Canadian Journal of Respiratory, Critical Care, and Sleep Medicine最新文献

{"title":"Chapitre 14: La prévention et la lutte contre la transmission de la tuberculose dans les milieux de soins de santé","authors":"B. L. Johnston, T. Ogunremi, K. Defalco, Noémie Savard, Stéphanie Smith","doi":"10.1080/24745332.2023.2226015","DOIUrl":"https://doi.org/10.1080/24745332.2023.2226015","url":null,"abstract":"POINTS CLÉS Le risque de transmission de Mycobacterium tuberculosis (M. tuberculosis) associée aux soins de santé varie selon le type de milieu de soins, le groupe professionnel des travailleurs de la santé, l’activité de soins réalisée, les facteurs de risque du patient, du résident, du client ou du travailleur de la santé, ainsi que l’efficacité des mesures de prévention et de lutte contre l’infection tuberculeuse. Le facteur qui contribue le plus à la transmission de M. tuberculosis associée aux soins de santé est la présence de personnes atteintes d’une tuberculose (TB) respiratoire non reconnue; par conséquent, les mesures appropriées de prévention et de lutte contre l’infection ne sont pas mises en œuvre. Ainsi, le respect de mesures techniques et administratives qui réduisent le risque de transmission, même en cas d’absence de soupçons de TB, la reconnaissance des personnes à risque de présenter une TB respiratoire, la mise en place immédiate de précautions contre la transmission par voie aérienne, le diagnostic rapide et la mise en route d’un traitement antimicrobien efficace sont les éléments les plus importants pour prévenir la transmission de la TB. Les milieux de soins éloignés et isolés où des populations à risque de TB respiratoire sont soignées devraient avoir accès à une expertise en matière de prévention et de lutte contre les infections ainsi que d’hygiène, de sécurité et de bien-être au travail afin de faciliter la mise en place des mesures techniques, administratives et de protection individuelle (ÉPI) recommandées. Tous les milieux de soins devraient être dotés d’un programme de prévention et de lutte contre l’infection tuberculeuse fondé sur une approche hiérarchique des mesures de prévention et de lutte contre les infections et qui comporte une politique et un processus de recherche de contacts dans l’éventualité où un patient, un résident, un client ou un travailleur de la santé recevrait un diagnostic de TB respiratoire. Les précautions contre la transmission par voie aérienne devaient être appliquées immédiatement à toutes les personnes admises dans un établissement de soins de santé qui présentent une TB respiratoire ou sont évaluées pour un tel diagnostic. Les personnes atteintes de TB respiratoire ou en évaluation pour un tel diagnostic devraient porter un masque médical lorsqu’elles sont dans un milieu de soins et à l’extérieur d’une chambre d’isolement des infections aéroportées. On recommande de réaliser un test cutané à la tuberculine initial chez tous les travailleurs de la santé de tous les milieux de soins. Les recommandations concernant la réalisation régulière et en série (répétée) de tests cutanés à la tuberculine chez les travailleurs de la santé varient en fonction du milieu, mais la réalisation régulière (répétée) de tels tests n’est plus recommandée d’emblée pour tous les travailleurs de la santé.","PeriodicalId":9471,"journal":{"name":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine","volume":"284 1","pages":"498 - 525"},"PeriodicalIF":0.8,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139290796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chapitre 1: L’épidémiologie de la tuberculose au Canada","authors":"A. Mounchili, Reshel Perera, Robyn S. Lee, H. Njoo, James D. Brooks","doi":"10.1080/24745332.2023.2225997","DOIUrl":"https://doi.org/10.1080/24745332.2023.2225997","url":null,"abstract":"","PeriodicalId":9471,"journal":{"name":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine","volume":"1 1","pages":"279 - 292"},"PeriodicalIF":0.8,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139291013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A brief history of lung cancer in Canada: Care, contributions and challenges","authors":"Stéphanie Mercier, Stephen Lam, Andrea Bezjak, Charles Butts, Andrew J. E. Seely, Paul Wheatley-Price","doi":"10.1080/24745332.2023.2255193","DOIUrl":"https://doi.org/10.1080/24745332.2023.2255193","url":null,"abstract":"AbstractFor over a century, lung cancer has been both the most common and the most lethal cancer in Canada, due to high populational tobacco exposure and other risk factors. Canada has significantly advanced the knowledge and treatment of lung cancer, as evidenced by important contributions to lung cancer screening, surgery, radiotherapy, systemic therapy, palliative and supportive care. There remain ongoing challenges to the provision of optimal lung cancer care in Canada, including: a gender gap in lung cancer rates and potential years of life lost, diagnostic and care inequity for Indigenous and other underrepresented populations, relatively low funding for lung cancer research, complex