Methylation analysis by targeted bisulfite sequencing in large for gestational age (LGA) newborns: the LARGAN cohort.

Background: In 1990, David Barker proposed that prenatal nutrition is directly linked to adult cardiovascular disease. Since then, the relationship between adult cardiovascular risk, metabolic syndrome and birth weight has been widely documented. Here, we used the TruSeq Methyl Capture EPIC platform to compare the methylation patterns in cord blood from large for gestational age (LGA) vs adequate for gestational age (AGA) newborns from the LARGAN cohort.

Feasibility and Acceptability of Implementing Site-Specific Patient-Reported Outcome Measure in Head and Neck Cancer Clinics: A Prospective Institutional Study.

Purpose: To assess the feasibility and acceptability of implementing the MD Anderson Symptom Inventory-Head and Neck (MDASI-HN) module in cancer clinics and its effect on patient-reported experience.

Methods: We conducted a prospective, longitudinal study at a tertiary cancer institution between September 2020 and August 2021. Patients with newly diagnosed head and neck (HN) cancer who were evaluated to receive radiation therapy with or without chemotherapy and could communicate in English were approached to participate.

Stakeholder Perspectives on Access to IBD Care: Proceedings From a National IBD Access Summit.

Background: Canada has among the highest incidence and prevalence rates of inflammatory bowel disease (IBD) in the world. While access to IBD specialty care can have a direct impact on health-related outcomes, the complexity of accessing IBD specialty care within Canada is not well understood and presents a barrier to implementation and evaluation of IBD specialty care.

Aim: The IBD Summit was held in partnership with Crohn's & Colitis Canada to identify barriers and facilitators of IBD specialty care by exploring the perceptions and experiences of key stakeholders of IBD care across Canada.

Locoregional Management of Breast Cancer: A Chronological Review.

Locoregional management of breast cancer is founded on evidence generated over a vast time period, much longer than the career span of many practicing physicians. Oncologists rely on specific patient and tumour characteristics to recommend modern-day treatments. However, some of this information may not have been available during prior periods in which the evidence was generated.

Radiation Therapy With Cyclin-Dependent Kinase 4/6 Inhibitors: A Multi-institutional Safety and Toxicity Study.

Purpose: Our purpose was to investigate radiation therapy (RT) toxicity when given with cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) compared with RT alone.

Methods And Materials: We conducted a retrospective cohort study of patients with hormonal receptor-positive and human epidermal growth factor-2 negative metastatic breast cancer treated with RT at 4 cancer centers in Alberta, Canada, between 2016 and 2020. Toxicity in patients treated with RT within 30 days of initiating to discontinuing CDK4/6i (RT + CDK4/6i) was compared with toxicity of RT in CDK4/6i-naïve patients (RT alone).

Periocular invasive melanoma manifestation in a patient using bimatoprost: case report and literature review.

Prostaglandin F analogs (PGAs) are considered efficacious in the first-line treatment of glaucoma. They have however been associated with a number of periocular side effects. We present a case of periocular hyperpigmentation and progression to lentigo maligna melanoma (LMM) in a patient using bimatoprost eye drops.

Developing and Assessing the Feasibility of Implementing a Surgical Objective Structured Clinical Skills Examination (S-OSCE).

Objective: To1 describe the development and evaluate the feasibility of a surgical objective structured clinical examination (OSCE) for the purpose of competency assessment based on the Royal College of Canada's CanMEDS framework.

Design: A unique surgical OSCE was developed to evaluate the clinical and surgical management of common orthopaedic problems using simulated patients and cadaveric specimens. Cases were graded by degree of difficulty (less complex, complex, more complex) Developing an assessment tool with significant resource utilization and good correlation with traditional methods is challenging.

Exaggerated Functional Impairment due to Malingered Neurocognitive Dysfunction Following Mild Traumatic Brain Injury.

Objective: Functional impairment associated with Neurocognitive Disorder is often claimed in medico-legal settings after mild Traumatic Brain Injury (mTBI). This case-control study examined self-reported functional impairment and the plausibility of chronic disability claims following uncomplicated mTBI.

Method: Independent Medical Evaluations included a battery of performance and symptom validity tests, along with self-reports of physical or emotional complaints and functional impairment.

Cyclooxygenase-1 serves a vital hepato-protective function in chemically induced acute liver injury.

Cyclooxygenase-1 (COX-1) is the constitutive form of the COX enzyme family, which produces bioactive lipids called prostanoids. Although the role of COX-2 in liver diseases has been studied, little is known about the function of COX-1 in liver injury. We aimed to investigate the role and mechanism of COX-1 in acute liver injury.

Maternal microcirculation and sidestream dark field imaging: a prospective assessment of the association between labour pain and analgesia on the microcirculation of pregnant women.

Background: Pregnancy places significant demands on the cardiovascular system leading to measurable changes in the macrocirculation and potentially the microcirculation. During labour, both uterine contractions and labour pain can further impact cardiovascular status. The objective of this observational study was to compare sublingual microcirculation in labouring parturients before and after epidural analgesia.

Can emergency medical services use turnaround time as a proxy for measuring ambulance offload time?

Background: "Offload delay" occurs when the transfer of care from paramedics to the emergency department (ED) is prolonged. Accurately measuring the delivery interval or "offload" is important, because it represents the time patients are waiting for definitive care. Because recording this interval presents a significant challenge, most emergency medical services systems only measure the complete at-hospital time or "turnaround interval," and most offload delay research and policy is based on this proxy.

