Specialty Medicine https://ubccpd.ca/ en VGH Commuter Centre https://ubccpd.ca/vgh-commuter-centre <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--title--rss.html.twig * field--node--title--resource.html.twig x field--node--title.html.twig * field--node--resource.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">VGH Commuter Centre</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--uid--rss.html.twig * field--node--uid--resource.html.twig x field--node--uid.html.twig * field--node--resource.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> <span>judy.c@ubc.ca</span> <!-- END OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--created--rss.html.twig * field--node--created--resource.html.twig x field--node--created.html.twig * field--node--resource.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Mon, 03/04/2024 - 16:06</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <drupal-render-placeholder callback="flag.link_builder:build" arguments="0=node&amp;1=1742&amp;2=bookmark" token="rx7R2J1X88r2t02_6lfo0XOfalSbLIURnts40D_rRBE"></drupal-render-placeholder> <!-- THEME DEBUG --> <!-- THEME HOOK: 'addtoany_standard' --> <!-- FILE NAME SUGGESTIONS: * addtoany-standard--node--resource.html.twig * addtoany-standard--node.html.twig x addtoany-standard.html.twig --> <!-- BEGIN OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <span class="a2a_kit a2a_kit_size_32 addtoany_list" data-a2a-url="https://ubccpd.ca/vgh-commuter-centre" data-a2a-title="VGH Commuter Centre"><a class="a2a_dd" href="https://www.addtoany.com/share" data-tooltip="Share"><span class="visually-hidden">Share</span><span class="CPD-Icon-Share"></span></a></span> <!-- END OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-topic-audience--rss.html.twig * field--node--field-topic-audience--resource.html.twig * field--node--field-topic-audience.html.twig * field--node--resource.html.twig * field--field-topic-audience.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-topic-audience field--type-entity-reference field--label-above"> <div class="field__label">Topic &amp; Audience</div> <div class="field__items"> <div class="field__item"><a href="/taxonomy/term/100" hreflang="en">Specialty Medicine</a></div> </div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-learning-activity--rss.html.twig * field--node--field-learning-activity--resource.html.twig * field--node--field-learning-activity.html.twig * field--node--resource.html.twig * field--field-learning-activity.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-learning-activity field--type-entity-reference field--label-above"> <div class="field__label">Learning Activity</div> <div class="field__items"> <div class="field__item"><a href="/node/1674" hreflang="en">Orthopaedic Update &amp; BCOA Annual Meeting</a></div> </div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> Mon, 04 Mar 2024 16:06:47 +0000 judy.c@ubc.ca 1742 at https://ubccpd.ca 2024-01-23 Trauma, Illness and Healing in a Toxic Culture https://ubccpd.ca/2024-01-23-trauma-illness-and-healing-toxic-culture <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--title--rss.html.twig * field--node--title--resource.html.twig x field--node--title.html.twig * field--node--resource.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">2024-01-23 Trauma, Illness and Healing in a Toxic Culture</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--uid--rss.html.twig * field--node--uid--resource.html.twig x field--node--uid.html.twig * field--node--resource.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> <span>steph.d@ubc.ca</span> <!-- END OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--created--rss.html.twig * field--node--created--resource.html.twig x field--node--created.html.twig * field--node--resource.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Wed, 01/24/2024 - 17:20</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <drupal-render-placeholder callback="flag.link_builder:build" arguments="0=node&amp;1=1708&amp;2=bookmark" token="cxe4V8npWBEHezZNvjmb7NvoUK0JqsNQd1MbtHUyBiI"></drupal-render-placeholder> <!-- THEME DEBUG --> <!-- THEME HOOK: 'addtoany_standard' --> <!-- FILE NAME SUGGESTIONS: * addtoany-standard--node--resource.html.twig * addtoany-standard--node.html.twig x addtoany-standard.html.twig --> <!-- BEGIN OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <span class="a2a_kit a2a_kit_size_32 addtoany_list" data-a2a-url="https://ubccpd.ca/2024-01-23-trauma-illness-and-healing-toxic-culture" data-a2a-title="2024-01-23 Trauma, Illness and Healing in a Toxic Culture"><a class="a2a_dd" href="https://www.addtoany.com/share" data-tooltip="Share"><span class="visually-hidden">Share</span><span class="CPD-Icon-Share"></span></a></span> <!-- END OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-topic-audience--rss.html.twig * field--node--field-topic-audience--resource.html.twig * field--node--field-topic-audience.html.twig * field--node--resource.html.twig * field--field-topic-audience.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-topic-audience field--type-entity-reference field--label-above"> <div class="field__label">Topic &amp; Audience</div> <div class="field__items"> <div class="field__item"><a href="/taxonomy/term/828" hreflang="en">Addiction Medicine</a></div> <div class="field__item"><a href="/taxonomy/term/13" hreflang="en">Family Medicine</a></div> <div class="field__item"><a href="/taxonomy/term/78" hreflang="en">Mental Health</a></div> <div class="field__item"><a href="/taxonomy/term/82" hreflang="en">Nurse Practitioners</a></div> <div class="field__item"><a href="/taxonomy/term/93" hreflang="en">Registered Nurses</a></div> <div class="field__item"><a href="/taxonomy/term/96" hreflang="en">Residents &amp; Students</a></div> <div class="field__item"><a href="/taxonomy/term/100" hreflang="en">Specialty Medicine</a></div> </div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-resource-thumbnail--rss.html.twig * field--node--field-resource-thumbnail--resource.html.twig * field--node--field-resource-thumbnail.html.twig * field--node--resource.html.twig * field--field-resource-thumbnail.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="blazy blazy--field blazy--field-resource-thumbnail blazy--field-resource-thumbnail--rss field field--name-field-resource-thumbnail field--type-entity-reference field--label-hidden field__item" data-blazy=""> <!-- THEME DEBUG --> <!-- THEME HOOK: 'blazy' --> <!-- BEGIN OUTPUT from 'modules/contrib/blazy/templates/blazy.html.twig' --> <div data-b-token="b-5c4db5e9a35" class="media media--blazy media--bundle--image media--image is-b-loading"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'image' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/image.html.twig' --> <img alt="" decoding="async" class="media__element b-lazy" loading="lazy" data-src="/sites/default/files/images/2024-01-23%20Intro%20Slides.png" src="data:image/svg+xml;charset=utf-8,%3Csvg%20xmlns%3D&#039;http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg&#039;%20viewBox%3D&#039;0%200%201%201&#039;%2F%3E" width="960" height="540" /> <!-- END OUTPUT from 'core/themes/classy/templates/field/image.html.twig' --> </div> <!-- END OUTPUT from 'modules/contrib/blazy/templates/blazy.html.twig' --> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--body--rss.html.twig * field--node--body--resource.html.twig * field--node--body.html.twig * field--node--resource.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><h4><strong>Tuesday, January 23, 2024</strong></h4> <p>Dr. Gabor Maté and Dr. Linda Uyeda (moderator) with ASL English Interpreters Tyler Churchman and Karly Sandboe</p> <p><em><strong>Please note:</strong> this webinar is intended only for health care professionals.</em></p> <h5>Recording:</h5> <p><iframe allow="autoplay" allowfullscreen="" height="405" src="https://ubc.ca.panopto.com/Panopto/Pages/Embed.aspx?id=a285c5dc-007a-4e97-a1ba-b062011b3754&amp;autoplay=false&amp;offerviewer=true&amp;showtitle=false&amp;showbrand=false&amp;captions=false&amp;interactivity=all" style="border: 1px solid #464646;" width="720"></iframe></p> <h5>Additional Resources:</h5> <!-- THEME DEBUG --> <!-- THEME HOOK: 'entity_embed_container' --> <!-- BEGIN OUTPUT from 'modules/contrib/entity_embed/templates/entity-embed-container.html.twig' --> <div data-embed-button="media" data-entity-embed-display="view_mode:media.inline" data-entity-type="media" data-entity-uuid="e20de1c9-d7c6-487b-a86e-7895c901d434" data-langcode="en" data-entity-embed-display-settings="[]" class="embedded-entity"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'media' --> <!-- FILE NAME SUGGESTIONS: * media--source-file.html.twig * media--file--inline.html.twig * media--file.html.twig * media--inline.html.twig x media.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/media/media.html.twig' --> <div> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-media-file--inline.html.twig * field--media--field-media-file--file.html.twig * field--media--field-media-file.html.twig * field--media--file.html.twig * field--field-media-file.html.twig * field--file.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-media-file field--type-file field--label-visually_hidden"> <div class="field__label visually-hidden">File</div> <div class="field__item"><span class="file file--application-pdf"></span><a href="/media/1829/download" data-filename="media-3619--Jan 23 Webinar Resources.pdf">Jan 23 Webinar Resources.pdf</a></div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/media/media.html.twig' --> </div> <!-- END OUTPUT from 'modules/contrib/entity_embed/templates/entity-embed-container.html.twig' --> <p> </p> <p>You can learn more about Dr. Gabor Maté's work at <a href="https://drgabormate.com/">drgabormate.com</a>.</p> </div> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--text-with-summary.html.twig' --> Wed, 24 Jan 2024 17:20:53 +0000 steph.d@ubc.ca 1708 at https://ubccpd.ca Nov 30 & Dec 7, 2023: Not Just a Prescription Pad: A Multimodal Approach to Chronic Non-Cancer Pain Management https://ubccpd.ca/nov-30-dec-7-2023-not-just-prescription-pad-multimodal-approach-chronic-non-cancer-pain-management <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--title--rss.html.twig * field--node--title--resource.html.twig x field--node--title.html.twig * field--node--resource.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">Nov 30 &amp; Dec 7, 2023: Not Just a Prescription Pad: A Multimodal Approach to Chronic Non-Cancer Pain Management</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--uid--rss.html.twig * field--node--uid--resource.html.twig x field--node--uid.html.twig * field--node--resource.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> <span>caldon.s@ubc.ca</span> <!-- END OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--created--rss.html.twig * field--node--created--resource.html.twig x field--node--created.html.twig * field--node--resource.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Mon, 12/04/2023 - 17:29</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <drupal-render-placeholder callback="flag.link_builder:build" arguments="0=node&amp;1=1649&amp;2=bookmark" token="_4BcuL-YzFz7oibCBCDZZKJGocAFHg3kKqfKdk4-G8c"></drupal-render-placeholder> <!-- THEME DEBUG --> <!-- THEME HOOK: 'addtoany_standard' --> <!-- FILE NAME SUGGESTIONS: * addtoany-standard--node--resource.html.twig * addtoany-standard--node.html.twig x addtoany-standard.html.twig --> <!-- BEGIN OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <span class="a2a_kit a2a_kit_size_32 addtoany_list" data-a2a-url="https://ubccpd.ca/nov-30-dec-7-2023-not-just-prescription-pad-multimodal-approach-chronic-non-cancer-pain-management" data-a2a-title="Nov 30 &amp; Dec 7, 2023: Not Just a Prescription Pad: A Multimodal Approach to Chronic Non-Cancer Pain Management"><a class="a2a_dd" href="https://www.addtoany.com/share" data-tooltip="Share"><span class="visually-hidden">Share</span><span class="CPD-Icon-Share"></span></a></span> <!-- END OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-topic-audience--rss.html.twig * field--node--field-topic-audience--resource.html.twig * field--node--field-topic-audience.html.twig * field--node--resource.html.twig * field--field-topic-audience.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-topic-audience field--type-entity-reference field--label-above"> <div class="field__label">Topic &amp; Audience</div> <div class="field__items"> <div class="field__item"><a href="/taxonomy/term/13" hreflang="en">Family Medicine</a></div> <div class="field__item"><a href="/taxonomy/term/82" hreflang="en">Nurse Practitioners</a></div> <div class="field__item"><a href="/taxonomy/term/53" hreflang="en">Pharmacy/Therapeutics</a></div> <div class="field__item"><a href="/taxonomy/term/90" hreflang="en">Physiotherapy</a></div> <div class="field__item"><a href="/taxonomy/term/96" hreflang="en">Residents &amp; Students</a></div> <div class="field__item"><a href="/taxonomy/term/100" hreflang="en">Specialty Medicine</a></div> </div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-learning-activity--rss.html.twig * field--node--field-learning-activity--resource.html.twig * field--node--field-learning-activity.html.twig * field--node--resource.html.twig * field--field-learning-activity.