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Winter is always the best time for reading. A fire, a cup of cocoa, and the Osteopathic Family Physician.

In this edition we have a review article on electronic cigarettes. When asking about smoking, is the question phrased in a way that the patient might be talking about electronic cigarettes? After reading the article this month, we knew that propylene glycol is commonly vaporized. The “vapes” also contain nicotine and various flavors and chemicals.

Smoking cannabis and cannabis oils can be part of the use of these devices. The article reviews the various devices and the fact that they can be purchased in many places, including on-line.

Thrombotic Thrombocytopenic Purpura-Hemolytic Uremic Syndrome-An Evidence Based Clinical Review presents a case embedded in a review article on the topic. Patients may have renal impairment, thrombocytopenia, microangiopathic hemolytic anemia, fever and or neurologic deficits. Depending on when in the course of the disease the patient presents, all the elements may not be present when first seen. Plasma exchange is the mainstay of treatment, so nephrology consultation is in order. The authors have done a nice review which is included in this volume.

The clinical image articles continue in this edition and are always a quick learning item. One is an elder with a fracture and the other a young adult with a rash and ocular findings.

The research article this month studies us, osteopathic family physicians and what we believe about our patient’s adherence to diabetes medicine. We apparently think they do what we suggest. The response rate was low, but it is an interesting read.

It has been my honor to edit this journal for the past three years after serving as associate editor for the prior three years. Dr. Januchowski will take over as editor after this edition. Please consider writing or reviewing for the Journal.