Prevention Strategies in Obesity Management: A Systematic Review Comparing Canadian and American Guidelines for Adults.

The fast-increasing obesity prevalence rates in children, youths, and adults in the last decade have made obesity prevention a global public health priority. The primary objective of this study is to evaluate the various obesity prevention strategies and guidelines implemented in the United States and Canada. Thus, for this study, a systematic review was performed on various online databases including PubMed, Scopus, Google Scholar, and MEDLINE.

Tenecteplase versus standard of care for minor ischaemic stroke with proven occlusion (TEMPO-2): a randomised, open label, phase 3 superiority trial.

Background: Individuals with minor ischaemic stroke and intracranial occlusion are at increased risk of poor outcomes. Intravenous thrombolysis with tenecteplase might improve outcomes in this population. We aimed to test the superiority of intravenous tenecteplase over non-thrombolytic standard of care in patients with minor ischaemic stroke and intracranial occlusion or focal perfusion abnormality.

Describing and Comparing Patient Factors Associated with Use of Parenteral Iron before and after Implementation of an Order Set for Parenteral Iron (DECODE IRON).

Background: In select clinical scenarios, IV administration of iron is suitable for management of iron deficiency anemia; however, for most patients, oral administration of iron is the mainstay of treatment. At the Red Deer Regional Hospital Centre, in Red Deer, Alberta, high utilization of IV iron has resulted in limited access to this medication for the treatment of ambulatory patients, as well as significant usage of health care resources.

Objectives: The primary objective was to compare patient characteristics, specifically pretreatment laboratory test results and previous use of oral iron, among those receiving IV iron therapy in an ambulatory setting before and after implementation of an iron sucrose order set.

Safety and efficacy of tenecteplase versus alteplase in stroke patients with carotid tandem lesions: Results from the AcT trial.

Background: Carotid tandem lesions ((TL) ⩾70% stenosis or occlusion) account for 15-20% of acute stroke with large vessel occlusion.

Aims: We investigated the safety and efficacy of intravenous tenecteplase (0.25 mg/kg) versus intravenous alteplase (0.

Patient Factors Associated with Prescribing of Iron for IV Administration: A Descriptive Study.

Background: IV administration of iron is appropriate for the treatment of iron deficiency anemia (IDA) when orally administered iron has not been effective, tolerated, or clinically appropriate. In Calgary, Alberta, high levels of IV iron utilization required review, because of significant health care resource utilization, high cost, and reduced accessibility.

Objectives: The primary objective was to describe the population of adult patients in Calgary with estimated glomerular filtration rate greater than or equal to 30 mL/min/1.

CAEP Position Statement: Emergency department management of people with opioid use disorder.

Deaths due to opioid overdose have reached unprecedented levels in Canada; over 12,800 opioid-related deaths occurred between January 2016 and March 2019, and overdose death rates increased by approximately 50% from 2016 to 2018.1 In 2016, Health Canada declared the opioid epidemic a national public health crisis,2 and life expectancy increases have halted in Canada for the first time in decades.3 Children are not exempt from this crisis, and the Chief Public Health Officer of Canada has recently prioritized the prevention of problematic substance use among Canadian youth.

Provincial Door-to-Needle Improvement Initiative Results in Improved Patient Outcomes Across an Entire Population.

Background And Purpose: Improving door-to-needle times (DNTs) for thrombolysis of acute ischemic stroke patients improves outcomes, but participation in DNT improvement initiatives has been mostly limited to larger, academic medical centers with an existing interest in stroke quality improvement. It is not known whether quality improvement initiatives can improve DNT at a population level, including smaller community hospitals. This study aims to determine the effect of a provincial improvement collaborative intervention on improvement of DNT and patient outcomes.

Medication management and pharmacokinetic changes after bariatric surgery.

Objective: To identify expected pharmacokinetic changes and provide practical recommendations for the medication management of chronic disease states after bariatric surgery.

Sources Of Information: MEDLINE, EMBASE, PubMed, Scopus, and the Cochrane Library were searched. The search was limited to studies in human adults.

Reducing Door-to-Needle Times for Ischaemic Stroke to a Median of 30 Minutes at a Community Hospital.

Background: Alteplase is an effective treatment for ischaemic stroke patients, and it is widely available at all primary stroke centres. The effectiveness of alteplase is highly time-dependent. Large tertiary centres have reported significant improvements in their door-to-needle (DTN) times.