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-learning-activity field--type-entity-reference field--label-above"> <div class="field__label">Learning Activity</div> <div class="field__items"> <div class="field__item"><a href="/not-just-a-prescription-pad-workshop" hreflang="en">Not Just A Prescription Pad: A Multimodal Approach To Chronic Non-Cancer Pain Management</a></div> </div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-resource-thumbnail--rss.html.twig * field--node--field-resource-thumbnail--resource.html.twig * field--node--field-resource-thumbnail.html.twig * field--node--resource.html.twig * field--field-resource-thumbnail.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="blazy blazy--field blazy--field-resource-thumbnail blazy--field-resource-thumbnail--rss field field--name-field-resource-thumbnail field--type-entity-reference field--label-hidden field__item" data-blazy=""> <!-- THEME DEBUG --> <!-- THEME HOOK: 'blazy' --> <!-- BEGIN OUTPUT from 'modules/contrib/blazy/templates/blazy.html.twig' --> <div data-b-token="b-a56aeff9824" class="media media--blazy media--bundle--image media--image is-b-loading"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'image' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/image.html.twig' --> <img alt="NJAPP" title="NJAPP - Nov 30, 2023" decoding="async" class="media__element b-lazy" loading="lazy" data-src="/sites/default/files/images/NJAPP%20Nov%2030%2C%202023.png" src="data:image/svg+xml;charset=utf-8,%3Csvg%20xmlns%3D&#039;http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg&#039;%20viewBox%3D&#039;0%200%201%201&#039;%2F%3E" width="1890" height="1078" /> <!-- END OUTPUT from 'core/themes/classy/templates/field/image.html.twig' --> </div> <!-- END OUTPUT from 'modules/contrib/blazy/templates/blazy.html.twig' --> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--body--rss.html.twig * field--node--body--resource.html.twig * field--node--body.html.twig * field--node--resource.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p><strong>November 30 &amp; December 7, 2023</strong></p> <p><em><strong>Please note:</strong> this webinar is intended only for health care professionals.</em></p> <h4>Part 1 — November 30, 2023 RECORDING <br /><iframe allow="autoplay" allowfullscreen="" aria-label="Panopto Embedded Video Player" height="405" src="https://ubc.ca.panopto.com/Panopto/Pages/Embed.aspx?id=e4a09035-8901-4420-9ac2-b0bb01310388&amp;autoplay=false&amp;offerviewer=true&amp;showtitle=true&amp;showbrand=true&amp;captions=false&amp;interactivity=all" style="border: 1px solid #464646;" width="720"></iframe></h4> <h4>Part 2 — December 7, 2023 RECORDING <br /><iframe allow="autoplay" allowfullscreen="" aria-label="Panopto Embedded Video Player" height="405" src="https://ubc.ca.panopto.com/Panopto/Pages/Embed.aspx?id=92954df4-111d-4a4a-8bc8-b0bb0135fd27&amp;autoplay=false&amp;offerviewer=true&amp;showtitle=true&amp;showbrand=true&amp;captions=false&amp;interactivity=all" style="border: 1px solid #464646;" width="720"></iframe></h4> <!-- THEME DEBUG --> <!-- THEME HOOK: 'entity_embed_container' --> <!-- BEGIN OUTPUT from 'modules/contrib/entity_embed/templates/entity-embed-container.html.twig' --> <div data-embed-button="media" data-entity-embed-display="view_mode:media.inline" data-entity-type="media" data-entity-uuid="72cc9dde-d7d6-48b7-93e7-9993f7f830a3" data-langcode="en" data-entity-embed-display-settings="[]" class="embedded-entity"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'media' --> <!-- FILE NAME SUGGESTIONS: * media--source-file.html.twig * media--file--inline.html.twig * media--file.html.twig * media--inline.html.twig x media.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/media/media.html.twig' --> <div> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-media-file--inline.html.twig * field--media--field-media-file--file.html.twig * field--media--field-media-file.html.twig * field--media--file.html.twig * field--field-media-file.html.twig * field--file.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-media-file field--type-file field--label-visually_hidden"> <div class="field__label visually-hidden">File</div> <div class="field__item"><span class="file file--application-pdf"></span><a href="/media/1777/download" data-filename="media-3518--NJAPP Resource Booklet_2023webinar.pdf">NJAPP Resource Booklet_2023webinar.pdf</a></div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/media/media.html.twig' --> </div> <!-- END OUTPUT from 'modules/contrib/entity_embed/templates/entity-embed-container.html.twig' --> <h4><strong>Dr. Launette Rieb and Dr. Peter Rothfel</strong></h4> </div> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--text-with-summary.html.twig' --> Mon, 04 Dec 2023 17:29:30 +0000 caldon.s@ubc.ca 1649 at https://ubccpd.ca 2023-09-19 Trans and Gender-Diverse Youth: Approaches to Supporting Health and Wellbeing https://ubccpd.ca/2023-09-19-trans-and-gender-diverse-youth-approaches-supporting-health-and-wellbeing <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--title--rss.html.twig * field--node--title--resource.html.twig x field--node--title.html.twig * field--node--resource.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">2023-09-19 Trans and Gender-Diverse Youth: Approaches to Supporting Health and Wellbeing</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--uid--rss.html.twig * field--node--uid--resource.html.twig x field--node--uid.html.twig * field--node--resource.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> <span>steph.d@ubc.ca</span> <!-- END OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--created--rss.html.twig * field--node--created--resource.html.twig x field--node--created.html.twig * field--node--resource.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Wed, 09/20/2023 - 18:32</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <drupal-render-placeholder callback="flag.link_builder:build" arguments="0=node&amp;1=1562&amp;2=bookmark" token="UGxZ_CPNQGZJ6iRpXxhxOP4PnoTykH7FqVD0rToiJXs"></drupal-render-placeholder> <!-- THEME DEBUG --> <!-- THEME HOOK: 'addtoany_standard' --> <!-- FILE NAME SUGGESTIONS: * addtoany-standard--node--resource.html.twig * addtoany-standard--node.html.twig x addtoany-standard.html.twig --> <!-- BEGIN OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <span class="a2a_kit a2a_kit_size_32 addtoany_list" data-a2a-url="https://ubccpd.ca/2023-09-19-trans-and-gender-diverse-youth-approaches-supporting-health-and-wellbeing" data-a2a-title="2023-09-19 Trans and Gender-Diverse Youth: Approaches to Supporting Health and Wellbeing"><a class="a2a_dd" href="https://www.addtoany.com/share" data-tooltip="Share"><span class="visually-hidden">Share</span><span class="CPD-Icon-Share"></span></a></span> <!-- END OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-topic-audience--rss.html.twig * field--node--field-topic-audience--resource.html.twig * field--node--field-topic-audience.html.twig * field--node--resource.html.twig * field--field-topic-audience.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-topic-audience field--type-entity-reference field--label-above"> <div class="field__label">Topic &amp; Audience</div> <div class="field__items"> <div class="field__item"><a href="/taxonomy/term/13" hreflang="en">Family Medicine</a></div> <div class="field__item"><a href="/taxonomy/term/78" hreflang="en">Mental Health</a></div> <div class="field__item"><a href="/taxonomy/term/41" hreflang="en">Pediatrics</a></div> <div class="field__item"><a href="/taxonomy/term/100" hreflang="en">Specialty Medicine</a></div> </div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-resource-thumbnail--rss.html.twig * field--node--field-resource-thumbnail--resource.html.twig * field--node--field-resource-thumbnail.html.twig * field--node--resource.html.twig * field--field-resource-thumbnail.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="blazy blazy--field blazy--field-resource-thumbnail blazy--field-resource-thumbnail--rss field field--name-field-resource-thumbnail field--type-entity-reference field--label-hidden field__item" data-blazy=""> <!-- THEME DEBUG --> <!-- THEME HOOK: 'blazy' --> <!-- BEGIN OUTPUT from 'modules/contrib/blazy/templates/blazy.html.twig' --> <div data-b-token="b-3b490962048" class="media media--blazy media--bundle--image media--image is-b-loading"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'image' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/image.html.twig' --> <img alt="" decoding="async" class="media__element b-lazy" loading="lazy" data-src="/sites/default/files/images/2023-09-19%20Intro%20Slides.jpg" src="data:image/svg+xml;charset=utf-8,%3Csvg%20xmlns%3D&#039;http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg&#039;%20viewBox%3D&#039;0%200%201%201&#039;%2F%3E" width="960" height="540" /> <!-- END OUTPUT from 'core/themes/classy/templates/field/image.html.twig' --> </div> <!-- END OUTPUT from 'modules/contrib/blazy/templates/blazy.html.twig' --> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--body--rss.html.twig * field--node--body--resource.html.twig * field--node--body.html.twig * field--node--resource.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><h4><strong>Tuesday, September 19, 2023</strong></h4> <p>Tor Broughton, Carrie Broughton, Dr. Rachel Cook, Scarlett Rayla, Dr. Sarah Autumn Trudeau and Dr. Shirley Sze (moderator)</p> <p><em><strong>Please note:</strong> this webinar is intended only for health care professionals.</em></p> <h5>Recording:</h5> <p><iframe allow="autoplay" allowfullscreen="" height="405" src="https://ubc.ca.panopto.com/Panopto/Pages/Embed.aspx?id=380e7a3f-9a8b-49b0-8d43-b028010aa016&amp;autoplay=false&amp;offerviewer=true&amp;showtitle=true&amp;showbrand=true&amp;captions=false&amp;interactivity=all" style="border: 1px solid #464646;" width="720"></iframe></p> <h5><strong>Resources:</strong></h5> <!-- THEME DEBUG --> <!-- THEME HOOK: 'entity_embed_container' --> <!-- BEGIN OUTPUT from 'modules/contrib/entity_embed/templates/entity-embed-container.html.twig' --> <div data-embed-button="media" data-entity-embed-display="view_mode:media.inline" data-entity-type="media" data-entity-uuid="610a8a55-3b02-4325-a38f-d4dc9c48a4e3" data-langcode="en" data-entity-embed-display-settings="[]" class="embedded-entity"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'media' --> <!-- FILE NAME SUGGESTIONS: * media--source-file.html.twig * media--file--inline.html.twig * media--file.html.twig * media--inline.html.twig x media.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/media/media.html.twig' --> <div> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-media-file--inline.html.twig * field--media--field-media-file--file.html.twig * field--media--field-media-file.html.twig * field--media--file.html.twig * field--field-media-file.html.twig * field--file.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-media-file field--type-file field--label-visually_hidden"> <div class="field__label visually-hidden">File</div> <div class="field__item"><span class="file file--application-pdf"></span><a href="/media/1695/download" data-filename="media-3285--Sept 19 Webinar Resources.pdf">Trans and Gender-Diverse Youth: Approaches to Supporting Health and Well-Being Resources - Sept 19, 2023.pdf</a></div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/media/media.html.twig' --> </div> <!-- END OUTPUT from 'modules/contrib/entity_embed/templates/entity-embed-container.html.twig' --> <div aria-label="Embedded entity widget" contenteditable="false" role="region" tabindex="-1"> <div class="embedded-entity" data-embed-button="media" data-entity-embed-display="view_mode:media.inline" data-entity-embed-display-settings="[]" data-entity-type="media" data-entity-uuid="ad9131f4-f7e3-4d86-b7c4-e87d8c7465a0" data-langcode="en"> </div> </div> </div> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--text-with-summary.html.twig' --> Wed, 20 Sep 2023 18:32:57 +0000 steph.d@ubc.ca 1562 at https://ubccpd.ca Helicobacter pylori. Patient handouts. This Changed My Practice (TCMP ) 2023. https://ubccpd.ca/helicobacter-pylori-patient-handouts-changed-my-practice-tcmp-2023 <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--title--rss.html.twig * field--node--title--resource.html.twig x field--node--title.html.twig * field--node--resource.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">Helicobacter pylori. Patient handouts. This Changed My Practice (TCMP ) 2023.