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https://www.readbyqxmd.com/read/28506439/clinical-review-loperamide-toxicity
#1
REVIEW
Peter E Wu, David N Juurlink
Loperamide is a nonprescription opioid widely used for the treatment of diarrhea. Although it is relatively safe at therapeutic doses, increasing reports describe its misuse and abuse at very high doses either for euphoric effects or to attenuate symptoms of opioid withdrawal. Life-threatening loperamide toxicity can result from the relatively new clinical syndrome of loperamide-induced cardiac toxicity. These patients are often young and may present in cardiac arrest or with unheralded, recurrent syncope in conjunction with ECG abnormalities, including marked QT-interval prolongation, QRS-interval widening, and ventricular dysrhythmias...
May 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28495030/intubation-and-salicylate-overdose
#2
Sophie Gosselin, Josh J Wang, Eric Villeneuve, David Juurlink, Robert S Hoffman
No abstract text is available yet for this article.
April 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28489463/comment-on-shively-et%C3%A2-al-acute-salicylate-poisoning-risk-factors-for-severe-outcome
#3
Jonathan Zipursky, David N Juurlink
No abstract text is available yet for this article.
July 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28489462/response-to-juurlink-letter-comment-on-shively-et%C3%A2-al-acute-salicylate-poisoning-risk-factors-for-severe-outcome
#4
Rachel M Shively, Robert S Hoffman, Alex F Manini
No abstract text is available yet for this article.
July 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28483845/guideline-for-opioid-therapy-and-chronic-noncancer-pain
#5
Jason W Busse, Samantha Craigie, David N Juurlink, D Norman Buckley, Li Wang, Rachel J Couban, Thomas Agoritsas, Elie A Akl, Alonso Carrasco-Labra, Lynn Cooper, Chris Cull, Bruno R da Costa, Joseph W Frank, Gus Grant, Alfonso Iorio, Navindra Persaud, Sol Stern, Peter Tugwell, Per Olav Vandvik, Gordon H Guyatt
No abstract text is available yet for this article.
May 8, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28421551/macrolides-digoxin-toxicity-and-the-risk-of-sudden-death-a-population-based-study
#6
Kieran L Quinn, Erin M Macdonald, Tara Gomes, Muhammad M Mamdani, Anjie Huang, David N Juurlink
INTRODUCTION: Digoxin is commonly prescribed to elderly patients with heart failure and atrial fibrillation, and macrolide antibiotics markedly increase the risk of digoxin toxicity. OBJECTIVE: The aim was to determine whether, in older patients receiving digoxin, macrolide antibiotics are associated with sudden death. METHODS: We used a population-based, nested, case-control design from January 1, 1994 to December 31, 2012 in a cohort of Ontario residents aged 66 years or older prescribed digoxin...
April 18, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28340102/impact-of-unrestricted-access-to-pregabalin-on-the-use-of-opioids-and-other-cns-active-medications-a-cross-sectional-time-series-analysis
#7
Herman Kwok, Wayne Khuu, Kimberly Fernandes, Diana Martins, Mina Tadrous, Samantha Singh, David N Juurlink, Tara Gomes
Objective. : Access to pregabalin via Ontario's public drug insurance program was expanded to an unrestricted model on April 1, 2013, from a prior authorization model. This study aims to identify the effect of expanded access on the rate of pregabalin use by publicly insured persons and to assess the characteristics of new patients initiating pregabalin following this expanded access. Methods. : We conducted a cross-sectional time series analysis using the linked health administrative records of residents of Ontario, Canada, with public drug coverage who were dispensed a prescription for pregabalin between April 1, 2006, and December 31, 2014...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28338548/lipophilic-%C3%AE-blockers-and-suicide-in-the-elderly
#8
Jonathan S Zipursky, Erin M Macdonald, Jin Luo, Tara Gomes, Muhammad M Mamdani, J Michael Paterson, David N Juurlink
No abstract text is available yet for this article.
