Amyloidosis is the extracellular deposition of insoluble amyloid fibrilprotein in any tissue or organ.[1] The most common subtypes of the disease are AL amyloidosis and AA reactive amyloidosis.[1] AL amyloidosis is a systemic disease caused by immunoglobulin light chain fragments, while AA amyloidosis is a potential complication of recurrent inflammation leading to the production of serum amyloid A, an acute phase reactant.[2] Pulmonary amyloidosis is a localized form of amyloid deposition that is confined to the lung parenchyma.[

Complex regional pain syndrome (CRPS), previously known as reflex sympathetic dystrophy (RSD) and causalgia, can be a debilitating complication of pain associated with limb trauma, including surgery. CRPS is associated with autonomic, sensory, and motor abnormalities, as well as physical changes to the skin and bone. Diagnosis is based on the Budapest Criteria (see box). CRPS can affect patients’ work, social activities, and psychological well-being.

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Far too many patients carry an inaccurate label of beta-lactam allergy and consequently receive alternative antibiotics, often with too broad a spectrum, a higher risk of adverse events, an increased chance of selecting for resistance, and greater cost. Ten percent of patients are labeled with a penicillin allergy and 2% with a cephalosporin allergy.

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The Canadian Medical Association Statement on Physician Health and Wellness identifies physician health as a quality indicator in the overall functioning of health systems[1]—in effect, positioning physician health as an additional component of the triple aim[2] (the GPSC’s version of which identifies the priority of “improving the patient and provider experience of care,” along with improving the health of populations and reducing the per capita cost of health care).

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First steps

Since the Neolithic Revolution 12 000 years ago, people have sought to make lasting alterations to the environment to meet their needs. The first stairs were thought to be simply hewn logs or stones placed in sequence to make incremental ascent and descent easier. Since the earliest Mesopotamian cities, stairs have been an integral part of the built environment.

Despite the enormous benefits that stairs provide, there are dangers associated with their use, and current standards of stair design may need to change to optimize user safety.

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