Publications by authors named "Aragon F"

Background: The effect of a liberal red-cell transfusion strategy as compared with a restrictive strategy in patients during the critical care period after an aneurysmal subarachnoid hemorrhage is unclear.

Methods: We randomly assigned critically ill adults with acute aneurysmal subarachnoid hemorrhage and anemia to a liberal strategy (mandatory transfusion at a hemoglobin level of ≤10 g per deciliter) or a restrictive strategy (optional transfusion at a hemoglobin level of ≤8 g per deciliter). The primary outcome was an unfavorable neurologic outcome, defined as a score of 4 or higher on the modified Rankin scale (range, 0 to 6, with higher scores indicating greater disability) at 12 months.

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Objectives: Our primary objective was to assess the association between symptoms at the time of surgery and postoperative pulmonary complications and mortality in patients with COVID-19. Our secondary objective was to compare postoperative outcomes between patients who had recovered from COVID-19 and asymptomatic patients and explore the effect of the time elapsed between infection and surgery in the former. Our hypotheses were that symptomatic patients had a higher risk of pulmonary complications, whereas patients who had recovered from the infection would exhibit outcomes similar to those of asymptomatic patients.

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  • Survivors of critical illness often experience physical dysfunction post-ICU discharge, and the CYCLE trial aims to evaluate the effectiveness of in-bed cycle ergometry for improving short-term physical function in these patients.!* -
  • The CYCLE trial, involving 360 patients across multiple centers, employs a prespecified statistical analysis plan to assess outcomes like the PFIT-s score three days after ICU discharge, while considering variables such as age, frailty, and sex.!* -
  • Funded in 2017, the CYCLE study completed enrollment in May 2023, with data analyses finished and first results expected to be published in 2024.!*
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Multiligament knee injuries (MLKIs) frequently require immediate intervention to prevent severe complications, including vascular injury. We present the case of a 51-year-old male who sustained a traumatic right knee dislocation following a motor vehicle accident. The patient exhibited significant tibiofemoral dissociation with Grade 3 instability, classified as Schenck KD IV.

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  • The study investigates how often to screen critically ill adults on ventilators and the best method for conducting spontaneous breathing trials (SBT) to successfully extubate them.
  • It involves a randomized clinical trial with 797 participants who required mechanical ventilation, comparing once-daily and more frequent screenings alongside two SBT techniques: pressure-supported and T-piece.
  • Results show no significant differences in the time to successful extubation based on screening frequency or SBT technique, indicating that both methods may be similarly effective.
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First Nations are most at risk of developing end-stage kidney disease. Kidney transplantation is the best treatment option for these patients; however, First Nations donors are underrepresented. The aim of this study was to describe and understand barriers and facilitators of culturally safe organ transplantation and donation from the perspective of First Nations and Health Professionals in the Province of Quebec, Canada.

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  • A study was conducted to evaluate the effects of the proton-pump inhibitor pantoprazole on critically ill patients undergoing invasive ventilation, comparing it to a placebo.
  • The trial included 4,821 patients and found that pantoprazole significantly reduced the incidence of clinically important upper gastrointestinal bleeding compared to placebo (1.0% vs. 3.5%).
  • However, there was no significant difference in overall mortality rates at 90 days between the pantoprazole group (29.1%) and the placebo group (30.9%).
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  • * A pilot randomized trial will involve 90 donors and 324 organ recipients across nine hospitals in Ontario and Québec, with participants receiving either tacrolimus or a placebo before organ retrieval.
  • * Researchers will assess the trial's feasibility, including donor enrollment and recipient consent, while monitoring graft function and survival; findings will be shared publicly through publications and conferences.
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  • Critical illness requiring invasive mechanical ventilation can lead to significant physical disability, and early in-bed cycle ergometry may help reduce this impairment when added to standard physiotherapy in ICU patients.
  • A study with 360 adult patients randomly assigned to either early in-bed cycling plus usual physiotherapy or just usual physiotherapy found no significant difference in physical function scores three days after ICU discharge.
  • The addition of cycling did not result in any serious adverse events, indicating it is safe, but did not enhance recovery outcomes compared to standard therapy alone.
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  • The study aimed to analyze how sex and gender are considered in acute care trials and whether there have been changes in reporting practices since the 2016 guidelines on sex and gender equity in research.
  • The systematic review included 88 trials published in major medical journals, finding that the representation of female participants was low at 34.2%, and only 28.4% reported race or ethnicity, predominantly featuring white and male participants.
  • Results revealed limited use of sex and gender-based analysis (SGBA), with cardiovascular trials performing better than ICU trials, indicating a significant need for improvement in inclusivity and reporting practices in clinical research.*
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Background: The amount of same-day surgery has increased markedly worldwide in recent decades, but there remains limited evidence on chronic postsurgical pain in this setting.

Methods: This study assessed pain 90 days after ambulatory surgery in an international, multicenter prospective cohort study of patients at least 45 yr old with comorbidities or at least 65 yr old. Pain was assessed using the Brief Pain Inventory.

