58 results match your criteria: "The London Health Sciences Centre[Affiliation]"
2024 Canadian Surgery Forum: Sept. 25-28, 2024.
Can J Surg
November 2024
From St. Michael's Hospital (Naveed, Deshpande, Gomez, Rezende-Neto, Ahmed, Beckett), and the University of Toronto (Naveed).
Perceptions of readiness for independent practice among graduating orthopedic surgery residents in Ontario in the last 30 years.
Can J Surg
November 2024
From Western University, London, Ont. (Ndoja) Schemitsch, Lanting); the London Health Sciences Centre, London, Ont. (Ndoja, Schemitsch, Lanting); HEC Montréal, Montréal, Que. (Howe); the University of Ottawa, Ottawa, Ont. (Papp); the Ottawa Hospital, Ottawa, Ont. (Papp).
Background: There is increasing concern regarding the lack of physicians and underresourcing of the medical system in Canada. The training of orthopedic surgeons has emerged as an area of particular concern. The purpose of this study was to gain insight into the outcomes of graduates of orthopedic surgery residency programs in Ontario in the last 30 years.
View Article and Find Full Text PDFAssessing Hospital Pharmacists' Scope of Clinical Practice in Ontario.
Can J Hosp Pharm
April 2024
, BSc, PharmD, ACPR, RPh, is with the London Health Sciences Centre, London, Ontario.
Background: Expansion of the scope of pharmacists' activities in hospital is associated with reductions in adverse events and drug-related readmissions. However, the breadth of hospital pharmacists' clinical activities varies widely across Ontario due to provisions in the provincial . Few data exist defining expanded scope in institutions across Ontario.
View Article and Find Full Text PDFCandidate Kidney Protective Strategies for Patients Undergoing Major Abdominal Surgery: A Secondary Analysis of the RELIEF Trial Cohort.
Anesthesiology
June 2024
Monash University, Melbourne, Australia; Department of Anaesthesia and Perioperative Medicine, Alfred Hospital, Melbourne, Australia.
Background: Acute kidney injury (AKI) is common after major abdominal surgery. Selection of candidate kidney protective strategies for testing in large trials should be based on robust preliminary evidence.
Methods: A secondary analysis of the Restrictive versus Liberal Fluid Therapy in Major Abdominal Surgery (RELIEF) trial was conducted in adult patients undergoing major abdominal surgery and randomly assigned to a restrictive or liberal perioperative fluid regimen.
Health care costs after total knee arthroplasty for satisfied and dissatisfied patients.
Can J Surg
October 2022
From the School of Physical Therapy, Faculty of Heath Sciences, Western University, London, Ont. (Marsh, Joshi); the Bone and Joint Institute, Western University, London, Ont. (Marsh, Vasarhelyi, Lanting); the London Health Sciences Centre, London, Ont. (Somerville, Vasarhelyi, Lanting); and the Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Vasarhelyi, Lanting).
Background: Evidence suggests that up to 21% of patients are dissatisfied after total knee arthroplasty (TKA), but the link between dissatisfaction and use of health care resources is unknown. The objective of this study was to compare costs after TKA between satisfied and dissatisfied patients.
Methods: This was a secondary analysis of a randomized clinical trial among patients who underwent primary TKA at our institution between 2015 and 2018.
The functional and structural associations of aberrant microglial activity in major depressive disorder.
J Psychiatry Neurosci
June 2022
From the Department of Neuroscience, Western University, London, Ont. (Cakmak, Schaefer, Sabesan, Palaniyappan); the Robarts Research Institute, Western University, London, Ont. (Cakmak, Palaniyappan); the Lawson Health Research Institute, London, Ont. (Liu, Poirier, Burhan, St. Lawrence, Théberge, Hicks, Finger, Anazodo); the Department of Medical Biophysics, Western University, London, Ont. (Poirier, Sabesan, St. Lawrence, Théberge, Hicks, Anazodo); the London Health Sciences Centre, London, Ont. (Schaefer, Poolacherla, Palaniyappan); the Department of Psychiatry, Western University, London, Ont. (Burhan, Théberge, Palaniyappan); the Department of Psychiatry, University of Toronto, Toronto, Ont. (Burhan); the Ontario Shores Centre for Mental Health Sciences, Whitby, Ont. (Burhan); the Department of Clinical Neurological Sciences, Western University, London, Ont. (Finger); the Department of Anesthesia and Perioperative Medicine, Western University, London, Ont. (Poolacherla).
