CMAJ

@cmaj.ca

The Canadian Medical Association Journal
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@cmaj.ca Oct 9, 2026, 5:00 PM

The bottle on the counter:
A rehab specialist encounters a patient who helps him process lingering grief
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260397

“On the drive home, I realized that my
anger was never really meant for her.
Anger was the shape my helplessness
took, the helplessness that remains with
me as a professional.”
— Ethan Bell BS

The bottle on the counter
DOI: 10.1503/cmaj.260397

@cmaj.ca Oct 8, 2026, 4:57 PM

🍂 Summer may be over, but its soundtrack can stick around.
Celebrate 1 million CMAJ Podcast downloads with six of our most-listened-to episodes + summer music picks from CMAJ staff, curated by family physician, artist & DJ Dr. Cindy Ochieng.
➡️ https://open.spotify.com/playlist/4t9f6zWsN0VL3la9i0zZGw

@cmaj.ca Oct 8, 2026, 4:30 PM

Refractory nausea after surgery:
This report describes a presentation of intractable nausea requiring readmission to hospital more than 2 weeks after total knee arthroplasty.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260372

$Postdischarge nausea and vomiting can occur anywhere from 24 hours to 1 week after hospital discharge, often occurs after surgery, and can vary in severity. Refractory nausea after surgery DOI: 10.1503/cmaj.260372$

@cmaj.ca Oct 7, 2026, 5:35 PM

Polyendocrine metabolic ovarian syndrome (PMOS) in adolescents:
PMOS affects approximately 8% of adolescents, and pelvic ultrasonography is not recommended for the diagnosis in this age group.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260021

Polyendocrine metabolic ovarian syndrome is a diagnosis of exclusion. Investigations for other causes of menstrual irregularities should be undertaken to rule out pregnancy, premature ovarian insufficiency, thyroid dysfunction, hyperprolactinemia, and non-classic congenital adrenal hyperplasia.

Polyendocrine metabolic ovarian syndrome in adolescents
DOI: 10.1503/cmaj.260021

@cmaj.ca Oct 7, 2026, 4:35 PM

Polyendocrine metabolic ovarian syndrome:
Polycystic ovarian syndrome (PCOS) was misleading, distorting how patients and clinicians understood a common, lifelong condition.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.261239

The term “polyendocrine metabolic ovarian syndrome” (PMOS) better reflects the lifelong endocrine and metabolic disorder in which ovarian abnormalities is one manifestation, not the defining cause.

Polyendocrine metabolic ovarian syndrome
DOI: 10.1503/cmaj.261239

@cmaj.ca Oct 6, 2026, 4:33 PM

Health impacts of daylight saving time:
In this analysis, the authors focus not on whether seasonal clock adjustments should end, but on which policy should be adopted if time changes are eliminated.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.261089

@cmaj.ca Oct 6, 2026, 4:28 PM

Severe maternal morbidity in Canada:
The results of this population-based cohort study are consistent with a broader body of evidence that structural and systemic factors, including anti-Black racism, contribute to inequities in maternal health.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.252020

Using nationally representative data on Black and White people in Canada, this study found rates of severe maternal morbidity to be consistently higher among Black people, findings that persisted after adjustment for sociodemographic and clinical characteristics.

Severe maternal morbidity in Canada
DOI: 10.1503/cmaj.252020

@cmaj.ca Oct 2, 2026, 6:15 PM

Dana:
This poem reflects on the writer's observations while spending time with her loved one.
➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.261028

“She dances to anything by Chris Stapleton.
No bradykinesia.”
— Kayla M. Huggard MPH

Dana
DOI: 10.1503/cmaj.261028

@cmaj.ca Oct 2, 2026, 5:15 PM

Vaccine product monographs:
Manufacturers urgently need to update their product monographs for SARS-CoV-2 mRNA vaccine, and regulators should implement measures to support regular updates.

Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260860

Inconsistencies between public health recommendations for vaccines and product monographs can raise hesitancy among physicians, other health professionals, and the public.

Vaccine product monographs
DOI: 10.1503/cmaj.260860

@cmaj.ca Oct 1, 2026, 6:15 PM

Immune thrombocytopenia:
Presentation of immune thrombocytopenia can range from an incidental blood work finding, petechiae, or minor mucocutaneous bleeding, to life-threatening hemorrhage.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.261081

(A) Wet purpura on tongue and buccal mucosa of a 48-year-old man with immune thrombocytopenia, as seen on day of presentation. (B) Resolution of wet purpura by day 4 of treatment.

