Pub Date : 2018-05-25DOI: 10.15273/DMJ.VOL44NO2.8507
Mike Wong
T story of the New Brunswick Provincial Lunatic Asylum reflects the evolution of mental health care in the Maritime provinces and in developed countries in general. The origins of the asylum demonstrate a burgeoning awareness of mental health as a priority for the provincial government, and the institution’s decline in the latter half of the twentieth century coincides with changing conceptions about the origins of mental illness, as well as its management. This article summarizes the history of the facility now known as Centracare, beginning with its inauguration as the oldest mental health institution in British North America and following the changes brought on during the deinstitutionalization movement that reshaped mental health services in New Brunswick and beyond.
{"title":"Centracare: A history of the New Brunswick Provincial Lunatic Asylum","authors":"Mike Wong","doi":"10.15273/DMJ.VOL44NO2.8507","DOIUrl":"https://doi.org/10.15273/DMJ.VOL44NO2.8507","url":null,"abstract":"T story of the New Brunswick Provincial Lunatic Asylum reflects the evolution of mental health care in the Maritime provinces and in developed countries in general. The origins of the asylum demonstrate a burgeoning awareness of mental health as a priority for the provincial government, and the institution’s decline in the latter half of the twentieth century coincides with changing conceptions about the origins of mental illness, as well as its management. This article summarizes the history of the facility now known as Centracare, beginning with its inauguration as the oldest mental health institution in British North America and following the changes brought on during the deinstitutionalization movement that reshaped mental health services in New Brunswick and beyond.","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129505391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-05-25DOI: 10.15273/DMJ.VOL44NO2.8508
Jonathan J. Oore
{"title":"Contour Study of the Auricle, Forearm, and Sprained Ankle. Medium: charcoal on paper.","authors":"Jonathan J. Oore","doi":"10.15273/DMJ.VOL44NO2.8508","DOIUrl":"https://doi.org/10.15273/DMJ.VOL44NO2.8508","url":null,"abstract":"","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132018615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-05-25DOI: 10.15273/dmj.vol44no2.8509
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{"title":"Recognized abstracts from Dalhousie Medicine 2018 RIM Research Day","authors":"- - -","doi":"10.15273/dmj.vol44no2.8509","DOIUrl":"https://doi.org/10.15273/dmj.vol44no2.8509","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130360096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-05-25DOI: 10.15273/DMJ.VOL44NO2.8506
S. George
{"title":"Medicine, Make-up, & Male Perspectives","authors":"S. George","doi":"10.15273/DMJ.VOL44NO2.8506","DOIUrl":"https://doi.org/10.15273/DMJ.VOL44NO2.8506","url":null,"abstract":"","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127533372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-23DOI: 10.15273/DMJ.VOL44NO1.7575
N. Humphreys, W. Gallacher
Takotsubo cardiomyopathy is a stress induced, transient cardiomyopathy that commonly presents with regional left ventricular akinesis or hypokinesis. The perioperative incidence of Takotsubo is estimated at 1:6700 cases and as such, should be familiar to practicing anesthesiologists. Point of care ultrasonography is a valuable tool for the evaluation of cardiac function and can be utilized in the perioperative setting by anesthesia staff. With some basic training in ultrasonography, one can quickly assess volume status and cardiac function, among other things. We present the case of a 73-year-old male undergoing an elective rotator cuff repair with an interscalene block under general anesthesia. Immediately following induction, the patient had a pulseless electrical activity arrest. Following immediate resuscitation, point of care ultrasonography was used to delineate the cause of the arrest and guide immediate management. Features consistent with Takotsubo cardiomyopathy – including regional left ventricular wall motion abnormalities with associated low ejection fraction – were identified on early ultrasound. The patient made a successful recovery and repeat cardiac imaging showed resolution of the wall motion abnormalities.
