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Download from the Organization UTMJ Website ( A student-run scientifc publication since 1923 University of Toronto Medical Journal Table of Contents PREFACE ORIGINAL RESEARCH 4 Preface from the Editors 33 To Study the Impact of Acne Vulgaris on the Quality of Life of Patients Amit Batra, Prithpal S Matreja, Amandeep Singh, Ashwani K Gupta, Naveen K Kansal, PML Khanna PERSPECTIVES 5 Riding the Medical Technology Wave to Empower Your Career in Medicine Carolyn McGregor CASE REPORTS 37 Rapidly Progressing De Novo Arachnoid Cyst in 7 Current Limitations and Opportunities for Surgical an Adult Patient Navigation Kenda Alhadid,* Renée Rochelle Cruickshank,* Alireza Ronnie Wong, Jamil Jivraj, Victor X. D. Yang Mansouri, David J. Mikulis, Taufik A. Valiante (*Co-Authors) OPINION EDITORIALS 10 Police, policy and privacy: A Commentary on Mental Health BOOK REVIEWS Information Disclosures by the Toronto Police Service 42 In Retrospect: Frankenstein and Medical Technology Phillip K. Gregoire Benjamin H. Chin-Yee 12 The State of Pharmaceutical Drug Coverage in Canada Liza Abraham, Patrick E. Steadman 13 Ebola: Context and Current Issues Maia Foster, Thomas M. Dashwood INTERVIEWS 15 Brain Stimulation and its Role in the Assessment and Management of Movement Disorders Ayan K. Dey 18 Paving the Way in Biomedical Engineering: An Interview with Dr. Molly Shoichet Amirah Momen 20 Healthy Lives for All, Until the Last Breath: An Interview with Dr. Alex Jadad Muskaan Vineet Gurnani, Arnav Agarwal 25 Exploring The Past, Present and Future of Health Technologies with Dr. Joseph Cafazzo Amirah Momen 29 Adding Years to Life: Physiatry, Neurorehabilitation, and Knowledge Translation Ayan K. Dey All articles are externally peer-reviewed with the exception of poetry, short stories and book reviews. All manuscripts are internally reviewed. Informed consent practices and any conflicts of interest are specified in the articles if applicable. Cover Artist: Front cover illustration by Diana Grossi, student of the Bionedical Communications Program (1T6), University of Toronto. UTMJ • Volume 92, Number 1, December 2014 1 ERRATA Our sincere apologies. This page contains the correct staff list for this UTMJ Issue. Volume 92, Number 1, 2014 A student-run scientifc publication since 1923 University of Toronto Medical Journal Editors-in-Chief Interview Editors Ilyse Darwish Catherine Brown Varuna Prakash Ayan Dey Amirah Momen Aliya Ramjaun Managing Editors Lisa Saldanha Florentina Teoderascu Teja Voruganti Johnny-Wei Bai Section Editors Angela Arisz Sumedha Arya Associate Editors Anand Bery Arnav Aggarwal Benjamin Chin-Yee Sabrina Agnihotri Timothy Chung Monica Blichowski Adrian Cozma Bonnie Cheung Kangping (Kathy) Cui Raymond Chu Sunit Das Mohammed Firdouse Rushi Gandhi Alanna Gilmour Sheliza Halani Inna Gong Dhruvin Hirpara Soroush Larjani Keith Lee Daniel Li Anath Lionel Nicholas Light Cristina Olteanu Rosamond Lougheed Ben Ouyang Ilya Mukovozov Zain Sohail Faisal Naqib Sarah Voll Yuhao Shi Anthony Wan Prachur Shrivastava Margaret Wu Luke Swenson Siqi Xue James Wang Paige Zhang Marie Yan Jeremy Zung Weining Yang Social Media Coordinator Copy Editors Saba Moghimi Sophie Roher Manni Singh Typesetting and Printing Type & Graphics Inc. University of Toronto Medical Journal, 1 King’s College Circle, Room 2260, Medical Sciences Building, Toronto, Canada M5S 1A8 E-mail: [email protected] • http://www.utmj.org • Phone: 416-946-3047 • Fax: 416-978-8730 UTMJ • Volume 92, Number 1, December 2014 Patrons The University of Toronto Medical Journal is funded in part by its subscribers and the Medical Society. Patronage to the Journal is sub- divided into five categories. UTMJ Friend – $75; UTMJ Patron – $75-99; UTMJ Advocate – $100-149; UTMJ Benefactor – $150-199; and UTMJ Grand Benefactor – >$200. To subscribe, please see the last page of the Journal. The UTMJ wishes to thank the following patrons for their generous donations: UTMJ Grand Benefactor Dr. Barry Goldlist UTMJ Benefactor Graduate Life Sciences Michael Baker Hugh D. McGowan UTMJ Advocate Dr. Anne Agur UTMJ Patron Jay Rosenfield Kathy Siminovitch Graham E. Trope UTMJ Friend Anne Agur Shabbir Alibhai Edward Cole Helen Demshar David Goldbloom Anna Jarvis Stephen Kraft Chetan Phadke Lannis Lee Tynes The Editors apologize for any omissions to the above list; this list represents the final version at press time. The list will be updated in future issues. UTMJ • Volume 92, Number 1, December 2014 3 Preface Preface from the Editors Dear Reader, t is our great pleasure to present to you the first issue Cafazzo shares his perspectives on how technology can enable of UTMJ’s 92nd volume. We are honoured at the oppor- self-management of patients, Dr. Alex Jadad talks about com- Itunity to be stewards of the Journal for the 2014-2015 munication