60 results on '"Kureshi, N"'
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2. Association between serum vitamin B12, folic acid & nitrosative stress in hypothyroidism
- Author
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Kureshi, N., primary, Aggarwal, J., primary, and Batra, J., primary
- Published
- 2023
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3. ESICM LIVES 2016: part two: Milan, Italy. 1–5 October 2016
- Author
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Sivakumar, S., Taccone, F. S., Desai, K. A., Lazaridis, C., Skarzynski, M., Sekhon, M., Henderson, W., Griesdale, D., Chapple, L., Deane, A., Williams, L., Strickland, R., Lange, K., Heyland, D., Chapman, M., Rowland, M. J., Garry, P., Westbrook, J., Corkill, R., Antoniades, C. A., Pattinson, K. T., Fatania, G., Strong, A. J., Myers, R. B., Lazaridis, C., Jermaine, C. M., Robertson, C. S., Rusin, C. G., Hofmeijer, J., Sondag, L., Tjepkema-Cloostermans, M. C., Beishuizen, A., Bosch, F. H., van Putten, M. J. A. M., Carteron, L., Patet, C., Solari, D., Oddo, M., Ali, M. A., Dias, C., Almeida, R., Vaz-Ferreira, A., Silva, J., Monteiro, E., Cerejo, A., Rocha, A. P., Elsayed, A. A., Abougabal, A. M., Beshey, B. N., Alzahaby, K. M., Pozzebon, S., Ortiz, A. Blandino, Cristallini, S., Lheureux, O., Brasseur, A., Vincent, J. L., Creteur, J., Taccone, F. S., Hravnak, M., Yousef, K., Chang, Y., Crago, E., Friedlander, R. M., Abdelmonem, S. A., Tahon, S. A., Helmy, T. A., Meligy, H. S., Puig, F., Dunn-Siegrist, I., Pugin, J., Gupta, S., Govil, D., Srinivasan, S., Patel, S. J., N, J. K., Gupta, A., Tomar, D. S., Shafi, M., Harne, R., Arora, D. P., Talwar, N., Mazumdar, S., Papakrivou, E. E., Makris, D., Manoulakas, E., Tsolaki, B., Karadodas, B., Zakynthinos, E., Garcia, I. Palacios, Martin, A. Diaz, Encinares, V. Sanchez, Ibañez, M. Pachón, Montero, J. Garnacho, Labrador, G., Cangueiro, T. Cebrero, Poulose, V., Koh, J., Kam, J. W., Yeter, H., Kara, A., Aktepe, O., Topeli, A., Tsolakoglou, I., Intas, G., Stergiannis, P., Kolaros, A. A., Chalari, E., Athanasiadou, E., Martika, A., Fildisis, G., Faivre, V., Mengelle, C., Favier, B., Payen, D., Poppe, A., Winkler, M. S., Mudersbach, E., Schreiber, J., Wruck, M. L., Schwedhelm, E., Kluge, S., Zöllner, C., Tavladaki, T., Spanaki, A. M., Dimitriou, H., Kondili, E., Choulaki, C., Meleti, E., Kafetzopoulos, D., Georgopoulos, D., Briassoulis, G., la Torre, A. García-de, de la Torre-Prados, M. V., Tsvetanova-Spasova, T., Nuevo-Ortega, P., Rueda-Molina, C., Fernández-Porcel, A., Camara-Sola, E., Salido-Díaz, L., García-Alcántara, A., Tavladaki, T., Spanaki, A. M., Dimitriou, H., Kondili, E., Choulaki, C., Meleti, D. E., Kafetzopoulos, D., Georgopoulos, D., Briassoulis, G., Suberviola, B., Riera, J., Rellan, L., Sanchez, M., Robles, J. C., Lopez, E., Vicente, R., Miñambres, E., Santibañez, M., Le Guen, M., Moore, J., Mason, N., Windpassinger, M., Plattner, O., Mascha, E., Sessler, D. I., Research, Outcomes, Melia, U., Fontanet, J., van den Berg, J. P., Struys, M. M. R. F., Vereecke, H. E. M., Jensen, E. W., Rood, P. J. T., van de Schoor, F., van Tertholen, K., Pickkers, P., van den Boogaard, M., Beardow, Z. J., Redhead, H., Paramasivam, K., Numan, T., van den Boogaard, M., Kamper, A. M., Rood, P., Peelen, L. M., Zeman, P. M., Slooter, A. J., van Ewijk, C. E., Jacobs, G. E., Girbes, A. R. J., Myatra, S. N., Harish, M. M., Prabu, N. R., Siddiqui, S., Kulkarni, A. P., Divatia, J. V., Murbach, L. D., Leite, M. A., Osaku, E. F., Costa, C. R. L. M., Pelenz, M., Neitzke, N. M., Moraes, M. M., Jaskowiak, J. L., Silva, M. M. M., Zaponi, R. S., Abentroth, L. R. L., Ogasawara, S. M., Jorge, A. C., Duarte, P. A. D., Hernández-Sánchez, N., Sánchez-Hurtado, L. A., García-Guillen, F. J., Ñamendys-Silva, S. A., Maghsoudi, B., Emami, M., Khosravi, M. B., Zand, F., Tabatabaie, H. R., Masjedi, M., Sabetiyan, G., Mokri, A., Troubleyn, J., Diltoer, M., Jacobs, R., Nguyen, D. N., De Waele, E., De Regt, J., Honoré, P. M., Van Gorp, V., Spapen, H. D., Contreras, R. S., Toapanta, N. D., Moreno, G., Sabater, J., Torrado, H., Gonzalez, M., Marin, M., Farigola, E., Gonzalez, A., Fernandez, J., Vera, A., Gisbert, X., Juliá, C., Uya, J., Corral, L., Elias-Jones, I., Gemmell, L., MacKay, A., Randall, D., Adwaney, A., Blunden, M., Prowle, J. R., Kirwan, C. J., Thomas, N., Martin, A., Owen, H., Darwin, L., Conway, D., Atkinson, D., Sharman, M., Moore, J., Barbanti, C., Amour, J., Gaudard, P., Rozec, B., Mauriat, P., M’rini, M., Leger, P. L., Cambonie, G., Liet, J. M., Girard, C., Laroche, S., Damas, P., Assaf, Z., Loron, G., Lecourt, L., Pouard, P., Randall, D., Adwaney, A., Blunden, M., Prowle, J.R., Kirwan, C. J., Kim, S. H., Na, S., Kim, J., Oh, S. Y., Jung, C. W., Yoo, S. H., Min, S. H., Chung, E. J., Lee, H., Lee, N. J., Lee, K. W., Suh, K. S., Ryu, H. G., Marshall, D. C., Goodson, R. J., Salciccioli, J. D., Shalhoub, J., Potter, E. K., Kirk-Bayley, J., Karanjia, N. D., Forni, L. G., Creagh-Brown, B. C., Bossy, M., Nyman, M., Tailor, A., Creagh-Brown, B., D’Antini, D., Spadaro, S., Valentino, F., Sollitto, F., Cinnella, G., Mirabella, L., Calvo, F. J. Redondo, Bejarano, N., Padilla, D., Baladron, V., Villajero, P., Villazala, R., Redondo, J., Yuste, A. S., Liu, J., Shen, F., Teboul, J. L., Anguel, N., Beurton, A., Bezaz, N., Richard, C., Monnet, X., Fossali, T., Colombo, R., Ottolina, D., Rossetti, M., Mazzucco, C., Marchi, A., Porta, A., Catena, E., Tollisen, K. H., Andersen, G. Ø., Heyerdahl, F., Jacobsen, D., de Waard, M. C., Girbes, A. R. J., van IJzendoorn, M. C. O., Buter, H., Kingma, W. P., Navis, G. J., Boerma, E. C., Rulisek, J., Balik, M., Zacharov, S., Kim, H. S., Jeon, S. J., Namgung, H., Lee, E., Lee, E., Cho, Y. J., Lee, Y. J., Huang, A., Cioccari, L., Luethi, N., Mårtensson, J., Bellomo, R., Forsberg, M., Edman, G., Höjer, J., Forsberg, S., Freile, M. T. Chiquito, Hidalgo, F. N., Molina, J. A. Martinez, Lecumberri, R., Rosselló, A. Figuerola, Travieso, P. Medrano, Leon, G. Tuero, Sanchez, J. Gonzalez, Frias, L. Sahuquillo, Rosello, D. Balsells, Verdejo, J. A. Garcia, Serrano, J. A. Noria, Winterwerp, D., van Galen, T., Vazin, A., Karimzade, I., Zand, A., Ozen, E., Ekemen, S., Akcan, A., Sen, E., Yelken, B. Buyukkidan, Kureshi, N., Fenerty, L., Thibault-Halman, G., Erdogan, M., Walling, S., Green, R. S., Clarke, D. B., Briassoulis, P., Kalimeris, K., Ntzouvani, A., Nomikos, T., Papaparaskeva, K., Politi, E., Kostopanagiotou, G., Crewdson, K., Rehn, M., Weaver, A., Brohi, K., Lockey, D., Wright, S., Thomas, K., Baker, C., Mansfield, L., Stafford, V., Wade, C., Watson, G., Bryant, A., Chadwick, T., Shen, J., Wilkinson, J., Furneval, J., Henderson, A., Hugill, K., Howard, P., Roy, A., Bonner, S., Baudouin, S., Ramírez, C. Sánchez, Escalada, S. Hípola, Viera, M. A. Hernández, Santana, M. Cabrera, Balcázar, L. Caipe, Monroy, N. Sangil, Campelo, F. Artiles, Vázquez, C. F. Lübbe, Santana, P. Saavedra, Santana, S. Ruiz, Carteron, L., Patet, C., Quintard, H., Solari, D., Bouzat, P., Oddo, M., Wollersheim, T., Malleike, J., Haas, K., Carbon, N., Schneider, J., Birchmeier, C., Fielitz, J., Spuler, S., Weber-Carstens, S., Enseñat, L., Pérez-Madrigal, A., Saludes, P., Proença, L., Gruartmoner, G., Espinal, C., Mesquida, J., Huber, W., Eckmann, M., Elkmann, F., Gruber, A., Lahmer, T., Mayr, U., Herner, A., Schellnegger, R., Schneider, J., Schmid, R. M., Ayoub, W., Samy, W., Esmat, A., Battah, A., Mukhtar, S., Mongkolpun, W., Cortés, D. Orbegozo, Cordeiro, C. P. R., Vincent, J. L., Creteur, J., Funcke, S., Groesdonk, H., Saugel, B., Wagenpfeil, G., Wagenpfeil, S., Reuter, D. A., Fernandez, M. M., Fernandez, R., Magret, M., González-Castro, A., Bouza, M. T., Ibañez, M., García, C., Balerdi, B., Mas, A., Arauzo, V., Añón, J. M., Ruiz, F., Ferreres, J., Tomás, R., Alabert, M., Tizón, A. I., Altaba, S., Llamas, N., Goligher, E C., Fan, E., Herridge, M., Vorona, S., Sklar, M., Dres, M., Rittayamai, N., Lanys, A., Urrea, C., Tomlinson, G., Reid, W. D., Rubenfeld, G. D., Kavanagh, B. P., Brochard, L. J., Ferguson, N. D., Neto, A. Serpa, de Abreu, M. Gama, Pelosi, P., Schultz, M. J., Guérin, C., Papazian, L., Reignier, J., Ayzac, L., Loundou, A., Forel, J. M., Rolland-Debord, C., Bureau, C., Poitou, T., Clavel, M., Perbet, S., Terzi, N., Kouatchet, A., Similowski, T., Demoule, A., Hunfeld, N., Trogrlic, Z., Ladage, S., Osse, R. J., Koch, B., Rietdijk, W., Devlin, J., van der Jagt, M., Picetti, E., Ceccarelli, P., Mensi, F., Malchiodi, L., Risolo, S., Rossi, I., Antonini, M. V., Servadei, F., Caspani, M. L., Roquilly, A., Lasocki, S., Seguin, P., Geeraerts, T., Perrigault, P. F., Dahyot-Fizelier, C., Paugam-Burtz, C., Cook, F., Cinotti, R., dit Latte, D. Demeure, Mahe, P. J., Fortuit, C., Feuillet, F., Asehnoune, K., Marzorati, C., Spina, S., Scaravilli, V., Vargiolu, A., Riva, M., Giussani, C., Sganzerla, E., Citerio, G., Barbadillo, S., de Molina, F. J. González, Álvarez-Lerma, F., Rodríguez, A., Zakharkina, T., Martin-Loeches, I., Matamoros, S., Povoa, P., Torres, A., Kastelijn, J., Hofstra, J. J., de Jong, M., Schultz, M., Sterk, P., Artigas, A., Bos, L. J., Moreau, A. S., Martin-Loeches, I., Povoa, P., Salluh, J., Rodriguez, A., Nseir, S., de Jong, E., van Oers, J. A., Beishuizen, A., Girbes, A. R. J., Nijsten, M. W. N., de