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					                                                 virtually overburdened and getting an
MEDICAL                                          initial diagnosis is challenging enough,"              EMERGENCY MEDICINE PHYSICIAN
                                                 said Dianne Carmichael, President and
JOURNAL                                          CEO of Best Doctors Canada, an expert
                                                                                                                         Brockville, Ontario - Full Time
March 8, 2010                                    medical consultation and advocacy                      Brockville General Hospital. Modern (2003) department, with CT, digital
                                                 service. Carmichael added that this rate of            imaging, and bedside ultrasound: 24,000 visits annually. Full complement of
                                                 misdiagnosis is not unique to Canada,                  specialty backup available locally. Tertiary care centres 1 hour away
      Information Supplied By
                                                 noting that for certain types of cancer this           (Kingston/Ottawa). Ideal candidate will be willing to relocate to the community.
                                                 figure can climb as high as 50 percent.
    For Subscriptions or Ad                      "We find that this trend is the same around            Brockville (population 24,000) is conveniently located along Hwy. 401, on the
Information call 1-800-503-4563                  the world, regardless of how a health care             St. Lawrence River, in the beautiful Thousand Islands region; 3 hours east of
                                                 system is funded. Overburdened systems                 Toronto, 2 hours west of Montreal.
                                                 combined with systemic fragmentation
     CMA PLEASED BUDGET HELD                     and lack of electronic health records                  Contact:
          THE LINE ON HEALTH                     (EHRs) serve to create an environment in               Carlene MacDonald, Physician Recruiter, email tel 613
The Canadian Medical Association (CMA)           which errors can happen. Sometimes this                345-5649, ext. 1154, Web site
welcomed the announcement yesterday              is the difference between life and death.
that the federal government will release         That means it's worth having your results                                               Ad Proof A
the $500 million promised for electronic         reviewed by another expert."                                        PHYSICIANS REQUIRED
medical records. It is also relieved that                                                                                         KELOWNA, B.C.
transfers to the provinces remain                      BRAIN CHEMICAL SHOWN TO
untouched. "Canada's doctors are                  PLAY ROLE IN SEVERE DEPRESSION                        Kelowna, Medi-Kel Clinics Ltd. seeks physicians from across
pleased to see that the federal                  The next advance in treating major
                                                                                                        Canada for well established family practice. Foreign graduates
government isn't planning to balance the         depression may relate to a group of brain
budget on the backs of Canadian                                                                         also welcome. Kelowna is located in the heart of the Okanagan
                                                 chemicals that are involved in virtually all
patients," said CMA President Dr. Anne           our brain activity, according to a study               in south-central British Columbia.. Kelowna has excellent
Doig. "As we saw with the cuts to health         published today in Biological Psychiatry.              schools, recreational facilities, restaurants and wineries. Truly a
care in the 1990s, the supposed cure             The study is co-authored by Drs. Andrea J.             great place to live and work.
ended up being much worse than the               Levinson and Zafiris J. Daskalakis of the
disease." After months of delay, the             Centre for Addiction and Mental Health                                        Contact Maria Varga,
federal budget signaled that the funds           (CAMH). This study shows that compared                                email:
promised to Canada Health Infoway in             to healthy individuals, people who have
2009 would finally flow. This move will          major depressive disorder have altered
speed up the introduction of electronic          functions of the neurotransmitter GABA
medical record systems in doctors' offices       (gamma-aminobutyric acid). In the study,
and ultimately improve patient care. "We         individuals with the most treatment-
applaud the government for releasing the         resistant forms of illness demonstrated the
$500 million earmarked in the last budget        greatest reductions of GABA levels in the
for electronic medical records," added Dr.       brain. This points to the possibility that
Doig. "The doctors of Canada have been           medications which correct a GABA
pushing for this since last summer and           imbalance could advance the treatment of
we're glad that our efforts paid off. The real   major depressive disorder. Approximately
winners, of course, will be our patients who     4% of Canadians experience major
will benefit from more efficient and             depressive disorder each year. Several
integrated care." The CMA was also glad          current medications for mood disorders
that the federal government recognized           correct imbalances in neurotransmitters
the importance of health promotion and           such as serotonin and dopamine.
