Benzodiazepine-Free Cardiac Anesthesia for Reduction of Postoperative Delirium: A Cluster Randomized Crossover Trial.

Importance: Delirium is common after cardiac surgery and associated with adverse outcomes. Intraoperative benzodiazepines may increase postoperative delirium but restricting intraoperative benzodiazepines has not yet been evaluated in a randomized trial.

Objective: To determine whether an institutional policy of restricted intraoperative benzodiazepine administration reduced the incidence of postoperative delirium.

Prioritizing questions and topics for the development of guidelines and consensus-based recommendations supported by ILAE: A scoping review and proposal of prioritization criteria.

Clinical practice guidelines (CPGs) and consensus-based recommendations (CBRs) require considerable effort, collaboration, and time-all within the constraints of finite resources. Professional societies, such as the International League Against Epilepsy (ILAE), must prioritize what topics and questions to address. Implementing evidence-based care remains a crucial challenge in clinical practice.

Persistent cross-species transmission systems dominate Shiga toxin-producing O157:H7 epidemiology in a high incidence region: A genomic epidemiology study.

Several areas of the world suffer a notably high incidence of Shiga toxin-producing . To assess the impact of persistent cross-species transmission systems on the epidemiology of O157:H7 in Alberta, Canada, we sequenced and assembled O157:H7 isolates originating from collocated cattle and human populations, 2007-2015. We constructed a timed phylogeny using BEAST2 using a structured coalescent model.

The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY study.

Objectives: To assess the contemporary malignancy rate in isolated de novo red patches in the bladder and associated risk factors for better selection of red patch biopsy.

Patients: Patients from the IDENTIFY dataset; Patients referred to secondary care with suspected urinary tract cancer and found to have isolated de novo red patches on cystoscopy.

Methods: We reported the unadjusted cancer prevalence in isolated de novo red patches that were biopsied; multivariable logistic regression was used to explore cancer-associated risk factors including age, sex, smoking, type of haematuria, LUTS, UTIs and a suspicious-looking red patch (as reported by the cystoscopist).

The Calgary Kids' Hand Rule: External Validation of a Prediction Model to Triage Pediatric Hand Fractures.

The Calgary Kids' Hand Rule (CKHR) is a clinical prediction rule intended to guide referral decisions for pediatric hand fractures presenting to the emergency department, identifying "complex" fractures that require surgical referral and optimizing care through better matching of patients' needs to provider expertise. The objective of this study was to externally validate the CKHR in two different tertiary pediatric hospitals in Canada. We partnered with British Columbia Children's Hospital (BCCH) and the Children's Hospital of Eastern Ontario (CHEO) to externally validate the CKHR using data from retrospective cohorts of pediatric hand fractures (via electronic medical record and x-ray review).

Natural history progression of MRI brain volumetrics in type II late-infantile and juvenile GM1 gangliosidosis patients.

Objective: GM1 gangliosidosis is a rare lysosomal storage disorder characterized by the accumulation of GM1 gangliosides in neuronal cells, resulting in severe neurodegeneration. Currently, limited data exists on the brain volumetric changes associated with this disease. This study focuses on the late-infantile and juvenile subtypes of type II GM1 gangliosidosis, aiming to quantify brain volumetric characteristics to track disease progression.

Effectiveness of a New Device for Hand, Wrist, and Forearm Rehabilitation: Feasibility Randomized Controlled Trial.

Background: Forearm, wrist, and hand impairments affect many individuals and impose a significant economic burden on health care systems. The FEPSim (flexion, extension, pronation, and supination) is designed for hand and wrist rehabilitation. It could become part of the standard care for upper extremity rehabilitation, aiming to improve range of motion, dexterity, and strength during therapeutic activities.

Nelonemdaz and Patients With Acute Ischemic Stroke and Mechanical Reperfusion: The RODIN Randomized Clinical Trial.

