Trends in lower-extremity amputations for diabetes and peripheral artery disease
Q&A with Dr. Charles de Mestral
Together, diabetes and peripheral artery disease account for more than 80 per cent of lower-extremity amputations in Canada. A recent study by St. Michael’s Hospital vascular surgeons, Dr. Mohammed Al-Omran and Dr. Charles de Mestral, has found that lower-extremity amputations related to diabetes and peripheral arterial disease have increased over the last decade in Ontario.
4 tips on handling Toronto’s slippery sidewalks this winter
Tips from Jessica Casey and Julia Filinski
Though it’s been a milder winter than usual in Toronto, fluctuating temperatures can pose unexpected risks for slips and falls. The warmer days and sudden temperature drops at night can create sheets of ice that are dangerous when unnoticed. The Falls Prevention Clinic at Providence Healthcare takes a holistic, interprofessional approach to addressing risks and prevention, and is available to the community through a referral from your family doctor. Occupational therapist Jessica Casey and physiotherapist Julia Filinski at Providence helped develop the Falls Prevention Clinic six years ago and shared their top tips for falls prevention and awareness.
Geriatric Psychiatric Clinic supports complex needs of older adults
Introduces the Geriatric Psychiatry Clinic at Providence
The Geriatric Psychiatry Clinic is part of a multidisciplinary program, The Regional Geriatric Program of Toronto, housed at Providence Healthcare since 1988. The role of the clinic’s geriatric psychiatrists is to assess, consult, and treat elderly patients who may have a mental health issue, dementia syndrome, behaviour disorder, or a psychosocial problem. Referrals to the clinic come primarily from family physicians, geriatricians, and neurologists. A critical component of the program is the community outreach service, which involves health care professionals visiting patients in their homes to identify factors that contribute to frailty in the elderly.
Community Health Navigators offer ‘safety net’ for patients going home
Comments by Monica McCullagh and Kelly Tough
At Providence Healthcare, the Community Health Navigator role supports patients after discharge and rehab patients receive either a live or an automated phone call – based on their preference – to check on how they’re doing. These calls happen at the 48-hour, 30-day and four-month points after discharge. Monica McCullagh, one of three Community Health Navigators (CHN), said the navigators make sure the discharge plans are being followed, that physician referrals are in motion and that they have the medications they need.
Traumatic brain injury in homeless people is underrecognized
Comments by Dr. Stephen Hwang
A recent review in The Lancet Public Health found the lifetime prevalence of any severity of traumatic brain injury (TBI) in homeless and marginally housed individuals was 53.1 percent, and the lifetime prevalence of either moderate or severe TBI was 22.5 percent. Dr. Stephen Hwang, an internist, homelessness researcher, and director of the Centre for Research on Inner City Health at St. Michael’s Hospital in Toronto, said living on the streets or in a shelter is a hazardous environment. He said neurologists treating homeless patients should be aware of the possibility that a history of TBI could be the cause of behavioral issues, seizures or unexplained cognitive deficits. He helped craft recommendations issued in October 2018 by the National Health Care for the Homeless Council that focus on the care of patients who are homeless and living with the effects of TBI.
Plastic-free periods: Reusable menstrual products are going mainstream (scroll for the article)
Interview with Dr. Yolanda Kirkham
Every year, tens of billions of single-use pads and tampons go into landfills — material that takes hundreds of years to decompose. The average user goes through between 5,000 and 15,000 pads and/or tampons in a lifetime. Reusable menstrual products have been available for a while, but they’re becoming increasingly mainstream. Dr. Yolanda Kirkham, a gynecologist at. St. Joseph’s Health Centre of Unity Health Toronto, said a lot of her patients have been using reusable products for several years, indicating those who make the switch end up sticking with it.
