The Canadian Journal of Diagnosis
2007 Back Issues
2001 • 2002 • 2003 • 2004 • 2005 • 2006 • 2007 • 2008 • 2009 • 2010 • 2011 • 2012
Jan • Feb • Mar • Apr • May • Jun • Jul • Aug • Sept • Oct • Nov • Dec
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December 2007: Volume 24, Number 12
Dalhousie Department of Emergency Medicine
Case of the Month
“I just can’t pee!”
Case in Point
“What’s this on my neck?”
Experts on Call
Answers to your questions from our medical experts
• Managing Asthma During Pregnancy
• Are Internal Exams Effective With Pap Smears?
• Troublesome Side-Effects of Topiramate
• Using Bisphosphonates: For How Long?
• When to Refer a Patient to a Nephrologist?
• BP and Lipid Targets for Glucose-Impaired Patients
• Reasons for Post-Vasectomy Pain
• Withdrawing Drugs from the Market
• When to Test for H. Pylori
• Can Tiotropium be Used in Prostate Cancer Patients?
• Flashbacks: A Manifestation of PTSD
• IV Atropine Use in Atrial Fibrillation
• Can Peanut “Dust” Cause an Allergic Reaction?
• About Ciclesonide
• When to Alter Low Thyroid-Stimulating Hormone
• Aspirating Knee Effusions: Therapeutic and Diagnostic Purposes?
• Administering Clopidogrel Following Stent Implantation
• Ordering CT Scans for First Episode Psychosis Patients
What's Your Diagnosis?
"Mommy, what’s wrong with my head?"
Endocrine Update
Anabolics in Osteoporosis
Photo Diagnosis
Illustrated cases with questions to test your diagnostic skills
• Roger’s Rash
• Blaze’s Blemishes
• Tamara’s Tongue
• Scarlett’s Scales
• Leonel’s Lesions
• Adam’s Acne
• Mallory’s Marks
• Owen’s Outbreak
• Frederick’s Feet
Simple Surgery: Minor Techniques in the FP’s Office
J. Barry Engelhardt, MD, CCFP, MHSc (Bioethics)
Patients often present to their FPs with skin lesions needing surgical intervention for diagnosis and/or treatment. With a little preparation and a small investment in equipment, most FPs can perform a wide variety of minor surgical techniques in their offices.
Preventing Disease with Diet and Exercise
Khursheed N. Jeejeebhoy, MBBS, PhD, FRCPC
Over the last century, our lifespan has increased by 30 years from 50- to 80-years-of-age. However, this increase in lifespan has come at a cost, which often means a long, but not necessarily healthy life. The real question is whether we are doomed to depend on our “bad” genes or can we change our environment; thus change the response of our genetic self to be healthy?
Epistaxis: Halting the Hemorrhage
Eduard Eksteen, FRCSC
Many FPs have patients presenting to their offices with a history of frequent epistaxis. Potentially, anyone can be affected by epistaxis and statistics show that 5% to 14% of Americans have nosebleeds at least once a year. This article will focus on patients who
need further investigation and/or should be referred to a specialist.
Common Street Drugs
Constance LeBlanc, MD, CCFP(EM), FCFP, MAEd; and Nancy G. Murphy, MD, CCFP(EM), ABFM, ABMT
Patients present to the ED with a broad spectrum of symptoms and conditions. Some of the most commonly-encountered drugs of abuse are marijuana, benzodiazepines and opioids. Recognizing the various clinical presentations of intoxication with these drugs of abuse are paramount to developing an approach to management in the ED. Read more for tips to avoiding pitfalls in caring for these patients.
Standing the Sprain: Chronic Ankle Pain
Ken Unger, DPM, DABPS, FACFAS
Ankle sprains are very common and account for 20% to 40% of all sports-related injuries. A careful history and physical examination with a good understanding of the anatomy must be performed to effectively help your patient. |
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November 2007, Volume 24, Number 11
Dalhousie Department of Emergency Medicine
Case of the Month
“Could it be the shots?”
Case in Point
“What’s this above my lip?”
Experts on Call
Answers to your questions from our medical experts
• Efficiency of Phosphodiesterase Type 5 Inhibitors
• Adjusting Long-Acting Insulins
• Side-Effects of Vincristine
• Bypassing an Egg Allergy to Administer a Vaccine
• Melatonin Suppression
• Can We Test for an Allergy to Cigarette Smoke?
• Adequate Lithium Levels in Geriatric Patients
• Testing for Acetylsalicylic Acid Resistance
• Proton Pump Inhibitors and Vitamin B12 Deficiency
• Pharmacotherapy for Panic Disorder
• Testosterone for the Aging Male
• Lower-Dose Estrogen vs. a Standard Dose
• Merits of Parathyroid Hormone Analgesics
• Looking at Inhaled Corticosteroids
• What is Prolotherapy?
• Severe Mastalgia: What Treatment is Effective?