Importance: Nelonemdaz selectively antagonizes the 2B subunit of the N-methyl-d-aspartate glutamate receptor and scavenges free radical species.

Objective: To evaluate whether nelonemdaz enhances the clinical outcomes of patients with acute ischemic stroke undergoing emergent reperfusion therapy.

Design, Setting, And Participants: This multicenter double-blind placebo-controlled randomized phase 3 trial (December 25, 2021, to June 30, 2023, in South Korea) recruited patients with acute ischemic stroke who met the following criteria: National Institutes of Health Stroke Scale score greater than or equal to 8, Alberta Stroke Program Early Computed Tomography score greater than or equal to 4, and endovascular thrombectomy within 12 hours after stroke onset.

International myeloma working group immunotherapy committee recommendation on sequencing immunotherapy for treatment of multiple myeloma.

T-cell redirecting therapy (TCRT), specifically chimeric antigen receptor T-cell therapy (CAR T-cells) and bispecific T-cell engagers (TCEs) represent a remarkable advance in the treatment of multiple myeloma (MM). There are several products available around the world and several more in development targeting primarily B-cell maturation antigen (BCMA) and G protein-coupled receptor class C group 5 member D (GRPC5D). The relatively rapid availability of multiple immunotherapies brings the necessity to understand how a certain agent may affect the safety and efficacy of a subsequent immunotherapy so MM physicians and patients can aim at optimal sequential use of these therapies.

The Apparent Diffusion Coefficient Color Map for Evaluating a Large Ischemic Core.

Introduction: Our previous work demonstrated that evaluating large ischemic cores using the apparent diffusion coefficient (ADC) could predict EVT outcomes, with the most frequent ADC (peak ADC) ≥520×10 mm/s associated with better clinical results. Since the degree of ADC reduction reflects the severity of ischemic stress, this study aimed to assess the utility of an ADC color map in visualizing this stress.

Patients And Methods: This retrospective cohort study included consecutive patients with a low Alberta Stroke Program Early Computed Tomography Score (ASPECTS) using diffusion-weighted imaging (DWI) who underwent successful EVT recanalization between April 2014 and March 2023.

Endovascular Thrombectomy for Extracranial Internal Carotid Artery Occlusions With Large Ischemic Strokes: Insights From the SELECT2 Trial.

Background And Objectives: Although previous trials have established the efficacy and safety of endovascular thrombectomy (EVT) in large ischemic core strokes, most of them excluded patients with extracranial internal carotid artery (e-ICA) occlusion. We aimed to compare outcomes in patients with e-ICA occlusion and large ischemic core infarcts treated with EVT vs medical management (MM).

Methods: This was a secondary analysis of the SELECT2 trial, a randomized controlled trial conducted at 31 international sites.

Long-Term Risks of Living Kidney Donation: State of the Evidence and Strategies to Resolve Knowledge Gaps.

Living-donor kidney transplantation is the preferred treatment for kidney failure. In the United States, rates of living kidney donation have been stagnant, which is partly related to concerns over medical and financial risks. Recent research has better characterized the risks of living kidney donation, although the field is limited by a lack of robust registries.

Identifying the Views and Needs of Family Physicians on Providing Care to Living Kidney Donors: A Cross-Sectional Survey.

Optimizing the long-term care and follow-up of living kidney donors (LKDs) has been challenging, and prior LKDs have reported suboptimal healthcare experiences. Long-term care of LKDs is largely undertaken by primary care practitioners such as family physicians (FPs). We conducted a cross-sectional survey of Canadian FPs (n = 151).

Multicenter validation of secondary hemophagocytic lymphohistiocytosis diagnostic criteria.

Background: Five fulfilled hemophagocytic lymphohistiocytosis (HLH)-2004 criteria, and the HScore are widely used and recommended by international expert consensus to diagnose secondary HLH. Both diagnostic scores have never been validated in heterogeneous patient cohorts of secondary HLH patients. We aimed to systematically optimize and validate diagnostic criteria of secondary HLH using a multicenter approach.