Lange, D. W., Bonvicini, D., Labate, D., Benacchio, L., Olivieri, A., Pizzirani, E., Lopez-Delgado, J. C., Gonzalez-Romero, M., Fuentes-Mila, V., Berbel-Franco, D., Romera-Peregrina, I., Martinez-Pascual, A., Perez-Sanchez, J., Abellan-Lencina, R., Ávila-Espinoza, R. E., Moreno-Gonzalez, G., Sbraga, F., Griffiths, S., Grocott, M. P. W., Creagh-Brown, B., Doyle, J., Wilkerson, P., Soon, Y., Huddart, S., Dickinson, M., Riga, A., Zuleika, A., Miyamoto, K., Kawazoe, Y., Morimoto, T., Yamamoto, T., Fuke, A., Hashimoto, A., Koami, H., Beppu, S., Katayama, Y., Ito, M., Ohta, Y., Yamamura, H., Rygård, S. L., Holst, L B., Wetterslev, J., Johansson, P. I., Perner, A., Soliman, I. W., de Lange, D. W., van Dijk, D., van Delden, J. J. M., Cremer, O. L., Slooter, A. J. C., Peelen, L. M., McWilliams, D., Snelson, C., Neves, A. Das, Loudet, C. I., Busico, M., Vazquez, D., Villalba, D., Veronesi, M., Lischinsky, A., López, F. J. L., Mori, L. Benito, Plotnikow, G., Díaz, A., Giannasi, S., Hernandez, R., Krzisnik, L., Cecotti, C., Viola, L., Lopez, R., Sottile, J. P., Benavent, G., Estenssoro, E., Chen, C. M., Lai, C. C., Cheng, K. C., Chou, W., Chan, K. S., Roeker, L. E., Horkan, C. M., Gibbons, F. K., Christopher, K. B., Weijs, P. J. M., Mogensen, K. M., Rawn, J. D., Robinson, M. K., Christopher, K. B., Tang, Z., Qiu, C., Ouyang, B., Cai, C., Guan, X., Regueira, T., Cea, L., Carlos, S. Juan, Elisa, B., Puebla, C., Vargas, A., Poulsen, M. K., Thomsen, L. P., Kjærgaard, S., Rees, S. E., Karbing, D. S., Wollersheim, T., Frank, S., Müller, M. C., Carbon, N. M., Skrypnikov, V., Pickerodt, P. A., Falk, R., Mahlau, A., Weber-Carstens, S., Lee, A., Inglis, R., Morgan, R., Barker, G., Kamata, K., Abe, T., Saitoh, D., Tokuda, Y., Green, R. S., Butler, M. B., Erdogan, M., Hwa, H. Tae, Gil, L. Jae, Vaquero, R. Hernández, Rodriguez-Ruiz, E., Lago, A. Lopez, Allut, J. L. Garcia, Gestal, A. Estany, Gonzalez, M. A. Garcia, Thomas-Rüddel, D. O., Schwarzkopf, D., Fleischmann, C., Reinhart, K., Suwanpasu, S., Sattayasomboon, Y., Filho, N. M. Filgueiras, Oliveira, J. C. A., Ballalai, C. S., De Lucia, C. V., Araponga, G. P., Veiga, L. N., Silva, C. S., Garrido, M. E., Ramos, B. B., Ricaldi, E. F., Gomes, S. S., Gemmell, L., MacKay, A., Wright, C., Docking, R. I., Doherty, P., Black, E., Stenhouse, P., Plummer, M. P., Finnis, M. E., Phillips, L. K., Kar, P., Bihari, S., Biradar, V., Moodie, S., Horowitz, M., Shaw, J. E., Deane, A. M., Yatabe, T., Inoue, S., Sakaguchi, M., Egi, M., Abdelhamid, Y. Ali, Plummer, M. P., Finnis, M. E., Phillips, L. K., Kar, P., Bihari, S., Biradar, V., Moodie, S., Horowitz, M., Shaw, J. E., Deane, A. M., Hokka, M., Egi, M., Mizobuchi, S., Kar, P., Plummer, M., Abdelhamid, Y. Ali, Giersch, E., Summers, M., Hatzinikolas, S., Heller, S., Chapman, M., Jones, K., Horowitz, M., Deane, A., Schweizer, R., Jacquet-Lagreze, M., Portran, P., Junot, S., Allaouchiche, B., Fellahi, J. L., Guerci, P., Ergin, B., Kapucu, A., Ince, C., Cioccari, L., Luethi, N., Crisman, M., Bellomo, R., Mårtensson, J., Shinotsuka, C. Righy, Fagnoul, D., Brasseur, A., Orbegozo, D., Vincent, J. L., Preiser, J. C., Preiser, J. C., Lheureux, O., Thooft, A., Brimioulle, S., Vincent, J. L., Iwasaka, H., Tahara, S., Nagamine, M., Ichigatani, A., Cabrera, A. Rugerio, Zepeda, E. Monares, Granillo, J. Franco, Sánchez, J. S. Aguirre, Montoya, A. A. Tanaka, Montenegro, A. Pedraza, Blanco, G. A. Gálvez, Robles, C. M. Coronado, Drolz, A., Horvatits, T., Roedl, K., Rutter, K., Kluge, S., Funk, G. C., Schneeweiss, B., Fuhrmann, V., Sabetian, G., Pooresmaeel, F., Zand, F., Ghaffaripour, S., Farbod, A., Tabei, H., Taheri, L., Anandanadesan, R., Metaxa, V., Teixeira, C., Pereira, S. M., Hernández-Marrero, P., Carvalho, A. S., Beckmann, M., Hartog, C. S., Schwarzkopf, D., Raadts, A., Robertsen, A., Førde, R., Skaga, N. O., Helseth, E., Honeybul, S., Ho, K., Lopez, P. Martinez, Gonzalez, M. Nieto, Ortega, P. Nuevo, Sola, E. Camara, Spasova, T., de la Torre-Prados, M. V., Kopecky, O., Rusinova, K., Waldauf, P., Cepeplikova, Z., Balik, M., Domínguez, J. Palamidessi, Almudevar, P. Matia, Carmona, S. Alcántara, Muñoz, J. J. Rubio, Castañeda, D. Palacios, Abellán, A. Naharro, Villamizar, P. Rodríguez, Ramos, J. Veganzones, Pérez, L. Pérez, Lucendo, A. Pérez, Ejarque, M. Camós, Estella, A., Camps, V. Lopez, Martín, M. C., Masnou, N., Barbosa, S., Varela, A., Palma, I., Cristina, L., Nunes, E., Pereira, I., Campello, G., Granja, C., Pande, R., Pandey, M., Varghese, S., Chanu, M., Van Dam, M. J., Ter Braak, E. W. M. T., Estella, A., Gracia, M., Viciana, R., Recuerda, M., Fontaiña, L. Perez, Tharmalingam, B., Kovari, F., Rose, L., Mcginlay, M., Amin, R., Burns, K., Connolly, B., Hart, N., Jouvet, P., Katz, S., Leasa, D., Mawdsley, C., Mcauley, D., Schultz, M., Blackwood, B., Denham, S., Worrall, R., Arshad, M., Isherwood, P., Khadjibaev, A., Sabirov, D., Rosstalnaya, A., Parpibaev, F., Sharipova, V., Blanco, G. A. Galvez, Guzman, C. I. Olvera, Sánchez, J. S. Aguirre, Granillo, J. Franco, Gupta, S., Govil, D., Srinivasan, S., Patel, S. J., N, J. K., Gupta, A., Shafi, M., Tomar, D. S., Harne, R., Arora, D. P., Talwar, N., Mazumdar, S., Cha, Y. S., Lee, S. J., Tyagi, N., Rajput, R. K., Taneja, S., Singh, V. K., Sharma, S. C., Mittal, S., Rao, B. K., Ayachi, J., Fraj, N., Romdhani, S., Khedher, A., Meddeb, K., Sma, N., Azouzi, A., Bouneb, R., Chouchene, I., El Ghardallou, M., Boussarsar, M., Jennings, R., Walter, E., Ribeiro, J. M., Moniz, I., Marçal, R., Santos, A. C., Candeias, C., e Silva, Z. Costa, Gomez, S. E. Zamora, Nieto, O. R. Perez, Gonzalez, J. A. Castanon, Cuellar, A. I. Vasquez, Mildh, H., Pettilä, V., Korhonen, A. M., Karlsson, S., Ala-Kokko, T., Reinikainen, M., Vaara, S. T., Zaleska-Kociecka, M., Grabowski, M., Dąbrowski, M., Wozniak, S., Piotrowska, K., Banaszewski, M., Imiela, J., Stepinska, J., Pérez, A. González, Ordoñez, P. Florez, Giribet, A., Cuervo, M. A. Alonso, Cuervo, R. Alonso, Esteban, M. A. Rodriguez, Fraile, L. Iglesias, Mittelbrum, C. Ponte, Albaiceta, G. Muñiz, Koeze, J., Keus, F., Dieperink, W., van der Horst, I. C. C., van Meurs, M., Zijlstra, J. G., Roberts, S., Caballero, C. Hernandez, Isgro, G., Hall, D., Beitland, S., Trøseid, A.-M. S., Brusletto, B. S., Waldum-Grevbo, B. E., Berg, J. P., Sunde, K., Huertas, D. García, Manzano, F., Quintana, M. M. Jiménez-, Osuna, A., Santiago-Ruiz, F., Rodríguez-Mejías, C., Wangensteen, R., Jamaati, H. R., Masjedi, M., Zand, F., Hashemian, S. M. R., Sabetian, G., Abbasi, G., Khaloo, V., Tabei, S. H.a., Kafilzadeh, A., Bakhodaei, H. Haddad, Diaz, J. A., Silva, R., Garcia, D. J., Luis, E., Gomez, M. N., Soriano, R., Gonzalez, P. L., Ibrahim, I. A., Rafik, M. M., Al-Ansary, A. M., Algendi, M. A., Ali, A. A., Fuhrmann, V., Roedl, K., Horvatits, T., Drolz, A., Rutter, K., Benten, D., Kluwe, J., Siedler, S., Kluge, S., Adedugbe, I., Bird, G. T., Kennedy, R. M., Sharma, S., Butler, M. B., Yugi, G., Haroon, B. A., Witter, T., Khaliq, W., Singer, M., Havaldar, A. A., Krishna, B., Sriram, S., Espinoza, E. D. Valenzuela, Pozo, M. O., Edul, V. S. Kanoore, Furche, M., Motta, M. F., Vazquez, A. Risso, Birri, P. N. 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C., Vieira, Jr, J. M., Azevedo, L. C. P., Nurses of the Central and General ICUs of Shiraz Namazi Hospital, Sedation an Delirium Group Hospital Universitari de Bellvitge, SPACeR group (Surrey Peri-operative, Anaesthesia and Critical Care Collaborative Research Group), for the PRoVENT investigators and the PROVE Network, SEMICYUC/GETGAG Working Group, TAVeM study group, POPC-CB investigators, DESIRE (DExmedetomidine for Sepsis in ICU Randomized Evaluation) Trial Investigators, GEMINI, Bioethics work group of SEMICYUC, The FINNAKI Study Group, Queen Square Neuroanaesthesia and Neurocritical Care Resreach Group, Renal Transplantation HUVR, GEMINI, EDISVAL Group, EDISVAL Group, PLUG Working group, TAVeM study Group, The FINNAKI Study Group, on behalf of Department of Professional Development, ESICM, Critical Care Research Group, SIRAKI group, and Grupo ESBAGA
- Published
- 2016
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4. P.185 Impact-detecting helmets as indicators of concussion and blood brain barrier integrity in university football players
- Author
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Jones, C, primary, Audas, L, additional, Kureshi, N, additional, Kamintsky, L, additional, Fenerty, L, additional, Wilson, L, additional, Atkinson, C, additional, Friedman, A, additional, and Clarke, DB, additional
- Published
- 2021
- Full Text
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5. P.184 Off-road vehicle fatalities and alcohol in patients with major traumatic brain injury: the risk of impaired driving
- Author
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Walling, S, primary, Kureshi, N, additional, Clarke, DB, additional, Erdogan, M, additional, and Green, RS, additional
- Published
- 2021
- Full Text
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6. P.230 Modic changes and clinical outcomes in patients undergoing lumbar surgery for disc herniation
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MacLean, MA, primary, Kureshi, N, additional, Shankar, J, additional, Stewart, S, additional, and Christie, SD, additional
- Published
- 2021
- Full Text
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7. LO67: Association between hypotension and mortality in critically ill patients with severe traumatic brain injury: experience at a single Canadian trauma center
- Author
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Green, R., primary, Erdogan, M., additional, Kureshi, N., additional, and Clarke, D., additional
