The Canadian Heart Failure (CAN-HF) Registry: A Canadian Multicentre, Retrospective Study of Outpatients with Heart Failure.

Background: Guideline-directed medical therapy (GDMT) reduces events in patients with heart failure (HF) with reduced ejection fraction (HFrEF). Despite this impact, underutilization of GDMT persists. This report sought to describe HF management in Canadian outpatients treated at specialized HF clinics (HFCs).

Population-Based Analysis of the Risk of Mycobacterial Infections Associated With Immune Checkpoint Inhibitors.

In this population-based study, we examined the risk of nontuberculous mycobacterial disease associated with immune checkpoint inhibitors among people with cancer. Using a nested case-control design, we identified 184 cases and 714 matched controls; there was no significant association on conditional logistic regression (adjusted odds ratio, 0.51 [95% confidence interval, .

Perioperative and periprocedural management of GLP-1 receptor-based agonists and SGLT2 inhibitors: narrative review and the STOP-GAP and STOP DKA-2 algorithms.

The GLP-1 receptor-based agonists (GLP-1RAs) and SGLT2 inhibitors (SGLT2i) are major 21 century breakthroughs in diabetes and obesity medicine but there are important safety considerations regarding the perioperative and periprocedural management of individuals who are treated with these agents. GLP-1RAs have been linked to an increased risk of retained gastric contents and pulmonary aspiration while SGLT2i can be associated with diabetic ketoacidosis. This manuscript provides a narrative review of the available evidence for perioperative and periprocedural risks in people prescribed GLP-1RAs and SGLT2i.

A deep learning pipeline for three-dimensional brain-wide mapping of local neuronal ensembles in teravoxel light-sheet microscopy.

Teravoxel-scale, cellular-resolution images of cleared rodent brains acquired with light-sheet fluorescence microscopy have transformed the way we study the brain. Realizing the potential of this technology requires computational pipelines that generalize across experimental protocols and map neuronal activity at the laminar and subpopulation-specific levels, beyond atlas-defined regions. Here, we present artficial intelligence-based cartography of ensembles (ACE), an end-to-end pipeline that employs three-dimensional deep learning segmentation models and advanced cluster-wise statistical algorithms, to enable unbiased mapping of local neuronal activity and connectivity.

Running Low: A Seasonal Analysis of Micronutrient Deficiencies on External-Load Measures in Elite Female Rugby League Players.

Unlabelled: Iron and vitamin D are essential for physiological mechanisms underpinning physical capacities characterizing team-sport performance. Yet, the impact of iron deficiency on physical capacities beyond endurance is not clear.

Purpose: The purpose of this study was to assess variations in seasonal micronutrient concentrations and how iron deficiency impacts external-load measures in elite female rugby league players.

Comparative Efficacy of Nonsteroid Immunosuppressive Medications in Childhood Nephrotic Syndrome.

Importance: Cyclophosphamide and calcineurin inhibitors are the most used nonsteroid immunosuppressive medications globally for children with various chronic inflammatory conditions. Their comparative effectiveness remains uncertain, leading to worldwide practice variation. Nephrotic syndrome is the most common kidney disease managed by pediatricians globally and suboptimal treatment is associated with high morbidity.

Characteristics of relapsed/refractory diffuse large B-cell lymphoma patients with durable responses to maveropepimut-S, pembrolizumab, and cyclophosphamide: Long-term follow-up from the SPiReL trial.

Introduction: Patients with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) have an unmet medical need. The objective of this trial was to assess the efficacy and toxicities of a novel triple immunotherapy regimen-pembrolizumab, low-dose cyclophosphamide, and maveropepimut-S (MVP-S). This regimen was designed to activate tumor-specific T cells by targeting the tumor-associated antigen survivin with MVP-S and reducing two important T cell inhibitory pathways: T cell exhaustion and regulatory T cells with pembrolizumab and metronomic cyclophosphamide, respectively.

The impact of preexisting psychiatric disorders on patient outcomes following primary total shoulder arthroplasty: A systematic review and quantitative synthesis.

Purpose: To summarize complication rates, reoperation rates, length-of-stay (LOS), patient-reported outcome measures (PROMs), and range of motion following total shoulder arthroplasty (TSA) in patients with preexisting psychiatric disorders (PDs) compared to controls.

Methods: Three databases (MEDLINE, PubMed, and EMBASE) were searched from inception to 4 March 2024 to identify studies comparing outcomes between patients undergoing anatomic (aTSA) or reverse TSA (rTSA) with or without a preexisting psychiatric condition. The authors adhered to the preferred reporting items for systematic reviews and meta-analyses and revised assessment of multiple systematic review guidelines.

Endoscopic Submucosal Dissection of Gastric High-Grade Foveolar Dysplasia With Normal Background Mucosa.

Most gastric neoplastic lesions appear in patients with gastric premalignant conditions. Here, we present the case of a 75-year-old woman with no prior history of infection, with a big gastric adenoma resected by endoscopic submucosal dissection. Histopathological examination revealed high-grade foveolar dysplasia.

Predicting brain tumour growth patterns using a novel MRI-based tumour spread map: application to radiotherapy planning.

