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#45: Ontario Health Care Plan

Welcome to 3P: Pills, Pearls, and Patients where we will discuss current events in medicine, stories from real patient-physician encounters, and gain insight into what it's like being a physician in today's society.

Please note that while the first episode is available to listen to without registration, accessing additional episodes will require you to subscribe and log in.

  Back to Pills, Pearls & Patients (3P)

Hello and welcome to the next episode of 3P: Pills, Pearls, and Patients. Today we're kind of having a standalone episode on Ontario's Health Care Plan.

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Dr. Marina Malak is a family physician in Mississauga, Ontario and a lecturer and faculty member at the University of Toronto. She is actively involved in medical advocacy, and is a board member of the Mississauga Primary Care Network. She is also a member of the National Committee of Continuing Professional Development at the College of Family Physicians of Ontario, and a member of the Research Ethics Board at Trillium Health Partners.

She is passionate about patient care; medical education; and promoting mental, physical, and emotional wellness. She enjoys reading, writing, public speaking, puzzles, doodling in her bullet journal, and creating drawings on Procreate.

Understanding Myofascial Pain Syndrome: Causes, Diagnosis, and Treatment

Teaser: 

Eugene K. Wai MD, MSc, CIP, FRCSC, 1 Ted Findlay, DO, CCFP, FCFP,2

1Associate Professor, Division of Orthopaedic Surgery, Cross Appointment to School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON.
2Clinical Associate Professor, Program Director, Family Medicine Chronic Pain Enhanced Skills R3, Department of Family Medicine, University of Calgary, Calgary, AB.

CLINICAL TOOLS

Abstract: Myofascial Pain Syndrome (MPS) is a chronic pain disorder characterized by localized pain originating from myofascial trigger points (MTrPs) within the skeletal muscle of the spine and should be included in the differential diagnosis for non-surgical back pain. The etiology of MPS is multifactorial, involving trauma, repetitive strain, and postural dysfunction, leading to the formation of hyperirritable nodules that cause both local and referred pain. Diagnosis is primarily clinical, relying on the identification of MTrPs through physical examination. Treatment approaches include pharmacological interventions, manual therapies, and needling techniques. Evidence for long-term efficacy remains limited. Future research is essential to establish reliable diagnostic criteria and effective treatment modalities for MPS.
Key Words: Myofascial pain syndrome, trigger points, diagnosis, treatment, chronic pain, musculoskeletal disorders, manual therapy, pharmacological interventions.

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. Myofascial Pain Syndrome (MPS) is characterized by the presence of hyperirritable nodules, or myofascial trigger points, within taut bands of skeletal muscle, leading to localized and referred pain.
2. MPS can be caused by factors such as trauma, repetitive strain, poor posture, and muscle deconditioning, with theories suggesting muscle fiber energy crises or neurogenic inflammation as the main contributors.
3. The diagnosis of MPS is primarily clinical, relying on physical examination including palpable nodules, local twitch responses, and reproduction of the patient’s pain with trigger point palpation. There are no standard imaging or lab tests.
4. Treatment includes a combination of exercise, manual therapy, pharmacological interventions, trigger point injections and dry needling. Dry needling has shown the most promise.
5. There is no established Clinical Practice Guideline for MPS, and high-quality evidence supporting the long- term efficacy of current treatments is lacking. Further research into pathophysiology and treatment strategies is needed.
1. Trigger points are active or latent—active points cause spontaneous pain and limit muscle function, while latent points are asymptomatic until palpated.
2. MPS involves localized pain and trigger points; fibromyalgia presents with widespread pain and central sensitization. Conditions may coexist but require different management strategies.
3. A multimodal approach, combining dry needling with other physical therapies, yields better outcomes compared to single-modality treatments.
4. Opioids have limited evidence of efficacy and the potential to delay recovery. Use non-opioid and non-invasive interventions.
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, Myofascial Pain Syndrome, Trigger Points, diagnosis, treatment, chronic pain, Musculoskeletal Disorders, Manual Therapy, pharmacological interventions

#44: Part 3 OB/GYN Series: Postpartum Mood Disorders

Welcome to 3P: Pills, Pearls, and Patients where we will discuss current events in medicine, stories from real patient-physician encounters, and gain insight into what it's like being a physician in today's society.

Please note that while the first episode is available to listen to without registration, accessing additional episodes will require you to subscribe and log in.

  Back to Pills, Pearls & Patients (3P)

Hello and welcome to the third episode in the OB/Gyn series. Today. We're talking about post partum mood disorders.

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Dr. Marina Malak is a family physician in Mississauga, Ontario and a lecturer and faculty member at the University of Toronto. She is actively involved in medical advocacy, and is a board member of the Mississauga Primary Care Network. She is also a member of the National Committee of Continuing Professional Development at the College of Family Physicians of Ontario, and a member of the Research Ethics Board at Trillium Health Partners.

She is passionate about patient care; medical education; and promoting mental, physical, and emotional wellness. She enjoys reading, writing, public speaking, puzzles, doodling in her bullet journal, and creating drawings on Procreate.

