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Editor's Note, Volume 7 Issue 6

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

I am pleased to introduce the last issue of 2017 of the Journal of Current Clinical Care.

Dr. Philippe Magown presents Chronic Neuropathic Pain in Primary Care—The Role of Neuromodulation. Neuropathic pain is a severe pain condition characterized by burning, tingling, or lancinating pain in the distribution of a nerve, dermatome, or sclerotome that affects patient function, quality of life, mood, and employment. Neuropathic pain is generally refractory to pain medications but amenable to gabapentinoids and antidepressants. When neuropathic pain is refractory to conservative medical management, neuromodulation is the next strategy. Spinal cord stimulation can provide clinically significant pain relief, improve quality of life and function for neuropathic pain conditions such as failed back surgery syndrome, complex regional pain syndrome, painful diabetic neuropathy, and refractory angina.

In their article, The Need for Obstructive Sleep Apnea Screening: A Wake-Up Call to Physicians, Drs. Colin M. Shapiro and Sharon A. Chung from the Youthdale Treatment Centres in Toronto examine Obstructive Sleep Apnea (OSA), a condition where patients stop breathing numerous times during sleep, a disorder linked to serious medical, socioeconomic, and psychological morbidity, yet most patients with OSA remain undetected. Physicians should consider symptoms of frequent/loud snoring, complaints of daytime sleepiness or fatigue, high blood pressure and obesity or excessive body fat distribution in the neck or upper chest area as possible indications of untreated OSA.

Dr. Michael Gordon, from the Baycrest Centre for Geriatric Care in Toronto offers Planning for the Future: Expected and Unexpected. End of life planning is difficult enough although once undertaken most people can express their wishes and preferences to their loved ones and those who will be their substitute decision makers. Having the final medical preferences, documents such as the advance directives (living wills) and the estate plan information readily available will make the emotionally difficult task of implementing all the components of an estate plan proceed as smoothly as possible.

I hope you enjoy this latest edition and add it to your holiday reading list. Please consider commenting or submitting an article of your own for the new year.
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