- Published
- 2019
- Full Text
- View/download PDF
8. Intracerebral hemorrhage in ICU: is it worth treating?
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- Subjects
intracerebral haemorrhage in intensive care - Published
- 2016
9. ESICM LIVES 2016: part two
- Author
-
Sivakumar, S., Taccone, F. S., Desai, K. A., Lazaridis, C., Skarzynski, M., Sekhon, M., Henderson, W., Griesdale, D., Chapple, L., Deane, A., Williams, L., Strickland, R., Lange, K., Heyland, D., Chapman, M., Rowland, M. J., Garry, P., Westbrook, J., Corkill, R., Antoniades, C. A., Pattinson, K. T., Fatania, G., Strong, A. J., Myers, R. B., Jermaine, C. M., Robertson, C. S., Rusin, C. G., Hofmeijer, J., Sondag, L., Tjepkema-Cloostermans, M. C., Beishuizen, A., Bosch, F. H., van Putten, M. J. A. M., Carteron, L., Patet, C., Solari, D., Oddo, M., Ali, M. A., Dias, C., Almeida, R., Vaz-Ferreira, A., Silva, J., Monteiro, E., Cerejo, A., Rocha, A. P., Elsayed, A. A., Abougabal, A. M., Beshey, B. N., Alzahaby, K. M., Pozzebon, S., Ortiz, A. Blandino, Cristallini, S., Lheureux, O., Brasseur, A., Vincent, J. L., Creteur, J., Hravnak, M., Yousef, K., Chang, Y., Crago, E., Friedlander, R. M., Abdelmonem, S. A., Tahon, S. A., Helmy, T. A., Meligy, H. S., Puig, F., Dunn-Siegrist, I., Pugin, J., Gupta, S., Govil, D., Srinivasan, S., Patel, S. J., N, J. K., Gupta, A., Tomar, D. S., Shafi, M., Harne, R., Arora, D. P., Talwar, N., Mazumdar, S., Papakrivou, E. E., Makris, D., Manoulakas, E., Tsolaki, B., Karadodas, B., Zakynthinos, E., Garcia, I. Palacios, Martin, A. Diaz, Encinares, V. Sanchez, Ibañez, M. Pachón, Montero, J. Garnacho, Labrador, G., Cangueiro, T. Cebrero, Poulose, V., Koh, J., Kam, J. W., Yeter, H., Kara, A., Aktepe, O., Topeli, A., Tsolakoglou, I., Intas, G., Stergiannis, P., Kolaros, A. A., Chalari, E., Athanasiadou, E., Martika, A., Fildisis, G., Faivre, V., Mengelle, C., Favier, B., Payen, D., Poppe, A., Winkler, M. S., Mudersbach, E., Schreiber, J., Wruck, M. L., Schwedhelm, E., Kluge, S., Zöllner, C., Tavladaki, T., Spanaki, A. M., Dimitriou, H., Kondili, E., Choulaki, C., Meleti, E., Kafetzopoulos, D., Georgopoulos, D., Briassoulis, G., la Torre, A. García-de, de la Torre-Prados, M. V., Tsvetanova-Spasova, T., Nuevo-Ortega, P., Rueda-Molina, C., Fernández-Porcel, A., Camara-Sola, E., Salido-Díaz, L., García-Alcántara, A., Meleti, D. E., Suberviola, B., Riera, J., Rellan, L., Sanchez, M., Robles, J. C., Lopez, E., Vicente, R., Miñambres, E., Santibañez, M., Le Guen, M., Moore, J., Mason, N., Windpassinger, M., Plattner, O., Mascha, E., Sessler, D. I., Research, Outcomes, Melia, U., Fontanet, J., van den Berg, J. P., Struys, M. M. R. F., Vereecke, H. E. M., Jensen, E. W., Rood, P. J. T., van de Schoor, F., van Tertholen, K., Pickkers, P., van den Boogaard, M., Beardow, Z. J., Redhead, H., Paramasivam, K., Numan, T., Kamper, A. M., Rood, P., Peelen, L. M., Zeman, P. M., Slooter, A. J., van Ewijk, C. E., Jacobs, G. E., Girbes, A. R. J., Myatra, S. N., Harish, M. M., Prabu, N. R., Siddiqui, S., Kulkarni, A. P., Divatia, J. V., Murbach, L. D., Leite, M. A., Osaku, E. F., Costa, C. R. L. M., Pelenz, M., Neitzke, N. M., Moraes, M. M., Jaskowiak, J. L., Silva, M. M. M., Zaponi, R. S., Abentroth, L. R. L., Ogasawara, S. M., Jorge, A. C., Duarte, P. A. D., Hernández-Sánchez, N., Sánchez-Hurtado, L. A., García-Guillen, F. J., Ñamendys-Silva, S. A., Maghsoudi, B., Emami, M., Khosravi, M. B., Zand, F., Tabatabaie, H. R., Masjedi, M., Sabetiyan, G., Mokri, A., Troubleyn, J., Diltoer, M., Jacobs, R., Nguyen, D. N., De Waele, E., De Regt, J., Honoré, P. M., Van Gorp, V., Spapen, H. D., Contreras, R. S., Toapanta, N. D., Moreno, G., Sabater, J., Torrado, H., Gonzalez, M., Marin, M., Farigola, E., Gonzalez, A., Fernandez, J., Vera, A., Gisbert, X., Juliá, C., Uya, J., Corral, L., Elias-Jones, I., Gemmell, L., MacKay, A., Randall, D., Adwaney, A., Blunden, M., Prowle, J. R., Kirwan, C. J., Thomas, N., Martin, A., Owen, H., Darwin, L., Conway, D., Atkinson, D., Sharman, M., Barbanti, C., Amour, J., Gaudard, P., Rozec, B., Mauriat, P., M’rini, M., Leger, P. L., Cambonie, G., Liet, J. 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Cambronero, Jiménez, R., Rebollo, S., Alejandro, O., Fernández, A., Moreno, S., Herrera, L., Ojados, A., Galindo, M., Murcia, J., Contreras, M., Sánchez-Argente, S., Bonilla, Y., Rodríguez, M. D., Allegue, J. M., Cakin, Ö., Parlak, H., Kirca, H., Mutlu, F., Aydınlı, B., Cengiz, M., Ramazanoglu, A., Jung, E.-J., Oh, S.-Y., Domenech, J. Cebrián, Montalvo, A. Pinos, Chornet, T. Ciges, Martinez, P. Concha, Ribas, M. Piñol, Costa, R. Gimeno, Ortega, A. Castellanos, Forbes, C., Prescott, H., Lal, A., Khan, F. A., Dela Pena, E. G., Dizon, J. S., Perez, P. P. P., Wong, C. M. J., Garach, M. Muñoz, Romero, O. Moreno, Puerta, R. Ramirez, Diaz, F. Acosta, Bailon, A. M. Perez, Pinel, A. Carranza, Maldonado, L. Peñas, Kalaiselvan, M. S., kumar, R. L. Siva, Renuka, M. K., Kumar, A. S. Arun, De Rosa, S., Ferrari, F., Checcacci, S. Carboni, Rigobello, A., Joannidis, M., Politi, F., Pellizzari, A., Bonato, R., Fernandez-Carmona, A., Macias-Guarasa, I., Gutierrez-Rodriguez, R., Martinez-Lopez, P., Diaz-Castellanos, M. A., Arias-Diaz, M., Aguilar-Alonso, E., Nikandish, R. N., Artemenko, V., Budnyuk, A., Bassi, G. Li, Senussi, T., Idone, F., Xiol, E. Aguilera, Travierso, C., Chiurazzi, C., Motos, A., Amaro, R., Hua, Y., Fernández-Barat, L., Ranzani, O. T., Bobi, Q., Rigol, M., Youn, A., Hwang, J. Gyung, Ossorio, M. E. Yuste, Figueira, H., Oliveira, R., Mota, A., Kamp, O., Cruciger, O., Aach, M., Kaczmarek, C., Waydhas, C., Schildhauer, T. A., Hamsen, U., Camprubí-Rimblas, M., Chimenti, L., Guillamat-Prats, R., Lebouvier, T., Bringué, J., Tijero, J., Gómez, M. N., Blanch, L., Tagliabue, G., Ji, M., Jagers, J. V. Suneby, Easton, P. A., Martins, A. M. C. R. P. F., Hong, J. Y., Shin, M. H., Park, M. S., Pomprapa, A., Hofferberth, M. B. T., Russ, M., Braun, W., Walter, M., Francis, R., Lachmann, B., Leonhardt, S., Landaverde-López, A., Canedo-Castillo, N. A., Esquivel-Chávez, A., Arvizu-Tachiquín, P. C., Baltazar-Torres, J. A., Cardoso, V., Krystopchuk, A., Castro, S., Melão, L., Firmino, S., Marreiros, A., Almaziad, S., Kubbara, A., Barnett, W., Nakity, R., Alamoudi, W., Altook, R., Tarazi, T., Fida, M., Safi, F., Assaly, R., Santini, A., Milesi, M., Maraffi, T., Pugni, P., Cavenago, M., Gattinoni, L., Protti, A., Perchiazzi, G., Borges, J. B., Bayat, S., Porra, L., Broche, L., Hedenstierna, G., Larsson, A., Roneus, A., Segelsjö, M., Vestito, M. C., Gremo, E., Nyberg, A., Castegren, M., Pikwer, A., Yoshida, T., Engelberts, D., Otulakowski, G., Katira, B., Post, M., Brochard, L., Amato, M. B. P., Koch, N., Hoellthaler, J., Mair, S., Phillip, V., Beitz, A., Baladrón, V., Villarejo, P., Steenstra, R. J., Banierink, H., Hof, J., van der Horst, I. C., Nijsten, M. W., Hoekstra, M., Sterz, F., Horvatits, K., Herkner, H., Kott, M., Zitta, K., Brandt, B., Schildhauer, C., Elke, G., Hummitzsch, L., Albrecht, M., González, L. Rey, Alonso, D. Cabestrero, Sánchez, R. de Pablo, Lucas, J. Higuera, Ferlitsch, A., Fauler, G., Trauner, M., Pischke, S., Fischer, L., Thaiss, F., Koch, M., Bangert, K., Lohse, A. W., Nashan, B., Sterneck, M., Faenza, S., Siniscalchi, A., Pierucci, E., Mancini, E., Ricci, D., Gemelli, C., Cuoghi, A., Magnani, S., Atti, M., Sotos, F., Cánovas, J., López, A., Burruezo, A., Torres, D., Herrera-Gutierrez, M. E., Barrueco-Francioni, J., Arias-Verdú, D., Lozano-Saez, R., Quesada-Garcia, G., Seller-Pérez, G., Figueiredo, A., Anzola, Y., Pereira, R., Bento, L., Lai, M., Deiana, M., Seller-Perez, G., Vardas, K., Ilia, S., Sertedaki, A., Charmadari, E., Stratakis, C. A., Briassouli, E., Goukos, D., Psarra, K., Botoula, E., Tsagarakis, S., Mageira, E., Routsi, C., Nanas, S., Campello, E., Radu, C. M., Su, H., Lam, Y. M., Willis, K., Pullar, V., Hubner, R. P., Tsang, J. L., de Guadiana-Romualdo, L. García, Rebollo-Acebes, S., Esteban-Torrella, P., Jiménez-Sánchez, R., Jiménez-Santos, E., Ortín-Freire, A., Hernando-Holgado, A., Albaladejo-Otón, M. D., Coelho, L., Rabello, L., Póvoa, P., Varis, E., Poukkanen, M., Jacob, S., Takala, J., Wilkman, E., Lundberg, O. H. M., Bergenzaun, L., Rydén, J., Rosenqvist, M., Melander, O., Chew, M. S., Kishihara, Y., Yasuda, H., Jimenez, R., Torrella, P. Esteban, Fernandez, A., Sanchez, S., Ortin, A., Prats, R. Guillamat, Aguilera, E., Marti, D., Fernandez, L., Ferrer, M., Lanziotti, V. S., Pulcheri, L., Ribeiro, M. O., Barbosa, A. P., e Silva, J. R. Lapa, Soares, M., Salluh, J. I. F., Marqués, M. Gil, Moreno, A. Puppo, Pizarraya, A. Gutierrez, Diaz, J. Pachón, Smani, Y., Connell, M. Mc, Zhang, L. A., Parker, R. S., Banerjee, I., Clermont, G., Norberg, E., Oras, J., Cuisinier, A., Maufrais, C., Payen, J. F., Nottin, S., Walther, G., Arib, S., Bilotta, F., Badenes, R., Rubulotta, F., Mirek, S., Monfort, B., Stazi, E., Roig, A. Lozano, Magnoni, S., Marando, M., Pifferi, S., Conte, V., Ortolano, F., Carbonara, M., Bertani, G., Scola, E., Cadioli, M., Triulzi, F., Colombo, A., Stocchetti, N., Rotzel, H. B., Lázaro, A. Serrano, Prada, D. Aguillón, Guimillo, M. Rodriguez, Piqueras, C. Sanchís, Guia, J. Romero, Simon, M. García, Arizmendi, A. Mesejo, Carratalá, A., El Maraghi, S., Yehia, A., Bakry, M., Shoman, A., Backes, F. N., Bianchin, M. M., Vieira, S. R. R., de Souza, A., Backes, A. N., Klein, C., Arunkumar, A. S., Lozano, A., Gallaher, C., Cattlin, S., Gordon, S., Picard, J., Fontana, V., Bond, O., Nobile, L., Mrozek, S., Delamarre, L., Capilla, F., Al-Saati, T., Fourcade, O., Dominguez-Berrot, A. M., Gonzalez-Vaquero, M., Vallejo-Pascual, M. E., Gupta, D., Ivory, B. D., Chopra, M., McCarthy, J., Felderhof, C. L., MacNeil, C., Maggiorini, M., Duska, F., Fumis, R. R. L., Junior, J. M. Vieira, Amarante, G., Skorko, A., Sanders, S., Aron, J., Kroll, R. J., Redfearn, C., Krishnan, P., Khalil, J. E., Kongpolprom, N., Gulia, V., Lourenço, E., Duro, C., Baptista, G., Alves, A., Arminda, B., Rodrigues, M., Hayward, J., Baldwin, F., Gray, R., Katinakis, P. A., Stijf, M., Ten Kleij, M., Jansen-Frederiks, M., Broek, R., de Bruijne, M., Spronk, P. E., Sinha, K., Luney, M., Palmer, K., Keating, L., Abu-Habsa, M., Bahl, R., Baskaralingam, N., Ahmad, A., Kanapeckaite, L., Bhatti, P., Glace, S., Jeyabraba, S., Lewis, H. F., Kostopoulos, A., Raja, M., West, A., Ely, A., Turkoglu, L. M., Zolfaghari, P., Baptista, J. P., Marques, M. P., Martins, P., Pimentel, J., Su, Y. C., Villacres, S., Stone, M. E., Parsikia, A., Medar, S., O’Dea, K. P., Porter, J., Tirlapur, N., Jonathan, J. M., Singh, S., Takata, M., McWhirter, E., Lyon, R., Hariz, M. L., Azmi, E., Alkhan, J., Movsisyan, V., Petrikov, S., Marutyan, Z., Aliev, I., Evdokimov, A., Antonucci, E., Merz, T., Hartmann, C., Calzia, E., Radermacher, P., Nußbaum, B., Huber-Lang, M., Gröger, M., Svoren-Jabalera, E., Davenport, E. E., Humburg, P., Knight, J., Hinds, C. J., Jun, I. J., Kim, W. J., Lee, E. H., Besch, G., Perrotti, A., Puyraveau, M., Baltres, M., Samain, E., Chocron, S., Pili-Floury, S., Plata-Menchaca, E. P., Sabater-Riera, J., Estruch, M., Boza, E., Toscana-Fernández, J., Bruguera-Pellicer, E., Ordoñez-Llanos, J., Pérez-Fernández, X. L., Cavaleiro, P., Tralhão, A., Arrigo, M., Lopes, J.-P., Lebrun, M., Cholley, B., PerezVela, J. L., MarinMateos, H., Rivera, J. J. Jimenez, Llorente, M. A. Alcala, De Marcos, B. Gonzalez, Fernandez, F. J. Gonzalez, Laborda, C. Garcia, Zamora, D. Fernandez, Delgado, J. C. Lopez, Imperiali, C., Dastis, M., Górka, J., Górka, K., Iwaniec, T., Frołow, M., Polok, K., Fronczek, J., Kózka, M., Musiał, J., Szczeklik, W., Sileli, M., Moursia, C., Maleoglou, H., Leleki, K., Uz, Z., Ince, Y., Papatella, R., Bulent, E., De Mol, B., Vicka, V., Gineityte, D., Ringaitiene, D., Norkiene, I., Sipylaite, J., Möller, C., Thomas-Rueddel, D. O., Vlasakov, V., Rochwerg, B., Theurer, P., Al Sibai, J. Zanabili, Camblor, P. Martinez, Fernandez, P. Alvarez, Gala, J. M. García, Guisasola, J. Silba, Tamura, T., Miyajima, I., Yamashita, K., Yokoyama, M., Dalampini, E., Nastou, M., Baddour, A., Ignatiadis, A., Asteri, T., Hathorn, K. E., Purtle, S. W., Viana, M. V., Tonietto, T. A., Gross, L. A., Costa, V. L., Tavares, A. L. J., Lisboa, B. O., Moraes, R. B., Vieira, S. R., Viana, L. V., Azevedo, M. J., Ceniccola, G. D., Pequeno, R. S. F., Holanda, T. P., Mendonça, V. S., Araújo, W. M. C., Carvalho, L. S. F., Segaran, E., Vickers, L., Brinchmann, K., Wignall, I., De Brito-Ashurst, I., del Olmo, R., Esteban, M. J., Vaquerizo, C., Carreño, R., Gálvez, V., Kaminsky, G., Nieto, B., Fuentes, M., De la Torre, M. A., Torres, E., Alonso, A., Velayos, C., Saldaña, T., Escribá, A., GRIP, J., Kölegård, R., Sundblad, P., Rooyackers, O., Naser, Ben, Jaziri, F., Jazia, A. Ben, Barghouth, M., Hentati, O., Skouri, W., El Euch, M., Mahfoudhi, M., Turki, S., Abdelghni, K. Ben, Abdallah, Ben, Maha, B. N. M., Lorente, M., Włudarczyk, A., Hałek, A., Bargouth, M., Bennasr, M., Abdelghani, K. Ben, Abdallah, T. Ben, Geenen, I. L., Parienti, J. J., Straaten, H. M. Oudemans-van, Shum, H. P., King, H. S., Chan, K. C., Yan, W. W., Londoño, J. Gonzalez, Cardenas, C. Lorencio, Pedrosa, M. Morales, Gubianas, C. Murcia, Bertolin, C. Fuster, Batllori, N. Vila, Sirvent, J. M., Mukhopadhyay, A., Chan, H. Y., Kowitlawakul, Y., Remani, D., Leong, C. S. F., Henry, C. J., Puthucheary, Z. A., Mendsaikhan, N., Begzjav, T., Lundeg, G., Dünser, M., Welsh, S. P., Guerra, E., Zerpa, M. C. l., Zechner, F., Berdaguer, F., Risso-Vazquez, A., Masevicius, F. D., Greaney, D., Magee, A., Fitzpatrick, G., Lugo-Cob, R. G., Tejeda-Huezo, B. C., Cano-Oviedo, A. A., Aydogan, M. S., Togal, T., Taha, A., Chai, H. Z., Kam, C., Razali, S. S. Yang, Sivasamy, V., Kuan, L. Y., Morales, M. A. Lopez, Pires, T., and Azevedo, L. C. P.
