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Message from the Division Director

Dear colleagues,

Some divisional updates:

  1. GIM citywide rounds continue on the last Friday of each month, with the next session on October 30th covering virtual clinics and Suboxone management. These rounds are accredited by the RCPSC. If you would like to join but have not received a calendar invitation with the Zoom link, please email joe.graves@uhn.ca.
  2. Thanks to everyone who continues to work on our COVID units and other GIM services. Also thanks to Dr. Ophyr Mourad and the GIM Working Group for their ongoing preparation for the redesign implementation in July 2021. We anticipate that this will bring improvements to the CTU experience for residents, faculty and patients. In the interim, we continue to benefit from the interventions that have been implemented over the past few years to improve the CTU experience, including developing rapid referral clinics and using the Acute Ambulatory Care Unit to divert admissions from the ED, creating post-discharge clinics to enable safe discharges, developing the ED admit resident rotation to assist with admissions at peak times, expanding hospitalist/non-teaching teams to reduce the census on CTU, and having nocturnists at some sites to cover non-CTU patients. For those who work on the clinical teaching units, useful documents outlining the roles and responsibilities of attending staff and residents are available here.
  3. COVID-19 has the potential to have a disproportionate effect on the academic productivity of female faculty with young children and others with responsibilities outside the workplace.  Dr. Lisa Richardson, in her capacity as Vice Chair of Culture and Inclusion, is working with the DoM to develop strategies for mitigating this. In the short-term, some may wish to maintain a COVID CV, recognizing that this may not be helpful in all circumstances. 

Sincerely,

Moira
Dr. Moira Kapral
Director, Division of General Internal Medicine, University of Toronto

Awards/Announcements
SMDM Award for Distinguished Service
Dr. Ahmed Bayoumi has received the 2020 Award for Distinguished Service from the Society for Medical Decision Making. This award recognizes leadership and contributions to the scientific and educational activities of the Society. Congratulations!

 
Faculty Lead – Black and Indigenous Resident Application and Mentorship Program
Dr. Mireille Norris (Division of Geriatrics) has been appointed the Department of Medicine Faculty Lead for the Black and Indigenous Resident Application and Mentorship Program. 
 
Ontario COVID-19 Science Advisory Table
Dr. Fahad Razak has been appointed to the Ontario COVID-19 Science Advisory Table. The Table’s mandate is to provide weekly summaries of relevant scientific evidence for the COVID-19 Health Command Table of the Province of Ontario, integrating information from existing scientific tables, Ontario’s universities and agencies, and the best global evidence. The Science Table summarizes its findings for the Health Command Table and for the public in Science Briefs.

https://covid19-sciencetable.ca/about/

Conferences

Acute Care Update: Registration Open
St. Joseph's Health Centre is pleased to announce the return of Acute Care Update 2020. The in-person annual conference has been cancelled. The 2020/21 version of Acute Care Update will be presented as four virtual programs hosted on ZOOM.

The 2020 Acute Care Update will be free of charge. To receive the ZOOM videoconference link, users must register for the program in advance.  For more information and to registration see here.

Editor's note: The sessions promise to be outstanding. Attendance encouraged.

Job Postings

Clinician Teacher/Clinician in Quality and Innovation, UHN/MSH

The Department of Medicine, Temerty Faculty of Medicine at the University of Toronto and the Divisions of General Internal Medicine and Geriatrics of the University Health Network (UHN) and Sinai Health System (SHS) are seeking to recruit 2 to 3 academic general internists to be based at UHN - Toronto Western Hospital and Sinai Health System. The successful candidate(s) should have an interest in inpatient and outpatient general internal medicine.  Candidates must currently hold or be eligible for a University of Toronto full-time clinical academic appointment at the rank of Lecturer or Assistant Professor and should fulfill the academic position description of a Clinician Teacher or Clinician in Quality and Innovation.  Read more….

Clinician Scientist, UHN/MSH

The Department of Medicine, Temerty Faculty of Medicine at the University of Toronto, Sinai Health System and University Health Network are seeking to recruit an academic General Internist to join the Divisions of General Internal Medicine and Geriatrics. The successful candidate should be eligible for a full-time clinical academic appointment at the rank of Lecturer or Assistant Professor with the position description of Clinician Scientist. Read more....

