The Canadian Journal of Diagnosis

2001 • 2002 • 2003 • 2004 • 2005 • 2006 • 2007 • 2008 • 2009 • 2010 • 2011 • 2012

	*December 2003* Feature 1 Blood Sugar Blues: Hypoglycemia and Antidepressants By Rachel Carson, BEng, MD There are several published case reports of the effects of antidepressants on glucose homeostasis. Dr. Carson takes a look at how some drugs can potentiate hypoglycemia. Feature 2 Anxiety Therapy Toolkit: 7 Suggestions for Busy Practitioners By Elspeth A. MacEwan, MD, FRCPC Patients with anxiety generally respond best to a combination of medication and psychotherapy. Dr. MacEwan lists some helpful treatment tips for general practitioners. Feature 3 Relief Without Addiction: Opiates for Chronic Pain By Howard Wu, MD, CCFP Discover the best treatment options for chronic pain and learn how to recognize addiction in your patients. Feature 4 What To Do About Venous Stasis Disease By Siobhan Ryan, MD, FRCPC; Gary Sibbald, MD, FRCPC; and Patricia Couts, RN Chronic venous insufficiency presents as a spectrum of features, but how are these features managed? This article provides some answers. Case of the Month “I can’d tawk pwobbewy” By Ryan Hennebury, MD, CCFP; and Sam G. Campbell, MB BCh, CCFP(EM) Emergency Department’s (ED) Case of the Month is a series of articles discussing topics important to family physicians working in the ED. Case in Point “What’s growing on my ear?” By Benjamin Barankin, MD This department features a case and discussion—tools for your daily practice. You Asked We Answered Answers to your questions from our medical experts This month: Obesity and metabolic rates RhoGAM® during pregnancy What’s Your Diagnosis? “Doctor, why can’t I eat?” By David Yue, MD Mr. Smith, a 58-year-old smoker, presented with a hoarse voice, which has persisted for four weeks. He was also noted to have a decreased appetite for the last month and weight loss of 60 pounds over the last 12 months. Photo Diagnosis Illustrated quiz on problems seen in everyday practice (various entries). ECG Clinic Review ECGs with a specialist from the University of Western Ontario, and the London Health Sciences Centre. Update Abstracts and news from the medical literature of interest to the primary care physician. This month: Asthma: From children to adults TEE and predicting recurrent stroke Malaria and globalization Can refractory dyspnea be managed with morphine? Women’s Health Abnormal Uterine Bleeding What’s the Cause? By Christine M. Derzko, MD, FRCSC This department features various topics in women’s health. Just Click It! A look at common medical issues on the Web This month: Mononucleosis CME Credit Quiz This test offers the opportunity to assess your knowledge and retention of the information presented in the articles in this issue. This test is prepared with the Dalhousie University CME department. Medical Briefs An abridged look at current events in and around the health-care industry. This month: Ketek™ approved in Canada New indication for Pariet™ Positive results in juvenile rheumatoid arthritis study New data in cardiovascular disease prevention The Best Medicine Funny medical anecdotes plus a cartoon!
	*November 2003* Feature 1 Botulinum Toxin: A New Alternative for Pain By James Filbey, MD, FRCPC Musculoskeletal pain is the second most common complaint heard by general practitioners. A newer approach is the use of botulinum toxin type A (BTX-A), which is emerging as a useful and effective treatment for a variety of soft tissue and musculoskeletal disorders. Feature 2 Drug Interactions: Coping With Chaos! By Kevin Pottie, MD, MCISc, CCFP; and Sheri Koshman, BSc Pharm As new drugs continue to emerge, family physicians face the formidable task of coping with the reality of drug interactions. This article presents a technology-enabled, practical approach to drug interactions. Feature 3 Focus On: Anemia in the Elderly By Peter R. Duggan, MD, FRCPC Anemia is a common finding in elderly patients. Dr. Duggan reviews the different types of anemia and the treatments available for each. Feature 4 Asthma: Clearing the Way By Warren Davidson, MD, FRCPC; and Tony R. Bai, MD, FRACP, FRCPC If left untreated, asthma can diminish a person’s quality of life. This article gives some insight on how to treat this common respiratory illness. Case of the Month “Take truce with the unruly spleen...” Bijon Das, MD, CCFP(EM); and Sam G. Campbell, MB BCh, CCFP(EM) Emergency Department’s (ED) Case of the Month is a series of articles discussing topics important to family physicians working in the ED. Case in Point “Doctor, I can’t stop the bleeding!” By Jerzy Pawlak, MD, MSc, PhD This department features a case and discussion—tools for your daily practice. Talking To Your Patients Calming the Angry Patient By Jason W. Busse, DC, MSc; and Mohit Bhandari, MD, MSc, FRCSC This department features ways in which family physicians can improve communication with their patients. What’s Your Diagnosis? “Can it be breast cancer?” By Mira Parai, MD, FRCPC; Mary Wells, MD, FRCSC; and