drug approval processes, restrictive funding structures for new treatments, poor access to palliative care and persistent stigma surrounding cigarette smoking and nicotine addiction. This paper highlights the significant Canadian contributions to the field of lung cancer, current challenges and future directions.Keywords: SCLCNSCLCCanadatobaccosmoking Author contributionsS. Lam, P. Wheatley-Price and S. Mercier were responsible for the conceptualization of the manuscript. S. Mercier and P. Wheatley-Price were responsible for the methodology and project administration. S. Mercier was responsible for investigation and writing of the original draft. P. Wheatley-Price, S. Lam, A. Bezjak, C. Butts and A.J.E. Seely were responsible for the resources. P. Wheatley-Price, S. Lam, A. Bezjak, C. Butts, A.J.E. Seely and S. Mercier were responsible for the review and editing of the manuscript. S. Mercier was responsible for the visualization of the project. The work was supervised by P. Wheatley-Price.Disclosure statementThe authors report no conflicts of interest.Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.","PeriodicalId":9471,"journal":{"name":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine","volume":"312 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136098406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canadian Thoracic Society Position Statement on Climate Change and Choice of Inhalers for Patients with Respiratory Disease","authors":"Samir Gupta, Simon Couillard, Geneviève Digby, Sze Man Tse, Samantha Green, Raymond Aceron, Chris Carlsten, Jill Hubick, Erika Penz","doi":"10.1080/24745332.2023.2254283","DOIUrl":"https://doi.org/10.1080/24745332.2023.2254283","url":null,"abstract":"","PeriodicalId":9471,"journal":{"name":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136057617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to the Canadian Thoracic Society Chronic Obstructive Pulmonary Disease Pharmacotherapy Guidelines in a real-world hospital setting","authors":"Mathieu D. Saint-Pierre","doi":"10.1080/24745332.2023.2255187","DOIUrl":"https://doi.org/10.1080/24745332.2023.2255187","url":null,"abstract":"AbstractRATIONALE The Canadian Thoracic Society (CTS) publishes chronic obstructive pulmonary disease (COPD) guidelines with recommendations regarding which inhaled pharmacotherapy to prescribe. A minimal amount is known about the implementation of these guidelines in routine clinical practice.OBJECTIVES The main goals of this review were to assess the adherence to the CTS COPD pharmacotherapy guidelines in a real-world setting of patients with a severe exacerbation, to determine predictors of increased guidelines adoption, and to review if subjects leaving the hospital without recommended inhaled therapy had a higher rate of readmission for COPD within 30 days.METHODS Patients treated in 2022 at Montfort Hospital for a COPD exacerbation (hospitalization or emergency department) were reviewed. Medication lists at the time of presentation and discharge were charted in addition to patient clinical characteristics and COPD admissions up to 30 days after the initial assessment. A comparison of COPD patients with and without recommended inhaled therapy optimization was performed.MEASUREMENTS AND MAIN RESULTS A total of 214 patients were admitted for a COPD exacerbation. From this sample, 111 were candidates for review of their inhaled therapy as per the CTS guidelines; however, only 22 (20%) received recommended optimization. Subjects who were admitted to inpatient units and those with spirometry results on file were more likely to receive appropriate pharmacotherapy at discharge (both p = 0.02). Patients not optimized as per the guidelines were at higher risk of readmission for a COPD exacerbation within 30 days (p = 0.02).CONCLUSIONS Adherence to the CTS COPD pharmacotherapy guidelines was low in a real-world hospital setting. Interventions that would help increase their adoption would result in improved patient outcomes.RÉSUMÉJUSTIFICATIONLa Société canadienne de thoracologie (SCT) publie des lignes directrices sur la maladie pulmonaire obstructive chronique (MPOC) comprenant des recommandations concernant la pharmacothérapie inhalée à prescrire. On sait peu de choses sur la mise en œuvre de ces lignes directrices dans la pratique clinique de routine.OBJECTIFSLes principaux objectifs de cette revue étaient d'évaluer le respect des directives de pharmacothérapie de la SCT sur la MPOC dans un contexte réel de patients présentant une exacerbation sévère, de déterminer les facteurs prédictifs d'une adoption accrue des directives et de déterminer si les sujets quittant l'hôpital sans recommandation de traitement inhalé présentaient un taux de réadmission plus élevé pour la MPOC dans les 30 jours.METHODESLes patients traités en 2022 à l'hôpital Montfort pour une exacerbation de MPOC (hospitalisation ou service des urgences) ont été étudiés. Les listes de médicaments au moment de la présentation et de la sortie ont été consignées en plus des caractéristiques cliniques