المؤلفون: Dixon, Claire, Holloway, Laureen, Lee, Teresa, Lo, Nick, Meier, Janice, Reid, Darlene

مصطلحات موضوعية: Physical Therapy, Physiotherapy, Systematic Review, Chronic Achilles Tendinopathy, Exercise

الوصف: Recorded by Eugene Barsky, Physiotherapy Outreach Librarian, UBC
This is a Systematic Review Presentation titled - "Pain-enduring Eccentric Exercise for the Treatment of Chronic Achilles Tendinopathy", created by Master of Physical Therapy Graduating Students, University of British Columbia - 2006, Presented on September 14-15, 2006, Vancouver, BC, Canada

الإتاحة: http://hdl.handle.net/2429/89Test

المؤلفون: Vieira, Fernando N., Masy, Veronique, LaRue, Ryan J., Laengert, Scott E., De Lannoy, Charles F., Rodrigues, Antenor, Sklar, Michael C., Lo, Nick, Petrosoniak, Andrew, Rezende-Neto, Joao, Brochard, Laurent J.

المصدر: Respiratory Care; Apr2024, Vol. 69 Issue 4, p395-406, 12p

مصطلحات موضوعية: OXYGEN saturation, CONTINUING education units, INFECTION control, PATIENT safety, HUMAN anatomical models, ERGONOMICS, QUALITATIVE research, RESEARCH funding, AEROSOLS, RESPIRATION, DESCRIPTIVE statistics, ISOLATION (Hospital care), TRACHEA intubation, HIGH-frequency ventilation (Therapy), SIMULATION methods in education, NASAL cannula, PRESSURE breathing, AIRWAY (Anatomy), VACUUM

مصطلحات جغرافية: ONTARIO

مستخلص: BACKGROUND: Aerosol barrier enclosure systems have been designed to prevent airborne contamination, but their safety has been questioned. A vacuum tent was designed with active continuous suctioning to minimize risks of aerosol dispersion. We tested its efficacy, risk of rebreathing, and usability on a bench, in healthy volunteers, and in an ergonomic clinical assessment study. METHODS: First, a manikin with airway connected to a breathing simulator was placed inside the vacuum tent to generate active breathing, cough, and CO2 production; high-flow nasal cannula (HFNC) was applied in the manikin's nares. Negative pressure was applied in the vacuum tent's apex port using wall suction. Fluorescent microparticles were aerosolized in the vacuum tent for qualitative assessment. To quantify particles inside and around vacuum tent (aerosol retention), an airtight aerosol chamber with aerosolized latex microparticles was used. The vacuum tent was tested on healthy volunteers breathing with and without HFNC. Last, its usability was assessed in 5 subjects by 5 different anesthesiologists for delivery of full anesthesia, including intubation and extubation. RESULTS: The vacuum tent was adjusted until no leak was visualized using fluorescent particles. The efficacy in retaining microparticles was confirmed quantitatively. CO2 accumulation inside the vacuum tent showed an inverse correlation with the suction flow in all conditions (normal breathing and HFNC 30 or 60 L/min) in bench and healthy volunteers. Particle removal efficacy and safe breathing conditions (CO2, temperature) were reached when suctioning was at least 60 L/min or 20 L/min > HFNC flow. Five subjects were successfully intubated and anesthetized without ergonomic difficulties and with minimal interference with workflow and an excellent overall assessment by the anesthesiologists. CONCLUSIONS: The vacuum tent effectively minimized aerosol dispersion. Its continuous suction system set at a high suction flow was crucial to avoid the spread of aerosol particles and CO rebreathing. [ABSTRACT FROM AUTHOR]

: Copyright of Respiratory Care is the property of American Association for Respiratory Care and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Wu, Vincent, Lo, Nick, Lin, R. Jun, Zirkle, Molly, Anderson, Jennifer, Lee, John M.

