Sample records for annual ontario thoracic

  1. Proceedings of the 41. annual Ontario Petroleum Institute conference : Ontario - New York oil and gas conference

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    A wide range of issues relevant to the petroleum industry in both Ontario and northern New York state were addressed with particular reference to the potential for hydrocarbon plays in the shale and carbonate rocks of the region. The 21 presentations and poster sessions discussed a variety of topics including the sedimentology and petrology of oil and natural gas reservoirs, with emphasis on their depositional histories and geological correlations. This included a review of sequence stratigraphy, source rocks, and hydrodynamics of hydrocarbon fluid flow in fractured reservoirs. Many of the papers reviewed exploration methods, market economics, and enhanced recovery techniques such as well stimulation and horizontal drilling. Several presentations also reviewed the recent advances that have been made in remote sensing techniques, ground truth measurement acquisition, and seismic surveys. Eight of the 21 presentations were processed separately for inclusion in the database. refs., tabs., figs.

  2. The Society of Thoracic Surgeons National Database 2016 Annual Report. (United States)

    Jacobs, Jeffrey P; Shahian, David M; Prager, Richard L; Edwards, Fred H; McDonald, Donna; Han, Jane M; D'Agostino, Richard S; Jacobs, Marshall L; Kozower, Benjamin D; Badhwar, Vinay; Thourani, Vinod H; Gaissert, Henning A; Fernandez, Felix G; Wright, Cameron D; Paone, Gaetano; Cleveland, Joseph C; Brennan, J Matthew; Dokholyan, Rachel S; Brothers, Leo; Vemulapalli, Sreekanth; Habib, Robert H; O'Brien, Sean M; Peterson, Eric D; Grover, Frederick L; Patterson, G Alexander; Bavaria, Joseph E


    The art and science of outcomes analysis, quality improvement, and patient safety continue to evolve, and cardiothoracic surgery leads many of these advances. The Society of Thoracic Surgeons (STS) National Database is one of the principal reasons for this leadership role, as it provides a platform for the generation of knowledge in all of these domains. Understanding these topics is a professional responsibility of all cardiothoracic surgeons. Therefore, beginning in January 2016, The Annals of Thoracic Surgery began publishing a monthly series of scholarly articles on outcomes analysis, quality improvement, and patient safety. This article provides a summary of the status of the STS National Database as of October 2016 and summarizes the articles about the STS National Database that appeared in The Annals of Thoracic Surgery 2016 series, "Outcomes Analysis, Quality Improvement, and Patient Safety."

  3. Proceedings of the Ontario Waterpower Association's 5. annual conference : the power of water

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    This conference examined issues critical to the positive growth of waterpower. Topics covered included water management planning; water resource economics; new development; adaptive management; dam safety and public safety around dams and operational best practices. The conference provided an effective forum for coordinating and promoting the common interests of the waterpower industry in Ontario and improving the competitiveness of the industry. Common interests were identified among various organizations, and representatives from government and non-government agencies, industry professionals and practitioners that were invited to participate in this event. The conference featured 15 presentations, of which 3 have been catalogued separately for inclusion in this database. refs., tabs., figs.

  4. Status of rainbow smelt in the U.S. waters of Lake Ontario, 2013: Section 12 of NYSDEC Lake Ontario Unit annual report 2013 (United States)

    Weidel, Brian C.; Connerton, Michael J.


    Rainbow Smelt Osmerus mordax are the second most abundant pelagic prey fish in Lake Ontario after Alewife Alosa psuedoharengus. The 2013, USGS/NYSDEC bottom trawl assessment indicated the abundance of Lake Ontario age-1 and older Rainbow Smelt decreased by 69% relative to 2012. Length frequency-based age analysis indicated that age-1 Rainbow Smelt constituted approximately 50% of the population, which is similar to recent trends where the proportion of age-1 has ranged from 95% to 42% of the population. While they constituted approximately half of the catch, the overall abundance index for age 1 was one of the lowest observed in the time series, potentially a result of cannibalism from the previous year class. Combined data from all bottom trawl assessments along the southern shore and eastern basin indicate the proportion of the fish community that is Rainbow Smelt has declined over the past 30 years. In 2013 the proportion of the pelagic fish catch (only pelagic species) that was Rainbow Smelt was the second lowest in the time series at 3.1%. Community diversity indices, based on bottom trawl catches, indicate that Lake Ontario fish community diversity, as assessed by bottom trawls, has sharply declined over the past 36 years and in 2013 the index was the lowest value in the time series. Much of this community diversity decline is driven by changes in the pelagic fish community and dominance of Alewife.

  5. German Heart Surgery Report 2015: The Annual Updated Registry of the German Society for Thoracic and Cardiovascular Surgery. (United States)

    Beckmann, Andreas; Funkat, Anne-Katrin; Lewandowski, Jana; Frie, Michael; Ernst, Markus; Hekmat, Khosro; Schiller, Wolfgang; Gummert, Jan F; Welz, Armin


    On the basis of a long-standing voluntary registry, which was founded by the German Society for Thoracic and Cardiovascular Surgery (GSTCVS), well-defined data of all heart, thoracic, and vascular surgery procedures performed in 78 German heart surgery departments during 2015 are analyzed. In 2015, a total of 103,967 heart surgery procedures (implantable cardioverter defibrillator, pacemaker, and extracardiac procedures without ECC excluded) were submitted to the database. Approximately 14.8% of the patients were at least 80 years old, resulting in an increase of 0.6% compared with the data of 2014. For 38,601 isolated coronary artery bypass grafting procedures (relationship on-/off-pump: 5:1), the unadjusted inhospital mortality was 2.7%. Concerning the 32,346 isolated heart valve procedures (including 10,606 catheter-based implantations) an unadjusted inhospital mortality of 4.4% was observed.This annual updated registry of the GSTCVS represents voluntary public reporting by accumulating actual information for nearly all heart surgical procedures in Germany, demonstrates advancements in heart medicine, and enables internal/external quality assurance for all participants. In addition, the registry demonstrates that the provision of heart surgery in Germany is appropriate and patients are treated nationwide in a round-the-clock service.

  6. Proceedings of the 2002 Annual Meeting of the Canadian Mathematics Education Study Group = Actes de la Rencontre Annuelle 2002 du Groupe Canadien d'Etude en Didactique des Mathematiques (26th, Kingston, Ontario, Canada, May 24-28, 2002) (United States)

    Simmt, Elaine, Ed.; Davis, Brent, Ed.


    This submission contains the Proceedings of the 2002 Annual Meeting of the Canadian Mathematics Education Study Group (CMESG), held at Queen's University in Kingston, Ontario. The CMESG is a group of mathematicians and mathematics educators who meet annually to discuss mathematics education issues at all levels of learning. The aims of the Study…

  7. Proceedings of the 2009 Annual Meeting of the Canadian Mathematics Education Study Group = Actes de la Rencontre Annuelle 2009 du Groupe Canadien d'Etude en Didactique des Mathematiques (33rd, Toronto, Ontario, Canada, June 5-June 9, 2009) (United States)

    Liljedahl, Peter, Ed.; Oesterle, Susan, Ed.; Abu-Bakare, Veda, Ed.


    This submission contains the Proceedings of the 2009 Annual Meeting of the Canadian Mathematics Education Study Group (CMESG), held at York University in Toronto, Ontario. The CMESG is a group of mathematicians and mathematics educators who meet annually to discuss mathematics education issues at all levels of learning. The aims of the Study Group…

  8. Proceedings of the 2005 Annual Meeting of the Canadian Mathematics Education Study Group = Actes de la Rencontre Annuelle 2005 du Groupe Canadien d'Etude en Didactique des Mathematiques (29th, Ottawa, Ontario, Canada, May 27-31, 2005) (United States)

    Liljedahl, Peter, Ed.


    This submission contains the Proceedings of the 2005 Annual Meeting of the Canadian Mathematics Education Study Group (CMESG), held at the University of Ottawa in Ottawa, Ontario. The CMESG is a group of mathematicians and mathematics educators who meet annually to discuss mathematics education issues at all levels of learning. The aims of the…

  9. Inter-annual to inter-decadal streamflow variability in Quebec and Ontario in relation to dominant large-scale climate indices (United States)

    Nalley, D.; Adamowski, J.; Khalil, B.; Biswas, A.


    The impacts of large-scale climate oscillations on hydrological systems and their variability have been documented in different parts of the world. Since hydroclimatic data are known to exhibit non-stationary characteristics, spectral analyses such as wavelet transforms are very useful in extracting time-frequency information from such data. As Canadian studies, particularly those of regions east of the Prairies, using wavelet transform-based methods to draw links between relevant climate indices [e.g., the El Niño Southern Oscillation (ENSO), the North Atlantic Oscillation (NAO), and the Pacific Decadal Oscillation (PDO)] and streamflow variability are not common, this study aims to analyze such relationships for the southern regions of Quebec and Ontario. Monthly and annual streamflow data with a record length of 55 years were used to capture streamflow variability at intra-annual, inter-annual and inter-decadal scales. The continuous wavelet transform spectra of monthly streamflow data revealed consistent significant 6- and 12-month periodicities, which are likely associated with strong seasonality factors. Its annual counterparts showed four different significant periodicities: up to 4 years, 4-6 years, 6-8 years, and greater than 8 years - all of which occurred after the late 1960s/early 1970s. Wavelet coherence analyses show that the influence of ENSO and NAO at the inter-annual scale occurs at 2-6 year periodicities, and the influence of PDO occur at periodicities up to 8 years and exceeding 16 years. Correlations between these climate indices and streamflow were computed to determine the time delay of streamflow response to the influence of ENSO, NAO, and PDO. The lag times ranged from 6-48 months (for monthly data) and 1-4 years (for annual data). This research contributes to our understanding of streamflow variability over the southern parts of Quebec and Ontario, and the role of ENSO, NAO, and PDO phenomena on this variability. These relationships can

  10. Results of forest insect and disease surveys in the Eastern Region of Ontario, 1987. Miscellaneous report No. 81. Annual publication

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    Keizer, A.


    Report for 1987 summarizing forest damage by insects, diseases and abiotic agents in the Eastern Region of Ontario. Included are summaries of forest decline and dieback evaluations as well as special surveys, infestation forecasts and miscellaneous pests in the forest districts of Napanee, Tweed, Carleton Place, Cornwall and Brockville. Textual descriptions of pests are accompanied by maps and statistical tables. Pests covered include birch leafminers, spruce budworm, gypsy moths, tent caterpillars, canker, needle rust, bark diseases, and leaf spot. Abiotic damage described in this report covers drought, frost injury, and snow and ice damage. Forest health reports and special surveys are also described.

  11. Proceedings of the 1982 Annual Meeting. Canadian Mathematics Education Study Group (Queen's University, Kingston, Ontario, June 3-7, 1982). (United States)

    Drost, Dale R., Ed.

    Papers from the 1982 annual meeting of the Canadian Mathematics Education Study Group are organized similarly to the meeting, presenting materials from the lectures, working groups, topic groups and panel groups. One lecture, by Davis, discussed a philosophy of computation in relation to computing. Vergnaud lectured on cognitive and developmental…

  12. Thoracic Splenosis

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    Dr. Vandana Jeebun


    Full Text Available A 22-year old man presented with the history of productive cough and also complained of some weight loss. Examination was essentially unremarkable. On detailed investigations like chest X-ray, CT thorax, Fine Needle Aspiration Cytology, Tc-99m scan, a diagnosis of thoracic splenosis was then made. To conclude, thoracic splenosis is a rare entity that needs patient’s reassurance and radiological surveillance. It should also be considered as differential diagnoses of the pleural based masses.

  13. Canadian Mathematics Education Study Group = Groupe Canadien d'etude en didactique des mathematiques. Proceedings of the 1995 Annual Meeting (Ontario, Canada, May 26-30, 1995). (United States)

    Pothier, Yvonne M., Ed.

    These proceedings contain the papers presented at the 1995 annual meeting of the Canadian Mathematics Education Study Group. Papers are organized into four sections: (1) plenary lectures; (2) working groups; (3) topic sessions; and (4) ad hoc sessions. Papers include: (1) "The Role of Epistemology in the Analysis of Teaching/Learning…

  14. Canadian Mathematics Education Study Group = Groupe Canadien d'etude en didactique des mathematiques. Proceedings of the 1993 Annual Meeting (York, Ontario, Canada, May 28-June 1, 1993). (United States)

    Quigley, Martyn, Ed.

    These proceedings contain papers presented at the 1993 annual meeting of the Canadian Mathematics Education Study Group. Papers are presented in four sections: (1) invited lectures; (2) working groups; (3) topic groups; and (4) ad hoc groups. Papers include: (1) "What is a Square Root? A Study of Geometrical Representation in Different…

  15. Bathymetry of Lake Ontario (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Bathymetry of Lake Ontario has been compiled as a component of a NOAA project to rescue Great Lakes lake floor geological and geophysical data and make it more...

  16. Ontario's Student Voice Initiative (United States)

    Courtney, Jean


    This article describes in some detail aspects of the Student Voice initiative funded and championed by Ontario's Ministry of Education since 2008. The project enables thousands of students to make their voices heard in meaningful ways and to participate in student-led research. Some students from grades 7 to 12 become members of the Student…

  17. Lake Ontario: Nearshore Variability (United States)

    We conducted a high-resolution survey with towed electronic instrumentation along the Lake Ontario nearshore (720 km) at a 20 meter contour. The survey was conducted September 6-10, 2008 with a shorter 300 km survey conducted August 14-15 for comparing of temporal variability. ...

  18. Thoracic spine pain

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    Aleksey Ivanovich Isaikin


    Full Text Available Thoracic spine pain, or thoracalgia, is one of the common reasons for seeking for medical advice. The epidemiology and semiotics of pain in the thoracic spine unlike in those in the cervical and lumbar spine have not been inadequately studied. The causes of thoracic spine pain are varied: diseases of the cardiovascular, gastrointestinal, pulmonary, and renal systems, injuries to the musculoskeletal structures of the cervical and thoracic portions, which require a thorough differential diagnosis. Facet, costotransverse, and costovertebral joint injuries and myofascial syndrome are the most common causes of musculoskeletal (nonspecific pain in the thoracic spine. True radicular pain is rarely encountered. Traditionally, treatment for thoracalgia includes a combination of non-drug and drug therapies. The cyclooxygenase 2 inhibitor meloxicam (movalis may be the drug of choice in the treatment of musculoskeletal pain.

  19. Lake trout rehabilitation in Lake Ontario (United States)

    Elrod, Joseph H.; O'Gorman, Robert; Schneider, Clifford P.; Eckert, Thomas H.; Schaner, Ted; Bowlby, James N.; Schleen, Larry P.


    Attempts to maintain the native lake trout (Salvelinus namaycush) population in Lake Ontario by stocking fry failed and the species was extirpated by the 1950s. Hatchery fish stocked in the 1960s did not live to maturity because of sea lamprey (Petromyzon marinus) predation and incidental commercial harvest. Suppression of sea lampreys began with larvicide treatments of Lake Ontario tributaries in 1971 and was enhanced when the tributaries of Oneida Lake and Lake Erie were treated in the 1980s. Annual stocking of hatchery fish was resumed with the 1972 year class and peaked at about 1.8 million yearlings and 0.3 million fingerlings from the 1985–1990 year classes. Survival of stocked yearlings declined over 50% in the 1980 s and was negatively correlated with the abundance of lake trout > 550 mm long (r = −0.91, P < 0.01, n = 12). A slot length limit imposed by the State of New York for the 1988 fishing season reduced angler harvest. Angler harvest in Canadian waters was 3 times higher in eastern Lake Ontario than in western Lake Ontario. For the 1977–1984 year classes, mean annual survival rate of lake trout age 6 and older was 0.45 (range: 0.35–0.56). In U.S. waters during 1985–1992, the total number of lake trout harvested by anglers was about 2.4 times greater than that killed by sea lampreys. The number of unmarked lake trout < 250 mm long in trawl catches in 1978–1992 was not different from that expected due to loss of marks and failure to apply marks at the hatchery, and suggested that recruitment of naturally-produced fish was nil. However, many of the obstacles which may have impeded lake trout rehabilitation in Lake Ontario during the 1980s are slowly being removed, and there are signs of a general ecosystem recovery. Significant recruitment of naturally produced lake trout by the year 2000, one interim objective of the rehabilitation plan for the Lake, may be achieved.

  20. Horizontal drilling in Ontario

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    Sidey, P.; Precul, L. [Sproule Associates Ltd., Calgary, AB (Canada)


    A review of oil and gas production in Ontario was presented with particular reference to drilling activity between 1987 to mid 2002 when 1450 vertical wells were drilled, of which 1100 were for petroleum production and the remainder were for gas storage, observation wells, private gas wells and stratigraphic tests. Of the 1100 vertical wells drilled for petroleum production, 40 per cent became gas wells, 16 per cent became oil wells, 4 per cent became oil and gas wells, and 40 per cent were dry. During the same time period, 133 horizontal wells were also drilled, mostly for petroleum. The most active operator was Talisman Energy, which drilled 101 of the 133 horizontal wells. The remainder were drilled by 12 other companies. Of the horizontal wells, 64 per cent became oil wells, 19 per cent became gas wells, and 17 per cent were dry. This presentation included graphs depicting which oil and gas pools saw vertical or horizontal drilling during the designated time period, and explained how the wells were classified. Both horizontal and vertical well targets were illustrated. Particular reference was made to Talisman Energy's Lake Erie Drilling program which revealed that horizontal wells have an initial production rate that is 5 times that expected from vertical wells. The Hillman Pool case study revealed that the initial rate of the average horizontal well is less than half that of the average vertical well. Horizontal drilling in the Lake Erie Morpeth Gas pool has also been a commercial success. This paper demonstrates that operators have maintained Ontario's oil and gas production at high levels. In 1997 widespread horizontal drilling began taking place in Ontario, and since then, approximately 30 per cent of the wells drilled in the province have been horizontal. 16 figs.


    Institute of Scientific and Technical Information of China (English)


    5.2 Upper respiratory tract, lung960697 Analysis of surgical treatment in474 patients with small cell lung cancer. BaiLianqi (白连启), et al. Beijing Res Inst TuberThorac Tumor, Beijing 101149. Chin J ThoracCardiovasc Surg 1996; 12(4): 211-213 The author summarized the effect and indi-cation of surgical resection of small cell lungcancer in 474 patients from 1957 to the end of

  2. International Student Support Services at Ontario Universities (United States)

    Smith, Clayton; Whiteside, Brenda; Blanchard, Suzanne; Martin, Chris


    In this article, the Ontario Committee on Student Affairs and the Ontario Undergraduate Student Alliance partnered to examine the availability and use of international student support services at Ontario universities. Results of the recently administered Ontario Committee on Student Affairs, Canadian Bureau of International Education, and…

  3. Ontario Teachers' Deprofessionalization and Proletarianization. (United States)

    Filson, Glen


    Discusses teachers' class location in capitalist societies in terms of major sociological perspectives. Identifies corporate capitalist class categories that distinguish professionals from proletarians, and applies these categories to Ontario teachers at different occupational levels. (44 references) (SV)

  4. The short-term impact of Ontario's generic pricing reforms.

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    Michael R Law

    Full Text Available BACKGROUND: Canadians pay amongst the highest generic drug prices in the world. In July 2010, the province of Ontario enacted a policy that halved reimbursement for generic drugs from the public drug plan, and substantially lowered prices for private purchases. We quantified the impact of this policy on overall generic drug expenditures in the province, and projected the impact in other provinces had they mimicked this pricing change. METHODS: We used quarterly prescription generic drug dispensing data from the IMS-Brogan CompuScript Audit. We used the price per unit in both the pre- and post-policy period and two economics price indexes to estimate the expenditure reduction in Ontario. Further, we used the post-policy Ontario prices to estimate the potential reduction in other provinces. RESULTS: We estimate that total expenditure on generic drugs in Ontario during the second half of 2010 was between $181 and $194 million below what would be expected if prices had remained at pre-policy level. Over half of the reduction in spending was due to savings on just 10 generic ingredients. If other provinces had matched Ontario's prices, their expenditures over during the latter half of 2010 would have been $445 million lower. DISCUSSION: We found that if Ontario's pricing scheme were adopted nationally, overall spending on generic drugs in Canada would drop at least $1.28 billion annually--a 5% decrease in total prescription drug expenditure. Other provinces should seriously consider both changes to their generic drug prices and the use of more competitive bulk purchasing policies.

  5. Thoracic ectopia cordis. (United States)

    Shad, Jimmy; Budhwani, Keshav; Biswas, Rakesh


    Ectopia cordis is defined as complete or partial displacement of the heart outside the thoracic cavity. It is a rare congenital defect in fusion of the anterior chest wall resulting in extra thoracic location of the heart. Its estimated prevalence is 5.5-7.9 per million live births. The authors had one such case of a 15-h-old full-term male neonate weighing 2.25 kg with an externally visible, beating heart over the chest wall. The neonate had difficulty in respiration with peripheral cyanosis. Patient died of cardiorespiratory arrest before any surgical intervention could be undertaken inspite of best possible resuscitative measures.

  6. Complete thoracic ectopia cordis. (United States)

    Alphonso, N; Venugopal, P S; Deshpande, R; Anderson, D


    Thoracic ectopia cordis is a rare congenital defect with very few reported survivors after surgical correction. We report a case of complete thoracic ectopia cordis with double outlet right ventricle. The diagnosis was established antenatally and a repair was undertaken soon after birth. The child remained stable and was extubated on the fifth post-operative day. Forty-eight hours later the child succumbed to an unexplained respiratory arrest. Also presented is a review of the different surgical strategies for this unusual condition.

  7. March 2014 Arizona thoracic society notes

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    Robbins RA


    Full Text Available No abstract available. Article truncated after 150 words. The March 2014 Arizona Thoracic Society meeting was a special meeting. In conjunction with the Valley Fever Center for Excellence and the Arizona Respiratory Center the Eighteenth Annual Farness Lecture was held in the Sonntag Pavilion at St. Joseph's Hospital at 6 PM on Friday, April 4, 2014. The guest speaker was Antonio "Tony" Catanzaro, MD from the University of California San Diego and current president of the Cocci Study Group. There were 57 in attendance representing the pulmonary, critical care, sleep, and infectious disease communities. After opening remarks by Arizona Thoracic Society president, Lewis Wesselius (a former fellow under Dr. Catanzaro at UCSD, John Galgiani, director of the Valley Fever Center for Excellence, gave a brief history of the Farness lecture before introducing Dr. Catanzaro. The lecture is named for Orin J. Farness, a Tucson physician, who was the first to report culture positive coccidioidomycosis (cocci or Valley Fever. ...


    Institute of Scientific and Technical Information of China (English)



    Objective. To investigate the unique characteristics and treatment of thoracic spine fractures.Methods. Severty-seven patients with thoracic spine fractures were retrospectively reviewed. Of these, therewere 37 compressior fractures, 34 fracture-dislocations, 3 burst fractures and 3 burst-dislocations. Twenty-six pa-tients had a complete lesion of the spinal cord, 14 sustained a neurologically incomplete injury, and 37 wereneurologically intact. Fifty-three patients were treated nonoperatively and 24 treated operatively.Results. All patients were followed up for 2 ~ 15 years. None of the 26 patients with a complete lesion recov-ered any significant function. Of 37 neurologically intact patients, 13 had local pain although all of them re-mained normal function. Two of 14 patients with incomplete paraplegia returned to normal, 7 recovered some func-tion and 5 did not recovered.Conclusions. E ecause of the unique anatomy and biomechanics of the thoracic spine, the classification common-ly applied to thoracolumbar fractures is not suitable for thoracic fractures. Fusion and instrumentation are indicat-ed when the fractures are unstable, while patients with incomplete lesion of the spinal cord may be the candidatesfor supplemented decompression.

  9. Effect of Thoracic Stretching, Thoracic Extension Exercise and Exercises for Cervical and Scapular Posture on Thoracic Kyphosis Angle and Upper Thoracic Pain


    Yoo, Won-gyu


    [Purpose] The purpose of this study was to investigate the effect of thoracic stretching, a thoracic extension exercise and exercises for cervical and scapular posture on thoracic kyphosis angle and upper thoracic pain. [Subject] A 36-year-old male, who complained of upper thoracic pain at the T1–4 level with forward head and round shoulders, was the subject. [Methods] He performed thoracic stretching (session 1), a thoracic extension exercise (session 2), and muscle exercises for cervical an...

  10. Reforming Ontario Early Learning: A Review (United States)

    Ryan, Thomas; Date, Gavin


    Herein, we address the reformation of Ontario early learning. Over the next 3 years, all 4- and 5-year-olds in Ontario (Canada) will be able to attend full-day early learning with child care, before and after school provided by the Government of Ontario Ministry of Education. The benefits of such a change are both academic and societal and are…

  11. Transmission system planning in Ontario

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    Barrie, D.; Macedo, F.X.; Mcconnach, J.S. [Ontario Hydro, Toronto, ON (Canada)


    In recent years, new and modified approaches to planning the large transmission system that serves the province of Ontario, Canada, have been necessary to accommodate the rapidly changing planning environment including slower uncertain growth, ageing of facilities, integration of demand side management and non utility generation options, increased competitiveness, increased financial stresses and affordable constraints. This paper describes some of the new and modified approaches and tools that have been adopted or are being developed by Ontario Hydro to cope with this changing environment. (author) 9 refs., 4 figs.

  12. Thoracic textilomas: CT findings

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    Machado, Dianne Melo; Zanetti, Glaucia; Araujo Neto, Cesar Augusto; Nobre, Luiz Felipe; Meirelles, Gustavo de Souza Portes; Silva, Jorge Luiz Pereira e; Guimaraes, Marcos Duarte; Escuissato, Dante Luiz; Souza Junior, Arthur Soares; Hochhegger, Bruno; Marchiori, Edson, E-mail: [Hospital Universitario Antonio Pedro (HUAP/UFF), Niteroi, RJ (Brazil)


    Objective: the aim of this study was to analyze chest CT scans of patients with thoracic textiloma. Methods: this was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus. Results: the majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and > 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%). Conclusions: it is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication. (author)

  13. [Thoracic actinomycosis: three cases]. (United States)

    Herrak, L; Msougar, Y; Ouadnouni, Y; Bouchikh, M; Benosmane, A


    Actinomycosis is a rare condition which, in the thoracic localisation, can mimic cancer or tuberculosis. We report a series of three case of thoracic actinomycosis treated in the Ibn Sina University Thoracic Surgery Unit in Rabat, Morocco. CASE N degrees 1: This 45-year-old patient presented a tumefaction on the left anterior aspect of the chest. Physical examination identified a parietal mass with fistulisation to the skin. Radiography demonstrated a left pulmonary mass. Transparietal puncture led to the pathological diagnosis of actinomycosis. The patient was given medical treatment and improved clinically and radiographically. CASE N degrees 2: This 68-year-old patient presented repeated episodes of hemoptysis. The chest x-ray revealed atelectasia of the middle lobe and bronchial fibroscopy demonstrated the presence of a bud in the middle lobar bronchus. Biopsies were negative. The patient underwent surgery and the histology examination of the operative specimen revealed pulmonary actinomycosis. The patient recovered well clinically and radiographically with antibiotic therapy. CASE N degrees 3: This 56-year-old patient presented cough and hemoptysis. Physical examination revealed a left condensation and destruction of the left lung was noted on the chest x-ray. Left pleuropulmonectomy was performed. Histological analysis of the surgical specimen identified associated Aspergillus and Actinomyces. The outcome was favorable with medical treatment. The purpose of this work was to recall the radiological, clinical, histological, therapeutic, outcome aspects of this condition and to relate the problems of differential diagnosis when can suggest other diseases.

  14. Mortality incidence in outpatient anesthesia for dentistry in Ontario. (United States)

    Nkansah, P J; Haas, D A; Saso, M A


    Studies determining anesthesia mortality rates in dentistry have been published, yet a similar investigation has never been conducted in Canada. Therefore the objective of this study was to determine the incidence of mortality when general anesthesia or deep sedation was administered by qualified dentists in the province of Ontario. Mortality data were obtained from the years 1973 to 1995 inclusive. The number of general anesthetics and deep sedations administered annually by qualified in dental offices was calculated by surveying all oral and maxillofacial surgeons and dental anesthetists in Ontario in 1990 and 1995. The results provided an estimate of 2,830,000 cases from 1973 to 1995 inclusive. Over this time period there were four deaths associated with cases in which either an oral and maxillofacial surgeon or dental anesthetist administered the general anesthetic or deep sedation, yielding a mortality rate of 1.4 per 1,000,000. This mortality incidence is similar to rates already published for outpatient dentistry.

  15. Planktonic diatoms of Lake Ontario (United States)

    Reinwand, Jerry F.


    The major species of diatoms in surface collections from Lake Ontario in September 1964 were Asterionella formosa, Fragilaria crotonensis, and Tabellaris fenestrata. Dominant species in the deep-water samples were Stephanodiscus astraea, S. astraea var. mintula, and F. crotonensis. The diatom flora in surface collections varied among several stations in the eastern end of the lake.

  16. PV gold rush in Ontario

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    Becker, Daniela


    As a result of the Green Energy Act, the installed PV capacity in the Canadian province of Ontario has tripled in the year 2010. A generous feed-in tariff, aiming at maximum local added value, has attracted numerous international manufacturers. However, the rigorous rules committing the companies to 60 % inland production have provoked harsh criticism. (orig.)

  17. Key Questions in Thoracic Surgery


    Subotic, Dragan R.


    This 1000-page textbook encompasses much more than the title suggests. In fact, the title “Key questions in thoracic surgery and pulmonology” would be more fitting. The specific format of the book, with precise questions and evidence-based, but equally clear answers covering all relevant fields of pulmonology and thoracic surgery, makes this 40-chapter book a “must read” not only for residents, but also for senior pulmonologists and thoracic surgeons.

  18. Effect of thoracic stretching, thoracic extension exercise and exercises for cervical and scapular posture on thoracic kyphosis angle and upper thoracic pain. (United States)

    Yoo, Won-Gyu


    [Purpose] The purpose of this study was to investigate the effect of thoracic stretching, a thoracic extension exercise and exercises for cervical and scapular posture on thoracic kyphosis angle and upper thoracic pain. [Subject] A 36-year-old male, who complained of upper thoracic pain at the T1-4 level with forward head and round shoulders, was the subject. [Methods] He performed thoracic stretching (session 1), a thoracic extension exercise (session 2), and muscle exercises for cervical and scapular posture (session 3). [Results] The upper thoracic pressure pain threshold increased after session 1, session 2, and session 3. The thoracic kyphosis angle decreased after session 1, session 2, and session 3. [Conclusion] We suggest that intervention for thoracic pain or kyphotic thoracic correction should use not only an approach for extending the thoracic muscles, but also an approach treating muscles in the cervical and scapular region.

  19. Public Attitudes Toward Education in Ontario, 1979. Second OISE Survey. Informal Series/15. (United States)

    Livingstone, D. W.; Hart, D. J.

    The purpose of this annual survey is to provide basic, ongoing profiles of the educational concerns on Ontarians. The 1979 survey involved a representative sample of 1,084 adults, 18 years of age and over, who were interviewed in their homes across Ontario, as well as a special sample of corporate executives (148 respondents), who replied to a…

  20. Thoracic damage control surgery. (United States)

    Gonçalves, Roberto; Saad, Roberto


    The damage control surgery came up with the philosophy of applying essential maneuvers to control bleeding and abdominal contamination in trauma patients who are within the limits of their physiological reserves. This concept was extended to thoracic injuries, where relatively simple maneuvers can shorten operative time of in extremis patients. This article aims to revise the various damage control techniques in thoracic organs that must be known to the surgeon engaged in emergency care. RESUMO A cirurgia de controle de danos surgiu com a filosofia de se aplicar manobras essenciais para controle de sangramento e contaminação abdominal, em doentes traumatizados, nos limites de suas reservas fisiológicas. Este conceito se estendeu para as lesões torácicas, onde manobras relativamente simples, podem abreviar o tempo operatório de doentes in extremis. Este artigo tem como objetivo, revisar as diversas técnicas de controle de dano em órgãos torácicos, que devem ser de conhecimento do cirurgião que atua na emergência.

  1. The effectiveness of a regulatory strategy in containing hospital costs. The Ontario experience, 1967-1981. (United States)

    Detsky, A S; Stacey, S R; Bombardier, C


    This study documents the increases in real inputs (e.g., labor and equipment) employed in Ontario's hospital sector between 1968 and 1981--a period of universal government-financed hospital insurance and a government regulatory strategy involving global budgeting. Total expenditures in Ontario increased by only 16 per cent in terms of real inputs, as compared with an increase of 101 per cent in the United States. Real inputs per patient-day increased at a mean annual rate of 0.68 per cent in Ontario versus 5.19 per cent in the United States (P less than 0.001). Real inputs per admission decreased at a mean annual rate of 1.12 per cent in Ontario, as compared with an increase of 4.15 per cent in the United States (P less than 0.0001). We conclude that regulation can contain the growth of real inputs employed in the hospital sector even in the face of an incentive structure that does not promote cost consciousness on the part of patients or physicians. Although the effect of this strategy on the quality of care is unknown, so far it appears to have been politically acceptable in Ontario.

  2. Thoracic endometriosis: 3 case reports

    Institute of Scientific and Technical Information of China (English)

    Song Ying-na; Lang Jing-he; Zhu Lan


    Abstract:Thoracic endometriosis is a rare disorder. It can be divided into pleural and pulmonary parenchymal endometriosis according to the site of the lesion. In this article 3 typical cases of thoracic endometriosis (case 1 is pleural endometriosis, case 2 and 3 are pulmonary parenchymal endometriosis) were described, and the various presentations, pathogenesis, diagnosis, and therapies of thoracic endometriosis were reviewed. The pathogenesis of thoracic endometriosis has not been established clearly yet. Recurrent right-sided pneumothorax or hemoptysis that occurs within days of the onset of menstruation is the most common manifestation. The correlation between the patient's symptoms and menses is essential to establish the diagnosis. Radiographic studies, bronchoscopy, and thoracoscopy may support the diagnosis. Pathologic evidence is not present universally. Therapeutic interventions include medical and surgical options, which should be individualized for each patient.

  3. Examining Competition in Ontario's Higher Education Market (United States)

    Farhan, Bayan Yousef


    Financial challenges have forced many publicly funded academic institutions in Ontario to adopt a corporate model and to use market tools to compete in the higher education market and maintain their enrolment and revenue levels. This study has analyzed how competition affects publicly funded universities in Ontario. Competition was examined by…

  4. Libraries in Ontario: MedlinePlus (United States)

    ... this page: Libraries in Ontario To use the sharing features on ... JavaScript. Barrie Royal Victoria Regional Health Centre Health Library 201 Georgian Drive Barrie, ON L4M 6M2 CANADA ...

  5. Educational Information in Ontario: A Government Perspective. (United States)

    Hildebrand, B. M.

    The Ontario Ministry of Education's role in funding educational research, and its procedures for the dissemination of educational research information are described. Two ministry initiatives are discussed in detail: the establishment of the Educational Information System for Ontario (EISO), a computerized search and retrieval service to access…

  6. Protectionist Measures in Postsecondary Ontario (Canada) TESL (United States)

    Jambor, Paul Z.


    TESL in Ontario, Canada, seems to be on an inauspicious path by having set up non-tariff protectionist measures in an apparent attempt to keep out a multinational TESL workforce, effectively going against the spirit of globalization. This paper highlights some of the differences between South Korean TEFL and TESL in Ontario; for the most part…

  7. CT of thoracic aortic aneurysms. (United States)

    Posniak, H V; Olson, M C; Demos, T C; Benjoya, R A; Marsan, R E


    Aneurysms of the thoracic aorta are most often the result of arteriosclerotic disease. Other causes include degeneration of the medial layer of the aortic wall, either idiopathically or due to genetic disorders such as Marfan syndrome; aortic dissection; trauma; syphilis and other bacterial infection; noninfective aortitis; and congenital anomaly. We review normal anatomy of the aorta and discuss our technique and interpretation of computed tomography (CT) in the evaluation of the thoracic aorta. We illustrate the CT appearance of different types of aortic aneurysms as well as discuss the use of CT for assessing complications of aneurysms, for postoperative follow-up, and in the differentiation of aortic aneurysm from a paraaortic mass.

  8. Lateral Thoracic Maningocele : Anaesthetic Implications

    Directory of Open Access Journals (Sweden)

    Nazeer Ahmed K


    Full Text Available Meningomyelocele is a broad term representing herniation of extracranial contents through a congenital defect in the vertebral column. If only cerebrospinal fluid (CSF and meninges herniate, it is termed as a meningocele. A meningoencephalocele is herniation of neural elements along with meninges. Anaesthetic challenges in management of thoracic meningomyelocele include securing the airway with intubation in lateral or supine position, intraoperative prone position with its associated complications and accurate assessment of blood loss and prevention of hypothermia. We report a case of a thoracic meningocele posted for resection and discuss its anaesthetic implications

  9. Western Ontario: Waterfowl breeding population survey: 1986 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for western Ontario during 1986. The primary purpose of the survey is to provide...

  10. Trio Estonia esineb Lõuna-Ontarios

    Index Scriptorium Estoniae


    Lõuna-Ontario muusikahuvilistel on tänu Eesti Sihtkapitalile Kanadas ja Cathedral Bluffs sümfooniaorkestrile harukordne võimalus saada oktoobrikuus osa kõrgetasemelise Trio Estonia musitseerimisest

  11. Western Ontario: Waterfowl breeding population survey: 1989 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for western Ontario during 1989. The primary purpose of the survey is to provide...

  12. Western Ontario: Waterfowl breeding population survey: 1995 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for western Ontario during 1995. The primary purpose of the survey is to provide...

  13. Western Ontario: Waterfowl breeding population survey: 1993 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for western Ontario during 1993. The primary purpose of the survey is to provide...

  14. Western Ontario: Waterfowl breeding population survey: 1994 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for western Ontario during 1994. The primary purpose of the survey is to provide...

  15. Western Ontario: Waterfowl breeding population survey: 1996 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for western Ontario during 1996. The primary purpose of the survey is to provide...

  16. Western Ontario: Waterfowl breeding population survey: 1987 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for western Ontario during 1987. The primary purpose of the survey is to provide...

  17. Western Ontario: Waterfowl breeding population survey: 1992 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for western Ontario during 1992. The primary purpose of the survey is to provide...

  18. The Ontario Brain Institute: completing the circle. (United States)

    Stuss, Donald T


    The Province of Ontario recognized the pressing need to improve the understanding, diagnosis, and treatment of brain disorders. It also recognized that maximizing the existing strengths through a province-wide integrated approach was a pivotal mechanism. To achieve this, the Province established the Ontario Brain Institute. The goal of this article is to introduce the elements of the Ontario Brain Institute to the neuroscience community: the motivation for establishing it, the philosophy behind its creation, the principles guiding its development, the rapid evolution of its functional structure, the tools available to achieve its vision, and the management structure to ensure success. The singular goal of the Province and the Ontario Brain Institute is a comprehensive system that assures that basic research is embedded in the clinical system and is facilitating product development to accelerate benefits to both health and the economy of health: science with impact.

  19. Western Ontario: Waterfowl breeding population survey: 1990 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for western Ontario during 1990. The primary purpose of the survey is to provide...

  20. Western Ontario: Waterfowl breeding population survey: 1997 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for western Ontario during 1997. The primary purpose of the survey is to provide...

  1. Western Ontario: Waterfowl breeding population survey: 1988 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for western Ontario during 1988. The primary purpose of the survey is to provide...

  2. Competency assessment of microbiology medical laboratory technologists in Ontario, Canada. (United States)

    Desjardins, Marc; Fleming, Christine Ann


    Accreditation in Ontario, Canada, requires that licensed clinical laboratories participate in external quality assessment (also known as proficiency testing) and perform competency evaluation of their staff. To assess the extent of ongoing competency assessment practices, the Quality Management Program--Laboratory Services (QMP-LS) Microbiology Committee surveyed all 112 licensed Ontario microbiology laboratories. The questionnaire consisted of a total of 21 questions that included yes/no, multiple-choice, and short-answer formats. Participants were asked to provide information about existing programs, the frequency of testing, what areas are evaluated, and how results are communicated to the staff. Of the 111 responding laboratories, 6 indicated they did not have a formal evaluation program since they perform only limited bacteriology testing. Of the remaining 105 respondents, 87% perform evaluations at least annually or every 2 years, and 61% include any test or task performed, whereas 16% and 10% focus only on problem areas and high-volume complex tasks, respectively. The most common methods of evaluation were review of external quality assessment (EQA) challenges, direct observation, and worksheet review. With the exception of one participant, all communicate results to staff, and most take remedial action to correct the deficiencies. Although most accredited laboratories have a program to assess the ongoing competency of their staff, the methods used are not standardized or consistently applied, indicating that there is room for improvement. The survey successfully highlighted potential areas for improvement and allowed the QMP-LS Microbiology Committee to provide guidance to Ontario laboratories for establishing or improving existing microbiology-specific competency assessment programs.

  3. Estimating the number of human cases of ceftiofur-resistant Salmonella enterica serovar Heidelberg in Québec and Ontario, Canada. (United States)

    Otto, Simon J G; Carson, Carolee A; Finley, Rita L; Thomas, M Kate; Reid-Smith, Richard J; McEwen, Scott A


    A stochastic model was used to estimate the number of human cases of ceftiofur-resistant Salmonella enterica serovar Heidelberg in Québec and Ontario attributable to chicken consumption and excess cases attributable to human prior antimicrobial consumption. The annual mean incidence of S. Heidelberg (Québec/Ontario) decreased from 70/62 cases per 100 000 in 2004 to 29/30 cases per 100 000 in 2007 (Québec)/2008 (Ontario), increasing to 59/45 cases per 100 000 in 2011. The annual mean incidence of ceftiofur-resistant cases from chicken decreased from 8/7 cases per 100 000 in 2004 to 1/1 cases per 100 000 in 2007 (Québec)/2008 (Ontario), increasing to 7/5 cases per 100 000 in 2011. The annual mean total number of excess ceftiofur-resistant cases from chicken attributable to human prior antimicrobial consumption (Québec/Ontario) decreased from 71/123 in 2004 to 6/24 in 2007 (Québec)/2008 (Ontario), but increased to 62/91 in 2011. This model will support future work to determine the increased severity, mortality and healthcare costs for ceftiofur-resistant Salmonella Heidelberg infections. These results provide a basis for the evaluation of future public health interventions to address antimicrobial resistance.

  4. Thoracic tumors : prognostic and thearapeutic improvements

    NARCIS (Netherlands)

    Jong, Wouter Karst de


    Thoracic tumors are a major burden of disease in many countries. Non-small cell lung cancer and small-cell lung cancer are the most common thoracic malignancies, both tumors are one of the most well-known of the less common thoracic tumors. In this thesis, new ways in estimating the prognosis of pat

  5. Thoracic aortic catastrophes : towards the endovascular solution

    NARCIS (Netherlands)

    Jonker, F.H.W.


    Descending thoracic aortic catastrophes include a variety of acute pathologies of the descending thoracic aorta, which are all associated with high morbidity and mortality rates, requiring immediate intervention. For this thesis, we explored the management and outcomes of several thoracic aortic cat

  6. Honouring and Sustaining the Teaching Profession in Ontario. Ontario College of Teachers. (United States)

    Grant, Linda R.; Adamson, Gary; Craig, Allan; Marrin, Mary; Squire, Frances A.

    This paper describes theoretical, political, and practical contexts for developing standards of practice for teaching, creating a framework for career-long professional learning and establishing a set of ethical standards for the profession. It positions the work of the Ontario College of Teachers within the broader context of Ontario education…

  7. Shoulder Pain After Thoracic Surgery

    DEFF Research Database (Denmark)

    Blichfeldt-Eckhardt, Morten R; Andersen, Claus; Ørding, Helle


    OBJECTIVES: To study the time course of ipsilateral shoulder pain after thoracic surgery with respect to incidence, pain intensity, type of pain (referred versus musculoskeletal), and surgical approach. DESIGN: Prospective, observational cohort study. SETTING: Odense University Hospital, Denmark....... PARTICIPANTS: Sixty patients for major lung resection. INTERVENTIONS: Postoperative observation of ipsilateral shoulder pain. MEASUREMENTS AND MAIN RESULTS: Postoperative numeric rating scale score of shoulder pain and thoracic pain and postoperative examination of the sites of shoulder pain...... for musculoskeletal involvement (muscle tenderness on palpation and movement) with follow-up 12 months after surgery. Clinically relevant pain was defined as a numeric rating scale score>3. Of the 60 patients included, 47 (78%) experienced ipsilateral shoulder pain, but only 25 (42%) reported clinically relevant...

  8. Robotic Surgery for Thoracic Disease (United States)

    Yoshida, Yasuhiro; Iwasaki, Akinori


    Robotic surgeries have developed in the general thoracic field over the past decade, and publications on robotic surgery outcomes have accumulated. However, controversy remains about the application of robotic surgery, with a lack of well-established evidence. Robotic surgery has several advantages such as natural movement of the surgeon’s hands when manipulating the robotic arms and instruments controlled by computer-assisted systems. Most studies have reported the feasibility and safety of robotic surgery based on acceptable morbidity and mortality compared to open or video-assisted thoracic surgery (VATS). Furthermore, there are accumulated data to indicate longer operation times and shorter hospital stay in robotic surgery. However, randomized controlled trials between robotic and open or VATS procedures are needed to clarify the advantage of robotic surgery. In this review, we focused the literature about robotic surgery used to treat lung cancer and mediastinal tumor. PMID:26822625

  9. Robotic Surgery for Thoracic Disease. (United States)

    Yamashita, Shin-Ichi; Yoshida, Yasuhiro; Iwasaki, Akinori


    Robotic surgeries have developed in the general thoracic field over the past decade, and publications on robotic surgery outcomes have accumulated. However, controversy remains about the application of robotic surgery, with a lack of well-established evidence. Robotic surgery has several advantages such as natural movement of the surgeon's hands when manipulating the robotic arms and instruments controlled by computer-assisted systems. Most studies have reported the feasibility and safety of robotic surgery based on acceptable morbidity and mortality compared to open or video-assisted thoracic surgery (VATS). Furthermore, there are accumulated data to indicate longer operation times and shorter hospital stay in robotic surgery. However, randomized controlled trials between robotic and open or VATS procedures are needed to clarify the advantage of robotic surgery. In this review, we focused the literature about robotic surgery used to treat lung cancer and mediastinal tumor.

  10. Nanotechnology applications in thoracic surgery. (United States)

    Hofferberth, Sophie C; Grinstaff, Mark W; Colson, Yolonda L


    Nanotechnology is an emerging, rapidly evolving field with the potential to significantly impact care across the full spectrum of cancer therapy. Of note, several recent nanotechnological advances show particular promise to improve outcomes for thoracic surgical patients. A variety of nanotechnologies are described that offer possible solutions to existing challenges encountered in the detection, diagnosis and treatment of lung cancer. Nanotechnology-based imaging platforms have the ability to improve the surgical care of patients with thoracic malignancies through technological advances in intraoperative tumour localization, lymph node mapping and accuracy of tumour resection. Moreover, nanotechnology is poised to revolutionize adjuvant lung cancer therapy. Common chemotherapeutic drugs, such as paclitaxel, docetaxel and doxorubicin, are being formulated using various nanotechnologies to improve drug delivery, whereas nanoparticle (NP)-based imaging technologies can monitor the tumour microenvironment and facilitate molecularly targeted lung cancer therapy. Although early nanotechnology-based delivery systems show promise, the next frontier in lung cancer therapy is the development of 'theranostic' multifunctional NPs capable of integrating diagnosis, drug monitoring, tumour targeting and controlled drug release into various unifying platforms. This article provides an overview of key existing and emerging nanotechnology platforms that may find clinical application in thoracic surgery in the near future.

  11. The Ontario Telemedicine Network: a case report. (United States)

    Brown, Edward M


    This article describes the evolution, current status, and future prospects of the Ontario Telemedicine Network (OTN). Started in the late 1990s (and formally established in 2006), OTN is a not-for-profit corporation primarily funded by the Government of Ontario, Canada, that aims to improve access to and quality of care throughout the Province. It covers a land mass larger than France and serves a population of just over 13 million, the vast majority of which live in a narrow strip close to the U.S. border. Telemedicine has been effective in reducing travel to usual sources of care, reducing hospital admissions, and improving efficiency and prompt access to care. The diffusion of telemedicine is accelerating in Ontario, and it is becoming an integral part of the health system.

  12. Lessons learned from Ontario wind energy disputes (United States)

    Fast, Stewart; Mabee, Warren; Baxter, Jamie; Christidis, Tanya; Driver, Liz; Hill, Stephen; McMurtry, J. J.; Tomkow, Melody


    Issues concerning the social acceptance of wind energy are major challenges for policy-makers, communities and wind developers. They also impact the legitimacy of societal decisions to pursue wind energy. Here we set out to identify and assess the factors that lead to wind energy disputes in Ontario, Canada, a region of the world that has experienced a rapid increase in the development of wind energy. Based on our expertise as a group comprising social scientists, a community representative and a wind industry advocate engaged in the Ontario wind energy situation, we explore and suggest recommendations based on four key factors: socially mediated health concerns, the distribution of financial benefits, lack of meaningful engagement and failure to treat landscape concerns seriously. Ontario's recent change from a feed-in-tariff-based renewable electricity procurement process to a competitive bid process, albeit with more attention to community engagement, will only partially address these concerns.

  13. Assessing Ontario's Personal Support Worker Registry

    Directory of Open Access Journals (Sweden)

    Audrey Laporte


    Full Text Available In response to the growing role of personal support workers (PSWs in the delivery of health care services to Ontarians, the Ontario government has moved forward with the creation of a PSW registry. This registry will be mandatory for all PSWs employed by publicly funded health care employers, and has the stated objectives of better highlighting the work that PSWs do in Ontario, providing a platform for PSWs and employers to more easily access the labour market, and to provide government with information for human resources planning. In this paper we consider the factors that brought the creation of a PSW registry onto the Ontario government’s policy agenda, discuss how the registry is being implemented, and provide an analysis of the strengths and weaknesses of this policy change.

  14. Opening Doors to Nursing Degrees: A Proposal from Ontario's Colleges (United States)

    Colleges Ontario, 2010


    Ontario needs to expand nursing education options to improve access to the nursing profession, create better pathways amongst all nursing occupations, and build Ontario's capacity to meet the province's long-term nursing needs. Ontario's colleges are capable of playing a larger role within a long-term provincial strategy for sustaining and…

  15. A Report on Accounting Education in Ontario Universities. (United States)

    Council of Ontario Universities, Toronto.

    A 1981 report on accounting education in Ontario universities, which was prepared by a study group of the Council of Ontario Universities (COU), is presented. The objective was to advise the COU on the feasibility of establishing a professional school or faculty of accounting in one or more Ontario universities. Attention was directed to the…

  16. "Strengthening" Ontario Universities: A Neoliberal Reconstruction of Higher Education (United States)

    Rigas, Bob; Kuchapski, Renée


    This paper reviews neoliberalism as an ideology that has influenced higher education generally and Ontario higher education in particular. It includes a discourse analysis of "Strengthening Ontario's Centres of Creativity, Innovation and Knowledge" (Ontario Ministry of Training, Colleges, and Universities, 2012), a government discussion…

  17. Clinical innovations in Philippine thoracic surgery


    Jose Luis. J. Danguilan


    Thoracic surgery in the Philippines followed the development of thoracic surgery in the United States and Europe. With better understanding of the physiology of the open chest and refinements in thoracic anesthetic and surgical approaches, Filipino surgeons began performing thoracoplasties, then lung resections for pulmonary tuberculosis and later for lung cancer in specialty hospitals dealing with pulmonary diseases—first at the Quezon Institute (QI) and presently at the Lung Center of the P...

  18. A New Vision for Higher Education in Ontario: Submitted by the Presidents of Ontario's 24 Public Colleges (United States)

    Colleges Ontario, 2009


    Ontario has an opportunity to implement meaningful and transformational changes that exploit the potential for growth in the new economy and drive it's prosperity to unprecedented levels. But the threats to Ontario's future are just as great. Failing to move forward now with significant measures could leave Ontario unprepared for the challenges…

  19. Transforming Ontario's Apprenticeship Training System: Supplying the Tradespersons Needed for Sustained Growth--A Proposal from Ontario's Colleges (United States)

    Colleges Ontario, 2009


    Ontario's colleges share the provincial government's belief that apprenticeship must play a greater role in addressing skills shortages and contributing to innovative, high-performance workplaces that enhance Ontario's competitiveness. Given the severity of the economic downturn, Ontario faces an immediate, serious challenge as apprenticeship…

  20. The fruit flies (Tephritidae) of Ontario (United States)

    Thirteen species of Tephritidae are newly recorded from Ontario, and alternative format keys are provided to the 31 genera and 72 species of fruit fly now known from, or likely to occur, in the province. Standard dichotomous keys to genera, and simplified field keys to genera and species are provide...

  1. Employer-Supported Child Care in Ontario. (United States)

    Ontario Ministry of Community and Social Services, Toronto.

    Six case studies describing current employer-supported child care services in Ontario are presented. The studies describe the PLADEC Day Care Center of the Kingston Psychiatric Hospital, the day care center at the Chedoke-McMaster Hospitals in Hamilton, the Early Learning Centre at Durham College in Oshawa, the Hydrokids day care center at the…

  2. Measuring Social Capital in Hamilton, Ontario (United States)

    Kitchen, Peter; Williams, Allison; Simone, Dylan


    Social capital has been studied by academics for more than 20 years and within the past decade there has been an explosion of growth in research linking social capital to health. This paper investigates social capital in Hamilton, Ontario by way of a telephone survey of 1,002 households in three neighbourhood groups representing high, mixed and…

  3. Ontario's Quality Assurance Framework: A Critical Response (United States)

    Heap, James


    Ontario's Quality Assurance Framework (QAF) is reviewed and found not to meet all five criteria proposed for a strong quality assurance system focused on student learning. The QAF requires a statement of student learning outcomes and a method and means of assessing those outcomes, but it does not require that data on achievement of intended…

  4. The Status of Benthos in Lake Ontario (United States)

    The benthic community of Lake Ontario was dominated by an amphipod (Diporeia spp.) prior to the 1990’s. Two dreissenid mussel species D. polymorpha (zebra) and D. bugensis (quagga) were introduced in 1989 and 1991 via ballast water exchange. D. bugensis was observed as deep as 85...

