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Jastaniah A, Mychaltchouk L, Genest A, Deckelbaum DL, Fata P, Khwaja K, McKendy K, Razek T, Wong E, Grushka J. Repeat imaging increases detection of delayed pseudoaneurysms in patients with high-grade solid organ injury following abdominal trauma. World J Surg 2024; 48:560-567. [PMID: 38501570 DOI: 10.1002/wjs.12060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 03/20/2024]
Abstract
BACKGROUND Nonoperative management of abdominal trauma can be complicated by the development of delayed pseudoaneurysms. Early intervention reduces the risk of rupture and decreases mortality. The objective of this study is to determine the utility of repeat computed tomography (CT) imaging in detecting delayed pseudoaneurysms in patients with abdominal solid organ injury. METHODS A retrospective cohort study reviewing Montreal General Hospital registry between 2013 and 2019. Patients with The American Association for the Surgery of Trauma (AAST) grade 3 or higher solid organ injury following abdominal trauma were identified. A chart review was completed, and demographics, mechanism of injury, Injury Severity Score (ISS) score, AAST injury grade, CT imaging reports, and interventions were collected. Descriptive analysis and logistic regression model were completed. RESULTS We identified 195 patients with 214 solid organ injuries. The average age was 38.6 years; 28.2% were female, 90.3% had blunt trauma, and 9.7% had penetrating trauma. The average ISS score was 25.4 (SD 12.8) in patients without pseudoaneurysms and 19.5 (SD 8.6) in those who subsequently developed pseudoaneurysms. The initial management was nonoperative in 57.0% of the patients; 30.4% had initial angioembolization, and 12.6% went to the operating room. Of the cohort, 11.7% had pseudoaneurysms detected on repeat CT imaging within 72 h. Grade 3 represents the majority of the injuries at 68.0%. The majority of these patients underwent angioembolization. CONCLUSIONS In patients with high-grade solid organ injury following abdominal trauma, repeat CT imaging within 72 h enabled the detection of delayed development of pseudoaneurysms in 11.7% of injuries. The majority of the patients were asymptomatic.
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Affiliation(s)
- Atif Jastaniah
- Department of Surgery, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | - Lydia Mychaltchouk
- McGill Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Alexandre Genest
- McGill Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Dan L Deckelbaum
- Department of Surgery, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | - Paola Fata
- Department of Surgery, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | - Kosar Khwaja
- Department of Surgery, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | - Katherine McKendy
- Department of Surgery, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | - Tarek Razek
- Department of Surgery, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | - Evan Wong
- Department of Surgery, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | - Jeremy Grushka
- Department of Surgery, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
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Shum-Tim L, Bichara-Allard S, Hopkins B, AlShahwan N, Hanley S, Manzano-Nunez R, Garcia AF, Deckelbaum D, Grushka J, Razek T, Fata P, Khwaja K, McKendy K, Jastaniah A, Wong EG. Vascular access complications associated with resuscitative endovascular balloon occlusion of the aorta in adult trauma patients: A systematic review and meta-analysis. J Trauma Acute Care Surg 2024; 96:499-509. [PMID: 37478348 DOI: 10.1097/ta.0000000000004109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
BACKGROUND Resuscitative endovascular balloon occlusion of the aorta (REBOA) is gaining popularity worldwide for managing hypotensive trauma patients. Vascular access complications related to REBOA placement have been reported, with some cases resulting in permanent morbidity. We aim to capitalize on the increase in literature to further describe and estimate the incidence of REBOA-associated vascular access complications in adult trauma patients. METHODS We searched Medline, EMBASE, Scopus, and CINAHL for studies reporting vascular access complications of REBOA in adult trauma patients from inception to October 14, 2021. Studies reporting data from adult trauma patients who underwent REBOA insertion were eligible. Exclusion criteria included patients 15 years and younger, nontrauma patients, non-REBOA use, non-vascular access complications and patient duplication. Study data was abstracted using the PRISMA checklist and verified independently by three reviewers. Meta-analysis of proportions was performed using a random effects model with Freeman-Turkey double-arcsine transformation. Post hoc meta-regression by year of publication, sheath-size, and geographic region was also performed. The incidence of vascular access complications from REBOA insertion was the primary outcome of interest. Subgroup analysis was performed by degree of bias, sheath size, technique of vascular access, provider specialty, geographical region, and publication year. RESULTS Twenty-four articles were included in the systematic review and the meta-analysis, for a total of 675 trauma patients who underwent REBOA insertion. The incidence of vascular access complications was 8% (95% confidence interval, 5%-13%). In post hoc meta-regression adjusting for year of publication and geographic region, the use of a smaller (7-Fr) sheath was associated with a decreased incidence of vascular access complications (odds ratio, 0.87; 95% confidence interval, 0.75-0.99; p = 0.046; R 2 = 35%; I 2 = 48%). CONCLUSION This study provides a benchmark for quality of care in terms of vascular access complications related to REBOA insertion in adult trauma patients. Smaller sheath size may be associated with a decrease in vascular access complications. LEVEL OF EVIDENCE Systematic Review and Meta-Analysis; Level III.
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Affiliation(s)
- Lukas Shum-Tim
- From the Division of Trauma Surgery (L.S.-T., S.B.-A., B.H., N.A.S., D.D., J.G., T.R., P.F., K.K., K.M.K., A.J., E.G.W.), McGill University, Montreal; Division of Vascular Surgery (S.H.), McGill University, Gatineau, QC, Canada; Department of Surgery, (NAS) King Saud University; Clinical Research Unit, Hospital del Mar Medical Research Institute (IMIM), (R.M.-N.), Barcelona, Spain; and Department of Surgery (A.F.G.), Fundación Valle del Lili, Cali, Colombia
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Moon J, Razek T, Grushka J, Deckelbaum D, Boulanger N, Watt L, Khwaja K, Fata P, McKendy K, Jastaniah A, Wong EG. Predictors of clinical deterioration and intensive care unit admission in trauma patients transferred from northern Quebec to a level 1 trauma centre: a retrospective cohort study. Can J Surg 2024; 67:E70-E76. [PMID: 38383031 PMCID: PMC10890791 DOI: 10.1503/cjs.005722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Trauma care in Nunavik, Quebec, is highly challenging. Geographic distances and delays in transport can translate into precarious patient transfers to tertiary trauma care centres. The objective of this study was to identify predictors of clinical deterioration during transport and eventual intensive care unit (ICU) admission for trauma patients transferred from Nunavik to a tertiary trauma care centre. METHODS This is a retrospective cohort study using the Montreal General Hospital (MGH) trauma registry. All adult trauma patients transferred from Nunavik and admitted to the MGH from 2010 to 2019 were included. Main outcomes of interest were hemodynamic and neurologic deterioration during transport and ICU admission. RESULTS In total, 704 patients were transferred from Nunavik and admitted to the MGH during the study period. The median age was 33 (interquartile range [IQR] 23-47) years and the median Injury Severity Score was 10 (IQR 5-17). On multiple regression analysis, transport time from site of injury to the MGH (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.01-1.06), thoracic injuries (OR 1.75, 95% CI 1.03-2.99), and head and neck injuries (OR 3.76, 95% CI 2.10-6.76) predicted clinical deterioration during transfer. Injury Severity Score (OR 1.04, 95% CI 1.01-1.08), abnormal local Glasgow Coma Scale score (OR 2.57, 95% CI 1.34-4.95), clinical deterioration during transfer (OR 4.22, 95% CI 1.99-8.93), traumatic brain injury (OR 2.44, 95% CI 1.05-5.68), and transfusion requirement at the MGH (OR 4.63, 95% CI 2.35-9.09) were independent predictors of ICU admission. CONCLUSION Our study identified several predictors of clinical deterioration during transfer and eventual ICU admission for trauma patients transferred from Nunavik. These factors could be used to refine triage criteria in Nunavik for more timely evacuation and higher level care during transport.
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Affiliation(s)
- Jeongyoon Moon
- From McGill University, Montréal, Que. (Moon, Razek, Grushka, Deckelbaum, Khwaja, Fata, McKendy, Jastaniah, Wong); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Nunavik, Que. (Boulanger); and the Ungava Tulattavik Health Center, Kuujjuaq, Nunavik, Que. (Watt)
| | - Tarek Razek
- From McGill University, Montréal, Que. (Moon, Razek, Grushka, Deckelbaum, Khwaja, Fata, McKendy, Jastaniah, Wong); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Nunavik, Que. (Boulanger); and the Ungava Tulattavik Health Center, Kuujjuaq, Nunavik, Que. (Watt)
| | - Jeremy Grushka
- From McGill University, Montréal, Que. (Moon, Razek, Grushka, Deckelbaum, Khwaja, Fata, McKendy, Jastaniah, Wong); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Nunavik, Que. (Boulanger); and the Ungava Tulattavik Health Center, Kuujjuaq, Nunavik, Que. (Watt)
| | - Dan Deckelbaum
- From McGill University, Montréal, Que. (Moon, Razek, Grushka, Deckelbaum, Khwaja, Fata, McKendy, Jastaniah, Wong); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Nunavik, Que. (Boulanger); and the Ungava Tulattavik Health Center, Kuujjuaq, Nunavik, Que. (Watt)
| | - Nathalie Boulanger
- From McGill University, Montréal, Que. (Moon, Razek, Grushka, Deckelbaum, Khwaja, Fata, McKendy, Jastaniah, Wong); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Nunavik, Que. (Boulanger); and the Ungava Tulattavik Health Center, Kuujjuaq, Nunavik, Que. (Watt)
| | - Larry Watt
- From McGill University, Montréal, Que. (Moon, Razek, Grushka, Deckelbaum, Khwaja, Fata, McKendy, Jastaniah, Wong); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Nunavik, Que. (Boulanger); and the Ungava Tulattavik Health Center, Kuujjuaq, Nunavik, Que. (Watt)
| | - Kosar Khwaja
- From McGill University, Montréal, Que. (Moon, Razek, Grushka, Deckelbaum, Khwaja, Fata, McKendy, Jastaniah, Wong); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Nunavik, Que. (Boulanger); and the Ungava Tulattavik Health Center, Kuujjuaq, Nunavik, Que. (Watt)
| | - Paola Fata
- From McGill University, Montréal, Que. (Moon, Razek, Grushka, Deckelbaum, Khwaja, Fata, McKendy, Jastaniah, Wong); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Nunavik, Que. (Boulanger); and the Ungava Tulattavik Health Center, Kuujjuaq, Nunavik, Que. (Watt)
| | - Katherine McKendy
- From McGill University, Montréal, Que. (Moon, Razek, Grushka, Deckelbaum, Khwaja, Fata, McKendy, Jastaniah, Wong); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Nunavik, Que. (Boulanger); and the Ungava Tulattavik Health Center, Kuujjuaq, Nunavik, Que. (Watt)
| | - Atif Jastaniah
- From McGill University, Montréal, Que. (Moon, Razek, Grushka, Deckelbaum, Khwaja, Fata, McKendy, Jastaniah, Wong); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Nunavik, Que. (Boulanger); and the Ungava Tulattavik Health Center, Kuujjuaq, Nunavik, Que. (Watt)
| | - Evan G Wong
- From McGill University, Montréal, Que. (Moon, Razek, Grushka, Deckelbaum, Khwaja, Fata, McKendy, Jastaniah, Wong); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Nunavik, Que. (Boulanger); and the Ungava Tulattavik Health Center, Kuujjuaq, Nunavik, Que. (Watt).
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Siegal DM, Belley-Côté EP, Lee SF, Hill S, D’Aragon F, Zarychanski R, Rochwerg B, Chassé M, Binnie A, Honarmand K, Lauzier F, Ball I, Al-Hazzani W, Archambault P, Duan E, Khwaja K, Lellouche F, Lysecki P, Marquis F, Naud JF, Shahin J, Shea J, Tsang JL, Wang HT, Crowther M, Arnold DM, Di Sante E, Marfo G, Kovalova T, Fonguh S, Vincent J, Connolly SJ. Small-Volume Blood Collection Tubes to Reduce Transfusions in Intensive Care: The STRATUS Randomized Clinical Trial. JAMA 2023; 330:1872-1881. [PMID: 37824152 PMCID: PMC10570918 DOI: 10.1001/jama.2023.20820] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 09/22/2023] [Indexed: 10/13/2023]
Abstract
Importance Blood collection for laboratory testing in intensive care unit (ICU) patients is a modifiable contributor to anemia and red blood cell (RBC) transfusion. Most blood withdrawn is not required for analysis and is discarded. Objective To determine whether transitioning from standard-volume to small-volume vacuum tubes for blood collection in ICUs reduces RBC transfusion without compromising laboratory testing procedures. Design, Setting, and Participants Stepped-wedge cluster randomized trial in 25 adult medical-surgical ICUs in Canada (February 5, 2019 to January 21, 2021). Interventions ICUs were randomized to transition from standard-volume (n = 10 940) to small-volume tubes (n = 10 261) for laboratory testing. Main Outcomes and Measures The primary outcome was RBC transfusion (units per patient per ICU stay). Secondary outcomes were patients receiving at least 1 RBC transfusion, hemoglobin decrease during ICU stay (adjusted for RBC transfusion), specimens with insufficient volume for testing, length of stay in the ICU and hospital, and mortality in the ICU and hospital. The primary analysis included patients admitted for 48 hours or more, excluding those admitted during a 5.5-month COVID-19-related trial hiatus. Results In the primary analysis of 21 201 patients (mean age, 63.5 years; 39.9% female), which excluded 6210 patients admitted during the early COVID-19 pandemic, there was no significant difference in RBC units per patient per ICU stay (relative risk [RR], 0.91 [95% CI, 0.79 to 1.05]; P = .19; absolute reduction of 7.24 RBC units/100 patients per ICU stay [95% CI, -3.28 to 19.44]). In a prespecified secondary analysis (n = 27 411 patients), RBC units per patient per ICU stay decreased after transition from standard-volume to small-volume tubes (RR, 0.88 [95% CI, 0.77 to 1.00]; P = .04; absolute reduction of 9.84 RBC units/100 patients per ICU stay [95% CI, 0.24 to 20.76]). Median decrease in transfusion-adjusted hemoglobin was not statistically different in the primary population (mean difference, 0.10 g/dL [95% CI, -0.04 to 0.23]) and lower in the secondary population (mean difference, 0.17 g/dL [95% CI, 0.05 to 0.29]). Specimens with insufficient quantity for analysis were rare (≤0.03%) before and after transition. Conclusions and Relevance Use of small-volume blood collection tubes in the ICU may decrease RBC transfusions without affecting laboratory analysis. Trial Registration ClinicalTrials.gov Identifier: NCT03578419.
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Affiliation(s)
- Deborah M. Siegal
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Emilie P. Belley-Côté
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Shun Fu Lee
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Stephen Hill
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Frédérick D’Aragon
- Department of Anesthesiology, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Ryan Zarychanski
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Bram Rochwerg
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Michaël Chassé
- Centre Hospitalier de l’Université de Montréal, Department of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Alexandra Binnie
- William Osler Health System – Brampton Civic and Etobicoke General, Brampton, Ontario, Canada
| | - Kimia Honarmand
- London Health Sciences Centre – CCTC and University Hospital, Department of Medicine, Western University, London, Ontario, Canada
| | - François Lauzier
- Centre Hospitalier Universitaire de Québec - Enfant-Jésus and Hôtel-Dieu, Department of Medicine, Department of Anesthesiology, Université Laval, Québec, Canada
| | - Ian Ball
- London Health Sciences Centre – CCTC and University Hospital, Department of Medicine, Western University, London, Ontario, Canada
| | - Waleed Al-Hazzani
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Patrick Archambault
- Hôtel-Dieu de Lévis, Department of Family Medicine and Urgent Care, Université Laval, Québec, Canada
| | - Erick Duan
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Niagara Health – St. Catharine’s General Hospital, St. Catharine’s, Ontario, Canada
| | - Kosar Khwaja
- Montreal General Hospital, Departments of Surgery and Critical Care Medicine, McGill University, Montréal, Québec, Canada
| | - François Lellouche
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Department of Medicine, Université Laval, Québec, Canada
| | - Paul Lysecki
- Joseph Brant Hospital, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - François Marquis
- Maisonneuve-Rosemont, Department of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Jean-François Naud
- Centre intégré universitaire de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec-CHAUR, Trois-Rivières, Québec, Canada
| | - Jason Shahin
- Royal Victoria Hospital, Department of Critical Care, McGill University, Montréal, Québec, Canada
| | - Jennifer Shea
- Saint John Regional Hospital, Department of Medicine, Memorial University, St. John, New Brunswick, Canada
| | - Jennifer L.Y. Tsang
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Niagara Health – St. Catharine’s General Hospital, St. Catharine’s, Ontario, Canada
| | - Han Ting Wang
- Maisonneuve-Rosemont, Department of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Mark Crowther
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Donald M. Arnold
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Emily Di Sante
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Gladys Marfo
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Tanya Kovalova
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Sylvanus Fonguh
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Jessica Vincent
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Stuart J. Connolly
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Kis A, Razek T, Grushka J, Boulanger N, Watt L, Deckelbaum D, Khwaja K, Fata P, Wong EG. Surgical, trauma and telehealth capacity in Indigenous communities in Northern Quebec: a cross-sectional survey. Can J Surg 2023; 66:E572-E579. [PMID: 38016727 DOI: 10.1503/cjs.013822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Delivering trauma and surgical care to Northern Quebec presents unique challenges owing to the region's remoteness, extreme weather and limited transport; the expansion of telehealth could help address these difficulties. We aimed to evaluate current surgical, trauma and telemedicine capacity in Nunavik, Quebec. METHODS We used validated assessment tools, including the Personnel, Infrastructure, Procedures, Equipment and Supplies survey, the International Assessment of Capacity for Trauma index and the Maryland Health Care Commission Telemedicine Readiness tool to evaluate surgical, trauma and telemedicine capacity, respectively. We adapted these tools to the Northern Quebec context through discussions with local leadership. Data were collected in 2 regional hospitals - the Ungava Tulattavik Health Centre (UTHC) and the Inuulitsivik Health Centre (IHC) - and 12 Centres locaux de services communautaires (CLSCs; local community services centres) in 6 villages along the Hudson Bay coast and 6 villages along the Ungava Bay coast through iterative discussions with 4 chief nurses from each regional hospital and set of CLSCs; resources were confirmed through on-site evaluation by the respondents. We performed a descriptive analysis of the data. RESULTS Surgical capacity was highest in the IHC (6.76) and lowest in the Ungava Bay CLSCs (5.52). Personnel (0%-0%) and procedures (13%-33%) were the least available resources. Trauma capacity was highest in the IHC (7.25) and lowest in the Hudson Bay CLSCs (5.58). Although equipment (90%-100%) and supplies (100%-100%) were readily available, personnel (0%-0%) and procedures (25%-56%) were lacking. The UTHC was most prepared for telehealth (67.80%), and the Ungava Bay CLSCs achieved a lower score (51.13%). Underdeveloped telehealth criteria included funding, administrative support, quality improvement and physical spaces (all 33%-67%). CONCLUSION Acute care capacity in Nunavik appears heterogeneous, with readily available equipment and supplies, but a lack of personnel capable of performing lifesaving procedures. To address the need for telemedicine, future initiatives should focus on improving funding, administrative support, physical spaces and quality-improvement initiatives.
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Affiliation(s)
- Allyson Kis
- From the Faculty of Medicine, McGill University, Montréal, Que. (Kis); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Que. (Boulanger); the Division of General Surgery, Department of Surgery, McGill University, Montréal, Que. (Razek, Grushka, Deckelbaum, Khwaja, Fata, Wong); and the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Watt)
| | - Tarek Razek
- From the Faculty of Medicine, McGill University, Montréal, Que. (Kis); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Que. (Boulanger); the Division of General Surgery, Department of Surgery, McGill University, Montréal, Que. (Razek, Grushka, Deckelbaum, Khwaja, Fata, Wong); and the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Watt)
| | - Jeremy Grushka
- From the Faculty of Medicine, McGill University, Montréal, Que. (Kis); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Que. (Boulanger); the Division of General Surgery, Department of Surgery, McGill University, Montréal, Que. (Razek, Grushka, Deckelbaum, Khwaja, Fata, Wong); and the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Watt)
| | - Nathalie Boulanger
- From the Faculty of Medicine, McGill University, Montréal, Que. (Kis); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Que. (Boulanger); the Division of General Surgery, Department of Surgery, McGill University, Montréal, Que. (Razek, Grushka, Deckelbaum, Khwaja, Fata, Wong); and the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Watt)
| | - Larry Watt
- From the Faculty of Medicine, McGill University, Montréal, Que. (Kis); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Que. (Boulanger); the Division of General Surgery, Department of Surgery, McGill University, Montréal, Que. (Razek, Grushka, Deckelbaum, Khwaja, Fata, Wong); and the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Watt)
| | - Dan Deckelbaum
- From the Faculty of Medicine, McGill University, Montréal, Que. (Kis); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Que. (Boulanger); the Division of General Surgery, Department of Surgery, McGill University, Montréal, Que. (Razek, Grushka, Deckelbaum, Khwaja, Fata, Wong); and the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Watt)
| | - Kosar Khwaja
- From the Faculty of Medicine, McGill University, Montréal, Que. (Kis); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Que. (Boulanger); the Division of General Surgery, Department of Surgery, McGill University, Montréal, Que. (Razek, Grushka, Deckelbaum, Khwaja, Fata, Wong); and the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Watt)
| | - Paola Fata
- From the Faculty of Medicine, McGill University, Montréal, Que. (Kis); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Que. (Boulanger); the Division of General Surgery, Department of Surgery, McGill University, Montréal, Que. (Razek, Grushka, Deckelbaum, Khwaja, Fata, Wong); and the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Watt)
| | - Evan G Wong
- From the Faculty of Medicine, McGill University, Montréal, Que. (Kis); the Régie régionale de la santé et des services sociaux du Nunavik, Kuujjuaq, Que. (Boulanger); the Division of General Surgery, Department of Surgery, McGill University, Montréal, Que. (Razek, Grushka, Deckelbaum, Khwaja, Fata, Wong); and the Ungava Tulattavik Health Centre, Kuujjuaq, Que. (Watt)
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Farag N, Germain A, Caminsky NG, Busque AA, Grenier T, Bracco D, Grushka J, Razek T, Deckelbaum D, Fata P, Khwaja K, McKendy K, Jastaniah A, Wong EG. Factors associated with bicycle helmet use and proper fit: a cross-sectional survey of Montreal cyclists during the COVID-19 pandemic. Can J Public Health 2023; 114:195-206. [PMID: 36763331 PMCID: PMC9913020 DOI: 10.17269/s41997-023-00747-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVES With increased bicycle use during the COVID-19 pandemic and growing availability of bicycle-sharing programs in Montreal, we hypothesize helmet use has decreased. The aim of this study was to evaluate helmet use and proper fit among Montreal cyclists during the pandemic relative to historical data. METHODS Nine observers collected data on bike type, gender, helmet use, and ethnicity using the iHelmet© app at 18 locations across the island of Montreal from June to September 2021. Proper helmet wear was assessed at one busy location. Multiple logistic regression was used to identify factors associated with helmet wear and results were compared to a historical study. RESULTS Of the 2200 cyclists observed, 1109 (50.4%) wore a helmet. Males (OR = 0.78, 95%CI = 0.65-0.95), young adults (OR = 0.65, 95%CI = 0.51-0.84), visible minorities (OR = 0.38, 95%CI = 0.28-0.53), and bike-share users (OR = 0.21, 95%CI = 0.15-0.28) were less likely to be wearing a helmet, whereas children (OR = 3.92, 95%CI = 2.17-7.08) and cyclists using racing bicycles (OR = 3.84, 95%CI = 2.62-5.62) were more likely to be wearing a helmet. The majority (139/213; 65.3%) of assessed cyclists wore properly fitting helmets. Children had the lowest odds of having a properly fitted helmet (OR = 0.13, 95%CI = 0.04-0.41). Compared to 2011, helmet use during the pandemic increased significantly (1109/2200 (50.4%) vs. 2192/4789 (45.8%); p = 0.032). CONCLUSION Helmet use among Montreal cyclists was associated with age, gender, ethnicity, and type of bicycle. Children were least likely to have a properly fitted helmet. The recent increase in popularity of cycling and expansion of bicycle-sharing programs reinforce the need for bicycle helmet awareness initiatives, legislation, and funding prioritization.
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Affiliation(s)
- Nardin Farag
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Alexandra Germain
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Natasha G Caminsky
- Division of General and Trauma Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue L9-120, Montreal, QC, H3G 1A4, Canada
- Centre for Global Surgery, McGill University, Montreal, QC, Canada
| | - Andrée-Anne Busque
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Tara Grenier
- Division of General and Trauma Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue L9-120, Montreal, QC, H3G 1A4, Canada
| | - David Bracco
- Department of Anesthesiology, McGill University, Montreal, QC, Canada
| | - Jeremy Grushka
- Division of General and Trauma Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue L9-120, Montreal, QC, H3G 1A4, Canada
- Centre for Global Surgery, McGill University, Montreal, QC, Canada
| | - Tarek Razek
- Division of General and Trauma Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue L9-120, Montreal, QC, H3G 1A4, Canada
- Centre for Global Surgery, McGill University, Montreal, QC, Canada
| | - Dan Deckelbaum
- Division of General and Trauma Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue L9-120, Montreal, QC, H3G 1A4, Canada
- Centre for Global Surgery, McGill University, Montreal, QC, Canada
| | - Paola Fata
- Division of General and Trauma Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue L9-120, Montreal, QC, H3G 1A4, Canada
- Centre for Global Surgery, McGill University, Montreal, QC, Canada
| | - Kosar Khwaja
- Division of General and Trauma Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue L9-120, Montreal, QC, H3G 1A4, Canada
- Centre for Global Surgery, McGill University, Montreal, QC, Canada
| | - Katherine McKendy
- Division of General and Trauma Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue L9-120, Montreal, QC, H3G 1A4, Canada
- Centre for Global Surgery, McGill University, Montreal, QC, Canada
| | - Atif Jastaniah
- Division of General and Trauma Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue L9-120, Montreal, QC, H3G 1A4, Canada
- Centre for Global Surgery, McGill University, Montreal, QC, Canada
| | - Evan G Wong
- Division of General and Trauma Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue L9-120, Montreal, QC, H3G 1A4, Canada.
- Centre for Global Surgery, McGill University, Montreal, QC, Canada.
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Deban M, Iqbal S, Beckett A, Posel N, Fleiszer DM, Razek T, Khwaja K. Virtual trauma patient simulation design using the McGill Simulation Complexity Score (MSCS): a breakthrough in trauma education. Can J Surg 2023; 66:E212-E218. [PMID: 37085290 PMCID: PMC10125161 DOI: 10.1503/cjs.003121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2021] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Virtual patient simulations are interactive, computer-based cases. We designed scenarios based on the McGill Simulation Complexity Score (MSCS), a previously described objective complexity score. We aimed to establish validity of the MSCS and introduce a novel learning tool in trauma education at our institution. METHODS After design of an easy and difficult patient scenario, we randomized medical students and residents to each perform 1 of the 2 scenarios. We conducted a 2-way analysis of variance of training level (medical student, resident) and scenario complexity (easy, difficult) to assess their effects on virtual time, the number of steps taken in the scenario, beneficial and harmful actions, and the ratio of beneficial over harmful actions. RESULTS Virtual patient scenarios were successfully designed using the MSCS. Twenty-four medical students and 12 residents participated in the easy scenario (MSCS = 3), and 27 medical students and 12 residents did the difficult scenario (MSCS = 18). Though beneficial actions were similar between students and residents, sudents performed more harmful actions, particularly when the scenario was difficult. One virtual patient died in the easy scenario and 3 died in the difficult one (all medical students). Performance varied with level of complexity and there was significant interaction between level of training and number of steps, as well as with number of harmful actions. Decreasing performance with increasing level of complexity, as defined by the MSCS, suggests this score can accurately quantify difficulty. CONCLUSION We established validity of the MSCS and showed its successful application on virtual patient scenario design.
