McGill Journal of Medicine

Approach to: Burn Injuries

Jason — Thu, 15 Oct 2026 00:00:00 -0400

Burn injuries are trauma cases with potentially complex pathophysiology and multi-organ considerations, especially in severe cases. Serious sequelae such as compartment syndrome and inhalational injuries must be considered in victims of severe burns. Burn severity is assessed via a combination of burn area and burn depth, using methods such as the rule of nines or the Lund-Browder charts for area and clinical examination to determine depth. Mild burns can be managed on an outpatient basis by family physicians, while major burns should be referred to the local burn center for management. Non-surgical treatment of burns includes dressings, cooling, pain relief, and monitoring for infection, while surgical treatment focuses on the debridement of non-viable tissue and wound closure.

Loco-Regional Anesthesia: Building on the Past to Solve Tomorrow’s Challenges

Philippe Harris — Thu, 15 Oct 2026 00:00:00 -0400

No abstract

From Pain Relief to Perioperative Physicians: How Anesthesiologists Transformed Surgical Care Through Humanism

Tracy Liu — Thu, 15 Oct 2026 00:00:00 -0400

The evolution of anesthesiology as a medical specialty reflects a continuous humanistic commitment to relieve suffering, preserve dignity, and protect patients from avoidable harm. In the preanesthetic era, surgical care was defined by extreme pain, limited precision, and high mortality. The introduction of ether anesthesia in 1846 made pain preventable and transformed surgery into a more controlled and humane practice. As procedures grew more complex, anesthesiologists’ role expanded from inducing unconsciousness to preventing physiologic harm through airway management, monitoring, and balanced anesthesia. That same patient-safety ethic broadened their responsibilities across the surgical journey: from preoperative risk assessment and optimization to postoperative recovery, surveillance, and critical care—thus cementing anesthesiologists today as the perioperative physicians. Beyond surgery, this humanistic mission also shaped the role of anesthesiology in chronic pain medicine and palliative care, where relieving suffering and preserving dignity remain central goals. Together, these developments show that anesthesiology is not merely technical support for surgery, but a humanistic discipline grounded in patient advocacy and safety across the continuum of care.

Hypomagnesemia and hypocalcemia due to long standing protein pump inhibitor use: A severe side effect of a commonly prescribed drug

Victor Polins Pedro M.D., Oriana Hoi Yun Yu MD, MSc, F.R.C.P. — Thu, 15 Oct 2026 00:00:00 -0400

Proton pump inhibitors (PPIs) are amongst the most prescribed medications in Canada. However, they are not without risk. While there are many acute and chronic reasons for the use of these drugs, they are often prescribed with no clear indication. In this case, we describe a patient who chronically used a PPI and presented with severe hypomagnesemia and profound hypocalcemia, which caused a collapsed esophagus. After extensive workup, it was deemed that his electrolyte imbalances were most likely due to his chronic PPI use, and his symptoms quickly improved with electrolyte replacement and cessation of the drug. This case illustrates the importance of judicious use of even the most used medications and argues for monitoring of electrolytes for those who use PPIs chronically.

Injury-related pediatric emergency department visits during the first 2 years of the COVID-19 pandemic

Thu, 15 Oct 2026 00:00:00 -0400

Objectives: To quantify the impact of COVID-19 and public health measures on pediatric injury-related Emergency Department (ED) visits during the first two years of the pandemic.

Methods: Retrospective longitudinal study assessing changes in monthly incidence of injury-related ED visits during the first two years of the COVID-19 pandemic (March 2020-February 2022) at a large Canadian tertiary pediatric hospital. Monthly fluctuations were assessed overall and by age categories (0-4, 5-11, 12-17 years). Secular time-trends and seasonality were accounted for by modelling the pre-pandemic trend using a 4-year historical control (April 2016-February 2020). We examined the impact of confinement periods (March-May 2020, October 2020-February 2021, December 2021-January 2022) on monthly fluctuations.

Results: Injury-related pediatric ED visits reached a low (-45%) in March 2020 (Incidence Risk Ratio (IRR): 0.55; 95% CI 0.50-0.61) and a peak (+30%) in January 2021 (IRR: 1.30; 95% CI 1.20-1.41) relative to historical controls. All three confinement periods coincided with a reduction in injury-related ED visits, and a re-increase once confinement ended. Fluctuations in injury-related ED visits differed between age groups, with no major change among 0-4-year-olds, a 56% reduction in visits at the onset of the pandemic among 5-11-year-olds (IRR: 0.44; 95% CI 0.37-0.54) and a 64% reduction among 12-17-year-olds (IRR: 0.36; 95% CI 0.28-0.45).

Conclusions: The consequences of COVID-19 on pediatric injury extended far beyond the first few months of the pandemic and varied according to age. Understanding the impact of confinement on pediatric injury may assist the development of injury prevention strategies and improve resource allocation.

