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Biomedical subjects

Trevor Bardell

Publications and source records attributed to Trevor Bardell.

9 recordsLinked to original sources
PubMed2005

Diagnosis and treatment of ectopic pregnancy.

Ectopic pregnancy is a life- and fertility-threatening condition that is commonly seen in Canadian emergency departments. Increases in the availability and use of hormonal markers, coupled with advances in formal and emergency ultrasonography have changed the diagnostic approach to the patient in the emergency department with first-trimester bleeding or pain. Ultrasonography should be the initial investigation for symptomatic women in their first trimester; when the results are indeterminate, the serum beta human chorionic gonadotropin (beta-hCG) concentration should be measured. Serial measurement of beta-hCG and progesterone concentrations may be useful when the diagnosis remains unclear. Advances in surgical and medical therapy for ectopic pregnancy have allowed the proliferation of minimally invasive or noninvasive treatment. Guidelines for laparoscopy and for methotrexate therapy are provided.

Abortifacient Agents, Nonsteroidal↗
PubMed2005

Recent developments in percutaneous tracheostomy: improving techniques and expanding roles.

PURPOSE OF REVIEW: The purpose of this review is to provide an update of recent developments pertaining to the use of percutaneous tracheostomy. Percutaneous tracheostomy has been established as an alternative to open surgical tracheostomy, but many key questions about the optimal use of this procedure remain unanswered. RECENT FINDINGS: Issues in percutaneous tracheostomy that have been addressed in the recent literature include the optimal method, timing, use of percutaneous tracheostomy in emergencies, safety in high-risk populations, confirmation of tracheal puncture, and outcomes. SUMMARY: Recent literature suggests that percutaneous tracheostomy is safe to use in an expanding population of patients, including patients with airway compromise and thrombocytopenia. Several methods seem to be safe alternatives to that originally described. Capnography has arisen as an alternative to bronchoscopy for confirmation of tracheal puncture. Recent evidence highlights that although tracheostomy may improve short-term outcome, these critically ill patients have a significant long-term risk of poor outcome. This must be taken into consideration when this procedure is offered.

Emergency Medicine↗
PubMed2003

Do medical students have the knowledge needed to maximize organ donation rates?

INTRODUCTION: The chronic shortage of organs for donation could be improved by increasing the numbers of potential and actual donors. Physicians can play a key role in solving this problem but may miss opportunities because they lack knowledge about organ donation to answer questions or concerns. Education of physicians early in their careers may lead to better procurement rates for donor organs. We carried out a study at Queen's University in Kingston, Ont., to determine whether medical students have sufficient knowledge of topics shown to affect organ donation rates. METHODS: Medical students from years 1-4 completed a self-administered questionnaire. Section 1 tested general knowledge about organ donation; section 2 tested the students' ability to identify potential donors; and section 3 dealt with the approach to the potential donor's family. Univariate predictors of mean test scores were assessed using the t-test. RESULTS: Of 322 medical students who received the questionnaire, 260 (81%) responded. The mean age of the students was 25 years and 54% were men. The mean knowledge score was 6.7 out of a possible score of 14. Third-year students had the best knowledge scores (7.6), followed by fourth- (7.4), second- (6.6) and first-year students (5.7). Teaching about organ donation and a student's comfort with approaching a family for organ donation were also predictive of higher knowledge scores. There was no correlation between knowledge score and age, gender or whether the student was carrying a signed donor card. Knowledge scores were low in all 3 sections. Thirty-six percent of students did not know that brain death means that the patient is dead rather than in a coma. Half the medical students believed that people of certain religious groups should not be approached about organ donation. CONCLUSIONS: Medical students possess limited knowledge about organ donation topics important for maximizing procurement rates. A teaching intervention designed to target these shortcomings may be beneficial.

Adult↗
PubMed2002

Excessive noise levels in the neonatal ICU: potential effects on auditory system development.

OBJECTIVE: Several recent studies have found exceedingly high noise levels in the neonatal intensive care unit (NICU) and in incubators. The purpose of this study was to perform a detailed noise assessment in a Canadian NICU. METHODS: A noise level meter was used to evaluate ambient noise levels in three rooms of the NICU and to compare those levels with measurements taken inside an occupied incubator. RESULTS: Mean hourly noise levels measured inside the incubator (61 dB) were significantly higher than those measured outside (55 dB). Ambient noise levels were also significantly higher in rooms where staff activity was greatest (59 dB). In addition, peak noise levels in excess of 120 dB were found. CONCLUSION: These findings are consistent with those of previous studies and suggest that noise levels in the NICU are excessive. Furthermore, staff activity is a significant contributor. The suggestion that noise in the NICU is detrimental to both auditory and central nervous system development is discussed and intervention strategies are recommended.

Child Development↗
PubMed2002

Organ donation: a pilot study of knowledge among medical and other university students.

BACKGROUND: Physicians' knowledge of and attitudes towards organ donation may be a factor in organ procurement rates. There is a lack of information about how Canadian medical students perceive organ donation, and what they know about it. OBJECTIVE: This pilot study assesses the knowledge and attitudes of university students toward organ donation. METHODS: Medical students completed a self-administered questionnaire after a lecture. Non-medical students completed the same questionnaire at the university student center. The questionnaire included a test that was used to assess knowledge about organ donation. Attitudes were assessed by determining whether the student carried a signed organ donor card, and their reasons if they did not. RESULTS: Of the 76 students in the first-year medical class, 39 responded. A sample of the first 40 non-medical students to visit a booth at the student centre was selected for comparative analysis. The mean age of medical students was 23.5 years; 23 for non-medical students. Of those surveyed, 56.6 per cent were women. Of medical students, 30.8 per cent reported carrying a signed card compared with 50 per cent of non-medical students. The most common reason for not carrying a card in both groups was apathy. Median test scores were 2.4/6 for both groups. Students carrying a signed card had a median test score of 2.7/6, with the median score for those not carrying signed cards being 2.2/6. CONCLUSION: More investigation of the knowledge and attitudes of medical students regarding organ donation is warranted.

Attitude of Health Personnel↗
PubMedDate not supplied

Smoking inside Canadian acute care hospitals.

OBJECTIVE: To assess smoking policies at Canadian acute care hospitals. METHOD: A questionnaire was designed, piloted and faxed to all acute care hospitals in Canada. The questionnaire was designed to address the following: what is the current policy regarding patient smoking? Are staff and/or visitors allowed to smoke inside the hospital? Is there a separate policy for psychiatric patients? Are smoking cessation products available at the hospital pharmacy? Is the policy governed by regional or municipal legislation? RESULTS: A total of 852 hospitals were included in the study. Of these, 476 responded to the questionnaire, for an overall response rate of 56%. Twenty-seven per cent of respondents allowed patient smoking inside the hospital. While staff smoking was not allowed inside most hospitals (93%), 32% of hospitals in Quebec allowed staff to smoke inside the building. Thirty per cent of hospitals had a separate policy for psychiatric patients, and 27% of hospitals had provisions for visitor smoking. Sixty-seven per cent of hospitals were able to offer patients smoking cessation products while they were in hospital. CONCLUSIONS: Many Canadian hospitals continue to allow smoking inside their facilities. There is considerable variation in hospital smoking policies across the country.

Canada↗