Volume 3, Number 7

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Editor's Note, Volume 3 Issue 7

D’Arcy Little, MD, CCFP, FRCPC
Medical Director, JCCC and HealthPlexus.NET

Beyond Rasouli: What has the Supreme Court said about Late-Stage Dementia and Continued Life-maintaining Treatment?

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

Abstract
With the rapidly increasing numbers of elders in North American Society, the prevalence of those living with dementia is clearly on the increase. According to the most recent document provided by the Alzheimer Society of Canada, The Rising Tide the growth in the numbers of those living with dementia will increase from 480,600 in 2008 (1.5% of Canada's population) to in the year 2038—1,125,200 people with dementia (2.8% of Canada's population).1 All the challenges that Canadian society faces with this growing population merely mirror the enormous complexities that those living with dementia, their families and health care professional providers must increasingly contend with. Government policy makers must find ways to address this increasing population in which Dementia plays a prominent role. The result of the Supreme Court ruling on the Rasouli case has major potential implication for those facing the later stages of dementia and those under whose care members of this population will be entrusted.
Key Words: dementia, aging population, substitute decision makers.

Treatment of a Patient with HBeAg-negative Chronic Hepatitis B

Ian PUN, MD, Family Physician, Scarborough, Ontario with help from Anthony Vu, 4th Year student, University of Toronto undergraduate life science, Rob Myers, MD, Associate Professor of Medicine, Hepatologist, and Director of the Viral Hepatitis Clinic at the University of Calgary, Calgary, AB.

Abstract
It is estimated that there are 350 million world wide carriers of the hepatitis B virus, mostly coming from Asia (Lai et al., 2005). With immigration of Chinese into Western countries, hepatitis B is now becoming established in countries where it was previously uncommon. Chronic hepatitis B infection is a prevalent disease especially in the Toronto and Vancouver areas where most Asians live. Fortunately, over the past decade effective anti-viral treatments have become available. Chronic hepatitis B is mostly an asymptomatic disease, therefore, serological and imaging tests should be used to identify, follow and treat those considered high risk.
Key Words: HBV DNA (hepatitis B DNA), cirrhosis, anti-viral tenofovir, FibroScan.

Clinico-Pathological Quiz

Members of the College of Family Physicians of Canada may claim one non-certified credit per hour for this non-certified educational program.

Mainpro+® Overview

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

Abstract
A case of a fleshy, granular, pedunculated growth from the oral cavity will be presented. A differential diagnosis of similar growths from the oral cavity and the treatment options will be discussed.
Key Words: congenital epulis, epulis fissuratum, granular cell tumour, immunohistochemistry S-100, vimentin, neurone specific enolase, CO2 laser excision.