Journal Articles

Divisional members have published the following journal articles since the last issue of the GIM newsletter:

1.  Accuracy of the Preferred Language Field in the Electronic Health Records of Two Canadian Hospitals.
Rajaram A, Thomas D, Sallam F, Verma AA, Rawal S.
Appl Clin Inform. 2020 Aug;11(4):644-649. doi: 10.1055/s-0040-1715896. Epub 2020 Sep 30.  PMID: 32998169 
 
2.  Rivaroxaban and Aspirin in Patients With Symptomatic Lower Extremity Peripheral Artery Disease: A Subanalysis of the COMPASS Randomized Clinical Trial.
Kaplovitch E, Eikelboom JW, Dyal L, Aboyans V, Abola MT, Verhamme P, Avezum A, Fox KAA, Berkowitz SD, Bangdiwala SI, Yusuf S, Anand SS.
JAMA Cardiol. 2020 Sep 30. doi: 10.1001/jamacardio.2020.4390. Online ahead of print.PMID: 32997098
 
3.  CaRE @ Home: Pilot Study of an Online Multidimensional Cancer Rehabilitation and Exercise Program for Cancer Survivors.
MacDonald AM, Chafranskaia A, Lopez CJ, Maganti M, Bernstein LJ, Chang E, Langelier DM, Obadia M, Edwards B, Oh P, Bender JL, Alibhai SM, Jones JM.
J Clin Med. 2020 Sep 25;9(10):E3092. doi: 10.3390/jcm9103092.
PMID: 32992759
 
4. Effect of a Housing Intervention on Selected Cardiovascular Risk Factors Among Homeless Adults With Mental Illness: 24-Month Follow-Up of a Randomized Controlled Trial.
Chum A, Wang R, Nisenbaum R, O'Campo P, Stergiopoulos V, Hwang S.
J Am Heart Assoc. 2020 Sep 25:e016896. doi: 10.1161/JAHA.119.016896. Online ahead of print.  PMID: 32975159
 
5. Predictors of Bleeding in the Perioperative Anticoagulant Use for Surgery Evaluation Study.
Tafur AJ, Clark NP, Spyropoulos AC, Li N, Kaplovitch E, MacDougall K, Schulman S, Caprini JA, Douketis J.
J Am Heart Assoc. 2020 Sep 24:e017316. doi: 10.1161/JAHA.120.017316. Online ahead of print.  PMID: 32969288
 
6. Finding Out Your Doctor Made a Mistake.
Detsky AS.
J Gen Intern Med. 2020 Sep 23. doi: 10.1007/s11606-020-06228-9. Online ahead of print.  PMID: 32968969 No abstract available.

7. Validating an Obstetrics and Gynaecology Longitudinal Integrated Clerkship Curriculum at the University of Toronto: A Four-Year Review.
Davidson A, Shore E, Shirreff L, Shah A, Shah R.
J Obstet Gynaecol Can. 2020 Jul 13:S1701-2163(20)30539-9. doi: 10.1016/j.jogc.2020.06.020. Online ahead of print.
PMID: 32962967
 
8.  Predicting Daily Sheltering Arrangements among Youth Experiencing Homelessness Using Diary Measurements Collected by Ecological Momentary Assessment.
Suchting R, Businelle MS, Hwang SW, Padhye NS, Yang Y, Santa Maria DM.
Int J Environ Res Public Health. 2020 Sep 20;17(18):E6873. doi: 10.3390/ijerph17186873.
PMID: 32962272
 
9.  COVID-19 and the decolonization of Indigenous public health.
Richardson L, Crawford A.
CMAJ. 2020 Sep 21;192(38):E1098-E1100. doi: 10.1503/cmaj.200852.
PMID: 32958575 No abstract available.
 
