Integrating a Longitudinal Course on the Principles of Research in an Outcomes-Based Undergraduate Medical Education Curriculum.

Background And Need For Innovation: Teaching and learning approaches can support medical students in developing the research skills necessary to be adept consumers of scientific research. Despite various influencing factors, existing literature on effective strategies in undergraduate medical education remains limited.

Goal Of Innovation: Using a spiraled curriculum, we created and evaluated a longitudinal course to enhance medical students' research abilities.

Long-Term Consequences of COVID-19 in Predominantly Immunonaive Patients: A Canadian Prospective Population-Based Study.

: Lingering symptoms are frequently reported after acute SARS-CoV-2 infection, a condition known as post-COVID-19 condition (PCC). The duration and severity of PCC in immunologically naïve persons remain unclear. Furthermore, the long-term consequences of these chronic symptoms on work and mental health are poorly documented.

Nurse Staffing Practices and Postoperative Atrial Fibrillation Among Cardiac Surgery Patients: A Multisite Cohort Study.

Background: Postoperative atrial fibrillation (POAF) is a frequent complication of cardiac surgery that is associated with increased morbidity, mortality, and costs. Recent studies suggest that nurse staffing practices are associated with adverse postoperative events, but whether these practices are also related to POAF occurrence is unknown.

Methods: To fill this knowledge gap, a cohort of 6401 cardiac surgery patients admitted to 2 Canadian university health centres (UHC A and UHC B) between 2014 and 2018 was studied.

The feasibility, reliability, and incremental value of two-dimensional speckle-tracking for the detection of significant coronary stenosis after treadmill stress echocardiography.

Background: Two-dimensional speckle-tracking echocardiography (STE) may help detect coronary artery disease (CAD) when combined with dobutamine stress echocardiography. However, few studies have explored STE with exercise stress echocardiography (ESE). We aimed to evaluate the feasibility, reliability, and incremental value of STE combined with treadmill ESE compared to treadmill ESE alone to detect CAD.

Novel Z Scores to Correct Biases Due to Ventricular Volume Indexing to Body Surface Area in Adolescents and Young Adults.

Background: Reference values for cardiac magnetic resonance imaging (cMRI) in children and young adults are scarce. This leads to risk stratification of patients with congenital heart diseases being based on volumes indexed to body surface area (BSA). We aimed to produce cMRI Z score equations for ventricular volumes in children and young adults and to test whether indexing to BSA resulted in an incorrect assessment of ventricular dilation according to sex, body composition, and growth.

Validation of an algorithm based on administrative data to detect new onset of atrial fibrillation after cardiac surgery.

Introduction: Postoperative atrial fibrillation (POAF) is a frequent complication of cardiac surgery associated with important morbidity, mortality, and costs. To assess the effectiveness of preventive interventions, an important prerequisite is to have access to accurate measures of POAF incidence. The aim of this study was to develop and validate such a measure.

Are hospital nurse staffing practices associated with postoperative cardiac events and death? A systematic review.

Introduction: Postoperative cardiac events are frequent complications of surgery, and their occurrence could be associated with suboptimal nurse staffing practices, but the existing evidence remains scattered. We systematically reviewed studies linking nurse staffing practices to postoperative cardiac events and two related outcomes, all-cause mortality and failure-to-rescue.

Methods: A systematic search of the English/French literature was undertaken in the CINAHL, PsychInfo, and Medline databases.

The effect of bromocriptine on left ventricular functional recovery in peripartum cardiomyopathy: insights from the BRO-HF retrospective cohort study.

Aims: Bromocriptine is thought to facilitate left ventricular (LV) recovery in peripartum cardiomyopathy (PPCM) through inhibition of prolactin secretion. However, this potential therapeutic effect remains controversial and was incompletely studied in diverse populations.

Methods And Results: Consecutive women with new-onset PPCM (n = 76) between 1994 and 2015 in Quebec, Canada, were classified according to treatment (n = 8, 11%) vs.

Re-using questions in classroom-based assessment: An exploratory study at the undergraduate medical education level.

Introduction: To alleviate some of the burden associated with the development of novel quality questions on a regular basis, medical education programs may favour the use of item banks. This practice answers the real pragmatic need of having to create exams de novo at each administration while benefiting from using psychometrically sound questions to assess students. Unfortunately, programs cannot prevent trainees from engaging in cheating behaviours such as content sharing, and little is known about the impact of re-using items.

Impact of an invasive strategy in the elderly hospitalized with acute coronary syndrome with emphasis on the nonagenarians.

Background: Published data about nonagenarians with acute coronary syndrome (ACS) were mainly descriptive and limited by small sample sizes and unadjusted outcomes. We aim to describe the characteristics, management, and the impact of an invasive strategy on major adverse events in elderly patients hospitalized with ACS with focus on the nonagerians.

Methods And Results: We analyzed data collected as part of the AMI-OPTIMA study, a cluster-randomized study of knowledge translation intervention versus usual care on optimal discharge medications in patients admitted with ACS at 24 Canadian hospitals.

Understanding the patient perspective on research access to national health records databases for conduct of randomized registry trials.

Background: Use of health administrative databases is proposed for screening and monitoring of participants in randomized registry trials. However, access to these databases raises privacy concerns. We assessed patient's preferences regarding use of personal information to link their research records with national health databases, as part of a hypothetical randomized registry trial.

