Imaging of Medical Patients with Acute Kidney Injury: Patterns of Ultrasound Use and the Role of Point-of-care Ultrasound at a Tertiary Care Center.

Background: The etiology of acute kidney injury (AKI) can be divided into pre-renal, renal, and post-renal causes. Ultrasound is the test of choice to identify post-renal AKI. While ultrasound is routinely used in the assessment of AKI, obstructive AKI is rare, leading to concerns of potential test overutilization.

Point of care ultrasound (POCUS) applications in the ambulatory internal medicine setting: A scoping review.

Introduction: Point of care ultrasound (POCUS) is an increasingly recognized tool in internal medicine, with evidence supporting its use largely derived in the inpatient setting. We endeavored to provide an overview of outpatient POCUS applications that could be relevant to the practice of internal medicine.

Methods: A scoping review was conducted using the JBI Evidence Synthesis framework.

Diagnostic accuracy of point-of-care ultrasonography for obstructive cause in patients with acute kidney injury: a prospective diagnosis cohort.

The aim of this study was to evaluate the test characteristics of point-of-care ultrasound (POCUS) in the diagnosis of obstructive acute kidney injury (AKI) in patients presenting with AKI to the Emergency Department (ED). This is a prospective diagnostic accuracy study that took place between July 6th, 2021 and July 6th, 2023 in the ED of an academic hospital. Adult patients visiting the ED and presenting with AKI were eligible for inclusion.

Eight Ways General Internists Can Practice High-Value, Low-Carbon Care: The Canadian Society of Internal Medicine's Climate Conscious Choosing Wisely Canada Recommendations.

Introduction: Climate change is the twenty-first century's biggest threat to human health. Paradoxically, North American healthcare delivery is carbon intensive. Addressing low-value interventions stands to reduce healthcare's carbon footprint.

A quality improvement initiative aimed at reducing service strain and improving physician wellness in internal medicine.

Introduction: Hospital strain has been shown to negatively impact physician wellness, educational experience, and patient care. To address rising service demands, a non-academic hospitalist service was implemented to reduce daily clinical teaching unit (CTU) census by approximately 30%. Secondary aims were to evaluate physician and trainee wellness on CTU as well as assess unintended adverse patient outcomes.

TRASH-CAN: An Approach to Promote Planetary Health Education and Research for Health Care Trainees.

As future health care leaders who work and train in diverse clinical settings, resident physicians are uniquely positioned to advance sustainable health care systems. However, residents are insufficiently educated about health care sustainability and given limited opportunities to engage in planetary health. This article introduces and reports on the early outcomes of the Trainee-Led Research and Audit for Sustainability in Healthcare Canada (TRASH-CAN), a resident-driven initiative launched in 2023 with the aim of reducing Canadian health care's environmental impact.

Environmentally sustainable opportunities for health systems: Metered-dose inhaler prescribing, dispensing, use and waste at a tertiary academic centre.

Background: The Canadian health sector's carbon footprint is among the highest in the world and is responsible for 4.6% of Canada's total greenhouse gas emissions, a quarter of which is linked to pharmaceuticals, with metered-dose inhalers (MDIs) contributing disproportionally high amounts.

Objectives: To describe MDI prescribing, dispensing, use and waste patterns at a Canadian tertiary care academic hospital.

Environmentally sustainable opportunities for health systems: metered-dose inhaler prescribing, dispensing, usage, and waste at The Ottawa Hospital.

Background: The carbon footprint of Canada's health sector is among the worst in the world, responsible for 4·6% of Canada's total greenhouse gas emissions. A quarter of emissions from Canada's health sector are linked to pharmaceuticals, including metered dose inhalers (MDIs). MDIs use propellants, such as hydrofluorocarbons, which act as greenhouse gas emissions and contribute to the health-care sector's overall carbon footprint.

Test characteristics of point-of-care ultrasonography in patients with acute kidney injury.

Background: Acute kidney injury is a common disorder that is associated with significant morbidity and mortality. Point-of-care ultrasonography (PoCUS) is an imaging modality performed at the bedside and is used to assess for obstructive causes of acute kidney injury. Little is known about the test characteristics of PoCUS in patients with acute kidney injury.

Start spreading the news: a deliberate approach to POCUS program development and implementation.

While there is an expanding body of literature on Point-of-Care Ultrasound (POCUS) pedagogy, administrative elements that are necessary for the widespread adoption of POCUS in the clinical environment have received little attention. In this short communication, we seek to address this gap by sharing our institutional experience with POCUS program development and implementation. The five pillars of our program, selected to tackle local barriers to POCUS uptake, are education, workflow, patient safety, research, and sustainability.

An overview of Internal Medicine Point-of-Care Ultrasound rotations in Canada.

Background: Point-of-care ultrasound (POCUS) is a growing part of internal medicine training programs. Dedicated POCUS rotations are emerging as a particularly effective tool in POCUS training, allowing for longitudinal learning and emphasizing both psychomotor skills and the nuances of clinical integration. In this descriptive paper, we set out to review the state of POCUS rotations in Canadian Internal Medicine training programs.

The Effect of Maternal Stress during Pregnancy on IQ and ADHD Symptomatology.

Objective: Maternal stress during pregnancy (MSDP) has been linked to a decrease in Intelligence Quotient (IQ) in the general population. The purpose of this study is to first examine the association between MSDP and IQ in children with Attention-Deficit/Hyperactivity Disorder (ADHD) and second, to confirm, in a large sample, the link between MSDP and ADHD behavioral symptomatology.

Methods: Four hundred ten children diagnosed with ADHD, ages six to 12, were consecutively recruited from the ADHD clinic and day hospital at the Douglas Institute from 1999 to 2013.