Background: Major depressive disorder (MDD) is a debilitating mental illness that has been linked to increases in markers of inflammation, as well as to changes in brain functional and structural connectivity, particularly between the insula and the subgenual anterior cingulate cortex (sgACC). In this study, we directly related inflammation and dysconnectivity in treatment-resistant MDD by concurrently measuring the following: microglial activity with [F]N-2-(fluoroethoxyl)benzyl-N-(4phenoxypyridin-3-yl)acetamide ([F]FEPPA) positron emission tomography (PET); the severity of MDD; and functional or structural connectivity among insula or sgACC nodes.
Methods: Twelve patients with treatment-resistant MDD (8 female, 4 male; mean age ± standard deviation 54.
Immunosuppressant Medication Use in Patients with Kidney Allograft Failure: A Prospective Multicenter Canadian Cohort Study.
J Am Soc Nephrol
June 2022
University of British Columbia Division of Nephrology, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Background: Patients with kidney transplant failure have a high risk of hospitalization and death due to infection. The optimal use of immunosuppressants after transplant failure remains uncertain and clinical practice varies widely.
Methods: This prospective cohort study enrolled patients within 21 days of starting dialysis after transplant failure in 16 Canadian centers.
Safety, quality and patient experience are the three key elements of a value-based patient-centred care model. The essential element that brings these together is workforce engagement. This case study illustrates how an outpatient physiotherapy team at a teaching hospital has adapted, evolved and enhanced new practices initiated at the clinician level.
View Article and Find Full Text PDFPerioperative gait analysis after total hip arthroplasty: Does outpatient surgery compromise patient outcomes?
Can J Surg
July 2021
From the Faculty of Health Sciences, Western University, London, Ont. (Zomar, Bryant, Hunter); the Bone and Joint Institute, Western University, London, Ont. (Zomar, Bryant); the London Health Sciences Centre, London, Ont. (Howard, Lanting); and the Schulich School of Medicine and Dentistry, Western University, London, Ont. (Howard, Lanting).
Background: There has been a continuing trend toward decreasing the length of hospital stay for patients undergoing total hip arthroplasty (THA). We aimed to investigate the impact of timing of discharge on gait and patient-reported outcomes early after THA.
Methods: In this prospective observational cohort study conducted from May 2014 to November 2015, we measured gait velocity, stride length, single-limb support and single-limb support symmetry in adults aged 18-75 years before direct anterior THA, at discharge from the hospital, and 2, 6 and 12 weeks postoperatively.
Medical assistance in dying and the trauma patient.
J Trauma Acute Care Surg
June 2021
From the London Health Sciences Centre Trauma Program (A.M., F.P., I.B.) London, ON Canada; Department of Surgery (K.N.V., N.G.P.), Western University, London, ON Canada; Division of General Surgery (K.N.V., N.G.P.), London Health Sciences Centre Trauma Program, London, ON Canada; Ethics Program (R.S.), London Health Sciences Centre, London, ON Canada; and Department of Medicine (I.B.) and Department of Epidemiology and Biostatistics (I.B.), Western University, London, ON Canada.
Prolonged surgical time increases the odds of complications following total knee arthroplasty.
Can J Surg
April 2021
From the Division of Orthopaedic Surgery, Western University, London, Ont. (Morcos); the Institute of Medical Science, University of Toronto, Toronto, Ont. (Nowak); and the London Health Sciences Centre, London, Ont. (Schemitsch).
Background: The aim of this study was to evaluate the influence of operating time on complications and readmission within 30 days of total knee arthroplasty (TKA) and to determine if there were specific time intervals associated with worse outcomes.