Immune thrombocytopenia
DOI: 10.1503/cmaj.261081

@cmaj.ca Oct 1, 2026, 5:10 PM

Symmetrical peripheral gangrene is ischemic necrosis of 2 or more extremities without large-vessel occlusion and should be considered in any patient with bilateral, distal, symmetric, acral ischemia and preserved or palpable pulses.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260550

Management of symmetrical peripheral gangrene is directed toward treating the underlying inflammatory driver, with anticoagulation balanced against bleeding (favouring reversible agents) and necrosis allowed to demarcate before débridement or amputation.

Symmetrical peripheral gangrene
DOI: 10.1503/cmaj.260550

@cmaj.ca Sep 30, 2026, 5:10 PM

This analysis indicates that implementing an NHS England–style diabetes prevention programme in Ontario and Quebec would be cost-effective — and likely cost saving — over a 35-year horizon for adults with prediabetes.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260187

The National Health Service (NHS) England’s Diabetes Prevention Programme (DPP) is a cost-effective, publicly funded program of structured dietary and physical activity counselling that has been shown to reduce the incidence of progression from prediabetes to type 2 diabetes.

Diabetes prevention programme
DOI: 10.1503/cmaj.260187

@cmaj.ca Sep 30, 2026, 4:07 PM

Periprosthetic joint infection complicates 1% to 2% of primary arthroplasties and often presents with pain, swelling, erythema, and wound drainage.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.251720

Unexplained new pain after total hip or knee arthroplasty should raise concern for periprosthetic joint infection.

Periprosthetic hip and knee infections
DOI: 10.1503/cmaj.251720

@cmaj.ca Sep 25, 2026, 5:20 PM

Distress (pain, fear) is the most common adverse reaction associated with vaccination. This clinical practice guideline presents evidence-based strategies to manage vaccination-related distress.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260123

Implementing the recommendations from the guideline on reducing distress during vaccine injections can improve the quality of vaccine delivery and promote person-centred care by aligning interventions with vaccine recipient and support person preferences.

Guideline on reducing distress during vaccine injections
DOI: 10.1503/cmaj.260123

@cmaj.ca Sep 24, 2026, 5:20 PM

Reframing chromic homelessness as a cognitive impairment crisis is essential but will require investment in diagnostic services, guardianship systems, interdisciplinary medical supports, and the construction of intensive housing facilities.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.252022

People experiencing homelessness have high rates of cognitive and functional impairment that may be severe, with several causes compounding each other over time.

Cognitive impairment and homelessness
DOI: 10.1503/cmaj.252022

@cmaj.ca Sep 23, 2026, 4:20 PM

Sarcoidosis:
Cutaneous lesions occur in approximately 25% to 33% of patients and are often the presenting feature.
Learn more ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260254

(A) Yellow-red plaques infiltrating tattoos, and psoriasiform plaques along the hairline, of a 57-year-old woman with sarcoidosis. (B) Marked resolution of both lesions after 3 months of oral prednisone and hydroxychloroquine.

Sarcoidosis
DOI: 10.1503/cmaj.260254

@cmaj.ca Sep 22, 2026, 8:15 PM

Did you know:
Engineered stone as used for countertops contains high concentrations of silica and carries a substantial risk of silicosis in exposed workers.
Learn more about silicosis from countertop work ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260081

Chest radiograph 2 years after the initial presentation showing progressive changes with diffuse small nodules typical of silicosis.

Silicosis from countertop work
DOI: 10.1503/cmaj.260081

@cmaj.ca Sep 22, 2026, 8:13 PM

Silicosis: what are the occupational risks?

CMAJ Volume 198, Issue 32, features new articles on silicosis from countertop work; bile acid diarrhea; guideline on reducing distress during vaccine injections, and more.
➡️ https://www.cmaj.ca/content/198/32

@cmaj.ca Sep 22, 2026, 8:11 PM

Bile acid diarrhea, an underrecognized cause of chronic diarrhea, occurs when excess bile acids reach the colon, causing increased fluid secretion and accelerated intestinal transit.

Here are 5 things to know about bile acid diarrhea ➡️ www.cmaj.ca/lookup/doi/10.1503/cmaj.260665

Typical presentations of bile acid diarrhea include chronic watery diarrhea, increased stool frequency, fecal urgency, and bloating.

Bile acid diarrhea
DOI: 10.1503/cmaj.260665

@cmaj.ca Sep 17, 2026, 7:10 PM

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.

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