How the design of a new trauma centre at St. Michael’s Hospital is meant to save precious seconds, and lives
Interviews with Candis Kokoski, Dr. Bernard Lawless, Dr. Andrew Petrosoniak and Dr. Carolyn Snider
The Toronto Star
Trauma teams at Toronto’s St. Michael’s Hospital spent countless hours in the last year and a half trying to shave minutes and seconds off treatment times for critically injured patients. But in the type of Level 1 trauma centre the hospital opened last week to the city’s most gravely injured patients, minutes and seconds are the medicine of life. The quicker, more coordinated and efficient the treatment, the greater the chance of survival, says Dr. Bernard Lawless, medical director of the hospital’s trauma program. The upgrade has a much better layout to more smoothly, efficiently manage patents as they come through the doors, said Dr. Lawless. The new equipment is certainly an upgrade in the incremental way that new versions of technologies typically improve on the older, but it’s the placement of the equipment, the logistical layout of the cabinets, the shelves, the smallest details — that will make the most difference.
Study finds female soccer players more likely to undergo medical assessments after head trauma than men
Research by Dr. Michael Cusimano
The Globe and Mail
Half of elite female soccer players who suffered a head-collision event received medical assessments, compared with a third of male players, according to a study by Dr. Michael Cusimano, a neurosurgeon and researcher at St. Michael’s Hospital. In the matches reviewed, 84 per cent of female athletes and 88 per cent of male athletes showed two or more visible signs of concussion after a head collision event, including clutching of the head or disequilibrium. Dr. Cusimano believes the differences in how head collision events are handled between the two genders may lie in the on-field officials – female referees officiate female matches.
– Additional coverage in The Toronto Star, CTV News and Sportsnet
Food insecurity can shorten lifespan
Comments by Dr. Gary Bloch
A new study shows that food insecurity – the lack of access to nutritious foods – can shorten someone’s lifespan by nine years. Dr. Gary Bloch, a family physician with St. Michael’s Hospital’s Academic Family Health team, was not involved in the study but says that the findings reinforce what he sees in his practice. Dr. Bloch said the prospect of dying earlier due to a lack of access to nutritious food is frightening and should be addressed at the social policy level.
Boys and young men more likely to die than girls and young women, study finds
Research by Dr. Joel Ray
The Canadian Press, via CBC News
A new study shows boys and young men are more likely to die than girls and young women, and they have a greater chance of dying due to injury, particularly from age 14 onwards. The study looked at 3.1 million children born in Ontario between 1990 and 2016 and examined who died and from what cause between the ages of one and 24. Lead author Dr. Joel Ray, a clinician-scientist at St. Michael’s Hospital in Toronto, said the jump in deaths during adolescence, particularly in boys, is likely due to an increase in risk-taking behaviours, but said biological factors and changes may play a role in those behaviours as well.
– Additional coverage on The Toronto Star
Bariatric Centre of Excellence opens at Unity Health Toronto
Comments by Sonya Canzian
Michael Garron Hospital (MGH) and Unity Health Toronto have partnered to open a Bariatric Centre of Excellence (BCoE) to provide their communities with access to bariatric surgical care close to home. A BCoE provides services with a team of experts who have adopted best practices to help people manage obesity. The Unity Health – MGH BCoE includes a Bariatric Assessment Centre (BAC) at Providence Healthcare and a partnership of three existing bariatric surgery sites: St. Michael’s Hospital, St. Joseph’s Health Centre and MGH. Together, the Centre provides comprehensive pre-operative, peri-operative and post-operative bariatric surgical care. Sonya Canzian, Chief Nursing and Health Professions Officer at Unity Health, said the partnership is a patient-focused solution that will benefit hundreds of people every year.
Caught in a crisis: crystal meth addiction in Canada
Comments by Dr. Carolyn Snider
Dr. Carolyn Snider, chief of St. Michael’s Hospital’s emergency department, believes it won’t be long until Toronto hospitals see the same levels of crystal meth cases as she did back in Winnipeg while working as an emergency physician. Dr. Snider saw crystal meth become the predominant substance among patients around 2017, and said it was a frustrating period, because as front-line staff were struggling to manage five or six patients actively suffering from meth psychosis at any given time, federal funding and national attention was directed at the opiate crisis. Now at St. Michael’s in Toronto, Dr. Snider sees that opioids are still very much a problem, but she has also seen several cases of meth hallucinations and psychosis, and believes that the drug is moving east.
