Agreement between the Maslach Burnout Inventory and the Copenhagen Burnout Inventory among emergency physicians and trainees.

Background: Emergency physicians have the highest rates of burnout among all specialties. Existing burnout tools include the Copenhagen Burnout Inventory (CBI) and single-item measures from the Maslach Burnout Inventory (MBI). While both were designed to measure burnout, how they conceptualize this phenomenon differs and their agreement is unclear.

Phase 4 Multinational Multicenter Retrospective and Prospective Real-World Study of Nivolumab in Recurrent and Metastatic Squamous Cell Carcinoma of the Head and Neck.

This study examined the real-world use of nivolumab in patients with recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). This was a multinational retrospective study (VOLUME) assessing treatment effectiveness and safety outcomes and a prospective study (VOLUME-PRO) assessing HRQoL and patient-reported symptoms. There were 447 and 51 patients in VOLUME and VOLUME-PRO, respectively.

The revised Approved Instructional Resources score: An improved quality evaluation tool for online educational resources.

Background: Free Open-Access Medical education (FOAM) use among residents continues to rise. However, it often lacks quality assurance processes and residents receive little guidance on quality assessment. The Academic Life in Emergency Medicine Approved Instructional Resources tool (AAT) was created for FOAM appraisal by and for expert educators and has demonstrated validity in this context.

Prognostic significance of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for advanced non-small cell lung cancer patients with high PD-L1 tumor expression receiving pembrolizumab.

Background: We investigated the association of peripheral blood inflammatory markers with overall survival (OS) in pembrolizumab treated advanced non-small cell lung cancer (aNSCLC) patients with programmed death ligand 1 (PD-L1) expression ≥50%. Clinical risk factors for development of immune-related adverse events (irAE) were also explored.

Methods: aNSCLC patients with high PD-L1 expression receiving pembrolizumab monotherapy outside of clinical trials were identified retrospectively.

Treatment of non-small-cell lung cancer after progression on nivolumab or pembrolizumab.

Background: Although PD-1 antibodies (PD1 Ab) are the standard of care for advanced non-small-cell lung cancer (ansclc), most patients will progress. We compared survival outcomes for patients with ansclc who received systemic therapy (st) after progression and for those who did not. Additionally, clinical characteristics that predicted receipt of st after PD1 Ab failure were evaluated.

Association of age with differences in immune related adverse events and survival of patients with advanced nonsmall cell lung cancer receiving pembrolizumab or nivolumab.

Objectives: To explore the association of age with development of immune related adverse events (irAE) and survival in patients with advanced nonsmall cell lung cancer (aNSCLC) receiving programmed cell death 1 antibodies (PD-1 Ab) outside of clinical trials.

Methods: A multicenter retrospective study of PD-1 Ab prescription for patients with aNSCLC between 06/2015-11/2018 at BC Cancer. Multivariable (MVA) logistic regression identified baseline variables associated with irAE manifested within 3 months of PD-1 Ab initiation.

How I Work Smarter: A Qualitative Analysis of Emergency Physicians' Strategies for Clinical and Non-clinical Productivity.

Introduction Emergency physicians' (EP) clinical and professional non-clinical environments can be stressful and lead to burnout. However, some EPs thrive in these environments. To date, there is limited research investigating the strategies that successful EPs use to be maximally productive.

Pembrolizumab for advanced nonsmall cell lung cancer: Efficacy and safety in everyday clinical practice.

Objectives: While pembrolizumab improves overall survival (OS) in a subset of advanced nonsmall cell lung cancer (aNSCLC) patients (pts) in clinical trials, individuals with poor Eastern Cooperative Oncology Group performance status (ECOG PS) were excluded. Furthermore, some studies have identified a potential link between improved pt outcomes and development of immune related adverse events (irAE.) In a large provincial cohort, we studied the efficacy and safety of pembrolizumab for poor ECOG PS pts and whether irAE correlate with improved OS.

Canadian perspectives: update on inhibition of -positive tumours in advanced non-small-cell lung cancer.

Background: Inhibition of the anaplastic lymphoma kinase (alk) oncogenic driver in advanced non-small-cell lung carcinoma (nsclc) improves survival. In 2015, Canadian thoracic oncology specialists published a consensus guideline about the identification and treatment of positive patients, recommending use of the alk inhibitor crizotinib in the first line. New scientific literature warrants a consensus update.

