The RNA exosome maintains cellular RNA homeostasis by controlling transcript abundance in the brain.

Intracellular ribonucleases (RNases) are essential in all aspects of RNA metabolism, including maintaining accurate RNA levels. Inherited mutations in genes encoding ubiquitous RNases are associated with human diseases, primarily affecting the nervous system. Recessive mutations in genes encoding an evolutionarily conserved RNase complex, the RNA exosome, lead to syndromic neurodevelopmental disorders characterized by progressive neurodegeneration, such as Pontocerebellar Hypoplasia Type 1b (PCH1b).

How to Select a Graduate School Program for a PhD in Biomedical Science.

The goal of this article is to provide guidance for those who have decided to apply to graduate school with the plan to obtain a PhD in biomedical science. Choosing an appropriate graduate school and program can seem like a daunting choice. There are numerous graduate training programs that offer excellent training with multiple specific program choices at any given institution.

Impact of QRS morphology and duration on outcomes after cardiac resynchronization therapy: Results from the Resynchronization-Defibrillation for Ambulatory Heart Failure Trial (RAFT).

Background: The impact of QRS morphology and duration on the effectiveness of cardiac resynchronization therapy (CRT) has been usually assessed separately. The interaction between these 2 simple ECG parameters and their effect on CRT has not been systematically assessed in a large-scale clinical trial.

Methods And Results: The Resynchronization-Defibrillation for Ambulatory Heart Failure Trial showed that implantable cardioverter defibrillator-CRT was associated with a significant reduction in the primary end point of all-cause mortality or heart failure hospitalization.

Development of the Champlain primary care cardiovascular disease prevention and management guideline: tailoring evidence to community practice.

Problem Addressed: A well documented gap remains between evidence and practice for clinical practice guidelines in cardiovascular disease (CVD) care.

Objective Of Program: As part of the Champlain CVD Prevention Strategy, practitioners in the Champlain District of Ontario launched a large quality-improvement initiative that focused on increasing the uptake in primary care practice settings of clinical guidelines for heart disease, stroke, diabetes, and CVD risk factors.

Program Description: The Champlain Primary Care CVD Prevention and Management Guideline is a desktop resource for primary care clinicians working in the Champlain District.

Motivational counselling for physical activity in patients with coronary artery disease not participating in cardiac rehabilitation.

Background: Many patients with coronary artery disease (CAD) fail to attend cardiac rehabilitation following acute coronary events because they lack motivation to exercise. Theory-based approaches to promote physical activity among non-participants in cardiac rehabilitation are required.

Design: A randomized trial comparing physical activity levels at baseline, 6, and 12 months between a motivational counselling (MC) intervention group and a usual care (UC) control group.

Degree and correlates of patient trust in their cardiologist.

Rationale And Objectives: Trust in one's doctor has been associated with increased treatment adherence, patient satisfaction and improved health status. This study investigated the level and correlates of patient trust in their cardiac specialist.

Methods: All 386 urban cardiologists in Southern Ontario (95 participating, response rate = 30%) were approached to recruit a sample of their coronary artery disease outpatients.

Man's best friend? Infective endocarditis due to Capnocytophaga canimorsus.

Infective endocarditis caused by zoonotic microorganisms is an uncommon clinical entity. A 55-year-old man was diagnosed with endocarditis due to Capnocytophaga canimorsus, a commensal bacterium contained in the saliva of dogs, that involved the aortic and tricuspid valves and was complicated by a para-aortic valve abscess and aorta-to-right atrial fistula. The patient was successfully treated with antibiotic therapy and surgical intervention.

Contribution of patient and physician factors to cardiac rehabilitation enrollment: a prospective multilevel study.

Background: Cardiac rehabilitation (CR) is an established means of reducing mortality, yet is grossly underutilized. This is due to both health system and patient-level factors; issues that have yet to be investigated concurrently. This study utilized a hierarchical design to examine physician and patient-level factors affecting verified CR enrollment.

Thermal therapy: a viable adjunct in the treatment of heart failure?

The aim of this work was to review and provide a summary of published literature on the clinical impact of thermal therapy (ie, warm water immersion, traditional sauna bathing, and dry infrared sauna) in patients with heart failure. Medline and Embase database literature searches were conducted, and studies that included measurement of heart failure-related clinical parameters were reviewed. Thermal therapy was found to have a positive impact on key heart failure-related parameters across multiple studies.

Contribution of patient and physician factors to cardiac rehabilitation referral: a prospective multilevel study.

Background: Cardiac rehabilitation (CR), in most developed countries, is a proven means of reducing mortality but it is grossly underutilized owing to factors involving both the health system and patients. These issues have not been investigated concurrently. To this end, we employed a hierarchical design to investigate physician and patient factors that affect verified CR referral.