</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--uid--rss.html.twig * field--node--uid--resource.html.twig x field--node--uid.html.twig * field--node--resource.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> <span>nina.z@ubc.ca</span> <!-- END OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--created--rss.html.twig * field--node--created--resource.html.twig x field--node--created.html.twig * field--node--resource.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Tue, 08/15/2023 - 19:11</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <drupal-render-placeholder callback="flag.link_builder:build" arguments="0=node&amp;1=1540&amp;2=bookmark" token="RWKofLtc3o2QcxvruSYgHsgYnLWLUjONd9fUVvuXZfg"></drupal-render-placeholder> <!-- THEME DEBUG --> <!-- THEME HOOK: 'addtoany_standard' --> <!-- FILE NAME SUGGESTIONS: * addtoany-standard--node--resource.html.twig * addtoany-standard--node.html.twig x addtoany-standard.html.twig --> <!-- BEGIN OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <span class="a2a_kit a2a_kit_size_32 addtoany_list" data-a2a-url="https://ubccpd.ca/helicobacter-pylori-patient-handouts-changed-my-practice-tcmp-2023" data-a2a-title="Helicobacter pylori. Patient handouts. This Changed My Practice (TCMP ) 2023."><a class="a2a_dd" href="https://www.addtoany.com/share" data-tooltip="Share"><span class="visually-hidden">Share</span><span class="CPD-Icon-Share"></span></a></span> <!-- END OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-topic-audience--rss.html.twig * field--node--field-topic-audience--resource.html.twig * field--node--field-topic-audience.html.twig * field--node--resource.html.twig * field--field-topic-audience.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-topic-audience field--type-entity-reference field--label-above"> <div class="field__label">Topic &amp; Audience</div> <div class="field__items"> <div class="field__item"><a href="/taxonomy/term/13" hreflang="en">Family Medicine</a></div> <div class="field__item"><a href="/taxonomy/term/82" hreflang="en">Nurse Practitioners</a></div> <div class="field__item"><a href="/taxonomy/term/100" hreflang="en">Specialty Medicine</a></div> </div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-learning-activity--rss.html.twig * field--node--field-learning-activity--resource.html.twig * field--node--field-learning-activity.html.twig * field--node--resource.html.twig * field--field-learning-activity.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-learning-activity field--type-entity-reference field--label-above"> <div class="field__label">Learning Activity</div> <div class="field__items"> <div class="field__item"><a href="/node/750" hreflang="en">This Changed My Practice Articles</a></div> </div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> Tue, 15 Aug 2023 19:11:46 +0000 nina.z@ubc.ca 1540 at https://ubccpd.ca TCMP Article: Management of Helicobacter pylori in 2023: who should be tested, treated, and how https://ubccpd.ca/tcmp-article-management-helicobacter-pylori-2023-who-should-be-tested-treated-and-how <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--title--rss.html.twig * field--node--title--resource.html.twig x field--node--title.html.twig * field--node--resource.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">TCMP Article: Management of Helicobacter pylori in 2023: who should be tested, treated, and how</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--uid--rss.html.twig * field--node--uid--resource.html.twig x field--node--uid.html.twig * field--node--resource.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> <span>nina.z@ubc.ca</span> <!-- END OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--created--rss.html.twig * field--node--created--resource.html.twig x field--node--created.html.twig * field--node--resource.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Thu, 08/10/2023 - 15:44</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <drupal-render-placeholder callback="flag.link_builder:build" arguments="0=node&amp;1=1536&amp;2=bookmark" token="lNivFUdiOXx74uWGfs9-Jw69YMXwv02CG8h8j6SceBs"></drupal-render-placeholder> <!-- THEME DEBUG --> <!-- THEME HOOK: 'addtoany_standard' --> <!-- FILE NAME SUGGESTIONS: * addtoany-standard--node--resource.html.twig * addtoany-standard--node.html.twig x addtoany-standard.html.twig --> <!-- BEGIN OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <span class="a2a_kit a2a_kit_size_32 addtoany_list" data-a2a-url="https://ubccpd.ca/tcmp-article-management-helicobacter-pylori-2023-who-should-be-tested-treated-and-how" data-a2a-title="TCMP Article: Management of Helicobacter pylori in 2023: who should be tested, treated, and how"><a class="a2a_dd" href="https://www.addtoany.com/share" data-tooltip="Share"><span class="visually-hidden">Share</span><span class="CPD-Icon-Share"></span></a></span> <!-- END OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-topic-audience--rss.html.twig * field--node--field-topic-audience--resource.html.twig * field--node--field-topic-audience.html.twig * field--node--resource.html.twig * field--field-topic-audience.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-topic-audience field--type-entity-reference field--label-above"> <div class="field__label">Topic &amp; Audience</div> <div class="field__items"> <div class="field__item"><a href="/taxonomy/term/13" hreflang="en">Family Medicine</a></div> <div class="field__item"><a href="/taxonomy/term/21" hreflang="en">Internal Medicine</a></div> <div class="field__item"><a href="/taxonomy/term/100" hreflang="en">Specialty Medicine</a></div> </div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-learning-activity--rss.html.twig * field--node--field-learning-activity--resource.html.twig * field--node--field-learning-activity.html.twig * field--node--resource.html.twig * field--field-learning-activity.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-learning-activity field--type-entity-reference field--label-above"> <div class="field__label">Learning Activity</div> <div class="field__items"> <div class="field__item"><a href="/node/750" hreflang="en">This Changed My Practice Articles</a></div> </div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-resource-thumbnail--rss.html.twig * field--node--field-resource-thumbnail--resource.html.twig * field--node--field-resource-thumbnail.html.twig * field--node--resource.html.twig * field--field-resource-thumbnail.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="blazy blazy--field blazy--field-resource-thumbnail blazy--field-resource-thumbnail--rss field field--name-field-resource-thumbnail field--type-entity-reference field--label-hidden field__item" data-blazy=""> <!-- THEME DEBUG --> <!-- THEME HOOK: 'blazy' --> <!-- BEGIN OUTPUT from 'modules/contrib/blazy/templates/blazy.html.twig' --> <div data-b-token="b-02265181839" class="media media--blazy media--bundle--image media--image is-b-loading"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'image' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/image.html.twig' --> <img alt="XR in MedEd" decoding="async" class="media__element b-lazy" loading="lazy" data-src="/sites/default/files/images/Research%20-%20immersive%20technology%20in%20medical%20education%20-%20hero%20image%20%281%29_0.png" src="data:image/svg+xml;charset=utf-8,%3Csvg%20xmlns%3D&#039;http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg&#039;%20viewBox%3D&#039;0%200%201%201&#039;%2F%3E" width="1600" height="900" /> <!-- END OUTPUT from 'core/themes/classy/templates/field/image.html.twig' --> </div> <!-- END OUTPUT from 'modules/contrib/blazy/templates/blazy.html.twig' --> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--body--rss.html.twig * field--node--body--resource.html.twig * field--node--body.html.twig * field--node--resource.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>August 9, 2023</p> <h3>Author</h3> <p><strong>Sander Veldhuyzen van Zanten, MD, FRCPC, MSc, MPH, PhD </strong>(<a href="https://thischangedmypractice.com/bios#vanZanten">biography and disclosures</a>)</p> <p><em>Disclosures: No disclosures relevant to this publication. Received peer and non-peer-reviewed funding for clinical studies of Helicobacter infection in the past. Received speaker fees and member of advisory boards for <i>H. pylori</i> related activities. None in the last five years. Mitigating potential bias: Only published trial data is presented. Recommendations are consistent with published Canadian and International guidelines (references 4-7). Recommendations are consistent with current practice patterns.</em></p> <h3>What gaps I have noticed</h3> <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) continues to be an important pathogen associated with peptic ulcer disease, dyspepsia, and gastric cancer.</p> <h3>Data that answers these gaps</h3> <p>The epidemiology of <i>H. pylori</i> in Canada is changing.<sup>1</sup> It can now rarely be found in second-generation Canadians, but the prevalence continues to be high in immigrants, children of immigrants, and First Nations Canadians. In an <i>H. pylori</i> positive individual the lifetime risk of developing gastric or duodenal ulcers is 5 to 15% and dyspepsia up to 25%. <i>H. pylori</i> is an important risk factor for development of gastric cancer, but this is rare, occurring in less than 1 in 1,000 infected individuals. Most infections are acquired in childhood, during the first 5–10 years of life.<sup>2,3</sup> In a substantial proportion of individuals, the infection remains dormant and causes no symptoms. Although most <i>H. pylori</i> infections are acquired in childhood, it is not recommended to routinely test family members of <i>H. pylori</i> infected individuals. Among adults, it is very unlikely that <i>H. pylori</i> is transmitted, even when there is close personal contact.</p> <p>Worldwide and in Canada the guidelines for the treatment of <i>H. pylori</i> infection changed in 2016.<sup>4-7</sup> Details of the medications used, the dosages, and frequencies, are listed in Table 1. Importantly, the recommended duration for most regimens is 14 days.</p> <h3>What I recommend (practice tips)</h3> <p><strong>Who should be tested for Helicobacter and how? </strong></p> <p>Generally speaking, do not test patients for <i>H. pylori</i> unless you are prepared to treat if they are positive.</p> <p>Patients who should be tested for <i>H. pylori</i>:</p> <ol> <li>Duodenal or gastric ulcer diagnosis (recent or in the past)</li> <li>Dyspepsia (epigastric pain dominant symptoms)</li> <li>First-degree family history of gastric cancer (especially if index case is young)</li> <li>High-risk groups (First Nations, immigrants)</li> </ol> <p><i>H. pylori</i> can be diagnosed by histology when biopsies are taken during gastroscopy. The urea breath test (UBT) is a very accurate and robust test to diagnose the infection.<sup>8</sup> More recently, the <i>H. pylori</i> stool antigen test (HpSAT) has been used more frequently.<sup>9</sup> It is an accurate test but it has a higher proportion of equivocal results than the UBT. Use of serology to detect <i>H. pylori</i> infection is not recommended as it cannot discriminate between a current active infection or an old (treated) infection in the past. Importantly, one has to stop PPIs (proton pump inhibitors) for 14 days prior to performing a urea breath test or HpSAT. The reason is that up to 20% of people while on PPIs may get false negative results due to suppression of the organism by the PPI.<sup>10</sup></p> <p>Although a large proportion of patients with duodenal or gastric ulcers are <i>H. pylori</i> positive, <i>H. pylori</i> negative ulcers are becoming more common. Therefore, it is recommended to document that a patient is <i>H. pylori</i> positive before initiating treatment. The most common cause of <i>H. pylori</i> negative ulcers are NSAIDs and antiplatelet agents.</p> <p><strong>Helicobacter treatment recommendations have changed</strong></p> <p>The conventional triple combination of a PPI, clarithromycin (<strong>Cl</strong>), and either amoxicillin (<strong>A</strong>) or metronidazole (<strong>Met</strong>) is no longer recommended because its success rates have decreased to less than 60%.<sup>11,12</sup> This includes the use of Hp-PAC®, the combination of lansoprazole, amoxicillin, and clarithromycin.</p> <p><strong>Recommended treatments</strong> (summarized in Table 1 below):</p> <ol> <li>The new recommended <strong>first-line therapy</strong> is called <strong>concomitant</strong> or <strong>ClAMet (</strong>using the initials of clarithromycin (<strong>Cl</strong>), amoxicillin (<strong>A</strong>), and metronidazole (<strong>Met</strong>)) given for <strong>14 days</strong>.<sup>4-7</sup> Its efficacy is 80–85%.</li> <li>The best <strong>second-line therapy</strong> is <strong>bismuth-based quadruple therapy </strong>(PPI, bismuth, metronidazole, and tetracycline) given for <strong>14 days</strong>. The higher dose of metronidazole 500 mg is the author’s preference as there is evidence that it can better overcome partial resistance to metronidazole.