Methotrexate for induction of remission in ulcerative colitis.

Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease. Corticosteroids and 5-aminosalicylates are the most commonly used therapies. However, many patients require immunosuppressive therapy for steroid-refractory and steroid-dependent disease.

Improvement of cardiac function by placenta-derived mesenchymal stem cells does not require permanent engraftment and is independent of the insulin signaling pathway.

Introduction: The objective of this work was to evaluate the efficacy of placenta-derived mesenchymal stem cell (MSC) therapy in a mouse model of myocardial infarction (MI). Since MSCs can be obtained from two different regions of the human term placenta (chorionic plate or villi), cells obtained from both these regions were compared so that the best candidate for cell therapy could be selected.

Methods: For the in vitro studies, chorionic plate MSCs (cp-MSCs) and chorionic villi MSCs (cv-MSCs) were extensively characterized for their genetic stability, clonogenic and differentiation potential, gene expression, and immunophenotype.

Electroencephalographic abnormalities and 5-year outcome in first-episode psychosis.

Objective: To examine the relation of electroencephalographic abnormalities to 5-year outcomes in first-episode psychosis (FEP).

Methods: Patients (n = 103) had their baseline electroencephalogram (EEG) classified by modified Mayo Clinic criteria. Symptoms and psychosocial functioning were rated after 5 years of treatment.

Collaborative hospital orientation: simulation as a teaching strategy.

For nurses, the stress caused by entering a new place of employment may give rise to insecurity and a lack of confidence. Lack of confidence in one's nursing skills can affect performance and, ultimately, patient care and safety. In healthcare, growing fiscal constraints have resulted in lost resources, and support for new nursing staff is limited by both time and cost considerations.

Mothers' "liquid gold": a quality improvement initiative to support early colostrum delivery via oral immune therapy (OIT) to premature and critically ill newborns.

Early breast milk, known as colostrum ("liquid gold") provides immune benefits to infants, offering potential risk reduction for nosocomial infection (NI) and necrotizing enterocolitis (NEC), a serious gastrointestinal emergency. Provision of colostrum is recognized as oral immune therapy (OIT) and is valuable to all NICU infants unable to feed orally. A quality improvement project was initiated by the multidisciplinary NICU Quality Care Council at London Health Sciences Centres-Victoria (LHSC-VH) to obtain mothers' colostrum for early OIT.

Treatment goals of pulmonary hypertension.

With significant therapeutic advances in the field of pulmonary arterial hypertension, the need to identify clinically relevant treatment goals that correlate with long-term outcome has emerged as 1 of the most critical tasks. Current goals include achieving modified New York Heart Association functional class I or II, 6-min walk distance >380 m, normalization of right ventricular size and function on echocardiograph, a decreasing or normalization of B-type natriuretic peptide (BNP), and hemodynamics with right atrial pressure <8 mm Hg and cardiac index >2.5 mg/kg/min(2).

Comparison of the clonality of urothelial carcinoma developing in the upper urinary tract and those developing in the bladder.

Purpose: To identify the origin of synchronous and metachronous urothelial carcinoma (UC) of the bladder and upper urinary tract to get a better understanding of the basic mechanism behind the multifocality of UC, which may provide a sound bases for the future development of new strategies for detection, prevention and therapy.

Methods: Six patients with UC of the bladder and synchronous or metachronous UC of the upper urinary tract were studied. Genetic analysis involving the study of loss of heterozygosity (LOH) has been evaluated on their tumours using well characterised and new markers of UC (D9S171, D9S177, D9S303 and TP53).

Azathioprine or 6-mercaptopurine for induction of remission in Crohn's disease.

Background: The results from controlled clinical trials investigating the efficacy of azathioprine and 6-mercaptopurine for the treatment of active Crohn's disease have been conflicting and controversial. An updated meta-analysis was performed to assess the effectiveness of these drugs for the induction of remission in active Crohn's disease.

Objectives: The primary objective was to determine the efficacy and safety of azathioprine and 6-mercaptopurine for induction of remission in active Crohn's disease.

Neurofibromatosis and velopharyngeal insufficiency: is there an association?

Objective: Velopharyngeal insufficiency (VPI) is an often underrecognized disorder of palatal and nasopharyngeal closure that leads to the production of hypernasal speech. However, the potential clinical association between VPI and neurofibromatosis type 1 (NF1) remains undefined in the literature. The purpose of this study sought to identify and describe the potential clinical association of VPI in NF1 patients.

