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Man wearing glasses and a protective mask stands outdoors amid heavy yellowish smog or haze, looking into the distance.
Woman wearing a mask walks through a neighborhood shrouded in thick orange smoke from wildfires.
Medetomidine is increasingly present in the unregulated drug supply, and people who abruptly discontinue use of unregulated opioids are at risk of medetomidine withdrawal. Medetomidine DOI: 10.1503/cmaj.260399
The 2025 Canadian guideline on hepatitis B virus recommends that all adults have 1-time triple serology, which includes hepatitis B surface antigen (HBsAg), HB surface antibody (HBsAb), and HB core antibody (HBcAb), irrespective of risk or clinical history. New diagnosis of hepatitis B DOI: 10.1503/cmaj.260032
Anaplasmosis is the second most common tick-borne disease in Canada, with rapidly rising incidence owing to the expanding geographic distribution of the blacklegged tick, Ixodes scapularis. Anaplasmosis and myocarditis DOI: 10.1503/cmaj.260142
Compared with SGLT2 inhibitors or GLP-1 receptor agonists alone, combined therapy did not significantly reduce the risk of major adverse cardiovascular or kidney events but was associated with lower risks of hospitalized heart failure. Combined therapy versus monotherapy in type 2 diabetes DOI: 10.1503/cmaj.250369
Negative-pressure pulmonary edema should be suspected in patients who rapidly develop acute hypoxemic respiratory distress after forceful inspiratory efforts against an occluded upper airway. Negative-pressure pulmonary edema DOI: 10.1503/cmaj.251553
Risk stratification is important to guide optimal treatment, particularly for intermediate-risk and high-risk pulmonary embolism, in which patients show cardiac dysfunction progressing to hemodynamic instability or cardiac arrest. Management of pulmonary embolism DOI: 10.1503/cmaj.250944
In older adults, new sedative prescriptions filled within 7 days after hospital discharge were associated with increased hazards of a fall, an emergency visit, hospital admission, and death within 30 days after discharge.
Any direct human contact with a bat, even in the absence of a visible bite or scratch, is an indication for PEP and should be discussed with public health authorities.
Swimming is widely regarded as one of the most effective full-body workouts, simultaneously loading almost all major muscle groups against the resistance of water while supporting cardiorespiratory fitness.
Purple discoloration of an indwelling Foley catheter and drainage bag, with preserved yellow coloration of the urine of a 88-year-old woman. Purple urine bag syndrome DOI: 10.1503/cmaj.260150
Eastern equine encephalitis should be considered in patients presenting with encephalopathy in regions where the virus circulates, such as southern Ontario and Quebec during times when mosquitoes are active. Neuroinvasive eastern equine encephalitis DOI: 10.1503/cmaj.252021
The 2026 Democratic Republic of Congo Ebola virus disease (EVD) outbreak involves Bundibugyo ebolavirus, which has a case fatality rate of 30% to 50%. Ebola virus disease DOI: 10.1503/cmaj.260834
Closeup of a doctor wearing protective medical gear, including a face shield, mask, and coveralls
(A) Photograph of the right hand of an 87-year-old woman with tophaceous gout, showing firm, chalky white nodular deposits involving the distal phalanges of the first and second digits; this was associated with her use of bempedoic acid. (B) Aspirate of distal digital nodule, yielding chalky, paste-like material consistent with monosodium urate crystal deposition. Gout associated with bempedoic acid DOI: 10.1503/cmaj.252158
Early initiation of immunotherapy should be considered in suspected paraneoplastic neurologic syndrome (PNS) to prevent irreversible neurologic damage. Paraneoplastic neurologic syndrome DOI: 10.1503/cmaj.251204
"Outside the emergency department at Vancouver General Hospital sits a bench. For eight years, I’ve watched it from the window of my office. When I first began working here, the bench functioned as shared space in the most ordinary way — a place for brief rest, for waiting, for a pause between destinations. Occasionally, someone would sit for a few minutes before moving on. Most days, it was empty. That has changed as housing has grown more precarious and social supports thinner."
