Disclaimer: While every attempt is made to ensure that drug dosages provided within the text of this journal and the website are accurate, readers are urged to check drug package inserts before prescribing. Views and opinions in this publication and the website are not necessarily endorsed by or reflective of those of the publisher.
Abstract As the population ages, advances in medical technology paradoxically result in the accumulation of multiple chronic health conditions—known as frailty. Despite increasing numbers of frail older adults, healthcare systems have not been designed to meet the challenges associated with caring for this patient population. This article describes the characteristics of health systems that exacerbate the complex issues associated with caring for those who are frail and reviews one possible model, known as PATH—Palliative and Therapeutic Harmonization, as a way to respond to these system challenges. Keywords: frailty, care planning, dementia, knowledge translation, health program.
Francesca Cheung, MD CCFP, is a family physician with a special interest in dermatology. She received the Diploma in Practical Dermatology from the Department of Dermatology at Cardiff University in Wales, UK. She is practising at the Lynde Centre for Dermatology in Markham, Ontario and works closely with Dr. Charles Lynde, MD FRCPC, an experienced dermatologist. In addition to providing direct patient care, she acts as a sub-investigator in multiple clinical studies involving psoriasis, onychomycosis, and acne.
Abstract Granuloma annulare (GA) is a benign and usually self-limited cutaneous condition that classically presents as arciform to annular plaques in a symmetrical and acral distribution. The exact etiology of GA is unknown. Two-thirds of patients with GA are less than 30 years old. GA is recognized based on its characteristic appearance and no specific investigation is necessary. Reassurance and clinical observation may be the treatment of choice for localized and asymptomatic disease. Spontaneous resolution occurs within 2 years in 50% of cases. Persistent lesions may be treated with very potent topical corticosteroids, intralesional corticosteroid injections, or cryotherapy. Use of more toxic treatments are controversial in recalcitrant cases. Keywords: Granuloma annulare, Overview, Paraneoplastic, Self-limiting, Treatment.
Zahra Bardai, BSc, MD, CCFP, MHSc, FCFP, Community Family Physician, Lecturer, University of Toronto, Assistant Clinical Professor (Adjunct), Department of Family Medicine, McMaster University, Hamilton, ON.
Abstract
Neural plasticity in the context of normal aging and dementia can be evaluated on a number of levels. Traditionally there has been much focus on cellular dysfunction, which is evidenced by the plaques and tangles that are the hallmarks of Alzheimer type dementia. Now, more than ever, there is an emerging spotlight on the preservation of functional levels despite failing cognition be it from normal aging, mild cognitive impairment (MCI) or diagnosed dementia. Neural plasticity can be viewed as the complex interaction between the neurons' electrical, biochemical and physical structure and the individual's behavioural, psychological and sociological activities.1 This article will briefly review the neurobiology of cognition and the sequence of events that lead to its demise. The remainder of this review concentrates on tangible, evidence based strategies to uphold clinical cognition through the aging process. Keywords: neural plasticity, aging, dementia, cognition, neurons.
…there were neurons in her head, not far from her ears, that were being strangled to death, too quietly for her to hear them. Some would argue that things were going so insidiously wrong that the neurons themselves initiated events that would lead to their own destruction. Whether it was molecular murder or cellular suicide, they were unable to warn her of what was happening before they died.
To use a Flexible or Rigid Endoscope is a Real Dilemma—A Case Report and Review of the Literature
Pradeep K. Shenoy, MD, DLO, FRCS, FACS,1 K.Bali, MD, MS(ORL),2 1ENT Service Chief, Campbellton Regional Hospital, NB, Campbellton, Canada. 2Deputy Head of Ear Nose and Throat Dept, Al Ain Hospital, Al Ain, UAE.
Abstract
A case of a sharp foreign body (needle) in the upper oesophagus is reported. A review of the literature of ingestion of sharp foreign bodies, failed extractions, different management techniques and complications is discussed. Keywords: sharp foreign body, flexible endoscopy, rigid endoscopy, IJV thrombosis, cervical oesophagotomy, oesophageal perforation, mediastinitis, cricopharyngoscope, oesophagoscope, colonoscope, Weerda diverticuloscope.
Charles Lynde, MD, FRCPC
Editor-in-Chief for the Dermatology Educational Resource @HealthPlexus and the Journal of Current Clinical Care.
Following on the footsteps of the recent announcement of the launch of the Dermatology Educational Resource, www.HealthPlexus.net recently interviewed Dr. Charles Lynde who was appointed as Editor-in-Chief for the newly re-focused educational channel. Dr. Barry Goldlist asked Dr. Lynde a few questions about the format and the plans for this project.
Treatment for Behavioral and Psychological Symptoms of Dementia
Dr. Robert Madan is currently the Acting Psychiatrist-in-Chief, Executive Medical Director for the Centre for Mental Health and the Medical Program Director for the Psychiatric Day Hospital at Baycrest.
Learning Objectives
By the end of the session, participants will be able to:
- Describe the problems with pharmacological treatment of behavioral symptoms of dementia;
- Describe a non-pharmacological approach to treating behavioral symptoms of dementia.
