December 2001

The Psychological Development of Very Young Children
By Yvon Gauthier, MD
Knowledge of the main variables at play in the early psychological development of a child will allow physicians to better understand this process and intervene when necessary.

Women’s Health Care
Barrier Methods of Contraception
By Jacqueline Hurst, BSc, MD
For many patients, abstinence is not an acceptable method of contraception. To prevent unplanned pregnancies and the spread of sexually transmitted infections, physicians must have a strong knowledge of the different barrier contraceptives available.

Common Mouth Diseases Part 1: Lips and Gums
By Jerzy K. Pawlak MD, MSc, PhD; Ted Kroczak MD; and Michal Sochocki, BSc
A proper mouth inspection is a very important part of a medical examination.

Diagnostic Aspects of Cystic Fibrosis
By Josée Chiarot, PhD; and Larry C. Lands, MD, PhD
As the most common lethal genetic disorder in the Caucasian population, cystic fibrosis needs to be diagnosed early to allow for appropriate treatment and genetic counselling.

My Patient and Values In the Paradigm of Health-Care Reform
By Monique Camerlain, MD, FRCPC
At a time when the Canadian health-care system is at the centre of controversy, physicians must keep in mind their responsibilities to their patients.

What’s Your Diagnosis?
"I’m Afraid It’s Not Pneumonia…"
By Jerzy K. Pawlak, MD, MSc, PhD; and Wanda Dabrowska, MD

The Medicine of History
Together Forever: The Life and Death of Chang and Eng
By Lawrence Segel, MD

November 2001

The Sports Medicine Specialist’s Approach to Legs and Ankles
By Aly S. Abdulla, BSC, MD, LMCC, CCPP, DipSportMed (CASM); and Faiza Abdulla, CDA
This is the second in a series on sports medicine. The intent of this series is to review easily diagnosed and managed musculoskeletal conditions that are commonly brought to the primary-care physician’s attention.

Women’s Health Care
Breast is Best for Babies: Part 2
By Alexander K.C. Leung, MBBS, FRCPC, FRCP(UK & Irel), FRCPCH, DCH(Lond & Irel), FRSH, FRAM, FHKCPaed, FHKAM, FAAP; and Reginald S. Sauve, MD, FRCPC
The advantages of breastfeeding, as discussed in Part 1 of this article, are many. Physicians must be aware of the related issues and problems and must know how to deal with them.

Non-Variceal Upper Gastrointestinal Bleeding
By Robert Enns, MD, FRCP
New developments in the treatment of upper gastrointstinal bleeding allow physicians to maximize the number of positive patient outcomes while minimizing costs and the length of hospital stays.

Diagnosis of the Aging Face
By David A.F. Ellis MD, FRCSC, FACS; and
Corey Moore MD, FRCSC
Treatment of the aging face requires an understanding of the basic pathophysiology of aging, the proper assessment and diagnosis of each individual component of the aging face and knowing what components the patient wants changed.

Approaching Aphthae
With Special Reference to Behçet’s Disease
By Seaver Lee Soon, MD; Suephy Chen, MD, MS; and
Mark E. Prince, MD, FRCSC
Recurrent aphthae, while often benign, can be symptomatic of a variety of severe underlying conditions. Physicians must be able to recognize such situations and treat these conditions.

The Medicine of History
Doing Bad in the Name of Good: The Tuskegee Syphilis Study
By Lawrence Segel, MD

October 2001

Overcoming a Stutter
By Carol Bock, MHSc, S-LP(C)
Through early recognition and treatment, a stutter that will reduce an individual’s quality of life can be prevented. In adults with a stutter, appropriate speech therapy can help.


Women’s Health Care: Breast is Best for Babies
By Alexander K.C. Leung, MBBS, FRCPC, FRCP(UK & Irel), FRCPCH, DCH(Lond & Irel), FRSH, FRAM, FHKCPaed, FHKAM, FAAP; and Reginald S. Sauve, MD, FRCPC
Physicians must be well versed in all aspects of breastfeeding, from the many avantages to potential problems.


Palliative Care in a Cancer Patient: A Multidisciplinary Approach
By staff from the Newfoundland Cancer Treatment and Research Foundation
Palliative care in the cancer patient demands teamwork. Physicians must have a strong understanding of the roles of team members.


A Diagnostic Approach to Pediatric Neck Lumps
By Adrian James, MA, FRCS; and Jack Friedberg, MD
A systematic approach to the diagnosis of neck lumps in children can ease what can be a difficult differential diagnosis.