  5. Air quality, mortality, and economic benefits of a smoke - free workplace law for non-smoking Ontario bar workers. (United States)

    Repace, J; Zhang, B; Bondy, S J; Benowitz, N; Ferrence, R


    We estimated the impact of a smoke-free workplace bylaw on non-smoking bar workers' health in Ontario, Canada. We measured bar workers' urine cotinine before (n = 99) and after (n = 91) a 2004 smoke-free workplace bylaw. Using pharmacokinetic and epidemiological models, we estimated workers' fine-particle (PM2.5 ) air pollution exposure and mortality risks from workplace secondhand smoke (SHS). workers' pre-law geometric mean cotinine was 10.3 ng/ml; post-law dose declined 70% to 3.10 ng/ml and reported work hours of exposure by 90%. Pre-law, 97% of workers' doses exceeded the 90th percentile for Canadians of working age. Pre-law-estimated 8-h average workplace PM2.5 exposure from SHS was 419 μg/m(3) or 'Very Poor' air quality, while outdoor PM2.5 levels averaged 7 μg/m(3) , 'Very Good' air quality by Canadian Air Quality Standards. We estimated that the bar workers' annual mortality rate from workplace SHS exposure was 102 deaths per 100000 persons. This was 2.4 times the occupational disease fatality rate for all Ontario workers. We estimated that half to two-thirds of the 10620 Ontario bar workers were non-smokers. Accordingly, Ontario's smoke-free law saved an estimated 5-7 non-smoking bar workers' lives annually, valued at CA $50 million to $68 million (US $49 million to $66 million).

  6. Green tide: indoor marihuana cultivation and its impact on Ontario

    Energy Technology Data Exchange (ETDEWEB)



    This paper discusses the apparent proliferation of marihuana grow-ops in Ontario over the last five years. Estimated revenues from indoor marihuana were detailed, as well as estimates of quantities of marihuana produced, forecasted trends and annual and weekly historical trends. The potential economic impact of this criminal activity was examined, with particular reference to increased police activities. The potential for fire and other human health risks included: exposure to mould associated with hydroponic cultivation and growth chemicals and higher concentrations of carbon dioxide and carbon monoxide. The socio-economic impact of grow ops were examined, with detailed estimates of law enforcement costs, insurance costs and costs to the justice system. Societal costs, such as environmental hazards, violence associated with organized crime, and the perceived threat to Ontario's children and communities were also outlined. Costs stemming from hydro theft were cited, including hydro repair and administration. Details of the bypass systems installed for hydro theft were also provided. It was concluded that it was unlikely that grow ops will be entirely eradicated. Measures that may limit the scope of grow ops included: developing avenues to increase effectiveness and efficiency of law enforcement approaches to grow ops, enhancing lines of communication and sharing of intelligence between police and other key stakeholders such as insurance companies, real estate agencies and banks and educating persons in the justice system on the issue of grow ops so that sentencing more accurately reflects the crime. It was recommended that lenient sentencing for marihuana possession and cultivation be re-examined. 70 refs., 12 tabs, 38 figs.

  7. Thoracic aorta stent grafting through transapical access.

    NARCIS (Netherlands)

    Saouti, N.; Vos, J.A.; Heuvel, D. van de; Morshuis, W.J.; Heijmen, R.H.


    BACKGROUND: To describe the transapical approach for thoracic endovascular aortic repair (TEVAR). METHODS: Three patients, 2 elective and 1 emergent, with thoracic aorta aneurysm are described with vascular or direct aortic inaccessible access, who underwent TEVAR through transapical access. The tec

  8. Bilateral locked facets in the thoracic spine

    NARCIS (Netherlands)

    M.H.A. Willems; Braakman, R. (Reinder); B. van Linge (Bert)


    textabstractTwo cases of traumatic bilateral locked facets in the thoracic spine are reported. Both patients had only minor neurological signs. They both made a full neurological recovery after surgical reduction of the locked facets. Bilateral locked facets are very uncommon in the thoracic spine.

  9. Lakewide estimates of alewife biomass and Chinook salmon abundance and consumption in Lake Ontario, 1989–2005: implications for prey fish sustainability (United States)

    Murry, Brent A.; Connerton, Michael J.; O'Gorman, Robert; Stewart, Donald J.; Ringlerd, Neil H.


    Stocking levels of Chinook salmon Oncorhynchus tshawytscha for Lake Ontario have been highly controversial since the early 1990s, largely because of uncertainties about lakewide abundance and rates of prey consumption. Previous estimates have focused on years before 1995; since then, however, the Lake Ontario ecosystem has undergone substantial changes, and there is new evidence of extensive natural recruitment. Presented here are new abundance estimates of Chinook salmon and alewives Alosa pseudoharengus in Lake Ontario and a reevaluation of the potential risk of alewife population collapse. We found that Lake Ontario has been supporting, on average (1989–2005), 1.83 × 106 (range, 1.08 × 106 to 3.24 × 106) Chinook salmon of ages 1–4, amounting to a mean annual biomass of 11.33 × 103 metric tons (range, 5.83 × 103 to 23.04 × 103 metric tons). During the same period (1989–2005), the lake supported an alewife biomass of 173.66 × 103 metric tons (range, 62.37 × 103 to 345.49 × 103 metric tons); Chinook salmon of ages 1–4 consumed, on average, 22% (range, 11–44%) of the alewife biomass annually. Because our estimates probably underestimate total consumption and because Chinook salmon are only one of several salmonine species that depend on alewives, predation pressure on the Lake Ontario alewife population may be high enough to raise concerns about long-term stability of this predator–prey system.

  10. An Outbreak of Foodborne Botulism in Ontario

    Directory of Open Access Journals (Sweden)

    Mona R Loutfy


    Full Text Available Botulism is a rare paralytic illness resulting from a potent neurotoxin produced by Clostridium botulinum. Botulism in Canada is predominately due to C botulinum type E and affects mainly the First Nations and Inuit populations. The most recent outbreak of botulism in Ontario was in Ottawa in 1991 and was caused by C botulinum type A. We report an outbreak of foodborne type B botulism in Ontario, which implicated home-canned tomatoes. The outbreak was characterized by mild symptoms in two cases and moderately severe illness in one case. The investigation shows the importance of considering the diagnosis of botulism in patients presenting with cranial nerve and autonomic dysfunction, especially when combined with gastrointestinal complaints; it also highlights the importance of proper home canning technique.

  11. Upgrading the dosimetry at Ontario Hydro

    Energy Technology Data Exchange (ETDEWEB)

    Hirning, C.R. [Ontario Hydro, Whitby, ON (Canada). Health Physics Dept.


    Ontario Hydro has embarked upon a major programme to replace and upgrade its external dosimetry systems. In two year`s time, the utility expects to have two state-of-the-art dosimetry systems in place: a new TLD dosimetry of legal record that was designed nearly 30 years ago; and an electronic dosimetry system which could eventually replace the TLD as the primary system. (Author).

  12. PET-Based Thoracic Radiation Oncology. (United States)

    Simone, Charles B; Houshmand, Sina; Kalbasi, Anusha; Salavati, Ali; Alavi, Abass


    Fluorodeoxyglucose-PET is increasingly being integrated into multiple aspects of oncology. PET/computed tomography (PET/CT) has become especially important in radiation oncology. With the increasing use of advanced techniques like intensity-modulated radiation therapy and proton therapy, PET/CT scans have played critical roles in the target delineation of tumors for radiation oncologists delivering conformal treatment techniques. Use of PET/CT is well established in lung cancer and several other thoracic malignancies. This article details the current uses of PET/CT in thoracic radiation oncology with a focus on lung cancer and describes expected future roles of PET/CT for thoracic tumors.

  13. Thiamine content of eggs and lengths of coho salmon (Oncorhynchus kisutch) in relation to abundance of alewife (Alosa pseudoharengus) in eastern Lake ontario, 2003 to 2006 (United States)

    Ketola, H.G.; Rinchard, J.; O'Gorman, R.; Begnoche, L.J.; Bishop, D.L.; Greulich, A.W.


    Early mortality syndrome in fry of Great Lakes salmonines is linked to reduced levels of thiamine in eggs, which reflects maternal consumption of forage fishes such as alewife (Alosa pseudoharengus) that contain thiaminase, an enzyme that destroys thiamine. We assessed annual variations in abundance and condition of alewives and thiamine status of coho salmon (Oncorhynchus kisutch) in Lake Ontario. We analyzed total thiamine in eggs of 20 coho salmon collected annually between 2003 and 2006 at the Salmon River Hatchery on the Salmon River, New York. Alewife abundance was assessed annually in southern and eastern Lake Ontario with bottom trawls during late April and early May. Mean thiamine concentration in eggs varied annually, with those collected in 2003 (2.5 nmol/g) being significantly higher than those collected in 2004 to 2006 (1.5 to 1.7 nmol/g). Although we did not test survival of fry, if reported threshold levels of thiamine for preventing mortality of Lake Michigan coho salmon fry apply, then many or most Lake Ontario coho salmon produced fry were likely to incur thiamine-deficiency mortality, especially during years 2004 to 2006. Comparison to indices of annual abundance of alewife in Lake Ontario with thiamine concentration in coho salmon eggs failed to show any significant correlations (P > 0.05). However, total length of female spawning coho salmon was positively correlated (P < 0.05) with increasing condition and estimated energy content of adult alewives in the previous spring. These results suggest that growth of coho salmon in Lake Ontario was first limited by energy intake, whereas the amount of thiamine provided by alewives was sufficient for growth (in length) but not for producing thiamine-adequate eggs.

  14. Analysis of passive-sampler monitored atmospheric ammonia at 74 sites across southern Ontario, Canada

    Directory of Open Access Journals (Sweden)

    X. H. Yao


    Full Text Available Weekly/biweekly concentrations of atmospheric NH3 were collected using passive samplers at 74 sites across southern Ontario, Canada during the period from June 2006 to March 2007 with tens of sites running as early as March 2006. The annual average of NH3 (AAN at all the sites across southwestern Ontario was over 1 µg m–3, a value that was recently proposed as the new critical level for protecting vegetation. High ANN values (3.6–6.1 µg m–3 were observed at eight sites located inside the intensive livestock production zones. The AAN values at the sites across southeastern Ontario were generally less than 1 µg m–3 and the values were less than 0.4 µg m–3 at non-agricultural sites. Regional transport from the southwest region to the southeast region was identified to be the main contributor to the observed NH3 at the southeastern non-agricultural sites. However, different transport mechanisms were proposed in different seasons. The transport of NH3 produced through bi-directional air-surface exchange along air mass trajectories was believed to be the main mechanism in the hot seasons while the transport of NH4NO3 produced at source locations followed by its evaporation at receptor sites was thought to be dominant in the cold seasons. A sharp increase in NH3 concentration was surprisingly observed at 20 out of the 74 sites during the coldest two weeks when ambient temperature was lower than −7 °C, and cannot be explained by known sources or with existing knowledge. Recently developed NH3 emission inventory for southern Ontario was also evaluated with the measurement data and emissions within two small zones were identified to be potentially underestimated.

  15. Trend in frequency of extreme precipitation events over Ontario from ensembles of multiple GCMs (United States)

    Deng, Ziwang; Qiu, Xin; Liu, Jinliang; Madras, Neal; Wang, Xiaogang; Zhu, Huaiping


    As one of the most important extreme weather event types, extreme precipitation events have significant impacts on human and natural environment. This study assesses the projected long term trends in frequency of occurrence of extreme precipitation events represented by heavy precipitation days, very heavy precipitation days, very wet days and extreme wet days over Ontario, based on results of 21 CMIP3 GCM runs. To achieve this goal, first, all model data are linearly interpolated onto 682 grid points (0.45° × 0.45°) in Ontario; Next, biases in model daily precipitation amount are corrected with a local intensity scaling method to make the total wet days and total wet day precipitation from each of the GCMs are consistent with that from the climate forecast system reanalysis data, and then the four indices are estimated for each of the 21 GCM runs for 1968-2000, 2046-2065 and 2081-2100. After that, with the assumption that the rate parameter of the Poisson process for the occurrence of extreme precipitation events may vary with time as climate changes, the Poisson regression model which expresses the log rate as a linear function of time is used to detect the trend in frequency of extreme events in the GCMs simulations; Finally, the trends and their uncertainty are estimated. The result shows that in the twenty-first century annual heavy precipitation days, very heavy precipitation days and very wet days and extreme wet days are likely to significantly increase over major parts of Ontario and particularly heavy precipitation days, very wet days are very likely to significantly increase in some sub-regions in eastern Ontario. However, trends of seasonal indices are not significant.

  16. March 2016 Arizona thoracic society ntoes

    Directory of Open Access Journals (Sweden)

    Robbins RA


    Full Text Available No abstract available. Article truncated at 150 words. The March 2016 Arizona Thoracic Society meeting was held on Wednesday, March 23, 2016 at the Scottsdale Shea Hospital beginning at 6:30 PM. This was a dinner meeting with case presentations. There were 17 in attendance representing the pulmonary, critical care, sleep, and radiology communities. Of note, Dr. Elijah Poulos drove from Flagstaff to attend the meeting. Dr. Rick Robbins gave a summary of ATS Hill Day and the possibility of collecting dues for the Arizona Thoracic Society along with American Thoracic Society dues. Dr. Robbins also presented the results of emailing the Table of Contents of the Southwest Journal of Pulmonary and Critical Care to the ATS members in Arizona, New Mexico, Colorado, and Nevada along with listing the contents in Inspirations the California Thoracic Society newsletter. The number of page views doubled over usual the following day. Dr. George Parides presented a short presentation on whether coccidioidomycosis nodules ...

  17. Puncture of thoracic lesions under sonographic guidance.


    Afschrift, M; Nachtegaele, P; Voet, D; Noens, L.; Van Hove, W; Van der Straeten, M; Verdonk, G


    Thirty-six punctures of thoracic lesions have been performed with a compound B-scanner or a real-time linear-array scanner for guidance. Twenty-three fluid collections were punctured and aspiration biopsies were performed on 13 echogenic lesions. All the punctures were successful at the first attempt. No complications occurred. The results confirm the usefulness of sonography for guiding punctures of thoracic fluid effusions and solid masses. Usually a static B-scanner is sufficient, but when...

  18. Clinical innovations in Philippine thoracic surgery. (United States)

    Danguilan, Jose Luis J


    Thoracic surgery in the Philippines followed the development of thoracic surgery in the United States and Europe. With better understanding of the physiology of the open chest and refinements in thoracic anesthetic and surgical approaches, Filipino surgeons began performing thoracoplasties, then lung resections for pulmonary tuberculosis and later for lung cancer in specialty hospitals dealing with pulmonary diseases-first at the Quezon Institute (QI) and presently at the Lung Center of the Philippines although some university and private hospitals made occasional forays into the chest. Esophageal surgery began its early attempts during the post-World War II era at the Philippine General Hospital (PGH), a university hospital affiliated with the University of the Philippines. With the introduction of minimally invasive thoracic surgical approaches, Filipino thoracic surgeons have managed to keep up with their Asian counterparts although the problems of financial reimbursement typical of a developing country remain. The need for creative innovative approaches of a focused multidisciplinary team will advance the boundaries of thoracic surgery in the Philippines.

  19. Insegnamiento dell'italiano nell'Ontario (The Teaching of Italian in Ontario) (United States)

    Verna, Anthony


    Paper read at the International Congress of Teachers of Italian held at the Universita Italiana per Stranieri in Perugia, Italy, August 27-28, 1971. Discusses the patterns of growth of Italian studies in Ontario at high school and university levels. (DS)

  20. Cytomegalovirus Immunoglobulin After Thoracic Transplantation (United States)

    Grossi, Paolo; Mohacsi, Paul; Szabolcs, Zoltán; Potena, Luciano


    Abstract Cytomegalovirus (CMV) is a highly complex pathogen which, despite modern prophylactic regimens, continues to affect a high proportion of thoracic organ transplant recipients. The symptomatic manifestations of CMV infection are compounded by adverse indirect effects induced by the multiple immunomodulatory actions of CMV. These include a higher risk of acute rejection, cardiac allograft vasculopathy after heart transplantation, and potentially bronchiolitis obliterans syndrome in lung transplant recipients, with a greater propensity for opportunistic secondary infections. Prophylaxis for CMV using antiviral agents (typically oral valganciclovir or intravenous ganciclovir) is now almost universal, at least in high-risk transplants (D+/R−). Even with extended prophylactic regimens, however, challenges remain. The CMV events can still occur despite antiviral prophylaxis, including late-onset infection or recurrent disease, and patients with ganciclovir-resistant CMV infection or who are intolerant to antiviral therapy require alternative strategies. The CMV immunoglobulin (CMVIG) and antiviral agents have complementary modes of action. High-titer CMVIG preparations provide passive CMV-specific immunity but also exert complex immunomodulatory properties which augment the antiviral effect of antiviral agents and offer the potential to suppress the indirect effects of CMV infection. This supplement discusses the available data concerning the immunological and clinical effects of CMVIG after heart or lung transplantation. PMID:26900989

  1. Education Governance Reform in Ontario: Neoliberalism in Context (United States)

    Sattler, Peggy


    This paper explores the relationship between neoliberal ideology and the discourse and practice of education governance reform in Ontario over the last two decades. It focuses on changes in education governance introduced by successive Ontario governments: the NDP government from 1990 to 1995, the Progressive Conservative government from 1995 to…

  2. Pedagogical over Punitive: The Academic Integrity Websites of Ontario Universities (United States)

    Griffith, Jane


    This study is a snapshot of how Ontario universities are currently promoting academic integrity (AI) online. Rather than concentrating on policies, this paper uses a semiotic methodology to consider how the websites of Ontario's publicly funded universities present AI through language and image. The paper begins by surveying each website and…

  3. Ontario Kindergarten Teachers' Social Media Discussions about Full Day Kindergarten (United States)

    Lynch, Meghan


    This exploratory netnographic study describes how a sample of Ontario kindergarten teachers perceive the new Ontario Full Day Kindergarten (FDK) curriculum. Discussions from teacher message boards, the comment sections of online news articles, and interviews with kindergarten teachers were analyzed and coded using a qualitative approach. Analysis…

  4. Endovascular treatment of thoracic aortic diseases

    Directory of Open Access Journals (Sweden)

    Davidović Lazar


    Full Text Available Bacground/Aim. Endovascular treatment of thoracic aortic diseases is an adequate alternative to open surgery. This method was firstly performed in Serbia in 2004, while routine usage started in 2007. Aim of this study was to analyse initial experience in endovacular treatment of thoracic aortic diseses of three main vascular hospitals in Belgrade - Clinic for Vascular and Endovascular Surgery of the Clinical Center of Serbia, Clinic for Vascular Surgery of the Military Medical Academy, and Clinic for Vascular Surgery of the Institute for Cardiovascular Diseases “Dedinje”. Methods. Between March 2004. and November 2010. 41 patients were treated in these three hospitals due to different diseases of the thoracic aorta. A total of 21 patients had degenerative atherosclerotic aneurysm, 6 patients had penetrating aortic ulcer, 6 had posttraumatic aneurysm, 4 patients had ruptured thoracic aortic aneurysm, 1 had false anastomotic aneurysm after open repair, and 3 patients had dissected thoracic aneurysm of the thoracoabdominal aorta. In 15 cases the endovascular procedure was performed as a part of the hybrid procedure, after carotidsubclavian bypass in 4 patients and subclavian artery transposition in 1 patient due to the short aneurysmatic neck; in 2 patients iliac conduit was used due to hypoplastic or stenotic iliac artery; in 5 patients previous reconstruction of abdominal aorta was performed; in 1 patient complete debranching of the aortic arch, and in 2 patients visceral abdominal debranching were performed. Results. The intrahospital mortality rate (30 days was 7.26% (3 patients with ruptured thoracic aneurysms died. Endoleak type II in the first control exam was revealed in 3 patients (7. 26%. The patients were followed up in a period of 1-72 months, on average 29 months. The most devastating complication during a followup period was aortoesofageal fistula in 1 patient a year after the treatment of posttraumatic aneurysm. Conversion was

  5. Air Quality in the Central Ontario Region (United States)

    Gbor, P. K.; Meng, F.; Singh, R.; Galvez, O.; Sloan, J. J.


    The Central Ontario Region (COR) is the most densely populated area in Canada. With a population of 7.3 million, it contains 23% of the total population of Canada. It extends from the extreme south west end of Ontario to the eastern end of the Greater Toronto Area (GTA) and includes the Niagara, Hamilton and Waterloo Regions,. The air quality of this region is frequently severely impaired in the summer months. In the larger metropolitan areas (Toronto and Hamilton) air pollution is a concern throughout the year. Local health authorities attribute about 1000 premature deaths per year in the GTA alone to air pollution. Average air pollution levels in Ontario have decreased significantly during the past 30 years, despite significant growth in both population and industry. The concentrations of SO2 and CO have decreased by over 80% and the concentration of NOX has decreased by about 50% over the past 26 years. Currently, the concentrations of NOX, CO, SO2 and VOCs in the COR are well below the Provincial and Federal air quality criteria. Ozone, PM2.5 and PM10, however, remain above the Provincial guidelines, so smog still remains a problem. The pollutants in the atmosphere of the COR are caused by both local emissions and long range transport. The COR contributes over 50% of the NOx, VOC and CO emissions in Ontario. Over 58% of NOX and CO emissions in the COR are due to mobile sources while about 50% of VOC and PM emissions are due to area sources. The proximity of the COR to the Canada-U.S. border makes it vulnerable to long range transport of pollutants stemming from the much larger population in the United States. The Canadian government, industries and non-governmental organizations are all taking steps to help reduce the level of pollution in Canada. The Canadian federal government also participates in extensive consultations and cooperative programs with the United States designed to reduce the mutually detrimental effects of cross-border pollution. These

  6. Evaluation of network RTK in southern Ontario (United States)

    Saeidi, Amir

    Network Real-Time Kinematic (RTK) has become popular in the past decade as an efficient method of precise, real-time positioning. Its relatively low cost and ease-of-use makes it a good candidate to replace static relative Global Positioning System (GPS) in, e.g., land surveying. A lack of previous studies aroused the interest of the Ministry of Transportation of Ontario (MTO) to request York University to complete a comprehensive study of the performance of network RTK in southern Ontario and whether it is a suitable method for MTO control surveying. Extensive fieldwork campaigns in the winter of 2010 and summer of 2011 were carried out and ˜300 hours of static and ˜50 hours of kinematic network RTK data were collected from three different service providers. A set of metrics were defined to characterize the performance of network RTK: availability, time-to-first-fix, precision, accuracy, solution integrity and moving average filtering. The data were used to characterize the horizontal performance of network RTK services and the results along with a set of guidelines and specifications were provided (Saeidi et al., 2011; Bisnath et al., 2012). This thesis presents the horizontal network RTK performance evaluation, as well as the vertical and kinematic performance. The aforementioned metrics are used to evaluate the quality of network RTK in southern Ontario, and to compare to similar services available in other locations. The result have revealed expected ˜2-3 cm (95%) precision for the horizontal and vertical components; however, large horizontal and vertical biases were observed, which can be as high as 4 cm. The solution integrity has shown that typically, 3σ solution uncertainties are larger than the actual errors, unless large biases exist. Moving average filtering has confirmed that due to large outliers and spikes in the solutions, 1 second observation periods are not sufficient to provide a precise solution; larger observation windows should be used, e

  7. [Video-assisted thoracic surgery, lung transplantation and mediastinitis: major issues in thoracic surgery in 2010]. (United States)

    Borro, José M; Moreno, Ramón; Gómez, Ana; Duque, José Luis


    We reviewed the major issues in thoracic surgery relating to the advances made in our specialty in 2010. To do this, the 43(rd) Congress of the Spanish Society of Pneumology and Thoracic Surgery held in La Coruña and the articles published in the Society's journal, Archivos de Bronconeumología, were reviewed. The main areas of interest were related to the development of video-assisted thoracic surgery, lung transplantation and descending mediastinitis. The new tumor-node-metastasis (TNM) classification (7(th) edition), presented last year, was still a topical issue this year. The First Forum of Thoracic Surgeons and the Update in Thoracic Surgery together with the Nurses' Area have constituted an excellent teaching program.

  8. Thoracic CT in the ED: a study of thoracic computed tomography utilisation.

    LENUS (Irish Health Repository)

    Williams, E


    The aim of this retrospective study was to investigate the use of thoracic Computed Tomography (CT) in the Emergency Department of a Dublin Academic Teaching Hospital over a six month period. Data was retrieved using the hospital\\'s computerised information system. There were 202 referrals in total for thoracic CT from the Emergency Department during this time period. The most common indication for thoracic CT referral was for the investigation of pulmonary embolism with 127 (63%) referrals. There were 40 (25%) referrals for suspected malignancy and lung disease, whilst 8 (4%) of the referrals were for investigation of thoracic aortic dissection, 8 (4%) for infection, and 6 (3%) were for investigation of thoracic injury. Only 8 (4%) of all referrals were for investigation of injury as a result of chest trauma.

  9. [Gastrontestinal hemorrhage following thoracic surgery]. (United States)

    Durić, O; Tvrtković, R; Budalica, M


    The authors discuss eight cases who suffered hemorrhaging stress ulcers out of 200 cases on whom Thoracotomies were performed. Presented is the common factor of the onset of this complication, it's diagnosis, and therapy. Listed below are the diagnoses and operative procedures used on these eight patients. Cysta Aerea Permagna Lobi Inf. Pulm. Dexter/operation: Mytomis Longitudinalis Ooesophagi. Caverna Bronchiectatica Permagna Lobi Inferior Pulmo Dexter/operation: Lobestomia Typica. Echinococcus Heaptis Complicatus, Empyema Pleurae Dexter/opetation: Decorticatio. Haemathorax Spontaneous Lobus Sinister/operation: Decorticatio Pleurae Sinister. Echi Comp. Cupolae Hepatis Permagnus/operation: Thoracotomia Phrenotomia, evacuatio, Triplex Drainage. Bronchiectasiae Lobi Medius et Inferior Pulmo Dexter/operation: Biblobectomia Typica. Carcinoma Bronchi Lobi Inferior Pulmo Dexter/operation: Lobectomia Typica. Gastric problems had troubled four of these eight patients in their past history. Bleeding in three patients occurred three days postoperatively, and in the remaining five, thirty days following their operation. Six patients had to be treated conservatively because of serious contraindications to reoperation. Four of them expired. Autopsy revealed: Pyothorax, Dehiscention Bronchi, Empyema, and Gastritis Errosiva with multiulcerations, hemoragia, and dilatation of the right heart. Two patients with recent stress ulcers were reoperated on, and were cured. The authors estimate that the occurrence of hemorrhaging stress ulcer following thoracic surgery are basically due to Hypoxia. The chain of events whic brought about the stress ulcer, however, began even before the operation, continued throughout the operation, and appeared postoperatively due to postoperative complications. The authors point out that these complications can be foreseen (early and late), but firstly, an attempt should be made to treat the patient with conservative therapy. Inasmuch as the hemorrhaging

  10. Asian perspective in surgery: thoracic surgery in Turkey. (United States)

    Turna, Akif


    Turkey with a population of 78 million is located between Asia and Europe geographically and culturally. There are 577 active pure thoracic surgeon and 37 thoracic surgery teaching units. Thoracic surgeons usually deal with lung cancer patients due to relatively higher rate of tobacco usage as well as inflammatory diseases such as pulmonary hydatid disease, bronchiectasis and empyema. Minimally invasive thoracic surgery has been a new approach which is being adapted by increasingly more surgeons. There are a number of reasons to predict that the number of thoracic surgical cases will be increased and new generation of thoracic surgeons will be operating more minimally invasive resectional surgeries for most lung cancer in future.

  11. Public perceptions of energy issues in Ontario

    Energy Technology Data Exchange (ETDEWEB)



    In October 2004, the Environics Research Group conducted a telephone survey of 608 adult Ontarians to collect information on matters regarding energy; consumer confidence and protection; responsibilities of the Ontario Energy Board; and consumer information preferences. This report summarizes the key findings of the survey. According to the survey, the most important electricity and natural gas issue was identified as being price and cost issues, followed by reliability of supply, conservation, keeping utilities publicly owned, finding renewable sources of energy, and over-consumption. The survey revealed that Ontarians show much interest in conserving energy to save money, to protect the environment and ensure future energy supply, but they are generally sceptical that their interests are being protected on electricity and natural gas price issues. At least 9 in 10 Ontarians consider the tasks of the Ontario Energy Board to be important. The majority of Ontarians prefer to receive energy conservation information through the mail and from public regulators over a government department or a company. 10 tabs.

  12. Cancer nursing in Ontario: defining nursing roles. (United States)

    Fitch, Margaret I; Mings, Deborah


    The delivery of cancer care in Ontario is facing unprecedented challenges. Shortages in nursing, as in all professional disciplines, are having an impact on the delivery of cancer care. Oncology nurses have a major role to play in the delivery of optimum cancer care. Oncology nursing, when adequately defined and supported, can benefit the cancer delivery system, patients, and families. A primary nursing model is seen as being key to the delivery of optimum cancer care. Primary nursing as a philosophy facilitates continuity of care, coordination of a patient's care plan, and a meaningful ongoing relationship with the patient and his/her family. Primary nursing, when delivered in the collaboration of a nurse-physician team, allows for medical resources to be used appropriately. Defined roles enable nurses to manage patients within their scope of practice in collaboration with physicians. Enacting other nursing roles, such as nurse practitioners and advanced practice nurses, can also enable the health care system to manage a broader number of patients with more complex needs. This article presents a position paper originally written as the basis for an advocacy and education initiative in Ontario. It is shared in anticipation that the work may be useful to oncology nurses in other jurisdictions in their efforts to advance oncology nursing and improvement of patient care.

  13. Thoracic aortic aneurysm: reading the enemy's playbook. (United States)

    Elefteriades, John A


    The vast database of the Yale Center for Thoracic Aortic Disease--which includes information on 3000 patients with thoracic aortic aneurysm or dissection, with 9000 catalogued images and 9000 patient-years of follow-up--has, over the last decade, permitted multiple glimpses into the "playbook" of this virulent disease. Understanding the precise behavioral features of thoracic aortic aneurysm and dissection permits us more effectively to combat this disease. In this monograph, we will first review certain fundamentals--in terms of anatomy, nomenclature, imaging, diagnosis, medical, surgical, and stent treatment. After reviewing these fundamentals, we will proceed with a detailed exploration of lessons learned by peering into the operational playbook of thoracic aortic aneurysm and dissection. Among the glimpses afforded in the behavioral playbook of this disease are the following: 1 Thoracic aortic aneurysm, while lethal, is indolent. Mortality usually does not occur until after years of growth. 2 The aneurysmal ascending thoracic aorta grows slowly: about 0.1 cm per year (the descending aorta grows somewhat faster). 3 Over a patient's lifetime, "hinge points" at which the likelihood of rupture or dissection skyrockets are seen at 5.5 cm for the ascending and 6.5 cm for the descending aorta. Intervening at 5 cm diameter for the ascending and 6 cm for the descending prevents most adverse events. 4 Symptomatic aneurysms require resection regardless of size. 5 The yearly rate of rupture, dissection, or death is 14.1% for a patient with a thoracic aorta of 6 cm diameter. 6 The mechanical properties of the aorta deteriorate markedly at 6 cm diameter (distensibility falls, and wall stress rises)--a finding that "dovetails" perfectly with observations of the clinical behavior of the thoracic aorta. 7 Thoracic aortic aneurysm and dissection are largely inherited diseases, with a predominantly autosomal-dominant pattern. The specific genetics are being elucidated at the

  14. Thoracic fractures and dislocations in motorcyclists

    Energy Technology Data Exchange (ETDEWEB)

    Daffner, R.H.; Deeb, Z.L.; Rothfus, W.E.


    Motorcyclists who are involved in accidents generally suffer severe multiple injuries, some of which are not readily apparent on initial examination. One such subtle injury is fracture, with or without dislocation, in the upper thoracic spine. The severe spinal cord damage produced by the injury is often overshadowed by cerebral or cervical injury. Proper diagnosis is further hampered by the fact that the upper thoracic region is difficult to examine radiographically on plain films, particularly when using portable equipment. Of a group of 14 motorcyclists having 26 fractures and/or dislocations in the thoracic region, 12 had 24 injuries between T3 and T8. These 24 injuries represented 56% of the fractures and/or dislocations encountered in a larger study of trauma to the thoracic vertebral column. All of these were flexion injuries, suffered when the individual was thrown from the motorcycle and struck a large, solid object. In three cases, the diagnosis was delayed as much as 48 h because proper films were not obtained initially. Because of the serious consequences of delayed treatment, we recommended that all motorcyclists who have sustained severe trauma be examined by overpenetrated film of the upper thoracic region.

  15. Thoracic CT findings at hypovolemic shock

    Energy Technology Data Exchange (ETDEWEB)

    Rotondo, A.; Angelelli, G. [Bari Univ. (Italy). Dept. of Radiology; Catalano, O. [S. Maria delle Grazie Hospital, Pozzuoli, Naples (Italy). Dept. of Radiology; Grassi, R. [Cardarelli Hospital, Naples (Italy). Dept. of Radiology; Scialpi, M. [S.S. Annunziata Hospital, Taranto (Italy). Dept. of Radiology


    Purpose: To describe and discuss the thoracic CT features of hypovolemic shock. Material and Methods: From a group of 18 patients with signs of hypovolemia on contrast-enhanced abdominal CT, 11 were selected for our study as having also undergone a complete chest examination. Pulse rate, blood pressure, trauma score value, Glasgow coma scale value, surgical result, and final outcome were retrospectively evaluated. The CT features analyzed were: decreased cardiac volume, reduced caliber of the thoracic aorta, aortic branches and caval venous system, increased enhancement of the aorta, and increased enhancement of the pulmonary collapses/contusions. Results: All 11 subjects presented severe injuries and hemodynamic instability; 7 were stable enough to undergo surgery; only 1 of the 11 survived. Two patients showed none of the features of thoracic hypovolemia. All the other patients presented at least two signs: reduced caliber of the thoracic aorta in 7 cases; decreased volume of the cardiac chambers and increased aortic enhancement in 6; decreased caliber of the aortic vessels in 4; decreased caliber of the caval veins in 3; and increased enhancement of the pulmonary collapses/contusions in 3. Conclusions: In patients with hypovolemia, CT may show several thoracic findings in addition to abdominal ones. Knowledge of these features is important for distinguishing them from traumatic injuries. (orig.)

  16. The Efficacy of Key Performance Indicators in Ontario Universities as Perceived by Key Informants (United States)

    Chan, Vivian


    The Ontario Ministry of Education and Training's Task Force on University Accountability first proposed key performance indicators (KPIs) for colleges and universities in Ontario in the early 1990s. The three main KPIs for Ontario universities are the rates of (1) graduation, (2) employment, and (3) Ontario Student Assistance Program loan default.…

  17. Change of paradigm in thoracic radionecrosis management. (United States)

    Dast, S; Assaf, N; Dessena, L; Almousawi, H; Herlin, C; Berna, P; Sinna, R


    Classically, muscular or omental flaps are the gold standard in the management of thoracic defects following radionecrosis debridement. Their vascular supply and antibacterial property was supposed to enhance healing compared with cutaneous flaps. The evolution of reconstructive surgery allowed us to challenge this dogma. Therefore, we present five consecutive cases of thoracic radionecrosis reconstructed with cutaneous perforator flaps. In four patients, we performed a free deep inferior epigastric perforator (DIEP) flap and one patient had a thoracodorsal perforator (TDAP) flap. Median time healing was 22.6 days with satisfactory cutaneous covering and good aesthetic results. There were no flap necrosis, no donor site complications. We believe that perforator flaps are a new alternative, reliable and elegant option that questions the dogma of muscular flaps in the management of thoracic radionecrosis.

  18. Epidemiology of Enterovirus D68 in Ontario.

    Directory of Open Access Journals (Sweden)

    Adriana Peci

    Full Text Available In August 2014, children's hospitals in Kansas City, Missouri and Chicago, Illinois notified the Centers for Disease Control and Prevention (CDC about increased numbers of pediatric patients hospitalized with severe respiratory illness (SRI. In response to CDC reports, Public Health Ontario Laboratories (PHOL launched an investigation of patients being tested for enterovirus D-68 (EV-D68 in Ontario, Canada. The purpose of this investigation was to enhance our understanding of EV-D68 epidemiology and clinical features. Data for this study included specimens submitted for EV-D68 testing at PHOL from September 1, 2014 to October 31, 2014. Comparisons were made between patients who tested positive for the virus (cases and those testing negative (controls. EV-D68 was identified in 153/907 (16.8% of patients tested. In the logistic regression model adjusting for age, sex, setting and time to specimen collection, individuals younger than 20 years of age were more likely to be diagnosed with EV-D68 compared to those 20 and over, with peak positivity at ages 5-9 years. Cases were not more likely to be hospitalized than controls. Cases were more likely to be identified in September than October (OR 8.07; 95% CI 5.15 to 12.64. Routine viral culture and multiplex PCR were inadequate methods to identify EV-D68 due to poor sensitivity and inability to differentiate EV-D68 from other enterovirus serotypes or rhinovirus. Testing for EV-D68 in Ontario from July to December, 2014 detected the presence of EV-D68 virus among young children during September-October, 2014, with most cases detected in September. There was no difference in hospitalization status between cases and controls. In order to better understand the epidemiology of this virus, surveillance for EV-D68 should include testing of symptomatic individuals from all treatment settings and patient age groups, with collection and analysis of comprehensive clinical and epidemiological data.

  19. Epidemiology of Enterovirus D68 in Ontario. (United States)

    Peci, Adriana; Winter, Anne-Luise; Warshawsky, Bryna; Booth, Tim F; Eshaghi, AliReza; Li, Aimin; Perusini, Stephen; Olsha, Romy; Marchand-Austin, Alex; Kristjanson, Erik; Gubbay, Jonathan B


    In August 2014, children's hospitals in Kansas City, Missouri and Chicago, Illinois notified the Centers for Disease Control and Prevention (CDC) about increased numbers of pediatric patients hospitalized with severe respiratory illness (SRI). In response to CDC reports, Public Health Ontario Laboratories (PHOL) launched an investigation of patients being tested for enterovirus D-68 (EV-D68) in Ontario, Canada. The purpose of this investigation was to enhance our understanding of EV-D68 epidemiology and clinical features. Data for this study included specimens submitted for EV-D68 testing at PHOL from September 1, 2014 to October 31, 2014. Comparisons were made between patients who tested positive for the virus (cases) and those testing negative (controls). EV-D68 was identified in 153/907 (16.8%) of patients tested. In the logistic regression model adjusting for age, sex, setting and time to specimen collection, individuals younger than 20 years of age were more likely to be diagnosed with EV-D68 compared to those 20 and over, with peak positivity at ages 5-9 years. Cases were not more likely to be hospitalized than controls. Cases were more likely to be identified in September than October (OR 8.07; 95% CI 5.15 to 12.64). Routine viral culture and multiplex PCR were inadequate methods to identify EV-D68 due to poor sensitivity and inability to differentiate EV-D68 from other enterovirus serotypes or rhinovirus. Testing for EV-D68 in Ontario from July to December, 2014 detected the presence of EV-D68 virus among young children during September-October, 2014, with most cases detected in September. There was no difference in hospitalization status between cases and controls. In order to better understand the epidemiology of this virus, surveillance for EV-D68 should include testing of symptomatic individuals from all treatment settings and patient age groups, with collection and analysis of comprehensive clinical and epidemiological data.

  20. Thoracic pain in a collegiate runner. (United States)

    Austin, G P; Benesky, W T


    This case study describes the process of examination, re-examination, and intervention for a collegiate runner with mechanical thoracic pain preventing athletic participation and limiting daily function. Unimpaired function fully returned in less than 3 weeks with biweekly sessions to re-establish normal and painfree thoracic mechanics via postural hygiene, exercise, mobilization, and manipulation. The outcome of this case study supports the original hypothesis that the pattern of impairments was in fact responsible for the functional limitations and disability in this athlete. At the time of publication the athlete was without functional limitations and had fully returned to competitive sprinting for the university track team.

  1. Asian perspective in surgery: thoracic surgery in Turkey


    Turna, Akif


    Turkey with a population of 78 million is located between Asia and Europe geographically and culturally. There are 577 active pure thoracic surgeon and 37 thoracic surgery teaching units. Thoracic surgeons usually deal with lung cancer patients due to relatively higher rate of tobacco usage as well as inflammatory diseases such as pulmonary hydatid disease, bronchiectasis and empyema. Minimally invasive thoracic surgery has been a new approach which is being adapted by increasingly more surge...

  2. Epidemiology of myasthenia gravis in Ontario, Canada. (United States)

    Breiner, Ari; Widdifield, Jessica; Katzberg, Hans D; Barnett, Carolina; Bril, Vera; Tu, Karen


    Incidence and prevalence estimates in myasthenia gravis have varied widely. Recent studies based on administrative health data have large sample sizes but lack rigorous validation of MG cases, and have not examined the North American population. Our aim was to explore trends in MG incidence and prevalence for the years 1996-2013 in the province of Ontario, Canada (population 13.5 million). We employed a previously validated algorithm to identify MG cases. Linking with census data allowed for the calculation of crude- and age/sex-standardized incidence and prevalence rates for the years 1996-2013. The regional distribution of MG cases throughout the province was examined. Mean age at the first myasthenia gravis encounter was 60.2 ± 17.1 years. In 2013, there were 3611 prevalent cases in Ontario, and the crude prevalence rate was 32.0/100,000 population. Age- and sex-standardized prevalence rates rose consistently over time from 16.3/100,000 (15.4-17.1) in 1996 to 26.3/100,000 (25.4-27.3) in 2013. Standardized incidence rates remained stable between 1996 (2.7/100,000; 95% CL 2.3-3.0) and 2013 (2.3/100,000; 2.1-2.6). Incidence was highest in younger women and older men, and geographic variation was evident throughout the province. In conclusion, this large epidemiological study shows rising myasthenia gravis prevalence with stable incidence over time, which is likely reflective of patients living longer, possibly due to improved disease treatment. Our findings provide accurate information on the Canadian epidemiology of myasthenia gravis and burden for health care resources planning for the province, respectively.

  3. 2001 USACE LRE Topobathy Lidar: Lake Ontario (NY) (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Office for Coastal Management received the 2001 Lake Ontario dataset with 2 separate metadata records in 2013 on a hard-drive device from the USGS Center for...

  4. Waterfowl breeding pair survey: Ontario, Quebec, and New York: 1997 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for Ontario, Quebec, and New York during 1997. The primary purpose of the survey is to...

  5. Western and Central Ontario: Waterfowl breeding population survey: 2000 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for Western and Central Ontario during 2000. The primary purpose of the survey is to...

  6. Evolution of Thoracic Surgery in Canada

    Directory of Open Access Journals (Sweden)

    Jean Deslauriers


    Full Text Available BACKGROUND: Canada’s contributions toward the 21st century’s practice of thoracic surgery have been both unique and multilayered. Scattered throughout are tales of pioneers where none had gone before, where opportunities were greeted by creativity and where iconic figures followed one another.

  7. Thoracic empyema caused by Campylobacter rectus. (United States)

    Ogata, Tomoyuki; Urata, Teruo; Nemoto, Daisuke; Hitomi, Shigemi


    We report a case of thoracic empyema caused by Campylobacter rectus, an organism considered as a periodontal pathogen but rarely recovered from extraoral specimens. The patient fully recovered through drainage of purulent pleural fluid and administration of antibiotics. The present case illustrates that C. rectus can be a cause of not only periodontal disease but also pulmonary infection.

  8. May 2014 Arizona thoracic society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA


    Full Text Available No abstract available. Article truncated after first 150 words. The May 2014 Arizona Thoracic Society meeting was held on Wednesday, 5/28/2014 at Scottsdale Shea Hospital beginning at 6:30 PM. There were 13 in attendance representing the pulmonary, critical care, sleep and radiology communities. A discussion was held regarding the Arizona Thoracic Society relationship with the American Lung Association. Several members volunteered to talk to the lung association regarding common ground to strengthen the relationship. The wine tasting with the California, New Mexico and Colorado Thoracic Societies at the American Thoracic Society International Meeting was a big success. There were about 55 at the meeting. The tasting will probably be held again next year. At the ATS meeting data was presented that pirfenidone was effective in reducing the progression of idiopathic pulmonary fibrosis (IPF. The data was published in the New England Journal of Medicine on 8/29/14 (1. Lewis Wesselius is one of the investigators enrolling patients in a phase ...

  9. April 2014 Arizona thoracic society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA


    Full Text Available No abstract available. Article truncated at 150 words. The April 2014 Arizona Thoracic Society meeting was held on Wednesday, 4/23/2014 at Scottsdale Shea Hospital beginning at 6:30 PM. There were 15 in attendance representing the pulmonary, critical care, sleep, pathology and radiology communities. It was announced that there will be a wine tasting with the California, New Mexico and Colorado Thoracic Societies at the American Thoracic Society International Meeting. The tasting will be led by Peter Wagner and is scheduled for the Cobalt Room in the Hilton San Diego Bayfront on Tuesday, May 20, from 4-8 PM. Guideline development was again discussed. The consensus was to await publication of the IDSA Cocci Guidelines and respond appropriately. George Parides, Arizona Chapter Representative, gave a presentation on Hill Day. Representatives of the Arizona, New Mexico and Washington Thoracic Societies met with their Congressional delegations, including Rep. David Schweikert, to discuss the Cigar Bill, NIH funding, and the Medicare Sustainable Growth ...

  10. February 2014 Arizona Thoracic Society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA


    Full Text Available No abstract available. Article truncated at 150 words. The February 2014 Arizona Thoracic Society was a dinner meeting sponsored by Select Specialty Hospital and held on Wednesday, 2/26/2014 at Shea Hospital beginning at 6:30 PM. There were 14 in attendance representing the pulmonary, critical care, sleep, and radiology communities. Gerald Swartzberg was presented a plaque as the Arizona Thoracic Society clinician of the year by George Parides (Figure 1. A discussion was held about having a wine tasting in San Diego at the ATS International Conference. Peter Wagner (Slurping Around with PDW has agreed to lead the conference. It was decided to extend invitations to the New Mexico, Colorado and California Thoracic Societies along with the Mayo Clinic. A question was raised about guideline development. It was felt that we should review the Infectious Disease Society of America Valley Fever guidelines and determine if the Arizona Thoracic Society might have something to contribute. Three cases were presented: Lewis ...

  11. March 2017 Arizona thoracic society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA


    Full Text Available No abstract available. Article truncated after 150 words. The March 2017 Arizona Thoracic Society meeting was held on Wednesday, March 22, 2017 at the HonorHealth Rehabilitation Hospital beginning at 6:30 PM. This was a dinner meeting with case presentations. There 11 attendance representing the pulmonary, critical care, sleep, thoracic surgery and radiology communities. There was a discussion of supporting the Tobacco 21 bill which had been introduced into the Arizona State Legislature. The bill was assigned to the House Commerce Committee but was not scheduled for a hearing by the Chair-Representative, Jeff Wininger from Chandler. It seems likely that the bill will be reintroduced in the future and the Arizona Thoracic Society will support the bill in the future. Three cases were presented: 1. Dr. Bridgett Ronan presented a 57-year-old man with cough and shortness of breath. His physical examination and spirometry were unremarkable. A thoracic CT scan showed large calcified and noncalcified pleural plaques and mediastinal lymphadenopathy. …

  12. Evaluation of Registration Methods on Thoracic CT

    DEFF Research Database (Denmark)

    Murphy, K.; van Ginneken, B.; Reinhardt, J.;


    EMPIRE10 (Evaluation of Methods for Pulmonary Image REgistration 2010) is a public platform for fair and meaningful comparison of registration algorithms which are applied to a database of intra-patient thoracic CT image pairs. Evaluation of non-rigid registration techniques is a non trivial task...

  13. Right thoracic curvature in the normal spine

    Directory of Open Access Journals (Sweden)

    Masuda Keigo


    Full Text Available Abstract Background Trunk asymmetry and vertebral rotation, at times observed in the normal spine, resemble the characteristics of adolescent idiopathic scoliosis (AIS. Right thoracic curvature has also been reported in the normal spine. If it is determined that the features of right thoracic side curvature in the normal spine are the same as those observed in AIS, these findings might provide a basis for elucidating the etiology of this condition. For this reason, we investigated right thoracic curvature in the normal spine. Methods For normal spinal measurements, 1,200 patients who underwent a posteroanterior chest radiographs were evaluated. These consisted of 400 children (ages 4-9, 400 adolescents (ages 10-19 and 400 adults (ages 20-29, with each group comprised of both genders. The exclusion criteria were obvious chest and spinal diseases. As side curvature is minimal in normal spines and the range at which curvature is measured is difficult to ascertain, first the typical curvature range in scoliosis patients was determined and then the Cobb angle in normal spines was measured using the same range as the scoliosis curve, from T5 to T12. Right thoracic curvature was given a positive value. The curve pattern was organized in each collective three groups: neutral (from -1 degree to 1 degree, right (> +1 degree, and left ( Results In child group, Cobb angle in left was 120, in neutral was 125 and in right was 155. In adolescent group, Cobb angle in left was 70, in neutral was 114 and in right was 216. In adult group, Cobb angle in left was 46, in neutral was 102 and in right was 252. The curvature pattern shifts to the right side in the adolescent group (p Conclusions Based on standing chest radiographic measurements, a right thoracic curvature was observed in normal spines after adolescence.

  14. Implementation of an agency to improve chronic kidney disease care in Ontario: lessons learned by the Ontario Renal Network. (United States)

    Woodward, Graham L; Iverson, Alex; Harvey, Rebecca; Blake, Peter G


    In 2009, Ontario's Ministry of Health and Long-Term Care initiated the transfer of oversight and coordination of chronic kidney disease (CKD) care to the Ontario Renal Network (ORN) under the auspices of Cancer Care Ontario (CCO). The aim was to replicate the quality improvement and change management practices used for cancer control within CKD. Much of the ORN's first three years were dedicated to building the infrastructure necessary to bridge the gap between provincial policy and clinical practice. This article explores the accomplishments, challenges and lessons learned over that period. The results, which are applicable to the management of chronic diseases in Ontario, Canada, and internationally, confirm that sustainable change takes time and requires strong leadership, transparency, accountability and communication, supported by a solid foundation of data and evidence.

  15. Twenty-first century probabilistic projections of precipitation over Ontario, Canada through a regional climate model ensemble (United States)

    Wang, Xiuquan; Huang, Guohe; Liu, Jinliang


    In this study, probabilistic projections of precipitation for the Province of Ontario are developed through a regional climate model ensemble to help investigate how global warming would affect its local climate. The PRECIS regional climate modeling system is employed to perform ensemble simulations, driven by a set of boundary conditions from a HadCM3-based perturbed-physics ensemble. The PRECIS ensemble simulations are fed into a Bayesian hierarchical model to quantify uncertain factors affecting the resulting projections of precipitation and thus generate probabilistic precipitation changes at grid point scales. Following that, reliable precipitation projections throughout the twenty-first century are developed for the entire province by applying the probabilistic changes to the observed precipitation. The results show that the vast majority of cities in Ontario are likely to suffer positive changes in annual precipitation in 2030, 2050, and 2080 s in comparison to the baseline observations. This may suggest that the whole province is likely to gain more precipitation throughout the twenty-first century in response to global warming. The analyses on the projections of seasonal precipitation further demonstrate that the entire province is likely to receive more precipitation in winter, spring, and autumn throughout this century while summer precipitation is only likely to increase slightly in 2030 s and would decrease gradually afterwards. However, because the magnitude of projected decrease in summer precipitation is relatively small in comparison with the anticipated increases in other three seasons, the annual precipitation over Ontario is likely to suffer a progressive increase throughout the twenty-first century (by 7.0 % in 2030 s, 9.5 % in 2050 s, and 12.6 % in 2080 s). Besides, the degree of uncertainty for precipitation projections is analyzed. The results suggest that future changes in spring precipitation show higher degree of uncertainty than other

  16. Meteorological Influences on Seasonal Variation of Fine Particulate Matter in Cities over Southern Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Jane Liu


    Full Text Available This study examines meteorological impacts on seasonal variation of fine particulate matter (PM2.5 in southern Ontario, Canada. After analyzing PM2.5 data at 12 cities in the region in 2006, we found that PM2.5 concentrations were 30–40% higher in summer (7–15 μg/m3 than in winter (4–11 μg/m3. High PM2.5 episodes occurred more frequently in warmer seasons. Analyses of surface meteorology, weather maps, and airflow trajectories suggest that these PM2.5 episodes were often related to synoptic transport of pollutants from highly polluted areas in the United States. The southerly or southwesterly winds associated with midlatitude cyclones play an important role in such transport. A typical weather pattern favoring the transport is suggested. When it was hot, humid, and stagnant with southerly or southwesterly winds, the likelihood of high PM2.5 occurrences was high. The Greater Golden Horseshoe and Southwestern Ontario regions had higher PM2.5 (6–12 μg/m3 annually than the northern region (4–6 μg/m3, reflecting combined effects of meteorology, regional transport, and local emissions. In the future, PM2.5 transport from the United States will likely increase in abundance because of possible prolonged accumulation at the pollution sources as the frequency of the midlatitude cyclones may reduce under climate change.

  17. Market Myths and Facts - the Ontario Context

    Energy Technology Data Exchange (ETDEWEB)

    Dorey, S.


    The world has learned much about electricity markets and what they can and can't do over the past few years, but some myths persist. Why they persist is a subject for those who study politics, interests and influence. This paper provides a perspective on myths which have affected the reliable and economic delivery of electricity to customers, particularly with respect to transmission. Hydro One effectively provides the transmission network for the Province of Ontario, Canada. As Hydro One is a wires company, the paper is not intended to address the issues which affect the generation or conservation sectors of the industry, except where they directly relate to the wires. The proposition of this paper is that electricity transmission is best treated as an essential public good. Transmission as a market participant and a traded commodity has generally not worked with respect to assuring that the system continues to be developed to meet the basic need of customers for reliable and affordable electricity. (auth)

  18. [Digital thoracic radiology: devices, image processing, limits]. (United States)

    Frija, J; de Géry, S; Lallouet, F; Guermazi, A; Zagdanski, A M; De Kerviler, E


    In a first part, the different techniques of digital thoracic radiography are described. Since computed radiography with phosphore plates are the most commercialized it is more emphasized. But the other detectors are also described, as the drum coated with selenium and the direct digital radiography with selenium detectors. The other detectors are also studied in particular indirect flat panels detectors and the system with four high resolution CCD cameras. In a second step the most important image processing are discussed: the gradation curves, the unsharp mask processing, the system MUSICA, the dynamic range compression or reduction, the soustraction with dual energy. In the last part the advantages and the drawbacks of computed thoracic radiography are emphasized. The most important are the almost constant good quality of the pictures and the possibilities of image processing.

