Improving multidisciplinary cancer conferences: a population-based intervention.

Background: Multidisciplinary cancer conferences (MCCs) facilitate the discussion of appropriate diagnostic and treatment options for an individual cancer patient. In 2007, a study conducted in Ontario found that 52 % of hospitals were able to provide access to MCCs. In 2006, Cancer Care Ontario published minimum standards for MCCs.

Skin-cleansing and care principles for special pediatric populations.

Good skin care has two overall goals: to support and maintain healthy stratum corneum function and to help restore barrier function perturbed by disease processes or injuries. In this article, we discuss the special attention that is required in the initial skin care of newborns, and we address what measures, beyond the basic skin care principles, are required for patients with conditions such as atopic dermatitis, acne, contact and allergic dermatitis, and diaper rash.

A lifetime of well skin care: practical recommendations for clinicians and patients.

The skin is an indicator of overall health throughout life, and the skin's lifelong care and environment are reflected with aging. The goal of skin care education by clinicians is to teach and reinforce habits that will support and maintain optimum stratum corneum barrier function throughout life and, when dermatologic conditions or injuries arise, that will aid in recovery of barrier function.

The chemistry of skin cleansers: an overview for clinicians.

Cleansers and other skin care products can be agents either of stratum corneum damage and skin barrier dysfunction or of maintaining or restoring healthy stratum corneum barrier structure and function. To guide patients toward beneficial choices most suitable for their individual skin conditions and needs, clinicians must be aware of and understand the ingredients in such skin care products and their potential effects on the stratum corneum barrier. In cleansers specifically, clinicians should be aware particularly of the benefits and potential problems associated with chemical components of surfactants, preservatives, and fragrances.

Update on the structure and function of the skin barrier: atopic dermatitis as an exemplar of clinical implications.

The healthy stratum corneum allows optimum permeability of water and provides the first line of defense against pathogenic and environmental assaults. The barrier functions of the stratum corneum are interrelated, coregulated, and interdependent. Research has demonstrated that three lipid species, which usually comprise 10% of the stratum corneum, are crucial to both its structure and its function; these must be present in sufficient quantities and in the correct proportions to provide optimum barrier function.

Understanding skin barrier differences: a demographic, cultural, and medical diversity viewpoint.

Important differences exist in the physiology of the stratum corneum barrier according to demographic, cultural, and medical factors. Understanding these differences is crucial to choosing strategies for optimum clinical management.

The hutterite variant of Treacher Collins syndrome: a 28-year-old story solved.

Treacher Collins syndrome (TCS), the best known form of mandibulofacial dysostosis (MFD) comprises a recognizable pattern of anomalies. In 1985, Lowry et al. reported on two Hutterite sisters born to apparently unaffected parents with TCS, raising the possibility of an autosomal recessive (AR) variant of TCS, subsequently given a unique Mendelian Inheritance of Man (MIM) number (248390).

Characterization of the gut-associated microbiome in inflammatory pouch complications following ileal pouch-anal anastomosis.

Introduction: Inflammatory complications following ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) are common and thought to arise through mechanisms similar to de novo onset inflammatory bowel disease. The aim of this study was to determine whether specific organisms in the tissue-associated microbiota are associated with inflammatory pouch complications.

Methods: Patients having previously undergone IPAA were recruited from Mount Sinai Hospital.

Ileal pouch symptoms do not correlate with inflammation of the pouch.

Background & Aims: Pouchitis is the most common complication after ileal pouch-anal anastomosis (IPAA). However, symptoms are not specific. The Pouchitis Disease Activity Index (PDAI) and the Pouchitis Activity Score (PAS) have been used to diagnose pouchitis.

What provider volumes and characteristics are appropriate for gastric cancer resection? Results of an international RAND/UCLA expert panel.

Background: A relationship between higher volume providers and improved outcomes has been suggested by some studies and has been used to construct guidelines for many diseases. For gastric cancer (GC), however, optimal volume cutoffs are not clear.

Methods: A multidisciplinary expert panel of 16 physicians from 6 countries scored 120 scenarios regarding provider characteristics for gastric resections for GC.

Mineralocorticoid receptor antagonists attenuate pulmonary inflammation and bleomycin-evoked fibrosis in rodent models.

Accumulating evidence indicates protective actions of mineralocorticoid antagonists (MR antagonists) on cardiovascular pathology, which includes blunting vascular inflammation and myocardial fibrosis. We examined the anti-inflammatory and anti-fibrotic potential of MR antagonists in rodent respiratory models. In an ovalbumin allergic and challenged Brown Norway rat model, the total cell count in nasal lavage was 29,348 ± 5451, which was blocked by spironolactone (0.

Mechanisms and ecological role of carbon transfer within coastal seascapes.

Worldwide, coastal systems provide some of the most productive habitats, which potentially influence a range of marine and terrestrial ecosystems through the transfer of nutrients and energy. Several reviews have examined aspects of connectivity within coastal seascapes, but the scope of those reviews has been limited to single systems or single vectors. We use the transfer of carbon to examine the processes of connectivity through multiple vectors in multiple ecosystems using four coastal seascapes as case studies.

Closing the quality loop: facilitating improvement in oncology practice through timely access to clinical performance indicators.

