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Musical Magic and the Mind

Teaser: 

I was sitting on my front porch in Toronto despite the low December temperature…

Related Terms: Medical Narratives
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Passing through the Pandemic—Turning our Stumbling blocks into Stepping Stones

Teaser: 

Dr. Marina Abdel Malak, MD, CCFP, BSc.N,

is a Family Physician in Mississauga, Ontario. She has served on several committees and groups, including The Primary Care Network and Collaborative Mental Health Network. She has a passion for medical education, patient empowerment, and increasing awareness about the relationship between mental, emotional, and physical health. Dr. Abdel Malak is highly involved in quality improvement initiatives, and her research interests include strategies to support physician wellness, patient self-management, and optimizing physician education.

CLINICAL TOOLS

Abstract: The COVID-19 pandemic has had lasting impacts on our lives. Issues such as access to healthcare, financial stability, socialization, burnout, and mental health have been highlighted by the pandemic. This article briefly highlights some of the challenges we have faced as communities— patients and healthcare providers alike­—and ends with a message of hope that stumbling blocks can be used as stepping stones for lasting, impactful change.
Key Words: COVID-19, pandemic, healthcare, socialization, burnout, mental health.
The COVID-19 pandemic has had a major impact on our lives the past two years.
At the forefront are such issues as access to healthcare, financial stability, socialization, burnout, and mental health.
Referrals to specialists have been delayed, prolonged, or nearly impossible to secure.
Gaps in our system should be identified, in equality, accessibility and lasting impactful changes should be made.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Preventive Health, COVID-19, pandemic, health care, socialization, burnout, mental health
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Liberty in the Time of Covid

Teaser: 

Anti-vaxxers scream at mandates (more likely to be a fine or prohibition on entering certain enterprises) as an assault on freedom, non-constitutional or contravening the Canada Health Act.

Related Terms: Medical Narratives
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Handing in My Numbers

Teaser: 

I put the phone down after the call that cancelled my number…

Related Terms: Medical Narratives
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Anatomy of a Lumbar Spine MRI: Indications for Imaging and Interpretation of Imaging for Surgical Referral

Teaser: 

1Samuel Yoon MD, MSc, 2Tiffany Lung MD, BKin, 3 Albert Yee MD, MSc, FRCSC, FIOR,

1Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada.2Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada. 3 Professor of Surgery, Department of Surgery, University of Toronto, Marvin Tile Chair Division Chief of Orthopaedic Surgery, Division of Spine Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

CLINICAL TOOLS

Abstract: Despite guidelines from multiple medical organizations including Choosing Wisely Canada, routine screening for low back pain symptoms with advanced imaging modalities such as Magnetic Resonance Imaging (MRI) persists. While sensitive, the high prevalence of asymptomatic or non-correlative degenerative findings limits their usefulness for routine screening. Given the constraints on Canadian healthcare resources this is a cause for significant concern. Lumbar MRI examinations should be ordered only with clear clinical indications and never for simple triage. Suitable indications include patients with symptoms of Cauda Equina Syndrome, suspected spinal malignancies, vertebral infections, or a progressive neurologic deficit correlating to a dermatomal and/or myotomal distribution.
Key Words: Appropriateness in diagnostic imaging, lumbar MRI, low back pain, surgical indications.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

You can take quizzes without subscribing; however, your results will not be stored. Subscribers will have access to their quiz results for future reference.

Pre-test CME Quiz Post-test CME Quiz
Lumbar spine MRI is not a useful screening tool as incidental degenerative findings are extremely common.
Routine lumbar MRI usage to investigate low back pain is inappropriate and can cause harm to patients through wasted time and resources, as well as possible nocebo effects.
Lumbar spine MRI is indicated if accompanying Red Flag symptoms, such as recent systemic illness, high suspicion for tumour, or progressive/severe neurological symptoms/signs are present with the back pain.
Elective referrals to spine surgical specialists should confirm that the patient's clinical spinal condition aligns with advanced imaging findings.
The majority of patients with low back pain will improve with conservative management modalities.
Understanding clinical patterns of lumbar related axial pain and lower extremity referred neurologic symptoms is a more useful guide for determining whether or not patients are surgical candidates than obtaining images of structural change.
Patients suspected of having Cauda Equina Syndrome or exhibiting rapid progressive neurological decline in a dermatomal/myotomal distribution should be referred immediately for surgical evaluation.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Back Health, Appropriateness in diagnostic imaging, lumbar MRI, low back pain, surgical indications
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MOVE IT! 'Prescribing Exercise' in Healthcare

Teaser: 

Dr. Marina Abdel Malak, MD, CCFP, BSc.N,

is a Family Physician in Mississauga, Ontario. She has served on several committees and groups, including The Primary Care Network and Collaborative Mental Health Network. She has a passion for medical education, patient empowerment, and increasing awareness about the relationship between mental, emotional, and physical health. Dr. Abdel Malak is highly involved in quality improvement initiatives, and her research interests include strategies to support physician wellness, patient self-management, and optimizing physician education.

CLINICAL TOOLS

Abstract: The benefits of physical activity are far reaching, ranging from cancer prevention to disease treatment. However, there may be confusion among healthcare providers how to recommend physical activity to their patients: how long, what activities, and how to do so. This article briefly reviews the benefits of exercise, and details strategies physicians can use to encourage their patients to be physically active.
Key Words: Exercise, physical activity, prescription, patient education, health promotion, lifestyle.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

You can take quizzes without subscribing; however, your results will not be stored. Subscribers will have access to their quiz results for future reference.

Pre-test CME Quiz Post-test CME Quiz
1) Physicians are in an optimal position to counsel their patients about physical activity
2) Guidelines for activity varies among individuals by age, and should be tailored to each patient
3) Exercise prescriptions can be used in practice to motivate and counsel patients on physical activity
Encouraging patients to become physically active is a core role of the physician.
Prescribing exercise significantly increases patients' motivation and integration of physical activity into their daily routines.
Exercise recommendations vary, but the general rule of 150 minutes a week is widely quoted.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Preventive Health, exercise, physical activity, prescription, patient education, health promotion, lifestyle
Disclaimer: 
Disclaimer at the end of each page