المصدر: Annals of Otology, Rhinology & Laryngology ; volume 131, issue 9, page 941-945 ; ISSN 0003-4894 1943-572X

مصطلحات موضوعية: General Medicine, Otorhinolaryngology

الوصف: Objectives: Within Otolaryngology—Head and Neck Surgery (OHNS), obstructive sleep apnea (OSA) patients are frequently encountered. To implement policies and screening measures for admission of OSA patients undergoing ambulatory surgery, actual rates of admission must first be determined. We aimed to evaluate rates and reasons for admission of OSA patients after ambulatory OHNS surgery. Methods: Retrospective chart review was undertaken of all OSA patients undergoing elective day-surgery OHNS procedures at a tertiary center from January 1, 2018 to December 31, 2019. The primary outcome measure was percentage of OSA patients admitted to hospital after ambulatory OHNS surgery. Secondary outcome measures included reasons for admission. American Society of Anesthesiologists (ASA) score, perioperative complications, and patient demographics were captured. Results: There were 118 OSA patients, out of 1942 cases performed during the review period. Thirty-eight were excluded as the procedures were not considered ambulatory. The remaining 80 OSA patients were included for analysis, with an average age of 51.7, SD 13.8, and 30 (38%) females. The admission rate was 47.5% (38/80 patients). Admitted patients were older ( P = .0061), and had higher ASA ( P = .039). Indication for surgery or type of surgery did not differ among admitted and non-admitted patients. The majority of patients, 97% (37/38 patients), were admitted for post-operative monitoring. Conclusion: More than half of OSA patients did not require admission to hospital after ambulatory OHNS surgery, unaffected by indications for surgery or type of surgery. Higher ASA score and older age were found in admitted as compared to non-admitted patients.

الإتاحة: https://doi.org/10.1177/00034894211048783Test

المؤلفون: Hammond, Marjorie, Law, Vivian, de Launay, Keelia Quinn, Cooper, Jeanette, Togo, Elikem, Silveira, Kyle, MacKinnon, David, Lo, Nick, Ward, Sarah E., Chan, Stephen K. W., Straus, Sharon E., Fahim, Christine, Wong, Camilla L.

المصدر: Canadian Journal of Anesthesia; 20240101, Issue: Preprints p1-10, 10p

مستخلص: Purpose: There is variable and suboptimal use of fascia iliaca compartment nerve blocks (FICBs) in hip fracture care. Our objective was to use an evidence-based and theory-informed implementation science approach to analyze barriers and facilitators to timely administration of FICB and select evidence-based interventions to enhance uptake. Methods: We conducted a qualitative study at a single centre using semistructured interviews and site observations. We interviewed 35 stakeholders including health care providers, managers, patients, and caregivers. We mapped barriers and facilitators to the Theoretical Domains Framework (TDF) and Consolidated Framework for Implementation Research (CFIR). We compared the rate and timeliness of FICB administration before and after evidence-based implementation strategies were applied. Results: The study identified 18 barriers and 11 facilitators within seven themes of influences of FICB use: interpersonal relationships between health care professionals; clinician knowledge and skills related to FICB; roles, responsibilities, and processes for delivering FICB; perceptions on using FICB for pain; patient and caregiver perceptions on using FICB for pain; communication of hip fracture care between departments; and resources for delivering FICBs. We mapped the behaviour change domains to eight implementation strategies: restructure the environment, create and distribute educational materials, prepare patients to be active participants, perform audits and give feedback, use local opinion leaders, use champions, train staff on FICB procedures, and mandate change. We observed an increase in the rates of FICBs administered (48% vs65%) and a decrease in the median time to administration (1.63 vs0.81 days). Conclusion: Our study explains why FICBs are underused and shows that the TDF and CFIR provide a framework to identify barriers and facilitators to FICB implementation. The mapped implementation strategies can guide institutions to improve use of FICB in hip fracture care.

المؤلفون: Hammond, Marjorie, Law, Vivian, de Launay, Keelia Quinn, Cooper, Jeanette, Togo, Elikem, Silveira, Kyle, MacKinnon, David, Lo, Nick, Ward, Sarah E., Chan, Stephen K. W., Straus, Sharon E., Fahim, Christine, Wong, Camilla L.

المساهمون: Ontario Ministry of Health and Long-Term Care, CIHR

المصدر: Canadian Journal of Anesthesia/Journal canadien d'anesthésie ; ISSN 0832-610X 1496-8975

مصطلحات موضوعية: Anesthesiology and Pain Medicine, General Medicine

الإتاحة: https://doi.org/10.1007/s12630-023-02665-2Test

المؤلفون: Baker, James E., Pavenski, Katerina, Pirani, Razak A., White, Alexander, Kataoka, Mark, Waddell, James P., Ho, Alexander, Schemitsch, Emil H., Lo, Nick, Bogoch, Earl R., Pronovost, Antoine, Luke, Katherine, Howell, Alanna, Nassis, Anna, Tsui, Albert K. Y., Tanzini, Rosa Maria, Pulendrarajah, Robisa, Mazer, C. David, Freedman, John, Hare, Gregory M. T.

