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J Torrie

Publications and source records attributed to J Torrie.

4 recordsLinked to original sources
PubMed1999

Comprehensive computerized diabetes registry. Serving the Cree of Eeyou Istchee (eastern James Bay).

PROBLEM BEING ADDRESSED: Diabetes is rapidly evolving as a major health concern in the Cree population of eastern James Bay (Eeyou Istchee). The Cree Board of Health and Social Services of James Bay (CBHSSJB) diabetes registry was the initial phase in the development of a comprehensive program for diabetes in this region. OBJECTIVE OF PROGRAM: The CBHSSJB diabetes registry was developed to provide a framework to track the prevalence of diabetes and the progression of diabetic complications. The database will also identify patients not receiving appropriate clinical and laboratory screening for diabetic complications, and will provide standardized clinical flow sheets for routine patient management. MAIN COMPONENTS OF PROGRAM: The CBHSSJB diabetes registry uses a system of paper registration forms and clinical flow sheets kept in the nine community clinics. Information from these sheets is entered into a computer database annually. The flow sheets serve as a guideline for appropriate management of patients with diabetes, and provide a one-page summary of relevant clinical and laboratory information. CONCLUSIONS: A diabetes registry is vital to follow the progression of diabetes and diabetic complications in the region served by the CBHSSJB. The registry system incorporates both a means for regional epidemiologic monitoring of diabetes mellitus and clinical tools for managing patients with the disease.

Adolescent↗
PubMed1996

Staged abdominal repair in critical illness.

Marlex mesh interposition as part of staged abdominal repair (M-STAR) was used on 68 occasions to reduce pressure during abdominal closure (46), facilitate multiple laparotomies (15), both indications (4) or defect repair (3), in 66 critical care admissions (median APACHE-II = 21). Physiological data before and after M-STAR performed for intra-abdominal pressure were retrospectively available on 33/36 ventilated occasions. Compliance improved (median Vt/[Paw-PEEP] 22.6 vs 30.3 ml/cm H2O, P < 0.0001), but efficiency of oxygenation (median PaO2/FiO2 136 vs 175 mmHg) and ventilation (median VE/PaCO2 243 vs 289 ml/min/mmHg) were unchanged. Heart rate fell (median 130 to 110, P = 0.01), blood pressure and inotrope dose did not change. Urine flow increased (median 60 to 110 ml/h, P = 0.007) but there was no clear trend in six-hourly serum creatinine. Seven bowel fistulae and three dehiscences occurred. Thirty-five patients survived critical care after 2-7 (median 2) M-STAR related operations and 3-63 (median 20) days. Thirty-one hospital survivors used 19-158 (median 47) hospital days; one patient was still in hospital at 39 months. Five patients died 1-55 months after hospital discharge. At follow-up 1-39 (median 7.5) months after critical care there were two fistulae, five stitch sinuses and five incisional hernias in the 27 survivors. M-STAR facilitates critical care and repeat laparotomy with acceptable surgical sequelae.

APACHE↗