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8. Worth the wait? Time course of supine shifts in body water compartments on variables of bioelectrical impedance analysis

Author

Ducharme Jeremy B., Hall Holly, Fennel Zachary J., Gerard-Osbourne Avadney, Houck Jonathan M., Clark Chloe, and Gibson Ann L.

Subjects
bia, tbw, icw, ecw, body fat, phase angle, Medicine (General), R5-920
Abstract

Bioelectrical impedance analysis (BIA) reference values are based on supine assessments. Little is known regarding the effects of time course shifts in body water compartments after assuming a supine position. The aim of this study was to characterize these effects and provide recommendations regarding the optimal waiting time to perform BIA. Thirty-eight healthy adults underwent BIA via the RJL Quantum Legacy analyzer immediately upon lying down and every 5 minutes for 15 minutes. Differences in resistance (R), reactance (Xc), intracellular (ICW), extracellular (ECW), total body water (TBW), body fat percentage (%BF), and phase angle (PhA) were assessed. There were small but significant increases in R, Xc, and %BF (all p

Published
2023
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12. An Environmental Scan of Academic Emergency Medicine at the 17 Canadian Medical Schools: Why Does this Matter to Emergency Physicians? – CORRIGENDUM

Author

Stiell, G., primary, Artz, J. D., additional, Lang, E. S., additional, Sherbino, J., additional, Morrison, L. J., additional, Christenson, J., additional, Perry, J. J., additional, Topping, C., additional, Woods, R., additional, Green, R. S., additional, Lim, R., additional, Magee, K., additional, Foote, J., additional, Meckle, G., additional, Mensour, M., additional, Field, S., additional, Chung, B., additional, Kuuskne, M., additional, Ducharme, J., additional, Klein, V., additional, and McEwen, J., additional

Published
2017
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13. Abstracts