Sushil Parai, MD, FRCPC Jenny, 86, presented with bilateral breast masses. Clinical and radiologic examinations were alarming enough to refer the patient to a surgeon for biopsy. Jenny had no other medical or surgical conditions. Photo Diagnosis Illustrated quiz on problems seen in everyday practice (various entries). ECG Clinic Review ECGs with a specialist from the University of Western Ontario, and the London Health Sciences Centre. Update Abstracts and news from the medical literature of interest to the primary care physician. This month: Potential Treatment for Cardiogenic Shock Testing for and Treating Influenza is Cost-Effective Depression Treatments Work for Optimizing the Smallpox Vaccine Cochlear Implants Associated With Meningitis? Women’s Health Pap Reports: What Now? By Prafull Ghatage, MB, ChB, FRCSC This department features various topics in women’s health. Just Click It! A look at common medical issues on the Web This month: GERD CME Credit Quiz This test offers the opportunity to assess your knowledge and retention of the information presented in the articles in this issue. This test is prepared with the Dalhousie University CME department. Medical Briefs An abridged look at current events in and around the health-care industry. This month: Cialis™ approved for ED Flexible dosing asthma treatment Ontario Drug Benefit now includes Plavix® Oral contraceptives
	*October 2003* Feature 1 Easing the Ouch: Relieving Short-Term Pain By Brian Goldman, MD, MCFP(EM) Pain is one of the most frequent clinical problems facing primary care physicians. Distinguishing the cause of the pain helps determine the most effective treatment. Dr. Goldman reviews the current treatment options. Feature 2 How Do I Screen For Colorectal Cancer? By Ted M. Ross, MD, FRCS(C); and Naomi Ross, RD, BSc Colorectal cancer is the second leading cause of death from cancer in Canada. This type of cancer is ideal for screening, but who should be screened and what tests are available? 20th Anniversary Special By medical specialists from across Canada Join us, and 11 medical experts in celebrating The Canadian Journal of Diagnosis’ 20th anniversary! Physicians from various fields of medicine—from cardiology to obstetrics to emergency medicine—discuss the changes, which, over the last 10 years, have shaped the way we practise medicine. *Topics:* 1. Cardiology by Ross Feldman, MD, FACP, FRCPC, on behalf of the Canadian Hypertension Education Program 2. Dermatology by Elizabeth O’Brien, MD, FRCPC 3. Infectious Diseases by John M.A. Embil, MD, FRCPC 4. Neurology by Serge Gauthier, MD, FRCPC 5. Obstetrics & Gynecology by Fay G. Weisberg, MD, FRCSC 6. Gastroenterology by Khursheed Jeejeebhoy, MBBS, PhD, FRCP, FRCPC 7. Endocrinology by M. Usman Chaudhry, MD, FACE 8. Emergency Medicine by Sam G. Campbell, MB BCh, CCFP(EM) 9. Rheumatology by Monique Camerlain, MD, FRCPC; and Denis Morrice, President and CEO, The Arthritis Society 10. Respirology by Cherdchai Nopmaneejumruslers, MD; and Charles K.N. Chan, MD, FRCPC, FCCP, FACP 11. Psychiatry by Yvon D. LaPierre, MD, MSc, FRCPC Case of the Month “It doesn’t hurt, but it does smell!” By Sam G. Campbell, MB BCh, CCFP(EM); Pat Croskerry, MD, PhD, CCFP(EM); and Jiri Dubec, MD, CCFP Emergency Department’s (ED) Case of the Month is a series of articles discussing topics important to family physicians working in the ED. Case in Point “Is it skin cancer?” By Benjamin Barankin, MD This department features a case and discussion—tools for your daily practice. Talking To Your Patients Informed Consent: Participating in Clinical Studies By Sheila Sprague, BSc; Beate P. Hanson, MD, MPH; and Mohit Bhandari, MD, MSc, FRCSC This department features ways in which family physicians can improve communication with their patients. Update Abstracts and news from the medical literature of interest to the primary care physician. This month: Vaccines: Is Younger Better? HRT and Breast Cancer Risk Depression Treatments Work for Low-Income Patients What’s Your Diagnosis? “What does this lump mean?” By Jerzy Pawlak, MD, MSc, PhD Chris, 52, presented with a mass on the right side of his neck which had been growing for the last two months. He has significant alcohol and smoking history, but otherwise has no significant past medical history. Photo Diagnosis Illustrated quiz on problems seen in everyday practice (various entries). ECG Clinic Review ECGs with a specialist from the University of Western Ontario, and the London Health Sciences Centre. Just Click It! A look at common medical issues on the Web This month: Asthma CME Credit Quiz This test offers the opportunity to assess your knowledge and retention of the information presented in the articles in this issue. This test is prepared with the Dalhousie University CME department. Medical Briefs An abridged look at current events in and around the health-care industry. This month: Quitting smoking Epilepsy treatment Prostate cancer Strokes and the ACCESS trial The Best Medicine Funny medical anecdotes plus a cartoon!
