Publications by authors named "Jacques Bouchard"

24 Publications

  • Page 1 of 1

Lumbar Fusion Surgery for Patients With Back Pain and Degenerative Disc Disease: An Observational Study From the Canadian Spine Outcomes and Research Network.

Global Spine J 2021 Jan 7:2192568220985470. Epub 2021 Jan 7.

University of Calgary Spine Program, University of Calgary, Alberta, Canada.

Study Design: Uncontrolled retrospective observational study.

Objectives: Surgery for patients with back pain and degenerative disc disease is controversial, and studies to date have yielded conflicting results. We evaluated the effects of lumbar fusion surgery for patients with this indication in the Canadian Spine Outcomes and Research Network (CSORN).

Methods: We analyzed data that were prospectively collected from consecutive patients at 11 centers between 2015 and 2019. Our primary outcome was change in patient-reported back pain at 12 months of follow-up, and our secondary outcomes were satisfaction, disability, health-related quality of life, and rates of adverse events.

Results: Among 84 patients, we observed a statistically significant improvement of back pain at 12 months that exceeded the threshold of Minimum Clinically Important Difference (MCID) (mean change -3.7 points, SD 2.6, p < 0.001, MCID = 1.2; 77% achieved MCID), and 81% reported being "somewhat" or "extremely" satisfied. We also observed improvements of Oswestry Disability Index (-17.3, SD 16.6), Short Form-12 Physical Component Summary (10.3, SD 9.6) and Short Form-12 Mental Component Summary (3.1, SD 8.3); all p < 0.001). The overall rate of adverse events was 19%.

Conclusions: Among a highly selective group of patients undergoing lumbar fusion surgery for degenerative disc disease, most experienced a clinically significant improvement of back pain as well as significant improvements of disability and health-related quality of life, with high satisfaction at 1 year of follow-up. These findings suggest that surgery for this indication may provide some benefit, and that further research is warranted.
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http://dx.doi.org/10.1177/2192568220985470DOI Listing
January 2021

ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice.