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Affiliation(s)
- Melina Deban
- From the Departments of Surgery (Deban, Beckett, Razek, Khwaja), Critical Care Medicine (Khwaja) and Nephrology (Iqbal), McGill University Health Centre; Faculty of Medicine Molson Informatics Unit (Posel, Fleiszer), McGill University, Montréal, Que
| | - Sameena Iqbal
- From the Departments of Surgery (Deban, Beckett, Razek, Khwaja), Critical Care Medicine (Khwaja) and Nephrology (Iqbal), McGill University Health Centre; Faculty of Medicine Molson Informatics Unit (Posel, Fleiszer), McGill University, Montréal, Que
| | - Andrew Beckett
- From the Departments of Surgery (Deban, Beckett, Razek, Khwaja), Critical Care Medicine (Khwaja) and Nephrology (Iqbal), McGill University Health Centre; Faculty of Medicine Molson Informatics Unit (Posel, Fleiszer), McGill University, Montréal, Que
| | - Nancy Posel
- From the Departments of Surgery (Deban, Beckett, Razek, Khwaja), Critical Care Medicine (Khwaja) and Nephrology (Iqbal), McGill University Health Centre; Faculty of Medicine Molson Informatics Unit (Posel, Fleiszer), McGill University, Montréal, Que
| | - David M Fleiszer
- From the Departments of Surgery (Deban, Beckett, Razek, Khwaja), Critical Care Medicine (Khwaja) and Nephrology (Iqbal), McGill University Health Centre; Faculty of Medicine Molson Informatics Unit (Posel, Fleiszer), McGill University, Montréal, Que
| | - Tarek Razek
- From the Departments of Surgery (Deban, Beckett, Razek, Khwaja), Critical Care Medicine (Khwaja) and Nephrology (Iqbal), McGill University Health Centre; Faculty of Medicine Molson Informatics Unit (Posel, Fleiszer), McGill University, Montréal, Que
| | - Kosar Khwaja
- From the Departments of Surgery (Deban, Beckett, Razek, Khwaja), Critical Care Medicine (Khwaja) and Nephrology (Iqbal), McGill University Health Centre; Faculty of Medicine Molson Informatics Unit (Posel, Fleiszer), McGill University, Montréal, Que.
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8
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Khwaja K, Deban M, Iqbal S, Alowais J, Al Bader B, Deckelbaum D, Razek T. The McGill Simulation Complexity Score (MSCS): a novel complexity scoring system for simulations in trauma. Can J Surg 2023; 66:E206-E211. [PMID: 37085295 PMCID: PMC10125157 DOI: 10.1503/cjs.002220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2020] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND In medical education, simulation can be defined as an activity in which an individual demonstrates skills, procedures and critical thinking using interactive mannequins in a setting closely resembling the clinical environment. To our knowledge, the complexity of trauma simulations has not previously been assessed. We aimed to develop an objective trauma simulation complexity score and assess its interrater reliability. METHODS The McGill Simulation Complexity Score (MSCS) was designed to address the need for objective evaluation of the complexity of trauma scenarios. Components of the score reflected the Advanced Trauma Life Support approach to trauma. The score was developed to take into account the severity of trauma injuries and the complexity of their management. We assessed interrater reliability at 5 high-fidelity simulation events. Interrater reliability was calculated using the Pearson correlation coefficient (PCC) and the intraclass correlation coefficient (ICC). RESULTS The MSCS has 5 categories: airway, breathing, circulation, disability, and extremities or exposure. The scale has 5 levels for each category, from 0 to 4; level increases with complexity, with 0 corresponding to normal or absent. Cases designed to lead to cardiac arrest, regardless of whether or not the trainee has the ability to resuscitate the simulated patient and regardless of the level of each category, are automatically assigned the maximum score. Between 3 and 9 raters used the MSCS to grade the level of complexity of 26 scenarios at the 5 events. The mean MSCS was 10.2 (range 3.0-20.0). Mean PCC and ICC values were both above 0.7 and therefore statistically significant. CONCLUSION The MSCS for trauma is an innovative scoring system with high interrater reliability.
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Affiliation(s)
- Kosar Khwaja
- From the Departments of Surgery (Khwaja, Deban, Alowais, Al Bader, Deckelbaum, Razek) and Critical Care Medicine (Khwaja), McGill University Health Centre, Montréal, Que. ; and the Department of Nephrology, McGill University Health Centre, Montréal, Que. (Iqbal)
| | - Melina Deban
- From the Departments of Surgery (Khwaja, Deban, Alowais, Al Bader, Deckelbaum, Razek) and Critical Care Medicine (Khwaja), McGill University Health Centre, Montréal, Que. ; and the Department of Nephrology, McGill University Health Centre, Montréal, Que. (Iqbal)
| | - Sameena Iqbal
- From the Departments of Surgery (Khwaja, Deban, Alowais, Al Bader, Deckelbaum, Razek) and Critical Care Medicine (Khwaja), McGill University Health Centre, Montréal, Que. ; and the Department of Nephrology, McGill University Health Centre, Montréal, Que. (Iqbal)
| | - Jalal Alowais
- From the Departments of Surgery (Khwaja, Deban, Alowais, Al Bader, Deckelbaum, Razek) and Critical Care Medicine (Khwaja), McGill University Health Centre, Montréal, Que. ; and the Department of Nephrology, McGill University Health Centre, Montréal, Que. (Iqbal)
| | - Bader Al Bader
- From the Departments of Surgery (Khwaja, Deban, Alowais, Al Bader, Deckelbaum, Razek) and Critical Care Medicine (Khwaja), McGill University Health Centre, Montréal, Que. ; and the Department of Nephrology, McGill University Health Centre, Montréal, Que. (Iqbal)
| | - Dan Deckelbaum
- From the Departments of Surgery (Khwaja, Deban, Alowais, Al Bader, Deckelbaum, Razek) and Critical Care Medicine (Khwaja), McGill University Health Centre, Montréal, Que. ; and the Department of Nephrology, McGill University Health Centre, Montréal, Que. (Iqbal)
| | - Tarek Razek
- From the Departments of Surgery (Khwaja, Deban, Alowais, Al Bader, Deckelbaum, Razek) and Critical Care Medicine (Khwaja), McGill University Health Centre, Montréal, Que. ; and the Department of Nephrology, McGill University Health Centre, Montréal, Que. (Iqbal)
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9
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Lau VI, Xie F, Fowler RA, Rochwerg B, Johnstone J, Lauzier F, Marshall JC, Basmaji J, Henderson W, Khwaja K, Loubani O, Niven DJ, Zarychanski R, Arabi YM, Cartin-Ceba R, Thabane L, Heels-Ansdell D, Cook DJ. Health economic evaluation alongside the Probiotics to Prevent Severe Pneumonia and Endotracheal Colonization Trial (E-PROSPECT): a cost-effectiveness analysis. Can J Anaesth 2022; 69:1515-1526. [PMID: 36289153 DOI: 10.1007/s12630-022-02335-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/06/2022] [Accepted: 06/21/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE We sought to compare the cost-effectiveness of probiotics and usual care with usual care without probiotics in mechanically ventilated, intensive care unit patients alongside the Probiotics to Prevent Severe Pneumonia and Endotracheal Colonization Trial (PROSPECT). METHODS We conducted a health economic evaluation alongside the PROSPECT randomized control trial (October 2013-March 2019). We adopted a public healthcare payer's perspective. Forty-four intensive care units in three countries (Canada/USA/Saudi Arabia) with adult critically ill, mechanically ventilated patients (N = 2,650) were included. Interventions were probiotics (Lactobacillus rhamnosus GG) vs placebo administered enterally twice daily. We collected healthcare resource use and estimated unit costs in 2019 United States dollars (USD) over a time horizon from randomization to hospital discharge/death. We calculated incremental cost-effectiveness ratios (ICERs) comparing probiotics vs usual care. The primary outcome was incremental cost per ventilator-associated pneumonia (VAP) event averted; secondary outcomes were costs per Clostridioides difficile-associated diarrhea (CDAD), antibiotic-associated diarrhea (AAD), and mortality averted. Uncertainty was investigated using nonparametric bootstrapping and sensitivity analyses. RESULTS Mean (standard deviation [SD]) cost per patient was USD 66,914 (91,098) for patients randomized to probiotics, with a median [interquartile range (IQR)] of USD 42,947 [22,239 to 76,205]. By comparison, for those not receiving probiotics, mean (SD) cost per patient was USD 62,701 (78,676) (median [IQR], USD 41,102 [23,170 to 75,140]; incremental cost, USD 4,213; 95% confidence interval [CI], -2,269 to 10,708). Incremental cost-effectiveness ratios for VAP or AAD events averted, probiotics were dominated by usual care (more expensive, with similar effectiveness). The ICERs were USD 1,473,400 per CDAD event averted (95% CI, undefined) and USD 396,764 per death averted (95% CI, undefined). Cost-effectiveness acceptability curves reveal that probiotics were not cost-effective across wide ranges of plausible willingness-to-pay thresholds. Sensitivity analyses did not change the conclusions. CONCLUSIONS Probiotics for VAP prevention among critically ill patients were not cost-effective. Study registration data www. CLINICALTRIALS gov (NCT01782755); registered 4 February 2013.
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Affiliation(s)
- Vincent I Lau
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, AB, Canada. .,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada. .,Department of Critical Care, Faculty of Medicine and Dentistry, University of Alberta, 8440 112 Street, Edmonton, AB, Canada.
| | - Feng Xie
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Programs for Health Economics and Outcomes Measures, Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
| | - Robert A Fowler
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Bram Rochwerg
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Division of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Jennie Johnstone
- Department of Infection Prevention and Control, Sinai Health, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - François Lauzier
- Departments of Medicine, Anesthesiology & Critical Care, Université Laval, Quebec, QC, Canada
| | - John C Marshall
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.,Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - John Basmaji
- Division of Critical Care Medicine, Department of Medicine, Western University, London, ON, Canada
| | - William Henderson
- Division of Critical Care Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kosar Khwaja
- Departments of Surgery and Critical Care Medicine, McGill University, Montreal, QC, Canada
| | - Osama Loubani
- Department of Critical Care, Dalhousie University, Halifax, NS, Canada
| | - Daniel J Niven
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ryan Zarychanski
- Sections of Critical Care and Hematology/Medical Oncology, University of Manitoba, Winnipeg, MB, Canada
| | - Yaseen M Arabi
- Intensive Care Department, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Rodrigo Cartin-Ceba
- Division of Pulmonary Medicine and Critical Care, Department of Critical Care, Mayo Clinic, Phoenix, AZ, USA
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Diane Heels-Ansdell
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Deborah J Cook
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Division of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada
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Selim Y, Di Lena É, Abu-Omar N, Baig Z, Verhoeff K, La J, Purich K, Albacete S, Valji R, Purich K, Safar A, Schellenberg M, Schellenberg M, Schellenberg M, Schellenberg M, Schellenberg M, Schellenberg M, Daza J, Glass LT, Verhoeff K, Johnson G, Guidolin K, Glass LT, Balvardi S, Gawad N, McKechnie T, McKechnie T, Purich K, Henley J, Imbert E, Li C, Skinner S, Lenet T, Lenet T, Metz J, Ahn H(S, Do U, Rouhi A, Greenberg B, Muaddi H, Park L, Vogt K, Bradley N, Deng SX, Murphy P, Alhabboubi M, Lie J, Laplante S, Lie J, Drung J, Nixon T, Allard-Coutu A, Mansouri S, Lee A, Tweedy J, D’Elia MA, Hopkins B, Srivastava A, Alibhai K, Lee C, Moon J(J, How N, Spoyalo K, Lalande A, Baig Z, Schweitzer C, Keogh J, Huo B, Patel YS, Patel YS, Jogiat U, McGuire AL, Jogiat U, Lee Y, Barber E, Akhtar-Danesh GG, Bondzi-Simpson A, Bowker R, Ahmadi N, Abdul SA, Patel P, Harrison L, Shi G, Shi G, Alaichi JA, Kidane B, Qu LC, Alaichi J, Mackay E, Lee J, Purich K, Castelo M, Caycedo-Marulanda A, Caycedo-Marulanda A, Brennan K, Brennan K, Brennan K, Garfinkle R, Sharma S, Candy S, Patel S, LeGal G, Spadafora S, Maclellan S, Trottier D, Jonker D, Asmis T, Mallick R, Ramsay T, Carrier M, McKechnie T, Shojaei D, Motamedi A, Ghuman A, Karimuddin A, Raval M, Brown C, Shojaei D, Wang H, Buie D, Wang H, McKechnie T, Buie D, Al Busaidi N, Rajabiyazdi F, Demian M, Boutros M, Farooq A, Brown C, Phang T, Ghuman A, Karimuddin A, McKechnie T, Raval M, Udwadia F, Marinescu D, Alqahtani M, Pang A, Vasilevsky CA, Boutros M, Oviedo SC, McFadden N, Spence R, Lee L, Hirsch G, Neumann K, Neumann K, Spence R, Johnson G, Singh H, Helewa R, Yilbas A, Netto FS, Katz J, Robitaille S, Sharma B, Khan U, Selzner M, Mocanu V, Dang J, Wilson H, Switzer N, Birch D, Karmali S, Mocanu V, Robitaille S, Jogiat U, Forbes H, Switzer N, Birch D, Karmali S, Verhoeff K, Mocanu V, Kung J, Purich K, Switzer N, Sadri H, Birch D, Karmali S, Tassé N, Tchernof A, Nadeau M, Dawe P, Beckett A, Biertho L, Lin A, Verhoeff K, Selznick S, Mocanu V, Kung JY, Birch DW, Karmali S, Switzer NJ, Fowler-Woods M, Fowler-Woods A, Shingoose G, Hatala A, Daeninck F, Wiseman V, Vergis A, Hardy K, Clouston K, Debru E, Sun W, Dang J, Switzer N, Birch D, Karmali S, De Gara C, Wiseman V, Halasz J, Dang J, Switzer N, Kanji A, Birch D, Modi R, Karmali S, Gu J, Jarrar A, Kolozsvari N, Wiseman V, Samarasinghe Y, Chen L, Hapugall A, Javidan A, McKechnie T, Doumouras A, Hong D, Laplante S, Stogryn S, Maeda A, Brennan K, Jackson T, Okrainec A, Birch D, Karmali S, Kanji A, Switzer N, Balas M, Gee D, Hutter M, Meireles O, Baker L, Jung J, Vergis A, Hardy K, Boudreau V, Hong D, Anvari M, Iranmanesh P, Barlow K, Cookson T, Bolis R, Ichhpuniani S, Shanthanna H, Shiroky J, Deghan S, Zevin B, Cloutier Z, Cookson T, Barlow K, Boudreau V, Anvari M, Brodie J, Johnson G, O’Brien E, Tedman-Aucoin K, Lawlor D, Murphy R, Twells L, Pace D, Ellsmere J, Evans B, Zhang T, Deehan E, Zhang L, Kao D, Hotte N, Birch D, Karmali S, Samarasinghe K, Walter J, Madsen K, Williams E, Kong W, Fundytus A, Holden J, Booth C, Patel S, Caycedo-Marulanda A, Chung W, Nanji S, Merchant S, Hansen B, Paszat L, Baxter N, Scheer A, Moon J(J, Ghezeljeh TN, Lapointe-Gagner M, Nguyen-Powanda P, Elhaj H, Rajabiyazdi F, Lee L, Feldman LS, Fiore J, Sutradhar R, Haas B, Moon J(J, Guttman M, Eskander A, Coburn N, Chesney T, Tillman B, Zuk V, Mahar A, Hsu A, Chan W, Hallet J, Moon J(J, Guidolin K, Servidio-Italiano F, Quereshy F, Sapisochin G, Prisman E, Mitmaker E, Walker R, Wu J, Nguyen A, Wiseman S, Moon J(J, Hong D, Gupta M, Pasternak J, Vergara-Fernandez O, Brar A, Conner J, Kirsch R, Brar M, Kennedy E, Govindarajan A, Paradis T, Gryfe R, MacRae H, Cohen Z, McLeod R, Swallow C, Ghasemi F, Delisle M, Stacey D, Abou-Khalil J, Balaa F, Bayat Z, Bertens K, Dingley B, Martel G, McAlpine K, Nessim C, Tadros S, Carrier M, Auer R, Lim D, Eskander A, Patel S, Coburn N, Sutradhar R, Chan W, Hallet J, Pickard F, Mathieson A, Hogan M, Seal M, Acidi B, Johnston W, Maalouf MF, Callegaro D, Brar S, Gladdy R, Chung P, Catton C, Khalili K, Honore C, Swallow C, Fu N, Kazazian K, Wachtel A, Pacholczyk K, Ng D, Swett-Cosentino J, Savage P, Shibahara Y, Kalimuthu S, Espin-Garcia O, Conner J, Yeung J, Darling G, Baronas V, Swallow C, Mercier F, Barabash V, Law C, Coburn N, Singh S, Myrehaug S, Chan W, Hallet J, Auer RC, Wiseman V, Muhn N, Heller B, Lovrics P, Ng D, Koerber D, Al-Sukhni E, Cyr D, Kazazian K, Swallow C, Apte S, Lie J, Nessim C, Ban J, Chen L, McKevitt E, Warburton R, Pao JS, Dingee C, Kuusk U, Bazzarelli A, Hong NL, Hajjar R, Gagliardi A, Nyhof B, Marfil-Garza B, Sandha G, Cooper D, Dajani K, Bigam D, Anderson B, Kin T, Lam A, Ehlebracht A, O’Gorman D, Senior P, Ricordi C, Shapiro AJ, Moser M, Lam H, Flemming J, Jalink D, Nanji S, Bennett S, Caminsky N, Zhang B, Tywonek K, Meyers B, Serrano P, Lenet T, Shorr R, Abou-Khalil J, Bertens K, Balaa F, Martel G, Caminsky N, Jayaraman S, Wei A, Mahar A, Kaliwal Y, Martel G, Coburn N, Hallet J, Williams P, Claasen M, Ivanics T, Gilbert R, Englesakis M, Gallinger S, Hansen B, Sapisochin G, Ivanics T, Claasen M, Gallinger S, Hansen B, Sapisochin G, Lenet T, Morin G, Abou-Khalil J, Balaa F, Martel G, Brind’Amour A, Bertens K, Balaa F, Bertens K, Martel G, Abou-Khalil J, Collin Y, Auer RC, Ivanics T, Toso C, Adam R, Ijzermans J, Sapisochin G, Polak W, Léveillé M, Lawson C, Collin Y, Tai LH, Phang T, Greene B, Jayaraman S, Tsang M, Al-Arnawoot A, Rajendran L, Lamb T, Turner A, Reid M, Rekman J, Mimeault R, Hopkins J, Abou-Khalil J, Bertens K, Martel G, Balaa F, Zhang C, Lemke M, Glinka J, Leslie K, Skaro A, Tang E, Hopkins J, Greene B, Tsang M, Jayaraman S, Bubis L, Jayaraman S, Tsang ME, Ganescu O, Vanounou T, Pelletier JS, Greene B, Levin Y, Tsang M, Jayaraman S, Ganescu O, Pelletier JS, Vanounou T, Choi WJ, Muaddi H, Ivanics T, Classen MP, Sapisochin G, Alam A, Caminsky N, Mansouri S, Lagace P, Lagace P, El-Kefraoui C, Mainprize M, Melland-Smith M, Verhoeff K, Verhoeff K, Nasser K, 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S, Caycedo-Marulanda A, Booth C, Bankhead C, Heneghan C, Zhang L, Flemming J, Djerboua M, Nanji S, Caycedo-Marulanda A, Merchant S, Patel S, Demian M, Sabboobeh S, Moon J, Hulme-Moir M, Liberman AS, Feinberg S, Hayden DM, Chadi SA, Demyttenaere S, Samuel L, Hotakorzian N, Quintin L, Morin N, Ghitulescu G, Faria J, Vasilevsky CA, Boutros M, Mckechnie T, Khamar J, Ichhpuniani S, Eskicioglu C, Patel S, Merchant S, Caycedo-Marulanda A, Bankhead C, Heneghan C, Govind S, Lee J, Lee Y, Hong D, Eskicioglu C, Lu J, Khamar J, Lee Y, Amin N, Hong D, Eskicioglu C, Cardenas L, Schep D, Doumouras A, Hong D, Wong R, Levine O, Eskicioglu C, Mueller C, Stein B, Charlebois P, Liberman S, Fried G, Feldman L, Wang A, Liberman S, Charlebois P, Stein B, Fiore JF, Feldman L, Lee L, Wang A, Liberman S, Charlebois P, Stein B, Fiore JF, Feldman L, Lee L, Barkun A, Levy J, Bogdan R, Hawel J, Elnahas A, Alkhamesi NA, Schlachta CM, Caycedo-Marulanda A, Iaboni N, Hurlbut D, Kaufmann M, Ren KYM, Jamzad A, Mousavi P, Fichtinger G, Nicol CJ, Rudan JF, Brennan K, Caycedo-Marulanda A, Merchant S, McClintock C, Patel SV, McClintock C, Bankhead C, Merchant S, Caycedo-Marulanda A, Booth C, Heneghan C, Zhang L, Huo B, Donaldson A, Flemming J, Nanji S, Caycedo-Marulanda A, Merchant S, Brogly S, Patel S, Lenet T, Park L, Murthy S, Musselman R, McKechnie T, Lee J, Biro J, Lee Y, Park L, Doumouras A, Hong D, Eskicioglu C, Singh H, Helewa R, Reynolds K, Sibley K, Doupe M, Brennan K, Flemming J, Nanji S, Merchant S, Djerboua M, Caycedo-Marulanda A, Patel S, Johnson G, Hochman D, Helewa R, Garfinkle R, Dell’Aniello S, Zelkowitz P, Vasilevsky CA, Brassard P, Boutros M, Zoughlami A, Abibula W, Amar A, Ghitulescu G, Vasilevsky CA, Brassard P, Boutros M, Araji T, Pang A, Vasilevsky CA, Boutros M, Ehlebracht A, Faria J, Ghitulescu G, Morin N, Pang A, Vasilevsky CA, Boutros M, Robitaille S, Oliver M, Charlebois P, Stein B, Liberman S, Feldman LS, Lee L, Kennedy E, Victor C, Govindarajan A, Zhang L, Brennan K, Djerboua M, Nanji S, Merchant SJ, Caycedo-Marulanda A, Flemming J, Robitaille S, Penta R, Pook M, Fiore JF, Feldman L, Lee L, Wong-Chong N, Marinescu D, Bhatnagar S, Morin N, Ghitulescu G, Vasilevsky CA, Faria J, Boutros M, Arif A, Ladua G, Bhang E, Brown C, Donellan F, Stuart H, Loree J, Patel S, Zhang L, MacDonald PH, Merchant S, Barnett KW, Caycedo-Marulanda A, Brown C, Karimuddin A, Stuart H, Ghuman A, Phang T, Raval M, Yoon HM, Fragoso G, Oliero M, Calvé A, Rendos HV, Gonzalez E, Brereton NJ, Cuisiniere T, Gerkins C, Djediai S, Annabi B, Diop K, Routy B, Laplante P, Cailhier JF, Taleb N, Alratrout H, Dagbert F, Loungnarath R, Sebajang H, Schwenter F, Wassef R, Ratelle R, Debroux E, Richard C, Santos MM, Hamad D, Alsulaim H, Monton O, Marinescu D, Pang A, Vasilevsky CA, Boutros M, Marinescu D, Alqahtani M, Pang A, Ghitulescu G, Vasilevsky CA, Boutros M, Marinescu D, Garfinkle R, Boutros M, Zwiep T, Greenberg J, Lenet T, Musselman R, Williams L, Raiche I, McIsaac D, Thavorn K, Fergusson D, Moloo H, Charbonneau J, Paré X, Frigault J, Letarte F, Ott M, Karanicolas P, Brackstone M, Ashmalla S, Weaver J, Tagalakis V, Boutros M, Stotland P, Caycedo-Marulanda A, Moloo H, Jayaraman S. 2022 Canadian Surgery Forum Sept. 15–17, 202201. 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Remote video-based suturing education with smartphones (REVISE): a randomized controlled trial68. Modified Delphi consensus on appropriate use of laboratory investigations in acute care surgery patients72. Impacts of inpatient food at a tertiary care centre on patient satisfaction, nutrition and planetary health73. Racial disparities in health outcomes for oncological surgery in Canada75. Risk of recurrent laryngeal nerve injury from thyroidectomy is lower when intraoperative nerve monitoring (IONM) is used: an analysis of 17 688 patients from the NSQIP database01. The impact of the COVID-19 pandemic on non-smallcell lung cancer pathologic stage and presentation02. Screening criteria evaluation for expansion in pulmonary neoplasias (screen)03. Robotic-assisted lobectomy for early-stage lung cancer provides better patient-reported quality of life than video-assisted lobectomy: early results of the RAVAL trial04. 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Externally benchmarking colorectal resection outcomes in our province against the ACS NSQIP risk calculator: identifying opportunities for improvement57. Externally benchmarking our provincial colectomy outcomes against the ACS NSQIP using the Codman Score: to identify possible opportunities for improvement of outcomes58. Rural v. urban documentation of recommended practices for optimal endoscopic colorectal lesion localization01. Incidence of in-hospital opioid use and pain after inguinal hernia repair02. Ventral hernia repair following liver transplantation: outcome of repair techniques and risk factors for recurrence01. Impact of the COVID-19 pandemic on bariatric surgery in North America: a retrospective analysis of 834 647 patients02. Patient selection and 30-day outcomes of SADI-S compared to RYGB: a retrospective cohort study of 47 375 patients03. New persistent opioid use following bariatric surgery: a systematic review and pooled proportion meta-analysis04. Bariatric surgery should be offered to active-duty military personnel: a retrospective study of the Canadian Armed Forces experience05. Opioid prescribing practices and use following bariatric surgery: a systematic review and pooled summary of data06. Sacred sharing circles: urban Indigenous Manitobans’ experiences with bariatric surgery07. Gastrogastric hernia after laparoscopic gastric great curve plication: a video presentation08. Characterization of comorbidities predictive of bariatric surgery09. Efficacy of preoperative high-dose liraglutide in patients with superobesity10. The effect of linear stapled gastrojejunostomy size in Roux-en-Y gastric bypass11. Fragility of statistically significant outcomes in randomized trials comparing bariatric surgeries12. Weight loss outcomes for patients undergoing conversion to Roux-en-Y gastric bypass after sleeve gastrectomy13. Are long waiting lists for bariatric surgery detrimental to patients? A single-centre experience14. Does upper gastrointestinal swallow study after bariatric surgery lead to earlier detection of leak?15. Pharmaceutical utilization before and after bariatric surgery16. Same-day discharge Roux-en-Y gastric bypass at a Canadian bariatric centre: pathway implementation and early experiences17. Safety and efficiency of performing primary bariatric surgery at an ambulatory site of a tertiary care hospital: a 5-year experience18. Impact of psychiatric diagnosis on weight loss outcomes 3 years after bariatric surgery19. Ursodeoxycholic acid (UDCA) for prevention of gallstone disease after laparoscopic sleeve gastrectomy (LSG): an Atlantic Canada perspective20. Fecal microbial transplantation and fibre supplementation in patients with severe obesity and metabolic syndrome: a randomized double-blind, placebo-controlled phase 2 trial01. Incidence, timing and outcomes of venous thromboembolism in patients undergoing surgery for esophagogastric cancer: a population-based cohort study04. Omission of axillary staging and survival in elderly women with early-stage breast cancer: a population-based cohort study05. Patients’ experiences receiving cancer surgery during the COVID-19 pandemic: a qualitative study06. Cancer surgery outcomes are better at high-volume centres07. Attitudes of Canadian colorectal cancer care providers toward liver transplantation for colorectal liver metastases: a national survey08. Quality of narrative central and lateral neck dissection reports for thyroid cancer treatment suggests need for a national standardized synoptic operative template09. Transoral endoscopic thyroidectomy vestibular approach (TOETVA): indications and technique10. Temporal trends in lymph node assessment as a quality indicator in colorectal cancer patients treated at a high-volume Canadian centre11. Molecular landscape of early-stage breast cancer with nodal metastasis12. Beta testing of a risk-stratified patient decision aid to facilitate shared decision making for postoperative extended thromboprophylaxis in patients undergoing major abdominal surgery for cancer13. Breast reconstruction use and impact on oncologic outcomes among inflammatory breast cancer patients: a systematic review14. Association between patient-reported symptoms and health care resource utilization: a first step to develop patient-centred value measures in cancer care15. Complications after colorectal liver metastases resection in Newfoundland and Labrador16. Why do patients with nonmetastatic primary retroperitoneal sarcoma not undergo resection?17. Loss of FAM46Cexpression predicts inferior postresection survival and induces ion channelopathy in gastric adenocarcinoma18. Liver-directed therapy of neuroendocrine liver metastases19. Neoadjuvant pembrolizumab use in microsatellite instability high (MSI-H) rectal cancer: benefits of its use in lynch syndrome20. MOLLI for excision of nonpalpable breast lesions: a case series22. Patients awaiting mastectomy report increased depression, anxiety, and decreased quality of life compared with patients awaiting lumpectomy for treatment of breast cancer23. Is microscopic margin status important in retroperitoneal sarcoma (RPS) resection? A systematic review and meta-analysis24. Absence of benefit of routine surveillance in very-low-risk and low-risk gastric gastrointestinal stromal tumors25. Effect of intraoperative in-room specimen radiography on margin status in breast-conserving surgery26. Active surveillance for DCIS of the breast: qualitative interviews with patients and physicians01 Outcomes following extrahepatic and intraportal pancreatic islet transplantation: a comparative cohort study02. Cholang-funga-gitis03. Evaluating the effect of a low-calorie prehepatectomy diet on perioperative outcomes: a systematic review and meta-analysis04. Toxicity profiles of systemic therapy for advanced hepatocellular carcinoma: a systematic review to guide neoadjuvant trials05. Should cell salvage be used in liver resection and transplantation? A systematic review and meta-analysis06. The association between surgeon and hospital variation in use of laparoscopic liver resection and short-term outcomes07. Systematic review and meta-analysis of prognostic factors for early recurrence in intrahepatic cholangiocarcinoma after curative-intent resection08. Impact of neoadjuvant chemotherapy on postoperative outcomes of patients undergoing hepatectomy for intrahepatic cholangiocarcinoma: ACS-NSQIP propensity-matched analysis09. The impact of prophylactic negative pressure wound therapy on surgical site infections in pancreatic resection: a systematic review and meta-analysis10. Does hepatic pedicle clamping increase the risk of colonic anastomotic leak after combined hepatectomy and colectomy? Analysis of the ACS NSQIP database11. Development of a culture process to grow a full-liver tissue substitute12. Liver transplantation for fibrolamellar hepatocellular carcinoma: an analysis of the European Liver Transplant Registry13. Arming beneficial viruses to treat pancreatic cancer14. Hepaticoduodenostomy versus hepaticojenunostomy for biliary reconstruction: a retrospective review of a single-centre experience15. Feasibility and safety of a “shared care” model in complex hepatopancreatobiliary surgery: a 5-year analysis of pancreaticoduodenectomy16. Laparoscopic v. open pancreaticoduodenectomy: initial institutional experience and NSQIP-matched analysis17. Laparoscopic spleen-preserving distal pancreatectomy: Why not do a Warshaw?18. The impact of COVID-19 on pancreaticoduodenectomy outcomes in a high-volume hepatopancreatobiliary centre19. Transitioning from open to minimally invasive pancreaticoduodenectomy: the learning curve factor in an academic centre20. Closed-incision negative-pressure wound therapy following pancreaticoduodenectomy for prevention of surgical site infections in high-risk patients21. Robotic Appleby procedure for recurrent pancreatic cancer22. The influence of viral hepatitis status on posthepatectomy complications in patients with hepatocellular carcinoma: a NSQIP analysis. Can J Surg 2022. [DOI: 10.1503/cjs.014322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Turgeon AF, Fergusson DA, Clayton L, Patton MP, Zarychanski R, English S, Docherty A, Walsh T, Griesdale D, Kramer AH, Scales D, Burns KEA, Boyd JG, Marshall JC, Kutsogiannis DJ, Ball I, Hébert PC, Lamontagne F, Costerousse O, St-Onge M, Lessard Bonaventure P, Moore L, Neveu X, Rigamonti A, Khwaja K, Green RS, Laroche V, Fox-Robichaud A, Lauzier F. Haemoglobin transfusion threshold in traumatic brain injury optimisation (HEMOTION): a multicentre, randomised, clinical trial protocol. BMJ Open 2022; 12:e067117. [PMID: 36216432 PMCID: PMC9557781 DOI: 10.1136/bmjopen-2022-067117] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Traumatic brain injury (TBI) is the leading cause of mortality and long-term disability in young adults. Despite the high prevalence of anaemia and red blood cell transfusion in patients with TBI, the optimal haemoglobin (Hb) transfusion threshold is unknown. We undertook a randomised trial to evaluate whether a liberal transfusion strategy improves clinical outcomes compared with a restrictive strategy. METHODS AND ANALYSIS HEMOglobin Transfusion Threshold in Traumatic Brain Injury OptimizatiON is an international pragmatic randomised open label blinded-endpoint clinical trial. We will include 742 adult patients admitted to an intensive care unit (ICU) with an acute moderate or severe blunt TBI (Glasgow Coma Scale ≤12) and a Hb level ≤100 g/L. Patients are randomly allocated using a 1:1 ratio, stratified by site, to a liberal (triggered by Hb ≤100 g/L) or a restrictive (triggered by Hb ≤70 g/L) transfusion strategy applied from the time of randomisation to the decision to withdraw life-sustaining therapies, ICU discharge or death. Primary and secondary outcomes are assessed centrally by trained research personnel blinded to the intervention. The primary outcome is the Glasgow Outcome Scale extended at 6 months. Secondary outcomes include overall functional independence measure, overall quality of life (EuroQoL 5-Dimension 5-Level; EQ-5D-5L), TBI-specific quality of life (Quality of Life after Brain Injury; QOLIBRI), depression (Patient Health Questionnaire; PHQ-9) and mortality. ETHICS AND DISSEMINATION This trial is approved by the CHU de Québec-Université Laval research ethics board (MP-20-2018-3706) and ethic boards at all participating sites. Our results will be published and shared with relevant organisations and healthcare professionals. TRIAL REGISTRATION NUMBER NCT03260478.
