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Full-Text Articles in Medicine and Health Sciences

Angiotensin Ii Type I Receptor Agonistic Autoantibodies Are Associated With Poor Allograft Survival In Liver Retransplantation., Qingyong Xu, Vivian C. Mcalister, Steve Leckie, Anton Skaro, Paul Marotta Jul 2019

Angiotensin Ii Type I Receptor Agonistic Autoantibodies Are Associated With Poor Allograft Survival In Liver Retransplantation., Qingyong Xu, Vivian C. Mcalister, Steve Leckie, Anton Skaro, Paul Marotta

Vivian C. McAlister

Angiotensin II type I receptor (AT1R) agonistic autoantibodies (AT1R-AA) are detrimental to kidney transplantation. Early studies suggested a similar negative effect in primary liver transplantation. Here, we studied AT1R-AA in a retrospective cohort of 94 patients who received a second liver transplant to determine their prevalence and effects. The concentrations of preformed AT1R-AA before transplantation were higher (p=0.019) in the 48 patients who lost their liver grafts than in the 46 patients whose grafts survived. About half (48/94, 51.1%) of the patients were positive for AT1R-AA>17U/ml before the second liver transplantation. In 22 (23.4%) patients, strong positive AT1R-AA (defined as …


Dr. Louis Kristal At 100: Witness To The Evolution Of Surgery In Canada, Vivian C. Mcalister Nov 2017

Dr. Louis Kristal At 100: Witness To The Evolution Of Surgery In Canada, Vivian C. Mcalister

Vivian C. McAlister

The lecture, though impromptu, was to be special, but maybe not as special as the medical school realized. Canadian Nobel Prize winner, Major Sir Frederick Banting was on his way to Britain when he took the opportunity to speak to Dalhousie University medical students. Banting had wished to pursue a career in orthopedic surgery, having worked with Professor Clarence Starr at the Canadian Orthopedic Hospital, Ramsgate, during the First World War and in the Hospital for Sick Children, Toronto, Ont., after that. Banting switched to a career in research following the stunning success of his insulin project, which he undertook …


The Future Of Resuscitative Endovascular Balloon Occlusion In Combat Operations., Shane A. Smith, Rich Hilsden, Andrew Beckett, Vivian C. Mcalister Sep 2017

The Future Of Resuscitative Endovascular Balloon Occlusion In Combat Operations., Shane A. Smith, Rich Hilsden, Andrew Beckett, Vivian C. Mcalister

Vivian C. McAlister

Damage control resuscitation and early thoracotomy have been used to increase survival after severe injury in combat. There has been a renewed interest in resuscitative endovascular balloon occlusion of the aorta (REBOA) in both civilian and military medical practices. REBOA may result in visceral and limb ischaemia that could be harmful if use of REBOA is premature or prolonged. The purpose of this paper is to align our experience of combat injuries with the known capability of REBOA to suggest an implementation strategy for the use of REBOA in combat care. It may replace the resuscitative effect of thoracotomy; can …


Calgary, Edmonton And The University Of Alberta: The Extraordinary Medical Mobilization By Canada's Newest Province., Mark Dacambra, Vivian C. Mcalister Aug 2017

Calgary, Edmonton And The University Of Alberta: The Extraordinary Medical Mobilization By Canada's Newest Province., Mark Dacambra, Vivian C. Mcalister

Vivian C. McAlister

The Canadian contribution of medical services to the British Empire during the First World War was a national endeavour. Physicians from across the country enlisted in local regiments to join. No other region provided more physicians per capita than the newly formed province of Alberta. Largely organized through the Medical School of the University of Alberta, the No. 11 Canadian Field Ambulance out of Edmonton and the No. 8 Canadian Field Ambulance out of Calgary ultimately enlisted between one-third and half of the province's doctors to the war campaign. Many individuals from this region distinguished themselves, including LCol J.N. Gunn …


Continuing A Long Tradition: The Canadian Journal Of Surgery At 60., Vivian C. Mcalister, Edward J. Harvey Aug 2017

Continuing A Long Tradition: The Canadian Journal Of Surgery At 60., Vivian C. Mcalister, Edward J. Harvey

Vivian C. McAlister

As 2017 marks the 60th anniversary of the Canadian Journal of Surgery, its editors in chief take a look back at the history leading to the creation of the journal and at how CJS maintains its original partnerships in order to continue its mission. Organized surgery has existed in Canada for more than 3 centuries. The CJS is the longest surviving of more than 20 journals reporting surgical endeavours. The editors rededicate its mission to the highest standard possible.


