By Dr. Steve Wong on December 19, 2018
More than ever, it seems, it’s important to share opinions that are backed by facts, be willing to revisit and update what you thought you knew before, and be inspired to seek out more information about something you learned anew.
By Drs. Terence Yung and Steve Ham on December 5, 2018
All postoperative troponin elevation should be treated seriously. Troponin elevation after surgery is associated with significant mortality at 30 days. Myocardial injury after non-cardiac surgery (MINS) diagnosis is made after other causes of troponin elevation are ruled out. Up to 90% of patients with a troponin elevation postoperatively do not exhibit any symptoms, yet their outcomes are still poor.
By Mark W. Hull MD MHSc on November 13, 2018
Over the last five years, on an ongoing basis, we have seen new HIV infections occurring in young gay, bisexual and other men who have sex with men (MSM). The majority of these individuals had had a prior negative HIV test within the last year, or were presenting with signs or symptoms supportive of an acute HIV infection, suggesting recent exposure and transmission of HIV infection, highlighting the need for novel HIV prevention strategies.
By Dr. Diane Villanyi on October 31, 2018
Under Section 230 of the Motor Vehicle Act, in addition to physicians, registered psychologists, optometrists and nurse practitioners are obliged to report a patient who may be unfit to drive. RoadSafetyBC has a dedicated phone line for medical professionals to help with complex cases.
By Michelle C. Danda, RN, BN on October 10, 2018
I realized that engagement is paramount when working with an ambivalent patient, because the change that they want to make is often important in their life, even if the clinician views it as a problem behavior. Motivational interviewing education has been shown to improve patient alliance and treatment adherence.
By Dr. Martha Spencer on September 19, 2018
Fecal incontinence (FI), defined as the involuntary passage of stool or the inability to control the expulsion of stool, is a common but under-reported condition that can affect people of all ages but has increased prevalence in older adults.
By Dr. Carol-Ann Saari on September 5, 2018
In the general population, approximately 75% of Canadians will report having experienced an adverse and potentially traumatic experience in their lifetime, with 9.2% meeting criteria for PTSD. We have to become trauma informed. Trauma informed practice (TIP) is a way of providing services that recognizes the need for physical and emotional safety, choice and control in decisions affecting one’s treatment and an environment where patients do not experience further traumatization.
By Lily Zhou on September 4, 2018
I used to feel crushed when looking up from notes during a presentation to a packed lecture hall of colleagues intensely concentrating…
By Dr. Colleen Varcoe and Dr. Heather Smith on August 15, 2018
Health equity-oriented care is now part of my daily practice; the tools created with, and provided by, the EQUIP study have helped to make health care inequity an issue that I can screen for and offer options for management.
By Drs. Terence Yung and Tony Wan on July 24, 2018
For those who had an elective hip or knee arthroplasty who have no other risk factors for VTE, after initial 5 days of DVT prophylaxis with rivaroxaban 10mg a day, I complete the remaining DVT prophylaxis with aspirin 81mg once daily for an additional 30 days for hip arthroplasty and 9 days for knee arthroplasty. Those who already were on once-daily 81mg aspirin prior to surgery will receive 162mg aspirin once daily instead in this period.
By Dr. Maia Love on July 4, 2018
Defining yourself as a person first, and your role as a professional second, has benefits in preventing burnout and creating more personal energy. Put your own oxygen mask on first.
By Dr. Min S. Phang, MRCP, FRCPC and Stacey Miller, PT on June 13, 2018
I now refer all children with cerebral palsy, or suspected cerebral palsy, to the Child Health BC Hip Surveillance Program. Information about the program is available at www.childhealthbc.ca/hips, including a referral form for physicians. The incidence of hip dislocations can be significantly reduced!
By Dr. Kelly Luu on May 23, 2018
Evidence shows that the strategy which physicians frequently employ, educating and training, is only the first step in the process of behavioural change. By helping patients shift their narratives about themselves, we can strengthen their ability to have sustained behavioural change.
By Dr. Andrew Howard, Tyler Schwaiger, Dr. Noah Silverberg, and Dr. Will Panenka on May 2, 2018
Rest might increase symptoms and recovery time following concussion or mild traumatic brain injury. Inactivity has been associated with physical deconditioning, social isolation, discouragement about recovery, and reactive anxiety and depression. Early mobilization and graded exercise programs can reduce post-concussive symptoms and recovery time.
By Dr. Vanessa Brcic and Dr. Devon Christie on April 18, 2018
What changed our practice was a fundamental recognition of trauma as a determinant of health, and furthermore, that PTSD is only the tip of the iceberg when it comes to trauma. Much lies under the surface for our patients.
By Dr. Leslie Sadownik on April 4, 2018
Women with chronic vulvar disorders will often report years of symptoms before an accurate diagnosis is made, and effective treatment is started.
By Dr. Vincent Hanlon on March 14, 2018
Mindfulness is the awareness that emerges through paying attention to the unfolding of experience moment by moment. This paying attention is done on purpose, in the present moment, and it’s non-judgmental.
By Dr. Duncan Etches on February 21, 2018
In summary, in place of pattern or algorithm driven medicine, clinical experience and ability to determine what is best for our patient lies at the heart of the art of medicine.
By Dr. Laura Sauvé on February 7, 2018
Vaccines are safe, but sometimes adverse events following immunizations do happen, and can be very concerning to families. If your patient has an AEFI, there is a voluntary reporting system. Public Health Officers in your local Health Authority will be able to answer most questions or concerns.
By Ruth Elwood Martin on January 23, 2018
To address the issue of health care discrimination and coordination of care people with incarceration history, the CCPHE has collaboratively developed Guidelines for Family Physicians working with Formerly Incarcerated People.
By Doson Chua, PharmD, FCSHP, BCPS(AQ) and Dr. Mustafa Toma on January 10, 2018
Sacubitril/valsartan is the first in class of ARNI and has proven its superiority in reducing mortality and morbidity in HFrEF as compared to the use of ACEI. Sacubitril/valsartan should be considered in patients who are symptomatic despite optimal or maximally tolerated guideline-driven HF therapies consisting of a beta blocker, ACEI/ARB and MRA. Monitoring of patients on sacubitril/valsartan is similar to ACEI.
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