Catch-AF-Early Diagnosis of Symptomatic Arrythmias in the Waiting Period Prior to Seeing a Cardiologist in Victoria, British Columbia.

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia. Given its often-paroxysmal nature, screening at a single time point, using a 12-lead electrocardiogram (ECG) or a Holter monitor, has limited benefit. The AliveCor KardiaMobile device is a validated ECG recorder that can be used for patient-directed arrhythmia diagnosis and symptom-rhythm correlation.

Safety and Efficacy of Intravenous Thrombolysis by Infarct Type in Patients with No Visible Occlusion: A Secondary Analysis of the AcT Trial.

Background: About 25% of patients with acute ischemic stroke have lacunar infarct on follow-up imaging. In this secondary analysis from the AcT (Alteplase Compared With Tenecteplase) trial, we assessed if there is variation in safety or efficacy of intravenous thrombolysis by infarct type in patients with no visible occlusion. We also determined if this effect differed between tenecteplase and alteplase.

The adoption and compliance to central line-associated bloodstream infection insertion and maintenance bundle programs in intensive care unit settings across Canada.

Evidence-based insertion and maintenance bundles are effective in reducing the incidence of central line-associated bloodstream infections (CLABSI) in intensive care unit (ICU) settings. We studied the adoption and compliance of CLABSI prevention bundle programs and CLABSI rates in ICUs in a large network of acute care hospitals across Canada.

Impact of Clinical Trial Enrollment on Thrombolysis Workflow in a Mobile Stroke Unit: Results from the AcT Trial.

Background: The Edmonton-based mobile stroke unit (MSU), which transports patients to the University of Alberta Hospital (UAH), enrolled patients in the Intravenous Tenecteplase Compared with Alteplase for Acute Ischemic Stroke (AcT) trial. We examined the feasibility of trial enrollment in MSU, its impact on acute stroke workflow metrics and functional outcomes at 90-120 days.

Methods: In this post hoc analysis, patients were divided into three groups based on enrollment site: MSU ( = 43), UAH ( = 273) and non-UAH ( = 1261).

Catheter Ablation or Antiarrhythmic Drugs for Ventricular Tachycardia.

Background: Patients with ventricular tachycardia and ischemic cardiomyopathy are at high risk for adverse outcomes. Catheter ablation is commonly used when antiarrhythmic drugs do not suppress ventricular tachycardia. Whether catheter ablation is more effective than antiarrhythmic drugs as a first-line therapy in patients with ventricular tachycardia is uncertain.

Consent-Related Outcomes in the Alteplase Compared to Tenecteplase Trial.

Background And Objectives: In recent years, researchers have sought to address the challenges of obtaining informed consent for participation in acute stroke trials. We studied outcomes related to the use of deferral of consent in the phase 3 Alteplase Compared to Tenecteplase (AcT) trial.

Methods: As part of our protocol, we captured methods of consent, participant withdrawals, door-to-randomization times, and door-to-needle times.

Inflammatory bowel disease uncovered in fecal immunochemical test positive patients in a Canadian provincial colon cancer screening program.

Inflammatory Bowel Disease (IBD) is a chronic inflammatory condition that usually affects younger adults but has a second incidence peak in the older population. Although diagnosis of IBD is driven by symptoms, some patients are asymptomatic and incidentally discovered while participating in colon screening program (CSP). We aimed to identify the incidence and outcome of IBD in fecal immunochemical test (FIT) positive patients in the British Columbia CSP.

False-negative sentinel lymph node biopsy for melanoma: a single-surgeon experience.

Background: The status of the regional lymph node basin is of prognostic importance in patients with melanoma, making the performance of sentinel lymph node biopsies (SLNBs) a key component of patient care management, particularly with the advent of immunotherapy for adjuvant treatment. The primary goal of our study was to assess the false-negative rate of SLNBs among patients with melanoma.

Methods: We conducted a retrospective review of patients with melanoma undergoing SLNB by a single surgeon between Jan.

Elective pelvic nodal irradiation in the setting of ultrahypofractionated versus moderately hypofractionated and conventionally fractionated radiotherapy for prostate cancer: Outcomes from 3 prospective clinical trials.

Background And Purpose: Data is needed regarding the use of ultrahypofractionated radiotherapy (UHRT) in the context of prostate cancer elective nodal irradiation (ENI), and how this compares to conventionally fractionated radiotherapy (CFRT) ENI with CFRT or moderately hypofractionated radiotherapy (MHRT) to the prostate.

Materials And Methods: Between 2011-2019, 3 prospective clinical trials of unfavourable intermediate or high-risk prostate cancer receiving CFRT (78 Gy in 39 fractions to prostate; 46 Gy in 23 fractions to pelvis), MHRT (68 Gy in 25 fractions to prostate; 48 Gy to pelvis), or UHRT (35-40 Gy in 5 fractions to prostate +/- boost to 50 Gy to intraprostatic lesion; 25 Gy to pelvis) were conducted. Primary endpoints included biochemical failure (Phoenix definition), and acute and late toxicities (CTCAE v3.