Methods: The American College of Surgeons’ National Surgical Quality Improvement Program database was used to identify patients 18 years of age and older who underwent TKA between 2006 and 2017, using procedural codes. Patient demographic characteristics, operation length and 30-day major and minor complication and readmission rates were captured.
In Their Own Words: What Do Healthcare Workers Want from Their Organization during the COVID-19 Pandemic?
Healthc Q
April 2021
Professor and chair in the Department of Psychiatry at the Schulich School of Medicine & Dentistry at Western University in London, ON, and chief of Psychiatry at the London Health Sciences Centre and St. Joseph's Health Care London in London, ON.
Pandemics are associated with heightened distress among healthcare workers (HCWs). We report qualitative findings from a two-stage survey administered to HCWs at a large acute care hospital in Ontario during the COVID-19 pandemic to identify their concerns and wellness needs. Responses reflected HCWs' desires to be heard, protected, prepared, supported and cared for by the organization.
View Article and Find Full Text PDFMagnetic Resonance Imaging Findings Are Associated with Long-Term Global Neurological Function or Death after Traumatic Brain Injury in Critically Ill Children.
J Neurotrauma
September 2021
Neuroscience and Mental Health Research Program, Hospital for Sick Children, Toronto, Ontario, Canada.
The identification of children with traumatic brain injury (TBI) who are at risk of death or poor global neurological functional outcome remains a challenge. Magnetic resonance imaging (MRI) can detect several brain pathologies that are a result of TBI; however, the types and locations of pathology that are the most predictive remain to be determined. Forty-two critically ill children with TBI were recruited prospectively from pediatric intensive care units at five Canadian children's hospitals.
View Article and Find Full Text PDFEvaluation of a population health strategy to reduce distracted driving: Examining all "Es" of injury prevention.
J Trauma Acute Care Surg
March 2021
From the London Health Sciences Centre and Children's Hospital (T.C.S., J.E., T.H., B.B., D.D.F., N.H.M., N.G.P.); Department of Paediatrics (T.C.S., J.G., D.D.F., N.H.M.), and Department of Pathology and Laboratory Medicine (T.C.S.), Schulich School of Medicine and Dentistry, University of Western Ontario; Middlesex London Health Unit (A. Penney); Department of Geography (J.G., A.C.), Faculty of Social Sciences; School of Health Studies, Faculty of Health Sciences, University of Western Ontario (J.G., A.C.); Children's Health Research Institute and Lawson Health Research Institute (J.G., D.D.F., T.C.S.); London Police Service (A. Pfeffer); Department of Surgery (N.H.M., N.G.P.), Schulich School of Medicine and Dentistry, University of Western Ontario; and Centre for Critical Illness Research (N.G.P.), London, Ontario, Canada.
Background: Cell phone use while driving (CPWD) increases the risk of crashing and is a major contributor to injuries and deaths. The objective of this study was to describe the evaluation of a multifaceted, evidence-based population health strategy for the reduction of distracted driving.
Methods: A multipronged campaign was undertaken from 2014 to 2016 for 16- to 44-year-olds, based on epidemiology, focused on personal stories and consequences, using the "Es" of injury prevention (epidemiology, education, environment, enforcement, and evaluation).
Venous thromboembolism in emergency general surgery patients: a single-centre retrospective cohort study.
Can J Surg
February 2020
From the Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Yang, Murphy, Sela, Govind, Leslie, Vogt); and the London Health Sciences Centre, London, Ont. (Allen).
Background: There is limited literature on the risk of venous thromboembolism (VTE) in emergency general surgery (EGS) patients. We undertook this study to identify the rate of symptomatic VTE for patients undergoing EGS operations.
Methods: We conducted a retrospective cohort study evaluating EGS patients who underwent operative intervention between March and December 2014.
Significant cost savings and similar patient outcomes associated with early discharge following total knee arthroplasty.
