Saskatchewan Health

About: Saskatchewan Health is a government organization based out in Regina, Saskatchewan, Canada. It is known for research contribution in the topics: Population & Health care. The organization has 442 authors who have published 489 publications receiving 7728 citations.

A case of multifocal cutaneous alternariosis in a patient with hairy cell leukemia

Abstract: We present a case of multifocal cutaneous alternariosis in a 69-year-old man with hairy cell leukemia. The patient presented with painful, violaceous nodules of the lower extremities and left forea...

Student Advocacy in Turbulent Times: Psychology Students for Social Responsibility at Widener University:

Abstract: This is the transcript of a workshop that took place on the grounds of Swarthmore College in Swarthmore, Pennsylvania on March 16, 2019. I want to begin by acknowledging that this workshop is taking place on the unceded territory of the Lenape people. As we talk about politics and identity both in and outside of the consulting room, it is important for me to acknowledge my position as a settler in this continent and the frame for this work that this position offers me. I have privilege as a descendant of colonizers, and my position as a White person with access to education affects my understanding of politics and identity in important ways. Psychology as a field is connected to White supremacy and colonialism because it developed in primarily White, Western nations by primarily White men and others who were generally privileged in terms of gender, class, and race. It is important to acknowledge these roots because it informs us of our position when sitting with clients. This history, and even continuing tradition in the field, of mainstream thinking that privileges particular ideas of health,

Association of Type 2 Diabetes and Hepatic Encephalopathy in Chronic Liver Disease Patients.

Abstract: Background Hepatic encephalopathy (HE) is an important complication of hepatic cirrhosis and is an independent predictor of mortality in patients with cirrhosis. The prevalence of type 2 diabetes continues to increase at an alarming rate around the world, with even more people being affected by prediabetes. Diabetes leads to increased gastric transit and orocecal time, increased glutamase activity, and intestinal bacterial overgrowth, which may increase intestinal ammonia production. Thus, we speculated that diabetes mellitus (DM) might predispose cirrhotic patients to development and/or exacerbation of HE. The main purpose of this study is to determine the association of DM with severe HE in patients with chronic liver disease (CLD). Methods This case-control study (122 cases and 122 controls) was conducted for 6 months on patients who fulfilled the inclusion criteria and were selected from the Medical department, Abbasi Shaheed Hospital, Karachi, after taking informed consent. Demographic data were presented as simple descriptive statistics giving mean and standard deviation and qualitative variables were presented as frequency and percentages. Chi-square was applied and the odds ratio (OR) was calculated taking a p-value of ≤ 0.05 as statistically significant. Results Out of a total of 244 patients, 122 patients had CLD with DM (case group) and 122 participants had CLD without DM (control group). The mean and standard deviation of age in the case and control groups in our study was 43.29±3.79 and 45.49±5.40. The mean and standard deviation of the duration of disease in the case and control groups in our study was 3.18±1.22 and 3.72±1.36. Males were 53 (43.44%) and 56 (45.10%) in the case and control groups, whereas females were 69 (56.56%) and 66 (54.10%) in the case and control groups, respectively. Out of 122 patients in the case group, 73 (59.84%) and 49 (40.16%) patients developed and did not develop severe HE, respectively. Out of 122 patients in the control group, 50 (40.98%) and 72 (59.02%) patients developed and did not develop severe HE, respectively. Binary logistic regression analysis showed an association of severe HE with DM (p-value: 0.93, OR: 1.033, 95% CI: 0.586-1.599). Conclusion This study demonstrates that HE is a common occurrence in CLD patients. There was not a direct relationship of DM with the severity of HE was observed. However, further research with larger sample size and involving a multicenter setting is warranted.

Reducing Unnecessary Noninvasive Testing for Inpatients With Unstable Angina: The RUNIT Protocol.

Abstract: Background Routine inpatient transthoracic echocardiography (TTE) for patients with unstable angina is common, but it anecdotally adds little value to clinical care. A practice audit at our academic hospital demonstrated that 61.5% of patients with troponin-negative chest pain (TNCP) had normal left ventriculography (LVG) during coronary angiography and normal TTE on the same admission (duplicate testing). Methods We developed the Reducing Non-Invasive Testing (RUNIT) protocol, a clinical algorithm applied by clinical nurses to patient with TNCP. We performed a prospective assessment of rate of duplicate testing before and after intervention. If patients met certain simple clinical criteria, their TTE was cancelled (RUNIT positive). Patients then proceeded to have either coronary angiography with LVG or noninvasive risk stratification. We aimed to reduce duplicate testing by 25% over a 1-year period. Balancing measures included pathology on ordered TTEs, 30-day readmission, length of stay, and number of LVG. Results Among 254 patients admitted with TNCP over 12 months, we reduced duplicate testing from 61.5% (before intervention) to 34% (P = 0.001). There was no clinical difference in 30-day readmission (0.9% vs 0.7%), and length of stay was significantly shorter in RUNIT positive (3.48 vs 4.16 days, P = 0.02). The majority of duplicate TTEs did not reveal any management-informing pathology. RUNIT-positive patients underwent more LVG than RUNIT-negative patients (78.3% vs 62.8%, P = 0.008). Conclusion We achieved a sustained reduction in reflexive TTE ordering in patients with TNCP, and we discuss the potential of nursing-led interventions to address other areas of low value care in cardiology.