Injury Profile Suffered By Targets Of Antipersonnel Improvised Explosive Devices: Prospective Cohort Study., Shane A. Smith, Melissa Devine, Joe Taddeo, Vivian C. Mcalister Jul 2017

Injury Profile Suffered By Targets Of Antipersonnel Improvised Explosive Devices: Prospective Cohort Study., Shane A. Smith, Melissa Devine, Joe Taddeo, Vivian C. Mcalister

Vivian C. McAlister

OBJECTIVE:
To describe pattern 1 injuries caused by the antipersonnel improvised explosive device (AP-IED) in comparison to those previously described for antipersonnel mines (APM).
DESIGN:
Prospective cohort study of 100 consecutive pedestrian victims of an AP-IED, with traumatic amputation without regard for gender, nationality or military status.
SETTING:
Multinational Medical Unit at Kandahar Air Field, Afghanistan.
PARTICIPANTS:
One hundred consecutive patients, all male, 6-44 years old.
MAIN OUTCOME MEASURES:
The details of injuries were recorded to describe the pattern and characterise the injuries suffered by the target of AP-IEDs. The level of amputation, the level of soft tissue injury, the …


Combat Vascular Trauma_ From Characterization To Innovation.Pdf, Shane A. Smith Dec 2016

Combat Vascular Trauma_ From Characterization To Innovation.Pdf, Shane A. Smith

Vivian C. McAlister

The way that soldiers are injured in modern conflicts has changed. Bullet and ballistic weapons are causing fewer casualties, and more commonly Improvised Explosive Devices (IED) are injuring them. The purpose of this thesis is to characterize the injury pattern of the antipersonnel IED (AP-IED) in victims from the Afghanistan conflict, to retrospectively examine the incidence and type of vascular trauma in a Canadian level 1 trauma center and to develop and novel device for control of junctional vascular injuries. 

The injury pattern of 100 consecutive AP-IED victims was recorded. Multiple amputations occurred in 70% of IED victims: 5 quadruple …


Datum Isn't; Data Are, Vivian C. Mcalister Jul 2016

Datum Isn't; Data Are, Vivian C. Mcalister

Vivian C. McAlister

Selection of manuscripts for publication in a scientific journal is a subjective process. Safeguards, such as using multiple independent reviewers, review templates and conflict of interest guidelines, try to make the process fair. It is clear to editors that some reviewers’ judgments are guided by whether they just liked a manuscript or not. The editor’s job is to divine if the reasons for the opinion are valid. For some manuscripts, the description “poorly written” weighs heavily in the mind of the reviewer. Use of the term “data” as a singular noun is often seen as a marker of either scientific …


Joint Survival Analysis Of Time To Drug Change And A Terminal Event With Application To Drug Failure Analysis Using Transplant Registry Data, Elizabeth Renouf, Charmaine B. Dean, David R. Bellhouse, Vivian C. Mcalister Jun 2016

Joint Survival Analysis Of Time To Drug Change And A Terminal Event With Application To Drug Failure Analysis Using Transplant Registry Data, Elizabeth Renouf, Charmaine B. Dean, David R. Bellhouse, Vivian C. Mcalister

Vivian C. McAlister

Statistical approaches for drug effectiveness studies after liver transplant have used a survival model with changes in treatment as a time-dependent covariate. However, the approach requires that changes in the time-dependent covariate be unrelated to survival outcome. Usually this is not the case, as one drug may be discontinued and an alternative chosen due to the declining health status of the patient. Other approaches examine only subjects who remain on the same drug over a time window, which discards valuable data and may lead to biased effects since this excludes data related to early deaths and to individuals who perform …


Hypertonic Salt Solution For Peri-Operative Fluid Management, Brad Shrum, Brian Church, Eric Mcarthur, Karen E. Burns, Tammy Znajda, Vivian C. Mcalister Jun 2016

Hypertonic Salt Solution For Peri-Operative Fluid Management, Brad Shrum, Brian Church, Eric Mcarthur, Karen E. Burns, Tammy Znajda, Vivian C. Mcalister