10.  Peri-Complication Diagnosis of Hepatitis C Infection: Risk Factors and Trends over Time.
Lapointe-Shaw L, Chung H, Sander B, Kwong JC, Holder L, Cerocchi O, Austin PC, Feld JJ.
Liver Int. 2020 Sep 21. doi: 10.1111/liv.14670. Online ahead of print.
PMID: 32956567
 
11.  Differences in fracture prevalence and in bone mineral density between Chinese and White Canadians: the Canadian Multicentre Osteoporosis Study (CaMos).
Morin SN, Berger C, Liu W, Prior JC, Cheung AM, Hanley DA, Boyd SK, Wong AKO, Papaioannou A, Rahme E, Goltzman D; CaMos Research Group.
Arch Osteoporos. 2020 Sep 21;15(1):147. doi: 10.1007/s11657-020-00822-4.
PMID: 32955674
 
12.  The suggested chemopreventive association of metformin with prostate cancer in diabetic patients.
Goldberg H, Mohsin FK, Berlin A, Chandrasekar T, Wallis CJD, Klaassen Z, Ahmad AE, Saskin R, Kenk M, Saarela O, Kulkarni GS, Alibhai SMH, Fleshner N.
Urol Oncol. 2020 Sep 17:S1078-1439(20)30401-4. doi: 10.1016/j.urolonc.2020.08.032. Online ahead of print.
PMID: 32951988
 
13.  Metformin in women with type 2 diabetes in pregnancy (MiTy): a multicentre, international, randomised, placebo-controlled trial.
Feig DS, Donovan LE, Zinman B, Sanchez JJ, Asztalos E, Ryan EA, Fantus IG, Hutton E, Armson AB, Lipscombe LL, Simmons D, Barrett JFR, Karanicolas PJ, Tobin S, McIntyre HD, Tian SY, Tomlinson G, Murphy KE; MiTy Collaborative Group.
Lancet Diabetes Endocrinol. 2020 Oct;8(10):834-844. doi: 10.1016/S2213-8587(20)30310-7.  PMID: 32946820
 
14.  Computerised clinical decision support systems and absolute improvements in care: meta-analysis of controlled clinical trials.
Kwan JL, Lo L, Ferguson J, Goldberg H, Diaz-Martinez JP, Tomlinson G, Grimshaw JM, Shojania KG.
BMJ. 2020 Sep 17;370:m3216. doi: 10.1136/bmj.m3216.
PMID: 32943437 Free PMC article.
 
15.  Delirium incidence, risk factors, and treatments in older adults receiving chemotherapy: A systematic review and meta-analysis.
Jung P, Puts M, Frankel N, Syed AT, Alam Z, Yeung L, Malik U, Rosario C, Ayala AP, Hudson J, Alibhai SMH.
J Geriatr Oncol. 2020 Sep 14:S1879-4068(20)30425-2. doi: 10.1016/j.jgo.2020.08.011. Online ahead of print.  PMID: 32943360
 
16.  When to replicate systematic reviews of interventions: consensus checklist.
Tugwell P, Welch VA, Karunananthan S, Maxwell LJ, Akl EA, Avey MT, Bhutta ZA, Brouwers MC, Clark JP, Cook S, Cuervo LG, Curran JA, Ghogomu ET, Graham IG, Grimshaw JM, Hutton B, Ioannidis JPA, Jordan Z, Jull JE, Kristjansson E, Langlois EV, Little J, Lyddiatt A, Martin JE, Marušić A, Mbuagbaw L, Moher D, Morton RL, Nasser M, Page MJ, Pardo Pardo J, Petkovic J, Petticrew M, Pigott T, Pottie K, Rada G, Rader T, Riddle AY, Rothstein H, Schüneman HJ, Shamseer L, Shea BJ, Simeon R, Siontis KC, Smith M, Soares-Weiser K, Thavorn K, Tovey D, Vachon B, Valentine J, Villemaire R, Walker P, Weeks L, Wells G, Wilson DB, White H.
BMJ. 2020 Sep 15;370:m2864. doi: 10.1136/bmj.m2864.
PMID: 32933948 No abstract available.
 