Efficacy of Nivolumab and Pembrolizumab in Patients With Advanced Non-Small-Cell Lung Cancer Needing Treatment Interruption Because of Adverse Events: A Retrospective Multicenter Analysis.

Introduction: The programmed death 1 antibodies (PD-1 Ab) nivolumab and pembrolizumab improve overall survival (OS) in advanced non-small-cell lung cancer (NSCLC). We evaluated the correlation between immune-related adverse events (irAE) and treatment interruption due to irAE on clinical efficacy of PD-1 Ab in advanced NSCLC.

Patients And Methods: Advanced NSCLC patients treated with PD-1 Ab between June 2015 to November 2017 at BC Cancer were identified.

Evaluation of emergency department ultrasound machines for the presence of occult blood.

Objectives: Bedside ultrasound in the emergency department is a common diagnostic tool, especially when evaluating trauma patients. Many trauma patients have blood on their chest and abdomen that may contact the probe during examination. The primary aim of this study was to investigate whether occult blood contamination was present on the emergency department ultrasound machine, both after daily use and after use in trauma.

Sleep and Exercise in Emergency Medicine Residents: An Observational Pilot Study Exploring the Utility of Wearable Activity Monitors for Monitoring Wellness.

Introduction Burnout is well-documented in residents and emergency physicians. Wellness initiatives are becoming increasingly prevalent, but there is a lack of data supporting their efficacy. In some populations, a relationship between sleep, exercise, and wellness has been documented; however, this relationship has not been established in emergency medicine (EM) residents or physicians.

Emergency medicine resident wellness: Lessons learned from a national survey.

Objectives: Emergency medicine (EM) residents face many challenges during residency. Given the negative effects of residency training and the paucity of information on EM resident wellness experiences, we conducted a national survey to characterize the current landscape of Canadian EM resident wellness.

Methods: A cross-sectional study of Canadian EM residents was done using an online survey created by a Canadian Association of Emergency Physicians Resident Section working group on wellness.

Localized prostate cancer presenting as a renal pseudo-tumour.

Malignant obstructive uropathy can be a result of common genitourinary malignancies (i.e., ureter, prostate, bladder, or kidney) or extrinsic processes, such as colon and ovarian tumours.

Social media in cancer care: opportunities to improve care in locally advanced breast cancer.

Purpose Of Review: To examine the current data supporting use of social media in breast cancer clinical care.

Recent Findings: Although opportunities to utilize social media to increase knowledge have been commonly seized, the opportunity to improve communication among clinicians is lagging. Locally advanced breast cancer (LABC) requires timely coordination of care among many specialists, and presents an excellent scenario for enhanced utilization of current IT strategies.

Patients with cirrhosis and denied liver transplants rarely receive adequate palliative care or appropriate management.

Background & Aims: Patients with cirrhosis who are receiving palliative care and are not eligible for liver transplantation (LT) are often hospitalized multiple times, with lack of expectations or understanding of death and dying. We evaluated how frequently these patients received appropriate and palliative care.

Methods: We performed a retrospective study of 102 consecutive adult patients (67% men; mean age, 55 years) who were removed from the list for or declined LT from January 2005 through December 2010 at the University of Alberta, Canada.

Endobronchial hamartoma.

We present images of an endobronchial hamartoma visible by bronchoscopy in the left lower lobe. A 56-year-old woman with a late presentation of an acute anterior myocardial infarction requires urgent heart transplantation and subsequently has trouble weaning off the ventilator. Bronchoscopic evaluation reveals a 1 cm endobronchial hamartoma obstruction the left lower lobe bronchus.

Liver transplantation in the critically ill: a multicenter Canadian retrospective cohort study.

Introduction: Critically ill cirrhosis patients awaiting liver transplantation (LT) often receive prioritization for organ allocation. Identification of patients most likely to benefit is essential. The purpose of this study was to examine whether the Sequential Organ Failure Assessment (SOFA) score can predict 90-day mortality in critically ill recipients of LT and whether it can predict receipt of LT among critically ill cirrhosis listed awaiting LT.

Breast cancer screening for women younger than 40.

The charts of 661 women aged 15 to 39 revealed that almost 50% of teenage patients had had breast screening examinations. Most of the physicians and residents involved began performing and teaching breast examination to patients in their teens. Concerned that it might do more harm than good, the Canadian guidelines do not advocate early screening.