June 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28323632/exposure-of-pt-5%C3%A2-5%C3%A2-3-and-rh-1%C3%A2-1%C3%A2-1-to-atomic-and-molecular-oxygen-do-defects-enhance-subsurface-oxygen-formation
#9
Rachael G Farber, Marie E Turano, Eleanor C N Oskorep, Noelle T Wands, Ludo B F Juurlink, Daniel R Killelea
Subsurface oxygen is known to form in transition metals, and is thought to be an important aspect of their ability to catalyze chemical reactions. The formation of subsurface oxygen is not, however, equivalent across all catalytically relevant metals. As a result, it is difficult to predict the stability and ease of the formation of subsurface oxygen in metals, as well as how the absorbed oxygen affects the chemical and physical properties of the metal. In comparing how a stepped platinum surface, Pt(5 5 3), responds to exposure to gas-phase oxygen atoms under ultra-high vacuum conditions to planar Rh(1 1 1), we are able to determine what role, if any, steps have on the capacity of a metal for subsurface oxygen formation...
April 26, 2017: Journal of Physics. Condensed Matter: An Institute of Physics Journal
https://www.readbyqxmd.com/read/28248145/better-studies-are-needed-to-guide-treatment-of-carbon-monoxide-poisoning
#10
David N Juurlink, Nicholas A Buckley, Michael Eddleston
No abstract text is available yet for this article.
March 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28246253/association-between-statin-use-and-ischemic-stroke-or-major-hemorrhage-in-patients-taking-dabigatran-for-atrial-fibrillation
#11
Tony Antoniou, Erin M Macdonald, Zhan Yao, Simon Hollands, Tara Gomes, Mina Tadrous, Muhammad M Mamdani, David N Juurlink
BACKGROUND: Dabigatran etexilate is a prodrug whose absorption is opposed by intestinal P-glycoprotein and which is converted by carboxylesterase to its active form, dabigatran. Unlike other statins, simvastatin and lovastatin are potent inhibitors of P-glycoprotein and carboxylesterase, and might either increase the risk of hemorrhage with dabigatran etexilate or decrease its effectiveness. METHODS: We conducted 2 population-based, nested case-control studies involving Ontario residents 66 years of age and older who started dabigatran etexilate between May 1, 2012, and Mar...
January 9, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28219963/overdose-risk-in-young-children-of-women-prescribed-opioids
#12
Yaron Finkelstein, Erin M Macdonald, Alejandro Gonzalez, Marco L A Sivilotti, Muhammad M Mamdani, David N Juurlink
BACKGROUND AND OBJECTIVE: Over the past 20 years, the prescribing of opioids has increased dramatically in North America, with parallel increases in opioid addiction, overdose, and associated deaths. We examined whether young children of women prescribed opioids were at increased risk of opioid overdose. METHODS: We conducted a population-based, nested case control study in Ontario, Canada, between 2002 and 2015. We identified children aged ≤10 years, whose mothers received publicly funded prescriptions for an opioid or a nonsteroidal antiinflammatory drug (comparator analgesic) in the preceding year...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28088181/acute-and-chronic-kidney-disease-in-elderly-patients-with-hip-fracture-prevalence-risk-factors-and-outcome-with-development-and-validation-of-a-risk-prediction-model-for-acute-kidney-injury
#13
Christine J Porter, Iain K Moppett, Irene Juurlink, Jessica Nightingale, Christopher G Moran, Mark A J Devonald
BACKGROUND: Hip fracture is a common injury in older people with a high rate of postoperative morbidity and mortality. This patient group is also at high risk of acute kidney injury (AKI) and chronic kidney disease (CKD), but little is known of the impact of kidney disease on outcome following hip fracture. METHODS: An observational cohort of consecutive patients with hip fracture in a large UK secondary care hospital. Predictive modelling of outcomes using development and validation datasets...
January 14, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/27992843/statin-use-and-kidney-cancer-survival-outcomes-a-systematic-review-and-meta-analysis
#14
REVIEW
Madhur Nayan, Nahid Punjani, David N Juurlink, Antonio Finelli, Peter C Austin, Girish S Kulkarni, Elizabeth Uleryk, Robert J Hamilton
BACKGROUND: Statin use has been associated with improved survival outcomes in various malignancies. Randomized controlled trials are currently underway evaluating their utility as adjunctive cancer therapies. However, studies evaluating the association between statin use and outcomes in kidney cancer yield conflicting results. METHODS: We searched MEDLINE and EMBASE to identify studies evaluating the association between statin use and kidney cancer survival outcomes...
