Sickle Cell Trait Does Not Cause "Sickle Cell Crisis" Leading to Exertion-Related Death: A Systematic Review.

Globally, an estimated 300 million individuals have sickle cell trait (SCT), the carrier state for sickle cell disease. While sickle cell disease (SCD) is associated with increased morbidity and shortened lifespan, SCT has a lifespan comparable to that of the general population. However, "sickle cell crisis" has been used as a cause of death for decedents with SCT in reports of exertion-related death in athletes, military personnel, and individuals in police custody.

Wildfire Smoke Contributions to Polycyclic Aromatic Hydrocarbon Loadings in Western Canadian Urban Surface Grime.

Wildfires emit large amounts of polycyclic aromatic hydrocarbons (PAHs) into the atmosphere. As PAHs emitted from anthropogenic sources are known to accumulate in urban surface grime present on building exteriors and windows, we hypothesized that PAH-containing wildfire smoke plumes could similarly increase PAH grime loadings. To explore this hypothesis, we coupled analysis of PAHs in grime samples collected from August to November 2021 in two historically smoke-affected Canadian cities, Calgary and Kamloops, with contemporaneous field- and model-based indicators of wildfire influence.

Effect of platelet-rich plasma versus placebo or corticosteroid for knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials.

Background: The effectiveness of intra-articular platelet-rich plasma (IA-PRP) injections for managing pain in knee osteoarthritis (KOA) remains inconsistent. Therefore, this study aimed to systematically review randomized controlled trials (RCTs) assessing the efficacy of IA-PRP.

Methods: A total of 21 studies meeting the inclusion criteria were selected from various scientific databases, all of which compared PRP to either a placebo or an active comparator, such as corticosteroids (CS), in the treatment of KOA.

Quality of undifferentiated chest pain evaluation and diagnosis guidelines: a systematic review and critical appraisal.

Chest pain is a symptom that is potentially life-threatening and requires quick and accurate evaluations. This article describes the quality of guidelines related to the evaluation and diagnosis of acute, undifferentiated chest pain. After systematically evaluating existing guidelines, we found that there exists a wide variety of quality in these documents.

Nutrition users' guides: systematic reviews part 1 -structured guide for methodological assessment, interpretation and application of systematic reviews and meta-analyses of non-randomised nutritional epidemiology studies.

Due to the challenges of conducting randomised controlled trials (randomised trials) of dietary interventions, evidence in nutrition often comes from non-randomised (observational) studies of nutritional exposures-called nutritional epidemiology studies. When using systematic reviews of such studies to advise patients or populations on optimal dietary habits, users of the evidence (eg, healthcare professionals such as clinicians, health service and policy workers) should first evaluate the rigour (validity) and utility (applicability) of the systematic review. Issues in making this judgement include whether the review addressed a sensible question; included an exhaustive literature search; was scrupulous in the selection of studies and the collection of data; and presented results in a useful manner.

Nutrition Users' Guides: RCTs Part 2 - structured guide for interpreting and applying study results from randomised controlled trials on therapy or prevention questions.

This article continues from a prior commentary on evaluating the risk of bias in randomised controlled trials addressing nutritional interventions. Having provided a synopsis of the risk of bias issues, we now address how to understand trial results, including the interpretation of best estimates of effect and the corresponding precision (eg, 95% CIs), as well as the applicability of the evidence to patients based on their unique circumstances (eg, patients' values and preferences when trading off potential desirable and undesirable health outcomes and indicators (eg, cholesterol), and the potential burden and cost of an intervention). Authors can express the estimates of effect for health outcomes and indicators in relative terms (relative risks, relative risk reductions, OR or HRs)-measures that are generally consistent across populations-and absolute terms (risk differences)-measures that are more intuitive to clinicians and patients.

Nutrition users' guides: RCTs part 1 - structured guide for assessing risk of bias in randomised controlled trials that address therapy or prevention questions.

The purpose of this article, part 1 of 2 on randomised controlled trials (RCTs), is to provide readers (eg, clinicians, patients, health service and policy decision-makers) of the nutrition literature structured guidance on interpreting RCTs. Evaluation of a given RCT involves several considerations, including the potential for risk of bias, the assessment of estimates of effect and their corresponding precision, and the applicability of the evidence to one's patient. Risk of bias refers to flaws in the design or conduct of a study that may lead to a deviation from measuring the underlying true effect of an intervention.

Upregulation of HSP90α in the lungs and circulation in sarcoidosis.

Background: Sarcoidosis is a systemic granulomatous disease of unknown cause. Natural improvement with favorable outcome is common, but a significant number of patients present with difficult to manage and progressive disease. The identification of biomarkers associated with disease activity and progression is warranted.

Regional variations in incidence of surgical site infection and associated risk factors in women undergoing cesarean section: A systematic review and Meta-Analysis.

Background: Surgical site infections (SSIs) are the most common postoperative complications after cesarean section (CS), with increased mortality, prolonged hospital stays, and increased healthcare costs.

Objective: To systematically estimate the global incidence and identify the risk factors associated with SSI, focusing on the variation between high- and low-income countries.

Search Strategy And Selection Criteria: Observational studies reporting on the incidence of SSI after CS were systematically searched in PubMed, Embase and SCOPUS.

The effects of age, fitness, and health on the passive stiffness of the intact low back and its impact on seated work in a healthy, working, female population.

