CMAJ open
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Multicenter Study Comparative Study Observational Study
Comparative effectiveness and safety of direct oral anticoagulants versus vitamin K antagonists in nonvalvular atrial fibrillation: a Canadian multicentre observational cohort study.
Direct oral anticoagulants (DOACs) have widely replaced warfarin for stroke prevention in nonvalvular atrial fibrillation. Our objective was to compare the safety and effectiveness of DOACs (dabigatran, rivaroxaban, apixaban) versus warfarin for stroke prevention in nonvalvular atrial fibrillation in the Canadian setting. ⋯ In this real-world study, DOACs were associated with similar risks of ischemic stroke or systemic embolization, and lower risks of bleeding and total mortality compared to warfarin. These findings support the use of DOACs for anticoagulation in nonvalvular atrial fibrillation.
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There is high risk of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in congregate settings, including shelters. This study describes a coronavirus disease 2019 (COVID-19) outbreak and corresponding reported symptomatology at a shelter in Toronto. ⋯ We found a high rate of SARS-CoV-2 infection in this shelter population. Our study underscores the high risk of SARS-CoV-2 transmission in congregate living settings and the importance of mobilizing timely testing and management of symptomatic, paucisymptomatic and asymptomatic residents in shelters.
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Many youth report driving under the influence of cannabis (DUIC) and riding with a cannabis-impaired driver (RWCD), and many perceive that cannabis causes limited impairment. We examined associations of perceived risk of regular cannabis use with DUIC and RWCD, exploring differences by sex and rural setting. ⋯ Students perceiving minimal risk from cannabis use reported greater engagement in cannabis-related risky driving behaviours. Given the importance of youth perceptions in shaping driving and passenger behaviours, efforts must be made to disseminate appropriate information regarding cannabis-related driving risks to high school students.