المصدر: Canadian Journal of Anesthesia/Journal canadien d'anesthésie ; volume 62, issue 11, page 1179-1187 ; ISSN 0832-610X 1496-8975

مصطلحات موضوعية: Anesthesiology and Pain Medicine, General Medicine

الإتاحة: https://doi.org/10.1007/s12630-015-0460-6Test

المؤلفون: Wu, Vincent¹, Lo, Nick², Lin, R. Jun¹, Zirkle, Molly¹, Anderson, Jennifer¹, Lee, John M.^1,3 john.lee@unityhealth.to

المصدر: Annals of Otology, Rhinology & Laryngology. Sep2022, Vol. 131 Issue 9, p941-945. 5p.

مصطلحات موضوعية: *NECK surgery, *HEAD surgery, *PATIENTS, *SURGICAL complications, *HOSPITAL admission & discharge, *COMPARATIVE studies, *SLEEP apnea syndromes, *GOVERNMENT policy, *AMBULATORY surgery, *OTOLARYNGOLOGY

مستخلص: Objectives: Within Otolaryngology--Head and Neck Surgery (OHNS), obstructive sleep apnea (OSA) patients are frequently encountered. To implement policies and screening measures for admission of OSA patients undergoing ambulatory surgery, actual rates of admission must first be determined. We aimed to evaluate rates and reasons for admission of OSA patients after ambulatory OHNS surgery. Methods: Retrospective chart review was undertaken of all OSA patients undergoing elective day-surgery OHNS procedures at a tertiary center from January 1, 2018 to December 31, 2019. The primary outcome measure was percentage of OSA patients admitted to hospital after ambulatory OHNS surgery. Secondary outcome measures included reasons for admission. American Society of Anesthesiologists (ASA) score, perioperative complications, and patient demographics were captured. Results: There were 118 OSA patients, out of 1942 cases performed during the review period. Thirty-eight were excluded as the procedures were not considered ambulatory. The remaining 80 OSA patients were included for analysis, with an average age of 51.7, SD 13.8, and 30 (38%) females. The admission rate was 47.5% (38/80 patients). Admitted patients were older (P = .0061), and had higher ASA (P = .039). Indication for surgery or type of surgery did not differ among admitted and non-admitted patients. The majority of patients, 97% (37/38 patients), were admitted for post-operative monitoring. Conclusion: More than half of OSA patients did not require admission to hospital after ambulatory OHNS surgery, unaffected by indications for surgery or type of surgery. Higher ASA score and older age were found in admitted as compared to non-admitted patients. [ABSTRACT FROM AUTHOR]

المؤلفون: Lo, Nick, Brull, Richard, Perlas, Anahi, Chan, Vincent W. S., McCartney, Colin J. L., Sacco, Raffaele, El-Beheiry, Hossam

المصدر: Canadian Journal of Anesthesia/Journal canadien d'anesthésie ; volume 55, issue 7, page 408-413 ; ISSN 0832-610X 1496-8975

مصطلحات موضوعية: Anesthesiology and Pain Medicine, General Medicine

الإتاحة: https://doi.org/10.1007/bf03016306Test

المؤلفون: Pavenski, Katerina, Ward, Sarah E., Hare, Gregory M.T., Freedman, John, Pulendrarajah, Robisa, Pirani, Razak A., Sheppard, Nicholas, Vance, Colm, White, Alexander, Lo, Nick, Waddell, James P., Ho, Alex, Schemitsch, Emil H., Kataoka, Mark, Bogoch, Earl R., Saini, Kiran, David Mazer, C., Baker, James E.