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Meeting Abstracts - Abstract
Introduction In addition to systemic hemodynamics, the management\ud of neurocritically ill patients is often informed by neuromonitoring. In\ud the absence of high-level evidence clinicians are often guided by personal\ud and local expertise. Little is known about practices as they pertain\ud to the use of such monitoring in patients with acute brain injury (ABI).\ud Objectives To investigate practices in bedside monitoring for ABI patients.\ud Particularly interested in differences among “neurointensivists”\ud (NIs; defined here as intensivists whose clinical practice is comprised\ud > 1/3 by neurocritical care) and other intensivists (OIs). Also, to\ud explore patterns specific to traumatic brain injury (TBI) and subarachnoid\ud hemorrhage (SAH), as well as preferences and availability of\ud particular technologies/devices.\ud Methods Electronic survey of 22 items including two case-based scenarios;\ud endorsed by SCCM (9,000 recipients) and ESICM (on-line\ud newsletter) in 2013. A sample size of 370 was calculated based on a\ud population of 10,000 physician members, a 5 % margin error, and\ud 95 % confidence interval. We summarized results using descriptive\ud statistics (proportions with 95 % confidence intervals). A chi-square\ud test was used to compare proportions of responses between NIs and\ud OIs with a significance p < 0.05.\ud Results There were 655 responders (66 % completion rate); 422(65 %)\ud were classified as OIs and 226(35 %) as NIs. More NIs follow\ud hemodynamic protocols for neurocritically-ill patients (56 % vs. 43 %, p\ud 0.001), in TBI (44.5 % vs. 33.3 %, p 0.007), and in SAH (38.1 % vs. 21.3 %,\ud p < 000.1). For delayed cerebral ischemia (DCI), more NIs target cardiac\ud index (CI) (35 % vs. 21 %, p 0.0001), and fluid responsiveness (62 % vs.\ud 53 %, p 0.03), use more bedside ultrasound (BUS) (42 % vs. 29 %, p\ud 0.005) and arterial waveform analysis (40 % vs. 29 %, p 0.02). For DCI\ud neuromonitoring, NIs use more angiography (57 % vs. 43 %, p 0.004),\ud TCD (46 % vs. 38 %, p 0.0001), and CTP (32 % vs.16 %, p 0.0001). For\ud CPP optimization in TBI, NIs use more arterial waveform analysis (45 %\ud vs. 35 %, p 0.019), and BUS (37 % vs. 27.7 %, p 0.023), while more OIs\ud monitor mixed venous oxygen saturation (54.1 % vs. 45 %, p 0.045). For\ud TBI neuromonitoring, NIs use more PbtO2 (28 % vs. 10 %, p 0.0001). In\ud the case scenario of raised ICP/low PbtO2, most employ analgosedation\ud (47 %) and osmotherapy (38 %). Fewer make use of preserved pressure\ud reactivity, particularly OIs (vasopressor use 23 % vs. 34 %, p 0.014).\ud Conclusions There is large heterogeneity in the use of monitoring protocols,\ud variables, and technologies/devices. “Neurointensivists” not only\ud employ more neuromonitoring but also more hemodynamic monitoring\ud in patients with acute brain injury. ICP/CPP remain the most commonly\ud followed neuro-variables in TBI patients, with low use of other\ud brain-physiology parameters, sugg
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- 2016
10. P.016 Early telephone follow-up for traumatic brain injury patients using the Rivermead post-concussion symptoms questionnaire
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Thibault-Halman, G, primary, Fenerty, L, additional, Taylor, P, additional, Kureshi, N, additional, Walling, S, additional, and Clarke, DB, additional
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- 2017
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11. P.102 Simulation-based training for surgical instrument recognition
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Clarke, DB, primary, Hong, M, additional, Kureshi, N, additional, Fenerty, L, additional, Thibault-Halman, G, additional, and D’Arcy, RC, additional
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- 2017
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12. P052: The effect of blood alcohol on outcomes in patients with major traumatic brain injury in Nova Scotia
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Green, R., primary, Kureshi, N., additional, Fenerty, L., additional, Thibault-Halman, G., additional, Erdogan, M., additional, Walling, S., additional, and Clarke, D.B., additional
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- 2016
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13. P053: Characteristics and patterns of major traumatic brain injury in Nova Scotia: a 12-year retrospective analysis
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Green, R., primary, Kureshi, N., additional, Fenerty, L., additional, Thibault-Halman, G., additional, Erdogan, M., additional, Walling, S., additional, and Clarke, D.B., additional
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- 2016
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14. Use of drains versus no drains after burr-hole evacuation of chronic subdural hematoma
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Moores, M, primary, Fenerty, L, additional, Thibault-Halman, G, additional, Kureshi, N, additional, Walling, S, additional, and Clarke, DB, additional
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- 2015
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15. Gene markers and complex disorders: a review
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Ms, Mahmood, Kureshi N, and Pm, Frossard
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Genetic Markers ,Cardiovascular Diseases ,Chromosome Mapping ,Humans ,Genetic Predisposition to Disease ,Minisatellite Repeats ,Polymorphism, Single Nucleotide ,Polymorphism, Restriction Fragment Length - Published
- 2004
16. Head and Neck Cancer Susceptibility: A Genetic Marker in the Methylenetetrahydrofolate Reductase Gene
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Kureshi, N., Ghaffar, S., Siddiqui, S., Salahuddin, I., and Frossard, P.M.
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Abstract Progress in the elucidation of molecular genetic changes that lead to the development of tumors should soon bring novel diagnostic and therapeutic procedures into clinical practice. In this respect, methylenetetrahydrofolate reductase (MTHFR) plays a central role in folate metabolism that affects DNA methylation and synthesis. DNA methylation is an epigenetic feature that influences cellular development and function. Germ line mutation C>T at nucleotide 677 of the MTHFR gene, which results in increased thermolability and diminished enzyme activity, is oncogenic, i.e. should be a contributor to molecular changes leading to cancerous phenotypes (it has also been shown independently to be implicated in cardiovascular disease phenotypes). Interestingly, it has been shown that MTHFR T677 allele homozygosity confers a sixfold increased risk for esophageal squamous cell carcinoma in Northern China. The purpose of this study was twofold: (1) to evaluate the putative association of MTHFR C677T and epithelial squamous cell carcinoma (ESCC) in Pakistan, and (2) to investigate whether de novo MTHFR C677T mutations are involved in the determination of ESCC phenotypes. We recruited 50 ESCC patients referred to the Otolaryngology Clinic of the Aga Khan University Hospital, and 54 age- and gender-matched control (disease-free) subjects. Our results show that T allele frequencies were 0.18 ± 0.05 in cases vs. 0.24 ± 0.05 in controls (as compared with 0.63 vs. 0.41 in the report from China). Although the association is not statistically significant, T alleles are actually more common amongst controls in the Pakistani population, which is the opposite of what would be expected and what has been reported amongst Chinese. Yet the frequency of deleterious T alleles is lower in Pakistan (range 0.180.24) than in other parts of the world. Our results indicate that MTHFR C677T cannot form the basis for a genetic test aimed at evaluating an individuals genetic susceptibility to ESCC in Pakistan. As the conversion of precancerous submucous fibrosis into overt cancer is a frequent occurrence in Pakistan, we proceeded to extract DNA samples in all ESCC patients, from whole blood, cancerous tissues and neighboring normal tissues. We sought to determine whether C677T genotypes were different in the three tissue samples from each ESCC patient. In all patients, identical genotypes (and therefore allele frequencies) were systematically observed in all three samples. This indicates that de novo MTHFR 677TC>T mutations are not part of the molecular etiology of ESCC. In conclusion, we can rule out a major involvement of the MTHFR gene in the determination of ESCC in Pakistan.Copyright © 2004 S. Karger AG, Basel- Published
- 2004
17. Re: ATV associated injuries: any changes after 20 years?
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Clarke D and Kureshi N
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- 2024
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18. Risk stratification of new-onset psychiatric disorders using clinically distinct traumatic brain injury phenotypes.
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Kureshi N, Nunes A, Feng C, Clarke DB, and Abidi SSR
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Background: Patients with traumatic brain injury (TBI) constitute a highly heterogeneous population, with varying risks for New-onset Psychiatric Disorders (NPDs). The objectives of this study were to identify TBI phenotypes and determine how NPDs differ among these phenotypes., Methods: Hospitalized TBI patients from 2003 to 2019 were obtained from the provincial trauma registry. Propensity score matching was conducted to balance covariates among patients with TBI and controls. To uncover heterogeneity in TBI, latent class analysis (LCA)-based clustering was applied. LCA was conducted separately for two TBI cohorts: those with and without pre-injury psychiatric conditions The effect of classes on NPDs was assessed using log binomial regression models., Results: A total of 3,453 patients with TBI and 13,112 controls were included in the analysis. In a conditional regression involving propensity matched patients with TBI and controls, TBI was significantly associated with the development of NPD-A (OR: 2.78; 95% CI: 2.49-3.09), as well as NPD-P (OR: 2.36; 95% CI: 2.07-2.70). Eight distinct latent classes were identified which differed in the incidence of NPDs. Four classes displayed a 53% (RR:1.53; 95% CI: 1.31-1.78), 48% (RR:1.48; 95% CI: 1.26-1.74), 28% (RR:1.28; 95% CI: 1.08-1.54), and 20% (RR: 1.20, 95%CI: 1.03-1.39), increased NPD risk., Conclusion: TBI is a significant predictor of NPDs. There are clinically distinguishable phenotypes with different patterns of NPD risk among patients with TBI. Identifying individuals with respect to their phenotype may improve risk stratification of patients with TBI and promote early intervention for psychiatric care in this vulnerable population., (© 2024. The Author(s).)
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- 2024
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19. Alcohol is a risk factor for helmet non-use and fatalities in off-road vehicle and motorcycle crashes.
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Kureshi N, Walling S, Erdogan M, Opra I, Green RS, and Clarke DB
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Objectives: Off-road vehicle (ORV) and motorcycle use is common in Canada; however, risk of serious injury is heightened when these vehicles are operated without helmets and under the influence of alcohol. This study evaluated the impact of alcohol intoxication on helmet non-use and mortality among ORV and motorcycle crashes., Methods: Using data collected from the Nova Scotia Trauma Registry, a retrospective analysis (2002-2017) of ORV and motorcycle crashes resulting in major traumatic brain injury was performed. Patients were grouped by blood alcohol concentration (BAC) as negative (< 2 mmol/L), legally intoxicated (2-17.3 mmol/L) or criminally intoxicated (> 17.3 mmol/L). Logistic regression models were constructed to test for helmet non-use and mortality., Results: A total of 424 trauma patients were included in the analysis (220 ORV, 204 motorcycle). Less than half (45%) of patients involved in ORV crashes were wearing helmets and 65% were criminally intoxicated. Most patients involved in motorcycle crashes were helmeted at time of injury (88.7%) and 18% were criminally intoxicated. Those with criminal levels of intoxication had 3.7 times the odds of being unhelmeted and were 3 times more likely to die prehospital compared to BAC negative patients. There were significantly increased odds of in-hospital mortality among those with both legal (OR = 5.63), and criminal intoxication levels (OR = 4.97) compared to patients who were BAC negative., Conclusion: Alcohol intoxication is more frequently observed in ORV versus motorcycle crashes. Criminal intoxication is associated with helmet non-use. Any level of intoxication is a predictor of increased in-hospital mortality., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
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- 2024
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20. Epidemiology and factors associated with mortality among pediatric major trauma patients in Nova Scotia: A 17-year retrospective analysis.