Age is associated with increased tissue stiffness and a higher risk of low back pain, particularly in older, sedentary workers who spend long periods sitting. This study explored how trunk stiffness changes with age and its relationship with posture during prolonged sitting in a sample of 37 women aged 20-65 years. Age was assessed as both Chronological Age and Fitness Age, with trunk stiffness measured using a passive trunk flexion apparatus.

Factors involved in the development of hospital-acquired conditions in older patients in acute care settings: a scoping review.

Background: Older patients hospitalized in acute care settings are at significant risk of presenting hospital-acquired conditions. Healthcare professionals should consider many factors involved in the development of such conditions, including factors related to the patients, as well as those related to the processes of care and the structure of hospitals. The aim of this study was to describe and identify the factors involved in the development of hospital-acquired conditions in older patients in acute care settings.

A Systematic Review and Meta-analysis of the Clinical Impact of Prophylactic Quinolones with Adjuvant Bacillus Calmette-Guérin Instillation for Non-muscle-invasive Bladder Cancer.

Background And Objective: Bacillus Calmette-Guérin (BCG) reduces disease recurrence and progression in intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC). BCG-associated adverse events during instillations are common, leading to treatment cessation. Prophylactic use of quinolones in conjunction with BCG instillations is one approach for reducing BCG-associated adverse events.

Social inclusion programming for older adults living in age-friendly cities: a scoping review.

Objectives: Creating age-friendly cities (AFCs) is essential for supporting older adults' well-being. The WHO's 2007 guide outlines key features of AFCs, including social inclusion. Despite increasing numbers of AFC programmes, diverse experiences of ageing are often overlooked.

Investigating the implementation of a Trial of Labour After Caesarean (TOLAC) delivery bundle with respect to decreasing caesarean delivery rates: a multisite quality improvement initiative.

Objectives: To study the effect of implementing a Trial of Labour After Caesarean (TOLAC) delivery bundle with respect to decreasing caesarean delivery rates across five hospitals.

Design: Prospective quality improvement study.

Setting: Five Canadian hospital sites participated, two academic centres and three community hospitals, with annual delivery rates ranging from 2500 to 7500 per site.

Comparison of the effectiveness of intra-infrapatellar fat pad and intra-articular glucocorticoid injection in knee osteoarthritis patients with Hoffa's synovitis: protocol for a multicentre randomised controlled trial.

Introduction: The infrapatellar fat pad and synovium are the sites of immune cell infiltration and the origin of proinflammation. Studies have shown that Hoffa's synovitis may be a sign of early-stage osteoarthritis (OA). However, there have been no effective interventions specifically for Hoffa's synovitis.

Peripheral Artery Disease Centres of Excellence in Canada - A Call to Action.

Peripheral artery disease (PAD) is responsible for a significant burden of morbidity and mortality in Canada. Despite the publication of recent guidelines outlining the diagnosis and management of PAD, delivery of care continues to be fragmented. With a growing number of medical and surgical techniques available, Centres of Excellence are a natural evolution in the advancement of care for patients living with PAD.

Anaphylaxis definition, overview, and clinical support tool: 2024 consensus report.

Background: The 2006 National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network (NIAID/FAAN) anaphylaxis criteria are widely used in clinical care and research. In 2020, the World Allergy Organization (WAO) published modified criteria that have not been uniformly adopted. Different criteria contribute to inconsistent care and research outcomes.

Non-atherosclerotic coronary causes of myocardial infarction in women.

Ischemic heart disease is the most common cardiovascular cause of death in women worldwide. Obstructive coronary atherosclerosis is the primary cause of myocardial infarction (MI), however, non-atherosclerotic mechanisms of MI, such as spontaneous coronary artery dissection, vasospasm, microvascular dysfunction, embolization, inflammation, coronary anomalies, infectious and infiltrative causes are increasingly being recognized. Emerging data suggest that women are two to five times more likely to have an MI in the absence of coronary atherosclerosis compared to men, but they continue to remain underdiagnosed and undertreated, partly due to underdiagnosis and limited understanding of these mechanisms.

A conserved chaperone protein is required for the formation of a non-canonical type VI secretion system spike tip complex.

Type VI secretion systems (T6SS) are dynamic protein nanomachines found in Gram-negative bacteria that deliver toxic effector proteins into target cells in a contact-dependent manner. Prior to secretion, many T6SS effector proteins require chaperones and/or accessory proteins for proper loading onto the structural components of the T6SS apparatus. However, despite their established importance, the precise molecular function of several T6SS accessory protein families remains unclear.

Cup-Cage Reconstruction for Pelvic Discontinuity: Encouraging Long-Term Survival.

Background: Pelvic discontinuity (PD) poses a difficult challenge in revision total hip arthroplasty (rTHA). There is a paucity of evidence assessing five- to ten-year outcomes of cup cages for PD. This study aimed to review the survivorship and outcomes of cup-cage constructs for PD.

An investigation of the mechanism of adjacent segment disease in a porcine spine model.

Background: Fusion changes the biomechanics of the spine leading to the potential development of adjacent segment disease. Despite many studies on adjacent segment disease, it is largely unknown how spinal fixation affects the mechanical properties of the adjacent disc. The purpose of this study was to assess whether axial compression causes mechanical disruption to the annulus when the caudal spinal level is immobilized or injured.