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Canadian C-Spine

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https://www.readbyqxmd.com/read/28947011/clinical-prediction-rules-the-importance-of-the-validation-phase
#1
Anick Nater, Michael G Fehlings
Commentary On: Hicks K.E., Zhao Y., Fallah N, Rivers C, Noonan V, Plashkes T, Wai EK, Roffey DM, Tsai E, Paquet J, Attabib N, Marion T, Ahn H, Phan P. A simplified clinical prediction rule for prognosticating independent walking after spinal cord injury: a prospective study from a Canadian multicenter spinal cord injury registry. The Spine Journal. Article in press.
October 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28940048/validity-and-reliability-of-clinical-prediction-rules-used-to-screen-for-cervical-spine-injury-in-alert-low-risk-patients-with-blunt-trauma-to-the-neck-part-2-a-systematic-review-from-the-cervical-assessment-and-diagnosis-research-evaluation-cadre-collaboration
#2
REVIEW
N Moser, N Lemeunier, D Southerst, H Shearer, K Murnaghan, D Sutton, P Côté
PURPOSE: To update findings of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) on the validity and reliability of clinical prediction rules used to screen for cervical spine injury in alert low-risk adult patients with blunt trauma to the neck. METHODS: We searched four databases from 2005 to 2015. Pairs of independent reviewers critically appraised eligible studies using the modified QUADAS-2 and QAREL criteria...
September 22, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28844294/cervical-spine-collar-removal-by-emergency-room-nurses-a-quality-improvement-project
#3
Guillaume Fontaine, Massimo Forgione, Francis Lusignan, Marc-André Lanoue, Simon Drouin
INTRODUCTION: The Canadian C-Spine Rule (CCR) is a clinical decision aid to facilitate the safe removal of cervical collars in the alert, orientated, low-risk adult trauma patient. Few health care settings have assessed initiatives to train charge nurses to use the CCR. This practice improvement project conducted in a secondary trauma center in Canada aimed to (1) train charge nurses of the emergency room to use the CCR, (2) monitor its use throughout the project period, and (3) compare the assessments of the charge nurses with those of emergency physicians...
August 22, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28728206/-subaxial-cervical-spine-injuries-treatment-recommendations-of-the-german-orthopedic-and-trauma-society
#4
Philipp Schleicher, Matti Scholz, Frank Kandziora, Andreas Badke, Florian Hans Brakopp, Helmut Klaus Friedrich Ekkerlein, Erol Gercek, Rene Hartensuer, Philipp Hartung, Jan-Sven Gilbert Jarvers, Philipp Kobbe, Stefan Matschke, Robert Morrison, Christian W Müller, Miguel Pishnamaz, Maximilian Reinhold, Klaus John Schnake, Gregor Schmeiser, Gregor Stein, Bernhard Ullrich, Thomas Weiß, Volker Zimmermann
In a consensus process during four sessions in 2016, the working group "lower cervical spine" of the German Society for Orthopedic and Trauma Surgery (DGOU), formulated "Therapeutic Recommendations for the Lower Cervical Spine", taking into consideration the current literature. Therapeutic goals are a permanently stable, painless cervical spine and the protection against secondary neurologic damage while retaining the greatest possible amount of motion and spinal profile. Due to its ease of use and its proven good reliability, the AOSpine classification for subaxial cervical injuries should be used...
October 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28722766/comparative-analysis-of-the-radiology-of-osteoporotic-vertebral-fractures-in-women-and-men-cross-sectional-and-longitudinal-observations-from-the-canadian-multicentre-osteoporosis-study-camos
#5
Brian C Lentle, Claudie Berger, Linda Probyn, Jacques P Brown, Lisa Langsetmo, Ben Fine, Kevin Lian, Arvind K Shergill, Jacques Trollip, Stuart Jackson, William D Leslie, Jerilynn C Prior, Stephanie M Kaiser, David A Hanley, Jonathan D Adachi, Tanveer Towheed, K Shawn Davison, Angela M Cheung, David Goltzman
We compared two methods for osteoporotic vertebral fracture (VF) assessment on lateral spine radiographs, the Genant semiquantitative (GSQ) technique and a modified algorithm-based qualitative (mABQ) approach. We evaluated 4465 women and 1771 men aged ≥50 years from the Canadian Multicentre Osteoporosis Study with available X-ray images at baseline. Observer agreement was lowest for grade 1 VFs determined by GSQ. Among physician readers, agreement was greater for VFs diagnosed by mABQ (ranging from 0.62 [95% confidence interval (CI) 0...
