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Canadian survey of clinical status at dialysis initiation 1998-1999: a multicenter prospective survey.

https://arctichealth.org/en/permalink/ahliterature188002
Source
Clin Nephrol. 2002 Oct;58(4):282-8
Publication Type
Article
Date
Oct-2002
Author
B M Curtis
B J Barret
K. Jindal
O. Djurdjev
A. Levin
P. Barre
K. Bernstein
P. Blake
E. Carlisle
P. Cartier
C. Clase
B. Culleton
C. Deziel
S. Donnelly
J. Ethier
A. Fine
G. Ganz
M. Goldstein
J. Kappel
G. Karr
S. Langlois
D. Mendelssohn
N. Muirhead
B. Murphy
G. Pylpchuk
E. Toffelmire
Author Affiliation
Division of Nephrology, Memorial University of Newfoundland, Canada.
Source
Clin Nephrol. 2002 Oct;58(4):282-8
Date
Oct-2002
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Canada
Creatinine - urine
Cross-Sectional Studies
Diabetes Mellitus - metabolism - physiopathology - therapy
Female
Food Habits
Glomerular Filtration Rate - physiology
Health Surveys
Humans
Kidney Failure, Chronic - metabolism - physiopathology - therapy
Male
Middle Aged
Prospective Studies
Renal Dialysis
Serum Albumin - metabolism
Treatment Outcome
Urban health
Abstract
The current growth in end-stage kidney disease populations has led to increased efforts to understand the impact of status at dialysis initiation on long-term outcomes. Our main objective was to improve the understanding of current Canadian nephrology practice between October 1998 and December 1999.
Fifteen nephrology centers in 7 provinces participated in a prospective data collection survey. The main outcome of interest was the clinical status at dialysis initiation determined by: residual kidney function, preparedness for chronic dialysis as measured by presence or absence of permanent peritoneal or hemodialysis access, hemoglobin and serum albumin. Uremic symptoms at dialysis initiation were also recorded, however, in some cases these symptom data were obtained retrospectively.
Data on 251 patients during 1-month periods were collected. Patients commenced dialysis at mean calculated creatinine clearance levels of approximately 10 ml/min, with an average of 3 symptoms. 35% of patients starting dialysis had been known to nephrologists for less than 3 months. These patients are more likely to commence without permanent access and with lower hemoglobin and albumin levels. Even of those known to nephrologists, only 66% had permanent access in place.
Patients commencing dialysis in Canada appear to be doing so in relative concordance with published guidelines with respect to timing of initiation. Despite an increased awareness of kidney disease, a substantial number of patients continues to commence dialysis without previous care by a nephrologist. Of those who are seen by nephrologists, clinical and laboratory parameters are suboptimal according to current guidelines. This survey serves as an important baseline for future comparisons after the implementation of educational strategies for referring physicians and nephrologists.
PubMed ID
12400843 View in PubMed
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Preliminary findings from a teleultrasound study in Alberta.

https://arctichealth.org/en/permalink/ahliterature203813
Source
Telemed J. 1998;4(3):267-76
Publication Type
Article
Date
1998
Author
M A Johnson
P. Davis
A J McEwan
G S Jhangri
R. Warshawski
A. Gargum
J. Ethier
W W Anderson
Author Affiliation
Department of Radiology & Diagnostic Imaging, University of Alberta Hospital, and Medical Imaging Consultants, Edmonton, Alberta, Canada.
Source
Telemed J. 1998;4(3):267-76
Date
1998
Language
English
Publication Type
Article
Keywords
Alberta
Algorithms
Humans
Prospective Studies
Telemedicine - organization & administration
Teleradiology
Ultrasonography - methods
Abstract
Ultrasound practice in Alberta requires direct supervision by an ultrasound-accredited specialist physician (sonologist). This requirement limits access to ultrasound examinations in many rural communities. A prospective study was performed to evaluate the adequacy of teleultrasound service in High Level, Alberta, with remote sonologist supervision from Edmonton, Alberta.
A total of 146 patients were evaluated in two groups. Group A (72 patients) was evaluated by both an on-site radiologist in High Level and a remote supervising radiologist in Edmonton. Group B (74 patients) was evaluated only by the remote supervising radiologist in Edmonton. The teleultrasound service included digital store-and-forward capabilities using a commercially available teleradiology system, with videoconferencing review for real-time scanning.
The teleultrasound service was helpful to the referring physician. It made transfer unnecessary in 42% of patients, and the results of the ultrasound assessment influenced management in 59% of patients. The sonographer on site and the remote radiologists agreed on the quality of the images. The information required for diagnosis was available from the sonographer's study in the majority of cases, with second-look scanning by the on-site radiologist or videoconferencing by the remote radiologist providing a major new diagnosis in only 1% of patients.
Teleultrasound service to High Level could be provided reliably with remote supervision, comparable to direct on-site supervision.
PubMed ID
9831751 View in PubMed
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Rotavirus infection in a geriatric population.

https://arctichealth.org/en/permalink/ahliterature243522
Source
Arch Intern Med. 1982 Feb;142(2):313-6
Publication Type
Article
Date
Feb-1982
Author
T J Marrie
S H Lee
R S Faulkner
J. Ethier
C H Young
Source
Arch Intern Med. 1982 Feb;142(2):313-6
Date
Feb-1982
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antibody formation
Cross Infection - immunology
Diarrhea - etiology
Female
Humans
Male
Nova Scotia
Personnel, Hospital
Reoviridae Infections - immunology
Rotavirus
Abstract
An outbreak of gastroenteritis affected 19 of 34 geriatric patients and four of 23 staff assigned to the ward in a period of 3 1/2 weeks in January 1980. Fourteen of the 19 patients with gastroenteritis (17 were tested properly) and four of the ten asymptomatic patients (five asymptomatic patients were not tested) showed evidence of rotavirus infection by virus positivity and/or a significant antibody response to rotavirus. One of the four staff members with gastroenteritis showed serologic evidence (three were tested) of rotavirus infection. Nine of the 18 asymptomatic staff members (two remaining staff members were not tested) showed a fourfold rise in antibody to rotavirus but four had antibody titers of 1:32 or more. The patients had diarrhea for a mean of 2.6 days. Most of them had five or fewer diarrheal stools in one day. Six patients had a severe illness and two died. Thirteen of 15 symptomatic patients who had serum samples, collected during the acute and convalescent phases, tested manifested high titers (greater than or equal to 1:32) of complement-fixing antibody to rotavirus antigen.
PubMed ID
6277261 View in PubMed
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