Continuous Glucose Monitoring-New Diagnostic Tool in Complex Pathophysiological Disorder of Glucose Metabolism in Children and Adolescents with Obesity.

Obesity is one of the leading causes of chronic diseases, and its prevalence is still rising in children and adolescent populations. Chronic cardiovascular complications result in metabolic syndrome (MS) and type 2 diabetes mellitus. Key factors in the development of MS are insulin resistance and low-grade inflammation.

Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort Study.

Objective: To determine timing and risk factors associated with readmission within 30 days of discharge following noncardiac surgery.

Background: Hospital readmission after noncardiac surgery is costly. Data on the drivers of readmission have largely been derived from single-center studies focused on a single surgical procedure with uncertainty regarding generalizability.

Association between Complications and Death within 30 days after General Surgery: A Vascular Events in Noncardiac Surgery Patients Cohort Evaluation (VISION) substudy.

Objective: To determine the epidemiology of post-operative complications among general surgery patients, inform their relationships with 30-day mortality, and determine the attributable fraction of death of each postoperative complication.

Background: The contemporary causes of post-operative mortality among general surgery patients are not well characterized.

Methods: VISION is a prospective cohort study of adult non-cardiac surgery patients across 28 centres in 14 countries, who were followed for 30 days after surgery.

Nonoperative management protocol for locally advanced rectal cancer.

Aim: The standard treatment for low rectal cancer is preoperative chemoradiotherapy followed by surgery with low anterior resection with diverting ileostomy or abdominoperineal resection, both of which have significant long-term effects on bowel and sexual function. Due to the high morbidity of surgery, there has been increasing interest in nonoperative management for low rectal cancer. The aim of this work is to conduct a pan-Canadian Phase II trial assessing the safety of nonoperative management for low rectal cancer.

Plantaris Tendon Autograft Can Restore Patellar Stability in Adolescent Medial Patellofemoral Ligament Reconstruction: A Technical Note.

Medial patellofemoral ligament reconstruction is a standard treatment option for patients with patellar instability. The main purpose of this study was to determine whether isolated anatomic medial patellofemoral ligament reconstruction using double folded, four-strand plantaris tendon autograft restores patellar stability in adolescent patients. Plantaris tendon autografts were harvested through proximal approach and used in four adolescent patients.

Evaluating equity of access and predictors of minimally invasive hysterectomy for endometrial and cervical cancer from 2000 to 2017 in Ontario, Canada: A population-based cohort study.

Introduction: We sought to assess the uptake of minimally invasive hysterectomy among patients with endometrial and cervical cancer in Ontario, Canada, and assess the equity of access to minimally invasive surgery (MIS) by evaluating associations with patient, disease, institutional, and provider factors.

Methods: This is a retrospective population-based cohort study of hysterectomy for endometrial and cervical cancer in Ontario (2000-2017). Surgical approach, clinicopathologic, sociodemographic, institutional, and provider factors were identified through administrative databases.

Airborne grass pollen and thunderstorms influence emergency department asthma presentations in a subtropical climate.

Background: Grass pollen is considered a major outdoor aeroallergen source worldwide. It is proposed as a mechanism for thunderstorm asthma that lightning during thunderstorms promotes electrical rupture of pollen grains that leads to allergic airway inflammation. However, most evidence of associations between grass pollen and asthma comes from temperate regions.

Bardet-Biedl syndrome caused by compound heterozygosity in BBS12 gene: a case report of one family with three affected members.

Introduction: Bardet-Biedl syndrome (BBS) is a rare genetic syndrome caused by a mutation in one of 26 different genes responsible for normal structure and/or function of primary cilia. The syndrome is characterized by multiorgan involvement with gradual onset of occurrence of clinical signs and symptoms resulting in great phenotypic variability and what is more important, often difficulties with establishing the timely diagnosis.

Case Report: We report a case of a one family with three members with BBS caused by a very rare mutation, a compound heterozygosity in gene.

Use of population-based electronic databases for the identification of patients with synchronous colorectal cancer and liver metastases potentially eligible for a surgical trial.

Background: Some population-based recruitment methods, such as registries and databases, have been used to increase enrolment in clinical trials by identifying eligible participants based on baseline characteristics; however; these methods have not been tested in surgical trials, in which accrual occurs before surgery. We evaluated the use of population-based electronic databases to identify patients who potentially could be accrued to the Simultaneous Resection of Colorectal Cancer with Synchronous Liver Metastases (RESECT) trial and compared it to the traditional methods used to accrue patients (e.g.

Perioperative optimization with nutritional supplements in patients undergoing gastrointestinal surgery for cancer: A randomized, placebo-controlled feasibility clinical trial.

Background: Perioperative nutritional supplementation may improve outcomes. Trials have not investigated the role of combination strategy using different types of nutritional supplements.

Methods: We conducted a single-site randomized pilot trial, among gastrointestinal cancer patients undergoing surgery, comparing perioperative nutritional supplements versus placebo (1 placebo to each supplement), to determine feasibility of a larger trial.

Clinical Characteristics in the Longitudinal Follow-Up of APECED Syndrome in Southern Croatia-Case Series.

Background: Autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED) is a rare monogenetic autosomal recessive disorder caused by a mutation in the autoimmune regulator () gene characterized by complex phenotypic characteristics discovered over years of follow-up.