Vivian C. McAlister

BACKGROUND:
Fluid excess may place people undergoing surgery at risk for various complications. Hypertonic salt solution (HS) maintains intravascular volume with less intravenous fluid than isotonic salt (IS) solutions, but may increase serum sodium. This review was published in 2010 and updated in 2016.
OBJECTIVES:
To determine the benefits and harms of HS versus IS solutions administered for fluid resuscitation to people undergoing surgery.
SEARCH METHODS:
In this updated review we have searched the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 4, 2016); MEDLINE (January 1966 to April 2016); EMBASE (January 1980 to April 2016); LILACS (January 1982 to …


In Vitro Three Dimensional Culture Of Hepatocellular Carcinoma To Measure Prognosis And Responsiveness To Chemotherapeutic Agents., Brad Shrum, Penny Costello, Warren Mcdonald, Christopher Howlett, Marisa Donnelly, Vivian C. Mcalister May 2016

In Vitro Three Dimensional Culture Of Hepatocellular Carcinoma To Measure Prognosis And Responsiveness To Chemotherapeutic Agents., Brad Shrum, Penny Costello, Warren Mcdonald, Christopher Howlett, Marisa Donnelly, Vivian C. Mcalister

Vivian C. McAlister

BACKGROUND:
Understanding the prognosis of hepatocellular carcinoma (HCC) informs plans for care. Tumor morphology and molecular markers have been correlated with outcomes. Three-dimensional tissue culture (3DTC) allows for direct in vitro measurement of a tumor's ability to grow and metastasize. The impact of chemotherapeutic agents, alone or in combinations, may also be measured.
METHODS:
All patients with a presumed diagnosis of HCC were eligible for this study including those undergoing resection, chemoembolization and transplantation. Concomitant diseases and outcomes were recorded. One mm(3) HCC specimens were grown in multiwell plates containing gel media, without and with chemotherapeutic agents.
RESULTS:
Tumors were …


Caregiver Fatigue And Surrogate End-Of-Life Decision Making, Vivian C. Mcalister Mar 2016

Caregiver Fatigue And Surrogate End-Of-Life Decision Making, Vivian C. Mcalister

Vivian C. McAlister

The Supreme Court of Canada ruling in the case of Carter versus Canada (2015 SCC 5) concerns the right of a competent adult to a physician-assisted death if his or her suffering from a grievous and irremediable medical condition is intolerable. Discussions of the ruling have extended the parameters to include competent minors and advanced directives. They may also have altered the way we look at a separate but related end-of-life scenario, withdrawal of life-support; the number of anesthetic agents used to cover a patient during the withdrawal of life-support appear to have increased recently.
How is it that all …


Joint Modelling In Liver Transplantation, Elizabeth Renouf Dec 2015

Joint Modelling In Liver Transplantation, Elizabeth Renouf

Vivian C. McAlister

In the setting of liver transplantation, clinical trials and transplant registries regularly collect repeated measurements of clinical biomarkers which may be strongly associated with a time-to-event such as graft failure or disease recurrence. Multiple time-to-event outcomes are routinely collected. However, joint models are rarely used. This thesis will describe important considerations for joint modelling in the setting of liver transplantation. We will focus on transplant registry data from the United States. We develop a new tool for joint modelling in the context where a critical health event can be tracked in the longitudinal biomarker and often presents as a non-linear …


Rebuilding Postgraduate Medical Education Programmes In Afghanistan, Vivian C. Mcalister Aug 2015

Rebuilding Postgraduate Medical Education Programmes In Afghanistan, Vivian C. Mcalister

Vivian C. McAlister

Conflict over the last three decades has resulted in profound disruption of the medical system in Afghanistan. The NATO Training Mission–Afghanistan (NTM-A) installed a graduate medical education (GME) advisory team with the mandate to help the Afghan faculty reconstruct modern teaching programs for core specialties including programs for assistant personnel.
Le conflit des trois deniers décades a entraîné de très importantes perturbations du système médical en Afghanistan. La Mission de Formation de l'OTAN –Afghanistan (NTM-A) a mis en place une équipe de conseillers en formation médicale (GME) avec la mission d'aider la faculté Afghane a reconstituer des programmes modernes d'enseignement …


A Model For Deceased-Donor Transplant Queue Waiting Times, Steve Drekic, David A. Stanford, Douglas Woolford, Vivian C. Mcalister Dec 2014

A Model For Deceased-Donor Transplant Queue Waiting Times, Steve Drekic, David A. Stanford, Douglas Woolford, Vivian C. Mcalister

Vivian C. McAlister

No abstract provided.


