D’Arcy Little, MD, CCFP, FRCPC, Medical Director, JCCC and www.healthplexus.net
I am pleased to introduce the next edition of the
Journal of Current Clinical Care. In this edition.
Dr. Shabbir M.H. Alibhai presents An Update on Cancer Screening in Older Adults. More than one-half of new cancers and over 70% of cancer deaths occur in adults age 65 or older. Systematic screening has been associated with reductions in cancer-related mortality for a variety of cancers, including breast, cervical, and colorectal cancer. Prostate cancer screening remains more controversial despite the recent publication of two large randomized trials of screening. In this article, he reviews evidence-based guidelines for cancer screening in adults and discusses the limitations of screening studies with respect to older adults.
Drs. Fatemeh Akbarian, Hatim Al Lawati, and Mohammad Ali Shafiee review an Approach to Proteinuria in Adults and Elderly. Proteinuria can create one of the greatest challenges in primary practice, especially in the geriatric population. It is typically detected by dipstick urinalysis, an ordinary, non-invasive test. This article will review the clinical significance of proteinuria in adults, especially in the elderly population, and provide a practical diagnostic approach in addition to a summary of non-specific antiproteinuric therapy.
In his article, Choosing a First-line Drug for Older Adults with Hypertension: An Evidence-Based Approach Dr. James M. Wright discusses choosing the optimal first-line drug for patients with hypertension that must address a hierarchy of treatment goals: reduction in mortality and morbidity, efficacy in lowering blood pressure, ensuring tolerability, and minimizing cost. This article examines the evidence for the different classes of first-line antihypertensive drugs in light of these four goals.
Drs. Andrew M. Johnson, H. Christopher Hyson, and Kaitlyn P. Roland review the Identification and Management of Impulse Control Disorders Among Individuals with Parkinson's Disease. Although Parkinson's disease is primarily considered to be a motor disorder, it has inarguable effects on cognition and personality. Treatment options for impulse control disorders tend to revolve around dopamine agonist dose reduction or cessation.
I hope you enjoy this issue of JCCC. We look forward to your comments and your article submissions.