Is Canada at risk from a mysterious Chinese virus related to SARS?
Comments by Dr. Kamran Khan
An illness in China has been identified as a new coronavirus, a large family of viruses that can make the jump from animals to humans and range from the common cold to much more serious illnesses, such as SARS or MERS. Given the fact that both SARS and the Wuhan outbreak both originated in open-air markets that sold both live and dead animals, the similar origins of the viruses are hard to ignore. Dr. Kamran Khan, an infectious disease physician and scientist at St. Michael’s Hospital in Toronto said there are some parallels thinking back to SARS, however we are getting information earlier in this outbreak. He said to get in front of threats, information must move faster than the diseases themselves.
‘I was pretty broken’: Man shares journey of learning to walk again after serious car crash
Patient story, with comments by Jeff Kestenberg and Dr. Ashley Verduyn
J.D. Penner, who was once an avid cyclist and runner, was seriously injured in an Etobicoke crash more than five years ago. He was left with nerve damage, a concussion and fractures all over his body, including the tibia and fibula, clavical, stemum, ribs, vertebra and right hand. After emergency surgery at St. Michael’s Hospital, Penner arrived at Providence Healthcare for between seven and eight weeks of rehabilitation, including learning how to walk again. Penner said he has a lot of love for Providence, and while he doesn’t consider himself to be particularly inspirational, he hopes that his journey might resonate with someone going through something similar.
– Video coverage on CTV News Toronto
East Toronto groups form community-focused health-care network
Mentions Providence and the Toronto East Ontario Health Team
A new integrated health care network is now up and running in East Toronto. Ontario’s Minister of Health and Deputy Premier Christine Elliott officially named the Toronto East Ontario Health Team, East Toronto Health Partners as it’s being called, as one of the first of 24 new health teams in Ontario. The new team consists of six anchor partners, all of whom have a long track record of working together. They are Michael Garron Hospital, Providence Healthcare, South Riverdale Community Health Centre, VHA Home HealthCare, WoodGreen Community Services and East Toronto Family Practice Network, which is the voice of 260 primary care physicians in East Toronto with the support of a number of organizations with similar offerings.
Induced labor tied to neonatal complications among women with diabetes before pregnancy
Research by Dr. Howard Berger
Routine induction of labour among women with diabetes before pregnancy is not associated with an increase in the rate of cesarean delivery, but is associated with certain neonatal complications, according to findings published in BMJ Open Diabetes Research and Care. Dr. Howard Berger, lead researcher and head of maternal fetal medicine at St. Michael’s Hospital, said based on this population-based, retrospective data, delivery of women with preexisting diabetes before 39 weeks’ gestation is associated with a higher rate of neonatal complications and does not reduce the cesarean section rate.
St. Joseph’s hospital gets money to help with wait times and overcrowding
Comments by Dr. Tim Rutledge
The Toronto Star
The Ontario government is providing up to $5 million in funding to cover costs of early planning of redevelopment at St. Joseph’s Health Centre. Dr. Tim Rutledge, president and chief executive of Unity Health Toronto, told a news conference the new facilities will help transform patient care in Toronto’s west end.
Not enough home care top concern for Ontario patients, study finds
Research by Dr. Tara Kiran
The three biggest problems for patients surveyed about their discharge from Ontario hospitals all concern publicly funded home care, according to new research published in an international medical journal. Dr. Tara Kiran, lead researcher of the study and a family physician at St. Michael’s Hospital, hopes the findings will encourage improvements in the hospital-to-home transition navigated by some one million patients every year in this province. The study involved more than 700 patients who had been admitted to Ontario hospitals over the previous three years.