Can J Surg
February 2019
From the School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ont. (Marsh); the Bone and Joint Institute, Western University, London, Ont. (Marsh, Howard, Lanting); the London Health Sciences Centre, London, Ont. (Somerville, Howard, Lanting); and the Schulich School of Medicine and Dentistry, Western University, London, Ont. (Somerville, Howard, Lanting).
Background: A substantial portion of the cost of total knee arthroplasty (TKA) results from the postoperative inpatient length of stay (LOS). Considering the annual increase in TKAs, reducing LOS represents a potential for cost savings. We sought to compare in-hospital costs and patient-reported outcomes for an early discharge protocol compared with the standard LOS following TKA.
View Article and Find Full Text PDFVoluntary Euthanasia - Implications for Organ Donation.
N Engl J Med
September 2018
From the Department of Medicine and the Department of Epidemiology and Biostatistics, Western University (I.M.B.), and the London Health Sciences Centre Ethics Program (R.S.) - both in London, ON, Canada; and the Center for Bioethics, Harvard Medical School, Boston (R.D.T.).
Canadian Surgery Forum 2018: St. John's, NL Sept. 13-15, 2018.
Can J Surg
August 2018
From McMaster University, Hamilton, Ont.
Troponin T monitoring to detect myocardial injury after noncardiac surgery: a cost-consequence analysis.
Can J Surg
June 2018
From the University Hospital of Düsseldorf, Düsseldorf, Germany (Lurati Buse); the University Hospital of Basel, Basel, Switzerland (Lurati Buse); the University of Calgary, Calgary, Alta. (Manns); McMaster University, Hamilton, Ont. (Lamy, Guyatt, Tiboni, Devereaux); the Hospital de Clínicas de Porto Alegre, Universidade Federal de Rio Grande do Sul, Brazil (Polanczyk); the Chinese University of Hong Kong, Sha Tin, NT, Hong Kong (Chan); the University of Malaya, Kuala Lampur, Malaysia (Wang); the Fundación Cardioinfantil - Instituto de Cardiología, Bogotá and Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia (Villar); St. John's Medical College and Research Institute, Bangalore, India (Sigamani); the Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio (Sessler); the HCor Research Institute (Hospital do CoraÇão), São Paulo, Brazil (Berwanger); the Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa (Biccard); Barts and The London School of Medicine and Dentistry, London, UK (Pearse); the Hospital de Sant Pau, Barcelona, Spain (Urrútia); the Jagiellonian University Medical College, Krakow, Poland (Szczeklik); the Hospital General Universitario Gregorio Marañón, Madrid, Spain (Garutti); the University of Manitoba, Winnipeg, Man. (Srinathan); the Universidad Peruana Cayetano Heredia, Lima, Peru (Malaga); the Christian Medical College, Ludhiana, India (Abraham); the George Institute for Global Health, University of Sydney, Sydney, Australia (Chow); the University of Alberta Hospital, Edmonton, Alta. (Jacka); the University College London, London, UK (Ackland); the London Health Sciences Centre, London, Ont. (Macneil); the University of Leeds, Leeds, UK (Sapsford); the Royal Liverpool Broadgreen University Hospital Trust, Liverpool, UK (Leuwer); and the HÔpital Pitié-Salpêtrière, Paris, France (Le Manach).
Background: Myocardial injury after noncardiac surgery (MINS) is a mostly asymptomatic condition that is strongly associated with 30-day mortality; however, it remains mostly undetected without systematic troponin T monitoring. We evaluated the cost and consequences of postoperative troponin T monitoring to detect MINS.
Methods: We conducted a model-based cost-consequence analysis to compare the impact of routine troponin T monitoring versus standard care (troponin T measurement triggered by ischemic symptoms) on the incidence of MINS detection.
Patient-perceived barriers to radiation therapy for breast cancer.
Can J Surg
April 2018
From the Schulich School of Medicine & Dentistry, Western University, London, Ont. (Guidolin, Lock, Brackstone); and the London Health Sciences Centre, London, Ont. (Lock, Brackstone).
