Michael Gordon, MD, MSc, FRCPC, Medical Program Director, Palliative Care, Baycrest Geriatric Health Care System, Professor of Medicine, University of Toronto, Toronto, ON.

Abstract
Physicians are used to using language in very special ways. We combine the normal syntax, grammar and rules of our mother tongue along with the special clinical terms derived from Latin or Greek which are often anglicized in North America. But there are terms used in the English language that we tend to avoid because they have associated with them negative stereotypes about certain groups of individuals and over time, no one would use some of these terms in public. The term tsunami has entered the lexicon recently of terms used to describe the challenges of the aging population. Its use has entered the popular media and amongst policy makers. Physicians must be attuned to the negative stereotype associated with the use of this term to describe the older patients that we collectively care for.
Key Words:Language and negative stereotypes, media use of terms, stigmatizing the elderly with words.

Jordan Isenberg,¹ Tessa Weinberg,² Nowell Solish,^3
1McGill University, Faculty of Medicine, Montreal, Quebec; ²The Royal College of Surgeons in Ireland, Faculty of Medicine, Dublin, Ireland;
³University of Toronto, Department of Dermatology, Toronto, Ontario.

Abstract
Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous malignancy. It is seen most frequently in those over 60 years old and in Caucasian males. It usually presents as an asymptomatic rapidly growing violatious nodule on a sun exposed area. The mainstay of treatment is surgical by standard wide local excision or MOHs chemosurgery. Radiation is added frequently for local control. The only factor significantly associated with overall survival is the stage of disease at presentation. This stresses the importance of early diagnosis and treatment.
Key Words: Merkel cell carcinoma, wide local excision, MOHs chemosurgery, adjuvant radiotherapy, review, case.

^1,2Darren M. Roffey PhD; ¹Simon Dagenais DC, PhD, MSc; ³Ted Findlay DO, CCFP; ^4,5Travis E. Marion MD, MSc; ⁶Greg McIntosh MSc; ^1,2,4,5Eugene K. Wai MD, MSc, FRCSC

¹University of Ottawa Spine Program, The Ottawa Hospital, Ottawa, ON, ²Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON,

³Department of Family Medicine, University of Calgary, Calgary, AB, ⁴Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, ON, ⁵Department of Surgery, Faculty of Medicine, University of Ottawa, ON, ⁶CBI Health Group, Toronto, ON,

Abstract

Obesity and low back pain are equally complex medical conditions with multi-factorial etiologies. Their clinical practice guidelines both include recommendations for screening and examination that can be easily implemented. There is sufficient information to compile a framework for the primary care provider, partnering with the patient and appropriate specialists, to manage obesity and low back pain in a structured fashion. Weight loss and exercise are paramount and should be recommended as the first options. Cognitive behavioural therapy, pharmacological treatment and bariatric surgery may then be implemented sequentially depending upon the effectiveness of the initial interventions.

Key Words: Obesity, low back pain, exercise, nutrition, cognitive behavioural therapy, bariatric surgery, weight loss, pharmacological, evidence-based guideline.