WHO observes July 28th as World Hepatitis Day and aims to eliminate Hepatitis B and C by 2030. The Pan-Canadian Sexually Transmitted and Blood-Borne Infections (STBBI) Framework for Action released in 2018 echoes this goal and calls for 80% of eligible people in Canada to receive hepatitis C treatment by 2030. In order to achieve these goals by 2030, high rates of testing and diagnosis are essential. New HCV therapies are well tolerated, require 8–12 weeks of treatment, are publicly funded in BC, and have cure rates of about 95%.
Recent evidence has emerged that shows cannabis smoking is related to significant patient morbidity. Namely, cannabis smoke exposure increased the risk of oropharyngeal cancer in a dose-dependent manner. Cannabis use may also be associated with hearing loss, vestibular dysfunction, tinnitus, and sinusitis.
Acute onset of monocular flashes and/or floaters is a common presentation to primary care providers. Most often, this represents a posterior vitreous detachment (PVD), an age-related condition with a prevalence that increases from 24% in adults aged 50 to 59 to 87% among those aged 80 to 89 years.
Primary biliary cholangitis (PBC) is the most common autoimmune liver disease with an incidence of 1 in 1000 in women over age 40. For decades, the only evidence-based treatment was ursodeoxycholic acid. Unfortunately, the rate of inadequate response to UDCA is up to 40%. In 2017, Health Canada approved the use of obeticholic acid (OCA) for the treatment of PBC. UDCA remains first-line therapy for PBC with a long record of use and generic preparations but in non-responders, OCA treatment should be considered.
The ingredients needed to create a happy workplace also largely reflect the principles of secure attachment. Across all levels within organizations, if people do not feel “safe, seen, soothed, and secure” they are more likely to make errors, breach safety protocols, and struggle working together as a team.
Between 5% to 10% of the population reports an allergy to penicillin. After careful assessment, over 90% of these individuals are found to carry a false allergy label. Having a penicillin allergy label carries many potential harms, including prolonged hospital stays, increased patient costs, risk of more side effects, and an increase in resistant organisms. As such, penicillin allergy has become a major public health concern.
Editor’s note: Here is the revised article on AUD by Dr. Harries, which more prominently emphasizes the stepwise approach in the BC AUD guidelines. We appreciate the patience of our readership and special thanks to Dr. Harries for his passion and commitment to treating AUD. We would also like to thank Dr. Keith Ahamad (co-chair […]
The integration of point of care ultrasound (PoCUS) in the emergency department workflow is not always easy, and these challenges have been amplified in the time of COVID-19. The COVID-19 pandemic has led to an increased interest in the use of handheld ultrasound devices as they simplify infection control procedures and take up little space in emergency rooms crowded with critical care equipment.
Despite intensive lowering of LDL-C using lipid-modifying therapy, residual ASCVD risk persists, particularly in those with hypertriglyceridemia. Icosapent ethyl has been shown to reduce residual ASCVD risk and cardiovascular death in select patients with hypertriglyceridemia while on statin therapy.
In the era of the COVID-19 pandemic, our most vulnerable patients (the elderly and those with chronic illnesses) are disproportionately at the highest risk of mortality. In this difficult and chaotic time, it’s more important than ever that we maintain a humanistic approach to care. This involves keeping the patient, and their values and preferences, front and center in our care.
I conducted a study examining effective peer support in rural Canadian physicians. (Spoiler alert: those who have had good peer support say it is essential to their career in medicine.) Here is what I am doing now to ensure I, and my team, can manage through this unprecedented time at work.
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.
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.
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.
If you employ people, you should have professionally drafted and implemented employment contracts. The time and cost of having contracts drafted and implemented are minor, in comparison to the time and cost of dealing with a wrongfully dismissed employee and their lawyer.
Tendinopathy of the lateral epicondyle can be a difficult problem to resolve. The Lateral Epicondyle Tendinopathy Toolkit is an excellent resource for physicians looking to quickly advise patients on interventions to manage both acute and chronic tennis elbow.
Identification of hereditary cancer families in BC is important to provide individuals at elevated cancer risk with appropriate screening and risk management recommendations.
Falls are a common geriatric syndrome and are the third leading cause of chronic disability worldwide. Improved cognitive function, in particular executive functions, is an important mechanism by which the exercise reduces falls and improves overall mobility.
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