• Best Medicine for Atrial Fibrillation
• The Risk of a GI Bleed with Acetylsalicylic Acid
• The Use of Aromatase Inhibitors in Breast Cancer
• Testing for Wilson’s Disease
• Antiendomysial Antibody Testing for Celiac Disease
What's Your Diagnosis?
"Doc, can I still smoke my pipe?"
Endocrine Update
The Surgeon and Hyperparathyroidism
Photo Diagnosis
Illustrated cases with questions to test your diagnostic skills
• Leilani’s Lesion
• Bertha’s Blue Toes
• Theodore’s Throat
• Emilia’s Eye
• Sovann’s Scalp
• Luther’s Lump
• Elvin’s Elbow
• Iris’ Irritation
• Craig’s Cracked Skin
• Elaina’s Eczema
Women’s Health
Victoria Davis, MD, FRCSC
No Simple Answer: The Question of Female Libido
The discussion of female libido is a complex one due to the numerous factors by which it can be influenced. Libido is sexual desire, an energy derived from primitive impulses. Dr. Davis’ review examines the female libido and the biological, psychosocial and context-related factors that may affect sexual interest.
Dermatology: 10 Pearls of Wisdom
Carrie Lynde, HBSc, LLB; Charles Lynde, MD, FRCPC; and John Kraft, MD
Overall, 15% to 30% of the problems that FPs encounter are dermatological in nature.
The authors of this article review 10 of the more common patient complaints and provide the reader with factors to consider when dealing with these issues.
C. Difficile: A Growing Threat
Richmond Sy, MD, FRCPC
Since the 1970s, when the relationship between C. difficile and antibiotic-related diarrhea was first identified,
C. difficile infections have become a mainstay of acute-care hospitals and nursing homes. Follow along as Dr. Sy reviews this infection which is becoming more prevalent in our society.
PSA: The Benefits of Screening
Andrew Feifer, BSc (Hons), MDCM; and Maurice Anidjar, MD, PhD
The discovery and clinical application of tumour markers in oncology has significantly enhanced our ability to diagnose, treat and follow patients with a variety of neoplasms. PSA in its association with prostate cancer, one of the most sensitive tumour markers discovered to date, has greatly impacted our ability to diagnose and treat prostate cancer at an earlier stage.
Drugs for Chronic Pain: No Easy Solution
Lori Montgomery, MD, CCFP
The causes of chronic pain range widely in number. Before prescribing there are some factors (biochemical, psychosocial and non-medical strategies) to consider. It is also of value to understand which medications will be of most help to your patient’s pain.
Urinary Incontinence: Practical Office Management
Ronald G. Gerridzen, MD, FRCSC, FACS; and Jennifer A. Mork, BA
Urinary incontinence is a significant health and quality of life issue which is placing an increasing burden on patients, their families, caregivers and the Canadian health system. It is important to note that primary care physicians can offer management advice to assist patients with their problems. |
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October 2007, Volume 24, Number 10
Dalhousie Department of Emergency Medicine
Case of the Month
A Knee-to-Knee Collision
Case in Point
“Why is my foot so sore?”
Experts on Call
Answers to your questions from our medical experts
• Comorbid Conditions in Psychiatry
• Hypothyroidism vs. Post-Partum Hypothyroidism
• Causes of Hypotension
• Inflammatory Bowel Disease and Osteoporosis
• Eosinophilic Esophagitis: Treatment and Follow-Up
• Treating Idiopathic Priapism
• A Surgeon’s Decision
• Latest Research on Skin Reactions/Diseases
• Uses of the Intrauterine Device
• Vitamins for Prostate Cancer Prevention?
• Hepatitis A and B Vaccination for
Life-Long Immunity?
• Screening for Abdominal Aortic Aneurysm
• Laser Therapy for Smoking Cessation?
• Safe, Alternative Therapies for Osteoporosis
• Treating Croup with Glucocorticoid Medications
• The Role of Digoxin in Coronary Heart Failure
• Virtual Colonoscopy to Detect Colon Cancer
• Has Rofecoxib Come Back on the Market?
• Lack of Sexual Interest in Older Women
• ACE Inhibitors and ARBs for Microalbuminuria
• Statins and Grapefruit. What’s the Deal?
• Following-Up on Elevated Transaminase Levels
• The Risk of a GI Bleed with Acetylsalicylic Acid
What's Your Diagnosis?
"Doc, what’s happening to my body?"
Endocrine Update
Diabetes and Renal Disease
Photo Diagnosis
Illustrated cases with questions to test your diagnostic skills
• Bruce’s Brown Plaque
• Serge’s Sore
• Ivan’s Infection
• Frank’s Feet
• Rachel’s Rash
• Ruby’s Red-Brown Nodule
• Pierson’s Papule
• Leroy’s Leg
• Nancy’s Nail
• Ben’s Bloody Stool
Celiac Disease: Hard to Handle
Yvette Leung, MD, CCFP, FRCPC; Alaa Rostom, MD, MSc(Epi), FRCPC; and Paul Beck, PhD
Celiac disease (CD) is a disorder characterized by chronic small intestinal inflammation in response to gluten found in wheat, rye and barley. Epidemiological studies from the last decade have shown that CD is much more common than previously thought and that a large number of patients with CD will not have GI symptoms. Continue reading for a thorough look at this digestive disease.
