2008-02-27 - In Quebec, it is estimated that 4800 patients are hospitalized each year for acute myocardial infarction with ST-segment elevation (STEMI). The immediate cause of this serious condition is the occlusion of a coronary artery by a thrombus that must be urgently cleared to minimize irreversible damage to the cardiac muscle. There are two treatments that can be used to reopen the occluded artery, fi brinolysis and primary percutaneous coronary intervention (PPCI). Both treatments are recommended in clinical practice guidelines of different countries. According to these guidelines and available evidence, it cannot be affi rmed that one of these methods of reperfusion is superior to the other for all patients in all clinical situations, at all times of the day. In this context, the best treatment for a particular patient will be that which is clinically appropriate and administered in a timely fashion, that is, within recommended delays. Such management is dependant on optimal organization and delivery of care and services.

Report prepared for AETMIS by Carole St-Hilaire.

Point-of-care testing (POCT) refers to analytical tests performed by qualified health professionals outside recognized and accredited public or private laboratories and outside health and social services institutions (as defined by law). This area of activity is not
currently regulated.  Faced with the growing reliance on POCT and the need to ensure that these tests are of high quality, safe and technically effective, the Ministère de la Santé et des Services sociaux (MSSS) decided to review the legislation and regulations applicable to POCT and to assess the need for governance oversight in this area. In that context, the MSSS asked AETMIS to support this review process by performing an exhaustive
literature review that would help provide an appropriate defi nition for POCT, draw up a list of Canada approved kits and instruments, flag the major issues associated with POCT, and identify the quality-control and quality-assurance measures proposed in Canada and around the world.

Report prepared for AETMIS by Khalil Moqadem and Gilles Pineau. 

Since the first hyperbaric chambers were built more than two centuries ago, the therapeutic use of hyperbaric oxygen (HBO) therapy has gradually expanded to several diseases and conditions. 

Report prepared for AETMIS by Brigitte Côté et Nieves Rodriguez.

In recent years, the emergence of new diagnostic techniques for detecting this disease has again raised the issue of the advisability of implementing a population screening program. In this context, the Agency considered it appropriate to produce an update on this issue.

Information Brief prepared for AETMIS by Laurie Lambert, Peter Bogaty, James Brophy and Lucy J. Boothroyd.

Percutaneous coronary intervention (PCI) is a technique for opening up or dilating coronary arteries narrowed or occluded by atherothrombotic lesions. It is generally performed in catheterization laboratories in facilities that have on-site cardiac surgery to deal with certain serious, albeit rare, complications that can occur. However, over the past several years, there have been pressures worldwide to perform PCI at facilities without on-site cardiac surgical support. Québec already has five such centres (more than in the rest of Canada combined), but the Ministère de la Santé et des Services sociaux continues to receive requests for opening new catheterization laboratories in hospitals without on-site cardiac surgery. Despite the advantages of this practice in terms of patient access, its advisability and safety are still debated.