Authors:
Jean Bousquet Josep M Anto Claus Bachert Tari Haahtela Torsten Zuberbier Wienczyslawa Czarlewski Anna Bedbrook Sinthia Bosnic-Anticevich G Walter Canonica Victoria Cardona Elisio Costa Alvaro A Cruz Marina Erhola Wytske J Fokkens Joao A Fonseca Maddalena Illario Juan-Carlos Ivancevich Marek Jutel Ludger Klimek Piotr Kuna Violeta Kvedariene Ltt Le Désirée E Larenas-Linnemann Daniel Laune Olga M Lourenço Erik Melén Joaquim Mullol Marek Niedoszytko Mikaëla Odemyr Yoshitaka Okamoto Nikos G Papadopoulos Vincenzo Patella Oliver Pfaar Nhân Pham-Thi Christine Rolland Boleslaw Samolinski Aziz Sheikh Mikhail Sofiev Charlotte Suppli Ulrik Ana Todo-Bom Peter-Valentin Tomazic Sanna Toppila-Salmi Ioanna Tsiligianni Arunas Valiulis Erkka Valovirta Maria-Teresa Ventura Samantha Walker Sian Williams Arzu Yorgancioglu Ioana Agache Cezmi A Akdis Rute Almeida Ignacio J Ansotegui Isabella Annesi-Maesano Sylvie Arnavielhe Xavier Basagaña Eric D Bateman Annabelle Bédard Martin Bedolla-Barajas Sven Becker Kazi S Bennoor Samuel Benveniste Karl C Bergmann Michael Bewick Slawomir Bialek Nils E Billo Carsten Bindslev-Jensen Leif Bjermer Hubert Blain Matteo Bonini Philippe Bonniaud Isabelle Bosse Jacques Bouchard Louis-Philippe Boulet Rodolphe Bourret Koen Boussery Fluvio Braido Vitalis Briedis Andrew Briggs Christopher E Brightling Jan Brozek Guy Brusselle Luisa Brussino Roland Buhl Roland Buonaiuto Moises A Calderon Paulo Camargos Thierry Camuzat Luis Caraballo Ana-Maria Carriazo Warner Carr Christine Cartier Thomas Casale Lorenzo Cecchi Alfonso M Cepeda Sarabia Niels H Chavannes Ekaterine Chkhartishvili Derek K Chu Cemal Cingi Jaime Correia de Sousa David J Costa Anne-Lise Courbis Adnan Custovic Biljana Cvetkosvki Gennaro D'Amato Jane da Silva Carina Dantas Dejan Dokic Yves Dauvilliers Giulia De Feo Govert De Vries Philippe Devillier Stefania Di Capua Gerard Dray Ruta Dubakiene Stephen R Durham Mark Dykewicz Motohiro Ebisawa Mina Gaga Yehia El-Gamal Enrico Heffler Regina Emuzyte John Farrell Jean-Luc Fauquert Alessandro Fiocchi Antje Fink-Wagner Jean-François Fontaine José M Fuentes Perez Bilun Gemicioğlu Amiran Gamkrelidze Judith Garcia-Aymerich Philippe Gevaert René Maximiliano Gomez Sandra González Diaz Maia Gotua Nick A Guldemond Maria-Antonieta Guzmán Jawad Hajjam Yunuen R Huerta Villalobos Marc Humbert Guido Iaccarino Despo Ierodiakonou Tomohisa Iinuma Ewa Jassem Guy Joos Ki-Suck Jung Igor Kaidashev Omer Kalayci Przemyslaw Kardas Thomas Keil Musa Khaitov Nikolai Khaltaev Jorg Kleine-Tebbe Rostislav Kouznetsov Marek L Kowalski Vicky Kritikos Inger Kull Stefania La Grutta Lisa Leonardini Henrik Ljungberg Philip Lieberman Brian Lipworth Karin C Lodrup Carlsen Catarina Lopes-Pereira Claudia C Loureiro Renaud Louis Alpana Mair Bassam Mahboub Michaël Makris Joao Malva Patrick Manning Gailen D Marshall Mohamed R Masjedi Jorge F Maspero Pedro Carreiro-Martins Mika Makela Eve Mathieu-Dupas Marcus Maurer Esteban De Manuel Keenoy Elisabete Melo-Gomes Eli O Meltzer Enrica Menditto Jacques Mercier Yann Micheli Neven Miculinic Florin Mihaltan Branislava Milenkovic Dimitirios I Mitsias Giuliana Moda Maria-Dolores Mogica-Martinez Yousser Mohammad Steve Montefort Ricardo Monti Mario Morais-Almeida Ralph Mösges Lars Münter Antonella Muraro Ruth Murray Robert Naclerio Luigi Napoli Leyla Namazova-Baranova Hugo Neffen Kristoff Nekam Angelo Neou Björn Nordlund Ettore Novellino Dieudonné Nyembue Robyn O'Hehir Ken Ohta Kimi Okubo Gabrielle L Onorato Valentina Orlando Solange Ouedraogo Julia Palamarchuk Isabella Pali-Schöll Peter Panzner Hae-Sim Park Gianni Passalacqua Jean-Louis Pépin Ema Paulino Ruby Pawankar Jim Phillips Robert Picard Hilary Pinnock Davor Plavec Todor A Popov Fabienne Portejoie David Price Emmanuel P Prokopakis Fotis Psarros Benoit Pugin Francesca Puggioni Pablo Quinones-Delgado Filip Raciborski Rojin Rajabian-Söderlund Frederico S Regateiro Sietze Reitsma Daniela Rivero-Yeverino Graham Roberts Nicolas Roche Erendira Rodriguez-Zagal Christine Rolland Regina E Roller-Wirnsberger Nelson Rosario Antonino Romano Menachem Rottem Dermot Ryan Johanna Salimäki Mario M Sanchez-Borges Joaquin Sastre Glenis K Scadding Sophie Scheire Peter Schmid-Grendelmeier Holger J Schünemann Faradiba Sarquis Serpa Mohamed Shamji Juan-Carlos Sisul Mikhail Sofiev Dirceu Solé David Somekh Talant Sooronbaev Milan Sova François Spertini Otto Spranger Cristiana Stellato Rafael Stelmach Michel Thibaudon Teresa To Mondher Toumi Omar Usmani Antonio A Valero Rudolph Valenta Marylin Valentin-Rostan Marilyn Urrutia Pereira Rianne van der Kleij Michiel Van Eerd Olivier Vandenplas Tuula Vasankari Antonio Vaz Carneiro Giorgio Vezzani Frédéric Viart Giovanni Viegi Dana Wallace Martin Wagenmann De Yun Wang Susan Waserman Magnus Wickman Dennis M Williams Gary Wong Piotr Wroczynski Panayiotis K Yiallouros Osman M Yusuf Heather J Zar Stéphane Zeng Mario E Zernotti Luo Zhang Nan Shan Zhong Mihaela Zidarn

Allergy 2021 01 23;76(1):168-190. Epub 2020 Oct 23.

University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.
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http://dx.doi.org/10.1111/all.14422DOI Listing
January 2021

Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence.

Authors:
Jean Bousquet Holger J Schünemann Akdis Togias Claus Bachert Martina Erhola Peter W Hellings Ludger Klimek Oliver Pfaar Dana Wallace Ignacio Ansotegui Ioana Agache Anna Bedbrook Karl-Christian Bergmann Mike Bewick Philippe Bonniaud Sinthia Bosnic-Anticevich Isabelle Bossé Jacques Bouchard Louis-Philippe Boulet Jan Brozek Guy Brusselle Moises A Calderon Walter G Canonica Luis Caraballo Vicky Cardona Thomas Casale Lorenzo Cecchi Derek K Chu Elisio M Costa Alvaro A Cruz Wienczyslawa Czarlewski Gennaro D'Amato Philippe Devillier Mark Dykewicz Motohiro Ebisawa Jean-Louis Fauquert Wytske J Fokkens Joao A Fonseca Jean-François Fontaine Bilun Gemicioglu Roy Gerth van Wijk Tari Haahtela Susanne Halken Despo Ierodiakonou Tomohisa Iinuma Juan-Carlos Ivancevich Marek Jutel Igor Kaidashev Musa Khaitov Omer Kalayci Jorg Kleine Tebbe Marek L Kowalski Piotr Kuna Violeta Kvedariene Stefania La Grutta Désirée Larenas-Linnemann Susanne Lau Daniel Laune Lan Le Philipp Lieberman Karin C Lodrup Carlsen Olga Lourenço Gert Marien Pedro Carreiro-Martins Erik Melén Enrica Menditto Hugo Neffen Gregoire Mercier Ralph Mosgues Joaquim Mullol Antonella Muraro Leyla Namazova Ettore Novellino Robyn O'Hehir Yoshitaka Okamoto Ken Ohta Hae Sim Park Petr Panzner Giovanni Passalacqua Nhan Pham-Thi David Price Graham Roberts Nicolas Roche Christine Rolland Nelson Rosario Dermot Ryan Boleslaw Samolinski Mario Sanchez-Borges Glenis K Scadding Mohamed H Shamji Aziz Sheikh Ana-Maria Todo Bom Sanna Toppila-Salmi Ioana Tsiligianni Marylin Valentin-Rostan Arunas Valiulis Erkka Valovirta Maria-Teresa Ventura Samantha Walker Susan Waserman Arzu Yorgancioglu Torsten Zuberbier

J Allergy Clin Immunol 2020 01 15;145(1):70-80.e3. Epub 2019 Oct 15.

Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin and Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, member of GA(2)LEN, Berlin, Germany.

The selection of pharmacotherapy for patients with allergic rhinitis aims to control the disease and depends on many factors. Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines have considerably improved the treatment of allergic rhinitis. However, there is an increasing trend toward use of real-world evidence to inform clinical practice, especially because randomized controlled trials are often limited with regard to the applicability of results. The Contre les Maladies Chroniques pour un Vieillissement Actif (MACVIA) algorithm has proposed an allergic rhinitis treatment by a consensus group. This simple algorithm can be used to step up or step down allergic rhinitis treatment. Next-generation guidelines for the pharmacologic treatment of allergic rhinitis were developed by using existing GRADE-based guidelines for the disease, real-world evidence provided by mobile technology, and additive studies (allergen chamber studies) to refine the MACVIA algorithm.
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http://dx.doi.org/10.1016/j.jaci.2019.06.049DOI Listing
January 2020

Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases.

Authors:
J Jean Bousquet Holger J Schünemann Alkis Togias Marina Erhola Peter W Hellings Torsten Zuberbier Ioana Agache Ignacio J Ansotegui Josep M Anto Claus Bachert Sven Becker Martin Bedolla-Barajas Michael Bewick Sinthia Bosnic-Anticevich Isabelle Bosse Louis P Boulet Jean Marc Bourrez Guy Brusselle Niels Chavannes Elisio Costa Alvaro A Cruz Wienczyslawa Czarlewski Wytske J Fokkens Joao A Fonseca Mina Gaga Tari Haahtela Maddalena Illario Ludger Klimek Piotr Kuna Violeta Kvedariene L T T Le Desiree Larenas-Linnemann Daniel Laune Olga M Lourenço Enrica Menditto Joaquin Mullol Yashitaka Okamoto Nikos Papadopoulos Nhân Pham-Thi Robert Picard Hilary Pinnock Nicolas Roche Regina E Roller-Wirnsberger Christine Rolland Boleslaw Samolinski Aziz Sheikh Sanna Toppila-Salmi Ioanna Tsiligianni Arunas Valiulis Erkka Valovirta Tuula Vasankari Maria-Teresa Ventura Samantha Walker Sian Williams Cezmi A Akdis Isabella Annesi-Maesano Sylvie Arnavielhe Xavier Basagana Eric Bateman Anna Bedbrook K S Bennoor Samuel Benveniste Karl C Bergmann Slawomir Bialek Nils Billo Carsten Bindslev-Jensen Leif Bjermer Hubert Blain Mateo Bonini Philippe Bonniaud Jacques Bouchard Vitalis Briedis Christofer E Brightling Jan Brozek Roland Buhl Roland Buonaiuto Giorgo W Canonica Victoria Cardona Ana M Carriazo Warner Carr Christine Cartier Thomas Casale Lorenzo Cecchi Alfonso M Cepeda Sarabia Eka Chkhartishvili Derek K Chu Cemal Cingi Elaine Colgan Jaime Correia de Sousa Anne Lise Courbis Adnan Custovic Biljana Cvetkosvki Gennaro D'Amato Jane da Silva Carina Dantas Dejand Dokic Yves Dauvilliers Antoni Dedeu Giulia De Feo Philippe Devillier Stefania Di Capua Marc Dykewickz Ruta Dubakiene Motohiro Ebisawa Yaya El-Gamal Esben Eller Regina Emuzyte John Farrell Antjie Fink-Wagner Alessandro Fiocchi Jean F Fontaine Bilun Gemicioğlu Peter Schmid-Grendelmeir Amiran Gamkrelidze Judith Garcia-Aymerich Maximiliano Gomez Sandra González Diaz Maia Gotua Nick A Guldemond Maria-Antonieta Guzmán Jawad Hajjam John O'B Hourihane Marc Humbert Guido Iaccarino Despo Ierodiakonou Maddalena Illario Juan C Ivancevich Guy Joos Ki-Suck Jung Marek Jutel Igor Kaidashev Omer Kalayci Przemyslaw Kardas Thomas Keil Mussa Khaitov Nikolai Khaltaev Jorg Kleine-Tebbe Marek L Kowalski Vicky Kritikos Inger Kull Lisa Leonardini Philip Lieberman Brian Lipworth Karin C Lodrup Carlsen Claudia C Loureiro Renaud Louis Alpana Mair Gert Marien Bassam Mahboub Joao Malva Patrick Manning Esteban De Manuel Keenoy Gailen D Marshall Mohamed R Masjedi Jorge F Maspero Eve Mathieu-Dupas Poalo M Matricardi Eric Melén Elisabete Melo-Gomes Eli O Meltzer Enrica Menditto Jacques Mercier Neven Miculinic Florin Mihaltan Branislava Milenkovic Giuliana Moda Maria-Dolores Mogica-Martinez Yousser Mohammad Steve Montefort Ricardo Monti Mario Morais-Almeida Ralf Mösges Lars Münter Antonella Muraro Ruth Murray Robert Naclerio Luigi Napoli Leila Namazova-Baranova Hugo Neffen Kristoff Nekam Angelo Neou Enrico Novellino Dieudonné Nyembue Robin O'Hehir Ken Ohta Kimi Okubo Gabrielle Onorato Solange Ouedraogo Isabella Pali-Schöll Susanna Palkonen Peter Panzner Hae-Sim Park Jean-Louis Pépin Ana-Maria Pereira Oliver Pfaar Ema Paulino Jim Phillips Robert Picard Davor Plavec Ted A Popov Fabienne Portejoie David Price Emmanuel P Prokopakis Benoit Pugin Filip Raciborski Rojin Rajabian-Söderlund Sietze Reitsma Xavier Rodo Antonino Romano Nelson Rosario Menahenm Rottem Dermot Ryan Johanna Salimäki Mario M Sanchez-Borges Juan-Carlos Sisul Dirceu Solé David Somekh Talant Sooronbaev Milan Sova Otto Spranger Cristina Stellato Rafael Stelmach Charlotte Suppli Ulrik Michel Thibaudon Teresa To Ana Todo-Bom Peter V Tomazic Antonio A Valero Rudolph Valenta Marylin Valentin-Rostan Rianne van der Kleij Olivier Vandenplas Giorgio Vezzani Frédéric Viart Giovanni Viegi Dana Wallace Martin Wagenmann De Y Wang Susan Waserman Magnus Wickman Dennis M Williams Gary Wong Piotr Wroczynski Panayiotis K Yiallouros Arzu Yorgancioglu Osman M Yusuf Heahter J Zar Stéphane Zeng Mario Zernotti Luo Zhang Nan S Zhong Mihaela Zidarn