	*September 2003* Feature 1 Is There an Alternative? Homeopathy in Medicine By Mel Borins, MD, CCFP, FCFP There are many controversies surrounding the use of homeopathy. The main questions are: Does it work? and What role can a medical physician play in the treatment of patients who use this alternative? Dr. Borins clues us in. Feature 2 Face to Face: Aggression in the Elderly By Adrienne F. Cohen, MD, BSc, FRCPC Caregivers consider aggression the most serious problem they encounter in dementia. Dr. Cohen reviews the approaches to dealing with aggression in the elderly and explains the difference between typical and atypical antipsychotic agents. Feature 3 Good Bones, Good Health, Good Life A Look at Osteoporosis By Monique Camerlain, MD, FRCPC Elderly patients with osteoporosis have a right to wellness. Dr. Camerlain goes over the tools physicians can use to provide their patients with good bones, good health, and a good life. Case of the Month “What was I thinking?” By Sam G. Campbell, MB BCh, CCFP(EM); Pat Croskerry, MD, PhD, CCFP(EM); and Jiri Dubec, MD, CCFP Emergency Department’s (ED) Case of the Month is a series of articles discussing topics important to family physicians working in the ED. Case in Point “What’s growing on my arm?” By Benjamin Barankin, MD This department features a case and discussion—tools for your daily practice. Talking To Your Patients Saying A Lot Without Saying A Word By Gary Matthys, MD; Emil H. Schemitsch, MD, FRCSC; and Mohit Bhandari, MD, MSc, FRCSC This new department features ways in which family physicians can improve communication with their patients. Update Abstracts and news from the medical literature of interest to the primary care physician. This month: Obesity and post-operative complications Health education via the Internet Smallpox vaccine ß-carotene and vitamin E efficacy Missing a celiac disease diagnosis What’s Your Diagnosis? “Doctor, am I dying?” By Jerzy Pawlak, MD, MSc, PhD Grace, a 77-year-old non-smoker, non-drinker with a medical history of phlebitis, varicose vein stripping, and cholecystectomy, presents to the emergency department with shortness of breath, weakness, and history of syncope. Photo Diagnosis Illustrated quiz on problems seen in everyday practice (various entries). ECG Clinic Review ECGs with a specialist from the University of Western Ontario, and the London Health Sciences Centre. Women’s Heallth What Says It’s Polycystic Ovary Syndrome? By Donna R. Chizen, BSc, MD, FRCSC Just Click It! A look at common medical issues on the Web This month: Allergic Rhinitis CME Credit Quiz This test offers the opportunity to assess your knowledge and retention of the information presented in the articles in this issue. This test is prepared with the Dalhousie University CME department. Medical Briefs An abridged look at current events in and around the health-care industry. This month: Depression, sleeplessness, and anxiety Osteoporosis in men Keeping patients on their thyroid supplements GERD and PPIs First topical antiarthritic in Canada Relief for COPD patients The Best Medicine Funny medical anecdotes plus a cartoon!
	*August 2003* Feature 1 To Treat or Not to Treat? Androgen Decline in the Aging Male By Donald Morrish, MD, PhD, FRCPC Recent studies show a definite decline in testosterone with advancing age. But is testosterone replacement the answer? Dr. Morrish explains the risks and benefits of this therapeutic option. Feature 2 What’s the Buzz? The Latest on HRT By Victoria J. Davis, MD, FRCSC With the barrage of studies being published about hormone replacement therapy, it can be difficult for physicians to maintain a balanced approach to treatment. Dr. Davis puts the latest data from the Women’s Health Initiative into perspective. Feature 3 On the Table: Food Allergies By Peter Vadas, MD, PhD, FRCPC, FACP Virtually any food is capable of inducing an allergic reaction. Find out how to characterize an allergen and how to diagnose and treat food allergies. Feature 4 Making the Right Call With Community-Acquired Pneumonia By Thomas J. Marrie, MD Learn how to diagnose pneumonia and discover tests that can help you determine its cause. Case of the Month All Stiff Necks are Not Created Equal By Ed Cain, MD, FRCP; and Sam G. Campbell, MB BCh, CCFP(EM) Emergency Department’s (ED) Case of the Month is a series of articles discussing topics important to family physicians working in the ED. Case in Point At Your Fingertips: Raynaud’s Disease By Jerzy Pawlak, MD This department features a case and discussion—tools for your daily practice. Talking To Your Patients “Doctor, everything hurts!” By Jason W. Busse, DC, MSc; and Mohit Bhandari, MD, MSc, FRCSC This new department features ways in which family physicians can improve communication with their patients. Update Abstracts and news from the medical literature of interest to the primary care physician. This month: Pain in children Cultured grafts Diabetes and diet Antibiotic resistance What’s Your Diagnosis? Mosquitoes on the Attack? By Irving Salit, MD, FRCPC In early September, while in central Ontario, Peter, 61, noted fever, urinary frequency, dysuria, abdominal pain, back pain, and achiness in his legs. He was started on ciprofloxacin and phenazopyridine, but he did not improve. Photo Diagnosis Illustrated quiz on problems seen in everyday practice (various entries). ECG Clinic Review ECGs with a specialist from the University of Western Ontario, and the London Health Sciences Centre. Just Click It! A look at common medical issues on the Web This month: Anemia CME Credit Quiz This test offers the opportunity to assess your knowledge and retention of the information presented in the articles in this issue. This test is prepared with the Dalhousie University CME department. Medical Briefs An abridged look at current events in and around the health-care industry. *This month:* Reducing “Bad” Cholesterol Good News for People With Diabetes Researcher Rewarded Some Relief for Constipation The Best Medicine Funny medical anecdotes plus a cartoon!