<sup>13</sup> This is a robust treatment that can also be used as first line. The downside of bismuth-based quadruple therapy (<strong>Bi-Quad</strong>) is that it is a complex regimen consisting of up to 24 pills a day. Some of the medications need to be taken twice and others four times a day. Bi-Quad also has more side effects than concomitant therapy.</li> <li>The <strong>third-line therapy</strong> is the combination of a PPI, amoxicillin, and levofloxacin (<strong>PPI-AL</strong>) given for <strong>14 days</strong>. The author uses the higher dose of levofloxacin 500 mg bid. Sometimes PPI-AL is given as second line instead of Bi-Quad because it is an easier regimen to take, but it is less well tested. PPI-AL should not be used as first-line therapy because the background rate of levofloxacin resistance is high in Canada, up to 15%.<sup>14</sup> This high rate is likely explained by the high use of fluoroquinolones for other indications.</li> <li>There is a <strong>fourth-line therapy</strong> consisting of a PPI with amoxicillin and rifabutin (<strong>Rif</strong>). In Canada, its efficacy is 62% when given as rescue therapy.<sup>15</sup> This is the only therapy for which the duration is <strong>10 days</strong> instead of 14 days. However, family physicians may want to consider referring patients to a GI specialist should the three first-choice therapies have failed. Use of rifabutin often needs special authorization. In the USA, a combination tablet of omeprazole, amoxicillin, and rifabutin (Talicia), has been available since 2019. It has been tested as a first-line therapy and the success rate of 10-day therapy was 84%.<sup>16 </sup>The tablet is not available in Canada and the decision to move the PPI-amoxicillin-rifabutin combination to first line requires more studies.</li> </ol> <p>If the above-listed four therapies are given in sequence to individuals who failed higher order therapies (i.e., start with concomitant, followed by B-Quad, etc.) the cumulative success rate is 96–97%.<sup>17, 18</sup> The first choice of therapy in patients with a true penicillin allergy is Bi-Quad. If that fails, the second line of therapy is triple therapy with PPI, Clarithromycin, and Metronidazole (PPI-CM) given for 14 days.<sup>4</sup></p> <p>One thing to note, although there are pharmacologic differences among the different PPIs, resulting in differences in acid suppression<sup>19</sup>, for day-to-day practice PPIs, when given in standard doses, are generally considered equal when treating common conditions such as Gastro Esophageal Reflux Disease (GERD) or peptic ulcer disease (PUD). For treatment of <i>H. pylori</i>, there is some evidence that using the more potent PPIs, such as esomeprazole or rabeprazole, slightly higher success rates are achieved compared to pantoprazole.<sup>20</sup></p> <p><strong>What patients need to know about the treatments </strong></p> <p>It is important that patients get a clear explanation about these treatments, preferably with a handout. Examples of handouts the author uses about the importance of <i>H. pylori</i> infection and the different treatments are available in the patient handouts section below. Prescribing anti-Helicobacter therapy is difficult to do well over the phone. It is helpful for patients to prescribe these treatments in a blister pack, as the regimens are complex. That way patients are not confused about which medications have to be taken and when. Patients should be told that compliance is very important as cure rates drop significantly if treatments are not taken for the full duration. See handouts for patients.</p> <p><strong>Is it necessary to test whether the treatment was successful? </strong></p> <p>It is generally recommended to test whether treatment was successful. In primary care, UBT or the stool antigen test are used for this. Importantly, one <strong>has to wait at least 4 weeks after the treatment was finished </strong>before re-testing is done to avoid getting false negative results. Once again, it is important that PPI therapy, if there is an ongoing need for it after the antibiotics are finished, is held for 14 days prior to the repeat testing for Helicobacter.<sup>10</sup> Patients can be managed during those 14 days with standard doses of antacids if they have symptoms while off the PPI. If the patient is negative after appropriate testing for cure was done, it is very unlikely such a patient will get re-infected later in life. In adults, most patients who are thought to have a re-infection, in fact, have a false negative test result in the past. They usually have recrudescence of their original <i>H. pylori</i> strain.<sup>21</sup></p> <p>Given that none of the current <i>H. pylori</i> therapies are 100% successful it is my practice to always test whether cure has been received after each treatment. I generally give a patient three or four rounds of treatment if needed but I should state that I have a special interest in <i>H. pylori</i>. What to do with patients who fail more than four therapies should be decided on a case-by-case basis. This may in part depend on the indication for treatment. An option is to refer the patient for antibiotic resistance testing for which a gastroscopy is required. Knowledge of the resistance pattern on the strain may guide further therapy. However, testing of <i>H. pylori</i> strains is not widely available in Canada and data on resistance are scarce. The data show that resistance to clarithromycin and metronidazole and also levofloxacin is high. Resistance to amoxicillin and tetracycline is rare.<sup>4,14, 22-24</sup></p> <p>Another management option is the decision not to treat Hp any further, but possibly observe these patients long-term. Long-term follow-up especially is a consideration, if there is a family history of gastric cancer or if more severe gastric metaplasia was present on histology.<sup>25,26</sup></p> <p><strong>Peptic ulcer disease</strong></p> <p>There are a few important recommendations in the management of patients diagnosed with acute peptic ulcer disease (duodenal or gastric ulcers), and especially bleeding ones, for example during a hospitalization. If they turn out to be <i>H. pylori</i> positive it is important to continue PPI therapy after the 14-day anti-Helicobacter treatment, for at least 8–16 weeks, to ensure adequate healing of the ulcer. Importantly, in such patients, the PPI should not be stopped until there is proof that the <i>H. pylori</i> infection has been successfully cured. The reason for this is that should treatment have failed to cure <i>H. pylori</i>, these patients are at risk of getting recurrent ulceration (with possible bleeding) if PPI maintenance therapy is not given.<sup>27</sup> A decision whether or not to continue PPI longer term should only be taken once cure of <i>H. pylori</i> has been established.</p> <p>There is evidence that anti-Helicobacter therapy is effective in the treatment of <i>H. pylori</i> positive gastric or duodenal ulcers. However, a proportion of such patients will require long-term PPI therapy because of ongoing symptoms even though <i>H. pylori</i> was cured. Another reason for ongoing acid-suppressive therapy may be that some of these patients, especially older ones (&gt; 65–70 years) require, for example, anticoagulation and/or antiplatelet agents for management of cardiovascular risk factors. Given that they, therefore, have an ongoing risk of developing (bleeding) ulcers it is reasonable to maintain such patients on a once-a-day PPI for ulcer prophylaxis.</p> <p><strong>The role of Helicobacter in dyspepsia and GERD </strong></p> <p>There is definite evidence that a test and treat strategy for <i>H. pylori</i> is efficacious in patients who present with dyspepsia symptoms in primary care.<sup>28</sup> Dyspepsia is defined as epigastric pain or discomfort which may be accompanied by other upper GI symptoms, such as burning sensation or excessive burping. Compared to no-antibiotic treatment, more patients will have permanent resolution of their dyspepsia symptoms following cure of the <i>H. pylori</i> infection. However, clinical trial data, including studies from Canada, have shown that more than 50% of dyspepsia patients will have ongoing dyspepsia symptoms, often requiring acid suppressive therapy, after successful cure of the infection.<sup>28</sup></p> <p>Another important comment on the management of dyspepsia is that there is good evidence that PPIs work in epigastric pain dominant dyspepsia (ulcer-like dyspepsia), and in those who have concomitant symptoms of heartburn (reflux-like dyspepsia). However, PPIs are generally not effective in so-called dysmotility-like dyspepsia where upper abdominal bloating rather than epigastric pain or discomfort is the dominant symptom.<sup>29</sup> In this subgroup of patients, PPIs do not provide benefits. In such patients overlap with possible IBS or other diagnoses needs to be further explored.</p> <p>In Canada nowadays, gastroesophageal reflux disease (GERD) is more common than dyspepsia. The diagnosis of GERD can be made based on the presence of dominant symptoms of heartburn and/or regurgitation.<sup>30</sup> Importantly the clinical course of GERD (frequency of symptoms, need for acid suppressive therapy) will not be altered by successful cure of a coexisting <i>H. pylori</i> infection.<sup>31</sup> It is important to tell patients about this as most of them will require ongoing maintenance therapy with PPI for control of their GERD symptoms even though <i>H. pylori</i> has been cured. For this reason, it is not recommended to routinely test for <i>H. pylori</i> at the time GERD is diagnosed in patients. This is in contrast to the patient who has dyspepsia, defined by epigastric pain or discomfort as the dominant symptom rather than heartburn, where a test for Helicobacter is recommended.<sup>30</sup></p> <p>The incidence of gastric cancer has been decreasing for decades in Canada but it is still more common than esophageal cancer.<sup> 32</sup> Apart from smoking, presence of <i>H. pylori</i> is the only other main modifiable risk factor for gastric cancer. It is recommended that all 1<sup>st</sup> degree relatives of gastric cancer patients are tested and, if positive, treated for Helicobacter, especially if the index case occurred at a younger age.<sup>25,32</sup> The risk of gastric cancer is much higher in First Nations people compared to the average Canadian population<sup>33,34,35 </sup>and the high prevalence of <i>H. pylori</i> is likely a partial explanation for this. The prevalence of <i>H. pylori</i> is also high in immigrants from certain areas, such as Southeast Asia and Central and South America. In those patients, one should have a low threshold to test for <i>H. pylori</i> infection. In general, in children, who have a 1<sup>st</sup> degree relative with gastric cancer, the recommendation is to wait with testing and treatment until after they have gone through puberty.