Clin Transl Allergy 2019 9;9:44. Epub 2019 Sep 9.

260University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.

Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy.

Main Body: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care.

Conclusion: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
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http://dx.doi.org/10.1186/s13601-019-0279-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734297PMC
September 2019

Overarching challenges to the implementation of competency-based medical education.

Med Teach 2017 Jun;39(6):588-593

e Royal College of Physicians and Surgeons of Canada , Ottawa , Canada.

Medical education is under increasing pressure to more effectively prepare physicians to meet the needs of patients and populations. With its emphasis on individual, programmatic, and institutional outcomes, competency-based medical education (CBME) has the potential to realign medical education with this societal expectation. Implementing CBME, however, comes with significant challenges. This manuscript describes four overarching challenges that must be confronted by medical educators worldwide in the implementation of CBME: (1) the need to align all regulatory stakeholders in order to facilitate the optimization of training programs and learning environments so that they support competency-based progression; (2) the purposeful integration of efforts to redesign both medical education and the delivery of clinical care; (3) the need to establish expected outcomes for individuals, programs, training institutions, and health care systems so that performance can be measured; and (4) the need to establish a culture of mutual accountability for the achievement of these defined outcomes. In overcoming these challenges, medical educators, leaders, and policy-makers will need to seek collaborative approaches to common problems and to learn from innovators who have already successfully made the transition to CBME.
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http://dx.doi.org/10.1080/0142159X.2017.1315075DOI Listing
June 2017

Development of a Competence-Based Spine Surgery Fellowship Curriculum Set of Learning Objectives in Canada.

Spine (Phila Pa 1976) 2016 Mar;41(6):530-7

*Laval University,Quebec City, Quebec †University of Toronto, Toronto, Ontario, Canada ‡University of Alberta, Edmonton, Alberta, Canada §University of Western Ontario, London, Ontario, Canada ¶University of British Columbia, Vancouver, British Columbia, Canada ||Dalhousie University, Halifax, Nova Scotia, Canada **University of Ottawa, Ottawa, Ontario, Canada ††University of Calgary, Calgary, Alberta, Canada §§The Scarborough Hospital, Scarborough, Ontario, Canada ¶¶University of Manitoba, Winnipeg, Manitoba, Canada ||||Vernon Jubilee Hospital, Vernon, BC ***Saint John Regional Hospital, Saint John, NB.

Study Design: Modified-Delphi expert consensus method.

Objective: The aim of this study was to develop competence-based spine fellowship curricula as a set of learning goals through expert consensus methodology in order to provide an educational tool for surgical educators and trainees. Secondarily, we aimed to determine potential differences among specialties in their rating of learning objectives to defined curriculum documents.

Summary Of Background Data: There has been recent interest in competence-based education in the training of future surgeons. Current spine fellowships often work on a preceptor-based model, and recent studies have demonstrated that graduating spine fellows may not necessarily be exposed to key cognitive and procedural competencies throughout their training that are expected of a practicing spine surgeon.

Methods: A consensus group of 32 spine surgeons from across Canada was assembled. A modified-Delphi approach refined an initial fellowship-level curriculum set of learning objectives (108 cognitive and 84 procedural competencies obtained from open sources). A consensus threshold of 70% was chosen with up to 5 rounds of blinded voting performed. Members were asked to ratify objectives into either a general comprehensive or focused/advanced curriculum.

