British Columbia Medical Journal

More than 150 000 people in British Columbia live with heart failure.[1] Considering that approximately half of all individuals with heart failure have heart failure with reduced ejection fraction (HFrEF), this translates to over 75 000 people in BC affected by HFrEF.[2] The Canadian Cardiovascular Society’s 2021 guidelines recommend treating HFrEF with four classes of medications, collectively referred to as guideline-directed medical therapy (GDMT): One of an angiotensin receptor-neprilysin...

As a physician, you may have patients who work as welders. Welding is fundamental to many industrial processes and occurs across a variety of industries. Here we review key chronic health outcomes related to welding and provide information on reporting related workplace exposures and diseases. Welding and allied processes have shared health hazards, such as ergonomic stressors, noise, welding fumes, irritating gases, fires, ultraviolet and infrared radiation, eye hazards, and electrical shocks.

Immunization coverage assessments are conducted to measure the percentage of people who have received certain vaccines. The assessments are used to: Understand population-level protection against vaccine-preventable diseases. Explore potential reasons for low vaccine coverage. Identify communities at higher risk for outbreaks. Inform population-level interventions, including resource allocation.

My preteen son came home from summer day camp and told me his counselor had given the group two rules: “Be on time” and “Don’t ask about my mints.” Naturally, he was very curious to know what these mints were and why they were so important. The “mints” were nicotine pouches: small, discreet sachets tucked between the upper lip and gum, where saliva releases nicotine for absorption by the oral mucosa.

The BC Drug and Poison Information Centre (DPIC) will be transitioning to a standardized, pan-Canadian protocol for intravenous N-acetylcysteine (NAC) for the treatment of acetaminophen overdose. The current three-bag regimen will be replaced by a single concentration given in two steps. DPIC is prepared to launch the provincewide transition to the revised protocol by 1 November 2026, though individual health authorities may launch at earlier or later dates.

Cryptogenic multifocal ulcerous stenosing enteritis (CMUSE) is a rare inflammatory pathology of unknown origin, with multiple ulcerative strictures confined to the small bowel. With less than 100 published cases worldwide as of 2020,[1] CMUSE has probably been underdiagnosed or misdiagnosed, mainly as Crohn disease or NSAID-induced enteropathy.[2] This case report demonstrates the complexity of diagnosing CMUSE and the importance of an accurate diagnosis to guide treatment.

Serotonin syndrome is a potentially life-threatening drug-induced toxidrome associated with increased serotonergic activity in both the peripheral and central nervous systems.[1] It is characterized by a dose-dependent spectrum of clinical findings, including cognitive impairment, autonomic hyperactivity, and neuromuscular abnormalities.[1,2] The spectrum of cognitive dysfunction associated with serotonin syndrome ranges from mild irritability to profound coma, while hyper-reflexivity,...

In family practice, it is now common for a patient to arrive with a phone in hand, along with a list of symptoms, search results, and questions prepared before the visit. Before I can even ask my first question, the patient has often reviewed possible diagnoses and may request a referral to a specific specialist. As we speak, I open the patient’s electronic medical record, review results, and consult an online clinical guidance resource. Between us sit two screens and layers of digital information.