Efficacy of Antithrombotic Therapy and Risk of Hemorrhagic Complication in Blunt Cerebrovascular Injury Patients with Concomitant Injury: A Systematic Review.

Background: The risk-benefit balance of antithrombotic therapy administration for blunt cerebrovascular injuries (BCVI) patients with concomitant injuries at high risk for bleeding is an ongoing therapeutic conundrum for trauma clinicians. We performed a systematic review to assess the reported efficacy and safety of treatment in this population with respect to prevention of ischemic stroke and risk of hemorrhagic complications.

Study Design: A systematic electronic literature search of MEDLINE, EMBASE, Cochrane Library, and Web of Science databases was performed from January 1, 1996 to December 31, 2021.

Prediction of massive transfusion with the Revised Assessment of Bleeding and Transfusion (RABT) score at Canadian level I trauma centers.

Background: Early damage control resuscitation and massive transfusion (MT) protocol activations improve outcomes in trauma patients with hemorrhagic shock, where scores to guide MT prediction are used including: the Assessment of Blood Consumption (ABC), Shock Index (SI), and Revised Assessment of Bleeding and Transfusion (RABT) scores. Our aim was to validate the RABT score in patients from two level I trauma centers in Canada.

Methods: A retrospective review of adult patients meeting trauma team activation criteria receiving >1 unit of red blood cells (RBCs) within 24 h of admission, from 2015 to 2020, was conducted.

Management of blunt cerebrovascular injuries at a Canadian level 1 trauma centre: Are we meeting the grade?

Background: Untreated blunt cerebrovascular injuries (BCVIs) are associated with high rates of death and disability due to stroke. We assessed alignment of clinical practice at our centre with current recommendations for management of BCVIs and examined rates of new and recurrent in-hospital stroke.

Methods: We retrospectively reviewed the BC Trauma Registry to identify all adult (age > 18 yr) patients with trauma with BCVIs at the largest level 1 trauma centre in British Columbia, Canada, from Apr.

Social and Structural Barriers to Primary Care Access Among Women Living With HIV in Metro Vancouver, Canada: A Longitudinal Cohort Study.

This study examines correlates of being unable to access primary care in the past 6 months among cisgender (cis) and trans women living with HIV (WLWH). Data were drawn from a longitudinal community-based cohort study of WLWH (ages 14+) in Metro Vancouver, Canada (2014-2017). Of 291 participants contributing 914 observations, 15.

Large bowel obstruction secondary to schistosomiasis-related colonic stricture.

Introduction: Intestinal involvement of schistosomiasis uncommonly involves the formation of non-obstructive polypoid lesions; however, obstructing fibrotic stenoses and strictures secondary to chronic infection are extremely rare with only nine reported cases in the literature.

Presentation Of Case: An 85-year-old Southeast Asian female originating from the Philippines presents with a one-day history of obstructive symptoms in the setting of chronic constipation over the past four months. Subsequent CT imaging and colonoscopy biopsy revealed a nodular cecal mural wall thickening with chronic inflammation and a single Schistosoma egg.

The Teacher-Learner Contract (TLC): An Objectives-Based Checklist for Surgical Shadowing.

Objective: A lack of structure and communication in physician shadowing experiences may prevent medical students from accruing its potential benefits. In this study, we evaluated the use of an objectives-based surgical shadowing teacher-learner contract (TLC) on the outcomes of shadowing experiences.

Design: Cross-sectional study with 30 unique student-surgeon pairs who participated in a 1-time shadowing experience between December 2016 and May 2017.

Rare constellation of abdominal vascular injuries in blunt trauma: Left gastric artery pseudoaneurysms and dissection.

Introduction: Abdominal visceral artery pseudoaneurysms and dissections in blunt trauma are uncommon, however, solitary vascular injury of the left gastric artery and development of multifocal dissections are extremely rare with only 5 reported cases in the literature.

Presentation Of Case: A 79-year-old male presents two days after a motor boating incident in profound hemorrhagic shock. Subsequent CT imaging revealed moderate hemoperitoneum, two pseudoaneurysms of the left gastric artery measuring 6 mm and 9 mm, as well as attenuation of the artery in keeping with a focal dissection and intramural thrombus, and no active extravasation.

Impact of sequential implementation of multimodal perioperative care pathways on colorectal surgical outcomes.

Background: Standardized care protocols offer the potential to reduce postoperative complication rates. The purpose of this study was to determine whether there was an additive benefit associated with the sequential implementation of the evidence-based surgical site infection bundle (SSIB) and enhanced recovery after surgery (ERAS) protocols for patients undergoing colorectal surgery in a community hospital.

Methods: Patients at a single institution who underwent elective colorectal surgery between Apr.

A day in the life of emergency general surgery in Canada: a multicentre observational study.

Background: Emergency general surgery (EGS) services are gaining popularity in Canada as systems-based approaches to surgical emergencies. Despite the high volume, acuity and complexity of the patient populations served by EGS services, little has been reported about the services' structure, processes, case mix or outcomes. This study begins a national surveillance effort to define and advance surgical quality in an important and diverse surgical population.

Process mapping as a framework for performance improvement in emergency general surgery.

Background: Emergency general surgery conditions are often thought of as being too acute for the development of standardized approaches to quality improvement. However, process mapping, a concept that has been applied extensively in manufacturing quality improvement, is now being used in health care. The objective of this study was to create process maps for small bowel obstruction in an effort to identify potential areas for quality improvement.

Processes of Health Care Delivery, Education, and Provider Satisfaction in Acute Care Surgery: A Systematic Review.

In recent years, significant workload, high acuity, and complexity of emergency general surgery conditions have led hospitals to replace the traditional on-call model with dedicated acute care surgery (ACS) service models. A systematic search of Ovid, EMBASE, and MEDLINE was undertaken to examine the impact of ACS services on health-care delivery processes and cost, education, and provider satisfaction. From 1827 papers, reviewers identified 22 studies that met inclusion criteria and subsequently used The Evidence-Based Practice for Improving Quality method and Newcastle-Ottawa Scale to score quality and level of evidence.

Attitudes of Health Professional Educators Toward the Use of Social Media as a Teaching Tool: Global Cross-Sectional Study.

Background: The use of social media in health education has witnessed a revolution within the past decade. Students have already adopted social media informally to share information and supplement their lecture-based learning. Although studies show comparable efficacy and improved engagement when social media is used as a teaching tool, broad-based adoption has been slow and the data on barriers to uptake have not been well documented.

Social Media in Health Science Education: An International Survey.

Background: Social media is an asset that higher education students can use for an array of purposes. Studies have shown the merits of social media use in educational settings; however, its adoption in health science education has been slow, and the contributing reasons remain unclear.

Objective: This multidisciplinary study aimed to examine health science students' opinions on the use of social media in health science education and identify factors that may discourage its use.