Dr. Laura Sauvé
Feb 07, 2018
Adverse events following immunizations (AEFI)
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. read more...
Ruth Elwood Martin
Jan 23, 2018
Guidelines for working with formerly incarcerated people
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. read more...
Doson Chua, PharmD, FCSHP, BCPS(AQ) and Dr. Mustafa Toma
Jan 10, 2018
Angiotensin Receptor Neprilysin Inhibitor (ARNI) in Heart Failure with Reduced Ejection Fraction (HFrEF): Sacubiltril/Valsartan and the PARADIGM HF Trial
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. read more...
Dr. Steve Wong
Dec 14, 2017
Letter from the editor
It's hard to believe that this is our 7th year at This Changed My Practice. Thanks for being part of our TCMP family. On behalf of all of us at This Changed My Practice, I wish all of you a happy, healthy holiday season! read more...
Dr. David Topps
Nov 29, 2017
Managing your passwords
Ever been frustrated by the number of passwords you have to keep track of in your daily life as a professional? At one time, you might have only a few – some simple ones for unimportant sites, some stronger ones and perhaps a really good one for your most important data. read more...
By Dr. Christy Sutherland and Emily Wagner
Nov 15, 2017
Managing opioid use disorder: buprenorphine/naloxone opioid agonist treatment
I no longer offer rapid methadone tapers to my patients. Buprenorphine/naloxone is now recommended as the first-line opioid agonist treatment for opioid use disorder in British Columbia. This is because of its superior safety profile when compared with methadone as well as an easier transition to take home dosing. read more...
Dr. Roberto Leon
Nov 01, 2017
Indications and value of self-administered vaginal swabs for STIs and vaginitis
I came across a publication in the British Medical Journal by Sarah A. Schoeman: Assessment of best single sample for finding chlamydia in women with and without symptoms: a diagnostic test study. Participants took a vaginal swab before a routine gynecological exam, and clinicians then took an endocervical swab during examination. read more...
Dr. Jennifer Robinson
Oct 18, 2017
MOVE an injury not RICE
MOVE an injury: Movement, not rest. Options: offer other options for cross training. Vary rehabilitation with strength, balance and agility drills. Ease back to activity early for emotional strength. read more...
Dr. Eileen Murray
Oct 03, 2017
Whether or not to use systemic corticosteroids to treat a skin disease
When I started out in dermatology, corticosteroids were the only systemic drug available to treat patients with severe allergic contact dermatitis (ACD), atopic dermatitis (AD), drug reactions and those with bullous diseases. Corticosteroids are potent and excellent immunosuppressive agents. The main problem with systemic use is the high risk of drug interactions, as well as multiple serious acute and long-term side effects. read more...
Dr. Taryl Felhaber
Sep 20, 2017
The risks of worklessness
Why should physicians encourage early and ultimate return to work whenever they can? In a nutshell, because it is usually in the patient’s best interest to remain in the workforce. read more...
Dr. Jennifer Grant
Sep 06, 2017
Evaluation of penicillin allergy
Recent data show that up to 90% of patients with a reported penicillin allergy are mislabelled and of those who are allergic, many beta-lactams can still be safely prescribed due to low risk of cross-reactivity. Mislabelling of penicillin allergy is due to many things including misdiagnosis (confusing a viral exanthema for allergy), purer formulations of antibiotics, loss of allergy and differences in side-chain structure. read more...
Drs. Christopher Cheung and Kenneth Gin
Aug 09, 2017
Management of Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation
Perioperative management of anticoagulation is challenging as physicians must consider the risks of stroke, systemic embolism, and perioperative bleeding. read more...
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