	*July 2003* Feature 1 Setting a New Standard Early Detection of Osteoporosis By Aliya Khan, MD, FRCPC, FACP and the ISCD Canadian Panel The International Society for Clinical Densitometry recently developed a new guideline for the practice of bone densitometry in Canada. Dr. Khan provides a summary of this first-ever comprehensive guide. Feature 2 Poorly Understood Conditions of the 21st Century By Lynn M. Marshall, MD, FAAEM, FRSM; Alison C. Bested, MD, FRCPC; and Riina I. Bray, BASc, MSc, MD, CCFP Review the symptoms and treatment of such poorly understood conditions as chronic fatigue syndrome, fibromyalgia, and multiple chemical sensitivity. Feature 3 A Breath of Life Advances in COPD By Dave C. Todd, MD; and Darcy D. Marciniuk, MD, FRCPC Learn how to diagnose and treat chronic obstructive pulmonary disease, an illness that affects more than 500,000 Canadians over 35. Feature 4 A Plethora of Options Antithrombotics Review By Mike McDonald, BSc, MD; and Robert C. Welsh, MD, FRCPC, FACC A summary of the most effective treatments for acute ST segment elevation myocardial infarction and acute coronary syndromes. Case of the Month The Back Pain Trap By Sam G. Campbell, MB, BCh, CCFP(EM) Emergency Department’s (ED) Case of the Month is a series of articles discussing topics important to family physicians working in the ED. Case in Point “What is this Numbing Sensation?” By David Yue, MD This new department features a case and discussion—tools for your daily practice. Talking To Your Patients Every Patient Has a Story By Komal Bhandari, MSW; and Mohit Bhandari, MD, MSc, FRCSC This new department features ways in which family physicians can improve communication with their patients. Update Abstracts and news from the medical literature of interest to the primary-care physician. This month: Vasodilators for aortic stenosis Pro-BNP Primary care patients with depression Baby sleep positions Weight Watchers® diet TIAs in the ED Acne treatment New GERD treatment Bipolar disorder Laparoscopic hernia repair What’s Your Diagnosis? “Why Do I Feel So Tired?” By Lynn M. Marshall, MD, FAAEM,FRSM; Alison C. Bested, MD, FRCPC; and Riina I. Bray, BASc, MSc, MD, CCFP Marie, a 37-year-old single oncology nurse presents to your office with daily symptoms of severe nausea, fatigue, difficulty concentrating and remembering, and aching muscles. Over the last few months, she has felt worse on encountering fresh paint, auto exhaust fumes, tobacco smoke, and scented products, which smell much stronger to her than they used to. Photo Diagnosis Illustrated quiz on problems seen in everyday practice (various entries). ECG Clinic Review ECGs with specialists from the University of Western Ontario, and the London Health Sciences Centre. CME Credit Quiz This test offers the opportunity to assess your knowledge and retention of the information presented in the articles in this issue. This test is prepared with the Dalhousie University CME department. Medical Briefs An abridged look at current events in and around the health-care industry. This month: Kiss Cold Sores Goodbye New Antidepressant Lowers Sexual Dysfunction Rate Improving Compliance in Patients With Bipolar Disorder New Eczema Treatment is Steroid-Free Survey Shows Better Use of Asthma Medication New Twist on an Old Formula A First in Type 2 Diabetes Treatment “Real World” Solutions for Schizophrenia Another Option for COPD Patients Combination Therapy for Low Testosterone The Best Medicine Funny medical anecdotes plus a cartoon!