des patients et des admissions pour MPOC jusqu'à 30 jours après l'évaluation initiale. U","PeriodicalId":9471,"journal":{"name":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135094174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CTS Guidelines: Setting the standard for care!","authors":"Mohit Bhutani","doi":"10.1080/24745332.2023.2257105","DOIUrl":"https://doi.org/10.1080/24745332.2023.2257105","url":null,"abstract":"","PeriodicalId":9471,"journal":{"name":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine","volume":"47 1","pages":"225 - 227"},"PeriodicalIF":0.8,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139343036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triple inhaled therapy for asthma in Canada","authors":"K. Chapman, M. Balter, S. Bhinder, A. Kaplan, A. McIvor, Panayiota Papadopoulos, K. Godbout","doi":"10.1080/24745332.2023.2237972","DOIUrl":"https://doi.org/10.1080/24745332.2023.2237972","url":null,"abstract":"Abstract A significant number of patients with asthma have poor control on their current inhaled therapies, typically a combination of inhaled corticosteroids (ICS) and long-acting beta-2 adrenergic bronchodilators (LABA). Adding a long-acting antimuscarinic agent (LAMA) has been shown to improve asthma control and the availability of triple therapy formulations (ICS/LABA/LAMA) in a single inhaler device or single inhaler triple therapy (SITT) mitigates the adherence concerns associated with use of multiple inhaler devices. Here, we provide an overview of the pivotal data concerning the use of triple asthma therapy in patients with poor control on ICS-LABA treatment, and present our expert approach to their application in the routine clinical management of such patients as well the appropriate sequencing of initiating triple therapy and seeking a referral for consideration of more advanced therapies.","PeriodicalId":9471,"journal":{"name":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82116057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchiectasis: From targets to therapies","authors":"A. Cantin","doi":"10.1080/24745332.2023.2236621","DOIUrl":"https://doi.org/10.1080/24745332.2023.2236621","url":null,"abstract":"","PeriodicalId":9471,"journal":{"name":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine","volume":"145 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74542631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"History of occupational asthma in Canada","authors":"S. Tarlo, André Cartier, M. Chan-Yeung, D. Cockcroft, D. Gautrin, E. Juniper, Jean-Luc Malo","doi":"10.1080/24745332.2023.2235362","DOIUrl":"https://doi.org/10.1080/24745332.2023.2235362","url":null,"abstract":"Abstract Canada has a long history of excellence and innovation in occupational asthma (OA). This article reviews its most significant achievements. Several Canadian clinical researchers were trained in part at the Brompton Hospital in London, UK, with Professor Jack Pepys, often referred to as the “father of occupational asthma.” They then settled in Canada in the 1970s and extended the British tradition in the study of OA. Important Canadian contributions as regards clinical aspects of diagnosis include: Improvement in the diagnosis by assessment of nonspecific bronchial responsiveness with pharmacological agents and of airway inflammation by examination of induced sputum, with methods developed and validated by the late Freddy Hargreave and colleagues, at McMaster University in Hamilton. Evaluation of several aspects of measurement of peak expiratory flow recordings. Improvement in the methodology of specific inhalation challenges with occupational agents. Furthermore, the outcome of OA was described, including its psycho-socio-economic aspects, and new scales of assessing impairment/disability proposed, then endorsed by international organizations. Prospective epidemiological studies were carried out, particularly in apprentices. The efficacy of surveillance programs was assessed. Many studies were carried out in workers exposed to Western red cedar on the west coast and snow-crab on the east coast. Irritant-induced asthma (nonimmunological OA) and variants of OA were also examined in original Canadian contributions. Canadian researchers have also played a major role as leaders of international conferences, as well as consensus documents and guidelines.","PeriodicalId":9471,"journal":{"name":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine","volume":"115 1","pages":"215 - 224"},"PeriodicalIF":0.8,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89309538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future is now!","authors":"Mohit Bhutani","doi":"10.1080/24745332.2023.2228641","DOIUrl":"https://doi.org/10.1080/24745332.2023.2228641","url":null,"abstract":"","PeriodicalId":9471,"journal":{"name":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine","volume":"51 1","pages":"171 - 172"},"PeriodicalIF":0.8,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139363156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}