{"title":"The use of point of care ultrasonography in the perioperative period: A case of Takotsubo cardiomyopathy","authors":"N. Humphreys, W. Gallacher","doi":"10.15273/DMJ.VOL44NO1.7575","DOIUrl":"https://doi.org/10.15273/DMJ.VOL44NO1.7575","url":null,"abstract":"Takotsubo cardiomyopathy is a stress induced, transient cardiomyopathy that commonly presents with regional left ventricular akinesis or hypokinesis. The perioperative incidence of Takotsubo is estimated at 1:6700 cases and as such, should be familiar to practicing anesthesiologists. Point of care ultrasonography is a valuable tool for the evaluation of cardiac function and can be utilized in the perioperative setting by anesthesia staff. With some basic training in ultrasonography, one can quickly assess volume status and cardiac function, among other things. We present the case of a 73-year-old male undergoing an elective rotator cuff repair with an interscalene block under general anesthesia. Immediately following induction, the patient had a pulseless electrical activity arrest. Following immediate resuscitation, point of care ultrasonography was used to delineate the cause of the arrest and guide immediate management. Features consistent with Takotsubo cardiomyopathy – including regional left ventricular wall motion abnormalities with associated low ejection fraction – were identified on early ultrasound. The patient made a successful recovery and repeat cardiac imaging showed resolution of the wall motion abnormalities.","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117249880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-23DOI: 10.15273/DMJ.VOL44NO1.7509
Mike Wong
{"title":"Competence and compassion: A history of the Halifax Infirmary","authors":"Mike Wong","doi":"10.15273/DMJ.VOL44NO1.7509","DOIUrl":"https://doi.org/10.15273/DMJ.VOL44NO1.7509","url":null,"abstract":"","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129298710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-23DOI: 10.15273/DMJ.VOL44NO1.7505
L. Nemiroff, A. Ghaly, D. Haldane, T. Witter
1 Department of Medicine, Dalhousie University, Halifax, NS, Canada 2 Department of Medicine, Division of Infectious Diseases, Dalhousie University, Halifax, NS, Canada 3 Department of Pathology, Clinical Director Provincial Public Health Laboratory Network of Nova Scotia, Director of Special Pathogens NSHA, Dalhousie University, Halifax, NS, Canada 4 Departments of Anesthesia and Medicine, Division of Critical Care, Dalhousie University, Halifax, NS, Canada
{"title":"The case of the critically ill fisherman","authors":"L. Nemiroff, A. Ghaly, D. Haldane, T. Witter","doi":"10.15273/DMJ.VOL44NO1.7505","DOIUrl":"https://doi.org/10.15273/DMJ.VOL44NO1.7505","url":null,"abstract":"1 Department of Medicine, Dalhousie University, Halifax, NS, Canada 2 Department of Medicine, Division of Infectious Diseases, Dalhousie University, Halifax, NS, Canada 3 Department of Pathology, Clinical Director Provincial Public Health Laboratory Network of Nova Scotia, Director of Special Pathogens NSHA, Dalhousie University, Halifax, NS, Canada 4 Departments of Anesthesia and Medicine, Division of Critical Care, Dalhousie University, Halifax, NS, Canada","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123910345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-23DOI: 10.15273/DMJ.VOL44NO1.7507
L. Allen
In the last decade there has been a major shift in clinical practice guidelines from the avoidance of allergenic foods for the purpose of preventing allergy development toward their early introduction before six months of age. The purpose of this article is to review current evidence for this change in recommendation and to evaluate its impli- cations for clinical practice. A literature review and analysis were conducted focusing on key clinical studies that influenced this change in practice over the past decade. The main findings supported the early introduction of peanut to the diet and highlighted two areas of uncertainty in the literature that have implications for adopting the new guidelines in clinical practice. First, current evidence lacks a clear definition of “high risk” for determining allergic predisposition in infants; and second, defining the ideal timing, amount, and frequency with which peanut and peanut containing foods are introduced into a child’s diet is not yet established in the literature. The principal conclusion underscored the importance of early and continual exposure to peanut regardless of risk of atopy.
{"title":"Peanut allergy prevention: Current evidence and implications for clinical practice","authors":"L. Allen","doi":"10.15273/DMJ.VOL44NO1.7507","DOIUrl":"https://doi.org/10.15273/DMJ.VOL44NO1.7507","url":null,"abstract":"In the last decade there has been a major shift in clinical practice guidelines from the avoidance of allergenic foods for the purpose of preventing allergy development toward their early introduction before six months of age. The purpose of this article is to review current evidence for this change in recommendation and to evaluate its impli- cations for clinical practice. A literature review and analysis were conducted focusing on key clinical studies that influenced this change in practice over the past decade. The main findings supported the early introduction of peanut to the diet and highlighted two areas of uncertainty in the literature that have implications for adopting the new guidelines in clinical practice. First, current evidence lacks a clear definition of “high risk” for determining allergic predisposition in infants; and second, defining the ideal timing, amount, and frequency with which peanut and peanut containing foods are introduced into a child’s diet is not yet established in the literature. The principal conclusion underscored the importance of early and continual exposure to peanut regardless of risk of atopy.","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129392091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-12DOI: 10.15273/DMJ.VOL43NO2.7058
M. Gostimir, Rosalind Ashton, J. Werier
A 32-year-old male presented with a 6-month history of a slowly expanding painful mass on the radial aspect of his right middle finger. The mass measured 1.5 x 1.0 cm with no irregularities in the overlying skin, neurovascular status, or joint range of motion. Radiographs were interpreted as showing an exostosis or osteochondroma. The lesion was resected but recurred one year later. A clinical photograph and plain x-ray are shown (Figure 1).
32岁男性，右中指桡侧有缓慢扩大的疼痛肿块，有6个月的病史。肿块尺寸为1.5 x 1.0 cm，覆盖的皮肤、神经血管状况或关节活动范围无不规则性。x线片显示为外生性增生或骨软骨瘤。病变被切除，但一年后复发。临床照片和x线平片(图1)。
{"title":"A recurrent lump on the hand","authors":"M. Gostimir, Rosalind Ashton, J. Werier","doi":"10.15273/DMJ.VOL43NO2.7058","DOIUrl":"https://doi.org/10.15273/DMJ.VOL43NO2.7058","url":null,"abstract":"A 32-year-old male presented with a 6-month history of a slowly expanding painful mass on the radial aspect of his right middle finger. The mass measured 1.5 x 1.0 cm with no irregularities in the overlying skin, neurovascular status, or joint range of motion. Radiographs were interpreted as showing an exostosis or osteochondroma. The lesion was resected but recurred one year later. A clinical photograph and plain x-ray are shown (Figure 1).","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130328048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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