Author

Crosby, E. T., Halpern, S., Bill, K. M., Flynnn, R. J., Moore, J., Navaneelan, C., Cunningham, A., Yu, P. Y. H., Gamling, D. R., McMorland, G. H., Perreault, C., Guay, J., Gaudreault, P., Hollman, C., Meloche, R., Hackman, T., Sheps, S. B., Murray, W. B., Heiman, P. A., Slinger, P., Triolet, W., Jain, U., Rao, T. L. K., Dasari, M., Pifarre, R., Sullivan, H., Calandra, D., Friesen, R. M., Bjornson, J., Hatton, G., Parlow, J. L., Casey, W. F., Broadman, L. M., Rice, L. J., Dailey, M., Andrews, W. R., Stigi, S., Jendrek, V., Shevde, K., Withington, D. E., Saoud, A. Tazi, Ramsay, J. G., Bilodeau, J., Johnson, D., Mayers, I., Doran, R. J., Wong, P. Y., Mullen, Brendan J., Wigglesworth, D., Byrick, R. J., Kay, J. Colin, Stubbing, J. F., Sweeney, B. P., Dagher, E., Dumont, L., Lagace, G., Chartrand, C., Badner, N. H., Sandier, A. N., Leitch, L., Koren, G., Erian, R. F., Bunegin, L., Shulman, D. L., Burrows, F., O’Sullivan, K., Bouchier, D., Kashin, B. A., Wynands, J. E., Villeneuve, E., Blaise, G., Guerrard, M. J., Buluran, J., Effa, E., Vaghadia, H., Jenkins, L. C., Janisse, T., Scudamore, C. H., Patel, P. M., Mutch, W. A. C., Ruta, T. S., McNeill, B. R., Murkin, J. M., Gelb, A. W., Farrar, J. K., Johnson, G. D., Adams, M. A., Lillicrap, D. P., Lindblad, T., Beattie, W. S., Buckley, D. N., Forrest, J. B., Lessard, M. R., Trépanier, C. A., Baribault, J. P., Brochu, J. G., Brousseau, C. A., Cote, J. J., Denault, P., Whang, P., Moudgil, G. C., Daly, N., Morrison, D. H., Ogilvie, R., Man, J., Ehler, T., Leitch, L. F., Dupuis, J. Y., Martin, R., Tessonnier, J. M., Barry, A. W., Milne, B., Quintin, L., Gillon, J. Y., Pujol, J. F., DeMonte, F., Zhang, C., Hamilton, J. T., Zhou, Y., Plourde, G., Picton, T. W., Kellett, A., Pilato, M. A., Bissonnette, B., Lerman, J., Brown, K. A., Dundee, J. W., Sosis, M., Dillon, F., Stetson, J. B., Voorhees, W. D., Bourland, J. D., Geddes, L. A., Shoenlein, W. E., O’Leary, G., Teasdale, S., Knill, R. L., Rose, E. A., Berko, S. L., Smith, C. E., Sadler, J. M., Bevan, J. C., Donati, F., Bevan, D. R., Tellez, J., Turner, D., Kao, Y. J., Salidivia, V., Roldan, L., Orrego, H., Carmicheal, F. J., Kent, A. P., Parker, C. J. R., Hunter, J. M., Finley, G. A., Goresky, G. V., Klassen, K., McDiarmid, C., Shaffer, E., Vaughan, M., Randolph, J., Szalados, J. E., Lazzell, V. A., Creighton, R. E., Poon, A. O., Mclntyre, B., Douglas, M. J., Swenerton, J. E., Farquharson, D. F., Landry, D., Petit, F., Riegert, D., Koch, J. P., Maggisano, R., Devitt, J. H., Jense, H. G., Dubin, S. A., Silverstein, P. I., Rodriguez, N., Wakefield, M. L., Williams, R., Dubin, S., Smith, J. J., Hofmann, V. C., Jarvis, A. P., Forbes, R. B., Murray, D. J., Dillman, J. B., Dull, D. L., Cohen, M. M., Cameron, C. B., Johnston, R. G., Konopad, E., Jivraj, K., Hunt, D., Eastley, R., Strunin, L., Fairbrass, M. J., Laganiere, S., McGilvery, M., Foster, B., Young, P., Weisel, D., Parra, L., Suarez Isla, B. A., Lopez, J. R., Hall, R. I., Hawwa, R., Kashtan, H., Edelist, G., Mallon, J., Kapala, D., Dhamee, M. Saeed, Reynolds, A. C., Olund, T., Entress, J., Kalbfleisch, J., Bell, S. D., Goldberg, M. E., Bracey, B. J., Goldhill, D. R., Bennett, M. H., Emmott, R. S., Innis, R. F., Yate, P. M., Flynn, P. J., Gill, S. S., Saunders, P. R., Geisecke, A. H., Feldman, J. M., Banner, M. J., Siriwardhana, S. A., Kawas, A., Lipton, J. L., Giesecke, A. H., Doyle, D. J., Volgyesi, G. A., Hillier, S. C., Gallagher, J., Hargaden, K., Hamil, M., Cunningham, A. J., Scott, W. A. C., Sielecka, D., Illing, L. H., Jani, K., Scarr, M., Maltby, J. R., Roy, J., McNulty, S. E., Torjman, M., Carey, C., Bracey, B., Markham, K., Durcan, J., Blackstock, D., DaSilva, C. A., Demars, P. D., Montgomery, C. J., Steward, D. J., Sessler, D. I., Laflamme, P., McDevitt, S., Kamal, G. D., Symreng, T., Tatman, D. J., Durcharme, J., Varin, F., Besner, J. G., Dyck, J. B., Chung, F., Arellano, R., Lim, G., Bailey, D. G., Bayliff, C. D., Cunningham, D. G., Ewen, A., Sheppard, S. D., Mahoney, L. T., Bacon, G. S., Rice, L. R., Newman, K., Loe, W., Toth, M., Pilato, M., Classen, K., McDiamid, C., Burrows, F. A., Irish, C. L., Casey, W., Hauser, G. J., Chan, M. M., Midgley, F. M., Holbrook, P. R., Elliott, M. E., Man, W. K., Finegan, B. A., Clanachan, A. S., Hudson, R. J., Thomson, I. R., Burgess, P. M., Rosenbloom, M., Fisher, J. M., O’Connor, J. P., Ralley, F. E., Robbins, G. R., Moote, C. A., Manninen, P. H., English, M., Farmer, C., Scott, A., White, I. W. C., Biehl, D., Donen, N., Mansfield, J., Cohen, M., Wade, J. G., Woodward, C., Ducharme, J., Gerardi, A., Mijares, A., Code, W. E., Hertz, L., Chung, A., Meier, H. M. R., Lautenschlaeger, E., Seyone, C., Wassef, M. R., Devitt, F. H., Cheng, D. C. H., Dyck, B., Chan, V. W. S., Ferrante, F. M., Arthur, G. R., Rice, L., Annallah, R. H., Etches, R. C., Loulmet, D., Lacombe, P., Hollmann, C., Tanguay, M., Blaise, G. A., Lenis, S. G., Fear, D. W., Lang, S. A., Ha, H. C., Germain, H., Neion, A., Dorian, P., Salter, D., Pollick, C., Cervenko, F., Parlow, J., Pym, J., Nakatsu, K., Elliott, D., Miller, D. R., Martineau, R. J., Ewing, D., Martineau, R. J., Knox, J. W. D., Oxorn, D. C., O’Connor, J. P., Whalley, D. G., Rogers, K. H., Kay, J. C., Mazer, C. D., Belo, S. E., Hew-Wing, P., Hew, E., Tessonier, J. M., Thibault, G., Testaert, E., Chartrand, D., Cusson, J. R., Kuchel, O., Larochelle, P., and Couture, J.

