Publications by authors named "Bartoszko J"
Background: Antimicrobial use data from inpatients in northern Canada suitable to inform stewardship programs are limited.
Objective: As a special project of the Canadian Nosocomial Infection Surveillance Program, to describe antimicrobial use for inpatients in northern Canadian acute care hospitals.
Methods: Participating acute care hospitals serving adult or mixed adult and pediatric populations in northern Canada submitted annual data on the use of all systemic antimicrobials from 2019 to 2021.
Article Synopsis
- Strongyloidiasis is a widespread parasitic infection affecting 300-600 million people, particularly in tropical regions, and poses serious health risks, especially during immunosuppression, with high fatality rates.
- There have been no significant global health initiatives targeting this disease until recently, when the WHO included it in their roadmap for controlling neglected tropical diseases, highlighting its importance.
- The new WHO guidelines recommend mass drug administration of ivermectin in areas with a prevalence of over 5%, aiming for effective public health strategies to combat strongyloidiasis.
Article Synopsis
- Reduced thrombin generation after cardiopulmonary bypass (CPB) can lead to bleeding in surgical patients, leading researchers to compare the effectiveness of frozen plasma (FP) and four-factor prothrombin complex concentrate (4F-PCC) in replenishing coagulation factors.
- LEX-211 (FARES-II) is a phase 3 study that randomly assigns adult cardiac surgery patients to receive either 4F-PCC or FP to evaluate which is more effective in managing bleeding post-surgery, with a focus on whether 4F-PCC is non-inferior to FP.
- The study aims to enroll about 410 patients, with results expected by 2025, after receiving ethical approval from all participating institutions.
Background: Iron-deficiency anaemia, occurring in 30-40% of patients undergoing cardiac surgery, is an independent risk factor for adverse outcomes. Our long-term goal is to assess if postoperative i.v.
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- The study investigates the potential benefits of Delayed Cold-Stored Platelets (DCSP) over standard Room Temperature Platelets (RTP) for improving the effectiveness and lifespan of platelets used in cardiac surgeries.
- The trial involves 50 adult patients scheduled for complex cardiac surgery, who will be randomly assigned to receive either RTP or DCSP, with the intervention lasting from the end of surgery to 24 hours afterward.
- The main goals are to assess the feasibility of a larger randomized controlled trial (RCT) and evaluate the safety and effectiveness of DCSP compared to RTP in reducing the total amount of blood products needed after surgery.
Extracorporeal membrane oxygenation for COVID-19-associated severe acute respiratory distress syndrome in Canada: Analysis of data from the Canadian Nosocomial Infection Surveillance Program.
J Assoc Med Microbiol Infect Dis Can
January 2024
Background: Extracorporeal membrane oxygenation (ECMO) for COVID-19 across Canada has not been well-described. We studied trends for patients with COVID-19-related acute respiratory distress syndrome who received ECMO.
Methods: Multicentre retrospective cohort study using data from the Canadian Nosocomial Infection Surveillance Program across four different waves.
Objectives: Combining multivariate and network meta-analysis methods simultaneously in a multivariate network meta-analysis (MVNMA) provides the methodological framework to analyze the largest amount of evidence relevant to decision-makers (i.e., from indirect evidence and correlated outcomes).
View Article and Find Full Text PDFGoal-directed administration of blood components including red cells, platelets, plasma, and factor concentrates plays a critical role in the management of intraoperative coagulopathy. Increasingly commonly used, purified and recombinant factor concentrates are being recognized for their logistical advantages and potentially superior efficacy. Three- and four-factor prothrombin concentrates, fibrinogen concentrates and activated factor VII have an evolving evidence base relative to frozen plasma and cryoprecipitate.
View Article and Find Full Text PDFPurpose: Anemia reduces the blood's ability to carry and deliver oxygen. Following cardiac surgery, anemia is very common and affects up to 90% of patients. Nevertheless, there is a paucity of data examining the prognostic value of postoperative anemia.
View Article and Find Full Text PDFPurpose: We aimed to evaluate the effect of the 2017 Canadian Cardiovascular Society (CCS) guidelines on troponin surveillance after noncardiac surgery.
Methods: This was a single-centre, retrospective, observational study. Patients aged 40 yr or older undergoing intermediate- to high-risk elective noncardiac surgery between 2016 and 2021 were included.
Plasmid genomic epidemiology of carbapenemase-producing in Canada, 2010-2021.
Antimicrob Agents Chemother
December 2023
Article Synopsis
- Carbapenems are vital last-resort antibiotics against multidrug-resistant infections, but their effectiveness is threatened by the global rise of carbapenem-resistant bacteria due to carbapenemase genes.
