Editor's Note, Volume 2 Issue 3
D’Arcy Little, MD, CCFP, FCFP, FRCPC
Medical Director, JCCC and HealthPlexus.NET
Dr. Francesca Cheung, a Family Physician and Senior Editor of the Dermatology Educational Resource reviews a challenging dermatological diagnosis, Granuloma annulare (GA). GA is a benign and usually self-limited skin condition that classically presents as arc-like or annular plaques in a symmetrical and acral distribution with an unknown etiology. The condition is commonly seen in children and young adults and has been described as a paraneoplastic condition.
Drs. Moorhouse and Mallery from the Division of Geriatric Medicine at Dalhousie University in Nova Scotia recognize that as our population ages, patients often develop an accumulation of multiple chronic health conditions—known as frailty. Their article Palliative and Therapeutic Harmonization (PATH): A New Model for Decision-Making in Frail Older Adults not only describes the features health systems that make caring for such patients difficult, but also reviews a model, known as PATH—Palliative and Therapeutic Harmonization, to respond to these system problems. In my role as a hospital-based radiologist, I see on a regular basis one of their tenets: when older adults present with acute decline in cognition, mobility or function, it is often a sign of underlying medical disease in a frail substrate. As clinicians we can definitely use an approach to this ever-increasing patient population.
Drs. Shenoy and Bali describe an approach to the complex problem of the removal of impacted sharp esophageal foreign bodies in their case study Sharp Foreign Bodies in the Upper Digestive Tract.
Dr. Bardai reviews the role of neural plasticity in the development and the amelioration of cognitive decline. Neural plasticity has been described as a "complex interaction between the neurons' electrical, biochemical and physical structure and the individual's behavioural, psychological and sociological activities." This article Neural Plasticity and Cognitive Reserve reviews the neurobiology of cognition, and the sequence of events that lead to its deterioration, as well as reviewing strategies for maintaining cognitive faculties in the aging process.
I hope you enjoy the issue as much as I enjoyed reviewing for you. As always, comments and questions are welcomed.
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