Published
1989
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18. Acute stroke management

Author

Ducharme, J., Currie, T., Ovens, H., Rutledge, T., and Thompson, J.

Subjects
Letter
Published
2001

19. Training tutors and parents to implement discrete-trials teaching with children diagnosed with autism

Author

Pear, J. (Psychology) Yu, C. T. (Psychology) Hrycaiko, D. (Kinesiology and Recreation Management) Ducharme, J. (Ontario Institute for Studies in Education of the University of Toronto), Martin, G. (Psychology), Fazzio, Daniela F., Pear, J. (Psychology) Yu, C. T. (Psychology) Hrycaiko, D. (Kinesiology and Recreation Management) Ducharme, J. (Ontario Institute for Studies in Education of the University of Toronto), Martin, G. (Psychology), and Fazzio, Daniela F.

Abstract

Discrete-trials teaching (DTT) is one of the principal techniques used in Applied Behaviour Analysis programs for children with autism. Although the demand for training individuals to implement DTT is high, published studies on strategies to do so are few. I conducted two experiments to investigate a training package for teaching individuals to implement DTT. In Experiment 1, I used a modified multiple-baseline design to evaluate the training package for teaching five university students to implement DTT to teach three tasks to a confederate role-playing a child with autism. Also, in an AB within-subject design with each participant, I compared two components of the training package, a Self-Instructional Manual and Feedback plus Demonstration. Experiment 2 was a systematic replication of Experiment 1, with 2 teaching assistants, a resource teacher, and 3 parents of children with autism as participants. In both experiments I assessed the generalization (G1) of participants’ ability to implement DTT (while teaching the confederate) to teach tasks not targeted for Feedback plus Demonstration, as well as generalization (G2) of DTT while teaching a child with autism. After an average of approximately 3 hours to master the self-instructional manual, participants’ DTT accuracy in both experiments improved from an average of 34% in Baseline to an average of 61% following the Self-Instructional Manual. Results appeared to be due to the Self-Instructional Manual phase for 9 of the 11 participants. Following an average of 35 minutes of Feedback plus Demonstration of DTT of one task, participants’ DTT accuracy improved to an average of 91% while teaching a confederate. The improvement appeared to be due to the intervention with 10 of the 11 participants. The participants’ DTT accuracy averaged 90% during G1 and 86% during G2. These results demonstrate that this training package has considerable potential for teaching DTT to tutors, educational assistants, and parents of childre

Published
2007

22. Deux solitudes: l'informatique dans les ecoles de gestion et dans les entreprises

Author

Lefebvre, L.-A., Lefebvre, E., and Ducharme, J.

Subjects
Canada -- Social policy, Business schools -- Study and teaching, Business enterprises -- Equipment and supplies, Computers -- Usage, Business, Business, international, United Nations. Economic Commission for Europe -- Records and correspondence
Published
1988

24. 193

Author

Fosnocht, D., primary, Homel, P., additional, Todd, K., additional, Crandall, C., additional, Choiniere, M., additional, Ducharme, J., additional, and Tanabe, P., additional

Published
2006
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25. 405

Author

Safdar, B., primary, Choiniere, M., additional, Crandall, C., additional, Ducharme, J., additional, Fosnocht, D.E., additional, Homel, P., additional, Tanabe, P., additional, and Todd, K.H., additional

Published
2006
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26. 196

Author

Ducharme, J., primary, Tanabe, P., additional, Todd, K., additional, Homel, P., additional, Fosnocht, D., additional, Choiniere, M., additional, and Crandall, C., additional

Published
2006
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27. (955)

Author

Choinière, M., primary, Crandall, C., additional, Ducharme, J., additional, Fosnocht, D., additional, Homel, P., additional, Tanabe, P., additional, and Todd, K., additional

Published
2006
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38. The impact on patient flow after the integration of nurse practitioners and physician assistants in 6 Ontario emergency departments.

