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Pediatric Scabies

Teaser: 

Ou Jia (Emilie) Wang,1 Joseph M. Lam, MD, FRCPC,2

1 Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
2Department of Pediatrics, Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada.

CLINICAL TOOLS

Abstract: Scabies, caused by the Sarcoptes scabiei var. hominis mite, is a common and highly contagious skin infestation that manifests with symptoms of intense itching and a generalized pruritic papular eruption. Crusted scabies, a severe form of the infestation, is more commonly seen in immunocompromised individuals. Scabies can affect individuals of all ages and is typically transmitted through close and prolonged skin-to-skin contact. Diagnosis relies heavily on clinical examination, with scabies preparation at multiple sites guided by dermoscopy. Management involves both treating the condition and preventing its spread to others, with the primary treatment being the application of topical scabicide medications to the entire body. Environmental decontamination measures are crucial in controlling the spread of scabies. Prompt diagnosis and treatment are essential to prevent complications and transmission to others.
Key Words: scabies, classic scabies, crusted scabies, infestations, pruritus, hypersensitivity reactions.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

You can take quizzes without subscribing; however, your results will not be stored. Subscribers will have access to their quiz results for future reference.

Pre-test CME Quiz Post-test CME Quiz
A large range of prevalence exists with scabies and scabies is not reportable in Canada. It disproportionately affects individuals living in poverty and crowded conditions.
A definitive diagnosis of scabies can be made through visualization through microscopy of skin scrapings and tape samples or through dermoscopy.
Treatment of patients and close contacts and environmental measures must be taken to prevent further spread and infestation.
In scabies infestation, the female mite burrows under the skin and triggers a hypersensitivity reaction with symptoms of pruritus and inflammation.
Classic scabies is more common, while crusted scabies is rarer and more severe.
First-line treatment is topical 5% permethrin cream head to toe including the scalp in infants and young children and from the neck down in adults with retreatment in one week.
Environmental decontamination is important to preventing reinfestation.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Dermatology, scabies, classic scabies, crusted scabies, infestations, pruritus, hypersensitivity reactions
Disclaimer: 
Disclaimer at the end of each page

#38: A Rapid Overview of Polycystic Ovarian Syndrome (PCOS)

Welcome to 3P: Pills, Pearls, and Patients where we will discuss current events in medicine, stories from real patient-physician encounters, and gain insight into what it's like being a physician in today's society.

Please note that while the first episode is available to listen to without registration, accessing additional episodes will require you to subscribe and log in.

  Back to Pills, Pearls & Patients (3P)

Hello and welcome to the next episode of 3P, Pills, Pearls and Patients. I'm your host, Dr. Marina Malak. And today we're going to be talking about polycystic ovarian syndrome.

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Dr. Marina Malak is a family physician in Mississauga, Ontario and a lecturer and faculty member at the University of Toronto. She is actively involved in medical advocacy, and is a board member of the Mississauga Primary Care Network. She is also a member of the National Committee of Continuing Professional Development at the College of Family Physicians of Ontario, and a member of the Research Ethics Board at Trillium Health Partners.

She is passionate about patient care; medical education; and promoting mental, physical, and emotional wellness. She enjoys reading, writing, public speaking, puzzles, doodling in her bullet journal, and creating drawings on Procreate.

Current Concepts in Spinal Cord Injury: Pearls for Primary Care Management

Teaser: 

Karlo M. Pedro, MD,1 Francois Dantas, MD,2 Peyton Lawrence, MD,3 Michael G. Fehlings, MD, PhD,4

1Division of Neurosurgery, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
2Division of Neurosurgery, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
3Division of Neurosurgery, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
4Division of Neurosurgery, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Institute of Medical Science, University of Toronto, Division of Neurosurgery and Spine Program, University of Toronto, Toronto, ON, Canada.

CLINICAL TOOLS

Abstract: Traumatic spinal cord injury (tSCI) is a devastating condition that can lead to severe and permanent sensory, motor, and autonomic dysfunction, significantly impacting an individual’s ability to function independently. Recent demographic changes have resulted in a notable increase in tSCI among the elderly, with falls emerging as the primary cause. Early recognition and prehospital management are crucial, emphasizing restriction of spinal motion and timely transfer to specialized centres. Since the time from injury to surgery significantly affects outcomes, decompression should not be delayed and offered in a timely manner to all tSCI patients. Additionally, emergent trauma care including conducting a thorough neurological assessment, maintaining adequate blood pressure and adopting a multidisciplinary approach, is essential for optimizing neurological outcomes and addressing long-term complications.
Key Words: Early surgery, geriatric trauma, neurotrauma, traumatic spinal cord injury.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

You can take quizzes without subscribing; however, your results will not be stored. Subscribers will have access to their quiz results for future reference.