17.  Diagnosis of Chronic Hepatitis B Peri-Complication: Risk factors and Trends over Time.
Lapointe-Shaw L, Chung H, Holder L, Kwong JC, Sander B, Austin PC, Janssen HLA, Feld JJ.
Hepatology. 2020 Sep 15. doi: 10.1002/hep.31557. Online ahead of print.
PMID: 32931613
 
18.  The association between loneliness and medication use in older adults.
Vyas MV, Watt JA, Yu AYX, Straus SE, Kapral MK.
Age Ageing. 2020 Sep 14:afaa177. doi: 10.1093/ageing/afaa177. Online ahead of print.  PMID: 32931548
 
19.  Risks of Serious Injury with Testosterone Treatment.
Yarnell CJ, Thiruchelvam D, Redelmeier DA.
Am J Med. 2020 Sep 11:S0002-9343(20)30775-0. doi: 10.1016/j.amjmed.2020.07.037. Online ahead of print.
PMID: 32926849
 
20.  Global evidence of gender inequity in academic health research: a living scoping review protocol.
Tricco AC, Lachance CC, Rios P, Darvesh N, Antony J, Radhakrishnan A, Anand SS, Baxter N, Burns KEA, Coyle D, Curran JA, Fiest K, Graham ID, Hawker G, Légaré F, Watt J, Witteman HO, Clark JP, Bourgeault IL, Leigh JP, Ahmed SB, Lawford K, Aiken A, Falk-Krzesinski HJ, Langlois EV, McCabe C, Shepperd S, Skidmore B, Pattani R, Leon N, Lundine J, Adisso L, El-Adhami W, Straus SE.
JBI Evid Synth. 2020 Sep 10. doi: 10.11124/JBIES-20-00078. Online ahead of print.  PMID: 32925395

21.  Atypical femur fractures: current understanding and approach to management.
Tile L, Cheung AM.
Ther Adv Musculoskelet Dis. 2020 Aug 21;12:1759720X20916983. doi: 10.1177/1759720X20916983. eCollection 2020.
PMID: 32913448  Free PMC article. Review.
 
22.  Harnessing the Power of Residents as Change Agents in Quality Improvement.
Lam PW, Wong BM.
Acad Med. 2020 Sep 8. doi: 10.1097/ACM.0000000000003727. Online ahead of print.  PMID: 32909996
 
23.  Physician Factors Associated with Inappropriate Vitamin B12 Prescribing in Ontario, Canada.
Silverstein WK, Lin Y, Dharma C, Croxford R, Cheung MC.
J Gen Intern Med. 2020 Sep 9. doi: 10.1007/s11606-020-06185-3. Online ahead of print.  PMID: 32909232 No abstract available.
 
24.  Aggressively find, test, trace and isolate to beat COVID-19.
Matukas LM, Dhalla IA, Laupacis A.
CMAJ. 2020 Sep 9:cmaj.202120. doi: 10.1503/cmaj.202120. Online ahead of print.  PMID: 32907821 No abstract available.
 
25.  Primary care of mothers and infants by the same or different physicians: a population-based cohort study.
Saunders NR, Ray JG, Diong C, Guan J, Cohen E.
CMAJ. 2020 Sep 8;192(36):E1026-E1036. doi: 10.1503/cmaj.191038.
PMID: 32900763 Free PMC article.
 
26.  Accuracy of contralateral Villalta score to assess for pre-existing chronic venous insufficiency in patients with unilateral deep vein thrombosis.
Galanaud JP, Ducruet T, Kahn SR; SOX trial investigators group.
J Thromb Haemost. 2020 Sep 8. doi: 10.1111/jth.15091. Online ahead of print.
PMID: 32898930
 
27.  What Should I Know About Medication Storage and Disposal?
Wu PE, Leong D.
JAMA Intern Med. 2020 Sep 8. doi: 10.1001/jamainternmed.2020.3316. Online ahead of print.  PMID: 32897361 No abstract available.

28.  Association of Fluoroquinolones With the Risk of Aortic Aneurysm or Aortic Dissection.
Gopalakrishnan C, Bykov K, Fischer MA, Connolly JG, Gagne JJ, Fralick M.
JAMA Intern Med. 2020 Sep 8:e204199. doi: 10.1001/jamainternmed.2020.4199. Online ahead of print.
PMID: 32897307  Free PMC article.
 
