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Message from the Division Director
Dear Colleagues,

Recently things have been particularly tough in all sorts of ways: rising hospitalizations and ICU admissions; younger, sicker patients; more school closures and lockdowns; public policies that fall short in the protection of essential workers and others at risk. I feel like I’ve written the same message so many times over this past year: we will get through this together. But I still believe that to be true. Everywhere I look I see examples of extraordinary dedication to patients, support of colleagues, political and community advocacy, and teams and systems working together. I know that when we look back on this period, we will be incredibly proud of everything we have done. So let us press on and do the work for which we have trained and that we do so well.

Although the weeks to come will be busy, please seek opportunities to rest when you can. At some sites, all non-essential meetings have been cancelled for the next two weeks with the goal of allowing people to focus on both patient and self-care, and other organizations may wish to do the same. When this wave is over, we will all need to prioritize building off-time into our schedules to recuperate.

I also want to take a moment to acknowledge the cancellation of this year’s Royal College Oral Examination in Internal Medicine.  Although I recognize the merits of this examination, cancelling it in the context of the pandemic is the right thing to do. Our healthcare system will be the better for having our highly skilled PGY3s able to fully contribute to essential patient care during this challenging third wave.

Yours,
Moira
Dr. Moira Kapral, Director, Division of General Internal Medicine, University of Toronto
Awards and Announcements

Dean’s Emerging Leader Award

Dr. Brian Wong is this year’s recipient of the Temerty Faculty of Medicine, Dean’s Emerging Leader Award. The Dean’s Emerging Leader Award is presented to alumni early in their career who have demonstrated outstanding service to Temerty Medicine, their local healthcare community, and scientific/academic achievement.  
 

Allan Knight Lifetime Achievement in Teaching Award

Dr. Mark Cheung has been awarded the Annual Sunnybrook Education Advisory Council Allan Knight Lifetime Achievement in Teaching Award.  

UHN/SHS Dept. of Medicine Citizenship Award

Dr. Mike Fralick is the GIM recipient of this quarter’s University Health Network/Sinai Health System Department of Medicine Citizenship Award, for his leadership role in coordinating COVID clinical trials and for taking on extra clinical work.

2021 OMA Resident Achievement Award

Dr. Billy Silverstein is this year’s recipient of the 2021 OMA Resident Achievement Award. This is a highly competitive award for excellence in leadership, teaching, advocacy, and professionalism. 

It's a boy!

Dr. Tarek Abdelhalim and wife Meghan joyfully welcome Malcolm Abdelhalim - Born at St. Michaels, 8 lbs 12 oz. Meghan and Malcolm are both doing great. Congratulations!
 

It's a boy!

Dr. Shaan Chugh and wife Shannon Riley welcomed Kian Chugh into the world on March 26, 2021. All are doing well, and his older sister Harper is so happy to have a younger brother. Congratulations!

Meetings 

University of Toronto GIM April Citywide Rounds RESCHEDULED

The GIM Citywide Rounds scheduled for Friday, April 30th have been cancelled due to COVID-19 and will be rescheduled for a later date.

 

U of T GIM Research Day 

This year's GIM Research Day will be held virtually on Friday, May 28th from 12pm to 1:30pm.

Please join us to enjoy short trainee presentations, and a keynote speech by Dr. Leora Horwitz.

If you would like to attend but have not received the calendar invitation with Zoom details, please email tina.teng@uhn.ca.
Journal Articles

Divisional members have published the following journal articles since the last issue of the GIM newsletter:
  1. Factors associated with SARS-CoV-2 positivity in 20 homeless shelters in Toronto, Canada, from April to July 2020: a repeated cross-sectional study.
    Kiran T, Craig-Neil A, Das P, Lockwood J, Wang R, Nathanielsz N, Rosenthal E, Snider C, Hwang SW.
    CMAJ Open. 2021 Mar 30;9(1):E302-E308. doi: 10.9778/cmajo.20200253. Print 2021 Jan-Mar.
    PMID: 33785478
     
  2. Intensive versus less-intensive antileukemic therapy in older adults with acute myeloid leukemia: A systematic review.
    Chang Y, Guyatt GH, Teich T, Dawdy JL, Shahid S, Altman JK, Stone RM, Sekeres MA, Mukherjee S, LeBlanc TW, Abel GA, Hourigan CS, Litzow MR, Michaelis LC, Alibhai SMH, Desai P, Buckstein R, MacEachern J, Brignardello-Petersen R.
    PLoS One. 2021 Mar 30;16(3):e0249087. doi: 10.1371/journal.pone.0249087. eCollection 2021.
    PMID: 33784346
     
