The Role of the Fracture Liaison Service in Osteoporosis Care.

Osteoporosis is a disease classified by the alteration of bony microarchitecture predisposing a person to fragility fractures. This costs the US $19 billion per year and is expected to rise as our population ages. Only 20% of patients with fragility fractures receive treatment for osteoporosis.

The Methodology of Clinical Studies Used by the FDA for Approval of High-Risk Orthopaedic Devices.

Background: The purpose of this investigation was to examine the methodology of clinical trials used by the U.S. Food and Drug Administration (FDA) to determine the safety and effectiveness of high-risk orthopaedic devices approved between 2001 and 2015.

Twitter Use among Academic Urology Programs.

Introduction: Twitter is a popular social media platform that has an important role in the urological community. Benefits include dissemination of knowledge, cross-institutional communication, amplification of conference content and greater engagement of the public, with increased departmental exposure. However, to date the use of Twitter by academic urology programs has yet to be examined.

Patient Similarity in Prediction Models Based on Health Data: A Scoping Review.

Background: Physicians and health policy makers are required to make predictions during their decision making in various medical problems. Many advances have been made in predictive modeling toward outcome prediction, but these innovations target an average patient and are insufficiently adjustable for individual patients. One developing idea in this field is individualized predictive analytics based on patient similarity.

Immediate versus delayed operative treatment of low-energy tibial plateau fractures.

Background: Current management of tibial plateau fractures requires careful soft-tissue management. Often a staged approach with temporary external fixation followed by delayed internal fixation is recommended. While proven in high-energy injuries, its relevance in treating low-energy fractures has not been investigated.

Clustering of risk-related modifiable behaviours and their association with overweight and obesity among a large sample of youth in the COMPASS study.

Background: Canadian youth exhibit a number of risky behaviours, some of which are associated with overweight and obesity. The purpose of this study was to examine the prevalence of 15 modifiable risk behaviours in a large sample of Canadian youth, to identify underlying subgroups based on patterns of health behaviours, and to examine the association between identified subgroups and overweight/obesity.

Methods: Data from 18,587 grades 9-12 students in Year 1 (2012-13) of the COMPASS study and latent class analysis were used to identify patterns and clustering among 15 health behaviours (e.

Glucose metabolism during the acute prostate cancer treatment trajectory: The influence of age and obesity.

Background & Aims: Obesity and age, key risk factors for aggressive prostate cancer, are associated with insulin resistance. Glucose-related parameters in patients with aggressive prostate cancer were compared with 2 reference groups: men of similar age and body mass index (BMI) without cancer, and healthy young men. Acute changes in these parameters following radiation treatment were also evaluated.

Mean HEART scores for hospitalized chest pain patients are higher in more experienced providers.

Background: The HEART score has been validated as a predictor of major adverse cardiac events (MACEs) in emergency department patients complaining of chest pain. Our objective was to determine the extent of physician variation in the HEART score of admitted patients stratified by years of experience.

Methods: We performed a retrospective medical record review at an academic tertiary care emergency department to determine HEART score, outcome of hospitalization, and 30-day MACE.

Food safety knowledge of undergraduate students at a Canadian university: results of an online survey.

Background: Foodborne diseases are an important public health issue, and young adults are an important demographic to target with food safety education. Our objective was to assess the food safety knowledge of undergraduate students at a Canadian university, to identify potential areas for such education.

Methods: In February 2015, we conducted an online survey of 485 undergraduate students at a university in Ontario, Canada.

Errors, Omissions, and Outliers in Hourly Vital Signs Measurements in Intensive Care.

Objective: To empirically examine the prevalence of errors, omissions, and outliers in hourly vital signs recorded in the ICU.

Design: Retrospective analysis of vital signs measurements from a large-scale clinical data warehouse (Multiparameter Intelligent Monitoring in Intensive Care III).

Setting: Data were collected from the medical, surgical, cardiac, and cardiac surgery ICUs of a tertiary medical center in the United States.

The Age of OrthoInfo: A Randomized Controlled Trial Evaluating Patient Comprehension of Informed Consent.

Background: Integral to an orthopaedic surgeon-patient informed consent discussion is the assessment of patient comprehension of their medical care. However, little is known about how to optimize patient comprehension of an informed consent discussion. The purpose of our study was to evaluate three time-controlled informed consent discussion methods to determine which optimized patient comprehension immediately after the discussion.

