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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 in Point Experts on Call • Managing Asthma During Pregnancy What's Your Diagnosis? Endocrine Update Photo Diagnosis • Roger’s Rash Simple Surgery: Minor Techniques in the FP’s Office 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 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 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 Common Street Drugs 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 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 in Point Experts on Call • Efficiency of Phosphodiesterase Type 5 Inhibitors What's Your Diagnosis? Endocrine Update Photo Diagnosis • Leilani’s Lesion Women’s Health 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 Overall, 15% to 30% of the problems that FPs encounter are dermatological in nature. C. Difficile: A Growing Threat Since the 1970s, when the relationship between C. difficile and antibiotic-related diarrhea was first identified, PSA: The Benefits of Screening 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 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 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 in Point Experts on Call • Comorbid Conditions in Psychiatry What's Your Diagnosis? Endocrine Update Photo Diagnosis • Bruce’s Brown Plaque Celiac Disease: Hard to Handle 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 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 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 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 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 in Point Experts on Call • ACE Inhibitors and Potassium Levels Complementary Medicine Melatonin for Jet Lag: Does it Work? What's Your Diagnosis? Endocrine Update Photo Diagnosis • Patrick’s Papules and Scales Women’s Health 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 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 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 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 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 in Point Experts on Call • Proton Pump Inhibitors in Children What's Your Diagnosis? Endocrine Update Photo Diagnosis • Malcolm’s Marks Heart Failure Guidelines: Helping Your Patients 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 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 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 in Point Experts on Call • ß-blockers and Allergy Injections What's Your Diagnosis? Complementary Medicine Pain in the Neck? Try Acupuncture Endocrine Update Photo Diagnosis • Nicole’s Nodule LUTS: Keeping an Even Flow 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 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 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
Case in Point Experts on Call • COX-2 Agents and Arthritis Options What's Your Diagnosis? Complementary Medicine Healing Herbs? Treatment for Back Pain Photo Diagnosis • Seymour’s Scales Women’s Health 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 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 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 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 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 in Point Experts on Call • Long-term Effects of PPI Usage What's Your Diagnosis? Complementary Medicine All Bent Out of Shape? Yoga for Lower Back Pain Photo Diagnosis • Robert’s Rash Women’s Health 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 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? 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.
Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease with a grim prognosis in most cases. |
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April 2007, Volume 24, Number 4
Case in Point Experts on Call • HPV and Anal Carcinoma What's Your Diagnosis? Which to Choose: Antidepressants or Eyesight? Complementary Medicine Helping the Hurt: Acupuncture for Tennis Elbow Photo Diagnosis • Polly’s Plaques Women’s Health 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 Dealing with the Pain: Understanding CDH 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 Bipolar disorder (BD) is a highly prevalent and complex syndrome of multifactorial origin. A Safe Retreat? Illness in the Returning Traveller 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 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
Case in Point Experts on Call • PSA Testing for Healthy 60-year-olds? Complementary Medicine Zinc for the Common Cold? What's Your Diagnosis? Photo Diagnosis • Patrick’s Papule Allergy Alert A Growing Nasal Problem Women’s Health 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 Chronic obstructive pulmonary disease (COPD) is the second most common cause of Be Aware! An Influenza Update 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? 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 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 Case in Point Experts on Call • How Frequently Should TSH be Taken? What's Your Diagnosis? Photo Diagnosis • Seth’s Scaly Papules Allergy Alert Worsening Cough in an Asthmatic Women’s Health 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 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 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 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? 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 “I can't open my eyes!” “Why is my neck discoloured?” Experts on Call • Flu Shot for Those on Chemotherapy? Complementary Medicine Headaches and Acupuncture Treatment "Am I having a heart attack?" Photo Diagnosis • Lydia’s Lower Teeth Allergy Alert Getting it Right Women’s Health Caring for the Breast Cancer Patient: A GP's Role Antithrombotic Therapy for AF and VTE: ACCP Treatment Guidelines 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 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. 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 The Appropriate Use of Antibiotics in Respiratory Tract Infections: Let History Inform Your Prescribing |
