Open Access Journals University of Manitoba
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A Cutaneous manifestation in a patient with Novel Coronavirus 2019 (COVID-19): A clinical case study
No full textThis case report describes a skin rash presented in a patient diagnosed with COVID-19. At the beginning of the COVID-19 pandemic in 2019, no skin involvement was initially observed, but more recent cases have been reported. (Marraha, 2020) Most of the cases were in Italy (eleven cases), Spain (nine cases), France (seven cases), and the United States (six cases). (Sameni, 2020) In a recent letter from Thailand, it was stated that almost all COVID‐19 patients had cutaneous signs. (Wollina, 2020
Intra-thecal Baclofen pump for treatment of spasticity in Spine Cord Injury (SCI) patient with a multi-disciplinary approach: To control spasticity
No full textCase-Study approach to the treatment of a spinal cord injury patient\u27s spasticity using an intrathecal baclofen pump and a multi-disciplinary team
CANADIAN PHYSICIAN ASSISTANT COMPETENCY FRAMEWORK 2021: Canadian EPA-PA
Get PDFThis document identifies the competencies and outcome-based goals for Physician Assistant education in Canada. Competency-based education allows for an outcome-based approach to curriculum delivery that directly addresses and assesses student preparation for clinical practice, patient navigation, and resource application. With the experience and feedback gathered from PA-program leadership, previous accreditation cycles, and practicing PAs, Canadian PA educators are proposing an updated competency framework reflecting competency-based medical education titled "Canadian Physician Assistant Competency Framework 2021 (Canadian EPA-PA)". The purpose of this document is to identify the competency-based goals and entrustable professional activities for Canadian PA education programs. Competency-based education allows for an outcomes-based approach to curriculum delivery that directly assesses learner preparation for clinical practice, patient navigation, and resource application. 
Warfarin versus DOACs in the prevention of thromboembolic stroke in patients with Afib. : Warfarin versus DOACs in the prevention of thromboembolic stroke in patients with Afib.
No full textABSTRACT
Preventing thromboembolic (TE) events “such as stroke” is an important part of managing patients with non-valvular atrial fibrillation (Afib). Over the last 50 years, oral anticoagulant treatment with the Vitamin K Antagonist (VKA) warfarin has played a crucial role in the secondary prevention of stroke for patients with Afib. Direct oral anticoagulant (DOACs), and their dominance over warfarin has arrived for treatment of Afib in the context of stroke prevention and research indicates DOACs are, for the most part, superior to warfarin in the secondary prevention of stroke in patients with non-valvular Afib. But what does the evidence tell us about risk versus benefits? The purpose of this review of literature is to conduct a systematic review of the advantages and disadvantages of DOACs, namely dabigatran, rivaroxaban, apixaban and edoxaban compared with warfarin in patients with (non-valvular) Afib.
In general, this review demonstrates the advantages of DOACs compared with warfarin including, DOACs are associated with lower rates of life-threatening and intracranial bleeding, DOACs have a rapid onset with peak effect within a few hours, they have predictable dose responses, thus eliminating the need for routine monitoring; and they have few, if any, important food or drug interactions, thus simplifying management. The findings of this systematic literature review suggest that in the secondary prevention of stroke in patients with non-valvular Afib, DOACs, demonstrate a significant advantage and enhanced safety profile over warfarin in reducing the risk of thromboembolic stroke compared with warfarin. As such, DOACs should be considered first-line therapy in the secondary prevention of stroke in patients with non-valvular Afib
Anthrax
Get PDFIntroduction: Anthrax is a highly contagious infectious disease that can lay dormant for many years. We present cases of anthrax linked to contaminated low-cost shaving brushes.
 
Are we providing ethical health care to new residents of Canada?
Get PDFAs mandated by the Canada Health Act, the intention of Canadian health care is to ensure the physical and mental well-being of residents of Canada by providing reasonable access to health services, without financial or other barriers. Is Canada meeting the objective of the Canada Health Act for those people who are new arrivals to the country? Health care is a universal, basic good and as such, it should be provided to all who reside within Canada, regardless of their immigration status. As this discussion highlights, Canada is falling short in the provision of health care to those residents who are not Canadian citizens. The current structure of care fails to meet the ethical principles of autonomy, beneficence, non-maleficence, and justice.  