Inappropriate dosing of direct oral anticoagulants in patients with atrial fibrillation.

Atrial fibrillation (AF) is a common cardiovascular disease for which newer oral anticoagulants are available. The main objective of this study was to evaluate the appropriateness in prescriptions of direct oral anticoagulant (DOACs), more specifically apixaban, dabigatran and rivaroxaban. This was a singlecentre, retrospective study conducted in the province of Quebec, Canada.

Barriers to Goals of Care Discussions With Patients Who Have Advanced Heart Failure: Results of a Multicenter Survey of Hospital-Based Cardiology Clinicians.

Background: Conversations about goals of care in hospital are important to patients who have advanced heart failure (HF).

Methods: We conducted a multicenter survey of cardiology nurses, fellows, and cardiologists at 8 Canadian teaching hospitals. The primary outcome was the importance of barriers to goals-of-care discussions in hospital (1 = extremely unimportant; 7 = extremely important).

Predictors of Direct Oral Anticoagulants Utilization for Thromboembolism Prevention in Atrial Fibrillation.

Purpose: Several factors have been associated with the prescription of direct oral anticoagulants (DOAC) over warfarin such as younger age, fewer concomitant medications, and lower CHADS2 or bleeding scores. The primary objective of this study was to identify predictors of DOAC choice compared with warfarin for patients who are starting a new oral anticoagulant (OAC) for atrial fibrillation (AF). The secondary objective was to describe the proportion of DOAC prescriptions in new users of OAC for AF.

Arrhythmic Risk Following Recovery of Left Ventricular Ejection Fraction in Patients with Primary Prevention ICD.

Background: Left ventricular ejection fraction (LVEF) recovers during follow-up in a significant proportion of patients implanted with a cardioverter defibrillator (ICD) for primary prevention. Little is known about the midterm arrhythmic risk in this population, particularly in relation to the presence or absence of ischemic cardiomyopathy.

Methods And Results: We retrospectively analyzed 286 patients with an ICD implanted for primary prevention between 2002 and 2010.

Patterns and Predictors of Use of Anticoagulants for the Treatment of Venous Thromboembolism Following Approval of Rivaroxaban.

Background: Few studies have identified patterns and predictors of use of direct oral anticoagulants for venous thromboembolism (VTE).

Objective: To describe the use of anticoagulants and assess predictors associated with the prescription of rivaroxaban over vitamin K antagonist (VKA) for the subsequent treatment of VTE.

Methods: This cross-sectional study was built with all consecutive patients newly diagnosed with acute VTE admitted between February 18, 2013, and September 18, 2013, in an academic tertiary care center in Quebec, Canada.

Multidetector cardiac tomography: a useful tool before cardiac resynchronization therapy.

Background: Left ventricular lead placement in a suitable coronary vein is a key determi-nant of responsiveness to cardiac resynchronization therapy (CRT). Multidetector cardiac tomography (MDCT) is a non-invasive alternative to depict cardiac venous anatomy although coronary sinus (CS) retrograde venography (RV) is the gold standard. The aim of this study was to evaluate the accuracy of MDCT to determine the presence of CS tributaries before CRT.

Patterns of oral anticoagulants use in atrial fibrillation.

Background: Novel oral anticoagulants are available for the management of atrial fibrillation and are considered more convenient to use than warfarin.

Objective: The main objective of this study was to describe patterns of oral anticoagulant use in the 6 months period following the availability of dabigatran at our hospital.

Methods: A cross-sectional study was conducted in a single University hospital in the province of Québec, Canada.

Impact of hemodialysis on the level of high-sensitivity cardiac troponins T in patients with end-stage renal disease.

Aim: The majority of patients with end-stage renal disease have chronically elevated concentrations of troponins, thus obscuring the diagnosis of myocardial infarction. We conducted a prospective study to examine the impact of hemodialysis on the level of high-sensitivity cardiac troponins T in asymptomatic patients with end-stage renal disease.

Methods: High-sensitivity cardiac troponins T were measured in 43 patients, before and after three dialysis sessions, over a one week period.

Beta-blockers are associated with increased risk of first cardiovascular events in non-diabetic hypertensive elderly patients.

Purpose: Although treatment should be considered for elderly patients with hypertension (HTN), the effectiveness of beta-blockers (BBs) compared with other medications is less clear. This study's objective is to assess the relative effectiveness of BBs in elderly primary prevention patients with uncomplicated HTN.

Methods: This is a population-based nested case-control study.

Effect of age and sex on echocardiographic left ventricular diastolic function parameters in patients with preserved ejection fraction and normal valvular function.

Background: We conducted a retrospective study to specify the effect of age and gender on echocardiographic left ventricular diastolic function parameters.

Methods: We included echocardiograms done in our institution between 1995 and 2007, for which data on diastolic function were available. In order to target a population as close aspossible to healthy subjects, echocardiograms reporting abnormal contraction, valvulopathy or extreme data were excluded.

Streptococcus anginosus pyogenic liver abscess following a screening colonoscopy.

A previously healthy 58-year-old man presented with a septic thrombosis of the right hepatic vein and a pyogenic liver abscess (PLA) one week after undergoing a screening colonoscopy. Blood cultures and a radiological drainage specimen were both positive for Streptococcus anginosus. Evolution was favourable after six weeks of antibiotherapy.