A5060448108- Sepsis Diagnosis and Treatment
- COVID-19 and healthcare impacts
- Infection Control and Ventilation
- Prenatal Substance Exposure Effects
- Bacterial Identification and Susceptibility Testing
- COVID-19 Clinical Research Studies
- COVID-19 epidemiological studies
- Cardiac Arrest and Resuscitation
- Healthcare cost, quality, practices
- Pregnancy and Medication Impact
- Breastfeeding Practices and Influences
- Attention Deficit Hyperactivity Disorder
- Diabetes and associated disorders
- Long-Term Effects of COVID-19
- Maternal Mental Health During Pregnancy and Postpartum
- Drug Transport and Resistance Mechanisms
- Pregnancy and preeclampsia studies
- Social Media in Health Education
- Opioid Use Disorder Treatment
- Clinical Laboratory Practices and Quality Control
- Venous Thromboembolism Diagnosis and Management
- Reproductive Health and Contraception
- Clinical Reasoning and Diagnostic Skills
- Poisoning and overdose treatments
- Neurological disorders and treatments
University of Toronto
2014-2024
Health Sciences Centre
2018-2023
National Patient Safety Foundation
2023
The Wilson Centre
2023
Sunnybrook Health Science Centre
2018-2023
3M (United States)
2017
Sunnybrook Hospital
2015-2017
Sunnybrook Research Institute
2015-2017
Institute for Clinical Evaluative Sciences
2015-2017
St Michaels Hospital
2017
Abstract Background Physicians face competing demands of maximizing pathogen coverage while minimizing unnecessary use broad-spectrum antibiotics when managing sepsis. We sought to identify physicians’ perceived likelihood achieved by their usual empiric antibiotic regimen, along with minimum thresholds they would be willing accept these patients. Methods conducted a scenario-based survey internal medicine physicians from across Canada using 2 × factorial design, varied infection source...
Drug efflux transporters in the placenta can significantly influence materno-fetal transfer of a diverse array drugs and other xenobiotics. To determine if clinically important drug transporter expression is altered pregnancies complicated by gestational diabetes mellitus (GDM-I) or type 1 (T1DM-I), we compared multidrug resistance protein (MDR1), resistance-associated 2 (MRP2) breast cancer (BCRP) via western blotting quantitative real-time polymerase chain reaction samples obtained from...
Among patients taking warfarin, lower socioeconomic status is associated with poorer control of anticoagulation. However, the extent to which influences risk hemorrhage unknown. We examined in older individuals newly commencing warfarin therapy for atrial fibrillation.We conducted a population-based cohort study 66 years or fibrillation who commenced between April 1, 1997, and November 30th 2011, Ontario, Canada. used neighborhood-level income quintiles as measure status. The primary outcome...
Small studies suggest that prescription stimulants can precipitate psychosis and mania. We conducted a population-based case-crossover study to examine whether hospitalization for or mania was associated with initiation of stimulant therapy. Between October 1, 1999 March 31, 2013, we studied 12,856 young people who received were subsequently hospitalized Of these, 183 commenced treatment during 1 2 prespecified 60-day intervals (defined as the "risk interval" "control interval,"...
Naloxone is life-saving when administered after opioid overdose. In March 2016, the Canadian government made antidote available without prescription, but anecdotal reports suggest members of public have difficulty in procuring it. We examined availability naloxone community pharmacies across Canada.We identified Canada (n = 10 296) and randomly selected 506, stratified using proportionate allocation by population size. excluded Alberta Manitoba because these provinces released data...
Background/context Unnecessary laboratory testing leads to considerable healthcare costs. Aspartate aminotransferase (AST), commonly ordered with alanine (ALT) and blood urea nitrogen (BUN), creatinine (Cr), often add little value patient management at significant cost. We undertook a choosing wisely based quality improvement initiative reduce the frequency of testing. Objectives To ratio AST/ALT BUN/Cr less than 5% for all inpatient outpatient test orders. Measures Absolute number BUN/Cr;...
Preventing and treating malaria in pregnancy is a global health priority. However little known regarding the impact of infection on maternal fetal disposition pharmaceuticals other xenobiotics. Our objective was to characterize expression key determinants drug-disposition tissues validated murine model experimental placental malaria. Balb/c mice were infected with <i>Plasmodium berghei</i> at mid gestation [gestational day (GD) 13] maternal, placental, collected GD19. Expression ABC drug...
Clopidogrel and angiotensin converting enzyme (ACE) inhibitors are commonly co-prescribed drugs. inhibits carboxylesterase 1 (CES1), the responsible for prodrug ACE (such as ramipril perindopril) to their active metabolites. The clinical implications of this potential drug interaction unknown. consequences between clopidogrel were examined.We conducted a nested case-control study Ontarians aged 66 years older treated with September 2003 March 31 2013 following acute myocardial infarction....
BACKGROUND Transfusion‐associated circulatory overload (TACO) is a leading cause of serious reactions. In regard to TACO, little known regarding biomarkers as predictor, their most informative timing, or thresholds significance differentiation from other STUDY DESIGN AND METHODS this study inpatients at risk for TACO (age ≥ 50 years) receiving 1 red blood cell unit, cardiac biomarkers, brain natriuretic peptide (BNP), N‐terminal pro‐BNP (NT‐proBNP), and high‐sensitivity troponin were...
<h3>Background:</h3> Identifying potentially avoidable admissions to Canadian hospitals is an important health system goal. With general internal medicine (GIM) accounting for 40% of hospital admissions, we sought develop a method identify and characterize patient, provider factors. <h3>Methods:</h3> We conducted observational study GIM at our institution from August 2019 February 2020. defined as that could be managed in appropriate safe manner the emergency department or ambulatory setting...
Objective Current scores for predicting sepsis outcomes are limited by generalizability, complexity, and electronic medical record (EMR) integration. Here, we validate a simple EMR-based score in large multi-centre cohort. Design A record-based predictor of illness severity (SEPSIS) was developed (4 additive lab-based predictors) using population-based retrospective cohort study. Setting Internal medicine services across four academic teaching hospitals Toronto, Canada from April 2010—March...
Abstract Background There is wide variation in mortality among patients hospitalized with COVID‐19. Whether this related to patient or hospital factors unknown. Objective To compare the risk of for COVID‐19 and determine whether majority that was explained by differences characteristics across sites. Design, Setting, Participants An international multicenter cohort study adults laboratory‐confirmed enrolled from 10 hospitals Ontario, Canada 8 Copenhagen, Denmark between January 1, 2020...
Abstract Background Current scores for predicting sepsis outcomes are limited by generalizability, complexity, and electronic medical record (EMR) integration. Here, we validate a simple EMR-based score in large multi-centre cohort. Methods A record-based predictor of illness severity (SEPSIS) was developed (4 additive lab-based predictors: Creatinine, Bilirubin, Platelet Count, Lactate) using retrospective cohort study patients admitted to internal medicine services from April 2010 - March...