Results: Twenty-eight of 32 consultants (88%) responded and participated in voting rounds. Seventy-eight (72%) cognitive and 63 (75%) procedural competency objectives reached 70% consensus in the first round. This increased to 82 cognitive and 73 procedural objectives by round 4. The final curriculum document evolved to include a general comprehensive curriculum (91 cognitive and 53 procedural objectives), a focused/advanced curriculum (22 procedural objectives), and a pediatrics curriculum (22 cognitive and 9 procedural objectives).

Conclusion: Through a consensus-building approach, the study authors have developed a competence-based curriculum set of learning objectives anticipated to be of educational value to spine surgery fellowship educators and trainees. To our knowledge, this is one of the first nationally based efforts of its kind that is also anticipated to be of interest by international colleagues.
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http://dx.doi.org/10.1097/BRS.0000000000001251DOI Listing
March 2016

Improvement of a low-level mesurement system used at LNHB.

Appl Radiat Isot 2016 Mar 27;109:425-429. Epub 2015 Nov 27.

CEA, LIST, Laboratoire National Henri Becquerel, Bât. 602 PC111, CEA-Saclay, 91191 Gif-sur-Yvette Cedex, France.

In this new approach, the active shielding of a low level spectrometer is monitored by an extendable dead time used as an "extendable GATE" signal. This concept is directly inspired from the live-timed anti-coincidence system implemented at LNE-LNHB (MTR2 modules). This allows a significant reduction in the cost and complexity of the system since several electronic modules are replaced by only one module dedicated specifically to this type of experiment. Settings of this new approach are detailed and results are discussed.
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http://dx.doi.org/10.1016/j.apradiso.2015.11.095DOI Listing
March 2016

Knowledge, attitudes and practice regarding Clostridium difficile: a survey of physicians in an academic medical center.

Am J Infect Control 2013 Mar 13;41(3):266-9. Epub 2012 Sep 13.

University of New Mexico School of Medicine, Albuquerque, NM, USA.

Using current guidelines, we surveyed physicians at our hospital to ascertain knowledge, attitudes, and practice regarding Clostridium difficile infection. The survey identified significant gaps in knowledge and practice. Infection control professionals should include physician education on Clostridium difficile infection diagnosis, isolation precautions, and treatment as part of a comprehensive control program.
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http://dx.doi.org/10.1016/j.ajic.2012.03.013DOI Listing
March 2013

Four-year trial of tiotropium in chronic obstructive pulmonary disease.

Can Fam Physician 2012 Aug;58(8):848-9

Department of Family and Community Medicine, University of Toronto, Ontario.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418984PMC
August 2012

Limitations of a spirometry interpretation algorithm.

Can Fam Physician 2011 Oct;57(10):1153-6

Department of Family and Community Medicine, University of Toronto, Ontario, Canada.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3192081PMC
October 2011

New spirometry interpretation algorithm: Primary Care Respiratory Alliance of Canada approach.

Can Fam Physician 2011 Oct;57(10):1148-52

Department of Family and Community Medicine, University of Toronto, Ontario, Canada.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3192080PMC
October 2011

Canadian clinical practice guidelines for acute and chronic rhinosinusitis.

J Otolaryngol Head Neck Surg 2011 May;40 Suppl 2:S99-193

Division of Otolaryngology-Head and Neck Surgery Centre Hospitalier de l'Université de Montréal, Université de Montréal Hotel-Dieu de Montreal, Montreal General Hospital, McGill University, Montreal, QC, Canada. desrosiers_martin@ hotmail.com

This document provides health care practitioners with information regarding the management of acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS) to enable them to better meet the needs of this patient population. These guidelines describe controversies in the management of acute bacterial rhinosinusitis (ABRS) and include recommendations that take into account changes in the bacteriologic landscape. Recent guidelines in ABRS have been released by American and European groups as recently as 2007, but these are either limited in their coverage of the subject of CRS, do not follow an evidence-based strategy, or omit relevant stakeholders in the development of guidelines and do not address the particulars of the Canadian health care environment.Advances in understanding the pathophysiology of CRS, along with the development of appropriate therapeutic strategies, have improved outcomes for patients with CRS. CRS now affects large numbers of patients globally, and primary care practitioners are confronted by this disease on a daily basis. Although initially considered a chronic bacterial infection, CRS is now recognized as having multiple distinct components (eg, infection, inflammation), which have led to changes in therapeutic approaches (eg, increased use of corticosteroids). The role of bacteria in the persistence of chronic infections and the roles of surgical and medical management are evolving. Although evidence is limited, guidance for managing patients with CRS would help practitioners less experienced in this area offer rational care. It is no longer reasonable to manage CRS as a prolonged version of ARS, but, rather, specific therapeutic strategies adapted to pathogenesis must be developed and diffused.Guidelines must take into account all available evidence and incorporate these in an unbiased fashion into management recommendations based on the quality of evidence, therapeutic benefit, and risks incurred. This document is focused on readability rather than completeness yet covers relevant information, offers summaries of areas where considerable evidence exists, and provides recommendations with an assessment of the strength of the evidence base and the degree of endorsement by the multidisciplinary expert group preparing the document.These guidelines have been copublished in both Allergy, Asthma, and Clinical Immunology and the Journal of Otolaryngology-Head and Neck Surgery.
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May 2011

Canadian clinical practice guidelines for acute and chronic rhinosinusitis. Executive summary.