29.  Second International Guidelines for the Diagnosis and Management of Hereditary Hemorrhagic Telangiectasia.
Faughnan ME, Mager JJ, Hetts SW, Palda VA, Lang-Robertson K, Buscarini E, Deslandres E, Kasthuri RS, Lausman A, Poetker D, Ratjen F, Chesnutt MS, Clancy M, Whitehead KJ, Al-Samkari H, Chakinala M, Conrad M, Cortes D, Crocione C, Darling J, de Gussem E, Derksen C, Dupuis-Girod S, Foy P, Geisthoff U, Gossage JR, Hammill A, Heimdal K, Henderson K, Iyer VN, Kjeldsen AD, Komiyama M, Korenblatt K, McDonald J, McMahon J, McWilliams J, Meek ME, Mei-Zahav M, Olitsky S, Palmer S, Pantalone R, Piccirillo JF, Plahn B, Porteous MEM, Post MC, Radovanovic I, Rochon PJ, Rodriguez-Lopez J, Sabba C, Serra M, Shovlin C, Sprecher D, White AJ, Winship I, Zarrabeitia R.
Ann Intern Med. 2020 Sep 8. doi: 10.7326/M20-1443. Online ahead of print.
PMID: 32894695
 
30. Engagement in primary health care among marginalized people who use drugs in Ottawa, Canada.
Kendall CE, Boucher LM, Donelle J, Martin A, Marshall Z, Boyd R, Oickle P, Diliso N, Pineau D, Renaud B, LeBlanc S, Tyndall M, Bayoumi AM.
BMC Health Serv Res. 2020 Sep 7;20(1):837. doi: 10.1186/s12913-020-05670-z.
PMID: 32894114 Free PMC article.
 
31.  The Impact of the COVID-19 Pandemic on Genitourinary Cancer Care: Re-envisioning the Future.
Wallis CJD, Catto JWF, Finelli A, Glaser AW, Gore JL, Loeb S, Morgan TM, Morgans AK, Mottet N, Neal R, O'Brien T, Odisho AY, Powles T, Skolarus TA, Smith AB, Szabados B, Klaassen Z, Spratt DE.
Eur Urol. 2020 Sep 3:S0302-2838(20)30676-X. doi: 10.1016/j.eururo.2020.08.030. Online ahead of print.
PMID: 32893062 Free PMC article. Review.
 
32.  Never too old to learn new tricks: Surveying Canadian healthcare professionals about learning needs in caring for older adults with cancer.
Puts M, Szumacher E, Dawe D, Fitch M, Jones J, Fülöp T, Alibhai SMH, Hsu T, Strohschein F; Canadian Network on Aging and Cancer.
J Geriatr Oncol. 2020 Sep 3:S1879-4068(20)30424-0. doi: 10.1016/j.jgo.2020.08.010. Online ahead of print.  PMID: 32891617
 
33.  Treatment of Chronic Hepatitis C in Young Children Reduces Adverse Outcomes and Is Cost-Effective Compared to Deferring Treatment to Adulthood.
Greenaway E, Haines A, Ling SC, Krahn M.
J Pediatr. 2020 Sep 2:S0022-3476(20)31124-0. doi: 10.1016/j.jpeds.2020.08.088. Online ahead of print.  PMID: 32890583
 
34.  Lowering of hemoglobin A1C and risk of cardiovascular outcomes and all-cause mortality, a meta-regression analysis.
Fralick M, Colacci M, Odutayo A, Siemieniuk R, Glynn RJ.
J Diabetes Complications. 2020 Nov;34(11):107704. doi: 10.1016/j.jdiacomp.2020.107704. Epub 2020 Jul 31.  PMID: 32888788
 
35.  Safety, effectiveness and sustainability of a laboratory intervention to de-adopt culture of midstream urine samples among hospitalized patients.
Mozafarihashjin M, Leis JA, Maze Dit Mieusement L, McCreight L, Poutanen S, Shrivastava A, So J, Soong C, van Horne L, Wong L, McGeer A.
Infect Control Hosp Epidemiol. 2020 Sep 2:1-8. doi: 10.1017/ice.2020.385. Online ahead of print.
PMID: 32873350

36. Association of Receipt of Palliative Care Interventions With Health Care Use, Quality of Life, and Symptom Burden Among Adults With Chronic Noncancer Illness: A Systematic Review and Meta-analysis.
Quinn KL, Shurrab M, Gitau K, Kavalieratos D, Isenberg SR, Stall NM, Stukel TA, Goldman R, Horn D, Cram P, Detsky AS, Bell CM. JAMA. 2020 Oct 13;324(14):1439-1450. doi: 10.1001/jama.2020.14205.
PMID: 33048152

Trainee Publications

1.  Delaying surgery for patients with a previous SARS-CoV-2 infection.
COVIDSurg Collaborative [including Agarwal A]. Br J Surg. 2020 Sep 25. doi: 10.1002/bjs.12050. Online ahead of print.  PMID: 32974904 No abstract available.
 