  19. Thoracic radiology in kidney and liver transplantation. (United States)

    Fishman, Joel E; Rabkin, John M


    Renal transplantation accounts for more than half of all solid organ transplants performed in the U.S., and the liver is the second most commonly transplanted solid organ. Although abdominal imaging procedures are commonplace in these patients, there has been relatively little attention paid to thoracic imaging applications. Preoperative imaging is crucial to aid in the exclusion of infectious or malignant disease. In the perioperative time period, thoracic imaging focuses both on standard intensive care unit care, including monitoring devices and their complications, and on the early infections that can occur. Postoperative management is divided into three time periods, and the principles governing the occurrence of infections and malignancies are reviewed. Anatomic and pathologic aspects unique to kidney and liver transplantation patients are also discussed.

  20. Palpation of the upper thoracic spine

    DEFF Research Database (Denmark)

    Christensen, Henrik Wulff; Vach, Werner; Vach, Kirstin;


    procedure. RESULTS: Using an "expanded" definition of agreement that accepts small inaccuracies (+/-1 segment) in the numbering of spinal segments, we found--based on the pooled data from the thoracic spine--kappa values of 0.59 to 0.77 for the hour-to-hour and the day-to-day intraobserver reliability......OBJECTIVE: To assess the intraobserver reliability (in terms of hour-to-hour and day-to-day reliability) and the interobserver reliability with 3 palpation procedures for the detection of spinal biomechanic dysfunction in the upper 8 segments of the thoracic spine. DESIGN: A repeated....... INTERVENTION: Three types of palpation were performed: Sitting motion palpation and prone motion palpation for biomechanic dysfunction and paraspinal palpation for tenderness. Each dimension was rated as "absent" or "present" for each segment. All examinations were performed according to a standard written...

  1. [Thoracic ectopia cordis with tetralogy of fallot]. (United States)

    Ben Khalfallah, A; Annabi, N; Ousji, M; Hadrich, M; Najai, A


    Ectopia cordis; very rare congenital malformation, characterized by an evisceration of the heart through a parietal defect. The thoracic localization is most frequent. We report the case of a full term baby girl without follow-up of the pregnancy, presenting a beating mass in thoracic position, expansive to the effort, covered by a translucent membrane corresponding to an ectopique position of the heart. Transthoracic echocardiography shows cardiac malformation: Fallot tetralogy. The precocious diagnosis is possible by prenatal ultrasound examination after 12th week of pregnancy. The surgical treatment remain the only hope for these neonates. It's results depends on the associated malformations and the neonatal complications especially the infections. The prognosis remains poor in spite of the progress of surgical techniques.

  2. Myelopathy with syringomyelia following thoracic epidural anaesthesia. (United States)

    Aldrete, J A; Ferrari, H


    Under general anaesthesia and muscle relaxation, a thoracic epidural catheter was inserted at the T8-T9 level in a 7-year-old boy scheduled to have a Nissen fundoplication to provide postoperative analgesia. After 4 ml of lignocaine 1.5% was injected through the catheter, hypotension resulted. Fifty-five minutes later 5 ml of bupivacaine 0.25% produced the same effect. In the recovery room a similar injection resulted in lower blood pressure and temporary apnoea. Sensory and motor deficits were noted the next day and four days later magnetic resonance imaging demonstrated spinal cord syringomyelia extending from T5 to T10. Four years later, dysaesthesia from T6 to T10 weakness of the left lower extremity and bladder and bowel dysfunction persist. The risks of inserting thoracic epidural catheters in patients under general anaesthesia and muscle relaxation are discussed, emphasising the possibility of spinal cord injury with disastrous consequences.

  3. An official American Thoracic Society workshop report

    DEFF Research Database (Denmark)

    Rosenfeld, Margaret; Allen, Julian; Arets, Bert H G M


    Although pulmonary function testing plays a key role in the diagnosis and management of chronic pulmonary conditions in children under 6 years of age, objective physiologic assessment is limited in the clinical care of infants and children less than 6 years old, due to the challenges of measuring...... lung function in this age range. Ongoing research in lung function testing in infants, toddlers, and preschoolers has resulted in techniques that show promise as safe, feasible, and potentially clinically useful tests. Official American Thoracic Society workshops were convened in 2009 and 2010...... to review six lung function tests based on a comprehensive review of the literature (infant raised-volume rapid thoracic compression and plethysmography, preschool spirometry, specific airway resistance, forced oscillation, the interrupter technique, and multiple-breath washout). In these proceedings...

  4. Comminuted fracture of the thoracic spine.

    LENUS (Irish Health Repository)

    Cashman, J P


    BACKGROUND: Road deaths fell initially after the introduction of the penalty points but despite this, the rate of spinal injuries remained unchanged. AIMS: We report a patient with a dramatic spinal injury, though without neurological deficit. We discuss the classification, management and economic impact of these injuries. METHODS: We describe the management of a patient with a comminuted thoracic spinal fracture without neurological injury. We conducted a literature review with regard to the availability of literature of the management of these injuries. RESULTS: This 17-year-old female was managed surgically and had a good functional outcome. There is no clear consensus in the published literature on the management of these injuries. CONCLUSIONS: Comminuted thoracic spinal factures are potentially devastating. Such a patient presents challenges in determining the appropriate treatment.

  5. Incidental Cardiac Findings on Thoracic Imaging.

    LENUS (Irish Health Repository)

    Kok, Hong Kuan


    The cardiac structures are well seen on nongated thoracic computed tomography studies in the investigation and follow-up of cardiopulmonary disease. A wide variety of findings can be incidentally picked up on careful evaluation of the pericardium, cardiac chambers, valves, and great vessels. Some of these findings may represent benign variants, whereas others may have more profound clinical importance. Furthermore, the expansion of interventional and surgical practice has led to the development and placement of new cardiac stents, implantable pacemaker devices, and prosthetic valves with which the practicing radiologist should be familiar. We present a collection of common incidental cardiac findings that can be readily identified on thoracic computed tomography studies and briefly discuss their clinical relevance.


    Directory of Open Access Journals (Sweden)

    Aurelia PREDA


    Full Text Available Respiratory reeducation is a way to recover the thoracic contusion. Correcting dyspnea induced by pain, decreases the required postcontuzional recovery time and, therefore, the required social reintegration time. This is achieved an increasing of the pacient life quality, and significant savings of human and material resources: reducing medical and somato-functional recovery costs, reducing the sick leave payment and the work days off to. The „TES” device has been designed in order to improve respiratory reeducation and to recover the thoracic contusion. A study showed that the postcontuzional recovery was significantly increased by using the physical exercises of respiratory reeducation. The „TES” device demonstrated his role in this.

  7. Thoracic Cavernous Lymphangioma Provoking Massive Chyloptysis

    Directory of Open Access Journals (Sweden)

    Robert Ferguson MD


    Full Text Available Chyloptysis is a relatively rare embodiment of disease that encompasses a lengthy differential and provides many diagnostic and therapeutic challenges. Presented here is the case of a young woman with massive chyloptysis due to a thoracic cavernous lymphangioma arising in the peripartum period. The severity of her condition mandated the use of cardiopulmonary bypass to resect her lymphangioma. We believe that the extent of her symptoms, etiology of disease, and surgical management represent a unique scenario in the literature.

  8. Thoracic surgery in India: challenges and opportunities


    Yendamuri, Sai


    India has the dubitable honor of being ranked first in the world with regards to lung disease burden. A good proportion of this disease burden is amenable to surgical treatment. However, patients have limited access to quality thoracic surgical care due to a number of obstacles. This review article summarizes these obstacles and the implied opportunities that exist in this nascent surgical discipline in the world’s second most populous country.

  9. Thoracic surgery in India: challenges and opportunities. (United States)

    Yendamuri, Sai


    India has the dubitable honor of being ranked first in the world with regards to lung disease burden. A good proportion of this disease burden is amenable to surgical treatment. However, patients have limited access to quality thoracic surgical care due to a number of obstacles. This review article summarizes these obstacles and the implied opportunities that exist in this nascent surgical discipline in the world's second most populous country.

  10. Monitoring and improving care in thoracic surgery


    Numan, R.C.


    Quality of Care (QoC) plays a central role in the way healthcare is delivered. In the world of thoracic surgery for lung cancer, surgeons are faced with complex and sometimes high-risk surgical resections on an aging patient population with an increasing incidence of frail physical health. This increasing complexity demands a multidisciplinary approach rearranging pre-, peri- and postoperative care in a way safety, efficiency and high quality are guaranteed. The safety and quality of healthca...

  11. Simple technique for maximal thoracic muscle harvest. (United States)

    Marshall, M Blair; Kaiser, Larry R; Kucharczuk, John C


    We present a modification of technique for standard muscle flap harvest, the placement of cutaneous traction sutures. This technique allows for maximal dissection of the thoracic muscles even through minimal incisions. Through improved exposure and traction, complete dissection of the muscle bed can be performed and the tissue obtained maximized. Because more muscle bulk is obtained with this technique, the need for a second muscle may be prevented.

  12. Chondromyxoid fibroma of two thoracic vertebrae

    Energy Technology Data Exchange (ETDEWEB)

    Bruder, E. [Department of Pathology, University Hospital of Zuerich, Ch-8091 Zuerich (Switzerland); Zanetti, M. [Department of Radiology, University Clinic Balgrist, Zuerich (Switzerland); Boos, N. [Department of Orthopedic Surgery, University Clinic Balgrist, Zuerich (Switzerland); Hochstetter, A.R. von [Department of Pathology, University Hospital, Zuerich (Switzerland)


    We report on a case of chondromyxoid fibroma involving two adjacent thoracic vertebrae with features of aggressive behaviour on radiographs, CT and MRI. Histology revealed typical chondromyxoid fibroma with unusually coarse calcifications. Chondromyxoid fibroma of the spine is rare, and only 30 of these tumours have been reported so far. Involvement of two contiguous vertebral bodies by chondromyxoid fibroma, as reported here, appears exceptional. (orig.) With 5 figs., 29 refs.

  13. [Septic arthritis of thoracic facet joint]. (United States)

    Ben Abdelghani, K; Gérard-Dran, D; Combe, B


    Septic arthritis of the facet joint is a rare condition. We report a case of septic arthritis of both a thoracic facet joint and a wrist. Clinical manifestations were consistent with a spondylodiscitis. Magnetic resonance imaging of the spine demonstrated infection of facet joints of T1 and T2. A surgical biopsy of the wrist isolated a type B streptococcus. The same organism was found in urine culture. The patient had an uneventful recovery on antibiotics.

  14. October 2012 Arizona thoracic society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA


    Full Text Available No abstract available. Article truncated at 150 words. A dinner meeting was held on 10/24/2012 at Scottsdale Shea beginning at 6:30 PM. There were 23 in attendance representing the pulmonary, critical care, sleep, infectious disease, pathology, and radiology communities. An announcement was made that the Colorado Thoracic Society has accepted an invitation to partner with the Arizona and New Mexico Thoracic Societies in the Southwest Journal of Pulmonary and Critical Care Medicine. Discussions continue to be held regarding a combined Arizona Thoracic Society meeting with Tucson either in Casa Grande or electronically. Six cases were presented: Dr. Tim Kuberski, chief of Infectious Disease at Maricopa Medical Center, presented a 48 year old female who had been ill for 2 weeks. A CT of the chest revealed a left lower lobe nodule and a CT of the abdomen showed hydronephrosis and a pelvic mass. Carcinoembryonic antigen (CEA was elevated. All turned out to be coccidioidomycosis on biopsy. CEA decreased …

  15. [Videothoracospy in thoracic trauma and penetrating injuries]. (United States)

    Lang-Lazdunski, L; Chapuis, O; Pons, F; Jancovici, R


    Videothoracoscopy represents a valid and useful approach in some patients with blunt chest trauma or penetrating thoracic injury. This technique has been validated for the treatment of clotted hemothorax or posttraumatic empyema, traumatic chylothorax, traumatic pneumothorax, in patients with hemodynamic stability. Moreover, it is probably the most reliable technique for the diagnosis of diaphragmatic injury. It is also useful for the extraction of intrathoracic projectiles and foreign bodies. This technique might be useful in hemodynamically stable patients with continued bleeding or for the exploration of patients with penetrating injury in the cardiac area, although straightforward data are lacking to confirm those indications. Thoracotomy or median sternotomy remain indicated in patients with hemodynamic instability or those that cannot tolerate lateral decubitus position or one-lung ventilation. Performing video-surgery in the trauma setting require expertise in both video-assisted thoracic surgery and chest trauma management. The contra-indications to videothoracoscopy and indications for converting the procedure to an open thoracotomy should be perfectly known by surgeons performing video-assisted thoracic surgery in the trauma setting. Conversion to thoracotomy or median sternotomy should be performed without delay whenever needed to avoid blood loss and achieve an adequate procedure.

  16. CT findings in severe thoracic sarcoidosis

    Energy Technology Data Exchange (ETDEWEB)

    Hennebicque, Anne-Sophie; Brillet, Pierre-Yves; Moulahi, Hassen; Brauner, Michel W. [UFR Bobigny, Department of Radiology, Federation MARTHA and EA 2363, Bobigny Cedex (France); Nunes, Hilario; Valeyre, Dominique [UFR Bobigny, Department of Pneumology, Federation MARTHA and EA 2363, Bobigny Cedex (France)


    Severe thoracic sarcoidosis includes manifestations with significant clinical and functional impairment and a risk of mortality. Severe thoracic sarcoidosis can take on various clinical presentations and is associated with increased morbidity. The purpose of this article was to describe the CT findings in severe thoracic sarcoidosis and to explain some of their mechanisms. Subacute respiratory insufficiency is a rare and early complication due to a high profusion of pulmonary lesions. Chronic respiratory insufficiency due to pulmonary fibrosis is a frequent and late complication. Three main CT patterns are identified: bronchial distortion, honeycombing and linear opacities. CT can be helpful in diagnosing some mechanisms of central airway obstruction such as bronchial distortion due to pulmonary fibrosis or an extrinsic bronchial compression by enlarged lymph nodes. An intrinsic narrowing of the bronchial wall by endobronchial granulomatous lesions may be suggested by CT when it shows evidence of bronchial mural thickening. Pulmonary hypertension usually occurs in patients with end-stage pulmonary disease and is related to fibrotic destruction of the distal capillary bed and to the resultant chronic hypoxemia. Several other mechanisms may contribute to the development of pulmonary hypertension including extrinsic compression of major pulmonary arteries by enlarged lymph nodes and secondary pulmonary veno-occlusive disease. Aspergilloma colonization of a cavity is the main cause of hemoptysis in sarcoidosis. Other rare causes are bronchiesctasis, necrotizing bronchial aspergillosis, semi-invasive pulmonary aspergillosis, erosion of a pulmonary artery due to a necrotic sarcoidosis lesion, necrosis of parenchymal sarcoidosis lesions and specific endobronchial macroscopic lesions. (orig.)

  17. Imaging of thoracic trauma; Radiologie des Thoraxtraumas

    Energy Technology Data Exchange (ETDEWEB)

    Uffmann, M.; Herold, C.J. [Universitaetsklinik Vienna (Austria). Inst. fuer Radiodiagnostik; Fuchs, M. [Universitaetsklinik Vienna (Austria). Inst. fuer Unfallchirurgie


    Blunt trauma to the chest results from transfer of kinetic energy to the human body. It may cause a wide range of mostly life-threatening injuries, including fractures of the thoracic skeleton, disintegration of the pleural space, contusion or laceration of pulmonary parenchyma and damage to the mediastinal structures. For a systematic approach it may be helpful to follow an organ-based evaluation of thoracic trauma. However, it should be borne in mind that subtle injuries may be associated with serious complications. Trauma to the chest may affect different anatomic compartments at the same time, requiring and extending diagnostic approach. Conventional radiography plays a major role in diagnosting thoracic trauma, complemented by ultrasound examination of the pleura and abdomen. It is well documented that CT scanning represents a major technological improvement for assessment of thoracic trauma. With the advent of fast helical CT scanning this method becomes more applicable for severly traumatized patients and potentially replaces other time-consuming procedures. State-of-the-art imaging of both projection and cross-sectional techniques provides useful information for immediate and appropriate treatment mandatory in patients with thoracic trauma. (orig.) [Deutsch] Das Trauma des Thorax ist Folge einer erheblichen, meist stumpfen Gewalteinwirkung auf den Brustkorb und geht mit einem weiten Spektrum an groesstenteils lebendsbedrohlichen Organverletzungen einher. Aus Gruenden der Uebersichtlichkeit koennen die thorakalen Verletzungen in solche des Skeletts, der Pleura, der Lungen und der mediastinalen Strukturen eingeteilt werden. Haeufig besteht jedoch eine enge Verzahnung der Pathologien, und einzelne Symptome koennen Indikatoren fuer weitere, schwerwiegende Verletzungen sein. Darueber hinaus sind extrathorakale Koerperpartien und Organsysteme oftmals mitbetroffen, so dass eine umfassende diagnostische Strategie angewendet werden muss. Die schnelle Erstversorgung

  18. Current Trend of Robotic Thoracic and Cardiovascular Surgeries in Korea: Analysis of Seven-Year National Data (United States)

    Kang, Chang Hyun; Bok, Jin San; Lee, Na Rae; Kim, Young Tae; Lee, Seon Heui; Lim, Cheong


    Background Robotic surgery is an alternative to minimally invasive surgery. The aim of this study was to report on current trends in robotic thoracic and cardiovascular surgical techniques in Korea. Methods Data from the National Evidence-based Healthcare Collaborating Agency (NECA) between January 2006 and June 2012 were used in this study, including a total of 932 cases of robotic surgeries reported to NECA. The annual trends in the case volume, indications for robotic surgery, and distribution by hospitals and surgeons were analyzed in this study. Results Of the 932 cases, 591 (63%) were thoracic operations and 340 (37%) were cardiac operations. The case number increased explosively in 2007 and 2008. However, the rate of increase regained a steady state after 2011. The main indications for robotic thoracic surgery were pulmonary disease (n=271, 46%), esophageal disease (n=199, 34%), and mediastinal disease (n=117, 20%). The main indications for robotic cardiac surgery were valvular heart disease (n=228, 67%), atrial septal defect (n=79, 23%), and cardiac myxoma (n=27, 8%). Robotic thoracic and cardiovascular surgeries were performed in 19 hospitals. Three large volume hospitals performed 94% of the case volume of robotic cardiac surgery and 74% of robotic thoracic surgery. Centralization of robotic operation was significantly (probotic surgeries. However, only 27% of cardiac surgeons and 23% of thoracic surgeons performed more than 10 cases of robotic surgery. Conclusion Trend analysis of robotic and cardiovascular operations demonstrated a gradual increase in the surgical volume in Korea. Meanwhile, centralization of surgical cases toward specific surgeons in specific hospitals was observed. PMID:26509124

  19. Bathymetry and absorbitivity of Titan's Ontario Lacus (United States)

    Hayes, A.G.; Wolf, A.S.; Aharonson, O.; Zebker, H.; Lorenz, R.; Kirk, R.L.; Paillou, P.; Lunine, J.; Wye, L.; Callahan, P.; Wall, S.; Elachi, C.


    Ontario Lacus is the largest and best characterized lake in Titan's south polar region. In June and July 2009, the Cassini RADAR acquired its first Synthetic Aperture Radar (SAR) images of the area. Together with closest approach altimetry acquired in December 2008, these observations provide a unique opportunity to study the lake's nearshore bathymetry and complex refractive properties. Average radar backscatter is observed to decrease exponentially with distance from the local shoreline. This behavior is consistent with attenuation through a deepening layer of liquid and, if local topography is known, can be used to derive absorptive dielectric properties. Accordingly, we estimate nearshore topography from a radar altimetry profile that intersects the shoreline on the East and West sides of the lake. We then analyze SAR backscatter in these regions to determine the imaginary component of the liquid's complex index of refraction (Kappa). The derived value, Kappa = (6.1-1.3+1.7) x 10-4, corresponds to a loss tangent of tan Delta = (9.2-2.0+2.5) x 10-4 and is consistent with a composition dominated by liquid hydrocarbons. This value can be used to test compositional models once the microwave optical properties of candidate materials have been measured. In areas that do not intersect altimetry profiles, relative slopes can be calculated assuming the index of refraction is constant throughout the liquid. Accordingly, we construct a coarse bathymetry map for the nearshore region by measuring bathymetric slopes for eleven additional areas around the lake. These slopes vary by a factor of ~5 and correlate well with observed shoreline morphologies.

  20. Parental perceptions of school-based influenza immunisation in Ontario, Canada: a qualitative study


    MacDougall, Donna; Crowe, Lois; Jennifer A Pereira; Kwong, Jeffrey C.; Quach, Susan; Wormsbecker, Anne E; Ramsay, Hilary; Salvadori, Marina I; Russell, Margaret L; ,


    Objective To understand the perspectives of Ontario parents regarding the advantages and disadvantages of adding influenza immunisation to the currently existing Ontario school-based immunisation programmes. Design Descriptive qualitative study. Participants Parents of school-age children in Ontario, Canada, who were recruited using a variety of electronic strategies (social media, emails and media releases), and identified as eligible (Ontario resident, parent of one or more school-age child...

  1. Thoracic fistulas of the pancreas and their complications in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Fritsch, R.; Schirg, E.; Buerger, D.


    The article reports on two thoracic fistulas of the pancreas in infants. Anamnesis revealed that recurring abdominal pain had occured in those children for years; at the time of their admission to hospital there was considerable dyspnoea with thoracic pain depending on the respiration. Fistulas of the pancreas with thoracic connection were identified as the cause. The article goes into the details of genesis, differential diagnosis and course of the disease.

  2. Neurotoxic behavioral effects of Lake Ontario salmon diets in rats

    Energy Technology Data Exchange (ETDEWEB)

    Hertzler, D.R. (State Univ. of New York, Oswego (USA))


    Six experiments were conducted to examine possible neurotoxic effects of the exposure to contaminants in Lake Ontario salmon administered through the diets of rats. Rats were fed different concentrations of fish (8%, 15% or 30%) in one of three diet conditions: Lake Ontario salmon, Pacific Ocean salmon, or laboratory rat chow only. Following 20 days on the diets, rats were tested for five minutes per day in a modified open field for one or three days. Lake Ontario salmon diets consistently produced significantly lower activity, rearing, and nosepoke behaviors in comparison with ocean salmon or rat chow diet conditions. A dose-response effect for concentration of lake salmon was obtained, and the attenuation effect occurred in males, females, adult or young animals, and postweaning females, with fish sampled over a five-year period. While only two of several potential contaminants were tested, both fish and brain analyses of mirex and PCBs relate to the behavioral effects.

  3. Standards for provision and accreditation of echocardiography in Ontario. (United States)

    Sanfilippo, Anthony J; Chan, Kwan L; Hughes, William G; Kingsbury, Kori J; Leong-Poi, Howard; Sasson, Zion; Wald, Robert


    In March of 2010, the Ontario Ministry of Health and Long-term Care and Ontario Medical Association jointly commissioned a Working Group to make recommendations regarding the provision and accreditation of echocardiographic services in Ontario. That commission undertook a process to examine all aspects of the provision, reporting and interpretation of echocardiographic examinations, including the echocardiographic examination itself, facilities, equipment, reporting, indications, and qualifications of personnel involved in the acquisition and interpretation of studies. The result was development of a set of 54 performance standards and a process for accreditation of echocardiographic facilities, initially on a voluntary basis, but leading to a process of mandatory accreditation. This article, and its accompanying Supplemental Material, outline the mandate, process undertaken, standards developed, and accreditation process recommended.

  4. [Inadvertent thoracic duct puncture during right axially central venous cannulation]. (United States)

    Kawashima, Shingo; Itagaki, Taiga; Adachi, Yushi; Ishii, Yasuhiro; Taniguchi, Midzuki; Doi, Matsuyuki; Sato, Shigehito


    A case of inadvertent thoracic duct puncture during right axially central venous cannulation is reported. The catheterization was performed under the real time ultrasound guidance technique and the coronal view image was continuously displayed. After confirming the feelings of venous puncture, clear yellow fluid was aspired into the connected syringe to the needle. Initially, an accidental thoracic puncture with subsequent pleural fluid aspiration was suspected;however, no finding of pleural effusion was observed with ultrasound imaging and computed tomography. Thus, an accidental thoracic duct puncture and the subsequent lymph fluid aspiration were suspected. Even in a right side approach for central venous catheterization, thoracic duct injury might ensure.

  5. The Financial Position of Universities in Ontario: 1986. Report 86-2. (United States)

    Council of Ontario Universities, Toronto. Research Div.

    Data on the financial position of Ontario's universities are provided. Statistical tables and graphs cover: expenditures per client served, 1977-1985; percentage increase in provincial operating grants and total budgetary expenditures, 1977-1986; Ontario Universities' share of provincial budgetary expenditures; growth of Ontario Gross Domestic…

  6. The Price of Restraint. Brief to the Ontario Council on University Affairs. (United States)

    Council of Ontario Universities, Toronto. Committee on Operating Grants.

    The Council of Ontario Universities' 1978 brief on operating support is presented. Section I compares funding recommendations for 1978-79 put forward by the Council on Ontario Universities (COU) and the Ontario Council on University Affairs (OCUS) with the provisions made for that year by the Minister of College and Universities (MCU). Section 2…

  7. Exploring the Gap between Teacher Certification and Permanent Employment in Ontario: An Integrative Literature Review (United States)

    Brock, Allison; Ryan, Thomas G.


    The following integrative literature review illuminates the perceptible time gap that currently exists for new Ontario teachers graduating and moving from teacher preparation programs to permanent members of the Ontario teaching community. At a time of oversupply of teachers, many new teachers within Ontario and beyond its borders become…

  8. Ascending and Descending into the System: A Comparison of Broadcasting Media Programs in Ontario Colleges (United States)

    Sianos, Helen


    In 2013 the Ontario Ministry of Training, Colleges and Universities released Ontario's Differentiation Policy Framework for Postsecondary Education, for colleges and universities in the province. All 24 Ontario colleges responded to this Framework by presenting their Strategic Mandate Agreements (SMA). The Framework contrasts the original…

  9. 77 FR 30451 - Safety Zone; Olcott Fireworks, Lake Ontario, Olcott, NY (United States)


    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Olcott Fireworks, Lake Ontario, Olcott, NY... establish a temporary safety zone on Lake Ontario, Olcott, NY. This proposed rule is intended to restrict vessels from a portion of Lake Ontario during the Olcott fireworks display. The safety zone established...

  10. The Ontario Curriculum in the Arts and the Creative Economy Agenda (United States)

    D'Andrea, Marisol


    The rhetoric of the creative economy agenda has influenced the revised Ontario curriculum in the arts for grades 9-12. Yet, increasing rhetorical and substantive support for a creative economy agenda in Ontario at large is not sufficiently reflected in the revised Ontario arts curriculum. The expanded agenda is not matched by expanded substantive…

  11. 77 FR 38492 - Safety Zone; Olcott Fireworks, Lake Ontario, Olcott, NY (United States)


    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Olcott Fireworks, Lake Ontario, Olcott, NY... temporary safety zone on Lake Ontario, Olcott, New York. This safety zone is intended to restrict vessels from a portion of Lake Ontario during the Olcott fireworks on July 3, 2012. The safety zone...

  12. Thoracic sympathetic block reduces respiratory system compliance

    Directory of Open Access Journals (Sweden)

    Fábio Ely Martins Benseñor

    Full Text Available CONTEXT AND OBJECTIVE: Thoracic epidural anesthesia (TEA following thoracic surgery presents known analgesic and respiratory benefits. However, intraoperative thoracic sympathetic block may trigger airway hyperreactivity. This study weighed up these beneficial and undesirable effects on intraoperative respiratory mechanics. DESIGN AND SETTING: Randomized, double-blind clinical study at a tertiary public hospital. METHODS: Nineteen patients scheduled for partial lung resection were distributed using a random number table into groups receiving active TEA (15 ml 0.5% bupivacaine, n = 9 or placebo (15 ml 0.9% saline, n = 10 solutions that also contained 1:200,000 epinephrine and 2 mg morphine. Under general anesthesia, flows and airway and esophageal pressures were recorded. Pressure-volume curves, lower inflection points (LIP, resistance and compliance at 10 ml/kg tidal volume were established for respiratory system, chest wall and lungs. Student’s t test was performed, including confidence intervals (CI. RESULTS: Bupivacaine rose 5 ± 1 dermatomes upwards and 6 ± 1 downwards. LIP was higher in the bupivacaine group (6.2 ± 2.3 versus 3.6 ± 0.6 cmH2O, p = 0.016, CI = -3.4 to -1.8. Respiratory system and lung compliance were higher in the placebo group (respectively 73.3 ± 10.6 versus 51.9 ± 15.5, p = 0.003, CI = 19.1 to 23.7; 127.2 ± 31.7 versus 70.2 ± 23.1 ml/cmH2O, p < 0.001, CI = 61 to 53. Resistance and chest wall compliance showed no difference. CONCLUSION: TEA decreased respiratory system compliance by reducing its lung component. Resistance was unaffected. Under TEA, positive end-expiratory pressure and recruitment maneuvers are advisable.

  13. Idiopathic thoracic aortic aneurysm at pediatric age. (United States)

    Marín-Manzano, E; González-de-Olano, D; Haurie-Girelli, J; Herráiz-Sarachaga, J I; Bermúdez-Cañete, R; Tamariz-Martel, A; Cuesta-Gimeno, C; Pérez-de-León, J


    A 6-year-old-boy presented with epigastric pain and vomiting over 1 year. Chest X-ray and esophagogastric transit showed a mediastinal mass. A chest computerized tomography angiogram demonstrated a descending thoracic aortic aneurysm. Analytical determinations carried out were all negative. The aneurysm was surgically repaired using a Dacron patch. The anatomopathological study described atherosclerotic lesions with calcifications, compatible with an atherosclerotic aneurysm wall. Aneurysms are uncommon in the pediatric population. Usually, no pathogenesis can be determined, and thus, such cases are grouped as idiopathic. Direct repair with or without patch is a therapeutic alternative in pediatric aneurysms and can allow the growth of the aortic circumference.

  14. Thoracic Outlet Syndrome Following Breast Implant Rupture

    Directory of Open Access Journals (Sweden)

    Raakhi Mistry, MBChB


    Full Text Available Summary: We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient.

  15. Thoracic outlet syndrome following breast implant rupture. (United States)

    Mistry, Raakhi; Caplash, Yugesh; Giri, Pratyush; Kearney, Daniel; Wagstaff, Marcus


    We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient.

  16. Thoracic ectopia cordis with anatomically normal heart. (United States)

    Gonçalves, Flávio Donizete; Novaes, Fernando Rotatori; Maia, Marcelo Alves; Barros, Francisco de Assis


    Ectopia cordis is a rare congenital malformation, which is commonly associated with other intracardiac defects. At two-day-old full-term baby girl was admitted to Santa Casade Misericórdia Hospital Montes Claros, NG, Brazil, with thoracic ectopia cordis. A transthoracic echocardiographic study did not identify any associated congenital heart diseases. The infant underwent surgical treatment using a rib graft to create a neo-sternum. She was discharged after presenting a good outcome on the 20th postoperative day.

  17. Digital subtraction angiography of the thoracic aorta

    Energy Technology Data Exchange (ETDEWEB)

    Grossman, L.B.; Buonocore, E.; Modic, M.T.; Meaney, T.F.


    Forty-three patients with acquired and congenital abnormalities of the thoracic aorta were studied using digital subtraction angiography (DSA) after an intravenous bolus injection of 40 ml of contrast material. Abnormalities studied included coarctation, pseudocoarctation, Marfan syndrome, cervical aorta, double aortic arch, aneurysm, dissection, and tumor. Twenty-four patients also had conventional angiography. DSA was accurate in 95% of cases; in the other 5%, involving patients with acute type I dissection, the coronary arteries could not be seen. The authors concluded that in 92% of their patients, DSA could have replaced the standard aortogram.

  18. Operativ behandling af thoracic outlet syndrome

    DEFF Research Database (Denmark)

    Birkeland, Peter; Stiasny, Jerzy


    of the brachial plexus. At surgery, we found and severed a fibrous band that compressed the inferior trunk. Postoperatively, the pain subsided and fine hand movements improved. One patient had no cervical rib, however, in the two other cases we found rudimentary cervical ribs. Magnetic resonance imaging......We present three cases with longstanding true neurogenic thoracic outlet syndrome. All patients had aching pain in the shoulder, arm and ulnar border of the hand. On examination, we found atrophy of the hand muscles. Electromyography revealed signs of compromised function of the inferior trunk...

  19. Video-Assisted Thoracic Sympathectomy for Hyperhidrosis. (United States)

    Milanez de Campos, Jose Ribas; Kauffman, Paulo; Gomes, Oswaldo; Wolosker, Nelson


    By the 1980s, endoscopy was in use by some groups in sympathetic denervation of the upper limbs with vascular indications. Low morbidity, cosmetic results, reduction in the incidence of Horner syndrome, and the shortened time in hospital made video-assisted thoracic sympathectomy (VATS) better accepted by those undergoing treatment for hyperhidrosis. Over the last 25 years, this surgical procedure has become routine in the treatment of hyperhidrosis, leading to a significant increase in the number of papers on the subject in the literature.

  20. Tidy Minds, Untidy Solutions: University Organization in Ontario. (United States)

    Smith, J. Percy


    The Ontario Council of University Affairs was established to counsel the provincial government concerning higher education and to act as a buffer between institutions and government. However, with no statutory authority, its advice has been largely ignored or rejected. A 1983 commission to rectify the situation has not succeeded. (MSE)

  1. Constructing Bullying in Ontario, Canada: A Critical Policy Analysis (United States)

    Winton, Sue; Tuters, Stephanie


    As the prevalence and negative effects of bullying become widely known, people around the world seem desperate to solve the bullying "problem". A sizeable body of research about many aspects of bullying and a plethora of anti-bullying programmes and policies now exist. This critical policy analysis asks: how does Ontario, Canada's…

  2. Administrators' Views on Teacher Evaluation: Examining Ontario's Teacher Performance Appraisal (United States)

    Maharaj, Sachin


    This study examines the views of administrators (i.e., principals and vice-principals) in Ontario, Canada, with regard to the province's Teacher Performance Appraisal process. A total of 178 responses were collected from a survey that examined five areas: 1) preparation and training; 2) classroom observations; 3) preparing the formal evaluation;…

  3. Shared Geospatial Metadata Repository for Ontario University Libraries: Collaborative Approaches (United States)

    Forward, Erin; Leahey, Amber; Trimble, Leanne


    Successfully providing access to special collections of digital geospatial data in academic libraries relies upon complete and accurate metadata. Creating and maintaining metadata using specialized standards is a formidable challenge for libraries. The Ontario Council of University Libraries' Scholars GeoPortal project, which created a shared…

  4. Prevalence of Problematic Video Gaming among Ontario Adolescents (United States)

    Turner, Nigel E.; Paglia-Boak, Angela; Ballon, Bruce; Cheung, Joyce T. W.; Adlaf, Edward M.; Henderson, Joanna; Chan, Vincy; Rehm, Jurgen; Hamilton, Hayley; Mann, Robert E.


    Video game playing has become a very popular activity among adolescents. Its impact on the mental health and well-being of players is just beginning to be explored. This paper reports on the prevalence of problematic gaming in a representative sample of 2,832 Ontario students in grades 7 to 12. The survey included questions about the school grade,…

  5. Institutional Diversity in Ontario's University Sector: A Policy Debate Analysis (United States)

    Piché, Pierre G.; Jones, Glen A.


    In order to meet the demands in a cost-effective manner of an emerging knowledge society that is global in scope, structural higher education policy changes have been introduced in many countries with a focus on systemic and programmatic diversity. There has been an ongoing debate about institutional diversity in Ontario higher education,…

  6. Implications of Key Performance Indicator Issues in Ontario Universities Explored (United States)

    Chan, Vivian


    Since 1998, the Ministry of Training, Colleges and Universities in Ontario, Canada, has required that data on specific key performance indicators (KPIs) be made public by its publicly funded universities. The information is intended to be used by universities to demonstrate their achievements, to improve their programmes and services, and to…

  7. Constructing Bullying in Ontario, Canada: A Critical Policy Analysis (United States)

    Winton, Sue; Tuters, Stephanie


    As the prevalence and negative effects of bullying become widely known, people around the world seem desperate to solve the bullying "problem". A sizeable body of research about many aspects of bullying and a plethora of anti-bullying programmes and policies now exist. This critical policy analysis asks: how does Ontario, Canada's…

  8. Omitted Costs, Inflated Benefits: Renewable Energy Policy in Ontario (United States)

    Gallant, Parker; Fox, Glenn


    The government of Ontario has adopted wind energy development as an alternative energy source. It enacted the Green Energy and Economy Act, May 2009, with the intention to fast track the approval process regarding industrial wind turbines. The Act legislated a centralized decision making process while removing local jurisdictional authority.…

  9. Provoking Dialogue: A Short History of Outdoor Education in Ontario (United States)

    Borland, James


    History helps educators more clearly describe the role of outdoor education in improving society by fostering awareness of human-nature interconnections. Five branches have shaped outdoor education in Ontario: (1) agricultural education; (2) environmental education; (3) outdoor adventure education; (4) ecological education; and (5) climate change…

  10. How Ontario Spread Successful Practices across 5,000 Schools (United States)

    Glaze, Avis


    Ontario embraced a provincial lead improvement plan that was designed to improve its 5,000 schools by focusing on literacy and numeracy, improving high school graduation, and improving public support for education. Its primary strategy was developing networks of educators and building their capacity for growth.

  11. Lake Ontario: Nearshore Conditions and Variability in Water Quality Parameters (United States)

    Interest in recent years has increased regarding conditions in the nearshore of the Great Lakes. We conducted a high-resolution survey of the Lake Ontario nearshore along the 20 m contour using towed electronic instrumentation. The 720 km survey was conducted September 6-10, 20...

  12. Financial Literacy in Ontario: Neoliberalism, Pierre Bourdieu and the Citizen (United States)

    Arthur, Chris


    Utilizing concepts from Pierre Bourdieu I argue that the implementation of financial literacy education in Ontario public schools will, if uncontested, support a neoliberal consumer habitus (subjectivity) at the expense of the critical citizen. This internalization of the neoliberal ethos assists state efforts to shift responsibility for…

  13. Lung cancer screening and video-assisted thoracic surgery

    DEFF Research Database (Denmark)

    Petersen, René Horsleben; Hansen, Henrik Jessen; Dirksen, Asger;


    The objective of this study is to report the impact of computed tomography (CT) screening on the use of Video-Assisted Thoracic Surgery (VATS) in a randomized screening trial.......The objective of this study is to report the impact of computed tomography (CT) screening on the use of Video-Assisted Thoracic Surgery (VATS) in a randomized screening trial....

  14. Surface anatomy and surface landmarks for thoracic surgery: Part II. (United States)

    Smith, Shona E; Darling, Gail E


    Surface anatomy is an integral part of a thoracic surgeon's armamentarium to assist with the diagnosis, staging, and treatment of thoracic pathology. As reviewed in this article, the surface landmarks of the lungs, heart, great vessels, and mediastinum are critical for appropriate patient care and should be learned in conjunction with classic anatomy.

  15. Depth of the thoracic epidural space in children.

    NARCIS (Netherlands)

    Masir, F.; Driessen, J.J.; Thies, K.C.; Wijnen, M.H.W.A.; Egmond, J. van


    Thoracic epidural anaesthesia in anaesthetized children requires a meticulous technique and may have an increased success rate when the distance between skin and epidural space is known. The objective of this observational study was to measure the skin to epidural distance (SED) during thoracic epid

  16. Video-Assisted Thoracic Surgery in Spontaneous Pneumothorax

    Directory of Open Access Journals (Sweden)

    Calvin SH Ng


    Full Text Available The proven safety and efficacy of minimal access video-assisted thoracic surgery has changed the way that spontaneous pneumothorax is managed. This review presents some of the experiences of the decade, discusses the controversies and reviews the current video-assisted thoracic surgical management of spontaneous pneumothorax.

  17. Pathology of the thoracic wall: congenital and acquired

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Pena, Pilar; Barber, Ignasi [Hospital Materno-Infantil, Pediatric Radiology, Barcelona (Spain)


    This review aims to cover the main congenital and acquired lesions that arise in the thoracic wall of infants and children. Imaging often plays an essential role in the evaluation of symptomatic and asymptomatic thoracic wall abnormalities. The use of appropriate imaging modalities for each condition will be addressed, as well as the range of benign and malignant conditions that can occur. (orig.)

  18. Outcomes of Endovascular Repair of Ruptured Descending Thoracic Aortic Aneurysms

    NARCIS (Netherlands)

    Jonker, Frederik H. W.; Verhagen, Hence J. M.; Lin, Peter H.; Heijmen, Robin H.; Trimarchi, Santi; Lee, W. Anthony; Moll, Frans L.; Athamneh, Husam; Muhs, Bart E.


    Background-Thoracic endovascular aortic repair offers a less invasive approach for the treatment of ruptured descending thoracic aortic aneurysms (rDTAA). Due to the low incidence of this life-threatening condition, little is known about the outcomes of endovascular repair of rDTAA and the factors t

  19. Outcomes of endovascular repair of ruptured descending thoracic aortic aneurysms

    NARCIS (Netherlands)

    F.H.W. Jonker; H.J.M. Verhagen (Hence); P.H. Lin (Peter); R.H. Heijmen (Robin); S. Trimarchi (Santi); W.A. Lee (Anthony); F.L. Moll (Frans); H. Athamneh (Husam); B.E. Muhs (Bart)


    textabstractBackground-: Thoracic endovascular aortic repair offers a less invasive approach for the treatment of ruptured descending thoracic aortic aneurysms (rDTAA). Due to the low incidence of this life-threatening condition, little is known about the outcomes of endovascular repair of rDTAA and

  20. Thoracic sympathectomy for digital ischemia : A summary of evidence

    NARCIS (Netherlands)

    Coveliers, Hans M. E.; Hoexum, Frank; Nederhoed, Johanna H.; Wisselink, Willem; Rauwerda, Jan A.


    Background: Thoracic sympathectomy is used in the management of a variety of upper limb disorders. We have analyzed the evidence for thoracic sympathectomy in the management of digital ischemia. Methods: We reviewed the English literature between 1980 and 2010. Our analysis included reports with the

  1. Thoracic Ganglioneuromas Resulting in Nonimmune Hydrops Fetalis

    Directory of Open Access Journals (Sweden)

    Paul Singh


    Full Text Available Introduction - Most often, ganglioneuromas affect older pediatric and adult patients. They are typically slow growing tumors that remain clinically silent until they become large enough to cause symptoms by compression of adjacent structures. Case - We report a case of a 22-year-old Hispanic gravida 2 para 1 female patient who was found to have massive hydrops fetalis at 20 completed gestational weeks. Fetal echocardiography revealed a narrowed distal ductal arch and proximal descending aorta. Cesarean delivery was undertaken at 29 completed gestational weeks for refractory labor and nonreassuring fetal status. The neonate expired at 47 minutes of life despite aggressive resuscitation. At autopsy, multiple thoracic masses were found adjacent to a compressed proximal descending aorta. Histological and immunohistochemical analysis confirmed the diagnosis of a ganglioneuroma, a rare type of neural crest tumor. Discussion - A variety of intrathoracic masses have previously been reported to cause hydrops fetalis including teratomas, fibrosarcomas, and lymphangiomas. To our knowledge, this case is the first description of hydrops fetalis caused by ganglioneuromas. We propose that multiple thoracic ganglioneuromas led to biventricular distal outflow tract obstruction and hydrops fetalis.

  2. Surgical efficacy of minimally invasive thoracic discectomy. (United States)

    Elhadi, Ali M; Zehri, Aqib H; Zaidi, Hasan A; Almefty, Kaith K; Preul, Mark C; Theodore, Nicholas; Dickman, Curtis A


    We aimed to determine the clinical indications and surgical outcomes for thoracoscopic discectomy. Thoracic disc disease is a rare degenerative process. Thoracoscopic approaches serve to minimize tissue injury during the approach, but critics argue that this comes at the cost of surgical efficacy. Current reports in the literature are limited to small institutional patient series. We systematically identified all English language articles on thoracoscopic discectomy with at least two patients, published from 1994 to 2013 on MEDLINE, Science Direct, and Google Scholar. We analyzed 12 articles that met the inclusion criteria, five prospective and seven retrospective studies comprising 545 surgical patients. The overall complication rate was 24% (n=129), with reported complications ranging from intercostal neuralgia (6.1%), atelectasis (2.8%), and pleural effusion (2.6%), to more severe complications such as pneumonia (0.8%), pneumothorax (1.3%), and venous thrombosis (0.2%). The average reported postoperative follow-up was 20.5 months. Complete resolution of symptoms was reported in 79% of patients, improvement with residual symptoms in 10.2%, no change in 9.6%, and worsening in 1.2%. The minimally invasive endoscopic approaches to the thoracic spine among selected patients demonstrate excellent clinical efficacy and acceptable complication rates, comparable to the open approaches. Disc herniations confined to a single level, with small or no calcifications, are ideal for such an approach, whereas patients with calcified discs adherent to the dura would benefit from an open approach.

  3. May 2013 Arizona Thoracic Society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA


    Full Text Available No abstract available. Article truncated at 150 words. A dinner meeting was held on Wednesday, 5/15/2013 at Scottsdale Shea beginning at 6:30 PM. There were 13 in attendance representing the pulmonary, critical care, sleep, thoracic surgery, and radiology communities. Dr. George Parides will have served his 2 year tenure as Arizona Thoracic Society President by July, 2013. However, he will be unable to attend the June meeting and for this reason Presidential elections were held. Dr. Lewis Wesselius was nominated and unanimously elected as President. Three cases were presented:1. Dr. Gerald Schwartzberg presented the case of a 49 year old woman with a history of Valley Fever in 2009. She was a nonsmoker and had no other known medical diseases. However, she developed shortness of breath beginning earlier this year along with a cough productive of clear, jelly-like sputum. Her physical was normal. Pulmonary function testing revealed restrictive disease with significant improvements in the FEV1 and FVC …

  4. Video-Assisted Thoracic Surgery Study Group. (United States)

    LoCicero, J


    Both patients and the medical profession are quick to embrace new technology, particularly when it may replace an existing surgical procedure. Unfortunately, the rapidity of acceptance is rarely associated with careful evaluation. Laparoscopy is a recent example of such widely embraced technology. Studies of laparoscopy that yielded good comparative data to more traditional methods were slow to accrue. This led to the exposure of its shortcomings through governmental reports and the lay press. To prevent this from happening in thoracoscopy, two types of studies are required so that valid conclusions about the new technology can be drawn. The first is an accounting of the new technology as procedures evolve around it. The data collected in such a study should contain basic information, including the indications for the procedure, how it was performed, procedure length, associated complications, and patient outcome. Such information provides a broad profile of the technology, emphasizing from the outset its potential strengths and weaknesses. The second type of study involves a more detailed concurrent comparison of the specific procedures utilizing this technology to the established traditional methods. Such randomized studies help to firmly establish through scientific process the place of the new technology. The Video-Assisted Thoracic Surgery Study Group was organized in early 1992 to address these concerns. From an initial four surgeons the group has grown to include more than 41 institutions. Currently the group is collecting data in a registry and has established three clinical trials to evaluate video-assisted thoracic surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Reliable positioning in a sparse GPS network, eastern Ontario (United States)

    Samadi Alinia, H.; Tiampo, K.; Atkinson, G. M.


    Canada hosts two regions that are prone to large earthquakes: western British Columbia, and the St. Lawrence River region in eastern Canada. Although eastern Ontario is not as seismically active as other areas of eastern Canada, such as the Charlevoix/Ottawa Valley seismic zone, it experiences ongoing moderate seismicity. In historic times, potentially damaging events have occurred in New York State (Attica, 1929, M=5.7; Plattsburg, 2002, M=5.0), north-central Ontario (Temiskaming, 1935, M=6.2; North Bay, 2000, M=5.0), eastern Ontario (Cornwall, 1944, M=5.8), Georgian Bay (2005, MN=4.3), and western Quebec (Val-Des-Bois,2010, M=5.0, MN=5.8). In eastern Canada, the analysis of detailed, high-precision measurements of surface deformation is a key component in our efforts to better characterize the associated seismic hazard. The data from precise, continuous GPS stations is necessary to adequately characterize surface velocities from which patterns and rates of stress accumulation on faults can be estimated (Mazzotti and Adams, 2005; Mazzotti et al., 2005). Monitoring of these displacements requires employing high accuracy GPS positioning techniques. Detailed strain measurements can determine whether the regional strain everywhere is commensurate with a large event occurring every few hundred years anywhere within this general area or whether large earthquakes are limited to specific areas (Adams and Halchuck, 2003; Mazzotti and Adams, 2005). In many parts of southeastern Ontario and western Québec, GPS stations are distributed quite sparsely, with spacings of approximately 100 km or more. The challenge is to provide accurate solutions for these sparse networks with an approach that is capable of achieving high-accuracy positioning. Here, various reduction techniques are applied to a sparse network installed with the Southern Ontario Seismic Network in eastern Ontario. Recent developments include the implementation of precise point positioning processing on acquired

  6. Women in Thoracic Surgery: 30 Years of History. (United States)

    Antonoff, Mara B; David, Elizabeth A; Donington, Jessica S; Colson, Yolonda L; Litle, Virginia R; Lawton, Jennifer S; Burgess, Nora L


    Women in Thoracic Surgery was founded in 1986, with 2016 marking its 30th anniversary. Reflecting back on the last 3 decades of history, accomplishments, and enormous strides in our field, we review the past, present, and future of this organization. Although women still constitute a small minority of practicing surgeons in our field today, opportunities currently abound for women in thoracic surgery. Owing much to the early female pioneers in the field and to the support of male sponsors and our national societies, Women in Thoracic Surgery has grown and prospered, as have its members and the global community of female thoracic surgeons as a whole. In celebration of our 30th anniversary, we share with the readership the rich history of Women in Thoracic Surgery and its goals for the future.

  7. A retrospective economic analysis of the Ontario red fox oral rabies vaccination programme. (United States)

    Shwiff, S A; Nunan, C P; Kirkpatrick, K N; Shwiff, S S


    Ontario initiated a red fox (Vulpes vulpes) oral rabies vaccination (ORV) programme in 1989. This study utilized a benefit-cost analysis to determine if this ORV programme was economically worthwhile. Between 1979 and 1989, prior to ORV baiting, the average annual human post-exposure treatments, positive red fox rabies diagnostic tests and indemnity payments for livestock lost to rabies were 2248, 1861 and $246,809, respectively. After baiting, from 1990 to 2000, a 35%, 66% and 41% decrease in post-exposure treatments, animal rabies tests and indemnity payments was observed, respectively. These reductions were viewed as benefits of the ORV programme, whereas total costs were those associated with ORV baiting. Multiple techniques were used to estimate four different benefit streams and the total estimated benefits ranged from $35,486,316 to $98,413,217. The annual mean ORV programme cost was $6,447,720, with total programme costs of $77,372,637. The average benefit-cost ratios over the analysis period were .49, 1.06, 1.27 and 1.36, indicating overall programme efficiency in three of the four conservative scenarios.

  8. The impact of infection on population health: results of the Ontario burden of infectious diseases study.

    Directory of Open Access Journals (Sweden)

    Jeffrey C Kwong

    Full Text Available BACKGROUND: Evidence-based priority setting is increasingly important for rationally distributing scarce health resources and for guiding future health research. We sought to quantify the contribution of a wide range of infectious diseases to the overall infectious disease burden in a high-income setting. METHODOLOGY/PRINCIPAL FINDINGS: We used health-adjusted life years (HALYs, a composite measure comprising premature mortality and reduced functioning due to disease, to estimate the burden of 51 infectious diseases and associated syndromes in Ontario using 2005-2007 data. Deaths were estimated from vital statistics data and disease incidence was estimated from reportable disease, healthcare utilization, and cancer registry data, supplemented by local modeling studies and national and international epidemiologic studies. The 51 infectious agents and associated syndromes accounted for 729 lost HALYs, 44.2 deaths, and 58,987 incident cases per 100,000 population annually. The most burdensome infectious agents were: hepatitis C virus, Streptococcus pneumoniae, Escherichia coli, human papillomavirus, hepatitis B virus, human immunodeficiency virus, Staphylococcus aureus, influenza virus, Clostridium difficile, and rhinovirus. The top five, ten, and 20 pathogens accounted for 46%, 67%, and 75% of the total infectious disease burden, respectively. Marked sex-specific differences in disease burden were observed for some pathogens. The main limitations of this study were the exclusion of certain infectious diseases due to data availability issues, not considering the impact of co-infections and co-morbidity, and the inability to assess the burden of milder infections that do not result in healthcare utilization. CONCLUSIONS/SIGNIFICANCE: Infectious diseases continue to cause a substantial health burden in high-income settings such as Ontario. Most of this burden is attributable to a relatively small number of infectious agents, for which many effective

  9. Computed tomographic morphometry of thoracic pedicles: safety pedicle parameter measurement of the Chinese immature thoracic spine. (United States)

    Zheng, Changkun; Huang, Qishan; Hu, Yuezheng; Wang, Xiangyang; Chen, Wei


    Our objective was to quantify the morphometric characteristics of the pedicles of the Chinese immature thoracic spine. A total of 120 patients aged 5-14 years underwent standard thoracic computed tomography (CT). The patients were grouped according to age: group 1 (5-8 years of age), group 2 (9-11 years of age) and group 3 (12-14 years of age). Images were reformatted, and multiplanar reconstructions were used to attain images of thoracic pedicles on sagittal, coronal and transverse planes. The measurements included the inner and outer pedicle diameters on the transverse plane, pedicle sagittal diameter, pedicle length and the pedicle angle on the transverse. (1) Pedicle diameters on the transverse plane decreased gradually from T1 to T4 and increased gradually from T5 to T12. The shortest transverse diameter of the thoracic pedicle was T4 or T5. (2) The sagittal diameter was significantly larger than the transverse diameter except at T1. (3) The length of the pedicle from the posterior cortex to the anterior cortex of the vertebra increased from T1 to T12. (4) The pedicle angle decreased gradually from T1 to T8 and became negative below the level of T10. The length of the pedicle changed with age significantly, but the pedicle angle changed with age insignificantly. The success of transpedicular fixation requires a better understanding of morphological features at different ages and reasonable selection of the diameter, length and direction of the pedicle screws based on X-ray and CT films.