Background: The treatment of glioblastomas (GBM) with radiation therapy is extremely challenging due to their invasive nature and high recurrence rate within normal brain tissue.

Purpose: In this work, we present a new metric called the tumour spread (TS) map, which utilizes diffusion tensor imaging (DTI) to predict the probable direction of tumour cells spread along fiber tracts. We hypothesized that the TS map could serve as a predictive tool for identifying patterns of likely recurrence in patients with GBM and, therefore, be used to modify the delivery of radiation treatment to pre-emptively target regions at high risk of tumour spread.

Future directions in the evaluation and management of newly diagnosed metastatic cancer.

There is a much debate regarding optimal selection in patients with metastatic cancer who should undergo local treatment (surgery or radiation treatment) to the primary tumor and/or metastases. Additionally, the optimal treatment of newly diagnosed metastatic cancer is largely unclear. Current prognostication systems to best inform these clinical scenarios are limited, as all metastatic patients are grouped together as having Stage IV disease without further incorporation of patient and disease-specific covariates that significantly impact patient outcomes.

A retrospective evaluation of patient characteristics and recommendations of a novel multidisciplinary clinic for persons with advanced disability from multiple sclerosis.

Context: Persons with advanced multiple sclerosis (MS) require care beyond the disease modifying treatments offered in conventional MS clinics to address their complex physical and psychosocial needs. In the novel MS Comprehensive and Palliative Care (MSCPC) Program, an MS neurologist, palliative care specialist, and physiatrist collaborate to identify these needs and improve symptom control.

Objectives: To characterize the medical, physical, and psychosocial concerns of persons with advanced disability from MS and describe the recommended interventions of the MSCPC Program.

Chronic kidney disease-mineral and bone disorder: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.

In 2017, Kidney Disease: Improving Global Outcomes (KDIGO) published a Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Since then, new lines of evidence have been published related to evaluating disordered mineral metabolism and bone quality and turnover, identifying and inhibiting vascular calcification, targeting vitamin D levels, and regulating parathyroid hormone. For an in-depth consideration of the new insights, in October 2023, KDIGO held a Controversies Conference on CKD-MBD: Progress and Knowledge Gaps Toward Personalizing Care.

Relationship Between Pre- and Post-Orchidectomy Serum Dihydrotestosterone and Prostate Cancer Severity in a Cohort of Nigerian Patients.

Introduction: Prostate cancer (PCa) is the commonest urologic cancer worldwide and the leading cause of male cancer deaths in Nigeria. In Nigeria, orchidectomy remains the primary androgen deprivation therapy. Dihydrotestosterone (DHT) is the active prostatic androgen, but its relationship with PCa severity has not been extensively studied in Africa.

Bladder rupture in late-pregnancy mares: Four cases.

This case series reports four late pregnancy broodmares that were diagnosed with bladder rupture. The initial presentations were abdominal discomfort (n = 3) and dystocia (n = 1). All mares (n = 4) were overdue or at their expected time of delivery.

Stereotactic body radiotherapy for non-spine bone metastases: A meta-analysis and international stereotactic radiosurgery society (ISRS) clinical practice guidelines.

Background: While SBRT to NSBM has become common, particularly in the oligometastatic population, the approach to treating non-spine bone metastases (NSBM) with stereotactic body radiotherapy (SBRT) varies widely across institutions and clinical trial protocols. We present a comprehensive systematic review of the literatures to inform practice recommendations on behalf of the International Stereotactic Radiosurgery Society (ISRS).

Methods: A systematic literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Dosimetric comparison of CyberKnife and conventional linac prostate SBRT plans: analysis of the PACE-B Study.

Purpose: In the PACE-B study, a non-randomised comparison of toxicity outcomes between stereotactic body radiotherapy (SBRT) platforms revealed fewer urinary side-effects with CyberKnife (CK) compared to conventional linac (CL) SBRT. This analysis compares baseline characteristics and planning dosimetry between the CK-SBRT and CL-SBRT cohorts in PACE-B, aiming to provide insight into possible reasons for differing toxicity outcomes between the platforms.

Methods: Dosimetric parameters for the surrogate urethra (SU), contoured urethra, bladder, bladder trigone (BT), and rectum were extracted from available CT planning scans of PACE-B SBRT patients.

Intranasal oxytocin for apathy in people with frontotemporal dementia (FOXY): a multicentre, randomised, double-blind, placebo-controlled, adaptive, crossover, phase 2a/2b superiority trial.

Background: No treatments exist for apathy in people with frontotemporal dementia. Previously, in a randomised double-blind, placebo-controlled, dose-finding study, intranasal oxytocin administration in people with frontotemporal dementia improved apathy ratings on the Neuropsychiatric Inventory over 1 week and, in a randomised, double-blind, placebo-controlled, crossover study, a single dose of 72 IU oxytocin increased blood-oxygen-level-dependent signal in limbic brain regions. We aimed to determine whether longer treatment with oxytocin improves apathy in people with frontotemporal dementia.

Implementation of the I-DECIDED tool for PIVC assessment and decision making: discussion paper.

Highlights: PIVCs often cause pain, irritation, or infection. Regular and careful catheter checks can decrease complications and improve patient outcomes. Implementation of the I-DECIDED® tool led to fewer idle catheters and complications.