Nicole Le Saux is Associate Professor in the Division of Infectious Diseases at the University of Ottawa *
As physicians we should be concerned about the inappropriate use of antibiotics. Have you ever had a patient with an extended spectrum beta-lactamase (ESBL), E. coli or Klebsiella urinary tract infection, a Clostridium difficile infection (CDI) or a drug-resistant N. gonorrhoeae?
Whereas resistant bacteria and CDI were rare a decade ago, these clinical situations are now commonplace in hospitals, long term care facilities and emergency departments. According to the Canadian Antimicrobial Resistance Surveillance System Report 2016 the rate of CDI in hospitalized patients is 3.4 cases per 1000 patient admissions (approximately one in every 300 patients admitted). As of 2014, 18.2% of isolates of Neisseria gonorrhoeae were resistant to penicillin with worrisome decreased susceptibility to cefixime, ceftriaxone and azithromycin. ...continue reading →
Barbara Zelek is Associate Professor and Co-Chair for the Section of Family Medicine at the Northern Ontario School of Medicine
Marathon, a rural community on the North shore of Lake Superior, made CMAJ headlines in 1997 because it boasted a stable workforce of seven physicians for the first time in over a decade. 2017 marks the 20th anniversary of that CMAJ article and of the arrival of Dr. Sarah Newbery and Dr. Eliseo Orrantia in Marathon.
The article described “a medical renaissance” taking place in Marathon and an end to “the revolving door that has affected rural medicine across the country”. That door has stopped revolving in Marathon since 1997 thanks, in many ways, to the leadership of Eli and Sarah.
Did you hear about Chris’s mint condition 1963 Shelby Cobra? Mechanics say he didn’t check the oil for decades, and the engine just seized one day on the way to work. When they opened it up, they say there wasn’t much left. Such a shame really.
Said Nobody. EVER.
Jazlin Mayhue is a researcher in Victoria, BC
Peter Hobza is a family physician in Victoria, BC
Robert O'Connor is a family physician in Victoria, BC
Introducing a new concept...
We all know folks who are not vigilant with preventive health for their body. However, a subset of them wouldn’t drive an irreplaceable million-dollar car until it was destroyed from lack of maintenance. A human’s life and body are irreplaceable, and worth at least a million dollars, when considering the price of an injury causing death. Therefore, it’s logical to help some people think of treating their body as well as a valuable car. ...continue reading →
The ASHG annual meeting takes place every fall towards the end of October or in early November, as the leaves are changing from green to reds and golds. Every four years the meeting also takes place against the backdrop of the US presidential elections. In 2012, in San Francisco, when the meeting ran from the 6th to the 10th of November, I recall standing in the main hall as part of the opening ‘mixer’ event, where several thousand scientists watched a big screen projection as President Obama was re-elected to office.
This year's meeting, which ran from the 18th to the 22nd of October, took place against the backdrop of a very different election ...continue reading →
Bonnie Larson is Family Physician at Calgary Urban Project Society (CUPS) Health Centre
Recently I called the emergency department from my outreach clinic in an urban shelter. Near the end of the day, the nurse mentioned that one of the clients staying there, a young aboriginal woman I will call Ms. Rain, was supposed to follow up on an abnormal lab result from a few days earlier. As I looked the patient up on the ancient clinic laptop, I thought about the promise I had made to my daughter that morning to try to be home by suppertime. I willed the computer to load the results a little faster so I could get home to my family.
Dr Rod Bergh is a general pediatrician who has practiced medicine since the early 1960s.
I have practiced Pediatrics for most of the 59 years since I graduated from Medical School and I have seen tremendous changes in our knowledge. For the past 16 years, I have restricted my practice to children with ADHD and have experienced the great satisfaction of seeing in this period about 3000 children turn their lives around.
Change is based on knowledge gained by research. However, I would like to point out an area where I believe we have ignored evidence, which has resulted in some less-than-optimal therapy for ADHD. ...continue reading →
David Cawthorpe is a Professor (Adjunct) in the Faculty of Medicine at the University of Calgary, Alberta
By the end of this month the 22nd International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP) Congress will have come and gone. As this will have been its second congress hosted in Canada since 1954, it is perhaps time to take stock.
In Istanbul, in 2008, our team got its first whiff of tear gas and we won the 2016 bid; it was the beginning of an exciting journey, wherein the hope was to form a national community around this torch, a mental health Olympics for children and adolescents. Did we succeed? A good question. Regionally, we hoped to gain access for at least 1000 participants who would never otherwise have the opportunity to attend such a world class event. Did we achieve this or will this congress have been just another big business venture? The proof will, no doubt, be in the residual pudding! ...continue reading →
Iris Gorfinkel is a General Practitioner and Founder & Principal Investigator of PrimeHealth Clinical Research in Toronto, Ontario
I’d been attending this particular patient’s medical needs as her GP for the past five years. Enid dressed impeccably, was a young 85 years of age and had the amenities that most elders dream about. She had her health, financial security, education and a strong intellect. What she was missing was companionship.
“If only I had someone to travel with,” she lamented.
Hardly 24 hours later, I was asked to see Fred who had been my patient for 7 years. He was a robust 87 year old, financially secure, well educated, and possessed a marvelous sense of humor. He had remained active despite having lost his partner to lung cancer the year before.
“I miss having someone when I travel,” he told me.
Dr Genevieve Gabb is a Senior Staff Specialist in General Medicine at the Royal Adelaide Hospital in Australia; she also works at the Veterans Heart Clinic, Repatriation General Hospital, Daw Park, in ambulatory cardiovascular medicine. Genevieve has an interest in drug safety, particularly in relation to medicines commonly used in the prevention and treatment of cardiovascular disease
We have scientific consensus that global temperatures are rising. Despite this, debate and argument continues about whether global warming is occurring, the extent, possible causes and potential solutions to the problem.
In early January 2013, as this debate continued to rage, the Australian Bureau of Meteorology was confronted with a dilemma. Forecast temperatures were so extreme that they exceeded the colour range available for its isotherm charts. Isotherm charts are used to indicate temperature across the continent, and have lines that join points of equal temperature. Different colours, starting with cool blues; increasing to yellows and a deep burnt orange are used to show areas of similar temperature. An ominous, solid black topped the scale, indicating a temperature of 50 degrees Celsius. ...continue reading →
Alumni of The Graduate Institute Geneva include former Secretary-General of the United Nations Kofi Annan. It seemed to me to be the obvious choice for a course on Global Health Diplomacy. Geneva hosts many of the well known international organizations in the world, including the headquarters of many of the agencies of the United Nations and the Red Cross. I joined a group of 30 executives from all over the world who got together to learn and share on the topic of Global Health Diplomacy. There were participants from government sector as well as the private sector, Ministers of Health and of Finance, diplomats and doctors, academics, clinicians, policy developers, philanthropists and activists. In a relatively short period of time we got to know each other, learn from each other’s diverse backgrounds, and build relationships. ...continue reading →