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Sadoway A, Kinden R, Erdogan M, Kureshi N, Johnson M, Green RS, and Emsley JG
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- Humans, Nova Scotia epidemiology, Male, Female, Retrospective Studies, Adolescent, Child, Child, Preschool, Incidence, Registries, Trauma Centers statistics & numerical data, Infant, Injury Severity Score, Accidents, Traffic mortality, Accidents, Traffic statistics & numerical data, Risk Factors, Hospital Mortality trends, Wounds and Injuries mortality, Wounds and Injuries epidemiology
- Abstract
Background: Major traumatic injury in the pediatric population requires further evaluation to improve patient outcomes. Relatively few Canadian studies have investigated pediatric trauma using population-based data. Our objectives were to describe the epidemiology of pediatric major trauma in Nova Scotia and identify factors associated with in-hospital mortality., Methods: Retrospective cohort study of pediatric major trauma patients (age <18 years) injured in Nova Scotia over a 17-year period (April 2001-March 2018). Data were collected from the Nova Scotia Trauma Registry. Characteristics were compared between patient subgroups using t-tests, chi-square analyses and Fisher's exact test. Temporal trends were evaluated using the Mann-Kendall test. Incidence and mortality rates were mapped using ArcGIS Pro. A multivariate logistic regression model was created to assess for factors associated with in-hospital mortality., Results: A total of 1258 injuries were observed over the 17-year study period. The incidence of pediatric major trauma was 41.7 per 100,000 person-years. Most patients were male (819/1258; 65.1 %) and resided in urban areas (764/1258; 60.7 %). Blunt trauma accounted for 86.2 % (1084/1258) of injuries, and motor vehicle collisions were the most common cause (448/1258; 35.6 %). Incidence and mortality rates were highest in the 15-17 year age group, with a trend towards increasing incidence among females (p = 0.011). Mortality was 17.2 % (217/1258) of patients; 10.9 % (137/1258) died pre-hospital. No trends were detected in mortality rates. The regression model showed increased odds of in-hospital mortality for every point increase in the ISS (OR 1.05; 95 % CI 1.02 to 1.09) and for every unit decrease in scene GCS (OR 0.63; 95 % CI 0.56-0.71). Rural patients were 2 times more likely to die in-hospital versus urban patients (OR 2.40; 95 % CI 1.01-5.69), and patients injured at home were 6 times more likely to die compared to those injured in other locations (OR 6.19; 95 % CI 1.01-38.11)., Conclusion: Pediatric trauma remains a major public health issue in Canada and beyond. Greater efforts are required to expand our understanding of trauma epidemiology and develop targeted injury prevention strategies, especially for rural inhabitants., Competing Interests: Declaration of competing interest No conflicts of interest are declared. The authors received no financial support for the research, authorship, or publication of this article., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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21. Off-road vehicle crashes: dangers of alcohol and drug impairment.
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Kureshi N, Clarke DB, Audas L, Magee K, Nassar B, Chan H, Yuan Y, Erdelyi S, and Brubacher JR
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- Humans, Male, Female, Adult, Middle Aged, Canada epidemiology, Prevalence, Substance Abuse Detection methods, Alcohol Drinking epidemiology, Alcohol Drinking adverse effects, Accidents, Traffic statistics & numerical data, Substance-Related Disorders epidemiology, Driving Under the Influence statistics & numerical data
- Abstract
Background: Impaired driving is a public health issue, yet little is known concerning the prevalence of substance use in drivers involved in off-road vehicle crashes. The goal of the present study was to describe the demographics and prevalence of alcohol and drug use in drivers of off-road vehicle crashes., Methods: In this observational substudy, we collected clinical and toxicological data on all moderately or severely injured off-road vehicle drivers who had blood samples obtained within 6 h of the crash. Clinical data were extracted from patients' medical charts and toxicology analyses were performed for blood alcohol, cannabinoids, recreational drugs, and impairing medications., Results: Thirty-three injured drivers met the inclusion criteria. The mean age was 37.6 ± 13.4 years and 79% were male. Blood alcohol was detected in 58% of drivers and 42% of these were above the legal limit. Tetrahydrocannabinol was positive in 12% of drivers, and 18% were positive for recreational drugs. Opiates were detected in 21% of drivers. Overall, 85% were positive for at least one substance and 39% tested positive for multiple substances., Conclusion: This study presents the first evidence of alcohol and drug use in off-road vehicle drivers after cannabis legalization in Canada. Our results show that over half of drivers in off-road vehicle crashes test positive for alcohol and 30% tested positive for THC, cocaine, or amphetamines. Opiates are also commonly detected in off-road vehicle drivers. Emergency department (ED) visits resulting from drug driving of off-road vehicles serve as an opportunity for screening, initiating treatment, and connecting patients to interventions for substance use disorders., (© 2024. The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU).)
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- 2024
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22. Spatial Hotspots and Sociodemographic Profiles Associated With Traumatic Brain Injury in Nova Scotia.
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Kureshi N, Abidi SSR, Clarke DB, Zeng W, and Feng C
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- Humans, Nova Scotia epidemiology, Spatial Analysis, Risk Factors, Residence Characteristics, Brain Injuries, Traumatic epidemiology
- Abstract
Traumatic brain injury (TBI) is a leading cause of death and disability, primarily caused by falls and motor vehicle collisions (MVCs). Although many TBIs are preventable, there is a notable lack of studies exploring the association of geographically defined TBI hotspots with social deprivation. Geographic information systems (GIS) can be used to identify at-risk neighborhoods (hotspots) for targeted interventions. This study aims to determine the spatial distribution of TBI by major causes and to explore the sociodemographic and economic characteristics of TBI hotspots and cold spots in Nova Scotia. Patient data for TBIs from 2003 to 2019 were obtained from the Nova Scotia Trauma Registry. Residential postal codes were geocoded and assigned to dissemination areas (DA). Area-based risk factors and deprivation status (residential instability [RI], economic dependency [ED], ethnocultural composition [EC], and situational vulnerability [SV]) from the national census data were linked to DAs. Spatial autocorrelation was assessed using Moran's I, and hotspot analysis was performed using Getis-Ord Gi* statistic. Differences in risk factors between hot and cold spots were evaluated using the Mann-Whitney U test for numerical variables and the χ
2 test or Fisher's exact test for categorical variables. A total of 5394 TBI patients were eligible for inclusion in the study. The distribution of hotspots for falls exhibited no significant difference between urban and rural areas ( p = 0.71). Conversely, hotspots related to violence were predominantly urban ( p = 0.001), whereas hotspots for MVCs were mostly rural ( p < 0.001). Distinct dimensions of deprivation were associated with falls, MVCs, and violent hotspots. Fall hotspots were significantly associated with areas characterized by higher RI ( p < 0.001) and greater ethnocultural diversity ( p < 0.001). Conversely, the same domains exhibited an inverse relationship with MVC hotspots; areas with low RI and ethnic homogeneity displayed a higher proportion of MVC hotspots. ED and SV exhibited a strong gradient with MVC hotspots; the most deprived quintiles displayed the highest proportion of MVC hotspots compared with cold spots (ED; p = 0.002, SV; p < 0.001). Areas with the highest levels of ethnocultural diversity were found to have a significantly higher proportion of violence-related hotspots than cold spots ( p = 0.005). This study offers two significant contributions to spatial epidemiology. First, it demonstrates the distribution of TBI hotspots by major injury causes using the smallest available geographical unit. Second, we disentangle the various pathways through which deprivation impacts the risk of main mechanisms of TBI. These findings provide valuable insights for public health officials to design targeted injury prevention strategies in high-risk areas.- Published
- 2024
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23. Pre-hospital mortality among pediatric trauma patients in Nova Scotia.
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Kinden RH, Sadoway A, Erdogan M, Kureshi N, Johnson M, Green RS, and Emsley JG
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- Male, Humans, Child, Hospital Mortality, Cohort Studies, Nova Scotia epidemiology, Injury Severity Score, Retrospective Studies, Trauma Centers, Accidents, Traffic, Wounds and Injuries therapy
- Abstract
Objectives: Limited data exist on pre-hospital pediatric trauma mortality in Canada. The Nova Scotia Trauma Registry is a provincial population-based registry that captures data from the Medical Examiner Service. This study examined the characteristics of pediatric trauma patient mortality in the pre-hospital and in-hospital settings., Methods: We conducted a cohort study of major pediatric traumas recorded in our provincial database from April 1, 2001 to March 31, 2018. Characteristics of pre-hospital and in-hospital deaths were compared with t tests and Chi-square analyses. Multivariate regression modeling was used to identify predictors of pre-hospital mortality. The geographic distribution of pre-hospital trauma was assessed using choropleth maps., Results: We identified 1,258 pediatric traumas, resulting in 217 deaths (137 pre-hospital, 80 in-hospital). Males accounted for 62.7% of fatalities. The 15-17 age group accounted for most deaths in both groups (pre-hospital 61.3%; in-hospital 41.3%). Injuries sustained in rural areas resulted in 74.7% of all deaths. For both groups, blunt trauma was the predominant injury type and motor vehicle collisions, the most prevalent injury mechanism. Patients who died pre-hospital had a higher mean age (13.3 vs. 10.7, p = 0.002) and a greater proportion were intentional injuries (23.4% vs. 15%; p = 0.02). Urban residency was more frequently observed in in-hospital deaths (57.5% vs. 36.5%, p < 0.001). Pre-hospital mortality was associated with increasing age (OR 1.1), higher injury severity score (OR 1.1), and intentional injury (OR 15.6)., Conclusion: Over 10% of major pediatric traumas resulted in pre-hospital death, primarily from motor vehicle collisions in rural areas. Compared to in-hospital mortality, patients who died pre-hospital were older with more severe injuries and more likely to have intentionally injured themselves. These results underscore the importance for emergency physicians and EMS systems to consider geographic factors and injury patterns, advocate for improved injury prevention programs, mental health supports, and delivery of on-scene critical care services., (© 2024. The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU).)
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- 2024
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24. Family and emergency physicians' knowledge and attitudes toward organ donation and deemed consent: Human Organ and Tissue Donation Act in Nova Scotia.
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Urquhart R, Kureshi N, Dirk J, Weiss M, and Beed S
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- Humans, Nova Scotia, Communication, Informed Consent, Physicians, Family, Tissue and Organ Procurement
- Abstract
Objective: To understand Nova Scotian family physicians' and emergency department (ED) physicians' knowledge of, attitudes about, and experience with organ donation and transplantation in the context of the Human Organ and Tissue Donation Act (HOTDA)., Design: An electronic, self-administered survey., Setting: Nova Scotia., Participants: All family physicians and ED physicians practising in Nova Scotia., Main Outcome Measures: Demographic characteristics, experience with organ donation and transplantation, knowledge about organ donation and HOTDA, attitudes toward organ donation and HOTDA, and opportunities for and barriers to the implementation of the HOTDA in clinical practice. Survey results were analyzed using descriptive statistics., Results: Overall, 211 family physicians and 73 ED physicians responded to the survey. Most respondents had favourable attitudes around organ donation and most supported a deemed consent model. Nearly three-quarters of family physicians indicated they have a conversation around organ donation only if it is initiated by the patient. In the ED setting, the most common barriers to organ donation and deemed consent were lack of familiarity with the organ donation referral process, refusal of permission from families, and unknown wishes of the deceased., Conclusion: Family physicians and ED physicians had positive attitudes toward organ donation, including high support for a deemed consent model. However, specific knowledge gaps and training topics were identified that should be addressed within the context of this model., (Copyright © 2024 the College of Family Physicians of Canada.)
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- 2024
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25. Blood-Brain Barrier Dysfunction and Exposure to Head Impacts in University Football Players.
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Jones CMA, Kamintsky L, Parker E, Kureshi N, Audas L, Wilson L, Champagne AA, Boulanger MM, DiStefano V, Fenerty L, Bowen C, Beyea S, Atkinson C, Clarke DB, and Friedman A
- Subjects
- Humans, Blood-Brain Barrier injuries, Canada, Prospective Studies, Universities, Brain Concussion diagnosis, Football injuries
- Abstract
Objective: To investigate the link between dysfunction of the blood-brain barrier (BBB) and exposure to head impacts in concussed football athletes., Design: This was a prospective, observational pilot study., Setting: Canadian university football., Participants: The study population consisted of 60 university football players, aged 18 to 25. Athletes who sustained a clinically diagnosed concussion over the course of a single football season were invited to undergo an assessment of BBB leakage., Independent Variables: Head impacts detected using impact-sensing helmets were the measured variables., Main Outcome Measures: Clinical diagnosis of concussion and BBB leakage assessed using dynamic contrast-enhanced MRI (DCE-MRI) within 1 week of concussion were the outcome measures., Results: Eight athletes were diagnosed with a concussion throughout the season. These athletes sustained a significantly higher number of head impacts than nonconcussed athletes. Athletes playing in the defensive back position were significantly more likely to sustain a concussion than remain concussion free. Five of the concussed athletes underwent an assessment of BBB leakage. Logistic regression analysis indicated that region-specific BBB leakage in these 5 athletes was best predicted by impacts sustained in all games and practices leading up to the concussion-as opposed to the last preconcussion impact or the impacts sustained during the game when concussion occurred., Conclusions: These preliminary findings raise the potential for the hypothesis that repeated exposure to head impacts may contribute to the development of BBB pathology. Further research is needed to validate this hypothesis and to test whether BBB pathology plays a role in the sequela of repeated head trauma., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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26. Views of leaders in under-represented and equity-denied communities on organ and tissue donation in Nova Scotia, Canada, in light of the Human Organ and Tissue Donation Act: a qualitative descriptive study.
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Urquhart R, Kendell C, Weiss M, Kureshi N, Dirk J, Cordoba W, and Beed S
- Subjects
- Female, Humans, Nova Scotia, North America, Qualitative Research, Focus Groups, Tissue and Organ Procurement
- Abstract
Objective: To explore the views of underserved and equity-denied communities in Nova Scotia, Canada, regarding organ and tissue donation and deemed consent legislation., Design: A qualitative descriptive study was undertaken, employing both interviews and focus groups., Setting: The province of Nova Scotia, Canada-the first jurisdiction in North America to implement deemed consent legislation for organ and tissue donation., Participants: Leaders of African Nova Scotian, Lesbian, Gay, Bisexual, Trans, Queer, Two Spirit (LGBTQ2S+) and Faith-based communities (Islam and Judaism) were invited to participate (n=11). Leaders were defined as persons responsible for community organisations or in other leadership roles, and were purposively recruited by the research team., Results: Through thematic analysis, four main themes were identified: (1) alignment with personal values as well as religious beliefs and perspectives; (2) trust and relationships, which need to be acknowledged and addressed in the context of deemed consent legislation; (3) cultural competence, which is essential to the roll-out of the new legislation and (4) communication and information to combat misconceptions and misinformation, facilitate informed decision-making, and mitigate conflict within families., Conclusions: Leaders of African Nova Scotian, LGBTQ2S+ and Faith-based communities in Nova Scotia are highly supportive of deemed consent legislation. Despite this, many issues exemplify the need for cultural competence at all levels. These findings should inform ongoing implementation of the legislation and other jurisdictions considering a deemed consent approach to organ and tissue donation., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2023
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27. Association between traumatic brain injury and mental health care utilization: evidence from the Canadian Community Health Survey.