J Otolaryngol Head Neck Surg 2011 May;40 Suppl 2:S91-8

Division of Otolaryngology-Head and Neck Surgery Centre Hospitalier de l'Université de Montréal, Université de Montréal Hotel-Dieu de Montreal, Montreal General Hospital, McGill University, Montreal, QC, Canada. desrosiers_martin@ hotmail.com

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May 2011

Canadian clinical practice guidelines for acute and chronic rhinosinusitis.

Allergy Asthma Clin Immunol 2011 Feb 10;7(1). Epub 2011 Feb 10.

Division of Otolaryngology - Head and Neck Surgery Centre Hospitalier de l'Université de Montréal, Université de Montréal Hotel-Dieu de Montreal, and Department of Otolaryngology - Head and Neck Surgery and Allergy, Montreal General Hospital, McGill University, Montreal, QC, Canada.

This document provides healthcare practitioners with information regarding the management of acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS) to enable them to better meet the needs of this patient population. These guidelines describe controversies in the management of acute bacterial rhinosinusitis (ABRS) and include recommendations that take into account changes in the bacteriologic landscape. Recent guidelines in ABRS have been released by American and European groups as recently as 2007, but these are either limited in their coverage of the subject of CRS, do not follow an evidence-based strategy, or omit relevant stakeholders in guidelines development, and do not address the particulars of the Canadian healthcare environment.Advances in understanding the pathophysiology of CRS, along with the development of appropriate therapeutic strategies, have improved outcomes for patients with CRS. CRS now affects large numbers of patients globally and primary care practitioners are confronted by this disease on a daily basis. Although initially considered a chronic bacterial infection, CRS is now recognized as having multiple distinct components (eg, infection, inflammation), which have led to changes in therapeutic approaches (eg, increased use of corticosteroids). The role of bacteria in the persistence of chronic infections, and the roles of surgical and medical management are evolving. Although evidence is limited, guidance for managing patients with CRS would help practitioners less experienced in this area offer rational care. It is no longer reasonable to manage CRS as a prolonged version of ARS, but rather, specific therapeutic strategies adapted to pathogenesis must be developed and diffused.Guidelines must take into account all available evidence and incorporate these in an unbiased fashion into management recommendations based on the quality of evidence, therapeutic benefit, and risks incurred. This document is focused on readability rather than completeness, yet covers relevant information, offers summaries of areas where considerable evidence exists, and provides recommendations with an assessment of strength of the evidence base and degree of endorsement by the multidisciplinary expert group preparing the document.These guidelines have been copublished in both Allergy, Asthma & Clinical Immunology and the Journal of Otolaryngology-Head and Neck Surgery.
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http://dx.doi.org/10.1186/1710-1492-7-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3055847PMC
February 2011

Acute cervical fractures in ankylosing spondylitis: an opportunity to correct preexisting deformity.

Spine (Phila Pa 1976) 2010 Apr;35(7):E248-52

Division of Orthopaedic Surgery, University of Calgary, Calgary, AB, Canada.

Study Design: A new technique for the management of traumatic cervical fracture in patients with chin-on-chest deformity in ankylosing spondylitis is presented. OBJECTIVE.: To present a new surgical technique for acute deformity correction through cervical fractures in the setting of kyphotic deformities.

Summary Of Background Data: Cervicothoracic kyphotic deformity in ankylosing spondylitis is currently treated with extension osteotomy in an elective setting. In elective extension osteotomies, the surgeon manipulates the head to generate osteoclasis, temporarily producing an unstable cervical fracture. Cervical fractures in ankylosing spondylitis are highly unstable and frequently associated with neurologic compromise. Most reports describe either no reduction and fixation in situ or reduction in preoperative traction followed by fixation.

Methods: A 60-year-old man with chronic ankylosing spondylitis and profound kyphotic deformity suffered a traumatic lower cervical spine fracture. He was treated with an acute cervical spine extension osteotomy through the fracture site using an anterior lengthening bar modification to a halo vest. The anterior lengthening bar allows controlled extension of the neck without manual manipulation by the surgeon.

Results: This patient presented with a chin-brow angle of approximately 90 degrees and was corrected to approximately 5 degrees to 8 degrees . No immediate or delayed complications were seen. After halo vest treatment for 3 months, an excellent postural correction was obtained.

Conclusion: Surgical extension osteotomy in the lower cervical spine through the fracture site using the anterior lengthening bar-halo extension brace seems to be a safe method for correcting spine flexion deformity in ankylosing spondylitis after traumatic fracture.
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http://dx.doi.org/10.1097/BRS.0b013e3181c7c8d2DOI Listing
April 2010

Safety of long-acting beta2-agonists in the management of asthma: a Primary Care Respiratory Alliance of Canada perspective.

Can Fam Physician 2010 Feb;56(2):119-20, 123-4

Department of Family and Community Medicine, University of Toronto, Ontario, Canada.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821225PMC
February 2010

Montelukast as add-on therapy with inhaled corticosteroids alone or inhaled corticosteroids and long-acting beta-2-agonists in the management of patients diagnosed with asthma and concurrent allergic rhinitis (the RADAR trial).

Can Respir J 2009 May-Jun;16 Suppl A:17A-31A

McMaster University, Hamilton, Canada.

Objective: To evaluate the effectiveness of montelukast as add-on therapy for patients diagnosed with asthma and concurrent allergic rhinitis who remain uncontrolled while receiving inhaled corticosteroid (ICS) monotherapy or ICS/long-acting beta-2-agonist (LABA) therapy in a community practice setting.