Apaziquone as an intravesical therapeutic agent for urothelial non-muscle-invasive bladder cancer.

Introduction: Urothelial carcinoma of the bladder is a disease prone to recurrence. A new cytotoxic drug, apaziquone, is an analog of mitomycin C. Given via intravesical instillations it has the ability to specifically target cancer cells.

Sargramostim (GM-CSF) for induction of remission in Crohn's disease.

Background: Crohn's disease is an inflammatory condition of the gut, thought to involve an overactive immune response to gut flora. A novel theory postulates possible immunodeficiency as a cause, and aims to use sargramostim (granulocyte macrophage colony stimulating factor, GM-CSF) to boost the immune system in an effort to test this hypothesis.

Objectives: The primary objectives were to determine the efficacy and safety of sargramostim for induction of remission in patients with clinically active Crohn's disease.

Wilms' tumor.

Wilms' tumor or nephroblastoma is the most frequent renal tumor in children and is associated with different congenital anomalies and syndromes. A significant number of studies in genetics and molecular biology have improved our understanding of this malignancy discovering as well how different genes play a critical role in the organogenesis process. Derived from these studies promising markers have emerged relating translational medicine with clinical prognosis, which has been traditionally defined by the histopathological changes and the tumoral stage.

Histologic variants of urothelial bladder cancer and nonurothelial histology in bladder cancer.

Bladder cancer can be classified histologically as urothelial or non-urothelial. Urothelial cancer has a propensity for divergent differentiation, which has increasingly been recognized in recent years due to heightened awareness and improved immunohistochemistry techniques. Furthermore, the recent World Health Organization classification of urothelial cancers improved clarity on this issue, with its listing of 13 histologic variants of urothelial cancer.

Effect of autologous platelet adhesives on dermal fat graft resorption following reconstruction of a superficial parotidectomy defect: a double-blinded prospective trial.

Background: Dermal fat grafts are used to reconstruct facial contour defects but may undergo variable resorption. Application of autologous platelet adhesive may improve outcomes. The primary objective was to compare resorption of dermal fat grafts for parotidectomy defects, between patients receiving autologous platelet adhesive versus controls.

Evaluation of a particle repositioning maneuver Web-based teaching module.

Objectives/hypothesis: To compare the pass rate of residents performing the Particle Repositioning Maneuver (PRM) after one of three interventions: 1) small group PRM instruction (SG); 2) standard classroom instruction (CI); and 3) Web-based learning module (WM). We hypothesize that our Web-based learning module is more effective than CI and as effective as SG.

Study Design: Prospective randomized control trial.

A rare case of classic testicular seminoma in an 86-year-old shows similar proliferation rate as in younger men.

We present a rare case of classic seminoma in an 86-year-old man. Combined mitotic count, the presence or absence of intravascular invasion, and the expression of PCNA, Ki67, and p53 were compared between this octogenarian and the tumors of four randomly selected standard younger men. These histologic features were chosen to compare the potential biologic activity of these tumors.

A meta-analysis of noninvasive weaning to facilitate liberation from mechanical ventilation.

Purpose: To summarize the evidence comparing noninvasive positive pressure ventilation (NPPV) and invasive positive pressure ventilation (IPPV) weaning on mortality, ventilator associated pneumonia and the total duration of mechanical ventilation among invasively ventilated adults with respiratory failure.

Source: Meta-analysis of randomized and quasi-randomized studies comparing early extubation with immediate application of NPPV to IPPV weaning. We selected randomized studies that 1) included adults, with respiratory failure, invasively ventilated for at least 24 hr; 2) compared extubation with immediate application of NPPV to weaning using IPPV; and 3) reported at least one clinically important outcome.

Erythropoietin dose requirements when converting from subcutaneous to intravenous administration among patients on hemodialysis.

Background: The optimal route for administration of exogenous erythropoietin remains controversial, particularly after the increased incidence in pure red cell aplasia. In Canada, the majority of hemodialysis units have converted to the intravenous route for administration of erythropoietin to potentially decrease the risk of pure red cell aplasia.

Objective: To compare the difference in the weight-adjusted, weekly erythropoietin dose (units/kg/wk) administered by the subcutaneous compared with the intravenous route in a chronic hemodialysis population followed for 12 months.