  3. Effectiveness and Safety of Direct Oral Anticoagulants in Patients with Nonvalvular Atrial Fibrillation and Weighing ≥ 120 Kilograms versus 60-120 Kilograms.
    Wiethorn EE, Bell CM, Wiggins BS.
    Am J Cardiovasc Drugs. 2021 Mar 30. doi: 10.1007/s40256-021-00470-0. Online ahead of print.
    PMID: 33782909
     
  4. Pseudoaneurysm of the brachial artery in a patient who uses intravenous drugs.
    Kovacs-Litman A, Gold WL.
    CMAJ. 2021 Mar 29;193(13):E448. doi: 10.1503/cmaj.201843.
    PMID: 33782172 
     
  5. Early Pregnancy Exposure to Angiotensin-Converting-Enzyme Inhibitors and Angiotensin Receptor Blockers Associated with Congenital Malformations and Stillbirths: A Systematic Review and Meta-analysis.
    Fu J, Tomlinson G, Feig DS.
    Diabetes Metab Res Rev. 2021 Mar 29. doi: 10.1002/dmrr.3453. Online ahead of print.
    PMID: 33779043
     
  6. A Pragmatic Non-Randomized Trial of Prehabilitation Prior to Cancer Surgery: Study Protocol and COVID-19-Related Adaptations.
    Santa Mina D, Sellers D, Au D, Alibhai SMH, Clarke H, Cuthbertson BH, Darling G, El Danab A, Govindarajan A, Ladha K, Matthew AG, McCluskey S, Ng KA, Quereshy F, Karkouti K, Randall IM.
    Front Oncol. 2021 Mar 10;11:629207. doi: 10.3389/fonc.2021.629207. eCollection 2021.
    PMID: 33777780
     
  7. Rural telemedicine use before and during the COVID-19 pandemic: A repeated cross-sectional study.
    Chu C, Cram P, Pang A, Stamenova V, Tadrous M, Bhatia RS.
    J Med Internet Res. 2021 Mar 24. doi: 10.2196/26960. Online ahead of print.
    PMID: 33769942
     
  8. Advise non-pharmacological therapy as first line treatment for chronic insomnia.
    Soong C, Burry L, Greco M, Tannenbaum C.
    BMJ. 2021 Mar 23;372:n680. doi: 10.1136/bmj.n680.
    PMID: 33757960 
     
  9. Population-Wide Peer Comparison Audit and Feedback to Reduce Antibiotic Initiation and Duration in Long-Term Care Facilities with Embedded Randomized Controlled Trial.
    Daneman N, Lee SM, Bai H, Bell CM, Bronskill SE, Campitelli MA, Dobell G, Fu L, Garber G, Ivers N, Lam JMC, Langford BJ, Laur C, Morris A, Mulhall C, Pinto R, Saxena FE, Schwartz KL, Brown KA.
    Clin Infect Dis. 2021 Mar 23:ciab256. doi: 10.1093/cid/ciab256. Online ahead of print.
    PMID: 33754632
     
  10. Post-exposure prophylaxis against SARS-CoV-2 in close contacts of confirmed COVID-19 cases (CORIPREV): study protocol for a cluster-randomized trial.
    Tan DHS, Chan AK, Jüni P, Tomlinson G, Daneman N, Walmsley S, Muller M, Fowler R, Murthy S, Press N, Cooper C, Lee T, Mazzulli T, McGeer A.
    Trials. 2021 Mar 22;22(1):224. doi: 10.1186/s13063-021-05134-7.
    PMID: 33752741
     
  11. The Temporal Relations of Traumatic Brain Injury, Victimization, Aggression, and Homelessness: A Developmental Trajectory.
    Cusimano MD, Korman MB, Carpino M, Feher A, Puvirajasingam J, Zhang S, Hwang SW, Tepperman L.
    Neurotrauma Rep. 2021 Feb 22;2(1):103-114. doi: 10.1089/neur.2020.0050. eCollection 2021 Feb.
    PMID: 33748815
     
  12. Dental Opioid Prescription Characteristics and the Risk of New, Persistent Use.
    Campbell TJ, Martins D, Tadrous M, Juurlink DN, Paterson JM, Mamdani MM, Mock D, Gomes T.
    Am J Prev Med. 2021 Mar 17:S0749-3797(21)00115-X. doi: 10.1016/j.amepre.2021.01.016. 
    PMID: 33744063
     