Author

Ducharme J, Alder RJ, Pelletier C, Murray D, and Tepper J

Abstract

OBJECTIVE: We sought to assess the impact of the integration of the new roles of primary health care nurse practitioners (NPs) and physician assistants (PAs) on patient flow, wait times and proportions of patients who left without being seen in 6 Ontario emergency departments (EDs). METHODS: We performed a retrospective review of health records data on patient arrival time, time of initial assessment by a physician, time of discharge from the ED and discharge status. RESULTS: Whether a PA or NP was directly involved in the care of patients or indirectly involved by being on duty, the wait times, lengths of stay and proportion of patients who left without being seen were significantly reduced. When a PA or NP were directly involved in patients' care, patients were 1.6 (95% confidence interval [CI] 1.3-2.1, p < 0.05) and 2.1 (95% CI 1.6-2.8, p < 0.05) times more likely to be seen within the wait time benchmarks, respectively. Lengths of stay were 30.3% (95% CI 21.6%-39.0%, p < 0.01) and 48.8% (95% CI 35.0%-62.7%, p < 0.01) lower when PAs and NPs, respectively, were involved. When PAs and NPs were not on duty, the proportion of patients who left without being seen were 44% (95% CI 31%-63%, p < 0.01) and 71% (95% CI 53%-96%, p < 0.05), respectively. CONCLUSION: The addition of PAs or NPs to the ED team can improve patient flow in medium-sized community hospital EDs. Given the ongoing shortage of physicians, use of alternative health care providers should be considered. These results require validation, as their generalizability to other locations or types of EDs is not known. [ABSTRACT FROM AUTHOR]

Published
2009
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41. The utility of multiple imaging modalities to diagnose acute aortic dissection.

Author

Hurley KF and Ducharme J

Abstract

A 21-year-old man with Marfan syndrome and known aortic root aneurysm presented to our emergency department with symptoms suggestive of acute aortic dissection. The patient was hemodynamically stable and bilateral upper extremity blood pressures were similar. There was no mediastinal widening on portable chest radiograph. Both contrast CT and retrograde angiography of the aorta failed to identify dissection. Subsequent transesophageal echocardiography demonstrated a Stanford classification type A dissection. This case demonstrates the utility of multiple imaging modalities for identifying aortic dissection in high-risk patients. [ABSTRACT FROM AUTHOR]

Published
2008
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42. Can urine cultures and reagent test strips be used to diagnose urinary tract infection in elderly emergency department patients without focal urinary symptoms?

Author

Ducharme J, Neilson S, and Ginn JL

Abstract

Objective: To compare the results of urine cultures and reagent strip testing in 2 groups of elderly emergency department (ED) patients: an asymptomatic group unlikely to have urinary tract infection (UTI), and a group who had vague symptoms and were considered at risk for UTI.Methods: We performed a prospective observational convenience study with 2 groups of 100 patients aged 65 or older. The asymptomatic group consisted of afebrile patients presenting to the ED with non-infectious complaints, while the symptomatic group included patients presenting with acute confusion, weakness or fever but no apparent urinary symptoms. We defined a positive urine culture as a single organism count greater than 100 000 CFU/mL in mid-stream specimens, or greater than 1000 CFU/mL in catheter specimens. We considered reagent strips positive if they demonstrated any reaction to the leukocyte-esterase assay, the nitrite assay or both.Results: Of the 33 positive cultures, 10 had negative reagent strips. Thirteen of the 14 positive nitrite tests were culture positive for a specificity of 92.8% and a sensitivity of 36.1%. Positive cultures did not infer a diagnosis of UTI. Of the 67 positive reagent strips, 41 (61.2%) were associated with negative cultures. Likelihood ratios (LRs) in both groups affirmed the inability of the reagent strips to help significantly in decision making, with positive and negative LR in the indeterminate range (control group: 2.8 and 0.31, symptomatic group: 2.7 and 0.46, respectively).Conclusion: In the elderly, reagent testing is an unreliable method of identifying patients with positive blood cultures. Moreover, positive urine culture rates are only slightly higher in patients with vague symptoms attributable to UTI than they are in (asymptomatic) patients treated for non-urologic problems, which suggests that many positive cultures in elderly patients with non- focal systemic symptoms are false-positive tests reflecting asymptomatic bacteriuria and not UTIs. Blood cultures, regarded by many as the criterion standard for UTI, do not have sufficient specificity to confirm the diagnosis of UTI in elderly patients with non-specific symptoms. [ABSTRACT FROM AUTHOR]

Published
2007
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48. Stereoselective pharmacokinetics of ifosfamide and its 2- and 3-N-dechloroethylated metabolites in female cancer patients.