Studies have shown that a number of women do not receive adjuvant radiation therapy following breast-conserving surgery; the reasons have not been well investigated. We reviewed the charts of 267 patients in our institution who did not receive radiation therapy following surgery in order to determine patient-stated reasons for nonreceipt. We found that 43% of patients did not receive radiation because they received a completion mastectomy.
View Article and Find Full Text PDFPatient-perceived barriers to radiation therapy for breast cancer.
Can J Surg
December 2017
From the Schulich School of Medicine & Dentistry, Western University, London, Ont. (Guidolin, Lock, Brackstone); and the London Health Sciences Centre, London, Ont. (Lock, Brackstone).
Studies have shown that a number of women do not receive adjuvant radiation therapy following breast-conserving surgery; the reasons have not been well investigated. We reviewed the charts of 267 patients in our institution who did not receive radiation therapy following surgery in order to determine patientstated reasons for nonreceipt. We found that 43% of patients did not receive radiation because they received a completion mastectomy.
View Article and Find Full Text PDFCanadian Guidelines for Controlled Pediatric Donation After Circulatory Determination of Death-Summary Report.
Pediatr Crit Care Med
November 2017
1Division of Pediatric Intensive Care, CHU de Quebec, Centre Mère-Enfant Soleil, Québec, QC, Canada.2Department of Pediatrics, Université Laval Faculté de Médecine, Québec, QC, Canada.3Canadian Blood Services Decreased Donation, Ottawa, ON, Canada.4Department of Medicine & Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada.5Division of Neonatal Intensive Care, University of Alberta & Stollery Children's Hospitals, Edmonton, AB, Canada.6Division of Critical Care, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.7Division of Paediatric Cardiac Intensive Care Unit, University of Alberta & Stollery Children's Hospitals, Edmonton, AB, Canada.8Division of Critical Care, BC Children's Hospital, Vancouver, BC, Canada.9Bioethics Program, University Health Network, Toronto, ON, Canada.10Critical Care Medicine, Département de pédiatrie, CHU Sainte-Justine, Montréal, QC, Canada.11Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada.12Department of Bioethics, Hospital for Sick Children, Toronto, ON, Canada.13Division of Paediatric Critical Care Medicine, Western University Children's Hospital, London, ON, Canada.14Division of Critical Care, Johns Hopkins All Children's Hospital, St. Petersburg, FL.15Information Specialist, Québec, QC, Canada.16Division of Pediatric Intensive Care, Janeway Childrens Health and Rehabilitation Centre, St. Johns, NL, Canada.17Division of Pediatric Intensive Care, Victoria General Hospital, Victoria, BC, Canada.18Division of Neonatal Intensive Care, Children's Hospital of the London Health Sciences Centre, London, ON, Canada.19Division of Pediatric Intensive Care, University of Alberta & Stollery Children's Hospitals, Edmonton, AB, Canada.20Division of Pediatric Critical Care, Hamilton Health Sciences, Hamilton, ON, Canada.21Canadian Blood Services Legal Department, Ottawa, ON, Canada.22Division of Pediatric Cardiology, Hospital for Sick Children, Toronto, ON, Canada.23Division of Cardiac Surgery, University of Alberta Hospital, Edmonton, AB, Canada.24Division of Nephrology, Hospital for Sick Children, Toronto, ON, Canada.25Division of Pediatric Anesthesia, Stollery Children's Hospital, Edmonton, AB, Canada.26Division of Pediatric Intensive Care, Alberta Children's Hospital, Calgary, AB, Canada.27Division of Neonatal Intensive Care, BC Women's Hospital + Health Centre, Vancouver, BC, Canada.28Division of Neonatology, Hospital for Sick Children, Toronto, ON, Canada.29Division of Critical Care, Montreal Children's Hospital, McGill University Health Centre and Research Institute, Montréal, QC, Canada.30Division of Critical Care, Montreal Children's Hospital, McGill University Health Centre and Research Institute, Montréal, QC, Canada.31Department of Pediatrics, McGill University, Montréal, QC, Canada.
Objectives: Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada.
Methods: We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology.