Author Archives: CMAJ

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Pat Rich is an Ottawa based medical writer and editor.

 

Cometh the hour, cometh the man.

It would be the very height of pretentiousness to apply this phrase to Dr. Liam Farrell, an author and former family physician from Rostrevor, Co. Down, Ireland and I am sure he would be the last person to do so.

But at a time when family medicine seems to be at its lowest ebb, if not globally then very much here in Canada, there is much to be said for having a physician who can so eloquently write about both the rigors and the ...continue reading

Hillel M. Finestone is a Physiatrist at the Elisabeth Bruyere Hospital and Professor, Division of Physical Medicine and Rehabilitation, University of Ottawa.

 

My 52-year-old patient took his BP at a pharmacy on 6 separate occasions.  Systolic BP values were high, ranging from 150-177. When I take his BP in the office it’s 168/98.  Yup, he has high BP.  He’s 10 pounds overweight, doesn’t have diabetes, doesn’t smoke and thinks that he was told that his BP was “probably high” 5 years ago, but he didn’t feel that medications would make a difference.

We talk about weight loss, healthy eating and reducing high sodium foods, that we don’t know why BP elevates but that medications really work and help stop strokes and heart attacks from occurring.  He agrees to my prescription of one medication and we discuss its side effects.  A drug information sheet is provided. ...continue reading

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Keegan Guidolin is a General Surgery resident at the University of Toronto

Han Yan is a Neurosurgery resident at the University of Toronto

 

 

Much attention has been paid of late to the phenomenon of social echo chambers - situations in which people’s beliefs are amplified and repeated in a closed system as no dissenting opinion originates from within the group. Echo chambers on social networking platforms such as Facebook and Twitter were identified as a factor contributing to the outcome of the 2017 US Presidential Election. We believe that social echo chambers exist in the real (non-digital) world as well, within social groups whose members may interact outside the group in general, but who discuss particular subjects only within the group. ...continue reading

Dr. Dhruvin Hirpara is a General Surgery resident at the University of Toronto

Dr. Nancy Baxter is a colorectal surgeon at St. Michael's Hospital

Dr. Fayez Quereshy  a surgical oncologist at the University Health Network.

 

Colorectal Cancer (CRC) is the second leading cause of cancer-related death amongst men, and the third leading cause of cancer-related death in women in Canada. Although screening has contributed to declining incidence in the elderly, recent epidemiological data reflect a rise in CRC among young adults. Data from the Canadian Cancer Registry suggest a steady increase in young-onset (15-49y) CRC, from 745 cases in 1969 to 1475 cases in 2010. In Ontario, the incidence of CRC has been increasing in young adults (30-49y) since 2005, from 6.17 per 100,000 to 9.08 per 100,000 for colon cancer, and 4.31 per 100,000 to 6.29 per 100,000 for rectal cancer. Evidence from other jurisdictions, including France, Australia, and the United States reflects similar trends in the rise of young-onset CRC. Why this apparent increase in CRC among younger people? We don’t yet know the cause but theories point to an interplay of several potential factors.

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Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK.

 

Liveability. What a cool, trendy word that immediately paints a vibrant picture in your mind. We know instinctively what it means as it conjures up an image of a healthy environment, an active lifestyle and personal wellbeing. No surprise, therefore that its used in advertising  to sell everything from domestic products to real estate.  If, on the other hand, we talk about the social determinants of health, most people don’t really know what we mean and they switch off. But, liveability gives us a common language to explain how there is so much more to health than just medicine.

This was a recurring theme at the conference on Creating Active and Liveable Societies hosted by the Centre of Excellence for Public Health in Belfast with a host of international experts. ...continue reading