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Affiliation(s)
- Alexis F Turgeon
- Population Health and Optimal Practices Research Unit (Trauma- Emergency-Critical Care Medicine), CHU de Québec-Universite Laval Research Center, Québec City, Québec, Canada
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Québec City, Québec, Canada
| | - Dean A Fergusson
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Lucy Clayton
- Population Health and Optimal Practices Research Unit (Trauma- Emergency-Critical Care Medicine), CHU de Québec-Universite Laval Research Center, Québec City, Québec, Canada
- Centre de Recherche du CHU Sainte-Justine, Montréal, Québec, Canada
| | - Marie-Pier Patton
- Population Health and Optimal Practices Research Unit (Trauma- Emergency-Critical Care Medicine), CHU de Québec-Universite Laval Research Center, Québec City, Québec, Canada
| | - Ryan Zarychanski
- Department of Internal Medicine, Section of Hematology/Oncology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Shane English
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Department of Critical Care, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Annemarie Docherty
- Centre for Medical Informatics, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Timothy Walsh
- Centre for Medical Informatics, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Donald Griesdale
- Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
- Division of Critical Care Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Center for Clinical Epidemiology & Evaluation, Vancouver General Hospital, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Andreas H Kramer
- Department of Critical Care Medicine, Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada
| | - Damon Scales
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Karen E A Burns
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, Unity Health Toronto-St. Michael's Hospital, Toronto, Ontario, Canada
| | - John Gordon Boyd
- Department of Medicine, Division of Neurology, Queen's University, Kingston, Ontario, Canada
- Department of Medicine, Division of Critical Care Medicine, Queen's University, Kingston, Ontario, Canada
| | - John C Marshall
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, Unity Health Toronto-St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | | | - Ian Ball
- Department of Medicine, Western University, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Paul C Hébert
- Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Francois Lamontagne
- Department of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Olivier Costerousse
- Population Health and Optimal Practices Research Unit (Trauma- Emergency-Critical Care Medicine), CHU de Québec-Universite Laval Research Center, Québec City, Québec, Canada
| | - Maude St-Onge
- Population Health and Optimal Practices Research Unit (Trauma- Emergency-Critical Care Medicine), CHU de Québec-Universite Laval Research Center, Québec City, Québec, Canada
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Québec City, Québec, Canada
- Department of Family and Emergency Medicine, Université Laval, Québec City, Québec, Canada
| | - Paule Lessard Bonaventure
- Population Health and Optimal Practices Research Unit (Trauma- Emergency-Critical Care Medicine), CHU de Québec-Universite Laval Research Center, Québec City, Québec, Canada
- Department of Surgery, Division of Neurosurgery, Université Laval, Québec City, Québec, Canada
| | - Lynne Moore
- Population Health and Optimal Practices Research Unit (Trauma- Emergency-Critical Care Medicine), CHU de Québec-Universite Laval Research Center, Québec City, Québec, Canada
- Department of Social and Preventive Medicine, Université Laval, Québec City, Québec, Canada
| | - Xavier Neveu
- Population Health and Optimal Practices Research Unit (Trauma- Emergency-Critical Care Medicine), CHU de Québec-Universite Laval Research Center, Québec City, Québec, Canada
| | - Andrea Rigamonti
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesiology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Kosar Khwaja
- Department of Critical Care Medicine, McGill University, Montréal, Québec, Canada
| | - Robert S Green
- Departments of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Critical Care, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Vincent Laroche
- Population Health and Optimal Practices Research Unit (Trauma- Emergency-Critical Care Medicine), CHU de Québec-Universite Laval Research Center, Québec City, Québec, Canada
- Department of Medicine, Université Laval, Québec City, Québec, Canada
| | - Alison Fox-Robichaud
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Francois Lauzier
- Population Health and Optimal Practices Research Unit (Trauma- Emergency-Critical Care Medicine), CHU de Québec-Universite Laval Research Center, Québec City, Québec, Canada
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Québec City, Québec, Canada
- Department of Medicine, Université Laval, Québec City, Québec, Canada
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Sohani ZN, Butler-Laporte G, Aw A, Belga S, Benedetti A, Carignan A, Cheng MP, Coburn B, Costiniuk CT, Ezer N, Gregson D, Johnson A, Khwaja K, Lawandi A, Leung V, Lother S, MacFadden D, McGuinty M, Parkes L, Qureshi S, Roy V, Rush B, Schwartz I, So M, Somayaji R, Tan D, Trinh E, Lee TC, McDonald EG. Low-dose trimethoprim-sulfamethoxazole for the treatment of Pneumocystis jirovecii pneumonia (LOW-TMP): protocol for a phase III randomised, placebo-controlled, dose-comparison trial. BMJ Open 2022; 12:e053039. [PMID: 35863836 PMCID: PMC9310160 DOI: 10.1136/bmjopen-2021-053039] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection of immunocompromised hosts with significant morbidity and mortality. The current standard of care, trimethoprim-sulfamethoxazole (TMP-SMX) at a dose of 15-20 mg/kg/day, is associated with serious adverse drug events (ADE) in 20%-60% of patients. ADEs include hypersensitivity reactions, drug-induced liver injury, cytopenias and renal failure, all of which can be treatment limiting. In a recent meta-analysis of observational studies, reduced dose TMP-SMX for the treatment of PJP was associated with fewer ADEs, without increased mortality. METHODS AND ANALYSIS A phase III randomised, placebo-controlled, trial to directly compare the efficacy and safety of low-dose TMP-SMX (10 mg/kg/day of TMP) with the standard of care (15 mg/kg/day of TMP) among patients with PJP, for a composite primary outcome of change of treatment, new mechanical ventilation, or death. The trial will be undertaken at 16 Canadian hospitals. Data will be analysed as intention to treat. Primary and secondary outcomes will be compared using logistic regression adjusting for stratification and presented with 95% CI. ETHICS AND DISSEMINATION This study has been conditionally approved by the McGill University Health Centre; Ethics approval will be obtained from all participating centres. Results will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT04851015.
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Affiliation(s)
- Zahra N Sohani
- Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Guillaume Butler-Laporte
- Department of Epidemiology, Occupational Health, and Biostatistics, McGill University, Montreal, Quebec, Canada
- Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Andrew Aw
- Division of Hematology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Sara Belga
- Division of Infectious Diseases, Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrea Benedetti
- Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Occupational Health, and Biostatistics, McGill University, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Alex Carignan
- Division of Microbiology and Infectious Diseases, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Matthew P Cheng
- Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Bryan Coburn
- Division of Infectious Diseases, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Cecilia T Costiniuk
- Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Chronic Viral Illness Service, McGill University, Montreal, Quebec, Canada
| | - Nicole Ezer
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Division of Respirology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Dan Gregson
- Departments of Pathology and Laboratory Medicine and Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Andrew Johnson
- Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kosar Khwaja
- Department of Epidemiology, Occupational Health, and Biostatistics, McGill University, Montreal, Quebec, Canada
- Department of Critical Care Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Alexander Lawandi
- Critical Care Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - Victor Leung
- Department of Laboratory Medicine & Pathology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sylvain Lother
- Department of Critical Care Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Derek MacFadden
- Division of Infectious Diseases, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Michaeline McGuinty
- Division of Infectious Diseases, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Leighanne Parkes
- Division of Medical Microbiology and Infectious Diseases, Lady Davis Institute for Medical Research, Montreal, Quebec, Canada
| | - Salman Qureshi
- Department of Epidemiology, Occupational Health, and Biostatistics, McGill University, Montreal, Quebec, Canada
- Division of Respirology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Critical Care Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Valerie Roy
- Division of Microbiology and Infectious Diseases, Centre Hospitalier Universitaire de Sherbrooke Hôtel-Dieu, Sherbrooke, Quebec, Canada
| | - Barret Rush
- Department of Critical Care Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ilan Schwartz
- Division of Infectious Diseases, University of Alberta, Edmonton, Alberta, Canada
| | - Miranda So
- Sinai Health System-University Health Network Antimicrobial Stewardship Program, University Health Network, Toronto, Ontario, Canada
| | - Ranjani Somayaji
- Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Darrell Tan
- Division of Infectious Diseases, St Michael's Hospital, Toronto, Ontario, Canada
| | - Emilie Trinh
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Division of Nephrology, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Todd C Lee
- Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Clinical Practice Assessment Unit, Montreal, Quebec, Canada
| | - Emily G McDonald
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Clinical Practice Assessment Unit, Montreal, Quebec, Canada
- Division of General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada
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13
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Lau VI, Fowler R, Pinto R, Tremblay A, Borgia S, Carrier FM, Cheng MP, Conly J, Costiniuk CT, Daley P, Duan E, Durand M, Fontela PS, Farjou G, Fralick M, Geagea A, Grant J, Keynan Y, Khwaja K, Lee N, Lee TC, Lim R, O'Neil CR, Papenburg J, Semret M, Silverman M, Sligl W, Somayaji R, Tan DHS, Tsang JLY, Weatherald J, Yansouni CP, Zarychanski R, Murthy S. Cost-effectiveness of remdesivir plus usual care versus usual care alone for hospitalized patients with COVID-19: an economic evaluation as part of the Canadian Treatments for COVID-19 (CATCO) randomized clinical trial. CMAJ Open 2022; 10:E807-E817. [PMID: 36199248 PMCID: PMC9477473 DOI: 10.9778/cmajo.20220077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The role of remdesivir in the treatment of hospitalized patients with COVID-19 remains ill-defined. We conducted a cost-effectiveness analysis alongside the Canadian Treatments for COVID-19 (CATCO) open-label, randomized clinical trial evaluating remdesivir. METHODS Patients with COVID-19 in Canadian hospitals from Aug. 14, 2020, to Apr. 1, 2021, were randomly assigned to receive remdesivir plus usual care versus usual care alone. Taking a public health care payer's perspective, we collected in-hospital outcomes and health care resource utilization alongside estimated unit costs in 2020 Canadian dollars over a time horizon from randomization to hospital discharge or death. Data from 1281 adults admitted to 52 hospitals in 6 Canadian provinces were analyzed. RESULTS The total mean cost per patient was $37 918 (standard deviation [SD] $42 413; 95% confidence interval [CI] $34 617 to $41 220) for patients randomly assigned to the remdesivir group and $38 026 (SD $46 021; 95% CI $34 480 to $41 573) for patients receiving usual care (incremental cost -$108 [95% CI -$4953 to $4737], p > 0.9). The difference in proportions of in-hospital deaths between remdesivir and usual care groups was -3.9% (18.7% v. 22.6%, 95% CI -8.3% to 1.0%, p = 0.09). The difference in proportions of incident invasive mechanical ventilation events between groups was -7.0% (8.0% v. 15.0%, 95% CI -10.6% to -3.4%, p = 0.006), whereas the difference in proportions of total mechanical ventilation events between groups was -5.7% (16.4% v. 22.1%, 95% CI -10.0% to -1.4%, p = 0.01). Remdesivir was the dominant intervention (but only marginally less costly, with mildly lower mortality) with an incalculable incremental cost effectiveness ratio; we report results of incremental costs and incremental effects separately. For willingness-to-pay thresholds of $0, $20 000, $50 000 and $100 000 per death averted, a strategy using remdesivir was cost-effective in 60%, 67%, 74% and 79% of simulations, respectively. The remdesivir costs were the fifth highest cost driver, offset by shorter lengths of stay and less mechanical ventilation. INTERPRETATION From a health care payer perspective, treating patients hospitalized with COVID-19 with remdesivir and usual care appears to be preferrable to treating with usual care alone, albeit with marginal incremental cost and small clinical effects. The added cost of remdesivir was offset by shorter lengths of stay in the intensive care unit and less need for ventilation. STUDY REGISTRATION ClinicalTrials. gov, no. NCT04330690.
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Affiliation(s)
- Vincent I Lau
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Robert Fowler
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Ruxandra Pinto
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Alain Tremblay
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Sergio Borgia
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - François M Carrier
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Matthew P Cheng
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - John Conly
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Cecilia T Costiniuk
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Peter Daley
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Erick Duan
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Madeleine Durand
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Patricia S Fontela
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - George Farjou
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Mike Fralick
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Anna Geagea
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Jennifer Grant
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Yoav Keynan
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Kosar Khwaja
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Nelson Lee
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Todd C Lee
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Rachel Lim
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Conar R O'Neil
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Jesse Papenburg
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Makeda Semret
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Michael Silverman
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Wendy Sligl
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Ranjani Somayaji
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Darrell H S Tan
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Jennifer L Y Tsang
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Jason Weatherald
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Cedric Philippe Yansouni
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Ryan Zarychanski
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Srinivas Murthy
- Department of Critical Care Medicine (Lau, Sligl), Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Alta.; Interdepartmental Division of Critical Care Medicine (Fowler), University of Toronto; Department of Critical Care Medicine (Pinto), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Respiratory Medicine (Tremblay, Lim, Weatherald), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Division of Infectious Diseases (Borgia), William Osler Health System, Brampton, Ont.; Division of Infectious Diseases (Borgia), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Critical Care Medicine (Carrier), Departments of Anesthesiology and Medicine, Centre hospitalier de l'Université de Montréal; Infectious Diseases and Medical Microbiology (Cheng), Department of Medicine, McGill University Health Centre, Montréal, Que.; Section of Infectious Diseases (Conly, Somayaji), Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alta.; Division of Infectious Diseases and Chronic Viral Illness Service (Costiniuk), Department of Medicine, McGill University Health Centre, Montréal, Que.; Department of Medicine and Laboratory Medicine (Daley), Memorial University, St. John's, NL; Division of Critical Care (Duan, Tsang), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Medicine (Duan, Tsang), Niagara Health, St. Catharines, Ont.; Department of Critical Care (Duan), St. Joseph's Healthcare, Hamilton, Ont.; Internal Medicine Service (Durand), Centre hospitalier de l'Université de Montréal; Division of Pediatric Critical Care (Fontela), Department of Pediatrics, McGill University, Montréal, Que.; Division of Infectious Disease (Farjou), Department of Medicine, Niagara Health, St. Catharines, Ont.; Department of Medicine (Fralick, Semret), Sinai Health, University of Toronto; Division of Critical Care Medicine (Geagea), Department of Medicine, North York General Hospital, Toronto, Ont.; Division of Medical Microbiology and Infectious Diseases (Grant), Department of Medicine, University of British Columbia, Vancouver, BC; Section of Infectious Diseases (Keynan), Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Departments of Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Dalla Lana School of Public Health (N. Lee), University of Toronto, Toronto, Ont.; Clinical Practice Assessment Unit (T. Lee), Department of Medicine, McGill University, Montréal, Que.; Division of Infectious Diseases (O'Neil), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Pediatric Infectious Diseases (Papenburg), Department of Pediatrics, Montreal Children's Hospital; Division of Microbiology (Papenburg), Department of Clinical Laboratory Medicine, McGill University Health Centre, Montréal, Que.; Division of Infectious Diseases (Silverman), Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; J.D. MacLean Centre for Tropical Diseases (Yansouni), Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, McGill University, Montréal, Que.; Department of Internal Medicine (Zarychanski), Sections of Hematology and Medical Oncology, and Critical Care, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Division of Infectious Diseases (Murthy), Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC
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Bradley NL, Leeper WR, Roberts D, Ball CG, Beckett A, Engels P, Joos E, Khwaja K, Kirkpatrick A, Lampron J, Minor S, Parry N, Rezende JN, Widder S, Ahmed N, Gillman L, Gomez D, Hameed M, Kim M, Murphy P, Nenshi R, Rice T, Vogt K. Resuscitative endovascular balloon occlusion of the aorta in Canada: a context-specific position paper from the Canadian Collaborative for Urgent Care Surgery (CANUCS). Can J Surg 2022; 65:E310-E316. [PMID: 35545282 PMCID: PMC9259435 DOI: 10.1503/cjs.015319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2021] [Indexed: 11/10/2022] Open
Abstract
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a well-described intervention for noncompressible torso hemorrhage. Several Canadian centres have included REBOA in their hemorrhagic shock protocols. However, REBOA has known complications and equipoise regarding its use persists. The Canadian Collaborative on Urgent Care Surgery (CANUCS) comprises surgeons who provide acute trauma care and leadership in Canada, with experience in REBOA implementation, use, education and research. Our goal is to provide evidence- and experience-based recommendations regarding institutional implementation of a REBOA program, including multidisciplinary educational programs, attention to device and care pathway logistics, and a robust quality assurance program. This will allow Canadian trauma centres to maximize patient benefits and minimize risks of this potentially life-saving technology.
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Affiliation(s)
- Nori L Bradley
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - W Robert Leeper
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Derek Roberts
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Chad G Ball
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Andrew Beckett
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Paul Engels
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Emilie Joos
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Kosar Khwaja
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Andrew Kirkpatrick
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Jacinthe Lampron
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Sam Minor
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Neil Parry
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Joao Neto Rezende
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Sandy Widder
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Najma Ahmed
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Lawrence Gillman
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - David Gomez
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Morad Hameed
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Michael Kim
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Patrick Murphy
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Rahima Nenshi
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Timothy Rice
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
| | - Kelly Vogt
- From the Department of Surgery, University of Alberta, Edmonton, Alta. (Bradley, Widder, Kim); the Department of Surgery, Western University, London, Ont. (Leeper, Parry, Vogt); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Roberts, Lampron); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Kirkpatrick); the Department of Surgery, University of Toronto, Toronto, Ont. (Beckett, Neto Rezende, Ahmed, Gomez); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels, Nenshi, Rice); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed), the Departments of Surgery and of Critical Care Medicine, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)
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Smith S, Allen L, Khwaja K, Joos E, Ball CG, Engels PT, Naji F, Lampron J, Widder S, Minor S, Jessula S, Parry NG, Vogt KN. Management of vascular trauma across Canada: A cohort study with implications for practice. Injury 2022; 53:1662-1666. [PMID: 35012752 DOI: 10.1016/j.injury.2021.12.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/30/2021] [Accepted: 12/29/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The aim of this study was to provide a description of vascular trauma and its management at trauma centers across Canada. METHODS This retrospective cohort study evaluated patients from 8 Canadian level 1 trauma centers (2011-2015). Medical records were queried to identify adult patients who survived to hospital with major vascular injury. Major vascular injury was defined as injury to named arterial or venous vessels in the legs, arms torso, and neck. Data collected included patient demographics, injury mechanism, injury details, management and clinical outcomes. RESULTS A total of 1330 patients were included. Patients were 76% male with a mean age of 43 (SD 18.8). Reported injuries were 63% blunt, 36% penetrating, and the remainder mixed. The most common specific mechanisms of injury were motor vehicle collision (36%), stabbing (26%), and falls (16%), with gunshot injuries accounting for <5%. Pre-hospital tourniquets were applied in 27 patients (2%). The mean Injury Severity Score (ISS) was 24 (SD 14.5). We identified injuries to named vessels of the neck (32%), thorax (23%), abdomen and pelvis (27%), upper extremity (14%) and lower extremity (10%). Specific vascular injuries included transection (50%), complete occlusion (11%), partial occlusion (39%), and pseudoaneurysm formation (11%). Injuries were managed non-operatively in 32%, with definitive open surgical management (24%), endovascular management (9%) and with damage control techniques in the operating room (3%). Amputation occurred in 10% of lower extremity and 5% of upper extremity injuries. Responsibility for vascular injury management was undertaken by a wide variety of specialists (n = 17). Overall, in-hospital mortality was 13%, and 2% of patients underwent amputation. CONCLUSION This study describes the nature and management of vascular injuries across Canada. The variability in injury mechanisms, management strategies, specialty responsible for management, and outcomes have important implications for practice change and knowledge translation.
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Affiliation(s)
- Shane Smith
- London Health Sciences Centre, London, Ontario, Canada.
| | - Laura Allen
- London Health Sciences Centre, London, Ontario, Canada.
| | - Kosar Khwaja
- McGill University Health Centre, Montreal, Quebec, Canada.
| | - Emilie Joos
- Vancouver Costal Health, Vancouver, British Columbia, Canada.
| | - Chad G Ball
- Foothills Medical Centre, Calgary, Alberta, Canada
| | - Paul T Engels
- Hamilton Health Sciences Centre, Hamilton, Ontario, Canada.
| | - Faysal Naji
- Hamilton Health Sciences Centre, Hamilton, Ontario, Canada.
| | | | - Sandy Widder
- Alberta Health Services, Edmonton, Alberta, Canada.
| | - Sam Minor
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.
| | - Samuel Jessula
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Neil G Parry
- London Health Sciences Centre, London, Ontario, Canada.
| | - Kelly N Vogt
- London Health Sciences Centre, London, Ontario, Canada.