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Background: Evidence regarding the relationship between the laterality of lymph node invasion (LNI) and the prostatic lobe affected is limited. Our aim was to review our records of patients with exclusively unilateral localised prostate cancer (PCa) with metastatic LN involvement.

Methods: Between 2006 and 2023, after radical prostatectomy and extended pelvic lymphadenectomy at our centre, thirty patients with intermediate-high risk unilateral PCa and pN1 disease were identified.

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  • Donor interventions can potentially improve the quality and quantity of transplantable organs, but there's limited high-quality evidence due to ethical, practical, and regulatory challenges.
  • A workshop of experts from Canada and the UK aimed to create guidance for conducting randomized controlled trials (RCTs) in this area, focusing on identifying stakeholders and unique challenges in donor intervention research.
  • Key challenges include navigating research ethics, standardizing outcome data, and addressing regulatory issues, but addressing these can lead to better organ transplantation outcomes through well-designed donor intervention RCTs.
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Intensive care unit healthcare workers (ICU HCW) are at risk of mental health disorders during emerging disease outbreaks. Numerous cross-sectional studies have reported psychological distress, anxiety, and depression amongst ICU HCW during the COVID-19 pandemic. However, few studies have followed HCW longitudinally, and none of these have examined the association between COVID-19 workload and mental health.

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The flow of water through a horizontal small-scale Venturi tube of rectangular cross-section is simulated using a modified version of the open-source code DualSPHysics, which is based on Smoothed Particle Hydrodynamics (SPH) methods. Water is simulated using the Murnaghan-Tait equation of state so that weak compressibility is allowed. The hydrodynamics is coupled to a Large-Eddy Simulation (LES) turbulence model.

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Purpose: Regional anesthesia may favour postoperative rehabilitation by inhibiting peripheral sensitization and secondary hyperalgesia. The literature on this subject is limited. In the present FUNCTION study, we sought to compare the functional recovery post orthopedic wrist surgery with regional versus general anesthesia.

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Importance: Blood collection for laboratory testing in intensive care unit (ICU) patients is a modifiable contributor to anemia and red blood cell (RBC) transfusion. Most blood withdrawn is not required for analysis and is discarded.

Objective: To determine whether transitioning from standard-volume to small-volume vacuum tubes for blood collection in ICUs reduces RBC transfusion without compromising laboratory testing procedures.

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  • The FAST-NAWC trial is a multicenter study that aims to compare different screening frequencies and techniques for spontaneous breathing trials in critically ill patients on ventilation in 20 North American ICUs.
  • The original protocols have been updated to include COVID-19 patients, and changes were made to the statistical analysis plan to accommodate data reporting for both COVID-19 and non-COVID-19 participants.
  • The trial has been registered on Clinical Trials.gov, and this update outlines the key protocol modifications and their purpose before the final follow-up and data analysis phases.
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Nowadays, the use of self-cleaning surfaces is increasing globally, especially after the COVID-2019 pandemic, and the use of nanoparticles has been shown as a plausible option for this purpose. In the present study, Cu-doped SnO nanocrystals were successfully synthesized (in the copper content range of 0-30 mol%) using the polymeric precursor method. The structural, morphological, vibrational, and antibacterial activity were carefully studied to unveil the effect of copper ions on the properties of the hosting matrix, aiming at maximizing the usage of Cu-doped SnO nanocrystals.

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Delirium is common after cardiac surgery and is associated with adverse outcomes. Administration of benzodiazepines before and after cardiac surgery is associated with delirium; guidelines recommend minimizing their use. Benzodiazepine administration during cardiac surgery remains common because of its recognized benefits.

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Background: Preconditioning deceased organ donors with calcineurin inhibitors (CNIs) may reduce ischemia-reperfusion injury to improve transplant outcomes.

Methods: We searched MEDLINE, EMBASE, Cochrane Library, and conference proceedings for animal models of organ donation and transplantation, comparing donor treatment with CNIs with either placebo or no intervention, and evaluating outcomes for organ transplantation. Reviewers independently screened and selected studies, abstracted data, and assessed the risk of bias and clinical relevance of included studies.

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Aortic dissection is a life-threatening acute condition characterized by the separation of the aortic wall's layers. It is caused by a tear in the internal vascular wall (intimal layer and middle layer), which results in bleeding between the layers and causes abrupt and excruciating pain. The appropriate consideration must be given to the condition's dynamic nature, and variations in clinical presentation, without neglecting the urgency for intervention.

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Introduction: In-bed leg cycling with critically ill patients is a promising intervention aimed at minimising immobility, thus improving physical function following intensive care unit (ICU) discharge. We previously completed a pilot randomised controlled trial (RCT) which supported the feasibility of a large RCT. In this report, we describe the protocol for an international, multicentre RCT to determine the effectiveness of early in-bed cycling versus routine physiotherapy (PT) in critically ill, mechanically ventilated adults.

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