	*June 2003* Feature 1 The ABCs of Hepatitis C A Primer for Family Physicians By Gilles D. Pinette, BSc, MD, CCFP Hepatitis C will have a significant effect on the Canadian medical landscape in the next 10 years. Dr. Pinette reviews the different types of infections (acute vs. chronic) and the treatments available. Feature 2 Stop the Clot! The Latest Anticoagulants By Kulit S. Grewal, MD, FRCPC There are currently a large variety of anticoagulant therapies available. From warfarin to factor Xa inhibitors, Dr. Grewal runs down the latest options. Feature 3 The Ongoing Battle Against MS By Mary Lou Myles, MD, FRCPC Follow the cases of Mary, James, and Kate, as Dr. Myles takes us through the diagnosis, treatment, and side-effect management of multiple sclerosis. Case of the Month “Oh Doctor, My Head!” By Sam G. Campbell, MB, BCh, CCFP(EM) Emergency Department’s (ED) Case of the Month is a series of articles discussing topics important to family physicians working in the ED. Case in Point Breathing Easy By George Porfiris, MD, CCFP(EM) This new department features a case and discussion—tools for your daily practice. Talking To Your Patients “What Would You Do If You Were in My Shoes?” By Victor M. Montori, MD, MSc; and Mohit Bhandari, MD, MSc, FRCSC This new department features ways in which family physicians can improve communication with their patients. The Den This department offers thoughtful stories and anecdotes by Canadian general practitioners. This month: No, thank YOU by Benjamin Barankin, MD Update Abstracts and news from the medical literature of interest to the primary-care physician. This month: Skin tightening Side-effects of SSRIs Should paramedics intubate? Interferon therapy Link between hormone therapy and breast cancer Nonsedating antihistamines Can flu vaccines prevent cardiac disease? Eplerenone in post-MI patients Anticipating neurologic damage What’s Your Diagnosis? “Why Am I Spitting Up Blood?” By Jerzy K. Pawlak, MD, MSc, PhD; and Wanda Dabrowska, MD A 78-year-old male has a long history of diabetes, hypertension, and hypercholesterolemia. He had a history of smoking at least 50 packs of cigarettes per year, but stopped smoking 18 years ago. However, he is still exposed to second-hand smoke, as his wife is a heavy smoker. Photo Diagnosis Illustrated quiz on problems seen in everyday practice (various entries). ECG Clinic Review ECGs with specialists from the University of Western Ontario, and the London Health Sciences Centre. CME Credit Quiz This test offers the opportunity to assess your knowledge and retention of the information presented in the articles in this issue. This test is prepared with the Dalhousie University CME department. Medical Briefs An abridged look at current events in and around the health-care industry. This month: New Role for Cozaar® STARTing Asthma Treatment Early Zometa®: A Broad Range of Functions Satisfaction Guaranteed With Levitra™ Altace®: Efficient and Cost-Effective for Heart Failure A More Economical Epilepsy Treatment Lipitor® Reducing Risk of Heart Attack and Stroke New Hope for Breast Cancer Patients Double the Dosage of URSO™ Pumping Up! The Best Medicine Funny medical anecdotes plus a cartoon!
	*May 2003* Feature 1 Too Many Sleepless Nights Looking at Obstructive Sleep Apnea By Valerie G. Kirk, MD, FRCPC Dr. Kirk discusses the clinical features of Obstructive sleep apnea (OSA), how to diagnose OSA, and the treatment options for OSA. Feature 2 The Limiting Factor: The Link Between Hypoglycemia and Diabetes By Vincent Woo, MD, FRCPC Dr. Woo discusses how hypoglycemia and oral antihyperglycemic agents are linked, how hypoglycemia and insulin are linked, and how hypoglycemia is treated. Feature 3 What’s New in The Treatment of Dementia? By David Hogan, MD, FACP, FRCPC Dr. Hogan discusses the symptoms of Alzheimer’s disease, the medications available, and the response you can anticipate from some of these medications. Feature 4 A Pain in The Ankle: How to Assess By Thomas Woods, BA/BPHE, BEd, MSc; James Leone, MD; Beate Hanson, MD, MPH; and Mohit Bhandari, MD, MSc, FRCSC There are an estimated 500,000 ankle injuries occurring in Canada each year. This article discusses what to look for in a physical exam, what type of tests should be done, and how to assess traumatic and non-traumatic ankle pain. Case of the Month “What Happened? Did I Faint?” By Ismail Cajee, MB, ChB, CCFP (EM), DA; and Sam Campbell, MB, BCh, CCFP (EM) Emergency Department’s (ED) Case of the Month is a series of articles discussing topics important to family physicians working in the ED. Case in Point Common Signs, Uncommon Disease By M. Usman Chaudhry, MD This new department features a case and discussion — tools for your daily practice. Talking To Your Patients Risky Business: Weighing the Risks of Therapy With Your Patients By Mohit Bhandari MD, MSc, FRCSC; Vikas Khera, BSc; and Holger Shünemann MD,PhD This new department features ways in which family physicians can improve communication with their patients. The Den This department offers thoughtful stories and anecdotes by Canadian general practitioners. This month: A Patient to Remember by Andrew W. Trevor, MD Update Abstracts and news from the medical literature of interest to the primary-care physician. This month: Does CRP Predict Inducible Ischemia? Is Carvedilol Safe for Patients With CHF? What’s the Deal With Vertebroplasty & Kyphoplasty? Ear Infections be Gone! Nondiabetic Renal Disease and Combination Therapy Reducing