Identifying barriers to preventive care among First Nations people at risk of lower extremity amputation: a qualitative study.

Background: First Nations people in Canada are overrepresented among those who have undergone nontraumatic lower extremity amputation, and are more likely to be younger, have diabetic foot infections and have no previous revascularization procedures than non-First Nations populations who have undergone lower extremity amputations. We sought to identify access barriers for high-risk First Nations patients, explore patients' experiences with health care systems and identify solutions.

Methods: Employing a community participatory research design, we engaged representatives from 2 communities.

The effect of peripheral arterial disease and intermittent claudication on gait regularity and symmetry.

Peripheral arterial disease (PAD) affects 20-30% of older adults and is associated with intermittent claudication (IC), which is walking-induced pain. This study compared the regularity and symmetry of gait between healthy older adults and adults with PAD, and between IC and non-IC conditions in the PAD group. Eighteen control (70.

Trends of limb amputation considering type, level, sex and age in Saskatchewan, Canada 2006-2019: an in-depth assessment.

Background: Most epidemiologic reports focus on lower extremity amputation (LEA) caused specifically by diabetes mellitus. However, narrowing scope disregards the impact of other causes and types of limb amputation (LA) diminishing the true incidence and societal burden. We explored the rates of LEA and upper extremity amputation (UEA) by level of amputation, sex and age over 14 years in Saskatchewan, Canada.

Stability of Discontinuous Galerkin Spectral Element Schemes for Wave Propagation when the Coefficient Matrices have Jumps.

We use the behavior of the norm of the solutions of linear hyperbolic equations with discontinuous coefficient matrices as a surrogate to infer stability of discontinuous Galerkin spectral element methods (DGSEM). Although the norm is not bounded in terms of the initial data for homogeneous and dissipative boundary conditions for such systems, the norm is easier to work with than a norm that discounts growth due to the discontinuities. We show that the DGSEM with an upwind numerical flux that satisfies the Rankine-Hugoniot (or conservation) condition has the same energy bound as the partial differential equation does in the norm, plus an added dissipation that depends on how much the approximate solution fails to satisfy the Rankine-Hugoniot jump.

A Case of an Aortic Dissection After Mechanical Chest Compression by LUCAS.

A 68-year-old man presented following a cardiac arrest. Cardiopulmonary resuscitation was performed by the Lund University Cardiopulmonary Assist System (LUCAS), a mechanical chest compression device. Investigations revealed an aortic dissection, which was likely an iatrogenic injury from mechanical cardiopulmonary resuscitation by LUCAS.

S100A9-RAGE Axis Accelerates Formation of Macrophage-Mediated Extracellular Vesicle Microcalcification in Diabetes Mellitus.

Objective: Vascular calcification is a cardiovascular risk factor and accelerated in diabetes mellitus. Previous work has established a role for calcification-prone extracellular vesicles in promoting vascular calcification. However, the mechanisms by which diabetes mellitus provokes cardiovascular events remain incompletely understood.

Factors associated with delay in carotid endarterectomy for patients with symptomatic severe internal carotid artery stenosis: a case-control study.

Background: The Canadian Best Practice Recommendations for Stroke Care (2008 update) recommend that patients with neurologic symptoms secondary to severe internal carotid artery stenosis undergo carotid endarterectomy within 14 days of symptom onset to prevent stroke. The purpose of this study was to identify patient and system factors associated with meeting, or failing to meet, the guideline.

Methods: In this case-control study, potential study participants were identified through an electronic search of the Discharge Abstract Database.

Economic implications of endovenous great saphenous ablation in a public health care system.

Background: In mid-2007, endovenous ablation (EVA) of the great saphenous vein was introduced into the publicly funded health care system in Saskatchewan, Canada. We hypothesize that the introduction of EVA resulted in a decrease in use of high ligation and stripping (HL/S), decreased costs to the health care system, and increased demand of patients for great saphenous vein ablative procedures.

Methods: We retrospectively reviewed administrative data to capture cases of HL/S between 2003 and 2014 and cases of EVA of the great saphenous vein (endovenous laser treatment and radiofrequency ablation) between 2007 and 2014.

Identification of Mature Atherosclerotic Plaque Proteome Signatures Using Data-Independent Acquisition Mass Spectrometry.