The Sports Medicine Specialist’s Approach to Feet and Toes
By A.S. Abdulla, BSC, MD, LMCC, CCPP, DipSportMed (CASM); and Faiza Abdulla, CDA
Problems with feet and toes are often seen in the general practitioner’s office. This article uses cases to illustrate appropriate approaches to common conditions.

September 2001

Major Headaches in Minors —Treating Children and Adolescents
By Abdulla Al-Garni, MD; Alexander K.C. Leung, MBBS, FRCPC, FRCP (U.K. and Ireland), FRCPCH, DCH (London and Ireland), FRSH, FRAM, FHKCPaed, FHKAM, FAAP; and Jean-François Lemay, FRCPC
Headaches are common in children, and while they are frequently harmless, they can also be the initial symptom of a serious underlying disorder.

Women’s Health Care Thromboembolic Disease: Its Importance for Mother and Baby
By Laura A. Magee, MD, FRCPC, MSc; Peter von Dadelszen, DPhil, FRCSC; and Nancy Kent, MD, FRCSC
Thrombophilia screening and thromboprophylaxis of women at risk of maternal and placental VTE is an area of rapid change and great controversy. Thromboprophylaxis for almost all cases must be considered empiric.

The Diagnosis of Inflammatory Bowel Disease
By Brennan M. Walters, MD; and Bruce R. Yacyshyn, MD, FRCPC
When considering a diagnosis of inflammatory bowel disease, a physician must be aware of other diseases which bear a similar clinical presentation.

Regulatory Disorders: A New Diagnostic Classification for Difficult Infants and Toddlers
By Jean-Victor P. Wittenberg, MD, FRCPC
Regulatory disorder is a new, and not yet fully validated, diagnosis used to explain infants who present challenges to caregivers from birth.

Suicide Prevention:Identification, Assessment and Management
By Monique Séguin, PhD; and Gustavo Turecki, MD, PhD
A suicidal patient can be especially challenging for a physician to handle. Improved detection and quick referral in the primary-care setting is an important step in suicide prevention.

August 2001

Scratching Beneath the Surface:Infectious Rashes in Children
By Rupesh Chawla, MD, FRCPC; Herbert Dele Davies, MD, FRCPC; and Taj Jadavji, MD, FRCPC
Rashes are extremely common in children, but there are multiple causes. A family physician looking at the history must focus on rash progression, associated symptoms and exposures.

Women’s Health Care Venous Disease and Phlebology
By Anne-Marie Lessard, MD, LCMC
Venous disease is progressive and chronic in nature, and the earlier it is detected, the better. Today, clinical examinations and new assessment techniques enable surgeons and phlebologists to work in tandem to obtain better results.

A Systematic Approach to a Painful Wrist
By Robert Wang, BSc; Jeremy Reed, MD; James Leone, MD; Mohit Bhandari, MD, MSc; and Jaydeep K. Moro, MD, FRCSC
Wrist injuries may not be life-threatening, but they are very significant in terms of how they affect daily functioning. The causes of wrist pain vary widely and, without an accurate diagnosis, treatment becomes increasingly difficult.

Atypical Chest Discomfort: A Practical and Efficient Diagnostic Approach
By John C. Peterson, MD, FRCPC (Cardio), DABIM
The constellation of symptoms involving atypical chest pain can be a true conundrum. A solid understanding of the investigational tools available is of utmost importance to the primary-care physician.

July 2001

Why Am I Losing My Hair? A Differential Diagnosis
By Louis Weatherhead, BSc, MBBS, FRCPC
While hair loss may seem common and even natural in some cases, it is anything but for the patient who is experiencing it. Family physicians need to be aware of the root causes of hair loss, so patients can access treatment as soon as possible.

Is Your Patient’s Workplace Causing Lung Disease?
By Susan M. Tarlo, MB, BS, FRCPC
The physician cannot underestimate the importance of thinking and asking about workplace exposure in all patients, especially those with lung disease.

Maternal Serum Screening: What Do The Results Mean?
By Bernard N. Chodirker, MD
While MSS is useful way to screen for fetal neural tube defects or chromosomal abnormalities, physicians must prepare their patients for the potential for false-positive or false-negative results.

June 2001

On the Horizon:Chronic Viral Hepatitis and Chronic Liver Disease
By Morris Sherman, MB, BCh, PhD, FRCPC
With a large pool of patients currently living with hepatitis B and hepatitis C in Canada today, a sharp increase in the incidence of cirrhosis, liver failure and hepatocellular carcinoma is being predicted.