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Kureshi N, Clarke DB, and Feng C
- Abstract
Background: Mental health disorders are a common sequelae of traumatic brain injury (TBI) and are associated with worse health outcomes including increased mental health care utilization. The objective of this study was to determine the association between TBI and use of mental health services in a population-based sample., Methods: Using data from a national Canadian survey, this study evaluated the association between TBI and mental health care utilization, while adjusting for confounding variables. A log-Poisson regression model was used to estimate unadjusted and adjusted prevalence ratios (PR) and 95% confidence intervals (CI)., Results: The study sample included 158,287 TBI patients and 25,339,913 non-injured individuals. Compared with those were not injured, TBI patients reported higher proportions of chronic mental health conditions (27% vs. 12%, p < 0.001) and heavy drinking (33% vs. 24%, p = 0.005). The adjusted prevalence of mental health care utilization was 60% higher in patients with TBI than those who were not injured (PR = 1.60, 95%; CI 1.05-2.43)., Conclusions: This study suggests that chronic mental health conditions and heavy drinking are more common in individuals with TBI. The prevalence of mental health care utilization is 60% higher in TBI patients compared with those who are not injured after adjusting for sociodemographic factors, mental health conditions, and heavy drinking. Future longitudinal research is required to examine the temporality and direction of the association between TBI and the use of mental health services., (© 2023. The Author(s).)
- Published
- 2023
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28. Nurse knowledge and attitudes towards organ donation and deemed consent: the Human Organ and Tissue Donation Act in Nova Scotia.
- Author
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Urquhart R, Kureshi N, Dirk J, Weiss M, and Beed S
- Subjects
- Humans, Nova Scotia, Tissue Donors, Surveys and Questionnaires, Health Knowledge, Attitudes, Practice, Informed Consent, Clinical Competence, Tissue and Organ Procurement
- Abstract
Purpose: In April 2019, the Human Organ and Tissue Donation Act (HOTDA) in Nova Scotia was modified to incorporate a deemed consent model. In this study, we sought to understand intensive care unit (ICU) and emergency department (ED) nurses' knowledge of and confidence around organ donation and transplantation, experiences with organ donors and recipients, attitudes toward organ donation and deemed consent, and perceived opportunities and barriers to a deemed consent approach in view of the legislative change., Methods: We sent an electronic, self-administered survey to all ICU and ED nurses in Nova Scotia. The survey queried respondents on their knowledge of, experience with, and attitudes around organ donation and HOTDA, and opportunities and barriers to the implementation of HOTDA in clinical practice. Survey results were analyzed using descriptive statistics., Results: One-hundred and ninety-four nurses responded to the survey. Nearly all (98%) supported organ donation, with 86% having signed an organ donor card to donate organs and/or tissues after death. A considerable majority (89%) also supported the new legislation. Nevertheless, a minority of respondents (13%) believed that deemed consent legislation would be considered a violation of the general principles of freedom and autonomy. The three most identified topics for ongoing training were coordination of the donation process (70%), clinical management of donors (70%), and family issues in decision-making (70%)., Conclusion: Intensive care unit and ED nurses had positive attitudes toward organ donation, including deemed consent model. The findings should inform educational initiatives in Nova Scotia and beyond to optimize organ donation processes and outcomes., (© 2022. Canadian Anesthesiologists' Society.)
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- 2023
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29. A population-based study on the epidemiology of firearm-related injury in Nova Scotia.
- Author
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Karkada M, Bennett N, Erdogan M, Kureshi N, Tansley G, and Green RS
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- Humans, Middle Aged, Male, Child, Adolescent, Young Adult, Adult, Aged, Aged, 80 and over, Female, Nova Scotia epidemiology, Injury Severity Score, Homicide, Retrospective Studies, Firearms, Wounds, Gunshot epidemiology
- Abstract
Objective: Firearm-related trauma is a significant cause of preventable mortality. In 2020, Nova Scotia experienced the largest mass shooting in Canadian history. The objective of this study was to describe the epidemiology of firearm-related injury and death in Nova Scotia and to assess for factors associated with mortality., Methods: A retrospective observational study of all major trauma patients in Nova Scotia who sustained firearm-related injuries between 2001 and 2020 was conducted. Data was collected from the Nova Scotia Trauma Registry and the Nova Scotia Medical Examiner Service. Injury rates were evaluated over time, by age/sex, and by intent (assault/homicide, self-harm, other), and were mapped by municipality. Characteristics of survivors and non-survivors were compared using t-tests and chi-square analysis. A multivariate logistic regression model was created to assess for predictors of mortality., Results: A total of 776 firearm-related injuries occurred over the 19-year study period, for an overall age- and sex-adjusted firearm injury rate of 4.44 per 100,000 population. Patients ranged in age from 6 to 92 years (mean 45.0±19.2 years) and most were male (95.6%; 742/776). Injuries were predominantly self-inflicted (65%; 504/776). The majority of patients died from their injuries (72%; 558/776); 64% (497/776) died at the scene. The overall age- and sex-adjusted firearm mortality rate was 3.18 per 100,000. Most non-survivors had injuries that were self-inflicted (83.2%; 464/558). Increasing age (OR 1.02, 95% CI 1.00-1.04) and increasing Injury Severity Score (OR 1.11, 95% CI 1.07-1.15) were associated with greater likelihood of mortality. Activation of the trauma team was associated with survival (OR 0.04, 95% CI 0.02-0.10)., Conclusion: Trauma patients with firearm-related injuries were predominantly male and most injuries were self-inflicted among middle-aged to older patients. Younger patients tended to be victims of homicide/assault and were more likely to survive their injuries., Competing Interests: Conflicts of Interest The authors declare they have no conflicts of interest, financial or otherwise., (Copyright © 2022. Published by Elsevier Ltd.)
- Published
- 2022
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30. Mandatory gunshot wound reporting in Nova Scotia: a pre-post-evaluation of firearm-related injury rates.
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Bennett N, Erdogan M, Karkada M, Kureshi N, and Green RS
- Subjects
- Adult, Humans, Incidence, Male, Mandatory Reporting, Middle Aged, Nova Scotia epidemiology, Firearms, Wounds, Gunshot epidemiology
- Abstract
Objective: Mandatory gunshot wound reporting laws have been enacted in much of Canada, yet there is a lack of evidence on whether these laws are effective in preventing firearm injuries. Our objective was to determine if the Gunshot Wounds Reporting Act in Nova Scotia had an effect on the number of firearm-related injuries in the province., Methods: Pre-post-study of major trauma patients in Nova Scotia who sustained a gunshot wound injury before and after enactment of the Gunshot Wounds Reporting Act (Bill 10) in 2008. Data were collected from the Nova Scotia Trauma Registry and the Nova Scotia Medical Examiner Service for a 6-year pre-period (2002-2007) and an 11-year post-period (2009-2019), allowing for a 1-year washout period. Patient characteristics in the pre- and post-periods were compared using t tests and Chi-square analysis. Gunshot wound traumas were analyzed as a time series using the AutoRegressive Integrated Moving Average (ARIMA) model., Results: A total of 722 firearm injuries were observed during the study period (pre-period = 259, post-period = 463). Mean age was 45.2 ± 19.3 years with males accounting for 95.3% (688/722) of cases. The majority of injuries were self-inflicted (65.1%; 470/722). The mean overall annualized rate of firearm injuries was 4.61 per 100,000 population in the pre-period and 4.45 per 100,000 in the post-period (reduction of 3.4%). No linear trends in the annual number of firearm injuries were observed over the study period. ARIMA modelling was an extremely poor predictor for gunshot wound trauma (R
2 = 0.012)., Conclusions: Although our findings suggest that there is no association between the Gunshot Wounds Reporting Act and the incidence of firearm injury, it is difficult to draw firm conclusions due to the complexity of this topic. Physicians need to be aware of the legal requirements of mandatory reporting when they encounter patients with gunshot wounds., (© 2022. The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU).)- Published
- 2022
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31. A proteomic surrogate for cardiovascular outcomes that is sensitive to multiple mechanisms of change in risk.
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Williams SA, Ostroff R, Hinterberg MA, Coresh J, Ballantyne CM, Matsushita K, Mueller CE, Walter J, Jonasson C, Holman RR, Shah SH, Sattar N, Taylor R, Lean ME, Kato S, Shimokawa H, Sakata Y, Nochioka K, Parikh CR, Coca SG, Omland T, Chadwick J, Astling D, Hagar Y, Kureshi N, Loupy K, Paterson C, Primus J, Simpson M, Trujillo NP, and Ganz P
- Subjects
- Biomarkers, Humans, Proteomics, Cardiovascular Diseases, Heart Failure drug therapy, Myocardial Infarction drug therapy, Stroke complications
- Abstract
A reliable, individualized, and dynamic surrogate of cardiovascular risk, synoptic for key biologic mechanisms, could shorten the path for drug development, enhance drug cost-effectiveness and improve patient outcomes. We used highly multiplexed proteomics to address these objectives, measuring about 5000 proteins in each of 32,130 archived plasma samples from 22,849 participants in nine clinical studies. We used machine learning to derive a 27-protein model predicting 4-year likelihood of myocardial infarction, stroke, heart failure, or death. The 27 proteins encompassed 10 biologic systems, and 12 were associated with relevant causal genetic traits. We independently validated results in 11,609 participants. Compared to a clinical model, the ratio of observed events in quintile 5 to quintile 1 was 6.7 for proteins versus 2.9 for the clinical model, AUCs (95% CI) were 0.73 (0.72 to 0.74) versus 0.64 (0.62 to 0.65), c -statistics were 0.71 (0.69 to 0.72) versus 0.62 (0.60 to 0.63), and the net reclassification index was +0.43. Adding the clinical model to the proteins only improved discrimination metrics by 0.01 to 0.02. Event rates in four predefined protein risk categories were 5.6, 11.2, 20.0, and 43.4% within 4 years; median time to event was 1.71 years. Protein predictions were directionally concordant with changed outcomes. Adverse risks were predicted for aging, approaching an event, anthracycline chemotherapy, diabetes, smoking, rheumatoid arthritis, cancer history, cardiovascular disease, high systolic blood pressure, and lipids. Reduced risks were predicted for weight loss and exenatide. The 27-protein model has potential as a "universal" surrogate end point for cardiovascular risk.
- Published
- 2022
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32. Virtual Health Care in a Postpandemic World: Implications for Patients With Neuropituitary Disorders.
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Kureshi N, Hebb ALO, Clarke DB, and Imran SA
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- Delivery of Health Care, Humans, COVID-19
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- 2022
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33. Long-Term Trends in the Epidemiology of Major Traumatic Brain Injury.
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Kureshi N, Erdogan M, Thibault-Halman G, Fenerty L, Green RS, and Clarke DB
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- Accidental Falls, Accidents, Traffic, Adult, Aged, Hospitalization, Humans, Male, Middle Aged, Retrospective Studies, Brain Injuries, Traumatic epidemiology
- Abstract
Traumatic brain injury (TBI) is a leading cause of death and disability among adults. Falls and motor vehicle collisions (MVCs) are the most common causes of TBI hospitalizations in Canada. The purpose of this study was to determine whether, at the provincial level, there have been significant changes in the injury rate and causes of major TBI. This was a retrospective cohort study of all patients in Nova Scotia who presented with major TBI (Abbreviated Injury Scale Head score ≥ 3) between 2002 and 2018. Prospectively entered data were collected from the Nova Scotia Trauma Registry. Annual injury rates were calculated based on 100,000 population (all ages) using population estimates from Statistics Canada. Linear regression was performed to analyze annual trends of major TBI within the province. There were 5590 major TBI patients in Nova Scotia during the 16-year study period. The overall annual rate of major TBI was 37 per 100,000 population. There was a 39% increase in the rate of major TBI over the study period (r = - 0.72, R2 = 0.51, p < 0.002). Patients had a mean age of 51 ± 25 years; 72% were male. The proportion of TBIs in males decreased significantly from 76% in 2002 to 69% in 2017 (p < 0.001). Mechanisms of injury were predominantly falls (45%) and MVCs (29%); the proportion of violent injuries was 11.5%. The rate of fall-related TBIs more than doubled between 2002 and 2017, increasing from 9.1 to 20.5 injuries per 100,000 (p < 0.001). Our findings demonstrate an increasing incidence of major TBI over a 16-year period with a greater than two-fold increase in the rate of fall-related TBI. These results are important for targeting TBI prevention efforts in reducing falls, especially in older adults., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2021
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34. Comparison of clinical and anatomical criteria for resuscitative endovascular balloon occlusion of the aorta (REBOA) among major trauma patients in Nova Scotia.
- Author
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Hurley S, Erdogan M, Kureshi N, Casey P, Smith M, and Green RS
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- Adult, Aorta, Humans, Nova Scotia epidemiology, Resuscitation, Retrospective Studies, Balloon Occlusion, Endovascular Procedures
- Abstract
Objectives: To perform a province-wide evaluation of adult major traumas and determine the proportion of patients who met clinical and/or anatomical criteria for resuscitative endovascular balloon occlusion of the aorta (REBOA)., Methods: This is a retrospective analysis of all major trauma patients (age > 16) presenting to the sole adult level 1 trauma centre in Nova Scotia over a 5-year period (2012-2017). Data were collected from the Nova Scotia Trauma Registry and medical charts. We identified potential REBOA candidates using either: (1) clinical criteria (primary survey, Focused Assessment with Sonography for Trauma, pelvic/chest X-ray); or (2) anatomical criteria (ICD-10-CA codes). Potential candidates with persistent hypotension were considered true REBOA candidates., Results: Overall 2885 patients were included in the analysis, of whom 248 (8.6%) patients were in shock (including 106 transfer patients) and had their charts reviewed. A total of 137 patients met clinical criteria for REBOA; 44 (1.5%) had persistent hypotension 10-20 min into resuscitation and were considered true REBOA candidates. There were 59 patients who met anatomical criteria for REBOA, of whom 15 (0.5%) patients had persistent hypotension and were true REBOA candidates. The 15 REBOA candidates based on anatomical criteria also met clinical criteria for REBOA., Conclusions: In this registry-based retrospective analysis, 1.5% of adult major trauma patients Nova Scotia were REBOA candidates based on resuscitative clinical presentation, while 0.5% were candidates based on post hoc anatomical injury patterns. Our findings suggest that using clinical findings and bedside imaging modalities as criteria may overestimate the number of candidates for REBOA.
- Published
- 2021
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35. Modic Change and Clinical Assessment Scores in Patients Undergoing Lumbar Surgery for Disk Herniation.