technologies for global public health innovation, academic year. In setting the agenda for the year, we could Dr. Mark Bayley discusses the specialty of physiatry and neuro- not think of a better or timelier topic for our first issue than rehabilitation, and Dr. Molly Shoichet describes advances in Medical Technology. There is perhaps no other sector that regenerative medicine and biomedical engineering. In addi- has undergone as much rapid acceleration and growth over tion to these highlights, we also have a unique examination of the past decade. Be it cutting-edge diagnostics, eHealth solu- medical technology in the classic novel Frankenstein, a case tions, or devices for patients to use at home, there is tremen- report on rapidly progressing arachnoid cysts, and opinion dous potential to improve patient outcomes, lower healthcare editorials from a number of students who are actively en- costs, and increase patient and provider satisfaction. At the gaged in advocacy around hot-button issues currently facing same time, we are continuously challenged to pay due consid- our healthcare system. eration to the iatrogenic effects of technology, and to make As we turn the page on another calendar year, it is cus- judicious, evidence-based use of these innovations. tomary to reflect on the challenges and triumphs of months We intentionally refrained from overly narrowing the past. UTMJ has certainly had its share of both: we spent many scope of this issue, and are thrilled at the resulting diversity of months navigating security breaches and technical setbacks perspectives. Dr. Carolyn McGregor comments on the effects that delayed our production process significantly. This issue, of medical technology on our careers in medicine, while Ron- however, is a clear triumph representing the hard work of nie Wong, Jamil Jivraj, and Dr. Victor Yang explore limitations many dedicated members of the UTMJ team (past and pres- and opportunities for surgical navigation technologies. We ent) who banded together to bring the Journal back on its are also pleased to present interviews from prominent phy- feet. We hope you will enjoy reading this issue as much as we sicians and scientists around Toronto: Dr. Robert Chen dis- have enjoyed producing it. cusses brain stimulation for movement disorders, Dr. Joseph Varuna Prakash and Ilyse Darwish Editors-in-Chief 4 UTMJ • Volume 92, Number 1, December 2014 Perspectives Riding the Medical Technology Wave to Empower Your Career in Medicine Carolyn McGregor, AM, PhD, SMIEEE, MACM, Faculty of Business and IT, University of Ontario Institute of Technology edical technology has changed greatly in the last cal knowledge and patient-related information, intelligently 90 years or so since the inception of this journal. At filtered or presented at appropriate times, to enhance patient Mthat time the term medical technology was largely care’.1 While these have been in existence in rudimentary used to describe equipment used in medical practice and, to form for over a decade, their functionality, purpose, accuracy, a much lesser extent, manually-transcribed medical records. and acceptance is set to accelerate. Additive manufacturing, Just over 50 years ago, intensive care units came into being now commonly referred to as “3D printing” enables the gen- that would ultimately generate the need for new medical eration of solid objects through the addition rather than re- technology that would enable higher frequency monitor- moval of the material used in manufacture through use of ing of many organs and systems within the body. However, data representing the required shape of the structure within around 30 to 40 years ago, medicine and healthcare together a digital file. This form of manufacture is set to disrupt health- with many other industries were beginning to undergo a new care significantly through inexpensive approaches to person- form of medical technology transformation through the use alized bone segment replacements and other applications. of mainframe computers to automate many previously-man- Serious games refers to computer games that are used in ual paper based tasks and to provide an electronic form of an educational context rather than for recreational gaming data persistence. The landscape of the use of computers and and this form of training is gaining use within the domain of related equipment for innovation in healthcare has changed healthcare as it enables inexpensive creation of multiple sce- dramatically since then, and the only thing that is certain in narios and easily supports repetition. The aim of immersive the years to come is that medical professionals must be armed reality games is to immerse any, some or all of the five senses with the tools to understand how to integrate new informa- within the
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