CETARS/CAR Practice Guideline on Imaging the Pregnant Trauma Patient.

Imaging of pregnant patients who sustained trauma often causes fear and confusion among patients, their families, and health care professionals regarding the potential for detrimental effects from radiation exposure to the fetus. Unnecessary delays or potentially harmful avoidance of the justified imaging studies may result from this understandable anxiety. This guideline was developed by the Canadian Emergency, Trauma and Acute Care Radiology Society (CETARS) and the Canadian Association of Radiologists (CAR) Working Group on Imaging the Pregnant Trauma Patient, informed by a literature review as well as multidisciplinary expert panel opinions and discussions.

A survey of resuscitative endovascular balloon occlusion of the aorta (REBOA) program implementation in Canadian trauma centres.

Objective: To determine how many Level 1 and Level 2 trauma centres in Canada have implemented a resuscitative endovascular balloon occlusion of the aorta (REBOA) program, and to identify facilitators and barriers to successful implementation of REBOA programs.

Methods: An electronic survey was developed and administered in November 2019 (updated in July 2021) via email to directors at all 32 Level 1 and Level 2 trauma centres across Canada, and to the medical director in PEI (no Level 1 or Level 2 capacity). Survey responses were supplemented by an online search in PubMed and the grey literature.

Comparison of clinical and anatomical criteria for resuscitative endovascular balloon occlusion of the aorta (REBOA) among major trauma patients in Nova Scotia.

Objectives: To perform a province-wide evaluation of adult major traumas and determine the proportion of patients who met clinical and/or anatomical criteria for resuscitative endovascular balloon occlusion of the aorta (REBOA).

Methods: This is a retrospective analysis of all major trauma patients (age > 16) presenting to the sole adult level 1 trauma centre in Nova Scotia over a 5-year period (2012-2017). Data were collected from the Nova Scotia Trauma Registry and medical charts.

Does Point of Care Ultrasound Improve Resuscitation Markers in Undifferentiated Hypotension? An International Randomized Controlled Trial From The Sonography in Hypotension and Cardiac Arrest in the Emergency Department (SHoC-ED) Series.

Introduction Point of Care Ultrasound (PoCUS) protocols are commonly used to guide resuscitation for patients with undifferentiated hypotension, yet there is a paucity of evidence for any outcome benefit. We undertook an international multicenter randomized controlled trial (RCT) to assess the impact of a PoCUS protocol on key clinical outcomes. Here we report on resuscitation markers.

Does Point-of-Care Ultrasonography Improve Clinical Outcomes in Emergency Department Patients With Undifferentiated Hypotension? An International Randomized Controlled Trial From the SHoC-ED Investigators.

Study Objective: Point-of-care ultrasonography protocols are commonly used in the initial management of patients with undifferentiated hypotension in the emergency department (ED). There is little published evidence for any mortality benefit. We compare the effect of a point-of-care ultrasonography protocol versus standard care without point-of-care ultrasonography for survival and clinical outcomes.

Neurogenic Effects of Low-Dose Whole-Body HZE (Fe) Ion and Gamma Irradiation.

Understanding the dose-toxicity profile of radiation is critical when evaluating potential health risks associated with natural and man-made sources in our environment. The purpose of this study was to evaluate the effects of low-dose whole-body high-energy charged (HZE) iron (Fe) ions and low-energy gamma exposure on proliferation and differentiation of adult-born neurons within the dentate gyrus of the hippocampus, cells deemed to play a critical role in memory regulation. To determine the dose-response characteristics of the brain to whole-body Fe-ion vs.

Longitudinal Relations Among Parental Monitoring Strategies, Knowledge, and Adolescent Delinquency in a Racially Diverse At-Risk Sample.

Parents raising youth in high-risk communities at times rely on active, involved monitoring strategies in order to increase both knowledge about youth activities and the likelihood that adolescents will abstain from problem behavior. Key monitoring literature suggests that some of these active monitoring strategies predict increases in adolescent problem behavior rather than protect against it. However, this literature has studied racially homogenous, low-risk samples, raising questions about generalizability.

Experiences of Children With Gay Fathers.

An online survey was distributed via snowball sampling and resulted in responses from 61 gay fathers raising children in 2 states. Fathers reported on the barriers they experienced and the pathways they took to becoming parents. They reported also on experiences of stigma directed at them and their children, especially from family members, friends, and people in religious institutions.

Central nervous system effects of whole-body proton irradiation.

Space missions beyond the protection of Earth's magnetosphere expose astronauts to an environment that contains ionizing proton radiation. The hazards that proton radiation pose to normal tissues, such as the central nervous system (CNS), are not fully understood, although it has been shown that proton radiation affects the neurogenic environment, killing neural precursors and altering behavior. To determine the time and dose-response characteristics of the CNS to whole-body proton irradiation, C57BL/6J mice were exposed to 1 GeV/n proton radiation at doses of 0-200 cGy and behavioral, physiological and immunohistochemical end points were analyzed over a range of time points (48 h-12 months) postirradiation.

Sit-to-stand transfer mechanics in healthy older adults: a comprehensive investigation of a portable lifting-seat device.

Purpose: To evaluate lower extremity mechanics and muscle activation associated with the sit-to-stand transfer using a portable lifting-seat device and to compare these data to an unassisted transfer in healthy young and older adults.

