It is my pleasure to introduce the latest issue of The Journal Of Current Clinical Care. This current issue has a number of key articles, for the primary care physician and specialist, alike that summarize a practical approach to important issues in daily practice.
From Dr. Shabbir Alibhai, we have an update on cancer screening in the older adult. Cancer remains a major cause of morbidity and mortality in older adults—as more than half of all new cancers and over 70% of cancer deaths occur in the over -65 age group. Cancer screening is an important tool to decrease the incidence and mortality from cancer in older adults. Dr. Alibhai reviews the evidence and the screening recommendations for this population.
Dr. James Wright reviews the choice of first line anti-hypertensive agents in the older adult. This article examines the evidence for the different classes of first-line antihypertensive drugs in the context of four important treatment goals: reduction in mortality and morbidity; efficacy in lowering blood pressure; ensuring tolerability; and minimizing cost.
Many may consider Parkinson’s disease as primarily a motor disorder. However, it has important effects on cognition and personality. Important neuropsychiatric sequelae of Parkinson’s, known as impulse-control disorders, can have significant negative effects on patients and their families. Examples are pathological gambling and hypersexuality. Dr. Andrew Johnson reviews the treatment options for this condition, including dopamine agonist dose reduction or cessation, the use of psychosocial strategies, and deep-brain stimulation of the subthalamic nucleus.
Proteinuria is frequently a marker of unsuspected kidney disease, progressive atherosclerosis, or a systemic disease. A strong correlation exists between urinary protein excretion and the progression of renal failure. Proteinuria is also a strong and independent predictor of increased risk for cardiovascular disease and death, especially in people with diabetes, hypertension, and chronic kidney disease. Dr. Fatemeh Akbarian et al. review the diagnosis and treatment of proteinuria in the adult.
Dr. Michael Gordon’s article discusses the sensitive issue of conflict among family members in the context of substitute decision making for patients with dementia. The article emphasizes that physicians must use the art of medicine, including their communication skills and sensitivities, to help families resolve their differences so that the best possible care can be provided to their family members.
I hope you enjoy the issue. As always your comments are welcome.
One of the marked changes in the practice of dermatology over the past thirty years has been the increased focus on acne. What was once considered a universal rite of passage that occasionally caused deeply disturbing scars is now considered—by patients and doctors alike—an insufferable condition that must be treated. Perhaps as a sign that available treatments are increasingly successful, acne is showing signs of affecting popular culture. Kid Acne, a British artist (not his real name!), decided to make his affliction his signature so as to stand out in the crowded hip-hop scene. The Uruguayan movie Acné (as you would have guessed, about a thirteen-year-old boy coming of age while enduring acne outbreaks) was a hit of Spanish-speaking cinema in 2008. Acne for Dummies by Dr. Herbert P. Goodheart (a remarkably good book!) ranks a respectable 76th in skin care/ beauty books on Amazon.ca.
