Browsing by Author "Laupland, Kevin B"
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Item Open Access 10 Years Later...(2013-01-01) Valiquette, Louis; Laupland, Kevin BItem Open Access Antimicrobial Shortages: Another Hurdle for Clinicians(2015-01-01) Valiquette, Louis; Laupland, Kevin BItem Open Access Bill C-442: Shining the Limelight on the Lyme-Like?(2014-01-01) Laupland, Kevin B; Valiquette, LouisItem Open Access Community-Onset Bloodstream Infection during the ‘After Hours’ Is not Associated with an increased Risk for Death(2012-01-01) Laupland, Kevin B; Kibsey, Pamela C; Galbraith, John CBACKGROUND/OBJECTIVE: Patients admitted to hospital during the ‘after hours’ (weekends and evenings) may be at increased risk for adverse outcome. The objective of the present study was to assess whether community-onset bloodstream infections presenting in the after hours are associated with death.METHODS: All patients in the Victoria area of British Columbia, who had first admissions with community-onset bloodstream infections between 1998 and 2005 were included. The day of admission to hospital, the day and time of culture draw, and all-cause, in-hospital mortality were ascertained.RESULTS: A total of 2108 patients were studied. Twenty-six per cent of patients were admitted on a weekend. Blood cultures were drawn on a weekend in 27% of cases and, in 43%, 33%, and 25% of cases, cultures were drawn during the day (08:00 to 17:59), the evening (18:00 to 22:59) and night (23:00 to 07:59), respectively. More than two-thirds (69%) of index cultures were drawn during the after hours (any time Saturday or Sunday and weekdays 18:00 to 07:59). The overall in-hospital case fatality rate was 13%. No difference in mortality was observed in relation to the day of the week of admission or time period of sampling. After-hours sampling was not associated with mortality in a multivariable logistic regression model examining factors associated with death.CONCLUSION: Presentation with community-onset, bloodstream infection during the after hours does not increase the risk of death.Item Open Access Digging for New Solutions(2015-01-01) Valiquette, Louis; Laupland, Kevin BItem Open Access Ebola Virus Disease(2014-01-01) Laupland, Kevin B; Valiquette, LouisItem Open Access Financial Impact of Health Care-associated Infections: When Money Talks(2014-01-01) Valiquette, Louis; Chakra, Claire Nour Abou; Laupland, Kevin BItem Open Access Get Shorty!(2015-01-01) Valiquette, Louis; Laupland, Kevin BItem Open Access Incidence, prevalence, and occurrence rate of infection among adults hospitalized after traumatic brain injury: study protocol for a systematic review and meta-analysis(BioMed Central, 2013-08-24) Scott, Brittney NV; Roberts, Derek J; Robertson, Helen Lee; Kramer, Andreas H; Laupland, Kevin B; Ousman, Shalina S; Kubes, Paul; Zygun, David AItem Open Access Influenza Mixes Its Pitches: Lessons Learned to Date from the Influenza A (H1N1) Pandemic(2009-01-01) Fisman, David N; Laupland, Kevin BItem Open Access Management of Severe Infections: A Time to Keep a Cool Head or a Hot Topic for Clinical Trials?(2014-01-01) Laupland, Kevin B; Valiquette, LouisItem Open Access Mycobacterium tuberculosis: 2014 Clinical Trials in Review(2015-01-01) Laupland, Kevin B; Valiquette, LouisItem Open Access New Antibacterials?(2010-01-01) Laupland, Kevin B; Fisman, David NItem Open Access Outpatient Parenteral Antimicrobial Therapy(2013-01-01) Laupland, Kevin B; Valiquette, LouisItem Open Access Polyclonal Intravenous Immunoglobulin for the Prophylaxis and Treatment of Infection in Critically Ill Adults(2002-01-01) Laupland, Kevin BInfection is a major cause of morbidity and mortality in critically ill patients. Despite advances in technology, its mortality rate has changed minimally over the past two decades, and new therapies are needed. Polyclonal intravenous immunoglobulin (IVIG) has been investigated both as a preventive and a treatment modality for sepsis and septic shock in critically ill adult patients. Prophylaxis