  10. Respiratory displacement of the thoracic aorta: physiological phenomenon with potential implications for thoracic endovascular repair. (United States)

    Weber, Tim Frederik; Tetzlaff, Ralf; Rengier, Fabian; Geisbüsch, Philipp; Kopp-Schneider, Annette; Böckler, Dittmar; Eichinger, Monika; Kauczor, Hans-Ulrich; von Tengg-Kobligk, Hendrik


    The purpose of this study was to assess the magnitude and direction of respiratory displacement of the ascending and descending thoracic aorta during breathing maneuvers. In 11 healthy nonsmokers, dynamic magnetic resonance imaging was performed in transverse orientation at the tracheal bifurcation during maximum expiration and inspiration as well as tidal breathing. The magnitude and direction of aortic displacement was determined relatively to resting respiratory position for the ascending (AA) and descending (DA) aorta. To estimate a respiratory threshold for occurrence of distinct respiratory aortic motion, the latter was related to the underlying change in anterior-posterior thorax diameter. Compound displacement between maximum expiration and inspiration was 24.3 +/- 6.0 mm for the AA in the left anterior direction and 18.2 +/- 5.5 mm for the DA in the right anterior direction. The mean respiratory thorax excursion during tidal breathing was 8.9 +/- 2.8 mm. The respiratory threshold, i.e., the increase in thorax diameter necessary to result in respiratory aortic displacement, was estimated to be 15.7 mm. The data suggest that after a threshold of respiratory thorax excursion is exceeded, respiration is accompanied by significant displacement of the thoracic aorta. Although this threshold may not be reached during tidal breathing in the majority of individuals, segmental differences during forced respiration impact on aortic geometry, may result in additional extrinsic forces on the aortic wall, and may be of significance for aortic prostheses designed for thoracic endovascular aortic repair.

  11. Video assisted thoracic surgery in children

    Directory of Open Access Journals (Sweden)

    Shah Rasik


    Full Text Available Thoracoscopic surgery, i.e., video assisted thoracic surgery (VATS has been in use in children for last 98 years. Its use initially was restricted to the diagnostic purposes. However, with the improvement in the optics, better understanding of the physiology with CO2 insufflation, better capabilities in achieving the single lung ventilation and newer vessel sealing devices have rapidly expanded the spectrum of the indication of VATS. At present many complex lung resections, excision of mediastinal tumors are performed by VATS in the experienced centre. The VATS has become the standard of care in empyema, lung biopsy, Mediastinal Lymphnode biopsy, repair of diaphragmatic hernia, etc. The article discusses the indications of VATS, techniques to achieve the selective ventilation and surgical steps in the different surgical conditions in children.

  12. Motion correction in thoracic positron emission tomography

    CERN Document Server

    Gigengack, Fabian; Dawood, Mohammad; Schäfers, Klaus P


    Respiratory and cardiac motion leads to image degradation in Positron Emission Tomography (PET), which impairs quantification. In this book, the authors present approaches to motion estimation and motion correction in thoracic PET. The approaches for motion estimation are based on dual gating and mass-preserving image registration (VAMPIRE) and mass-preserving optical flow (MPOF). With mass-preservation, image intensity modulations caused by highly non-rigid cardiac motion are accounted for. Within the image registration framework different data terms, different variants of regularization and parametric and non-parametric motion models are examined. Within the optical flow framework, different data terms and further non-quadratic penalization are also discussed. The approaches for motion correction particularly focus on pipelines in dual gated PET. A quantitative evaluation of the proposed approaches is performed on software phantom data with accompanied ground-truth motion information. Further, clinical appl...

  13. Immunomodulatory Effects of Anesthetics during Thoracic Surgery

    Directory of Open Access Journals (Sweden)

    Khaled Mahmoud


    (=25 anesthesia. The primary outcome measures included alveolar and plasma concentrations of interleukin-8(IL-8 and tumour necrosis factor-α (TNF-α, whereas secondary outcome measures were alveolar and plasma concentrations of malondialdehyde (MDA, superoxide dismutase (SOD, and changes in alveolar albumin concentrations and cell numbers. Results. Alveolar and plasma concentrations of IL-8 and TNF-α were significantly lower in the isoflurane group, whereas alveolar and plasma concentrations of MDA were significantly lower in the propofol group. Alveolar and plasma SOD levels increased significantly in the propofol group whereas they showed no significant change in the isoflurane group. Furthermore, the isoflurane group patients developed significantly lower alveolar albumin concentrations and cell numbers. Conclusion. Isoflurane decreased the inflammatory response associated with OLV during thoracic surgery and may be preferable over propofol in patients with expected high levels of proinflammatory cytokines like cancer patients.

  14. Impedance plethysmography of thoracic region: impedance cardiography.

    Directory of Open Access Journals (Sweden)

    Deshpande A


    Full Text Available Impedance plethysmograms were recorded from thoracic region in 254 normal subjects, 183 patients with coronary artery disease, 391 patients with valvular heart disease and 107 patients with congenital septal disorder. The data in 18 normal subjects and 55 patients showed that basal impedance decreases markedly during exercise in patients with ischaemic heart disease. Estimation of cardiac index by this technique in a group of 99 normal subjects has been observed to be more consistent than that of the stroke volume. Estimation of systolic time index from impedance plethysmograms in 34 normal subjects has been shown to be as reliable as that from electrocardiogram, phonocardiogram and carotid pulse tracing. Changes in the shape of plethysmographic waveform produced by valvular and congenital heart diseases are briefly described and the role of this technique in screening cardiac patients has been highlighted.

  15. Idiopathic Thoracic Spontaneous Spinal Epidural Hematoma

    Directory of Open Access Journals (Sweden)

    Abdurrahman Aycan


    Full Text Available A 33-year-old male patient experienced temporary sensory loss and weakness in the right lower extremity one month prior to admission. The patient was admitted to a private clinic with a three-day history of acute onset of sensory loss and weakness in both lower extremities and was treated and followed up with a prediagnosis of transverse myelitis and the Guillain-Barre syndrome (GBS. The patient was subsequently transferred to our clinic and the neurologic examination revealed paraplegia in both lower extremities, positive bilateral Babinski signs, and hypesthesia below the T10 dermatome with saddle anesthesia. The patient had urinary incontinence and thoracic magnetic resonance imaging (MRI showed an image of a mass compressing the medulla.

  16. Impedance plethysmographic observations in thoracic outlet syndrome.

    Directory of Open Access Journals (Sweden)

    Nerurkar S


    Full Text Available Forty patients with symptoms of neuro-vascular compression in the upper extremities were subjected to impedance plethysmographic study using Parulkar′s method. Two patients recorded decreased blood flow (BFI in supine position and were diagnosed as having partial occlusion at subclavian level. Sixteen of the patients recorded decreased BFI on 90 degrees abduction and hyper-abduction. Twelve of these patients had radiological evidence of anomalous cervicle ribs. In remaining four patients extrinsic impression on the subclavian artery due to fibrous deposits was confirmed by arteriography. Remaining 22 patients recorded normal impedance plethysmograms. Impedance plethysmography thus provided a non-invasive modality for confirmation of vascular compression in thoracic outlet syndrome.

  17. A reappraisal of adult thoracic surface anatomy. (United States)

    Mirjalili, S Ali; Hale, Samuel J M; Buckenham, Tim; Wilson, Ben; Stringer, Mark D


    Accurate surface anatomy is essential for safe clinical practice. Numerous inconsistencies in clinically important surface markings exist between and within anatomical reference texts. The aim of this study was to investigate key thoracic surface anatomical landmarks in vivo using computed tomographic (CT) imaging. High-resolution thoracic CT scans from 153 supine adults (mean age 63, range 19-89 years; 53% female) taken at end tidal inspiration were analyzed by dual consensus reporting to determine the surface anatomy of the sternal angle, central veins, heart, lungs, and diaphragm. Patients with kyphosis/scoliosis, distorting space-occupying lesions, or visceromegaly were excluded. The position of the cardiac apex, formation of the brachiocephalic veins, and vertebral levels of the sternal angle, xiphisternal joint, and aortic hiatus were consistent with commonly accepted surface markings although there was a wide range of normal variation. In contrast, common surface markings were markedly inaccurate for the following: the position of the tracheal bifurcation, aortic arch, and azygos vein termination (below the plane of the sternal angle at T5-T6 vertebral level in most individuals); the superior vena cava/right atrial junction (most often behind the fourth costal cartilage); the lower border of the lung (adjacent to T12 vertebra posteriorly); and the level at which the inferior vena cava and esophagus traverse the diaphragm (T11 in most). Surface anatomy must be reappraised using modern imaging in vivo if it is to be evidence based and fit for purpose. The effects of gender, age, posture, respiration, build, and ethnicity also deserve greater emphasis.


    Directory of Open Access Journals (Sweden)

    S. V. Vissarionov


    Full Text Available The results of surgical treatment of 263 patients with thoracic scoliosis from 13 to 18 years old with deformity 50-152° (Cobb are presented. It was used three tactical variants with dorsal instrumentation Cotrel-Dubousset (CDI. Operation correction in idiopathic thoracic scoliosis varies within in limits from 46,2 to 95%. Lost of correction in 10 years follow up period was 5,10-10,15%. Authors concluded that tactic of surgical treatment of idiopathic thoracic scoliosis should be individual and depends on patient's age, growth potential, and degree of deformation and mobility of the curve.

  19. Endovascular Repair of a Ruptured Descending Thoracic Aortic Aneurysm (United States)

    DeFrain, Michael; Strickman, Neil E.; Ljubic, Branimir J.; Dougherty, Kathryn G.; Gregoric, Igor D.


    Endovascular aneurysm repair has considerable potential advantages over the surgical approach as a treatment for thoracic aortic rupture, in part because open surgical repair of ruptured thoracic aortic aneurysms is associated with high mortality and morbidity rates. We describe the successful endovascular deployment of stent-grafts to repair a contained rupture of a descending thoracic aortic aneurysm in an 86-year-old man whose comorbidities prohibited surgery. Two months after the procedure, magnetic resonance angiography showed a patent stent-graft, a patent left subclavian artery, and complete exclusion of the aneurysm. PMID:16878637

  20. The Ecological History of Lake Ontario According to Phytoplankton (United States)

    Allinger, L. E.; Reavie, E. D.


    Lake Ontario's water quality has fluctuated since European settlement and our understanding of the cause-and-effect linkages between observed ecosystem shifts and stressors are evolving and improving. Changes in the physical and chemical environment of the lake due to non-indigenous species, pollution, sedimentation, turbidity and climate change altered the pelagic primary producers, so algal assessments have been valuable for tracking long-term conditions. We present a chronological account of pelagic algal assessments and some nearshore areas to summarize past and present environmental conditions in Lake Ontario. This review particularly focuses on diatom-based assessments as their fossils in sediments have revealed the combined effects of environmental insults and recovery. This review recaps the long-term trends according to three unique regions: Hamilton Harbor, the main lake basin and the Bay of Quinte. We summarize pre-European settlement, eutrophication throughout most of the 20th century, subsequent water quality improvement due to nutrient reductions and filter-feeding dreissenid colonization and contemporary pelagic, shoreline and embayment impairments. Recent pelagic phytoplankton data suggest that although phytoplankton biovolume remains stable, species composition has shifted to an increase in spring eutrophic diatoms and summer blue-green algae. Continued monitoring and evaluation of historical data will assist in understanding and responding to the natural and anthropogenic drivers of Lake Ontario's environmental conditions. As such we have initiated a new paleolimnological investigation, supported by the Environmental Protection Agency-Great Lakes National Program Office, to reconstruct the long-term environmental history of Lake Ontario and will present preliminary results.

  1. Postexposure Treatment and Animal Rabies, Ontario, 1958-2000 (United States)

    Nunan, Christopher P.; Honig, Janet M.; Ball, David G. A.; Hauschildt, Peggy; LeBer, Charles A.


    This paper investigates the relationship between animal rabies and postexposure treatment (PET) in Ontario by examining the introduction of human diploid cell vaccine (HDCV) in 1980 and the initiation of an oral rabies vaccination program for wildlife in 1989. Introducing HDCV led to an immediate doubling of treatments. Both animal rabies and human treatments declined rapidly after the vaccination program was introduced, but human treatments have leveled off at approximately 1,000 per year. PMID:11897079

  2. Wastewater quality control at Sarnia (Ontario, Canada) petrochemical industries

    Energy Technology Data Exchange (ETDEWEB)

    Vianna, Arlinda C. [Servico Nacional de Aprendizagem Industrial (SENAI), Salvador, BA (Brazil); Souza, Eliane S.; Himmelman, William [Lambton College, Sarnia, ON (Canada)


    Ontario industries are required by law to meet strict regulations under the provinces under MISA initiative (Municipal-Industrial Strategy for Abatement). The petroleum-petrochemical area was selected as a leader in the development of new environmental objectives, and monitoring and training programs. Sarnia has become a world leader in industrial environmental control systems and the approach toward zero emissions. 4 refs., 6 figs., 2 tabs.

  3. Helicobacter pylori Infection in Ontario: Prevalence and Risk Factors

    Directory of Open Access Journals (Sweden)

    Farah Naja


    Full Text Available BACKGROUND: Helicobacter pylori has been classified by the World Health Organization as a type I carcinogen. Nearly 50% of the world’s population is estimated to be infected with H pylori. Prevalence patterns of the infection are different between developing and developed countries. The present study had two objectives – to estimate the prevalence of H pylori infection in Ontario, and to evaluate the relationship between the infection and various demographic characteristics and selected lifestyle factors.

  4. Adaptation to climate change in the Ontario public health sector

    Directory of Open Access Journals (Sweden)

    Paterson Jaclyn A


    Full Text Available Abstract Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%, severe weather (68% and poor air-quality (57%. Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into

  5. The organization of district health councils in Ontario


    Dixon, F Maureen


    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University. This action research project with district health councils (DHCs) in Ontario, Canada, took place between 1976 and 1980. The purpose of the research was to identify the most effective forms of organization for DHCs, bodies set up to provide a local focus for planning and coordination of health services in the Province. The research method was based on social analysis, a method developed ove...

  6. An ecoregion-specific ammonia emissions inventory of Ontario dairy farming: Mitigation potential of diet and manure management practices (United States)

    Chai, Lilong; Kröbel, Roland; MacDonald, Douglas; Bittman, Shabtai; Beauchemin, Karen A.; Janzen, H. Henry; McGinn, Sean M.; Vanderzaag, Andrew


    The Canadian ammonia (NH3) emissions model and a survey of dairy farm practices were used to quantify effects of management on emissions from dairy farms in Ontario Canada. Total NH3 emissions from dairy farming were 21 Gg NH3-N yr-1 for the four ecoregions of the province. Annual emission rates ranged from 12.8 (for calves in ecoregions of Manitoulin-Lake Simcoe-Frontenac) to 50 kg NH3-N animal-1 yr-1 (for lactating cows in ecoregions of St. Lawrence Lowlands) (mean of 27 kg NH3-N animal-1 yr-1). The St. Lawrence Lowlands ecoregion had the highest emission rate because more dairy manure was managed as solid manure in that ecoregion. Total dairy cattle N intake (diet-N) was 81 Gg N yr-1, 23% of which was retained in animal products (e.g., milk, meat, and fetus), 47% was returned to the land, and 30% was emitted as gas (i.e., NH3-N, N2O-N, NO-N, and N2-N) and nitrate-N leaching/runoff. Ammonia volatilization constituted the largest loss of diet-N (26%), as well as manure-N (34%). Reducing the fraction of solid manure by 50% has the potential to mitigate NH3 emissions by 18% in Ontario ecoregions.

  7. The Capacity to Detect Change Stream Fish Communities Characteristics at the Site-Level in the Lake Ontario Basin (United States)

    Jones, Nicholas Edward; Petreman, Ian Charles


    We investigate natural inter-annual variability of fish community measures within streams of the Lake Ontario basin. Given this variability, we examined coefficients of variation (CV) among the community measures and three scenarios pertaining to the capacity of biologists to detect changes in the fish community at the stream site level. Results indicate that Ontario's stream fish communities are highly variable in time. Young-of-the-year rainbow trout growth was the least variable whereas biomass density scored the highest CV of 0.50 among streams (range 0.22-0.99). Given the CVs and relatively equal sample sizes, our measures of the fish community can be ranked from least to most powerful: biomass, density, richness, diversity, and growth of young-of-the-year rainbow trout. Only large changes in measures can typically be detected. For instance, it would take 4-6 years of monitoring before and after a pulse perturbation to detect a 50 % change in species richness or diversity. We suggest that monitoring abundance is unlikely to result in the detection of small impacts within a short period of time and that large effects can be masked by low statistical power. This evidence voices the need for more research into better sampling methods, experimental designs, and choice of indicators to support monitoring programs for flowing waters.

  8. The potential for green power marketing in Ontario

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, B. [EcoPathways Consulting Inc., Whitby, ON (Canada)


    A review of Ontario Hydro`s green power program was provided. Market research indicates that the public is interested in renewable energy, that a significant portion of the public claim to be `green` consumers, and that they are willing to pay a premium for green power. There is, however, very little actual experiential evidence to show who is truly willing to pay and what price would be acceptable. Sources of `green electricity` include renewables such as hydro, solar, wind, biomass from farm and forest waste, methane from landfills, and geothermal. Public support in Ontario, and in most other parts of Canada, is strong for investment by power utilities in `green electricity`. In a limited program, Ontario Hydro is currently offering greenpower pricing for some of its proposed green power projects. To those willing to pay, a premium of 4 cents per kWh will be added to the current costs from the electricity retailer. The general impression of industry experts is that the demand for green power is there, however, the supply is not. Continued delays and uncertainty about the power industry`s future structure are considered to be the major impediments to implementing the green program. 1 tab., 7 figs.

  9. Traffic pollution and health : international and Ontario experiences

    Energy Technology Data Exchange (ETDEWEB)

    Finkelstein, M.M. [McMaster Univ., Hamilton, ON (Canada). McMaster Inst. of Environment and Health]|[McMaster Univ., Hamilton, ON (Canada). Dept. of Family Medecine]|[Toronto Univ., ON (Canada). Dept. of Family Medecine]|[Toronto Univ., (Canada). Dept. of Public Health Sciences


    International and Ontario experience related to traffic pollution and health were discussed. The presentation opened with a table about deaths per day resulting from sulphur dioxide and smoke micrograms per cubic metre. It discussed the constituents of air pollution focusing on gas and particulates as well as atmospheric chemistry and indoor air pollution sources. Outdoor sources of air pollutants include naturally occurring pollutants such as volcanic eruptions, dust storms, vegetation emissions, and fires as well as human generated sources such as stationary and mobile sources and diesel engine pollution. Each type of pollutant was discussed in detail. Air pollution and human health was then presented in the context of traffic pollution and children, major epidemiologic studies of the health effects of pollutants, pollution and mortality in Vancouver, as well as other studies of a similar nature. The Hamilton/Toronto cohort study was one study that was highlighted in particular. The study concluded that living close to traffic in Hamilton and Toronto is associated with increased risk of circulatory disease hospital admissions and mortality. The presentation concluded with a discussion of air pollution and health in Ontario and recommendations made by the Ontario Medical Association. tabs., figs.

  10. Alberta's and Ontario's liquor boards: why such divergent outcomes? (United States)

    Bird, Malcolm G


    The provinces of Alberta and Ontario have chosen very different methods to distribute alcoholic beverages: Alberta privatized the Alberta Liquor Control Board (ALCB) in 1993 and established a private market to sell beverage alcohol, while Ontario, in stark contrast, opted to retain and expand the Liquor Control Board of Ontario (LCBO). This article examines the reasons for the divergent policy choices made by Ralph Klein and Mike Harris' Conservative governments in each province. The article draws on John Kingdon's “multiple streams decision-making model,” to examine the mindsets of the key decision-makers, as well as “historical institutionalism,” to organize the pertinent structural, historical and institutional variables that shaped the milieu in which decision-makers acted. Unique, province-specific political cultures, histories, institutional configurations (including the relative influence of a number of powerful actors), as well as the fact that the two liquor control boards were on opposing trajectories towards their ultimate fates, help to explain the different decisions made by each government. Endogenous preference construction in this sector, furthermore, implies that each system is able to satisfy all relevant stakeholders, including consumers.

  11. The geographic distribution of tuberculosis and pyridoxine supply in Ontario. (United States)

    McGuigan, M A; Yamada, J


    Acute poisoning with isoniazid causes generalized convulsions which should be treated with intravenous pyridoxine and a rapidly-acting anticonvulsant. The purpose of this study was to determine the correlation between the distribution of tuberculosis (as a proxy for isoniazid use) and acute care hospital supplies of intravenous pyridoxine (the antidote for isoniazid overdose). The distribution of tuberculosis was based on Ontario public health regions. The study was descriptive using simple linear regression to assess the degree of correlation. Only 15.6% of Ontario acute care hospitals have enough intravenous pyridoxine to treat an average isoniazid overdose. The distribution of tuberculosis and the number of hospitals in the region correlated best with hospital supplies of pyridoxine, although these variables explained only 22% and 23.7%, respectively, of the variation in supply. It does not appear that the distribution of tuberculosis is a major determinant of the availability of the isoniazid antidote, pyridoxine. Acute care hospitals in Ontario should re-evaluate their need for pyridoxine in light of the incidence of tuberculosis in their regions. Each hospital should stock at least 5 Gm of intravenous pyridoxine; additional amounts may be appropriate if there is an increased incidence in the area.

  12. A critical review of financial measures as reported in the Ontario hospital balanced scorecard. (United States)

    Parkinson, John; Tsasis, Peter; Porporato, Marcela


    For Ontario hospitals in Canada, the Financial Performance and Condition measures in the Ontario hospital balanced scorecard are especially of interest since in the foreseeable future, they may be linked to provincial government funding decisions. However, we find that these measures lack valuable information on key attributes that affect organizational performance. We suggest changes that focus on key drivers of performance and reflect the operational realities of Ontario hospitals.

  13. OISE/UT Evaluation of the Implementation of the National Literacy and Numeracy Strategies. Second Annual Report. Watching & Learning 2. (United States)

    Earl, Lorna; Levin, Ben; Leithwood, Ken; Fullan, Michael; Watson, Nancy

    This, the second of three annual reports by the Ontario Institute for Studies in Education (OISE), continues to track central policy and developments in the implementation of the British National Literacy and Numeracy Strategies (NLS and NNS). The report considers value for money in their funding and on the perception and experience of the…

  14. OISE/UT Evaluation of the Implementation of the National Literacy and Numeracy Strategies. Summary: First Annual Report. Watching & Learning. (United States)

    Earl, Lorna; Fullan, Michael; Leithwood, Ken; Watson, Nancy

    The National Literacy and the National Numeracy Strategies (NLNS) are part of the British government's major education reform initiative, an attempt to significantly raise standards of achievement in schools. This report is a summary of the first annual report from the Ontario Institute for Studies in Education of the University of Toronto…

  15. Notch signaling in descending thoracic aortic aneurysm and dissection

    NARCIS (Netherlands)

    Zou, S.; Ren, P.; Nguyen, M.; Coselli, J.S.; Shen, Y.H.; Lemaire, S.A.


    BACKGROUND: Descending thoracic aortic aneurysm and dissection (DTAAD) is characterized by progressive medial degeneration, which may result from excessive tissue destruction and insufficient repair. Resistance to tissue destruction and aortic self-repair are critical in preventing medial degenerati

  16. Robotic thoracic surgery: The state of the art

    Directory of Open Access Journals (Sweden)

    Arvind Kumar


    Although the cumulative experience worldwide is still limited and evolving, Robotic Thoracic Surgery is an evolution over VATS. There is however a lot of concern among established high-volume VATS centers regarding the superiority of the robotic technique. We have over 7 years experience and believe that any new technology designed to make minimal invasive surgery easier and more comfortable for the surgeon is most likely to have better and safer outcomes in the long run. Our only concern is its cost effectiveness and we believe that if the cost factor is removed more and more surgeons will use the technology and it will increase the spectrum and the reach of minimally invasive thoracic surgery. This article reviews worldwide experience with robotic thoracic surgery and addresses the potential benefits and limitations of using the robotic platform for the performance of thoracic surgical procedures.

  17. Dual cervical thoracic coil for spine magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Totterman, S.; Foster, T.H.; Plewes, D.B.; Simon, J.H.; Ekholm, S.; Wicks, A. (Rochester Univ., NY (USA). Dept. of Radiology Rochester Univ., NY (USA). Dept. of Physics and Astronomy)

    The need for repositioning of surface coils and patients in MR examinations of the cervical and thoracic spin prolongs examination time. A new receiver design is proposed which overcomes this problem. The device is composed of two actively decoupled receiver coils mounted on the frame of a Philadelphia collar. These coils may be used separately to image either the thoracic or cervical spine or together to produce larger field-of-view images of the combined region. Signal-to-noise ratios of the separate cervical and thoracic spine images are not degraded as a result of mounting the receivers together. The full cervical and thoracic region is shown to be imaged at a signal-to-noise ratio significantly higher than that afforded by the body coil. A retrospective review of our case load suggests that a time saving could be achieved in approximately 1/3 of spine examinations by using this coil. (orig.).

  18. Complete Thoracic Ectopia Cordis. Report of A Case


    ERK, K.; Yüksel, M


    SUMMARY Complete thoracic ectopia cordis is a rare anomaly. 17-hour of age a newborn baby had been attempted to the operative correction is reported and the pertinent literature is briefly revived. Unfortunately surgery is not satisfactory on this anomaly.

  19. Thoracic and respirable particle definitions for human health risk assessment (United States)

    Provides estimates of the thoracic and respirable fractions, for adults and children during typical activities during both nasal and oral inhalation, that may be used in the design of experimental studies and interpretation of evidence of health effects.

  20. [Perioperative pain management for abdominal and thoracic surgery]. (United States)

    Englbrecht, J S; Pogatzki-Zahn, E M


    Abdominal and thoracic surgical procedures can result in significant acute postoperative pain. Present evidence shows that postoperative pain management remains inadequate especially after "minor" surgical procedures. Various therapeutic options including regional anesthesia techniques and systemic pharmacotherapy are available for effective treatment of postoperative pain. This work summarizes the pathophysiological background of postoperative pain after abdominal and thoracic surgery and discusses the indication, effectiveness, risks, and benefits of the different therapeutic options. Special focus is given to the controversial debate about the indication for epidural analgesia, as well as various alternative therapeutic options, including transversus abdominis plane (TAP) block, paravertebral block (PVB), wound infiltration with local anesthetics, and intravenous lidocaine. In additional, indications and contraindications of nonopioid analgesics after abdominal and thoracic surgery are discussed and recommendations based on scientific evidence and individual risk and benefit analysis are made. All therapeutic options discussed are eligible for clinical use and may contribute to improve postoperative pain outcome after abdominal and thoracic surgical procedures.

  1. Thoracic Sympathectomy for Severe Refractory Multivessel Coronary Artery Spasm. (United States)

    Cardona-Guarache, Ricardo; Pozen, Jonah; Jahangiri, Arehzo; Koneru, Jayanthi; Shepard, Richard; Roberts, Charlotte; Abbate, Antonio; Cassano, Anthony


    Coronary artery spasm is a rare but potentially fatal disease. Herein, we report a case of recurrent ST-segment myocardial infarctions and ventricular fibrillation complicating severe multivessel coronary artery spasm successfully treated with bilateral thoracic surgical sympathectomy.

  2. An improved retractor for cardiac and thoracic operations. (United States)

    McEnany, M T


    Several standard abdominal wall retractors have been modified to improve exposure at the extremes of thoracic and groin incisions and to enhance the efficiency and comfort of the assistant in supplying adequate visibility in these areas.

  3. Clinical pathway for thoracic surgery in the United States


    Wei, Benjamin; Cerfolio, Robert J.


    The paradigm for postoperative care for thoracic surgical patients in the United States has shifted with efforts to reduce hospital length of stay and improve quality of life. The increasing usage of minimally invasive techniques in thoracic surgery has been an important part of this. In this review we will examine our standard practices as well as the evidence behind both general contemporary postoperative care principles and those specific to certain operations.

  4. Clinical pathway for thoracic surgery in the United States (United States)

    Wei, Benjamin


    The paradigm for postoperative care for thoracic surgical patients in the United States has shifted with efforts to reduce hospital length of stay and improve quality of life. The increasing usage of minimally invasive techniques in thoracic surgery has been an important part of this. In this review we will examine our standard practices as well as the evidence behind both general contemporary postoperative care principles and those specific to certain operations. PMID:26941967

  5. Current Evidence and Insights about Genetics in Thoracic Aorta Disease



    Thoracic aortic aneurysms have been historically considered to be caused by etiologic factors similar to those implied in abdominal aortic aneurysms. However, during the past decade, there has been increasing evidence that almost 20% of thoracic aortic aneurysms may be associated with a genetic disease, often within a syndromic or familial disorder. Moreover, the presence of congenital anomalies, such as bicuspid aortic valve, may have a unique common genetic underlying cause. Finally, also s...

  6. Increased incidence of thoracic wall deformities in related Bengal kittens. (United States)

    Charlesworth, Timothy M; Sturgess, Christopher P


    Clinical records made during routine vaccinations were compared between populations of domestic shorthair cats and Bengal kittens. An increased incidence (12/244) of thoracic wall deformity was detected amongst the Bengal kittens. Deformities detected were: pectus excavatum (five), unilateral thoracic wall concavity (six) and scoliosis (one). Five-generation pedigrees were analysed for the affected kittens that showed a high degree of common ancestry indicating the likelihood of a familial cause.

  7. Lake sturgeon population attributes and reproductive structure in the Namakan Reservoir, Minnesota and Ontario (United States)

    Shaw, S. L.; Chipps, Steven R.; Windels, S. K.; Webb, M.A.H.; McLeod, D. T.; Willis, D.W.


    Quantified were the age, growth, mortality and reproductive structure of lake sturgeon (Acipenser fulvescens) collected in the US and Canadian waters of the Namakan Reservoir. The hypotheses were tested that (i) age and growth of lake sturgeon in the Namakan Reservoir would differ by sex and reproductive stage of maturity, and (ii) that the relative strength of year-classes of lake sturgeon in the reservoir would be affected by environmental variables. To quantify age, growth and mortality of the population, existing data was used from a multi-agency database containing information on all lake sturgeon sampled in the reservoir from 2004 to 2009. Lake sturgeon were sampled in the Minnesota and Ontario waters of the Namakan Reservoir using multi-filament gillnets 1.8 m high and 30–100 m long and varying in mesh size from 178 to 356 mm stretch. Reproductive structure of the lake sturgeon was assessed only during spring 2008 and 2009 using plasma testosterone and estradiol-17β concentrations. Ages of lake sturgeon >75 cm ranged from 9 to 86 years (n = 533, mean = 36 years). A catch-curve analysis using the 1981–1953 year classes estimated total annual mortality of adults to be 4.8% and annual survival as 95.2%. Using logistic regression analysis, it was found that total annual precipitation was positively associated with lake sturgeon year-class strength in the Namakan Reservoir. A 10 cm increase in total annual precipitation was associated with at least a 39% increase in the odds of occurrence of a strong year class of lake sturgeon in the reservoir. Plasma steroid analysis revealed a sex ratio of 2.4 females: 1 male and, on average, 10% of female and 30% of male lake sturgeon were reproductively mature each year (i.e. potential spawners). Moreover, there was evidence based on re-captured male fish of both periodic and annual spawning, as well as the ability of males to rapidly undergo gonadal maturation prior to spawning. Knowledge of lake sturgeon

  8. Thoracic solitary pedunculated osteochondroma in a child: a case report

    Directory of Open Access Journals (Sweden)

    Wali Z


    Full Text Available Zubair Wali,1 Khalid I Khoshhal21Department of Orthopedic Surgery, King Fahd Hospital, Almadinah Almunawwarah, Saudi Arabia; 2Department of Orthopedic Surgery, College of Medicine, Taibah University, Almadinah Almunawwarah, Saudi ArabiaObjective: This case report describes the rare presentation of a thoracic pedunculated osteochondroma in a child, arising from the lamina of the fourth thoracic vertebra.Clinical features: A 7-year-old girl was referred for the evaluation of a swelling in her back. The patient was suffering from atraumatic, progressive painless back swelling, of approximately 2 years duration. The physical examination showed a healthy child, with a well-defined mass, about 4 × 6 cm, located around the midline of the upper thoracic spine. No clinical signs of hereditary multiple exostoses were detected. Plain radiographs and computerized tomography were suggestive of a pedunculated osteochondroma arising from the lamina of the fourth thoracic vertebra.Intervention and outcome: The patient underwent surgical excision of the mass. The pathologist confirmed the diagnosis. Follow up for 2 years did not show any evidence of clinical or radiological recurrence.Conclusion: The current report describes a rare case and the management of a solitary pedunculated osteochondroma arising from the lamina of the fourth thoracic vertebra in a child below the age of 10 years.Keywords: benign tumors, hereditary multiple exostoses, spine column tumors, thoracic vertebra

  9. November 2015 Arizona thoracic society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA


    Full Text Available No abstract available. Article truncated after 150 words. The November 2015 Arizona Thoracic Society meeting was held on Wednesday, November 18, 2015 at the Scottsdale Shea Hospital beginning at 6:30 PM. This was a dinner meeting with case presentations. There were 14 in attendance representing the pulmonary, critical care, sleep, and radiology communities. There were 3 case presentations: 1. Dr. Gerald Schwartzberg presented a case of a 56-year-old man with a history of diabetes, alcoholism and tobacco abuse who has a history of Mycobacterium avium-intracellulare (MAI with a residual thin-walled cavity in his right upper lobe (RUL. After quitting drinking and smoking and years of being asymptomatic, he presented with hemoptysis. Chest x-ray showed increasing density in the RUL. CT scan showed an intracavitary density in his previous cavity presumably a fungus ball. Sputum cultures are pending. Discussion followed on management of fungus balls. Bronchoscopy was recommended to view the bronchial anatomy to exclude other diagnosis as well ...

  10. Total Spinal Block after Thoracic Paravertebral Block. (United States)

    Beyaz, Serbülent Gökhan; Özocak, Hande; Ergönenç, Tolga; Erdem, Ali Fuat; Palabıyık, Onur


    Thoracic paravertebral block (TPVB) can be performed with or without general anaesthesia for various surgical procedures. TPVB is a popular anaesthetic technique due to its low side effect profile and high analgesic potency. We used 20 mL of 0.5% levobupivacaine for a single injection of unilateral TPVB at the T7 level with neurostimulator in a 63 year old patient with co-morbid disease who underwent cholecystectomy. Following the application patient lost consciousness, and was intubated. Haemodynamic instability was normalised with rapid volume replacement and vasopressors. Anaesthetic drugs were stopped at the end of the surgery and muscle relaxant was antagonised. Return of mucle strenght was shown with neuromuscular block monitoring. Approximately three hours after TPVB, spontaneous breathing started and consciousness returned. A total spinal block is a rare and life-threatening complication. A total spinal block is a complication of spinal anaesthesia, and it can also occur after peripheral blocks. Clinical presentation is characterised by hypotension, bradicardia, apnea, and cardiac arrest. An early diagnosis and appropriate treatment is life saving. In this case report, we want to present total spinal block after TPVB.

  11. November 2013 Arizona thoracic society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA


    Full Text Available No abstract available. Article truncated at 150 words. The November Arizona Thoracic Society meeting was held on Wednesday, 11/20/2013 at Shea Hospital beginning at 6:30 PM. There were 26 in attendance representing the pulmonary, critical care, sleep, nursing, radiology, and infectious disease communities. As per the last meeting a separate area for upcoming meetings has been created in the upper left hand corner of the home page on the SWJPCC website. A short presentation was made by Timothy Kuberski MD, Chief of Infectious Disease at Maricopa Medical Center, entitled “Clinical Evidence for Coccidioidomycosis as an Etiology for Sarcoidosis”. Isaac Yourison, a medical student at the University of Arizona, will be working with Dr. Kuberski on his scholarly project. Mr. Yourison hypothesizes that certain patients diagnosed with sarcoidosis in Arizona really have coccidioidomycosis. It would be predicted that because of the immunosuppression, usually due to steroids, the sarcoidosis patients would eventually express the Coccidioides infection. The investigators will be …

  12. August 2013 Arizona Thoracic Society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA


    Full Text Available No abstract available. Article truncated after first 150 words. The August Arizona Thoracic Society meeting was held on Wednesday, 8/28/2013 at Shea Hospital beginning at 6:30 PM. There were 23 in attendance representing the pulmonary, critical care, sleep, and pathology communities. A brief discussion was held about the audio-visual aids available. It was generally agreed that our current projector is inadequate. Judd Tillinghast will inquire about using a hospital overhead projector. If that is not possible, it was agreed to purchase a new projector. Plans for telecasting the meeting between Phoenix and Tucson continue. A trial of a link between Shea and the University in Tucson failed. Once the link is successfully established, it is hoped that the meeting can be telecasted. There were 6 cases presented: 1. Dr. Thomas Colby, pulmonary pathologist from Mayo Clinic Arizona, presented the case of a 10 year old boy with chronic dyspnea for > 4 yrs. He had growth retardation since age …

  13. Zur Problematik des Thoracic Outlet-Syndroms

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    Mamoli B


    Full Text Available Das Thoracic Outlet-Syndrom (TOS ist ein äußerst kontrovers diskutiertes Engpasssyndrom, das für ca. 4 % aller nicht-traumatischen Paresen des Plexus brachialis verantwortlich ist [1]. Nach Wilbourn [2] wird zwischen einem neurogenen TOS (klassisches TOS und einem fraglichen (disputed TOS differenziert. Aus pathophysiologischer Sicht wird ein neurogenes (ca. 90 % aller TOS, ein arterielles und ein venöses TOS differenziert [3, 4]. Die einzelnen Formen können aufgrund unterschiedlicher Symptome gut voneinander abgegrenzt werden. Häufigste Ursachen sind abnorme anatomische Strukturen (fibröse Bänder etc. oder über Jahre ausgeübte muskuläre Tätigkeiten (z. B. Sportler, Musiker. Zur Diagnose werden klinische, lektrophysiologische, radiologische und Neuroimaging-Verfahren herangezogen. Wenngleich die neuen Techniken wie MRT, MRA und Sonographie die diagnostische Sicherheit erhöht haben, ähnelt die Diagnose eines TOS einem Indizienprozess und erfordert eine sorgfältige Analyse aller Daten. Therapeutisch ist bis heute der Wert der konservativen Therapie nicht durch kontrollierte Studien belegt. Die Therapieansätze basieren auf pathophysiologischen Überlegungen. Während beim vaskulären TOS ein rasches chirurgisches Eingreifen erforderlich ist, sollte beim neurogenen TOS, außer bei Progredienz der Symptomatik, zunächst ein konservativer Therapieversuch unternommen werden.

  14. March 2013 Arizona thoracic society notes

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    Robbins RA


    Full Text Available No abstract available. Article truncated after 150 words. A dinner meeting was held on Wednesday, 3/20/2013 at Scottsdale Shea beginning at 6:30 PM. There were 14 in attendance representing the pulmonary, critical care, sleep, infectious disease, nursing, and radiology communities.Copies of the book “Breathing in America: Diseases, Progress, and Hope” were distributed.Three cases were presented:1.Tim Kuberski, infectious diseases from Maricopa, presented a 49 year old woman with a history of alcoholism who presented with RML pneumonia. Despite azithromycin and cephtriaxone she developed progressive respiratory failure and a right pleural effusion. A right chest tube was placed. Cultures of blood and the pleural fluid were negative. She was suspected of having an anaerobic infection. Follow-up CT scan showed abscess formation in her RML with areas of dense consolidation on the left and a left pleural effusion. Discussion focused on whether RML resection should be performed. Most favored a surgical approach. 2.Andrew Goldstein, thoracic surgery, presented a …

  15. September 2013 Arizona thoracic society notes

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    Robbins RA


    Full Text Available No abstract available. Article truncated at 150 words. The September Arizona Thoracic Society meeting was held on Wednesday, 9/25/2013 at Shea Hospital beginning at 6:30 PM. There were 13 in attendance representing the pulmonary, critical care, sleep, and pathology communities. After a brief discussion, Gerry Swartzberg was selected as Arizona’s 2014 nominee for Clinician of the Year. There was 1 case presented: Dr. Thomas Colby, pulmonary pathologist from Mayo Clinic Arizona, presented the case of a 67 year old woman with multiple pulmonary nodules. The largest was 1.2 cm CT scan. She had a fine needle aspiration of one of the nodules. The pathology revealed spindle-shaped cells which were synaptophysin + (also known as the major synaptic vesicle protein p38. Synaptophysin marks neuroendocrine tissue and on this basis the patient was diagnosed with multiple carcinoid tumors. Aguayo et al. (1 described six patients with diffuse hyperplasia and dysplasia of pulmonary neuroendocrine cells, multiple carcinoid tumorlets, and peribronchiolar fibrosis …

  16. December 2013 Arizona thoracic society notes

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    Richard A. Robbins


    Full Text Available No abstract available. Article truncated at 150 words. A breakfast meeting of the Arizona Thoracic Society and the Tucson winter lung series was held on Saturday, 12/14/2013 at Kiewit Auditorium on the University of Arizona Medical Center Campus beginning at 8:30 AM. There were 31 in attendance. A lecture was presented by Joe G. N. "Skip" Garcia, MD, the senior vice president for health sciences at the University of Arizona. The title of Garcia’s talk was “Personalizing Medicine in Cardiopulmonary Disorders: The Post ACA Landscape”. Garcia began with reiterating that the Affordable Care Act (ACA, Obamacare is fact and could pose a threat to academic medical centers. However, he views the ACA as an opportunity to develop personalized medicine which grew from the human genome project. Examples cited included the genetic variability among patients in determining the dose of warfarin and bronchodilator response to beta agonists in asthma (1,2. Garcia’s laboratory has studied predominately 6 diseases including the …

  17. June 2014 Arizona thoracic society notes

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    Robbins RA


    Full Text Available No abstract available. Article truncated at 150 words. The June 2014 Arizona Thoracic Society meeting was held on Wednesday, 6/25/14 at the Bio5 building on the University of Arizona Medical Center campus in Tucson beginning at 5:30 PM. This was a dinner meeting with case presentations. There were about 33 in attendance representing the pulmonary, critical care, sleep, pathology and radiology communities. Four cases were presented: Eric Chase presented a 68 year old incarcerated man shortness of breath, chest pain and productive cough. The patient was a poor historian. He was supposed to be receiving morphine for back pain but this had been held. He also had a 45 pound weight loss over the past year. His PMH was positive for COPD, hypertension, congestive heart failure, chronic back pain and hepatitis C. Past surgical history included a back operation and some sort of chest operation. On physical examination he was tachypneic, tachycardic and multiple scars over his neck ...

  18. August 2014 Arizona thoracic society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA


    Full Text Available No abstract available. Article truncated after 150 words. The August 2014 Arizona Thoracic Society meeting was held on Wednesday, 8/27/14 at Scottsdale Shea Hospital beginning at 6:30 PM. This was a dinner meeting with case presentations. There were about 30 in attendance representing the pulmonary, critical care, sleep and radiology communities. A presentation was given by Julie Reid of the American Lung Association in Arizona on their Lung Force initiative. This is an initiative to make women more aware that lung cancer is the number 1 cause of cancer deaths in women. There will be a fund raising Lung Force Walk on November 15, 2014 in Phoenix. More information can be found at or or contact Julie Reid at JReid@Lung or (602 258-7505. A discussion was instigated by Dr. Parides on whether there is an increased risk of clinical Valley Fever in patients previously treated who begin therapy with biological therapy for rheumatoid arthritis. The ...

  19. September 2012 Arizona thoracic society notes

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    Robbins RA


    Full Text Available No abstract available. Article truncated at 150 words. A dinner meeting was held on 9/26//2012 at Scottsdale Shea beginning at 6:30 PM. There were 18 in attendance representing the pulmonary, critical care, sleep, pathology, and radiology communities.A discussion was held on Pending Premium Cigar Legislation HR. 1639 and S.1461, the "Traditional Cigar Manufacturing and Small Business Jobs Preservation Act of 2011”. This bill would exempt "premium cigars" from FDA oversight. The definition of premium cigars is so broad that candy flavored cigars, cigarillos and blunts would be exempted from FDA regulation. Teenage cigar smoking is increasing and this legislation may result in a further increase. The Arizona Thoracic Society is opposed to this bill. Dr. Robbins is to put a link on the Southwest Journal of Pulmonary and Critical Care website linking to the ATS website. This will enable members to contact their Congressmen opposing this legislation. A discussion was also held on a proposed combined Tucson/Phoenix …

  20. Seroprevalence of Toxoplasma gondii infection among veterinary staff in Ontario, Canada (2002: Implications for teratogenic risk

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    Soldin Offie


    Full Text Available Abstract Background Toxoplasma gondii infection is embryotoxic in humans. It is mainly transmitted through raw/undercooked meat and ingestion of oocysts in cat feces. There remains controversy about the actual risk of cats transmitting the disease to humans. Our primary objective was to determine the seroprevalence of T. gondii antibody among veterinary staff, to ascertain whether they have an increased risk through occupational exposure. Our secondary objective was to examine their practices regarding cats, toxoplasma infection, and pregnancy. Methods Veterinary staff attending the 2002 Annual Ontario Veterinary Medical Association Conference were invited to discuss their toxoplasma seroprevalence. Interested attendees completed a questionnaire and a physician drew blood samples to determine T. gondii titres using the ELISA IgG test. Results We collected 161 completed questionnaires, and 141 blood samples. There were 20 (14.2%, CI95%:8.4–19.9% reactive titres among the veterinarian staff (80% females aged 30–45. All were regularly exposed to cats, washed their hands when in contact and few wore gloves routinely. Conclusions These findings of low positive rates may be used to reassure veterinary staff that their exposure to cats does not appear to increase their risk of contracting toxoplasma infection and that pregnant women are not at an increased risk by owning a cat.

  1. Windsor, Ontario Exposure Assessment Study: Design and Methods Validation of Personal, Indoor and Outdoor Air Pollution Monitoring (United States)

    The Windsor, Ontario Exposure Assessment Study evaluated the contribution of ambient air pollutants to personal and indoor exposures of adults and asthmatic children living in Windsor, Ontario, Canada. In addition, the role of personal, indoor, and outdoor air pollution exposures...


    Makungu, Modesta; du Plessis, Wencke M; Barrows, Michelle; Groenewald, Hermanus B; Koeppel, Katja N


    The red panda ( Ailurus fulgens ) is classified as an endangered species by the International Union for Conservation of Nature and Natural Resources. The natural distribution of the red panda is in the Himalayas and southern China. Thoracic diseases such as dirofilariasis, hypertrophic cardiomyopathy, tracheal obstruction, lung worm infestation, and pneumonia have been reported in the red panda. The aim of this study was to describe the normal radiographic thoracic anatomy of captive red pandas as a species-specific reference for routine health examinations and clinical cases. Right lateral (RL) and dorsoventral (DV) inspiratory phase views of the thorax were obtained in 11 adult captive red pandas. Measurements were made and ratios calculated to establish reference ranges for the mean vertebral heart score on the RL (8.34 ± 0.25) and DV (8.78 ± 0.34) views and the mean ratios of the caudal vena cava diameter to the vertebral body length above tracheal bifurcation (0.67 ± 0.05) and tracheal diameter to the width of the third rib (2.75 ± 0.24). The majority of animals (10/11) had 14 thoracic vertebrae, except for one animal that had 15 thoracic vertebrae. Rudimentary clavicles were seen in 3/11 animals. The ovoid, oblique cardiac silhouette was more horizontally positioned and elongated in older animals. A redundant aortic arch was seen in the oldest animal. The trachea was seen with mineralized cartilage rings in all animals. The carina was clearly seen in the majority of animals (10/11). Variations exist in the normal radiographic thoracic anatomy of different species. Knowledge of the normal radiographic thoracic anatomy of the red panda should prove useful for routine health examinations and in the diagnosis of thoracic diseases.

  3. The burden of mental illness and addiction in ontario. (United States)

    Ratnasingham, Sujitha; Cairney, John; Manson, Heather; Rehm, Jürgen; Lin, Elizabeth; Kurdyak, Paul


    Objectif : Le service de Santé publique de l’Ontario et l’Institut pour les sciences évaluatives cliniques ont collaboré pour estimer le fardeau de la maladie attribuable aux trouble mentaux et aux toxicomanies en Ontario. Méthodes : Les années de vie ajustées en fonction de la santé ont servi à estimer le fardeau. Le concept est semblable aux années de vie ajustées en fonction de l’incapacité qui ont servi aux études sur le fardeau mondial de la maladie. Les sources de données sur les maladies mentales et les toxicomanies utilisées étaient notamment des données administratives sur la santé de la province de l’Ontario, des données d’enquête de Statistique Canada et du Centre de toxicomanie et de santé mentale, des données de l’état civil du Bureau du registraire général de l’Ontario, et des données de l’enquête épidémiologique américaine. Résultats : Les 5 affections dont le fardeau est le plus élevé sont : la dépression majeure, le trouble bipolaire affectif, les troubles liés à l’utilisation d’alcool (TUA), la phobie sociale, et la schizophrénie. Le fardeau de la dépression est le double de celui de l’affection mentale la plus proche (c’est-à-dire, le trouble bipolaire affectif) et est plus lourd que le fardeau combiné des 4 cancers les plus répandus en Ontario. Les TUA étaient le seul groupe de maladies dont une proportion substantielle du fardeau était attribuable au décès précoce. Les estimations du fardeau pour les autres affections étaient principalement attribuables à l’incapacité. Conclusions : Le fardeau de ces affections en Ontario est aussi plus lourd que celui d’autres affections, comme le cancer et les maladies infectieuses, ce qui s’explique en grande partie par la prévalence élevée, la chronicité, et l’âge de début de la plupart des troubles mentaux et des problèmes de toxicomanie. Les résultats servent de base importante à l’évaluation future des

  4. MRI findings in thoracic outlet syndrome

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    Aralasmak, Ayse; Sharifov, Rasul; Kilicarslan, Rukiye; Alkan, Alpay [Bezmialem Vakif University, Department of Radiology, Fatih/Istanbul (Turkey); Cevikol, Can; Karaali, Kamil; Senol, Utku [Akdeniz University, Department of Radiology, Antalya (Turkey)


    We discuss MRI findings in patients with thoracic outlet syndrome (TOS). A total of 100 neurovascular bundles were evaluated in the interscalene triangle (IS), costoclavicular (CC), and retropectoralis minor (RPM) spaces. To exclude neurogenic abnormality, MRIs of the cervical spine and brachial plexus (BPL) were obtained in neutral. To exclude compression on neurovascular bundles, sagittal T1W images were obtained vertical to the longitudinal axis of BPL from spinal cord to the medial part of the humerus, in abduction and neutral. To exclude vascular TOS, MR angiography (MRA) and venography (MRV) of the subclavian artery (SA) and vein (SV) in abduction were obtained. If there is compression on the vessels, MRA and MRV of the subclavian vessels were repeated in neutral. Seventy-one neurovascular bundles were found to be abnormal: 16 arterial-venous-neurogenic, 20 neurogenic, 1 arterial, 15 venous, 8 arterial-venous, 3 arterial-neurogenic, and 8 venous-neurogenic TOS. Overall, neurogenic TOS was noted in 69%, venous TOS in 66%, and arterial TOS in 39%. The neurovascular bundle was most commonly compressed in the CC, mostly secondary to position, and very rarely compressed in the RPM. The cause of TOS was congenital bone variations in 36%, congenital fibromuscular anomalies in 11%, and position in 53%. In 5%, there was unilateral brachial plexitis in addition to compression of the neurovascular bundle. Severe cervical spondylosis was noted in 14%, contributing to TOS symptoms. For evaluation of patients with TOS, visualization of the brachial plexus and cervical spine and dynamic evaluation of neurovascular bundles in the cervicothoracobrachial region are mandatory. (orig.)

  5. Emergency thoracic ultrasound and clinical risk management (United States)

    Interrigi, Maria Concetta; Trovato, Francesca M; Catalano, Daniela; Trovato, Guglielmo M


    Purpose Thoracic ultrasound (TUS) has been proposed as an easy-option replacement for chest X-ray (CXR) in emergency diagnosis of pneumonia, pleural effusion, and pneumothorax. We investigated CXR unforeseen diagnosis, subsequently investigated by TUS, considering its usefulness in clinical risk assessment and management and also assessing the sustainability of telementoring. Patients and methods This observational report includes a period of 6 months with proactive concurrent adjunctive TUS diagnosis telementoring, which was done using freely available smartphone applications for transfer of images and movies. Results Three hundred and seventy emergency TUS scans (excluding trauma patients) were performed and telementored. In 310 cases, no significant chest pathology was detected either by CXR, TUS, or the subsequent work-up; in 24 patients, there was full concordance between TUS and CXR (ten isolated pleural effusion; eleven pleural effusion with lung consolidations; and three lung consolidation without pleural effusion); in ten patients with lung consolidations, abnormalities identified by CXR were not detected by TUS. In 26 patients, only TUS diagnosis criteria of disease were present: in 19 patients, CXR was not diagnostic, ie, substantially negative, but TUS detected these conditions correctly, and these were later confirmed by computed tomography (CT). In seven patients, even if chest disease was identified by CXR, such diagnoses were significantly modified by ultrasound, and CT confirmed that TUS was more appropriate. The overall respective individual performances of CXR and TUS for the diagnosis of a pleural–pulmonary disease in emergency are good, with accuracy >95%. Conclusion About 20% of pneumonia cases were detectable only by CXR and 20% only by TUS and not by CXR; ie, about 40% of patients may have been misdiagnosed if, by chance, only one of the two tools had been used. The concurrent use of TUS and CXR increases the overall sensitivity and

  6. Thoracic injury: a review of 276 cases

    Institute of Scientific and Technical Information of China (English)

    Moosa Zargar; Ali Khaji; Mojgan Karbakhsh Davari


    Objective: Chest injury, one of the most important aspects of trauma, directly accounts for 25% of all traumarelated deaths and plays a major contributing role in another 25% of trauma deaths. This paper aimed to explore the spectrum and outcome of thoracic injuries seen in a multi centric study of trauma patients.Methods: A total of 276 consecutive trauma patients in 6 general hospitals were analyzed. The feature of injury,injury severity score (ISS), clinical treatment and mortality were recorded in a prospective manner and analyzed retrospectively. Multiple logistic regression analysis was used to determine the independent predictors of mortality following the chest trauma.Results: There were 246 males ( 89.1%) and 30 females (10.9% ) ranging from 3 to 80 years with a mean age of (34 ± 17) years. Road traffic accident was the main cause of injury, especially for pedestrians, followed by stab wound (89 cases, 32.1% ) and falling injuries (32 cases,11.6% ), respectively. Haemothorax or pneumothorax (50.4%) and rib fracture (38.6%) were the most common types of chest injury. Extremity fracture was the most common associated injury with the rate of 37% ( 85/230), followed by head injury (25.2% ) and abdominal trauma (19.6%). These injuries contributed significantly to the morbidity and mortality of trauma patients.Conclusions: According to the results, most patients with chest injury can be treated conservatively with close observation and tube thoracostomy. The presence of blunt trauma, head injury and abdominal injury independently adversely affect mortality after chest trauma. It is necessary to investigate the causes and patterns of injuries resulting from stab wound for effective prevention.