The Role of AI and Deep Learning in Diagnosing Rare Diseases through Electronic Medical Records

Teaser: 

D'Arcy Little MD CCFP FCFP FRCPC,

Medical Director, Journal of Current Clinical Care and www.healthplexus.net, Adjunct Clinical Lecturer, Departments of Medical Imaging and Family Medicine, University of Toronto, Toronto, ON.

CLINICAL TOOLS

Abstract: This essay provides a comprehensive overview of how AI and deep learning can enhance the diagnosis of rare diseases by analyzing EMRs, highlighting both the potential benefits and challenges.
Key Words: AI, deep learning, EMRs, diagnosis, benefits, challenges.

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
AI and Deep Learning in Healthcare: AI, particularly deep learning, is capable of processing vast amounts of data from Electronic Medical Records (EMRs) to detect patterns associated with rare diseases. This helps clinicians identify subtle signals that may be missed in traditional diagnostic approaches.
EMRs as Rich Data Sources: EMRs house a wealth of information, including clinical notes, lab results, imaging studies, and treatment histories. AI can analyze this complex data and identify patterns that point to rare diseases, which are often missed due to the low prevalence and variability in clinical presentation.
Natural Language Processing (NLP): One of the most valuable applications of AI is its ability to analyze unstructured clinical notes using NLP. This allows AI to extract relevant symptoms, disease progression, and treatment responses that may suggest a rare disease.
Integration of Multi-Modal Data: AI’s strength lies in its ability to combine multiple types of medical data, such as genetic information, imaging studies, and clinical findings. This comprehensive approach is particularly useful in diagnosing rare diseases that require a holistic view of a patient’s health.
Clinical Decision Support: AI can be embedded in clinical decision support systems to offer real-time diagnostic suggestions, including considerations for rare diseases. This reduces diagnostic delays, which are common with rare conditions, and guides healthcare providers to further testing or specialist referrals.
Early Diagnosis of Rare Diseases: AI can recognize unique combinations of symptoms and lab findings that may indicate a rare disease early in the patient’s clinical course, allowing for quicker intervention and improved patient outcomes.
NLP Unlocks Hidden Insights: Clinical notes, which are often unstructured, contain valuable information that can be missed by manual review. NLP algorithms can uncover subtle indicators of rare diseases that can lead to earlier recognition and diagnosis.
Enhanced Diagnostic Accuracy: By combining genetic data, imaging, and clinical information, AI provides a more accurate diagnosis for complex cases, especially when rare diseases are involved, making the diagnostic process more reliable.
Real-Time Decision Support: AI-driven clinical decision support systems can flag less common conditions and suggest rare diseases for consideration when typical diagnoses do not fit. This prompts clinicians to think beyond common conditions.
Ethical Considerations in AI Use: Although AI has tremendous potential, its recommendations should be used in conjunction with clinical judgment. Providers should ensure they understand AI-generated insights to avoid over-reliance on automated systems and maintain patient-centered care.
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: Radiology, AI, deep learning, EMRs, diagnosis, benefits, challenges
Disclaimer: 
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#12: Rare Diseases Imaging in Primary Care

Welcome to Inside Radiology: A Primary Care Perspective where we explore the world of radiology and its applications in primary care.

Please note that while the first episode is available to listen to without registration, accessing additional episodes will require you to subscribe and log in.

  Inside Radiology: A Primary Care Perspective

Hello and welcome to another episode of Inside Radiology: A Primary Care podcast. I'm your host, Dr. D'Arcy Little. Today we're going to be discussing our episode number 12, which is Rare Diseases Imaging in Primary Care.

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Welcome to Inside Radiology: A Primary Care Perspective podcast! I'm Dr. D'Arcy Little, your host. As a community radiologist and former family physician, I'm passionate about empowering primary care doctors with the knowledge and insights they need. With my unique perspective, I aim to bridge the gap between primary care and radiology, presenting the complexities of radiology in a way that resonates with you. My goal is to equip you with tools to enhance patient care and decision-making. Join me on this educational journey as we explore the world of radiology, tailored for primary care physicians like you. Together, let's elevate primary care radiology.

#43: The Future of Medicine, Part 5

Welcome to 3P: Pills, Pearls, and Patients where we will discuss current events in medicine, stories from real patient-physician encounters, and gain insight into what it's like being a physician in today's society.

Please note that while the first episode is available to listen to without registration, accessing additional episodes will require you to subscribe and log in.

  Back to Pills, Pearls & Patients (3P)

Welcome to the next episode in our series of what the Future of Medicine holds.

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Dr. Marina Malak is a family physician in Mississauga, Ontario and a lecturer and faculty member at the University of Toronto. She is actively involved in medical advocacy, and is a board member of the Mississauga Primary Care Network. She is also a member of the National Committee of Continuing Professional Development at the College of Family Physicians of Ontario, and a member of the Research Ethics Board at Trillium Health Partners.

She is passionate about patient care; medical education; and promoting mental, physical, and emotional wellness. She enjoys reading, writing, public speaking, puzzles, doodling in her bullet journal, and creating drawings on Procreate.