Author

Granvil, Camille, Ducharme, Julie, Leyland-Jones, Brian, Trudeau, Marc, Wainer, Irving, Granvil, C P, Ducharme, J, Leyland-Jones, B, Trudeau, M, and Wainer, I W

Subjects
ANTINEOPLASTIC agents, CHEMISTRY, COMPARATIVE studies, KIDNEYS, RESEARCH methodology, MEDICAL cooperation, PELVIC tumors, RESEARCH, EVALUATION research, IFOSFAMIDE
Abstract

The pharmacokinetics of the R and S enantiomers of ifosfamide (IFF) and of its 2- and 3-N-dechloroethylated metabolites (2-DCE-IFF and 3-DCE-IFF) were investigated in 14 cancer patients treated with a 3-h infusion of (R,S)-IFF (3 g/m2) with mesna uroprotection. An enantioselective gas chromatographic-mass spectrometric (GC-MS) assay was used to determine the concentrations in plasma and urine. The AUCs of (R)-IFF were significantly larger than those of (S)-IFF (2480 +/- 200 vs 1960 +/- 150 microM.h). The terminal half-lives (7.57 +/- 0.99 h) and mean residence times (11.17 +/- 1.10 h) of (R)-IFF were significantly longer than those of (S)-IFF, 6.03 +/- 0.82 h and 9.37 +/- 0.88 h, respectively. The mean volume of distribution at steady rate of (R)-IFF (25.68 +/- 0.80 l/m2) was slightly smaller than that of (S)-IFF (27.35 +/- 0.89 l/m2). While the renal clearances of (R)-IFF and (S)-IFF were similar, the nonrenal clearance was significantly lower for (R)-IFF (30.20 +/- 2.70 vs 41.40 +/- 3.55 ml/m2 per min) as was total clearance (41.52 +/- 2.90 vs 52.37 +/- 3.75 ml/m(2) per min). The AUC values for all of the DCE metabolites from (S)-IFF were significantly greater than those from (R)-IFF with 47% of the measured AUC accounted for by DCE from (S)-IFF compared to only 20% for (R)-IFF. Therefore, the enantioselective difference in IFF elimination can be partially explained by differences in N-dechloroethylation. [ABSTRACT FROM AUTHOR]

Published
1996
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50. N,N-Diethyl-4-(phenylpiperidin-4-ylidenemethyl)benzamide:  A Novel, Exceptionally Selective, Potent δ Opioid Receptor Agonist with Oral Bioavailability and Its Analogues

Author

Wei, Z.-Y., Brown, W., Takasaki, B., Plobeck, N., Delorme, D., Zhou, F., Yang, H., Jones, P., Gawell, L., Gagnon, H., Schmidt, R., Yue, S.-Y., Walpole, C., Payza, K., St-Onge, S., Labarre, M., Godbout, C., Jakob, A., Butterworth, J., Kamassah, A., Morin, P.-E., Projean, D., Ducharme, J., and Roberts, E.

Abstract

The design, synthesis, and pharmacological evaluation of a novel class of δ opioid receptor agonists, N,N-diethyl-4-(phenylpiperidin-4-ylidenemethyl)benzamide (6a) and its analogues, are described. These compounds, formally derived from SNC-80 (2) by replacing the piperazine ring with a piperidine ring containing an exocyclic carbon carbon double bond, were found to bind with high affinity and exhibit excellent selectivity for the δ opioid receptor as full agonists. 6a, the simplest structure in the class, exhibited an IC50 = 0.87 nM for the δ opioid receptors and extremely high selectivity over the μ receptors (μ/δ = 4370) and the κ receptors (κ/δ = 8590). Rat liver microsome studies on a selected number of compounds show these olefinic piperidine compounds (6) to be considerably more stable than SNC-80. This novel series of compounds appear to interact with δ opioid receptors in a similar way to SNC-80 since they demonstrate similar SAR. Two general approaches have been established for the synthesis of these compounds, based on dehydration of benzhydryl alcohols (7) and Suzuki coupling reactions of vinyl bromide (8), and are herewith reported.

Published
2000

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