Cardiologists' charting varied by risk factor, and was often discordant with patient report.

Objective: To assess the completeness of cardiac risk factor documentation by cardiologists, and agreement with patient report.

Study Design And Setting: A total of 68 Ontario cardiologists and 789 of their ambulatory cardiology patients were randomly selected. Cardiac risk factor data were systematically extracted from medical charts, and a survey was mailed to participants to assess risk factor concordance.

Treating the right patient at the right time: access to specialist consultation and non-invasive testing.

The Council of the Canadian Cardiovascular Society commissioned working groups to examine issues of access to, and wait times for, various aspects of cardiovascular care. The present article summarizes the deliberations on targets for medically acceptable wait times for access to cardiovascular specialist evaluation and on the performance of noninvasive testing needed to complete this evaluation. Three categories of referral indications were identified: those requiring hospitalization due to substantial ongoing risk of mortality and morbidity; those requiring an expedited early review in an ambulatory setting; and, finally, a larger category in which delays of two to six weeks can be justified.

Determinants of physical activity after hospitalization for coronary artery disease: the Tracking Exercise After Cardiac Hospitalization (TEACH) Study.

Background: Little is known about physical activity levels in patients with coronary artery disease (CAD) who are not engaged in cardiac rehabilitation. We explored the trajectory of physical activity after hospitalization for CAD, and examined the effects of demographic, medical, and activity-related factors on the trajectory.

Design: A prospective cohort study.

Comparison of mortality patterns in patients with ST-elevation myocardial infarction arriving by emergency medical services versus self-transport (from the prospective Ottawa Hospital STEMI Registry).

Emergency medical services (EMSs) play a key role in the recognition and treatment of ST-elevation of myocardial infarction (STEMI). We sought to determine contemporary use of EMS in patients with STEMI and its relation to treatment, morbidity, and mortality patterns. Patients who arrived by EMS were compared with those who arrived by self-transport.

Profile of the cardiovascular specialist physician workforce in Canada, 2004.

The Canadian Cardiovascular Society (CCS) examined the demand for cardiovascular care, the supply of specialist physicians to provide that care and physician survey data on human resource issues, including workload, wait times, satisfaction and future intentions. The CCS used data from the National Physician Survey 2004, the CCS Cardiovascular Specialist Physician Workforce Survey 2001, the Canadian Medical Association's Physician Resource Evaluation Template and procedural volumes from the Canadian Institute for Health Information to analyze key human resource planning issues for cardiologists and cardiac surgeons. There are indications in the 2004 survey data that the average workload continues to be very heavy, with an average workweek of between 55 h (cardiologists) and 64 h (cardiac surgeons), and an additional on-call responsibility of between 106 h (cardiologists) and 196 h (cardiac surgeons) per month, of which 38 h (cardiologists) to 45 h (cardiac surgeons) are spent with patients.

Combined angioplasty and pharmacological intervention versus thrombolysis alone in acute myocardial infarction (CAPITAL AMI study).

Objectives: We compared a strategy of tenecteplase (TNK)-facilitated angioplasty with one of TNK alone in patients presenting with high-risk ST-segment elevation myocardial infarction (STEMI).

Background: Previous trials show that thrombolysis followed by immediate angioplasty for the treatment of STEMI does not improve ischemic outcomes compared with thrombolysis alone and is associated with excessive bleeding complications. Since the publication of these trials, however, significant pharmacological and technological advances have occurred.

Early effects of statin therapy on endothelial function and microvascular reactivity in patients with coronary artery disease.

Background: Recent data suggest an early outcome benefit with reduction in cholesterol using statin therapy in patients with coronary artery disease (CAD). This may be caused by effects of low-density lipoprotein cholesterol (LDL-C) reduction on endothelial function and vascular reactivity in the coronary bed. The aim of this randomized placebo-controlled study was to examine the early effects of important reductions in LDL-C on myocardial perfusion and peripheral endothelial function.

Effect of Orlistat in obese patients with heart failure: a pilot study.

Heart failure is the leading cause of hospitalization. Obesity is increasingly common and is a major public health problem. The aim of this study is to assess whether obese patients with heart failure can benefit from losing weight via an orlistat-assisted diet.

Severe aortic insufficiency secondary to an aortic bioprosthesis tear.

A patient with a 10-year-old Medtronic Hancock II porcine aortic bioprosthesis developed severe aortic insufficiency. A transesophageal echocardiogram showed a long and mobile mass attached to the bioprosthesis which was consistent with a torn cusp. The patient underwent replacement of the prosthesis with a mechanical valve.