Barriers and facilitators to the implementation of rapid HIV testing in Canadian Emergency Departments: a mixed methods study.

Objectives: 1 in 7 Canadians with Human Immunodeficiency Virus (HIV) do not know their status. Patients at increased risk of HIV routinely access the emergency department (ED), yet few are tested, representing a missed opportunity for diagnosis and linkage-to-care. Rapid HIV testing provides reliable results within the same ED encounter but is not routinely implemented.

Healthcare workers' perspectives on a prescription phone program to meet the health equity needs of patients in the emergency department: a qualitative study.

Objectives: People experiencing homelessness and marginalization face considerable barriers to accessing healthcare services. Increased reliance on technology within healthcare has exacerbated these inequities. We evaluated a hospital-based prescription phone program aimed to reduce digital health inequities and improve access to services among marginalized patients in Emergency Departments.

Closed loop stimulation with His bundle lead placement.

Unlabelled: Closed-loop stimulation (CLS; BIOTRONIK SE & Co. KG, Berlin, Germany) is a rate-responsive algorithm that analyzes intracardiac impedance trends using a standard lead placed in the right ventricle. It is unknown whether CLS could perform adequately with His bundle (HB) lead placement, as contractility dynamics may be attenuated in this region compared to the right ventricle apex.

Phenobarbital for the management of severe acute alcohol withdrawal (the PHENOMANAL trial): a pilot randomized controlled trial.

Background: Benzodiazepines are considered first-line treatment for patients experiencing severe acute alcohol withdrawal syndrome (sAAWS). Although several medications have been evaluated as potential adjuvant treatments for sAAWS, barbiturates show particular promise.

Objective: In the PHENOMANAL trial, we will assess the feasibility of conducting an allocation-concealed, quadruple-blinded, randomized controlled trial (RCT) comparing symptom-triggered benzodiazepine therapy with either a single dose of adjuvant intravenous (IV) phenobarbital (7.

The ART of conversation: feasibility and acceptability of a pilot peer intervention to help transition complex HIV-positive people from hospital to community.

Objectives: To pilot a peer-based intervention for people living with HIV who used substances, had challenges with antiretroviral adherence and would be discharged from hospital to community.

Study Design: A community-based, quasi-experimental pilot intervention study designed to assess feasibility, acceptability and connection to a community-based HIV organisation.

Setting: This study was conducted in Toronto, Canada, at Casey House (CH; hospital for people living with HIV) in collaboration with the AIDS Committee of Toronto (ACT; community-based HIV organisation).

Fetal spine ossification: the gender and individual differences illustrated by ultrasonography.

The spatial and temporal pattern of manifestation of ossification nuclei of the spinal column in fetal life have been well established by histologic and radiologic studies. Sonographic evaluation of the fetal spine depends on visualization of the ossification centers, but the sequence of development of ossification centers in the vertebral column obtained by embryologists and sonographers and radiology are conflicting. We carried out a longitudinal study to establish the ultrasonographic appearance and timing of development of primary ossification centers of the fetal spine in the first and second trimesters of pregnancy.

[A comprehensive management system for heart failure improves clinical outcomes and reduces medical resource utilization].

Background: Hospital admissions for heart failure are common and readmission rates are high. Many admissions and readmissions may be avoidable, so that alternative strategies are needed to improve long-term management.

Methods: We conducted a randomized trial of the effect of a guideline-based intervention on rates of readmission within 90 days of hospital discharge and costs of care for patients who were hospitalized due to decompensated heart failure.

[Proposed protocol for the ambulatory management of patients discharged with heart failure diagnosis: collaborative project Venice-HF].

Background: Hospital admissions for heart failure are common and readmission rates are high. Many admissions and readmissions may be avoidable, so that alternative strategies are needed to improve long-term management.

Methods: We conducted a randomized trial of the effect of a guideline-based intervention on rates of readmission within 90 days of hospital discharge and costs of care for patients who were hospitalized due to decompensated heart failure.

Ossification timing of sacral vertebrae by ultrasound in the mid-second trimester of pregnancy.

Objectives: The aim of the study was to establish the ossification timing of sacral vertebrae by ultrasonography in the second trimester of pregnancy, for the diagnosis of caudal regression syndrome with isolated sacral agenesis.

Methods: The study was carried out on 77 normal single pregnancies, at gestational ages ranging from 15 to 21 weeks, using high-resolution transabdominal echography. The sacral region was visualized in a coronal plane, when the fetus was in anterodorsal position.

Spine length measurement in the first trimester of pregnancy.

Objectives: The aim of the study was to evaluate spine length as an indicator of skeletal growth in the first trimester of pregnancy and to provide a nomogram of spine length at the end of the first trimester of pregnancy.

Methods: The study was carried out on 420 single pregnancies, at gestational ages ranging from 11 to 14 weeks, using high-resolution transabdominal echography. Biparietal diameter and crown-rump length (CRL) were measured to date the pregnancy.

