EM:RAP 2016 July Canadian Edition

John Michael B., M.D. -

I enjoyed your discussion of Lyme disease. as someone who works in the emergency department and also has a clinic as a family doctor this is becoming an increasing problem. There is no question that every decade or so we have a new disease that explains the vague symptoms of chronic fatigue, malaise, generalized unhappiness and fibromyalgia. Nonetheless the proponents of this actually have the IGeneX lab which, as you rightly point out, has an enormous false positive rate. In fact over 50% of the samples from healthy volunteers sent to it were positive for the disease even though there was no history in the test subjects of exposure. There are, of course, significant problems when taking any test which lacks specificity and applying it to the population at large. I do think that there will be certain changes in recommendations, for example I do believe the 36 hour rule for tic implantation is probably going to be reduced. I think you are right point out that this is a clinical diagnosis at least within the first few weeks when the blood test would be lacking sensitivity. Unfortunately veterinarians and naturopaths are making this diagnosis using the private labs in the USA and patients are coming and demanding long-term treatment with antibiotics.

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Break Through The Plateau Full episode audio for MD edition 244:17 min - 340 MB - M4AEM:RAP 2016 Juillet Résumé en Francais Français 36:30 min - 50 MB - MP3EM:RAP 2016 July Aussie Edition Australian 30:02 min - 41 MB - MP3EM:RAP 2016 July Canadian Edition Canadian 28:33 min - 39 MB - MP3EM:RAP 2016 July German Edition Deutsche 146:43 min - 202 MB - MP3EM:RAP 2016 Julio Resumen Español Español 79:25 min - 109 MB - MP3EM:RAP 2016 July Board Review Answers 162 KB - PDFEM:RAP 2016 July Board Review Questions 499 KB - PDFEM:RAP 2016 July Individual MP3 291 MB - ZIPEM:RAP 2016 July Written Summary 522 KB - PDFEMRAP Resumen en Español Julio 2016 1 MB - PDF