Nutrition in the Neoadjuvant Gastric Cancer Patient, is early administration appropriate? : Nutrition in the Neoadjuvant Gastric Cancer Patient
No full textABSTRACT
Purpose: Gastric cancer is one of the world\u27s leading cancers. Despite the availability of testing, patients often present with advanced (stage III or stage IV) gastric cancer. These patients are always in a state of malnutrition and will be sarcopenic secondary to pain, loss of appetite, nausea, vomiting and dysphagia. Treatment for this cancer includes radical surgery, sometimes chemotherapy and rarely radiotherapy. It is already well documented that nutrition is critical to patient outcomes during chemotherapy, surgery and healing; because of this, many measures are already in place to improve nutrition in these patients. This literature review will look directly at the use of enteral feeding (EN) of gastric cancer patients prior to or in conjunction with neoadjuvant chemotherapy (NACT).
Methods: Research was focused on the keywords: nutrition, gastric cancer, enteral feeding and neoadjuvant nutrition. Several electronic journals were reviewed, National Center for Biotechnology Information (NCBI), PubMed, QxMD Read, Science Direct, as well, a search was conducted through Alberta Health Services Knowledge Resource Service (KRS).
Results: The combined information within each of the articles reviewed all recognized that early nutrition supplementation had positive impacts on maintaining albumin levels, an increase in the patient\u27s immunity, improved healing and shortened length of hospital stay.
Conclusion: All patients receive nutrition throughout their hospital stay; research indicates that the earlier nutrition is given to a patient, the better the overall outcomes of chemotherapy, surgery, shortened length of stay, and quality of life.
Keywords: nutrition, gastric cancer, enteral feeding and neoadjuvant nutrition
Investigating Physician Assistant Burnout Amidst the COVID-19 Global Pandemic: A Qualitative Survey Response From Practicing PAs in Canada: Burnout among Canadian PA during COVID
No full textThe purpose of this study was to determine if there is an underlying element of burnout among practicing Physician Assistants (PAs) across Canada during the global COVID-19 pandemic and uncover any potential solutions for this arduous problem. A survey encompassing the Maslach Burnout Inventory (MBI)and qualitative questions were emailed to practicing Canadian PAs. A total of 118 practicings PAs fully completed the survey; the majority reported high levels of burnout, specifically on depersonalization and emotional exhaustion subscales, while all maintained a high level of personal accomplishment simultaneously. The majority of respondent PAs listed increased staffing, increased time off/consistent scheduling, and pandemic pay among others as major solutions to alleviate burnout in the future. In conclusion, Canadian PAs working during the global pandemic are indeed experiencing burnout, all while displaying a high level of resilience in certain MBI subscales. The individual responses provided by these frontline workers may highlight critical solutions that may be generalized to other healthcare jobs in order to prevent future occupational burnout
Human Papilloma Virus: Pathogen Challenge
No full textAbstract
Purpose. A review of the history and discovery of the human papiloma virus, was conducted along with the development and difficulities of distribution of the vaccine.
Method. Articles from PubMed, CDC, and FDA were reviewed.
Results. Reading from the journals show a long duration of time from when the disease was initially introduced, to recognition and finally development of a vaccine.
Conclusion. Despite acknowledgement that the vaccine has the pontial to reduce or even rid the disease and so reduce the number of cancers originating from the virus, there are still groups who feel the vaccine has no place in their society
Cricothyrotomy Following Airway Hemorrhage from a Hypopharyngeal Cancer: A Clinical Case Study: A Physician Assistant\u27s First Encounter with an Emergency Surgical Airway
No full textThis clinical study describes an emergency cricothyrotomy on a hospital inpatient awaiting major head and neck surgery for a hypopharyngeal cancer. The clinical presentation of this patient highlights the emergent interventions for a bleeding upper airway, that can quickly lead to complete airway obstruction. Early recognition of an unstable airway is critical for patient outcomes in the head and neck cancer population.