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   2020| July-September  | Volume 25 | Issue 3  
    Online since June 24, 2020

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The occasional temporomandibular joint reduction
Mitchell Crozier, Sarah M Giles
July-September 2020, 25(3):118-123
DOI:10.4103/CJRM.CJRM_98_19  PMID:32611879
  3,371 234 -
Demographics, prevalence and outcomes of diabetes in pregnancy in NW Ontario
Ruben Hummelen, Ribal Kattini, Jenna Poirier, Sharen Madden, Holly Ockenden, Joseph Dooley, Len Kelly
July-September 2020, 25(3):99-104
DOI:10.4103/CJRM.CJRM_71_19  PMID:32611874
Introduction: Diabetes in pregnancy confers increased risk. This study examines the prevalence and birth outcomes of diabetes in pregnancy at the Sioux Lookout Meno Ya Win Health Centre (SLMHC) and other small Ontario hospitals. Methods: This was a retrospective study of maternal profile: age, parity, comorbidities, mode of delivery, neonatal birth weight, APGARS and complications. Data were compared to other Ontario hospitals offering an equivalent level of obstetrical services. Results: Type 2 diabetes mellitus in pregnancy is far more prevalent in mothers who deliver at SLMHC (relative risk [RR]: 20.9, 95% confidence interval [CI]: 16.0–27.2); the rates of gestational diabetes (GDM) are double (RR: 2.0, 95% CI: 1.7–2.3). SLMHC mothers with diabetes were on average 5 years younger and of greater parity with increased substance use. Neonates largely had equivalent outcomes except for increased macrosomia, neonatal hypoglycaemia and hyperbilirubinaemia in GDM pregnancies. Conclusion: Patients with diabetes in pregnancy at SLMHC differ substantially from mothers delivering at Ontario hospitals with a comparable level of service. Programming and resources must meet the service needs of these patients.
  2,925 350 -
Could it be COVID-19? Atypical presentations in a pandemic
Claire Schiller, Elaine M Blau
July-September 2020, 25(3):126-127
DOI:10.4103/CJRM.CJRM_34_20  PMID:32611881
  1,823 256 -
The impact of the HEART score on the prevalence of cardiac testing and patient outcomes in a rural emergency department
Zachary C. D. Kuehner, Meghan D Dmitriew, Luke K Wu, Anthony D Shearing
July-September 2020, 25(3):105-111
DOI:10.4103/CJRM.CJRM_77_19  PMID:32611875
Introduction: This study was conducted to examine the use of the HEART score for risk stratification of chest pain patients presenting to rural Ontario emergency departments (EDs), assessing both its validity in a rural context and its utility in health-care resource management. Methods: This study was a retrospective chart review of adult patients presenting to the ED with chest pain. The HEART score was assessed for its ability to risk-stratify patients (high, moderate and low) in terms of the likelihood of a major adverse cardiac event (MACE) within 6 weeks. The prevalence of follow-up testing for each risk category of patients was then determined such that the potential impact on health resource management was estimated based on the number of tests ordered in low-risk patients. Results: Of the 215 charts included, 24 (11.2%) patients experienced a MACE within 6 weeks. None of the patients with a low HEART score experienced a MACE. In comparison, the incidence of MACE in moderate- and high-risk groups was calculated to be 13.9% (95% confidence interval [CI] [5.91% and 21.89%, respectively]) and 66.7% (95% CI [46.54% and 86.86%, respectively]). Eighteen percent of the low-risk patients received follow-up testing with no positive results suggestive of acute coronary syndrome. Conclusion: Our results provide external validation of the predictive value of the HEART score in determining the risk of MACE in patients presenting to a rural ED with chest pain. Our results also suggest that rates of follow-up testing in low-risk patients may be reduced in communities with limited access to resources.
  1,684 193 1
Rural and Remote 2020
Peter Hutten-Czapski
July-September 2020, 25(3):95-95
DOI:10.4103/CJRM.CJRM_33_20  PMID:32611870
  1,606 220 -
President's Message. Summer 2020 – Traversing uncertainty
Gabe Woollam
July-September 2020, 25(3):97-97
DOI:10.4103/CJRM.CJRM_32_20  PMID:32611872
  1,493 185 -
Message du Président. Des temps insensés
Gabe Woollam
July-September 2020, 25(3):98-98
DOI:10.4103/1203-7796.287624  PMID:32611873
  1,482 151 -
Two cases: Situations for artificial surfactant, beyond prematurity
Timothy M Wehner, Laura Noack, J Kerry MacDonald
July-September 2020, 25(3):112-114
DOI:10.4103/CJRM.CJRM_73_19  PMID:32611876
  1,430 153 -
Conférence 2020 en région
Peter Hutten-Czapski
July-September 2020, 25(3):96-96
DOI:10.4103/1203-7796.287623  PMID:32611871
  1,415 160 -
Steady on, Doc*
Laura B N Downing
July-September 2020, 25(3):124-125
DOI:10.4103/CJRM.CJRM_30_20  PMID:32611880
  1,237 100 -
Country cardiograms case #67
Charles William Helm
July-September 2020, 25(3):115-115
DOI:10.4103/CJRM.CJRM_39_19  PMID:32611877
  1,114 142 -
Need for organised human involvement to produce rural physicians
Kazuhiko Kotani
July-September 2020, 25(3):128-129
DOI:10.4103/CJRM.CJRM_11_20  PMID:32611882
  1,102 131 -
Country cardiograms case #67: Answer
Charles William Helm
July-September 2020, 25(3):116-117
DOI:10.4103/1203-7796.287692  PMID:32611878
  924 103 -