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The Canadian Medical Association Journal
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Permission to exist:
"My most profound validation came not from colleagues or committees, but from my patients"
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250941
November 24, 2025 at 6:32 PM
Involuntary treatment for substance use:
Instead of instituting ethically fraught interventions with weak evidentiary support, provinces should strengthen and evaluate a full spectrum of patient-centred, evidence-based services, for patients.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250910
November 24, 2025 at 6:32 PM
Thymic hyperplasia:
Thymic hyperplasia, common in children and adolescents, is unusual in adults owing to age-related involution.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250929
Thymic hyperplasia in an adult with Graves disease
A 47-year-old man with discomfort in the upper chest, difficulty swallowing food and drinks, and weight loss of 10 kg over 2 months underwent computed tomography (CT), which excluded malignancy but sh...
www.cmaj.ca
November 24, 2025 at 6:30 PM
Extreme heat exposure:
Extreme heat poses substantial health risks, with older adults, people with chronic illnesses, and those unable to limit exposure most at risk.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250951
Staying cool during heat exposure
Extreme heat poses substantial health risks, with older adults, people with chronic illnesses, and those unable to limit exposure most at risk (unhoused people, those without air-conditioning, workers...
www.cmaj.ca
November 24, 2025 at 6:29 PM
Myocardial infarction with nonobstructive coronary arteries:
Until recently, MINOCA was thought to be uncommon; however, recent analyses have estimated that 6-15% of acute coronary syndrome occurs in the absence of obstructive coronary artery disease.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250774
Myocardial infarction with nonobstructive coronary artery disease in a 56-year-old woman
Key points A 56-year-old woman presented to the emergency department with a 2-day history of central chest pain and dyspnea. Her medical history included having had a myocardial infarction (MI) with n...
www.cmaj.ca
November 24, 2025 at 6:29 PM
A pediatric asthma clinical pathway embedded in an electronic medical record for use by primary care practices did not improve the proportion of children in primary care who were prescribed or dispensed a controller medication for asthma.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.241694
A cluster randomized controlled trial of an electronic medical record–based pathway for pediatric asthma in primary care in Alberta
Background: Primary care physicians, who manage the care of most children with asthma, often do not optimally assess disease control, prescribe asthma controller medications, or provide family asthma ...
www.cmaj.ca
November 24, 2025 at 6:28 PM
Myocardial infarction with nonobstructive coronary artery disease: what is the management?

CMAJ Volume 197, Issue 40, features new articles on myocardial infarction with nonobstructive coronary arteries; involuntary treatment for substance use, and more.
➡️ www.cmaj.ca/content/197/40
November 24, 2025 at 6:28 PM
Staff physician burnout:
Burnout among staff physicians threatens teaching quality, patient safety, and the sustainability of both the clinical learning environment and the broader health care system.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250852
Advancing the well-being of staff physicians in Canada
Key points Canada’s health care systems are under strain, with 6.5 million people in Canada lacking a primary care provider,[1][1] which increases patient complexity and volumes and contributes to phy...
www.cmaj.ca
November 17, 2025 at 6:36 PM
Occult toddler's fracture:
A toddler’s fracture is a nondisplaced tibial fracture in a young child between the ages of 1 and 4 years, typically resulting from a low-energy injury.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250808
Radiologically occult toddler’s fracture in a 3-year-old girl
A 3-year-old girl presented to the emergency department with limping. On the morning of the presentation, she had jumped off a stair step and subsequently refused to stand. Although we did not observe...
www.cmaj.ca
November 17, 2025 at 6:35 PM
Cardiac thrombus:
The differential diagnosis of a left atrial mass is broad, including thrombus, infection, myxoma, lipoma, sarcoma, and metastatic tumour.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250697
Cardiac thrombus despite anticoagulation in a 76-year-old man
A 76-year-old man on dabigatran for rate-controlled atrial fibrillation had follow-up transthoracic echocardiography (TTE) after bioprosthetic valve replacements. An echogenic, nonmobile mass (3.8 × 1...
www.cmaj.ca
November 17, 2025 at 6:34 PM
Fertility preservation and cancer treatment:
Ovarian tissue cryopreservation is the only fertility preservation option for patients with ovaries who cannot undergo ovarian stimulation.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250519
Fertility preservation by ovarian tissue transportation and centralized cryobanking for a 20-year-old woman with Hodgkin lymphoma
Key points A 20-year-old pediatric cancer survivor presented to her local oncology centre in southwestern Ontario with right supraclavicular adenopathy. She had a history of stage IIA Hodgkin lymphoma...
www.cmaj.ca
November 17, 2025 at 6:33 PM
Patient expectations and pay inequality:
Physician and patient identities influence the ways that expectations are formed, communicated, and perceived, helping explain observed differences in income based on physician gender, race, and immigration status.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250665
November 17, 2025 at 6:31 PM
Fertility preservation prior to cancer treatment: what are the options?