No Specialty Alone: The Wilder Penfield Strategy., Vivian C. Mcalister Jul 2014

No Specialty Alone: The Wilder Penfield Strategy., Vivian C. Mcalister

Vivian C. McAlister

To gather knowledge and to find out new knowledge is the noblest occupation of the physician. To apply that knowledge with understanding and sympathy to the relief of human suffering is the loveliest occupation; and to do both with unassuming faithfulness sets the seal on the whole. — Edward Archibald, 1934. C JS has posted to its website (www.canjsurg.ca)a “work-in-progress” commentary as part of the CJS consensus protocol. The authors’ goal is to develop a statement regarding gastrointestinal endoscopy training for general surgery residents.


Aucune Spécialité N'Est Une Île : La Stratégie De Wilder Penfield, Vivian C. Mcalister Jul 2014

Aucune Spécialité N'Est Une Île : La Stratégie De Wilder Penfield, Vivian C. Mcalister

Vivian C. McAlister

Acquérir des connaissances et en découvrir de nouvelles est la plus noble occupation du médecin. Appliquer ces connaissances en faisant preuve de compréhension et d’empathie pour le soulagement de la souffrance humaine est la plus belle profession; et faire les deux avec une fidélité sans prétention est le couronnement de la profession. — Edward Archibald, 1934. Le JCC a publié sur son site web (www.canjsurg.ca) un commentaire « en évolution » dans le cadre du protocole de consensus du JCC. 2 L’objectif des auteurs est d’élaborer un énoncé sur la formation des résidents en chirurgie générale en endoscopie gastrointestinale. 3 …


Treatment Of Rectal War Wounds, O J. Van Waes, J A. Halm, J Vermeulen, Vivian C. Mcalister Jul 2014

Treatment Of Rectal War Wounds, O J. Van Waes, J A. Halm, J Vermeulen, Vivian C. Mcalister

Vivian C. McAlister

Treatment strategies for penetrating rectal injuries (PRI) in civilian settings are still not uniformly agreed, in part since high-energy transfer PRI, such as is frequently seen in military settings, are not taken into account. Here, we describe three cases of PRI, treated in a deployed combat environment, and outline the management strategies successfully employed. We also discuss the literature regarding PRI management. Where there is a major soft tissue component, repetitive debridement and vacuum therapy is useful. A loop or end colostomy should be used, depending on the degree of damage to the anal sphincter complex.


Reuse Of Liver Grafts Following Brain Death Of The Initial Recipient, Hideaki Tanaka, Vivian C. Mcalister, Mark Levstik, Cameron Ghent, Paul Marotta, Douglas Quan, William Wall May 2014

Reuse Of Liver Grafts Following Brain Death Of The Initial Recipient, Hideaki Tanaka, Vivian C. Mcalister, Mark Levstik, Cameron Ghent, Paul Marotta, Douglas Quan, William Wall

Vivian C. McAlister

AIM: To determine if there is a reasonable prospect of success of a re-use liver transplantation.

METHODS: We systematically searched for reports of liver graft re-use using electronic searches of PubMed and Web of Knowledge. We performed hand searches of references lists of articles reporting re-use of grafts.

RESULTS:A systematic review of the literature reveals 28 liver transplantations using previously transplanted grafts. First and second recipients ranged in age from 4 to 72 years and 29 to 62 years respectively. Liver disease in the first recipient was varied including 5 (18%) patients with fulminant liver failure who died subsequently of …


Education Through Recreation, Vivian C. Mcalister Mar 2014

Education Through Recreation, Vivian C. Mcalister

Vivian C. McAlister

The concept of education through recreation was first applied in the 19th century to childhood develop ment. George H. Read, the Chicago sociologist who identified the developmental role of play in childhood, divided human activity into 3 general types: work, art and play. The principle was broadened to include young adults, but the emphasis was restricted to phys - ical activities. It was the basis for the rise of organized sports and initiatives such as the Olympic Games. Another Chicago sociologist, Nels Anderson, who spent a considerable part of his career at the University of New Brunswick, developed the concept …


