Editor's Note, Volume 11 Issue 2
D’Arcy Little, MD, CCFP, FCFP, FRCPC Medical Director, JCCC and HealthPlexus.NETI am pleased to introduce the Spring edition of the Journal of Current Clinical Care.
Dr. Marina Abdel Malak presents Athletes and their Hearts: What the Primary Care Physician Should Recognize. Physicians will undoubtedly follow athletic patients in their practice, and must therefore be aware of the cardiac adaptations that occur in these patients. Athletic heart syndrome is a term used to describe the physiologic adaptation that the heart undergoes in response to intense physical activity. Although these are adaptive responses, physicians need to ensure that these changes are not due to pathological causes such as hypertrophic cardiomyopathy, other genetic or congenital disorders, etc. To do so, physicians must take a through history from the athlete, conduct a physical exam, and order investigations as appropriate. If a pathologic cause is not identified and AHS is noted to be the sole cause of these changes, the athlete should still be counselled on how to safely participate in physical activity.
In their article, Primary Care Approach to Degenerative Cervical Myelopathy, Drs. Ali Moghaddamjou, Jetan H. Badhiwala, Michael G. Fehlings explore Degenerative cervical myelopathy is an umbrella term describing all degenerative conditions that present with cervical myelopathy due to compression of the spinal cord. The role of primary care physicians in early identification is vital as delayed diagnosis can lead to irreversible neurological impairment. Patients often present with subtle neurological deficits associated with neck or upper extremity pain. Screening for upper motor neuron signs, gait disturbances, fine motor abnormalities and bowel bladder symptoms is critical. Currently, surgical decompression is the treatment of choice but with future advancements in non-operative treatments, PCPs are expected to play a larger role in treatment plans.
Dr. Michael Gordon offers insights on The One-Way Street of MAID. Recent articles about MAID in the media highlight the growing interest and controversy since in its legalization in Canada in June 2016. In February 2020 there were modifications to the 2016 law removing the stipulation that death must be reasonably foreseeable and allowing for a waiver of final consent among other changes. There is still controversy about the law ranging from complete rejection of the principles underlying to those who believe stipulations about mental illness and "guardrails" protecting from abuse of it. MAID can be obtained in Canada and there are communities of physicians who have dedicated themselves to organize MAID supporters who are available along with nurse practitioners to carry out the process with consenting patients.
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