  7. Endoscopic Follow-Up of Positive Fecal Occult Blood Testing in the Ontario FOBT Project

    Directory of Open Access Journals (Sweden)

    Lawrence Paszat


    Full Text Available BACKGROUND: The Ontario FOBT Project is a pilot study of fecal occult blood testing (FOBT for colorectal cancer screening conducted among age-eligible volunteers (50 to 75 years in 12 of 37 public health regions in Ontario.

  8. Bologna through Ontario Eyes: The Case of the Advanced Diploma in Architectural Technology (United States)

    Mitchell, Amy D.; Feltham, Mark; Trotter, Lane


    Inspired by Ontario's burgeoning interest in postsecondary student mobility, this article examines how elements of Europe's Bologna Process can help bridge the college--university divide of Ontario's postsecondary system. Via discourse analysis of relevant qualification frameworks and program standards, it argues that the current system…

  9. The Relationship between Parental Substance Abuse and Child Maltreatment: Findings from the Ontario Health Supplement (United States)

    Walsh, Christine; MacMillan, Harriet L.; Jamieson, Ellen


    Objective: This study examined the relationship between reported exposure to child abuse and a history of parental substance abuse (alcohol and drugs) in a community sample in Ontario, Canada. Method: The sample consisted of 8,472 respondents to the Ontario Mental Health Supplement (OHSUP), a comprehensive population survey of mental health. The…

  10. The Social Habitus of Drama: The Ontario Drama Curriculum in Theory and Practice (United States)

    Gallagher, Kathleen


    In this article, the author considers the place of drama in the formal curriculum in Ontario, Canada by considering its position in relation to curriculum theory and the texts that formally articulate it as a discipline to be taught in schools. The drama curriculum in Ontario aims to engage young people in activities and experiences that invite…

  11. Ontario Universities Benefits Survey, 1987-88. Part I: Benefits Excluding Pensions. (United States)

    University of Western Ontario, London.

    Results of the 1987-1988 survey of benefits, excluding pensions, for 17 Ontario, Canada, universities are presented. Information is provided on the following areas: administration and insurance plans, communication of benefits, proposed changes in benefits, provision of life and dismemberment insurance, maternity leave policy, Ontario health…

  12. Validation of Six Short and Ultra-short Screening Instruments for Depression for People Living with HIV in Ontario: Results from the Ontario HIV Treatment Network Cohort Study

    DEFF Research Database (Denmark)

    Choi, Stephanie KY; Boyle, Eleanor; Burchell, Ann;


    of current depression in HIV-positive patients attending HIV specialty care clinics in Ontario. Methods A multi-centre validation study was conducted in Ontario to examine the validity and accuracy of three instruments (the Center for Epidemiologic Depression Scale [CESD20], the Kessler Psychological...... Distress Scale [K10], and the Patient Health Questionnaire depression scale [PHQ9]) and their short forms (CESD10, K6, and PHQ2) in diagnosing current major depression among 190 HIV-positive patients in Ontario. Results from the three instruments and their short forms were compared to results from the gold...... positive predictive value (0.49–0.58) at their optimal cut-points. Conclusion Among people in HIV care in Ontario, Canada, the three instruments and their short forms performed equally well and accurately. When further in-depth assessments become available, shorter instruments might find greater clinical...

  13. Re Inquiry into the Confidentiality of Health Records in Ontario. (United States)


    Several members of the Royal Canadian Mounted Police testified at hearings conducted by a commission appointed to study the confidentiality of health records. On approximately 300 occasions, the police had obtained medical information from physicians and hospitals in Ontario without the prior consent of the patient. The court established that the identity of persons who had furnished the information was privileged information for physicians and other persons subject to the control of a hospital board, but not for various employees of the hospital who were not subject to professional standards of discipline.

  14. Nongastrointestinal helminths in marten (Martes americana) from Ontario, Canada. (United States)

    Seville, R S; Addison, E M


    Six species of nongastrointestinal nematodes were recovered from 405 marten, (Martes americana), examined from six areas in Ontario, Canada in 1992 to 1993. Three species (Crenosoma petrowi, Eucoleus aerophilus, Filaroides martis) were found in the respiratory tract, one in the urinary bladder (Pearsonema plica), one in the kidney (Dioctophyme renale), and one in the musculature (Trichinella sp. larvae). This is the first report of F. martis and P. plica from this host. In addition a specimen of Dracunculus insignis collected from a marten pelt was received. Based on our results, martens are primary definitive hosts for few nongastrointestinal nematodes. Animals in more southern areas had greater species richness than those from higher latitudes.

  15. The identification of liquid ethane in Titan's Ontario Lacus. (United States)

    Brown, R H; Soderblom, L A; Soderblom, J M; Clark, R N; Jaumann, R; Barnes, J W; Sotin, C; Buratti, B; Baines, K H; Nicholson, P D


    Titan was once thought to have global oceans of light hydrocarbons on its surface, but after 40 close flybys of Titan by the Cassini spacecraft, it has become clear that no such oceans exist. There are, however, features similar to terrestrial lakes and seas, and widespread evidence for fluvial erosion, presumably driven by precipitation of liquid methane from Titan's dense, nitrogen-dominated atmosphere. Here we report infrared spectroscopic data, obtained by the Visual and Infrared Mapping Spectrometer (VIMS) on board the Cassini spacecraft, that strongly indicate that ethane, probably in liquid solution with methane, nitrogen and other low-molecular-mass hydrocarbons, is contained within Titan's Ontario Lacus.

  16. 46 CFR 401.405 - Basic rates and charges on the St. Lawrence River and Lake Ontario. (United States)


    ... Lake Ontario. 401.405 Section 401.405 Shipping COAST GUARD (GREAT LAKES PILOTAGE), DEPARTMENT OF... § 401.405 Basic rates and charges on the St. Lawrence River and Lake Ontario. Except as provided in.... registered pilots in the St. Lawrence River and Lake Ontario. (a) Area 1 (Designated Waters): Service...

  17. Anesthesia for thoracic surgery: A survey of middle eastern practice

    Directory of Open Access Journals (Sweden)

    Abdelazeem Eldawlatly


    Full Text Available Purpose: The main objective of this survey is to describe the current practice of thoracic anesthesia in the Middle Eastern (ME region. Methods: A prospective online survey. An invitation to participate was e-mailed to all members of the ME thoracic-anaesthesia group. A total of 58 members participated in the survey from 19 institutions in the Middle East. Questions concerned ventilation strategies during one-lung ventilation (OLV, anesthesia regimen, mode of postoperative analgesia, use of lung isolation techniques, and use of i.v. fluids. Results: Volume-controlled ventilation was favored over pressure-controlled ventilation (62% vs 38% of respondents, P<0.05; 43% report the routine use of positive end-expiratory pressure. One hundred percent of respondents report using double-lumen tube (DLT as a first choice airway to establish OLV. Nearly a third of respondents, 31.1%, report never using bronchial blocker (BB in their thoracic anesthesia practice. Failure to pass a DLT and difficult airway are the most commonly cited indications for BB use. Regarding postoperative analgesia, the majority 61.8% favor thoracic epidural analgesia over other techniques (P<0.05. Conclusions: Our survey provides a contemporary snapshot of the ME thoracic anesthetic practice.

  18. Image quality of mixed convolution kernel in thoracic computed tomography. (United States)

    Neubauer, Jakob; Spira, Eva Maria; Strube, Juliane; Langer, Mathias; Voss, Christian; Kotter, Elmar


    The mixed convolution kernel alters his properties geographically according to the depicted organ structure, especially for the lung. Therefore, we compared the image quality of the mixed convolution kernel to standard soft and hard kernel reconstructions for different organ structures in thoracic computed tomography (CT) images.Our Ethics Committee approved this prospective study. In total, 31 patients who underwent contrast-enhanced thoracic CT studies were included after informed consent. Axial reconstructions were performed with hard, soft, and mixed convolution kernel. Three independent and blinded observers rated the image quality according to the European Guidelines for Quality Criteria of Thoracic CT for 13 organ structures. The observers rated the depiction of the structures in all reconstructions on a 5-point Likert scale. Statistical analysis was performed with the Friedman Test and post hoc analysis with the Wilcoxon rank-sum test.Compared to the soft convolution kernel, the mixed convolution kernel was rated with a higher image quality for lung parenchyma, segmental bronchi, and the border between the pleura and the thoracic wall (P kernel, the mixed convolution kernel was rated with a higher image quality for aorta, anterior mediastinal structures, paratracheal soft tissue, hilar lymph nodes, esophagus, pleuromediastinal border, large and medium sized pulmonary vessels and abdomen (P kernel cannot fully substitute the standard CT reconstructions. Hard and soft convolution kernel reconstructions still seem to be mandatory for thoracic CT.

  19. Factors associated with seat belt use: an evaluation from the Ontario Health Survey. (United States)

    Sahai, V S; Pitblado, J R; Bota, G W; Rowe, B H


    This study examines the factors associated with seat belt use for drivers and passengers in Ontario. Using the 1990 Ontario Health Survey, a population-based survey of non-institutionalized Ontario residents, factors associated with seat belt use among drivers and passengers were identified and are reported as unadjusted and adjusted odds ratios (OR; 95% CI). Seat belt non-use in Ontario drivers was most strongly associated with younger age (p Seat belt non-use in passengers was associated with younger age (p seat belt use has been shown to reduce injuries in the event of a crash. Any strategy to increase seat belt use in Ontario should be targeted to involve both drivers and passengers. Attention should be paid to increasing seat belt usage by younger adults, males, and especially those living in northern and rural regions.

  20. Video-assisted thoracoscopic surgery for penetrating thoracic trauma

    Directory of Open Access Journals (Sweden)

    Jin Jian


    Full Text Available Purpose: For penetrating thoracic trauma, there is no consensus on whether operative exploration or conservative treatment is better. In this study, we compared the clinical effect of video-assisted thoracoscopic surgery (VATS and thoracotomy on the patients with penetrating thoracic trauma. Methods: From January 2000 to December 2010, 123 patients with penetrating thoracic trauma were treated in Affiliated Hospital of Chengdu University. Based on the inclusion criteria, 80 patients were enrolled and randomly assigned into VATS and thoracotomy group. Results: The operation time, amount of bleeding and drainage in VATS group were all lower than traditional operation (p < 0.05. Conclusion: The results indicate that VATS has the merits of shorter operation time, non-blind area, exact surgical path and less bleeding comparing with traditional operation.

  1. Current evidence and insights about genetics in thoracic aorta disease. (United States)

    Bisleri, Gianluigi; Bagozzi, Lorenzo; Muneretto, Claudio


    Thoracic aortic aneurysms have been historically considered to be caused by etiologic factors similar to those implied in abdominal aortic aneurysms. However, during the past decade, there has been increasing evidence that almost 20% of thoracic aortic aneurysms may be associated with a genetic disease, often within a syndromic or familial disorder. Moreover, the presence of congenital anomalies, such as bicuspid aortic valve, may have a unique common genetic underlying cause. Finally, also sporadic forms have been found to be potentially associated with genetic disorders, as highlighted by the analysis of rare variants and expression of specific microRNAs. We therefore sought to perform a comprehensive review of the role of genetic causes in the development of thoracic aortic aneurysms, by analyzing in detail the current evidence of genetic alterations in syndromes such as Marfan, Loeys-Dietz, and Ehler-Danlos, familial or sporadic forms, or forms associated with bicuspid aortic valve.

  2. Update on anesthetic complications of robotic thoracic surgery. (United States)

    Campos, J; Ueda, K


    In the last decade, there has been increasing use of the da Vinci® robot surgical system to perform minimally invasive thoracic surgery. The robotic technology can be applied for surgery of the lungs, mediastinum, and esophagus. A number of case reports have been shown steep learning curve, and promising surgical outcome with this new technology. However, anesthesia management of the robotic thoracic surgery can be complex and requires further education. For example, most of the cases require sufficient lung collapse in order to provide adequate surgical field. In addition, a unique operative setting, such as patient positioning and capnothorax can make anesthesia management further challenging. Hence, anesthesiologists should have better awareness of adverse events or complications related to the robotic surgery to accomplish successful anesthesia management. This review will focus on the potential complications of robotic thoracic surgery involving the lungs, mediastinum and esophagus.

  3. Magnetic resonance imaging of congenital abnormalities of the thoracic aorta

    Energy Technology Data Exchange (ETDEWEB)

    Soler, R.; Rodriguez, E.; Requejo, I.; Fernandez, R. [Department of Radiology, Hospital Juan Canalejo, La Coruma (Spain); Raposo, I. [Department of Pediatric Cardiology, Hospital Juan Canalejo, La Coruna (Spain)


    This article outlines the ability of MR imaging in the detection and presurgical evaluation of congenital abnormalities of the thoracic aorta (CATA). Congenital abnormalities of the thoracic aorta may be found incidentally on chest radiographs in patients without symptoms, or it can be associated with clinical findings which are very variable depending on the association with congenital cardiac malformations or vascular ring. When CATA is suspected as the cause of anomalies in the mediastinum in asymptomatic patients, confirmation of the abnormality should be by MR imaging allowing precise evaluation of the thoracic aorta and origin of the principal arteries. When CATA is considered because clinical findings indicate coarctation of the aorta, vascular ring or associated cardiac disorder, evaluation with ultrasound can be complemented by MR, which in most cases will replace the diagnostic catheterization. (orig.) With 12 figs., 24 refs.

  4. Current Evidence and Insights about Genetics in Thoracic Aorta Disease

    Directory of Open Access Journals (Sweden)

    Gianluigi Bisleri


    Full Text Available Thoracic aortic aneurysms have been historically considered to be caused by etiologic factors similar to those implied in abdominal aortic aneurysms. However, during the past decade, there has been increasing evidence that almost 20% of thoracic aortic aneurysms may be associated with a genetic disease, often within a syndromic or familial disorder. Moreover, the presence of congenital anomalies, such as bicuspid aortic valve, may have a unique common genetic underlying cause. Finally, also sporadic forms have been found to be potentially associated with genetic disorders, as highlighted by the analysis of rare variants and expression of specific microRNAs. We therefore sought to perform a comprehensive review of the role of genetic causes in the development of thoracic aortic aneurysms, by analyzing in detail the current evidence of genetic alterations in syndromes such as Marfan, Loeys-Dietz, and Ehler-Danlos, familial or sporadic forms, or forms associated with bicuspid aortic valve.

  5. Solitary calvarial metastases : An unusual presentation of thoracic neuroblastoma

    Directory of Open Access Journals (Sweden)

    Grover S


    Full Text Available A primary thoracic origin occurs only in 20% of neuroblastomas, and their classical presentation is mediastinal or cord compression. Skeletal metastases of neuroblastomas are characteristically multiple, and calvarial deposits usually show simultaneous involvement of orbit. Solitary metastases in neuroblastoma, is an unusual entity and its presentation as a large calvarial mass, especially from a thoracic primary, is rare. Furthermore, calvarial metastases are relatively uncommon in children compared to adults. We discuss the clinical, radiographic, CT features, and differential diagnosis of a large calvarial mass with sunray spiculation in a child, which was due to a solitary metastases from an occult thoracic neuroblastoma. The possibility of neuroblastoma presenting in this unique fashion and the importance of considering a chemosensitive tumor such as neuroblastoma in the differential diagnosis of a solitary calvarial mass in a child is highlighted by our report.

  6. The experimental validation of free fat grafts in thoracic surgery. (United States)

    Murakami, Junichi; Ueda, Kazuhiro; Hayashi, Masataro; Kondo, Tomoko; Hamano, Kimikazu


    We evaluated the viability of free fat grafts in the thoracic cavity using 3-month old male swine (n = 2). After left caudal lobectomy, 1-3 g of subcutaneous fat tissue harvested via the thoracotomy site was implanted in the chest cavity. At re-thoracotomy 6 weeks after implantation, all of the implanted fat grafts (n = 15) were found to have closely adhered to the parietal pleura and visceral pleura. There was a significant decrease by ∼30% in the weight of the fat grafts after implantation. Regardless of the weight loss, the implanted fat graft showed normal structuring without scar formation in the central area. Our results may suggest that free fat pads, which weighed up to 3 g, were successfully cultured in the thoracic cavity until the implanted tissues integrated into the surrounding tissues. Therefore, the free fat pad can be used as a biomaterial for some purposes in thoracic surgery.

  7. Extrapleural Inner Thoracic Wall Lesions: Multidetector CT Findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Soo; Kim, Young Tong; Jou, Sung Shik [Soonchunhyang University, Cheonan Hospital, Cheonan (Korea, Republic of)


    The extrapleural space is external to the parietal pleura in the thorax. The structures within and adjacent to this region include the fat pad, endothoracic fascia, intercostal muscles, connective tissue, nerves, vessels, and ribs. Further, the space is divided into the inner and outer thoracic wall by the innermost intercostal muscle. Extrapleural lesions in the inner thoracic wall are classified as air-containing lesions, fat-containing lesions, and soft tissue-containing lesions according on their main component. Air-containing lesions include extrapleural air from direct chest trauma and extrapleural extension from pneumomediastinum. Prominent extrapleural fat is seen in decreased lung volume conditions, and can also be seen in normal individuals. Soft tissue-containing lesions include extrapleural extensions from a pleural or chest wall infection as well as tumors and extrapleural hematoma. We classify extrapleural lesions in the inner thoracic wall and illustrate their imaging findings

  8. Regulating Traditional Chinese Medicine Practitioners and Acupuncturists in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Glen E. Randall


    Full Text Available In 2006, the Ontario government passed the Traditional Chinese Medicine Act, which granted Traditional Chinese Medicine practitioners and Acupuncturists (TCM/A practitioners self-regulatory status under the Regulated Health Professions Act, 1991. The goal of the legislation was to create a new regulatory college that would set and enforce high standards of care and safety in order to enhance public protection and access to a range of traditional and alternative therapies. In April 2013, the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario was officially launched. Several factors account for the government’s decision to delegate self-regulatory authority to TCM/A practitioners through the creation of a regulatory college. In particular, the government’s decision seems to have been influenced by lobbying of some practitioners, greater public acceptance of alternative medicines, patient safety concerns related to acupuncture cases in the media, and the precedence of self-regulatory status being granted to these practitioners in other provinces. The degree to which the legislation has achieved its goals is difficult to determine given the short period of time the regulatory college has existed. However, the fact that the college has developed standards of practice to guide TCM/A practitioners and has a process in place to address public complaints is an early indication of movement toward achieving the policy’s goals.

  9. Tobacco Retail Outlets and Vulnerable Populations in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Michael O. Chaiton


    Full Text Available Interest has been increasing in regulating the location and number of tobacco vendors as part of a comprehensive tobacco control program. The objective of this paper is to examine the distribution of tobacco outlets in a large jurisdiction, to assess: (1 whether tobacco outlets are more likely to be located in vulnerable areas; and (2 what proportion of tobacco outlets are located close to schools. Retail locations across the Province of Ontario from Ministry of Health Promotion data were linked to 2006 Census data at the neighbourhood level. There was one tobacco retail outlet for every 1,000 people over age 15 in Ontario. Density of outlets varied by public health unit, and was associated with the number of smokers. Tobacco outlets were more likely to be located in areas that had high neighbourhood deprivation, in both rural and urban areas. Outlets were less likely to be located in areas with high immigrant populations in urban areas, with the reverse being true for rural areas. Overall, 65% of tobacco retailers were located within 500 m of a school. The sale of tobacco products is ubiquitous, however, neighbourhoods with lower socio-economic status are more likely to have easier availability of tobacco products and most retailers are located within walking distance of a school. The results suggest the importance of policies to regulate the location of tobacco retail outlets.

  10. Linezolid resistance in Enterococcus faecium isolated in Ontario, Canada. (United States)

    Patel, Samir N; Memari, Nader; Shahinas, Dea; Toye, Baldwin; Jamieson, Frances B; Farrell, David J


    Recent studies have described linezolid-resistant MRSA and vancomycin-resistant enterococci (VRE) occurring worldwide, including an outbreak of linezolid-resistant MRSA. The objective of this study was to determine if linezolid-resistant enterococci are present in clinical isolates in Ontario, Canada. From January 2010 to June 2012, all enterococcal isolates submitted to the Public Health Ontario Laboratory (PHOL) for confirmation of VRE and susceptibility testing were included in this study. Of 2829 enterococcal isolates tested, 12 Enterococcus faecium were found to be resistant to linezolid. All linezolid-resistant isolates were also resistant to ampicillin, ciprofloxacin, and vancomycin. In addition, 33% of isolates were non-susceptible to daptomycin, whereas 41% were resistant to quinupristin/dalfopristin. Molecular characterization of these isolates showed that 8/12 isolates (66.7%) contained the mutation G2576T in 23S rRNA, which has been associated with linezolid resistance. Amplification and sequencing of L3- and L4-coding genes did not reveal mutations associated with linezolid resistance. One isolate contained the cfr gene, which is associated with linezolid resistance, and has been found in staphylococcal species and E. faecalis. These data show that occurrence of linezolid resistance is still rare among enterococcal isolates referred to PHOL though detection of cfr in E. faecium is concerning as it has the potential to disseminate among other enterococci.

  11. Introducing Midwifery-led Birth Centres to Ontario

    Directory of Open Access Journals (Sweden)

    Cristina A. Mattison


    Full Text Available In Ontario, maternal health systems are changing, with an increasing variety of childbirth options being offered to low-risk pregnant women. Midwifery became a regulated profession in the province in 1994: providing primary care throughout pregnancy, labour and for up to six weeks postpartum. Currently there are three midwifery-led birth centres operating in Ontario, two of which opened in early 2014. The Ministry of Health and Long-Term Care (MoHLTC has launched these new birth centres in order to offer women more choice in health care provider and birth setting. This shift is representative of the MoHLTC’s push to move services out of hospitals and into community-based settings. While the birth centre initiative is in its early stages and a formal program evaluation is needed, it has the potential, if scaled up, to decrease the need for hospital beds as well as reduce health care costs through more appropriate care for low-risk pregnancies, leading to fewer interventions.

  12. Expanding the Scope of Practice for Pharmacists in Ontario

    Directory of Open Access Journals (Sweden)

    Glen Edward Randall


    Full Text Available On 15 December 2009 the Regulated Health Professions Statute Law Amendment Act, 2009 (Bill 179 received Royal Assent in Ontario. The resulting legislative amendments were intended to strengthen government oversight of the health regulatory colleges, promote interprofessional collaboration, and make better use of health professionals’ existing skills and training by enhancing the scope of practice for several health professions in order to improve health system efficiency. Among the most notable scope of practice enhancements were those given to pharmacists, who would be permitted to: modify and renew existing prescriptions, prescribe a limited range of drugs independent of a physician, and administer medications such as vaccinations via injection or inhalation. The reform was driven in large part by the government’s concerns related to the rising cost of health care, the public’s desire for greater access to services, and demonstrated successes of similar reforms in other jurisdictions. While the Ontario reform has had some clear success, such as expanding the public’s access to influenza vaccinations, to date, the evidence of achieving other goals remains weak. In particular, there is no clear evidence of improved health system efficiency and associated cost effectiveness. Moreover, it is possible that Ontario’s umbrella regulatory model may be making interprofessional collaboration more, rather than less, difficult to realize.

  13. Degrees of change: Steps towards an Ontario global warming strategy

    Energy Technology Data Exchange (ETDEWEB)

    Spivak, M.; Jessup, P.; Lourie, B.; Macdonald, M.; Makuch, Z.; Valiante, M.; Warner, B.


    The measures and policy strategies that would be required to achieve a 20% reduction in Ontario carbon dioxide emissions by 2005 are explored. Estimates of primary and secondary energy use and CO{sub 2} emissions for 1988 and 2005 are presented, and three strategies are examined in each end-use sector: energy efficiency, fuel switching, and renewable energy measures. For the residential, commercial, transport, industrial, and iron/steel industry sectors, a profile of CO{sub 2} emissions and energy intensity trends is offered, opportunities for CO{sub 2} reduction and measures to reduce CO{sub 2} emissions are described, and the economic and social implications are discussed. Natural gas cogeneration is examined as a technological option for reducing CO{sub 2} emissions and creating important opportunities for the Ontario economy. The role of energy utility reform in CO{sub 2} emissions reduction is assessed in an examination of the key factors needed for the design and implementation of demand side management programs that achieve high participation rates and significant reductions in energy demand. 102 refs., 6 figs., 53 tabs.

  14. Emergency thoracic ultrasound and clinical risk management

    Directory of Open Access Journals (Sweden)

    Interrigi MC


    Full Text Available Maria Concetta Interrigi,1 Francesca M Trovato,2,3 Daniela Catalano,3,4 Guglielmo M Trovato3,5 1Accident and Emergency Department, Ospedale Cannizzaro, Catania, 2Accident and Emergency Department, Ospedale Civile, Ragusa, 3Department of Clinical and Experimental Medicine, The School of Medicine, University of Catania, 4Postgraduate School of Clinical Ultrasound, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Policlinico, University of Catania, 5Postgraduate School of e-Learning and ICT in Health Sciences, The School of Medicine, University of Catania, Catania, Italy Purpose: Thoracic ultrasound (TUS has been proposed as an easy-option replacement for chest X-ray (CXR in emergency diagnosis of pneumonia, pleural effusion, and pneumothorax. We investigated CXR unforeseen diagnosis, subsequently investigated by TUS, considering its usefulness in clinical risk assessment and management and also assessing the sustainability of telementoring. Patients and methods: This observational report includes a period of 6 months with proactive concurrent adjunctive TUS diagnosis telementoring, which was done using freely available smartphone applications for transfer of images and movies. Results: Three hundred and seventy emergency TUS scans (excluding trauma patients were performed and telementored. In 310 cases, no significant chest pathology was detected either by CXR, TUS, or the subsequent work-up; in 24 patients, there was full concordance between TUS and CXR (ten isolated pleural effusion; eleven pleural effusion with lung consolidations; and three lung consolidation without pleural effusion; in ten patients with lung consolidations, abnormalities identified by CXR were not detected by TUS. In 26 patients, only TUS diagnosis criteria of disease were present: in 19 patients, CXR was not diagnostic, ie, substantially negative, but TUS detected these conditions correctly, and these were later confirmed by computed

  15. MAT2A mutations predispose individuals to thoracic aortic aneurysms. (United States)

    Guo, Dong-chuan; Gong, Limin; Regalado, Ellen S; Santos-Cortez, Regie L; Zhao, Ren; Cai, Bo; Veeraraghavan, Sudha; Prakash, Siddharth K; Johnson, Ralph J; Muilenburg, Ann; Willing, Marcia; Jondeau, Guillaume; Boileau, Catherine; Pannu, Hariyadarshi; Moran, Rocio; Debacker, Julie; Bamshad, Michael J; Shendure, Jay; Nickerson, Deborah A; Leal, Suzanne M; Raman, C S; Swindell, Eric C; Milewicz, Dianna M


    Up to 20% of individuals who have thoracic aortic aneurysms or acute aortic dissections but who do not have syndromic features have a family history of thoracic aortic disease. Significant genetic heterogeneity is established for this familial condition. Whole-genome linkage analysis and exome sequencing of distant relatives from a large family with autosomal-dominant inheritance of thoracic aortic aneurysms variably associated with the bicuspid aortic valve was used for identification of additional genes predisposing individuals to this condition. A rare variant, c.1031A>C (p.Glu344Ala), was identified in MAT2A, which encodes methionine adenosyltransferase II alpha (MAT IIα). This variant segregated with disease in the family, and Sanger sequencing of DNA from affected probands from unrelated families with thoracic aortic disease identified another MAT2A rare variant, c.1067G>A (p.Arg356His). Evidence that these variants predispose individuals to thoracic aortic aneurysms and dissections includes the following: there is a paucity of rare variants in MAT2A in the population; amino acids Glu344 and Arg356 are conserved from humans to zebrafish; and substitutions of these amino acids in MAT Iα are found in individuals with hypermethioninemia. Structural analysis suggested that p.Glu344Ala and p.Arg356His disrupt MAT IIα enzyme function. Knockdown of mat2aa in zebrafish via morpholino oligomers disrupted cardiovascular development. Co-transfected wild-type human MAT2A mRNA rescued defects of zebrafish cardiovascular development at significantly higher levels than mRNA edited to express either the Glu344 or Arg356 mutants, providing further evidence that the p.Glu344Ala and p.Arg356His substitutions impair MAT IIα function. The data presented here support the conclusion that rare genetic variants in MAT2A predispose individuals to thoracic aortic disease.

  16. Prospective Evaluation of Thoracic Ultrasound in the Detection of Pneumothorax (United States)

    Schwarz, K. W.; Hamilton, D. R.; Kirkpatrick, A. W.; Billica, R. D.; Williams, D. R.; Diebel, L. N.; Sargysan, A. E.; Dulchavsky, S. A.


    Introduction: Pneumothorax (PTX) occurs commonly in trauma patients and is confirmed by examination and radiography. Thoracic ultrasound (VIS) has been suggested as an alternative method for rapidly diagnosing PTX when X-ray is unavailable as in rural, military, or space flight settings; however, its accuracy and specificity are not known. Methods: We evaluated the accuracy of thoracic U/S detection of PTX compared to radiography in stable, emergency patients with a high suspicion of PTX at a Level-l trauma center over a 6-month period. Following University and NASA Institutional Review Board approval, informed consent was obtained from patients with penetrating or blunt chest trauma, or with a history consistent with PTX. Whenever possible, the presence or absence of the " lung sliding" sign or the "comet tail" artifact were determined by U/S in both hemithoraces by residents instructed in thoracic U/S before standard radiologic verification of PTX. Results were recorded on data sheets for comparison to standard radiography. Results: Thoracic VIS had a 94% sensitivity; two PTX could not be reliably diagnosed due to subcutaneous air; the true negative rate was 100%. In one patient, the VIS exam was positive while X ray did not confirm PTX; a follow-up film 1 hour later demonstrated a small PTX. The average time for bilateral thoracic VIS examination was 2 to 3 minutes. Conclusions: Thoracic ultrasound reliably diagnoses pneumothorax. Presence of the "lung sliding" sign conclusively excludes pneumothorax. Expansion of the FAST examination to include the thorax should be investigated.


    Institute of Scientific and Technical Information of China (English)

    Bin Yu; Jian-guo Zhang; Gui-xing Qiu; Yi-peng Wang; Xi-sheng Weng


    Objective To define the criteria of posterior selective thoracic fusion in patients with adolescent idiopathic scoliosis.Methods By reviewing the medical records and roentgenograms of 17 patients with adolescent idiopathic scoliosis who underwent posterior selective thoracic fusion, the curve type, Cobb angle, apical vertebral rotation and translation, trunk shift, and thoracolumbar kyphosis were measured and analyzed.Results There were 17 King type Ⅱ patients (PUMC type: Ⅱb1 13, Ⅱc3 4). The coronal Cobb angle of thoracic curve before and after operation were 56.9°and 21.6° respectively, the mean correction rate was 60.1%. The coronal Cobb angle of lumbar curve before and after operation were 34.8° and 12.1° respectively, and the mean spontaneous correction rate was 64.8%.At final follow-up, the coronal Cobb angle of thoracic and lumbar curve were 23.5° and 15.2° respectively, there were no significant changes in the coronal Cobb angle, apical vertebral translation and rotation compared with that after operation.One patient had 12° of thoracolumbar kyphosis after operation, no progression was noted at final follow-up. There was no trunk decompensation or deterioration of the lumbar curve. In this group, 3.9 levels were saved compared with fusing both the thoracic and lumbar curves.Conclusion Posterior selective thoracic fusion can be safely and effectively performed in King type Ⅱ patients with a moderate and flexible lumbar curve, which can save more mobile segments and at the same time can maintain a good coronal and sagittal balance.

  18. Three dimensional model for surgical planning in resection of thoracic tumors

    Directory of Open Access Journals (Sweden)

    Min P. Kim


    Conclusion: Three-dimensional printed model provide better visualization of complex thoracic tumors, aid in counseling the patient about the surgical procedure and assisted in surgical resection of thoracic malignancy.

  19. Three-Dimensional Reconstruction of Thoracic Structures: Based on Chinese Visible Human

    Directory of Open Access Journals (Sweden)

    Yi Wu


    Full Text Available We managed to establish three-dimensional digitized visible model of human thoracic structures and to provide morphological data for imaging diagnosis and thoracic and cardiovascular surgery. With Photoshop software, the contour line of lungs and mediastinal structures including heart, aorta and its ramus, azygos vein, superior vena cava, inferior vena cava, thymus, esophagus, diaphragm, phrenic nerve, vagus nerve, sympathetic trunk, thoracic vertebrae, sternum, thoracic duct, and so forth were segmented from the Chinese Visible Human (CVH-1 data set. The contour data set of segmented thoracic structures was imported to Amira software and 3D thorax models were reconstructed via surface rendering and volume rendering. With Amira software, surface rendering reconstructed model of thoracic organs and its volume rendering reconstructed model were 3D reconstructed and can be displayed together clearly and accurately. It provides a learning tool of interpreting human thoracic anatomy and virtual thoracic and cardiovascular surgery for medical students and junior surgeons.

  20. Electrical impedance measured changes in thoracic fluid content during thoracentesis

    DEFF Research Database (Denmark)

    Petersen, J R; Jensen, B V; Drabaek, H;


    of each 500 ml, and at the end of the thoracentesis. We found a close linear correlation (r = 0.97) between changes in Z0 and the volume of aspirated pleural effusion (y = 0.415.x+0.093). The variability of the estimated thoracic fluid volumes was analysed with a plot of the residuals from the regression...... line, and we found that changes in thoracic fluid volume estimated by impedance technique would be within +/- 302 ml (= 2 SD). However, the absolute value of Z0 before thoracentesis could not differentiate the group of patients with pleural effusion from normal subjects (n = 28)....

  1. Modified uniportal video-assisted thoracic surgery in children. (United States)

    Fernandez-Pineda, Israel; Seims, Aaron D


    Video-assisted thoracic surgery (VATS) has been traditionally performed by a multi-port approach, but uniportal VATS is gaining popularity among thoracic surgeons. The use of only one intercostal space may result in less pain, but competition among camera and operating instruments may be a disadvantage. In children, the limited space in the thorax makes the uniportal VATS difficult to accomplish. We present a modification of the uniportal VATS, using a single skin incision but placing the thoracoscope in the superior or inferior intercostal space relative to the working instruments to increase instrument range of motion within a single intercostal space.

  2. Modified uniportal video-assisted thoracic surgery in children (United States)

    Fernandez-Pineda, Israel; Seims, Aaron D.


    Video-assisted thoracic surgery (VATS) has been traditionally performed by a multi-port approach, but uniportal VATS is gaining popularity among thoracic surgeons. The use of only one intercostal space may result in less pain, but competition among camera and operating instruments may be a disadvantage. In children, the limited space in the thorax makes the uniportal VATS difficult to accomplish. We present a modification of the uniportal VATS, using a single skin incision but placing the thoracoscope in the superior or inferior intercostal space relative to the working instruments to increase instrument range of motion within a single intercostal space. PMID:27251823

  3. Study on hemodynamics in patient-specific thoracic aortic aneurysm

    Institute of Scientific and Technical Information of China (English)


    The objective of this study is to investigate the hemodynamics in patient-specific thoracic aortic aneurysm and discuss the reason for formation of aortic plaque.A 3-Dimensional pulsatile blood flow in thoracic aorta with a fusiform aneurysm and 3 main branched vessels was studied numerically with the average Reynolds number of 1399 and the Womersley number of 19.2.Based on the clinical 2-Dimensional CT slice data,the patient-specific geometry model was constructed using medical image process software.Un...

  4. Prevention and Management of Nerve Injuries in Thoracic Surgery. (United States)

    Auchincloss, Hugh G; Donahue, Dean M


    Nerve injuries can cause substantial morbidity after thoracic surgical procedures. These injuries are preventable, provided that the surgeon has a thorough understanding of the anatomy and follows important surgical principles. When nerve injuries occur, it is important to recognize the options available in the immediate and postoperative settings, including expectant management, immediate nerve reconstruction, or auxiliary procedures. This article covers the basic anatomy and physiology of nerves and nerve injuries, an overview of techniques in nerve reconstruction, and a guide to the nerves most commonly involved in thoracic operative procedures.

  5. Palmar hyperhidrosis - CT guided chemical percutaneous thoracic sympathectomy

    Energy Technology Data Exchange (ETDEWEB)

    Adler, O.B.; Engel, A.; Rosenberger, A. (Technion-Israel Inst. of Tech., Haifa (Israel). Dept. of Diagnostic Radiology); Dondelinger, R. (Centre Hospitalier, Luxembourg (Luxembourg). Dept. of Diagnostic Radiology)


    Palmar hyperhidrosis or excessive sweating of the hands causes, to those affected, emotional and physical disturbance and impediment in professional and social life. The cause is unknown. Sweat glands are innervated by the sympathic chain of the autonomous nervous system. The center of sympathic regulation of the upper extremities is located between the segments of D.2-D.9 of the spinal cord. Accepted treatment consists of surgery aimed to excise the third thoracic sympathic ganglion. CT guided chemical percutaneous thoracic sympathectomy presents an alternative, which in the event of failure does not prevent ensuing surgery. The preliminary experience with this procedure in 50 patients is presented and discussed. (orig./GDG).

  6. Changes in proprioception and pain in patients with neck pain after upper thoracic manipulation


    Yang, Jinmo; Lee, Byoungkwon; Kim, Changbeom


    [Purpose] The purpose of this study was to conduct cervical stability training and upper thoracic manipulation for patients with chronic neck pain and then investigate the changes of cervical proprioception and pain. [Subjects and Methods] Subjects were 30 workers with mechanical neck pain, who were randomly divided into an upper thoracic manipulation group and a cervical stability training group. Upper thoracic manipulation after cervical stability training was conducted for the upper thorac...

  7. Glacially-streamlined hard and soft beds of the paleo- Ontario ice stream in Southern Ontario and New York state (United States)

    Eyles, Nick; Doughty, Mike


    An extensive tract of glacially-streamlined terrain across a large part of Southern Ontario, Canada, is recognized as the footprint of the paleo-Ontario Ice Stream (OIS) within the easternmost Great Lakes sector of the last Laurentide Ice Sheet. The upstream part is a drumlinized and megagrooved 'hard bed' underlain by Cambro-Ordovician carbonates and sandstones. Subglacial plucking of jointed limestone on the lateral margins of drumlinized escarpment interfluves and rock drumlins generated a large flux of coarse debris within the ice base, recorded by sporadic spreads of hummocky rubble moraine. Downstream, the hard bed passes underneath a streamlined 'soft' bed of till-cored ('drift') drumlins and megaridges of the classic Peterborough and New York State drumlin fields. The boundary between the two bed types is a ~ 10 km wide 'mixed bed' of isolated drift drumlins resting on drumlinized rock suggesting a common erosional origin. Spatial variation in the geomorphology of ~ 2500 drift drumlins, indicates that megaridges are clones resulting from the erosion and dissection of larger parent drumlins. A large moraine system may mark the final collapse and melt of the ice stream, accompanying abrupt flow switching of its margin.

  8. Is Ontario Hydro for sale? Provincial commission recommends dissolving Utility`s 90-year monopoly

    Energy Technology Data Exchange (ETDEWEB)



    The possible breakup and privatization of Ontario Hydro was discussed, triggered by the recent release of the Macdonald Commission report which found that `there is no longer a sound economic rationale for allowing a large monopoly to dominate the electricity system`. The essence of the Committee`s recommendation was (1) to allow all electricity generators, including out-of-province suppliers to compete on equal terms for Ontario business;, (2) operate Ontario Hydro`s four nuclear generation plants as separate competing entities and keep them in public ownership, (3) provide open non-discriminatory access to Ontario`s transmission system, (4) move responsibility for managing Ontario Hydro`s high-voltage transmission assets to an independent {sup T}ransmission Grid Company`, (5) reduce the number of distribution utilities from the current total of 307, and (6) create community-based organizations to serve remote communities that are not connected to the transmission system. The expectation is that competition will lead to lower energy prices and more choice for consumers. No action from the Ontario government is expected for several months, and not without extensive consultation with the industry and consumers.

  9. Ruptured thoracic intraspinal dermoid cyst in a patient with skeletal abnormalities of thoracic spine – A case report

    Directory of Open Access Journals (Sweden)

    Mrudang Raval


    Full Text Available Spinal dermoids are congenital multi- or unilocular benign cystic tumors lined by squamous epithelium containing skin appendages. The tumours become acutely symptomatic following infection or rupture. We present a very rare case of ruptured thoracic spinal dermoid cyst in a 12 year old girl with congenital vertebral abnormalities, who presented with back ache of recent onset and a 5 year history of unnoticed slipping of footwear while walking. Magnetic resonance imaging reveals a lesion in the thoracic spine with fat droplets in bilateral frontal horns of lateral ventricle and cisterns of brain. Other additional findings were also noted.

  10. Awake transapical aortic valve implantation using thoracic epidural anesthesia. (United States)

    Mukherjee, Chirojit; Walther, Thomas; Borger, Michael Andrew; Kempfert, Joerg; Schuler, Gerhard; Mohr, Friedrich Wilhelm; Ender, Joerg


    Transapical aortic valve implantation is a minimally invasive, beating-heart procedure that normally requires a general anesthetic. We herein report an 85-year-old patient with impaired pulmonary function who underwent successful transapical aortic valve implantation while awake, using a thoracic epidural anesthetic.

  11. Video-Assisted Thoracic Placement of Epicardial Leads

    NARCIS (Netherlands)

    Schouwenburg, Jasper J.; Klinkenberg, Theo J.; Maass, Alexander H.; Mariani, Massimo A.


    Cardiac resynchronization therapy is one of the cornerstones of heart failure treatment. Inability to access the coronary sinus or one of its sidebranches is one of the most common causes of therapeutic failure. We describe a technique using video-assisted thoracic surgery for epicardial placement o

  12. Thoracic outlet syndrome in musicians - an approach to treatment. (United States)

    Campbell, R M


    Thoracic outlet syndrome (TOS) can affect the skill of instrumental musicians. This paper details the way in which symptomatic TOS affects the musician and describes two cases of symptomatic TOS in a drummer and a violinist. Evaluation tools and treatment techniques are described.

  13. A Rare Case: Gastric Cancer; Involving Primery Thoracal Vertebral Metastases

    Directory of Open Access Journals (Sweden)

    Harun Arslan


    Full Text Available Primery bone metastases rarely occur in gastric cancer. Bone metastases indicate that the prognosis is bad. In that article we present a case that is diagnosed as a gastric cancer with primary bone metasteses that caused pathologic thoracal vertebral fracture seenby computer ised tomography.

  14. Imaging Techniques for Diagnosis of Thoracic Aortic Atherosclerosis

    NARCIS (Netherlands)

    Jansen Klomp, W.W.; Brandon Bravo Bruinsma, G.J.; Hof, van 't A.W.; Grandjean, J.G.; Nierich, A.P.


    The most severe complications after cardiac surgery are neurological complications including stroke which is often caused by emboli merging from atherosclerosis in the ascending aorta to the brain. Information about the thoracic aorta is crucial in reducing the embolization risk for both surgical op

  15. Diseases of the thoracic aorta and pulmonary arteries

    NARCIS (Netherlands)

    Salgado, R.; Habets, J.; Budde, R. P J; Leiner, T.


    Many acute and chronic clinical entities can affect the great thoracic arteries. As clinical findings are often unreliable, (mostly) noninvasive imaging plays a crucial role both in the initial assessment of critically ill patients, and in the follow-up of chronic conditions. Imaging also forms an i

  16. Video-assisted thoracoscopic surgery for acute thoracic trauma

    Directory of Open Access Journals (Sweden)

    Michael Goodman


    Full Text Available Background: Operative intervention for thoracic trauma typically requires thoracotomy. We hypothesized that thoracoscopy may be safely and effectively utilized for the acute management of thoracic injuries. Materials and Methods: The Trauma Registry of a Level I trauma center was queried from 1999 through 2010 for all video-assisted thoracic procedures within 24 h of admission. Data collected included initial vital signs, operative indication, intraoperative course, and postoperative outcome. Results: Twenty-three patients met inclusion criteria: 3 (13% following blunt injury and 20 (87% after penetrating trauma. Indications for urgent thoracoscopy included diaphragmatic/esophageal injury, retained hemothorax, ongoing hemorrhage, and open/persistent pneumothorax. No conversions to thoracotomy were required and no patient required re-operation. Mean postoperative chest tube duration was 2.9 days and mean length of stay was 5.6 days. Conclusion: Video-assisted thoracoscopic surgery is safe and effective for managing thoracic trauma in hemodynamically stable patients within the first 24 h post-injury.

  17. Study of 433 Operated Cases of Thoracic Trauma. (United States)

    Çakmak, Muharrem; Nail Kandemir, Mehmet


    Patients with thoracic trauma constitute one third of all the trauma cases. Of traumatic patients, 20-25 % die because of thoracic trauma. Our aim was to compare our clinical experience and the results with the related literature. Four hundred thirty-three patients, who underwent surgical interventions due to thoracic trauma, were evaluated. The latest form of treatment applied were taken as the criteria for the quantitative detection of patients. Continuous variables were expressed as mean ± standard deviation, while categorical variables were explained as number and percentage. The significance of the analysis results was evaluated using Fisher's exact test. p values tamponade in 1 patient (0.23 %). It was demonstrated that 385 of 433 patients examined in the study underwent tube thoracostomy, 41 were treated with thoracotomy, while 6 of them underwent video-assisted thoracoscopic surgery (VATS), and 1 underwent sternotomy. No correlation was observed between mortality, morbidity, and gender and type of trauma and location of trauma (p > 0.05). However, statistically significant correlation was found between mortaxlity, morbidity, and the presence of concomitant injuries, the duration between injury and admission being more than 1 h (p < 0.05). Urgent intervention, early diagnosis, and fast transport are vital for patients with thoracic injuries.

  18. Postoperative Complications after Thoracic Surgery in the Morbidly Obese Patient

    Directory of Open Access Journals (Sweden)

    Lebron Cooper


    Full Text Available Little has been recently published about specific postoperative complications following thoracic surgery in the morbidly obese patient. Greater numbers of patients who are obese, morbidly obese, or supermorbidly obese are undergoing surgical procedures. Postoperative complications after thoracic surgery in these patients that can lead to increased morbidity and mortality, prolonged hospital stay, and increased cost of care are considered. Complications include difficulties with mask ventilation and securing the airway, obstructive sleep apnea with risk of oversedation, pulmonary complications related to reduced total lung capacity, reduced functional residual capacity, and reduced vital capacity, risks of aspiration pneumonitis and ventilator-associated pneumonia, cardiomyopathies, and atrial fibrillation, inadequate diabetes management, positioning injuries, increased risk of venous thrombosis, and pulmonary embolism. The type of thoracic surgical procedure may also pose other problems to consider during the postoperative period. Obese patients undergoing thoracic surgery pose a challenge to those caring for them. Those working with these patients must understand how to recognize, prevent, and manage these postoperative complications.

  19. Clinical application of thoracic paravertebral anesthetic block in breast surgeries

    Directory of Open Access Journals (Sweden)

    Sara Socorro Faria


    Full Text Available INTRODUCTION: Optimum treatment for postoperative pain has been of fundamental importance in surgical patient care. Among the analgesic techniques aimed at this group of patients, thoracic paravertebral block combined with general anesthesia stands out for the good results and favorable risk-benefit ratio. Many local anesthetics and other adjuvant drugs are being investigated for use in this technique, in order to improve the quality of analgesia and reduce adverse effects. OBJECTIVE: Evaluate the effectiveness and safety of paravertebral block compared to other analgesic and anesthetic regimens in women undergoing breast cancer surgeries. METHODS: Integrative literature review from 1966 to 2012, using specific terms in computerized databases of articles investigating the clinical characteristics, adverse effects, and beneficial effects of thoracic paravertebral block. RESULTS: On the selected date, 16 randomized studies that met the selection criteria established for this literature review were identified. Thoracic paravertebral block showed a significant reduction of postoperative pain, as well as decreased pain during arm movement after surgery. CONCLUSION: Thoracic paravertebral block reduced postoperative analgesic requirement compared to placebo group, markedly within the first 24 h. The use of this technique could ensure postoperative analgesia of clinical relevance. Further studies with larger populations are necessary, as paravertebral block seems to be promising for preemptive analgesia in breast cancer surgery.

  20. Shared Genetic Risk Factors of Intracranial, Abdominal, and Thoracic Aneurysms

    NARCIS (Netherlands)

    van 't Hof, Femke N G; Ruigrok, Ynte M; Lee, Cue Hyunkyu; Ripke, Stephan; Anderson, Graig; de Andrade, Mariza; Baas, Annette F; Blankensteijn, Jan D; Böttinger, Erwin P; Bown, Matthew J; Broderick, Joseph; Bijlenga, Philippe; Carrell, David S; Crawford, Dana C; Crosslin, David R; Ebeling, Christian; Eriksson, Johan G; Fornage, Myriam; Foroud, Tatiana; von Und Zu Fraunberg, Mikael; Friedrich, Christoph M; Gaál, Emília I; Gottesman, Omri; Guo, Dong-Chuan; Harrison, Seamus C; Hernesniemi, Juha; Hofman, Albert; Inoue, Ituro; Jääskeläinen, Juha E; Jones, Gregory T; Kiemeney, Lambertus A L M; Kivisaari, Riku; Ko, Nerissa; Koskinen, Seppo; Kubo, Michiaki; Kullo, Iftikhar J; Kuivaniemi, Helena; Kurki, Mitja I; Laakso, Aki; Lai, Dongbing; Leal, Suzanne M; Lehto, Hanna; LeMaire, Scott A; Low, Siew-Kee; Malinowski, Jennifer; McCarty, Catherine A; Milewicz, Dianna M; Mosley, Thomas H; Nakamura, Yusuke; Nakaoka, Hirofumi; Niemelä, Mika; Pacheco, Jennifer; Peissig, Peggy L; Pera, Joanna; Rasmussen-Torvik, Laura; Ritchie, Marylyn D; Rivadeneira, Fernando; van Rij, Andre M; Santos-Cortez, Regie Lyn P; Saratzis, Athanasios; Slowik, Agnieszka; Takahashi, Atsushi; Tromp, Gerard; Uitterlinden, André G; Verma, Shefali S; Vermeulen, Sita H; Wang, Gao T; Han, Buhm; Rinkel, Gabriël J E; de Bakker, Paul I W


    BACKGROUND: Intracranial aneurysms (IAs), abdominal aortic aneurysms (AAAs), and thoracic aortic aneurysms (TAAs) all have a familial predisposition. Given that aneurysm types are known to co-occur, we hypothesized that there may be shared genetic risk factors for IAs, AAAs, and TAAs. METHODS AND RE

  1. Xanthorrhizol induces endothelium-independent relaxation of rat thoracic aorta. (United States)

    Campos, M G; Oropeza, M V; Villanueva, T; Aguilar, M I; Delgado, G; Ponce, H A


    Xanthorrhizol, a bisabolene isolated from the medicinal plant Iostephane heterophylla, was assayed on rat thoracic aorta rings to elucidate its effect and likely mechanism of action, by measuring changes of isometric tension. Xanthorrhizol (1, 3, 10, 30 and 100 microg/mL) significantly inhibited precontractions induced by KCI-; (60mM), noradrenaline (10(-6) M) or CaCl2 (1.0 mM). Increasing concentrations of external calcium antagonized the inhibitory effect on KCl-induced contractions. The vasorelaxing effect of xanthorrhizol was not affected by indomethacin (10 microM) or L-NAME (100 microM) in intact rat thoracic aorta rings precontracted by noradrenaline, which suggested that the effect was not mediated through either endothelium-derived prostacyclin (PGI2) or nitric oxide release from endothelial cells. Endothelium removal did not affect the relaxation induced by xanthorrhizol on rat thoracic aorta rings, discarding the participation of any substance released by the endothelium. Xanthorrhizol inhibitory effect was greater on KCI- and CaCl2-induced contractions than on those induced by noradrenaline. Xanthorrhizol inhibitory effect in rat thoracic aorta is likely explained for interference with calcium availability by inhibiting calcium influx through both voltage- and receptor-operated channels.

  2. Surgical treatment for thoracic hydatidosis: review of 1230 cases

    Institute of Scientific and Technical Information of China (English)

    WU Ming-bai; ZHANG Li-wei; ZHU Hui; QIAN Zhong-xi


    @@ Hydatid disease, a serious health problem, is endemic in many sheep and cattle raising areas. Though many kinds of medicines were used experimentally, operation is the only effective treatment for thoracic hydatidosis. The surgical treatments of 1230 patients with the disease in our division between June 1957 and December 2002 are discussed below.

  3. Survey of Neisseria gonorrhoeae Antimicrobial Susceptibility in Ontario

    Directory of Open Access Journals (Sweden)

    Vivian G Loo


    Full Text Available The minimal inhibitory concentrations (MICs of penicillin, tetracycline, erythromycin, cefoxitin, ceftriaxone and spectinomycin were determined for 300 consecutive strains of Neisseria gonorrhoeae collected from physicians’ offices in Ontario. Only four isolates were found to produce beta-lactamase. Of the remaining 296 isolates, five (1.7% had penicillin MICs greater than or equal to 1 mg/L, 78 (26.3% had tetracycline MICs greater than or equal to 1 mg/L, 13 (4.4% had cefoxitin MICs greater than or equal to 1 mg/L and 43 (14.5% had erythromycin MICs greater than or equal to 1 mg/L. Two isolates (0.7% had high level tetracycline resistance with MICs greater than or equal to 16 mg/L. All N gonorrhoeae isolates were susceptible to ceftriaxone and to spectinomycin.

  4. Videoconferencing and dietitian services in rural Ontario communities. (United States)

    Stenlund, Diana


    Registered dietitians (RDs) are regulated health professionals in short supply in Ontario and throughout Canada. Projected workforce studies indicate the situation will likely worsen. Accessing these nutrition specialists is an even greater concern for residents living in rural or remote regions of the province. Smaller communities are increasingly using telehealth as a way to deliver health care services and to improve access to health care professionals. The adoption of interactive videoconferencing as a telehealth application is examined as an alternative approach for accessing RDs in rural communities. While valid reasons exist for implementing videoconferencing, other issues must be considered. These include costs, technological requirements, organizational readiness, and legal and ethical concerns. Future research must fully address the concept of videoconferencing in relation to the Canadian dietetic workforce and practice requirements.