Morbidity in Type 2 diabetes: A Multifactorial Intervention Difficulties Diagnosing the Flu in Vaccinated Adults What’s Your Diagnosis? “Why is my Skin so Fragile?” By Elizabeth Satter MD; and Catherine Maari, MD, FRCPC Mr. Young, a 67-year-old homeless male, was admitted to the hospital for a course of intravenous antibiotic for severe pneumonia. He has multiple, small 3 mm to 4 mm, erosions and scars on the dorsum of his hands and face, mostly in areas of sun exposure Photo Diagnosis Illustrated quiz on problems seen in everyday practice (various entries). ECG Clinic Review ECGs with specialists from the University of Western Ontario, and the London Health Sciences Centre, CME Credit Quiz This test offers the opportunity to assess your knowledge and retention of the information presented in the articles in this issue. This test is prepared with the Dalhousie University CME department. Medical Briefs An abridged look at current events in and around the health-care industry. This month: Can Sunscreen Irritate My Skin? Enalapril helps Fight Diabetes as Well Gleevec Helps Patients With Newly Diagnosed CML Stomping Out Community-Acquired Pneumonia Things Are Looking Up for Patients with ED A New Agent in The Battle Against H.Pylori Patients With COPD Can Breath Easier First New Treatment Approved in Nine Years for Bipolar Disorder The Best Medicine Funny medical anecdotes plus a cartoon!
	*April 2003* Feature 1 Why Can’t I Eat Bread? Dealing With Celiac Disease By Flavio Habal, MD, PhD, FRCP A 31-year-old female was referred for assessment of elevated liver enzymes and fatigue. Dr. Habal discusses how to investigate celiac disease, the treatment options, and what type of followup is required. Learn all about the gluten-free diet. Feature 2 Not Just the Teenage Blues: Adolescent Depression and Suicidality By Brian Greenfield, MD, FRCP, ABPN Melanie, 15-years-old, is brought to the emergency room after her school guidance counsellor is told she is thinking about suicide. Dr. Greenfield discusses how to recognise depression, the genetic and biologic factors, and how to treat pediatric depression. Feature 3 Hemochromatosis: A Primer for GPs By Dawna Gilchrist, MD; Loree Larratt, MD; and A. Robert Turner, MD This article delves into the issue of genetic screening for hemochromatosis. Dr. Gilchrist, Dr. Larratt and Dr. Turner discuss the advantages and disadvantages of genetic diagnosis and how to treat a patient with HFE hemochromatosis. Feature 4 What To Do About Ear Trauma: Investigating the Common Concerns By Vitaly E. Kisilevsky, MD; N. Prepageran, MD, FRCS; Michael Hawke, MD, FRSC; and John A. Rutka, MD, FRCS Since physicians who are not specially trained in otology often provide the initial care of ear injuries, proper recognition and treatment are critical to avoid possible complications, and to improve treatment outcomes. This article looks at how to treat external, middle and inner ear trauma. Case of the Month All That Glitters is Not Gold By Kirk Magee, MD, FRCPC; and Sam G. Campbell, MB BCh, CCFP(EM) Emergency Department’s (ED) Case of the Month is a series of articles discussing topics important to family physicians working in the ED. Case in Point What Are These Sores in My Mouth? By Mitchell B. Rubin, MD This new department features a case and discussion — tools for your daily practice. Talking To Your Patients Communicating Bad News to Diverse Patient Populations By Mohit Bhandari, MD, MSc, FRCSC; and Sonia Dosanjh, MSW This new department features ways in which family physicians can improve communication with their patients. The Den This department offers thoughtful stories and anecdotes by Canadian general practitioners. This month: An Unforgettable Gift by Dennis Glubish, MD, CCFP, FCFP Update Abstracts and news from the medical literature of interest to the primary-care physician. This month: New Surgical Approach to Obesity How Common is Diastolic Dysfunction? Crohn’s Disease: New Risk Factor Diuretics Versus ACE Inhibitors For Hypertension How Accurate is The Clinical Diagnosis of Dementia? Treating Nevi With Lasers: Safe and Effective? Laparoscopic Fundoplication for GERD Lyme Disease Without the Rash What’s Your Diagnosis? Doctor! I Can’t Stand The Noise in my Ear! By Wladyslaw Wojcik, MD, FRCP(C); Jerzy K. Pawlak, MD, MSC, PhD; and Russell Knaus, MD, CCFP A 46-year-old lady presented with a history of troubling whistling sound in her left ear for the past week. She noted the sound increased with bending. She had some neck pain six weeks earlier and went for chiropractic therapy. She did not have any acute neck pain following the visit to the chiropractor. Photo Diagnosis Illustrated quiz on problems seen in everyday practice (various entries). ECG Clinic Review ECGs with specialists from the University of Western Ontario, and the London Health Sciences Centre, CME Credit Quiz This test offers the opportunity to assess your knowledge and retention of the information presented in the articles in this issue. This test is prepared with the Dalhousie University CME department. Medical Briefs An abridged look at current events in and around the health-care industry. This month: First Therapy For Severe Sepsis ACEI Helps Hypertensives Largest Study on Seizure Freedom A Breath of Relief: Something New in COPD New Anemia Drug Covered by Provinces Kidney Failure in Diabetics Mounting Finding Low-Cost Therapy for ARD Antibiotic Resistance in Canada The Best Medicine Funny medical anecdotes plus a cartoon!
