This survey aims to understand how clinical guidelines are interpreted and practiced.

This survey gives you the chance to offer feedback on key principles underlying a timely CT scan. This is part of a wider project aiming to improve the time it takes for a patient to receive an emerge...

This survey aims to understand how clinical guidelines are interpreted and practiced.

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CALGARY, AB, March 11, 2025 /CNW/ - (TSX: ARX) ARC Resources Ltd. ("ARC" or the "Company"), announced today it has entered into a long-term sale and purchase agreement ("SPA" or "the Agreement") with ...

This article documents the creation of EMLAP (Early Modern Latin Alchemical Prints), a machine-readable corpus of one hundred Latin alchemical printed works produced within the TOME (The Origins of...

Background Restoration of intestinal continuity is a key consideration for patients having a stoma created under emergency conditions. There is contrasting evidence about the outcomes of stoma reversal for these patients. This research aims to describe the post-operative outcomes of stoma reversal after emergency formation, and whether these are affected by the timing of reversal. Methods A retrospective review of a prospectively maintained emergency laparotomy (EmLap) database for 4 hospitals was performed between 2018 and 2021. Adult patients undergoing emergency stoma formation were identified and followed up until 2024. Those undergoing stoma reversal surgery were included in the final analysis. A Cox proportional-hazards model was created to identify factors associated with increased time to reversal. Results 1775 patients had an EmLap, with 505 (28.5%) having a stoma created. Of those patients with a stoma, 97 patients (19.2%) died within one year post-operatively. 146 (28.9%) of the emergency stoma patients underwent stoma reversal, with median time to reversal of 16.9 months. Median post-operative length of stay was 7 days, and 52.1% of patients sustained complications within 30 days post-operatively. Patients reversed within 18 months of stoma formation had fewer significant complications (7.9% v 35.1%, p < 0.001), a shorter length of stay (6 days v 7 days, p < 0.001), and reduced post-operative ileus rates (21.3% v 64.9%, p < 0.001) than those reversed after this period. Receiving adjuvant therapy for malignancy (adjusted Hazard ratio 0.36, 0.17–0.78, p = 0.001) and being male (adjusted Hazard ratio 0.69, 0.49–0.97, p = 0.032) were significantly associated with increased time to reversal. Conclusion Emergency stoma formation is commonly performed during EmLap, but the majority of emergency stomas are never reversed. The complication profile for reversing these stomas is significant, but early reversal is associated with better post-operative outcomes. Standards of care for emergency stoma patients would be welcome in order to improve outcomes for this cohort.

Introduction Emergency laparotomy (EmLap) is a complex clinical arena, delivering time-sensitive, definitive care to a high-risk patient cohort, with significant rates of post-operative morbidity and mortality. Embedding perioperative care pathways within this complex setting has the potential to improve post-operative outcomes, however, requires an in-depth understanding of their design, delivery and outcome assessment. Delivering and implementing complex interventions such as perioperative pathways require transparent reporting with detailed and indepth description of all components during the assessment and evaluation phase. The aim of this systematic review was to identify the current design and reporting of perioperative pathways in the EmLap setting. Methods The OVID SP versions of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched between January 1950 and December 2023. All randomised and non-randomised cohort studies reporting outcomes on perioperative care pathways in adult patients (> 18 years old) undergoing major emergency abdominal surgery were included. A narrative description of all perioperative pathways included was reported to identify design and description of the pathway including the delivery and timing of component interventions. All pathways were evaluated against the Template for Intervention Description and Replication (TIDieR) checklist. Results Eleven RCTs and 19 non-randomised studies were identified, with most studies considered to be at moderate risk of bias. Twenty-six unique pathways were identified and described, delivering a total of 400 component interventions across 44,055 patients. Component interventions were classified into 24 domains across the perioperative pathway. Twenty studies (66.6%) did not report the TIDieR framework items, with thirteen studies reporting less than 50% of all items. Two hundred and fifty individual outcomes were reported across pathways, with the most commonly reported outcomes related to morbidity, mortality and length of stay. Conclusion Current perioperative pathways in EmLap setting are underpinned by variable component interventions, with a lack of in-depth intervention reporting and evaluation. Future studies should incorporate the TIDieR checklist when reporting on perioperative pathways in the EmLap setting. Clinical trial number Not applicable.

This project aims to understand how pathways for emergency laparotomy are working as the first stage in seeking to streamline care and improve outcomes.

Cedar LNG gives ARC Resources increased access to international pricing for natural gas ​Cedar LNG gives ARC Resources increased access to international pricing for natural gas    ARC Resources (TSX:ARX) has inked an LNG offtake agreement with ExxonMobil LNG Asia Pacific (EMLAP), with the LNG to be supplied through the Cedar LNG terminal in Kitimat. &#013; ARC today announced EMLAP will take 1.5 million tonnes per annum (mtpa) of LNG for the duration of ARC’s 20-year tolling agreement with Cedar LNG, which is expected to be in operation in 2028.