Jacky Lo¹, Joseph M. Lam, MD, FRCSC^2
1Medical student, Department of Pediatrics, University of British Columbia, Vancouver, BC.
²Clinical Assistant Professor, Departments of Pediatrics and Dermatology, University of British Columbia, Vancouver, BC.

Abstract
Diaper dermatitis is one of the most common skin conditions seen in the pediatric population and can cause significant distress for infants and their families. While many diaper rashes can resolve with simple treatments, having a thorough understanding of different diaper lesions can help rule out more serious conditions, guide treatment and alleviate some of the caregivers' anxiety. The following review article will provide an overview of select common and uncommon diaper eruptions.
Key Words: diaper dermatitis, pediatric, diaper rash, treatment.

Dr. Hamilton Hall, MD, FRCSC, is a Professor in the Department of Surgery at the University of Toronto. He is the Medical Director, CBI Health Group and Executive Director of the Canadian Spine Society in Toronto, Ontario.
Greg McIntosh, MSc, completed his Masters in Epidemiology from the University of Toronto's Faculty of Medicine. He is currently the Director of Clinical Research for CBI Health Group and research consultant to the Canadian Spine Society.

Abstract
This article highlights the myths and misunderstandings surrounding the straight leg raise (SLR) test for sciatica. Unfortunately, neither intra- nor inter-observer reliability of the passive SLR test has ever been agreed upon. In addition, there is poor consensus about what constitutes a positive SLR test in terms of pain location, leg elevation limitation or clinical significance. Until there are stricter performance standards and uniform agreement, researchers and clinicians should interpret the test with caution. We believe a true positive SLR should be the reproduction or exacerbation of the typical leg dominant pain in the affected limb at any degree of passive elevation. Those with only increased back pain or any leg pain other than that presenting as the chief complaint should be regarded as false positives.
Key Words: low back pain, straight leg raise, sciatica, irritative test.

Curtis M. Marcoux, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
Dr. Pradeep Shenoy, MD, DLO, FRCS, FACS, is the ENT service chief, Campbellton Regional Hospital, Campbellton, New Brunswick, Canada.

Abstract
Dizziness is the third most common symptom seen in patients of all age groups who present to emergency departments, outpatient clinics and physicians offices. Assessing dizziness requires a differentiation of potential causes through a comprehensive medical history and thorough physical exam. The most common causes of dizziness are peripheral vestibular disorders, however disorders of the central nervous system must be ruled out. Understanding how to distinguish between various underlying causes of vertigo is essential for the timely diagnosis and effective management of patients with this symptom. In this review, an overview of the epidemiology, etiology, presentation, diagnosis and treatment of the most common causes of vertigo will be presented, touching on some of the more rare determinants.
Key Words: Vertigo, dizziness, BPPV, vestibular neuronitis, Meniere's disease, vestibular migraine, vertebrobasilar insufficiency.

Dr. Pradeep Shenoy, MD, DLO, FRCS, FACS, is the ENT service chief, Campbellton Regional Hospital, Campbellton, New Brunswick, Canada.

Abstract
A case of pyogenic granuloma of gingiva is presented. Aetiology factors, clinical presentations and different treatment modalities are discussed after reviewing the literature.
Key Words: Pyogenic granuloma, Gingival hyperplasia, Peripheral giant cell granuloma, peripheral ossifying fibroma, lobular capillary haemangioma.

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.

Ian PUN, MD, Family Physician, Scarborough, Ontario.
OSCAR McMaster EMR user since 2010.

Abstract
As of 2014, over 75% of primary care physicians in Ontario have adopted,¹ or are in the process of adopting an EMR. Those physicians who are new to using EMR will find many pitfalls, many of which are common and are preventable. I will specifically deal with the OSCAR McMASTER EMR and what issues I saw my fellow colleagues and myself experience in the Ontario context.
Key Words: Hardware, Network, OSCAR McMaster EMR, issues, scanning, lab, HL7.

^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

Recognizing that the increasing incidence of obesity coincides with the rising prevalence of LBP, there is growing interest in establishing the relationship between over-weight and back pain. It is likely that any association is multi-factorial and that the connection is not as mechanistically simple as previously believed. Systemic inflammation associated with obesity may be an important contributor. Proposed treatment options vary from cognitive behavioural therapy to bariatric surgery with none yet fully proven. Despite the ambiguity, it appears prudent for primary care providers treating obese patients with LBP to recommend weight loss and exercise.

Key Words: Obesity, low back pain, inflammation, intervertebral disc, multi-factorial, causality, association.