<a id="table1"></a></p> <p><strong>Table 1: The most commonly used treatments for <i>H. pylori</i> infection</strong></p> <table border="1"> <tbody> <tr> <td width="110"><strong>Treatment</strong></td> <td width="460"><strong>Medications</strong></td> </tr> <tr> <td width="110">Concomitant Therapy (ClAMET)</td> <td width="450"> <ol> <li>Proton Pump Inhibitor | 1 tablet given twice a day</li> <li>Amoxicillin | 1 gram given twice a day</li> <li>Clarithromycin | 500 mg given twice a day</li> <li>Metronidazole | 500 mg given twice a day</li> </ol> </td> </tr> <tr> <td width="110">Bismuth-based Quadruple Therapy<br /> (Bi-Quad)</td> <td width="450"> <ol> <li>Proton Pump Inhibitor | 1 tablet given twice a day</li> <li>Bismuth-salicylate | 2 tablets given 4 times a day</li> <li>Metronidazole | 250–500 mg given 4 times a day</li> <li>Tetracycline | 500 mg given 4 times a day</li> </ol> </td> </tr> <tr> <td width="110">PPI-Amoxicillin-Levofloxacin<br /> (P-AL)</td> <td width="450"> <ol> <li>Proton Pump Inhibitor | 1 tablet given twice a day</li> <li>Levofloxacin | 250–500 mg given twice a day</li> <li>Amoxicillin | 1 gram given twice a day</li> </ol> </td> </tr> <tr> <td width="110">Rifabutin-based Triple Therapy<br /> (P-A-Rif)</td> <td width="450"> <ol> <li>Proton Pump Inhibitor | 1 tablet given twice a day</li> <li>Amoxicillin | 1 gram given twice a day</li> <li>Rifabutin | 150 mg given twice a day</li> </ol> </td> </tr> <tr> <td colspan="2" width="516"><strong>Treatments that no longer should be used:</strong></td> </tr> <tr> <td width="110">PPI-CA Triple Therapy</td> <td width="450"> <ol> <li>Proton Pump Inhibitor | 1 tablet given twice a day</li> <li>Clarithromycin | 500 mg given twice a day</li> <li>Amoxicillin | 1 gram given twice a day</li> </ol> </td> </tr> <tr> <td width="110">PPI-CM Triple Therapy</td> <td width="450"> <ol> <li>Proton pump inhibitor | 1 tablet given twice a day</li> <li>Clarithromycin | 500 mg given twice a day</li> <li>Metronidazole | 500 mg given twice a day</li> </ol> </td> </tr> </tbody> </table> <ul> <li><em>Proton Pump Inhibitor=PPI. Options: Omeprazole 20mg, Pantoprazole 40 mg, Lansoprazole 30 mg, Rabeprazole 20mg, Esomeprazole 40mg, Dexlansoprazole 60mg </em></li> <li><em>Cl=Clarithromycin</em></li> <li><em>M= Metronidazole</em></li> <li><em>A= Amoxicillin</em></li> <li><em>B= Bismuth subsalicylate</em></li> <li><em>T= Tetracycline</em></li> <li><em>L=Levofloxacin<a id="patient-handouts"></a></em></li> </ul> <h3>Handouts for patients</h3> <ol> <li><a href="https://med-fom-tcmp.sites.olt.ubc.ca/files/2023/08/Patient-Handout-Helicobacter-infection-of-the-stomach-van-Zanten.pdf">Helicobacter infection of the stomach</a></li> <li><a href="https://med-fom-tcmp.sites.olt.ubc.ca/files/2023/08/Patient-Handout-Helicobacter-infection-of-the-stomach-CLAMET-van-Zanten.pdf">Concomitant Therapy (CLAMET)</a></li> <li><a href="https://med-fom-tcmp.sites.olt.ubc.ca/files/2023/08/Patient-Handout-Helicobacter-infection-of-the-stomach-Bi-Quad-van-Zanten.pdf">Bismuth-based Quadruple Therapy (Bi-Quad)</a></li> <li><a href="https://med-fom-tcmp.sites.olt.ubc.ca/files/2023/08/Patient-Handout-Helicobacter-infection-of-the-stomach-P-AL-van-Zanten.pdf">PPI-Amoxicillin-Levofloxacin Therapy (P-AL)</a></li> <li><a href="https://med-fom-tcmp.sites.olt.ubc.ca/files/2023/08/Patient-Handout-Helicobacter-infection-of-the-stomach-P-A-Rif-van-Zanten.pdf">Rifabutin-based Triple Therapy (P-A-Rif)</a></li> </ol> <h3>PathwaysBC Resources</h3> <p><em>Helicobacter pylori</em> associated duodenal/gastric ulcer: adult patient treatment recommendations. Bugs &amp; Drugs. Accessed July 19, 2023. <a href="https://pathwaysbc.ca/ci/1886">https://pathwaysbc.ca/ci/1886</a></p> <p><strong>Patient handouts for tests, emailable via PathwaysBC:</strong></p> <ol> <li>Patient instructions: <i>Helicobacter pylori</i> stool antigen test. LifeLabs. Accessed July 19, 2023. <a href="https://pathwaysbc.ca/ci/5953">https://pathwaysbc.ca/ci/5953</a></li> <li>Patient instructions: <i>Helicobacter pylori</i> urea breath test. LifeLabs. Accessed July 19, 2023. <a href="https://pathwaysbc.ca/ci/1977">https://pathwaysbc.ca/ci/1977</a></li> </ol> <h3>Will this change your practice?</h3> <p><a class="btn btn-primary" href="https://thischangedmypractice.com/management-of-helicobacter-pylori/#discussion" rel=" noopener" target="_blank" title="Vote and see how your colleagues are voting">Vote</a></p> <h3>Earn credits:</h3> <p><a class="btn btn-primary" href="https://thischangedmypractice.com/management-of-helicobacter-pylori/#discussion" title="Earn 0.25 credits by completing a survey">Learning activity</a></p> <h3>References</h3> <ol> <li>Veldhuyzen van Zanten SJ, Pollak PT, Best LM, Bezanson GS, Marrie T. Increasing prevalence of <em>Helicobacter pylori</em> infection with age: continuous risk of infection in adults rather than cohort effect. <em>J Infect Dis</em>. 1994;169(2):434-437. doi:10.1093/infdis/169.2.434 (Request with <a href="https://www.cpsbc.ca/registrants/library/make-request">CPSBC</a> or view with <a href="https://go.exlibris.link/mC7PWkLv">UBC</a>)</li> <li>Hooi JKY, Lai WY, Ng WK, et al. Global prevalence of <em>Helicobacter pylori</em> infection: systematic review and meta-analysis. <em>Gastroenterology</em>. 2017;153(2):420-429. doi:10.1053/j.gastro.2017.04.022 (<a href="https://www.sciencedirect.com/science/article/pii/S0016508517355312/pdfft?md5=400349e98c149b26a168e11da7b7feef&amp;pid=1-s2.0-S0016508517355312-main.pdf">View</a>)</li> <li>Malaty HM, El-Kasabany A, Graham DY, et al. Age at acquisition of <em>Helicobacter pylori</em> infection: a follow-up study from infancy to adulthood. <em>Lancet</em>. 2002;359(9310):931-935. doi:10.1016/S0140-6736(02)08025-X (View with <a href="https://www.cpsbc.ca/proxyauth/?url=https%3A%2F%2Fwww.sciencedirect.com%2Fscience%2Farticle%2Fpii%2FS014067360208025X%2Fpdfft%3Fmd5%3D3d7df02c71bdeba4d6c6718864b63af2%26pid%3D1-s2.0-S014067360208025X-main.pdf">CPSBC</a> or <a href="http://ezproxy.library.ubc.ca/login?url=https://dx.doi.org/10.1016/S0140-6736(02)08025-X">UBC</a>)</li> <li>Fallone CA, Chiba N, van Zanten SJO, et al. The Toronto consensus for the treatment of <em>Helicobacter pylori</em> infection in adults. <em>Gastroenterology</em>. 2016;151(1):51-69.e14 (Request with <a href="https://www.cpsbc.ca/registrants/library/make-request">CPSBC</a> or view with <a href="http://ezproxy.library.ubc.ca/login?url=https://dx.doi.org/10.1053/j.gastro.2016.04.006">UBC</a>)</li> <li>Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG clinical guideline: treatment of <em>Helicobacter pylori</em> Infection [published correction appears in Am J Gastroenterol. 2018 Jul;113(7):1102]. <em>Am J Gastroenterol</em>. 2017;112(2):212-239. doi:10.1038/ajg.2016.563 (View with <a href="https://www.cpsbc.ca/proxyauth/?url=https%3A%2F%2Fovidsp.ovid.com%2Fovidweb.cgi%3FT%3DJS%26CSC%3DY%26NEWS%3DN%26PAGE%3Dfulltext%26AN%3D00000434-201702000-00012%26LSLINK%3D80%26D%3Dovft">CPSBC</a> or <a href="http://ezproxy.library.ubc.ca/login?url=https://dx.doi.org/10.1038/ajg.2016.563">UBC</a>)</li> <li>Malfertheiner P, Megraud F, O’Morain CA, et al. Management of <em>Helicobacter pylori</em> infection—the Maastricht V/Florence consensus report. <em>Gut</em>. 2017;66(1):6-3. (<a href="https://gut.bmj.com/content/gutjnl/66/1/6.full.pdf">View</a>)</li> <li>Malfertheiner P, Megraud F, Rokkas T, et al. Management of <em>Helicobacter pylori</em> infection: the Maastricht VI/Florence consensus report. <em>Gut</em>. 2022;gutjnl-2022. doi:10.1136/gutjnl-2022-327745 (<a href="https://gut.bmj.com/content/gutjnl/71/9/1724.full.pdf?with-ds=yes">View</a>)</li> <li>Chiba N, van Zanten SJO. 13C-Urea breath tests are the non-invasive method of choice for <em>Helicobacter pylori</em> detection. <em>Can J Gastroenterol</em>. 1999;13(8):681-683. doi:10.1155/1999/683452 (Request with <a href="https://www.cpsbc.ca/registrants/library/make-request">CPSBC</a> or view with <a href="https://go.exlibris.link/c8PtHmGJ">UBC</a>)</li> <li>Best LM, Takwoingi Y, Siddique S, et al. Non-invasive diagnostic tests for <em>Helicobacter pylori</em> infection.<em> Cochrane Database Syst Rev</em>. 2018;3(3):CD012080. doi:10.1002/14651858.CD012080.pub2 (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513531/pdf/CD012080.pdf">View</a>)</li> <li>Graham DY, Opekun AR, Hammoud F, et al. Studies regarding the mechanism of false negative urea breath tests with proton pump inhibitors. <em>Am J Gastroenterol</em>. 2003;98(5):1005-1009. doi:10.1111/j.1572-0241.2003.07426 (View with <u><a href="https://www.cpsbc.ca/proxyauth/?url=https%3A%2F%2Fsearch.ebscohost.com%2Flogin.aspx%3Fdirect%3Dtrue%26AuthType%3Dcookie%2Cip%2Cuid%26db%3Dmdc%26AN%3D12809820%26site%3Deds-live%26scope%3Dsite">CPSBC</a></u> or <a href="https://go.exlibris.link/pCykfcrC">UBC</a>)</li> <li>Graham DY, Fischbach L. <i>Helicobacter pylori</i> treatment in the era of increasing antibiotic resistance. <em>Gut</em>. 2010;59(8):1143-1153. doi:10.1136/gut.2009.192757 (Request with <a href="https://www.cpsbc.ca/registrants/library/make-request">CPSBC</a> or view with <a href="https://go.exlibris.link/9L0sPY01">UBC</a>)</li> <li>Rodgers C, van Zanten SV. A meta-analysis of the success rate of <i>Helicobacter pylori</i> therapy in Canada. <em>Can J Gastroenterol</em>. 2007;21(5):295-300. doi:10.1155/2007/419784 (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657711/pdf/cjg21295.pdf">View</a>)</li> <li>Dore MP, Lu H, Graham DY. Role of bismuth in improving <i>Helicobacter pylori</i> eradication with triple therapy. <em>Gut</em>. 2016;65(6):870-878. doi:10.1136/gutjnl-2015-310084 (Request with <a href="https://www.cpsbc.ca/registrants/library/make-request">CPSBC</a> or view with <a href="https://go.exlibris.link/dPsyxGHp">UBC</a>)</li> <li>Best L, Cooper-Lesins G, Haldane D, Veldhuyzen van Zanten SJO. <em>Helicobacter pylori</em> antibiotic resistance in Canadian populations (abstr S1293). Gastroenterology. 2004;126:S1293. A-189 (<a href="https://www.gastrojournal.org/article/S0016-5085(04)80009-X/pdf">View</a>, pg 46)</li> <li>van Zanten SV, Desai S, Best L, et al. Rescue therapy using a rifabutin-based regimen is effective for cure of <i>Helicobacter pylori</i> infection. <em>Can J Gastroenterol</em>. 2010;24(5):303-306. doi:10.1155/2010/637908 (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886571/pdf/cjg24303.pdf">View</a>)</li> <li>Graham DY, Canaan Y, Maher J, Wiener G, Hulten KG, Kalfus IN. Rifabutin-Based Triple Therapy (RHB-105) for <em>Helicobacter pylori </em>eradication: a double-blind, randomized, controlled trial. <em>Ann Intern Med</em>. 2020;172(12):795-802. doi:10.7326/M19-3734 (Request with <a href="https://www.cpsbc.ca/registrants/library/make-request">CPSBC</a> or view with <a href="https://go.exlibris.link/4vQTBDWc">UBC</a>)</li> <li>Buttenschoen J, D'Souza P, Veldhuyzen van Zanten S. Cumulative results of <i>Helicobacter pylori</i> therapy using sequential therapy, bismuth quadruple therapy, levofloxacin-based triple therapy, and other regimens. <em>Can J Gastroenterol Hepatol</em>. 2016;30(Suppl A):A-229. doi: 10.1155/2016/4792898 (<a href="https://downloads.hindawi.com/journals/cjgh/2016/4792898.pdf">View</a>)</li> <li>Krahn T, van Zanten S. A142 Trends in <i>Helicobacter pylori</i> treatment and cure in Edmonton: 2015-2020. <em>J Can Assoc Gastroenterol</em>. 2021;4:129-131 (<a href="https://academic.oup.com/jcag/article-pdf/4/Supplement_1/129/36456111/gwab002.140.pdf">View</a>)</li> <li>Graham DY, Tansel A. Interchangeable Use of proton pump inhibitors based on relative potency. <em>Clin Gastroenterol Hepatol</em>. 2018;16(6):800-808.e7. doi:10.1016/j.cgh.2017.09.033 (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913203/pdf/nihms-1061632.pdf">View</a>)</li> <li>Fernández-Salazar L, Campillo A, Rodrigo L, et al. Effectiveness and safety of high-dose dual therapy: results of the European registry on the management of <em>Helicobacter pylori </em>infection (Hp-EuReg). <em>J Clin Med</em>. 2022;11(12):3544. Published 2022 Jun 20. doi:10.3390/jcm11123544 (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225562/pdf/jcm-11-03544.pdf">View</a>)</li> <li>Xia HX, Windle HJ, Marshall DG, Smyth CJ, Keane CT, O'Morain CA. Recrudescence of <i>Helicobacter pylori</i> after apparently successful eradication: novel application of randomly amplified polymorphic DNA fingerprinting. <em>Gut</em>. 1995;37(1):30-34. doi:10.1136/gut.37.1.30 (<a href="https://gut.bmj.com/content/gutjnl/37/1/30.full.pdf">View</a>)</li> <li>Best LM, Haldane DJ, Bezanson GS, Veldhuyzen van Zanten SJ. Helicobacter pylori: primary susceptibility to clarithromycin in vitro in Nova Scotia. <em>Can J Gastroenterol</em>. 1997;11(4):298-300. doi:10.1155/1997/159637. (Request with <a href="https://www.cpsbc.ca/registrants/library/make-request">CPSBC</a> or view with <a href="https://go.exlibris.link/JzhytMfg">UBC</a>)</li> <li>Fallone CA. Epidemiology of the antibiotic resistance of <i>Helicobacter pylori</i> in Canada. <em>Can J Gastroenterol</em>. 2000;14(10):879-882. doi:10.1155/2000/562159 (Request with <a href="https://www.cpsbc.ca/registrants/library/make-request">CPSBC</a> or view with <a href="https://go.exlibris.link/43xgJKZn">UBC</a>)</li> <li>Morse AL, Goodman KJ, Munday R, et al. A randomized controlled trial comparing sequential with triple therapy for <i>Helicobacter pylori</i> in an Aboriginal community in the Canadian North [published correction appears in Can J Gastroenterol. 2014 Mar;28(3):167]. <em>Can J Gastroenterol</em>. 2013;27(12):701-706. doi:10.1155/2013/143047 (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3915012/pdf/cjg27701.pdf">View</a>)</li> <li>Choi IJ, Kim CG, Lee JY, et al. Family History of gastric cancer and <i>Helicobacter pylori</i> treatment. <em>N Engl J Med</em>. 2020;382(5):427-436. doi:10.1056/NEJMoa1909666 (Request with <a href="https://www.cpsbc.ca/registrants/library/make-request">CPSBC</a> or view with <a href="https://go.exlibris.link/QkvR68zF">UBC</a>)</li> <li>Gupta S, Li D, El Serag HB, et al. AGA Clinical Practice Guidelines on Management of Gastric Intestinal Metaplasia. <em>Gastroenterology</em>. 2020;158(3):693-702. doi:10.1053/j.gastro.2019.12.003 (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340330/pdf/nihms-1603234.pdf">View</a>)</li> <li>Chan FK, Chung SC, Suen BY, et al. Preventing recurrent upper gastrointestinal bleeding in patients with <i>Helicobacter pylori</i> infection who are taking low-dose aspirin or naproxen. <em>N Engl J Med</em>. 2001;344(13):967-973. doi:10.1056/NEJM200103293441304 (<a href="https://www.nejm.org/doi/pdf/10.1056/NEJM200103293441304?articleTools=true">View</a>)</li> <li>Chiba N, Van Zanten SJ, Sinclair P, Ferguson RA, Escobedo S, Grace E. Treating <i>Helicobacter pylori</i> infection in primary care patients with uninvestigated dyspepsia: the Canadian adult dyspepsia empiric treatment-Helicobacter pylori positive (CADET-Hp) randomised controlled trial. <em>BMJ</em>. 