Joan Saary - Academia.edu (original) (raw)

Papers by Joan Saary

Cerebral circulation, cognition and behavior, 2024

Occupational Medicine, Jun 1, 2002

Trimethyl tin chloride (TMTC) is a highly toxic organotin compound that affects four main target ... more Trimethyl tin chloride (TMTC) is a highly toxic organotin compound that affects four main target organs: the brain, liver, immune system and skin. Exposure can occur by inhalation, ingestion or direct skin absorption. Trimethyl tin is but one of many hazardous substances with potentially serious health consequences to which individuals working in research laboratories may be exposed. We report a preventable case of TMTC exposure. Better understanding of the Canadian Workplace Hazardous Materials Information System (WHMIS) legislation and its applicability to the research laboratory situation would prevent such unnecessary exposure to hazardous substances.

A patent foramen ovale (PFO) is a small opening between the right and left cardiac atria, a persi... more A patent foramen ovale (PFO) is a small opening between the right and left cardiac atria, a persisting remnant of a physiologic communication present in the fetal heart. This normally closes after birth, but remains patent through to adulthood in up to a third of normal adults. A patent PFO is a potential conduit for blood clot (resulting in a stroke), or venous gas bubbles during decompression, (resulting in type II neurologic decompression sickness). There has been considerable controversy about the significance of a PFO as a possible mechanism for type II decompression sickness. Despite the high prevalence of PFO in the general population, and the relatively common occurrence of venous gas bubbles in diving and altitude exposures, the incidence of type II DCS in diving or with altitude exposure is low. This paper reviews the literature with respect to the potential for rightto-left embolization through a PFO, relation of PFO to DCS, screening techniques for PFO, and treatment options. The literature supports a relationship between the presence and size of PFO and cryptogenic stroke (stroke, generally in younger individuals with no other identifiable risk factors). The weight of evidence also favours an increased relative risk of type II DCS with a PFO, although the absolute increase in risk accrued is small. The gold standard for PFO screening is a trans-esophageal echocardiographic (TEE) and colour flow study, but trans-cranial Doppler (TCD) with contrast is a promising technique with good accuracy compared with TEE.

American Journal of Contact Dermatitis, Jun 1, 2003

Contact Dermatitis, Jun 1, 2001

Exposure to wood dust and other chemicals used in particleboard manufacture may cause contact der... more Exposure to wood dust and other chemicals used in particleboard manufacture may cause contact dermatitis. To assess the prevalence and nature of skin complaints in the refining and drying department of a particleboard manufacturing facility following introduction of a new process, workers were assessed by a physician, using a standardized questionnaire concerning symptoms, past and family history, workplace exposures, and use of protective equipment. Cutaneous examination and patch testing were then performed. Questionnaire results showed that workers complained of rash, nasal and eye irritation, as well as cough and bothersome odours. Cutaneous examination identified a heterogeneity of skin problems, with dermatitis being mainly irritant rather than allergic. Quaternium-15 (Dowicil 200) was the only allergen to which more than 1 individual reacted. Aside from the odours, exposure to wood dust could account for the other reported symptoms. Allergic reactions on patch testing were few and did not explain the dermatitis; most skin reactions were irritant. Recommendations to the company included improved dust control, through ventilation and personal hygiene measures, as well as protective clothing. The investigation highlights how the introduction of a new process may focus attention on health complaints that have been present for some time before.

Journal of Clinical Epidemiology, Apr 1, 2008

Objective: Health care researchers have not taken full advantage of the potential to effectively ... more Objective: Health care researchers have not taken full advantage of the potential to effectively convey meaning in their multivariate data through graphical presentation. The aim of this paper is to translate knowledge from the fields of analytical chemistry, toxicology, and marketing research to the field of medicine by introducing the radar plot, a useful graphical display method for multivariate data. Study Design and Setting: Descriptive study based on literature review. Results: The radar plotting technique is described, and examples are used to illustrate not only its programming language, but also the differences in tabular and bar chart approaches compared to radar-graphed data displays. Conclusion: Radar graphing, a form of radial graphing, could have great utility in the presentation of health-related research, especially in situations in which there are large numbers of independent variables, possibly with different measurement scales. This technique has particular relevance for researchers who wish to illustrate the degree of multiple-group similarity/consensus, or group differences on multiple variables in a single graphical display.