2.  Developing trustworthy recommendations as part of an urgent response (1-2 weeks): a GRADE concept paper GRADE Rapid Guidelines project group.
Akl EA, Morgan RL, Rooney AA, Beverly B, Katikireddi SV, Agarwal A, Alper BS, Alva-Diaz C, Amato L, Ansari MT, Brozek J, Chu DK, Dahm P, Darzi AJ, Falavigna M, Gartlehner G, Pardo-Hernandez H, King V, Klugarová J, Langendam MWM, Lockwood C, Mammen M, Mathioudakis AG, McCaul M, Meerpohl JJ, Minozzi S, Mustafa RA, Nonino F, Piggott T, Qaseem A, Riva J, Rodin R, Sekercioglu N, Skoetz N, Traversy G, Thayer K, Schünemann H.J Clin Epidemiol.  2020 Sep 30:S0895-4356(20)31123-9. doi: 10.1016/j.jclinepi.2020.09.037. Online ahead of print.  PMID: 33010401

3.  The worldwide clinical trial research response to the COVID-19 pandemic-the first 100 days.
Janiaud P, Axfors C, Hooft JV, Saccilotto R, Agarwal A, Appenzeller-Herzog C, Contopoulos-Ioannidis DG, Danchev V, Dirnagl U, Ewald H, Gartlehner G, Goodman SN, Haber NA, Ioannidis AD, Ioannidis JPA, Lythgoe MP, Ma W, Macleod M, Malički M, Meerpohl JJ, Min Y, Moher D, Nagavci B, Naudet F, Pauli-Magnus C, O'Sullivan JW, Riedel N, Roth JA, Sauermann M, Schandelmaier S, Schmitt AM, Speich B, Williamson PR, Hemkens LG.

F1000 Res. 2020;9:1193.

4. Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: an international, multicenter, comparative cohort study.
Glasbey JC, Bhangu A; COVIDSurg Collaborative [incl: Agarwal A]
.J Clin Oncol. 2020 Oct 6:JCO2001933 [Epub ahead of print]

5.  Corticosteroids for COVID-19: living guidance.
World Health Organization [incl: Agarwal A].
WHO/2019-nCoV/Corticosteroids/2020.1

6.  Risk-assessment models for VTE and bleeding in hospitalized medical patients: an overview of systematic reviews.
Darzi AJ, Repp AB, Spencer FA, Morsi RZ, Charide R, Etxeandia-Ikobaltzeta I, Bauer KA, Burnett AE, Cushman M, Dentali F, Kahn SR, Rezende SM, Zakai NA, Agarwal A, Karam SG, Lotfi T, Wiercioch W, Waziry R, Iorio A, Akl EA, Schünemann HJ.Blood Adv. 2020 Oct 13;4(19):4929-4944. doi: 10.1182/bloodadvances.2020002482.  PMID: 33049056

7. Physician Factors Associated with Inappropriate Vitamin B12 Prescribing in Ontario, Canada.
Silverstein WK, Lin Y, Dharma C, Croxford R, Cheung MC.
J Gen Intern Med. 2020 Sep 9. doi: 10.1007/s11606-020-06185-3. Online ahead of print.  PMID: 32909232 No abstract available.

 
8.  Predicting the Risk of Right Ventricular Failure in Patients Undergoing Left Ventricular Assist Device Implantation: A Systematic Review
Claudia Frankfurter, Micaela Molinero, Julie K.K Vishram-Nielsen, Farid Foroutan, Susanna Mak, Vivek Rao, Filio Billia, Ani Orchanian-Cheff, Ana Carolina Alba. Circ Heart Fail 2020 Oct; 13(10)
:e006994 
PMID: 32981331  

 

 


For future newsletters, please email information on your contributions to joe.graves@uhn.ca.


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To submit items for inclusion in this bulletin, or to subscribe, please email Dr. Moira Kapral at Moira.Kapral@uhn.ca







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