Pre-test CME Quiz Post-test CME Quiz
Falls are increasingly becoming the primary cause of traumatic spinal cord injury, particularly among the elderly population, underscoring the need for heightened awareness and proactive preventive measures.
Early recognition and appropriate prehospital management, including prompt transfer to specialized trauma centers, are crucial in saving the injured spine.
Neuroprotective strategies, such as maintaining adequate spinal cord perfusion and implementing early surgical decompression, are essential for attenuating the secondary injury cascade.
Multidisciplinary care is imperative for restoring functional independence, with a comprehensive approach addressing not only physical rehabilitation but also social, mental, and spiritual needs in patients with tSCI.
With an aging population and more fall-related mechanisms, the most common form of spinal cord injury (SCI) is an incomplete cervical SCI called central cord injury where the arms and hands are more affected than the legs. These patients usually have pre-existing degenerative changes and can experience cord contusion in the absence of a cervical fracture.
“Time is spine” is a key principle which guides spinal cord injury management. Most patients with a SCI require surgery, optimally within 24 hours after injury. Expeditious workup and referral/transfer of patients with a SCI to a specialized spine facility is important.
Be aware that 10-15% of patients with one spine fracture will have a second non-contiguous spine fracture. The presence of a spine fracture in one area should prompt a full spine CT.
Hemodynamic management of patients with a spinal cord injury is important to maintain cord perfusion. Mean arterial pressure should be maintained at greater than 80 mm Hg.
Methylprednisolone (a potent ant-inflammatory corticosteroid) and riluzole (a sodium-glutamate antagonist) are options in treating patients with an acute spinal cord injury and are optimally given within 8-12 hours after injury.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Back Health, Early surgery, geriatric trauma, neurotrauma, traumatic spinal cord injury

Xerosis and Ichthyosis: A Brief Review

Teaser: 

Manish Toofany,1 Joseph M. Lam, MD, FRCPC,2

1 Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
2Department of Pediatrics, Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada.

CLINICAL TOOLS

Abstract: Xerosis is a common skin condition that becomes more prevalent with age and is a prominent feature in ichthyosis. It primarily resulting from abnormalities in the stratum corneum, influenced by factors like natural moisturizing factors, lipid synthesis, and genetic pathologic variants. The diagnosis of xerosis and ichthyosis is usually made clinically, though specific investigations may aid in the diagnosis of specific ichthyoses. Both conditions can have a considerable negative impact on the quality of life of patients. Management includes moisturization and taking preventive measures to maintain skin health and to prevent xerosis.
Key Words: xerosis, ichthyosis, stratum corneum, natural moisturizing factors.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

You can take quizzes without subscribing; however, your results will not be stored. Subscribers will have access to their quiz results for future reference.

Pre-test CME Quiz Post-test CME Quiz
Xerosis is a common condition worldwide and it is a prominent feature of both syndromic and non-syndromic ichthyoses.
Both xerosis and ichthyosis can have a considerable negative impact on the quality of life of patients.
The diagnosis of xerosis and inherited ichthyoses is based on history, clinical manifestations, associated abnormalities, and family history, but several specific investigations may aid in the diagnosis of syndromic ichthyoses.
Managing xerosis includes applying topical moisturizers with key components like lipids and humectants while proactive preventive measures are vital for preventing triggers of the condition.
Understanding and addressing triggers such as temperature, low humidity, sunlight exposure, and environmental conditions like air conditioning or heating can be essential in managing xerosis effectively.
Evaluating the overall severity of xerosis and ichthyosis may include the use of established tools like the Dermatology Life Quality Index (DLQI) and the newer Ichthyosis Scoring System (ISS) to assess their impact on patients’ quality of life.
Identifying signs such as brittle hair, neurological abnormalities, and palmoplantar keratoderma can be suggestive of syndromic ichthyoses. These indicators are valuable for recognizing these rare conditions and guiding further examination or evaluation.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Dermatology, xerosis, ichthyosis, stratum corneum, natural moisturizing factors
Disclaimer: 
Disclaimer at the end of each page

#4: Interview with Dr. David Messika

Ladies and gentlemen, welcome to another episode of Med Talks where we go beyond the white coat. My name is Moiz Lakhani, I'm the co-host. And today we are joined by an exceptional guest. He is a cardiologist who is internationally known for his efforts in valvular heart disease. He's the director for the Valve Center at the University of Ottawa Heart Institute.

Please note that while the first episode is available to listen to without registration, accessing additional episodes will require you to subscribe and log in.

  Back to Med Talks: Beyond the White Coat

00;00;00;00 - 00;00;44;05
ML: Dr. Messika, thank you so much for joining us today.

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Alykhan Abdulla, BSC, MD, LMCC, CCFPC, DipSportMed CASEM, FCFCP, CTH (ISTM), CCPE, Masters Cert Phys Leader, ICD.D is the Medical Director of The Kingsway Health Centre, The Kingsway Travel Clinic, and The Kingsway Cosmetic Clinic. He is also the Assistant Professor at the University of Ottawa Faculty of Medicine and Academic Clinical Professor at the University of Ottawa Faculty of Nursing. In addition he is the Director of UOttawa Undergraduate Medical Education Leadership Development Curricula. Dr. Abdulla is the Editor in Chief Journal of Current Clinical Care Sports Medicine section. He is the Board Director Bruyere Continuing Care, ESO-OHT Primary Care Table, Ontario Medical Foundation, College of Family Physicians of Canada, 700 Sussex Drive Board (OCLCC 713), The Rideau Club Finance & Audit and Past Chair Section of General and Family Practice Ontario Medical Association.

Moiz Lakhani, BHSc graduate from McMaster University and current medical student at the University of Ottawa, co-hosts the Med Talks: Beyond the White Coat podcast. A 2021 Cansbridge fellow, Moiz has spoken at the UN HQ, Youth Assembly Conferences, and WISE in Qatar. He's also a 2022 Diana Award recipient, the highest honor for youth in social action and humanitarian work.