Post Archives

Dr. Daniel Kim
February 3, 2016

Enhance the valsalva to (actually) terminate SVT

Supraventricular tachycardia (SVT) is a dysrhythmia characterized by abrupt onset, regular rate that usually exceeds 150 beats/minute, and lack of identifiable P waves on ECG. SVT is caused by an abnormal circuit that allows a wave of depolarization to repeatedly travel in circular fashion in cardiac tissue via a reentry circuit that may reside in the atrioventricular (AV) node or outside the AV node in an accessory pathway. read more...

Kishore Mulpuri
January 20, 2016

Screening for developmental dysplasia of the hip: an evidence-based approach to practice

Developmental Dysplasia of the Hip (DDH) is a spectrum of hip joint abnormalities ranging from mild dysplasia to severe, frank dislocations. Left untreated, DDH can lead to serious complications later in life including osteoarthritis of the hip and total hip replacement. read more...

Dr. N. John Bosomworth
January 6, 2016

Weight loss in healthy people

There is no evidence for benefit of weight loss in healthy people. The safest body size trajectory in healthy people is a stable weight. It takes a modest amount of exercise to attain good metabolic benefit. It takes substantial exercise commitment to produce weight loss or to prevent weight regain. Mediterranean diet reduces cardiac risk factors and mortality. read more...

Dr. Steve Wong
December 16, 2015

Letter from the editor

As 2015 comes to a rapid close, I wanted to once again thank all of our authors and readers for their active participation at This Changed My Practice (TCMP). read more...

Sue Barlow, OT and Jennifer Loffree, OT
December 2, 2015

Concussion rehabilitation

The statistics regarding recovery from concussion indicate that the majority of individuals will be symptom-free at 3 months; within 6 months 70-75% will be symptom free; and within a year 10% will have 1 persisting symptom and 5% will have 4 or more persisting symptoms read more...

Dr. Paul Thiessen
November 18, 2015

A simple new technique for collecting urine in infants

What changed my practice was this simple new technique reported in an article from Spain which described a new method to obtain a midstream urine collection in which the infant is held upright and someone rubs over the suprapubic region while gently tapping over the lumbar region of the spine. read more...

Dr. Antoinette van den Brekel
October 28, 2015

Postnatal investigation of antenatally detected hydronephrosis

Health care providers caring for pregnant women and newborns are often faced with a finding of fetal hydronephrosis on routine screening antenatal ultrasound; in fact it is seen in 1 to 2% of fetuses screened. Babies at risk of rapidly progressive renal injury due to urinary tract obstruction need to be evaluated and referred for specialized care urgently, prior to discharge from hospital. read more...

Dr. Ric Arseneau
October 13, 2015

Hope for patients with fatigue, pain, and unexplained symptoms

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. read more...

Dr. Karen Nordahl
September 30, 2015

Exercise during pregnancy

It has been shown that 55% of pregnant patients reported some form of back pain during their pregnancy when questioned. Studies have demonstrated that if we get pregnant women moving, specifically working their pelvic floor with Kegel exercises and their ‘core’ they may have better pregnancy outcomes. read more...

James McCormack
September 16, 2015

Cardiovascular outcomes and blood pressure, glucose, and cholesterol numbers

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. read more...

Dr. Catherine Allaire
September 2, 2015

Management of cyclical pelvic pain

Endometriosis is a very common condition affecting an estimated 10% of women of reproductive age. Severe dysmenorrhea is the most common symptom of endometriosis and the earliest one to occur. read more...

Dr. Anne Antrim
August 19, 2015

This app changed my practice – Read by QxMD

Read by QxMD provides the current research and opinions on topics in your field in a user-friendly manner so that I am not the last person in the province using Ribavarin for RSV infection when everyone else has read about the lack of efficacy. read more...

Douglas Cave, PhD
August 3, 2015

Recognizing the Potential Influence of the Interpersonal Gap in Teaching

I was frustrated at times that the students and residents did not always follow the instructions I gave. Their work was sometimes incomplete, off topic, or plainly wrong. While this was not true for most students, it was consistently true for a few each year. Teaching about empathy for example, I would invite residents to practice doing an interview with each other using empathic reflections and they would do it incorrectly. read more...

Dr. Clara van Karnebeek and Dr. Sylvia Stockler
July 29, 2015

This app changed my practice – Treatable Intellectual Disability Endeavor in B.C. (TIDE) – Treatable ID App

Affecting 2-3% of Canadians, intellectual disability (ID) is a lifelong, devastating condition defined by deficits in cognitive functioning (IQ<70) and adaptive skills. It is called global developmental disability (GDD) in children less than 5 years of age; it is defined as deficits in 2 or more developmental domains. In Canada, approximately 7,600-11,500 children are born annually with GDD. Identification of GDD or ID in children is the essential first step and often a task for the primary care practitioner. read more...

Dr. Randall White
July 8, 2015

Measurement of depressive symptoms improves outcomes in primary care

Simple use of a self-rated symptom checklist can double the odds of response to antidepressant medication in primary-care patients. read more...

Dr. Sue Murphy
July 3, 2015

Open book exams – something to consider?

One of the topics examined in my initial “professionalism” course are the bylaws and Standards of Practice of the licensing body. Bearing in mind that the end goal is that students should be able to apply these standards to practice, not just memorise them, the multiple choice question (MCQ) exam format I have used contained a typical practice scenario with a variety of possible options for action, with instructions for the student to select the “best” option. read more...

Dr. Jane Buxton and Erica Tsang
June 24, 2015

BC Take Home Naloxone Program

Opioid overdose is a major cause of morbidity and mortality worldwide, and constitutes a serious public health issue. Throughout British Columbia (BC), the landscape of opioid overdose has evolved, first with oxycodone and more recently, illicit fentanyl. read more...

Dr. Kourosh Afshar
June 10, 2015

Role of imaging in management of undescended testis (UDT)

UDT is one of the common causes for referral to Pediatric Urologists. 1-2% of boys have UDT at age of 12 months. UDT is associated with increased risk of malignancy (relative risk 2.75-8). read more...