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MacLean MA, Kureshi N, Shankar J, Stewart SA, and Christie SD
- Subjects
- Adult, Aged, Female, Humans, Lumbar Vertebrae diagnostic imaging, Lumbar Vertebrae surgery, Middle Aged, Retrospective Studies, Treatment Outcome, Intervertebral Disc Degeneration, Intervertebral Disc Displacement diagnostic imaging, Intervertebral Disc Displacement surgery, Spinal Fusion
- Abstract
Study Design: Retrospective cohort study., Objective: To examine the relationship between preoperative Modic change (MC) and postoperative clinical assessment scores for patients receiving lumbar discectomy or transforaminal lumbar interbody fusion for lumbar disk herniation., Summary of Background Data: Lumbar disk herniation is a risk factor for MC development. MC on spinal magnetic resonance imaging (MRI) has been associated with worse preoperative and postoperative clinical assessment scores., Materials and Methods: We reviewed data for 285 primary single-level surgeries. Preoperative and 12-month postoperative assessment scores were recorded using the visual analog scale leg pain, Oswestry Disability Index, and Short Form-36 Physical Component Summary. MC subgroup on preoperative MRI was recorded by a single neuroradiologist., Results: One hundred seventy-nine patients (female, 56%; age-53±13 y) with preoperative MRI were included. Age and sex were similar across MC subgroups. The sample prevalence of MC on preoperative MRI was 62%, and MC2 was the most common subgroup (35%). No differences in preoperative assessment scores were identified, regardless of presence or absence of MC. For the overall cohort, improvement in assessment scores were observed: Short Form-36 improved an average of 8.2 points [95% CI (95% CI), 5.8-10.7], Oswestry Disability Index by 11.3 points (95% CI, 8.7-14.0), and visual analog scale by 2.8 points (95% CI, 2.1-3.5). In nearly all cases, MCID values were met, even when stratifying by MC subgroup. Few differences in postoperative assessment scores were identified when comparing across MC1, MC2, or no MC groups., Conclusions: Statistically and clinically significant improvement in postoperative clinical assessment scores was observed for both lumbar discectomy and transforaminal lumbar interbody fusion groups. MC on preoperative MRI was not associated with worse preoperative or postoperative clinical assessment scores., Level of Evidence: Level III., Competing Interests: The authors declare no conflict of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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36. Knowledge transfer and retention of simulation-based learning for neurosurgical instruments: a randomised trial of perioperative nurses.
- Author
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Clarke DB, Galilee AI, Kureshi N, Hong M, Fenerty L, and D'Arcy RCN
- Abstract
Introduction: Previous studies have shown that simulation is an acceptable method of training in nursing education. The objectives of this study were to determine the effectiveness of tablet-based simulation in learning neurosurgical instruments and to assess whether skills learnt in the simulation environment are transferred to a real clinical task and retained over time., Methods: A randomised controlled trial was conducted. Perioperative nurses completed three consecutive sessions of a simulation. Group A performed simulation tasks prior to identifying real instruments, whereas Group B (control group) was asked to identify real instruments prior to the simulation tasks. Both groups were reassessed for knowledge recall after 1 week., Results: Ninety-three nurses completed the study. Participants in Group A, who had received tablet-based simulation, were 23% quicker in identifying real instruments and did so with better accuracy (93.2% vs 80.6%, p<0.0001) than Group B. Furthermore, the simulation-based learning was retained at 7 days with 97.8% correct instrument recognition in Group A and 96.2% in Group B while maintaining both speed and accuracy., Conclusion: This is the first study to assess the effectiveness of tablet-based simulation training for instrument recognition by perioperative nurses. Our results demonstrate that instrument knowledge acquired through tablet-based simulation training results in improved identification and retained recognition of real instruments., Competing Interests: Competing interests: DBC and RCND are members of the medical advisory board and stock option holders with Conquer Experience. The authors have no financial relationships with Conquer Experience that may have influenced the submitted work; specifically, the authors did not receive research funding or financial compensation from Conquer Experience for this study. Furthermore, study conception, study design, acquisition of data, statistical analysis, interpretation and drafting of the manuscript were performed independently by the research team without participation from Conquer Experience. No one from Conquer Experience has seen, or participated in, any part of the writing of the manuscript., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2020
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37. Trauma recidivism in a Canadian province: a 14-year registry review.
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Erdogan M, Kureshi N, Asbridge M, and Green RS
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- Age Factors, Female, Hospitalization, Humans, Injury Severity Score, Intensive Care Units, Male, Middle Aged, Nova Scotia epidemiology, Recurrence, Registries, Sex Factors, Wounds and Injuries epidemiology
- Abstract
Objectives: To determine the rate of recurrent major trauma (i.e., trauma recidivism) using a provincial population-based trauma registry. We compared outcomes between recidivists and non-recidivists, and assessed factors associated with recidivism and mortality., Methods: Review of all adult (>17 years) major trauma patients in Nova Scotia (2001-2015) using data from the Nova Scotia Trauma Registry. Outcomes of interest were mortality, duration of hospital stay, and in-hospital complications. Multiple regression was used to assess factors associated with recidivism and mortality., Results: Of 9,365 major trauma patients, 2% (150/9365) were recidivists. Mean age at initial injury was 52 ± 21.5 years; 73% were male. The mortality rate for both recidivists and non-recidivists was 31%. However, after adjusting for potential confounders the likelihood of mortality was over 3 times greater for recidivists compared to non-recidivists (OR 3.67, 95% CI 2.06-6.54). Other factors associated with mortality included age, male gender, penetrating injury, Injury Severity Score, trauma team activation (TTA) and admission to the intensive care unit. The only variables associated with recidivism were age (OR 0.98, 95% CI 0.97-1.00) and TTA (OR 0.59, 95% CI 0.34-0.96)., Conclusions: This is the first provincial investigation of major trauma recidivism in Canada. While recidivism was infrequent (2%), the adjusted odds of mortality were over three times greater for recidivists. Further research is warranted to determine the effectiveness of strategies for reducing rates of major trauma recidivism such as screening and brief intervention in cases of violence or substance abuse.
- Published
- 2019
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38. In reply: Apneic oxygenation during emergency airway management.
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Tan E, Loubani O, Kureshi N, and Green RS
- Subjects
- Airway Management, Respiration, Artificial
- Published
- 2019
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39. Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre.
- Author
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Erdogan M, Kureshi N, Karim SA, Tallon JM, Asbridge M, and Green RS
- Subjects
- Accidents, Traffic statistics & numerical data, Adult, Aged, Alcoholic Intoxication blood, Cohort Studies, Female, Humans, Male, Middle Aged, Nova Scotia, Patient Care Team statistics & numerical data, Registries, Retrospective Studies, Wounds and Injuries blood, Wounds and Injuries diagnosis, Alcoholic Intoxication diagnosis, Blood Alcohol Content, Guideline Adherence statistics & numerical data, Substance Abuse Detection statistics & numerical data, Tertiary Care Centers statistics & numerical data, Trauma Centers statistics & numerical data
- Abstract
Objectives: Although alcohol screening is an essential requirement of level I trauma centre accreditation, actual rates of compliance with mandatory alcohol testing in trauma patients are seldom reported. Our objective was to determine the prevalence of blood alcohol concentration (BAC) testing in patients requiring trauma team activation (TTA) for whom blood alcohol testing was mandatory, and to elucidate patient-level, injury-level and system-level factors associated with BAC testing., Design: Retrospective cohort study., Setting: Tertiary trauma centre in Halifax, Canada., Participants: 2306 trauma patients who required activation of the trauma team., Primary Outcome Measure: The primary outcome was the rate of BAC testing among TTA patients. Trends in BAC testing over time and across patient and injury characteristics were described. Multivariable logistic regression examined patient-level, injury-level and system-level factors associated with testing., Results: Overall, 61% of TTA patients received BAC testing despite existence of a mandatory testing protocol. Rates of BAC testing rose steadily over the study period from 33% in 2000 to 85% in 2010. Testing varied considerably across patient-level, injury-level and system-level characteristics. Key factors associated with testing were male gender, younger age, lower Injury Severity Score, scene Glasgow Coma Scale score <9, direct transport to hospital and presentation between midnight and 09:00 hours, or on the weekend., Conclusions: At this tertiary trauma centre with a policy of empirical alcohol testing for TTA patients, BAC testing rates varied significantly over the 11-year study period and distinct factors were associated with alcohol testing in TTA patients., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2018
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40. Does apneic oxygenation prevent desaturation during emergency airway management? A systematic review and meta-analysis.
- Author
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Tan E, Loubani O, Kureshi N, and Green RS
- Subjects
- Bias, Humans, Randomized Controlled Trials as Topic, Emergencies, Intubation, Intratracheal adverse effects, Oxygen metabolism
- Abstract
RéSUMé: OBJECTIF: L'oxygénation apnéique (OA) par lunettes nasales est une méthode de prévention de la désaturation en oxygène au cours des intubations en urgence. L'objectif de cette revue systématique était de déterminer l'efficacité de l'OA sur la prévention de la désaturation en oxygène au cours des intubations en urgence., Source: Des recherches systématiques ont été effectuées dans trois bases de données électroniques (MEDLINE, EMBASE et CINAHL) pour identifier les études portant sur la prévention de la désaturation en oxygène au moyen de l'OA par lunettes nasales. Notre critère d'évaluation principal était l'incidence des désaturations telle que définie dans chaque étude; nous avons ensuite évalué l'incidence de la désaturation sévère en oxygène (SpO
2 < 80%). Une méta-analyse a été effectuée sur les études présentant des données sur la désaturation en oxygène telle que définie par chaque étude et chez des patients ayant une désaturation sévère pour générer une estimation groupée de l'effet., Constatations Principales: Au total, 544 études ont été examinées, parmi lesquelles dix (2 322 patients) satisfaisaient tous les critères d'éligibilité. Comparativement à l'absence d'OA, l'utilisation de cette méthode a été associée à une réduction de la désaturation en oxygène (risque relatif [RR] : 0,76; intervalle de confiance à 95% [IC] : 0,61 à 0,95; P = 0,02), mais n'a pas été associée à une réduction de la désaturation sévère (RR, 0,65; IC à 95% : 0,38 à 1,11; P = 0,12). Néanmoins, il y avait une hétérogénéité significative des facteurs liés aux patients, des interventions et des définitions de la désaturation en oxygène entre les études., Conclusion: Nos constatations suggèrent que l'OA par lunettes nasales est associée à un moindre risque de désaturation en oxygène au cours des intubations en urgence. Cependant, compte de tenu de l'hétérogénéité des études, d'autres essais de grande qualité sont nécessaires pour déterminer quels patients pourraient bénéficier de l'OA au cours des intubations d'urgence.- Published
- 2018
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41. Occipital osteomylelitis and epidural abscess after occipital nerve block: A case report.
- Author
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Christie SD, Kureshi N, Beauprie I, and Holness RO
- Abstract
Occipital neuralgia is a paroxysmal jabbing pain in the distribution of the greater or lesser occipital nerves accompanied by diminished sensation in the affected area. Occipital nerve block is a common diagnostic and therapeutic tool used in the course of occipital neuralgia and is considered a safe treatment with few localized adverse events. Occipital nerve block is also indicated for cervicogenic and cluster headache and is often used as a rescue treatment for headaches not responding to conventional therapies. We describe a case of epidural abscess formation 16 days following occipital nerve block in a patient with no underlying medical conditions. This case report emphasizes the importance of strict aseptic technique to reduce infection rates in patients undergoing this procedure, despite the overall safety of occipital nerve block. Clinicians must remain aware of acute and late complications arising postprocedure for the safe practice of this technique., (© 2018 Sean D. Christie, Nelofar Kureshi, Ian Beauprie, and Renn O. Holness. Published with license by Taylor & Francis.)
- Published
- 2018
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42. Device and Medication Preferences of Canadian Physicians for Emergent Endotracheal Intubation in Critically Ill Patients.
- Author
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Green RS, Fergusson DA, Turgeon AF, McIntyre LA, Kovacs GJ, Griesdale DE, Zarychanski R, Butler MB, Kureshi N, and Erdogan M
- Subjects
- Adult, Aged, Canada, Emergency Medicine methods, Equipment Design, Female, Health Care Surveys, Humans, Intensive Care Units, Laryngoscopes, Male, Middle Aged, Practice Patterns, Physicians', Critical Illness therapy, Intubation, Intratracheal instrumentation, Intubation, Intratracheal methods, Outcome Assessment, Health Care, Surveys and Questionnaires
- Abstract
Objectives: Various medications and devices are available for facilitation of emergent endotracheal intubations (EETIs). The objective of this study was to survey which medications and devices are being utilized for intubation by Canadian physicians., Methods: A clinical scenario-based survey was developed to determine which medications physicians would administer to facilitate EETI, their first choice of intubation device, and backup strategy should their first choice fail. The survey was distributed to Canadian emergency medicine (EM) and intensive care unit (ICU) physicians using web-based and postal methods. Physicians were asked questions based on three scenarios (trauma; pneumonia; heart failure) and responded using a 5-point scale ranging from "always" to "never" to capture usual practice., Results: The survey response rate was 50.2% (882/1,758). Most physicians indicated a Macintosh blade with direct laryngoscopy would "always/often" be their first choice of intubation device in the three scenarios (mean 85% [79%-89%]) followed by video laryngoscopy (mean 37% [30%-49%]). The most common backup device chosen was an extraglottic device (mean 59% [56%-60%]). The medications most physicians would "always/often" administer were fentanyl (mean 45% [42%-51%]) and etomidate (mean 38% [25%-50%]). EM physicians were more likely than ICU physicians to paralyze patients for EETI (adjusted odds ratio 3.40; 95% CI 2.90-4.00)., Conclusions: Most EM and ICU physicians utilize direct laryngoscopy with a Macintosh blade as a primary device for EETI and an extraglottic device as a backup strategy. This survey highlights variation in Canadian practice patterns for some aspects of intubation in critically ill patients.
- Published
- 2017
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43. Long-Term Effects of Education and Legislation Enforcement on All-Age Bicycle Helmet Use: A Longitudinal Study.