Design: An eight-week, multicentre, open-label, observational study. Patients were 15 years of age or older and, while treated with an ICS or ICS/LABA, had allergic rhinitis and uncontrolled asthma symptoms by at least two criteria as per the Canadian Asthma Consensus Guidelines. The primary outcome measure was the percentage of patients with controlled asthma symptoms after eight weeks of treatment with montelukast 10 mg once daily added to ICS or ICS/LABA therapy.

Results: In total, 1004 patients participated in the survey phase of the study. Of these patients, 319 continued in the treatment phase and 301 (94.4%) completed the eight-week assessment. At baseline, all patients had uncontrolled asthma symptoms based on the Canadian Asthma Consensus Guidelines; at the eight-week assessment, 229 patients (76.1%) achieved asthma control. According to the Asthma Control Questionnaire (as determined by scores of 0.75 or less), 164 patients (54.7%) achieved well-controlled asthma at week 8. The mean (+/- SD) Asthma Control Questionnaire score decreased from 2.03+/-0.80 to 0.92+/-0.80 (P<0.001) for all patients, representing a clinically significant improvement. A statistically and clinically significant reduction in the overall Mini Rhinitis Quality of Life Questionnaire score was achieved with a decrease from 2.57+/-1.20 to 1.12+/-1.00 (-1.45+/-1.35; P<0.001). Patient and physician satisfaction rates with montelukast add-on therapy were also significantly increased when compared with baseline treatment.

Conclusion: Montelukast add-on therapy is effective for managing asthma and allergic rhinitis symptoms in patients who were previously uncontrolled with ICS or ICS/LABA treatment.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3486712PMC
http://dx.doi.org/10.1155/2009/145071DOI Listing
October 2009

Playing cards on asthma management: a new interactive method for knowledge transfer to primary care physicians.

Can Respir J 2007 Nov-Dec;14(8):480-4

Institut Universitaire de cardiologie et de pneumologie, Hôpital Laval, Québec, Canada.

Objectives: To describe an interactive playing card workshop in the communication of asthma guidelines recommendations, and to assess the initial evaluation of this educational tool by family physicians.

Design: Family physicians were invited to participate in the workshop by advertisements or personal contacts. Each physician completed a standardized questionnaire on his or her perception of the rules, content and properties of the card game.

Setting: A university-based continuing medical education initiative.

Participants: Primary care physicians.

Main Outcome Measures: Physicians' evaluation of the rules, content and usefulness of the program.

Results: The game allowed the communication of relevant asthma-related content, as well as experimentation with a different learning format. It also stimulated interaction in a climate of friendly competition. Participating physicians considered the method to be an innovative tool that facilitated reflection, interaction and learning. It generated relevant discussions on how to apply guideline recommendations to current asthma care.

Conclusions: This new, interactive, educational intervention, integrating play and scientific components, was well received by participants. This method may be of value to help integrate current guidelines into current practice, thus facilitating knowledge transfer to caregivers.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2677773PMC
http://dx.doi.org/10.1155/2007/504931DOI Listing
March 2008

Emerin is hyperphosphorylated and redistributed in herpes simplex virus type 1-infected cells in a manner dependent on both UL34 and US3.

J Virol 2007 Oct 25;81(19):10792-803. Epub 2007 Jul 25.

Department of Microbiology, The University of Iowa, 3-432 Bowen Science Building, Iowa City, IA 52242, USA.

Cells infected with wild-type herpes simplex virus type 1 (HSV-1) show disruption of the organization of the nuclear lamina that underlies the nuclear envelope. This disruption is reflected in changes in the localization and phosphorylation of lamin proteins. Here, we show that HSV-1 infection causes relocalization of the LEM domain protein emerin. In cells infected with wild-type virus, emerin becomes more mobile in the nuclear membrane, and in cells infected with viruses that fail to express UL34 protein (pUL34) and US3 protein (pUS3), emerin no longer colocalizes with lamins, suggesting that infection causes a loss of connection between emerin and the lamina. Infection causes hyperphosphorylation of emerin in a manner dependent upon both pUL34 and pUS3. Some emerin hyperphosphorylation can be inhibited by the protein kinase Cdelta (PKCdelta) inhibitor rottlerin. Emerin and pUL34 interact physically, as shown by pull-down and coimmunoprecipitation assays. Emerin expression is not, however, necessary for infection, since virus growth is not impaired in cells derived from emerin-null transgenic mice. The results suggest a model in which pUS3 and PKCdelta that has been recruited by pUL34 hyperphosphorylate emerin, leading to disruption of its connections with lamin proteins and contributing to the disruption of the nuclear lamina. Changes in emerin localization, nuclear shape, and lamin organization characteristic of cells infected with wild-type HSV-1 also occur in cells infected with recombinant virus that does not make viral capsids, suggesting that these changes occur independently of capsid envelopment.
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http://dx.doi.org/10.1128/JVI.00196-07DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2045475PMC
October 2007

Orthopaedic surgery core curriculum: the spine.

Postgrad Med J 2007 Apr;83(978):268-72

Department of Surgery, Laval University, Quebec City, Quebec, Canada.

Objective: To develop a core curriculum for orthopaedic surgery and to conduct a national survey to assess the importance of 281 items in the curriculum. Attention was focused specifically on 24 items pertaining to the curriculum that are pertinent to the spine.