  13. Stillbirth in Canada: anachronistic definition and registration processes impede public health surveillance and clinical care.
    Joseph KS, Lee L, Arbour L, Auger N, Darling EK, Evans J, Little J, McDonald SD, Moore A, Murphy PA, Ray JG, Scott H, Shah P, VanDenHof M, Kramer MS.
    Can J Public Health. 2021 Mar 19. doi: 10.17269/s41997-021-00483-x.
    PMID: 33742313
     
  14. Digital Applications Targeting Medication Safety in Ambulatory High-Risk CKD Patients: Randomized Controlled Clinical Trial.
    Ong SW, Jassal SV, Porter EC, Min KK, Uddin A, Cafazzo JA, Rac VE, Tomlinson G, Logan AG.
    Clin J Am Soc Nephrol. 2021 Mar 18:CJN.15020920. doi: 10.2215/CJN.15020920. 
    PMID: 33737321
     
  15. Decentralizing PrEP delivery: Implementation and dissemination strategies to increase PrEP uptake among MSM in Toronto, Canada.
    Charest M, Sharma M, Chris A, Schnubb A, Knox DC, Wilton J, Shahin R, Chan A, Mishra S, Grace D, Bayoumi AM, Maxwell J, Bogoch II, Tan DHS.
    PLoS One. 2021 Mar 18;16(3):e0248626. doi: 10.1371/journal.pone.0248626. eCollection 2021.
    PMID: 33735209
     
  16. Regional variation in cost of neonatal intensive care for extremely preterm infants.
    Rolnitsky A, Urbach D, Unger S, Bell CM.
    BMC Pediatr. 2021 Mar 17;21(1):134. doi: 10.1186/s12887-021-02600-8.
    PMID: 33731048
     
  17. A Cold Case.
    Hempel AK, Gold WL, Luther RA.
    Clin Infect Dis. 2021 Mar 15;72(6):1081-1083. doi: 10.1093/cid/ciaa1638.
    PMID: 33720321 
     
  18. Does Housing Improve Health Care Utilization and Costs? A Longitudinal Analysis of Health Administrative Data Linked to a Cohort of Individuals With a History of Homelessness.
    Wiens K, Nisenbaum R, Sucha E, Aubry T, Farrell S, Palepu A, Duhoux A, Gadermann A, Hwang SW.
    Med Care. 2021 Apr 1;59(Suppl 2):S110-S116. doi: 10.1097/MLR.0000000000001379.
    PMID: 33710082
     
  19. Global prevalence of burnout among postgraduate medical trainees: a systematic review and meta-regression.
    Naji L, Singh B, Shah A, Naji F, Dennis B, Kavanagh O, Banfield L, Alyass A, Razak F, Samaan Z, Profetto J, Thabane L, Sohani ZN.
    CMAJ Open. 2021 Mar 8;9(1):E189-E200. doi: 10.9778/cmajo.20200068. Print 2021 Jan-Mar.
    PMID: 33688027
     
  20. Health care costs associated with chronic hepatitis C virus infection in Ontario, Canada: a retrospective cohort study.
    Wong WWL, Haines A, Bremner KE, Yao Z, Calzavara A, Mitsakakis N, Kwong JC, Sander B, Thein HH, Krahn MD.
    CMAJ Open. 2021 Mar 8;9(1):E167-E174. doi: 10.9778/cmajo.20200162. Print 2021 Jan-Mar.
    PMID: 33688024
     
  21. White blood cell count and clustered components of metabolic syndrome: A study in western Iran.
    Hedayati MT, Montazeri M, Rashidi N, Yousefi-Abdolmaleki E, Shafiee MA, Maleki A, Farmani M, Montazeri M.
    Caspian J Intern Med. 2021 Winter;12(1):59-64. doi: 10.22088/cjim.12.1.59.
    PMID: 33680399
     
  22. Journey into the unknown: considering the international medical graduate perspective on the road to Canadian residency during the COVID-19 pandemic.
    Gutman A, Tellios N, Sless RT, Najeeb U.
    Can Med Educ J. 2021 Feb 26;12(1):e89-e91. doi: 10.36834/cmej.70503. eCollection 2021 Feb.
    PMID: 33680236
     
  23. Diabetes after pregnancy: a study protocol for the derivation and validation of a risk prediction model for 5-year risk of diabetes following pregnancy.
    Read SH, Rosella LC, Berger H, Feig DS, Fleming K, Kaul P, Ray JG, Shah BR, Lipscombe LL.
    Diagn Progn Res. 2021 Mar 8;5(1):5. doi: 10.1186/s41512-021-00095-6.
    PMID: 33678196
     