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Zakhari A, Kanimba V, Wong E, Rulisa S, Ntakiyiruta G, Ruhungande L, Rousseau M, Kushner A, Groen R, Dakermandji M, Wilson M, Liberman AS, Khwaja K, Razek T, Kyamanywa P, Deckelbaum D. Obstetrics and Gynaecology in Rwanda: A Retrospective Review of Surgical Output and Geographical Variation. Journal of Obstetrics and Gynaecology Canada 2022. [DOI: 10.1016/j.jogc.2022.02.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ali K, Azher T, Baqi M, Binnie A, Borgia S, Carrier FM, Cavayas YA, Chagnon N, Cheng MP, Conly J, Costiniuk C, Daley P, Daneman N, Douglas J, Downey C, Duan E, Duceppe E, Durand M, English S, Farjou G, Fera E, Fontela P, Fowler R, Fralick M, Geagea A, Grant J, Harrison LB, Havey T, Hoang H, Kelly LE, Keynan Y, Khwaja K, Klein G, Klein M, Kolan C, Kronfli N, Lamontagne F, Lau R, Fralick M, Lee TC, Lee N, Lim R, Longo S, Lostun A, MacIntyre E, Malhamé I, Mangof K, McGuinty M, Mergler S, Munan MP, Murthy S, O'Neil C, Ovakim D, Papenburg J, Parhar K, Parvathy SN, Patel C, Perez-Patrigeon S, Pinto R, Rajakumaran S, Rishu A, Roba-Oshin M, Rushton M, Saleem M, Salvadori M, Scherr K, Schwartz K, Semret M, Silverman M, Singh A, Sligl W, Smith S, Somayaji R, Tan DHS, Tobin S, Todd M, Tran TV, Tremblay A, Tsang J, Turgeon A, Vakil E, Weatherald J, Yansouni C, Zarychanski R. Remdesivir for the treatment of patients in hospital with COVID-19 in Canada: a randomized controlled trial. CMAJ 2022; 194:E242-E251. [PMID: 35045989 PMCID: PMC8863204 DOI: 10.1503/cmaj.211698] [Citation(s) in RCA: 80] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2021] [Indexed: 12/15/2022] Open
Abstract
Background: The role of remdesivir in the treatment of patients in hospital with COVID-19 remains ill defined in a global context. The World Health Organization Solidarity randomized controlled trial (RCT) evaluated remdesivir in patients across many countries, with Canada enrolling patients using an expanded data collection format in the Canadian Treatments for COVID-19 (CATCO) trial. We report on the Canadian findings, with additional demographics, characteristics and clinical outcomes, to explore the potential for differential effects across different health care systems. Methods: We performed an open-label, pragmatic RCT in Canadian hospitals, in conjunction with the Solidarity trial. We randomized patients to 10 days of remdesivir (200 mg intravenously [IV] on day 0, followed by 100 mg IV daily), plus standard care, or standard care alone. The primary outcome was in-hospital mortality. Secondary outcomes included changes in clinical severity, oxygen- and ventilator-free days (at 28 d), incidence of new oxygen or mechanical ventilation use, duration of hospital stay, and adverse event rates. We performed a priori subgroup analyses according to duration of symptoms before enrolment, age, sex and severity of symptoms on presentation. Results: Across 52 Canadian hospitals, we randomized 1282 patients between Aug. 14, 2020, and Apr. 1, 2021, to remdesivir (n = 634) or standard of care (n = 648). Of these, 15 withdrew consent or were still in hospital, for a total sample of 1267 patients. Among patients assigned to receive remdesivir, in-hospital mortality was 18.7%, compared with 22.6% in the standard-of-care arm (relative risk [RR] 0.83 (95% confidence interval [CI] 0.67 to 1.03), and 60-day mortality was 24.8% and 28.2%, respectively (95% CI 0.72 to 1.07). For patients not mechanically ventilated at baseline, the need for mechanical ventilation was 8.0% in those assigned remdesivir, and 15.0% in those receiving standard of care (RR 0.53, 95% CI 0.38 to 0.75). Mean oxygen-free and ventilator-free days at day 28 were 15.9 (± standard deviation [SD] 10.5) and 21.4 (± SD 11.3) in those receiving remdesivir and 14.2 (± SD 11) and 19.5 (± SD 12.3) in those receiving standard of care (p = 0.006 and 0.007, respectively). There was no difference in safety events of new dialysis, change in creatinine, or new hepatic dysfunction between the 2 groups. Interpretation: Remdesivir, when compared with standard of care, has a modest but significant effect on outcomes important to patients and health systems, such as the need for mechanical ventilation. Trial registration: ClinicalTrials.gov, no. NCT04330690.
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Affiliation(s)
- Karim Ali
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Tanweer Azher
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Mahin Baqi
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Alexandra Binnie
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Sergio Borgia
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - François M Carrier
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Yiorgos Alexandroa Cavayas
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Nicolas Chagnon
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Matthew P Cheng
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - John Conly
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Cecilia Costiniuk
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Peter Daley
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Nick Daneman
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Josh Douglas
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Catarina Downey
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Erick Duan
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Emmanuelle Duceppe
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Madeleine Durand
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Shane English
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - George Farjou
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Evradiki Fera
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Patricia Fontela
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Rob Fowler
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Michael Fralick
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Anna Geagea
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Jennifer Grant
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Luke B Harrison
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Thomas Havey
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Holly Hoang
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Lauren E Kelly
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Yoav Keynan
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Kosar Khwaja
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Gail Klein
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Marina Klein
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Christophe Kolan
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Nadine Kronfli
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Francois Lamontagne
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Rob Lau
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Michael Fralick
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Todd C Lee
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Nelson Lee
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Rachel Lim
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Sarah Longo
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Alexandra Lostun
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Erika MacIntyre
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Isabelle Malhamé
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Kathryn Mangof
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Marlee McGuinty
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Sonya Mergler
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Matthew P Munan
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Srinivas Murthy
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Conar O'Neil
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Daniel Ovakim
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Jesse Papenburg
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Ken Parhar
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Seema Nair Parvathy
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Chandni Patel
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Santiago Perez-Patrigeon
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Ruxandra Pinto
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Subitha Rajakumaran
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Asgar Rishu
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Malaika Roba-Oshin
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Moira Rushton
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Mariam Saleem
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Marina Salvadori
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Kim Scherr
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Kevin Schwartz
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Makeda Semret
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Michael Silverman
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Ameeta Singh
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Wendy Sligl
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Stephanie Smith
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Ranjani Somayaji
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Darrell H S Tan
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Siobhan Tobin
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Meaghan Todd
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Tuong-Vi Tran
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Alain Tremblay
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Jennifer Tsang
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Alexis Turgeon
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Erik Vakil
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Jason Weatherald
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Cedric Yansouni
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
| | - Ryan Zarychanski
- Niagara Health (Ali, Tsang), St. Catharines, Ont.; Biomedical Sciences (Azher), Memorial University of Newfoundland, St. John's, Nfld.; William Osler Health System (Baqi, Binnie, Borgia, Havey), Brampton, Ont.; Hôpital du Sacré-Coeur de Montréal (Cavayas), Montréal, Que.; Emergency Department (Chagnon), Montfort Hospital, Ottawa, Ont.; Departments of Pediatrics (Fontela, Papenburg), Surgery and Critical Care Medicine (Khwaja), McGill University, Montréal, Que.; Divisions of Infectious Diseases (Cheng, Costiniuk, Harrison, M. Klein, Kronfli, T. Lee, Semret, Yansouni), Chronic Viral Illness Service (Costiniuk, M. Klein), Medical Microbiology (Cheng, Yansouni), Internal Medicine (Malhamé, T. Lee), and Infectious Diseases and Immunity in Global Health Program (M. Klein, Kronfli, T. Lee, Papenburg) McGill University Health Centre, Montréal, Que.; Division of Respirology (Lim, Weatherald), Cumming School of Medicine (Conly, Somayaji), and Departments of Critical Care Medicine (Parhar), Repiratory Medicine (Tremblay) and Interventional Pulmonary Medicine (Vakil), University of Calgary, Calgary, Alta.; Health Sciences Centre (Tremblay), University of Calgary, Calgary, Alta.; Discipline of Laboratory Medicine (Daley), Memorial University of Newfoundland, St. John's, Nfld.; Lion's Gate Hospital (Douglas), Vancouver, BC; CCTS at Sunnybrook Research Institute - Centre for Clinical Trial Support (Downey, G. Klein, Lau, Longo, Mangoff, Mergler, Patel, Rajakumaran, Roba-Oshin, Saleem, Tobin, Todd), Toronto, Ont.; Departments of Medicine and Critical Care Medicine (Fowler) and Division of Infectious Diseases (Daneman), Sunnybrook Hospital, Toronto, Ont.; Department of Critical Care Medicine (Pinto, Rishu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Division of Critical Care (Duan), Department of Medicine (Tsang), McMaster University, Hamilton, Ont.; Departments of Anesthesiology (Carrier), Medicine (Duceppe, Kolan), Intensive Care Medicine (Carrier) and Internal Medicine (Duceppe, Kolan) and Internal Medicine Service (Durand), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Que.; Departments of Medicine (English) and Infectious Diseases (McGuinty), The Ottawa Hospital, Ottawa, Ont.; Department of Medicine (English), Ottawa Hospital Research Institute, Ottawa, Ont.; Niagara Health (Farjou, Tsang), St. Catharines, Ont.; Markham Stouffville Hospital (Fera), Markham, Ont.; Division of General Internal Medicine (Fralick), Department of Medicine, Sinai Health System; Department of Medicine and Critical Care Medicine (Geagea, Lostun), North York General Hospital, Toronto, Ont.; Departments of Pediatrics (Murthy) and Pathology and Laboratory Medicine (Grant), Faculty of Medicine, University of British Columbia, Vancouver, BC; Island Health Authority (Ovakim), University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Hoang), Department of Medicine, Grey Nuns Community Hospital, Edmonton, Alta.; Department of Pharmacology and Therapeutics (Kelly), George and Fay Yee Centre for Healthcare Innovation, University of Manitoba; Departments of Infectious Disease and Medical Microbiology (Keynan) and Internal Medicine (Zarychanski), University of Manitoba, Winnipeg, Man.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (Lamontagne), Sherbrooke, Que.; Departments of Critical Care (MacIntyre, Sligl) and Medicine (Singh, Smith), Division of Infectious Diseases (O'Neil), University of Alberta, Edmonton, Alta.; Department of Critical Care Medicine (Munan), Misericordia Community Hospital, Edmonton, Alta.; Misericordia Hospital - Covenant Health (Scherr), Edmonton, Alta.; St. Joseph's Health Care (Parvathy), London, Ont.; Department of Medicine (Perez-Patrigeon), Queen's University, Kingston, Ont.; Queensway Carleton Hospital (Rushton), Nepean, Ont.; Public Health Agency of Canada (Salvadori), Ottawa, Ont.; Unity Health Toronto (Schwartz), Toronto, Ont.; Dalla Lana School of Public Health (N. Lee, Schwartz), University of Toronto, Toronto, Ont.; Department of Medicine (Silverman), Western University, London, Ont.; Division of Infectious Diseases (Tan), St. Michael's Hospital, Toronto, Ont.; Department of Anesthesiology and Critical Care Medicine (Turgeon, Tran), CHU de Québec-Université Laval, Québec, Que
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18
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Johnstone J, Meade M, Lauzier F, Marshall J, Duan E, Dionne J, Arabi YM, Heels-Ansdell D, Thabane L, Lamarche D, Surette M, Zytaruk N, Mehta S, Dodek P, McIntyre L, English S, Rochwerg B, Karachi T, Henderson W, Wood G, Ovakim D, Herridge M, Granton J, Wilcox ME, Goffi A, Stelfox HT, Niven D, Muscedere J, Lamontagne F, D’Aragon F, St.-Arnaud C, Ball I, Nagpal D, Girard M, Aslanian P, Charbonney E, Williamson D, Sligl W, Friedrich J, Adhikari NK, Marquis F, Archambault P, Khwaja K, Kristof A, Kutsogiannis J, Zarychanski R, Paunovic B, Reeve B, Lellouche F, Hosek P, Tsang J, Binnie A, Trop S, Loubani O, Hall R, Cirone R, Reynolds S, Lysecki P, Golan E, Cartin-Ceba R, Taylor R, Cook D. Effect of Probiotics on Incident Ventilator-Associated Pneumonia in Critically Ill Patients: A Randomized Clinical Trial. JAMA 2021; 326:1024-1033. [PMID: 34546300 PMCID: PMC8456390 DOI: 10.1001/jama.2021.13355] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
IMPORTANCE Growing interest in microbial dysbiosis during critical illness has raised questions about the therapeutic potential of microbiome modification with probiotics. Prior randomized trials in this population suggest that probiotics reduce infection, particularly ventilator-associated pneumonia (VAP), although probiotic-associated infections have also been reported. OBJECTIVE To evaluate the effect of Lactobacillus rhamnosus GG on preventing VAP, additional infections, and other clinically important outcomes in the intensive care unit (ICU). DESIGN, SETTING, AND PARTICIPANTS Randomized placebo-controlled trial in 44 ICUs in Canada, the United States, and Saudi Arabia enrolling adults predicted to require mechanical ventilation for at least 72 hours. A total of 2653 patients were enrolled from October 2013 to March 2019 (final follow-up, October 2020). INTERVENTIONS Enteral L rhamnosus GG (1 × 1010 colony-forming units) (n = 1321) or placebo (n = 1332) twice daily in the ICU. MAIN OUTCOMES AND MEASURES The primary outcome was VAP determined by duplicate blinded central adjudication. Secondary outcomes were other ICU-acquired infections including Clostridioides difficile infection, diarrhea, antimicrobial use, ICU and hospital length of stay, and mortality. RESULTS Among 2653 randomized patients (mean age, 59.8 years [SD], 16.5 years), 2650 (99.9%) completed the trial (mean age, 59.8 years [SD], 16.5 years; 1063 women [40.1%.] with a mean Acute Physiology and Chronic Health Evaluation II score of 22.0 (SD, 7.8) and received the study product for a median of 9 days (IQR, 5-15 days). VAP developed among 289 of 1318 patients (21.9%) receiving probiotics vs 284 of 1332 controls (21.3%; hazard ratio [HR], 1.03 (95% CI, 0.87-1.22; P = .73, absolute difference, 0.6%, 95% CI, -2.5% to 3.7%). None of the 20 prespecified secondary outcomes, including other ICU-acquired infections, diarrhea, antimicrobial use, mortality, or length of stay showed a significant difference. Fifteen patients (1.1%) receiving probiotics vs 1 (0.1%) in the control group experienced the adverse event of L rhamnosus in a sterile site or the sole or predominant organism in a nonsterile site (odds ratio, 14.02; 95% CI, 1.79-109.58; P < .001). CONCLUSIONS AND RELEVANCE Among critically ill patients requiring mechanical ventilation, administration of the probiotic L rhamnosus GG compared with placebo, resulted in no significant difference in the development of ventilator-associated pneumonia. These findings do not support the use of L rhamnosus GG in critically ill patients. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02462590.
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Affiliation(s)
| | | | | | | | | | | | - Yaseen M. Arabi
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | - Peter Dodek
- University of British Columbia, Vancouver, Canada
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ian Ball
- Western University, London, Canada
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19
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Turkdogan S, Kay-Rivest E, Giroux M, Piché C, Khwaja K, Mascarella M, Khalife S, Alohali S, Kost K. Percutaneous Tracheostomy With a Demistifier Canopy in the COVID-19 Era: A Safe Technique in the Intensive Care Unit. Ear Nose Throat J 2021; 102:312-318. [PMID: 33734882 DOI: 10.1177/01455613211001595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Endoscopic percutaneous tracheostomy (PT) is a safe technique that is performed frequently by otolaryngologists and intensivists. New challenges have been identified in order to maintain the safety of this procedure during the COVID-19 pandemic. A novel approach, using a modified demistifier canopy, was developed during the first wave of the pandemic and implemented for 17 consecutive percutaneous tracheostomies in order to enhance procedural safety. METHODS A protocol was developed after performing a literature review of tracheostomy in COVID-19 patients. A multidisciplinary tracheostomy team was established, including the departments of otolaryngology, critical care, and respiratory therapy. Simulation was performed prior to each PT, and postoperative debriefings were done. RESULTS A protocol and technical description of PT using a modified demistifier canopy covering was written and video documented. Data were collected on 17 patients who underwent this procedure safely in our tertiary care hospital. There were no procedure-related complications, and no evidence of COVID-19 transmission to any member of the health care team during the study period. CONCLUSION As patients continue to recover from COVID-19, their need for tracheostomy will increase. The technique described provides a safe, multidisciplinary method of performing PT in COVID-19 patients.
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Affiliation(s)
- Sena Turkdogan
- Department of Otolaryngology-Head and Neck surgery, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Emily Kay-Rivest
- Department of Otolaryngology-Head and Neck surgery, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Melanie Giroux
- Department of Respiratory Therapy, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Chantal Piché
- Department of Respiratory Therapy, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Kosar Khwaja
- Department of Critical Care Medicine, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Marco Mascarella
- Department of Otolaryngology-Head and Neck surgery, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Sarah Khalife
- Department of Otolaryngology-Head and Neck surgery, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Sama Alohali
- Department of Otolaryngology-Head and Neck surgery, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Karen Kost
- Department of Otolaryngology-Head and Neck surgery, Royal Victoria Hospital, Montreal, Quebec, Canada
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20
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Alnumay A, Caminsky N, Eustache JH, Valenti D, Beckett AN, Deckelbaum D, Fata P, Khwaja K, Razek T, McKendy KM, Wong EG, Grushka JR. Feasibility of intraoperative angioembolization for trauma patients using C-arm digital subtraction angiography. Eur J Trauma Emerg Surg 2021; 48:315-319. [PMID: 33398439 DOI: 10.1007/s00068-020-01530-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/12/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE Hemodynamically unstable trauma patients who would benefit from angioembolization (AE) typically also require emergent surgery for their injuries. The critical decision of transferring a patient to the operating room versus the interventional radiology (IR) suite can be bypassed with the advent of intra-operative AE (IOAE). Previously limited by the availability of costly rooms termed RAPTOR (resuscitation with angiography, percutaneous techniques and open repair) suites, it has been suggested that using C-arm digital subtraction angiography (DSA) is a comparable alternative. This case series aims to establish the feasibility and safety of IOAE. METHODS We conducted a retrospective analysis of all trauma patients at our level 1 trauma center who underwent IOAE with a concomitant surgical intervention from January 2011 to May 2019. Descriptive analyses were conducted. RESULTS A total of 49 patients (80% male, 44 ± 17 years, 92% blunt) underwent IOAE using the C-arm DSA during the study period. All but one patient underwent exploratory laparotomy, 56% of which underwent an additional surgical procedure (ex. exploratory thoracotomy, orthopedic). Either Gelfoam® (Pfizer, New York, USA) (90%), coils (2.0%), or a combination (8.2%) were used for embolization. Internal iliac embolization was performed in 88% of cases (59% bilateral). IOAE was successful in all but four cases (8.2%) and thirty-day mortality was 31%. CONCLUSION IOAE appears to be a feasible and safe management option in severe trauma patients with the advantage of concurrent operative intervention and ongoing active resuscitation with good success in hemorrhage control.
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Affiliation(s)
- Abdulaziz Alnumay
- Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, 1650 Cedar Ave Room L9-421, Montreal, QC, H3G 1A4, Canada
| | - Natasha Caminsky
- Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, 1650 Cedar Ave Room L9-421, Montreal, QC, H3G 1A4, Canada
| | - Jules Hugo Eustache
- Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, 1650 Cedar Ave Room L9-421, Montreal, QC, H3G 1A4, Canada
| | - David Valenti
- Division of Interventional Radiology, Department of Radiology, McGill University Health Centre, Montreal General Hospital Site, 1650 Cedar, Ave Room C5-118, Montreal, QC, H3G 1A4, Canada
| | - Andrew Neil Beckett
- Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, 1650 Cedar Ave Room L9-421, Montreal, QC, H3G 1A4, Canada
| | - Dan Deckelbaum
- Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, 1650 Cedar Ave Room L9-421, Montreal, QC, H3G 1A4, Canada
| | - Paola Fata
- Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, 1650 Cedar Ave Room L9-421, Montreal, QC, H3G 1A4, Canada
| | - Kosar Khwaja
- Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, 1650 Cedar Ave Room L9-421, Montreal, QC, H3G 1A4, Canada
| | - Tarek Razek
- Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, 1650 Cedar Ave Room L9-421, Montreal, QC, H3G 1A4, Canada
| | - Katherine Marlene McKendy
- Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, 1650 Cedar Ave Room L9-421, Montreal, QC, H3G 1A4, Canada
| | - Evan Gordon Wong
- Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, 1650 Cedar Ave Room L9-421, Montreal, QC, H3G 1A4, Canada
| | - Jeremy Richard Grushka
- Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, 1650 Cedar Ave Room L9-421, Montreal, QC, H3G 1A4, Canada.
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21
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Fleishman A, Khwaja K, Schold JD, Comer CD, Morrissey P, Whiting J, Vella J, Kayler LK, Katz D, Jones J, Kaplan B, Pavlakis M, Mandelbrot DA, Rodrigue JR. Pain expectancy, prevalence, severity, and patterns following donor nephrectomy: Findings from the KDOC Study. Am J Transplant 2020; 20:2522-2529. [PMID: 32185880 PMCID: PMC7483675 DOI: 10.1111/ajt.15861] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/14/2020] [Accepted: 03/03/2020] [Indexed: 01/25/2023]
Abstract
Postoperative pain is an outcome of importance to potential living kidney donors (LKDs). We prospectively characterized the prevalence, severity, and patterns of acute or chronic postoperative pain in 193 LKDs at six transplant programs. Three pain measurements were obtained from donors on postoperative Day (POD) 1, 3, 7, 14, 21, 28, 35, 41, 49, and 56. The median pain rating total was highest on POD1 and declined from each assessment to the next until reaching a median pain-free score of 0 on POD49. In generalized linear mixed-model analysis, the mean pain score decreased at each pain assessment compared to the POD3 assessment. Pre-donation history of mood disorder (adjusted ratio of means [95% confidence interval (CI)]: 1.40 [0.99, 1.98]), reporting "severe" on any POD1 pain descriptors (adjusted ratio of means [95% CI]: 1.47 [1.12, 1.93]) and open nephrectomy (adjusted ratio of means [95% CI]: 2.61 [1.03, 6.62]) were associated with higher pain scores across time. Of the 179 LKDs who completed the final pain assessment, 74 (41%) met criteria for chronic postsurgical pain (CPSP), that is, any donation-related pain on POD56. Study findings have potential implications for LKD education, surgical consent, postdonation care, and outcome measurements.
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Affiliation(s)
- A Fleishman
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | - K Khwaja
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | - JD Schold
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
| | - CD Comer
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA
| | - P Morrissey
- Transplant Center, Rhode Island Hospital, Providence, RI
| | - J Whiting
- Maine Transplant Center, Maine Medical Center, Portland, ME
| | - J Vella
- Maine Transplant Center, Maine Medical Center, Portland, ME
| | - LK Kayler
- Montefiore Einstein Center for Transplantation, Bronx, NY,Regional Center of Excellence for Transplantation & Kidney Care, Erie County Medical Center, University of Buffalo, Buffalo, NY
| | - D Katz
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - J Jones
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - B Kaplan
- Baylor Scott and White Health, Temple, TX
| | - M Pavlakis
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | - DA Mandelbrot
- Department of Medicine, University of Wisconsin, Madison, WI
| | - JR Rodrigue
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
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22
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Hopkins B, Eustache J, Ganescu O, Cipolla J, Kaneva P, Fried GM, Khwaja K, Vassiliou M, Fata P, Lee L, Feldman LS. S116: Impact of incisional negative pressure wound therapy on surgical site infection after complex incisional hernia repair: a retrospective matched cohort study. Surg Endosc 2020; 35:3949-3960. [PMID: 32761478 DOI: 10.1007/s00464-020-07857-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/28/2020] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Incisional negative pressure wound therapy (iNPWT) may reduce surgical site infections (SSI), which can have devastating consequences after incisional hernia repair. Few comparative studies investigate the effectiveness of this wound management strategy in this population. The objective of this study is to determine the effect of iNPWT on the incidence of SSI after complex incisional hernia repair. METHODS All adult patients undergoing open incisional hernia repair at a single center from 2016 to 2019 were reviewed. A commercial iNPWT dressing was used at the discretion of the surgeon. Patients were grouped by type of dressing; iNPWT and standard sterile dressings (SSD). Coarsened exact matching was used to create balanced cohorts for comparison using age, sex, American Society of Anesthesiologists classification, wound classification, and surgical urgency. The primary outcome was the composite incidence of superficial and deep SSI within 30 days. Secondary outcomes included non-infectious surgical site occurrences (SSO), overall complications, length of stay (LOS), emergency department visits, and readmission at 30 days. RESULTS 134 patients underwent complex hernia repair, with 114 patients included after matching (34 iNPWT, 51 SSD). Composite incidence of superficial and deep SSI was 19.3% (11.8% vs. 27.5%, p = 0.107), with significantly lower rates of deep SSI in patients receiving iNPWT (2.9% vs. 17.6%, p = 0.045). After accounting for residual differences between groups, iNPWT was associated with decreased incidence of composite SSI (RR 0.36, 95% CI [0.16, 0.87]). Median LOS was longer in patients with iNPWT (7 vs. 5 days, p = 0.001). There were no differences in SSO, overall complications, readmission, or emergency department visits. CONCLUSION In patients undergoing incisional hernia repair, the use of iNPWT was associated with a lower incidence of SSI at 30 days. Future studies should focus on cost effectiveness of iNPWT, its impact on long-term hernia recurrences, and the identification of patient selection criteria in this population.
