Editor's Note, Volume 7 Issue 1
D’Arcy Little, MD, CCFP, FRCPC
Medical Director, JCCC and HealthPlexus.NET
I am pleased to introduce the first issue of the Journal of Current Clinical Care for the new year.
Drs. Parham Rasoulinejad, Jennifer C. Urquhart, and Christopher S. Bailey present Current Management of Symptomatic Lumbar Disc Herniation. Lumbar disc herniation is a common cause of low back pain and radiculopathy (sciatica). Diagnosis is initially made based on history and physical examination and ruling out red flags, particularly surgical emergencies such as Cauda Equina Syndrome. A trial of conservative treatment consisting of physical rehabilitation and oral medication is usually successful for back dominant pain. When persistent radiculopathy indicates lumbar discectomy the diagnosis must confirmed imaging but, due to very high rates of asymptomatic disc herniation, imaging cannot replace clinical diagnosis. For disabling leg dominant pain discectomy results in faster recovery but has a similar long-term outcomes compared to conservative treatment.
In their article, Sudden Sensorineural Hearing Loss—A Medical Emergency, Dr. Pradeep Shenoy and Ms. Stephanie Bellemare-Gagnon, from Campbellton Regional Hospital in New Brunswick review the impact of sudden hearing loss. Usually unilateral and rarely bilateral can be associated with tinnitus and vertigo. In most cases it is idiopathic, although various explanations such as infective, vascular, and immune causes have been postulated. The authors reviewed the literature and what follows is a survey of current research and suggested treatments for sudden hearing loss.
Dr. Mchael Gordon, from the Baycrest Centre for Geriatric Care in Toronto offers two articles in this edition. An ethical discussion on Why Families Should Consider Forgoing CPR, an important conversation for family members to have before it's too late.
In his second article, Dementia: Hearing Loss May Contribute to Symptoms, Dr. Gordon examines the impact that hearing impairment can have and further complicate dementia symptoms. It is important to determine categorically that a link exists so that people might be more readily convinced to seek hearing evaluation and proper amplification if required.
I hope you enjoy this latest edition. Please consider commenting or submitting an article of your own.