Blood pressure and metabolic profile after surgical menopause: comparison with fertile and naturally-menopausal women.

In 1978 a random sample (367 men and 568 women aged 18-65 years) taken from the general population of a north-eastern Italian town was screened for cardiovascular risk; 16 years later, the women were invited to a second screening. Three groups were identified at the initial screening (fertile, naturally menopausal and surgically menopausal) and four in the longitudinal study (137 remained fertile during the whole study, 205 became naturally menopausal, 56 were ovariectomised and 127 were already going through the menopause). The protocol included a questionnaire, blood pressure (BP) measurement, and blood exams.

Noninvasive risk stratification in women with uncomplicated acute myocardial infarction.

The aim of our study was to compare the prognostic value of stress echocardiography and exercise electrocardiography after uncomplicated non-Q-wave acute myocardial infarction in a series of 89 female patients. Our data show that stress echocardiography has independent predictive value in a female patient population recovering from uncomplicated acute myocardial infarction.

Should digoxin be proscribed in elderly subjects in sinus rhythm free from heart failure? A population-based study.

Increased mortality in digoxin-treated subjects has been demonstrated in patients with recent myocardial infarction. Those with congestive heart failure (CHF) due to causes other than myocardial infarction seem to be free from this effect. No information is currently available concerning mortality in elderly people who are frequently prescribed digitalis even in the absence of CHF.

Genetic variability in the renin-angiotensin system: prevalence of alleles and genotypes.

Background: Variants of the human genes coding for renin, angiotensin-converting enzyme (ACE), angiotensinogen (AGT) and the angiotensin II type-I receptor (AT1R) are inconsistently associated with cardiovascular-renal disease, possibly because of genetic differences in the background populations.

Methods: This systematic review of the literature investigated genetic variation in the renin system according to race, sex and age. Across studies with relevant information, multivariate analyses also accounted for the methods of genotyping and the enrollment of subjects as controls, cases or groups studied cross-sectionally.

Effects of caffeine on glucose tolerance: a placebo-controlled study.

Objective: The investigation was performed to study the effects of 200 mg oral caffeine on glucose tolerance.

Design: Single-blind Latin square with active treatment (caffeine) and placebo.

Setting: The University of Padova, Department of Internal Medicine.

Characterisation of hypertensive patients according to 24 H peripheral resistance.

To clarify whether a circadian rhythm of peripheral resistance exists in humans and whether hypertensive patients represent a homogeneous category in this respect, 15 normotensives aged 31 +/- 4 years and 30 hypertensives aged 41 +/- 13 years were confined to bed for 22 h and forearm flow recorded automatically. Night-time BP values were higher in hypertensive patients (Group B) whose night/day ratios of mean BP were below the 95% C.I.

Leg versus forearm flow: 24 h monitoring in 14 normotensive subjects and in 14 age-matched hypertensive patients confined to bed.

A circadian blood pressure rhythm has been demonstrated in the majority of subjects, even if inactive during daytime. A rhythm of leg blood flow and peripheral resistance, with higher values during sleep than during waking, has also been recently shown in subjects confined to bed. Doubts still persist on whether such a rhythm also exists in the forearm, and whether or not its trend is similar to that found in the leg.

Chronic pelvic pain: oral contraceptives and non-steroidal anti-inflammatory compounds.

A correct classification of female pelvic pain originating from gynaecological disorders is essential if the most appropriate therapy is to be chosen. Certain types of non-steroidal anti-inflammatory drugs and oral contraceptives reduce the production of prostaglandins, which are responsible in large part for primary dysmenorrhoea. Oestroprogestin formulations become the drugs of choice if the patient also requests contraception.

The deletion/insertion polymorphism of the angiotensin converting enzyme gene and cardiovascular-renal risk.

Objective: This meta-analysis attempted to derive pooled estimates for the associations between various cardiovascular-renal disorders and the deletion/insertion (D/I) polymorphism of the angiotensin converting enzyme (ACE) gene.

Methods: Case-control studies were combined, using the Mantel-Haenszel approach. Joint P values for continuous variables were calculated by Stouffer's method.

Blood pressure, serum cholesterol and nutritional state in Tanzania and in the Amazon: comparison with an Italian population.

Objective: To confirm that westernization of dietary habits represents a stimulus for the expression of cardiovascular risk.

Design: Three representative age- and sex-matched samples of general populations of three continents were compared cross-sectionally by analysis of variance.

Participants: In total 1110 subjects aged 22-89 years, divided into three groups (370 from Tanzania and Uganda, 370 from the Amazonian region of Brazil, and 370 from northern Italy; 111 men and 259 women in each group).

Conventional and ambulatory blood pressure and menopause in a prospective population study.

Whether menopause would be associated with a rise in blood pressure (BP) was prospectively assessed in a cohort study. A total of 315 women (30-70 years at follow-up) were randomly selected from the population. They were matched on age and rank of body mass index with 315 men.