Heaving a Sigh of Relief with Sleep Apnea
Jeffrey Mellor, MD, FRCPC
Disruptive snoring and obstructive sleep apnea (OSA) are common in our increasingly obese society. Periodic limb movement disorder may be associated with restless legs syndrome and is often under appreciated as causing lack of sleep. Follow along as Dr. Mellor reviews the typical signs of OSA and provides a means of treatment.
Elevation of Serum Creatinine: When to Screen, When to Refer
Bruce F. Culleton, MD, FRCPC; and Jolanta Karpinski, MD, FRCPC
In this article, Dr. Culleton and Dr. Karpinski discuss the use of serum creatinine in the detection of chronic kidney disease along with suggested monitoring of these patients and indications for referral to a nephrologist.
Taking the Test: Deep-Vein Thrombosis and Pulmonary Embolism
Russell D. Hull, MBBS, MSc; and M. Jeanne Sheldon, BA
There is no single, non-invasive test to accurately diagnose deep-vein thrombosis and pulmonary embolism. Diagnostic pathways have been investigated and reported upon in the literature. Based on the results of clinical trials, firm recommendations can be made for diagnostic testing in patients with suspected venous thrombosis. Read on to find out more.
Erectile Dysfunction: A Predictor of Cardiovascular Health
Jack Barkin, MD, FRCS, FACS, FICS, DABU
Though not life-threatening in itself, erectile dysfunction (ED) affects one’s quality of life. It has been found that 52% of men between the ages of 40 and 70 will have some degree of ED. Recently, it has also been discovered that ED may be an early marker of impending CV disease. In this article, Dr. Barkin reviews ED and its known association/ correlation with CV disease and its risk factors.
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September 2007, Volume 24, Number 9
Dalhousie Department of Emergency Medicine
Case of the Month
“Is my mother insane?”
Case in Point
“What are these spots?”
Experts on Call
Answers to your questions from our medical experts
• ACE Inhibitors and Potassium Levels
• High Sperm Count and Infertility
• Treating Ascites
• Testosterone Therapy and Sleep Apnea
• Men and the Transmission of HPV
• Appropriately Treating Major Depression
• Elevated Serum Insulin in Young Women
• Urine Testing vs. Vaginal Swabs for Chlamydia
• Cephalosporins and Penicillin Allergy
• Intervention and the Delusional Patient
• Risk of Osteonecrosis of the Jaw
• Risk Associated with Angioplasty
• Tiotropium and Prostate Cancer
• Screening for Barrett’s Esophagus
• Symptoms of Grave’s Thyrotoxicosis
• Prognosis for Hodgkin’s Lymphoma
• Treating Polymyalgia Rheumatica
• When to Switch the Oral Contraceptive Pill
Complementary Medicine
An evidence-based review of alternative therapies
Melatonin for Jet Lag: Does it Work?
What's Your Diagnosis?
"Mommy, I can’t open my eye!"
Endocrine Update
Vitamin D and Skeletal Health
Photo Diagnosis
Illustrated cases with questions to test your diagnostic skills
• Patrick’s Papules and Scales
• Neo’s Nodules
• Steve’s Stomach
• Elijah’s Ear
• Boyd’s Boil
• Spiro’s Spots
• Pammy’s Painful Lesions
• Everett’s Eye
• Bobby’s Back
Women’s Health
David Cenaiko, MD, FRCSC
Hormone Replacement Therapy and Bio-Equivalents: Looking at the Options
Since the publication of the Women’s Health Initiative study in 2002, the use of estrogen and progestin (hormone replacement therapies [HRT]) in the treatment of menopause has declined significantly due to fears of CV events and cancer. However, a large number of women continue to suffer from menopausal symptoms and are seeking treatment. Read on to learn about the recommended use of HRT and the role of bio-equivalents to help deal with unpleasant menopausal symptoms.
Keeping Cool: How to Approach Night Sweats
Jeffrey P. Schaefer, MSc, MD, FRCPC
Though night sweats are variably defined in medical literature and statistical information is sparse, they are nonetheless a real problem for those patients presenting to their FP’s office. In this article, Dr. Schaefer reviews the prevalence of night sweats, their possible causes along with a suggested method of work-up.
When the Pain Won’t Stop: Managing Chronic Daily Headache
Arnolda Eloff, MB, ChB, Mmed
Chronic daily headache (CDH) is classified as 15 headache days per month. The one-year prevalence of CDH in adults is about 4% of the population. Though not curable, Dr. Eloff provides a general overview of CDH, along with important factors to consider when dealing with migraine pain, to assist in providing a better quality of life for sufferers.
Alleviating the Anxiety: Behavioural Problems in Dementia
Inge Loy-English, BA, MD, FRCPC
Behavioural and psychological problems are nearly inevitable in Alzheimer’s disease. The prevalence of some type of difficulty has been estimated at close to 90%. Learn how the nature of the problem can be different, as well as the cause and response to treatment, depending on the stage of the disease.
