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Canadian guidelines

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https://www.readbyqxmd.com/read/28936069/prehospital-management-of-acute-stroke-in-rural-versus-urban-responders
#1
Gregory Hansen, Simerpreet Bal, Kerri Lynn Schellenberg, Susan Alcock, Esseddeeg Ghrooda
OBJECTIVE: Stroke guideline compliance of rural Canadian prehospital emergency medical services (EMS) care in acute stroke is unknown. In this quality assurance study, we sought to compare rural and urban care by prehospital EMS evaluation/management indicators from patients assessed at an urban Canadian stroke center. MATERIALS AND METHODS: One hundred adult patients were randomly selected from the stroke registry. Patients were transported through Rural EMS bypass protocols or urban EMS protocols (both bypass and direct) to our stroke center between January and December 2013...
August 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28935065/no-250-recurrent-urinary-tract-infection
#2
Annette Epp, Annick Larochelle
OBJECTIVE: To provide an update of the definition, epidemiology, clinical presentation, investigation, treatment, and prevention of recurrent urinary tract infections in women. OPTIONS: Continuous antibiotic prophylaxis, post-coital antibiotic prophylaxis, and acute self-treatment are all efficient alternatives to prevent recurrent urinary tract infection. Vaginal estrogen and cranberry juice can also be effective prophylaxis alternatives. EVIDENCE: A search of PubMed and The Cochrane Library for articles published in English identified the most relevant literature...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28935064/no-231-guidelines-for-the-management-of-vasa-previa
#3
Robert Gagnon
OBJECTIVES: To describe the etiology of vasa previa and the risk factors and associated condition, to identify the various clinical presentations of vasa previa, to describe the ultrasound tools used in its diagnosis, and to describe the management of vasa previa. OUTCOMES: Reduction of perinatal mortality, short-term neonatal morbidity, long-term infant morbidity, and short-term and long-term maternal morbidity and mortality. EVIDENCE: Published literature on randomized trials, prospective cohort studies, and selected retrospective cohort studies was retrieved through searches of PubMed or Medline, CINAHL, and the Cochrane Library, using appropriate controlled vocabulary (e...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28935062/no-260-ultrasound-in-twin-pregnancies
#4
Lucie Morin, Kenneth Lim
OBJECTIVE: To review the literature with respect to the use of diagnostic ultrasound in the management of twin pregnancies. To make recommendations for the best use of ultrasound in twin pregnancies. OUTCOMES: Reduction in perinatal mortality and morbidity and short- and long-term neonatal morbidity in twin pregnancies. Optimization of ultrasound use in twin pregnancies. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library in 2008 and 2009 using appropriate controlled vocabulary (e...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28935057/no-349-substance-use-in-pregnancy
#5
Alice Ordean, Suzanne Wong, Lisa Graves
OBJECTIVES: To improve awareness and knowledge of problematic substance use in pregnancy and to provide evidence-based recommendations for the management of this challenging clinical issue for all health care providers. OPTIONS: This guideline reviews the use of screening tools, general approach to care, and recommendations for the clinical management of problematic substance use in pregnancy. OUTCOMES: Evidence-based recommendations for screening and management of problematic substance use during pregnancy and lactation...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28930365/duration-and-quality-of-sleep-among-canadians-aged-18-to-79
#6
Jean-Philippe Chaput, Suzy L Wong, Isabelle Michaud
This article provides recent estimates of the duration and quality of sleep of Canadian adults and of the percentage who adhere to sleep duration guidelines (7 to 9 hours per night at ages 18 to 64, and 7 to 8 hours per night at age 65 or older). The study is based on 10,976 respondents aged 18 to 79 from the 2007-to-2013 Canadian Health Measures Survey, a nationally representative, cross-sectional survey. Sleep duration and quality were self-reported. Mean sleep duration was 7.12 hours per night at ages 18 to 64 and 7...
September 20, 2017: Health Reports
https://www.readbyqxmd.com/read/28925929/canadian-guidelines-for-controlled-pediatric-donation-after-circulatory-determination-of-death-summary-report
#7
Matthew J Weiss, Laura Hornby, Bram Rochwerg, Michael van Manen, Sonny Dhanani, V Ben Sivarajan, Amber Appleby, Mary Bennett, Daniel Buchman, Catherine Farrell, Aviva Goldberg, Rebecca Greenberg, Ram Singh, Thomas A Nakagawa, William Witteman, Jill Barter, Allon Beck, Kevin Coughlin, Alf Conradi, Cynthia Cupido, Rosanne Dawson, Anne Dipchand, Darren Freed, Karen Hornby, Valerie Langlois, Cheryl Mack, Meagan Mahoney, Deepak Manhas, Christopher Tomlinson, Samara Zavalkoff, Sam D Shemie
OBJECTIVES: Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. METHODS: We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28925912/epidemiologic-features-of-invasive-group-a-streptococcus-infection-in-a-rural-hospital-6-year-retrospective-report-and-literature-review
#8
Kassandra Loewen, Natalie Bocking, Cai-Lei Matsumoto, Mike Kirlew, Len Kelly
INTRODUCTION: High rates of invasive group A Streptococcus disease were suspected by clinicians in northwestern Ontario. Patients with sepsis were being encountered with bacteremia positive for group A Streptococcus. This study was designed to assess the incidence of invasive group A Streptococcus infection in the region and provide best-practice treatment information. METHODS: We performed a retrospective chart review at the Sioux Lookout Meno Ya Win Health Centre (SLMHC) from 2009 to 2014 to examine rates of infection due to invasive group A Streptococcus and outcomes...