  5. Drinking, cannabis use and driving among Ontario students. (United States)

    Adlaf, Edward M; Mann, Robert E; Paglia, Angela


    Little is known about the risk of injury among adolescents who drive after the use of alcohol or cannabis or ride in cars driven by drunk drivers. We examined data from self-administered interviews with 1846 students in grades 7 to 13 who participated in the 2001 Ontario Student Drug Use Survey about their experiences related to alcohol, cannabis and driving during the 12 months preceding the survey. In all, 31.9% of the students reported being a passenger in a car driven by a drunk driver; of the students in grades 10 to 13 who had a driver's licence, 15.1% reported driving within an hour after consuming 2 or more drinks, and 19.7% reported driving within an hour after using cannabis. Our study shows that a sizeable proportion of adolescents are exposed to alcohol- and drug-related driving risks.

  6. Regulating Traditional Chinese Medicine Practitioners and Acupuncturists in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Glen E. Randall


    Full Text Available In 2006, the Ontario government passed the Traditional Chinese Medicine Act, which granted Traditional Chinese Medicine practitioners and Acupuncturists (TCM/A practitioners self-regulatory status under the Regulated Health Professions Act, 1991. The goal of the legislation was to create a new regulatory college that would set and enforce high standards of care and safety in order to enhance public protection and access to a range of traditional and alternative therapies. In April 2013, the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario was officially launched. Several factors account for the government’s decision to delegate self-regulatory authority to TCM/A practitioners through the creation of a regulatory college. In particular, the government’s decision seems to have been influenced by lobbying of some practitioners, greater public acceptance of alternative medicines, patient safety concerns related to acupuncture cases in the media, and the precedence of self-regulatory status being granted to these practitioners in other provinces. The degree to which the legislation has achieved its goals is difficult to determine given the short period of time the regulatory college has existed. However, the fact that the college has developed standards of practice to guide TCM/A practitioners and has a process in place to address public complaints is an early indication of movement toward achieving the policy’s goals. Le gouvernement de l'Ontario a fait voter en 2006 la Loi sur les praticiens en médecine traditionnelle chinoise, qui accorde aux praticiens en médecine traditionnelle chinoise et aux acupuncteurs (praticiens en MTC/A le statut de profession autonome dans le cadre la Loi sur les professions de la santé réglementées de 1991. Le but de la Loi était de créer un ordre professionnel capable d'établir et appliquer des normes de qualité et de sécurité des soins, ceci dans le but d

  7. Stent-graft repair for acute traumatic thoracic aortic rupture. (United States)

    Neuhauser, B; Czermak, B; Jaschke, W; Waldenberger, P; Fraedrich, G; Perkmann, R


    Traumatic rupture of the thoracic aorta is potentially life-threatening and leads to death in 75 to 90 per cent of cases at the time of injury. In high-risk patients, as traumatic injuries of the aorta combine with multiple associated injuries, endoluminal repair is now reported as a promising therapeutic strategy with encouraging results. This study determined the outcome of patients with traumatic thoracic aortic injury treated endovascularly during the past 7 years at our institution. Thirteen patients, 11 males and 2 females (mean age, 39 years; range, 19-82), with traumatic rupture of the otherwise unremarkable descending aorta (10 acute, 3 chronic), out of a series of 64 endovascular thoracic stent-graft procedures, were treated by implantation of Talent (n = 8), Vanguard (n = 5), and Excluder (n = 2) self-expanding devices between January 1996 and August 2003. The immediate technical success rate was 92 per cent (12/13). One patient showed a proximal endoleak type I, which was treated successfully by an additional stent-graft procedure. Secondary success rate was 100 per cent. The mortality rate was 0 per cent. Two additional stent-graft procedures were performed due to type I endoleaks after 18 and 28 months. There was no other intervention-related morbidity or mortality during the mean follow-up time of 26.4 months' (range, 6-86). Endovascular stent-graft repair of traumatic thoracic aortic injuries is a safe, effective, and low-morbidity alternative to open thoracic surgery and has promising midterm results.

  8. Uniextrapedicular kyphoplasty for the treatment of thoracic osteoporotic vertebral fractures. (United States)

    Ge, Zhaohui; Ma, Rong; Chen, Zhen; Zhang, Huiyong; Ding, Huiqiang; Liang, Siming; Suo, Zhigang


    Osteoporotic vertebral compression fractures are common and cause pain and disability. Most osteoporotic vertebral compression fractures occur in the lower thoracic and thoracolumbar spine. Percutaneous balloon kyphoplasty through a transpedicular approach is a classic procedure performed to treat osteoporotic vertebral compression fractures. However, due to the slender morphology of the pedicles, small pedicle size, and the angular severity of thoracic kyphosis, performing kyphoplasty in middle and high thoracic levels is technically challenging. The purpose of this retrospective study was to evaluate the clinical outcomes of single-balloon kyphoplasty for the treatment of thoracic osteoporotic vertebral compression fractures via an extrapedicular approach. Between July 2004 and May 2008, thirty-eight patients with thoracic osteoporotic vertebral compression fractures underwent percutaneous kyphoplasty via a unilateral extrapedicular approach. Average patient age was 60.3 years. Symptomatic levels ranged from T4 to T12. All affected vertebrae were identified via physical examination, magnetic resonance imaging, and radiographs. Pain relief, vertebral height restoration, and kyphosis correction were compared pre- and postoperatively using the visual analog scale and radiographs. The operation was successful in all patients. Average injected bone cement volume was 3.2±1.4 mL. Mean follow-up was 9.5 months. Visual analog scale pain score improved in 36 of 38 patients postoperatively. Mean visual analog scale pain score was 8.92±0.682 preoperatively and 2.40±0.31 postoperatively and remained at 2.80±0.34 until last follow-up. Mean middle body height correction ratio was 50.9%±34.6%. No lateral wedging was found in the coronal alignment of the treated vertebrae. Three (7.9%) patients sustained cement extravasation with no adverse events. Kyphoplasty through a unilateral extrapedicular approach can achieve convergent and proper cement filling in the affected

  9. Penetrating thoracic injury with retained foreign body: can video-assisted thoracic surgery take up the leading role in acute management? (United States)

    Yu, Peter S Y; Chan, Herman H M; Lau, Rainbow W H; Capili, Freddie G; Underwood, Malcolm J; Wan, Innes Y P


    Video-assisted thoracic surgery (VATS) is widely adopted in acute management of patient with thoracic trauma, but its use in penetrating thoracic injuries with retained foreign bodies were rarely reported. We described three of such cases using VATS as the first line approach. Identification of injuries, control of bleeders, clot evacuation, resection of damaged lung parenchyma and safe retrieval of foreign bodies were all performed via complete VATS within short operative time. Patient were uneventfully discharged during early post-operative period. We suggest that, for haemodynamically stable patients, VATS offers a safe and minimally-invasive alternative to conventional thoracotomy for penetrating thoracic injury with retained foreign bodies.

  10. Hydroacoustic measures of Mysis relicta abundance and distribution in Lake Ontario (United States)

    Rudstam, L. G.; Schaner, T.; Gal, G.; Boscarino, B.T.; O'Gorman, R.; Warner, D.M.; Johannsson, O.E.; Bowen, K.L.


    Mysis relicta can be observed on echograms as a sound scattering layer when they migrate into the water column at night to feed on zooplankton. However, quantitative measures of mysid abundance with hydroacoustics requires knowledge of mysid target strength (TS), a method of removing fish echoes and contribution from noise, and an understanding of the effect of range on the ability of hydroacoustics to detect mysids (the detection limit). Comparisons of paired net data and acoustics data from July 7, 2005 yielded a mysid TS of -86.3 dB (9 mm animal) and a biomass TS of -58.4 dB (g dry wt)-1. With ambient noise levels (Sv of -125 dB at 1 m depth) and this TS, we can detect a mysid density of 1 m-3 at 60 m depth with a signal to noise ratio of 3 dB. We present a method to remove backscattering from both noise and fish and apply this method and the new TS data to whole lake acoustic data from Lake Ontario collected in July 25-31, 2005 with a 120 kHz echosounder as part of the annual standard fish survey in that lake. Mysis abundance was strongly depth dependent, with highest densities in areas with bottom depth > 100 m, and few mysids in areas with bottom depth 100 m, 100-75 m, 75-50 m, 50-30 m, < 30 m), the whole-lake average mysid density was 118 m-2 (CV 21%) and the whole-lake average mysid biomass was 0.19 g dry wt m-2 (CV 22%) in July 2005. The CVs of these densities also account for uncertainty in the TS estimates. This is comparable to whole-lake density estimates using vertical net tows in November, 2005 (93 m-2, CV 16%). Copyright ?? 2008 AEHMS.

  11. Nuclear resurrection: Must Ontario fire up more reactors to power its future?

    Energy Technology Data Exchange (ETDEWEB)

    Dewar, E.


    An extensive historical review of Canada's nuclear reactor program is provided. The author also examines the role of nuclear power generation in Ontario's energy future, concluding that given the limited capacity for additional hydro power, and the uncertainty of natural gas supply, nuclear power will likely remain a significant source of energy for Ontario for the foreseeable future. Nevertheless, the challenge to bring nuclear power generation under control remains, considering that despite the best efforts of generations of nuclear engineers, politicians and regulators the industry appears close to being unmanageable, and Ontario taxpayers are likely to be paying its old debt far into the future. The current contingent of reactors is rapidly aging and the disposal of used nuclear fuel still defies a satisfactory solution. These formidable challenges notwithstanding, best estimates are that Ontario has few viable alternatives, and will have to embark on a new cycle of nuclear construction before the end of this decade.

  12. Neoliberalism and Ontario Teachers’ Unions: A “Not-So” Common Sense Revolution

    Directory of Open Access Journals (Sweden)

    Duncan MacLellan


    Full Text Available This paper will critically analyze the degree to which the Ontario government, led by then Premier Mike Harris, embarked on a neoliberal agenda that led to a crisis in Ontario’s educational system. The period from 1995-2000 was one of the most contentious in Ontario’s educational history, and two pieces of legislation, The College of Teachers Act (Bill 31 and the Education Quality Improvement Act (Bill 160, pitted teacher unions, in particular, the Ontario Secondary School Teachers’ Federation (OSSTF and the Ontario English Catholic Teachers’ Association (OECTA, against the Harris government. Bill 160 led to a ten-day protest by teachers across Ontario, which signaled a dramatic shift in teacher and state relations that marked a crisis period in Ontario’s educational sector.

  13. Waterfowl breeding population survey: Northern Saskatchewan, northern Manitoba and western Ontario: May-June 1959 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for northern Saskatchewan, northern Manitoba, and western Ontario during 1959. The...

  14. Pilot study: Waterfowl breeding population survey: Ontario, Quebec, and New York: May 1995 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for Ontario, Quebec, and New York during 1995. The primary purpose of the survey is to...

  15. Southern Ontario, Quebec, and New York: Waterfowl breeding population survey: 2000 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for Southern Ontario, Quebec, and New York during 2000. The primary purpose of the survey...

  16. Waterfowl breeding pair survey for western Ontario: May 27 through June 1, 1973 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for western Ontario during 1973. The primary purpose of the survey is to provide...

  17. Waterfowl breeding population survey: New York, Eastern Ontario, and Southern Quebec: 1999 (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the Waterfowl Breeding Population and Habitat Survey for New York, Eastern Ontario, and Southern Quebec during 1999. The primary purpose of...

  18. Validation of Six Short and Ultra-short Screening Instruments for Depression for People Living with HIV in Ontario: Results from the Ontario HIV Treatment Network Cohort Study

    DEFF Research Database (Denmark)

    Choi, Stephanie KY; Boyle, Eleanor; Burchell, Ann


    Objective Major depression affects up to half of people living with HIV. However, among HIV-positive patients, depression goes unrecognized 60–70% of the time in non-psychiatric settings. We sought to evaluate three screening instruments and their short forms to facilitate the recognition...... of current depression in HIV-positive patients attending HIV specialty care clinics in Ontario. Methods A multi-centre validation study was conducted in Ontario to examine the validity and accuracy of three instruments (the Center for Epidemiologic Depression Scale [CESD20], the Kessler Psychological...... Distress Scale [K10], and the Patient Health Questionnaire depression scale [PHQ9]) and their short forms (CESD10, K6, and PHQ2) in diagnosing current major depression among 190 HIV-positive patients in Ontario. Results from the three instruments and their short forms were compared to results from the gold...

  19. Environmental Factors in an Ontario Community with Disparities in Colorectal Cancer Incidence


    Sritharan, Jeavana; Kamaleswaran, Rishikesan; McFarlan, Ken; Lemonde, Manon; George, Clemon; Sanchez, Otto


    Objective: In Ontario, there are significant geographical disparities in colorectal cancer incidence. In particular, the northern region of Timiskaming has the highest incidence of colorectal cancer in Ontario while the southern region of Peel displays the lowest. We aimed to identify non-nutritional modifiable environmental factors in Timiskaming that may be associated with its diverging colorectal cancer incidence rates when compared to Peel. Methods: We performed a systematic review to ide...

  20. Prevalence of paratuberculosis in the dairy goat and dairy sheep industries in Ontario, Canada

    DEFF Research Database (Denmark)

    Bauman, Cathy A.; Jones-Bitton, Andria; Menzies, Paula;


    A cross-sectional study was undertaken (October 2010 to August 2011) to estimate the prevalence of paratuberculosis in the small ruminant dairy industries in Ontario, Canada. Blood and feces were sampled from 580 goats and 397 sheep (lactating and 2 y of age or older) that were randomly selected.......8%) and for dairy sheep was 48.3% (95% PI: 27.6% to 74.3%). These data indicate that a paratuberculosis control program for small ruminants is needed in Ontario....

  1. Thoracic kyphosis and rate of incident vertebral fractures: the Fracture Intervention Trial (United States)

    Vittinghoff, E.; Kado, D. M.; Lane, N. E.; Ensrud, K. E.; Shipp, K.


    Summary Biomechanical analyses support the theory that thoracic spine hyperkyphosis may increase risk of new vertebral fractures. While greater kyphosis was associated with an increased rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture. Introduction Biomechanical analyses suggest hyperkyphosis may increase risk of incident vertebral fracture by increasing the load on vertebral bodies during daily activities. We propose to assess the association of kyphosis with incident radiographic vertebral fracture. Methods We used data from the Fracture Intervention Trial among 3038 women 55–81 years of age with low bone mineral density (BMD). Baseline kyphosis angle was measured using a Debrunner kyphometer. Vertebral fractures were assessed at baseline and follow-up from lateral radiographs of the thoracic and lumbar spine. We used Poisson models to estimate the independent association of kyphosis with incident fracture, controlling for age and femoral neck BMD. Results Mean baseline kyphosis was 48° (SD = 12) (range 7–83). At baseline, 962 (32 %) participants had a prevalent fracture. There were 221 incident fractures over a median of 4 years. At baseline, prevalent fracture was associated with 3.7° greater average kyphosis (95 % CI 2.8–4.6, p < 0.0005), adjusting for age and femoral neck BMD. Before adjusting for prevalent fracture, each 10° greater kyphosis was associated with 22 % increase (95 % CI 8–38 %, p = 0.001) in annualized rate of new radiographic vertebral fracture, adjusting for age and femoral neck BMD. After additional adjustment for prevalent fracture, estimated increased annualized rate was attenuated and no longer significant, 8 % per 10° kyphosis (95 % CI −4 to 22 %, p = 0.18). Conclusions While greater kyphosis increased the rate of

  2. Photodynamic Therapy in Non-Gastrointestinal Thoracic Malignancies

    Directory of Open Access Journals (Sweden)

    Biniam Kidane


    Full Text Available Photodynamic therapy has a role in the management of early and late thoracic malignancies. It can be used to facilitate minimally-invasive treatment of early endobronchial tumours and also to palliate obstructive and bleeding effects of advanced endobronchial tumours. Photodynamic therapy has been used as a means of downsizing tumours to allow for resection, as well as reducing the extent of resection necessary. It has also been used successfully for minimally-invasive management of local recurrences, which is especially valuable for patients who are not eligible for radiation therapy. Photodynamic therapy has also shown promising results in mesothelioma and pleural-based metastatic disease. As new generation photosensitizers are being developed and tested and methodological issues continue to be addressed, the role of photodynamic therapy in thoracic malignancies continues to evolve.

  3. Intraoperative fluorescence diagnosis for removal of cervical and thoracic ependymoma

    Directory of Open Access Journals (Sweden)

    A. M. Zaytcev


    Full Text Available The case of successful intraoperative fluorescence diagnosis (IOFD for removal of cervical and thoracic ependymoma performed in P.A. Herzen MCRI is reported. For FD we used the Alasens (Research Institute of Organic Semi-Finished Products and Dyes. The drug solution was given per os at a dose of 20 mg/kg body weight 2.5 h before surgery. IOFD was per-formed 3 h after intake of photosensitizer. For fluorescence diagnosis there was average in-tensity of fluorescence in tumor and no fluorescence in normal spinal tissues. The extent of surgery was determined according to results of IOFD. The control MRI of cervical and supeior thoracic spine with contrast enhancement and follow-up confirmed definitive removal of tumor and showed no postoperative complications.

  4. Thoracic spinal trauma associated with closed thoraco-abdominal injury

    Institute of Scientific and Technical Information of China (English)

    路磊; 吴立文; 范广宇


    Objective: To explore the management of thoracic spinal trauma (TST) associated with closed thoraco-abdominal injuries (CTAI). Methods: A retrospective study was made on 259 patients with TST admitted to our department as an emergency treatment from January 1996 to June 2001. We summarized the clinical features of TST associated with CTAI. Results: Among 259 patients with thoracic spinal trauma, 112 were associated with CTAI. Traffic accident was the most common cause. The force causing upper TST was more violent than that causing the lower. Pulmonary complications were the leading cause of death in this group. Surgery could not improve neurological function for completely paraplegic patients.Conclusions: The reason that upper TST has the tendency to be associated with CTAI is its special anatomical feature. Routine ultrasonic examination can avoid misdiagnosis of latent closed abdominal injuries associated with spinal injury. The presence of potential injuries, especially CTAI, should be considered when deciding whether or not to perform surgery early.

  5. Thoracic injury potential of basic competition taekwondo kicks. (United States)

    Serina, E R; Lieu, D K


    A major concern in competition taekwondo is the injury potential posed by many of the powerful kicks used. An investigation of the kinetics of four kicks frequently used in competition was performed with high speed video. Velocities were measured, and energy was calculated. Typical values for basic swing kicks were 15 ms-1 and 200 J. Basic thrust kicks possessed 45% less velocity but 28% more energy than swing kicks. Linkage models were developed to simulate the motion and kinetics of the kicking leg. Injury potential was evaluated through thoracic compression and viscous criterion models. These models predict a significant probability of serious injury with all kicks, with thoracic deflections from 3 to 5 cm and peak viscous tolerance values from 0.9-1.4 ms-1, when no protective body equipment is used.

  6. Spinal accessory neuropathy, droopy shoulder, and thoracic outlet syndrome. (United States)

    Al-Shekhlee, Amer; Katirji, Bashar


    Droopy shoulder has been proposed as a cause of thoracic outlet syndrome. Two patients developed manifestations of neurovascular compression upon arm abduction, associated with unilateral droopy shoulder and trapezius muscle weakness caused by iatrogenic spinal accessory neuropathies following cervical lymph node biopsies. The first patient developed a cold, numb hand with complete axillary artery occlusion when his arm was abducted to 90 degrees. The second patient complained of paresthesias in digits 4 and 5 of the right hand, worsened by elevation of the arm, with nerve conduction findings of right lower trunk plexopathy (low ulnar and medial antebrachial cutaneous sensory nerve action potentials). Spinal accessory nerve grafting (in the first patient) coupled with shoulder strengthening physical exercises in both patients resulted in gradual improvement of symptoms in 2 years. These two cases demonstrate that unilateral droopy shoulder secondary to trapezius muscle weakness may cause compression of the thoracic outlet structures.

  7. Distal thoracic oesophageal perforation secondary to blunt trauma: Case report

    Directory of Open Access Journals (Sweden)

    Tandon Ruchi


    Full Text Available Abstract Background Traumatic perforation of the distal oesophagus due to blunt trauma is a very rare condition and is still associated with a significant morbidity and mortality. This is further exacerbated by delayed diagnosis and management as symptoms and signs are often masked by or ascribed to more common blunt thoracic injuries. Case report We present a case of a distal oesophageal perforation, secondary to a fall from a third storey window, which was masked by concomitant thoracic injuries and missed on both computed tomography imaging and laparotomy. The delay in his diagnosis significantly worsened the patient's recovery by allowing the development of an overwhelming chest sepsis that contributed to his death. Conclusion Early identification of an intrathoracic oesophageal perforation requires deliberate consideration and is essential to ensure a favorable outcome. Treatment should be individualised taking into account the nature of the oesophageal defect, time elapsed from injury and the patient's general condition.

  8. Endovascular repair of traumatic thoracic aortic injuries: a critical appraisal. (United States)

    Lin, Peter H; Huynh, Tam T; Kougias, Panagiotis; Wall, Mathew J; Coselli, Joseph S; Mattox, Kenneth L


    Blunt trauma to the thoracic aorta is life-threatening, with instant fatality in at least 75% of victims. If left untreated, nearly half of those who survive the initial injury will die within the first 24 hours. Surgical repair has been the standard treatment of blunt aortic injury, but immediate operative intervention is frequently difficult due to concomitant injuries. Although endovascular treatment of traumatic aortic disruption is less invasive than conventional repair via thoracotomy, this strategy remains controversial in young patients due to anatomical considerations and device limitations. This article reviews the likely advantages of endovascular interventions for blunt thoracic aortic injuries. Potential limitations and clinical outcomes of this minimally invasive technique are also discussed.

  9. Local complications of hydatid disease involving thoracic cavity: Imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Turgut, A.T. [Department of Radiology, Ankara Training and Research Hospital, Ankara (Turkey)], E-mail:; Altinok, T. [Department of Thoracic Surgery, Meram Faculty of Medicine, Selcuk University, Konya (Turkey); Topcu, S. [Department of Thoracic Surgery, Faculty of Medicine, Kocaeli University, Izmit (Turkey); Kosar, U. [Department of Radiology, Ankara Training and Research Hospital, Ankara (Turkey)


    Hydatid disease, a worldwide zoonosis, is caused by the larval stage of the Echinococcus tapeworm. Although it can involve almost every organ of the body, lung involvement follows in frequency the hepatic infestation in adults and is the predominating site in children. Radiologically, hydatidosis usually demonstrates typical findings, but many patients are at risk of developing various complications of hydatid disease with atypical imaging findings and these are rarely described in the literature. In this pictorial review, the imaging features of local complications of hydatid disease involving the thorax including intrapulmonary or pleural rupture, infection of the ruptured cysts, reactions of the adjacent tissues, thoracic wall invasion and iatrogenic involvement of pleura are described. Additionally, imaging characteristics of transdiaphragmatic thoracic involvement of hepatic hydatid disease are presented. To prevent the development of subsequent catastrophic results, all radiologists need to be aware of the atypical imaging appearances of complications of pulmonary hydatid disease.


    Directory of Open Access Journals (Sweden)

    Md. Khaleel


    Full Text Available Vertebral anomalies are of interest not only to anatomist, but also to orthopedician, neurologist & neurosurgeons. Various vertebral anomalies of anatomic interest have been reported namely; occipitalisation, sacralisation, lumbarisation, absence of posterior elements of vertebral arch & vertebral s ynostosis. The fusion of vertebral column is rare anomalies usually congenital in origin. The fusion of thoracic vertebrae can present many clinical sign including congenital scoliosis. A study on 594 dry adult human vertebrae of unknown age & sex collected from the department of anatomy and phase I students of KBNIMS, Kalaburagi, Karnataka. The study was done over a period of 6 months (July to December 2014 during routine osteology classes for 1 year MBBS, we found the fusion of typical thoracic vertebrae between T 3 & T 4 . The cause could be failure of re - segmentation of somitomeres or acquired.

  11. [Thoracic aortic dissection revealed by systemic cholesterol embolism]. (United States)

    Braem, L; Paule, P; Héno, P; Morand, J J; Mafart, B; La Folie, T; Varlet, P; Mioulet, D; Fourcade, L


    Systemic cholesterol embolism is a rare complication of atherosclerosis, and has various presentations. Arterial catheterisms are a common cause. However, the association with an aortic dissection has been exceptionally reported. We report the observation of a 70 year-old man, with coronary artery disease, hypertension, diabetes and dyslipidemia. Six months before hospitalization, a coronary angioplasty was performed due to recurrent angina. The association of purpuric lesions on the feet, with acute renal failure confirmed cholesterol embolism syndrome. Transoesophageal echocardiography showed a dissection of the descending thoracic aorta associated with complex atheroma. The evolution was marked by the pulpar necrosis of a toe and by a worsening of the renal failure, requiring definitive hemodialysis. Further echographic control highlighted the rupture of the intimal veil of the dissection. Cholesterol embolism syndrome may reveal an aortic dissection in patients without thoracic symptoms. In such cases, transoesophageal echocardiography is a useful and non-invasive examination.

  12. Effects of thoracic paravertebral block with bupivacaine versus combined thoracic epidural block with bupivacaine and morphine on pain and pulmonary function after cholecystectomy

    DEFF Research Database (Denmark)

    Bigler, D; Dirkes, W; Hansen, R;


    Twenty patients undergoing elective cholecystectomy via a subcostal incision were randomized in a double-blind study to either thoracic paravertebral blockade with bupivacaine 0.5% (15 ml followed by 5 ml/h) or thoracic epidural blockade with bupivacaine 7 ml 0.5% + morphine 2 mg followed by 5 ml...

  13. Impact of lumbar spine posture on thoracic spine motion and muscle activation patterns. (United States)

    Nairn, Brian C; Drake, Janessa D M


    Complex motion during standing is typical in daily living and requires movement of both the thoracic and lumbar spine; however, the effects of lumbar spine posture on thoracic spine motion patterns remain unclear. Thirteen males moved to six positions involving different lumbar (neutral and flexed) and thoracic (flexed and twisted) posture combinations. The thoracic spine was partitioned into three segments and the range of motion from each posture was calculated. Electromyographical data were collected from eight muscles bilaterally. Results showed that with a flexed lumbar spine, the lower-thoracic region had 14.83 ° and 15.6 1 ° more flexion than the upper- and mid-thoracic regions, respectively. A flexed lumbar spine significantly reduced the mid-thoracic axial twist angle by 5.21 ° compared to maximum twist in the mid-thoracic region. Functional differences emerged across muscles, as low back musculature was greatest in maintaining flexed lumbar postures, while thoracic erector spinae and abdominals showed bilateral differences with greater activations to the ipsilateral side. Combined postures have been previously identified as potential injury modulators and bilateral muscle patterns can have an effect on loading pathways. Overall, changes in thoracic motion were modified by lumbar spine posture, highlighting the importance of considering a multi-segmented approach when analyzing trunk motion.

  14. An in vivo study of the primary and coupled rotations of the thoracic spine. (United States)

    Willems, J M; Jull, G A; J, K-F Ng


    OBJECTIVE: To provide preliminary data on three-dimensional thoracic spine kinematics measured in vivo. DESIGN: This study measured the three planes of thoracic spine motion in normal subjects using an external measuring device. BACKGROUND: Few studies have investigated the primary and associated coupled rotations in the thoracic spine in vivo. Most knowledge of motion characteristics comes from in vitro studies which have limitations. There is a lack of agreement on the patterns of thoracic coupled motion especially that between lateral flexion and axial rotation. METHODS: Thoracic motion was examined in 60 normal subjects (30 males, 30 females) aged 18-24 years. The primary and coupled rotations of the thoracic regions T(1-4), T(4-8), T(8-12) were measured using a 3 SPACE Fastrak system. RESULTS: The three thoracic regions displayed the characteristic variations in range and distribution of primary rotations previously described. The pattern of coupled motion varied between subjects but an ipsilateral pattern predominated between lateral flexion and axial rotation in the middle and lower thoracic regions while the upper thoracic region was found to exhibit either a contralateral or ipsilateral pattern. Gender did not influence results. CONCLUSIONS: The pattern of coupled motion in the thoracic spine demonstrated some variability between subjects in vivo. Lateral flexion and axial rotation were strongly coupled with overall, their relationship being predominantly ipsilateral.

  15. Understanding physiotherapists' roles in ontario primary health care teams. (United States)

    Dufour, Sinéad Patricia; Lucy, S Deborah; Brown, Judith Belle


    Objectif : Comprendre les rôles des physiothérapeutes et comment ils sont appliqués au sein des équipes de fournisseurs de soins de santé primaires en Ontario. Méthodes : Suivant une méthode théorique à base empirique pratique, 12 physiothérapeutes pratiquant dans des équipes de soins de santé primaires de l'Ontario ont participé à 18 entrevues personnelles détaillées semi-structurées. Toutes les entrevues ont été enregistrées, transcrites verbatim et entrées ensuite dans NVIVO-8. Le codage a suivi trois stades analytiques progressifs et était de nature répétitive, guidé par une théorie à base empirique. On a créé un système explicatif. Résultats : Les physiothérapeutes négocient leur place au sein des équipes de soins de santé primaires en jouant cinq rôles interdépendants : (1) gestionnaire; (2) évaluateur; (3) collaborateur; (4) éducateur; (5) représentant. Ces cinq rôles subissent l'influence de trois strates contextuelles : (1) équipe interprofessionnelle; (2) communauté et population desservies; (3) structure organisationnelle et financement. Le mandat du Canada au niveau des soins de santé primaires (accès, équipe, information et vie saine) circonscrit les contextes qui agissent sur les rôles joués. Conclusions : Pour s'acquitter du mandat relatif aux soins de santé primaires, les physiothérapeutes jouent de multiples rôles qui reposent sur une perspective holistique générale de la santé dans le contexte d'une équipe interprofessionnelle basée sur la collaboration et de la communauté, en suivant une approche des soins éclairée par des éléments probants. Il semble y avoir de multiples façons d'intégrer avec succès les physiothérapeutes dans les équipes de soins de santé primaires, à condition que les rôles joués soient contextualisés et conformes au mandat relatif aux soins de santé primaires.

  16. Thoracic spine disc-related abnormalities: longitudinal MR imaging assessment

    Energy Technology Data Exchange (ETDEWEB)

    Girard, Charles J.; Schweitzer, Mark E.; Morrison, William B.; Parellada, Joan A. [TJUH Radiology, Philadelphia, Pennsylvania (United States); Carrino, J.A. [Department of Radiology ASB-1, Harvard Medical School, Brigham and Women' s Hospital, L1, Room 002B, 75 Francis Street, MA 02115, Boston (United States)


    To describe and characterize the temporal changes in disc-related disorders of the thoracic spine using MR imaging. A retrospective longitudinal cohort study was carried out of 40 patients with two sequential thoracic spine MR images at variable intervals. The images were assessed for baseline presence of, new incidence of and changes in disc herniation, degenerative disc disease, endplate marrow signal alteration and Schmorl nodes. The range of follow-up was 4-149 weeks. Baseline presence was: disc herniation, 10% (49/480); degenerative disc disease, 14% (66/480); endplate marrow signal alteration, 2.3% (11/480); Schmorl nodes 9.6% (46/480). Most pre-existing lesions tended to remain unchanged. Herniations showed the most change, tending to improve in 27%. New incidence was: disc herniation, 1.5% (7/480), degenerative disc disease, 2% (10/480); endplate marrow signal alteration, 1.6% (8/480); Schmorl nodes, 2.1% (10/480). Disc degeneration was first visible at an 11-week interval and once established almost never changed over many weeks to months. Endplate signal alterations (Modic changes) were uncommon. Schmorl nodes show no change from baseline for up to 2 1/2 years. All findings predominated in the lower intervertebral levels from T6 to T10. The most prevalent thoracic spine disc-related findings are degeneration and herniation. Disc herniations predominate in the lower segments and are a dynamic phenomenon. Disc degeneration can be rapidly evolving but tends to remain unchanged after occurrence. Endplate marrow signal changes were an uncommon manifestation of thoracic disc disease. Schmorl nodes showed the least change over time. (orig.)

  17. Clinical Practice Guidelines for postoperative period of thoracic surgery.

    Directory of Open Access Journals (Sweden)

    Frank Carlos Alvarez Li


    Full Text Available Clinical Practice Guidelines for postoperative period of thoracic surgery. It is the period between the suture of the surgical wound and the total rehabilitation of the patient, which usually occurs in the Intensive Care Unit. This document includes a review and update of the main aspects such as classification, postoperative treatment, stressing the actions to face any complication. It includes assessment guidelines focused on the most important aspects to be accomplished.

  18. Minimal Invasive Percutaneous Fixation of Thoracic and Lumbar Spine Fractures

    Directory of Open Access Journals (Sweden)

    Federico De Iure


    Full Text Available We studied 122 patients with 163 fractures of the thoracic and lumbar spine undergoing the surgical treatment by percutaneous transpedicular fixation and stabilization with minimally invasive technique. Patient followup ranged from 6 to 72 months (mean 38 months, and the patients were assessed by clinical and radiographic evaluation. The results show that percutaneous transpedicular fixation and stabilization with minimally invasive technique is an adequate and satisfactory procedure to be used in specific type of the thoracolumbar and lumbar spine fractures.

  19. Pancreatic cancer and chronic thoracic back pain: a case report


    Yurkiw, Dennis J


    A male with persistent thoracic spine pain and clinical symptoms suggesting a more grave condition than mechanical back pain is presented. The patient had previously been attended to by a medical doctor and a chiropractor. The symptom picture and the ineffectiveness of previously administered chiropractic care suggests a medical referral with further investigation. The importance of history taking is emphasized. An accurate diagnosis and administration of the appropriate treatment is paramoun...

  20. Spectrum of esophageal abnormality seen on thoracic CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Hee; Cho, Soon Gu; Jeon, Yong Sun; Jeong, Seok [Inha university Hospital, Incheon (Korea, Republic of); Kim, Hyung Jin [Samsung Medical Center, Seoul (Korea, Republic of)


    A variety of diseases involve the esophagus including esophagitis, benign or malignant tumors, varices, and esophageal perforation. We reviewed the thoracic CT of these various esophageal diseases, and classified them by similar CT findings. The CT findings were circumferential wall thickening, nodular wall thickening, abnormal luminal dilatation, fistula formation, and mass or mass like lesion. Although CT alone has limited diagnostic ability in esophageal disease, it may have an important role in diagnosing submucosal dissection, fistula, perforation, and intramural abscess.

  1. Transient cortical blindness after thoracic endovascular aneurysm repair. (United States)

    Vallabhaneni, Raghuveer; Jim, Jeffrey; Derdeyn, Colin P; Sanchez, Luis A


    We report a patient who presented with transient cortical blindness 12 hours after completion of a thoracic endovascular aneurysm repair. Computed tomography of the brain demonstrated no acute findings. The patient's symptoms resolved spontaneously after 72 hours. To our knowledge, this is the first report of transient cortical blindness after endovascular aortic aneurysm repair. This is an uncommon diagnosis that is important to recognize in a modern vascular surgery practice.

  2. Opportunities and barriers for a crop-based energy sector in Ontario (United States)

    Klupfel, Ellen Joanne

    This study investigates the existing opportunities and barriers for expanding the crop-based energy sector in Ontario. The investigation takes place at a time when growing concerns about sustainability---environmental, social, and economic---are encouraging the exploration of alternatives to energy systems based on fossil fuels, and concerns around the future viability of rural communities are making agriculturally-based and rural-based energy production systems attractive to many. To explore opportunities and barriers for the crop-based energy sector, this thesis addresses the question: What is the political-economic context within which the crop-based energy sector operates in Ontario? Taking an institutional approach, the study involved 26 interviews with individuals whose organizations influence Ontario's crop-based energy sector (that includes the biofuels ethanol and biodiesel), developed a model outlining relationships between the crop-based energy sector and other sectors of the economy, as well as the state, and implemented a survey of Ontario Members of Provincial Parliament's perspectives on biofuels. This research examines the balance of power of knowledge, production, security, finance, and technology for Ontario's crop-based energy sector. The overall balance of power currently rests with the petroleum sector. Through force field analysis, the study also identifies the key opportunities and barriers for the growth and development of the biofuels sector. These opportunities include climate change and rural development agendas, and the barriers include the petroleum sector, cost of production, and some sectors of the state. A few overarching conclusions emerge from this research: (1) Change in Ontario's crop-based energy sector is driven foremost by political and economic forces; (2) Climate change is the most significant driving force for the development and expansion of Ontario's crop-based energy sector; (3) Production cost and resistance from the

  3. Pulmonary Complications following Thoracic Spinal Surgery: A Systematic Review (United States)

    Gabel, Brandon C.; Schnell, Eric C.; Dettori, Joseph R.; Jeyamohan, Shiveindra; Oskouian, Rod


    Study Design Systematic review. Objective To determine the frequency of pulmonary effusion, pneumothorax, and hemothorax in adult patients undergoing thoracic corpectomy or osteotomy for any condition and to determine if these frequencies vary by surgical approach (i.e., anterior, posterior, or lateral). Methods Electronic databases and reference lists of key articles were searched through September 21, 2015, to identify studies specifically evaluating the frequency of pulmonary effusion, pneumothorax, and hemothorax in patients undergoing thoracic spine surgery. Results Fourteen studies, 13 retrospective and 1 prospective, met inclusion criteria. The frequency across studies of pulmonary effusion ranged from 0 to 77%; for hemothorax, 0 to 77%; and for pneumothorax, 0 to 50%. There was no clear pattern of pulmonary complications with respect to surgical approach. Conclusions There is insufficient data to determine the risk of pulmonary complications following anterior, posterior, or lateral approaches to the thoracic spine. Methods for assessing pulmonary complications were not well reported, and data is sparse. PMID:27099821

  4. FOXE3 mutations predispose to thoracic aortic aneurysms and dissections. (United States)

    Kuang, Shao-Qing; Medina-Martinez, Olga; Guo, Dong-Chuan; Gong, Limin; Regalado, Ellen S; Reynolds, Corey L; Boileau, Catherine; Jondeau, Guillaume; Prakash, Siddharth K; Kwartler, Callie S; Zhu, Lawrence Yang; Peters, Andrew M; Duan, Xue-Yan; Bamshad, Michael J; Shendure, Jay; Nickerson, Debbie A; Santos-Cortez, Regie L; Dong, Xiurong; Leal, Suzanne M; Majesky, Mark W; Swindell, Eric C; Jamrich, Milan; Milewicz, Dianna M


    The ascending thoracic aorta is designed to withstand biomechanical forces from pulsatile blood. Thoracic aortic aneurysms and acute aortic dissections (TAADs) occur as a result of genetically triggered defects in aortic structure and a dysfunctional response to these forces. Here, we describe mutations in the forkhead transcription factor FOXE3 that predispose mutation-bearing individuals to TAAD. We performed exome sequencing of a large family with multiple members with TAADs and identified a rare variant in FOXE3 with an altered amino acid in the DNA-binding domain (p.Asp153His) that segregated with disease in this family. Additional pathogenic FOXE3 variants were identified in unrelated TAAD families. In mice, Foxe3 deficiency reduced smooth muscle cell (SMC) density and impaired SMC differentiation in the ascending aorta. Foxe3 expression was induced in aortic SMCs after transverse aortic constriction, and Foxe3 deficiency increased SMC apoptosis and ascending aortic rupture with increased aortic pressure. These phenotypes were rescued by inhibiting p53 activity, either by administration of a p53 inhibitor (pifithrin-α), or by crossing Foxe3-/- mice with p53-/- mice. Our data demonstrate that FOXE3 mutations lead to a reduced number of aortic SMCs during development and increased SMC apoptosis in the ascending aorta in response to increased biomechanical forces, thus defining an additional molecular pathway that leads to familial thoracic aortic disease.

  5. Morphology of the thoracic limb bones in the giant anteater

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    Fabrício Singaretti de Oliveira


    Full Text Available The giant anteater has a grayish-brown pelage with white and black tones, its skull is elongated, cylindrical, and there are no teeth. Its tail is long, with thick and long bristles, resembling a flag. This is an endangered species, due to the constant degradation of its habitat, in addition to deaths caused by fires and roadkills. Thus, this paper aimed to describe the morphology of the thoracic limb bones in Myrmecophaga tridactyla, focusing on its main bone accidents. We used two specimens of giant anteater collected on highways in the state of Minas Gerais, Brazil, after death due to being run over. The scapula, humerus, radius, ulna, and the hand bones showed particular characteristics adapted to the species’ lifestyle and habits. In general, the scapula resembles that in human beings and the humerus is similar to that in armadillo, the radius and ulna exhibit articular surfaces which enable a wide range of rotational movements in the forearm, the carpal bones are also similar in number and shape to those in human beings, and the fingers are well developed in the giant anteater, having long, strong and sharp claws, especially in the third finger. Thus, the anatomical description of the thoracic limb bones in the giant anteater showed to be important, providing a deeper understanding both of the functional aspects of the thoracic limb and the comparative anatomy of wild animals.

  6. Posteriorly migrated thoracic disc herniation: a case report

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    Miyakoshi Naohisa


    Full Text Available Abstract Introduction Posterior epidural migration of thoracic disc herniation is extremely rare but may occur in the same manner as in the lumbar spine. Case presentation A 53-year-old Japanese man experienced sudden onset of incomplete paraplegia after lifting a heavy object. Magnetic resonance imaging revealed a posterior epidural mass compressing the spinal cord at the T9-T10 level. The patient underwent emergency surgery consisting of laminectomy at T9-T10 with right medial facetectomy, removal of the mass lesion, and posterior instrumented fusion. Histological examination of the mass lesion yielded findings consistent with sequestered disc material. His symptoms resolved, and he was able to resume walking without a cane 4 weeks after surgery. Conclusions Pre-operative diagnosis of posterior epidural migration of herniated thoracic disc based on magnetic resonance imaging alone may be overlooked, given the rarity of this pathology. However, this entity should be considered among the differential diagnoses for an enhancing posterior thoracic extradural mass.

  7. CT and MR imaging of the thoracic aorta

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    Di Cesare Ernesto


    Full Text Available At present time, both CT and MRI are valuable techniques in the study of the thoracic aorta. Nowadays, CT represents the most widely employed technique for the study of the thoracic aorta. The new generation CTs show sensitivities up to 100% and specificities of 98-99%. Sixteen and wider row detectors provide isotropic pixels, mandatory for the ineludible longitudinal reconstruction. The main limits are related to the X-ray dose expoure and the use of iodinated contrast media. MRI has great potential in the study of the thoracic aorta. Nevertheless, if compared to CT, acquisition times remain longer and movement artifact susceptibility higher. The main MRI disadvantages are claustrophobia, presence of ferromagnetic implants, pacemakers, longer acquisition times with respect to CT, inability to use contrast media in cases of renal insufficiency, lower spatial resolution and less availability than CT. CT is preferred in the acute aortic disease. Nevertheless, since it requires iodinated contrast media and X-ray exposure, it may be adequately replaced by MRI in the follow up of aortic diseases. The main limitation of MRI, however, is related to the scarce visibility of stents and calcifications.

  8. Thoracic radiography and oxidative stress indices in heartworm affected dogs

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    P. K. Rath


    Full Text Available Aim: The aim was to study the pathomorphological changes through thoracic radiography and status of oxidative stress parameters in heartworm affected dogs in Odisha. Materials and Methods: A total of 16 dogs with clinically established diagnosis of dirofilariasis by wet blood smear and modified Knott’s test and equal numbers of dogs as control were included in this study. The present study was conducted in heartworm affected dogs to see the pathomorphological changes through thoracic radiography. Similarly, the evaluation was undertaken for observing any alterations in oxidative stress status in affected as well as non-affected, but healthy control dogs by adopting standard procedure. Results: Thoracic radiography revealed cardiac enlargement, round heart appearance suggestive of right ventricular hypertrophy, tortuous pulmonary artery and darkening of lungs. Alterations in oxidative stress indices showed a significant rise of lipid peroxidase activity, non-significant rise of superoxide dismutase and a significant although reverse trend for catalase levels in affected dogs in comparison to Dirofilaria negative control but apparently healthy dogs. Conclusions: Radiographic changes, as well as alterations in oxidative stress parameters, may not be diagnostic for heartworm infection, but useful for detecting heartworm disease, assessing severity and evaluating cardiopulmonary parenchyma changes and gives a fair idea about the degree of severity of the disease. It aids as contributing factors in disease pathogenesis.

  9. Thoracic aortic aneurysm in a buck associated with caseous lymphadenitis

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    R.R. Pinheiro


    Full Text Available This paper reports the clinical, bacteriological and pathological findings of a thoracic aortic aneurysm in a four-year-old Anglo-Nubian goat buck, related to a framework of visceral caseous lymphadenitis. General clinical examination showed heart rate of 75 beats per minute, respiratory rate of 20 movements per minute and ruminal movements of four movements per minute. Superficial lymph nodes were normal upon palpation. Rectal temperature was slightly high (40.5°C. Blood test showed an intense leukocytosis (54,000/µL, characterized by strong neutrophil shift to the left. At necropsy, a large blood clot was detected in the thoracic cavity. The thickening of the myocardium and dilatation of the aorta in the thoracic portion, presenting a saculiform format was also observed. A large number of abscesses were disseminated in the media and intima layers of aorta. The aorta lumen obstruction by arterial plaques consisting of inflammatory infiltrate, predominantly neutrophilic was also detected. Abscesses were found spread in turbinate, rumen, reticulum, kidneys, liver, spleen, testicles and aorta wall. The microbiological exam of exudate confirmed Corynebacterium pseudotuberculosis as the causal agent.

  10. Instantaneous Respiratory Estimation from Thoracic Impedance by Empirical Mode Decomposition

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    Fu-Tai Wang


    Full Text Available Impedance plethysmography provides a way to measure respiratory activity by sensing the change of thoracic impedance caused by inspiration and expiration. This measurement imposes little pressure on the body and uses the human body as the sensor, thereby reducing the need for adjustments as body position changes and making it suitable for long-term or ambulatory monitoring. The empirical mode decomposition (EMD can decompose a signal into several intrinsic mode functions (IMFs that disclose nonstationary components as well as stationary components and, similarly, capture respiratory episodes from thoracic impedance. However, upper-body movements usually produce motion artifacts that are not easily removed by digital filtering. Moreover, large motion artifacts disable the EMD to decompose respiratory components. In this paper, motion artifacts are detected and replaced by the data mirrored from the prior and the posterior before EMD processing. A novel intrinsic respiratory reconstruction index that considers both global and local properties of IMFs is proposed to define respiration-related IMFs for respiration reconstruction and instantaneous respiratory estimation. Based on the experiments performing a series of static and dynamic physical activates, our results showed the proposed method had higher cross correlations between respiratory frequencies estimated from thoracic impedance and those from oronasal airflow based on small window size compared to the Fourier transform-based method.

  11. The cost of treating severe refractory asthma in the UK: an economic analysis from the British Thoracic Society Difficult Asthma Registry. (United States)

    O'Neill, Stephen; Sweeney, Joan; Patterson, Chris C; Menzies-Gow, Andrew; Niven, Rob; Mansur, Adel H; Bucknall, Christine; Chaudhuri, Rekha; Thomson, Neil C; Brightling, Chris E; O'Neill, Ciaran; Heaney, Liam G


    Severe refractory asthma poses a substantial burden in terms of healthcare costs but relatively little is known about the factors which drive these costs. This study uses data from the British Thoracic Society Difficult Asthma Registry (n=596) to estimate direct healthcare treatment costs from an National Health Service perspective and examines factors that explain variations in costs. Annual mean treatment costs among severe refractory asthma patients were £2912 (SD £2212) to £4217 (SD £2449). Significant predictors of costs were FEV1% predicted, location of care, maintenance oral corticosteroid treatment and body mass index. Treating individuals with severe refractory asthma presents a substantial cost to the health service.

  12. Thoracic wall reconstruction using ultrasound images to model/bend the thoracic prosthesis for correction of pectus excavatum (United States)

    Fonseca, João Gomes; Moreira, Antonio H. J.; Rodrigues, Pedro L.; Fonseca, Jaime C.; Pinho, A. C. M.; Correia-Pinto, Jorge; Rodrigues, Nuno F.; Vilaça, João L.


    Pectus excavatum is the most common congenital deformity of the anterior thoracic wall. The surgical correction of such deformity, using Nuss procedure, consists in the placement of a personalized convex prosthesis into sub-sternal position to correct the deformity. The aim of this work is the CT-scan substitution by ultrasound imaging for the pre-operative diagnosis and pre-modeling of the prosthesis, in order to avoid patient radiation exposure. To accomplish this, ultrasound images are acquired along an axial plane, followed by a rigid registration method to obtain the spatial transformation between subsequent images. These images are overlapped to reconstruct an axial plane equivalent to a CT-slice. A phantom was used to conduct preliminary experiments and the achieved results were compared with the corresponding CT-data, showing that the proposed methodology can be capable to create a valid approximation of the anterior thoracic wall, which can be used to model/bend the prosthesis.

  13. Heart and Stroke Foundation of Ontario (HSFO high blood pressure strategy's hypertension management initiative study protocol

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    Von Sychowski Shirley


    Full Text Available Abstract Background Achieving control of hypertension prevents target organ damage at both the micro and macrovascular level and is a highly cost effective means of lowering the risk for heart attack and stroke particularly in people with diabetes. Clinical trials demonstrate that blood pressure control can be achieved in a large proportion of people. Translating this knowledge into widespread practice is the focus of the Hypertension Management Initiative, which began in 2004 with the goal of improving the management of this chronic health condition by primary care providers and patients in the community. Methods This study will test the effect of a systems change on the management of high blood pressure in real world practice in primary care in Ontario, Canada. The systems change intervention involves an interprofessional educational program bringing together physicians, nurses and pharmacists with tools for both providers and patients to facilitate blood pressure management. Each of two waves of subjects were enrolled over a 6 month period with the initial enrollment between waves separated by 9 months. Blood pressure will be measured with the BpTru ® automated blood pressure device. To determine the effectiveness of the intervention, a before and after analysis within all subjects will compare blood pressure at baseline to annual measurements for the three year study. To assess whether the intervention has an impact on blood pressure control independent of community trends, a betwen group comparison of baseline blood pressures in the delayed wave will be made with the immediate wave during the same time period, so that the immediate wave has experienced the intervention for at least 9 months. The total enrollment goal is 5,000 subjects. The practice locations include 10 Family Health Teams (FHTs and 1 Community Health Centre (CHC and approximately 49 primary care physicians, 15 nurse practitioners, 37 registered nurses and over 150

  14. Spatial extent and dissipation of the deep chlorophyll layer in Lake Ontario during the Lake Ontario lower foodweb assessment, 2003 and 2008 (United States)

    Watkins, J. M.; Weidel, Brian M.; Rudstam, L. G.; Holek, K. T.


    Increasing water clarity in Lake Ontario has led to a vertical redistribution of phytoplankton and an increased importance of the deep chlorophyll layer in overall primary productivity. We used in situ fluorometer profiles collected in lakewide surveys of Lake Ontario in 2008 to assess the spatial extent and intensity of the deep chlorophyll layer. In situ fluorometer data were corrected with extracted chlorophyll data using paired samples from Lake Ontario collected in August 2008. The deep chlorophyll layer was present offshore during the stratified conditions of late July 2008 with maximum values from 4–20 μg l−1 corrected chlorophyll a at 10 to 17 m depth within the metalimnion. Deep chlorophyll layer was closely associated with the base of the thermocline and a subsurface maximum of dissolved oxygen, indicating the feature's importance as a growth and productivity maximum. Crucial to the deep chlorophyll layer formation, the photic zone extended deeper than the surface mixed layer in mid-summer. The layer extended through most of the offshore in July 2008, but was not present in the easternmost transect that had a deeper surface mixed layer. By early September 2008, the lakewide deep chlorophyll layer had dissipated. A similar formation and dissipation was observed in the lakewide survey of Lake Ontario in 2003.

  15. Total Revenue and Expenses for Provincially Assisted Universities of Ontario for the Fiscal Year Ended April 30, 1976. Report to the Council of Ontario Universities. (United States)

    Council of Ontario Universities, Toronto.

    Financial data are presented here for Ontario's twenty universities: Brock, Carleton, Guelph, Lakehead, Laurentian, Algoma, Nipissing, Hearst, McMaster, Oise, Ottawa, Queen's, Ryerson, Toronto, Trent, Waterloo, Western, Wilfrid Laurier, Windsor, and York. Contents include summary tables operating expenses by object of expense and by functional…

  16. Science-seeking behaviour of Conservation Authorities in Ontario. (United States)

    Sheikheldin, Gussai; Krantzberg, Gail; Schaefer, Karl


    The communication of science to science users is evolving to an approach that translates knowledge to targeted audiences. Under this evolution, knowledge brokers play an increasingly important role and users help 'pull' the required science to meet a policy or management imperative. To do this effectively, more insight is required into the knowledge seeking behaviour of science users and practitioners. The findings from a series of interviews that identify the science needs of Ontario's Conservation Authorities (CAs) are presented. Results indicate that emerging functions, such as source water protection and integrated water resource planning, require more science input than mature functions. Senior CA officials view personal communication with their knowledgeable staff as the most used, accessible, trustworthy, relevant, shared, and preferable source of science information. While the internet and media were considered highly accessible, they were not viewed as trustworthy. We found no relationship between CA size and science use. Further research is needed to identify where junior and intermediate CA staff obtain their science knowledge from and whether this varies as a function of CA size. Our findings will be of interest to both policy/program communities and science providers.

  17. Ontario FIT - From poster child to industry crisis

    Energy Technology Data Exchange (ETDEWEB)

    Roeper, Uwe [ORTECH Consulting (Canada)


    Ortech is a consulting firm that provides engineering services to investors and developers in planning and operating solar, wind and water projects. This study discusses the issues involved in the renewable energy Feed-in Tariff (FIT) program in Ontario. Initially hailed as the poster child of innovative renewable programs in North America, the FIT program has been under increasing attack from political parties, anti wind groups and legal suits. The reason was the negative media coverage of noise, birdlife and health effects. Criticism was first voiced over health concerns and lack of consultation. Local governments and the legislature debated these issues and began to split along political lines over them. The lack of public support was because there was insufficient effort put into creating public awareness. Boosting grass-roots support by creating awareness is a recommendation of the paper, which also emphasises the need for a win-win strategy when the government is involved. It can be concluded that the FIT program has gone from poster child to industry crisis but has provided several learning opportunities along the way.

