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CMAJ
@cmaj.ca
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The Canadian Medical Association Journal
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A medical student reflects on moving through clinical environments as a wheelchair user, and on the quiet labour required to navigate spaces that were not designed with every body in mind.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260779
Hands land on the back of your chair before you can answer. The frame jolts forward. Your balance shifts. For a brief, sharp second, your body is no longer yours.
September 17, 2026 at 7:10 PM
cmaj.ca
Left circumflex myocardial infarction, a subtype of acute coronary syndrome, is under-recognized and undertreated.
Here are 5 things to know ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260030
Of left circumflex myocardial infarctions, 33% lack ST-segment elevation and are misclassified as non–ST segment elevation myocardial infarction.
September 16, 2026 at 4:05 PM
cmaj.ca
What causes severe dyslipidemia in children, and what further investigations are needed?
What therapeutic lifestyle modifications should be recommended?
When should pharmacologic therapy be considered?
What follow-up actions are needed?
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260584
Many monogenic processes cause primary dyslipidemia, the most common of which is familial hypercholesterolemia, an autosomal codominant condition.
September 15, 2026 at 4:01 PM
cmaj.ca
The clearest benefit of British Columbia’s decriminalization policy is reduced arrests for drug possession, which represents a meaningful change in how people who use drugs experience and interact with the justice system.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.261198
The lesson from BC is not that decriminalization is irrelevant, but that such policies must be supported within prepared, trusted, and adequately resourced systems.
September 14, 2026 at 5:56 PM
cmaj.ca
Drug decriminalization and health outcomes:
The research findings suggest that decriminalization effectively reduced criminalization of drug possession but did not, in isolation, produce direct impacts on outcomes related to drug toxicity.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260038
Drug decriminalization and recriminalization in BC were associated with substantial changes in police-reported drug possession incidents but no corresponding changes in drug toxicity deaths or hospitalizations when compared to other regions in Canada.
September 14, 2026 at 5:54 PM
cmaj.ca
Drug decriminalization: what are the impacts on crime and health outcomes?

CMAJ Volume 198, Issue 31, features new articles on drug decriminalization and health outcomes; familial hypercholesterolemia; left circumflex myocardial infarction, and more.
➡️ https://www.cmaj.ca/content/198/31
2 police officers leading a woman away with handcuffs
September 14, 2026 at 5:37 PM
cmaj.ca
Recombinant herpes zoster vaccination:
Herpes zoster (shingles) is associated with major neuro- and cardiovascular events, and recombinant zoster vaccine is associated with lower risk of acute myocardial infarction and stroke.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.252032
Recombinant zoster vaccine is the only authorized shingles vaccine in Canada. A 2-dose series yields 85% to 90% efficacy over 11 years. The vaccine is recommended for all adults aged 50 years and older (regardless of previous chickenpox, shingles, or receipt of the discontinued live-attenuated vaccine) and 18 years and older if immunocompromised or due to be. Recombinant herpes zoster vaccination DOI: 10.1503/cmaj.252032
September 11, 2026 at 4:35 PM
cmaj.ca
We don't talk about our dead:
A neurosurgeon reflects on unwritten rules of his profession
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260727
“No one teaches physicians how to carry a child’s death. Everyone improvises privately and calls it coping.” — Mirko Micovic MD PhD We don't talk about our dead DOI: 10.1503/cmaj.260727
September 10, 2026 at 8:00 PM
cmaj.ca
Patients with epidemiologic risk factors for TB infection and a high risk to reactivate, or patients with epidemiologic, clinical, and radiologic features of TB disease, should be promptly assessed and treated for TB infection or disease as appropriate.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260343
New or worsening hemoptysis during antituberculous treatment warrants urgent re-evaluation to assess for vascular complications like Rasmussen aneurysm. Cavitary pulmonary tuberculosis DOI: 10.1503/cmaj.260343
September 10, 2026 at 4:35 PM
cmaj.ca
Outpatient hyperkalemia and risk of death:
Research findings support urgent emergency department referrals and underscore the need for standardized reporting and management guidelines.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.252008
Presentation to the emergency department within 24 hours of a severe outpatient hyperkalemia result is associated with lower rates of immediate and short-term death. Outpatient hyperkalemia and risk of death DOI: 10.1503/cmaj.252008
September 9, 2026 at 4:30 PM
cmaj.ca
Regulatory oversight of ice arena air quality:
At least 12 poisoning incidents from carbon monoxide (CO) and
nitrogen dioxide (NO2) at Canadian ice arenas have been reported in the media in the past 10 years.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.261120
Health Canada has indicated best practices regarding air quality in ice arenas, but these are not enforced in most provinces and territories. Implementation and enforcement of air quality regulations in ice arenas have been effective in preventing CO and NO2 poisonings in Minnesota; such enforcement is needed in Canada. Regulatory oversight of ice arena air quality DOI: 10.1503/cmaj.261120
September 8, 2026 at 4:15 PM
cmaj.ca
Serotonin toxicity:
The condition results from acute, excessive serotonergic activity at serotonin receptors following initiation or dose escalation of a serotonergic agent, overdose, or through drug–drug interactions.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260159
Serotonin toxicity is a potentially life-threatening adverse reaction to serotonergic agents. Serotonin toxicity DOI: 10.1503/cmaj.260159
August 28, 2026 at 8:45 PM
cmaj.ca
Tinea incognito:
Topical corticosteroid application over dermatophytosis (fungal infections) can lead to tinea incognito.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260512
(A) Multiple erythematous plaques with interspersed pustules over the malar region and forehead of a 38-year-old woman. (B) Resolution of tthe erythematous plaques following 7 days of oral and topical antifungal therapy. Tinea incognito DOI: 10.1503/cmaj.260512
August 27, 2026 at 4:45 PM
cmaj.ca
What features differentiate a new stroke from post-stroke recrudescence? What causes post-stroke recrudescence? What investigations are recommended? What should patients and families be told about management and prognosis?
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.251837
Post-stroke recrudescence is the transient recurrence of stroke deficits after initial improvement. Post-stroke recrudescence DOI: 10.1503/cmaj.251837
August 26, 2026 at 8:40 PM
cmaj.ca
Hypertriglyceridemia-induced pancreatitis:
Diabetic ketoacidosis with severe hypertriglyceridemia-induced acute pancreatitis as the initial presentation of type 2 diabetes is a rare, severe metabolic emergency.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260244
Hypertriglyceridemia should be considered in all patients presenting with acute pancreatitis. Hypertriglyceridemia-induced pancreatitis DOI: 10.1503/cmaj.260244
August 25, 2026 at 8:30 PM
cmaj.ca
Dependent on the immunity of others:
A father reflects on his medical student son’s death from measles
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260060
“I want people to understand what declining immunization rates mean for individuals who cannot receive all vaccines.” — Pascal Muijtjens Dependent on the immunity of others DOI: 10.1503/cmaj.260060
August 25, 2026 at 4:45 PM
cmaj.ca
This qualitative research study describes restrictive policies that challenge blood donation among Black people in Canada and underscore deep mistrust in the health care and blood donation systems owing to historical and current racial discrimination ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250123
Blood donation supports critical treatments; however, Black people in Canada face multiple barriers to donating blood, including restrictive blood donation policies, institutional and systemic racism in health systems, historic anti-Black racism, and lack of confidence in blood donation systems. Systemic racial barriers to blood donation DOI: 10.1503/cmaj.250123
August 24, 2026 at 4:25 PM
cmaj.ca
Updated HIV prophylaxis guidelines: what clinicians need to know
This week on #CMAJPodcasts we discuss HIV prophylaxis guidelines with Dr. Darrell Tan and Natasha Lawrence ➡️ www.cmaj.ca/transcript-250511
August 24, 2026 at 3:01 PM
cmaj.ca
Serotonin syndrome: what is the latest on management?