July 19, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28673827/the-impact-of-spine-stability-on-cervical-spinal-cord-injury-with-respect-to-demographics-management-and-outcome-a-prospective-cohort-from-a-national-spinal-cord-injury-registry
#6
Jérôme Paquet, Carly S Rivers, Dilnur Kurban, Joel Finkelstein, Jin W Tee, Vanessa K Noonan, Brian K Kwon, R John Hurlbert, Sean Christie, Eve C Tsai, Henry Ahn, Brian Drew, Christopher S Bailey, Daryl R Fourney, Najmedden Attabib, Michael G Johnson, Michael G Fehlings, Stefan Parent, Marcel F Dvorak
BACKGROUND CONTEXT: Emergent surgery for patients with a traumatic spinal cord injury (SCI) is seen as the gold standard in acute management. However, optimal treatment for those with the clinical diagnosis of central cord syndrome (CCS) is less clear, and classic definitions of CCS do not identify a unique population of patients. PURPOSE: The study aimed to test the authors' hypothesis that spine stability can identify a unique group of patients with regard to demographics, management, and outcomes, which classic CCS definitions do not...
July 1, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28554588/pathologic-c-spine-fracture-with-low-risk-mechanism-and-normal-physical-exam
#7
Andrew Hunter, Jolion McGreevy, Judith Linden
Cervical spinal fracture is a rare, but potentially disabling complication of trauma to the neck. Clinicians often rely on clinical decision rules and guidelines to decide whether or not imaging is necessary when a patient presents with neck pain. Validated clinical guidelines include the Canadian C-Spine Rule and the Nexus criteria. Studies suggest that the risks of a pathologic fracture from a simple rear end collision are negligible. We present a case of an individual who presented to an emergency department (ED) after a low speed motor vehicle collision complaining of lateral neck pain and had multiple subsequent visits for the same complaint with negative exam findings...
September 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28275838/economic-evaluation-of-a-population-based-osteoporosis-intervention-for-outpatients-with-non-traumatic-non-hip-fractures-the-catch-a-break-1i-type-c-fls
#8
S R Majumdar, D A Lier, D A Hanley, A G Juby, L A Beaupre
Fracture liaison services (FLS) are advocated to improve osteoporosis treatment after fragility fracture, but there are few economic analyses of different models. A population-based 1i [=type C] FLS for non-hip fractures was implemented and it costs $44 per patient and it was very cost-effective ($9200 per QALY gained). Small operational changes would convert it from cost-effective to cost-saving. INTRODUCTION: After fragility fracture, <20% of patients receive osteoporosis treatment...
June 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28251880/choosing-wisely-canada%C3%A2-five-tests-procedures-and-treatments-to-question-in-emergency-medicine
#9
Amy H Y Cheng, Sam Campbell, Lucas B Chartier, Tom Goddard, Kirk Magee, Jill McEwen, Atul K Kapur, Brian R Holroyd, Suneel Upadhye, Stephanie Couperthwaite, Brian H Rowe
OBJECTIVES: Choosing Wisely Canada (CWC) is an initiative to encourage patient-physician discussions about the appropriate, evidence based use of medical tests, procedures and treatments. We present the Canadian Association of Emergency Physicians' (CAEP) top five list of recommendations, and the process undertaken to generate them. METHODS: The CAEP Expert Working Group (EWG) generated a candidate list of 52 tests, procedures, and treatments in emergency medicine whose value to care was questioned...