- Author
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Huybers S, Fenerty L, Kureshi N, Thibault-Halman G, LeBlanc JC, Clarke DB, and Walling S
- Subjects
- Adolescent, Adult, Age Factors, Bicycling education, Bicycling legislation & jurisprudence, Canada, Child, Female, Health Knowledge, Attitudes, Practice, Humans, Longitudinal Studies, Male, Sex Factors, Young Adult, Bicycling statistics & numerical data, Head Protective Devices statistics & numerical data
- Abstract
Bicycle-related injuries are a leading cause of child and youth hospitalizations in Canada. The use of helmets while bicycling reduces the risk of brain injuries. This study investigated the long-term effect of legislation coupled with enforcement to improve helmet use rates. We conducted a longitudinal observational study of helmet use at 9, 11, and 14 years after bicycle helmet legislation was enacted. Data were compared to baseline observations collected after legislation was passed in 1997. A comprehensive enforcement and educational diversion program, Operation Headway-Noggin Knowledge (OP-NK), was developed and implemented in partnership with regional police during the study period. Helmet use was sustained throughout the post-legislation period, from 75.3 % in the year legislation was enacted to 94.2 % 14 years post-legislation. The increase in helmet use was seen among all age groups and genders. Helmet legislation was not associated with changes in bicycle ridership over the study years. OP-NK was associated with improved enforcement efforts as evidenced by the number of tickets issued to noncompliant bicycle riders. This observational study spans a 16-year study period extending from pre-legislation to 14 years post all-age bicycle helmet legislation. Our study results demonstrate that a comprehensive approach that couples education and awareness with ongoing enforcement of helmet legislation is associated with long-term sustained helmet use rates. The diversion program described herein is listed among best practices by the Public Health Agency of Canada.
- Published
- 2017
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44. Use of intraosseous devices in trauma: a survey of trauma practitioners in Canada, Australia and New Zealand.
- Author
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Engels PT, Erdogan M, Widder SL, Butler MB, Kureshi N, Martin K, and Green RS
- Subjects
- Australia, Canada, Humans, New Zealand, Emergency Medicine statistics & numerical data, Infusions, Intraosseous instrumentation, Infusions, Intraosseous statistics & numerical data, Practice Patterns, Physicians' statistics & numerical data, Wounds and Injuries therapy
- Abstract
Background: Although used primarily in the pediatric population for decades, the use of intraosseous (IO) devices in the resuscitation of severely injured adult trauma patients has recently become more commonplace. The objective of this study was to determine the experience level, beliefs and attitudes of trauma practitioners in Canada, Australia and New Zealand regarding the use of IO devices in adult trauma patients., Methods: We administered a web-based survey to all members of 4 national trauma and emergency medicine organizations in Canada, Australia and New Zealand. Survey responses were analyzed using descriptive statistics, univariate comparisons and a proportional odds model., Results: Overall, 425 of 1771 members completed the survey, with 375 being trauma practitioners. IO devices were available to 97% (353 of 363), with EZ-IO being the most common. Nearly all physicians (98%, 357 of 366) had previous training with IO devices, and 85% (223 of 261) had previously used an IO device in adult trauma patients. Most respondents (79%, 285 of 361) were very comfortable placing an IO catheter in the proximal tibia. Most physicians would always or often use an IO catheter in a patient without intravenous access undergoing CPR for traumatic cardiac arrest (84%, 274 of 326) or in a hypotensive patient (without peripheral intravenous access) after 2 attempts or 90 s of trying to establish vascular access (81%, 264 of 326)., Conclusion: Intraosseous devices are readily available to trauma practitioners in Canada, Australia and New Zealand, and most physicians are trained in device placement. Most physicians surveyed felt comfortable using an IO device in resuscitation of adult trauma patients and would do so for indications broader than current guidelines.
- Published
- 2016
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- View/download PDF
45. Resuscitation Prior to Emergency Endotracheal Intubation: Results of a National Survey.
- Author
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Green RS, Fergusson DA, Turgeon AF, McIntyre LA, Kovacs GJ, Griesdale DE, Zarychanski R, Butler MB, Kureshi N, and Erdogan M
- Subjects
- Canada, Critical Care, Critical Illness, Cross-Sectional Studies, Crystalloid Solutions, Fluid Therapy methods, Humans, Isotonic Solutions administration & dosage, Reproducibility of Results, Surveys and Questionnaires, Emergency Medicine, Intubation, Intratracheal methods, Physicians, Resuscitation methods
- Abstract
Introduction: Respiratory failure is a common problem in emergency medicine (EM) and critical care medicine (CCM). However, little is known about the resuscitation of critically ill patients prior to emergency endotracheal intubation (EETI). Our aim was to describe the resuscitation practices of EM and CCM physicians prior to EETI., Methods: A cross-sectional survey was developed and tested for content validity and retest reliability by members of the Canadian Critical Care Trials Group. The questionnaire was distributed to all EM and CCM physician members of three national organizations. Using three clinical scenarios (trauma, pneumonia, congestive heart failure), we assessed physician preferences for use and types of fluid and vasopressor medication in pre-EETI resuscitation of critically ill patients., Results: In total, 1,758 physicians were surveyed (response rate 50.2%, 882/1,758). Overall, physicians would perform pre-EETI resuscitation using either fluids or vasopressors in 54% (1,193/2,203) of cases. Most physicians would "always/often" administer intravenous fluid pre-EETI in the three clinical scenarios (81%, 1,484/1,830). Crystalloids were the most common fluid physicians would "always/often" administer in congestive heart failure (EM 43%; CCM 44%), pneumonia (EM 97%; CCM 95%) and trauma (EM 96%; CCM 96%). Pre-EETI resuscitation using vasopressors was uncommon (4.9%). Training in CCM was associated with performing pre-EETI resuscitation (odds ratio, 2.20; 95% CI, [1.44-3.36], p<0.001)., Conclusion: Pre-EETI resuscitation is common among Canadian EM and CCM physicians. Most physicians use crystalloids pre-EETI as a resuscitation fluid, while few would give vasopressors. Physicians with CCM training were more likely to perform pre-EETI resuscitation.
- Published
- 2016
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46. Critical illness myopathy in a cervical spine-injured patient.
- Author
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Pencle FK, Kureshi N, Benstead T, and Christie SD
- Abstract
Neuromuscular weakness acquired in the intensive care unit (ICU) causes significant impairment in critically ill patients. The spectrum of critical illness neuromuscular disease includes critical illness myopathy, critical illness polyneuropathy or both, and occurs in approximately one-third of patients admitted to the ICU and those who are ventilated for at least 7 days. Recognized risk factors include sepsis, systemic inflammatory response syndrome, multi-organ failure, neuromuscular blocking agents and corticosteroids, however the absence of predisposing factors should not preclude critical illness neuromuscular disease. A 23-year-old male suffered a cervical spine injury and was admitted to the ICU. Two weeks post admission, he lost all power in his upper limbs, neck and face. Nerve conduction studies and needle electromyography were performed 4 weeks and 3 months after the injury, suggesting that myopathy was the likely cause of weakness. The definitive diagnosis of critical illness myopathy was based on muscle biopsy demonstrating myosin filament loss. Evaluation of new-onset weakness in ICU patients is essential to distinguish neurological causes from complications of critical illness. Signs and symptoms of critical illness neuromuscular disease must be identified early to encourage recovery, promote rehabilitation, and reduce morbidity and mortality.
- Published
- 2016
- Full Text
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47. Achieving all-age helmet use compliance for snow sports: strategic use of education, legislation and enforcement.
- Author
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Fenerty L, Heatley J, Young J, Thibault-Halman G, Kureshi N, Bruce BS, Walling S, and Clarke DB
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Consumer Behavior statistics & numerical data, Female, Humans, Male, Mass Media, Middle Aged, Nova Scotia epidemiology, Policy Making, Program Evaluation, Social Marketing, Young Adult, Athletic Injuries prevention & control, Brain Injuries, Traumatic prevention & control, Guideline Adherence statistics & numerical data, Head Protective Devices statistics & numerical data, Head Protective Devices supply & distribution, Health Education legislation & jurisprudence, Health Education organization & administration, Health Promotion methods, Snow Sports injuries
- Abstract
Background: Nova Scotia is the first jurisdiction in the world to mandate ski and snowboard helmet use for all ages at ski hills in the province. This study represents a longitudinal examination of the effects of social marketing, educational campaigns and the introduction of helmet legislation on all-age snow sport helmet use in Nova Scotia., Methods: A baseline observational study was conducted to establish the threshold of ski and snowboarding helmet use. Based on focus groups and interviews, a social marketing campaign was designed and implemented to address factors influencing helmet use. A prelegislation observational study assessed the effects of social marketing and educational promotion on helmet use. After all-age snow sport helmet legislation was enacted and enforced, a postlegislation observational study was conducted to determine helmet use prevalence., Results: Baseline data revealed that 74% of skiers and snowboarders were using helmets, of which 80% were females and 70% were males. Helmet use was high in children (96%), but decreased with increasing age. Following educational and social marketing campaigns, overall helmet use increased to 90%. After helmet legislation was enacted, 100% compliance was observed at ski hills in Nova Scotia., Conclusions: Results from this study demonstrate that a multifaceted approach, including education, legislation and enforcement, was effective in achieving full helmet compliance among all ages of skiers and snowboarders., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)
- Published
- 2016
- Full Text
- View/download PDF
48. Simulation-based training for burr hole surgery instrument recognition.
- Author
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Clarke DB, Kureshi N, Hong M, Sadeghi M, and D'Arcy RC
- Subjects
- Canada, Curriculum, Educational Measurement, Evidence-Based Medicine, Humans, Program Evaluation, Reproducibility of Results, User-Computer Interface, Brain Injuries surgery, Clinical Competence standards, Computer Simulation standards, Internship and Residency, Neurosurgery education, Simulation Training standards
- Abstract
Background: The use of simulation training in postgraduate medical education is an area of rapidly growing popularity and research. This study was designed to assess the impact of simulation training for instrument knowledge and recognition among neurosurgery residents., Methods: This was a randomized control trial of first year residents from neurosurgery residency training programs across Canada. Eighteen neurosurgery trainees were recruited to test two simulation-based applications: PeriopSim™ Instrument Trainer and PeriopSim™ for Burr Hole Surgery. The intervention was game-based simulation training for learning neurosurgical instruments and applying this knowledge to identify correct instruments during a simulated burr hole surgery procedure., Results: Participants showed significant overall improvement in total score (p < 0.0005), number of errors (p = 0.019) and time saved (p < 0.0005), over three testing sessions when using the PeriopSim™ Instrument Trainer. Participants demonstrated further performance-trained improvements when using PeriopSim™ Burr Hole Surgery., Conclusions: Training in the recognition and utilization of simulated surgical instruments by neurosurgery residents improved significantly with repetition when using PeriopSim™ Instrument Trainer and PeriopSim™ for Burr Hole Surgery.
- Published
- 2016
- Full Text
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49. A Retrospective Evaluation of Pediatric Major Trauma Related to Sport and Recreational Activities in Nova Scotia.
- Author
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Green RS, Butler MB, Kureshi N, and Erdogan M
- Subjects
- Adolescent, Athletic Injuries diagnosis, Child, Child, Preschool, Female, Humans, Incidence, Male, Nova Scotia epidemiology, Retrospective Studies, Seasons, Trauma Severity Indices, Athletic Injuries epidemiology, Hospitalization trends, Recreation
- Abstract
Objectives: A small proportion of pediatric sport- and recreation-related injuries are serious enough to be considered "major trauma." However, the immediate and long-term consequences in cases of pediatric major trauma are significant and potentially life-threatening. The objective of this study was to describe the incidence and outcomes of pediatric major traumas related to sport and recreational activities in Nova Scotia., Methods: This study was a retrospective case series. Data on major pediatric traumas related to sport and recreational activities on a provincial scope were extracted from the Nova Scotia Trauma Program Registry between 2000 and 2013. We evaluated frequency, type, severity, and outcomes of major traumas. Outcomes assessed included length of hospital stay, admission to a special care unit (SCU), and mortality., Results: Overall, 107 children aged three to 18 years sustained a major trauma (mean age 12.5 [SD 3.8]; 84% male). Most injuries were blunt traumas (97%). The greatest proportion were from cycling (59, 53%), followed by hockey (8, 7%), skateboarding (7, 7%) and skiing (7, 7%). The Nova Scotia Pediatric Trauma Team was activated in 27% of cases. Mean in-hospital length of stay was five days (SD 5.6), and nearly half (49%) of patients required SCU admission. Severe traumatic brain injury occurred in 52% of cases, and mortality in five cases., Conclusions: Over a 13-year period, the highest incidence of pediatric major trauma related to sport and recreational activities was from cycling, followed by hockey. Severe traumatic brain injury occurred in over half of pediatric major trauma patients.
- Published
- 2016
- Full Text
- View/download PDF
50. A Predictive Model for Personalized Therapeutic Interventions in Non-small Cell Lung Cancer.
- Author
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Kureshi N, Abidi SS, and Blouin C
- Subjects
- Aged, Carcinoma, Non-Small-Cell Lung classification, Carcinoma, Non-Small-Cell Lung genetics, Data Mining, Databases, Factual, ErbB Receptors genetics, Female, Humans, Lung Neoplasms classification, Lung Neoplasms genetics, Male, Middle Aged, Mutation genetics, Pattern Recognition, Automated, Support Vector Machine, Antineoplastic Agents therapeutic use, Carcinoma, Non-Small-Cell Lung drug therapy, Decision Trees, Lung Neoplasms drug therapy, Models, Biological, Precision Medicine
- Abstract
Non-small cell lung cancer (NSCLC) constitutes the most common type of lung cancer and is frequently diagnosed at advanced stages. Clinical studies have shown that molecular targeted therapies increase survival and improve quality of life in patients. Nevertheless, the realization of personalized therapies for NSCLC faces a number of challenges including the integration of clinical and genetic data and a lack of clinical decision support tools to assist physicians with patient selection. To address this problem, we used frequent pattern mining to establish the relationships of patient characteristics and tumor response in advanced NSCLC. Univariate analysis determined that smoking status, histology, epidermal growth factor receptor (EGFR) mutation, and targeted drug were significantly associated with response to targeted therapy. We applied four classifiers to predict treatment outcome from EGFR tyrosine kinase inhibitors. Overall, the highest classification accuracy was 76.56% and the area under the curve was 0.76. The decision tree used a combination of EGFR mutations, histology, and smoking status to predict tumor response and the output was both easily understandable and in keeping with current knowledge. Our findings suggest that support vector machines and decision trees are a promising approach for clinical decision support in the patient selection for targeted therapy in advanced NSCLC.
- Published
- 2016
- Full Text
- View/download PDF
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