Female patients admitted to hospital with traumatic brain injury were less likely than male patients to be admitted to specialized trauma centres, independent of clinical and socioeconomic factors. Trauma centres and traumatic brain injury DOI: 10.1503/cmaj.251721
Patients with prior mild or moderate immediate reactions to an iodinated contrast media (ICM) should be switched to a different ICM. Hypersensitivity reactions to contrast DOI: 10.1503/cmaj.260319
The crisis in anesthesiology human resources in Canada makes intelligent workforce deployment essential; however, existing surgical risk indices were not designed for cataract surgery, and no preoperative profile reliably predicts which patients will need anesthesiologist intervention. anesthesiology human resources DOI: 10.1503/cmaj.260327
People with sight loss report being treated as incompetent and not being addressed directly by their health care providers. Providers should clearly introduce themselves each time, state their role, and speak directly to the patient — not to the patient’s companion. Living with visual impairment DOI: 10.1503/cmaj.251872
axial views from thoracoabdominal computed tomography of a 33-year old man after intravenous iodinated contrast administration at portal time, displaying a circumferential subcapsular defect of splenic enhancement (arrows), related to isolated splenic infarction. Splenic infarction and sickle cell trait DOI: 10.1503/cmaj.252096
In cataract surgery, care provided or overseen by a physician anesthesiologist was associated with significantly lower odds of an emergency department visit, hospital admission, or death than if sedation was delivered without physician anesthesiologist involvement; however, effect sizes were small and of limited clinical importance, and costs were higher. Cataract surgery and anesthesiology DOI: 10.1503/cmaj.250814
Living with visual impairment: how can physicians support patients? New articles on living with visual impairment; splenic infarction and sickle cell trait; recurrent pustular psoriasis of pregnancy, and more.
Compared with alternatives, acetaminophen is the best studied analgesic and antipyretic in pregnancy and has the most reassuring maternal and fetal safety profiles.
Clinical presentation of immune checkpoint inhibitor–related eruptive keratoacanthoma in an 86-year-old man. (A) Discrete erythematous papules on the forearms and dorsal hands. (B) Hyperkeratotic and crateriform appearance of the tumour.
Infants with limb disuse or pseudoparalysis need systematic evaluation for a broad differential diagnosis, as serious pathologies can occur without fever or systemic symptoms.
High-quality and ethical health research with Indigenous Peoples should be grounded in the notion of relationships and reciprocity to promote safe, meaningful, community-driven, respectful, and culturally appropriate research activities
Cover of CMAJ featuring a woman in a medical consultation, highlighting articles on research costs, weight loss, sleep, and ADHD.
"To this day, bladder dysfunction remains an embarrassing and isolating problem for me and adequate treatment is a challenge, though no longer out of embarrassment about addressing it." In their own words: urinary incontinence DOI: 10.1503/cmaj.260760
Urinary incontinence in adult females is common and undertreated, often owing to underreporting as patients may mistakenly think urinary incontinence is a normal part of aging. Female urinary incontinence DOI: 10.1503/cmaj.241715
Contributing factors to locally acquired ascariasis infections include exposure to geographic regions with limited sanitation infrastructure and contact with infected humans or swine populations. locally acquired ascariasis DOI: 10.1503/cmaj.251445
Intracardiac and pulmonary shunts should be considered in the differential diagnosis of hypoxia when there is an insufficient rise of arterial oxygen saturation despite supplemental oxygen. platypnea–orthodeoxia syndrome DOI: 10.1503/cmaj.251337
Climate change is driving the emergence and re-emergence of climate-sensitive infectious diseases in Canada. Physicians play a key role in identifying where and when these diseases emerge and alerting public health professionals to cases. climate change and emerging diseases DOI: 10.1503/cmaj.260668
Rocky Mountain spotted fever is caused by Rickettsia rickettsii and spread by several tick species including American dog, Rocky Mountain wood, and brown dog ticks.
Timely first-trimester syphilis screening was not received in 1 out of 5 pregnancies in Ontario.
Close-up of a mouth showing irregular grey-white plaques and erosions on the soft palate and tonsils in a 35-year-old man with syphilis.
Canada's aging population increases the burden on unpaid caregivers as care costs and needs rise sharply in the last year of life.
Arginine vasopressin disorders cause failure to produce or respond to the antidiuretic hormone arginine vasopressin, previously called diabetes insipidus.
Research highlights growing evidence linking endometriosis to adverse pregnancy outcomes like preeclampsia and preterm birth.
Endometriosis affects about 10% of reproductive-age females, causing endometrium-like tissue growth outside the uterus with pelvic pain and infertility.