  24. Sarilumab in patients admitted to hospital with severe or critical COVID-19: a randomised, double-blind, placebo-controlled, phase 3 trial.
    Lescure FX, Honda H, Fowler RA, Lazar JS, Shi G, Wung P, Patel N, Hagino O; Sarilumab COVID-19 Global Study Group.
    Lancet Respir Med. 2021 Mar 4:S2213-2600(21)00099-0. doi: 10.1016/S2213-2600(21)00099-0. Online ahead of print.
    PMID: 33676590
     
  25. Associations of resilience with quality of life levels in adults experiencing homelessness and mental illness: a longitudinal study.
    Mejia-Lancheros C, Woodhall-Melnik J, Wang R, Hwang SW, Stergiopoulos V, Durbin A.
    Health Qual Life Outcomes. 2021 Mar 4;19(1):74. doi: 10.1186/s12955-021-01713-z.
    PMID: 33663538
     
  26. Comparison of Palliative Care Delivery in the Last Year of Life Between Adults With Terminal Noncancer Illness or Cancer.
    Quinn KL, Wegier P, Stukel TA, Huang A, Bell CM, Tanuseputro P.
    JAMA Netw Open. 2021 Mar 1;4(3):e210677. doi: 10.1001/jamanetworkopen.2021.0677.
    PMID: 33662135
     
  27. A Clinical Communication Tool (Loop) for Team-Based Care in Pediatric and Adult Care Settings: Hybrid Mixed Methods Implementation Study.
    Husain A, Cohen E, Dubrowski R, Jamieson T, Kurahashi AM, Lokuge B, Rapoport A, Saunders S, Stasiulis E, Stinson J, Subramaniam S, Wegier P, Barwick M.
    J Med Internet Res. 2021 Mar 3;23(3):e25505. doi: 10.2196/25505.
    PMID: 33656445
     
  28. Drug-induced liver injury.
    Kumachev A, Wu PE.
    CMAJ. 2021 Mar 1;193(9):E310. doi: 10.1503/cmaj.202026.
    PMID: 33649170 
     
  29. Alcohol Sales and Alcohol-Related Emergencies During the COVID-19 Pandemic.
    Zipursky JS, Stall NM, Silverstein WK, Huang Q, Chau J, Hillmer MP, Redelmeier DA.
    Ann Intern Med. 2021 Mar 2:M20-7466. doi: 10.7326/M20-7466. Online ahead of print.
    PMID: 33646838
     
  30. Remdesivir for patients with COVID-19.
    Wu PE, Morris AM.
    CMAJ. 2021 Jan 25;193(4):E125. doi: 10.1503/cmaj.202505. Epub 2021 Jan 6.
    PMID: 33408097
     
  31. Twenty articles that critical care clinicians should read about COVID-19.
    Tsang JLY, Binnie A, Fowler RA.
    Intensive Care Med. 2021 Mar;47(3):337-341. doi: 10.1007/s00134-020-06329-3. Epub 2021 Jan 3.
    PMID: 33392643
     
  32. Patterns and predictors of high-cost users of the health system: a data linkage protocol to combine a cohort study and randomised controlled trial of adults with a history of homelessness.
    Wiens K, Rosella LC, Kurdyak P, Hwang SW.
    BMJ Open. 2020 Dec 30;10(12):e039966. doi: 10.1136/bmjopen-2020-039966.
    PMID: 33380481
     
  33. The case for relaxing no-visitor policies in hospitals during the ongoing COVID-19 pandemic.
    Munshi L, Evans G, Razak F.
    CMAJ. 2021 Jan 25;193(4):E135-E137. doi: 10.1503/cmaj.202636. Epub 2020 Dec 18.
    PMID: 33355198
     
  34. Association Between ABO and Rh Blood Groups and SARS-CoV-2 Infection or Severe COVID-19 Illness : A Population-Based Cohort Study.
    Ray JG, Schull MJ, Vermeulen MJ, Park AL.
    Ann Intern Med. 2021 Mar;174(3):308-315. doi: 10.7326/M20-4511. Epub 2020 Nov 24.
    PMID: 33226859
     
  35. The associations between direct and delayed critical care unit admission with mortality and readmissions among patients with heart failure.
    Raslan IR, Ross HJ, Fowler RA, Scales DC, Stelfox HT, Mak S, Tu JV, Farkouh ME, Stukel TA, Wang X, van Diepen S, Wunsch H, Austin PC, Lee DS.
    Am Heart J. 2021 Mar;233:20-38. doi: 10.1016/j.ahj.2020.11.002. Epub 2020 Nov 6.
    PMID: 33166518
     
  36. How discourses of gender equity during COVID-19 become exclusionary: Lessons from parenthood.
    Lorello GR, Kuper A, Soklaridis S, Schrewe B.
    J Eval Clin Pract. 2021 Feb;27(1):9-11. doi: 10.1111/jep.13509. Epub 2020 Nov 4.
    PMID: 33150668