  18. Woodland caribou range occupancy in northwestern Ontario: past and present

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    G.D. Racey


    Full Text Available A zone of continuous woodland caribou (Rangifer tarandus caribou distribution is defined for northwestern Ontario. This zone establishes a benchmark for measuring the success of future management of habitat and conservation of populations. Inventory of key winter, summer and calving habitats reaffirms the concept of a dynamic mosaic of habitat tracts that supports caribou across the landscape. The historical range recession leading to this current distribution has been associated with resource development, fire and hunting activities over the past 150 years, and numerous attempts at conservation over the last 70 years. The decline was apparently phased according to several periods of development activity: i early exploitation in the early to mid-1800s; ii isolation and extirpation of southern populations due to rapid changes in forest use and access between 1890 and 1930; and iii further loss of the southernmost herds due to forest harvesting of previously inaccessible areas since the 1950s. Lessons learned from history support current conservation measures to manage caribou across broad landscapes, protect southern herds, maintain caribou habitat as part of continuous range, maintain large contiguous tracts of older forest and ensure connectivity between habitat components.

  19. Caribou nursery site habitat characteristics in two northern Ontario parks

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    Natasha L. Carr


    Full Text Available To prevent further range recession, habitat features essential to the life-history requisites of woodland caribou (Rangifer tarandus caribou such as calving and nursery sites need to be protected for the persistence of the species. Woodland caribou may minimize predation risk during calving by either spacing out or spacing away from predators in the forest to calve on islands, wetlands, or shorelines. Our objective was to determine the characteristics of shoreline habitats used as calving and nursery sites by female woodland caribou in northern Ontario. Detailed vegetation and other site characteristics were measured at nursery sites used by cow-calf pairs in Wabakimi and Woodland Caribou Provincial Parks for comparison with shoreline sites that were not used by caribou within each park. Differences in habitat variables selected by female caribou in the two study areas reflect broad ecoregional differences in vegetation and topography. In Wabakimi Provincial Park, understorey tree density and ground detection distance played key roles in distinguishing nursery sites from sites that were not used. In Woodland Caribou Provincial Park, groundcover vegetation and shrub density were important in the selection of nursery sites by female caribou. Generally, female caribou in both parks selected nursery sites with greater slope, lower shrub density but thicker groundcover vegetation, including greater lichen abundance, and higher densities of mature trees than shoreline sites that were not used. The identification of these important features for caribou nursery sites provides a basis for improving their protection in future management policies and legislation.

  20. Physical activity in Ontario preschoolers: prevalence and measurement issues. (United States)

    Obeid, Joyce; Nguyen, Thanh; Gabel, Leigh; Timmons, Brian W


    Early childhood is a critical period for the development of active living behaviours; however, very little is known about the physical activity levels of preschoolers from Canada. The objectives of this study were to (i) examine physical activity in a sample of Ontario preschoolers by using high-frequency accelerometry to determine activity and step counts; (ii) assess the relationship between step counts and physical activity; (iii) examine the influence of epoch length or sampling interval on physical activity; and (iv) compare measured physical activity to existing recommendations. Thirty 3- to 5-year-old children wore accelerometers to monitor habitual physical activity in 3-s epochs over a 7-day period. Preschoolers engaged in an average of 220 min of daily physical activity, 75 min of which were spent in moderate-to-vigorous physical activity (MVPA), and they accumulated 7529 ± 1539 steps·day(-1). Preschoolers who engaged in more MVPA also took more steps on a daily basis (r = 0.81, p physical activity per day for preschool-age children. Our data highlight important methodological considerations when measuring physical activity in preschoolers and the need for preschool-specific physical activity guidelines for Canadian children.

  1. Aphid Transmission of the Ontario Isolate of Plum Pox Virus. (United States)

    Lowery, D Thomas; Vickers, Patricia M; Bittner, Lori A; Stobbs, Lorne W; Foottit, Robert G


    Utilization of timed virus acquisition access probes in studies of plum pox virus (PPV) transmission by aphids demonstrated that endemic species transmitted the virus readily from plum, Prunus domestica (L.) Batsch; peach, P. persica (L.); or dwarf flowering almond, P. glandulosa Thunberg., to peach seedlings. The green peach aphid, Myzus persicae (Sulzer), was shown to be the most efficient vector. Acquisition of virus by green peach aphids from infected peach leaves resulted in 18-28% infected peach seedlings, while aphids previously fed on infected leaves of plum transferred virus to 36% of peach seedlings. Although the spirea aphid, Aphis spiraecola (Patch), was a less efficient vector than M. persicae it is perhaps more important for the spread of PPV due to its greater abundance and occurrence earlier in the season when peach trees are thought to be more susceptible to infection. Virus transmission rates varied depending on the virus source and healthy test plant species. In contrast to many previous studies, aphid inoculation of the experimental host Nicotiana benthamiana Domin occurred at a low rate, never exceeding 4%. Acquisition of PPV by M. persicae from infected peach fruit was greatly reduced compared with acquisition from leaves. The results of this research indicate that the Ontario isolate of PPV-D is readily transmissible by aphids to peach and natural spread of the virus needs to be considered in future management or eradication programs.

  2. Linking traditional knowledge and environmental practice in Ontario. (United States)

    McGregor, Deborah


    Beginning in the late 1980s with the release of Our Common Future by the World Commission on Environment and Development, followed by the development of international accords such as the 1992 Convention on Biological Diversity, international pressure to resolve Indigenous rights issues has been steadily mounting. Successive Canadian governments have been striving increasingly to recognize and incorporate Aboriginal traditional knowledge into resource management planning. Following more than a decade of such efforts, the question of how to achieve such incorporation appropriately remains inadequately answered. This essay contributes to the resolution of this issue by first clarifying some key differences between Aboriginal and non-Aboriginal definitions of "traditional knowledge." Then, three Ontario case studies are briefly described that highlight the most and least successful aspects of previous undertakings. Among the lessons learned are the need to value traditional knowledge on a par with Western science while recognizing the particular capabilities of each system, and the requirement that Aboriginal peoples and their knowledge participate on a mutually respectful basis.

  3. Free-hand thoracic pedicle screws placed by neurosurgery residents: a CT analysis


    Wang, Vincent Y.; Chin, Cynthia T.; Lu, Daniel C.; Smith, Justin S.; Chou, Dean


    Free-hand thoracic pedicle screw placement is becoming more prevalent within neurosurgery residency training programs. This technique implements anatomic landmarks and tactile palpation without fluoroscopy or navigation to place thoracic pedicle screws. Because this technique is performed by surgeons in training, we wished to analyze the rate at which these screws were properly placed by residents by retrospectively reviewing the accuracy of resident-placed free-hand thoracic pedicle screws u...

  4. Lymphatics of the Mediastinum, Esophagus and Lungs: Thoracic Surgeon's Point of View


    Ciprian Bolca


    The anatomy of the thoracic lymphatic system is very complex and not completely known yet. Thoracic malignancies, especially lung and esophageal cancers, are rapidly increasing as incidence. A good knowledge of the thoracic lymphatic system is very important in staging, diagnosis and treatment of these malignancies. The complete lymphadenectomy has a crucial role in both to achieve a correct postoperative stage and a complete resection of pathologic tissue. The article is a glimpse on the lym...

  5. Bochdalek hernia presenting with initial local fat infiltration of the thoracic cavity in a leukemic child


    Kang, Zhen; Min, Xiangde; Wang, Liang


    Local fat infiltration of the thoracic cavity is a rare initial presentation of Bochdalek hernia. We report a case of Bochdalek hernia in a child with leukemia that demonstrated initial local fat infiltration of the thoracic cavity on computed tomography scan and progressed to an obvious diaphragmatic hernia on subsequent follow-up. We suggest that initial local fat infiltration of the thoracic cavity on computed tomography scan may indicate a potential diaphragmatic hernia.

  6. Intraspinal penetrating stab injury to the middle thoracic spinal cord with no neurologic deficit. (United States)

    Li, Xinning; Curry, Emily J; Blais, Micah; Ma, Richard; Sungarian, Arno S


    The annual incidence of traumatic spinal cord injury worldwide is estimated to be 35 patients per million. Nonmissile penetrating spinal injuries most commonly occur in the thoracic region, and the majority has neurologic deficits on admission. The management of patients who lack neurologic deficits is controversial due to the risk of neurologic status alteration intraoperatively. However, failure to intervene increases the risk of infection, delayed onset of neurologic deficits, and worsening functional outcome.A 17-year-old boy presented with an intradural T7-T8 knife penetration injury to the spinal cord with no neurologic deficit. Rapid surgical intervention was critical because the knife was lodged between the 2 hemispheres of the spinal cord. The patient was intubated in the lateral position, transferred to the prone position on a Jackson table, and underwent surgical decompression with laminectomy 1 level above and below the injury site, removal of the knife blade in the original path of trajectory, and repair of the dural tear with a collagen matrix. The patient sustained no neurologic sequelae from the penetrating knife injury. He was able to ambulate at discharge and had no complications. To our knowledge, this is the only report of a patient with intradural spinal cord penetration by a foreign object (knife blade) presenting with a normal neurologic preoperative examination that persisted throughout the course of postoperative care.

  7. Canadian Thoracic Society: Presenting a New Process for Clinical Practice Guideline Production

    Directory of Open Access Journals (Sweden)

    Samir Gupta


    Full Text Available A key mandate of the Canadian Thoracic Society (CTS is to promote evidence-based respiratory care through clinical practice guidelines (CPGs. To improve the quality and validity of the production, dissemination and implementation of its CPGs, the CTS has revised its guideline process and has created the Canadian Respiratory Guidelines Committee to oversee this process. The present document outlines the basic methodological tools and principles of the new CTS guideline production process. Important features include standard methods for choosing and formulating optimal questions and for finding, appraising, and summarizing the evidence; use of the Grading of Recommendations Assessment, Development and Evaluation system for rating the quality of evidence and strength of recommendations; use of the Appraisal of Guidelines for Research and Evaluation instrument for quality control during and after guideline development and for appraisal of other guidelines; use of the ADAPTE process for adaptation of existing guidelines to the local context; and use of the GuideLine Implementability Appraisal tool to augment implementability of guidelines. The CTS has also committed to develop guidelines in new areas, an annual guideline review cycle, and a new formal process for dissemination and implementation. Ultimately, it is anticipated that these changes will have a significant impact on the quality of care and clinical outcomes of individuals suffering from respiratory diseases across Canada.

  8. From Diagnosis to Treatment: Clinical Applications of Nanotechnology in Thoracic Surgery. (United States)

    Digesu, Christopher S; Hofferberth, Sophie C; Grinstaff, Mark W; Colson, Yolonda L


    Nanotechnology is an emerging field with potential as an adjunct to cancer therapy, particularly thoracic surgery. Therapy can be delivered to tumors in a more targeted fashion, with less systemic toxicity. Nanoparticles may aid in diagnosis, preoperative characterization, and intraoperative localization of thoracic tumors and their lymphatics. Focused research into nanotechnology's ability to deliver both diagnostics and therapeutics has led to the development of nanotheranostics, which promises to improve the treatment of thoracic malignancies through enhanced tumor targeting, controlled drug delivery, and therapeutic monitoring. This article reviews nanoplatforms, their unique properties, and the potential for clinical application in thoracic surgery.

  9. Supraclavicular scalenectomy for thoracic outlet syndrome--functional outcomes assessed using the DASH scoring system.

    LENUS (Irish Health Repository)

    Glynn, Ronan W


    To evaluate supraclavicular scalenectomy ± cervical rib excision for thoracic outlet syndrome (TOS), employing Disability of Arm, Shoulder, and Hand (DASH) scoring for functional assessment post-decompression.

  10. TEVAR for Flash Pulmonary Edema Secondary to Thoracic Aortic Aneurysm to Pulmonary Artery Fistula. (United States)

    Bornak, Arash; Baqai, Atif; Li, Xiaoyi; Rey, Jorge; Tashiro, Jun; Velazquez, Omaida C


    Enlarging aneurysms in the thoracic aorta frequently remain asymptomatic. Fistulization of thoracic aortic aneurysms (TAA) to adjacent structures or the presence of a patent ductus arteriosus and TAA may lead to irreversible cardiopulmonary sequelae. This article reports on a large aneurysm of the thoracic aorta with communication to the pulmonary artery causing pulmonary edema and cardiorespiratory failure. The communication was ultimately closed after thoracic endovascular aortic aneurysm repair allowing rapid symptom resolution. Early diagnosis and closure of such communication in the presence of TAA are critical for prevention of permanent cardiopulmonary damage.

  11. Preprocedural ultrasound examination versus manual palpation for thoracic epidural catheter insertion

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    Ahmed M Hasanin


    Conclusion: Preprocedural ultrasound imaging increased the incidence of first pass success in thoracic epidural catheter insertion and reduced the catheter insertion time compared to manual palpation method.

  12. Canadian federalism and the Canadian health care program: a comparison of Ontario and Quebec. (United States)

    Palley, H A


    The Quebec and Ontario health insurance and health service delivery systems, developed within the parameters of federal regulations and national financial subsidies, provide generally universal and comprehensive basic hospital and medical benefits and increasingly provide for the delivery of long-term care services. Within a framework of cooperative federalism, the health care systems of Ontario and Quebec have developed uniquely. In terms of vital statistics, the health of Ontario and Quebec residents generally is comparable. In viewing expenditures, Quebec has a more clearly articulated plan for providing accessible services to low-income persons and for integrating health and social services, although it has faced some difficulties in seeking to achieve the latter goal. Its plans for decentralized services are counter-balanced by a strong provincial role in health policy decision-making. Quebec's political culture also allows the province to play a stronger role in hospital planning and in the regulation of physician income than one finds in Ontario. These political dynamics allow Quebec an advantage in control of costs. In Ontario, in spite of some recent setbacks, physician interests and hospital sector interests play a more active role in health system bargaining and are usually able to influence remuneration and resource allocation decisions more than physician interests and hospital sector interests in Quebec.

  13. Sexual difference in mercury concentrations of lake trout (Salvelinus namaycush) from Lake Ontario (United States)

    Madenjian, C.P.; Keir, M.J.; Whittle, D.M.


    We determined total mercury (Hg) concentrations in 50 female lake trout (Salvelinus namaycush) and 69 male lake trout from Lake Ontario (Ontario, Canada and New York, United States). Results showed that, on average, males were 8% higher in Hg concentration than females in Lake Ontario. We also used bioenergetics modeling to determine whether a sexual difference in gross growth efficiency (GGE) could explain the observed sexual difference in Hg concentrations. According to the bioenergetics modeling results, male GGE was about 3% higher than female GGE, on average. Although the bioenergetics modeling could not explain the higher Hg concentrations exhibited by the males, a sexual difference in GGE remained a plausible explanation for the sexual difference in Hg concentrations of the lake trout. In an earlier study, male lake trout from Lake Ontario were found to be 22% higher in polychlorinated biphenyl (PCB) concentration than females from Lake Ontario. Thus, although males were higher in both Hg and PCB concentrations, the degree of the sexual difference in concentration varied between the two contaminants. Further research on sexual differences in Hg excretion rates and Hg direct uptake rates may be needed to resolve the disparity in results between the two contaminants.

  14. Structure and characteristics of community-based multidisciplinary wound care teams in Ontario: an environmental scan. (United States)

    Abrahamyan, Lusine; Wong, Josephine; Pham, Ba'; Trubiani, Gina; Carcone, Steven; Mitsakakis, Nicholas; Rosen, Laura; Rac, Valeria E; Krahn, Murray


    Multidisciplinary team approach is an essential component of evidence-based wound management in the community. The objective of this study was to identify and describe community-based multidisciplinary wound care teams in Ontario. For the study, a working definition of a multidisciplinary wound care team was developed, and a two-phase field evaluation was conducted. In phase I, a systematic survey with three search strategies (environmental scan) was conducted to identify all multidisciplinary wound care teams in Ontario. In phase II, the team leads were surveyed about the service models of the teams. We identified 49 wound care teams in Ontario. The highest ratio of Ontario seniors to wound team within each Ontario health planning region was 82,358:1; the lowest ratio was 14,151:1. Forty-four teams (90%) participated in the survey. The majority of teams existed for at least 5 years, were established as hospital outpatient clinics, and served patients with chronic wounds. Teams were heterogeneous in on-site capacity of specialized diagnostic testing and wound treatment, team size, and patient volume. Seventy-seven percent of teams had members from three or more disciplines. Several teams lacked essential disciplines. More research is needed to identify optimal service models leading to improved patient outcomes.

  15. Modelling the long term impact of climate change on the carbon budget of Lake Simcoe, Ontario using INCA-C. (United States)

    Oni, S K; Futter, M N; Molot, L A; Dillon, P J


    This study presents a process-based model of dissolved organic carbon concentration ([DOC]) in catchments draining into Lake Simcoe, Ontario. INCA-C, the Integrated Catchment model for Carbon, incorporates carbon biogeochemical processes in a terrestrial system with hydrologic flow paths to simulate watershed wide [DOC]. The model successfully simulates present-day inter-annual and seasonal [DOC] dynamics in tributaries draining catchments with mixed or contrasting land cover in the Lake Simcoe watershed (LSW). The sensitivity of INCA-C to soil moisture, hydrologic controls and land uses within a watershed demonstrates its significance as a tool to explore pertinent environmental issues specific to the LSW. Projections of climate change under A1B and A2 SRES scenarios suggest a continuous monotonic increase in [DOC] in surface waters draining into Lake Simcoe. Large variations in seasonal DOC dynamics are predicted to occur during summer with a possibility of displacement of summer [DOC] maxima towards winter and a prolongation of summer [DOC] levels into the autumn. INCA-C also predicts possible increases in dissolved inorganic carbon in some tributaries with rising temperature suggesting increased CO(2) emissions from rivers as climate changes.

  16. Household-level dynamics of food waste production and related beliefs, attitudes, and behaviours in Guelph, Ontario. (United States)

    Parizeau, Kate; von Massow, Mike; Martin, Ralph


    It has been estimated that Canadians waste $27 billion of food annually, and that half of that waste occurs at the household level (Gooch et al., 2010). There are social, environmental, and economic implications for this scale of food waste, and source separation of organic waste is an increasingly common municipal intervention. There is relatively little research that assesses the dynamics of household food waste (particularly in Canada). The purpose of this study is to combine observations of organic, recyclable, and garbage waste production rates to survey results of food waste-related beliefs, attitudes, and behaviours at the household level in the mid-sized municipality of Guelph, Ontario. Waste weights and surveys were obtained from 68 households in the summer of 2013. The results of this study indicate multiple relationships between food waste production and household shopping practices, food preparation behaviours, household waste management practices, and food-related attitudes, beliefs, and lifestyles. Notably, we observed that food awareness, waste awareness, family lifestyles, and convenience lifestyles were related to food waste production. We conclude that it is important to understand the diversity of factors that can influence food wasting behaviours at the household level in order to design waste management systems and policies to reduce food waste.

  17. Identification of potential regional sources of atmospheric total gaseous mercury in Windsor, Ontario, Canada using hybrid receptor modeling

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    U. S. Akhtar


    Full Text Available Windsor (Ontario – the automotive capital of Canada does not have any significant mercury (Hg sources. However, Windsor experiences trans-boundary air pollution as it is located immediately downwind of industrialized regions of the United States of America. A study was conducted in 2007 aimed to identify the potential regional sources of total gaseous mercury (TGM and investigate the effects of regional sources and other factors on seasonal variability of TGM concentrations in Windsor.

    TGM concentration was measured at the University of Windsor campus using a Tekran® 2537A Hg vapour analyzer. An annual mean of 2.02±1.63 ng/m3 was observed in 2007. The average TGM concentration was high in the summer (2.48 ng/m3 and winter (2.17 ng/m3, compared to spring (1.88 ng/m3 and fall (1.76 ng/m3. Hybrid receptor modeling potential source contribution function (PSCF was used by incorporating 72-h backward trajectories and measurements of TGM in Windsor. The results of PSCF were analyzed in conjunction with the Hg emissions inventory of North America (by state/province to identify regions affecting Windsor. In addition to annual modeling, seasonal PSCF modeling was also conducted. The potential source region was identified between 24–61° N and 51–143° W. Annual PSCF modeling identified major sources southwest of Windsor, stretching from Ohio to Texas. The emissions inventory also supported the findings, as Hg emissions were high in those regions. Results of seasonal PSCF modeling were analyzed to find the combined effects of regional sources, meteorological conditions, and surface reemissions, on intra-annual variability of Hg concentrations. It was found that the summer and winter highs of atmospheric Hg can be attributed to areas where large numbers of coal fired power plants are located in the USA. Weak atmospheric dispersion due to low winds and high reemission from surfaces due

  18. Preschool Early Literacy Programs in Ontario Public Libraries

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    Shelley Stagg Peterson


    Full Text Available This paper reports on research examining how library staff in 10 Ontario libraries’ preschool literacy programs support three- and four-year-old children’s early literacy and school readiness as well as their parents’ and caregivers’ literacy interactions with their children. Multiple data sources included surveys of 82 parents/caregivers, observations of a sample of 65 of the 198 children at the sessions we visited, and interviews with10 library staff. Observations were analyzed for evidence of children’s development of print motivation, phonological awareness, vocabulary, narrative skills, and print awareness: early literacy skills and knowledge that have been shown to be reliably and significantly correlated with future reading success. Analysis of the observational and interview data showed that the programs have been very successful in fostering children’s readiness to participate in school activities and their motivation to read. Participating children learned new vocabulary, demonstrated an awareness of rhymes and sounds of language, and showed an understanding of books that were read by library staff: all early literacy behaviours that are foundational to later literacy development. The programs have also provided parents/caregivers with new ways to interact with children to engage them with books and with print at home. The development of children’s school readiness skills and parents’ awareness of how to support their children’s literacy are outcomes extending beyond library staff goals for their library programs and should be included in literature advertising the programs. Print awareness is an area of literacy development that library staff could encourage to a greater extent, however. Very few instances of such behaviour were observed, with most of the observations taking place in two of the preschool early literacy programs. Concomitantly, developing children’s print awareness is a recommended topic for

  19. Evaluation of external biosecurity practices on southern Ontario sow farms. (United States)

    Bottoms, Kate; Poljak, Zvonimir; Dewey, Cate; Deardon, Rob; Holtkamp, Derald; Friendship, Robert


    External biosecurity protocols, aimed at preventing the introduction of new pathogens to the farm environment, are becoming increasingly important in the swine industry. Although assessments at the individual farm level occur regularly, efforts to cluster swine herds into meaningful biosecurity groups and to summarize this information at the regional level are relatively infrequent. The objectives of this study were: (i) to summarize external biosecurity practices on sow farms in southern Ontario; (ii) to cluster these farms into discrete biosecurity groups and to describe their characteristics, the variables of importance in differentiating between these groups, and their geographic distribution; and (iii) to identify significant predictors of biosecurity group membership. Data were collected using the Production Animal Disease Risk Assessment Program's Survey for the Breeding Herd. A subset of variables pertaining to external biosecurity practices was selected for two-step cluster analysis, which resulted in 3 discrete biosecurity groups. These groups were named by the authors as: (i) high biosecurity herds that were open with respect to replacement animals, (ii) high biosecurity herds that were closed with respect to replacement animals, and (iii) low biosecurity herds. Variables pertaining to trucking practices and the source of replacement animals were the most important in differentiating between these groups. Multinomial logistic regression provided insight into which demographic and neighborhood variables serve as significant predictors of biosecurity group membership (pbiosecurity group that was open with respect to replacement animals, relative to the low biosecurity group, increased 1.001 times for each additional sow (p=0.001). The odds of belonging to the high biosecurity group that was open with respect to replacement animals, relative to the low biosecurity group, were 6.5 times greater for farms that produced genetic animals than for farms that

  20. Evaluation of offshore stocking of Lake Trout in Lake Ontario (United States)

    Lantry, B.F.; O'Gorman, R.; Strang, T.G.; Lantry, J.R.; Connerton, M.J.; Schanger, T.


    Restoration stocking of hatchery-reared lake trout Salvelinus namaycush has occurred in Lake Ontario since 1973. In U.S. waters, fish stocked through 1990 survived well and built a large adult population. Survival of yearlings stocked from shore declined during 1990–1995, and adult numbers fell during 1998–2005. Offshore stocking of lake trout was initiated in the late 1990s in response to its successful mitigation of predation losses to double-crested cormorants Phalacrocorax auritus and the results of earlier studies that suggested it would enhance survival in some cases. The current study was designed to test the relative effectiveness of three stocking methods at a time when poststocking survival for lake trout was quite low and losses due to fish predators was a suspected factor. The stocking methods tested during 2000–2002 included May offshore, May onshore, and June onshore. Visual observations during nearshore stockings and hydroacoustic observations of offshore stockings indicated that release methods were not a direct cause of fish mortality. Experimental stockings were replicated for 3 years at one site in the southwest and for 2 years at one site in the southeast. Offshore releases used a landing craft to transport hatchery trucks from 3 to 6 km offshore out to 55–60-m-deep water. For the southwest site, offshore stocking significantly enhanced poststocking survival. Among the three methods, survival ratios were 1.74 : 1.00 : 1.02 (May offshore : May onshore : June onshore). Although not statistically significant owing to the small samples, the trends were similar for the southeast site, with survival ratios of 1.67 : 1.00 : 0.72. Consistent trends across years and sites indicated that offshore stocking of yearling lake trout during 2000–2002 provided nearly a twofold enhancement in survival; however, this increase does not appear to be great enough to achieve the 12-fold enhancement necessary to return population abundance to restoration

  1. Isotope hydrology of the Chalk River Laboratories site, Ontario, Canada (United States)

    Peterman, Zell; Neymark, Leonid; King-Sharp, K.J.; Gascoyne, Mel


    This paper presents results of hydrochemical and isotopic analyses of groundwater (fracture water) and porewater, and physical property and water content measurements of bedrock core at the Chalk River Laboratories (CRL) site in Ontario. Density and water contents were determined and water-loss porosity values were calculated for core samples. Average and standard deviations of density and water-loss porosity of 50 core samples from four boreholes are 2.73 ± 12 g/cc and 1.32 ± 1.24 percent. Respective median values are 2.68 and 0.83 indicating a positive skewness in the distributions. Groundwater samples from four deep boreholes were analyzed for strontium (87Sr/86Sr) and uranium (234U/238U) isotope ratios. Oxygen and hydrogen isotope analyses and selected solute concentrations determined by CRL are included for comparison. Groundwater from borehole CRG-1 in a zone between approximately +60 and −240 m elevation is relatively depleted in δ18O and δ2H perhaps reflecting a slug of water recharged during colder climatic conditions. Porewater was extracted from core samples by centrifugation and analyzed for major dissolved ions and for strontium and uranium isotopes. On average, the extracted water contains 15 times larger concentration of solutes than the groundwater. 234U/238U and correlation of 87Sr/86Sr with Rb/Sr values indicate that the porewater may be substantially older than the groundwater. Results of this study show that the Precambrian gneisses at Chalk River are similar in physical properties and hydrochemical aspects to crystalline rocks being considered for the construction of nuclear waste repositories in other regions.

  2. A Atmospheric Dispersion Model for the Sudbury, Ontario, Area. (United States)

    Huhn, Frank Jones


    A mathematical model was developed and tested to predict the relationship between sulphur oxide and trace metal emissions from smelters in the Sudbury, Ontario area, and atmospheric, precipitation, lake water and sediment chemistry. The model consists of atmospheric and lake chemistry portions. The atmospheric model is a Gaussian crosswind concentration distribution modification to a box model with a uniform vertical concentration gradient limited by a mixing height. In the near-field Briggs' plume rise and vertical dispersion terms are utilized. Oxidation, wet and dry deposition mechanisms are included to account for the gas, liquid and solid phases separately. Important improvements over existing models include (1) near- and far-field conditions treated in a single model; (2) direct linkage of crosswind dispersion to hourly meteorological observations; (3) utilization of maximum to minimum range of input parameters to realistically model the range of outputs; (4) direct linkage of the atmospheric model to a lake model. Precipitation chemistry as calculated by the atmospheric model is related to lake water and sediment chemistry utilizing a mass balance approach and assuming a continuously stirred reactor (CSTR) model to describe lake circulation. All inputs are atmospheric, modified by hydrology, soil chemistry and sedimentation. Model results were tested by comparison with existing atmospheric and precipitation chemistry measurements, supplemented with analyses of lake water and sediment chemistry collected in a field program. Eight pollutant species were selected for modeling: sulphur dioxide, sulphate ion, hydrogen ion, copper, nickel, lead, zinc, and iron. The model effectively predicts precipitation chemistry within 150 km of Sudbury, with an average prediction to measurement ratio of 90 percent. Atmospheric concentrations are effectively predicted within 80 km, with an average prediction to measurement ratio of 81 percent. Lake chemistry predictions are

  3. Looking inside the black box: a theory-based process evaluation alongside a randomised controlled trial of printed educational materials (the Ontario printed educational message, OPEM to improve referral and prescribing practices in primary care in Ontario, Canada

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    Lemyre Louise


    Full Text Available Abstract Background Randomised controlled trials of implementation strategies tell us whether (or not an intervention results in changes in professional behaviour but little about the causal mechanisms that produce any change. Theory-based process evaluations collect data on theoretical constructs alongside randomised trials to explore possible causal mechanisms and effect modifiers. This is similar to measuring intermediate endpoints in clinical trials to further understand the biological basis of any observed effects (for example, measuring lipid profiles alongside trials of lipid lowering drugs where the primary endpoint could be reduction in vascular related deaths. This study protocol describes a theory-based process evaluation alongside the Ontario Printed Educational Message (OPEM trial. We hypothesize that the OPEM interventions are most likely to operate through changes in physicians' behavioural intentions due to improved attitudes or subjective norms with little or no change in perceived behavioural control. We will test this hypothesis using a well-validated social cognition model, the theory of planned behaviour (TPB that incorporates these constructs. Methods/design We will develop theory-based surveys using standard methods based upon the TPB for the second and third replications, and survey a subsample of Ontario family physicians from each arm of the trial two months before and six months after the dissemination of the index edition of informed, the evidence based newsletter used for the interventions. In the third replication, our study will converge with the "TRY-ME" protocol (a second study conducted alongside the OPEM trial, in which the content of educational messages was constructed using both standard methods and methods informed by psychological theory. We will modify Dillman's total design method to maximise response rates. Preliminary analyses will initially assess the internal reliability of the measures and use

  4. 3D geometric reconstruction of thoracic aortic aneurysms

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    Mohiaddin Raad H


    Full Text Available Abstract Background The thoracic aortic aneurysm (TAA is a pathology that involves an expansion of the aortic diameter in the thoracic aorta, leading to risk of rupture. Recent studies have suggested that internal wall stress, which is affected by TAA geometry and the presence or absence of thrombus, is a more reliable predictor of rupture than the maximum diameter, the current clinical criterion. Accurate reconstruction of TAA geometry is a crucial step in patient-specific stress calculations. Methods In this work, a novel methodology was developed, which combines data from several sets of magnetic resonance (MR images with different levels of detail and different resolutions. Two sets of images were employed to create the final model, which has the highest level of detail for each component of the aneurysm (lumen, thrombus, and wall. A reference model was built by using a single set of images for comparison. This approach was applied to two patient-specific TAAs in the descending thoracic aorta. Results The results of finite element simulations showed differences in stress pattern between the coarse and fine models: higher stress values were found with the coarse model and the differences in predicted maximum wall stress were 30% for patient A and 11% for patient B. Conclusion This paper presents a new approach to the reconstruction of an aneurysm model based on the use of several sets of MR images. This enables more accurate representation of not only the lumen but also the wall surface of a TAA taking account of intraluminal thrombus.

  5. Lower thoracic rib stress fractures in baseball pitchers. (United States)

    Gerrie, Brayden J; Harris, Joshua D; Lintner, David M; McCulloch, Patrick C


    Stress fractures of the first rib on the dominant throwing side are well-described in baseball pitchers; however, lower thoracic rib fractures are not commonly recognized. While common in other sports such as rowing, there is scant literature on these injuries in baseball. Intercostal muscle strains are commonly diagnosed in baseball pitchers and have a nearly identical presentation but also a highly variable healing time. The diagnosis of a rib stress fracture can predict a more protracted recovery. This case series presents two collegiate baseball pitchers on one team during the same season who were originally diagnosed with intercostal muscle strains, which following magnetic resonance imaging (MRI) were found to have actually sustained lower thoracic rib stress fractures. The first sustained a stress fracture of the posterior aspect of the right 8th rib on the dominant arm side, while the second presented with a left-sided 10th rib stress fracture on the nondominant arm side. In both cases, MRI was used to visualize the fractures as plain radiographs are insensitive and commonly negative early in patient presentation. Patients were treated with activity modification, and symptomatic management for 4-6 weeks with a graduated return to throwing and competition by 8-10 weeks. The repetitive high stresses incurred by pitching may cause either dominant or nondominant rib stress fractures and this should be included in the differential diagnosis of thoracic injuries in throwers. It is especially important that athletic trainers and team physicians consider this diagnosis, as rib fractures may have a protracted course and delayed return to play. Additionally, using the appropriate imaging techniques to establish an accurate diagnosis can help inform return-to-play decisions, which have important practical applications in baseball, such as roster management and eligibility.

  6. Treatment of traumatic rupture of the thoracic aorta

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    Davidović Lazar


    Full Text Available INTRODUCTION Interest for traumatic thoracic aorta rupture stems from the fact that its number continually increases, and it can be rapidly lethal. OBJECTIVE The aim of this study is to present early and long term results as well as experiences of our team in surgical treatment of traumatic thoracic aorta rupture. METHOD Our retrospective study includes 12 patients with traumatic thoracic aorta rupture treated between 1985 and 2007. There were 10 male and two female patients of average age 30.75 years (18-74. RESULTS In six cases, primary diagnosis was established during the first seven days days after trauma, while in 6 more than one month later. In 11 cases, classical open surgical procedure was performed, while endovascular treatment was used in one patient. Three (25% patients died, while two (16.6% had paraplegia. Nine patients (75% were treated without complications, and are in good condition after a mean follow-up period of 9.7 years (from one month to 22 years. CONCLUSION Surgical treatment requires spinal cord protection to prevent paraplegia, using cardiopulmonary by-pass (three of our cases or external heparin-bonded shunts (five of our cases. Cardiopulmonary by-pass is followed with lower incidence of paraplegia, however it is not such a good solution for patients with polytrauma because of hemorrhage. The endovascular repair is a safe and feasible procedure in the acute phase, especially because of traumatic shock and polytrauma which contributes to higher mortality rate after open surgery. On the other hand, in chronic postrauamatic aortic rupture, open surgical treatment is connected with a lower mortality rate and good long-term results. There have been no published data about long-term results of endovascular treatment in the chronic phase.

  7. Physiological Interaction of Heart and Lung in Thoracic Irradiation

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    Ghobadi, Ghazaleh; Veen, Sonja van der [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Bartelds, Beatrijs [Center for Congenital Heart Disease, Beatrix Children Hospital, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Boer, Rudolf A. de [Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Dickinson, Michael G. [Center for Congenital Heart Disease, Beatrix Children Hospital, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Jong, Johan R. de [Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Faber, Hette; Niemantsverdriet, Maarten [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Brandenburg, Sytze [Kernfysisch Versneller Instituut, University of Groningen, Groningen (Netherlands); Berger, Rolf M.F. [Center for Congenital Heart Disease, Beatrix Children Hospital, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Langendijk, Johannes A. [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Coppes, Robert P. [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Luijk, Peter van, E-mail: [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands)


    Introduction: The risk of early radiation-induced lung toxicity (RILT) limits the dose and efficacy of radiation therapy of thoracic tumors. In addition to lung dose, coirradiation of the heart is a known risk factor in the development RILT. The aim of this study was to identify the underlying physiology of the interaction between lung and heart in thoracic irradiation. Methods and Materials: Rat hearts, lungs, or both were irradiated to 20 Gy using high-precision proton beams. Cardiopulmonary performance was assessed using breathing rate measurements and F{sup 18}-fluorodeoxyglucose positron emission tomography ({sup 18}F-FDG-PET) scans biweekly and left- and right-sided cardiac hemodynamic measurements and histopathology analysis at 8 weeks postirradiation. Results: Two to 12 weeks after heart irradiation, a pronounced defect in the uptake of {sup 18}F-FDG in the left ventricle (LV) was observed. At 8 weeks postirradiation, this coincided with LV perivascular fibrosis, an increase in LV end-diastolic pressure, and pulmonary edema in the shielded lungs. Lung irradiation alone not only increased pulmonary artery pressure and perivascular edema but also induced an increased LV relaxation time. Combined irradiation of lung and heart induced pronounced increases in LV end-diastolic pressure and relaxation time, in addition to an increase in right ventricle end-diastolic pressure, indicative of biventricular diastolic dysfunction. Moreover, enhanced pulmonary edema, inflammation and fibrosis were also observed. Conclusions: Both lung and heart irradiation cause cardiac and pulmonary toxicity via different mechanisms. Thus, when combined, the loss of cardiopulmonary performance is intensified further, explaining the deleterious effects of heart and lung coirradiation. Our findings show for the first time the physiological mechanism underlying the development of a multiorgan complication, RILT. Reduction of dose to either of these organs offers new opportunities to

  8. Reduction of uterus dose in clinical thoracic computed tomography

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    Danova, D.; Keil, B.; Kaestner, B.; Klose, K.J.; Heverhagen, J.T. [Marburg Univ. (Germany). Dept. of Diagnostic Radiology; Wulff, J.; Fiebich, M.; Zink, K. [Univ. of Applied Sciences Giessen-Friedberg (Germany). Inst. of Medical Physics and Radiation Protection


    Purpose: The aim of this study was to investigate the potential dose reduction in the uterus as a result of lead apron protection during thoracic CT scans. Moreover, the distribution of the radiation dose in the uterus was determined in order to obtain information about the ratio of internally and externally scattered radiation. Materials and Methods: The uterus doses during thoracic CT were determined by measuring organ doses using an Alderson-RANDO {sup registered} -Phantom and thermoluminescent dosimeters. A 0.25 mm lead equivalent protective apron was used to shield the abdominal area. Three measurement conditions were evaluated: without lead apron, covered with lead apron and wrapped with lead apron. The uterus dose with and without shielding describes the mean value and standard deviation of all examinations and all measurement points in the organ. Results: The uterus dose by thoracic CT was measured to be approximately 66.5 {+-} 3.1 {mu}Gy. If the abdomen is covered with a 0.25 mm Pb equivalent lead apron in the front area and on both sides, the uterus dose is reduced to 49.4 {+-} 2.8 {mu}Gy (26 % reduction, p < 0.001). If a lead apron is wrapped around the abdomen, providing 0.50 mm Pb shielding in the anterior section due to overlap, and 0.25 mm Pb in the posterior section and on both sides, the uterus dose is reduced even more to 43.8 {+-} 2.5 {mu}Gy (34 % reduction, p < 0.001). The dose distribution when the lead apron covers the abdomen shows that the shielding is effective for the scatter radiation that comes from the anterior part. Moreover, the wrapped apron protects the uterus from all directions and is even more effective for dose reduction than the covering apron. Conclusion: Our findings demonstrate that protective aprons are an effective dose reduction technique without additional costs and little effect on patient examination time. (orig.)

  9. The demonstration projects: creating the capacity for nursing health human resource planning in Ontario's healthcare organizations. (United States)

    Burkoski, Vanessa; Tepper, Joshua


    Timely access to healthcare services requires the right number, mix and distribution of appropriately educated nurses, physicians and other healthcare professionals. In Ontario, as in several other jurisdictions, changing demographics, patterns of health service utilization and an aging workforce have created challenges related to the supply of nurses available now and in the future to deliver quality patient care. From 2006 to 2009, the Nursing Secretariat (NS) of Ontario's Ministry of Health and Long-Term Care (the ministry) undertook a progressive and comprehensive approach to address the issue of nursing supply across the province through the introduction of 17 Nursing Health Human Resources Demonstration Projects (demonstration projects). The demonstration projects initiative has led to the creation of a unique collection of best practices, tools and resources aimed at improving organizational planning capacity. Evaluation of the initiative generated recommendations that may guide the ministry toward policy and program development to foster improved nursing health human resource planning capacity in Ontario healthcare organizations.

  10. Student Perceptions of Literacy after the Ontario Secondary Literacy Course: A Qualitative Inquiry

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    Thomas G. Ryan


    Full Text Available Adolescent literacy has emerged via the high-stakesstandardized test known as the Ontario Secondary School Literacy Test (OSSLTas a critical area of debate and study. Research has indicated a directconnection between literacy and identity, and that student literacy practicesdiffer from traditional measures of literacy located in school curriculum andevaluated via standardized tests such as the OSSLT. Outcomes such as limitedachievement, difficulties with literacy and the development of literacy skills,and subsequent below standard scorescan diminish student self-concept, lower self-esteem, and impede self-efficacy.This ethnographic case study illuminated the impact of OSSLT and subsequentmandatory enrolment in the Ontario Secondary School Literacy Course usingsemi-structured interviews involving high-school students from a northernOntario secondary school. Previous related research outcomes, whichdemonstrated a connection between standardized test scores and self-concept,were realized via participants’ understanding and perception of literacy, andthrough mitigating factors impacting literacy engagement and achievement.

  11. Needlescopic video-assisted thoracic surgery pleurodesis for primary pneumothorax. (United States)

    Sihoe, Alan D L; Hsin, Michael K Y; Yu, Peter S Y


    Conventional video-assisted thoracic surgery (VATS) is already well established as the approach of choice for definitive surgical management for primary pneumothorax. However, VATS itself is a constantly evolving technique. The needlescopic VATS (nVATS) approach uses the existing chest drain wound as a working port and adds only two 3-mm ports to provide equally effective pleurodesis as conventional VATS. Staple resection of bullae or blebs plus complete mechanical parietal pleural abrasion is achievable using nVATS. By potentially reducing morbidity for the individual patient, the nVATS approach may lower thresholds for surgical candidacy-even for first episodes of primary pneumothorax.

  12. [MR investigation of spinal cord herniation in the thoracic spine]. (United States)

    Kenéz, József; Barsi, Péter; Várallyay, György; Bobest, Mátyás; Veres, Róbert


    Transdural herniation of the spinal cord is thought to be previously extremely rare and very often misdiagnosed. Possible reasons may be iatrogenic and traumatic or in about one third of cases it may be unknown, where the probable origin might be a congenital dural defect. The pathology may show characteristic and misleading MR patterns of the thoracic spine, emphasising the importance of these patterns. This anomaly can lead to progressive Brown-Sequard syndrome. Surgical intervention, consisting the repair of the dural defect may result in improvement or even complete regression of the neurologic deficits.

  13. Mediastinal pancreatic pseudocyst with isolated thoracic symptoms: a case report

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    Drescher Robert


    Full Text Available Abstract Introduction Mediastinal pancreatic pseudocysts represent a rare complication of acute or chronic pancreatitis. Case presentation A 55-year-old man with a history of chronic pancreatitis was admitted with intermittent dyspnea, dysphagia and weight loss. Chest X-ray, computed tomography and magnetic resonance imaging revealed a large paracardial pancreatic pseudocyst causing cardiac and esophageal compression. Conclusion Mediastinal pancreatic pseudocysts are a rare complication of chronic pancreatitis. These pseudocysts may lead to isolated thoracic symptoms. For accurate diagnostic and therapy planning, a multimodal imaging approach is necessary.

  14. Thoracic involvement in generalised lymphatic anomaly (or lymphangiomatosis

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    Francesca Luisi


    Full Text Available Generalised lymphatic anomaly (GLA, also known as lymphangiomatosis, is a rare disease caused by congenital abnormalities of lymphatic development. It usually presents in childhood but can also be diagnosed in adults. GLA encompasses a wide spectrum of clinical manifestations ranging from single-organ involvement to generalised disease. Given the rarity of the disease, most of the information regarding it comes from case reports. To date, no clinical trials concerning treatment are available. This review focuses on thoracic GLA and summarises possible diagnostic and therapeutic approaches.

  15. Thoracic outlet syndrome: a neurological and vascular disorder. (United States)

    Klaassen, Zachary; Sorenson, Edward; Tubbs, R Shane; Arya, Rahul; Meloy, Patrick; Shah, Rajnil; Shirk, Samuel; Loukas, Marios


    Thoracic outlet syndrome (TOS) is a condition arising from compression of the subclavian vessels and/or brachial plexus as the structures travel from the thoracic outlet to the axilla. Despite the significant pathology associated with TOS, there remains some general disagreement among experts on the specific anatomy, etiology, and pathophysiology of the condition, presumably because of the wide variation in symptoms that manifest in presenting patients, and because of lack of a definitive gold standard for diagnosis. Symptoms associated with TOS have traditionally been divided into vascular and neurogenic categories, a distinction based on the underlying structure(s) implicated. Of the two, neurogenic TOS (nTOS) is more common, and typically presents as compression of the brachial plexus; primarily, but not exclusively, involving its lower trunk. Vascular TOS (vTOS) usually involves compression of the vessel, most commonly the subclavian artery or vein, or is secondary to thrombus formation in the venous vasculature. Any anatomical anomaly in the thoracic outlet has the potential to predispose a patient to TOS. Common anomalies include variations in the insertion of the anterior scalene muscle (ASM) or scalenus minimus muscle, the presence of a cervical rib or of fibrous and muscular bands, variations in insertion of pectoralis minor, and the presence of neurovascular structures, which follow an atypical course. A common diagnostic technique for vTOS is duplex imaging, which has generally replaced more invasive angiographic techniques. In cases of suspected nTOS, electrophysiological nerve studies and ASM blocks provide guidance when screening for patients likely to benefit from surgical decompression of TOS. Surgeons generally agree that the transaxillary approach allows the greatest field of view for first rib excision to relieve compressed vessels. Alternatively, a supraclavicular approach is favored for scalenotomies when the ASM impinges on surrounding

  16. Damage control surgery for severe thoracic and abdominal injuries

    Institute of Scientific and Technical Information of China (English)

    HUANG Xian-kai; ZHU Yu-jun; ZHANG Lian-yang


    Objective: To investigate the application of damage control surgery in treatment of patients with severe thoracic and abdominal injuries.Methods: A retrospective study was done on 37 patients with severe thoracic and abdominal injuries who underwent damage control surgery from January 2000 to October 2006 in our department. There were 8 cases of polytrauma ( with thoracic injury most commonly seen), 21 of polytrauma (with abdominal injury most commonly seen) and 8 of single abdominal trauma. Main organ damage included smashed hepatic injuries in 17 cases,posterior hepatic veins injuries in 8, pancreaticoduodenal injuries in 7, epidural or subdural hemorrhage in 4,contusion and laceration of brain in 5, severe lung and bronchus injuries in 4, pelvis and one smashed lower limb wound in 3 and pelvic fractures and retroperitoneal hemorrhage in 6. Injury severity score (ISS) was 28-45 scores (38.4 scores on average), abbreviated injury scale (ALS) ≥ 4.13. The patients underwent arteriography and arterial embolization including arteria hepatica embolization in 4 patients, arteria renalis embolization in 2 and pelvic arteria retroperitoneal embolization in 7. Once abbreviated operation finished, the patients were sent to ICU for resuscitation. Twenty-four cases underwent definitive operation within 48 hours after initial operation, 5 underwent definitive operation within 72 hours after initial operation, 2 cases underwent definitive operation postponed to 96 hours after initial operation for secondary operation to control bleeding because of abdominal cavity hemorrhea.Two cases underwent urgent laparotomy and decompression because of abdominal compartment syndrome and 2 cases underwent secondary operation because of intestinal fistulae (1 case of small intestinal fistula and 1 colon fistula) and gangrene of gallbladder.Results: A total of 28 patients survived, with a survival rate of 75.68%, and 9 died (4 died within 24 hours and 5 died 3-9 days after injury). The

  17. Aneurysm growth after late conversion of thoracic endovascular aortic repair

    Directory of Open Access Journals (Sweden)

    Hirofumi Kasahara


    Full Text Available A 69-year-old man underwent thoracic endovascular aortic repair of a descending aortic aneurysm. Three years later, he developed impending rupture due to aneurysmal expansion that included the proximal landing zone. Urgent open surgery was performed via lateral thoracotomy, and a Dacron graft was sewn to the previous stent graft distally with Teflon felt reinforcement. Postoperatively, four sequential computed tomography scans demonstrated that the aneurysm was additionally increasing in size probably due to continuous hematoma production, suggesting a possibility of endoleaks. This case demonstrates the importance of careful radiologic surveillance after endovascular repair, and also after partial open conversion.

  18. Idiopathic dural herniation of the thoracic spinal cord

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    Hausmann, O.N. [National Hospital for Neurology and Neurosurgery, London (United Kingdom). Lysholm Radiological Dept.; Moseley, I.F. [National Hospital for Neurology and Neurosurgery, London (United Kingdom). Lysholm Radiological Dept.


    Symptomatic anterior or anterolateral dural herniation of the spinal cord is rare, and not uncommonly misdiagnosed, both clinically and radiologically. We present four patients with a radiological diagnosis of herniation of the thoracic spinal cord, and review the current literature. All affected patients have been adults, typcially presenting with long-standing, unexplained sensory symptoms and eventually developing a Brown-Sequard syndrome, with or without motor changes. Herniation occurs in the upper or midthoracic region, between the T2 and T8 levels. (orig.)

  19. Thoracic complications of deeply situated serous neck infections. (United States)

    Colmenero Ruiz, C; Labajo, A D; Yañez Vilas, I; Paniagua, J


    Nine cases of complicated deep neck infections, occurring during a period of twelve years are presented. Complications observed were cervico-thoracic necrotizing fasciitis in 3 cases, purulent pleural effusion in 6 cases, pericardial effusion in 2, mediastinitis in 8 cases, jugular vein thrombosis and rupture of the innominate artery in one case each. Although 2 cases were managed initially with blind endotracheal intubation, all cases finally required tracheostomy. A cervico-mediastinal approach was useful for the early mediastinal involvement. Two patients died because of inadequacy of the multiple surgical procedures resulting in persistent infection and multi-organ failure and one because of uncontrollable bleeding after innominate artery rupture.

  20. Cadaveric nerve allotransplantation in the treatment of persistent thoracic neuralgia. (United States)

    Barbour, John R; Yee, Andrew; Moore, Amy M; Trulock, Elbert P; Buchowski, Jacob M; Mackinnon, Susan E


    When relief from neuralgia cannot be achieved with traditional methods, neurectomy may be considered to abate the stimulus, and primary opposition of the terminal nerve ending is recommended to prevent neuroma. Nerve repair with autograft is limited by autologous nerves available for large nerve defects. Cadaveric allografts provide an unlimited graft source without donor-site morbidities, but are rapidly rejected unless appropriate immunosuppression is achieved. An optimal treatment method for nerve allograft transplantation would minimize rejection while simultaneously permitting nerve regeneration. This report details a novel experience of nerve allograft transplantation using cadaveric nerve grafts to desensitize persistent postoperative thoracic neuralgia.

  1. Yellow nail syndrome following thoracic surgery: A new association?

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    Banta D


    Full Text Available An 80-year-old man presented with the characteristic triad of yellow nail syndrome (chronic respiratory disorders, primary lymphedema and yellow nails in association with coronary artery bypass graft surgery. Treatment with mechanical pleurodesis and vitamin E resulted in near complete resolution of the yellow nails, pleural effusions, and lower extremity edema. The etiology of the yellow nail syndrome has been described as an anatomical or functional lymphatic abnormality. Several conditions have previously been described as associated with this disease. This is the first report of the association of this syndrome with thoracic surgery.

  2. Pregnancy and Thoracic Aortic Disease: Managing the Risks. (United States)

    Wanga, Shaynah; Silversides, Candice; Dore, Annie; de Waard, Vivian; Mulder, Barbara


    The most common aortopathies in women of childbearing age are bicuspid aortic valve, coarctation of the aorta, Marfan syndrome, Ehlers-Danlos syndrome, Loeys-Dietz syndrome, SMAD3 aortopathy, Turner syndrome, and familial thoracic aneurysm and dissection. The hemodynamic and hormonal changes of pregnancy increase the risk of progressive dilatation or dissection of the aorta in these women. The presence of hypertension increases the risk further. Therefore, appropriate preconception counselling is advised. For women who become pregnant, serial follow-up by a specialized multidisciplinary team throughout pregnancy and postpartum period is required. In this review we discuss risk assessment and management strategies for women with aortopathies.

  3. Public awareness of income-related health inequalities in Ontario, Canada

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    Shankardass Ketan


    Full Text Available Abstract Introduction Continued action is needed to tackle health inequalities in Canada, as those of lower income continue to be at higher risk for a range of negative health outcomes. There is arguably a lack of political will to implement policy change in this respect. As a result, we investigated public awareness of income-related health inequalities in a generally representative sample of Ontarians in late 2010. Methods Data were collected from 2,006 Ontario adults using a telephone survey. The survey asked participants to agree or disagree with various statements asserting that there are or are not health inequalities in general and by income in Ontario, including questions pertaining to nine specific conditions for which inequalities have been described in Ontario. A multi-stage process using binary logistic regression determined whether awareness of health inequalities differed between participant subgroups. Results Almost 73% of this sample of Ontarians agreed with the general premise that not all people are equally healthy in Ontario, but fewer participants were aware of health inequalities between the rich and the poor (53%–64%, depending on the framing of the question. Awareness of income-related inequalities in specific outcomes was considerably lower, ranging from 18% for accidents to 35% for obesity. Conclusions This is the first province-wide study in Canada, and the first in Ontario, to explore public awareness on health inequalities. Given that political will is shaped by public awareness and opinion, these results suggest that greater awareness may be required to move the health equity agenda forward in Ontario. There is a need for health equity advocates, physicians and researchers to increase the effectiveness of knowledge translation activities for studies that identify and explore health inequalities.

  4. Optimizing the detection of venous invasion in colorectal cancer: The Ontario, Canada, experience and beyond

    Directory of Open Access Journals (Sweden)

    Heather eDawson


    Full Text Available Venous invasion (VI is a well-established independent prognostic indicator in colorectal cancer (CRC. Its accurate detection is particularly important in stage II CRC as it may influence the decision to administer adjuvant therapy. The Royal College of Pathologists (RCPath of the United Kingdom state that VI should be detected in at least 30% of CRC resection specimens. However, our experience in Ontario, Canada suggests that this (conservative benchmark is rarely met. This article highlights the Ontario experience with respect to VI reporting and the key role that careful morphologic assessment, elastin staining and knowledge transfer has played in improving VI detection provincially and beyond.

  5. Austerity, Competitiveness and Neoliberalism Redux: Ontario Responds to the Great Recession

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    Carlo Fanelli


    Full Text Available This article examines the deepening integration of market imperatives throughout the province of Ontario. We do this by, first, examining neoliberalism’s theoretical underpinnings, second, reviewing Ontario’s historical context, and third, scrutinizing the Open Ontario Plan, with a focus on proposed changes to employment standards legislation. We argue that contrary to claims of shared restraint and the pressing need for public austerity, Premier McGuinty’s Liberal’s have re-branded and re-packaged core neoliberal policies in such a manner that costs are socialized and profits privatized, thereby intensifying class polarization along with its racialized and gendered diversities.