Haemophilia Infants Gross Motor Development: Comparisons With Full-Term and Preterm Infants of the Same Nationality.

Introduction: Infants with haemophilia, due to parental overprotection, have difficulty developing their full motor repertoire of typical gross motor development. It is of great clinical importance to evaluate the motor development of these infants with a standardized assessment tool.

Aim: To study the gross motor development in infants with haemophilia, using the Alberta Infant Motor Scale (AIMS) and compare it with full-term (FT) and preterm infants (PT).

Hand position during chest compression in infantile piglets - Do you need to encircle the chest with the 2-thumb-technique?

Background: The Pediatric Life Support Consensus on Science With Treatment Recommendations states that chest compressions (CC) be performed with the 2-thumb-encircling and if the chest can not be encircled the 2-finger-technique.

Aim: To compare the hemodynamic effects of four different compression methods during CC in a piglet model of infant asphyxia.

Methods: Nine asphyxiated infant piglets were randomized to CC with 2-thumb-encircling, 2-thumb-, 2-finger-, and one-hand-techniques for one minute at each technique.

Management of Labral Tears in the Hip: A Consensus Statement.

Background: Inconsistencies in the workup of labral tears in the hip have been shown to result in a delay in treatment and an increased cost to the medical system.

Purpose: To establish consensus statements among Canadian nonoperative/operative sports medicine physicians via a modified Delphi process on the diagnosis, nonoperative and operative management, and rehabilitation and return to play (RTP) of those with labral tears in the hip.

Study Design: A consensus statement.

Systematic Review of Granulomatous Invasive Fungal Sinusitis Management.

Objectives: Granulomatous invasive fungal sinusitis (GIFS) affects immunocompetent individuals. There is ongoing debate over whether surgery, antifungal medication, or a combined approach is the best treatment. This article summarizes reports about GIFS and its management.

Mental Health of Black Canadians: A Scoping Review.

Black Canadians frequently experience significant challenges when attempting to access mental health care, resulting in discrepancies in mental health outcomes. This article describes a scoping review that aimed to understand the range and nature of research conducted on the mental health of black Canadians and to identify the gaps in this literature. An established methodological framework guided the scoping review process.

Reliability of the Alberta Infant Motor Scale (AIMS) When Used via Telehealth for Neurodevelopmentally High-Risk Infants.

Aims: To assess the reliability of the Alberta Infant Motor Scale (AIMS) when conducted recorded telehealth sessions by novice and expert raters.

Methods: Ten assessors (six novice, four expert) independently rated recorded telehealth assessments of 23 neurodevelopmentally high-risk infants twice. Inter- and intra-rater reliability of subscale scores, total score and percentile rankings were determined.

The long reach of adversity: Intermediary pathways from maternal adverse childhood experiences to child socio-emotional and cognitive outcomes.

Background: This longitudinal study with multi-informant (maternal, paternal, and experimenter) and multimethod (questionnaires, behavioral observations, and standardized assessments) data tests an intergenerational model from mothers' adverse childhood experiences (ACEs) to their children's socio-emotional and cognitive outcomes.

Methods: Participants were 501 children (50.7% male) and caregivers (56.

Exploring the Implementation of Cognitive Screening in First-Episode Psychosis Settings: The CogScreen Implementation Study.

Aim: Accurate and appropriate cognitive screening can significantly enhance early psychosis care, yet no screening tools have been validated for the early psychosis population and little is known about current screening practices, experiences, or factors that may influence implementation. CogScreen is a hybrid type 1 study aiming to validate two promising screening tools with young people with first episode psychosis (primary aim) and to understand the context for implementing cognitive screening in early psychosis settings (secondary aim). This protocol outlines the implementation study, which aims to explore the current practices, acceptability, feasibility and determinants of cognitive screening in early psychosis settings from the perspective of key stakeholders.