In 2012 UBC CPD received the Royal College Accredited CPD Provider Innovation Award for This Changed My Practice.
By Drs. Lawrence Chow and Rose Hatala on May 6, 2020
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.
By Dr. Alice S Chang, Dr. Michael J Diamant, Dr. Margot K Davis, and Dr. Krishnan Ramanathan on October 30, 2019
Cardiac amyloidosis (CA) is an infiltrative disease that is being increasingly identified in those with HFpEF. Amyloidosis is a group of heterogeneous disorders characterized by the deposition of misfolded protein that aggregates into fibrils, affecting multiple organs including the heart, neural tissues, kidneys, and the gastrointestinal tract.
By Dr. Janet Simons on June 26, 2019
Formulae to adjust total calcium for the albumin concentration should be abandoned. The use of these formulae overestimates ionized calcium in patients with hypoalbuminemia, causing false negatives for hypocalcemia and false positives for hypercalcemia. Measurement of ionized calcium is now relatively inexpensive and is available in most hospitals and many outpatient settings.
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 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 Drs. Christopher Cheung and Kenneth Gin on August 9, 2017
Perioperative management of anticoagulation is challenging as physicians must consider the risks of stroke, systemic embolism, and perioperative bleeding.
Elevated Lipoprotein (a) is a common reason for unexplained premature or recurrent coronary heart disease and stroke
By Dr. Gordon Francis on April 26, 2017
High Lp(a) is a major CVD risk factor that should be measured and acted upon in patients and families where there is history of premature CV events but lack of clear risk factors, and in patients with known CVD and recurrent events despite treatment to LDL-C target.
By Drs. Charlie Chen and Hayden Rubensohn on April 12, 2017
What is the patient willing to consent to as treatment if his/her condition were to seriously deteriorate? The Serious Illness Conversation Guide developed by Ariadne Labs provides a framework for physicians to engage in care planning with patients in a manner acceptable to the patient.
First Canadian guideline on perioperative cardiac risk assessment and management for patients undergoing non-cardiac surgery
By Drs. Terence Yung and Erin Morley on March 22, 2017
Physicians who see patients for preoperative assessment often face the dilemma of accurately determining a patients’ cardiac risk. Patients may have limited mobility and thus do not necessarily elicit cardiac symptoms even if there is significant flow-limiting coronary artery disease.
By Dr. Ric Arseneau on February 8, 2017
The PLEASE trial (Persistent Lyme Empiric Antibiotic Study Europe) was published in the New England Journal of Medicine in March 2016. This randomized, double-blind, placebo-controlled study assessed whether longer-term antibiotic treatment of persistent symptoms attributed to Lyme disease leads to better outcomes than does shorter-term treatment.
By Dr. Ric Arseneau on November 30, 2016
Chronic Fatigue Syndrome (CFS) – also known as Myalgic Encephalomyelitis (ME) and Systemic Exertion Intolerance Disease (SEID) – is a common clinical condition. Yet, it is under- recognized and diagnosed. An estimated 84–91% of patients with the condition remain undiagnosed.
By Drs. Christopher Cheung and Kenneth Gin on June 22, 2016
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.
By Drs. Erica Tsang and Iain Mackie on February 17, 2016
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.
By Dr. Ric Arseneau on October 13, 2015
Fatigue, pain, and unexplained symptoms are commonly seen in physician offices, however they are often experienced as “unsatisfying” for doctors. Our patients need an explanatory model to help them understand their illness. If we don’t provide one, patients will create their own or seek one elsewhere.
By James McCormack on September 16, 2015
Numerous observational studies have consistently shown in many (but not all) patient populations a correlation between people with higher blood pressure, glucose, and cholesterol numbers, and a greater risk of cardiovascular events such as heart attacks, strokes, and other unwanted outcomes.
By Dr. Nadia Zalunardo on September 15, 2014
The most common cause of death among individuals with chronic kidney disease is cardiovascular disease. For most people with CKD, the risk of cardiovascular death exceeds the risk of developing end stage kidney disease.
By Dr. Natasha Press on March 5, 2014
The most recent AHA guidelines (2007) have limited antibiotic prophylaxis to those patients at highest-risk for developing endocarditis and who are undergoing high-risk invasive procedures.
By Drs. Kam Shojania and Neda Amiri on September 23, 2013
Rheumatoid arthritis has been described to be associated with an increased risk of cardiovascular disease. This risk appears to be multifactorial in nature. However, there is emerging evidence that glucocorticoids play a role.
By Dr. Jason Hart on November 20, 2012
In April 2012, NEJM published The EINSTEIN-PE study, which looked at the use of oral Rivaroxaban for the treatment of symptomatic pulmonary embolism in 4833 patients.
By Dr. Jiri Frohlich on August 20, 2012
Several studies established that apo B is a better predictor of risk both at baseline and on treatment than LDL-C due to the fact that small dense LDL particles are much more atherogenic as they easily penetrate the endothelial space.