Aerospace medicine and human performance, Dec 1, 2021

BACKGROUND: Knowledge of the clinical course and consequences of COVID-19 initially evolved in th... more BACKGROUND: Knowledge of the clinical course and consequences of COVID-19 initially evolved in the context of severe presentations and among those with comorbidities. However, understanding the outcomes of milder infections in healthy individuals is important for safe return-to-duty in extreme environments or to occupations requiring significant fitness. We reviewed the literature to characterize the nature and timing of persistent and emergent clinical sequelae in milder COVID-19 cases to facilitate development of post-COVID-19 screening and surveillance protocols.METHODS: We searched databases including EMBASE, MEDLINE, Cochrane COVID-19 study register, gray literature, clinical trial registries, and relevant health and disease prevention sources for publications from 2019 to February 18th, 2021, documenting COVID-19 sequelae. Articles were included if the COVID-19 severity was mild and there were no, or only minor, pre-existing comorbidities. Persistent and emergent sequelae were then stratified based on time since diagnosis.RESULTS: Among those with mild COVID-19, sequelae were shown to emerge or persist for months following presumed recovery. Among those with no comorbidities, cardiac, hematological, and respiratory sequelae emerged after 1-2 mo, and primarily cardiac abnormalities persisted at ≥ 3 mo. Among those with minor comorbidities, persistent respiratory abnormalities, fatigue, dyspnea, and headache were common, and mental health symptoms emerged by 1-2 mo postinfection.DISCUSSION: After presumed recovery from mild COVID-19, a range of symptoms can persist and later emerge. Whether these are new or previously unrecognized is unclear. Under-recognized COVID-19 sequelae may increase the risk of subtle or sudden incapacitation and have implications for return-to-work (RTW) screening and surveillance for safety-critical roles.Tucci V, Saary J. Persistent and emergent clinical sequelae of mild COVID-19. Aerosp Med Hum Perform. 2021; 92(12):962–969.

BMJ, Dec 13, 2012

Commercial investment is bringing space tourism closer to reality. Marlene Grenon and colleagues ... more Commercial investment is bringing space tourism closer to reality. Marlene Grenon and colleagues outline what doctors will need to know Although perhaps unfamiliar with the specific physiological changes associated with commercial air travel, most physicians will have travelled by plane and many will have attended a passenger in need of medical assistance while on a commercial flight. They are, however, unlikely to have experience of space travel.

Th is thesis presents a new conceptual model of occupational outcome based on the results of inpu... more Th is thesis presents a new conceptual model of occupational outcome based on the results of input from 5 key stakeholder groups in the field of occupational health including patients, healthcare providers, employers, unions, and insurers. Data from 77 participants who took part in one of either 18 individual interviews or 11 focus groups were qualitatively content analyzed.

The challenges associated with providing medical support to astronauts on long duration lunar or ... more The challenges associated with providing medical support to astronauts on long duration lunar or planetary missions are significant. Experience to date in space has included short duration missions to the lunar surface and both short and long duration stays on board spacecraft and space stations in low Earth orbit. Live actor, terrestrial analogue setting simulation provides a means of studying multiple aspects of the medical challenges of exploration class space missions, though few if any published models exist upon which to construct systems-simulation test beds. Current proposed and projected moon mission scenarios were analyzed from a systems perspective to construct such a model. A resulting topological mapping of high-level architecture for a reference lunar mission with presumed EVA excursion and international mission partners is presented. High-level descriptions of crew operational autonomy, medical support related to crew-member status, and communication characteristics within and between multiple teams are presented. It is hoped this modeling will help guide future efforts to simulate medical support operations for research purposes, such as in the use of live actor simulations in terrestrial analogue environments.

Contact Dermatitis, Feb 1, 2001

Case Report A 55-year-old man developed an itchy, erythematous oedematous well-defined plaque 12 ... more Case Report A 55-year-old man developed an itchy, erythematous oedematous well-defined plaque 12 h after the application of an electrosurgical earthing plate on the left thigh. He was self-employed and worked as a windscreen repair mechanic. He was right handed and had a chronic dermatitis involving the right-thumb pulp and index finger. His work involved the use of acrylic resins to repair cracks in windscreens, although he protected his hands with latex gloves. Patch tests were performed to an extended European standard series, a (meth)acrylates series (Chemotechnique), his windscreen resin and the electrosurgical earthing plate (Niko). The reactions are shown in Table 1 and include several (meth)acrylates. There was a positive reaction to the patient's windscreen resin, suggesting that this exposure led to sensitization. (Meth)acrylates are present in the adhesive that attaches the electrosurgical earthing plate to the skin, which accounts for the acute allergic contact dermatitis that our patient developed at this site.

npj Microgravity

Knowledge transfer among research disciplines can lead to substantial research progress. At first... more Knowledge transfer among research disciplines can lead to substantial research progress. At first glance, astronaut health and rare diseases may be seen as having little common ground for such an exchange. However, deleterious health conditions linked to human space exploration may well be considered as a narrow sub-category of rare diseases. Here, we compare and contrast research and healthcare in the contexts of rare diseases and space health and identify common barriers and avenues of improvement. The prevalent genetic basis of most rare disorders contrasts sharply with the occupational considerations required to sustain human health in space. Nevertheless small sample sizes and large knowledge gaps in natural history are examples of the parallel challenges for research and clinical care in the context of both rare diseases and space health. The two areas also face the simultaneous challenges of evidence scarcity and the pressure to deliver therapeutic solutions, mandating expedi...

Handbook of Space Pharmaceuticals, 2022

Aerospace Medicine and Human Performance, 2021