Medical and Surgical Concerns in Paediatric Patients with Achondroplasia: A Retrospective Chart Review

Thu, 15 Oct 2026 00:00:00 -0400

Background: Achondroplasia is the most common skeletal dysplasia and is associated with a wide range of medical and surgical comorbidities beyond short stature. Comprehensive descriptions of the clinical manifestations and management of these comorbidities within paediatric populations remain limited. We aimed to describe the spectrum of medical and surgical comorbidities and their management in paediatric patients with achondroplasia seen at a tertiary care centre.

Methods: We created a registry of patients seen at the Skeletal Dysplasia Clinic and conducted a retrospective cohort study of 60 patients with achondroplasia seen between January 2018 and October 2021. We collected longitudinal data on referrals, medical concerns, and medical and surgical management.

Results: Among the 60 patients included, neurological and orthopedic concerns were commonly observed. Foramen magnum stenosis/cervicomedullary compression required surgery in 37% of patients. Genu varum was treated operatively in 23% of patients. Central sleep apnea affected 25% of patients, and obstructive sleep apnea affected 62%. Fifty-three percent of patients underwent tonsillectomy/adenoidectomy surgery, and 18% received a continuous positive airway pressure (CPAP) machine. Auditory concerns were also prevalent, and myringotomy tubes were inserted in 48% of patients.

Conclusion: Paediatric patients with achondroplasia experience a broad range of medical and surgical comorbidities requiring multidisciplinary management. This study describes the spectrum of clinical manifestations and management strategies observed in a tertiary care setting and highlights the complexity of care required for this population.

Cardiac Involvement in Melanoma: A Review of Clinical Manifestations and Management Strategies

Dr., Dr. , Ethan Bendayan — Thu, 15 Oct 2026 00:00:00 -0400

Cardiac involvement in melanoma, while clinically uncommon, presents significant diagnostic and therapeutic challenges due to its often silent course and nonspecific manifestations. Melanoma, a highly metastatic skin cancer, can spread to the heart, often remaining asymptomatic until advanced stages, when it may cause nonspecific symptoms such as chest pain and arrhythmias. This review explores the epidemiology, pathophysiology, and clinical manifestations of melanoma-related cardiac metastases, emphasizing the importance of advanced imaging techniques for early detection. It also discusses current management strategies, including immunotherapy and targeted therapies, which have improved survival outcomes. However, despite these advances, the prognosis for patients with cardiac metastases remains poor, highlighting the need for further research into more effective treatments.

The roles of perivascular adipose tissue in obesity-related hypertension

Cam Ly Nguyen, Ernesto L. Schiffrin — Thu, 15 Oct 2026 00:00:00 -0400

Background: Obesity and hypertension (HTN) are two of the most prevalent and pressing current global health issues due to their associated morbidity and mortality. Obese individuals are more susceptible to developing HTN. Perivascular adipose tissue (PVAT) has been posited to be the fourth layer of the normal arterial wall. PVAT can modulate vascular tone, vascular endothelial function, and vascular smooth muscle cell growth and proliferation, contributing to HTN.

Results: In obesity-related HTN, PVAT exhibits abnormal vasoactive adipokine production and immune cell recruitment as well as enhanced inflammation, which exacerbate blood pressure elevation and lead to target organ damage. Distinct immune cell populations have been identified to infiltrate PVAT, which can become potential therapeutic targets.

Conclusion: This paper reviews PVAT dysfunction in obesity-related HTN, highlighting the vasoactive factor release, immune cell infiltration, and inflammation, as well as implications for therapeutic approaches.

The 14th edition of the Dr. Richard Deckelbaum Global Surgery Conference Abstracts

Thu, 15 Oct 2026 00:00:00 -0400

Using Gamification to Improve Medical Student Education: An Emphasis on Anatomy, Pathology, and Pharmacology

Nabeel Abu-Mahfouz — Thu, 15 Oct 2026 00:00:00 -0400

Traditionally, medical training utilized rote memorization strategies, didactic lectures, and dissections of cadaveric donors to convey information. As significant as these traditional methodologies have been in shaping medical training, they often fail to maintain student engagement and do not always foster the deep conceptual understanding necessary for clinical proficiency. Given the high cognitive loads experienced by medical students, new methodologies that maximize motivation, recall, and hands-on practice are increasingly researched. Gamification, defined as the integration of game elements such as points, levels, rewards, leaderboards, and interactive simulations, has gained traction as an effective educational tool.

This article addresses the use of gamification in medical education, namely in pathology, anatomy, and pharmacology. Empirical studies are utilized to examine how educational tools with a gamified format enhance motivation, problem-solving, and the application of information. Key advantages include increased student engagement, improved recall, and a more interactive approach to medical training. However, challenges such as cognitive overload, varied student preferences, and resource constraints are also analyzed. By evaluating the effectiveness and limitations of gamification, this paper contributes to a growing discourse on innovative educational strategies that can improve medical training, with the goal of better preparing students for clinical practice.