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Affiliation(s)
- Brent Hopkins
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Ave., L9.309, Montreal, QC, H3G 1A4, Canada.,Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Jules Eustache
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Ave., L9.309, Montreal, QC, H3G 1A4, Canada.,Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Olivia Ganescu
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Josie Cipolla
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Pepa Kaneva
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Ave., L9.309, Montreal, QC, H3G 1A4, Canada
| | - Gerald M Fried
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Ave., L9.309, Montreal, QC, H3G 1A4, Canada.,Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Kosar Khwaja
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Ave., L9.309, Montreal, QC, H3G 1A4, Canada.,Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Melina Vassiliou
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Ave., L9.309, Montreal, QC, H3G 1A4, Canada.,Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Paola Fata
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Ave., L9.309, Montreal, QC, H3G 1A4, Canada.,Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Lawrence Lee
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Ave., L9.309, Montreal, QC, H3G 1A4, Canada. .,Department of Surgery, McGill University Health Centre, Montreal, QC, Canada.
| | - Liane S Feldman
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Ave., L9.309, Montreal, QC, H3G 1A4, Canada.,Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
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23
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Wang Y, Alnumay A, Paradis T, Beckett A, Fata P, Khwaja K, Razek T, Grushka J, Deckelbaum DL. Management of Open Abdomen After Trauma Laparotomy: A Comparative Analysis of Dynamic Fascial Traction and Negative Pressure Wound Therapy Systems. World J Surg 2020; 43:3044-3050. [PMID: 31506714 DOI: 10.1007/s00268-019-05166-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Management of the post-traumatic open abdomen (OA) using negative pressure wound therapy (NPWT) alone is associated with low rates of primary fascial closure. The abdominal reapproximation anchor (ABRA) system exerts dynamic medial fascial traction and may work synergistically with NPWT to facilitate primary fascial closure. METHODS Patients with an OA following trauma laparotomy between 2009 and 2018 were identified from a prospectively maintained institutional database. Patients treated with ABRA in conjunction with NPWT (ABRA) versus NPWT alone (NPWT) were compared in terms of primary fascial closure rate, number of surgeries to closure, tracheostomy duration, length of stay and incidence of entero-atmospheric fistula. Multivariable linear regression was performed to identify predictors of tracheostomy duration. RESULTS We identified 48 patients [ABRA, 12 and NPWT, 36]. The ABRA group was significantly younger (25 vs. 37 years, p = 0.027) and included a lower proportion of males (58% vs. 89%, p = 0.032). Groups were similar with respect to the incidence of hollow viscus injury, injury severity score and abdominal abbreviated injury score. Compared to the NPWT group, the ABRA group had a significantly higher rate of primary fascial closure (100% vs. 28%, p < 0.001), fewer surgeries to abdominal closure (2 vs. 2.5, p = 0.023) and shorter duration of tracheostomy (15.5 vs. 36 days, p = 0.008). There were no differences in length of stay or incidence of entero-atmospheric fistula. On multivariable linear regression, ABRA placement was an independent predictor of shorter tracheostomy duration, after adjusting for covariates (β = - 0.294, p = 0.036). CONCLUSION For the post-traumatic OA, ABRA coupled with NPWT achieves a higher rate of primary fascial closure compared to NPWT alone, while requiring fewer surgeries and a shorter duration of tracheostomy.
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Affiliation(s)
- Yifan Wang
- Division of Trauma Surgery, McGill University Health Centre, McGill University, 1650 Cedar Avenue, L9-411, Montreal, QC, H3G 1A4, Canada
| | - Abdulaziz Alnumay
- Division of Trauma Surgery, McGill University Health Centre, McGill University, 1650 Cedar Avenue, L9-411, Montreal, QC, H3G 1A4, Canada
| | - Tiffany Paradis
- Division of Trauma Surgery, McGill University Health Centre, McGill University, 1650 Cedar Avenue, L9-411, Montreal, QC, H3G 1A4, Canada
| | - Andrew Beckett
- Division of Trauma Surgery, McGill University Health Centre, McGill University, 1650 Cedar Avenue, L9-411, Montreal, QC, H3G 1A4, Canada
| | - Paola Fata
- Division of Trauma Surgery, McGill University Health Centre, McGill University, 1650 Cedar Avenue, L9-411, Montreal, QC, H3G 1A4, Canada
| | - Kosar Khwaja
- Division of Trauma Surgery, McGill University Health Centre, McGill University, 1650 Cedar Avenue, L9-411, Montreal, QC, H3G 1A4, Canada
| | - Tarek Razek
- Division of Trauma Surgery, McGill University Health Centre, McGill University, 1650 Cedar Avenue, L9-411, Montreal, QC, H3G 1A4, Canada.,Centre for Global Surgery, McGill University, Montreal, QC, Canada
| | - Jeremy Grushka
- Division of Trauma Surgery, McGill University Health Centre, McGill University, 1650 Cedar Avenue, L9-411, Montreal, QC, H3G 1A4, Canada
| | - Dan L Deckelbaum
- Division of Trauma Surgery, McGill University Health Centre, McGill University, 1650 Cedar Avenue, L9-411, Montreal, QC, H3G 1A4, Canada. .,Centre for Global Surgery, McGill University, Montreal, QC, Canada.
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Kawaguchi A, Bernier G, Lacroix J, El Salti S, Cheng MP, Lee TC, Khwaja K, Jouvet P. Comparison of two methods to clear the airways of critically ill children and adults with COVID-19 infection: a structured summary of a study protocol for a pilot randomized controlled trial. Trials 2020; 21:610. [PMID: 32620174 PMCID: PMC7332538 DOI: 10.1186/s13063-020-04533-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 11/29/2022] Open
Abstract
Objectives As there is no treatment for COVID-19 with a proven mortality benefit at this moment in the pandemic, supportive management including mechanical ventilation is the core management in an intensive care unit (ICU). It is a challenge to provide consistent care in this situation, highly demanding and leading to potential staff shortages in ICU. We need to reduce unnecessary exposure of healthcare workers to the virus. This study aims to examine the impact of care using a non-invasive oscillating device (NIOD) for chest physiotherapy in the care of mechanically ventilated patients with COVID-19. In particular, we aim to explore if a NIOD performed by non-specialized personnel is not inferior to the standard chest physiotherapy (CPT) undertaken by physiotherapists caring for patients with COVID-19. Trial design A pilot multicenter prospective crossover noninferiority randomized controlled trial. Participants All mechanically ventilated patients with COVID-19 admitted to one of the two ICUs, and CPT ordered by the responsible physician. The participants will be recruited from two intensive care units in Canadian Academic Hospitals (one pediatric and one adult ICU). Intervention and comparator We will implement NIOD and CPT alternatingly for 3 h apart over 3 h. We will apply a pragmatic design, so that other procedures including hypertonic saline nebulization, intermittent positive pressure ventilation, suctioning (e.g., oral or nasal), or changing the ventilator settings or modality (i.e., increasing positive end-expiratory pressure or changing the nasal mask to total face continuous positive airway pressure) can be provided at the direction of bedside intensivists in charge. Main outcomes The primary outcome measurement is the oxygenation level before and after the procedure (SpO2/FiO2 ratio). For cases with invasive ventilation (i.e., the use of an endotracheal tube to deliver positive pressure) and non-invasive ventilation, we will also document expiratory tidal volume, vital signs, and any related complications such as vomiting, hypoxemia, or unexpected extubation. We will collect the data before, 10 min after, and 30 min after the procedure. Randomization The order of the procedures (i.e., NIOD or CPT) will be randomly allocated using manual generated random numbers for each case. Randomization will be carried out by the independent research assistant in the study coordinating center by using opaque sealed envelopes, assigning an equal number of cases to each intervention arm. Stratification will be applied for age (> 18 years or ≤ 18 years of age) and the study sites. Blinding (masking) No blinding will be performed. Numbers to be randomized (sample size) We estimate the necessary sample size as 25 for each arm (total 50 cases), with a power of 0.90 and an alpha of 0.05, with a non-inferiority design. Trial status The protocol version number 1 was approved on 27 March 2020. Currently, recruitment has not yet started, with the start scheduled by the mid-June 2020 and the end anticipated by December 2020. Trial registration ClinicalTrials.gov NCT04361435. Registered on 28 April 2020 Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional File 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this letter serves as a summary of the key elements of the full protocol.
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Affiliation(s)
- Atsushi Kawaguchi
- Department of Pediatrics, University of Montreal, CHU Sainte-Justine, 3175 Chemin de Côte Sainte Catherine, Quebec, QB, H3T 1C5, Canada.,Department of Pediatrics, Children's Hospital Eastern Ontario, University of Ottawa, Ottawa, Canada
| | | | - Jacques Lacroix
- Department of Pediatrics, University of Montreal, CHU Sainte-Justine, 3175 Chemin de Côte Sainte Catherine, Quebec, QB, H3T 1C5, Canada
| | - Saly El Salti
- Department of Pediatrics, University of Montreal, CHU Sainte-Justine, 3175 Chemin de Côte Sainte Catherine, Quebec, QB, H3T 1C5, Canada
| | - Matthew P Cheng
- Divisions of Infectious Diseases and Medical Microbiology, McGill University Health Centre, Quebec, Canada.,McGill Interdisciplinary Initiative in Infection and Immunity, Quebec, Canada
| | - Todd C Lee
- McGill Interdisciplinary Initiative in Infection and Immunity, Quebec, Canada.,Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Quebec, Canada
| | - Kosar Khwaja
- Réseau de Recherche en Santé Respiratoire du Québec, Quebec, Canada
| | - Philippe Jouvet
- Department of Pediatrics, University of Montreal, CHU Sainte-Justine, 3175 Chemin de Côte Sainte Catherine, Quebec, QB, H3T 1C5, Canada.
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Bugaev N, Rattan R, Goodman M, Mukherjee K, Robinson BRH, McDonald AA, Bogert JN, Croft CA, Edavettal M, Engels PT, Jayaraman V, Khwaja K, Kasotakis G, Lawless RA, Maine RG, Hasenboehler EA, Schroeder ME, Schroll RW, Kim D, Mentzer C, Litt J, Como JJ. Preperitoneal packing for pelvic fracture-associated hemorrhage: A systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma. Am J Surg 2020; 220:873-888. [PMID: 32600847 DOI: 10.1016/j.amjsurg.2020.05.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/29/2020] [Accepted: 05/31/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Nikolay Bugaev
- Division of Trauma & Acute Care Surgery, Tufts Medical Center, Tufts University, School of Medicine, 800 Washington st, #4488, Boston, MA, USA.
| | - Rishi Rattan
- Division of Trauma Surgery & Critical Care, DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, 1800 NW 10th Ave, Miami, FL, 33136, USA.
| | - Michael Goodman
- Division of Trauma, Critical Care, and Acute Care Surgery, University of Cincinnati, Department of Surgery, 231 Albert Sabin Way, ML 0558, Cincinnati, OH, 45267, USA.
| | - Kaushik Mukherjee
- Division of Acute Care Surgery, Loma Linda University Medical Center, 11175 Campus Street, CP 21111, Loma Linda, CA, 92350, USA.
| | - Bryce R H Robinson
- Harborview Medical Center, University of Washington, Norm Maleng Building, 410 9th Ave., Seattle, WA, 98104, USA.
| | - Amy A McDonald
- Department of Surgery, Louis Stokes Cleveland VA Medical Center, 10701 East Blvd, Cleveland, OH, 44106, USA.
| | - James N Bogert
- Division of Trauma, St. Joseph Hospital and Medical Center, Creighton University, College of Medicine, Phoenix Campus, 500 W Thomas Rd Ste 400, Phoenix, AZ, 85013, USA.
| | - Chasen A Croft
- Department of Surgery, Division of Trauma and Acute Care Surgery, University of Florida Health Science Center, 1600 SW Archer Road, Box 100108, Gainesville, FL, 32610, USA.
| | - Mathew Edavettal
- Department of Surgery, Lake Havasu Regional Medical Center, 101 Civic Center Ln, Lake Havasu City, AZ, 86403, USA.
| | - Paul T Engels
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton, Ontario, L8L 2X2, Canada.
| | - Vijay Jayaraman
- Saint Francis Hospital and Medical Center, Trinity Health of New England, 114 Woodland St, Hartford, CT, 06105, USA.
| | - Kosar Khwaja
- Departments of Surgery and Critical Care Medicine, McGill University Health Centre, 1650 Cedar Avenue, L9.411, Montreal, Quebec, H3G 1A4, Canada.
| | - George Kasotakis
- Division of Trauma and Critical Care Surgery, Department of Surgery, Duke University School of Medicine, 40 Duke Medicine Circle Clinic 2B/2C, Durham, NC, 27710, USA.
| | - Ryan A Lawless
- Department of Surgery, Denver Health and Hospital Authority, 777 Bannock St. MC 0206, Denver, CO, 80204, USA.
| | - Rebecca G Maine
- Division of Burn, Trauma and Critical Care, Harborview Medical Center, University of Washington, 325 9th Ave, Seattle, WA, 98104, USA.
| | - Erik A Hasenboehler
- Department of Orthopaedic Surgery, Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, Adult and Trauma Surgery, 4940 Eastern Ave. Bldg A 667, Baltimore, 21224, MD, USA.
| | - Mary E Schroeder
- Division of Acute Care Surgery, Department of Surgery, Rutgers-Robert Wood Johnson University Hospital, 125 Paterson Street, New Brunswick, NJ, 08901, USA.
| | - Rebecca W Schroll
- Division of Trauma, Critical Care and Acute Care Surgery, Tulane University Medical Center, 1415 Tulane Ave, New Orleans, LA, 70112, USA.
| | - Dennis Kim
- Division of Trauma, Acute Care Surgery, Surgical Critical Care, LA County Harbor-UCLA Medical Center, 1000 W Carson St, Torrance, CA, 90502, USA.
| | - Caleb Mentzer
- Division of Trauma, Critical Care, & Acute Care Surgery, 853 N. Church St. Suite 500, Spartanburg Regional Medical Center, Spartanburg, SC, 29303, USA.
| | - Jeff Litt
- Division of Acute Care Surgery, Department of General Surgery, University of Missouri, 1 Hospital Dr, Columbia, MO, 65212, USA.
| | - John J Como
- Department of Surgery, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, USA.
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26
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Ball CG, Murphy P, Verhoeff K, Albusadi O, Patterson M, Widder S, Hameed SM, Parry N, Vogt K, Kortbeek JB, MacLean AR, Engels PT, Rice T, Nenshi R, Khwaja K, Minor S. A 30-day prospective audit of all inpatient complications following acute care surgery: How well do we really perform? Can J Surg 2020; 63:E150-E154. [PMID: 32216251 DOI: 10.1503/cjs.019118] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Acute care surgery (ACS) and emergency general surgery (EGS) services must provide timely care and intervention for patients who have some of the most challenging needs. Patients treated by ACS services are often critically ill and have both substantial comorbidities and poor physiologic reserve. Despite the widespread implemention of ACS/EGS services across North America, the true postoperative morbidity rates remain largely unknown. Methods In this prospective study, inpatients at 8 high-volume ACS/EGS centres in geographically diverse locations in Canada who underwent operative interventions were followed for 30 days or until they were discharged. Readmissions during the 30-day window were also captured. Preoperative, intraoperative and postoperative variables were tracked. Standard statistical methodology was employed. Results A total of 601 ACS/EGS patients were followed for up to 30 inpatient or readmission days after their index emergent operation. Fifty-one percent of patients were female, and the median age was 51 years. They frequently had substantial medical comorbidities (42%) and morbid obesity (15%). The majority of procedures were minimally invasive (66% laparoscopic). Median length of stay was 3.3 days and the early readmission (< 30 d) rate was 6%. Six percent of patients were admitted to the critical care unit. The overall complication and mortality rates were 34% and 2%, respectively. Cholecystitis (31%), appendicitis (21%), bowel obstruction (18%), incarcerated hernia (12%), gastrointestinal hemorrhage (7%) and soft tissue infections (7%) were the most common diagnoses. The morbidity and mortality rates for open surgical procedures were 73% and 5%, respectively. Conclusion Nontrauma ACS/EGS procedures are associated with a high postoperative morbidity rate. This study will serve as a prospective benchmark for postoperative complications among ACS/EGS patients and subsequent quality improvement across Canada.
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Affiliation(s)
- Chad G. Ball
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
| | - Patrick Murphy
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
| | - Kevin Verhoeff
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
| | - Omar Albusadi
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
| | - Matthew Patterson
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
| | - Sandy Widder
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
| | - S. Morad Hameed
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
| | - Neil Parry
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
| | - Kelly Vogt
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
| | - John B. Kortbeek
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
| | - Anthony R. MacLean
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
| | - Paul T. Engels
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
| | - Timothy Rice
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
| | - Rahima Nenshi
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
| | - Kosar Khwaja
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
| | - Samuel Minor
- From the Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (Ball, Albusadi, Patterson, Kortbeek, MacLean); Western University, London, Ont. (Murphy, Parry, Vogt); the University of Alberta, Edmonton, Alta. (Verhoeff, Widder); the University of British Columbia, Vancouver, B.C. (Hameed); McMaster University, Hamilton, Ont. (Engels, Rice, Nenshi); McGill University, Montréal, Que. (Khwaja); and Dalhousie University, Halifax, N.S. (Minor)
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Sarwar A, Weinstein J, Ali A, Curry M, Khwaja K, Bullock A, Faintuch S, Ahmed M. 3:18 PM Abstract No. 239 Feasibility of radiation segmentectomy with resin microspheres prescribed using medical internal radiation dosimetry model. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Bekdache O, Paradis T, Bracco D, Elbahrawy A, Khwaja K, Deckelbaum DL, Fata P, Beckett A, Razek T, Grushka J. Intermittent use of resuscitative endovascular balloon occlusion of the aorta in penetrating gunshot wound of the lower extremity. Can J Surg 2019; 62:E9-E12. [PMID: 31782649 DOI: 10.1503/cjs.017018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Summary The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in penetrating injuries is an emerging adjunct in the civilian trauma surgeon’s toolbox for the management of traumatic hemorrhagic shock. Furthermore, within the Canadian civilian context, little has been reported with regard to its use as an assisted damage-control measure in vascular reconstruction of the lower extremity. We report a case of penetrating gunshot injury of the lower extremity where the preoperative deployment of REBOA had a remarkable positive impact in the resuscitation phase and the intraoperative control of blood loss. A description of the procedure and the advantage gained from REBOA are discussed.
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Affiliation(s)
- Omar Bekdache
- From the Trauma Program, McGill University Health Centre, Montreal, Que. (Beckett, Bekdache, Bracco, Elbahrawy, Khwaja, Deckelbaum, Fata, Razek, Grushka); the Faculty of Medicine, McGill University, Montreal, Que. (Paradis); the Medical Research Institute, Alexandria University, Alexandria, Egypt (Elbahrawy); and the Royal Canadian Medical Services, Montreal, Que. (Beckett)
| | - Tiffany Paradis
- From the Trauma Program, McGill University Health Centre, Montreal, Que. (Beckett, Bekdache, Bracco, Elbahrawy, Khwaja, Deckelbaum, Fata, Razek, Grushka); the Faculty of Medicine, McGill University, Montreal, Que. (Paradis); the Medical Research Institute, Alexandria University, Alexandria, Egypt (Elbahrawy); and the Royal Canadian Medical Services, Montreal, Que. (Beckett)
| | - David Bracco
- From the Trauma Program, McGill University Health Centre, Montreal, Que. (Beckett, Bekdache, Bracco, Elbahrawy, Khwaja, Deckelbaum, Fata, Razek, Grushka); the Faculty of Medicine, McGill University, Montreal, Que. (Paradis); the Medical Research Institute, Alexandria University, Alexandria, Egypt (Elbahrawy); and the Royal Canadian Medical Services, Montreal, Que. (Beckett)
| | - Aly Elbahrawy
- From the Trauma Program, McGill University Health Centre, Montreal, Que. (Beckett, Bekdache, Bracco, Elbahrawy, Khwaja, Deckelbaum, Fata, Razek, Grushka); the Faculty of Medicine, McGill University, Montreal, Que. (Paradis); the Medical Research Institute, Alexandria University, Alexandria, Egypt (Elbahrawy); and the Royal Canadian Medical Services, Montreal, Que. (Beckett)
| | - Kosar Khwaja
- From the Trauma Program, McGill University Health Centre, Montreal, Que. (Beckett, Bekdache, Bracco, Elbahrawy, Khwaja, Deckelbaum, Fata, Razek, Grushka); the Faculty of Medicine, McGill University, Montreal, Que. (Paradis); the Medical Research Institute, Alexandria University, Alexandria, Egypt (Elbahrawy); and the Royal Canadian Medical Services, Montreal, Que. (Beckett)
| | - Dan L. Deckelbaum
- From the Trauma Program, McGill University Health Centre, Montreal, Que. (Beckett, Bekdache, Bracco, Elbahrawy, Khwaja, Deckelbaum, Fata, Razek, Grushka); the Faculty of Medicine, McGill University, Montreal, Que. (Paradis); the Medical Research Institute, Alexandria University, Alexandria, Egypt (Elbahrawy); and the Royal Canadian Medical Services, Montreal, Que. (Beckett)
| | - Paola Fata
- From the Trauma Program, McGill University Health Centre, Montreal, Que. (Beckett, Bekdache, Bracco, Elbahrawy, Khwaja, Deckelbaum, Fata, Razek, Grushka); the Faculty of Medicine, McGill University, Montreal, Que. (Paradis); the Medical Research Institute, Alexandria University, Alexandria, Egypt (Elbahrawy); and the Royal Canadian Medical Services, Montreal, Que. (Beckett)
| | - Andrew Beckett
- From the Trauma Program, McGill University Health Centre, Montreal, Que. (Beckett, Bekdache, Bracco, Elbahrawy, Khwaja, Deckelbaum, Fata, Razek, Grushka); the Faculty of Medicine, McGill University, Montreal, Que. (Paradis); the Medical Research Institute, Alexandria University, Alexandria, Egypt (Elbahrawy); and the Royal Canadian Medical Services, Montreal, Que. (Beckett)
| | - Tarek Razek
- From the Trauma Program, McGill University Health Centre, Montreal, Que. (Beckett, Bekdache, Bracco, Elbahrawy, Khwaja, Deckelbaum, Fata, Razek, Grushka); the Faculty of Medicine, McGill University, Montreal, Que. (Paradis); the Medical Research Institute, Alexandria University, Alexandria, Egypt (Elbahrawy); and the Royal Canadian Medical Services, Montreal, Que. (Beckett)
| | - Jeremy Grushka
- From the Trauma Program, McGill University Health Centre, Montreal, Que. (Beckett, Bekdache, Bracco, Elbahrawy, Khwaja, Deckelbaum, Fata, Razek, Grushka); the Faculty of Medicine, McGill University, Montreal, Que. (Paradis); the Medical Research Institute, Alexandria University, Alexandria, Egypt (Elbahrawy); and the Royal Canadian Medical Services, Montreal, Que. (Beckett)
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Prakash I, Neves O, Cumbe E, Hamadani F, Razek T, Fata P, Beckett A, Khwaja K, Grushka J, Wong EG, Jacobe M, de Costa A, Deckelbaum DL, Yohannan P. The Financial Burden of Road Traffic Injuries in Mozambique: A Hospital-Related Cost-of-Illness Study of Maputo Central Hospital. World J Surg 2019; 43:2959-2966. [PMID: 31506715 DOI: 10.1007/s00268-019-05152-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Road traffic injuries (RTIs) are increasingly being recognized for their significant economic impact. Mozambique, like other low-income countries, suffers staggering rates of road traffic collisions. To our knowledge, this is the first study to estimate direct hospital costs of RTIs using a bottom-up, micro-costing approach in the Mozambican context. This study aims to calculate the direct, inpatient costs of RTIs in Mozambique and compare it to the financial capacity of the Mozambican public health care system. METHODS This was a retrospective, single-centre study. Charts of all patients with RTIs admitted to Maputo Central Hospital over a period of 2 months were reviewed. The costs were recorded and analysed based on direct costs, human resource costs, and overhead costs. Costs were calculated using a micro-costing approach. RESULTS In total, 114 patients were admitted and treated for RTIs at Maputo Central Hospital during June-July 2015. On average, the hospital cost per patient was US$ 604.28 (IQR 1033.58). Of this, 44% was related to procedural costs, 23% to diagnostic imaging costs, 17% to length-of-stay costs, 9% to medication costs, and 7% to laboratory test costs. The average annual inpatient cost of RTIs in Mozambique was almost US$ 116 million (0.8% of GDP). CONCLUSION The financial burden of RTIs in Mozambique represents approximately 40% of the annual public health care budget. These results help highlight the economic impact of trauma in Mozambique and the importance of an organized trauma system to reduce such costs.
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Affiliation(s)
- Ipshita Prakash
- Department of Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada.,Centre for Global Surgery, McGill University, Montreal, QC, Canada
| | | | - Eduardo Cumbe
- Department of Surgery, Maputo Central Hospital, Maputo, Mozambique
| | - Fadi Hamadani
- Department of Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada.,Centre for Global Surgery, McGill University, Montreal, QC, Canada
| | - Tarek Razek
- Department of Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada.,Centre for Global Surgery, McGill University, Montreal, QC, Canada
| | - Paola Fata
- Department of Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada
| | - Andrew Beckett
- Department of Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada
| | - Kosar Khwaja
- Department of Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada
| | - Jeremy Grushka
- Department of Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada
| | - Evan G Wong
- Department of Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada.,Centre for Global Surgery, McGill University, Montreal, QC, Canada
| | - Mario Jacobe
- Department of Surgery, Maputo Central Hospital, Maputo, Mozambique
| | - Assis de Costa
- Department of Surgery, Maputo Central Hospital, Maputo, Mozambique
| | - Dan L Deckelbaum
- Department of Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada. .,Centre for Global Surgery, McGill University, Montreal, QC, Canada.