2002;324(7344):1012-1016. doi:10.1136/bmj.324.7344.1012 (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC102778/pdf/1012.pdf">View</a>)</li> <li>Moayyedi P, Delaney BC, Vakil N, Forman D, Talley NJ. The efficacy of proton pump inhibitors in nonulcer dyspepsia: a systematic review and economic analysis. <em>Gastroenterology</em>. 2004;127(5):1329-1337. doi:10.1053/j.gastro.2004.08.026 (Request with <a href="https://www.cpsbc.ca/registrants/library/make-request">CPSBC</a> or view with <a href="https://go.exlibris.link/tmw0kWtH">UBC</a>)</li> <li>Veldhuyzen van Zanten SJ, Flook N, Chiba N, et al. An evidence-based approach to the management of uninvestigated dyspepsia in the era of Helicobacter pylori. Canadian Dyspepsia Working Group. <em>CMAJ</em>. 2000;162(12 Suppl):S3-S23 (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232536/pdf/cmaj_162_12_s3.pdf">View</a>)</li> <li>Moayyedi P, Bardhan C, Young L, Dixon MF, Brown L, Axon AT. <i>Helicobacter pylori</i> eradication does not exacerbate reflux symptoms in gastroesophageal reflux disease. <em>Gastroenterology</em>. 2001;121(5):1120-1126. doi:10.1053/gast.2001.29332 (Request with <a href="https://www.cpsbc.ca/registrants/library/make-request">CPSBC</a> or view with <a href="https://go.exlibris.link/P4LLd8yk">UBC</a>)</li> <li>Canadian Cancer Statistics Advisory Committee in collaboration with the Canadian Cancer Society, Statistics Canada and the Public Health Agency of Canada. <em>Canadian Cancer Statistics 2021</em>. Toronto, ON: Canadian Cancer Society; 2021. Accessed July 31, 2023 (<a href="https://cdn.cancer.ca/-/media/files/research/cancer-statistics/2021-statistics/2021-pdf-en-final.pdf">View</a>)</li> <li>Goodman KJ, Jacobson K, Veldhuyzen van Zanten S. <i>Helicobacter pylori</i> infection in Canadian and related Arctic Aboriginal populations. <em>Can J Gastroenterol</em>. 2008;22(3):289-295. doi:10.1155/2008/258610 (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2662204/pdf/cjg22289.pdf">View</a>)</li> <li>Cheung J, Goodman K, Munday R, et al. <i>Helicobacter pylori</i> infection in Canada's Arctic: searching for the solutions. <em>Can J Gastroenterol</em>. 2008;22(11):912-916. doi:10.1155/2008/614538 (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2661193/pdf/cjg22912.pdf">View</a>)</li> <li>Colquhoun A, Hannah H, Corriveau A, et al. Gastric Cancer in Northern Canadian Populations: A focus on cardia and non-cardia subsites. <em>Cancers (Basel)</em>. 2019;11(4):534. Published 2019 Apr 15. doi:10.3390/cancers11040534 (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520747/pdf/cancers-11-00534.pdf">View</a>)</li> </ol> </div> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--text-with-summary.html.twig' --> Thu, 10 Aug 2023 15:44:29 +0000 nina.z@ubc.ca 1536 at https://ubccpd.ca 2023-06-22 Climate Change: Understanding and Managing the Significant Health Impacts of Extreme Heat Events https://ubccpd.ca/2023-06-22-climate-change-extreme-heat-events <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--title--rss.html.twig * field--node--title--resource.html.twig x field--node--title.html.twig * field--node--resource.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">2023-06-22 Climate Change: Understanding and Managing the Significant Health Impacts of Extreme Heat Events</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--uid--rss.html.twig * field--node--uid--resource.html.twig x field--node--uid.html.twig * field--node--resource.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> <span>naeema.a@ubc.ca</span> <!-- END OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--created--rss.html.twig * field--node--created--resource.html.twig x field--node--created.html.twig * field--node--resource.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Thu, 06/29/2023 - 23:56</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <drupal-render-placeholder callback="flag.link_builder:build" arguments="0=node&amp;1=1508&amp;2=bookmark" token="NwF_Kp1DuQHQ9NKJVi5REIGOsE4X9eWNBz3C51_4xLY"></drupal-render-placeholder> <!-- THEME DEBUG --> <!-- THEME HOOK: 'addtoany_standard' --> <!-- FILE NAME SUGGESTIONS: * addtoany-standard--node--resource.html.twig * addtoany-standard--node.html.twig x addtoany-standard.html.twig --> <!-- BEGIN OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <span class="a2a_kit a2a_kit_size_32 addtoany_list" data-a2a-url="https://ubccpd.ca/2023-06-22-climate-change-extreme-heat-events" data-a2a-title="2023-06-22 Climate Change: Understanding and Managing the Significant Health Impacts of Extreme Heat Events"><a class="a2a_dd" href="https://www.addtoany.com/share" data-tooltip="Share"><span class="visually-hidden">Share</span><span class="CPD-Icon-Share"></span></a></span> <!-- END OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-topic-audience--rss.html.twig * field--node--field-topic-audience--resource.html.twig * field--node--field-topic-audience.html.twig * field--node--resource.html.twig * field--field-topic-audience.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-topic-audience field--type-entity-reference field--label-above"> <div class="field__label">Topic &amp; Audience</div> <div class="field__items"> <div class="field__item"><a href="/taxonomy/term/13" hreflang="en">Family Medicine</a></div> <div class="field__item"><a href="/taxonomy/term/96" hreflang="en">Residents &amp; Students</a></div> <div class="field__item"><a href="/taxonomy/term/100" hreflang="en">Specialty Medicine</a></div> </div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-resource-thumbnail--rss.html.twig * field--node--field-resource-thumbnail--resource.html.twig * field--node--field-resource-thumbnail.html.twig * field--node--resource.html.twig * field--field-resource-thumbnail.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="blazy blazy--field blazy--field-resource-thumbnail blazy--field-resource-thumbnail--rss field field--name-field-resource-thumbnail field--type-entity-reference field--label-hidden field__item" data-blazy=""> <!-- THEME DEBUG --> <!-- THEME HOOK: 'blazy' --> <!-- BEGIN OUTPUT from 'modules/contrib/blazy/templates/blazy.html.twig' --> <div data-b-token="b-b62f5ee91e6" class="media media--blazy media--bundle--image media--image is-b-loading"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'image' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/image.html.twig' --> <img alt="" title="AMR webinar thumbnail.PNG" decoding="async" class="media__element b-lazy" loading="lazy" data-src="/sites/default/files/images/heatdome%20webinar%20thumbnail.PNG" src="data:image/svg+xml;charset=utf-8,%3Csvg%20xmlns%3D&#039;http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg&#039;%20viewBox%3D&#039;0%200%201%201&#039;%2F%3E" width="491" height="277" /> <!-- END OUTPUT from 'core/themes/classy/templates/field/image.html.twig' --> </div> <!-- END OUTPUT from 'modules/contrib/blazy/templates/blazy.html.twig' --> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--body--rss.html.twig * field--node--body--resource.html.twig * field--node--body.html.twig * field--node--resource.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><h4><strong>Thursday, June 22, 2023</strong></h4> <p>Brooks Hogya, Dr. Emily Newhouse, Dr. Glen Kenny, Dr. Heather Lindsay, Dr. Kyle Merritt, Dr. Sarah Henderson, Dr. Bruce Hobson (moderator)</p> <p><em><strong>Please note:</strong> this webinar is intended only for health care professionals.</em></p> <h5>Recording:</h5> <p><iframe allow="autoplay" allowfullscreen="" height="405" src="https://ubc.ca.panopto.com/Panopto/Pages/Embed.aspx?id=583287d2-305d-43f2-aeb2-afcf01468a07&amp;autoplay=false&amp;offerviewer=true&amp;showtitle=true&amp;showbrand=true&amp;captions=false&amp;interactivity=all" style="border: 1px solid #464646;" width="720"></iframe></p> <h5>Resources:</h5> <!-- THEME DEBUG --> <!-- THEME HOOK: 'entity_embed_container' --> <!-- BEGIN OUTPUT from 'modules/contrib/entity_embed/templates/entity-embed-container.html.twig' --> <div data-embed-button="media" data-entity-embed-display="view_mode:media.inline" data-entity-type="media" data-entity-uuid="f8a3defc-7ffa-4aa3-a3f9-157ad3db2353" data-langcode="en" data-entity-embed-display-settings="[]" class="embedded-entity"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'media' --> <!-- FILE NAME SUGGESTIONS: * media--source-file.html.twig * media--file--inline.html.twig * media--file.html.twig * media--inline.html.twig x media.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/media/media.html.twig' --> <div> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-media-file--inline.html.twig * field--media--field-media-file--file.html.twig * field--media--field-media-file.html.twig * field--media--file.html.twig * field--field-media-file.html.twig * field--file.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-media-file field--type-file field--label-visually_hidden"> <div class="field__label visually-hidden">File</div> <div class="field__item"><span class="file file--application-pdf"></span><a href="/media/1663/download" data-filename="media-3216--Extreme Heat Slides_D1.pdf">2023-06-22 Webinar Slides</a></div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/media/media.html.twig' --> </div> <!-- END OUTPUT from 'modules/contrib/entity_embed/templates/entity-embed-container.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'entity_embed_container' --> <!-- BEGIN OUTPUT from 'modules/contrib/entity_embed/templates/entity-embed-container.html.twig' --> <div data-embed-button="media" data-entity-embed-display="view_mode:media.inline" data-entity-type="media" data-entity-uuid="538cb9cf-7736-45ec-bcd6-e6f9e863a56b" data-langcode="en" data-entity-embed-display-settings="[]" class="embedded-entity"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'media' --> <!-- FILE NAME SUGGESTIONS: * media--source-file.html.twig * media--file--inline.html.twig * media--file.html.twig * media--inline.html.twig x media.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/media/media.html.twig' --> <div> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-media-file--inline.html.twig * field--media--field-media-file--file.html.twig * field--media--field-media-file.html.twig * field--media--file.html.twig * field--field-media-file.html.twig * field--file.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-media-file field--type-file field--label-visually_hidden"> <div class="field__label visually-hidden">File</div> <div class="field__item"><span class="file file--application-pdf"></span><a href="/media/1664/download" data-filename="media-3221--2023-22-06 Webinar Resources.pdf">2023-06-22 Webinar Resources</a></div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/media/media.html.twig' --> </div> <!-- END OUTPUT from 'modules/contrib/entity_embed/templates/entity-embed-container.html.twig' --> </div> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--text-with-summary.html.twig' --> Thu, 29 Jun 2023 23:56:48 +0000 naeema.a@ubc.ca 1508 at https://ubccpd.ca 2023-05-30 Antimicrobial Resistance: Best Clinical Practices to Minimize This Threat https://ubccpd.ca/2023-05-30-antimicrobial-resistance-best-clinical-practices <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--title--rss.html.twig * field--node--title--resource.html.twig x field--node--title.html.twig * field--node--resource.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">2023-05-30 Antimicrobial Resistance: Best Clinical Practices to Minimize This Threat</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--uid--rss.html.twig * field--node--uid--resource.html.twig x field--node--uid.html.twig * field--node--resource.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> <span>naeema.a@ubc.ca</span> <!-- END OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--created--rss.html.twig * field--node--created--resource.html.twig x field--node--created.html.twig * field--node--resource.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Mon, 06/05/2023 - 16:05</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <drupal-render-placeholder callback="flag.link_builder:build" arguments="0=node&amp;1=1493&amp;2=bookmark" token="MqeCpJHCirlSFckqlBgVGrnVR6g3F5ERhwPZ2yRYEDs"></drupal-render-placeholder> <!-- THEME DEBUG --> <!-- THEME HOOK: 'addtoany_standard' --> <!-- FILE NAME SUGGESTIONS: * addtoany-standard--node--resource.html.twig * addtoany-standard--node.html.twig x addtoany-standard.html.twig --> <!-- BEGIN OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <span class="a2a_kit a2a_kit_size_32 addtoany_list" data-a2a-url="https://ubccpd.ca/2023-05-30-antimicrobial-resistance-best-clinical-practices" data-a2a-title="2023-05-30 Antimicrobial Resistance: Best Clinical Practices to Minimize This Threat"><a class="a2a_dd" href="https://www.addtoany.com/share" data-tooltip="Share"><span class="visually-hidden">Share</span><span class="CPD-Icon-Share"></span></a></span> <!