2017: Canadian Journal of Rural Medicine
https://www.readbyqxmd.com/read/28923185/sleep-duration-trends-and-trajectories-among-youth-in-the-compass-study
#9
Karen A Patte, Wei Qian, Scott T Leatherdale
OBJECTIVES: Limited Canadian studies have examined youth sleep over time. This study explored sleep duration over recent years among youth, patterns over the course of secondary school, and subgroups at greater risk of sleep deprivation and problematic trajectories. DESIGN: Longitudinal survey. PARTICIPANTS/SETTING: Secondary school students in Ontario and Alberta, Canada. MEASURES AND ANALYSES: In cross-sectional analyses, student-reported sleep duration was analyzed in three waves of the COMPASS study (Y2: 2013/2014, Y3: 2014/2015, Y4: 2015/2016), and differences by student-level (race/ethnicity, grade, sex) and school-level (urbanicity, median household income) variables were tested in the most recent wave...
October 2017: Sleep Health
https://www.readbyqxmd.com/read/28922268/early-exercise-in-critically-ill-youth-and-children-a-preliminary-evaluation-the-weecycle-pilot-trial
#10
Karen Choong, Saif Awladthani, Adeeb Khawaji, Heather Clark, Asm Borhan, Ji Cheng, Sam Laskey, Charmaine Neu, Aimee Sarti, Lehana Thabane, Brian W Timmons, Katina Zheng, Samah Al-Harbi
OBJECTIVES: To determine the feasibility of conducting a full trial evaluating the efficacy of early mobilization using in-bed cycling as an adjunct to physiotherapy, on functional outcomes in critically ill children. DESIGN: Single center, pilot, randomized controlled trial. SETTING: Twelve-bed tertiary care, medical-surgical PICU at McMaster Children's Hospital, Hamilton, ON, Canada. PATIENTS: Children 3-17 years old who were limited to bed-rest with an expected PICU stay of at least 48 hours...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28921833/guideline-of-guidelines-asymptomatic-microscopic-haematuria
#11
REVIEW
Brian J Linder, Edward J Bass, Hugh Mostafid, Stephen A Boorjian
OBJECTIVE: To review major organizational guidelines on the evaluation and management of asymptomatic microscopic haematuria (AMH). METHODS: This is a review of the haematuria guidelines from 1.) American Urological Association (AUA), 2.) consensus statement from the Canadian Urological Association, Canadian Urologic Oncology Group, and Bladder Cancer Canada, 3.) American College of Physicians (ACP), 4.) Joint Consensus Statement of the Renal Association (RA) and British Association of Urological Surgeons (BAUS), and 5...
September 16, 2017: BJU International
https://www.readbyqxmd.com/read/28903742/can-you-un-ring-the-bell-a-qualitative-study-of-how-affect-influences-cancer-screening-decisions
#12
S Michelle Driedger, Gary Annable, Melissa Brouwers, Donna Turner, Ryan Maier
BACKGROUND: The belief that early detection is the best protection against cancer underlies cancer screening. Emerging research now suggests harms associated with early detection may sometimes outweigh the benefits. Governments, cancer agencies, and organizations that publish screening guidelines have found it is difficult to "un-ring the bell" on the message that "early detection is your best protection" because of its widespread communication and enduring resonance. This study explores affective factors-and their interplay with relevant analytical factors-in public/laypersons' decision making about cancer screening...
September 13, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28893597/evaluation-of-a-provincial-intervention-to-reduce-redundant-hemoglobin-a1c-testing
#13
Irene Ma, Maggie Guo, Jeannine Viczko, Christopher Naugler
BACKGROUND: The Canadian Diabetes Association recommends testing most individuals with diabetes mellitus using HbA1c once every 3months. In Alberta, Canada, a provincial intervention to reduce inappropriate HbA1c test orders was implemented to align with this guideline, where only one HbA1c test request every 90days for most individuals can be processed. Here, we evaluated the provincial intervention to reduce redundant HbA1c testing in Alberta. METHODS: Total counts of all HbA1c tests ordered within Edmonton and Calgary, Alberta, were collected from the respective Laboratory Information Systems each month between January 2013 and December 2016...
September 8, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28886671/canadian-schizophrenia-guidelines-schizophrenia-and-other-psychotic-disorders-with-coexisting-substance-use-disorders
#14
David Crockford, Donald Addington
OBJECTIVE: Persons with schizophrenia and other psychotic disorders frequently have coexisting substance use disorders that require modifications to treatment approaches for best outcomes. The objectives of this review were to identify evidence-based practices best practices that improve outcomes for individuals with schizophrenia and substance used disorders. METHOD: We reviewed guidelines that were published in the last 5 years and that included systematic reviews or meta-analyses...
