The Canadian Medical Association Journal is reporting that 27 per cent of children awaiting surgery at a pediatric hospital end up going under the knife past the target date.
The report, part of a study conducted by researchers from the Hospital for Sick Children and the Canadian Paediatric Surgical Wait Times Project, examined 64,012 surgeries conducted at pediatric health centres nationwide. Of the types of surgeries that were delayed, the most common were dental (45 per cent), ophthalmology (43 per cent) and plastic (35 per cent). Cancer, neurosurgery and cardiac surgery rounded out the list.
The study comes as previous federal governments have vowed to crack down on wait-times, combined with similar commitments from the provinces, which deliver health care.
“Despite receipt of surgery within six months of the decision to treat for 90 per cent of patients, clinically derived targets found that 27 per cent of children waited too long for their specific condition,” co-author Dr. James Wright of The Hospital for Sick Children writes.
Of concern is the impact delaying surgery can have on children, the authors say. It can affect physical and cognitive development and, in cases where surgery is needed to correct a particular condition, can have a serious impact on a child’s quality of life.
A related research article backed up that concern, particularly when it comes to waiting for surgery and the effect it has on outcomes and risks. Those authors found that wait times exceeding three months for teenagers with scoliosis increases the likelihood of complications and additional surgeries.
“The highest risks of adverse events due to prolonged wait times occurred in patients who were skeletally immature and had larger curvatures of the spine,” wrote Dr. Henry Ahn of St. Michael’s Hospital in Toronto, pointing out the progressive nature of the disease can make surgery more challenging.
Ahn and his co-authors concluded a three-month wait time helps minimize any subsequent risk by reducing the progression of scoliosis and subsequently decreases the need for additional surgery.
While doctors and researchers are typically jumping over one another for available grant funding, there is one grant that has not yet been tapped and might point to a bias against gay and bisexual men, according to an article in the Canadian Medical Association Journal.
The grant in question, worth about $500,000, is aimed at “supporting clinical research necessary to justify relaxing the current … ban on gay and bisexual men as eligible blood donors.”
Canadian Blood Services policy does not allow men who have ever had sex with another man dating back to 1977 to ever donate blood or blood products due to what was and is still seen as the risk of tainting the blood supply with products potentially laced with HIV or hepatitis C.
Jason Behrmann and Vardit Ravitsky of the of University of Montreal write that new screening methods allow early detection of HIV and hepatitis B and C, which can protect the blood supply.
“This case also provides an illuminating example as to why it is necessary for Canadian guidelines regarding ethic conduct for research involving humans to continue to foster fairness and equity in research,” the pair writes. “Ignoring a grant that encourages the inclusion of sexual minorities in clinical research therefore runs contrary to national standards of scientific excellence.”
Individuals who are tall and obese — especially men — have a significantly higher risk of developing blood clots in deep veins.
Published online in this week’s Arteriosclerosis, Thrombosis and Vascular Biology: Journal of the American Heart Association, the study looked at height and weight in both men and women and their risk of developing a blood clot, which can lead to an embolism. Such a condition is called venous thromboembolism (VTE).
The study team out of Norway analyzed the height and weight of 26,714 men and women aged 25 to 97 years who had taken part in regular health surveys. The median follow-up was 12.5 years. Between 1994 and 2007, 461 VTEs were recorded.
For statistical purposes, men five-feet-seven or shorter were considered short, while measuring six-feet were considered tall. For women, short was five-feet-two while tall was five-feet-six. Traditional body mass index measurements were used to determine obesity.
The researchers found that, compared to short, normal-weight men, the risk of developing VTE was 2.11 times higher in short, obese men, 2.57 times higher in tall, normal weight men and 5.28 times higher in tall, obese men. Compared to short, normal weight women, the risk was 1.83 times higher for short, obese women, not increased at all in tall, normal weight women, and 2.77 times higher in tall, obese women.
“The combination of obesity and a tall stature was associated with a substantially increased risk of VTE, especially in men, suggesting synergistic effects of obesity and height on risk of VTE in both sexes,” the researchers wrote.
The team also said the difference between the risk for tall, obese men and tall, obese women can be explained by the simple fact that women are traditionally shorter than men.