  6. Shifting Currents: Science Technology Society and Environment in Northern Ontario Schools



    The focus is on the practices of secondary science teachers in rural, resource-extraction-based communities in the boreal region of northern Ontario, Canada. In 2008 the Ontario Ministry of Education mandated that science teaching and learning should bring to the forefront consideration of the impacts of science on society and environment, and include environmental education; topics that are particularly pertinent given the location(s) of the study in logging and mining towns. Three years aft...

  7. Penetrating thoracic spinal cord injury with ice pick extending into the aorta. A technical note and review of the literature

    Directory of Open Access Journals (Sweden)

    Rani Nasser


    Conclusion: To the author′s knowledge, this challenging case represents the first description of a successful removal of a penetrating thoracic spinal foreign body that terminated within the lumen of the thoracic aorta.

  8. Associations between vertebral fractures, increased thoracic kyphosis, a flexed posture and falls in older adults : a prospective cohort study

    NARCIS (Netherlands)

    van der Jagt-Willems, Hanna C.; de Groot, Maartje H.; van Campen, Jos P. C. M.; Lamoth, Claudine J. C.; Lems, Willem F.


    Background: Vertebral fractures, an increased thoracic kyphosis and a flexed posture are associated with falls. However, this was not confirmed in prospective studies. We performed a prospective cohort study to investigate the association between vertebral fractures, increased thoracic kyphosis and/

  9. Extracorporeal membrane oxygenation before induction of anesthesia in critically ill thoracic transplant patients

    NARCIS (Netherlands)

    Waterbolk, TW; Brugemann, J; van der Bij, W; Huyzen, RJ


    Cardiorespiratory failure just before surgery in critically ill thoracic transplant patients can have catastrophic consequences. We judged the cardiorespiratory condition in three of 160 thoracic transplant procedures performed in our center too unstable for a safe induction of anesthesia. In these

  10. Diagnostic accuracy of post-mortem MRI for thoracic abnormalities in fetuses and children

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    Arthurs, Owen J. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); UCL Institute of Child Health, London (United Kingdom); Thayyil, Sudhin; Addison, Shea [Imperial College London, Perinatal Neurology and Neonatology, London (United Kingdom); Olsen, Oystein E. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); Wade, Angie [UCL Institute of Child Health, Paediatric Epidemiology and Biostatistics Unit, London (United Kingdom); Jones, Rod; Norman, Wendy; Taylor, Andrew M. [UCL Institute of Cardiovascular Science, Centre for Cardiovascular Imaging, London (United Kingdom); Great Ormond Street Hospital for Children NHS Foundation Trust, Cardiorespiratory Division, London (United Kingdom); Scott, Rosemary J. [University College London Hospital NHS Trust, Department of Histopathology, London (United Kingdom); Robertson, Nicola J. [UCL Institute for Women' s Health, Academic Neonatology, London (United Kingdom); Chitty, Lyn S. [UCL Institute of Child Health, Genetics and Genomic Medicine, London (United Kingdom); UCLH NHS Foundation Trusts, London (United Kingdom); Sebire, Neil J. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Histopathology, London (United Kingdom); UCL Institute of Child Health, London (United Kingdom); Owens, Catherine M. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); UCL Institute of Cardiovascular Science, Centre for Cardiovascular Imaging, London (United Kingdom); Great Ormond Street Hospital for Children NHS Foundation Trust, Cardiorespiratory Division, London (United Kingdom); Collaboration: Magnetic Resonance Imaging Autopsy Study (MaRIAS) Collaborative Group


    To compare the diagnostic accuracy of post-mortem magnetic resonance imaging (PMMR) specifically for non-cardiac thoracic pathology in fetuses and children, compared with conventional autopsy. Institutional ethics approval and parental consent was obtained. A total of 400 unselected fetuses and children underwent PMMR before conventional autopsy, reported blinded to the other dataset. Of 400 non-cardiac thoracic abnormalities, 113 (28 %) were found at autopsy. Overall sensitivity and specificity (95 % confidence interval) of PMMR for any thoracic pathology was poor at 39.6 % (31.0, 48.9) and 85.5 % (80.7, 89.2) respectively, with positive predictive value (PPV) 53.7 % (42.9, 64.0) and negative predictive value (NPV) 77.0 % (71.8, 81.4). Overall agreement was 71.8 % (67.1, 76.2). PMMR was most sensitive at detecting anatomical abnormalities, including pleural effusions and lung or thoracic hypoplasia, but particularly poor at detecting infection. PMMR currently has relatively poor diagnostic detection rates for the commonest intra-thoracic pathologies identified at autopsy in fetuses and children, including respiratory tract infection and diffuse alveolar haemorrhage. The reasonable NPV suggests that normal thoracic appearances at PMMR exclude the majority of important thoracic lesions at autopsy, and so could be useful in the context of minimally invasive autopsy for detecting non-cardiac thoracic abnormalities. (orig.)

  11. Thoracic stent grafts with a distal fenestration for the celiac axis

    NARCIS (Netherlands)

    Tielliu, IFJ; Verhoeven, ELG; Zeebregts, CJ; Prins, TR; van den Dungen, JJAM


    Descending thoracic aneurysms can be treated with a stent graft provided that there is sufficient proximal and distal aortic neck length above the celiac axis. One of the options for the treatment of thoracic aneurysms with a too short distal neck is described in this report. For this purpose, a ste

  12. Different Approaches to Ultrasound-guided Thoracic Paravertebral Block: An Illustrated Review

    NARCIS (Netherlands)

    Krediet, A.C.; Moayeri, N.; Geffen, G.J. van; Bruhn, J.; Renes, S.; Bigeleisen, P.E.; Groen, G.J.


    Given the fast development and increasing clinical relevance of ultrasound guidance for thoracic paravertebral blockade, this review article strives (1) to provide comprehensive information on thoracic paravertebral space anatomy, tailored to the needs of a regional anesthesia practitioner, (2) to i

  13. Different Approaches to Ultrasound-guided Thoracic Paravertebral Block An Illustrated Review

    NARCIS (Netherlands)

    Krediet, Annelot C.; Moayeri, Nizar; van Geffen, Geert-Jan; Bruhn, Joergen; Renes, Steven; Bigeleisen, Paul E.; Groen, Gerbrand J.


    Given the fast development and increasing clinical relevance of ultrasound guidance for thoracic paravertebral blockade, this review article strives (1) to provide comprehensive information on thoracic paravertebral space anatomy, tailored to the needs of a regional anesthesia practitioner, (2) to i

  14. Late neurological recovery of paraplegia after endovascular repair of an infected thoracic aortic aneurysm. (United States)

    Mees, Barend M E; Bastos Gonçalves, Frederico; Koudstaal, Peter J; Verhagen, Hence J M


    Spinal cord ischemia is a potentially devastating complication after thoracic endovascular aorta repair (TEVAR). Patients with spinal cord ischemia after TEVAR often develop paraplegia, which is considered irreversible, and have significant increased postoperative morbidity and mortality. We report the case of a patient with unusual late complete neurologic recovery of acute-onset paraplegia after TEVAR for an infected thoracic aortic aneurysm.

  15. Myocardial revascularization with both internal thoracic arteries 25 years after delayed repair for aortic coarctation. (United States)

    Gaudino, Mario; Farina, Piero; Cammertoni, Federico; Massetti, Massimo


    Aortic coarctation has been reported to cause alterations in the internal thoracic arteries that make these vessels unsuitable to be used as grafts for myocardial revascularization, especially if coarctation repair was performed in adulthood. This is the first reported bilateral internal thoracic grafting for myocardial revascularization in a patient who had undergone aortic coarctation repair 25 years earlier.

  16. Ligation of the thoracic duct for the treatment of chylothorax in heart diseases

    Directory of Open Access Journals (Sweden)

    Pêgo-Fernandes Paulo M.


    Full Text Available In children, chylothorax occurs mainly after cardiac and thoracic surgeries. One of the recommended postsurgery treatments is ligation of the thoracic tract, when all other conservative treatments have failed. We report 4 cases of chylothorax in patients who were successfully treated with this approach, which resulted in a decrease in pleural drainage without recurrent chylothorax.

  17. A Primer on Health Economic Evaluations in Thoracic Oncology. (United States)

    Whittington, Melanie D; Atherly, Adam J; Bocsi, Gregary T; Camidge, D Ross


    There is growing interest for economic evaluation in oncology to illustrate the value of multiple new diagnostic and therapeutic interventions. As these analyses have started to move from specialist publications into mainstream medical literature, the wider medical audience consuming this information may need additional education to evaluate it appropriately. Here we review standard practices in economic evaluation, illustrating the different methods with thoracic oncology examples where possible. When interpreting and conducting health economic studies, it is important to appraise the method, perspective, time horizon, modeling technique, discount rate, and sensitivity analysis. Guidance on how to do this is provided. To provide a method to evaluate this literature, a literature search was conducted in spring 2015 to identify economic evaluations published in the Journal of Thoracic Oncology. Articles were reviewed for their study design, and areas for improvement were noted. Suggested improvements include using more rigorous sensitivity analyses, adopting a standard approach to reporting results, and conducting complete economic evaluations. Researchers should design high-quality studies to ensure the validity of the results, and consumers of this research should interpret these studies critically on the basis of a full understanding of the methodologies used before considering any of the conclusions. As advancements occur on both the research and consumer sides, this literature can be further developed to promote the best use of resources for this field.

  18. Breast Surgery Using Thoracic Paravertebral Blockade and Sedation Alone

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    James Simpson


    Full Text Available Introduction. Thoracic paravertebral block (TPVB provides superior analgesia for breast surgery when used in conjunction with general anesthesia (GA. Although TPVB and GA are often combined, for some patients GA is either contraindicated or undesirable. We present a series of 28 patients who received a TPVB with sedation alone for breast cancer surgery. Methods. A target controlled infusion of propofol or remifentanil was used for conscious sedation. Ultrasound guided TPVB was performed at one, two, or three thoracic levels, using up to 30 mL of local anesthetic. If required, top-up local infiltration analgesia with prilocaine 0.5% was performed by the surgeon. Results. Most patients were elderly with significant comorbidities and had TPVB injections at just one level (54%. Patient choice and anxiety about GA were indications for TVPB in 9 patients (32%. Prilocaine top-up was required in four (14% cases and rescue opiate analgesia in six (21%. Conclusions. Based on our technique and the outcome of the 28 patients studied, TPVB with sedation and ultrasound guidance appears to be an effective and reliable form of anesthesia for breast surgery. TPVB with sedation is a useful anesthetic technique for patients in which GA is undesirable or poses an unacceptable risk.

  19. FBN1 Mutations in Patients With Descending Thoracic Aortic Dissections (United States)

    Brautbar, Ariel; LeMaire, Scott A.; Franco, Luis M.; Coselli, Joseph S.; Milewicz, Dianna M.; Belmont, John W.


    Aortic aneurysm and dissection cause significant morbidity and mortality. There are several known single gene disorders that predispose to isolated aortic disease and eventually aneurysm and dissection. FBN1 mutations are associated with multiple clinical phenotypes, including Marfan syndrome (MFS), MASS phenotype, and familial ectopia lentis, but rarely with isolated aortic aneurysm and dissection. In this report, we describe three patients who presented with primary descending thoracic aortic dissection and who were found to have an FBN1 mutation. None of the patients fulfilled clinical criteria for the diagnosis of MFS, and all had few or none of the skeletal features typical of the condition. Two patients had a history of long-term hypertension, and such a history was suspected in the third patient. These observations suggest that some individuals with FBN1 mutations have significant aortic disease involvement of other systems that is typical of FBN1 mutation-related syndromes. Superimposed risk factors, such as hypertension, may weaken the aortic wall and eventually lead to aortic dissection. Given that the cost continues to decrease, we suggest that diagnostic DNA sequencing for FBN1 mutations in patients with thoracic aortic aneurysms and dissection may be a practical clinical step in evaluating such patients and at-risk family members. PMID:20082464

  20. Unusual thoracic CT manifestations of osteosarcoma: review of 16 cases

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    Rastogi, Ruchi; Garg, Rachana; Thulkar, Sanjay [All India Institute of Medical Sciences, Department of Radiology, New Delhi (India); Bakhshi, Sameer; Gupta, Ajay [All India Institute of Medical Sciences, Department of Medical Oncology, New Delhi (India)


    Pulmonary metastases are common in osteosarcoma and the most common appearance is of multiple well-defined nodules in the lung parenchyma. However, a variety of atypical locations and presentations of osteosarcoma metastasis can occur in the thorax. We present a review of the thoracic CT findings in 16 patients with histopathologically confirmed osteosarcoma with unusual thoracic manifestations. The 16 patients were selected out of a total 136 patients who received a chest CT scan for osteosarcoma during a period of 3 years in a tertiary care hospital. Unusual imaging findings included a solitary large ossified lung mass, ossified mediastinal and hilar lymph nodes, an esophagomediastinal fistula, lymphangitic carcinomatosis, pulmonary artery tumor emboli, a solitary large pleural deposit along the major fissure, multiple pleural deposits, diffuse pleural calcification, pneumothorax, diaphragmatic deposits, an isolated chest wall deposit without lung involvement, and primary osteosarcoma of the rib. Our findings of lymphangitic carcinomatosis in a living patient as well as calcified mediastinal lymphadenopathy leading to esophageal fistula are unique in the literature, and there are only a few case reports of our other findings. (orig.)

  1. Endovascular stent-graft management of thoracic aortic diseases

    Energy Technology Data Exchange (ETDEWEB)

    Dake, Michael D. E-mail:


    The traditional standard therapy for descending thoracic aortic aneurysm (TAA) is open operative repair with graft replacement of the diseased aortic segment. Despite important advances in surgical techniques, anesthetic management, and post-operative care over the last 30 years, the mortality and morbidity of surgery remains considerable, especially in patients at high risk for thoracotomy because of coexisting severe cardiopulmonary abnormalities or other medical diseases. The advent of endovascular stent-graft technology provides an alternative to open surgery for selected patients with TAA. The initial experience suggests that stent-graft therapy potentially may reduce the operative risk, hospital stay and procedural expenses of TAA repair. These potential benefits are especially attractive for patients at high risk for open TAA repair. Current results of endovascular TAA therapy document operative mortalities of between 0 and 4%, aneurysm thrombosis in 90 and 100% of cases, and paraplegia as a complication in 0 and 1.6% of patients. The early success of stent-graft repair of TAA has fostered the application of these devices for the management of a wide variety of thoracic aortic pathologies, including acute and chronic dissection, intramural hematoma, penetrating ulcer, traumatic injuries, and other diseases. The results of prospective controlled trials that compare the outcomes of stent-graft therapy with those of surgical treatment in patients with specific types of aortic disease are anxiously awaited before recommendations regarding the general use of these new devices can be made with confidence.

  2. Endovascular treatment of thoracic aortic aneurysms: a review

    Energy Technology Data Exchange (ETDEWEB)

    Thurnher, Siegfried A. [Department of Radiology, University Hospital, Wien (Austria); Grabenwoeger, Martin [Department of Cardio-Thoracic Surgery, University of Vienna (Austria)


    Open surgical repair is considered the traditional treatment for patients with thoracic aortic aneurysms (TAA). In view of the persistent perioperative mobidity and mortality, endovascular stent-graft placement as a minimally invasive and potentially safer treatment for aneurysm of the descending aorta was introduced in 1992. Since then, progress has been made and several institutions have substantiated the safety and effectiveness of stent grafts in the repair of descending TAAs or type-B aortic dissections. Currently, both custom-designed, home-made, and commercially available stent grafts are used. Prior to placement of the endoprosthesis, three major prerequisites must be considered: the localization and morphology of the aneurysm; the distal vascular access of sufficient size; and a limited tortuosity of the abdominal and thoracic aorta. Although short-term results are encouraging, severe complications, including paraplegia, cerebral strokes, and aortic rupture, have been encountered. The long-term durability of currently available stent-graft systems is nonexistent and material fatigue are of major concern to both surgeons and radiologists. Nevertheless, endovascular stent-graft placement could become the procedure of choice in a substantial number of patients with descending TAA. (orig.)

  3. Thoracic applications of dual-source CT technology. (United States)

    Boroto, Kahimano; Remy-Jardin, Martine; Flohr, Thomas; Faivre, Jean-Baptiste; Pansini, Vittorio; Tacelli, Nunzia; Schmidt, Bernhard; Gorgos, Andrei; Remy, Jacques


    Among the various imaging modalities available, CT has remained over time the core imaging technique for the evaluation of respiratory disorders. The recent advent of dual-source CT offers innovative approaches to investigate thoracic diseases, based on the use of one or two tubes as well as single or dual energy to scan the entire thorax. Two major options can be used in clinical practice with promising results. Dual source, single-energy scanning allows scanning of the entire thorax with ultra-high temporal resolution which opens the field of integrated cardiothoracic imaging without ECG gating as well as optimized evaluation of pediatric and adult patients with limited ability to cooperate. Dual-source, dual-energy acquisitions represent another very innovative means of investigating respiratory disorders, adding tissue characterization and functional analysis to morphological evaluation. The purpose of this review article is to provide results on preliminary experiences with the above-mentioned scanning conditions with dual-source CT and to envisage potential forthcoming applications in the field of thoracic imaging.

  4. [Complications of thyroid surgery: cervical thoracic duct injuries]. (United States)

    Avenia, N; Sanguinetti, A; Santoprete, S; Monacelli, M; Cirocchi, R; Lucchini, R; Galasse, S; Calzolari, F; Urbani, M; D'Ajello, F; Puma, F


    Thoracic duct injury is uncommon in surgery of the neck: relatively more common after laryngeal and esophageal surgery, rare in thyroid surgery. From January 1986 to June 2009 were treated 14 patients with lesions of the cervical thoracic duct undergo surgery for thyroid disease: 4 goitre cervico-mediastinal and 10 total thyroidectomy for cancer, 9 of which have laterocervical left lymphadenectomy. In 2 cases, the intraoperative detection has allowed immediate ligature. In 12 patients a cervical chylous fistula without chilothorax was found: 5 low-flow fistulas and 7 high-flow fistulas. Of the 5 cases of low-flow fistula, 4 were recovered after 1 month of conservative treatment, only 1 patient required surgical correction. The 7 patients with high-flow fistula were undergoing surgery: 4 in the first week post-operative and 3 after a period of more than 30 days of medical therapy. In patients with high-flow fistula prolonged medical treatment does not provide benefit and increase the risk of complications during and after surgery.

  5. Thoracic skeletal defects and cardiac malformations: a common epigenetic link? (United States)

    Weston, Andrea D; Ozolins, Terence R S; Brown, Nigel A


    Congenital heart defects (CHDs) are the most common birth defects in humans. In addition, cardiac malformations represent the most frequently identified anomaly in teratogenicity experiments with laboratory animals. To explore the mechanisms of these drug-induced defects, we developed a model in which pregnant rats are treated with dimethadione, resulting in a high incidence of heart malformations. Interestingly, these heart defects were accompanied by thoracic skeletal malformations (cleft sternum, fused ribs, extra or missing ribs, and/or wavy ribs), which are characteristic of anterior-posterior (A/P) homeotic transformations and/or disruptions at one or more stages in somite development. A review of other teratogenicity studies suggests that the co-occurrence of these two disparate malformations is not unique to dimethadione, rather it may be a more general phenomenon caused by various structurally unrelated agents. The coexistence of cardiac and thoracic skeletal malformations has also presented clinically, suggesting a mechanistic link between cardiogenesis and skeletal development. Evidence from genetically modified mice reveals that several genes are common to heart development and to formation of the axial skeleton. Some of these genes are important in regulating chromatin architecture, while others are tightly controlled by chromatin-modifying proteins. This review focuses on the role of these epigenetic factors in development of the heart and axial skeleton, and examines the hypothesis that posttranslational modifications of core histones may be altered by some developmental toxicants.

  6. Thoracic Wall Necrotizing Fasccitiss in a Neonate: a Case Report

    Directory of Open Access Journals (Sweden)

    Serdar Onat


    Full Text Available Necrotizing fasciitis (NF is a rapidly progressive and potentially life-threatening infection of superficial fascia and subcutaneous tissue. Thoracic wall is one of the rarest locations for NF. Broadspectrum antibiotics receiving, early surgical debridement, and skin grafting are life saving in NF. We report a 7-day-old female neonate who had left sided thoracic wall NF. She had undergone extensive surgical debridement within 4 hours of hospital admission, and reconstruction of skin defect by split-thickness skin grafting later. Early diagnosis is important, as prompt surgical debridement offers the best chance for survival. Early and extensive surgical debridement is a widely accepted clinical approach and the mainstay of effective treatment. The goals of surgical intervention are to remove all necrotic tissues, and to help control the progression of NF. Reconstruction of skin defects should be performed by early split-thickness skin grafting like our patient or primary closure. Because early wound resurfacing prevents fluid, electrolyte, and protein loss from the wound site, and decreases secondary infection. Although chest wall NF is rare in neonates, it is a rapidly spreading, highly lethal infection. A high index of suspicion, early diagnosis, and aggressive approach are essential to its successful treatment.

  7. Automated lung segmentation algorithm for CAD system of thoracic CT

    Institute of Scientific and Technical Information of China (English)


    Objective: To design and test the accuracy and efficiency of our lung segmentation algorithm on thoracic CT image in computer-aided diagnostic (CAD) system, especially on the segmentation between left and right lungs. Methods: We put forward the base frame of our lung segmentation firstly. Then, using optimal thresholding and mathematical morphologic methods, we acquired the rough image of lung segmentation. Finally, we presented a fast self-fit segmentation refinement algorithm, adapting to the unsuccessful left-right lung segmentation of thredsholding. Then our algorithm was used to CT scan images of 30 patients and the results were compared with those made by experts. Results: Experiments on clinical 2-D pulmonary images showed the results of our algorithm were very close to the expert's manual outlines, and it was very effective for the separation of left and right lungs with a successful segmentation ratio 94.8%. Conclusion: It is a practicable fast lung segmentation algorithm for CAD system on thoracic CT image.

  8. Drinking water contamination in Walkerton, Ontario: positive resolutions from a tragic event. (United States)

    Holme, R


    In May 2000, Escherichia coli O157:H7 and Campylobacter jejuni contaminated the drinking water supply in Walkerton, Ontario. Seven people died and over 2,000 were ill as a result. The Ontario Provincial Government set up a judicial Inquiry into the circumstances surrounding the outbreak and also moved quickly to introduce a new Drinking Water Regulation that incorporated some significant requirements for drinking water providers. The Inquiry itself was in three parts: (a) part 1 related to the events that occurred in Walkerton and why the water contamination occurred; (b) part 1A related specifically to the role of the Provincial Government in the event; and (c) part 2 related to the future of drinking water safety in Ontario with potential to influence regulation on a wider basis. A number of other actions were taken after Walkerton. In August 2000, the Ontario Government, through the Regulatory body, the Ontario Ministry of the Environment (MOE) (a) re-issued and revised the Ontario Drinking Water Objectives (ODWO) as the Ontario Drinking Water Standards (ODWS) and (b) introduced new regulations governing drinking water in Ontario--the Ontario Drinking Water Protection Regulation. One of the key features of the Drinking Water Protection Regulation was the requirement to produce an independent Engineers' Report on all water systems. This paper provides a unique perspective on the Walkerton tragedy and its aftermath. The author was active in many aspects of the resulting activity (Chair of the Ontario Water Works Association's (a section of the AWWA) Special Committee involved in Part 2 of the Walkerton Inquiry; author of several of the Engineers' Reports mandated by Regulation; reviewer on behalf of the Regulator of Engineers' Reports submitted by others). The Engineers' Reports were of interest because (1) the drinking water providers (mostly municipalities) were mandated by regulation to complete the Reports by specific dates and are paying for the Reports, (2

  9. La implementación de programas de educación en medios: el caso Ontario Implementing Mandates in Media Education: The Ontario Experience

    Directory of Open Access Journals (Sweden)

    Barry Duncan


    Full Text Available Este artículo expone un informe sobre la educación en alfabetización mediática en Ontario. Brinda una visión general del plan de estudios para la alfabetización mediática propuesta por el gobierno regional. Específicamente, describe varias aproximaciones para la enseñanza acerca de los medios, así como la teoría que apuntala los documentos del plan de estudios y las prácticas en el aula. También describe el trabajo de organizaciones y asociaciones clave que ayudaron a priorizar la educación en alfabetización mediática, y ofrece sugerencias para el desarrollo exitoso y la implementación de programas de alfabetización mediática. La conclusión discute los retos y el curso futuro de la alfabetización mediática más allá del caso Ontario, centrándose en nueve tesis clave para el éxito en su implementación en todo el mundo. This analysis presents a report on media literacy education in Ontario. It provides an overview of the curriculum for media literacy that is mandated by the provincial government. Specifically, it describes various approaches for teaching about the media as well as the theory that underpins curriculum documents and classroom practices. The analysis also describes the work of key organizations and partnerships that helped prioritize media literacy education, and offers suggestions for the successful development and implementation of media literacy programs. The conclusion discusses the challenges and future directions for media literacy beyond the Ontario case, focusing on nine key tenets for success in its implementation worldwide.

  10. GPS coordinate time series measurements in Ontario and Quebec, Canada (United States)

    Samadi Alinia, Hadis; Tiampo, Kristy F.; James, Thomas S.


    New precise network solutions for continuous GPS (cGPS) stations distributed in eastern Ontario and western Québec provide constraints on the regional three-dimensional crustal velocity field. Five years of continuous observations at fourteen cGPS sites were analyzed using Bernese GPS processing software. Several different sub-networks were chosen from these stations, and the data were processed and compared to in order to select the optimal configuration to accurately estimate the vertical and horizontal station velocities and minimize the associated errors. The coordinate time series were then compared to the crustal motions from global solutions and the optimized solution is presented here. A noise analysis model with power-law and white noise, which best describes the noise characteristics of all three components, was employed for the GPS time series analysis. The linear trend, associated uncertainties, and the spectral index of the power-law noise were calculated using a maximum likelihood estimation approach. The residual horizontal velocities, after removal of rigid plate motion, have a magnitude consistent with expected glacial isostatic adjustment (GIA). The vertical velocities increase from subsidence of almost 1.9 mm/year south of the Great Lakes to uplift near Hudson Bay, where the highest rate is approximately 10.9 mm/year. The residual horizontal velocities range from approximately 0.5 mm/year, oriented south-southeastward, at the Great Lakes to nearly 1.5 mm/year directed toward the interior of Hudson Bay at stations adjacent to its shoreline. Here, the velocity uncertainties are estimated at less than 0.6 mm/year for the horizontal component and 1.1 mm/year for the vertical component. A comparison between the observed velocities and GIA model predictions, for a limited range of Earth models, shows a better fit to the observations for the Earth model with the smallest upper mantle viscosity and the largest lower mantle viscosity. However, the

  11. A normalized thoracic coordinate system for atlas mapping in 3D CT images

    Institute of Scientific and Technical Information of China (English)


    In this paper, a normalized thoracic coordinate system (NTCS) is defined for rapidly mapping the 4D thoracic organ atlas into individual CT volume images. This coordinate system is defined based on the thoracic skeleton. The coordinate values are normalized by the size of the individual thorax so that this coordinate system is universal to different individuals. For compensating the respiratory motion of the organs, a 4D dynamic torso atlas is introduced. A method for mapping this dynamic atlas into the individual image using the NTCS is also proposed. With this method, the dynamic atlas was mapped into the clinical thoracic CT images and rough positions of the organs were found rapidly. This NTCS-based 4D atlas mapping method may provide a novel way for estimating the thoracic organ positions in low-resolution molecular imaging modalities, as well as in modern 4D medical images.

  12. Parasites in the thoracic ganglion of Pachygrapsus marmoratus (Brachyura: Grapsidae from the coast of Portugal

    Directory of Open Access Journals (Sweden)

    Kuris A.M.


    Full Text Available We examined 149 marbled shore crabs, Pachygrapsus marmoratus, from the coast of Portugal for parasites. In particular, we focused our effort on the crab thoracic ganglion. The thoracic ganglion is the largest concentration of nervous tissue in a crab and thus, parasites associated with this organ are well situated to influence host behavior. We found metacercariae of two microphallid trematode species in the thoracic ganglion. We also found a microsporan and an apicomplexan associated with the thoracic ganglion. Other parasites not associated with the thoracic ganglion included gregarine trophozoites which were present in the digestive diverticulae in some of the crabs and the entoniscid isopod, Grapsion cavolini.Metacercariae of one of the trematodes (probably Microphallus pachygrapsi (Deblock and Prevot, may influence the mortality of its host.

  13. Lottery promotions at the point-of-sale in Ontario, Canada. (United States)

    Planinac, Lynn C; Cohen, Joanna E; Reynolds, Jennifer; Robinson, Daniel J; Lavack, Anne; Korn, David


    We documented the extent of point-of-sale (POS) lottery promotions in Ontario, Canada and the relationship between lottery promotions and store and city characteristics. This is the first quantitative study of POS lottery promotions. A total of 366 stores-independent and chain convenience stores, gas stations and grocery stores-were visited across 20 cities in Ontario. Data collectors unobtrusively observed the type of lottery promotions in each store and completed a data collection checklist. A lottery promotion index was created and hierarchical linear modeling (HLM) was conducted to examine the relationship between extent of lottery promotions and independent variables such as neighbourhood socioeconomic status and city prevalence of lottery ticket purchasing. POS lottery promotions were widespread across Ontario, with the highest level of promotion found in independent convenience stores. In the multivariable HLM model, none of the remaining independent variables remained statistically significant, except for store type. Lottery promotions are extensive at the POS in Ontario. These findings can help initiate discussions around the appropriateness and possible future regulation of this form of advertising.

  14. Education as a Spectral Technology: Corporate Culture at Work in Ontario's Schools (United States)

    Martin, Susan Marie


    This paper addresses the sweeping neoliberal reforms implemented in Ontario's schools in 2000, and conceptualises them within the terms of "millennial capitalism" (Comaroff & Comaroff, 2000). A close reading of secondary school curriculum documents and the umbrella policies that shape education from ages 5 to 18 years reveals…

  15. The Ontario Energy Board`s draft standard supply service code: effects on air quality

    Energy Technology Data Exchange (ETDEWEB)

    Gibbons, J.; Bjorkquist, S. [Ontario Clean Air Alliance, Toronto, ON (Canada)


    The Ontario Clean Air Alliance (OCAA), a coalition of 67 organizations, takes issue with the Ontario Energy Board`s draft document `Standard Supply Service Code`, particularly sections 2.2.2. and 2.5.2 which they claim are not in the public interest unless the Ontario government implements the OCAA`s recommended emission caps. The alliance is of the view that without strict new environmental regulations the proposed Code would encourage the use of coal for electricity generation. Public health, the environment, consumer interests, job creation and promotion of a competitive electricity market would all be jeopardized by this development, the alliance states. The argument is supported by extensive reference to the Final Report of the Ontario Market Design Committee (MDC) which also emphasized the importance of combining the introduction of competition with appropriate environmental regulations, singling out the emission cap and trade program, and recommending that it be launched concurrently with the electricity market opening for competition. The view of the MDC was that public support for restructuring would not be forthcoming in the absence of regulatory measures to control power plant emissions. 25 refs.

  16. Regulatory and institutional developments in the Ontario wine and grape industry

    Directory of Open Access Journals (Sweden)

    Carew R


    Full Text Available Richard Carew,1 Wojciech J Florkowski21Agriculture and Agri-Food Canada, Pacific Agri-Food Research Centre, Summerland, BC, Canada; 2Department of Agricultural and Applied Economics, University of Georgia, Griffin, GA, USAAbstract: The Ontario wine industry has undergone major transformative changes over the last two decades. These have corresponded to the implementation period of the Ontario Vintners Quality Alliance (VQA Act in 1999 and the launch of the Winery Strategic Plan, "Poised for Greatness," in 2002. While the Ontario wine regions have gained significant recognition in the production of premium quality wines, the industry is still dominated by a few large wine companies that produce the bulk of blended or "International Canadian Blends" (ICB, and multiple small/mid-sized firms that produce principally VQA wines. This paper analyzes how winery regulations, industry changes, institutions, and innovation have impacted the domestic production, consumption, and international trade, of premium quality wines. The results of the study highlight the regional economic impact of the wine industry in the Niagara region, the success of small/mid-sized boutique wineries producing premium quality wines for the domestic market, and the physical challenges required to improve domestic VQA wine retail distribution and bolster the international trade of wine exports. Domestic success has been attributed to the combination of natural endowments, entrepreneurial talent, established quality standards, and the adoption of improved viticulture practices.Keywords: Ontario, wine, quality standards

  17. A Review of (Elementary) School Self-Assessment Processes: Ontario and Beyond (United States)

    Ryan, Thomas G.; Telfer, Leslie


    This review draws attention to issues related to school self-assessment. This process has been similarly implemented in a variety of jurisdictions globally in the past decade hence their inclusion herein as an attempt to understand the school self-assessment process which has also been developed for use in local Ontario (Canadian) elementary…

  18. Long-Run Impact of the Thirty Cent Revision in Ontario's Minimum Wage on Five Industries. (United States)

    McKenna, Ian B.

    To determine the effect of a legislated increase in the minimum wage in Ontario, 219 establishments in five industries were surveyed. The industries were shoe factories; luggage, handbag, and small leather goods manufacturers; hosiery mills, children's clothing industry; and the foundation garment industry. Data were gathered at three different…

  19. The Representation and Appropriation of Indigenous Cultures at Ontario Summer Camps. (United States)

    Hamilton, Ty


    Interviews with directors at five Ontario summer camps found that three camps exposed children to stereotypes of Indigenous peoples and to cultural appropriation. This is inconsistent with goals of educating campers about and showing respect for Indigenous cultures. Given the current issues of land-claims and Aboriginal rights, non-Indigenous…

  20. A Reexamination of Ontario's Science Curriculum: Toward a More Inclusive Multicultural Science Education? (United States)

    Mujawamariya, Donatille; Hujaleh, Filsan; Lima-Kerckhoff, Ashley


    The rapid diversification of communities in Ontario has necessitated the provincial government to reevaluate public school curriculums and policies to make schools more inclusive and reflective of its diverse population. This article critically analyzes the content of the latest revised science curricula for Grades 1 to 10 and assesses the degree…

  1. Demand for Substance Abuse Treatment Related to Use of Crystal Methamphetamine in Ontario: An Observational Study (United States)

    Brands, Bruna; Corea, Larry; Strike, Carol; Singh, Veeran-Anne S.; Behrooz, Renee C.; Rush, Brian


    Concerns about methamphetamine/crystal methamphetamine (MA) have featured prominently in the Canadian media and on addiction treatment agency agendas. We examined MA admissions at addiction treatment agencies to determine if a service gap existed. In 2006, all addiction treatment agencies (n = 124) in Ontario, Canada were invited to complete an…

  2. Sense of Belonging and Mental Health in Hamilton, Ontario: An Intra-Urban Analysis (United States)

    Kitchen, Peter; Williams, Allison; Chowhan, James


    This paper examines geographic variations in sense of community belonging in Hamilton, Ontario. It also identifies the most significant health and social factors associated with belonging in the city. The research employs data from the 2007/08 Canadian Community Health Survey for respondents aged 18 or over living in the Hamilton Census…

  3. Legal requirements for human-health based appeals of wind energy projects in ontario. (United States)

    Engel, Albert M


    In 2009, the government of the province of Ontario, Canada passed new legislation to promote the development of renewable energy facilities, including wind energy facilities in the province. Throughout the legislative process, concerns were raised with respect to the effect of wind energy facilities on human health. Ultimately, the government established setbacks and sound level limits for wind energy facilities and provided Ontario residents with the right to appeal the approval of a wind energy facility on the ground that engaging in the facility in accordance with its approval will cause serious harm to human health. The first approval of a wind facility under the new legislation was issued in 2010 and since then, Ontario's Environmental Review Tribunal as well as Ontario's courts has been considering evidence proffered by appellants seeking revocation of approvals on the basis of serious harm to human health. To date, the evidence has been insufficient to support the revocation of a wind facility approval. This article reviews the legal basis for the dismissal of human-health based appeals.

  4. Ten years of photonics education at the college level in Ontario: results and by-products (United States)

    Nantel, Marc


    In 2000, there was no way for an Ontario student to obtain a credential in optics, laser or photonics without going through graduate school. This was in, arguably, the world-leading jurisdiction in photonics-enabled telecommunications industry. To alleviate this problem and supply the job market with highly-qualified people in the field of optics and photonics, the Ontario Centres of Excellence - then as Photonics Research Ontario - partnered with Algonquin College (Ottawa) and Niagara College (Welland) to establish over the past decade a suite of programs: a 1-year Certificate in Advanced Lasers, a 2-year Diploma for Photonics Engineering Technician, a 3-year Diploma for Photonics Engineering Technologists and a 4-year Bachelor of Applied Technology - Photonics. Much has been learnt along the way - the crucial need for industrial partner and government support, for example - and many course corrections had to be made (telecom bust, anyone?). The author will share the results of this 10-year journey so far, the lessons learnt, and a view to the next ten years for these programs and photonics education in Ontario in general.

  5. Evaluation of a Family and Community Engagement Strategy in Three Ontario Communities (United States)

    Black, Glenda L.; Cantalini-Williams, Maria; Elliott-Johns, Susan E.; Wideman, Ron


    The Learning Partnership (TLP) initiated a Family and Community Engagement Strategy (FACES) initiative in three Ontario communities to foster active and responsive relationships among community partners and enhanced family engagement in transitions to school. A case study research design, grounded in participatory action research, was used to…

  6. A heuristic simulation model of Lake Ontario circulation and mass balance transport (United States)

    McKenna, J.E.; Chalupnicki, M.A.


    The redistribution of suspended organisms and materials by large-scale currents is part of natural ecological processes in large aquatic systems but can contribute to ecosystem disruption when exotic elements are introduced into the system. Toxic compounds and planktonic organisms spend various lengths of time in suspension before settling to the bottom or otherwise being removed. We constructed a simple physical simulation model, including the influence of major tributaries, to qualitatively examine circulation patterns in Lake Ontario. We used a simple mass balance approach to estimate the relative water input to and export from each of 10 depth regime-specific compartments (nearshore vs. offshore) comprising Lake Ontario. Despite its simplicity, our model produced circulation patterns similar to those reported by more complex studies in the literature. A three-gyre pattern, with the classic large counterclockwise central lake circulation, and a simpler two-gyre system were both observed. These qualitative simulations indicate little offshore transport along the south shore, except near the mouths of the Niagara River and Oswego River. Complex flow structure was evident, particularly near the Niagara River mouth and in offshore waters of the eastern basin. Average Lake Ontario residence time is 8 years, but the fastest model pathway indicated potential transport of plankton through the lake in as little as 60 days. This simulation illustrates potential invasion pathways and provides rough estimates of planktonic larval dispersal or chemical transport among nearshore and offshore areas of Lake Ontario. ?? 2011 Taylor & Francis.

  7. Public Attitudes toward Education in Ontario. 1984. Fifth OISE Survey. Informal Series/62. (United States)

    Livingstone, D. W.; And Others

    This survey involved a representative sample of 1,046 adults who were interviewed, and a special sample of corporate executives (127) who responded to a mailed questionnaire. Chapter 1 presents findings on the Ontario public's general assessments of the quality of high school education and their dispositions toward public expenditures on various…

  8. Graduate Studies in Computer-Based Education at the Ontario Institute for Studies in Education. (United States)

    Rubincam, Irvin

    This overview of the programs, activities, and facilities relating to computer-based education at the Ontario Institute for Studies in Education (OISE) includes, (1) a brief account of the history and mission of OISE; (2) a description of the OISE Computer Applications Department and its merger with the Department of Measurement and Evaluation in…

  9. Public Attitudes toward Education in Ontario, 1982. Fourth OISE Survey. Informal Series/51. (United States)

    Livingstone, D. W.; And Others

    Results of the Ontario Institute for Studies in Education 1982 Survey, intended primarily to offer ongoing profiles of mass attitudes on major issues of current educational reform, are reported. In addition to documenting trends in public support for general curricular and financing options, the survey focuses on attitudes towards alternative ways…

  10. Writings Relating to Literacy Done at the Ontario Institute for Studies in Education. (United States)

    Draper, James A., Ed.

    This bibliography contains about three hundred citations of publications on aspects of literacy by faculty and research officers at the Ontario Institute for Studies in Education (OISE) in Toronto, over 45 theses completed by OISE students, and almost 40 publications by OISE graduates. The list was compiled from the results of a survey of OISE…

  11. The Effects on Monopsony on Strategy and Leadership in Ontario Colleges. Professional File. Number 28 (United States)

    Cooke, Michael


    The period 1995 to 2005 was one of significant turbulence for Ontario colleges, marked by increasing globalization, immigration, disruptions in the labour market, new technologies and dramatic reductions in government operating grants. This study examines how colleges and their leaders responded to those strategic challenges in their official…

  12. The Muirkirk Mammoth : A Late Pleistocene woolly mammoth (Mammuthus primigenius) skeleton from southern Ontario, Canada

    NARCIS (Netherlands)

    Harington, C. R.; Mol, Dick; van der Plicht, Johannes


    The Muirkirk Mammoth, found in 1895 2.4 km northeast of the village of Muirkirk in southern Ontario, is the most complete woolly mammoth (Mammuthus primigenius) skeleton known from Canada. Approximate tusk measurements and extreme wear on the sixth molars indicate it is best referred to an old male.

  13. Education as a Spectral Technology: Corporate Culture at Work in Ontario's Schools (United States)

    Martin, Susan Marie


    This paper addresses the sweeping neoliberal reforms implemented in Ontario's schools in 2000, and conceptualises them within the terms of "millennial capitalism" (Comaroff & Comaroff, 2000). A close reading of secondary school curriculum documents and the umbrella policies that shape education from ages 5 to 18 years reveals how…

  14. Stressful, Hectic, Daunting: A Critical Policy Study of the Ontario Teacher Performance Appraisal System (United States)

    Larsen, Marianne A.


    Teacher performance appraisal policies are a part of a global complex of accountability based teacher policies. This paper is a study of the Ontario teacher performance appraisal (TPA) system. First, the paper describes the education reform contexts associated with the origins and adoption of the TPA policy. Then the paper reports on the results…

  15. Colleges of Applied Arts and Technology of Ontario. Background Papers on Current Issues. (United States)

    Association of Colleges of Applied Arts and Technology of Ontario, Willowdale.

    Background information is provided on a number of conditions affecting Ontario's community colleges. The first section, dealing with financial issues, considers the college environment in the 1980s; examines the provincial government's perspective on priorities, the allocation process, government funding, and budgetary expenditures and trends; and…

  16. Rates of Mental Illness and Associated Academic Impacts in Ontario's College Students (United States)

    Holmes, Alana; Silvestri, Robert


    Staff at campus-based counselling and disability centres in 15 of Ontario's 24 community colleges completed 3,536 surveys on 1,964 individual students querying the presence of mental illness and academic challenges as reported by students accessing these services. Survey data were analyzed to determine prevalence rates of mental disorders and…

  17. The Impact of Canadian Social Discourses on L2 Writing Pedagogy in Ontario (United States)

    Kalan, Amir


    This paper attempts to illustrate the impact of Canadian social, political, and academic discourses on second language writing pedagogy in Ontario schools. Building upon the views that regard teacher knowledge as teachers' sociocultural interactions and lived experiences, and not merely intellectual capabilities gained within teacher preparation,…

  18. Positivism and Post-World War I Elementary School Reform in Ontario (United States)

    Milewski, Patrice


    Following the end of World War I, the Ontario Department of Education initiated a series of reforms aimed at both elementary and secondary schooling. This article examines the reforms that were made to elementary school curriculum and pedagogy. These were initiated within the context of a call for a general reconstruction of education and society…

  19. Youth Environmental Science Outreach in the Mushkegowuk Territory of Subarctic Ontario, Canada (United States)

    Karagatzides, Jim D.; Kozlovic, Daniel R.; De Iuliis, Gerry; Liberda, Eric N.; General, Zachariah; Liedtke, Jeff; McCarthy, Daniel D.; Gomez, Natalya; Metatawabin, Daniel; Tsuji, Leonard J. S.


    We connected youth of the Mushkegowuk Territory (specifically Fort Albany First Nation) with environmental science and technology mentors in an outreach program contextualized to subarctic Ontario that addressed some of the environmental concerns identified by members of Fort Albany First Nation. Most activities were community-based centering on…

  20. The Evolution of Online Education at a Small Northern Ontario University: Theory and Practice (United States)

    Carter, Lorraine; Graham, Robert Douglas


    One of the major influences on university education in Ontario is the growing use of Internet technologies. These new technologies have led faculty and learning experts at universities to talk about online and technology-enhanced learning with a fervour not often found on most campuses. Among other things, these discussions have challenged…

  1. Adolescent Tobacco and Cannabis Use: Young Adult Outcomes from the Ontario Child Health Study (United States)

    Georgiades, Katholiki; Boyle, Michael H.


    Background: This study examines the longitudinal associations between adolescent tobacco and cannabis use and young adult functioning. Methods: Data for analysis come from the Ontario Child Health Study (OCHS), a prospective study of child health, psychiatric disorder and adolescent substance use in a general population sample that began in 1983,…

  2. Comparative diets of subyearling Atlantic salmon and subyearling coho salmon in Lake Ontario tributaries (United States)

    Johnson, James H.; Ringler, Neil H.


    Restoration of Atlantic salmon (Salmo salar) in Lake Ontario could potentially be negatively affected by the presence of non-native salmonids that are naturalized in the basin. Coho salmon (Oncorhynchus kisutch) have been spawning successfully in Lake Ontario tributaries for over 40 years and their juveniles will reside in streams with juvenile Atlantic salmon for one year. This study sought to examine interspecific diet associations between these species, and to compare diets to the composition of the benthos and drift in three Lake Ontario tributaries. Aquatic insects, mainly ephemeropterans and chironomids were the major prey consumed by subyearling Atlantic salmon whereas terrestrial invertebrates made up only 3.7% of the diet. Ephemeropterans and chironomids were the primary aquatic taxa consumed by subyearling coho salmon but, as a group, terrestrial invertebrates (41.8%) were the major prey. In sympatry, Atlantic salmon fed more actively from the benthos whereas the diet of coho salmon was more similar to the drift. The different feeding pattern of each species resulted in low interspecific diet similarity. There is likely little competition between these species for food in Lake Ontario tributaries as juveniles.

  3. Tensions and Fissures: The Politics of Standardised Testing and Accountability in Ontario, 1995-2015 (United States)

    Pinto, Laura Elizabeth


    While Ontario has received international accolades for its enactment of province-wide standardised testing upon the formation of the Education Quality and Accountability Office (EQAO), a closer look at provincial assessments over a 20-year span reveals successes as well as systemic tensions and fissures. The purpose of this paper is twofold.…

  4. Induction Programs in Ontario Schools: Raising Questions about Pre-Service Programs and Practica. (United States)

    Cole, Ardra; McNay, Margaret


    Views the first-year teacher induction program as a logical extension of the student teaching experience and the next step in long-term teacher development. Outlines the goals of pre-service practica in Ontario universities and suggests related goals for induction programs. Contains 17 references. (SV)

  5. Increasing Research Capacity in Ontario Child Welfare Organizations: A Unique University-Child Welfare Agency Partnership (United States)

    Fallon, Barbara; Trocmé, Nico; Van Wert, Melissa; Budau, Krista; Ballantyne, Mary; Lwin, Kristen


    The objective of this article is to describe the successes and challenges of a unique knowledge mobilization initiative that was funded through the Social Sciences and Humanities Research Council of Canada. This initiative focused on promoting knowledge mobilization by increasing the capacity of child welfare organizations in Ontario to conduct…

  6. Financial Report of Ontario Universities, 1993-94. Volume I - Universities. (United States)

    Council of Ontario Universities, Toronto.

    This report provides detailed financial information for provincially-assisted colleges and universities in Ontario (Canada) for the fiscal year ended April 30, 1994. It describes university accounting procedures, principles for reporting financial data, and definitions. Nine tables provide summary information on revenue, expenses, fund balances,…

  7. Muse, Ruse, Subterfuge: Transdisciplinary "Praxis" in Ontario's Post-Secondary Bricolage? (United States)

    Mitchell, Richard C.; Moore, Shannon A.


    In late 2013, Canada's national newspaper reported that the implementation of Ontario's "differentiation policy framework" was the province's "boldest step yet to compel universities and colleges to make hard choices about how they spend their resources...a draft policy designed to stretch limited provincial dollars by narrowing…

  8. Educational Technology Decision-Making: Technology Acquisition for 746,000 Ontario Students (United States)

    Ribeiro, Jason


    The author explores the technology procurement process in Ontario's publicly funded school districts to determine if it is aligned with relevant research, is grounded in best practices, and enhances student learning. Using a qualitative approach, 10 senior leaders (i.e., chief information officers, superintendents, etc.) were interviewed to reveal…

  9. An Exploration of the Implementation of Restorative Justice in an Ontario Public School (United States)

    Reimer, Kristin


    This qualitative case study explores the implementation of restorative justice within one Ontario Public School. Restorative justice is a philosophy and a process for dealing with harmful behaviour, viewing such behaviour as a violation of relationships, not rules. My research seeks to present how restorative justice has been implemented in one…

  10. Comparing health system performance assessment and management approaches in the Netherlands and Ontario, Canada

    NARCIS (Netherlands)

    A.R. Tawfik-Shukor (Ali); N.S. Klazinga (Niek); O.A. Arah (Onyebuchi)


    textabstractBackground. Given the proliferation and the growing complexity of performance measurement initiatives in many health systems, the Netherlands and Ontario, Canada expressed interests in cross-national comparisons in an effort to promote knowledge transfer and best practise. To support thi

  11. Ontario Universities Benefits Survey, 1990-91: Part I, Benefits Excluding Pensions. (United States)

    Council of Ontario Universities, Toronto.

    The report details, in tabular form, non-pension benefits offered by each of 17 Ontario universities. These include: supplementary health insurance; long term disability; sick leave entitlement; sick leave-benefits continuance; long term disability-benefits continuance; life insurance; survivor benefit; dental plan; post-retirement benefits;…

  12. Ontario University Benefits Survey. Part I (All Benefits Excluding Pensions). December 1, 1979. (United States)

    University of Western Ontario, London.

    Results of a survey of benefits (excluding pensions) provided by Ontario universities are presented. Responses are presented by university concerning the following aspects of general benefits: administration and insurance plans, communication of benefits, proposed changes in benefits, provision of life and dismemberment insurance, and maternity…

  13. Epidemiology of serogroup B invasive meningococcal disease in Ontario, Canada, 2000 to 2010

    Directory of Open Access Journals (Sweden)

    Dang Vica


    Full Text Available Abstract Background Invasive meningococcal disease (IMD caused by serogroup B is the last major serogroup in Canada to become vaccine-preventable. The anticipated availability of vaccines targeting this serogroup prompted an assessment of the epidemiology of serogroup B disease in Ontario, Canada. Methods We retrieved information on confirmed IMD cases reported to Ontario’s reportable disease database between January 1, 2000 and December 31, 2010 and probabilistically-linked these cases to Public Health Ontario Laboratory records. Rates were calculated with denominator data obtained from Statistics Canada. We calculated a crude number needed to vaccinate using the inverse of the infant ( Results A total of 259 serogroup B IMD cases were identified in Ontario over the 11-year period. Serogroup B was the most common cause of IMD. Incidence ranged from 0.11 to 0.27/100,000/year, and fluctuated over time. Cases ranged in age from 13 days to 101 years; 21.4% occurred in infants, of which 72.7% were Conclusions Although rare, the proportion of IMD caused by serogroup B has increased and currently causes most IMD in Ontario, with infants having the highest risk of disease. Although serogroup B meningococcal vaccines are highly anticipated, our findings suggest that decisions regarding publicly funding serogroup B meningococcal vaccines will be difficult and may not be based on disease burden alone.

  14. 76 FR 11436 - Application to Export Electric Energy; Ontario Power Generation (United States)


    ... Application to Export Electric Energy; Ontario Power Generation AGENCY: Office of Electricity Delivery and... applied to renew its authority to transmit electric energy from the United States to Canada pursuant to... authorized OPG to transmit electric energy from the United States to Canada as a power marketer for a...

  15. Exploring the Digital Divide: The Use of Digital Technologies in Ontario Public Schools (United States)

    Chen, Bodong


    Combining data from a school principal survey with student demographics and achievement data, the present study aimed to develop a much needed understanding of ICT usage in Ontario's K-12 public schools. Results indicated equitable first-order access to technology for schools, early integration of ICT from the earliest grades, frequent application…

  16. An Historical Perspective on the Idea of Institutional Diversity and Differentiation in Ontario Higher Education (United States)

    Skolnik, Michael L.


    Institutional differentiation has frequently been an object of interest in higher education policymaking in Ontario. Occasionally this interest has motivated policy actions intended to increase differentiation, but more often government policy has aimed at limiting institutional differentiation -- or it has had that effect by default. The focus of…

  17. Pathways from College to University: A Social Science Example from Ontario (United States)

    LeSage, Ann; Samis, John; Hinch, Ron; Longo, Fabiola; DiGiuseppe, Maurice; Goodman, William; Percival, Jennifer; De La Rocha, Arlene; Rodrigues, Anna; Raby, Phil; Sanchez, Otto


    This study evaluates the impact of a College to University Pathway Program in the Faculty of Social Science and Humanities at The University of Ontario Institute of Technology. The findings support the assertion that Pathway students perform as well as or better than students who enter university directly from secondary school. This finding is…

  18. Making Schools Safe and Inclusive: Gay-Straight Alliances and School Climate in Ontario (United States)

    Kitchen, Julian; Bellini, Christine


    Gay-straight alliances (GSAs) have become widespread in Ontario schools and, starting in 2012, all schools are required to permit students to form GSAs. While American research suggests that GSAs have a positive impact on school safety and inclusion, there is little research on the impact of GSAs in Canadian schools. This study, based on a survey…


    A two-well forced-gradient experiment involving virus and microsphere transport was carried out in a sandy aquifer in Borden, Ontario, Canada. Virus traveled at least a few meters in the experiment, but virus concentrations at observation points 1 and 2.54 m away from the injecti...

  20. Know How? Show How: Experienced Teachers Share Best Practices through Ontario Program (United States)

    Amato, Lindy; Anthony, Paul; Strachan, Jim


    Launched in 2007, the Teacher Learning and Leadership Program, out of Ontario, Canada, operates on the belief that classroom teachers know their learning needs and the needs of their students best. Additionally, the program assumes teachers have the greatest knowledge of how to build and foster multiple learning networks in order to share their…