September 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28886670/canadian-treatment-guidelines-on-psychosocial-treatment-of-schizophrenia-in-children-and-youth
#15
Tania Lecomte, Sabina Abidi, Iliana Garcia-Ortega, Irfan Mian, Kevin Jackson, Kim Jackson, Ross Norman
OBJECTIVE: A panel of experts, including researchers, clinicians and people with lived experience, was brought together to develop the new Canadian schizophrenia guidelines for the psychosocial treatment of children and youth with schizophrenia or psychotic disorders. METHOD: The ADAPTE process, which relies on adapting existing high-quality guidelines, was used. Existing guidelines for children and youth (mostly from the National Institute for Health and Care Excellence [NICE]), as well as CPA adult guidelines, were reviewed and discussed in terms of their adaptability to the Canadian context and their level of recommendation for children and youth...
September 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28886669/canadian-practice-guidelines-for-comprehensive-community-treatment-for-schizophrenia-and-schizophrenia-spectrum-disorders
#16
Donald Addington, Elizabeth Anderson, Martina Kelly, Alain Lesage, Chris Summerville
OBJECTIVE: The objective of this review is to identify the features and components of a comprehensive system of services for people living with schizophrenia. A comprehensive system was conceived as one that served the full range of people with schizophrenia and was designed with consideration of the incidence and prevalence of schizophrenia. The system should provide access to the full range of evidence-based services, should be recovery oriented, and should provide patient-centred care...
September 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28882920/the-hat-trick-programme-for-improving-physical-activity-healthy-eating-and-connectedness-among-overweight-inactive-men-study-protocol-of-a-pragmatic-feasibility-trial
#17
Cristina M Caperchione, Joan L Bottorff, John L Oliffe, Steven T Johnson, Kate Hunt, Paul Sharp, Kayla M Fitzpatrick, Ryley Price, S Larry Goldenberg
INTRODUCTION: Physical activity, healthy eating and maintaining a healthy weight are associated with reduced risk of cardiovascular disease, type 2 diabetes and cancer and with improved mental health. Despite these benefits, many men do not meet recommended physical activity guidelines and have poor eating behaviours. Many health promotion programmes hold little appeal to men and consequently fail to influence men's health practices. HAT TRICK was designed as a 12-week face-to-face, gender-sensitised intervention for overweight and inactive men focusing on physical activity, healthy eating and social connectedness and was delivered in collaboration with a major junior Canadian ice hockey team (age range 16-20 years)...
September 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28874892/treatment-patterns-and-trends-in-patients-dying-of-prostate-cancer-in-quebec-a-population-based-study
#18
A Dragomir, J Rocha, M Vanhuyse, F L Cury, W Kassouf, J Hu, A G Aprikian
INTRODUCTION: Since just after the year 2000 in Quebec, the management of metastatic castration-resistant prostate cancer (mcrpc) has evolved considerably, with the inclusion of docetaxel-based chemotherapy, bone-targeted therapies (zoledronic acid and denosumab), and more recently, abiraterone, enzalutamide, and cabazitaxel for docetaxel-refractory patients. In the present study, we aimed to analyze contemporary mcrpc management patterns and therapy utilization trends in Quebec. METHODS: The study cohort consisted of patients dying of prostate cancer (pca) between January 2001 and December 2013, selected from Quebec public health care insurance databases...
August 2017: Current Oncology
https://www.readbyqxmd.com/read/28866763/bone-health-is-maintained-while-fat-mass-is-reduced-in-pre-pubertal-children-with-obesity-participating-in-a-1-year-family-centered-lifestyle-intervention
#19
Tamara R Cohen, Tom J Hazell, Catherine A Vanstone, Celia Rodd, Hope A Weiler
Diet and physical activity (PA) influence bone health in children. This study tested whether increasing milk and milk products and weight-bearing types of PA favorably changed bone outcomes assessed by dual-energy X-ray absorptiometry (DXA) and bone biomarkers in children with obesity participating in a 1-year family-centered lifestyle intervention. Children were randomized to one of three groups: Control (Ctrl; no intervention), Standard treatment (StnTx: two servings milk and milk products/day; meet PA guidelines plus weight-bearing PA three times/week), or Modified treatment (ModTx: four servings milk and milk products/day; meet PA guidelines plus daily weight-bearing PA)...
September 2, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/28862104/regulatory-framework-for-conducting-clinical-research-in-canada
#20
Josmar K Alas, Glenys Godlovitch, Connie M Mohan, Shelly A Jelinski, Aneal A Khan
Research in human subjects is at the core of achieving improvements in health outcomes. For clinical trials, in addition to the peer review of the results before publication, it is equally important to consider whether the trial will be conducted in a manner that generates data of the highest quality and provides a measure of safety for the participating subjects. In Canada, there is no definitive legislation that governs the conduct of research involving human subjects, but a network of regulations at different levels does provide a framework for both principal investigators and sponsors...
September 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
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