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
Sarah Hanafi is a Psychiatry Resident (R1) at McGill University
I started my Geriatrics rotation on the Restorative Care unit. Having trained mostly in acute care, I found myself perplexed by this care model. On the surface, many patients seemed to suffer from maladaptive personality traits that hindered their graduation to primary care. It felt like a bizarre blend between an internal medicine ward and a long-term care facility; this mirrored the disorientation I felt in managing patients who had few medical problems, per se, but lacked the means — whether intrinsic or extrinsic — to cope. ...continue reading
The new Canadian guideline presents evidence-based recommendations for prescribing of opioids for chronic non-cancer pain, including maximum dose recommendations, avoiding opioids in high-risk populations, and guidance for tapering.
Jason Busse, Associate Professor in the Department of Anesthesia at McMaster University and researcher with the Michael G. DeGroote National Pain Centre in Hamilton, Ontario, co-authored the guideline (open access). In this podcast, he speaks with Dr. Diane Kelsall, interim editor-in-chief, CMAJ, and explains the recommendations.
Listen to the author interview: