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Letter from the editor

By Dr. Steve Wong on December 19, 2011

As 2011 draws to a close, I’d like to take an opportunity to thank all of our readers for their support, suggestions, and encouragement. It’s been a very gratifying experience for all of us involved at This Changed My Practice.

What is the correct dosing for Vitamin D?

By Dr. Kenneth Madden on December 6, 2011

Every year, one-third of older adults (age greater than 65) experience one or more falls. One therapy with the potential to reduce both falling and fractures is vitamin D supplementation, possibly due to a direct stimulation of vitamin D receptors on muscle tissue.

Vapor rub for treatment of nocturnal cough and cold symptoms in children

By Dr. Paul Thiessen on November 22, 2011

Upper respiratory infections are the most common illnesses seen in childhood, and the symptoms are often disruptive for both the child and the whole family.

Non-suicidal self-injury: reducing future risk

By Dr. Shirley Sze on November 7, 2011

I now recognize the inherent high risk of successful suicide (10%) in this population and the need to address non-suicidal self injury with the seriousness that it deserves.

The most important question never asked about sleep

By Dr. Judy Allen on October 24, 2011

Prior to working at a Sleep Clinic had failed to ask the most important question when assessing insomnia concerns in patients with or without a primary psychiatric disorder. Before resorting to sedative hypnotic, antidepressant and/or antipsychotic polypharmacy…

Improving end-of-life care for patients with advanced cancer

By Dr. Sharlene Gill on October 11, 2011

In a recent randomized trial patients with advanced lung cancer who received both chemotherapy and also received care and support from a palliative care team immediately after their diagnosis lived almost three months longer than those who received chemotherapy alone.

It’s just a runny nose!

By Dr. George Luciuk on September 25, 2011

Nasal woes can cause lots of complications. Most of them start insidiously but can progress steadily. Awareness by the family physician of what “can happen” is very important.

Spreading pain with neuropathic features may be induced by opioid medications

By Dr. Launette Rieb on September 12, 2011

It is worth considering OIPS in the differential diagnosis when pain appears to be spreading, especially when features of allodynia and hyperalgesia are present.

Community acquired pneumonia

By Dr. Yazdan Mirzanejad on August 29, 2011

By going through guidelines derived over 10 years, there are 5 major evidences that changed my way of managing community acquired pneumonia.

Don’t request testosterone levels for women’s low sexual desire

By Dr. Rosemary Basson on August 15, 2011

Although men with repeatedly low serum testosterone levels typically have low sexual desire, no such link has been identified in women.

This app changed my practice: Pocket A1C

By Dr. Steve Wong on July 20, 2011

In response to reader requests and the increasing interest in mobile apps, we are launching a series of articles highlighting useful iPhone apps. These will appear approximately once every three months.

Treating Hepatitis C – the future is now!

By Dr. Eric Yoshida on July 18, 2011

This year, based on the phase III studies published in the New England Journal of Medicine, the FDA approved the new protease inhibitors, telapravir and boceprevir in combination with pegIFN and ribavirin for patients with HCV G1 infections.

Proton pump inhibitors and Clostridium difficile infection

By Dr. Ted Steiner on July 4, 2011

Based on recent literature, my current practice is to carefully consider whether PPIs or H2 blockers are truly indicated in inpatients, and to stop them if they are not.

Tailoring therapy for type 2 diabetes: the role of incretins

New targets for Diabetes (A1C): Why we are aiming at ‘only’ 7 percent

By Dr. Breay Paty on June 20, 2011

Recent studies suggest that the relationship between glucose control (A1C) and cardiovascular disease is more complex than we may have realized.

Advocating Fallopian Tube removal at the time of hysterectomy to prevent ovarian cancer

By Dr. Sarah Finlayson on June 5, 2011

A growing body of knowledge reveals that the majority of cases of high grade serous “ovarian” cancer actually are fallopian tube cancers.

Weed is not just an herb

By Dr. Carol-Ann Saari on May 24, 2011

I watched as a functioning youth became more and more psychotic as he smoked large amounts of marijuana every day, and I saw how difficult it was to treat his psychosis even after the marijuana stopped.

Prostate Specific Antigen – Does the new data support its utility for prostate cancer screening?

By Dr. Peter Black on May 9, 2011

Most of the data on which we base our prostate cancer screening practices is indirect and not definitively linked to the decrease in mortality that has been observed.

Acute Ischemic Stroke: Thombolysis is an Effective Therapy

By Dr. Devin Harris on April 26, 2011

Thombolysis for acute ischemic stroke is a small component of comprehensive acute stroke therapy. However, there now should be no debate into its effectiveness and the widespread adoption of its use in carefully selected patients should be supported.

Self-management of mood problems

By Dr. Dan Bilsker on April 11, 2011

Innovative forms of service delivery have the potential to greatly expand the scope of depression intervention. Series of self-management workbooks designed to teach depressed individuals evidence-based skills for mood management, available for free download from http://www.comh.ca/selfcare/.

New therapies and new end points in the treatment of Crohn’s Disease

By Dr. Brian Bressler on March 28, 2011

Effectively treating the inflammation in patients with Crohn’s disease has now allowed us to treat not just the symptoms associated with Crohn’s disease, but the disease itself.

Management of maternal thyroid disease in pregnancy

By Dr. Graeme Wilkins on March 14, 2011

Overt hypothyroidism is seen in 0.3 to 0.5% of the general population and subclinical hypothyroidism (high TSH and normal free T4) is seen in 2-3%. Thyroid antibodies are identified in 5-15% of women.

Chronic ulcers and biofilms

By Dr. Brian Kunimoto on February 28, 2011

The concept of biofilm in chronic wounds is in its infancy at the present time. It is just now being proposed that they play an important role in the pathogenesis of non-healing.

The outcomes of prematurity

By Dr. Anne Antrim on January 31, 2011

NICU experience has a profound effect on children and their families. As caregivers, we need to specifically ask about potential issues and offer advocacy for these families in the community and in the schools.

Advance care plan (ACP) for patients with multiple co-morbidities

Monitoring of cardiovascular disease risk in people with chronic mental illness

By Dr. Randall White on January 17, 2011

The evidence has become impossible to ignore that people with chronic mental illness are dying from heart attacks and strokes at a higher rate than the general population.

Smoking Cessation

By Dr. Shirley Sze on January 3, 2011

Tobacco kills twice as many people in BC as motor vehicle crashes, alcohol, suicide and homicide combined. Providing a brief intervention of 3 minutes will double the chance of patients quitting.

Awards
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In 2014 TCMP won the CFPC Continuing Professional Development (CPD) Award. This award recognizes a MAINPRO®-accredited educational program that has provided an exceptional learning experience to practicing or practice-eligible CFPC members.
In 2012 UBC CPD received the Royal College Accredited CPD Provider Innovation Award for This Changed My Practice.