disease prevention. The $6 million for           However, many patients do not benefit
ParticipACTION, the $45 million for the          from these medications. "Our findings
Northern Food Mail program, the $285             build on the idea that some current
million for Aboriginal Health initiatives and    medications do not help many patients
the extension of the First Nations Water         because those drugs don't affect the
and Wastewater Program are all wise              GABA-related brain chemistry," says study
investments. "The easiest way to save            author Dr. Andrea Levinson. The GABA
money in our health care system is to try to     neurotransmitter and its receptors are
keep people from having to access it in the      involved in many different brain functions.
first place," concluded Dr. Doig. "Money         Imbalances in GABA also are relevant to            excessive brain activity that in depression    stimulation (TMS) was used to measure
spent now on health promotion and                bipolar disorder, schizophrenia, and               may lead to excessive negative thinking."      how GABA acts physiologically in the
disease prevention will pay huge                 anxiety disorder. The GABA                         In addition, today's study points to the       brain. GABA receptors were found to be
dividends in the future."                        neurotransmitter and its receptors are             reason why electroconvulsive therapy is        dysfunctional in the three groups with
                                                 critical to how humans think and act, Dr.          still the most efficacious therapy for major   major depressive disorder when
    IT'S WORTH GETTING A SECOND                  Levinson adds. "We apply so many                   depressive disorder, Dr. Levinson adds.        compared to healthy subjects. In people
                 OPINION                         conscious and unconscious perceptions              "Electroconvulsive therapy may act on          who were the least responsive (treatment-
Canada's health experts are among the            and judgments to our actions at every              GABA brain chemicals in a way that can         resistant) to medications, the physiological
very best in the world, but Canadians may        second, without even realizing that we are         reset the balance," she says. This study of    effect of GABA in the brain was at its
be surprised to learn that when it comes to      doing so," she says. "GABA is part of the          85 people is the largest such research         lowest. "We are advancing the goal of a
reading their pathology reports, it is           brain system that allows us to fine-tune our       effort on GABA and major depressive            truly personalized medicine," says study
imperative that they seek a second               moods, thoughts, and actions with an               disorder to date. It compared four groups:     co-author Dr. Daskalakis. "It is intriguing to
opinion. "Our experience in over 30              incredible level of detail." "It's a little like   25 individuals with treatment-resistant        think that we may soon be able to apply
countries around the world based on tens         driving a car. You need the accelerator, but       depression, 16 with major depression who       simple brain stimulation to identify which
of thousands of exhaustive reviews over          at every stage you need the brakes to              were unmedicated, 19 individuals with          treatments are most likely to help the
the last twenty years, is that on average,       work. Some of our neurotransmitters apply          major depression who were successfully         individual person, eliminating the
22 percent of the time, the initial diagnosis    the spark and the gas to the engine, and           treated with medication and had normal         guesswork. That is, through these findings
is incorrect. We believe that your health is     GABA supplies the brakes," she says.               mood, and a control group of 25 healthy        we may be able to one day determine who
too important not to get a second look.          "GABA provides the necessary inhibitory            individuals. In all groups, a thumb twitch     is and who is not going to respond to
However, our healthcare system is                effect that we need in order to block out          response to transcranial magnetic (brain)      traditional pharmacological approaches to
depression." The journal published a              — but that can mean high anxiety. The
separate editorial to highlight the potential     cancer society's new guidance released                          Hope, Healing & Possibilities:
for an individualized approach to                 Wednesday urges doctors to: • Discuss the
diagnosing depression, one that would             pros and cons of testing with patients,
                                                                                                       A Comprehensive Approach to Treatments
include brain stimulation to identify low         offering written information or videos that                For Autism, PDD, AD(H)D, and Related Disorders
levels of the GABA neurotransmitters. Dr.         discuss the likelihood of false test results                  March 26 - 28, 2010 • Edmonton, Alberta
Daskalakis has international expertise in         and the side effects of treatment. • Stop This conference is for parents, care givers, educators, and practioners. It features some of the