CMAJ Volume 197, Issue 39, features new articles on fertility preservation by cryobanking; staff physician burnout; family physician pay inequality, and more.
➡️ www.cmaj.ca/content/197/39
November 17, 2025 at 6:31 PM
This week on #CMAJPodcasts, we discuss access to mental health care for Black youth with Mercedes Sobers and Dr. Amy Gajaria. They unpack study findings and describe a program offering culturally adapted care and trust-building.
➡️ www.cmaj.ca/transcript-241733
November 3, 2025 at 7:01 PM
Government partnerships and virtual care:
Independent evaluation of corporate virtual care partnerships can confirm that equity, safety, privacy, and transparency criteria are met and maintained.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250639
Government partnerships with corporate virtual primary care
Key points More than 6.5 million people in Canada do not have access to a regular primary care clinician.[1][1] Health workforce challenges across the country have adversely affected primary care acce...
www.cmaj.ca
November 3, 2025 at 6:07 PM
Halo nevi:
Adult-onset halo nevi are associated with a 1% risk of developing primary cutaneous melanoma 1 year after halo nevus diagnosis.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250684
Eruptive halo nevi and vitiligo in a 40-year-old woman
A 40-year-old woman presented to our dermatology clinic for assessment of new nevi surrounded by depigmented skin, as well as separate depigmented patches, which had appeared suddenly within 1 month o...
www.cmaj.ca
November 3, 2025 at 6:07 PM
Eustachian tube dysfunction:
Allergic rhinitis, chronic rhinosinusitis, gastroesophageal reflux disease, and smoking increase risk and severity of eustachian tube dysfunction.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250163
Eustachian tube dysfunction in adults
It is caused by inflammation or narrowing of the eustachian tube, which leads to aural fullness and muffled hearing (obstructive dysfunction) or, less commonly, hearing one’s own voice amplified (patu...
www.cmaj.ca
November 3, 2025 at 6:07 PM
Pediatric abdominal trauma poses a diagnostic challenge, balancing the need to rule out clinically important intra-abdominal injury against the risks of radiation exposure, given children’s increased sensitivity to radiation-induced malignancies.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250736
Blunt abdominal trauma in a 6-year-old boy and need for imaging
A 6-year-old boy presents to the emergency department after a motor vehicle collision at 90 km/h. The child was properly restrained, had no loss of consciousness, and experienced 1 episode of emesis a...
www.cmaj.ca
November 3, 2025 at 6:06 PM
Distance to primary care:
More than 1 in 10 patients in urban or suburban regions who were rostered to a family physician in a patient enrolment model in Ontario lived farther than 30 km from their family doctor.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.250265
Distance to primary care and its association with health care use and quality of care in Ontario: a cross-sectional study
Background: In Canada, patients who move may choose to stay on their original family physician’s roster, creating long distances to seek primary care. We sought to explore how distance to primary care...
www.cmaj.ca
November 3, 2025 at 6:06 PM
Corporate virtual primary care: what are the impacts on access and equity?

CMAJ Volume 197, Issue 37, features new articles on government partnerships and virtual care; distance to primary care; pediatric blunt abdominal trauma, and more.
➡️ www.cmaj.ca/content/197/37
November 3, 2025 at 6:04 PM
"The escalation of opioid use among youth is being overlooked. Existing addiction services are also inadequate to meet the needs of young people with opioid use disorder (OUD)."
— The Globe and Mail ➡️ www.theglobeandmail.com/canada/artic...

Learn more in the CMAJ ➡️ doi.org/10.1503/cmaj...
Canada’s youth are part of the opioid crisis and need treatment
Despite investment in harm-reduction initiatives, safer supply, and treatment for adult patients, the opioid overdose crisis in Canada continues. More than 18 people in Canada still die every day from...
doi.org
October 27, 2025 at 10:21 PM
Yes, and….:
"'Yes, and …' is a philosophy of resilience, a way of not dwelling, of keeping the pedals turning when the road disappears."
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.251072
Yes, and …
It’s another Saturday clinic, a welcome break from my PhD work of writing statistical codes, drafting manuscripts, and stressing over grant deadlines. One day a week, I get to trade my desk for the cl...
www.cmaj.ca
October 27, 2025 at 7:11 PM
Rational opioid prescribing:
Rational opioid prescribing not only respects the pharmacology of opioids, but also funnels fewer patients into chronic use and addiction.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.251666
Opioid prescribing in Canada: a continued retreat from God’s own medicine
[See related article at www.cmaj.ca/lookup/doi/10.1503/cmaj.250670][1] Key points In this issue’s research article, Rebić and colleagues show that rates of opioid prescribing across 6 Canadian provin...
www.cmaj.ca
October 27, 2025 at 7:11 PM
Youth and the opioid crisis:
"There is no excuse for health systems’ inaction and lack of investment to provide evidence-based addictions services for youth."
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.251682
October 27, 2025 at 7:10 PM
Bed-based care for substance use disorders:
The RE-AIM framework can be used to both guide implementation of complex interventions and evaluate the extent to which models of bed-based care for substance use disorders are effective and should be maintained
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.240955
Bed-based care as a response to the overdose crisis: an approach to informing and evaluating proposed expansion
Key points Despite the introduction of many innovative approaches to the prevention and management of substance use disorder (SUD) by clinicians, peers, public health practitioners, policy-makers and ...
www.cmaj.ca
October 27, 2025 at 7:10 PM