Women’s Health Care Ambulatory Management of Gestational Diabetes
By David M. Thompson, MD, Colleen J. Marshall, RN, Suet On Tong, BN, Sharon E. Kozak, BSN and Daphne Lucci, RDN, CDE
A look at some case examples of gestational diabetes (GD), which affects up to 5% of all pregnancies and, if untreated, can lead to a number of complications.

Summer Sneezes: Seasonal Allergic Rhinoconjunctivitis
By Karen Binkley, BSc, MD, FRCPC
Allergic rhinoconjunctivitis is a common condition that can seriously degrade quality of life for those afflicted.

Putting Chronic Heartburn on Ice
By James Baughan, MD, and R.J. Bailey, MD
Complaints of gastroesophageal reflux disease (GERD) such as heartburn are common in today’s population.

Exercise: A Prescription for Cancer Patients
By Aly Abdulla, BSc, MD, LMCC, CCFP, DipSportMed, and Faiza Abdulla, CDA
The overall benefits of exercise are well-known, but only recently has it been identified as an asset in the field of cancer recovery.

Tropical Fever in the Returning Traveller
By J.D. MacLean, MD
When a patient presents with fever after having travelled through tropical regions, a physician must establish an etiological diagnosis as soon as possible.

May 2001

Chronic Cough: The Keys to Diagnostic and Therapeutic Success
By Robert S. Hauptman, BMSc, MD
A chronic cough is approached with a certain degree of trepidation by many phsycians. However, most chronic coughs which present in non-smoking individuals between the ages of three and 65 are caused by no more than three easily identifiable conditions.

Women’s Health Care: Women and Stroke
Stroke risk factors specific to women and cerebrovascular disease prevention were among the subjects in a lecture delivered by Dr. Robin Brey of the University of Texas at a lecture sponsored by the Heart and Stroke Foundation of Ontario in April.

Special Supplement: Bone and Joint Health
The spotlight is on three important issues relating to bones this month:

A Systematic Approach to Adult Hip Pain, Part 2
By Robert Wang, BSc, Mohit Bhandari, MD, MSc, and Richard J. Lachowski, MD, FRCPC
A painful hip can be tricky to diagnose and challenging to treat. In the second part of this two-part article, common conditions that cause hip pain are discussed.

The Significance of Vertebral Fractures
By David A. Hanley, MD, FRCPC
Once dismissed as a cosmetic problem, the serious implications of vertebral fractures are no longer ignored. Today, tools are available to prevent a large portion of these fractures.

Common Primary Tumors of Bone
By Jeffrey M. Muir, MSc, Mohit Bhandari, MD, MSc, and R. Brett Dunlop, MD, FRCSC
Malignant bone tumors are relatively rare, yet they are a source of significant patient morbidity. A systematic approach with radiographic analysis can identify potential problematic lesions and, in consequence, save lives.

April 2001

Gastrointestinal Polyps in the Bowel
By Matt Muirhead,MD and R.J. Bailey, MD, FRCP(C
A tumurous mass protruding into the lumen of the gut known as a polyp can be an important precursor of malignant disease. Screening for polyps in the pre-malignant phase is vital, as colorectal cancer is the second leading cause of death in North America.

Women’s Health Care Epithelial Ovarian Cancer: Not So Asymptomatic
By Diane M. Provencher, MD
For women living in industrialized countries, it is the fifth most frequent cancer and presents a special challenge in identifying and managing individuals or families where ovarian cancer is hereditary. Access to new treatments may yield valuable therapeutic options.

Understanding Tremor in the Elderly
By Joel Hurwitz, MB, FRCPC, FCP
For the clinician, sorting out tremor disorders, an important and common symptom/sign in older patients, can be both challenging and rewarding in a professional sense. Distinguishing different types of tremor in the elderly demands a keen sense of observation, proper investigation anda knowledge of the range of treatment modalities available.

A Systematic Approach to Adult Hip Pain, Part 1
By Robert Wang, BSc, Mohit Bhandari, MD, MSc, and Richard J. Lachowski, MD, FRCPC
The complex anatomy and biomechanics affecting the hip are put under the magnifying glass. Determining the cause of a painful hip can be a major challenge for a physician.

Clearing The Air: Nasal Obstruction and Sinusitis
By Jack Shahin, MD, FRCPC
Respiratory infections are a common sight for the medical practitioner and the sheer volume of patients has an enormous impact on the health care system. Though often mislabeled, sinusitis is readily treatable, with excellent success rates.