Study Design: A cross-sectional survey of a random sample of orthopaedic surgeons whose primary affiliation was non-academic, representing the provinces and territories of Canada

Methods: A questionnaire containing 281 items was developed. A random group of 131 (out of 156) orthopaedic surgeons whose primary affiliation is non-academic completed the questionnaire. The data were analysed quantitatively using average mean scores, histograms, the modified Hotelling's T2 test and the Benjimini-Hochberg procedure.

Results: 131 of 156 (84%) orthopaedic surgeons participated, in this study. 14 of 24 items were ranked at no less than 3 out of 4 thus suggesting that 58% of the items are important or probably important to know by the end of residency (SD< or =0.07). Residents need to learn the diagnosis and principles of managing patients with common conditions of the spine.

Conclusions: The study shows, with reliable statistical evidence, that orthopaedic residents are no longer expected to be able to perform spinal fusions with proficiency on completion of residency. Is the exposure to surgical spine problems and the ability to be comfortable with operating expectations specific to the fellowship level? If so, the focus during residency or increasing accredited spine fellowships needs to be addressed to ensure that enough spine surgeons are educated to meet the future healthcare demands projected for Canada.
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http://dx.doi.org/10.1136/pgmj.2006.053900DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600031PMC
April 2007

International Primary Care Respiratory Group (IPCRG) Guidelines: management of allergic rhinitis.

Prim Care Respir J 2006 Feb 27;15(1):58-70. Epub 2005 Dec 27.

Department of General Practice, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen, AB25 2AY, UK.

The association between the upper and lower airways has been recognised for almost 2000 years. Epidemiological data suggest that most asthma patients also suffer from allergic rhinitis, and that both diseases share similar trigger factors and pathophysiology. This IPCRG Guideline on the management of rhinitis in primary care is fully consistent with the ARIA guidelines. It highlights the treatment goals and the classification of the condition according to symptom frequency (intermittent or persistent) and severity (mild or moderate-severe). It covers the need for allergen avoidance, pharmacologic therapy including immunotherapy, alternative therapies, management of ocular symptoms, the management of co-existing allergic rhinitis and asthma, and the need for follow-up and ongoing care for patients with rhinitis.
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http://dx.doi.org/10.1016/j.pcrj.2005.11.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6730679PMC
February 2006

International Primary Care Respiratory Group (IPCRG) Guidelines: management of chronic obstructive pulmonary disease (COPD).

Prim Care Respir J 2006 Feb 18;15(1):48-57. Epub 2006 Jan 18.

James Fisher Medical Centre, 4, Tolpuddle Gardens, Bournemouth, Hants BH9 3LQ, UK.

COPD is a common and under-diagnosed disease which is increasing in prevalence worldwide. A more aggressive and optimistic approach must be adopted towards its management in primary care. This IPCRG Guideline on the management of COPD in primary care is fully consistent with GOLD guidelines. It highlights the goals of COPD treatment and the need for spirometric testing to make the diagnosis. It covers the classification of the disease according to disease severity, non-pharmacologic therapy including smoking cessation, avoidance of risk factors, patient education, pharmacologic therapy including the use of oxygen treatment, the management of exacerbations, the role of pulmonary rehabilitation, and the need for monitoring and ongoing care for COPD patients.
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http://dx.doi.org/10.1016/j.pcrj.2005.11.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6730681PMC
February 2006

Confidence in spine training among senior neurosurgical and orthopedic residents.

Spine (Phila Pa 1976) 2006 Apr;31(7):831-7

Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada.

Study Design: A cross-sectional survey of senior neurosurgical and orthopedic residents.

Objective: To evaluate the confidence of senior orthopedic and neurosurgery residents in performing spinal surgical procedures and their need for further training. The content and exposure to spine training as well as anticipated practice profile were characterized.

Summary Of Background Data: Spinal surgery is performed by specialists with backgrounds in orthopedic surgery and neurosurgery. As this subspecialty evolves, the need to modify training programs to keep up with technological and medical advances becomes increasingly clear. The primary objective of this study was to evaluate the self-assessed confidence and perceived need for further training of senior orthopedic and neurosurgical residents in performing a number of spinal surgical procedures.

Methods: An evaluation of self-assessed surgical competence of senior orthopedic and neurosurgery residents in Canada was undertaken by mail-out questionnaire. A follow-up questionnaire was mailed to nonresponders 3 months later. Survey results were summarized using SPSS statistical software, and descriptive and comparative analyses were performed.

Results: Significant differences in time and exposure to spine training differentiated the neurosurgical and orthopedic residencies (37% and 16% of total residency time devoted to spine, respectively). Neurosurgical residents reported significantly higher levels of confidence for all 25 surgical procedures. Of those residents anticipating incorporating spine into their practice, 29% of neurosurgery residents planned on entering a spine fellowship compared with 17% of their orthopedic colleagues.

Conclusions: Training in spine surgery constitutes a considerably larger proportion of neurosurgery residency than orthopedic residency. Neurosurgery residents graduate with significantly higher levels of confidence to perform spine surgery, while orthopedic residents report significantly higher need for additional training in spine surgery. The majority of neurosurgery graduates report that they will include spine in their clinical practice, while most orthopedic graduates will exclude it.
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http://dx.doi.org/10.1097/01.brs.0000207238.48446.ceDOI Listing
April 2006

Gradual multiplanar cervical osteotomy to correct kyphotic ankylosing spondylitic deformities.

Can J Surg 2002 Jun;45(3):215-8

Division of Orthopaedic Surgery, University of Ottawa, Ont.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3686958PMC
June 2002