Statin Prescriptions for High-Risk Patients Are Increased by Laboratory-Initiated Framingham Risk Scores: A Quality-Improvement Initiative.

Low rates of cardiovascular preventive therapy with statin medications is a significant public health problem in Canada. There is a pressing need for public health interventions to increase the use of statin medications, especially among high-risk patients. In this article, we present the results of a quality assurance pilot program to provide laboratory-reported Framingham Risk Score (FRS) to physicians.

Implementation of an intervention to reduce population-based screening for vitamin D deficiency: a cross-sectional study.

Background: We describe the implementation of an intervention in Alberta in support of the Choosing Wisely Canada recommendation against population screening for vitamin D deficiency (as determined by serum total 25-hydroxyvitamin D testing). We hypothesized that the introduction of a specialized requisition for vitamin D testing would reduce the annual number of vitamin D tests performed.

Methods: We performed a cross-sectional observational study that included all vitamin D tests ordered in Alberta between Apr.

Comparison of 13 Commercially Available Cardiac Troponin Assays in a Multicenter North American Study.

Background: We examined the concordance of 13 commercial cardiac troponin (cTn) assays [point-of-care, high-sensitivity (hs), and conventional] using samples distributed across a continuum of results.

Methods: cTnI (11 assays) and cTnT (2 assays) were measured in 191 samples from 128 volunteers. cTn assays included Abbott (iSTAT, STAT, and hs), Alere (Cardio 3), Beckman (AccuTnI+3), Pathfast (cTnI-II), Ortho (Vitros), Siemens (LOCI, cTnI-Ultra, Xpand, Stratus CS), and Roche [4th Generation (Gen), hs].

Health Literacy, Knowledge, and Patient Satisfaction Before Kidney Transplantation.

Background: Poor health literacy is associated with inferior outcomes in kidney transplant recipients, and knowledge remains suboptimal in this population. The goal of this study was to characterize the health literacy, kidney transplant knowledge, medication beliefs, and education satisfaction in a cohort of patients waiting to undergo kidney transplantation.

Methods: All patients on the wait-list in 1 Canadian center were invited to participate in the study.

Omega-3 polyunsaturated fatty acid supplementation in the prevention of cardiovascular disease.

Introduction: Omega-3 polyunsaturated fatty acids (PUFAs) have purported protective cardiovascular (CV) effects. We sought to assess the evidence available for the use of omega-3 PUFAs for the prevention of cardiovascular disease (CVD).

Methods: A systematic literature search was conducted using MEDLINE and EMBASE from 1999 to 2015.

Canadian family physician knowledge and attitudes toward laboratory utilization management.

Objectives: Mitigation of unnecessary and redundant laboratory testing is an important quality assurance priority for laboratories and represents an opportunity for cost savings in the health care system. Family physicians represent the largest utilizers of laboratory testing by a large margin. Engagement of family physicians is therefore key to any laboratory utilization management initiatives.

Relationship of Paternity Status, Welfare Reform Period, and Racial/Ethnic Disparities in Infant Mortality.

The objective of this study was to examine the relationship of paternity status, welfare reform period, and racial/ethnic disparities in infant mortality. The study used retrospective analysis of birth outcomes data from singleton birth/infant death data in Milwaukee, Wisconsin, from 1993 to 2009. Multivariate logistic regression was used to examine the relationship between paternity status, welfare reform period, and infant mortality, adjusting for maternal and infant characteristics.

Survey of Alberta hospital pharmacists' perspectives on additional prescribing authorization.

Purpose: The results of a survey to determine reasons for the slow adoption of prescribing authority by hospital pharmacists in the Canadian province of Alberta are presented.

Methods: A Web-based survey was conducted to elucidate pharmacist perspectives on additional prescribing authorization (APA), which permits independent prescribing by Alberta pharmacists who complete a peer-reviewed application process (at the time of the survey, only 52 hospital pharmacists had been granted APA). The survey elicited demographic data and practice characteristics and explored perspectives on APA and their influence on the decision to apply or not apply for APA.

Benefits of a Histamine-Reducing Diet for Some Patients with Chronic Urticaria and Angioedema.

Urticaria and angioedema symptoms result primarily from the physiological actions of histamine. Some individuals with urticaria have a decreased ability to degrade dietary histamine before it enters the circulation. Foods high in histamine, such as fermented foods, may exacerbate urticaria and angioedema in these individuals.