A5018324309- Bacterial Identification and Susceptibility Testing
- Antibiotic Use and Resistance
- Sepsis Diagnosis and Treatment
- Health Systems, Economic Evaluations, Quality of Life
- Nosocomial Infections in ICU
- Central Venous Catheters and Hemodialysis
- Antimicrobial Resistance in Staphylococcus
- Ethics in Clinical Research
- Electrolyte and hormonal disorders
- SARS-CoV-2 and COVID-19 Research
- Biomedical Ethics and Regulation
- Adrenal Hormones and Disorders
- Patient-Provider Communication in Healthcare
- Urinary Tract Infections Management
- Meta-analysis and systematic reviews
- Ethics and Legal Issues in Pediatric Healthcare
- Viral Infections and Outbreaks Research
- Neonatal and Maternal Infections
- Disaster Response and Management
- COVID-19 Clinical Research Studies
- COVID-19 and healthcare impacts
- Influenza Virus Research Studies
- Cardiac Arrest and Resuscitation
- Respiratory Support and Mechanisms
- Hormonal Regulation and Hypertension
Sunnybrook Health Science Centre
2016-2025
Health Sciences Centre
2016-2025
University of Toronto
2016-2024
McMaster University
2023
University of British Columbia
2023
Canadian Armed Forces
2023
Niagara Health System
2023
William Osler Health System
2023
Institute for Work & Health
2023
Institute for Clinical Evaluative Sciences
2016-2023
<h3>Background</h3> Recent studies have reported a high prevalence of relative adrenal insufficiency in patients with liver cirrhosis. However, the effect corticosteroid replacement on mortality this high-risk group remains unclear. We examined low-dose hydrocortisone cirrhosis who presented septic shock. <h3>Methods</h3> enrolled and shock aged 18 years or older randomized double-blind placebo-controlled trial. Relative was defined as serum cortisol increase less than 250 nmol/L 9 μg/dL...
The 2009-2010 influenza A (H1N1pdm09) pandemic caused substantial morbidity and mortality among young patients; however, estimates have been confounded by regional differences in eligibility criteria inclusion of selected populations. In 2013-2014, H1N1pdm09 became North America's dominant seasonal strain. Our objective was to compare the baseline characteristics, resources, treatments with outcomes critically ill patients Mexican Canadian hospitals 2014 using consistent...
<h3>Background:</h3> Randomized controlled trials (RCTs) provide essential evidence to inform practice, but the many necessary steps result in lengthy times initiation, which is problematic case of rapidly emerging infections such as COVID-19. This study aimed describe start-up timelines for Canadian Treatments COVID-19 (CATCO) RCT. <h3>Methods:</h3> We surveyed hospitals participating CATCO and ethics submission sites using a structured data abstraction form. measured durations from...
Introduction Bloodstream infections are a leading cause of mortality and morbidity; the duration treatment for these is understudied. Methods analysis We will conduct an international, multicentre randomised clinical trial shorter (7 days) versus longer (14 antibiotic among hospitalised patients with bloodstream infections. The include 3626 across 60 hospitals 6 countries. blood cultures confirming pathogenic bacterium after hospital admission. Exclusion criteria patient factors (severe...
Observational research focused upon emerging infectious diseases such as Ebola virus, Middle East respiratory syndrome, and Zika virus has been challenging to quickly initiate. We aimed determine the duration of start-up procedures barriers encountered for an observational study outbreaks. At 1 pediatric 5 adult intensive care units, we measured durations from protocol receipt a variety outbreak milestones, including ethics board (REB) approval, data sharing agreement (DSA) execution,...
<h3>Background:</h3> Surveillance of antimicrobial resistance is vital to guiding empirical treatment infections. Collating and reporting routine data on clinical isolate testing may offer more timely information about patterns than traditional surveillance network methods. <h3>Methods:</h3> Using microbiology collected from the Bacteremia Antibiotic Length Actually Needed for Clinical Effectiveness retrospective cohort study, we conducted a descriptive secondary analysis among critically...
Importance The COVID-19 pandemic created unprecedented challenges for clinical trials worldwide, threatening premature closure and trial integrity. Every phase of research operations was affected, often requiring modifications to protocol design implementation. Objectives To identify the barriers, solutions, opportunities associated with continuing critical care that were interrupted during pandemic, generate suggestions future trials. Design, Setting, Participants This mixed-methods study...
The optimal treatment duration for patients with bloodstream infection is understudied. Bacteremia Antibiotic Length Actually Needed Clinical Effectiveness (BALANCE) pilot randomized clinical trial (RCT) determined that it was feasible to enroll and randomize intensive care unit (ICU) 7 versus 14 days of treatment, served as the vanguard ongoing BALANCE main RCT. We performed this BALANCE-Ward RCT examine feasibility impact potentially extending include hospitalized on non-ICU wards.We...
Background A multidisciplinary approach has been recommended for the management of patients with infective endocarditis. We evaluated impact case conferences on morbidity, mortality, and quality care these patients. Methods conducted a quasi-experimental study consecutive admitted endocarditis before (2013/10/1–2015/10/12, n = 97) after (2015/10/13–2017/11/30, 80) implementation to discuss medical surgical management. These occurred as face-to-face discussions or electronically (for...
We used modified contingent valuation methodology to determine how noninferiority margin sizes influence clinicians' willingness accept clinical trial results that compare mortality in critically ill children.
Objective To describe antibiotic treatment durations that pediatric infectious diseases (ID) and critical care clinicians usually recommend for bloodstream infections in critically ill children. Design Anonymous, online practice survey using five common pediatric-based case scenarios of infections. Setting Pediatric intensive units Canada, Australia New Zealand. Participants intensivists, nurse practitioners, ID physicians pharmacists. Main outcome measures Recommended syndromes associated...
Informed consent forms (ICFs) for randomised clinical trials (RCTs) can be onerous and lengthy. The process has the potential to overwhelm patients with information, leading them miss elements of study that are critical an informed decision. Specifically, overly long complicated ICFs have increase barriers trial participation mild cognitive impairment, those who do not speak English as a first language or among lower medical literacy. In turn, this influence recruitment, completion external...
The BALANCE study is a randomised clinical trial (3626 participants) designed to assess the non-inferiority of 7 days (short-course) antibiotic therapy compared with 14 for bacteraemia using pragmatic endpoint 90-day survival. Based on pilot data, approximately 30% enrolees will have urinary tract infection (UTI) as source bacteraemia. We aim short-course patients UTIs.Participating sites in four countries be invited join this substudy. All participants substudy enrolled main study....
Abstract Background Bloodstream infections (BSIs) cause significant morbidity and mortality in critically ill children but treatment duration is understudied. We describe the durations of antimicrobial that receive explore factors associated with duration. Methods conducted a retrospective observational cohort study six pediatric intensive care units (PICUs) across Canada. Associations between patient-, infection- pathogen-related characteristics were explored using multivariable regression...