المصدر: Bone and Joint Institute

مصطلحات موضوعية: Medicine and Health Sciences

الوصف: © 2018 AABB BACKGROUND: Tranexamic acid (TXA) therapy is effective in reducing postoperative red blood cell (RBC) transfusion in total joint arthroplasty (TJA), yet uncertainty persists regarding comparative efficacy and safety among specific patient subgroups. We assessed the impact of a universal TXA protocol on RBC transfusion, postoperative hemoglobin (Hb), and adverse outcomes to determine whether TXA is safe and effective in TJA, both overall and in clinically relevant subgroups. STUDY DESIGN AND METHODS: A retrospective observational study was performed on patients undergoing TJA at our institution spanning 1 year before and after the implementation of a universal protocol to administer intravenous (IV) TXA. The primary outcome was percentage of patients transfused, and secondary outcomes were perioperative Hb and occurrence of adverse events (death, myocardial infarction, stroke, seizure, pulmonary embolism, deep vein thrombosis, and acute kidney injury). Outcomes were compared in pre- and post-protocol groups with χ 2 analysis. Logistic regression compared risk of transfusion in pre- and post-protocol subgroups of patients with differing risk for transfusion (anemia, body mass index [BMI], and sex). RESULTS: No differences were found in baseline patient characteristics across pre- and post-protocol groups (n = 1084 and 912, respectively). TXA use increased from 32.3% to 92.2% while transfusion rates decreased from 10.3% to 4.8% (p < 0.001). Postoperative Day 3 Hb increased from 95.8 to 101.4 g/L (p < 0.001). Logistic regression demonstrated reduced transfusion in post-protocol subgroups regardless of sex, anemia, or BMI (p < 0.001). No increase in adverse events was observed (p = 0.8451). CONCLUSIONS: Universal TXA was associated with a reduction of RBC transfusion, overall and in clinically relevant subgroups, strengthening the rationale for universal therapy.

العلاقة: https://ir.lib.uwo.ca/boneandjointpub/1056Test

الإتاحة: https://doi.org/10.1111/trf.14995Test
https://ir.lib.uwo.ca/boneandjointpub/1056Test

المؤلفون: Pavenski, Katerina, Ward, Sarah E., Hare, Gregory M.T., Freedman, John, Pulendrarajah, Robisa, Pirani, Razak A., Sheppard, Nicholas, Vance, Colm, White, Alexander, Lo, Nick, Waddell, James P., Ho, Alex, Schemitsch, Emil H., Kataoka, Mark, Bogoch, Earl R., Saini, Kiran, David Mazer, C., Baker, James E.

المساهمون: University of Toronto, Department of Anesthesia Merit Awards, St. Michael's Hospital Academic Health Science Center Alternative Funding Plan Innovation Fund

المصدر: Transfusion ; volume 59, issue 1, page 207-216 ; ISSN 0041-1132 1537-2995

الوصف: BACKGROUND Tranexamic acid (TXA) therapy is effective in reducing postoperative red blood cell (RBC) transfusion in total joint arthroplasty (TJA), yet uncertainty persists regarding comparative efficacy and safety among specific patient subgroups. We assessed the impact of a universal TXA protocol on RBC transfusion, postoperative hemoglobin (Hb), and adverse outcomes to determine whether TXA is safe and effective in TJA, both overall and in clinically relevant subgroups. STUDY DESIGN AND METHODS A retrospective observational study was performed on patients undergoing TJA at our institution spanning 1 year before and after the implementation of a universal protocol to administer intravenous (IV) TXA. The primary outcome was percentage of patients transfused, and secondary outcomes were perioperative Hb and occurrence of adverse events (death, myocardial infarction, stroke, seizure, pulmonary embolism, deep vein thrombosis, and acute kidney injury ). Outcomes were compared in pre‐ and post‐protocol groups with χ 2 analysis. Logistic regression compared risk of transfusion in pre‐ and post‐protocol subgroups of patients with differing risk for transfusion (anemia, body mass index [BMI], and sex). RESULTS No differences were found in baseline patient characteristics across pre‐ and post‐protocol groups (n = 1084 and 912, respectively). TXA use increased from 32.3% to 92.2% while transfusion rates decreased from 10.3% to 4.8% (p < 0.001). Postoperative Day 3 Hb increased from 95.8 to 101.4 g/L (p < 0.001). Logistic regression demonstrated reduced transfusion in post‐protocol subgroups regardless of sex, anemia, or BMI (p < 0.001). No increase in adverse events was observed (p = 0.8451). CONCLUSIONS Universal TXA was associated with a reduction of RBC transfusion, overall and in clinically relevant subgroups, strengthening the rationale for universal therapy.

الإتاحة: https://doi.org/10.1111/trf.14995Test