Thromboxane inhibitors attenuate inflammatory and fibrotic changes in rat liver despite continued ethanol administrations.

Background: Thromboxane levels are increased in rats fed ethanol (EtOH), whereas thromboxane inhibitors reduce alcoholic liver injury. The aim of this study is to determine whether thromboxane inhibitors could attenuate the already established alcoholic liver injury.

Methods: Rats were fed EtOH and liquid diet for 6 weeks by intragastric infusion to induce liver injury after which EtOH was continued for 2 more weeks, and the rats were treated with either a thromboxane synthase inhibitor (TXSI) or a thromboxane receptor antagonist (TXRA).

Acetylcholine receptor gamma-subunits mRNA isoforms expressed in denervated rat muscle.

The fetal acetylcholine (ACh) receptor, composed of the alphabetagammadelta subunits, is expressed in fetal, neonatal, and denervated muscle. Single-channel recording has revealed three kinetically distinct classes in neonatal and denervated muscle, suggesting that at least three forms of the gamma-subunit are required. To account for the kinetic classes observed, we compared the messenger ribonucleic acid (mRNA) forms expressed in neonatal and denervated muscle using reverse transcriptase polymerase chain reaction, cloning, and RNAse protection assays.

Brain activity and cognitive status in pediatric patients: development of a clinical assessment protocol.

The purpose of this study was to test the validity of a new computerized task to assess children's cognitive problem-solving skills using the brain event-related potentials. This event-related potential-computerized cognitive problem-solving task does not require a child to give a verbal or motor (ie, pointing) response. The event-related potential waveforms were recorded from 20 typically developing children.

Sex differences in the acetylcholine receptor kinetics of postnatal and denervated rat muscle.

Single-channel recording from visualised endplates in freshly dissociated muscles from postnatal and denervated rat muscle revealed the presence of a low conductance, fetal type of acetylcholine receptor. Kinetic analysis showed a main component in the burst durations with a mean of 10.8 +/- 2.

HRT to prevent cardiovascular disease. What studies show, how to advise patients.

How should you advise postmenopausal patients who are considering estrogen therapy? Do the potential cardiovascular benefits outweigh the risks? Does hormone therapy improve the cardiovascular risk profile in women with established coronary artery disease? In this article, Drs Wood and Cox help clarify the current clinical data for and against hormone replacement therapy for prevention of cardiovascular disease. In addition, they discuss current treatment recommendations and future directions in hormone therapy.

Preschoolers classified as having attention-deficit hyperactivity disorder (ADHD): DSM-IV symptom endorsement pattern.

In the present study, 50 preschoolers were formally and independently classified using both the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and third edition-revised (DSM-III-R) criteria for attention-deficit hyperactivity disorder (ADHD). The sample consisted of 25 preschoolers classified as having ADHD and 25 typically developing preschoolers for comparison; the sample was matched on gender, age, and socioeconomic status. All 50 preschoolers were without neurologic or neurodevelopmental disorders, oppositional defiant disorder, or language delay.

Calcified subcutaneous arterioles with infarcts of the subcutis and skin ("calciphylaxis") in chronic renal failure.

Patients with chronic renal failure (CRF) are at increased risk for pathological calcifications because of increased serum calcium-phosphorus products. A minority, including those undergoing dialysis, develop a syndrome of deep skin ulcerations in association with calcification of subcutaneous arterioles. The body distribution of the skin lesions may be proximal (central), distal (peripheral), or both.

Should noncardiac chest pain be treated empirically? A cost-effectiveness analysis.

Background: Chest pain is a common clinical problem, but up to 30% of patients who present with chest pain lack coronary disease. Subsequent investigation often reveals an esophageal source for the pain, with gastroesophageal reflux disease identified most frequently. Controversy exists regarding whether to establish the cause or to empirically treat as reflux.

Thrombosed giant coronary artery aneurysm presenting as an intracardiac mass.

Giant coronary artery aneurysms are rare in adults and are usually found in association with Kawasaki's disease arising in childhood. We report a case of a thrombosed giant right coronary artery aneurysm presenting as an intracardiac mass detected after inferior wall myocardial infarction. Histologic analysis indicated that fibromuscular dysplasia was the underlying cause of the aneurysm.

Brain activity and language assessment using event-related potentials: development of a clinical protocol.

To test the validity of a new computerized task to assess children's receptive vocabulary, event-related potentials (ERPs) were recorded from 56 typically developing children ranging in age from 5 to 12 years. This ERP-computerized vocabulary task does not require a child to give a verbal or motor (i.e.

Medial smooth muscle cell loss in arterial allografts occurs by cytolytic cell induced apoptosis.

Objective: Experimental arterial allografts, used as models of chronic rejection, undergo marked loss of smooth muscle cells (SMC) from their media prior to the development of occlusive, intimal proliferative lesions. Medial SMC loss has been described in human heart transplants, and may be related to the development of occlusive coronary lesions which are the hallmark of chronic rejection. This SMC loss does not exhibit the characteristics of necrotic cell death.

Asynchronous pulmonary hyperplasia associated with tracheal atresia: pathologic and prenatal sonographic findings.

We describe a case of pulmonary hyperplasia associated with tracheal atresia and a complete obstruction to the egress of pulmonary secretions. In classical pulmonary hyperplasia associated with cartilagenous laryngeal atresia and a persistent pharyngotracheal duct, the histologic appearance of the lungs is normal but exhibits "synchronous" hypermaturity. The histologic pattern in our case is much less mature, resembles CAM type III, and exhibits "asynchronous" development.