Methods: 7 patients were recruited in this case series in a period of the last 37 years from Southern Croatia. All patients were screened for R257X mutations.

Medium-Term Increases in Ambient Grass Pollen Between 1994-1999 and 2016-2020 in a Subtropical Climate Zone.

Grass pollen is the major outdoor trigger of allergic respiratory diseases. Climate change is influencing pollen seasonality in Northern Hemisphere temperate regions, but many aspects of the effects on grass pollen remain unclear. Carbon dioxide and temperature rises could increase the distribution of subtropical grasses, however, medium term shifts in grass pollen in subtropical climates have not yet been analysed.

The Role of Urotensin-II in Obesity and Metabolic Syndrome in Pediatric Population.

Background: Urotensin-II (U-II) is a short cyclic peptide that is widely recognized as one of the most potent vasoconstrictors. U-II plays a role in the pathophysiology of MS, participating in the development of essential hypertension, insulin resistance, hyperglycemia, and a proinflammatory state.

Methods: This study comprised 52 obese children and adolescents with a body mass index (BMI) z score > 2, aged 10 to 18 years.

Prophylaxis extension for venous thromboembolism after major abdominal and pelvic surgery for cancer (prevent): Quality improvement transitioned into a cohort study.

Background: Extended venous thromboembolism prophylaxis after abdominopelvic cancer surgery has not been widely adopted. We compared outcomes of patients pre- and postimplementation of extended venous thromboembolism prophylaxis with low molecular weight heparin.

Methods: Prospectively collected data from a quality initiative project aimed at prescribing extended venous thromboembolism prophylaxis after abdominopelvic cancer surgery was compared with previously published data from a prospective cohort without extended venous thromboembolism prophylaxis.

Simultaneous resection for synchronous colorectal cancer liver metastases: A feasibility clinical trial.

Background And Objectives: We tested the feasibility of a simultaneous resection clinical trial in patients with synchronous colorectal cancer liver metastases to obtain the necessary information to plan a randomized trial.

Methods: Multicenter feasibility single-arm trial enrolling patients with synchronous colorectal cancer liver metastases eligible for simultaneous resection. Prespecified criteria for feasibility were: proportion of eligible patients enrolled ≥66%, and the proportion of enrolled patients who completed simultaneous resection ≥75%.

THE ROLE OF ULTRASOUND ELASTOGRAPHY IN THE DIAGNOSIS OF PATHOLOGIC CONDITIONS OF TESTICLES AND SCROTUM.

Several years ago, elastography emerged as a potentially very useful ultrasound technique that is currently used in diagnostic workup of the breast, liver and some other organ systems, whereas for other ones it is still mainly in the phase of research. The aim of the study was to compare elasticity index (EI) of testicles using strain elastography in healthy subjects and those with pathologic changes of testicles/scrotum. A total of 117 patients were included in the study.

Identification and Adjudication of Adverse Events Following Rectal Cancer Surgery: Observational Case Series in a Region of Ontario, Canada.

Background: For patients undergoing rectal cancer surgery, we evaluated whether suboptimal preoperative surgeon evaluation of resection margins is a latent condition factor-a factor that is common, unrecognized, and may increase the risk of certain adverse events, including local tumour recurrence, positive surgical margin, nontherapeutic surgery, and in-hospital mortality.

Methods: In this observational case series of patients who underwent rectal cancer surgery during 2016 in Local Health Integrated Network 4 region of Ontario (population 1.4 million), chart review and a trigger tool were used to identify patients who experienced the adverse events.

Chronic hyponatremia based on maxillary sinus mass.

Summary: This is a case report of a child with chronic hyponatremia due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH) as a paraneoplastic manifestation of olfactory neuroblastoma (OFN). We hereby report a clinical presentation as well as a pragmatic approach to one of the most common electrolytic disorders in the pediatric population and have emphasized the necessity of involving the sinonasal area in the diagnostic procedure while evaluating possible causes of SIADH. This report indicates that the chronicity of the process along with the gradual onset of hyponatremia occurrence is responsible for the lack of neurological symptoms at the moment of disease presentation.

Weight Loss Following Hepatopancreatobiliary Surgery. How Much is Too Much? A Retrospective Cohort Study.

. Postoperative weight loss is common following hepato-pancreato-biliary (HPB) surgical resections; however, the extent of weight loss and the association with poor outcomes have not been well described. We assessed the average percentage of weight loss and risk factors associated with sustained postoperative weight loss.

High-Intensity vs Low-Intensity Knowledge Translation Interventions for Surgeons and Their Association With Process and Outcome Measures Among Patients Undergoing Rectal Cancer Surgery.

Importance: Surgeon-directed knowledge translation (KT) interventions for rectal cancer surgery are designed to improve patient measures, such as rates of permanent colostomy and in-hospital mortality, and to improve survival.

Objective: To evaluate the association of sustained, iterative, integrated KT rectal cancer surgery interventions directed at all surgeons with process and outcome measures among patients undergoing rectal cancer surgery in a geographic region.

Design, Setting, And Participants: This quality improvement study used administrative data from patients who underwent rectal cancer surgery from April 1, 2004, to March 31, 2015, in 14 health regions in Ontario, Canada.