the electrophysiology of psychiatric              routinely giving the rectal exam because it world’s foremost autism experts speaking on a wide range of topics featuring the latest
disorders, particularly related to GABA.          has not clearly shown a benefit, though it research on the treatment of Autism Spectrum Disorders. This conference is an excellent
This study was conducted at the Centre for        can remain an option. Use past PSA opportunity for those seeking evidence to support the use of various biomedical treatment
Addiction and Mental Health, with                 readings to determine how often follow-up options. It will provide a comprehensive overview of latest biomedical breakthroughs and
coauthors in Melbourne, Australia.                tests are needed and to guide research in the treatment for Autism Spectrum Disorders
Funders of the study were the Ontario             conversations about treatment. Cancer                       For More Information:
Mental Health Foundation, the Canadian            experts have been having second                   1-866-928-8476, Fax: 780-416-4330 Email:
Institutes of Health Research, and                thoughts in recent years about the value of
NARSAD.                                           regular screening to detect certain types of                                       Ad Proof A
                                                  cancer in its early stages. Last year, a                        PHYSICIANS REQUIRED
    CANCER SOCIETY CASTS MORE                     government task force said most women
     DOUBT ON PROSTATE TESTS                      don't need mammograms in their 40s, and           Englehart, Ont - Two positions available to complete our
Months after experts discounted the               a doctors group said most women in their          complement of six. High-income salaried position as a member of
importance of routine mammograms and              20s don't need annual Pap tests. The new          our Family Health Team. One in six, Scott Sessional. No
Pap smears for many women, the                    advice on prostate cancer runs counter to         obstetrics. Eight weeks paid leave for vacation/CME. Generous
American Cancer Society is warning more           what men have been told on TV and other           hospital and underserviced area incentives including housing.
explicitly than ever that regular testing for     public service campaigns for several              Excellent schools, recreational facilities, organized activities in
prostate cancer is of questionable value          years. Prostate cancer screening became
too, and can do men more harm than                a medical mantra in the 1990s, thanks to
good. The cancer society has not                  the development of the PSA test. Some
recommended routine screening for most            celebrities became advocates for regular                     Telephone Lois Kozak, CEO, at: 705 544-2301;
men since the mid-1990s, and that is not          testing, including former New York Mayor                             or e-mail:
changing. But the organization is urging          Rudy Giuliani, who credited a PSA test
doctors to talk frankly with their patients       during a routine exam with helping him                                             Ad Proof A
about the risks and limitations of the PSA        beat prostate cancer a decade ago. Actor                       PHARMACIST REQUIRED
blood test when offering it. Two big studies      Brad Garrett from "Everybody Loves
last year suggested prostate cancer               Raymond" had an on-the-air digital rectal                          STETTLER, ALBERTA
screening doesn't necessarily save lives,         exam for a TV special. For American men,
and any benefits can come at a high price.        prostate cancer is the second-deadliest                      SAVAGE VALUE DRUG MART is looking for
The widely used PSA test often spots              cancer after lung cancer. An estimated                         a Full Time and/or Part Time Pharmacist.
cancers too slow-growing to be deadly. It         192,000 new cases and 27,000 deaths                                           Competitive wage.
can yield false-positive readings that result     from it occurred last year in the United
in unnecessary biopsies. And it can lead to       States. But it is often a slow-growing
treatments that can cause impotence and           cancer, and depending on a man's age, he
                                                                                                                            Please contact Scott at
incontinence. "We had a revolution" when          may be more likely to die of something                               403-742-3367 or 403-742-1481
PSA tests became available and prostate           else. Another problem with the PSA test is
cancer screenings kicked into high gear,          that an elevated or fast-rising PSA reading call for annual tests after age 50. The prostate specific antigen. Annual tests are
said Dr. Len Lichtenfeld, the cancer              can indicate the presence of cancer, but group said men should be offered a recommended for 2.5 or higher, and a 4
society's deputy chief medical officer.           can also be caused by something minor, baseline test at 40, with follow-ups based suggests consideration of a biopsy. Early
"Now we're having an evolution. We're             such as an infection or an enlarged on each man's situation. The group also prostate cancer has no symptoms.
