Canadian Medical Association Journal

Nov 5, 2024 | cmaj.ca | Devesh V. Oberoi

Sanjit Bagchi recently highlighted the surge in cases of dengue in India. 1 It is worth noting that chikungunya, another disease borne by the Aedes egypti mosquito, also poses a major health threat to large populations. 2 The 2 diseases have similar symptoms, although hemorrhagic manifestations are relatively rare with chikungunya. Therefore, care should be taken when caring for patients suffering from either of these diseases as the diagnosis could be incorrect.

Oct 29, 2024 | cmaj.ca

Fig. 2: Cellular perspective of the erection pathway. The signal (nitric oxide) is released from nerve endings or from endothelial cells and activates a cascade reaction, which ultimately leads to an increased cellular concentration of cGMP (cyclic guanosine monophosphate). This second messenger molecule induces a series of events that lead to smooth-muscle relaxation through a reduction in the intracellular calcium ion concentration. The enzyme PDE-5 (phosphodiesterase type 5) reverses this effect by metabolizing the cGMP to GMP rapidly. The clinically important inhibitors of this enzyme (sildenafil, vardenafil and tadalafil) all act to promote smooth-muscle relaxation by their ability to allow cGMP to accumulate when nitric oxide is released, as is the case when sexual stimulation is present. Photo: Christine Kenney

Oct 28, 2024 | cmaj.ca | Zhou Zhu |Jun Li

A 23-year-old man presented to our dermatology department with a 2-month history of a painless, nonpruritic ulcer on his right thumb (Figure 1A). He reported sex with men and a history of HIV. He had stopped antiretroviral therapy 1 year previously. He recalled the onset of diffuse erythema on his limbs and trunk, along with patchy alopecia, 1 month before presentation. Physical examination revealed onychoptosis and crusted ulceration of the right nail bed with redness and swelling at the border.

Oct 15, 2024 | cmaj.ca | Catherine Varner

In this issue of CMAJ, Mehra and colleagues1 review the diagnosis and management of early pregnancy loss, commonly referred to as miscarriage, which affects 1 in 5 pregnancies in Canada. The symptoms of early pregnancy loss, such as vaginal bleeding and pain, often begin mildly and increase over a period of days to several weeks. Patients have reported appalling experiences of seeking care for such symptoms in Canada’s health systems.

Oct 7, 2024 | cmaj.ca | Samira Jeimy |Nancy Yu |Edmond S. Chan |Vicki Cook

L’immunothérapie orale est une option thérapeutique pour les nourrissons et les enfants d’âge préscolaire qui ont des allergies alimentaires, comme solution de rechange à l’évitement des aliments en causeOn associe l’allergie alimentaire à un fardeau médical et psychosocial substantiel1. Sa prise en charge se limitait autrefois à l’évitement de l’allergène.