CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
-
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Comparing the quality of oral anticoagulant management by anticoagulation clinics and by family physicians: a randomized controlled trial.
There is growing evidence that better outcomes are achieved when anticoagulation is managed by anticoagulation clinics rather than by family physicians. We carried out a randomized controlled trial to evaluate these 2 models of anticoagulant care. ⋯ Anticoagulation clinics provided better oral anticoagulant management than family physicians, but the differences were relatively modest.
-
Anaphylaxis is a severe systemic allergic reaction that is potentially fatal. It requires prompt recognition and immediate management. Anaphylaxis has a rapid onset with multiple organ-system involvement and is mostly caused by specific antigens in sensitized individuals. ⋯ Epinephrine is the treatment of choice and should be administered immediately. Secondary measures include circulatory support, H(1) and H(2) antagonists, corticosteroids and, occasionally, bronchodilators. Post-treatment observation of these patients is necessary, and they should remain within ready access of emergency care for the following 48 hours.
-
Comparative Study
Investigation of a nosocomial outbreak of severe acute respiratory syndrome (SARS) in Toronto, Canada.
Severe acute respiratory syndrome (SARS) was introduced into Canada by a visitor to Hong Kong who returned to Toronto on Feb. 23, 2003. Transmission to a family member who was later admitted to a community hospital in Toronto led to a large nosocomial outbreak. In this report we summarize the preliminary results of the epidemiological investigation into the transmission of SARS between 128 cases associated with this hospital outbreak. ⋯ Evidence to date suggests that SARS is a severe respiratory illness spread mainly by respiratory droplets. There has been no evidence of further transmission within the hospital after the elapse of 2 full incubation periods (20 days).