learning more about what PSA really tells         prostate. A biopsy is needed to confirm has stood by the rectal exam as a standard Advanced disease may interfere with
us." He added: "We don't know that it truly       cancer, and that can cause unnecessary part of screening, saying it can find cancer urination or cause blood in the urine. Many
saves lives the way people want it to save        pain and fear. The new recommendations that the blood test does not. The cancer men with slow-growing cancers have been
lives." Some doctors and advocates are            could be "game changers" in two respects, society last issued guidelines in 2001, successfully treated after symptoms
troubled by the new guidelines. "Prostate         said Dr. John Davis, a urologist who directs which said merely that doctors should offer appear. There are few good treatments for
cancer is still something to be respected if      prostate cancer screening for the screening and discuss the risks and very advanced cases, though researchers
not feared, and we still need to be vigilant. I   University of Texas M.D.Anderson Cancer benefits. The new guidelines back away reported Wednesday that an experimental
hope primary care docs or insurance               Center in Houston. First, it may mean even more, dropping the sentence that drug extended survival by 10 weeks. They
companies don't use the 'softening' of the        many doctors will stop routinely giving the doctors should offer prostate screening. were hopeful that the drug, cabazitaxel,
guidelines as an excuse to not do                 PSA test during regular physicals and will Instead, the society said that some might be more effective in stopping earlier
screening at all," said Dr. David Roberts,        discuss it with their patients first, he said. evidence indicates periodic screening can cancers. The society's new guidelines
medical director of an Atlanta clinic that        About 41 percent of men 50 and older get save lives but that there is uncertainty rankle Skip Lockwood, president and CEO
caters to businessmen. Dr. Stephen                annual prostate cancer screenings, he about the value of finding prostate cancer of Zero — The Project to End Prostate
Freedland, an associate professor of              said. Second, the guidelines could have a early. Screening should not take place Cancer, formerly known as the National
urology at Duke University Medical                chilling effect on community screening unless the patient is fully informed of the Prostate Cancer Coalition. Lockwood's
Center, warned that the medical                   clinics in which hundreds of men line up trade-offs, the society said. Men at group recommends annual PSA tests for
establishment seems to be moving                  and get free, quick exams, Davis said. average risk should get detailed men beginning at 45, and conducts mobile
backward on cancer screening. "We have            That was the intent, said Dr. Andrew Wolf, information around age 50, the society prostate cancer screening programs. The
seen dramatic drops in mortality from             a University of Virginia physician who led said. Men at higher risk, including blacks group provides information about the risks
breast, prostate and cervical at a time           the group that wrote the new guidelines. and men with a father or brother who had and benefits of screening, and connects
when screening has been increasing, and           "Yes, the guideline was explicitly crafted to prostate cancer before age 65, should get men to follow-up care if needed, he said.
now we are stepping off the pedal. I don't        put a damper on those community prostate the information beginning at 45. Men with What bothers him most in the new
think that is the right answer," he said. Men     screening activities that do not offer men more than one close relative with prostate guidance is "the certainty of its tone,"
will need to weigh their fear of having a         the opportunity to make an informed cancer before 65 should get such Lockwood said. "We acknowledge that
potentially aggressive cancer versus              decision whether to screen," Wolf said. information at 40. For men who want to be the PSA test is lacking. I think nobody
treatment that can cause ugly side effects.       Last year, the American Urological screened regularly, the new guidelines disagrees on that fact. I think that we all
Another option if cancer is found is              Association — a longtime proponent of recommend every other year if the PSA understand that this is not cut and dry —
watchful waiting — that is, doing nothing         regular prostate screening — backed off its reading is less than 2.5, a measure of not an all-or-nothing situation," he said.
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