Trainee Publications

  1. Drug-drug interactions with warfarin: a systematic review and meta-analysis.
    Wang M, Zeraatkar D, Obeda M, Lee M, Garcia C, Nguyen L, Agarwal A, Al-Shalabi F, Benipal H, Ahmad A, Abbas M, Vidug K, Holbrook A.
    Br J Clin Pharmacol. 2021 Mar 26.
    doi: 10.1111/bcp.14833.
    PMID: 33769581 
  2. Bearing witness to the lived experiences of the pandemic’s essential workers
    Bansal R, Agarwal A, Marwaha S.
    Healthy Debate. 2021 Mar 26.
  3. Drug treatments for covid-19: living systematic review and network meta-analysis [third update; 31 Mar 2021].
    Siemieniuk RAC, Bartoszko JJ, Ge L, Zeraatkar D, Izcovich A, Kum E, Pardo-Hernandez H, Qasim A, Martinez JPD, Rochwerg B, Lamontagne F, Han MA, Liu Q, Agarwal A, Agoritsas T, Chu DK, Couban R, Cusano E, Darzi A, Devji T, Fang B, Fang C, Flottorp SA, Foroutan F, Ghadimi M, Heels-Ansdell D, Honarmand K, Hou L, Hou X, Ibrahim Q, Khamis A, Lam B, Loeb M, Marcucci M, McLeod SL, Motaghi S, Murthy S, Mustafa RA, Neary JD, Rada G, Riaz IB, Sadeghirad B, Sekercioglu N, Sheng L, Sreekanta A, Switzer C, Tendal B, Thabane B, Tomlinson G, Turner T, Vandvik PO, Vernooij RWM, Viteri-Garcia A, Wang Y, Yao L, Ye Z, Guyatt GH, Brignardello-Petersen R.
    BMJ. 2021 Mar 31;370:m2980.
  4. A living WHO guideline on drugs for covid-19 [third update; 31 Mar 2021]
    Rochwerg B, Siemieniuk RAC, Agoritsas T, Lamontagne F, Askie L, Lytvyn L, Agarwal A, Leo YS, Macdonald H, Zeng L, Amin W, Burhan E, Bausch FJ, Calfee CS, Cecconi M, Chanda D, Du B, Geduld h, Gee P, Harley N, Hashimi M, Hunt B, Kabra SK, Kanda S, Kawano-Dourado L, Kim YJ, Kissoon N, Kwizera A, Mahaka I, Manai H, Mino G, Nsutebu E, Pshenichnaya N, Qadir N, Sabzwari S, Sarin R, Shankar-Hari M, Sharland M, Shen Y, Ranganthan SS, Souza JP, Stegemann M, Sutter AD, Ugarte S, Venkatapuram S, Dat VQ, Vuyiseka D, Wijewickrama A, Maguire B, Zeraatkar D, Bartoszko JJ, Ge L, Brignardello-Petersen R, Owen A, Guyatt GH, Diaz J, Jacobs M, Vandvik PO.
    BMJ. 2021 Mar 31;370:m3379.
  5. Therapeutics and COVID-19: living guideline
    World Health Organization [including Agarwal A – methods resource team and living systematic review/NMA team]
    WHO Headquarters: Geneva, Switzerland. 31 March 2021.
    WHO/2019-nCoV/therapeutics/2021.1
  6. Cover page: Volume 16, Issue 1.
    Gandhi P, Agarwal A.
    Can J Gen Intern Med. 2021 Mar;16:1:1.
  7. Health care in hues: Walk a mile in their shoes
    Gandhi P, Agarwal A.
    Healthy Debate. 2021 Apr 9.
  8. Pseudoaneurysm of the brachial artery in a patient who uses intravenous drugs.
    Kovacs-Litman A, Gold WL.
    CMAJ. 2021 Mar 29;193(13):E448. doi: 10.1503/cmaj.201843.
    PMID: 33782172 
  9. A Cold Case.
    Hempel AK, Gold WL, Luther RA.
    Clin Infect Dis. 2021 Mar 15;72(6):1081-1083. doi: 10.1093/cid/ciaa1638.
    PMID: 33720321 
  10. Drug-induced liver injury.
    Kumachev A, Wu PE.
    CMAJ. 2021 Mar 1;193(9):E310. doi: 10.1503/cmaj.202026.
    PMID: 33649170 

For future newsletters, please email information on your contributions to tina.teng@uhn.ca.


Copyright © 2021, Department of Medicine, University of Toronto, All rights reserved.

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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