Stopping the Drug Seeker: Recognizing Drug Diversion
Brian Goldman, MD, MCFP(EM), FACEP
Opioid analgesics that are obtained from licit sources, such as physicians and pharmacists, can be diverted to the street for sale to recreational drug abusers as well as addicts. Reviewing the relevant data, Dr. Goldman shows how prescription opioid abuse/dependence is lower than illicit drugs and teaches us how to recognize and stop potential drug seekers. |
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August 2007, Volume 24, Number 8
Dalhousie Department of Emergency Medicine
Case of the Month
Overdose Aftermathy
Case in Point
“What’s on my lip?”
Experts on Call
Answers to your questions from our medical experts
• Proton Pump Inhibitors in Children
• Best Hypoglycemic Drug for a Diabetic
• Removing an Ear Wax Plug: Who Should Do It?
• Treating Advanced Liver Failure
• Chronic Obstructive Pulmonary Disease Treatment Alternatives
• Prognosis of T1 Tumours
• Nut Allergy Manifestations
• Steroids for Ulcerative Colitis?
• Prophylactic Antibiotics, Children and Ureteric Reflux
• A Look at Post-Stroke Depression
• Ankylosing Spondylitis Markers
• Lycopene and Indole-3-Carbinol: Chemoprevention?
• Characteristics of Lewy Body Dementia
• Should You Stop Bisphosphonates After 10 Years?
What's Your Diagnosis?
"Why does my stomach hurt"
Endocrine Update
Catching the Cracks: Male Osteoporosis
Photo Diagnosis
Illustrated cases with questions to test your diagnostic skills
• Malcolm’s Marks
• Percy’s Peeling Mouth
• Haleigh’s Hair
• Stefan’s Skin
• Nella’s Neck
• Barden’s Back
• Grace’s Growths
• Samson’s Scrotum
Heart Failure Guidelines: Helping Your Patients
Ben Tyrrell, MD, FRCPC; and Justin A. Ezekowitz, MBBCh, MSc, FRCPC
Heart failure (HF) is a cause of significant morbidity and mortality in Canada. The Canadian Cardiovascular Society has recently provided an update for the diagnosis and management of HF. Follow along in this review to learn about the latest in helping your patients with HF.
Getting to the Root of Geriatric Pain
Omar Rahaman, MD, CCFP, COE
Chronic pain management in a geriatric population is a challenging problem for physicians. Older individuals are at a higher risk of having poor pain control because of their multiple sources of pain as a result of their comorbid medical conditions. In this article, Dr. Rahaman explains how to assess and manage geriatric pain.
Figuring Out Dermatological Fungal Infections
Richard M. Haber, MD, FRCPC
Superficial dermatological fungal infections are caused by dermatophytes. Dermatophytes are keratophilic superficial fungal infections that typically involve the skin, nails and hair. Read on to find out the distribution, the source of infection and taxonomy of dermatophytes. |
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July 2007, Volume 24, Number 7
Dalhousie Department of Emergency Medicine
Case of the Month
Fighter's Folly
Case in Point
“What is this on the tip of my nose?”
Experts on Call
Answers to your questions from our medical experts
• ß-blockers and Allergy Injections
• Contraindicated Treatments in Sleep Apnea and CHF
• Overcoming Chronic Insomnia
• Dealing with GI Stromal Tumours
• Do Finasteride or Selenium Prevent Prostate Cancer?
• Combining Allergy Serums
• Common Causes of Dysphagia
• What is the Usefulness of Human Leukocyte Antigen-B27 Testing?
• Homocysteine Levels and CV Risk
• Pap Smears for Hysterectomy Patients?
• Which PSA Velocity to Use?
• Following-up on a Previous Hodgkin’s Diagnosis
• Understanding and Managing Encopresis
• Screening for Acromegaly
• Calcium Supplementation in Osteoporosis
What's Your Diagnosis?
"What is causing this patient’s ascites?"
Complementary Medicine
An evidence-based review of alternative therapies
Pain in the Neck? Try Acupuncture
Endocrine Update
Medically Managing Primary Hyperparathyroidism
Photo Diagnosis
Illustrated cases with questions to test your diagnostic skills
• Nicole’s Nodule
• Pierre’s Paralysis
• Hank’s Hemoptysis
• Plato’s Patches
• Paul’s Pruritus
• Felicia’s Fat Face
• Peigi’s Plaques
• Diane’s Discomfort
• Suzanne’s Spots
• Pacey’s Papules
LUTS: Keeping an Even Flow
Howard Evans, MD, FRCSC
Formerly known as benign prostatic hypertrophy, urinary symptoms have recently been renamed to lower urinary tract symptoms (LUTS). In this article, Dr. Evans takes you through the pathophysiology, diagnosis and management of LUTS.