March 2, 2017: CJEM
https://www.readbyqxmd.com/read/28034592/densitometer-specific-differences-in-the-correlation-between-body-mass-index-and-lumbar-spine-trabecular-bone-score
#10
Gillian Mazzetti, Claudie Berger, William D Leslie, Didier Hans, Lisa Langsetmo, David A Hanley, Christopher S Kovacs, Jerrilyn C Prior, Stephanie M Kaiser, K Shawn Davison, Robert Josse, Alexandra Papaioannou, Jonathan R Adachi, David Goltzman, Suzanne N Morin
Trabecular bone score (TBS) is a gray-level texture measure derived from lumbar spine dual-energy X-ray absorptiometry (DXA) images that predicts fractures independent of bone mineral density (BMD). Increased abdominal soft tissue in individuals with elevated body mass index (BMI) absorbs more X-rays during image acquisition for BMD measurement and must be accommodated by the TBS algorithm. We aimed to determine if the relationship between BMI and TBS varied between 2 major manufacturers' densitometers, because different densitometers accommodate soft tissues differently...
April 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/27842904/yield-of-computed-tomography-of-the-cervical-spine-in-cases-of-simple-assault
#11
Matthew L Uriell, Jason W Allen, Brendan P Lovasik, Marc D Benayoun, Robert M Spandorfer, Chad A Holder
BACKGROUND: Computed tomography (CT) of the cervical spine (C-spine) is routinely ordered for low-impact, non-penetrating or "simple" assault at our institution and others. Common clinical decision tools for C-spine imaging in the setting of trauma include the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian Cervical Spine Rule for Radiography (CCR). While NEXUS and CCR have served to decrease the amount of unnecessary imaging of the C-spine, overutilization of CT is still of concern...
January 2017: Injury
https://www.readbyqxmd.com/read/27506928/the-annual-marine-feeding-aggregation-of-atlantic-sturgeon-acipenser-oxyrinchus-in-the-inner-bay-of-fundy-population-characteristics-and-movement
#12
M J Dadswell, S A Wehrell, A D Spares, M F Mclean, J W Beardsall, L M Logan-Chesney, G S Nau, C Ceapa, A M Redden, M J W Stokesbury
Atlantic sturgeon Acipenser oxyrinchus aggregate to feed from May to October in Minas Basin (45° N; 64° W), a large, cul-de-sac embayment of the inner Bay of Fundy. The aggregation consists mainly of migrants from the Saint John, NB and Kennebec Rivers, ME (99%). During 2004-2015, 4393 A. oxyrinchus were taken as by-catch by commercial fish trawlers or at intertidal fishing weirs, and 1453 were marked and/or sampled and released. Fork length (LF ) ranged from 458 to 2670 mm, but 72·5% were <1500 mm. Mass (M) ranged from 0·5 to 58·0 kg...
October 2016: Journal of Fish Biology
https://www.readbyqxmd.com/read/27477359/retraction-notice-to-kidney-function-and-rate-of-bone-loss-at-the-hip-and-spine-the-canadian-multicentre-osteoporosis-study-am-j-kidney-dis-55-2-291-299
#13
Sophie A Jamal, Victoria J D Swan, Jacques P Brown, David A Hanley, Jerilynn C Prior, Alexandra Papaioannou, Lisa Langsetmo, Robert G Josse
No abstract text is available yet for this article.
August 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27454805/utility-of-computed-tomographic-imaging-of-the-cervical-spine-in-trauma-evaluation-of-ground-level-fall
#14
Marc D Benayoun, Jason W Allen, Brendan P Lovasik, Matthew L Uriell, Robert M Spandorfer, Chad A Holder
BACKGROUND: Computed tomography (CT) of the cervical spine (C-spine) is routinely ordered for low-risk mechanisms of injury, including ground-level fall. Two commonly used clinical decision rules (CDRs) to guide C-spine imaging in trauma are the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian Cervical Spine Rule for Radiography (CCR). METHODS: Retrospective cross-sectional study of 3,753 consecutive adult patients presenting to an urban Level I emergency department who received C-spine CT scans were obtained over a 6-month period...
