Dr. Roberto Leon
Jul 12, 2016
Part 2: Minimizing the pain of the IUD insertion: all effort required
Up until recently, pain management with IUDs (intrauterine devices) insertion was not commonly performed, as most users were multiparous women and the insertion was reasonably straightforward. However, because the IUDs provide unsurpassed protection against a pregnancy along with many other advantages, its acceptance is dramatically increasing, especially in nulliparous women and adolescents. read more...
Drs. Christopher Cheung and Kenneth Gin
Jun 22, 2016
Comparing intensive versus standard blood-pressure control: The SPRINT Trial
Hypertension affects over 1 in 5 Canadians and is one of the leading causes of cardiovascular disease, including coronary artery disease and heart failure. Uncontrolled hypertension is a risk factor for stroke (both ischemic and hemorrhagic), retinopathy, chronic kidney disease (CKD), and peripheral vascular disease. Epidemiologic studies show that the risk of cardiovascular disease increases above a blood pressure of 115/75 mmHg. read more...
Dr. Soren Gantt
Jun 08, 2016
Diagnosis and management of congenital cytomegalovirus infection
Approximately 1 out of every 150 live-born infants has congenital CMV infection (cCMV). Of these, most are asymptomatic. However, more than 20% will suffer permanent neurologic sequelae, including hearing loss, intellectual disability, and visual deficits. In fact, cCMV is responsible for 25% of all childhood hearing loss, and is the second most common cause of intellectual disability after Down syndrome. read more...
Dr. Taryl Felhaber
May 25, 2016
Non-hormonal treatments for menopausal symptoms
Every woman transitions through menopause, although not all women have bothersome symptoms. Some women’s symptoms may be so disturbing as to lead them to think they are dying, as was the case with a patient in my practice several years ago. read more...
Dr. Eileen Murray
May 11, 2016
Nail fungus
Fungal infections particularly of the feet are a common problem. If only the skin is involved topical treatment with any of the antifungal creams works well. However, often fungal infections are ignored by patients and chronic skin infection can lead to infection of the nails. read more...
Dr. Roberto Leon
Apr 27, 2016
Part 1: Who should be offered an IUD, and selection of the appropriate IUD
Intrauterine devices (IUDs) are a safe, very effective, rapidly reversible and highly acceptable contraception amongst women. Yet it is resisted by many physicians. A recent study in Seattle (1) found that half or fewer of the physicians sampled do not follow the recommended guidelines, advising against using an IUD to nulliparous women, 20 years old or less, or women with a prior history of STI, PID or ectopic pregnancy. read more...
Dr. Kevin Fairbairn
Apr 13, 2016
The Alvarado Score in Acute Appendicitis
Appendicitis can often present itself in the black box of abdominal pain. Fortunately at times the history and physical can give practitioners a clear window, straight through the fascia, to an unhappy appendix. read more...
Drs. Neda Amiri and Kam Shojania
Mar 30, 2016
Part 2: Treating Gout – Practice Tips and Clinical Pearls
Despite being one of the most common forms of arthritis afflicting adults, optimal care of patients with gout including treatment of acute attacks as well as long-term management is not always achieved. read more...
Dr. Christina Williams
Mar 16, 2016
Surgery versus IVF in endometriosis infertility
In my early days as a reproductive physician, I made the diagnosis of “unexplained infertility” when ovulatory, male or tubal factors were absent. I advised the “keep trying” policy as pregnancy rates of 50% were expected in the second year of infertility. read more...
Dr. Hector Baillie
Mar 02, 2016
When quality trumps quantity: a clinician’s perspective
When a very old patient comes to my hospital for a pacemaker, I now spend longer with them. I explain what this device can do, and what it cannot do. Do they understand? Where are your family members, they need to understand too? I take time to get informed consent, when previously obtaining the signature was the most important part of the exercise. read more...
Drs. Erica Tsang and Iain Mackie
Feb 17, 2016
Screening for occult cancer in unprovoked venous thromboembolism (VTE)
An unprovoked venous thromboembolism (VTE), either through a deep venous thrombosis or pulmonary embolism, may be the earliest sign of malignancy. In patients presenting with unprovoked VTE, a limited occult malignancy screening strategy is sufficient, compared to routinely adding CT imaging of the abdomen and pelvis. read more...
Dr. Daniel Kim
Feb 03, 2016
Enhance the valsalva to (actually) terminate SVT
Supraventricular tachycardia (SVT) is a dysrhythmia characterized by abrupt onset, regular rate that usually exceeds 150 beats/minute, and lack of identifiable P waves on ECG. SVT is caused by an abnormal circuit that allows a wave of depolarization to repeatedly travel in circular fashion in cardiac tissue via a reentry circuit that may reside in the atrioventricular (AV) node or outside the AV node in an accessory pathway. read more...
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