Post Archives

Doson Chua, PharmD, FCSHP, BCPS(AQ) and Dr. Mustafa Toma
January 10, 2018

Angiotensin Receptor Neprilysin Inhibitor (ARNI) in Heart Failure with Reduced Ejection Fraction (HFrEF): Sacubiltril/Valsartan and the PARADIGM HF Trial

Sacubitril/valsartan is the first in class of ARNI and has proven its superiority in reducing mortality and morbidity in HFrEF as compared to the use of ACEI. Sacubitril/valsartan should be considered in patients who are symptomatic despite optimal or maximally tolerated guideline-driven HF therapies consisting of a beta blocker, ACEI/ARB and MRA. Monitoring of patients on sacubitril/valsartan is similar to ACEI. read more...

Dr. Steve Wong
December 14, 2017

Letter from the editor

It's hard to believe that this is our 7th year at This Changed My Practice. Thanks for being part of our TCMP family. On behalf of all of us at This Changed My Practice, I wish all of you a happy, healthy holiday season! read more...

Dr. David Topps
November 29, 2017

Managing your passwords

Ever been frustrated by the number of passwords you have to keep track of in your daily life as a professional? At one time, you might have only a few – some simple ones for unimportant sites, some stronger ones and perhaps a really good one for your most important data. read more...

By Dr. Christy Sutherland and Emily Wagner
November 15, 2017

Managing opioid use disorder: buprenorphine/naloxone opioid agonist treatment

I no longer offer rapid methadone tapers to my patients. Buprenorphine/naloxone is now recommended as the first-line opioid agonist treatment for opioid use disorder in British Columbia. This is because of its superior safety profile when compared with methadone as well as an easier transition to take home dosing. read more...

Dr. Roberto Leon
November 1, 2017

Indications and value of self-administered vaginal swabs for STIs and vaginitis

I came across a publication in the British Medical Journal by Sarah A. Schoeman: Assessment of best single sample for finding chlamydia in women with and without symptoms: a diagnostic test study. Participants took a vaginal swab before a routine gynecological exam, and clinicians then took an endocervical swab during examination. read more...

Dr. Jennifer Robinson
October 18, 2017

MOVE an injury not RICE

MOVE an injury: Movement, not rest. Options: offer other options for cross training. Vary rehabilitation with strength, balance and agility drills. Ease back to activity early for emotional strength. read more...

Dr. Eileen Murray
October 3, 2017

Whether or not to use systemic corticosteroids to treat a skin disease

When I started out in dermatology, corticosteroids were the only systemic drug available to treat patients with severe allergic contact dermatitis (ACD), atopic dermatitis (AD), drug reactions and those with bullous diseases. Corticosteroids are potent and excellent immunosuppressive agents. The main problem with systemic use is the high risk of drug interactions, as well as multiple serious acute and long-term side effects. read more...

Dr. Taryl Felhaber
September 20, 2017

The risks of worklessness

Why should physicians encourage early and ultimate return to work whenever they can? In a nutshell, because it is usually in the patient’s best interest to remain in the workforce. read more...

Dr. Jennifer Grant
September 6, 2017

Evaluation of penicillin allergy

Recent data show that up to 90% of patients with a reported penicillin allergy are mislabelled and of those who are allergic, many beta-lactams can still be safely prescribed due to low risk of cross-reactivity. Mislabelling of penicillin allergy is due to many things including misdiagnosis (confusing a viral exanthema for allergy), purer formulations of antibiotics, loss of allergy and differences in side-chain structure. read more...

Drs. Christopher Cheung and Kenneth Gin
August 9, 2017

Management of Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation

Perioperative management of anticoagulation is challenging as physicians must consider the risks of stroke, systemic embolism, and perioperative bleeding. read more...

Michael Lee & Isabeau Iqual
August 8, 2017

Backward Course Design

Like many teachers, I begin to plan my course by creating course-level learning objectives and after that design the course to meet these. read more...

Dr. Anne Antrim
July 18, 2017

Review of the topic of Autism Spectrum Disorder

The current definition of Autism Spectrum Disorder has 2 criteria: “persistent impairment in reciprocal social communication and social interactions” AND “restricted, repetitive patterns of behavior”. The symptoms must be present from early childhood, but may not manifest till the social demands exceed the capacity of the child to respond. read more...