| | - Prem Yohannan
- Department of Surgery, Maputo Central Hospital, Maputo, Mozambique
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30
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Mador B, Fuselli P, Choudhary D, Bokhari F, Tanenbaum B, Tze N, Wong TH, Grant I, Sahi S, Tanenbaum B, Figueira S, Knight H, Grant I, Beno S, Moore L, Macpherson A, Laverty C, Watson I, Watson I, Laverty C, Bérubé M, Cowan S, Homer K, Bouderba S, Soltana K, Fransblow L, Fransblow L, Bérubé M, Gonthier C, Bryson A, Bokhari F, Rados A, Courval V, Masales C, Trust MD, Hogan J, Warriner Z, Lalande A, Chung D, Tanenbaun B, Kuper T, Mckee J, Bratu I, Makish A, Versolatto A, Ramagnano S, Mehrnoush V, Kang D, Moore L, Schellenberg M, LeBreton M, Javidan AP, Schwartz G, Doucet J, Cunningham A, Clarke R, Paradis T, Beamish I, Hilsden R, Raizman I, Green R, Green R, Green R, Esmail R, Moon J(J, Cheng V, Brisson A, Beno S, Heck C, Koeck E, Schneider P, Bal C, Ko YM(D, Martinez M, Kim D, Tierney J, Emigh B, Lie J, Tierney J, MacLean A, Milton L, Bradley N, Kim M, White J, Harris I, Tekian A, Babul S, Cowle S, Turcotte K, Dhillon R, Chadha K, Fu CY, Bajan F, Welsh S, Kaminsky M, Dennis A, Starr F, Butler C, Messer T, Poulakidas S, Ramagnano S, Grushka J, Beckett A, Filteau C, Larocque J, Nadkarni N, Chua WC, Loo L, Ang ASH, Iau PTC, Goo JTT, Chan KC, Adam TN, Seow DCC, Ng YS, Malhotra R, Chan AWM, Matchar DB, Van Nguyen H, Ong MEH, Lampron J, Bougie A, Brown C, Patel A, Edwards L, Spitz K, Ramagnano S, Lampron J, Nucete M, Lindsey S, Lampron J, Figueira S, Matar M, Michael D, Rosenfield D, Harvey G, Jessa K, Tardif PA, Mercier E, Berthelot S, Lecky F, Cameron P, Archambault P, Tien H, Beckett A, Nathens A, Luz LTD, Benjamin S, Chisholm A, Benjamin S, Chisholm A, Tien H, Beckett A, Nathens A, Luz LTD, Pasquotti T, Klassen B, Brisson A, Tze N, Fawcett V, Tsang B, Kabaroff A, Verhoeff K, Turner S, Kim M, Widder S, Fung C, Widder S, Kim M, Moore L, Lecky F, Lawrence T, Soltana K, Mansour T, Moore L, Bouderba S, Turgeon A, Krouchev R, Mercier E, Friedman D, Souranis A, Slapcoff L, Friedman D, Fakir MB, Turcotte V, Valiquette MP, Bernard F, Giroux M, Côté MÈ, Gagné A, Dollé S, Gélinas C, Belcaïd A, Truchon C, Moore L, Clément J, Pelletier LP, Ivkov V, Gamble K, Constable L, Haegert J, Bajani F, Fu CY, Welsh S, Kaminsky M, Dennis A, Starr F, Messer T, Butler C, Tatebe L, Poulakidas S, Thauvette D, Engels P, Klassen B, Coates A, De Silva S, Schellenberg M, Biswas S, Inaba K, Cheng V, Warriner Z, Love B, Demetriades D, Schellenberg M, Inaba K, Trust MD, Love B, Cheng V, Strumwasser A, Demetriades D, Joos E, Dawe P, Hameed M, Evans D, Garraway N, Gawaziuk J, Cristall N, Logsetty S, Ramagnano S, Federman N, Murphy P, Parry N, Leeper R, McBeth P, Wachs J, Hamilton D, Ball C, Gillman L, Kirkpatrick A, Dulai S, Falconer C, McLachlin M, Armstrong A, Parry N, Vogt K, Shi Q, Coates A, Engels P, Rice T, Nathens A, Naidu D, Brubacher J, Chan H, Erdelyi S, Kubasiak J, Bokhari F, Kaminsky M, Lauzier F, Tardif PA, Lamontagne F, Chassé M, Stelfox HT, Kortbeek J, Lessard-Bonaventure P, Truchon C, Turgeon A, Cheng V, Inaba K, Foran C, Warriner Z, Trust MD, Clark D, Demetriades D, Levesque K, Lampron J, Nathens A, Tien H, Luz LTD, Jing R, McFarlan A, Liu M, Sander B, Fowler R, Rizoli S, Ferrada P, Murthi S, Nirula R, Edwards S, Cantrell E, Han J, Haase D, Singleton A, Birkas Y, Casola G, Coimbra R, Condron M, Schreiber M, Azarow K, Hamilton N, Long W, Maxwell B, Jafri M, Whitman L, Wilson H, Wong H, Grushka J, Razek T, Fata P, Deckelbaum D, Kawaja K, Beckett A, Razek T, Deckelbaum D, Grushka J, Fata P, Beckett A, Lund M, Leeper R, Conn LG, Strauss R, Haas B, Beckett A, Nathens A, Tien H, Callum J, Luz LTD, Higgins S, Coles J, Erdogan M, Coles J, Higgins S, Erdogan M, Erdogan M, Kureshi N, Fenerty L, Thibault-Halman G, Walling S, Clarke DB, Vis C, Nosworthy S, Razek T, Boulanger N, Deckelbaum D, Grushka J, Fata P, Beckett A, Khwaja K, Schellenberg M, Inaba K, Warriner Z, Trust MD, Matsushima K, Lam L, Demetriades D, Lakha N, Wong H, McLauchlin L, Ashe CS, Logie SA, Lenton-Brym T, Rosenfield D, McDowall D, Wales P, Principi T, Mis J, Kaminsky M, Bokhari F, Rahbar E, Cotton B, Bryan P, MacGillivray S, Thompson G, Wishart I, Hameed M, Joos E, Evans D, Garraway N, Dawe P, Wild J, Widom K, Torres D, Blansfield J, Shabahang M, Dove J, Fluck M, Hameed M, Roux L, Nicol A, Schulenberg L, Fredericks C, Messer T, Starr F, Dennis A, Bokhari F, Kaminsky M, Teixeira P, Coopwood B, Aydelotte J, Cardenas T, Ali S, Brown C, Dawe P, Fredericks C, Matta LD, Messer T, Starr F, Dennis A, Kaminsky M, Bokhari F, Jiang HY, Yoon J, Kim M, Widder S, Hameed M, Wray C, Agarwal A, Harvin J. 2019 Trauma Association of Canada Annual Scientific Meeting Abstracts. Can J Surg 2019; 62:S3-S35. [PMID: 31091053 DOI: 10.1503/cjs.008619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Bekdache O, Paradis T, Shen YBH, Elbahrawy A, Grushka J, Deckelbaum D, Khwaja K, Fata P, Razek T, Beckett A. Resuscitative endovascular balloon occlusion of the aorta (REBOA): indications: advantages and challenges of implementation in traumatic non-compressible torso hemorrhage. Trauma Surg Acute Care Open 2019; 4:e000262. [PMID: 31245615 PMCID: PMC6560484 DOI: 10.1136/tsaco-2018-000262] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Resuscitative endovascular balloon occlusion of the aorta (REBOA) is regaining popularity in the treatment of traumatic non-compressible torso bleeding. Advances in invasive radiology coupled with new damage control measures assisted in the refinement of the technique with promising outcomes. The literature continues to have substantial heterogeneity about REBOA indications, applications, and the challenges confronted when implementing the technique in a level I trauma center. Scoping reviews are excellent platforms to assess the diverse literature of a new technique. It is for the first time that a scoping review is adopted for this topic. Advances in invasive radiology coupled with new damage control measures assisted in the refinement of the technique with promising outcomes. The literature continues to have substantial heterogeneity about REBOA indications, applications, and the challenges confronted when implementing the technique in a level I trauma center. Scoping reviews are excellent platforms to assess the diverse literature of a new technique. It is for the first time that a scoping review is adopted for this topic. Methods Critical search from MEDLINE, EMBASE, BIOSIS, COCHRANE CENTRAL, PUBMED and SCOPUS were conducted from the earliest available dates until March 2018. Evidence-based articles, as well as gray literature at large, were analyzed regardless of the quality of articles. Results We identified 1176 articles related to the topic from all available database sources and 57 reviews from the gray literature search. The final review yielded 105 articles. Quantitative and qualitative variables included patient demographics, study design, study objectives, methods of data collection, indications, REBOA protocol used, time to deployment, zone of deployment, occlusion time, complications, outcome, and the level of expertise at the concerned trauma center. Conclusion Growing levels of evidence support the use of REBOA in selected indications. Our data analysis showed an advantage for its use in terms of morbidities and physiologic derangement in comparison to other resuscitation measures. Current challenges remain in the selective application, implementation, competency assessment, and credentialing for the use of REBOA in trauma settings. The identification of the proper indication, terms of use, and possible advantage of the prehospital and partial REBOA are topics for further research. Level of evidence Level III.
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Affiliation(s)
- Omar Bekdache
- Department of Trauma and Acute Care Surgery, McGill University Health Centre, Montreal, Quebec, Canada.,Department of Surgery, Tawam Hospital - Johns Hopkins, Al Ain, Abu Dhabi, United Arab Emirates
| | - Tiffany Paradis
- Department of Surgery, McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | - Yu Bai He Shen
- Department of Surgery, McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | - Aly Elbahrawy
- Department of Trauma and Acute Care Surgery, McGill University Health Centre, Montreal, Quebec, Canada.,Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Jeremy Grushka
- Department of Trauma and Acute Care Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Dan Deckelbaum
- Department of Trauma and Acute Care Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Kosar Khwaja
- Department of Trauma and Acute Care Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Paola Fata
- Department of Trauma and Acute Care Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Tarek Razek
- Department of Trauma and Acute Care Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Andrew Beckett
- Department of Trauma and Acute Care Surgery, McGill University Health Centre, Montreal, Quebec, Canada.,Department of Surgery, Royal Canadian Medical Services, Montreal, Quebec, Canada
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Bekdache O, Paradis T, Shen YBH, Elbahrawy A, Grushka J, Deckelbaum DL, Khwaja K, Fata P, Razek T, Beckett A. Resuscitative endovascular balloon occlusion of the aorta (REBOA): a scoping review protocol concerning indications-advantages and challenges of implementation in traumatic non-compressible torso haemorrhage. BMJ Open 2019; 9:e027572. [PMID: 30782953 PMCID: PMC6368000 DOI: 10.1136/bmjopen-2018-027572] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Haemorrhage remains the leading cause of preventable death in trauma. Damage control measures applied to patients in extremis in order to control exsanguinating bleeding from non-compressible torso injuries use different techniques to limit blood flow from the aorta to the rest of the body. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is regaining momentum recently as an adjunct measure that can provide the same results using less invasive approaches. This scoping review aims to provide a comprehensive understanding of the existing literature on REBOA. The objective is to analyse evidence and non-evidence-based medical reports and to describe current gaps in the literature about the best indication and implementation strategies for REBOA. METHODS AND ANALYSIS Using the five-stage framework of Arksey and O'Malley's scoping review methodology as a guide, we will perform a systematic search in the following databases: MEDLINE, EMBASE, BIOSIS, COCHRANE CENTRAL, PUBMED and SCOPUS from the earliest available publications. The aim is to identify diverse studies related to the topic of REBOA. For a comprehensive search, we will explore organisational websites, key journals and hand-search reference lists of key studies. Data will be charted and sorted using a descriptive analytical approach. ETHICS AND DISSEMINATION Ethics approval is not necessary as the data are collected from publicly available sources and there will be no consultative phase. The results will be disseminated through presentations at local, national, clinical and medical education conferences and through publication in a peer-reviewed journal.
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Affiliation(s)
- Omar Bekdache
- Department of Trauma and Acute Surgical Care, McGill University Health Centre, Montreal, Quebec, Canada
| | - Tiffany Paradis
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Yu Bai He Shen
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Aly Elbahrawy
- Department of Trauma and Acute Surgical Care, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Jeremy Grushka
- Department of Trauma and Acute Surgical Care, McGill University Health Centre, Montreal, Quebec, Canada
| | - Dan L Deckelbaum
- Department of Trauma and Acute Surgical Care, McGill University Health Centre, Montreal, Quebec, Canada
| | - Kosar Khwaja
- Department of Trauma and Acute Surgical Care, McGill University Health Centre, Montreal, Quebec, Canada
| | - Paola Fata
- Department of Trauma and Acute Surgical Care, McGill University Health Centre, Montreal, Quebec, Canada
| | - Tarek Razek
- Department of Trauma and Acute Surgical Care, McGill University Health Centre, Montreal, Quebec, Canada
| | - Andrew Beckett
- Department of Trauma and Acute Surgical Care, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Surgery, Royal Canadian Medical Services, Montreal, Quebec, Canada
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Bracco D, Deckelbaum D, Artho G, Khwaja K, Mulder DS, Gruska J, Razek T. Additional and repeated computed tomography in interfacility trauma transfers: Room for standardization. Surgery 2018; 164:872-878. [PMID: 30149940 DOI: 10.1016/j.surg.2018.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 07/02/2018] [Accepted: 07/09/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Despite the recommendations of the Advanced Trauma Life Support course of the American College of Surgeons, patients undergo computed tomography (CT) in local hospitals before transfer to a trauma center. The problem of repeat CTs caused by technical and protocol issues is ongoing. The objective is to measure the importance of repeat CTs and CTs involving other body regions. METHODS All secondary transfers to our level 1 facility with CT at the local hospital over 9 years were reviewed. Patients were considered to have had a repeat CT if the same body region or an another body region was scanned as a part of the initial assessment but not for reasons of clinical follow-up. RESULTS Of 6,292 patients received from local hospitals, 685 (12%) had undergone 1097 CT scans at the local hospitals. Patients being scanned in local hospitals were sicker (injury severity score: 21 vs 13) and required more intensive care unit admissions (38% vs 29%) and more ventilation (32% vs 22%). Thirty-nine percent of CTs were repeated, and 55% of these patients required imaging of another body part. CONCLUSION Repeat and additional images remain a major issue in trauma transfers. Improvement requires standardization of CT protocols and change in the approach of local hospitals from "finding and requiring need level 1 trauma center" to "not missing any injuries."
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Affiliation(s)
- David Bracco
- Department of Anesthesia, Montreal General Hospital, McGill University Health Center, Montreal, Canada.
| | - Dan Deckelbaum
- Department of Trauma Surgery, Montreal General Hospital, McGill University Health Center, Montreal, Canada
| | - Giovanni Artho
- Department of Radiology, Montreal General Hospital, McGill University Health Center, Montreal, Canada
| | - Kosar Khwaja
- Department of Trauma Surgery, Montreal General Hospital, McGill University Health Center, Montreal, Canada
| | - David S Mulder
- Department of Trauma Surgery, Montreal General Hospital, McGill University Health Center, Montreal, Canada; Department of Cardiothoracic Surgery, Montreal General Hospital, McGill University Health Center, Montreal, Canada
| | - Jeremy Gruska
- Department of Trauma Surgery, Montreal General Hospital, McGill University Health Center, Montreal, Canada
| | - Tarek Razek
- Department of Trauma Surgery, Montreal General Hospital, McGill University Health Center, Montreal, Canada
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DeGirolamo K, D'Souza K, Apte S, Ball CG, Armstrong C, Reso A, Widder S, Mueller S, Gillman LM, Singh R, Nenshi R, Khwaja K, Minor S, de Gara C, Hameed SM. A day in the life of emergency general surgery in Canada: a multicentre observational study. Can J Surg 2018; 61:237-243. [PMID: 30067181 PMCID: PMC6066383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Emergency general surgery (EGS) services are gaining popularity in Canada as systems-based approaches to surgical emergencies. Despite the high volume, acuity and complexity of the patient populations served by EGS services, little has been reported about the services' structure, processes, case mix or outcomes. This study begins a national surveillance effort to define and advance surgical quality in an important and diverse surgical population. METHODS A national cross-sectional study of EGS services was conducted during a 24-hour period in January 2017 at 14 hospitals across 7 Canadian provinces recruited through the Canadian Association of General Surgeons Acute Care Committee. Patients admitted to the EGS service, new consultations and off-service patients being followed by the EGS service during the study period were included. Patient demographic information and data on operations, procedures and complications were collected. RESULTS Twelve sites reported resident coverage. Most services did not include trauma. Ten sites had protected operating room time. Overall, 393 patient encounters occurred during the study period (195/386 [50.5%] operative and 191/386 [49.5%] nonoperative), with a mean of 3.8 operations per service. The patient population was complex, with 136 patients (34.6%) having more than 3 comorbidities. There was a wide case mix, including gallbladder disease (69 cases [17.8%]) and appendiceal disease (31 [8.0%]) as well as complex emergencies, such as obstruction (56 [14.5%]) and perforation (23 [5.9%]). CONCLUSION The characteristics and case mix of these Canadian EGS services are heterogeneous, but all services are busy and provide comprehensive operative and nonoperative care to acutely ill patients with high levels of comorbidity.
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Affiliation(s)
- Kristin DeGirolamo
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Karan D'Souza
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Sameer Apte
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Chad G Ball
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Christopher Armstrong
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Artan Reso
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Sandy Widder
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Sarah Mueller
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Lawrence M Gillman
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Ravinder Singh
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Rahima Nenshi
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Kosar Khwaja
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Samuel Minor
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Chris de Gara
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - S Morad Hameed
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
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DeGirolamo K, D'Souza K, Apte S, Ball CG, Armstrong C, Reso A, Widder S, Mueller S, Gillman LM, Singh R, Nenshi R, Khwaja K, Minor S, de Gara C, Hameed SM. A day in the life of emergency general surgery in Canada: a multicentre observational study. Can J Surg 2018; 61:13517. [PMID: 29806805 DOI: 10.1503/cjs.013517] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Emergency general surgery (EGS) services are gaining popularity in Canada as systems-based approaches to surgical emergencies. Despite the high volume, acuity and complexity of the patient populations served by EGS services, little has been reported about the services' structure, processes, case-mix or outcomes. This study begins a national surveillance effort to define and advance surgical quality in an important and diverse surgical population. METHODS A national cross-sectional study of EGS services was conducted during a 24-hour period in January 2017 at 14 hospitals across 7 Canadian provinces recruited through the Canadian Association of General Surgeons Acute Care Committee. Patients admitted to the EGS service, new consultations and off-service patients being followed by the EGS service during the study period were included. Patient demographic information and data on operations, procedures and complications were collected. RESULTS Twelve sites reported resident coverage. Most services did not include trauma. Ten sites had protected operating room time. Overall, 393 patient encounters occurred during the study period (195/386 [50.5%] operative and 191/386 [49.5%] nonoperative), with a mean of 3.8 operations per service. The patient population was complex, with 136 patients (34.6%) having more than 3 comorbidities. There was a wide case-mix, including gallbladder disease (69 cases [17.8%]) and appendiceal disease (31 [8.0%]) as well as complex emergencies, such as obstruction (56 [14.5%]) and perforation (23 [5.9%]). CONCLUSION The characteristics and case-mix of these Canadian EGS services are heterogeneous, but all services are busy and provide comprehensive operative and nonoperative care to acutely ill patients with high levels of comorbidity.
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Affiliation(s)
- Kristin DeGirolamo
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Karan D'Souza
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Sameer Apte
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Chad G Ball
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Christopher Armstrong
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Artan Reso
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Sandy Widder
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Sarah Mueller
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Lawrence M Gillman
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Ravinder Singh
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Rahima Nenshi
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Kosar Khwaja
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Samuel Minor
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - Chris de Gara
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
| | - S Morad Hameed
- From the Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC (DeGirolamo, Hameed); the Faculty of Medicine, University of British Columbia, Vancouver, BC (D'Souza); the Department of Surgery, University of Alberta, Edmonton, Alta. (Apte, Widder, de Gara); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball, Armstrong, Reso); the Department of Surgery, University of Saskatchewan, Saskatoon, Sask. (Mueller); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Gillman); the Department of Surgery, Northern Ontario School of Medicine, North Bay, Ont. (Singh); the Department of Surgery, McMaster University, Hamilton, Ont. (Nenshi); the Department of Surgery, McGill University, Montréal, Que. (Khwaja); the Department of Surgery, Dalhousie University, Halifax, NS (Minor); and the Department of Trauma Services, Vancouver General Hospital, Vancouver, BC (Hameed)
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Wang Y, Stanek A, Grushka J, Fata P, Beckett A, Khwaja K, Razek T, Deckelbaum DL. Incidence and factors associated with development of heterotopic ossification after damage control laparotomy. Injury 2018; 49:51-55. [PMID: 29191669 DOI: 10.1016/j.injury.2017.11.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 11/12/2017] [Accepted: 11/25/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The incidence of heterotopic ossification (HO) following damage control laparotomy (DCL) is unknown. Abdominal wall reconstruction may prove more challenging in patients with HO. This study examines the incidence and factors associated with HO in patients with an open abdomen following DCL. METHODS A retrospective review of all patients with an open abdomen after DCL at a level 1 trauma centre from 2009 to 2015 was conducted. Demographics and peri-operative outcomes of patients with and without HO were compared. Univariate and multivariable binary logistic regression models were used to determine the association of peri-operative factors with the development of HO. RESULTS 68 patients were included, of which 36 (53%) developed HO. On univariate analysis, development of HO was significantly associated with hollow viscus injury (OR, 3.89; CI 1.42-10.7), greater number of abdominal surgeries prior to definitive closure (OR, 1.84; CI, 1.10-3.05), non-fascial closure (OR, 4.33; CI, 1.44-13.1) and higher peak ALP (OR 1.01; CI, 1.00-1.02). The presence of a hollow viscus injury remained an independent predictor of HO on multivariable analysis after adjusting for covariates (OR, 3.77; CI, 1.22-11.6). CONCLUSION Heterotopic ossification develops in a high proportion of trauma patients following damage control laparotomy, particularly in the presence of hollow viscus injury. Its impact on delayed abdominal wall reconstruction and the efficacy of prophylaxis strategies merit further investigation.
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Affiliation(s)
- Yifan Wang
- Division of Trauma Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Agatha Stanek
- Division of Diagnostic Radiology, McGill University Health Centre, Montreal, QC, Canada
| | - Jeremy Grushka
- Division of Trauma Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Paola Fata
- Division of Trauma Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Andrew Beckett
- Division of Trauma Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Kosar Khwaja
- Division of Trauma Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Tarek Razek
- Division of Trauma Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Dan L Deckelbaum
- Division of Trauma Surgery, McGill University Health Centre, Montreal, QC, Canada.
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Alali AS, Mukherjee K, McCredie VA, Golan E, Shah PS, Bardes JM, Hamblin SE, Haut ER, Jackson JC, Khwaja K, Patel NJ, Raj SR, Wilson LD, Nathens AB, Patel MB. Beta-blockers and Traumatic Brain Injury: A Systematic Review, Meta-analysis, and Eastern Association for the Surgery of Trauma Guideline. Ann Surg 2017; 266:952-961. [PMID: 28525411 PMCID: PMC5997270 DOI: 10.1097/sla.0000000000002286] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To determine if beta-(β)-blockers improve outcomes after acute traumatic brain injury (TBI). BACKGROUND There have been no new inpatient pharmacologic therapies to improve TBI outcomes in a half-century. Treatment of TBI patients with β-blockers offers a potentially beneficial approach. METHODS Using MEDLINE, EMBASE, and CENTRAL databases, eligible articles for our systematic review and meta-analysis (PROSPERO CRD42016048547) included adult (age ≥ 16 years) blunt trauma patients admitted with TBI. The exposure of interest was β-blocker administration initiated during the hospitalization. Outcomes were mortality, functional measures, quality of life, cardiopulmonary morbidity (e.g., hypotension, bradycardia, bronchospasm, and/or congestive heart failure). Data were analyzed using a random-effects model, and represented by pooled odds ratio (OR) with 95% confidence intervals (CI) and statistical heterogeneity (I). RESULTS Data were extracted from 9 included studies encompassing 2005 unique TBI patients with β-blocker treatment and 6240 unique controls. Exposure to β-blockers after TBI was associated with a reduction of in-hospital mortality (pooled OR 0.39, 95% CI: 0.27-0.56; I = 65%, P < 0.00001). None of the included studies examined functional outcome or quality of life measures, and cardiopulmonary adverse events were rarely reported. No clear evidence of reporting bias was identified. CONCLUSIONS In adults with acute TBI, observational studies reveal a significant mortality advantage with β-blockers; however, quality of evidence is very low. We conditionally recommend the use of in-hospital β-blockers. However, we recommend further high-quality trials to answer questions about the mechanisms of action, effectiveness on subgroups, dose-response, length of therapy, functional outcome, and quality of life after β-blocker use for TBI.
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Affiliation(s)
- Aziz S. Alali
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada
| | - Kaushik Mukherjee
- Division of Acute Care Surgery, Department of Surgery, Loma Linda University Medical Center, Loma Linda, CA
- Eastern Association for the Surgery of Trauma
| | | | - Eyal Golan
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada
- Department of Critical Care, University Health Network, Toronto, ON, Canada
- Division of Critical Care and Department of Medicine, Mackenzie Health, Toronto, ON, Canada
| | - Prakesh S. Shah
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - James M. Bardes
- Department of Surgery, West Virginia University; Department of Surgery, USC+LAC, Los Angeles, CA
- Eastern Association for the Surgery of Trauma
| | - Susan E. Hamblin
- Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, TN
| | - Elliott R. Haut
- Departments of Surgery, Anesthesiology / Critical Care Medicine, and Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
- Eastern Association for the Surgery of Trauma
| | - James C. Jackson
- Division of Pulmonary and Critical Care Medicine and Center for Health Services Research, Department of Medicine, Vanderbilt University Medical Center; Research Service, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System
| | - Kosar Khwaja
- Departments of Surgery and Critical Care Medicine, McGill University Health Centre, Montreal, QC, Canada
- Eastern Association for the Surgery of Trauma
| | - Nimitt J. Patel
- Division of Trauma, Critical Care, and Burns, Department of Surgery, MetroHealth Medical Center, Cleveland, OH
- Eastern Association for the Surgery of Trauma
| | - Satish R. Raj
- Department of Cardiac Sciences, Libin Cardiovascular Institute, University of Calgary, Alberta, Canada
| | - Laura D. Wilson
- Department of Communication Sciences and Disorders, Oxley College of Health Sciences, The University of Tulsa; Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine
| | - Avery B. Nathens
- Department of Surgery, University of Toronto, Toronto, ON, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Mayur B. Patel
- Eastern Association for the Surgery of Trauma
- Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Departments of Surgery, Neurosurgery, and Hearing and Speech Sciences, Section of Surgical Sciences, Vanderbilt Brain Institute, Vanderbilt Center for Health Services Research, Vanderbilt University Medical Center; Surgical Service, General Surgery Section, Nashville VA Medical Center, Tennessee Valley Healthcare System, US Department of Veterans Affairs, Nashville, TN
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Madani A, Niculiseanu P, Marini W, Kaneva PA, Mappin-Kasirer B, Vassiliou MC, Khwaja K, Fata P, Fried GM, Feldman LS. Biologic mesh for repair of ventral hernias in contaminated fields: long-term clinical and patient-reported outcomes. Surg Endosc 2016; 31:861-871. [PMID: 27334966 DOI: 10.1007/s00464-016-5044-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 06/11/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Guidelines recommend biologic prosthetics for ventral hernia repair (VHR) in contaminated fields, yet long-term and patient-reported data are limited. We aimed to determine the long-term rate of hernia recurrence, and other clinical and patient-reported outcomes following the use of porcine small intestine submucosa (PSIS) for VHR in a contaminated field. METHODS Consecutive patients undergoing open VHR with PSIS mesh in a contaminated field from 2004 to 2014 were prospectively evaluated for hernia recurrence and other post-operative complications. Multivariate logistic and Cox regression analyses identified predictors of hernia recurrence and surgical site infection. Patient-reported outcomes were evaluated using SF-36, Hernia-Related Quality-of-Life Survey (HerQLes) and Body Image Questionnaire instruments. RESULTS Forty-six hernias were repaired in clean-contaminated [16 (35 %)], contaminated [11 (24 %)] and dirty [19 (41 %)] fields. Median follow-up was 47 months [interquartile range: 31-79] and all patients had greater than 12-month follow-up. Sixteen patients (35 %) were not re-examined. Incidence of surgical site events and surgical site infection were 43 % (n = 20) and 56 % (n = 25), respectively. American Society of Anesthesiologists score 3 or greater was an independent predictor of surgical site infection (odds ratio 5.34 [95 % confidence interval 1.01-41.80], p = 0.04). Hernia recurrence occurred in 61 % (n = 28) with a median time to diagnosis of 16 months [interquartile range 8-26]. After bridged repair, 16 of 18 patients (89 %) recurred, compared to 12 of 28 (43 %) when fascia was approximated (p < 0.01). Bridged repair was an independent predictor of recurrence (odds ratio 10.67 [95 % confidence interval 2.42-76.08], p < 0.01). Patients with recurrences had significantly worse scores on the SF-36 mental health component and self-perceived body image, whereas HerQLes scores were similar. CONCLUSIONS Hernia recurrences and wound infections are high with the use of biologic PSIS mesh in contaminated surgical fields. Careful consideration is warranted using this approach.
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Affiliation(s)
- Amin Madani
- Department of Surgery, McGill University Health Centre, 1650 Cedar Avenue, Rm D6-257, Montreal, QC, H3G 1A4, Canada.