-- END OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-topic-audience--rss.html.twig * field--node--field-topic-audience--resource.html.twig * field--node--field-topic-audience.html.twig * field--node--resource.html.twig * field--field-topic-audience.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-topic-audience field--type-entity-reference field--label-above"> <div class="field__label">Topic &amp; Audience</div> <div class="field__items"> <div class="field__item"><a href="/taxonomy/term/13" hreflang="en">Family Medicine</a></div> <div class="field__item"><a href="/taxonomy/term/96" hreflang="en">Residents &amp; Students</a></div> <div class="field__item"><a href="/taxonomy/term/100" hreflang="en">Specialty Medicine</a></div> </div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-resource-thumbnail--rss.html.twig * field--node--field-resource-thumbnail--resource.html.twig * field--node--field-resource-thumbnail.html.twig * field--node--resource.html.twig * field--field-resource-thumbnail.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="blazy blazy--field blazy--field-resource-thumbnail blazy--field-resource-thumbnail--rss field field--name-field-resource-thumbnail field--type-entity-reference field--label-hidden field__item" data-blazy=""> <!-- THEME DEBUG --> <!-- THEME HOOK: 'blazy' --> <!-- BEGIN OUTPUT from 'modules/contrib/blazy/templates/blazy.html.twig' --> <div data-b-token="b-b62f5ee91e6" class="media media--blazy media--bundle--image media--image is-b-loading"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'image' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/image.html.twig' --> <img alt="" title="AMR webinar thumbnail.PNG" decoding="async" class="media__element b-lazy" loading="lazy" data-src="/sites/default/files/images/heatdome%20webinar%20thumbnail.PNG" src="data:image/svg+xml;charset=utf-8,%3Csvg%20xmlns%3D&#039;http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg&#039;%20viewBox%3D&#039;0%200%201%201&#039;%2F%3E" width="491" height="277" /> <!-- END OUTPUT from 'core/themes/classy/templates/field/image.html.twig' --> </div> <!-- END OUTPUT from 'modules/contrib/blazy/templates/blazy.html.twig' --> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--body--rss.html.twig * field--node--body--resource.html.twig * field--node--body.html.twig * field--node--resource.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><h4><strong>Tuesday, May 30, 2023</strong></h4> <p>Dr. Edith Blondel-Hill, Dr. David Patrick, Dr. Tracy Monk, Dr. Simon Moore (moderator)</p> <p><em><strong>Please note:</strong> this webinar is intended only for health care professionals.</em></p> <h5>Recording:</h5> <p><iframe allow="autoplay" allowfullscreen="" height="405" src="https://ubc.ca.panopto.com/Panopto/Pages/Embed.aspx?id=b10335d8-6671-4bac-919f-afe10176251b&amp;autoplay=false&amp;offerviewer=true&amp;showtitle=true&amp;showbrand=true&amp;captions=false&amp;interactivity=all" style="border: 1px solid #464646;" width="720"></iframe></p> <h5>Resources:</h5> <!-- THEME DEBUG --> <!-- THEME HOOK: 'entity_embed_container' --> <!-- BEGIN OUTPUT from 'modules/contrib/entity_embed/templates/entity-embed-container.html.twig' --> <div data-embed-button="media" data-entity-embed-display="view_mode:media.inline" data-entity-type="media" data-entity-uuid="105d6d06-ee0c-4a67-9cf7-c1e697e38ec9" data-langcode="en" data-entity-embed-display-settings="[]" class="embedded-entity"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'media' --> <!-- FILE NAME SUGGESTIONS: * media--source-file.html.twig * media--file--inline.html.twig * media--file.html.twig * media--inline.html.twig x media.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/media/media.html.twig' --> <div> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-media-file--inline.html.twig * field--media--field-media-file--file.html.twig * field--media--field-media-file.html.twig * field--media--file.html.twig * field--field-media-file.html.twig * field--file.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-media-file field--type-file field--label-visually_hidden"> <div class="field__label visually-hidden">File</div> <div class="field__item"><span class="file file--application-pdf"></span><a href="/media/1647/download" data-filename="media-3189--AMR Slide Deck.pdf">2023-05-30 Webinar Slides</a></div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/media/media.html.twig' --> </div> <!-- END OUTPUT from 'modules/contrib/entity_embed/templates/entity-embed-container.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'entity_embed_container' --> <!-- BEGIN OUTPUT from 'modules/contrib/entity_embed/templates/entity-embed-container.html.twig' --> <div data-embed-button="media" data-entity-embed-display="view_mode:media.inline" data-entity-type="media" data-entity-uuid="ed46d55b-3f18-440e-9351-3c8ae5aa34c6" data-langcode="en" data-entity-embed-display-settings="[]" class="embedded-entity"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'media' --> <!-- FILE NAME SUGGESTIONS: * media--source-file.html.twig * media--file--inline.html.twig * media--file.html.twig * media--inline.html.twig x media.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/media/media.html.twig' --> <div> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-media-file--inline.html.twig * field--media--field-media-file--file.html.twig * field--media--field-media-file.html.twig * field--media--file.html.twig * field--field-media-file.html.twig * field--file.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-media-file field--type-file field--label-visually_hidden"> <div class="field__label visually-hidden">File</div> <div class="field__item"><span class="file file--application-pdf"></span><a href="/media/1646/download" data-filename="media-3188--May 30 Webinar Resources.pdf">2023-05-30 Webinar Resources</a></div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/media/media.html.twig' --> </div> <!-- END OUTPUT from 'modules/contrib/entity_embed/templates/entity-embed-container.html.twig' --> </div> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--text-with-summary.html.twig' --> Mon, 05 Jun 2023 16:05:58 +0000 naeema.a@ubc.ca 1493 at https://ubccpd.ca TCMP Article: Managing syphilis during pregnancy — practice tip https://ubccpd.ca/tcmp-article-managing-syphilis-during-pregnancy-practice-tip <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--title--rss.html.twig * field--node--title--resource.html.twig x field--node--title.html.twig * field--node--resource.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">TCMP Article: Managing syphilis during pregnancy — practice tip</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--uid--rss.html.twig * field--node--uid--resource.html.twig x field--node--uid.html.twig * field--node--resource.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> <span>nina.z@ubc.ca</span> <!-- END OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--created--rss.html.twig * field--node--created--resource.html.twig x field--node--created.html.twig * field--node--resource.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Tue, 05/16/2023 - 21:03</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <drupal-render-placeholder callback="flag.link_builder:build" arguments="0=node&amp;1=1501&amp;2=bookmark" token="j03yGUkZFXbYiYsY1mAXUS9PkflP8UTZFXA_BZCJBiE"></drupal-render-placeholder> <!-- THEME DEBUG --> <!-- THEME HOOK: 'addtoany_standard' --> <!-- FILE NAME SUGGESTIONS: * addtoany-standard--node--resource.html.twig * addtoany-standard--node.html.twig x addtoany-standard.html.twig --> <!-- BEGIN OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <span class="a2a_kit a2a_kit_size_32 addtoany_list" data-a2a-url="https://ubccpd.ca/tcmp-article-managing-syphilis-during-pregnancy-practice-tip" data-a2a-title="TCMP Article: Managing syphilis during pregnancy — practice tip"><a class="a2a_dd" href="https://www.addtoany.com/share" data-tooltip="Share"><span class="visually-hidden">Share</span><span class="CPD-Icon-Share"></span></a></span> <!-- END OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-topic-audience--rss.html.twig * field--node--field-topic-audience--resource.html.twig * field--node--field-topic-audience.html.twig * field--node--resource.html.twig * field--field-topic-audience.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-topic-audience field--type-entity-reference field--label-above"> <div class="field__label">Topic &amp; Audience</div> <div class="field__items"> <div class="field__item"><a href="/taxonomy/term/13" hreflang="en">Family Medicine</a></div> <div class="field__item"><a href="/taxonomy/term/21" hreflang="en">Internal Medicine</a></div> <div class="field__item"><a href="/taxonomy/term/80" hreflang="en">Midwifery</a></div> <div class="field__item"><a href="/taxonomy/term/84" hreflang="en">Obstetrics</a></div> <div class="field__item"><a href="/taxonomy/term/100" hreflang="en">Specialty Medicine</a></div> </div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-learning-activity--rss.html.twig * field--node--field-learning-activity--resource.html.twig * field--node--field-learning-activity.html.twig * field--node--resource.html.twig * field--field-learning-activity.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-learning-activity field--type-entity-reference field--label-above"> <div class="field__label">Learning Activity</div> <div class="field__items"> <div class="field__item"><a href="/node/750" hreflang="en">This Changed My Practice Articles</a></div> </div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-resource-thumbnail--rss.html.twig * field--node--field-resource-thumbnail--resource.html.twig * field--node--field-resource-thumbnail.html.twig * field--node--resource.html.twig * field--field-resource-thumbnail.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="blazy blazy--field blazy--field-resource-thumbnail blazy--field-resource-thumbnail--rss field field--name-field-resource-thumbnail field--type-entity-reference field--label-hidden field__item" data-blazy=""> <!-- THEME DEBUG --> <!-- THEME HOOK: 'blazy' --> <!-- BEGIN OUTPUT from 'modules/contrib/blazy/templates/blazy.html.twig' --> <div data-b-token="b-02265181839" class="media media--blazy media--bundle--image media--image is-b-loading"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'image' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/image.html.twig' --> <img alt="XR in MedEd" decoding="async" class="media__element b-lazy" loading="lazy" data-src="/sites/default/files/images/Research%20-%20immersive%20technology%20in%20medical%20education%20-%20hero%20image%20%281%29_0.png" src="data:image/svg+xml;charset=utf-8,%3Csvg%20xmlns%3D&#039;http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg&#039;%20viewBox%3D&#039;0%200%201%201&#039;%2F%3E" width="1600" height="900" /> <!-- END OUTPUT from 'core/themes/classy/templates/field/image.html.twig' --> </div> <!-- END OUTPUT from 'modules/contrib/blazy/templates/blazy.html.twig' --> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--body--rss.html.twig * field--node--body--resource.html.twig * field--node--body.html.twig * field--node--resource.html.twig * field--body.html.twig x field--text-with-summary.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--text-with-summary.html.twig' --> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>May 17, 2023</p> <div>Receive 0.25 Mainpro+ or MOC Section 2* study credits per article. <p>&nbsp;</p> <hr /> <h3>Authors</h3> <p><strong>Rohit Vijh, MD MPH CCFP</strong> (<a href="https://thischangedmypractice.com/bios/#RohitVijh">biography and disclosures</a>)<br /> <em>Disclosures: Board Member Vancouver Division of Family Practice Locuum Family Physician, Mid Main Community Health Centre CBT Skills Physician Facilitator, CBT Skills STI Sessional Physician, BCCDC Public Health and Preventive Medicine Resident, UBC PGME Clinical Instructor, Department of Family Practice, Faculty of Medicine, UBC (receive payments for teaching UGME/PGME students). Mitigating potential bias: Recommendations are consistent with published guidelines (BCCDC, PHAC, Perinatal Services BC) Recommendations are consistent with current practice patterns Treatments or recommendations in this article are unrelated to products/services/treatments involved in disclosure statements.</em></p> <p><strong>Jason Wong, MD MPH CCFP FRCPC</strong> (<a href="https://thischangedmypractice.com/bios/#JasonWong">biography, no disclosures</a>)</p> <h3>What care gaps or frequently asked questions have we noticed?