L’Éducation Par Les Loisirs, Vivian C. Mcalister Mar 2014

L’Éducation Par Les Loisirs, Vivian C. Mcalister

Vivian C. McAlister

Le concept de l’éducation par les loisirs a été appliqué pour la première au 19e siècle au développement de l’en fant 2 . George H. Read, sociologue de Chicago qui a identi fié le rôle du jeu dans le développement de l’enfant, avait divisé l’activité humaine en 3 grandes catégories : travail, art et jeu 2 . Le principe a été élargi pour inclure les jeunes adultes, mais l’accent était limité aux activités physiques 3 . Cette façon de penser a été à la base de la croissance des sports organisés et des initiatives telles que les Jeux olympiques. Un …


The Death Of Tecumseh, Vivian C. Mcalister Mar 2014

The Death Of Tecumseh, Vivian C. Mcalister

Vivian C. McAlister

In the 1930s, University of Western Ontario surgeon, Dr Edwin Seaborn recorded a series of interviews with members of the Saugeen First Nation to learn about their medical practices. Seaborn used a wax cylinder recording device owned by the medical school. One interview dealt with the death of Shawnee war chief Tecumseh, as told by the grandson of an eye witness to the event. British, Canadian and First Nations' forces retreated eastward up the trail by the Thames River in October 1813. Tecumseh insisted they turn to fight the advancing Americans. The night before the Battle of the Thames, Tecumseh …


A Queuing Model To Address Waiting Time Inconsistency In Solid-Organ Transplantation, David A. Stanford, Jung Min Lee, Natasha Chandok, Vivian C. Mcalister Feb 2014

A Queuing Model To Address Waiting Time Inconsistency In Solid-Organ Transplantation, David A. Stanford, Jung Min Lee, Natasha Chandok, Vivian C. Mcalister

Vivian C. McAlister

Organ transplantation is a vital therapy for the treatment of many patients. Due to blood compatibility rules, there has been a pattern in many jurisdictions for differing organ types where recipients of blood type O experience longer waiting times than those of other blood types, partly due to crosstransplantation of too many O organs to compatible donors of other blood types. In response to this, a recent development in some jurisdictions is a change in the rules to insist upon ABO-identical transplantation. The literature review herein enables us to conclude that unrestricted cross-transplantation has not achieved equity of access across …


Scarpa's Fascia And Clinical Signs: The Role Of The Membranous Superficial Fascia In The Eponymous Clinical Signs Of Retroperitoneal Catastrophe., Shanoor Ullah, Robert Grant, Marjorie Johnson, Vivian C. Mcalister Sep 2013

Scarpa's Fascia And Clinical Signs: The Role Of The Membranous Superficial Fascia In The Eponymous Clinical Signs Of Retroperitoneal Catastrophe., Shanoor Ullah, Robert Grant, Marjorie Johnson, Vivian C. Mcalister

Vivian C. McAlister

This article deals with the history of membranous superficial fascia (Antonio Scarpa, Abraham Colles), the history of clinical signs that use discoloration of the torso (Cullen's sign, Grey Turner's sign, Fox's sign, Bryant's sign) and then describes anatomical dissection studies to link the two.

INTRODUCTION: The membranous superficial fascia (MSF) was described early in the 19th century, as was its role in the clinical sign of urethral disruption. Clinical signs of haemorrhage or leakage of pancreatic and biliary fluid into the retroperitoneum, which were described throughout the 20th century, all relied on circumscribed discolouration of the skin of the torso. …


Absence Of The Genicular Arterial Anastomosis As Generally Depicted In Textbooks., Maher Sabalbal, Marjorie Johnson, Vivian C. Mcalister Aug 2013

Absence Of The Genicular Arterial Anastomosis As Generally Depicted In Textbooks., Maher Sabalbal, Marjorie Johnson, Vivian C. Mcalister

Vivian C. McAlister

This article reviews the history of anatomical research, starting with John Hunter and Astley Cooper, into the arterial anastomosis at the knee and uses dissection to determine the reality. The final draft is available below. (Ann R Coll Surg Engl. 2013 Sep;95(6):405-9)