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Canada.
| | - Petru Niculiseanu
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Canada
| | - Wanda Marini
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Canada
| | - Pepa A Kaneva
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Canada
| | - Benjamin Mappin-Kasirer
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Canada
| | - Melina C Vassiliou
- Department of Surgery, McGill University Health Centre, 1650 Cedar Avenue, Rm D6-257, Montreal, QC, H3G 1A4, Canada
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Canada
| | - Kosar Khwaja
- Department of Surgery, McGill University Health Centre, 1650 Cedar Avenue, Rm D6-257, Montreal, QC, H3G 1A4, Canada
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Canada
| | - Paola Fata
- Department of Surgery, McGill University Health Centre, 1650 Cedar Avenue, Rm D6-257, Montreal, QC, H3G 1A4, Canada
| | - Gerald M Fried
- Department of Surgery, McGill University Health Centre, 1650 Cedar Avenue, Rm D6-257, Montreal, QC, H3G 1A4, Canada
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Canada
| | - Liane S Feldman
- Department of Surgery, McGill University Health Centre, 1650 Cedar Avenue, Rm D6-257, Montreal, QC, H3G 1A4, Canada
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Canada
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Ntakiyiruta G, Wong EG, Rousseau MC, Ruhungande L, Kushner AL, Liberman AS, Khwaja K, Dakermandji M, Wilson M, Razek T, Kyamanywa P, Deckelbaum DL. Trauma care and referral patterns in Rwanda: implications for trauma system development. Can J Surg 2016; 59:35-41. [PMID: 26812407 DOI: 10.1503/cjs.008115] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Trauma remains a leading cause of death worldwide. The development of trauma systems in low-resource settings may be of benefit. The objective of this study was to describe operative procedures performed for trauma at a tertiary care facility in Kigali, Rwanda, and to evaluate geographical variations and referral patterns of trauma care. METHODS We retrospectively reviewed all prospectively collected operative cases performed at the largest referral hospital in Rwanda, the Centre Hospitalier Universitaire de Kigali (CHUK), between June 1 and Dec. 1, 2011, for injury-related diagnoses. We used the Pearson χ² and Fisher exact tests to compare cases arising from within Kigali to those transferred from other provinces. Geospatial analyses were also performed to further elucidate transfer patterns. RESULTS Over the 6-month study period, 2758 surgical interventions were performed at the CHUK. Of these, 653 (23.7%) were for trauma. Most patients resided outside of Kigali city, with 337 (58.0%) patients transferred from other provinces and 244 (42.0%) from within Kigali. Most trauma procedures were orthopedic (489 [84.2%]), although general surgery procedures represented a higher proportion of trauma surgeries in patients from other provinces than in patients from within Kigali (28 of 337 [8.3%] v. 10 of 244 [4.1%]). CONCLUSION To our knowledge, this is the first study to highlight geographical variations in access to trauma care in a low-income country and the first description of trauma procedures at a referral centre in Rwanda. Future efforts should focus on maturing prehospital and interfacility transport systems, strengthening district hospitals and further supporting referral institutions.
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Affiliation(s)
- Georges Ntakiyiruta
- From the Department of Surgery, University of Rwanda, Kigali, Rwanda (Ntakiyiruta, Ruhungande, Kyamanywa); the Department of Surgery, McGill University, Montreal, Que. (Wong, Rousseau, Liberman, Khwaja, Dakermandji, Wilson, Razek, Deckelbaum); the Centre for Global Surgery, McGill University Health Centre, Montreal, Que. (Wong, Rousseau, Razek, Deckelbaum); the Surgeons Overseas, New York, NY (Wong, Kushner); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Kushner); and the Department of Surgery, Columbia University, New York, NY (Kushner)
| | - Evan G Wong
- From the Department of Surgery, University of Rwanda, Kigali, Rwanda (Ntakiyiruta, Ruhungande, Kyamanywa); the Department of Surgery, McGill University, Montreal, Que. (Wong, Rousseau, Liberman, Khwaja, Dakermandji, Wilson, Razek, Deckelbaum); the Centre for Global Surgery, McGill University Health Centre, Montreal, Que. (Wong, Rousseau, Razek, Deckelbaum); the Surgeons Overseas, New York, NY (Wong, Kushner); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Kushner); and the Department of Surgery, Columbia University, New York, NY (Kushner)
| | - Mathieu C Rousseau
- From the Department of Surgery, University of Rwanda, Kigali, Rwanda (Ntakiyiruta, Ruhungande, Kyamanywa); the Department of Surgery, McGill University, Montreal, Que. (Wong, Rousseau, Liberman, Khwaja, Dakermandji, Wilson, Razek, Deckelbaum); the Centre for Global Surgery, McGill University Health Centre, Montreal, Que. (Wong, Rousseau, Razek, Deckelbaum); the Surgeons Overseas, New York, NY (Wong, Kushner); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Kushner); and the Department of Surgery, Columbia University, New York, NY (Kushner)
| | - Landouald Ruhungande
- From the Department of Surgery, University of Rwanda, Kigali, Rwanda (Ntakiyiruta, Ruhungande, Kyamanywa); the Department of Surgery, McGill University, Montreal, Que. (Wong, Rousseau, Liberman, Khwaja, Dakermandji, Wilson, Razek, Deckelbaum); the Centre for Global Surgery, McGill University Health Centre, Montreal, Que. (Wong, Rousseau, Razek, Deckelbaum); the Surgeons Overseas, New York, NY (Wong, Kushner); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Kushner); and the Department of Surgery, Columbia University, New York, NY (Kushner)
| | - Adam L Kushner
- From the Department of Surgery, University of Rwanda, Kigali, Rwanda (Ntakiyiruta, Ruhungande, Kyamanywa); the Department of Surgery, McGill University, Montreal, Que. (Wong, Rousseau, Liberman, Khwaja, Dakermandji, Wilson, Razek, Deckelbaum); the Centre for Global Surgery, McGill University Health Centre, Montreal, Que. (Wong, Rousseau, Razek, Deckelbaum); the Surgeons Overseas, New York, NY (Wong, Kushner); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Kushner); and the Department of Surgery, Columbia University, New York, NY (Kushner)
| | - Alexander S Liberman
- From the Department of Surgery, University of Rwanda, Kigali, Rwanda (Ntakiyiruta, Ruhungande, Kyamanywa); the Department of Surgery, McGill University, Montreal, Que. (Wong, Rousseau, Liberman, Khwaja, Dakermandji, Wilson, Razek, Deckelbaum); the Centre for Global Surgery, McGill University Health Centre, Montreal, Que. (Wong, Rousseau, Razek, Deckelbaum); the Surgeons Overseas, New York, NY (Wong, Kushner); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Kushner); and the Department of Surgery, Columbia University, New York, NY (Kushner)
| | - Kosar Khwaja
- From the Department of Surgery, University of Rwanda, Kigali, Rwanda (Ntakiyiruta, Ruhungande, Kyamanywa); the Department of Surgery, McGill University, Montreal, Que. (Wong, Rousseau, Liberman, Khwaja, Dakermandji, Wilson, Razek, Deckelbaum); the Centre for Global Surgery, McGill University Health Centre, Montreal, Que. (Wong, Rousseau, Razek, Deckelbaum); the Surgeons Overseas, New York, NY (Wong, Kushner); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Kushner); and the Department of Surgery, Columbia University, New York, NY (Kushner)
| | - Marc Dakermandji
- From the Department of Surgery, University of Rwanda, Kigali, Rwanda (Ntakiyiruta, Ruhungande, Kyamanywa); the Department of Surgery, McGill University, Montreal, Que. (Wong, Rousseau, Liberman, Khwaja, Dakermandji, Wilson, Razek, Deckelbaum); the Centre for Global Surgery, McGill University Health Centre, Montreal, Que. (Wong, Rousseau, Razek, Deckelbaum); the Surgeons Overseas, New York, NY (Wong, Kushner); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Kushner); and the Department of Surgery, Columbia University, New York, NY (Kushner)
| | - Marnie Wilson
- From the Department of Surgery, University of Rwanda, Kigali, Rwanda (Ntakiyiruta, Ruhungande, Kyamanywa); the Department of Surgery, McGill University, Montreal, Que. (Wong, Rousseau, Liberman, Khwaja, Dakermandji, Wilson, Razek, Deckelbaum); the Centre for Global Surgery, McGill University Health Centre, Montreal, Que. (Wong, Rousseau, Razek, Deckelbaum); the Surgeons Overseas, New York, NY (Wong, Kushner); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Kushner); and the Department of Surgery, Columbia University, New York, NY (Kushner)
| | - Tarek Razek
- From the Department of Surgery, University of Rwanda, Kigali, Rwanda (Ntakiyiruta, Ruhungande, Kyamanywa); the Department of Surgery, McGill University, Montreal, Que. (Wong, Rousseau, Liberman, Khwaja, Dakermandji, Wilson, Razek, Deckelbaum); the Centre for Global Surgery, McGill University Health Centre, Montreal, Que. (Wong, Rousseau, Razek, Deckelbaum); the Surgeons Overseas, New York, NY (Wong, Kushner); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Kushner); and the Department of Surgery, Columbia University, New York, NY (Kushner)
| | - Patrick Kyamanywa
- From the Department of Surgery, University of Rwanda, Kigali, Rwanda (Ntakiyiruta, Ruhungande, Kyamanywa); the Department of Surgery, McGill University, Montreal, Que. (Wong, Rousseau, Liberman, Khwaja, Dakermandji, Wilson, Razek, Deckelbaum); the Centre for Global Surgery, McGill University Health Centre, Montreal, Que. (Wong, Rousseau, Razek, Deckelbaum); the Surgeons Overseas, New York, NY (Wong, Kushner); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Kushner); and the Department of Surgery, Columbia University, New York, NY (Kushner)
| | - Dan L Deckelbaum
- From the Department of Surgery, University of Rwanda, Kigali, Rwanda (Ntakiyiruta, Ruhungande, Kyamanywa); the Department of Surgery, McGill University, Montreal, Que. (Wong, Rousseau, Liberman, Khwaja, Dakermandji, Wilson, Razek, Deckelbaum); the Centre for Global Surgery, McGill University Health Centre, Montreal, Que. (Wong, Rousseau, Razek, Deckelbaum); the Surgeons Overseas, New York, NY (Wong, Kushner); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Kushner); and the Department of Surgery, Columbia University, New York, NY (Kushner)
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Pauyo T, Debas HT, Kyamanywa P, Kushner AL, Jani PG, Lavy C, Dakermandji M, Ambrose H, Khwaja K, Razek T, Deckelbaum DL. Systematic Review of Surgical Literature from Resource-Limited Countries: Developing Strategies for Success. World J Surg 2016; 39:2173-81. [PMID: 26037025 DOI: 10.1007/s00268-015-3102-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Injuries and surgical diseases are leading causes of global mortality. We sought to identify successful strategies to augment surgical capacity and research endeavors in low-income countries (LIC's) based on existing peer-reviewed literature. METHODS A systematic review of literature from or pertaining to LIC's from January 2002 to December 2011 was performed. Variables analyzed included type of intervention performed, research methodology, and publication demographics such as surgical specialty, partnerships involved, authorship contribution, place and journal of publication. FINDINGS A total of 2049 articles met the inclusion criteria between 2002 and 2011. The two most common study methodologies performed were case series (44%) and case reports (18%). A total of 43% of publications were without outcome measures. Only 21% of all publications were authored by a collaboration of authors from low-income countries and developed country nationals. The five most common countries represented were Nepal (429), United States (408), England (170), Bangladesh (158), and Kenya (134). Furthermore, of countries evaluated, Nepal and Bangladesh were the only two with a specific national journal. INTERPRETATION Based on the results of this research, the following recommendations were made: (1) Describe, develop, and stimulate surgical research through national peer-reviewed journals, (2) Foster centers of excellence to promote robust research competencies, (3) Endorse partnerships across regions and institutions in the promotion of global surgery, and (4) Build on outcome-directed research.
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Affiliation(s)
- Thierry Pauyo
- Centre for Global Surgery, McGill University Health Centre, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada,
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Mak NTJJ, Iqbal S, de Varennes B, Khwaja K. Outcomes of post-cardiac surgery patients with persistent hyperlactatemia in the intensive care unit: a matched cohort study. J Cardiothorac Surg 2016; 11:33. [PMID: 26906890 PMCID: PMC4765137 DOI: 10.1186/s13019-016-0411-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 01/12/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Higher morbidity and mortality rates are seen amongst patients presenting with hyperlactatemia in the postoperative period. The purpose of this study was to determine the relationship between persistent elevations in lactate and poor ICU outcome in post-cardiac surgery patients. METHODS This was a retrospective matched cohort analysis of cardiac surgery patients undergoing bypass and/or valve surgery in a university hospital centre. Selection criteria were: cardiac bypass and/or valve surgery; admission to the ICU for > 24 h postoperatively; and peak lactate ≥ 3.0 mmol/L. Hyperlactatemic patients were matched to 2 normolactatemic patients. Multivariable conditional logistic regression was used to determine predictors of hyperlactatemia and mortality. RESULTS Four hundred sixty-nine post-cardiac surgery patients were admitted to the ICU for > 24 h. 144 of these patients had an arterial blood lactate ≥ 3.0 mmol/L. Amongst the mortalities, 78.9 % presented with hyperlactatemia. Independent risk factors predictive of a lactate ≥ 3.0 mmol/L were preoperative IABP insertion (RR 2.8, CI 1.1-7.2) and postoperative acute kidney injury (RR 3.2, CI 2.1-5.4). Patients whose lactate concentrations continued to increase >30 h postoperatively were more likely to die (RR 8.44 CI 2.50-28.53). CONCLUSIONS The persistence of hyperlactatemia is a more important determinant of postoperative outcome than the absolute value of the peak lactate concentration. A simple postoperative lactate washout does not sufficiently explain this lactate accumulation. Mortality is proposed to be secondary to a state of ongoing hypoperfusion.
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Affiliation(s)
- Nicole T J J Mak
- Division of General Surgery, Vancouver General Hospital, 950 West 10th Avenue, Vancouver, Canada.
| | - Sameena Iqbal
- Department of Nephrology, McGill University Health Centre, Montréal, Canada.
| | - Benoit de Varennes
- Division of Cardiothoracic Surgery, McGill University Health Centre, Montréal, Canada.
| | - Kosar Khwaja
- Departments of Surgery and Critical Care Medicine, McGill University Health Centre, 1650 Cedar Ave. L9.411, Montréal, QC, H3G 1A4, Canada.
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Wong EG, Ntakiyiruta G, Rousseau MC, Ruhungande L, Kushner AL, Liberman AS, Khwaja K, Dakermandji M, Wilson M, Razek T, Kyamanywa P, Deckelbaum DL. Acute care surgery in Rwanda: Operative epidemiology and geographic variations in access to care. Surgery 2015; 158:37-43. [PMID: 25991047 DOI: 10.1016/j.surg.2015.04.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 04/13/2015] [Accepted: 04/15/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Surgical management of emergent, life-threatening diseases is an important public health priority. The objectives of this study were to (1) describe acute care general surgery procedures performed at the largest referral hospital in Rwanda and (2) understand the geographic distribution of disease presentations and referral patterns. METHODS We performed a retrospective review of prospectively collected acute care surgery cases performed at the Centre Hospitalier Universitaire de Kigali (CHUK) in Rwanda between June 1 and December 1, 2011. Using Pearson's χ(2) test and the Fisher exact test, we compared cases originating from within Kigali and transfers from other provinces. Geospatial analyses also were used to further describe transfer patterns. RESULTS During the study period, 2,758 surgical interventions were performed, of which 25.6% (707/2,758) were general surgery operations. Of these, 45.4% (321/707) met the definition of acute care surgery. Only about one-third-32.3% (92/285)-of patients resided within Kigali, whereas about two-thirds-67.7% (193/285)-were transferred from other provinces. Most patients transferred from other provinces were younger than 18 years of age (40.4%; 78/193), and 83.0% (39/47) of patients older than 50 years of age originated from outside of Kigali. Specific operative indications and surgical procedures varied substantially between patients from Kigali and patients transferred from other provinces. CONCLUSION Emergency surgical conditions remain important contributors to the global burden of disease, particularly in low- and middle-income countries. Geographic variations exist in terms of operative diagnoses and procedures, which implies a need for improved access to surgical care at the district level with defined transfer mechanisms to greater-level care facilities when needed.
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Affiliation(s)
- Evan G Wong
- Department of Surgery, McGill University, Montreal, Quebec, Canada; Centre for Global Surgery, McGill University Health Centre, Montreal, Quebec, Canada; Surgeons Overseas, New York, NY.
| | | | - Mathieu C Rousseau
- Department of Surgery, McGill University, Montreal, Quebec, Canada; Centre for Global Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Adam L Kushner
- Surgeons Overseas, New York, NY; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Surgery, Columbia University, New York, NY
| | | | - Kosar Khwaja
- Department of Surgery, McGill University, Montreal, Quebec, Canada
| | - Marc Dakermandji
- Department of Surgery, McGill University, Montreal, Quebec, Canada
| | - Marnie Wilson
- Department of Surgery, McGill University, Montreal, Quebec, Canada
| | - Tarek Razek
- Department of Surgery, McGill University, Montreal, Quebec, Canada; Centre for Global Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Dan L Deckelbaum
- Department of Surgery, McGill University, Montreal, Quebec, Canada; Centre for Global Surgery, McGill University Health Centre, Montreal, Quebec, Canada
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St-Louis E, Sudarshan M, Al-Habboubi M, El-Husseini Hassan M, Deckelbaum DL, Razek TS, Feldman LS, Khwaja K. The outcomes of the elderly in acute care general surgery. Eur J Trauma Emerg Surg 2015; 42:107-13. [PMID: 26038035 DOI: 10.1007/s00068-015-0517-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 03/11/2015] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Elderly patients form a growing subset of the acute care surgery (ACS) population. Older age may be associated with poorer outcomes for some elective procedures, but there are few studies focusing on outcomes for the elderly ACS population. Our objective is to characterize differences in mortality and morbidity for acute care surgery patients >80 years old. METHODS A retrospective review of all ACS admissions at a large teaching hospital over 1 year was conducted. Patients were classified into non-elderly (<80 years old) and elderly (≥80 years old). In addition to demographic differences, outcomes including care efficiency, mortality, postoperative complications, and length of stay were studied. Data analysis was completed with the Student's t test for continuous variables and Fisher's exact test for categorical variables using STATA 12 (College Station, TX, USA). RESULTS We identified 467 non-elderly and 60 elderly patients with a mean age-adjusted Charlson score of 3.2 and 7.2, respectively (p < 0.001) and a mortality risk of 1.9 and 11.7 %, respectively (p < 0.001). The elderly were at risk of longer duration (>4 days) hospital stay (p = 0.05), increased postoperative complications (p = 0.002), admission to the ICU (p = 0.002), and were more likely to receive a non-operative procedure (p = 0.003). No difference was found (p = NS) for patient flow factors such as time to consult general surgery, time to see consult by general surgery, and time to operative management and disposition. CONCLUSIONS Compared to younger patients admitted to an acute care surgery service, patients over 80 years old have a higher risk of complications, are more likely to require ICU admission, and stay longer in the hospital.
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Affiliation(s)
- E St-Louis
- Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada.
| | - M Sudarshan
- Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada.
| | - M Al-Habboubi
- Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada.
| | - M El-Husseini Hassan
- Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada.
| | - D L Deckelbaum
- Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada.
| | - T S Razek
- Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada.
| | - L S Feldman
- Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada.
| | - K Khwaja
- Division of General Surgery, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada.
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Roizblatt D, Eamer G, Roberts D, Ball C, Banfield J, Greene B, Veigas P, Moore L, Schellenberg M, Ali J, Ali J, Xiao J, Babul S, Goeres P, Babsail AM, Rice T, MacGillivray S, Addioui A, Tardif PA, Porgo TV, Matar M, Tze N, Rae R, Alali A, Da Luz LT, Vogt K, Da Luz LT, Murphy P, Ali J, Mador B, Muakkassa F, Faidim S, Kirkpatrick A, Kirkpatric A, Laviolette M, Taylor S, Engels P, Hossri S, Snider C, Kortbeek J, Green R, Green R, Green R, Snider C, Green R, Lee C, Green R, Driedger M, Clement J, Charan NKD, Sowers N, Neuhaus N, Hardy I, Younus M, Ibrahim-Zada I, Marrer AMP, Bailey K, Bennett S, Gillman L, Hossri S, Cyr K, Yanchar N, Hinton M, Bernal E, Chisholm A, Hogan A, Watson I, Hogan A, Hogan A, Hewitson L, Rouse C, Rouse C, Al-Thani H, Masson-Trottier M, Mydeen MF, Sne N, Peralta R, Bracco D, Bracco D, Bekdache O, Bracco D, Bracco D, Padim P, Omar M, Yazdani S, Hussein Z, Zargaran E, Fong D, Almaawali A, Tien H, Alshlwi S, Moffat B, Biswas S, Hassan ME, Biswas S, Biswas S, LaLande A, Al Rawahi A, Min A, Phelan B, Harrington J, Mucciaccio M, Alhinai F, Knight H, Young D, Alam A, Waggott M, McKee J, Al-Masrouri S, Al Hinai A, McKee J, Mckee J, Semprun C, Collins D, Kim D, Grenier T, Curtis S, Dufrsne P, Curtis S, Khan S, Curtis S, Appel J, Appel J, Stewart TC, Keenan A, Thakore J, Younus A, Marrero AMP, Mapiour D, Hamadani F, Nascimento B, McGowan M, Kokoski C, Logsetty S, Lawless B, McBeth P, Di Battista A, Rao J, Alhabboubi M, Neto JR, Alhabboubi M, Neto JR, Rao J, Neto JR, Menezes A, Gillard K, Almansoori K, Nash N, Babsail A, Alhabboubi M, Hamadani F, Benyayer D, Malo C, Deckelbaum D, Khwaja K, Beckett A, Razek T, Fata P, Bratu I, Craig J, Faris P, Ball C, Tiruta C, Xiao J, McBeath P, Kubes P, Doig C, Kirkpatrick A, Lampron J, Rizoli S, Callum J, Nascimento B, Da Luz LT, Lauzier F, Berthelot S, Stelfox HT, Kortbeek J, Simons R, Bourgeois G, Clement J, Stevens K, Mehmood A, Gautam S, Zafarm I, Sorvari A, Adam R, Ondiveeran H, Bedaysie H, Ali E, Sorvari A, Briggs S, Wilson C, Robertson HL, Roberts D, Kirkpatrick A, Zeiler F, Unger B, Gillman L, Alhadhrami B, Elhusseini M, Alhalbboubi M, Abdulla M, Chughtai T, Fata P, Khwaja K, Razek T, Beckett A, Sne N, Rice J, Reid S, Li J, Baillie F, Somers A, Robinson T, Boone A, Sandhu N, Wishart I, Saint-Vil D, Crevier L, Beaudinn M, Moore L, Moore L, Lavoie A, Nshimyumukiza L, Turgeon A, Bourgeois G, Lapointe J, Cisse B, Duplantie J, Tran A, Margie O, Yelle JD, Pagliarello G, Lampron J, Grenier T, Lampron J, Bakry H, Malla A, Faidi S, Coates A, Engels P, Neto AC, DaCosta LD, Inaba K, Rhind S, Nascimento B, Rizoli S, Moffat B, Leeper W, Charyk-Stewart T, Malthaner R, Gray D, Parry N, Pena CES, Tien H, Nathens A, Nascimento B, Parry N, Sothilingam N, Vogt K, Moffat B, Gray D, Batey B, Charyk-Stewart T, Sovari A, Henry S, Nascimento B, Rizoli S, Marley R, Salvator A, Yetmar Z, Horattas I, Erck D, Landry BA, Coates A, Patlas M, Tien H, LaPorta A, McKee J, Wright-Beatty H, Keillorn J, Brien S, Roberts D, Wong J, Beckett A, Mador B, Ball C, Louw D, McKee I, McKee J, Panebianco N, Parfitt RJ, Roberts D, Hamilton D, Sevcik B, Lampron J, Waggott M, Stelfox HT, Boyd J, Erdogan M, Widder S, Butler M, Kureshi N, Martin K, Green R, Fasanya C, Barrett N, Cyr K, Camorlinga P, Quigley S, Kureschi N, Erdogan M, Butler M, Kureshi N, Erdogan M, Butler M, Kureshi N, Erdogan M, Longsetty S, Jian D, Fergusson D, Turgeon A, McIntyre L, Kovacs G, Griesdale D, Butler M, McLeod S, Klingel M, Van Aarsen K, Franc J, Peddle M, Fergusson D, Turgeon A, McIntyre L, Kovacs G, Griesdale D, Butler M, Gupta A, Wells B, Dixon E, Ball C, Moore L, Rajaram K, Froese P, Erdogan M, Green R, Younus M, Torres D, Widom K, Leonard D, Baro S, Dove J, Blansfield J, Shabahang M, Timmons S, Wild J, McFaull S, Beaudin M, Saint-Vil D, Torres D, Widom K, Leonard D, Baro S, Dove J, Blansfield J, Shabahang M, Wild J, Friese R, Rhee P, Veercruysse G, Joseph B, Wang A, Coates A, Pelletier H, Calligan D, Amath A, Knight H, Lampron J, Brindley P, Paton-Gay D, Engels P, Park J, Widder S, Fasanya C, Snider C, Barrett N, Cheng A, Mikrogianakis A, Dhanani S, Bhanji F, Lalani A, Al-Harthi F, Mehta S, Wolf S, Arnoldo B, Kowalske K, Phelan H, Benjamin S, Hogan A, Woodford S, Watson I, Woodford S, Watson I, Hogan A, Woodford S, Chisholm A, Louis R, St. Pierre E, Louis R, Woodford S, Watson I, Atkinson P, Mekwan J, Verheul G, Lewis D, Hayre J, French J, Watson I, Benjamin S, Fraser J, Chisholm A, Sealy B, Erdogan M, Green R, Atkinson P, Hayre J, French J, Watson I, Benjamin S, Fraser J, Chisholm A, Sealy B, Erdogan M, Green R, Atkinson P, El-Menyar A, Consunji R, Zarour A, Abdulrahman H, Parchani A, Peralta R, Cyr CE, Arbour C, Gosselin N, Marcotte K, Johnson A, Rice T, Rice J, Passos E, Fan J, Baillie F, Jichici D, Healey A, Consunji R, El Menyar A, Shaltout H, Abdi H, Tarakieh H, Abdulrahman H, Parchani A, Zarour A, Al Thani H, Deckelbaum D, Grenier T, Razek T, Boniface R, Museru L, Lalande A, Deckelbaum D, Razek T, Deckelbaum D, Grenier T, Razek T, Marcoux J, Maleki M, Deckelbaum D, Razek T, Canestrini S, Tuma M, McFarlan A, Neto JR, Veigas P, Rizoli S, Belmont CCG, Moore L, Tardif PA, Dufresne P, Bonaventure PL, McFarlan A, Veigas P, Neto JR, Rizoli S, Lakha N, Simons R, Ramsey D, Hameed M, Nicol A, Spence R, Navsaria P, Lakha N, Hussein Z, Wong H, Martinez R, Shangguan E, Asselstine J, Nascimento B, Brenneman F, Alhadhrami B, Bracco D, Razek T, Grush J, Vogt K, Ahghari M, Parry N, MacDonald R, Gray D, Iqbal S, Fong N, Grushka J, Deckelbaum D, St-Laurent L, Eckert E, Razek T, Khwaja K, Boniface R, Munthali V, Bracco D, Deckelbaum D, Museru L, Razek T, Kirkpatrick A, Roberts D, Doig C, Alhinai F, Xiao J, Kortbeek J, Rizoli S, Perez A, Shek P, Grodecki R, Veigas P, Peng H, Fraser J, Pishe T, Middeton J, Chisholm A, Benjamin S, Watson I, Atkinson P, Stewart TC, Penney A, McLeod S, Klingel M, Van Aarsen K, Hedges C, Dukelow A, Bradford P, Levy D, Kirkpatrick A, Doig C, Roberts D, Xiao J, Al Rawahi A, Keenan A, Waggott M, Lally S, Xiao J, Rados A, Williams A, Vis C, Perlman R, Callum J, Nascimento B, Tien H, Keenan A, Knight H, Tien H, Wright-Beatty H, Keillor J, LaPorta A, Brien S, Roberts D, Ball C, Louw D, Kirkpatrick A, Garraway N, Smith T, Simons R, Hameed M, Ball C, Roberts D, Filips D, Kirkpatrick A, Mckee I, Bouclin M, Atkinson I, Roberts D, McKee I, Kirkpatrick A, Tien H, Alam A, Nathens A, Nascimento B, Kim G, Putnam B, de Virgilio C, Maciel J, Neville A, Bongard F, Bricker S, Plurad D, Tze N, Odenbach J, Grokiert R, Falconer C, Courchesne C, Campbell S, Newton A, Moore L, Clement J, Falconer C, Sevcik B, VanRiper L, Wilkes H, Hussein A, Newton A, Alisc E, Hoysted C, Landolt M, Parri N, Lytle M, Stanley R, Kharbanda A, Babl F, Kassam-Adams N, Fichter K, Rao J, Harris Y, Nahachewsky D, Rao J, Parry N, Batey B, Fleiszer T, Fraser DD, Klassen B, Waggott M, Briereley Y, McMillan J, Robinson S, Williams D, Wild J, Widder S, Qosa H, Khwaja K, Razek T, Perez A, Rizoli S, Trpcic S, Adhikari N, Lamontagne F, Cumyn A, Burns K, Scales D, Duffett M, Henry B, McFarlan A, Zakrison T, Young A, MacKinnon D, Dainty K, Denbok J, Mcgowan M, Blight A, Bakker A, Barratt L, Butorac E, Gaunt K, Gawaziuk J, Lim S, Chateau D, Khan S, Doupe M, Sareen J, Sekhon M, Hameed M, Schuurman N, Dodek P, Ayas N, Vu E, Griesdale D, Rhind S, Hassan S, Perez A, Topolovec-Vranic J, Da Luz LT, Kenjilnaba, Neto AC, Trpcic S, Da Costa LD, Baker A, Rizoli S, Appel J, Lyster K, Grushka J, Hassan ME, Baabsail A, Khwaja K, Deckelbaum D, Razek T, Fata P, Ahmed N, Rotstein O, Rizoli S, Gao ZH, Duong M, Deckelbaum D, Razek T, Shum-Tim D, Khwaja K, Rizoli S, Abreu E, Rotstein O, Appel J, Fichter K, Abreu E, Machado C, Neto MP, Godinho J, Bernardes A, Rizoli S, Fry N, Liang M, Khwaja K, Brenneman F, Bleszynski M, Buczkowski A, Parry N, Martindale R, Evans D, Fraser S, Stephens M, Rao J, Kirkpatrick A, Knowlton L, Hameed M, Almansorri D, Mutiso V, Saleh A, Hawes H, Hogan J, Kromm J, Menon M, Benns M. Trauma Association of Canada Annual Scientific Meeting, Westin Calgary Calgary, Alberta, Apr. 10–11, 2015Outcomes and opportunities for improvement in self-inflicted blunt and penetrating traumaAbdominal compartment syndrome in the childActive negative pressure peritoneal therapy after abbreviated