Spreading Relief: Update on Topical Steroids
Afsaneh Alavi, MD; and R. Gary Sibbald, BSv, FRCPC (Med) (Derm), FAPWCA (Med)
Topical steroids were introduced to medicine almost half a century ago. Today corticosteroid cream and ointment formulations have an important role in the management of skin disease, including eczema and dermatitis. Come and read Dr. Alavi and Dr. Sibbald’s update on the use of topical steroids for dermatological problems.
Epistaxis: Controlling the Course
Michael K. Howlett, MD, CCFP(EM), MHSA
Epistaxis, or a nose bleed, is a common disorder; 60% of the population will experience at least one episode in their lifetime. Though most episodes are not serious (< 10% of patients seek medical attention) the incidence of severe nasal bleeding increases with age. Read on to learn more about this condition from Dr. Howlett. |
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June 2007, Volume 24, Number 6
Dalhousie Deparment of Emergency Medicine
Case of the Month
"I probably shouldn't have tried that jump!"
Case in Point
“My legs are so dry and itchy!”
Experts on Call
Answers to your questions from our medical experts
• COX-2 Agents and Arthritis Options
• Obesity-Causing Malignancy
• Dealing with GAD
• H. pylori and Halitosis
• Risk of Prostate Cancer with Testosterone Therapy
• Mango Allergy
• Role of CA125 in Ovarian Cancer Screening
• Testing for an Allergy to Antibiotics
• Dealing with Intermittent Episodes of Bronchospasm
• Abdominal pain in a West African Immigrant
• Antifungals for Schizophrenia?
• Total Testosterone
• Efficacy of Glucosamine in Patients with Osteoarthritis
• Taking Bisphosphonates
• Difference between ACE inhibitors?
• Testosterone Therapy Contraindications
• Prevalence of Cancer
• When not to Use Antidepressants in Depression
What's Your Diagnosis?
"Doctor, what's this lump?"
Complementary Medicine
An evidence-based review of alternative therapies
Healing Herbs? Treatment for Back Pain
Photo Diagnosis
Illustrated cases with questions to test your diagnostic skills
• Seymour’s Scales
• Marissa’s Mass
• Burt’s Bumps
• Eric’s Eye
• Sully’s Sores
• Brooke’s Blemishes
• Belinda’s Blisters
• Guido’s Growth
• Peggy’s Papules
• Livvy’s Lesions
• Hugo’s Hands
• Roman’s Rash
Women’s Health
Norah Neylon, MB BS; Marc Tischkowitz, MB ChB, PhD; and William Foulkes, MB BS, PhD
A Family Affair? Breast Cancer Genetics
Breast cancer is the most frequently diagnosed cancer in Canadian women. Yet, the early diagnosis of breast cancer is a major challenge. Read on to learn about the vital role that a FP can play in identifying women who are at high-risk.
Demystifying Insulin Treatment
Amir Hanna, MB, BCh, FRCPC
Insulin treatment is needed in Type 2 diabetes when individual treatment goals are not attained by other means. In this review, Dr. Hanna unmasks what the primary care physician needs to know about the indications for insulin treatment, the barriers to insulin therapy and more.
Rising to the Challenge: The PCP and IBD
Alan B. R. Thomson, MD, PhD, FRCPC(C), FACP, FACG, AGAF
Approximately 150,000 Canadians have some form of inflammatory bowel disease (IBD). Unfortunately, only two to three individuals with Crohn’s disease or ulcerative colitis are followed by each physician. In this article, Dr. Thomson outlines how the primary care physician (PCP) can help to manage the individuals waiting to consult with a specialist.
Improving the Outcomes of STEMI
Shelley Valaire, ACP; and Robert Welsh, MD, FRCPC
CV disease is the leading cause of morbidity and mortality in Western nations. Acute STEMI is associated with a high-risk of mortality and is a common antecedent event leading to other CV conditions, including congestive heart failure and cardiac arrhythmias. In this article, the authors describe how timely and effective reperfusion substantially reduces rates of mortality and morbidity.
What's New in Clinical Research
Keith Dawson, MD, FRCPC; and Claude Garceau, MD, FRCPC
Current Research on the Prevention and Treatment of Type 2 Diabetes |
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May 2007, Volume 24, Number 5
Dalhousie Department of Emergency Medicine
Case of the Month
"Bring anything back from vacation?"
Case in Point
“What's this on my head?”
Experts on Call
Answers to your questions from our medical experts
• Long-term Effects of PPI Usage
• Dealing with Shift Work and Sleep
• Diagnosing Intestinal Cystitis
• ACE inhibitors and Anaphylaxis
• Cause of Oro-Pharyngeal Cancer
• Eosinophilic Pneumonia
• Which Antidepressant for a Diabetic?
• The Health Risk of Expired Medications
• OP Screening in Men
• What Causes Cracks in a Tongue?
• Which Parameter is Most Important in Hypothyroidism?
• When to Refer to a Urologist
• Stem Cell Transplant and Multiple Myeloma
• Antihistamine Use Following a Yellow-Jacket Sting
• Who Requires a DEXA Scan?