Purpose: Health care organizations and professionals are being called on to develop clear and transparent measures of quality and to demonstrate the application of the data to performance improvement at the system and provider levels.

Materials And Methods: Cancer Care Ontario (CCO) initiated a pathology reporting project aimed at improving the quality of cancer pathology by standardizing the content, format, and transmission of reports to a central registry and enabling the information to be available for planning, quality measurement, and quality improvement. This population-based quality-improvement project involved more than 400 Ontario pathologists and more than 100 hospitals.

Outcomes following surgery for perforating Crohn's disease.

Background: The most common indications for surgery for patients with ileocolic Crohn's disease are fibrostenotic or perforating disease. The objective was to compare surgical outcomes of patients with perforating versus non-perforating disease following ileocolic resection.

Methods: This was a retrospective review of all patients who had their first ileocolic resection between 1990 and 2010, identified from a prospectively maintained inflammatory bowel disease database.

Role of Evidence-Based Reviews in Surgery in teaching critical appraisal skills and in journal clubs.

Background: Evidence-Based Reviews in Surgery (EBRS) is a program developed to teach critical appraisal skills to general surgeons and residents. The purpose of this study was to assess the use of EBRS by general surgery residents across Canada and to assess residents' opinions regarding EBRS and journal clubs.

Methods: We surveyed postgraduate year 2-5 residents from 15 general surgery programs.

Radical diffusion limits to photoinhibited superresolution lithography.

Photoinhibited superresolution (PInSR) lithography is a two-color, one-photon scheme that promises high throughput far-field patterning at deep subwavelength scales. The technique requires that active species are confined for some minimum time to the illuminated area where they are generated. We investigate here the extent to which this condition is met for published materials.

Modification of triclosan scaffold in search of improved inhibitors for enoyl-acyl carrier protein (ACP) reductase in Toxoplasma gondii.

Through our focused effort to discover new and effective agents against toxoplasmosis, a structure-based drug design approach was used to develop a series of potent inhibitors of the enoyl-acyl carrier protein (ACP) reductase (ENR) enzyme in Toxoplasma gondii (TgENR). Modifications to positions 5 and 4' of the well-known ENR inhibitor triclosan afforded a series of 29 new analogues. Among the resulting compounds, many showed high potency and improved physicochemical properties in comparison with the lead.

Liver resection for colorectal cancer metastases.

Questions: Should surgery be considered for colorectal cancer (crc) patients who have liver metastases plus (a) pulmonary metastases, (b) portal nodal disease, or (c) other extrahepatic metastases (ehms)?What is the role of chemotherapy in the surgical management of crc with liver metastases in (a) patients with resectable disease in the liver, or (b) patients with initially unresectable disease in the liver that is downsized with chemotherapy ("conversion")?What is the role of liver resection when one or more crc liver metastases have radiographic complete response (rcr) after chemotherapy?

Perspectives: Advances in chemotherapy have improved survival in crc patients with liver metastases. The 5-year survival with chemotherapy alone is typically less than 1%, although two recent studies with folfox or folfoxiri (or both) reported rates of 5%-10%. However, liver resection is the treatment that is most effective in achieving long-term survival and offering the possibility of a cure in stage iv crc patients with liver metastases.

Development of a triclosan scaffold which allows for adaptations on both the A- and B-ring for transport peptides.

The enoyl acyl-carrier protein reductase (ENR) enzyme is harbored within the apicoplast of apicomplexan parasites providing a significant challenge for drug delivery, which may be overcome through the addition of transductive peptides, which facilitates crossing the apicoplast membranes. The binding site of triclosan, a potent ENR inhibitor, is occluded from the solvent making the attachment of these linkers challenging. Herein, we have produced 3 new triclosan analogs with bulky A- and B-ring motifs, which protrude into the solvent allowing for the future attachment of molecular transporters for delivery.

What studies are appropriate and necessary for staging gastric adenocarcinoma? Results of an international RAND/UCLA expert panel.

Background: The approach for staging gastric adenocarcinoma (GC) has not been well defined, with heterogeneity in the application of staging modalities.

Methods: Utilizing a RAND/UCLA appropriateness methodology (RAM), a multidisciplinary expert panel of 16 physicians scored 84 GC staging scenarios. Appropriateness was scored from 1 to 9.

Three dimensional live cell lithography.

We investigate holographic optical trapping combined with step-and-repeat maskless projection stereolithography for fine control of 3D position of living cells within a 3D microstructured hydrogel. C2C12 myoblast cells were chosen as a demonstration platform since their development into multinucleated myotubes requires linear arrangements of myoblasts. C2C12 cells are positioned in the monomer solution with multiple optical traps at 1064 nm and then encapsulated by photopolymerization of monomer via projection of a 512x512 spatial light modulator illuminated at 405 nm.

Characterization of detector modulation-transfer function with noise, edge, and holographic methods.

We developed a new method for characterization of detector performance used in the transmission electron microscope (TEM) based on the measured contrast of holographic fringes. The new method changes spatial frequency of the measured holographic fringes, generated by an electrostatic biprism and Schottky or cold field-emission gun, to sample the modulation-transfer function (MTF) of the detector. The MTF of a Gatan Ultrascan™ 1000 charged-coupled detector (CCD) is evaluated using the new method and the results are compared to the established noise and slanted-edge method results.