laparotomy: The intraperitoneal vacuum randomized controlled trialUse of a novel combined RFA/saline energy instrument for arresting ongoing hemorrhage from solid organ injuriesHealth care costs of burn patients from homes without fire sprinklersPenetrating trauma in eastern Ontario: a descriptive analysisThresholds of rotational thrombelastometry (ROTEM) used for the diagnosis and management of bleeding trauma patients: a systematic reviewA quality indicator to measure hospital complications for injury admissionsThromboelastography (TEG) in the management of trauma: implications for the developing worldPotential role of the rural trauma team development course (RTTDC) in the United Arab Emirates (UAE)Applicability of the advanced disaster medical response (ADMR) course, Trinidad and TobagoInflammatory mediators in intra-abdominal sepsis or injury: a scoping reviewEvaluation of the online Concussion Awareness Training Toolkit (CATT) for parents, players and coachesUltrasound assessment of optic nerve sheath diameter (ONSD) in healthy volunteersThe benefits of epidural analgesia in flail chest injuriesMandatory reporting rates of injured alcohol-impaired drivers with suspected alcohol dependence in a level 1 Canadian trauma centre: a single institution’s experienceSimulation implementation in a new pediatric residency program in Haiti: trauma specificsManagement of skull fractures in children younger than 1 year of ageResource use in patients who have sustained a traumatic brain injury within an integrated Canadian trauma system: a multicentre cohort studyResource use intensity in a mature, integrated Canadian trauma system: a multicentre cohort studyRates and determinants of unplanned emergency department visits and readmissions within 30 days following discharge from the trauma service — the Ottawa Hospital experienceAlcohol — screening, brief intervention and referral to treatment (SBIRT): Is it readily available in Canadian trauma centres?Management of traumatic occult hemothorax: a survey among trauma providers in CanadaAn audit of venous thromboembolism prophylaxis: a quality assurance project at our level 1 trauma centreCatecholamines as outcome markers in traumatic brain injuryAre we missing the missed injury? The burden of traumatic missed injuries diagnosed after hospital dischargeThe use of fibrinogen concentrate in trauma: a descriptive systematic reviewVery early initiation of chemical venous thromboembolism prophylaxis after solid organ injury is safe: a call for a national prospective multicentre studyThe 2 student to 1 faculty (2:1) model of teaching the Advanced Trauma Operative Management (ATOM) courseTrauma transfusion in the elderlyCocaine and benzodiazepines are more predictive of an injury severity score greater than 15 compared to alcohol or tetrahydrocannabinol in trauma patients under 18 years oldAre we missing traumatic bowel and mesenteric injuries?The marriage of surgical simulation and telementoring for damage control surgical training of operational first-respondersAdding remote ultrasound control to remote just-in-time telementored trauma ultrasound: a pilot studyDescriptive analysis of morbidity and mortality associated with falls at a level 1trauma centreDevelopment of an ICU transition questionnaire: evaluating the transfer process from ICU, ward, and patient/family stakeholder perspectivesUse of IO devices in trauma: A survey of trauma practitioners in Canada, Australia and New ZealandTime to reversal of medication-induced coagulopathy in traumatic intracranial hemorrhageMeta-analysis of randomized control trials of hospital based violence interventions on repeat intentional injuryBlunt injury of a horseshoe kidney, case report and review of the literatureLegal consequences for alcohol-impaired drivers involved in motor vehicle collisions: a systematic reviewA characterization of major adult sport-related trauma in Nova Scotia, 2000–2013Is hockey the most dangerous pediatric sport? An evaluation of pediatric sport-related injuries treated in Nova ScotiaInterim results of a pilot randomized control trial of an ED-based violence intervention programPre-intubation resuscitation by Canadian physicians: results of a national surveyFirst-responder accuracy using SALT during mass-casualty incident simulationEmergent endotracheal intubation: medications and device choices by Canadian resuscitation physicians“Oh the weather outside is frightful”: Severe injury secondary to falls while installing residential Christmas lightsCan we speak the same language? Understanding Quebec’s inclusive trauma systemAn unusual segmental clavicle fracture treated with titanium elastic nailImpact of the age of stored blood on trauma patient mortality: a systematic reviewInterhospital transfer of traumatic brain injury: utilization of helicopter transportCheerleading injuries: a Canadian perspectivePre-hospital mode of transport in a rural trauma system: air versus groundAnalysis of 15 000 patient transfers to level 1 trauma centre: Injury severity does not matter — just drive, drive, drive!The effects of legislation on morbidity and mortality associated with all-terrain vehicle and motorcycle crashes in Puerto RicoAssessing how pediatric trauma patients are supported nutritionally at McMaster Children’s HospitalOutcomes of conservative versus operative management of stable penetrating abdominal traumaS.T.A.R.T.T. — Evolution of a true multidisciplinary trauma crisis resource management simulation courseDevelopment of criteria to identify traumatic brain injury patients NOT requiring intensive care unit monitoringAssigning costs to visits for injuries due to youth violence — the first step in a cost-effectiveness analysisThere’s no TRIK to it — development of the Trauma Resuscitation in Kids courseResilient despite childhood trauma experiencesA five-year, single-centre review of toxic epidermal necrolysis managementAll in the family: creating and implementing an inclusive provincial trauma registryLessons learned from a provincial trauma transfer systemThe NB Trauma Program: 5 years laterProvincial coordination of injury prevention: the New Brunswick (NB) experienceImproving access and uptake of trauma nursing core course (TNCC): a provincial approachULTRASIM: ultrasound in trauma simultation. Does the use of ultrasound during simulated trauma scenarios improve diagnostic abilities?Traumatic tale of 2 cities, part 1: Does being treated by different EMS affect outcomes in trauma patients destined for transport to level 1 trauma centres in Halifax and Saint John?Traumatic tale of 2 cities, part 2: Does being treated by different hospitals affect outcome in trauma patients destined for transport to Level 1trauma centres in Halifax and Saint John?Protective devices use in road traffic injuries in a developing countryFunctional and anatomical connectivity and communication impairments in moderate to severe traumatic brain injuryCaring and communicating in critical cases: Westlock trauma form, a resource for rural physiciansMonitoring of ocular nerve sheath in traumatic raised intracranial pressure (Moonstrip Study): a prospective blinded observational trialEstablishing an alcohol screening and brief intervention for trauma patients in a multicultural setting in the Middle East: challenges and opportunitiesThe poor compliance to seat belt use in Montréal: an 18 461 road user iPhone-based studyAn iPad-based data acquisition for core trauma registry data in 6 Tanzanian hospitals: 1 year and 13 462 patients later“The Triple-Q Algorithm”: a practical approach to the identification of liver topographyA pan-Canadian bicycle helmet use observational studyDoor to decompression: the new benchmark in trauma craniotomiesAre missed doses of pharmacological thromboprophylaxis a risk factor for thromboembolic complications?Complications following admission for traumatic brain injuryExcessive crystalloid infusion in the first 24 hours is not associated with increased complications or mortalitySBIRT: plant, tend, growReal time electronic injury surveillance in an African trauma centreSBIRT in concert: establishing a new initiativeReview of the current knowledge of the pathophysiology of acute traumatic coagulopathy: implications for current trauma resuscitation practicesFactors associated with primary fascial closure rates in patients undergoing damage control laparotomyFree intraperitoneal fluid on CT abdomen in blunt trauma: Is hospital admission necessary?The need for speed — the time cost of off-site helipadsEndovascular management of penetrating Zone III retroperitoneal injuries in selective patients: a case reportMeasured resting energy expenditure in patients with open abdomens: preliminary data of a prospective pilot studyTraumatic inferior gluteal artery pseudoaneurysm: case report and review of literaturePancreatico duodenectomy, SMA, SMV repair and delayed reconstruction following blunt abdominal trauma. A case report with discussion of trauma whipple and complex pancreatico duodenal injuriesA retrospective evaluation of the effect of the Trauma Team Training program in TanzaniaDoes procalcitonin measurement predict clinical outcomes in critically ill/injured adults managed with the open abdomen technique?In trauma, conventional ROTEM and TEG results are not interchangeable but are similar in clinical applicabilitySevere trauma in the province of New Brunswick: a descriptive epidemiological studyPartnering for success — a road safety strategy for London and regionEvaluation of a patient safety initiative of rapid removal of backboards in the emergency departmentActive negative pressure peritoneal therapy and C-reactive protein levels after abbreviated laparotomy for abdominal trauma or intra-abdominal sepsisA comparison of outcomes: Direct admissions vs. interhospital transfers April 2009–March 2014YEE HA or YEE OUCH! A 5-year review of large animal-related incidentsEarly goal-directed therapy for prevention of hypothermia-related transfusion, morbidity and mortality in severely injured trauma patientsImproving care of adolescent trauma patients admitted to adult trauma centres by fostering collaboration between adult and pediatric partnersExpediting operational damage control laparotomy closure: iTClam v. suturing during damage control surgical simulation trainingAre conventional coagulation tests inadequate in the assessment of acute traumatic coagulopathy?Predictors of long-term outcomes in patients admitted to emergency general surgery services: a systematic review of literatureUse of the iTClamp versus standard suturing techniques for securing chest tubes: A randomized cadaver studyiTClamp application for control of simulated massive upper extremity arterial hemorrhage by tactical policeAssessing performance in the trauma roomThe deadly need for methadone/opiate educationTrends in the management of major abdominal vascular injuries: 2000–2014Addressing high school seniors’ risky behaviours through a hospital-based and peer teaching outreach programScreening for risk of post-traumatic stress disorder after injury in acutely injured children: a systematic reviewThe impact of trauma centre designation levels on surgical delay, mortality and complications: a multicentre cohort studyHow many acutely injured children report subsequent stress symptoms?The frequency of coagulopathy and its significance in an emergency neurotrauma facilityPsychosocial care for injured children: The views of 2500 emergency department physicians and nurses from around the worldDevelopment of the Trauma Electronic Document (TED)Development of trauma team activation criteria for an urban trauma centreBrains and brawn: evaluation of a sports skills and concussion awareness campRegional trauma networks: a tale of 2 pilotsContinuous data quality improvement in a provincial trauma registryDoes the Rural Trauma Team Development Course shorten transfer time?Epidemiology of trauma in Puerto RicoCT scans facilitate early discharge of trauma patientsFeasibility of data collection in a conflict zone to assess the impact on emergency health care deliveryConsent for Emergency Research (CONfER): a national survey of Canadian research ethics board practicesMaking handover safer for our trauma patients through the lens of trauma team leadersChallenges and opportunities to improve trauma transitions of care from emergency to intensive care nursingPhysical disorder following major injury: a population-based studyToward an inclusive trauma system: regional trauma system development in OntarioTraumatic brain injury in British Columbia: current incidence, injury patterns and risk factorsAcute cytokine and chemokine profiles in brain-injured patients: relationship to sympathetic activation and outcomeMultidisciplinary trauma simulation training in a tertiary care centreNon-operative management of blunt splenic injuries: routine radiologic follow-up may reduce the time of activity restrictionModified triple layer peritoneal-aponeurotic transposition: a new strategy to close the open abdomenMesenchymal stem cells locate and differentiate to the trauma site in a blunt rat liver trauma model: preliminary resultsThree indications for the “open abdomen”, anatomical, logistical and physiological: How are they different?Development of an urban trauma centre using lean methodologyThe impact of standardized care in 191 patients with chest tube thoracostomyComplex abdominal wall reconstruction: recommendations from the Canadian Abdominal Wall Reconstruction GroupCompensatory behaviours and cognitions in persons with history of traumaDevelopment of the Kenyatta National Hospital — University of Alberta Orthopedic Trauma Assessment Tool: phase 1 resultsRisk-taking behaviour negatively affects outcome in burn patients. Can J Surg 2015. [DOI: 10.1503/cjs.003415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Deckelbaum DL, Gosselin-Tardif A, Ntakiyiruta G, Liberman S, Vassiliou M, Rwamasirabo E, Gasakure E, Fata P, Khwaja K, Razek T, Kyamanywa P. An innovative paradigm for surgical education programs in resource-limited settings. Can J Surg 2015; 57:298-9. [PMID: 25265101 DOI: 10.1503/cjs.001514] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
The burden of surgical disease in low-income countries remains significant, in part owing to continued surgical workforce shortages. We describe a successful paradigm to expand Rwandan surgical capacity through the implementation of a surgical education partnership between the National University of Rwanda and the Centre for Global Surgery at the McGill University Health Centre. Key considerations for such a program are highlighted.
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Affiliation(s)
- Dan L Deckelbaum
- McGill University Health Centre, Centre for Global Surgery, Montréal, Que
| | | | | | - Sender Liberman
- McGill University Health Centre, Centre for Global Surgery, Montréal, Que
| | - Melina Vassiliou
- McGill University Health Centre, Centre for Global Surgery, Montréal, Que
| | - Emile Rwamasirabo
- National University of Rwanda, Department of Surgery, Kigali, Rwanda
| | - Emmanuel Gasakure
- National University of Rwanda, Department of Surgery, Kigali, Rwanda
| | - Paola Fata
- McGill University Health Centre, Centre for Global Surgery, Montréal, Que
| | - Kosar Khwaja
- McGill University Health Centre, Centre for Global Surgery, Montréal, Que
| | - Tarek Razek
- McGill University Health Centre, Centre for Global Surgery, Montréal, Que
| | - Patrick Kyamanywa
- National University of Rwanda, Department of Surgery, Kigali, Rwanda
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Gosselin-Tardif A, Butler-Laporte G, Vassiliou M, Khwaja K, Ntakiyiruta G, Kyamanywa P, Razek T, Deckelbaum DL. Enhancing medical students' education and careers in global surgery. Can J Surg 2014; 57:224-5. [PMID: 25078923 DOI: 10.1503/cjs.027713] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
With surgical conditions being significant contributors to the global burden of disease, efforts aimed at increasing future practitioners' understanding, interest and participation in global surgery must be expanded. Unfortunately, despite the increasing popularity of global health among medical students, possibilities for exposure and involvement during medical school remain limited. By evaluating student participation in the 2011 Bethune Round Table, we explored the role that global surgery conferences can play in enhancing this neglected component of undergraduate medical education. Study results indicate high rates of student dissatisfaction with current global health teaching and opportunities, along with high indices of conference satisfaction and knowledge gain, suggesting that global health conferences can serve as important adjuncts to undergraduate medical education.
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Affiliation(s)
| | | | - Melina Vassiliou
- McGill University Health Centre, Center for Global Surgery, Montréal, Que
| | - Kosar Khwaja
- McGill University Health Centre, Center for Global Surgery, Montréal, Que
| | | | - Patrick Kyamanywa
- The National University of Rwanda, Department of Surgery, Kigali, Rwanda
| | - Tarek Razek
- McGill University Health Centre, Center for Global Surgery, Montréal, Que
| | - Dan L Deckelbaum
- McGill University Health Centre, Center for Global Surgery, Montréal, Que
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Crowther M, Cook D, Guyatt G, Zytaruk N, McDonald E, Williamson D, Albert M, Dodek P, Finfer S, Vallance S, Heels-Ansdell D, McIntyre L, Mehta S, Lamontagne F, Muscedere J, Jacka M, Lesur O, Kutsiogiannis J, Friedrich J, Klinger JR, Qushmaq I, Burry L, Khwaja K, Sheppard JA, Warkentin TE. Heparin-induced thrombocytopenia in the critically ill: interpreting the 4Ts test in a randomized trial. J Crit Care 2014; 29:470.e7-15. [PMID: 24726205 DOI: 10.1016/j.jcrc.2014.02.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 01/09/2014] [Accepted: 02/10/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Thrombocytopenia occurs in 20% to 45% of critically ill medical-surgical patients. The 4Ts heparin-induced thrombocytopenia (HIT) score (with 4 domains: Thrombocytopenia, Timing of thrombocytopenia, Thrombosis and oTher reason[s] for thrombocytopenia) might reliably identify patients at low risk for HIT. Interobserver agreement on 4Ts scoring is uncertain in this setting. OBJECTIVE To evaluate whether a published clinical prediction rule (the "4Ts score") reliably rules out HIT in "low-risk" intensive care unit (ICU) patients as assessed by research coordinators (who prospectively scored) and 2 adjudicators (who scored retrospectively) during an international heparin thromboprophylaxis trial (PROTECT, NCT00182143). METHODS Of 3746 medical-surgical ICU patients in PROTECT, 794 met the enrollment criteria for this HIT substudy. Enrollment was predicated on one of the following occurring in ICU: platelets less than 50×10(9)/L, platelets decreased to 50% of ICU admission value (if admission value<100×10(9)/L), any venous thrombosis, or if HIT was otherwise clinically suspected. Independently, 4Ts scores were completed in real time by research coordinators blinded to study drug and laboratory HIT results, and retrospectively by 2 adjudicators blinded to study drug, laboratory HIT results, and research coordinators' scores; the adjudicators arrived at consensus in all cases. Of the 763 patients, 474 had a central or local laboratory HIT test performed and had 4Ts scoring by adjudicators; 432 were scored by trained research coordinators. Heparin-induced thrombocytopenia was defined by a centrally performed positive serotonin release assay (SRA). RESULTS Of the 474 patients with central adjudication, 407 (85.9%) had a 4Ts score of 3 or lower, conferring a low pretest probability (PTP) of HIT; of these, 6 (1.5% [95% confidence interval, 0.7%-3.2%) had a positive SRA. Fifty-nine (12.4%) had a moderate PTP (4Ts score of 4-5); of these, 4 (6.8%) had a positive SRA. Eight patients had a high PTP (4Ts score of ≥6); of these, 1 (12.5%) had a positive SRA. Raw agreement between research coordinators and central adjudication on each domain of the 4Ts score and low, intermediate, and high PTP was good. However, chance-corrected agreement was variable between adjudicators (weighted κ values of 0.31-0.93) and between the adjudicator consensus and research coordinators (weighted κ values of 0.13 and 0.78). Post hoc review of the 6 SRA-positive cases with an adjudicated low PTP demonstrated that their scores would have been increased if the adjudicators had had additional information on heparin exposure prior to ICU admission. In general, the fourth domain of 4Ts (oTher causes of thrombocytopenia) generated the most disagreement. CONCLUSIONS Real-time 4Ts scoring by research coordinators at the time of testing for HIT was not consistent with 4Ts scores obtained by central adjudicators. The results of this comprehensive HIT testing highlight the need for further research to improve the assessment of PTP scoring of HIT for critically ill patients.
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Affiliation(s)
- Mark Crowther
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Deborah Cook
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada.
| | - Gordon Guyatt
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Nicole Zytaruk
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Ellen McDonald
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - David Williamson
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Martin Albert
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Peter Dodek
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Simon Finfer
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Shirley Vallance
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Diane Heels-Ansdell
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Lauralyn McIntyre
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Sangeeta Mehta
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Francois Lamontagne
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - John Muscedere
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Michael Jacka
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Olivier Lesur
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Jim Kutsiogiannis
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Jan Friedrich
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - James R Klinger
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Ismael Qushmaq
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Lisa Burry
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Kosar Khwaja
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Jo-Ann Sheppard
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
| | - Theodore E Warkentin
- St Joseph's Healthcare, Critical Care Research Office, Hamilton, Ontario, Canada
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48
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Brown DR, Heidary B, Bell N, Appleton L, Simons RK, Evans DC, Hameed SM, Taunton J, Khwaja K, O'Connor M, Garraway N, Hennecke P, Kuipers D, Taulu T, Quinn L. Creating a gold medal Olympic and Paralympics health care team: a satisfaction survey of the mobile medical unit/polyclinic team training for the Vancouver 2010 winter games. BMC Res Notes 2013; 6:462. [PMID: 24225074 PMCID: PMC3843529 DOI: 10.1186/1756-0500-6-462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 11/08/2013] [Indexed: 11/30/2022] Open
Abstract
Background The mobile medical unit/polyclinic (MMU/PC) was an essential part of the medical services to support ill or injured Olympic or Paralympics family during the 2010 Olympic and Paralympics winter games. The objective of this study was to survey the satisfaction of the clinical staff that completed the training programs prior to deployment to the MMU. Methods Medical personnel who participated in at least one of the four training programs, including (1) week-end sessions; (2) web-based modules; (3) just-in-time training; and (4) daily simulation exercises were invited to participate in a web-based survey and comment on their level of satisfaction with training program. Results A total of 64 (out of 94 who were invited) physicians, nurses and respiratory therapists completed the survey. All participants reported favorably that the MMU/PC training positively impacted their knowledge, skills and team functions while deployed at the MMU/PC during the 2010 Olympic Games. However, components of the training program were valued differently depending on clinical job title, years of experience, and prior experience in large scale events. Respondents with little or no experience working in large scale events (45%) rated daily simulations as the most valuable component of the training program for strengthening competencies and knowledge in clinical skills for working in large scale events. Conclusion The multi-phase MMU/PC training was found to be beneficial for preparing the medical team for the 2010 Winter Games. In particular this survey demonstrates the effectiveness of simulation training programs on teamwork competencies in ad hoc groups.
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Affiliation(s)
- D Ross Brown
- Trauma Services, Vancouver General Hospital, 855 West 12th Avenue, Vancouver, British Columbia, V5Z 1 M9, Canada.
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49
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Lee J, Iqbal S, Gursahaney A, Nouh T, Khwaja K. Medicine versus surgery/anesthesiology intensivists: a retrospective review and comparison of outcomes in a mixed medical-surgical-trauma ICU. Can J Surg 2013; 56:275-9. [PMID: 23883499 DOI: 10.1503/cjs.005412] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND With various types of complex patients being treated in a mixed medical- surgical- trauma intensive care unit (ICU), we hypothesized that there should be no difference in patient mortality with respect to the core training of the intensivist. METHODS We reviewed the cases of all patients admitted to a mixed medical-surgical-trauma ICU at a Canadian university teaching hospital in 2007. Patients were assigned to 1 of 2 treatment groups (internal medicine, surgery/anesthesiology) based on the treating intensivist's training. Our primary outcome was to compare patient mortality in the ICU between the groups. We used generalized estimating equations to determine 10-day mortality after admission to the ICU. A multivariate Cox hazard model was used to determine statistical significance and 95% confidence intervals (CIs) for 11- to 60-day mortality in the ICU. RESULTS A total of 961 patients were admitted from January to December, 2007. We found no significant difference between the groups in 10-day mortality (odds ratio 0.73, 95% CI 0.46-1.18, p = 0.20) and 11- to 60-day mortality (hazard ratio 1.43, 95% CI 0.62-3.30, p = 0.40) after admission to the ICU. CONCLUSION In a large university trauma centre that operates a mixed medicine- surgical-trauma ICU, there was no significant difference in mortality between patients managed by intensivists with core training in internal medicine and those managed by intensivists with training in surgery/anesthesiology.
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Affiliation(s)
- James Lee
- Department of Surgery and Critical Care Medicine, Montreal General Hospital, McGill University, Montréal, Que
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50
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Grenier T, Deckelbaum DL, Boulva K, Drudi L, Feyz M, Rodrigue N, Tze N, Fata P, Khwaja K, Chughtai T, Razek T. A descriptive study of bicycle helmet use in Montreal, 2011. Can J Public Health 2013; 104:e400-4. [PMID: 24183181 DOI: 10.17269/cjph.104.3936] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 09/26/2013] [Accepted: 09/17/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of this study was to describe bicycle helmet use among Montreal cyclists as a step towards injury prevention programming. METHODS Using a cross-sectional study design, cyclists were observed during 60-minute periods at 22 locations on the island of Montreal. There were 1-3 observation periods per location. Observations took place between August 16 and October 31, 2011. Standard statistical methods were used, unadjusted and adjusted odds ratios and 95% confidence interval were calculated. RESULTS A total of 4,789 cyclists were observed. The helmet-wearing proportion of all cyclists observed was 46% (95% CI 44-47). Women had a higher helmet-wearing proportion than men (50%, 95% CI 47-52 vs. 44%, 95% CI 42-45, respectively). Youth had the highest helmet-wearing proportion (73%, 95% CI 64-81), while young adults had the lowest (34%, 95% CI 30-37). Visible minorities were observed wearing a helmet 29% (95% CI 25-34) of the time compared to Caucasians, 47% (95% CI 46-49). BIXI (bike sharing program) riders were observed wearing a helmet 12% (95% CI 10-15) of the time compared to riders with their own bike, 51% (95% CI 49-52). CONCLUSIONS Although above the national average, bicycle helmet use in Montreal is still considerably low given that the majority of cyclists do not wear a helmet. Injury Prevention Programs could target the entire cyclist population, but special attention may be warranted in specific groups such as young men, visible minorities, BIXI riders, and those riding in tourist areas. Additionally, a collaborative enterprise with the bicycle sharing system BIXI Montreal™ could prove to be fruitful in addressing the availability of bike helmets for BIXI riders.
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Affiliation(s)
- Tara Grenier
- McGill University Health Centre- Montreal General Hospital: Trauma Program.
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