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hormonothérapie substitutive chez les personnes présentant des antécédents de cancer gynécologique","authors":"Maryam Kotait, Alison L. Shea, J. Nguyen","doi":"10.1503/cmaj.231066-f","DOIUrl":"https://doi.org/10.1503/cmaj.231066-f","url":null,"abstract":"","PeriodicalId":10359,"journal":{"name":"CMAJ : Canadian Medical Association Journal","volume":"22 4","pages":"E506 - E507"},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140706475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christine Ibrahim, Victor M Tang, Daniel M Blumberger, Bernard Le Foll
{"title":"Abandon du tabagisme au moyen de la stimulation magnétique transcrânienne répétitive","authors":"Christine Ibrahim, Victor M Tang, Daniel M Blumberger, Bernard Le Foll","doi":"10.1503/cmaj.230806-f","DOIUrl":"https://doi.org/10.1503/cmaj.230806-f","url":null,"abstract":"","PeriodicalId":10359,"journal":{"name":"CMAJ : Canadian Medical Association Journal","volume":"59 2","pages":"E497 - E500"},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140704795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Shuldiner, Michael E. Green, Tara Kiran, Shahriar Khan, E. Frymire, Rahim Moineddin, Meghan Kerr, Mina Tadrous, D. Nowak, Jeffrey C. Kwong, Jia Hu, Holly O. Witteman, Bryn Hamilton, Isaac Bogoch, Lydia-Joy Marshall, Sophia Ikura, Stacey Bar-Ziv, David Kaplan, Noah Ivers
Background: Variations in primary care practices may explain some differences in health outcomes during the COVID-19 pandemic. We sought to evaluate the characteristics of primary care practices by the proportion of patients unvaccinated against SARS-CoV-2. Methods: We conducted a population-based, cross-sectional cohort study using linked administrative data sets in Ontario, Canada. We calculated the percentage of patients unvaccinated against SARS-CoV-2 enrolled with each comprehensive-care family physician, ranked physicians according to the proportion of patients unvaccinated, and identified physicians in the top 10% (v. the other 90%). We compared characteristics of family physicians and their patients in these 2 groups using standardized differences. Results: We analyzed 9060 family physicians with 10 837 909 enrolled patients. Family physicians with the largest proportion (top 10%) of unvaccinated patients (n = 906) were more likely to be male, to have trained outside of Canada, to be older, and to work in an enhanced fee-for-service model than those in the remaining 90%. Vaccine coverage (≥ 2 doses of SARS-CoV-2 vaccine) was 74% among patients of physicians with the largest proportion of unvaccinated patients, compared with 87% in the remaining patient population. Patients in the top 10% group tended to be younger and live in areas with higher levels of ethnic diversity and immigration and lower incomes. Interpretation: Primary care practices with the largest proportion of patients unvaccinated against SARS-CoV-2 served marginalized communities and were less likely to use team-based care models. These findings can guide resource planning and help tailor interventions to integrate public health priorities within primary care practices.
{"title":"Characteristics of primary care practices by proportion of patients unvaccinated against SARS-CoV-2: a cross-sectional cohort study","authors":"J. Shuldiner, Michael E. Green, Tara Kiran, Shahriar Khan, E. Frymire, Rahim Moineddin, Meghan Kerr, Mina Tadrous, D. Nowak, Jeffrey C. Kwong, Jia Hu, Holly O. Witteman, Bryn Hamilton, Isaac Bogoch, Lydia-Joy Marshall, Sophia Ikura, Stacey Bar-Ziv, David Kaplan, Noah Ivers","doi":"10.1503/cmaj.230816","DOIUrl":"https://doi.org/10.1503/cmaj.230816","url":null,"abstract":"Background: Variations in primary care practices may explain some differences in health outcomes during the COVID-19 pandemic. We sought to evaluate the characteristics of primary care practices by the proportion of patients unvaccinated against SARS-CoV-2. Methods: We conducted a population-based, cross-sectional cohort study using linked administrative data sets in Ontario, Canada. We calculated the percentage of patients unvaccinated against SARS-CoV-2 enrolled with each comprehensive-care family physician, ranked physicians according to the proportion of patients unvaccinated, and identified physicians in the top 10% (v. the other 90%). We compared characteristics of family physicians and their patients in these 2 groups using standardized differences. Results: We analyzed 9060 family physicians with 10 837 909 enrolled patients. Family physicians with the largest proportion (top 10%) of unvaccinated patients (n = 906) were more likely to be male, to have trained outside of Canada, to be older, and to work in an enhanced fee-for-service model than those in the remaining 90%. Vaccine coverage (≥ 2 doses of SARS-CoV-2 vaccine) was 74% among patients of physicians with the largest proportion of unvaccinated patients, compared with 87% in the remaining patient population. Patients in the top 10% group tended to be younger and live in areas with higher levels of ethnic diversity and immigration and lower incomes. Interpretation: Primary care practices with the largest proportion of patients unvaccinated against SARS-CoV-2 served marginalized communities and were less likely to use team-based care models. These findings can guide resource planning and help tailor interventions to integrate public health priorities within primary care practices.","PeriodicalId":10359,"journal":{"name":"CMAJ : Canadian Medical Association Journal","volume":"12 7","pages":"E432 - E440"},"PeriodicalIF":0.0,"publicationDate":"2024-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140732712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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