August 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27330655/prospective-validation-of-modified-nexus-cervical-spine-injury-criteria-in-low-risk-elderly-fall-patients
#15
John Tran, Donald Jeanmonod, Darin Agresti, Khalief Hamden, Rebecca K Jeanmonod
INTRODUCTION: The National Emergency X-radiography Utilization Study (NEXUS) criteria are used extensively in emergency departments to rule out C-spine injuries (CSI) in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation...
May 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27161303/the-canadian-c-spine-rule
#16
Bruno Tirotti Saragiotto, Zoe A Michaleff
No abstract text is available yet for this article.
July 2016: Journal of Physiotherapy
https://www.readbyqxmd.com/read/27032898/a-comparison-of-two-methods-to-evaluate-a-narrow-spinal-canal-routine-magnetic-resonance-imaging-versus-three-dimensional-reconstruction
#17
COMPARATIVE STUDY
Luciana Gazzi Macedo, Anna Bodnar, Michele C Battié
BACKGROUND CONTEXT: In routine clinical practice, the presence of lumbar spinal stenosis (LSS) is assessed on axial magnetic resonance images (MRI) typically acquired using a preselected spine sagittal angle. Given the natural lordosis of the lumbar spine, not all axial slices will be parallel to the disc and perpendicular to the spinal canal and, thus, are not optimal for the assessment of dural sac cross-sectional area (DCSA). PURPOSE: The objective of this study was to compare DCSA measurements from routinely acquired clinical images with three-dimensional (3D)-reconstructed images...
July 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27032009/utility-of-computed-tomography-imaging-of-the-cervical-spine-in-trauma-evaluation-of-ground-level-fall
#18
Marc D Benayoun, Jason W Allen, Brendan P Lovasik, Matthew Uriell, Robert M Spandorfer, Chad A Holder
BACKGROUND: CT of the cervical spine is routinely ordered for low-risk mechanisms of injury, including ground level fall (GLF). Two commonly employed clinical decision rules (CDRs) to guide C-spine imaging in trauma are the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian Cervical Spine Rule for Radiography (CCR). METHODS: Retrospective cross-sectional study of 3,753 consecutive adult patients presenting to an urban Level I ED who received C-spine CT scans were obtained over a six month period...
March 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26827890/cervical-spine-evaluation-in-the-bluntly-injured-patient
#19
REVIEW
Tanya L Zakrison, Brian H Williams
BACKGROUND: Cervical spine injuries causing spinal cord trauma are rare in blunt trauma yet lead to devastating morbidity and mortality when they occur. There exists considerable debate in the literature about the best way for clinicians to proceed in ruling out cervical spine injuries in alert or obtunded blunt trauma patients. METHODS: We reviewed the current literature and practice management guidelines to generate clinical recommendations for the detection and clearance of cervical spine injuries in the blunt trauma patient...
September 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/26796288/facilitators-and-barriers-to-application-of-the-canadian-c-spine-rule-by-emergency-department-triage-nurses
#20
Catherine M Clement, Ian G Stiell, Maureen A Lowe, Jamie C Brehaut, Lisa A Calder, Christian Vaillancourt, Jeffrey J Perry
OBJECTIVES: We recently conducted a multicentre implementation study on the use of the Canadian C-Spine Rule (CCR) by emergency department (ED) nurses to clear the c-spine in alert and stable trauma patients (n = 4506). The objective of this study was to conduct a survey of nurses, physicians, and administrators to evaluate their views on the facilitators and barriers to the implementation of the CCR. METHODS: We conducted both a paper-based and an electronic survey of the three different ED hospital staff groups of nine large teaching hospitals in Ontario, including six regional trauma centres...
July 2016: International Emergency Nursing
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