Elevated C-Peptides, Abdominal Obesity, and Abnormal Adipokine Profile are Associated With Higher Gleason Scores in Prostate Cancer.

Background: Prostate cancer development is associated with numerous lifestyle factors (i.e., physical activity, nutrition intake) and metabolic perturbations.

Partial nephrectomy in a patient with dwarfism.

We describe the case of a 50-year-old male with achondroplastic dwarfism who presents with a renal mass in his left kidney concerning for renal cell carcinoma. The patient successfully underwent a robotic partial nephrectomy, which revealed a T1a renal cell carcinoma. The tumor was excised successfully without any intraoperative complications demonstrating that a robotic partial nephrectomy is technically both safe and effective in patients with achondroplastic dwarfism.

Novel Technique for Femoral Head Reconstruction using Allograft following Obturator Hip Dislocation.

Introduction: Obturator hip dislocations with an associated osteochondral fracture of the femoral head are uncommon. The treatment of these injuries is challenging and the functional outcomes are poor. Though the injury pattern has been described previously in literature, there are few published reports regarding treatment options.

Lower Abdominal Pain.

Although most frequently presenting with lower abdominal pain, appendicitis, colitis, and diverticulitis can cause pain throughout the abdomen and can cause peritoneal and retroperitoneal symptoms. Evaluation and management of lower intestinal disease requires a nuanced approach by the emergency physician, sometimes requiring computed tomography, ultrasonography, MRI, layered imaging, shared decision making, serial examination, and/or close follow-up. Once a presumed or confirmed diagnosis is made, appropriate treatment is initiated, and may include surgery, antibiotics, and/or steroids.

The use of a brief mental health screener to enhance the ability of police officers to identify persons with serious mental disorders.

Police agencies in Canada and elsewhere have received much criticism over how they respond to persons with serious mental disorders. The adequacy of training provided to police officers on mental health issues and in particular on recognizing indicators of serious mental disorders has been a major concern. This paper describes the process that led to the development of a new brief mental health screener (interRAI Brief Mental Health Screener, BMHS) designed to assist police officers to better identify persons with serious mental disorders.

Food safety knowledge, attitudes and self-reported practices among Ontario high school students.

Objectives: To measure the food safety knowledge, attitudes and self-reported practices of high school students in Ontario.

Methods: We administered a school-wide paper survey to the student body (n = 2,860) of four Ontario high schools. We developed the survey by selecting questions from existing, validated questionnaires, prioritizing questions that aligned with the Canadian Partnership for Consumer Food Safety Education's educational messages and the food safety objectives from the 2013 Ontario High School Curriculum.

THE SYNERGY TO ENABLE GLYCEMIC CONTROL FOLLOWING EMERGENCY DEPARTMENT DISCHARGE PROGRAM FOR ADULTS WITH TYPE 2 DIABETES: STEP-DIABETES.

Objective: To evaluate a diabetes (DM) care delivery model among hyperglycemic adults with type 2 DM being discharged from the emergency department (ED) to home. The primary hypothesis was that a focused education and medication management intervention would lead to a greater short-term improvement in glycemic control compared to controls.

Methods: A 4-week, randomized controlled trial provided antihyperglycemic medications management using an evidence-based algorithm plus survival skills diabetes self-management education (DSME) for ED patients with blood glucose (BG) levels ≥200 mg/dL.

Use of caffeinated energy drinks among secondary school students in Ontario: Prevalence and correlates of using energy drinks and mixing with alcohol.

Objectives: Caffeinated energy drinks have become increasingly popular among young people, raising concern about possible adverse effects, including increased alcohol consumption and related risk behaviours. The current study examined consumption of caffeinated energy drinks and use of energy drinks with alcohol, as well as associations with socio-demographic and behavioural characteristics, among a sample of secondary school students in Ontario.

Methods: Survey data from 23,610 grade 9-12 students at 43 purposefully sampled Ontario secondary schools participating in the baseline wave (2012/13) of the COMPASS study were analyzed using generalized linear mixed-effects models.

Multiphoton microscopy: a potential intraoperative tool for the detection of carcinoma in situ in human bladder.

Context: Urothelial carcinoma in situ (CIS) is a precursor of invasive bladder cancer, which if left untreated, will likely progress to more aggressive disease. Approximately 50% of CIS lesions are missed on routine cystoscopy owing to their flat architecture. Furthermore, many benign but abnormal-appearing areas may be biopsied owing to lack of cellular resolution of cystoscopes.