Nichole Fairbrother
Mar 20, 2019
Anxiety disorders among pregnant and postpartum women
Unwanted, intrusive thoughts of accidental harm to one’s infant are reported by 100% of new mothers, and unwanted, intrusive thoughts of intentionally harming one’s infant are reported by 50% of new mothers. Ask specifically about unwanted, intrusive thoughts of infant-related harm. Educate pregnant women and normalize the occurrence of the thoughts. Reassure women that, in the absence of any additional risk factors for child abuse, disclosure of these thoughts will not result in any action on the part of the care provider/physician. read more...
Dr. Muxin (Max) Sun
Mar 06, 2019
Decreasing pain of osteoarthritic knees
I have decreased my frequency of giving steroid injections for decreasing pain of osteoarthritic knees. I educate patients on evidence, placebo effects and risks. I recommend less invasive therapies including physiotherapy, exercise (quadriceps and hip abductor strengthening, Tai Chi), hot compress, antiinflammatory creams, weight loss, TENS machine, orthopedic & orthotic devices, etc. read more...
Dr. Leslie Sadownik
Feb 13, 2019
Help – the steroids are not working – Helping women with refractory vulvar lichen sclerosus
Lichen sclerosus (LS) is a chronic skin disorder with a remitting and relapsing clinical course. Women commonly present with severe vulvar itch and an urge to scratch the skin. The recommended treatment is a course of topical steroids. Most women will improve with treatment. However, some will report, “the steroids did not help”. Here are some practice tips to help. read more...
Drs. Maysam Khalfan and Kam Shojania
Jan 30, 2019
Pearls and Pitfalls of Rheumatologic Lab Investigations
Patients who present with non-specific symptoms are sometimes tested with rheumatologic lab investigations as part of a ‘panel’ of tests. When these tests come back positive, it can lead to more confusion, patient anxiety, misdiagnosis or unnecessary referral. read more...
Andrea Holmes
Jan 16, 2019
Dietary and physical activity recommendations for cancer survivors
Breast and prostate cancer survivors want to know what to eat to prevent cancer from coming back. HealthLink BC healthy eating resources that support successful dietary and physical activity change for prostate and breast cancer survivors are available for your patients. read more...
Dr. Steve Wong
Dec 19, 2018
Letter from the editor
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. read more...
Drs. Terence Yung and Steve Ham
Dec 05, 2018
Postoperative “troponinitis” is not benign: highlighting the importance of surveillance
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. read more...
Mark W. Hull MD MHSc
Nov 13, 2018
HIV pre-exposure prophylaxis (PrEP) for individuals at risk for HIV infection
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. read more...
Dr. Diane Villanyi
Oct 31, 2018
Driving assessment in older adults
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. read more...
Michelle C. Danda, RN, BN
Oct 10, 2018
Learning to meet my patient where they are at – how letting go changed my practice
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. read more...
Dr. Martha Spencer
Sep 19, 2018
Fecal incontinence: just ask!
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. read more...
Dr. Carol-Ann Saari
Sep 05, 2018
Trauma Informed Practice (TIP) makes perfect (or at least it is a good start)
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. read more...
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