Atherosclerosis is a chronic inflammatory disease with complex pathobiology and one of the most common causes of cardiovascular events. The process is characterized by complex vascular remodeling processes that require the actions of numerous proteins. The composition of atherosclerotic plaque is increasingly recognized as a major factor governing the occurrence of cardiovascular or neurological symptoms.

Prevalence of Extracranial Venous Narrowing on Magnetic Resonance Venography Is Similar in People With Multiple Sclerosis, Their Siblings, and Unrelated Healthy Controls: A Blinded, Case-Control Study.

Purpose: The study sought to assess and compare the prevalence of narrowing of the major extracranial veins in subjects with multiple sclerosis and controls, and to assess the sensitivity and specificity of magnetic resonance venography (MRV) for describing extracranial venous narrowing as it applies to the chronic cerebrospinal venous insufficiency theory, using catheter venography (CV) as the gold standard.

Methods: The jugular and azygos veins were assessed with time-of-flight MRV in this assessor-blinded, case-control study of subjects with multiple sclerosis, their unaffected siblings, and unrelated controls. The veins were evaluated by diameter and area, and compared with CV.

The Nature of Iron Deposits Differs between Symptomatic and Asymptomatic Carotid Atherosclerotic Plaques.

Iron within atherosclerotic plaque has been implicated as a catalyst of oxidative stress that causes progression of plaque, and plaque rupture. Iron is believed to accumulate within plaque by incorporation of erythrocytes following plaque rupture and hemorrhage. There is only indirect evidence to support this hypothesis.

Geographic disparities in the burden of ruptured and unruptured abdominal aortic aneurysms.

Background: The province of Saskatchewan presents unique challenges for the care of ruptured abdominal aortic aneurysms (AAAs), including variable access to health care resources and long transportation distances to tertiary vascular care. This study assessed the rates of ruptured and total AAA to determine regional variations within Saskatchewan and ascertain whether there are areas of high AAA prevalence that would possibly benefit from the implementation of a targeted screening program.

Methods: All diagnoses of AAA from 2001 to 2012 in the province of Saskatchewan were reviewed, with patients grouped by health region of residence.

Patient and observer scar assessment scores favour the late appearance of a transverse cervical incision over a vertical incision in patients undergoing carotid endarterectomy for stroke risk reduction.

Background: Carotid endarterectomy (CEA) is a very common operation, but there is no agreement on the appropriate orientation of the surgical incision.

Methods: We retrospectively reviewed the charts of patients who had undergone CEA between Jul. 1, 2010, and Dec.

Distal revascularization and interval ligation (DRIL) procedure requires a long bypass for optimal inflow.

Background: Distal revascularization and interval ligation (DRIL) is commonly used to treat ischemic steal syndrome caused by arteriovenous hemodialysis access and has been associated with good outcomes. However, the literature lacks technical details of a successful intervention. We tested the hypothesis that a brachial-level arteriovenous fistula (AVF) generates a zone of low arterial blood pressure in the brachial artery near the AVF origin.

Prevalence of extracranial venous narrowing on catheter venography in people with multiple sclerosis, their siblings, and unrelated healthy controls: a blinded, case-control study.

Background: Chronic cerebrospinal venous insufficiency has been proposed as a unique combination of extracranial venous blockages and haemodynamic flow abnormalities that occurs only in patients with multiple sclerosis and not in healthy people. Initial reports indicated that all patients with multiple sclerosis had chronic cerebrospinal venous insufficiency. We aimed to establish the prevalence of venous narrowing in people with multiple sclerosis, unaffected full siblings, and unrelated healthy volunteers.

Ruptured abdominal aortic aneurysms in southern Saskatchewan: a 10-year mortality review.

The Regina Qu'Appelle Health Region (RQHR) provides all tertiary vascular care for southern Saskatchewan and portions of southwestern Manitoba. The present study was undertaken to determine the regional mortality rates following rupture of an abdominal aortic aneurysm and to compare these rates with the published literature. A retrospective chart review was undertaken on all cases of ruptured abdominal aortic aneurysms (rAAA) presenting to the RQHR between March 1, 1996, and February 28, 2006.

Axillary artery to right atrium shunt for hemodialysis access in a patient with advanced central vein thrombosis: a case report.

Central venous thrombosis presents a challenge to the treatment of hemodialysis patients requiring vascular access. We present the case of a patient with renal failure and virulent thrombophilia causing severe central venous thrombosis. We discuss the use of a hemodialysis shunt from the right axillary artery to the right atrium and describe the technical details and the pitfalls encountered in our utilization of this technique.