• ACE inhibitors, Type 1 Diabetes and Children
• Determining the Dose for Testosterone Replacement
What's Your Diagnosis?
"Doctor, my stomach hurts!"
Complementary Medicine
An evidence-based review of alternative therapies
All Bent Out of Shape? Yoga for Lower Back Pain
Photo Diagnosis
Illustrated cases with questions to test your diagnostic skills
• Robert’s Rash
• Morty’s Mole
• Harrison’s Hand
• Lennon’s Lesion
• Lila’s Lip
• Scout’s Scales
• Louisa’s Lump
• Isaac’s Infection
• Potter’s Papules
• Frank’s Fistula
• Trent’s Testicle
• Osanna’s Outbreak
Women’s Health
Traci McGee, MA, RCC, RMFT
The Different Faces of PPD and Anxiety
This article combines current literature with Ms. McGee’s applied perspective as a Clinical Counsellor providing > 50 monthly psychotherapeutic treatment sessions for women referred with symptoms of post-partum depression and anxiety. The focus of this article is on mental health disorders presented by women within a year of childbirth, including risk factors, symptoms and treatments.
2007 CHEP Guidelines: An Annual Update
On behalf of the Canadian Hypertension Education Program (CHEP)
Hypertension is a health risk that is preventable by following an appropriate lifestyle and is relatively easy to manage. 2007 marks the eighth consecutive year that the Canadian Hypertension Education Program (CHEP) has updated recommendations for the management of hypertension. Read on for the new key messages.
Pain in the Neck: Could it be Neurological?
Colin Chalk, MD, CM, FRCPC
Neck pain is the third most common musculoskeletal complaint seen by family doctors. It is important to identify patients in whom neck pain has a serious cause and those in whom a neurological disorder is present. In this article, Dr. Chalk demonstrates that the approach to a patient’s neck pain can be separated into four questions.
Detecting and Dealing with IFP
Geetika Verma, MD, FRCPC; and Charles K. N. Chan, MD, FRCPC, FCCP, FACP
Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease with a grim prognosis in most cases.
Step-by-step, this article explains how to recognize, investigate and treat IPF. |
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April 2007, Volume 24, Number 4
Dalhousie Deparment of Emergency Medicine
Case of the Month
"Don't worry, that's the 'safe' drug."
Case in Point
“Why are my arms rough and bumpy?”
Experts on Call
Answers to your questions from our medical experts
• HPV and Anal Carcinoma
• How to Treat Resistant Depression
• Polyneuropathy and Osteoporosis
• Ginseng Use to Prevent Common Colds?
• Which Insulin to Use?
• Which Meds for Irritable Bladder?
• Can Diabetic Peripheral Neuropathy be Reversed?
• Psyllium Allergies
• BMD Testing for Women on Medroxyprogesterone?
• Men, Estrogen and Breast Cancer
• Diagnosing Hyperaldosternoism
• Food-Induced Rhinitis
• Measuring Serum Calcium
• Role of Diet in Diverticulosis
• Celiac Disease in Children
What's Your Diagnosis?
Joel Lamoure, RPh, BScPhm, FASCP
Which to Choose: Antidepressants or Eyesight?
Complementary Medicine
An evidence-based review of alternative therapies
Helping the Hurt: Acupuncture for Tennis Elbow
Photo Diagnosis
Illustrated cases with questions to test your diagnostic skills
• Polly’s Plaques
• Tom’s Tonsils
• Harper’s Hand
• Samuel’s Scans
• Petula’s Patches
• Nate’s Nails
• Ferris’ Finger
• Charlie’s Chest Pain
• Preston’s Pustules
• Buddy’s Bump
• Pierre’s Pigmentation
• Paul’s Papules
• Ellen’s Eyes
Women’s Health
Steve Wong, MD, FRCPC
Look Out: CAD in Women
The diagnosis of coronary artery disease (CAD) in women can be particularly difficult. In this article, Dr. Wong reviews recent data on the presentation and diagnosis of coronary
disease and discusses the emerging marker of high-sensitivity CRP.
Dealing with the Pain: Understanding CDH
Lucy M. Vieira, MD, FRCPC
Did you know that 12% of the population is estimated to have migraines? Most have one to two attacks per month and 3% of headaches, per year, transform to chronic daily headache (CDH). Through her article, Dr. Vieira aims to provide the primary care physician with an approach to the treatment of daily headache, which often originates from episodic migraine.
Recognizing the Problem: BD in Your Patients
Hanna O. Woldeyohannes, HBSc; and Roger S. McIntyre, MD, FRCPC
Bipolar disorder (BD) is a highly prevalent and complex syndrome of multifactorial origin.
BD is estimated to affect approximately 2% to 4% of the general population and possibly
30% of all individuals treated for depression in the primary care setting. Actuarial estimates position BD as possibly the most costly mental disorder.
