CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Delay to breast cancer diagnosis following an abnormal screening result is associated with anxiety and personal disruption. We assessed the patterns and timeliness of diagnostic follow-up after breast cancer screening for women with abnormal results who attended organized screening programs in 7 provinces. ⋯ Women undergoing assessment of an abnormal breast cancer screening result waited many weeks for a diagnosis, especially when a biopsy was performed. To ensure that targets for timeliness, adopted nationally in 1999, are realized, improved models of care or dissemination of existing efficient techniques to reach a diagnosis will be needed.
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Tissue plasminogen activator (tPA) injected intravenously within 3 hours of symptom onset has emerged as a treatment option for acute ischemic stroke. Although controversial and not universally accepted, its use in carefully selected patients is supported by evidence from randomized controlled trials and by mounting community experience. ⋯ Then we summarize a growing literature of postmarketing phase IV studies and discuss the limitations and challenges that lie ahead. Our aim is to provide clinicians with an overview of this evolving therapy.
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Brain injury is an important health concern, yet there are few population-based analyses on which to base prevention initiatives. This study aimed, first, to calculate rates of potential brain injury within a defined Canadian population and, second, to describe the external causes, natures and disposition from the emergency department of these injuries. ⋯ The results indicate the relative importance of several external causes of injury. The findings from our geographically distinct population are useful in establishing rational priorities for the prevention of brain injury.