CMAJ Volume 198, Issue 29, features new articles on serotonin toxicity; tinea incognito; systemic racial barriers to blood donation, and more.
➡️ https://www.cmaj.ca/content/198/29
August 24, 2026 at 2:01 PM
cmaj.ca
Metacarpophalangeal joint dislocation:
Metacarpophalangeal joint dislocations may be missed if they are subtle or if the appropriate 3-view radiographs are not obtained.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.251814
"Figure 1 (A) Anterior–posterior and (B) lateral radiographic images of the left index finger of a 15-year-old boy showing dorsal dislocation at the metacarpophalangeal joint. The proximal phalanx (white arrow) is not articulating with the metacarpal head (asterisk)."
August 14, 2026 at 7:40 PM
cmaj.ca
Children with medical complexity:
Early conversations about what a safe discharge requires, including caregiver readiness and home care realities, can shape clinical decisions.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260404
Families describe feeling most supported when discharge planning begins early and is framed as a shared goal, not a sudden event.
August 13, 2026 at 7:40 PM
cmaj.ca
Telemetry monitoring:
Telemetry (continuous remote cardiac rhythm monitoring) can detect arrhythmias, abnormal QT intervals, and electrocardiographic changes suggestive of myocardial ischemia.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.252113
Between 30% and 90% of noncritical care telemetry use is inappropriate or is continued longer than recommended.
August 12, 2026 at 7:40 PM
cmaj.ca
Vancomycin infusion reaction is an idiopathic, non immunoglobulin E-mediated anaphylactoid reaction that results in endogenous histamine release from mast cells. Never use the term “red man syndrome” to describe it.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.251714
Vancomycin infusion reaction was once named “red man syndrome” because manifestations include flushing that shows red in those who are White, but this term has long been used as a racial slur toward people of Indigenous decent in North America and is not acceptable.
August 11, 2026 at 7:40 PM
cmaj.ca
Emergency departments across Canada are seeing record patient volumes, bed shortages and overcrowding.

This week on #CMAJPodcasts we discuss emergency physician burnout and attrition with Drs. Kerstin de Wit and Jillian Horton
➡️ www.cmaj.ca/transcript-251863
August 11, 2026 at 7:30 PM
cmaj.ca
Hemoperitoneum pregnancy:
Uterine fibroids in pregnancy are mostly asymptomatic, but as many as 20% will develop complications such as degeneration, torsion of a pedunculated fibroid, or spontaneous rupture.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.251938
Ultrasound of a 36-year-old primigravida woman with an exophytic fibroid (arrow) at point of maximal tenderness. Approximate myometrial thickness and distance from fibroid to gestational sac (arrowhead) ranged from 5 mm to 12 mm (double arrow). Hemoperitoneum pregnancy DOI: 10.1503/cmaj.251938
August 11, 2026 at 5:55 PM