January 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/27989494/self-monitoring-of-blood-glucose-impact-of-quantity-limits-in-public-drug-formularies-on-provincial-costs-across-canada
#15
Sandra R Knowles, Kathy Lee, J Michael Paterson, Baiju R Shah, Muhammad M Mamdani, David N Juurlink, Tara Gomes
OBJECTIVES: For most patients with diabetes, routine use of blood glucose test strips (BGTS) has not been shown to be beneficial, yet the economic implications of broad publicly funded reimbursement for BGTS are substantial. We assessed the potential impact of BGTS quantity limits on utilization and costs for 6 publicly funded drug plans across Canada. METHODS: A cross-sectional analysis was conducted in 6 provinces (Alberta, Saskatchewan, Manitoba, Nova Scotia, Newfoundland and Labrador and Prince Edward Island) for patients who received at least 1 prescription for BGTS in 2014 through the public drug program...
December 15, 2016: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/27973601/high-dose-opioid-prescribing-and-opioid-related-hospitalization-a-population-based-study
#16
Kimberly Fernandes, Diana Martins, David Juurlink, Muhammad Mamdani, J Michael Paterson, Luke Spooner, Samantha Singh, Tara Gomes
AIMS: To examine the impact of national clinical practice guidelines and provincial drug policy interventions on prevalence of high-dose opioid prescribing and rates of hospitalization for opioid toxicity. DESIGN: Interventional time-series analysis. SETTING: Ontario, Canada, from 2003 to 2014. PARTICIPANTS: Ontario Drug Benefit (ODB) beneficiaries aged 15 to 64 years from 2003 to 2014. INTERVENTIONS: Publication of Canadian clinical practice guidelines for use of opioids in chronic non-cancer pain (May 2010) and implementation of Ontario's Narcotics Safety and Awareness Act (NSAA; November 2011)...
2016: PloS One
https://www.readbyqxmd.com/read/27873754/addressing-the-limitations-of-the-cdc-guideline-for-prescribing-opioids-for-chronic-noncancer-pain
#17
Jason W Busse, David Juurlink, Gordon H Guyatt
No abstract text is available yet for this article.
December 6, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/27866006/the-cardiovascular-safety-of-dutasteride
#18
Sean C Skeldon, Erin M Macdonald, Michael R Law, Anjie Huang, J Michael Paterson, Muhammad M Mamdani, David Juurlink
PURPOSE: Randomized controlled trials suggest an increased risk of heart failure with dutasteride, which inhibits both the type 1 and type 2 isoforms of 5α-reductase. In contrast, no such association has been suggested for finasteride, which selectively inhibits the type 2 isoform. We investigated the risk of cardiovascular events among patients receiving dutasteride relative to finasteride. MATERIALS AND METHODS: We performed a population based cohort study of Ontario men 66 years old or older who commenced treatment with dutasteride or finasteride between October 1, 2005 and March 31, 2015...
May 2017: Journal of Urology
https://www.readbyqxmd.com/read/27820619/association-of-a-blood-glucose-test-strip-quantity-limit-policy-with-patient-outcomes-a-population-based-study
#19
Tara Gomes, Diana Martins, Mina Tadrous, J Michael Paterson, Baiju R Shah, Jack V Tu, David N Juurlink, Anna Chu, Muhammad M Mamdani
Importance: Given their high costs, payers have considered implementing quantity limits for reimbursement of blood glucose test strips. The effect of these limits on patient outcomes is unknown. Objective: To determine whether the introduction of quantity limits for blood glucose test strips in August 2013 was associated with changes in clinical outcomes. Design, Setting, and Participants: Cross-sectional time series analysis from April 2008 to March 2015 of residents of Ontario, Canada, aged 19 years and older with diabetes who were eligible for public drug coverage...
January 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27815768/diabetes-and-kidney-cancer-outcomes-a-propensity-score-analysis
#20
Madhur Nayan, Antonio Finelli, Michael A S Jewett, David N Juurlink, Peter C Austin, Girish S Kulkarni, Robert J Hamilton
There is conflicting evidence whether diabetes is associated with survival outcomes in patients undergoing a nephrectomy for renal cell carcinoma. We performed a retrospective review of 1034 patients undergoing nephrectomy for unilateral, M0, renal cell carcinoma between 2000 and 2016 at a tertiary academic center. Inverse probability of treatment weights were derived from a propensity score model based on various clinical, surgical, and pathological characteristics. We used Cox proportional hazard models to evaluate the association between diabetes and disease-free survival, cancer-specific survival, and overall survival in the sample weighted by the inverse probability of treatment weights...
February 2017: Endocrine
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