Methods: Bilateral lower extremity and low back musculature electromyography, three-dimensional leg and trunk motion, and ground reaction forces were recorded from 10 young (mean age = 25) and 10 older (mean age = 69) adults during five trials of (i) no assist and (ii) assisted transfers. Data were time normalized to represent the period of seat-off to standing.

Continuing clopidogrel during elective total hip and knee arthroplasty: assessment of bleeding risk and adverse outcomes.

Limited research assessing risks of continued clopidogrel perioperatively in patients undergoing elective orthopedic procedures exists. Patients that underwent elective primary or revision total knee arthroplasty (TKA) or total hip arthroplasty (THA) from 2007 to 2012 while taking clopidogrel at the time of surgical evaluation were retrospectively identified. Patient demographics, last dose of clopidogrel, intraoperative blood loss, blood transfusion, and presence of 30-day adverse cardiac events (ACE) were collected.

X-ray microbeam irradiation of the contusion-injured rat spinal cord temporarily improves hind-limb function.

Spinal cord injury is a devastating condition with no effective treatment. The physiological processes that impede recovery include potentially detrimental immune responses and the production of reactive astrocytes. Previous work suggested that radiation treatment might be beneficial in spinal cord injury, although the method carries risk of radiation-induced damage.

Interleaved carbon minibeams: an experimental radiosurgery method with clinical potential.

Purpose: To evaluate the efficacy of "interleaved carbon minibeams" for ablating a 6.5-mm target in a rabbit brain with little damage to the surrounding brain. The method is based on the well-established tissue-sparing effect of arrays of thin planes of radiation.

Is there a dose response for valgus unloader brace usage on knee pain, function, and muscle strength?

Objective: To examine whether there was a dose response for valgus unloader brace wear on knee pain, function, and muscle strength in participants with medial compartment knee osteoarthritis.

Design: In this single-group study, participants with medial compartment knee osteoarthritis were followed for approximately 6 months.

Setting: Recruitment was conducted in the general community, and testing was performed at a university laboratory.

Disentangling Ethnic and Contextual Influences Among Parents Raising Youth in High-Risk Communities.

This article reports on analyses examining contextual influences on parenting with an ethnically and geographically diverse sample of parents (predominantly mothers) raising 387 children (49% ethnic minority; 51% male) in high-risk communities. Parents and children were followed longitudinally from first through tenth grades. Contextual influences included geographical location, neighborhood risk, SES, and family stress.

Solving problems using matrix, network, and hierarchy diagrams: the consequences of violating construction conventions.

In order for a diagram to be useful for solving a problem, it must be constructed so that its perceptual features facilitate inferences relevant to that problem. In Experiment 1, we established the construction conventions, which relate to how information is assigned to different parts of the diagram, for three spatial representations-networks, hierarchies, and matrices. In Experiment 2, participants solved problems using diagrams that either followed or violated these conventions.

Cytosolic prostaglandin E2 synthase (cPGES) expression is decreased in discrete cortical regions in psychiatric disease.

The number of adults in the US affected by bipolar disorder, depression, or schizophrenia is approaching 15 million. Despite decades of research, etiologies of these illnesses remain elusive. Theories of aberrant brain morphology, neurotransmission, and signal conduction have provided the heuristic framework for a large body of literature, with attention focused upon hypotheses of monoamine signaling underlying psychiatric disease.

Acute morphine exposure potentiates the development of HSV-1-induced encephalitis.

A devastating consequence of HSV-1 infection is development of HSV-1-induced encephalitis (HSVE). While only a minority of individuals infected with HSV-1 experiences HSVE, clearly defined variables that consistently predict development of the disease remain to be elucidated. The current study examined the effects of a single dose of morphine prior to infection with HSV-1 on the development of HSVE in BALB/cByJ mice.

Reconsidering hepatorenal syndrome. Throw in the towel? Not so fast!

For many years, hepatorenal syndrome was considered a uniformly and rapidly fatal complication of end-stage liver disease. Although the syndrome still carries a poor long-term prognosis, increased understanding of its hemodynamic derangements has led to new pharmacologic treatments that significantly improve short-term outcomes. In this article, Drs Tong, Hurley, and Hayashi discuss a case of remarkable reversal of hepatorenal syndrome with use of oral midodrine hydrochloride, subcutaneous octreotide acetate, and intravenous albumin.

Infection with an endemic human herpesvirus disrupts critical glial precursor cell properties.

Human herpesvirus 6 (HHV-6), a common resident virus of the human CNS, has been implicated in both acute and chronic inflammatory--demyelinating diseases. Although HHV-6 persists within the human CNS and has been described to infect mature oligodendrocytes, nothing is known about the susceptibility of glial precursors, the ancestors of myelin-producing oligodendrocytes, to viral infection. We show that HHV-6 infects human glial precursor cells in vitro.

COX-3: a splice variant of cyclooxygenase-1 in mouse neural tissue and cells.

We have detected an expressed mRNA encoding a splice variant of COX-1 in the mouse central nervous system. This isoform, referred to as COX-3, is identical in sequence to COX-1 except for the in-frame retention of intron 1. Like its counterpart COX-1, COX-3 does not generally appear to be induced by acute inflammatory stimulation.

Facial nerve axotomy in aged and young adult rats: analysis of the glial response.

With increasing age, there is a trend towards greater morbidity and injury extent with brain injury. Because several reports have suggested that microglia and astrocytes have an exacerbated response to brain injury in the aged, we set out to explore glial responses to facial nerve axotomy. This model was chosen because the glial responses are well-characterized in young rats and there is no perturbation of the blood-brain barrier (BBB).