Test Characteristics of Emergency Medicine-Performed Point-of-Care Ultrasound for the Diagnosis of Acute Cholecystitis: A Systematic Review and Meta-analysis.

Acute cholecystitis accounts for up to 9% of hospital admissions for acute abdominal pain, and best practice entails early surgical management. Ultrasound is the standard modality used to confirm diagnosis. Our objective was to perform a systematic review and meta-analysis to determine the diagnostic accuracy of emergency physician-performed point-of-care ultrasound for the diagnosis of acute cholecystitis when compared with a reference standard of final diagnosis (informed by available surgical pathology, discharge diagnosis, and radiology-performed ultrasound).

Early detection and prevention of head and neck cancers.

Squamous cell carcinoma forms the vast majority of head and neck malignancies, with advanced disease incurring poor long-term survival. Early detection and prompt specialist referral allows the patient a greater chance of cure. Furthermore, basal cell carcinoma is the most common malignancy in humans, with the vast majority presenting in the head and neck region.

A regional effort: the current landscape of inguinal hernia repair and postoperative opioid prescription practices in Eastern Ontario.

Inguinal hernia repairs are commonly performed by general surgeons in academic and community centres. The optimal strategy for postoperative analgesia is evolving, particularly because of concerns over opioid prescribing given the current opioid crisis. Efforts to address opioid overprescribing have been emphasized in our academic hospital system.

Timing of pharmacologic venous thromboembolism prophylaxis initiation for trauma patients with nonoperatively managed blunt abdominal solid organ injury: a systematic review and meta-analysis.

Background: Blunt abdominal solid organ injury is common and is often managed nonoperatively. Clinicians must balance risk of both hemorrhage and thrombosis. The optimal timing of pharmacologic venous thromboembolism prophylaxis (VTEp) initiation in this population is unclear.

Financial implications of trauma patients at a Canadian level 1 trauma center: a retrospective cohort study.

Background: Trauma is a cause of significant morbidity and mortality globally, and patients with major trauma require specialized settings for multidisciplinary care. We sought to enumerate the variability of costs of caring for patients at a Canadian level 1 trauma center.

Methods: A retrospective analysis of all adult patients admitted to The Ottawa Hospital trauma service between June 2013 and June 2018 was conducted.

Intraoperative balloon occlusion of the aorta for blood management in sacral and pelvic tumor resection: A systematic review and meta-analysis.

Background: Neoplasms of the sacrum and pelvis are challenging to manage due to their complex vascularity and size and are at high risk of bleeding during resection. Intra-aortic balloon occlusion (IABO) has been used in trauma to control massive blood loss, but its efficacy and safety in oncologic sacral and pelvic surgery are unknown. The primary objective of this systematic review and meta-analysis was to assess the effectiveness of IABO in providing hemorrhage control during resection of sacral and pelvic tumors.

The Web-based CanMEDS Resident Learning Portfolio Project (WEBCAM): how we got started.

The CanMEDS framework is ubiquitous in Canadian postgraduate medical education; however, training programs do not have a universal method of assessing competence. We set out to develop a novel portfolio that allowed trainees to generate a longitudinal record of their training and development within the framework. The portfolio provided an objective means for the residency program director to document and evaluate resident progress within the CanMEDS roles.

Diffuse descending necrotising mediastinitis and pleural empyema secondary to acute odontogenic infection resulting in severe dysphagia.

We report a case of acute odontogenic sepsis in a 59-year-old man, presenting with diffuse, descending necrotising mediastinitis complicated by pleural empyema. Despite surviving the odds, his recovery was complicated by severe dysphagia, resulting in gastrostomy feeding for 6 months. Until now, severe dysphagia following descending necrotising mediastinitis has been unreported.

Simple interventions can greatly improve clinical documentation: a quality improvement project of record keeping on the surgical wards at a district general hospital.

Clinical documentation is an integral part of the healthcare professional's job. Good record keeping is essential for patient care, accurate recording of consultations and for effective communication within the multidisciplinary team. Within the surgical department at the Great Western Hospital, Swindon, the case notes were deemed to be bulky and cumbersome, inhibiting effective record keeping, potentially putting patients' at risk.

Partial versus complete fundoplication for the correction of pediatric GERD: a systematic review and meta-analysis.

Background: There is no consensus as to what extent of "wrap" is required in a fundoplication for correction of gastroesophageal reflux disease (GERD).

Objective: To evaluate if a complete (360 degree) or partial fundoplication gives better control of GERD.

Methods: A systematic search of MEDLINE and Scopus identified interventional and observational studies of fundoplication in children.

Reporting quality of statistical methods in surgical observational studies: protocol for systematic review.

Background: Observational studies dominate the surgical literature. Statistical adjustment is an important strategy to account for confounders in observational studies. Research has shown that published articles are often poor in statistical quality, which may jeopardize their conclusions.

Ancillary testing for diagnosis of brain death: a protocol for a systematic review and meta-analysis.

Background: The essential clinical diagnostic components of brain death must include evidence for an established etiology capable of causing brain death, two independent clinical confirmations of the absence of all brainstem reflexes and an apnea test, and exclude confounders that can mimic brain death. Numerous confounders can render the clinical neurological determination of death (NDD) virtually impossible. As such, clinicians must rely on additional ancillary testing.

Relaxin gene family in teleosts: phylogeny, syntenic mapping, selective constraint, and expression analysis.

Background: In recent years, the relaxin family of signaling molecules has been shown to play diverse roles in mammalian physiology, but little is known about its diversity or physiology in teleosts, an infraclass of the bony fishes comprising approximately 50% of all extant vertebrates. In this paper, 32 relaxin family sequences were obtained by searching genomic and cDNA databases from eight teleost species; phylogenetic, molecular evolutionary, and syntenic data analyses were conducted to understand the relationship and differential patterns of evolution of relaxin family genes in teleosts compared with mammals. Additionally, real-time quantitative PCR was used to confirm and assess the tissues of expression of five relaxin family genes in Danio rerio and in situ hybridization used to assess the site-specific expression of the insulin 3-like gene in D.

A survey of general dental practitioners in Merseyside regarding urgent appointments and suspected cancer referrals.

Aims: The aims of this study were to investigate the current situation regarding unregistered patients in the Mersey region who seek an urgent dental appointment, and to gather information on suspected oral cancer cases seen by dentists in the previous two years and about how such cases are referred.

Methods: The survey took the form of a short questionnaire sent in May 2006 to all general dental practitioners (GDPs) in the Mersey region who were registered with the regional postgraduate dental office.

Results: A total of 904 GDPs were identified and 572 (63%) returned completed survey responses.