with IVIG has been shown to reduce significantly the incidence of infection, particularly pneumonia, in selected postsurgical intensive care patients. However, it does not reduce mortality. The risk-benefit and cost effectiveness of this therapeutic intervention have not been determined, and its routine use is therefore not recommended. Treatment with IVIG has been shown in a number of small trials and a meta-analysis to reduce dramatically sepsis and septic shock mortality. However, a large, unpublished randomized trial has apparently shown no mortality benefit with this therapy. Despite limited evidence, IVIG has become the standard of care for the management of group A streptococcal toxic shock syndrome. At present, clinical equipoise exists for the use of IVIG in the treatment of sepsis and septic shock, and further study is needed.Item Open Access Population-Based Surveillance for Hypermucoviscosity Klebsiella pneumoniae Causing Community-Acquired Bacteremia in Calgary, Alberta(2013-01-01) Peirano, Gisele; Pitout, Johann DD; Laupland, Kevin B; Meatherall, Bonnie; Gregson, Daniel BThe characteristics of hypermucoviscosity isolates among Klebsiella pneumoniae causing community-acquired bacteremia were investigated. The hypermucoviscous phenotype was present in 8.2% of K pneumoniae isolates, and was associated with rmpA and the K2 serotype; liver abscesses were the most common clinical presentation. The present analysis represents the first population-based surveillance study of hypermucoviscosity among K pneumoniae causing bacteremia.Item Open Access Routine Immunization of Adults in Canada: Review of the Epidemiology of Vaccine-Preventable Diseases and Current Recommendations for Primary Prevention(2009-01-01) Parkins, Michael D; McNeil, Shelly A; Laupland, Kevin BVaccination is one of the greatest achievements in public health of the 20th century. However, the success of vaccine uptake and adherence to immunization guidelines seen in pediatric populations has not been observed among adult Canadians. As a result of the disparity in susceptibility to vaccine-preventable disease, there has been an increasing shift of vaccine-preventable childhood diseases into adult populations. Accordingly, morbidity and mortality due to vaccine-preventable illnesses now occur disproportionately in adults. All Canadians, irrespective of age, should have immunity to measles, mumps, rubella, tetanus, diphtheria, pertussis and varicella. All adult Canadians with significant medical comorbidities or those older than 65 years of age should receive the pneumococcal polysaccharide vaccine and yearly trivalent inactivate influenza vaccines. The present review summarizes the burden of illness of these vaccine-preventable diseases in the Canadian adult population and reviews the current immunization recommendations. Vaccination of all Canadians to these common agents remains a vital tool to decrease individual morbidity and mortality and reduce the overall burden of preventable disease in Canada.Item Open Access Selective Digestive Tract Decontamination: A Tough Pill to Swallow(2009-01-01) Laupland, Kevin B; Fisman, David NItem Open Access Sildenafil Treatment of Primary Pulmonary Hypertension(2003-01-01) Laupland, Kevin B; Helmersen, Doug; Zygun, David A; Viner, Sidney MA 37-year-old woman with primary pulmonary hypertension and worsening symptomatology underwent pulmonary artery (PA) catheterization and vasodilator trials. Oxygen had no effect, but 10 parts/million of nitric oxide reduced mean PA (PAm) pressure by 20%. Prostacyclin infusion at 8 ng/kg/min decreased the PAm pressure by 11%, but further dose increases were limited by systemic hypotension. Sildenafil in doses of 25 mg or higher resulted in an average decrease of 14% in PAm pressure. Sildenafil is a potentially useful treatment option for patients with primary pulmonary hypertension, and further investigation is warranted.Item Open Access Something Old, Something New, Something Borrowed...(2013-01-01) Valiquette, Louis; Laupland, Kevin B