	*March 2003* Feature 1 Tapping Into the Problem: Ascites By Elaine Yong, BSc, MD; and Mary Anne Cooper, MSc, MD, FRCPC Learn how to investigate ascites, what tests should be taken on ascitic fluid, how to treat ascites and what spontaneous bacterial peritonitis means. Dr. Yong and Dr. Cooper discuss the case of a man presenting with extended abdominal girth. Feature 2 Finding a Balance Bipolar Disorders By Chris Gorman MD, FRCPC A mixture of depression and mania occurs in up to 40% of patients and is often confused with depression and co-morbid anxiety. Learn the symptoms of depression and mania, new medical interventions, and the importance of psychotherapy. Feature 3 The ABCs of Common Skin Problems By Benjamin Barankin, MD; and Lyn Guenther, MD, FRCPC Skin problems represent approximately 15% to 20% of visits to primary-care providers. Learn how to take a history and what to look for in a physical exam. Feature 4 Why are my Wrists so Stiff and Sore? Approaching Arthritic Symptoms By Volodko Bakowsky, MD, FRCPC According to the 1990 Ontario Health Survey, MSK symptoms were the most frequent reason for patients consulting a health-care professional. Through two case studies, Dr. Bakowsky gives a basic arthritis primer for GPs. Case of the Month Ethical Dilemma: What to do when a Patient Refuses Care By Merril Pauls, MHSc, CCFP (EM) This new department features a case and discussion — tools for your daily practice. The Den This department offers thoughtful stories and anecdotes by Canadian general practitioners. This month: Honour to be There, By James Chan, MD, FRCPC, IntMed Update Abstracts and news from the medical literature of interest to the primary-care physician. This month: Benefits of Mammography for Older Women HRT Disappoints Alternative Therapies and Menopause Are Diuretics Helping Acute Renal Failure? Can Nuts Decrease Diabetes Risk? Deep Brain Stimulation Promising for Epilepsy? What’s Your Diagnosis? An Unrecognised Cause of Fever By Lynfa Stroud, MD; and Anita Rachlis, MD, FRCPC A 47-year-old woman presented to the emergency department (ED) with a 24-hour history of fever, rigors, and bilateral knee pain. Her past medical history was significant for rheumatoid arthritis, diagnosed nine years ago. This subsequently evolved into mixed connective tissue disease with scleroderma and inflammatory myositis. Photo Diagnosis Illustrated quiz on problems seen in everyday practice (various entries). ECG Clinic Review ECGs with specialists from the University of Western Ontario, and the London Health Sciences Centre. CME Credit Quiz This test offers the opportunity to assess your knowledge and retention of the information presented in the articles in this issue. This test is prepared with the Dalhousie University CME department. Medical Briefs An abridged look at current events in and around the health-care industry. This month: Clozaril Decreases Suicide Risk Canadians in Chronic Pain? Easing Alzheimer’s Symptoms Hope for Sun Damaged Skin? New Fellowship for Parkinson’s Good News for Eczema Sufferers The Best Medicine Funny medical anecdotes plus a cartoon!
