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#4: Understanding Radiology Reports

Welcome to Inside Radiology: A Primary Care Perspective where we explore the world of radiology and its applications in primary care.

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 Inside Radiology: A Primary Care Perspective

Hello. Welcome back to another episode of Inside Radiology, a Primary Care Perspective podcast. I'm Dr. D'Arcy Little, your host. I'm a community radiologist and a former family physician. And in today's episode, we're looking at radiology reports.

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Welcome to Inside Radiology: A Primary Care Perspective podcast! I'm Dr. D'Arcy Little, your host. As a community radiologist and former family physician, I'm passionate about empowering primary care doctors with the knowledge and insights they need. With my unique perspective, I aim to bridge the gap between primary care and radiology, presenting the complexities of radiology in a way that resonates with you. My goal is to equip you with tools to enhance patient care and decision-making. Join me on this educational journey as we explore the world of radiology, tailored for primary care physicians like you. Together, let's elevate primary care radiology.

Opioid Use in Patients Undergoing Spine Surgery

Teaser: 

Eric J. Crawford MD, FRCSC,1 Ronit Kulkarni,2 Rajesh Kumar MBBS, FRCS, FCPS, FACS, FEBNS, MRCPS,3 Ted Findlay DO, CCFP, FCFP,4 Christopher J. Nielsen MD, FRCSC,5 Stephen J. Lewis MD, FRCSC,6 Robert A. Ravinsky MDCM, MPH, FRCSC,7

1 Divisions of Orthopaedic and Spine Surgery, Sunnybrook Health Sciences Centre, Toronto, ON.
2 Medical University of South Carolina, College of Medicine, Charleston, SC.
3Division of Spine Surgery, Sunnybrook Health Sciences Centre & Department of Surgery, University of Toronto, Toronto, ON.
4Calgary Chronic Pain Center at Alberta Health Services, Calgary, AB.
5Division of Orthopaedic Surgery, Toronto Western Hospital, University Health Network & Department of Surgery, University of Toronto, Toronto, ON.
6Division of Orthopaedic Surgery, Toronto Western Hospital, University Health Network & Department of Surgery, University of Toronto, Toronto, ON.
7Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, SC.

CLINICAL TOOLS

Abstract: Opioid medications have long been known for their analgesic properties and play an important role in the treatment of acute post-surgical pain. However, in recent years there has been an increase in chronic opioid therapy (COT) for painful conditions, in particular spinal disorders. These patients can have increased postoperative analgesic requirements and may be at increased risk of complications after surgery. In this evidence-based review, we provide guidance for managing opioid and analgesic medications for patients on COT from the preoperative assessment to post-surgical management including recommendations for appropriate opioid reduction.
Key Words: low back pain, surgery, opioid sparing, peri-operative pain management.

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
1. Pre-operative chronic opioid usage is associated with poorer surgical outcomes.
2. Pre-operative chronic opioid usage is associated with prolonged post-surgical opioid therapy.
3. Pre-operative opioid tapering can achieve clinical surgical outcomes comparable to an opioid-naïve group.
4. Non-pharmacological or non-narcotic medications may help reduce pre-operative opioid usage.
5. A clear plan for a post-surgical opioid taper should be prepared prior to surgery.
The OPAL trial notes that opioids for acute non-specific low back or neck pain present no significant difference to placebo for pain at 6 weeks.
Buprenorphine is commonly used as an opioid rotation pre-operatively to assist in opioid weaning.
Discontinuing opioid prescriptions should be considered if there is a lack of overall and clinically meaningful improvement in function, quality of life or pain, or lack of progress towards meeting agreed therapeutic goals.
Gabapentin in doses over 1800 mg/day is associated with 60% increased odds of opioid related death.
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, low back pain, surgery, opioid sparing, peri-operative pain management

#11: Transitioning to Congregate Living

RS: Hello and welcome to another episode of Medical Narratives with Dr. Michael Gordon. I'm Regina Starr. And today we're discussing a topic that many seniors and their families face at some point in their lives. The challenge of deciding when to leave one's home for congregate living, such as a retirement home, an assisted living facility, or a nursing home. To help us with this complex issue, joining us today is Dr. Michael Gordon, an expert in the care of the elderly.

Hello Dr. Gordon. Welcome to the show.

MG: Hello and good morning.

Please note, that to access this episode in full instead of the teaser available just below you would need to login.

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Dr. Michael Gordon recently retired after a fulfilling career as a geriatrician that spanned 56 years, 44 of which he spent working at the Baycrest Center in Toronto. He is Emeritus Professor of Medicine at the University of Toronto. Dr. Gordon is a recognized ethicist and a thought leader on all topics of care of the elderly and end-of-life decisions. Currently, Dr. Gordon provides part-time professional medical consulting mainly in the domain of cognition and memory loss.

Medicine and the Humanities

Teaser: 

Michael Gordon, MD, MSc, FRCPC,

Emeritus Professor of Medicine, Member, Joint Centre for Bioethics, University of Toronto, Toronto, ON.

CLINICAL TOOLS

Abstract: In the earliest writing of stories, physicians and illnesses often played an important role. Some of the renowned scholars in the Jewish tradition, like Moses Maimonides was a philosopher, a prolific writer, and a physician. A few of the world-famous authors include: François Rabelais (1483-1553), Anton Chekhov (1860-1904), Arthur Conan Doyle (1859-1930), Oliver Sacks (1933-2015) and the contemporary Abraham Verghese (1955-), to name just a few. The connection between medicine and the humanities appears to have diminished in some domains due partially to the focus on the scientific advances in medicine and the diminished focus on the humanities, especially in higher education. This I suggest, is a problem for medicine.
Key Words: medical humanities, education, medical students.
The exposure to the humanities in the education of physicians provides an expanded framework of understanding the person beneath the patient.
Education in the humanities should be a prerequisite or even a component of a more humanistic medical education.
As part of connecting to new patients it is important to find out who they are before asking why they are in your office or hospital bed.
Explore as many ways to connect to the patient on their life’s experiences, cultures or backgrounds in order to promote a therapeutic relationship of trust.
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: Law and Ethics, medical humanities, education, medical students