A Safe Retreat? Illness in the Returning Traveller
Tobey Audcent, MD, FRCPC; and Nicole Le Saux, MD, FRCP
Increased recreational travel, globalization of economies, immigration and more Canadian families returning overseas to visit friends and relatives has increased the frequency of international travel. In this review, Dr. Audcent and Dr. Le Saux examine the three most common causes of non-specific fever in the returning traveller.
What's New in Clinical Research
Yves Lacourcière, MD; Eliofotisti Psaradellis, BSc; Monica R. Joch, MSc; Fotini Sampalis, MD, PhD; John S. Sampalis, MSc, PhD; and Natacha Bastien, PhD; for the TITRATION Group
Effectiveness and Safety of Losartan in the Management of Essential Hypertension: A Prospective Cohort Study |
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March 2007, Volume 24, Number 3
Dalhousie Deparment of Emergency Medicine
Case of the Month
"This guy has only one leg to stand on!"
Case in Point
“My complexion bothers me”
Experts on Call
Answers to your questions from our medical experts
• PSA Testing for Healthy 60-year-olds?
• How to Manage a Thyroid Cyst
• Which colon cancer screening protocol to use?
• Treating a Obese, Hypertensive TRD Patient
• Treating OSA
• Synthroid and Change in Diabetic Control
• Recommendations for Clopidogrel Use
• About Hiccups
• When to Stop Alendronate and Risedronate?
• When to Avoid Fluoroquinolones
• Treating Bulimia Nervosa
• Managing Recurring Aphthous Ulcers
• Calcium and Vitamin D Use in Osteoporosis
• Testing for Peanut and Nut Allergies in Children
• Kegel Exercises
• Pamidronate: In Hospital or At a Clinic?
Complementary Medicine
An evidence-based review of alternative therapies
Zinc for the Common Cold?
What's Your Diagnosis?
"Doctor, I can't stand this pain!"
Photo Diagnosis
Illustrated cases with questions to test your diagnostic skills
• Patrick’s Papule
• Bobby’s Blemishes
• May’s Malformation
• Fiona’s Fissure
• Leland’s Lesions
• Earl’s Eyes
• Nadina’s Nodule
• Bernadette’s Blisters
• Monica’s Mass
• Emily’s Ear
• Trudy’s Tongue
• Raquel’s Rash
Allergy Alert
A case-based update
A Growing Nasal Problem
Women’s Health
Ladan Sadrehashemi, MD, FRCPC; and Nicolas Misri
To Medicate or Not to Medicate? Antidepressant Use in Pregnancy
The general public and most physicians are apprehensive about using any medications during pregnancy. The current research for the use of psychotropic medications in the antenatal period is at best controversial. Read on to find out more.
COPD: The Increasing Role of the FP
Alan Kaplan, MD, CCFP(EM)
Chronic obstructive pulmonary disease (COPD) is the second most common cause of
morbidity in those > 40-years-of-age in Canada. How can you, as practitioners, make a
difference? In this article, Dr. Kaplan explains that it is important to be aware that there are things that can be done for your patient with COPD at any stage of the illness.
Be Aware! An Influenza Update
Lil Miedzinski, MD, FRCP
What do you really know about influenza? Who are the hosts? What are the characteristics of influenza A? What is the diagnosis? In this review, Dr. Miedzinski explains what you should be aware of with regards to influenza.
Fast Food: Loving it to Death?
Michael McDonald, MD, FRCPC; and Justin A. Ezekowitz, MBBCh, MSc, FRCPC
Recently, evidence has emerged to support the contention that fast food itself is contributing to the problem of obesity. This article reports on the results of The Coronary Artery Risk Development in Young Adults (CARDIA) study and the association between fast food, weight gain and insulin resistance over a 15-year period in the US.
ADHD: Not Only for the Young
Lily Hechtman, MD, FRCP
Attention deficit hyperactivity disorder (ADHD) is well known and recognized as a condition of children and adolescents, which affects 5% to 8% of the school-aged population. However, long-term prospective follow-up studies have shown that 50% to 60% of children with ADHD continue to have symptoms of the syndrome in adulthood. In this article, Dr. Hechtman explores this issue, the methods of assessment and treatment for adults with ADHD. |
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February 2007, Volume 24, Number 2
Case of the Month
Slip, Trip and... Flail?
Case in Point
“What’s this on my cheek?”
Experts on Call
Answers to your questions from our medical experts
• How Frequently Should TSH be Taken?
• Prednisone for Allergic Reactions
• Following Patients on Systemic Steroids
• Warfarin and Thromboembolic Complications
• Managing a Cold Thyroid Nodule
• Assisting Cannabis Withdrawal
• Correcting an Undescended Testis
• Combining H2 Receptor Blockers and PPIs
• Pimecrolimus, Tacrolimus and Cancer
• Routine Drug Screening and Crystal Meth
• LABAs and COPD
• Chronic Constipation vs. IBS
• Glucosamine Use in Shellfish Allergy
• Treating Pneumonia in Patients with COPD
What's Your Diagnosis?
"Doctor, why am I so sick?"