- In Canada, a specific carbapenemase type has been identified as prevalent, capable of breaking down various antibiotics, and commonly found on mobile genetic elements like plasmids and transposons.
- Through whole genome sequencing of 829 carbapenemase-producing isolates from 2010 to 2021, researchers discovered diverse plasmid clusters responsible for resistance spread, revealing both clonal and horizontal transmission patterns across different bacterial strains in Canada.
Purpose: Cold-stored platelets (CSP) are an increasingly active topic of international research. They are maintained at 1-6 °C, in contrast to standard room-temperature platelets (RTP) kept at 20-24 °C. Recent evidence suggests that CSP have superior hemostatic properties compared with RTP.
View Article and Find Full Text PDFBackground: Placenta accrete spectrum (PAS) is a significant risk factor for postpartum hemorrhage and effective blood product management is critical in ensuring patient safety. In PAS patients undergoing cesarean section (CS) blood transfusion management guided by the combined clinical experience of the anesthesiologist and surgeon with point-of-care coagulation testing appears safe and effective. We describe and evaluate our experience and identify potential areas for improvement with blood product management in this patient population.
View Article and Find Full Text PDFWe aimed to assess the impact of allocation concealment and blinding on the results of coronavirus disease 2019 (COVID-19) trials, using the World Health Organization COVID-19 database (to February 2022). We identified 488 randomized trials comparing drug therapeutics with placebo or standard care in patients with COVID-19. We performed random-effects meta-regressions comparing the results of trials with and without allocation concealment and blinding of health-care providers and patients.
View Article and Find Full Text PDFCardiac surgery is associated with numerous peri- and post-operative haemostatic complications and blood transfusion requirements. Complex procedures such as redo-sternotomy heart transplantation or type A aortic dissection repairs are at high-risk for severe coagulopathy and significant transfusion requirements. However, current practice guidelines do not specifically address high-risk surgeries, resulting in variable practice.
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- Trends in severe COVID-19 outcomes in Canada highlight a shift in hospitalization rates and associated risks during different waves of the pandemic, particularly higher admissions in the later waves.
- A study conducted across 155 hospitals included both adults and children, examining data from March 2020 to May 2022, focusing on severe outcomes such as ICU admissions and death rates.
- Findings indicate that while overall hospitalizations increased in later waves, the rates of severe outcomes were lower, especially among vaccinated patients compared to the unvaccinated.
Factor V Leiden is the commonest hereditary prothrombotic allele, affecting 1% to 5% of the world's population. The objective of this study was to characterize the perioperative and postoperative outcomes of patients with Factor V Leiden compared to patients without a diagnosis of hereditary thrombophilia. This was a focused systematic review of studies including adult (>18 years) patients with Factor V Leiden (heterozygous or homozygous) undergoing noncardiac surgery.
View Article and Find Full Text PDFPeople living with HIV (PLHIV) need lifelong medical care. However, retention in HIV care is not measured uniformly, making it challenging to compare or pool data. The objective of this study within a review (SWAR) is to describe the assortment of definitions used for retention in HIV care in randomized controlled trials (RCTs).
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- The study aimed to evaluate how trustworthy and impactful preprint trial reports were during the COVID-19 pandemic by comparing their methods and results with later published versions.
- Researchers reviewed a total of 356 trials, finding that 101 were only preprints, while others were published later; the average time to publication for preprints was about six months.
- Results showed that there were minimal differences in key methods and results between preprints and published articles, with only a small percentage affecting the certainty of evidence in treatment effectiveness comparisons.
Objective: To compare the effects of interleukin 6 receptor blockers, tocilizumab and sarilumab, with or without corticosteroids, on mortality in patients with covid-19.
Design: Systematic review and network meta-analysis.
Data Sources: World Health Organization covid-19 database, a comprehensive multilingual source of global covid-19 literature, and two prospective meta-analyses (up to 9 June 2021).
Importance: Excessive bleeding requiring fibrinogen replacement is a serious complication of cardiac surgery. However, the relative cost-effectiveness of the 2 available therapies-fibrinogen concentrate and cryoprecipitate-is unknown.
Objective: To determine cost-effectiveness of fibrinogen concentrate vs cryoprecipitate for managing active bleeding in adult patients who underwent cardiac surgery.
Objectives: To quantify the prognostic effects of demographic and modifiable factors in streptococcal toxic shock syndrome (STSS).
Design: Systematic review and meta-analysis.
Data Sources: MEDLINE, EMBASE and CINAHL from inception to 19 September 2022, along with citations of included studies.