Primary Malignant Meningeal Melanoma Complicated by Cerebral Venous Sinus Thrombosis: An Illustrative Case With a Systematic Review of the Literature.

Melanocytic tumors of the central nervous system (CNS) such as meningeal melanoma are exceedingly rare tumours derived from leptomeningeal melanocytes. We report an illustrative case of a previously healthy 47-year-old male who presented with tonic-clonic seizure. Magnetic resonance imaging (MRI) with contrast demonstrated a homogenously enhancing right temporal extra-axial lesion.

Topical insulin to treat a conjunctival defect after glaucoma surgery: A case report.

Purpose: Insulin has been postulated as a novel and effective treatment for re-epithelialization of the ocular surface and different pathologies have been suggested as possible indications.

Observations: A 69-year-old diabetic male was referred for a left non-healing conjunctival epithelial defect over the superotemporal scleral patch used in the placement of the Ahmed ClearPath. In the left eye, he was on latanoprost/timolol once daily, prednisolone 1 % once daily and tobramycin/dexamethasone ointment at night.

A review of the role for pelvic floor physiotherapy in postmenopausal women with urinary incontinence.

Urinary incontinence is a prevalent condition affecting women. Pelvic floor physiotherapy is a specialized field of physiotherapy dedicated to assessing and treating pelvic floor muscles. This therapy has demonstrated benefits in addressing stress urinary incontinence in premenopausal women, with numerous studies supporting its efficacy in this population.

The treatment effect across ASPECTS in acute ischemic stroke: Analysis from the AcT trial.

Background: Early ischemic changes on baseline imaging are commonly evaluated for acute stroke decision-making and prognostication.

Aims: We assess the association of early ischemic changes on clinical outcomes and whether it differs between intravenous tenecteplase and Alteplase.

Methods: Data are from the phase 3, Alteplase compared to Tenecteplase (AcT) trial.

Hyperbaric Oxygen Post Established Stroke.

Background And Purpose: Hyperbaric oxygen therapy (HBOT) has been reported to improve neurological function in the chronic phase of stroke in a single trial having significant limitations, including a lack of a sham control.

Methods: We conducted a single-center, parallel-group, randomized trial to determine the effectiveness of HBOT compared with a sham control in adults who were 6 to 36 months post-ischemic stroke. The treatment group received 40 sessions of HBOT at the Vancouver General Hospital Hyperbaric Unit.

Interhospital Transfer for Endovascular Stroke Treatment in Canada: Results From the OPTIMISE Registry.

Background: Interhospital transfer for patients with stroke due to large vessel occlusion for endovascular thrombectomy (EVT) has been associated with treatment delays.

Methods: We analyzed data from Optimizing Patient Treatment in Major Ischemic Stroke With EVT, a quality improvement registry to support EVT implementation in Canada. We assessed for unadjusted differences in baseline characteristics, time metrics, and procedural outcomes between patients with large vessel occlusion transferred for EVT and those directly admitted to an EVT-capable center.

Glutathione-mediated redox regulation in Cryptococcus neoformans impacts virulence.

The fungal pathogen Cryptococcus neoformans is well adapted to its host environment. It has several defence mechanisms to evade oxidative and nitrosative agents released by phagocytic host cells during infection. Among them, melanin production is linked to both fungal virulence and defence against harmful free radicals that facilitate host innate immunity.

Evaluation of the QIAstat-Dx Respiratory SARS-CoV-2 Panel for detection of pathogens in nasopharyngeal and lower respiratory tract specimens.

This study evaluates the performance of the QIAstat-Dx Respiratory SARS-CoV-2 Panel (RS2P) for the detection of respiratory pathogens. RS2P testing was performed on 440 specimens, including 82 negatives and 358 specimens positive for 1 or more targets (520 targets initially detected). Initial testing was performed on multiple platforms during routine laboratory workflow.

Worldwide Survey on Approach to Thrombolysis in Acute Ischemic Stroke With Large Vessel Occlusion.

Background And Objectives: With recent trials suggesting that endovascular thrombectomy (EVT) alone may be noninferior to combined intravenous thrombolysis (IVT) with alteplase and EVT and that tenecteplase is non-inferior to alteplase in treating acute ischemic stroke, we sought to understand current practices around the world for treating acute ischemic stroke with large vessel occlusion (LVO) depending on the center of practice (IVT-capable vs IVT and EVT-capable stroke center).

Methods: The electronic survey launched by the Practice Current section of Neurology: Clinical Practice included 6 clinical and 8 demographic questions. A single-case scenario was presented of a 65-year-old man presenting with right hemiplegia with aphasia with a duration of 1 hour.