Photo Diagnosis
Illustrated cases with questions to test your diagnostic skills
• Seth’s Scaly Papules
• Cory’s Crossed Eyes
• Dan’s Diagnosis
• Norman’s Nodule
• Bianca’s Bumpy Tongue
• Becca’s Back Pain
• Thelma’s Thinning Scalp
• Peggy’s Pain
• Elton’s Elbow
• Leonora’s Lesion
Allergy Alert
A case-based update
Worsening Cough in an Asthmatic
Women’s Health
David C. Cumming, MB, ChB, FRCOG, FRCSC
Improving Quality of Life: Dealing with AUB
In this article, Dr. Cumming describes various approaches to abnormal uterine bleeding (AUB) and how the FP can manage the majority of problems. Four vignettes illustrate the common patterns of bleeding and their management.
Botox®: Beauty and Beyond
Betsé Edguer, MD, FRCPC
Although the cosmetic injection of Botox® is a familiar application in the reduction of facial wrinkles, this article explores the therapeutic benefit of Botox® in the treatment of muscle hyperactivity disorders, autonomic nervous system disorders and in pain disorders.
Hoarseness: The Good, The Bad and the Ugly
David Goldstein, MD, FRCSC; Mark Shrime, MD; and Jonathan Irish, MD, FRCSC, FACS
Though hoarseness can be benign, it is also one of the earliest symptoms of laryngeal cancer. Therefore, it is important that FPs are able to recognize features suggestive of malignancy in order to allow for the early diagnosis and treatment of this highly curable cancer.
Chronic Thromboembolic Pulmonary Hypertension
Marc de Perrot, MD, MSc
A recent study demonstrated that up to 43% of patients have residual pulmonary hypertension (PH) one year after an episode of acute pulmonary emboli and that 5% can develop severe PH overtime. Thus, the condition is more much frequent than previously estimated and should be recognized when encountered.
Investigating Outpatient CAD: Which Test for Which Patient?
Eli Rosenberg, BSc, MD; and Gabor Gyenes, PhD, MD
Appropriately diagnosing chest pain and possibly coronary artery disease (CAD) can be difficult. In this review, Dr. Rosenberg and Dr. Gyenes guide readers through the additional investigative steps necessary to aid in ruling CAD in or out. |
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January 2007, Volume 24, Number 1
Case of the Month
“I can't open my eyes!”
Case in Point
“Why is my neck discoloured?”
Experts on Call
Answers to your questions from our medical experts
• Flu Shot for Those on Chemotherapy?
• The Importance of Serum PSA Levels
• Treating Allergic Conjunctivitis in Toddlers
• Dealing with White-Coat Hypertension
• Managing a Baker Cyst in the Knee
• Acute Dystonia, an Antipsychotic Side-Effect?
• Tiotropium and Prostate Cancer
• Following Impaired Glucose Tolerance
• Recycled Paper Allergies
• GOAL Study Recommendations
• H. pylori in Children
• Return to Play Guidelines
Complementary Medicine
An evidence-based review of alternative therapies
Headaches and Acupuncture Treatment
What's Your Diagnosis?
"Am I having a heart attack?"
Photo Diagnosis
Illustrated cases with questions to test your diagnostic skills
• Lydia’s Lower Teeth
• Robert’s Red Papule
• Edgar’s Eruption
• Parker’s Plaque
• Tommy’s Tongue
• Chandler’s Chest
• Paige’s Particles
• Herald’s Horn
• Tracey’s Tooth Decay
• Ivan’s Itch
Allergy Alert
A case-based update
Getting it Right
Women’s Health
Winson Y. Cheung, MD; and Sunil Verma, MD, MSEd, FRCPC
Caring for the Breast Cancer Patient: A GP's Role
Antithrombotic Therapy for AF and VTE: ACCP Treatment Guidelines
James D. Douketis, MD, FRCPC; and Alessandra Malato, MD
This article examines: antithrombotic treatment approaches that are currently recommended by the American College of Chest Physicians (ACCP) for patients with atrial fibrillation (AF) or venous thromboembolism (VTE), what treatments should be avoided and what potential new treatments have emerged in the last one year to two years.
Chronic Kidney Disease: Measuring the Risk
Sameena Iqbal, MD, FRCP, MSc
How does one measure renal function? What is the importance of measuring kidney function? How does one modify a patient’s cardiovascular risk factor? These are just some of the questions answered by Dr. Iqbal in this article on chronic kidney disease.
Seizures and Epilepsy: An Evidence-Based Approach
S. Nizam Ahmed, MD, FRCPC, DABPN, DABCN
Physicians are often faced with the question of when and whether to start antiepileptic medications (AEDs) after the first or additional unprovoked seizures. Seizure-free patients on AEDs also seek counselling from their physicians regarding the risks and benefits of discontinuing these drugs. In this article, Dr. Ahmed reviews the answers to these questions.
What's New in Clinical Research
Allison McGeer, MD, FRCPC; and James Kellner, MD, MSc, FRCPC
The Appropriate Use of Antibiotics in Respiratory Tract Infections: Let History Inform Your Prescribing |
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