INTRODUCTION Textbook representations of the genicular arterial anastomosis show a large direct communication between the descending branch of the lateral circumflex femoral artery (DBLCFA) and a genicular branch of the popliteal artery but this is not compatible with clinical experience. The aim of this study was to determine whether the arterial anastomosis at the knee is sufficient, in …


Fellows Serving In Afghanistan Thank Royal College With Special Gift May 2013

Fellows Serving In Afghanistan Thank Royal College With Special Gift

Vivian C. McAlister

In recognition of support given to Fellows serving in Afghanistan, a flag box was
commissioned by officers and recently presented to the Royal College. Past-President Louis
Francescutti, MD, FRCPC, himself an Honorary Colonel of 1 Field Ambulance Edmonton,
accepted the gift on behalf of the organization. Crafted by the Udin brothers of Kabul, the
flag box is engraved with the Royal College crest, as well as with the Canadian and Afghani
national flags. It will be displayed in the Roddick Room — the Royal College’s library.
Helping locals regain health, rebuild health care

For over a decade, many Fellows of …


Fellows Serving In Afghanistan Thank Royal College With Special Gift, Dialogue May 2013

Fellows Serving In Afghanistan Thank Royal College With Special Gift, Dialogue

Vivian C. McAlister

In recognition of support given to Fellows serving in Afghanistan, a flag box was commissioned by officers and recently presented to the Royal College. Past-President Louis Francescutti, MD, FRCPC, himself an Honorary Colonel of 1 Field Ambulance Edmonton, accepted the gift on behalf of the organization. Crafted by the Udin brothers of Kabul, the flag box is engraved with the Royal College crest, as well as with the Canadian and Afghani national flags. It will be displayed in the Roddick Room — the Royal College’s library. For over a decade, many Fellows of the Royal College, both civilians and Canadian …


Short- And Long-Term Outcomes Of Third Liver Transplantation At Single Centre, Hideyi Tanaka, Mamoun Al Basheer, Jeffrey Shum, Michael Bloch, Roberto Hernandez Alejandro, Vivian C. Mcalister, William Wall, Douglas Quan May 2013

Short- And Long-Term Outcomes Of Third Liver Transplantation At Single Centre, Hideyi Tanaka, Mamoun Al Basheer, Jeffrey Shum, Michael Bloch, Roberto Hernandez Alejandro, Vivian C. Mcalister, William Wall, Douglas Quan

Vivian C. McAlister

Purpose Although three or more liver transplantation (LT)s in the same patient arouse not only medical but also ethical issues in the context of organ shortage, it is a fact that additional liver retransplantation (reLT) is the only lifesaving treatment option for those with graft failure after a second LT. However, little is known regarding the risks and benefits associated with a third LT. Methods We analyzed fifteen cases of third LT and 48 of second LT performed between January 2000 and December 2010. Clinical outcomes were compared with those of second LT cases performed during the same period. Results …


Role Of Persistent Processus Vaginalis In Hydroceles Found In A Tropical Population, Vivian C. Mcalister, Vincent Trottier May 2013

Role Of Persistent Processus Vaginalis In Hydroceles Found In A Tropical Population, Vivian C. Mcalister, Vincent Trottier

Vivian C. McAlister

BACKGROUND:

Lymphatic obstruction by Wuchereria bancrofti is thought to be the mechanism for development of tropical hydrocele in men and for elephantiasis, mostly in women. Hydrocele prevalence is used to determine the effectiveness of para site eradication programs. METHODS:

We maintained a prospective log of operations performed at 1 Canadian Field Hospital during its relief mission to Léogâne, Haiti. Information regarding duration of symptoms, type of previous surgery (if any), surgical approach, associated inguinal hernia and volume and appearance of hydrocele fluid in patients with tropical hydroceles were recorded. RESULTS:

From January to March 2010, 4922 patients were seen, none …


Debate At The Royal College Summit On The Future Of General Surgery Apr 2013

Debate At The Royal College Summit On The Future Of General Surgery

Vivian C. McAlister

Royal College of Physicians and Surgeons of Canada Task Force to address the Future of General Surgery, in Ottawa 13 May 2013: Dr Vivian McAlister debating with Dr Bill Pollett