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Marrie T.J.,Dalhousie University | Costain N.,Dalhousie University | La Scola B.,Aix - Marseille University | Patrick W.,Dalhousie University | And 5 more authors.
Seminars in Respiratory and Critical Care Medicine

The term atypical pneumonia was first used in 1938, and by the 1970s it was widely used to refer to pneumonia due to Mycoplasma pneumoniae, Legionella pneumophila (or other Legionella species), and Chlamydophila pneumoniae. However, in the purest sense all pneumonias other than the classic bacterial pneumonias are atypical. Currently many favor abolition of the term atypical pneumonia. This review categorizes atypical pneumonia pathogens as conventional ones; viral agents and emerging atypical pneumonia pathogens. We emphasize viral pneumonia because with the increasing availability of multiplex polymerase chain reaction we can identify the agent(s) responsible for viral pneumonia. By using a sensitive assay for procalcitonin one can distinguish between viral and bacterial pneumonia. This allows pneumonia to be categorized as bacterial or viral at the time of admission to hospital or at discharge from the emergency department and soon thereafter further classified as to the etiology, which should be stated as definite or probable. Copyright © 2012 by Thieme Medical Publishers, Inc. Source

Malik B.A.,University of Alberta | Gibbons K.,University of Alberta | Spady D.,University of Alberta | Lees G.,University of Alberta | And 2 more authors.
International Journal of Colorectal Disease

Purpose: Health-related quality of life (HRQL) is not well studied in proctocolectomy patients with pediatric onset of ulcerative colitis (UC). We aimed to (1) compare the HRQL of proctocolectomy patients with those treated with conventional therapy and (2) determine factors that influence HRQL in UC patients < 18 years. Methods: Chart review was done on patients diagnosed with pediatric onset of UC (<18) at the Stollery Children's Hospital. HRQL was evaluated in 88 patients using disease- and age-specific questionnaires; IMPACT III (<18) and Inflammatory Bowel Disease Questionnaire (IBDQ; ≥18). Demographics, disease characteristics, disease index (PUCAI), HRQL EuroQoL visual analog scale (EQ-5D/VAS) were collected and analyzed from all patients. Results: Sixty-five respondents completed the IMPACT III (74 %) and 23 patients completed the IBDQ (26 %). Thirty-three surgical patients (34 %) responded (mean IMPACT III score = 148.9 ± 12.7; mean IBDQ = 171.2 ± 40.1). There was no significant difference in IMPACT III scores of surgical patients vs. medically treated patients (148.9 ± 12.7 vs. 140.6 ± 19.4, p = 0.09). Patients with high IMPACT scores (>143 points) were most likely to be in remission (p = 0.05), they were less likely to be on medication (p < 0.05), have parent/guardian with postsecondary education (p = 0.01), did not suffer from fatigue (p < 0.01), and did not report depression (p < 0.02). The IMPACT correlation with PUCAI (adjusted r 2 = 0.33) and EQ-VAS (adjusted r 2 = 0.45) was strong. Conclusions: Surgical patients reported to have a HRQL comparable to or better than the nonsurgical patients. Depression, fatigue, parent/guardian education, and drugs influence HRQL. © 2012 Springer-Verlag. Source

Wiart L.,University of Alberta | Rosychuk R.J.,University of Alberta | Rosychuk R.J.,Edmonton Clinic Health Academy ECHA | Wright F.V.,Bloorview Research Institute | Wright F.V.,University of Toronto
BMC Neurology

Background: Robot assisted gait training (RAGT) is considered to be a promising approach for improving gait-related gross motor function of children and youth with cerebral palsy. However, RAGT has yet to be empirically demonstrated to be effective. This knowledge gap is particularly salient given the strong interest in this intensive therapy, the high cost of the technology, and the requirement for specialized rehabilitation centre resources. Methods: This is a research protocol describing a prospective, multi-centre, concurrent mixed methods study comprised of a randomized controlled trial (RCT) and an interpretive descriptive qualitative design. It is a mixed methods study designed to determine the relative effectiveness of three physical therapy treatment conditions (i.e., RAGT, a functional physical therapy program conducted over-ground (fPT), and RAGT + fPT) on gait related motor skills of ambulatory children with cerebral palsy. Children with cerebral palsy aged 5-18 years who are ambulatory (Gross Motor Function Classification System Levels II and III) will be randomly allocated to one of four treatment conditions: 1) RAGT, 2) fPT, 3) RAGT and fPT combined, or 4) a maintenance therapy only control group. The qualitative component will explicate child and parent experiences with the interventions, provide insight into the values that underlie their therapy goals, and assist with interpretation of the results of the RCT. Discussion: n/a. Trial Registration:NCT02391324Registered March 12, 2015. © 2016 Wiart et al. Source

Leon S.L.,University of Ottawa | Cappelli M.,University of Ottawa | Ali S.,Edmonton Clinic Health Academy ECHA | Craig W.,Edmonton Clinic Health Academy ECHA | And 6 more authors.
Paediatrics and Child Health (Canada)

OBJECTIVE: To describe emergency mental health services in major paediatric centres across Canada. METHODS: A cross-sectional study of mental health services in emergency departments (EDs) from all 15 Canadian tertiary care paediatric centres was conducted. RESULTS: Fifteen individuals participated and were either a paediatric emergency physician with administrative responsibilities (60%) or an emergency mental health care provider (40%). Four participants reported that their ED used an evidence-based guideline, tool or policy, and one participant reported their ED based its services on published research evidence. Reported ED-based mental health resources included a crisis intervention team (five EDs), a mental health nurse (six EDs) and a social worker (five EDs). Thirteen participants reported on-site consultation with child psychiatry and six reported urgent follow-up as an adjunct service to ED care. CONCLUSIONS: There is a wide variety of mental health care practices in Canadian paediatric EDs. Consideration of which resources are required to ensure evidence-based, effective services are provided to children and youth is necessary. © 2013 Pulsus Group Inc. Source

Scott O.,Edmonton Clinic Health Academy ECHA | Galicia-Connolly E.,Edmonton Clinic Health Academy ECHA | Adams D.,Edmonton Clinic Health Academy ECHA | Surette S.,Edmonton Clinic Health Academy ECHA | And 3 more authors.
Journal of Biomedicine and Biotechnology

Some cruciferous plants may serve as preventive treatments for several medical conditions; our objective was to systematically investigate their safety in humans. Four electronic databases were searched, and, of 10,831 references identified, 50 were included. Data were extracted by two independent reviewers, whereafter the association between interventions and adverse events was assessed. Adverse events in 53 subjects were identified through clinical trials; of these, altered drug metabolism was rated as certainly/likely caused by cruciferous plants. Adverse events in 1247 subjects were identified through observational studies, of which none received high causality ratings. Adverse events in 35 subjects were identified through case reports, of which allergies and warfarin resistance were rated as certainly/likely caused by cruciferous plants. We conclude that cruciferous plants are safe in humans, with the exception of allergies. Individuals treated with warfarin should consult their physician. Further investigation of uses of cruciferous plants in preventative medicine is warranted. Copyright 2012 Ori Scott et al. Source

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