	*February 2003* Feature 1 Starving to be Thin- Anorexia and Bulimia Nervosa in Adolescents By Jorge L. Pinzon, MD, FRCPC; and Shirley Jones, RN Anorexia and bulimia nervosa can be extremely difficult to treat, especially in adolescents. Here, we take a look at the best ways to approach young people with these disorders. Feature 2 “The Itch That Rashes”: An Update in Atopic Dermatitis By Catherine McCuaig, MD, FRCPC Winter is a peak season for skin dryness, which could lead to increased incidences of atopic dermatitis. Dr. McCuaig reviews the treatment options, which include ointments and antibiotics. Feature 3 Oral Hypoglycemic Agents: What’s New? By Hasnain Khandwala, MD By 2010, it is projected that three million Canadians will be diagnosed with diabetes. Dr. Khandwala reports on the latest therapies for this highly prevalent disorder. Feature 4 Treating Tricky Tonsillitis By Paolo Campisi, MSc, MD, FRCSC; and Ted L. Tewfik, MD, FRCSC Peritonsillar cellulitis and abscess are the most common deep infections of the head and neck in children. Inadequate treatment of these infections may have devastating consequences. Learn more about how to treat and manage peritonsillar infections. Case of the Month Two Problems for the Price of One By John Ross, MD, FRCPC; and Sam Campbell, MD BCh, CCFP(EM) This new department features a case and discussion — tools for your daily practice. The Den This department offers thoughtful stories and anecdotes by Canadian general practitioners. This month: The Incredible Doctor-Patient Relationship, By Dr. W. Michael Myles. Update Abstracts and news from the medical literature of interest to the primary-care physician. This month: New Vaccine Against HPV Could Prevent Cervical Cancer Diagnosing Bacterial Vaginosis Rhythm Control vs. Rate Control for Patients with AF B1 –Blockers May Help Patients with Peripheral Arterial Disease or Asthma Predicting Cardiovascular Risk What’s Your Diagnosis? A Modern Tale of Scurvy By Flavio Habal, MD, PhD, FRCP A 71-year-old female was referred for assessment of weakness, fatigue, and petechial rash over the lower trunk. Aside from a long-standing history of epigastric burning, she was relatively healthy. Her epigastric pain was often aggravated with raw vegetables and fruit, which she avoided. Photo Diagnosis Illustrated quiz on problems seen in everyday practice (various entries). ECG Clinic Review ECGs with specialists from the University of Western Ontario, and the London Health Sciences Centre. CME Credit Quiz This test offers the opportunity to assess your knowledge and retention of the information presented in the articles in this issue. This test is prepared with the Dalhousie University CME department. Medical Briefs An abridged look at current events in and around the health-care industry. This month: Atomoxetine Reduces ADHD Symptoms New Three-Day Treatment for Pediatric AOM Cardiovascular Death Reduced with Losartan Relieving Menstrual Migraines Making Diabetes Management Easier for Canadians Pfizer Awards Lipoprotein Science Researcher The Best Medicine Funny medical anecdotes plus a cartoon!
	*January 2003* Feature 1 Zapping Varicose Veins-Improving the Quality of Life for Sufferers By Jeannette Soriano, MD Venous diseases affect many people and are a major cost to our health-care system. Dr. Soriano discusses the multitude of ways to treat varicose veins so physicians can help put an end to their patients’ pain. Feature 2 Disease or Epidemic? Childhood Obesity By Peter Nieman, MB, ChB, FRCPC Dr. Nieman defines the rapid spread of childhood obesity as an epidemic and reveals how doctors can evaluate their patients’ situation. He also discusses the importance of exercise, nutrition and behavioural modification. Feature 3 A Heart-Burning Issue: Gastroesophageal Reflux Disease By Khursheed Jeejeebhoy, MB, BS, PhD, FRCP, FRCPC Though heartburn is a very common disease, for the 44% of people who experience it monthly, the pain is very real. Dr. Jeejeebhoy uses two case studies to show how gastroesophageal reflux disease can be diagnosed and managed. Case of the Month Fluids for Septic Shock By Sam Campbell, MD, CCFP and Janet MacIntyre, MD, MSc This new department features a case and discussion — tools for your daily practice. The Den This department offers thoughtful stories and anecdotes by Canadian general practitioners. This month: Just in the Nick of Time, By Brendan Chiu, MD, BSc (Med.) Update Abstracts and news from the medical literature of interest to the primary-care physician. This month: The Pros and Cons of HRT for Menopausal Women Antidepressants May Help Patients Butt Out Steroids to Treat Meningitis? Reducing Inappropriate Prescribing of Antibiotics for children with URTIs What’s Your Diagnosis? The Weakening Rash By Cathering Maari, MD, FRCPC A 27-year-old woman complains of a slightly tender rash of two months duration. It started with swelling over her eyelids and cheeks and went on to develop a red and purple colour. The erythematous confluent rash extended to involve her shoulders and back, and was associated with severe pruritus. She also reported progressive muscle weakness which severely interfered with her daily activities. Photo Diagnosis Illustrated quiz on problems seen in everyday practice (various entries). ECG Clinic Review ECGs with specialists from the University of Western Ontario, and the London Health Sciences Centre. CME Credit Quiz This test offers the opportunity to assess your knowledge and retention of the information presented in the articles in this issue. This test is prepared with the Dalhousie University CME department. Medical Briefs An abridged look at current events in and around the health-care industry. This month: Alternative Treatment for Heart Failure GlaxoSmithKline Considers Environment Putting a Spotlight on Hypertension The Best Medicine Funny medical anecdotes plus a cartoon!