</h3> <p>Many clinicians consider syphilis to be an uncommon condition in BC. However, infectious syphilis rates are climbing in BC and syphilis has re-emerged as a public health threat. While the syphilis epidemic in BC has been ongoing since 2015, the epidemiology of syphilis in BC has recently changed. Previously, most infectious syphilis cases were among gay, bisexual, and other men who have sex with men (gbMSM). However, in 2022, for the first time in over a decade, the majority of infectious syphilis cases diagnosed in BC are among heterosexual individuals, raising concerns of increases in congenital syphilis.</p> <h3>Data that answers these questions or gaps</h3> <p>Nationally, the number of infectious syphilis cases for females has increased by 729% from 2017–2021.<sup>1</sup> Likewise, in BC infectious syphilis among females and heterosexual individuals has been increasing dramatically.<sup>2</sup> From 2015 to 2022, infectious syphilis cases among females have increased nineteen-fold, from 28 to 545 cases, respectively; proportionally, infectious cases among females have increased from less than 4% in 2015 to 28% in 2022 of all infectious syphilis cases reported in BC.<sup>2</sup> Similarly, the proportion of infectious syphilis cases among heterosexual individuals increased nineteen-fold, from less than 3% in 2015 to 57% in 2022. Of the infectious syphilis cases diagnosed among females in 2022, over 90% occurred among females in child-bearing years (15–49 years old) and 5% were diagnosed during the prenatal period.<sup>2</sup></p> <p>These increases in syphilis among females have raised concerns of congenital syphilis. Congenital syphilis is a severe, often debilitating, and potentially lethal infection that is the result of in-utero transmission of syphilis. In Canada, the number of early congenital syphilis cases has increased rapidly from 4 cases in 2016 to 96 cases in 2021.<sup>1</sup> BC reported its first cases of early congenital syphilis in 2019 after having zero cases between 2014 and 2018.<sup>2</sup></p> <p>In response to the congenital syphilis case in BC as well as increasing cases of infectious syphilis among females, the Provincial Health Officer declared a provincial syphilis outbreak in 2019. As part of the outbreak response, universal screening for syphilis was recommended for all pregnant individuals in BC at the time of delivery, in addition to the recommendation for a syphilis screen in the first trimester or first prenatal visit.<sup>3</sup></p> <p>Provincial surveillance data found that there were 19 cases of infectious syphilis diagnosed at delivery since universal screening at delivery was implemented in October 2019 until the end of September 2022. Eleven (58%) of these maternal syphilis cases did not have another syphilis test during the current pregnancy while the remaining 8 (42%) had a previous non-reactive test during the current pregnancy. During the same period, there were 11 early congenital syphilis cases reported. Three resulted in stillbirth or neonatal loss. The delivering parent of 6 of these 11 early congenital syphilis cases had no or limited access to prenatal care while the other 5 had a previous negative screen for syphilis in the first or second trimester. These data suggest that universal screening at delivery is identifying individuals infected with syphilis who may not have been identified with risk-based screening alone. In fact, over 10% of individuals who had a syphilis screen at delivery did not have evidence of another syphilis screen in that current pregnancy.</p> <p>A chart review of all female infectious syphilis cases in BC from March 2018 to 2020 was conducted to better understand the risk factors and drivers of syphilis and identify opportunities for prevention. Most cases had experiences with housing instability, substance use, and mental illness among those who reported concurrent conditions. Similar risk factors were found among cases diagnosed during pregnancy.<sup>4</sup> These findings reinforce the importance of upstream social and structural factors as drivers of syphilis. Thus, there is a need to consider these concurrent factors to support overall health and well-being of people infected with syphilis.</p> <h3>What we recommend (practice tip)</h3> <p>Pregnant persons should be screened for syphilis during the first trimester (or first prenatal visit), and at delivery (or any time after week 35 for those planning home births) in BC.<sup>3,5</sup> Pregnant persons with ongoing risk for syphilis infection, such as new sexual partner(s), transactional sex, illicit drug use, or unstable housing, should also be screened for syphilis at 28–32 weeks of pregnancy.<sup>5</sup> From March 2018 to 2020, 90% of the maternal syphilis cases in BC were classified as early latent, which is the asymptomatic stage of syphilis.<sup>4</sup> This finding underscores the importance of screening to identify syphilis. Furthermore, given that primary syphilis lesions are painless, and secondary syphilis presents in a myriad of ways — making a clinical diagnosis of syphilis often challenging. Therefore, maintain a high clinical suspicion for syphilis and inquire about risk factors for syphilis, such as new or multiple sexual partners.</p> <p>People delivering a stillborn infant after 20 weeks gestation should be tested for syphilis as well.<sup>5</sup> For stillbirths, clinical specimens (e.g., placenta, umbilical cord blood) should be sent for syphilis testing to confirm the congenital syphilis diagnosis. Additional investigations may be indicated. Clinicians are available for consultation (see below).</p> <p>Intramuscular benzathine penicillin G 2.4 million units in a single dose (administered into a divided dose of 1.2 million units given IM into each hip/buttock at the same visit) is the recommended treatment for infectious syphilis, including in pregnant individuals.<sup>6</sup> Additional doses may be required depending on the duration of the infection.<sup>6</sup> There is no satisfactory alternative to penicillin for the treatment of syphilis in pregnancy as the recommended alternate treatment with doxycycline is contraindicated during pregnancy.<sup>6</sup></p> <p>As a result, &nbsp;we recommend penicillin desensitization followed by treatment with penicillin. Health-care providers can utilize the <a href="https://www.dropthelabel.ca/">Drop The Label</a> penicillin allergy de-labelling tool to aid in their assessment and management of patients with suspected or proven penicillin allergy.</p> <p>Infants with possible or confirmed congenital syphilis require treatment with aqueous crystalline penicillin G IV 100,000–150,000 units/kg/day, administered as 50,000 units/kg per dose every 12 hours during the first 7 days of life and every 8 hours thereafter for a total of 10 days.<sup>6</sup></p> <p>Physicians who have questions about syphilis screening or treatment can contact the BCCDC public health nurse at 604-707-5607 or physician at 604-707-5610. Physicians can also speak with a clinician at Oak Tree Clinic directly for urgent referrals.</p> <h3>Will this change your practice?</h3> <p><a class="btn btn-primary" href="https://thischangedmypractice.com/managing-syphilis-during-pregnancy-practice-tip/#discussion" rel=" noopener" target="_blank" title="Vote and see how your colleagues are voting">Vote</a></p> <h3>References</h3> <ol> <li>Public Health Agency of Canada. Infectious syphilis and congenital syphilis in Canada, 2021 (infographic). Accessed May 17, 2023. <a href="https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2022-48/issue-11-12-november-december-2022/infectious-congenital-syphilis-canada-2021.html">(View)</a></li> <li>BC Centre for Disease Control. British Columbia Syphilis Quarterly Indicators 2022Q4 Report. <a href="http://www.bccdc.ca/health-professionals/data-reports/sti-reports">(View)</a></li> <li>Perinatal Services BC. New recommendations for syphilis screening in pregnancy. Updated September 3, 2019. Accessed May 17, 2023. <a href="http://www.perinatalservicesbc.ca/about/news-stories/stories/new-recommendations-for-syphilis-screening">(View)</a>.</li> <li>Willemsma K, Barton L, Stimpson R, et al. Characterizing female infectious syphilis cases in British Columbia to identify opportunities for optimization of care.&nbsp;<i>Can Commun Dis Rep</i>. 2022;48(2-3):68-75. Published 2022 Feb 24. doi:10.14745/ccdr.v48i23a03 (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8889918/pdf/CCDR-48-68.pdf" rel="noopener" target="_blank">View</a>)</li> <li>Public Health Agency of Canada. Syphilis guide: Screening and diagnostic testing. Updated 2022. May 17, 2023. <a href="http://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/syphilis/screening-diagnostic-testing.html">(View)</a>.</li> <li>BC Centre for Disease Control. British Columbia treatment guidelines: Sexually transmitted infections in adolescents and adults 2014. May 17, 2023. <a href="http://www.bccdc.ca/resource-gallery/Documents/Communicable-Disease-Manual/Chapter%205%20-%20STI/CPS_BC_STI_Treatment_Guidelines_20112014.pdf">(View)</a>.</li> </ol> <p><a class="btn btn-primary" href="https://thischangedmypractice.com/accreditation?pageid=7908&amp;pagetitle=Managing+syphilis+during+pregnancy+%E2%80%94+practice+tip#Managing%20syphilis%20during%20pregnancy%20%E2%80%94%20practice%20tip" target="_blank" title="Earn credits and let us know how you will change your practice">Earn credits</a></p> </div> </div> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--text-with-summary.html.twig' --> Tue, 16 May 2023 21:03:47 +0000 nina.z@ubc.ca 1501 at https://ubccpd.ca Orthopaedic Research Day Agenda https://ubccpd.ca/orthopaedic-research-day-agenda <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--title--rss.html.twig * field--node--title--resource.html.twig x field--node--title.html.twig * field--node--resource.html.twig * field--title.html.twig * field--string.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <span class="field field--name-title field--type-string field--label-hidden">Orthopaedic Research Day Agenda </span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--title.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--uid--rss.html.twig * field--node--uid--resource.html.twig x field--node--uid.html.twig * field--node--resource.html.twig * field--uid.html.twig * field--entity-reference.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <span class="field field--name-uid field--type-entity-reference field--label-hidden"> <!-- THEME DEBUG --> <!-- THEME HOOK: 'username' --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> <span>judy.c@ubc.ca</span> <!-- END OUTPUT from 'core/themes/classy/templates/user/username.html.twig' --> </span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--uid.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--created--rss.html.twig * field--node--created--resource.html.twig x field--node--created.html.twig * field--node--resource.html.twig * field--created.html.twig * field--created.html.twig * field.html.twig --> <!-- BEGIN OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <span class="field field--name-created field--type-created field--label-hidden">Thu, 04/27/2023 - 15:22</span> <!-- END OUTPUT from 'core/themes/classy/templates/field/field--node--created.html.twig' --> <drupal-render-placeholder callback="flag.link_builder:build" arguments="0=node&amp;1=1473&amp;2=bookmark" token="XSFRaczjNFf2cgSeaWp2CynszbG85iVDMsBi_9wOBl4"></drupal-render-placeholder> <!-- THEME DEBUG --> <!-- THEME HOOK: 'addtoany_standard' --> <!-- FILE NAME SUGGESTIONS: * addtoany-standard--node--resource.html.twig * addtoany-standard--node.html.twig x addtoany-standard.html.twig --> <!-- BEGIN OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <span class="a2a_kit a2a_kit_size_32 addtoany_list" data-a2a-url="https://ubccpd.ca/orthopaedic-research-day-agenda" data-a2a-title="Orthopaedic Research Day Agenda "><a class="a2a_dd" href="https://www.addtoany.com/share" data-tooltip="Share"><span class="visually-hidden">Share</span><span class="CPD-Icon-Share"></span></a></span> <!-- END OUTPUT from 'modules/contrib/addtoany/templates/addtoany-standard.html.twig' --> <!-- THEME DEBUG --> <!-- THEME HOOK: 'field' --> <!-- FILE NAME SUGGESTIONS: * field--field-topic-audience--rss.html.twig * field--node--field-topic-audience--resource.html.twig * field--node--field-topic-audience.html.twig * field--node--resource.html.twig * field--field-topic-audience.html.twig * field--entity-reference.html.twig x field.html.twig --> <!-- BEGIN OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> <div class="field field--name-field-topic-audience field--type-entity-reference field--label-above"> <div class="field__label">Topic &amp; Audience</div> <div class="field__items"> <div class="field__item"><a href="/taxonomy/term/100" hreflang="en">Specialty Medicine</a></div> </div> </div> <!-- END OUTPUT from 'themes/custom/de_theme/templates/field/field.html.twig' --> Thu, 27 Apr 2023 15:22:09 +0000 judy.c@ubc.ca 1473 at https://ubccpd.ca