Foreign body-type giant cell reaction with extensive granulation tissue and intense inflammation after chemotherapy mimicking residual lymphoma on FDG PET.

Foreign body-type giant cell reaction is typically a biological and immunological reaction to the presence of foreign bodies such as catheters, parasites or biomaterials with a collection of fused macrophages (giant cell). We reported an unusual case of [F]FDG PET findings in diffuse large B cell lymphoma in the urinary bladder following incomplete resection and chemotherapy. As the restaging [F]FDG PET showed intense [F]FDG uptake in the urinary bladder at the resection site concerning for recurrence, the lesion was subsequently resected and histopathology showed extensive granulation tissue with foreign body-type giant cell reaction with no suspected foreign bodies or neoplasia.

An overview of Internal Medicine Point-of-Care Ultrasound rotations in Canada.

Background: Point-of-care ultrasound (POCUS) is a growing part of internal medicine training programs. Dedicated POCUS rotations are emerging as a particularly effective tool in POCUS training, allowing for longitudinal learning and emphasizing both psychomotor skills and the nuances of clinical integration. In this descriptive paper, we set out to review the state of POCUS rotations in Canadian Internal Medicine training programs.

Diagnosis of Pulmonary Embolism during Pregnancy.

Although rare, pulmonary embolism (PE) remains one of the most common causes of severe maternal morbidity and mortality during pregnancy. Among pregnant women with suspected PE, the prevalence of confirmed disease is far lower than in the general population, reflecting the fear of missing the diagnosis and a low threshold to suspect PE in this setting. Two prospective management outcome trials have recently assessed two different diagnostic algorithms based on the assessment of clinical probability, D-dimer, venous compression ultrasonography of the lower limbs (CUS), and computed tomography pulmonary angiography (CTPA).

Comparison of image quality and depiction of microscopic fat at 2-D and 3-D T1-Weighted (T1W) chemical shift (dual-echo) MRI for evaluation of adrenal adenomas.

Objective: To compare image quality and detection of microscopic fat in adrenal adenomas imaged with 2-D and 3-D chemical shift imaging (CSI) and, to derive parameters which best match 2-D and 3-D-CSI.

Methods: This two-phase, retrospective, and phantom + prospective study was IRB approved. First, a retrospective assessment of 50 consecutive adrenal adenomas imaged at 1.

Proportion of malignancy in Bosniak classification of cystic renal masses version 2019 (v2019) classes: systematic review and meta-analysis.

Objectives: Determine the proportion of malignancy within Bosniak v2019 classes.

Methods: MEDLINE and EMBASE were searched. Eligible studies contained patients with cystic renal masses undergoing CT or MRI renal protocol examinations with pathology confirmation, applying Bosniak v2019.

Case 309.

A 64-year-old man presented with a 6-month history of lightheadedness, intermittent balance, and coordination difficulties. Two months before admission, symptoms became more substantial and persistent, with a worsening sense of disequilibrium and unsteady gait. He reported difficulties pronouncing words and mild word-finding difficulties.

A scoping review of complication prediction models in spinal surgery: An analysis of model development, validation and impact.

Background: Predictive analytics are being used increasingly in the field of spinal surgery with the development of models to predict post-surgical complications. Predictive models should be valid, generalizable, and clinically useful. The purpose of this review was to identify existing post-surgical complication prediction models for spinal surgery and to determine if these models are being adequately investigated with internal/external validation, model updating and model impact studies.

Identifying barriers and facilitators to routine preoperative frailty assessment: a qualitative interview study.

Purpose: Preoperative frailty assessment is recommended by multiple practice guidelines and may improve outcomes, but it is not routinely performed. The barriers and facilitators of routine preoperative frailty assessment have not been formally assessed. Our objective was to perform a theory-guided evaluation of barriers and facilitators to preoperative frailty assessment.

Redefining the role of routine postoperative bloodwork following uncomplicated bariatric surgery.

Background: A quality improvement opportunity was identified to de-adopt the low-value care practice of routinely performing bloodwork for all patients undergoing elective bariatric surgery. While these patients are typically discharged on postoperative day 1 (POD1) after bloodwork is performed, it is uncommon for the discharge plan to change due to unexpected laboratory abnormalities alone.

Methods: Patients undergoing bariatric surgery between September 2020 and April 2021 only had POD1 bloodwork if there were perioperative clinical concerns, they had insulin-dependent diabetes, or they were therapeutically anticoagulated.

The use of tissue adhesive in management of genitourinary fistulas: a systematic review and case report.

Introduction And Hypothesis: Articles are getting published on the use of tissue adhesive for vesicovaginal fistula. The objective is to carry out a systematic review on their effectiveness and complications.

Methods: A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

The diagnostic accuracy of MRI for evaluating the posterolateral corner in acute knee dislocation.

Objective: To investigate the diagnostic performance of preoperative MRI in evaluating posterolateral corner (PLC) structures after acute knee dislocation (KD) and determine the correlation of MRI with operative findings for grading structure integrity.

Methods: Acute knee (femorotibial) dislocations between 2005 and 2020 with preoperative MRI and surgical posterolateral corner repair were identified from a single academic institution. From MRI, integrity was evaluated for PLC structures: lateral collateral ligament (LCL), popliteus tendon (PT), biceps femoris tendon (BFT), and ligamento-capsular complex (LCC).

Rule-based natural language processing for automation of stroke data extraction: a validation study.

Purpose: Data extraction from radiology free-text reports is time consuming when performed manually. Recently, more automated extraction methods using natural language processing (NLP) are proposed. A previously developed rule-based NLP algorithm showed promise in its ability to extract stroke-related data from radiology reports.

A Time Series Analysis Evaluating Antibiotic Prescription Rates in Long-Term Care during the COVID-19 Pandemic in Alberta and Ontario, Canada.

The COVID-19 pandemic affected access to care, and the associated public health measures influenced the transmission of other infectious diseases. The pandemic has dramatically changed antibiotic prescribing in the community. We aimed to determine the impact of the COVID-19 pandemic and the resulting control measures on oral antibiotic prescribing in long-term care facilities (LTCFs) in Alberta and Ontario, Canada using linked administrative data.

Telemedicine as an Untapped Opportunity for Parkinson's Nurses Training in Personalized Care Approaches.

(1) Background: Parkinson nurses (PN) take over important functions in the telemedical care of person's with Parkinson's disease (PwPs). This requires special competencies that have so far been largely unexplored. The aim of the article is to identify competencies of PN operating in a personalized care model.

Illicit Drug Use and Endoscopy: When Do We Say No?

Background: Illicit drug use (IDU) is often encountered in patients undergoing elective ambulatory surgical procedures such as endoscopy. Given the variety of systemic effects of these drugs, sedation and anesthetics are believed to increase the risk of cardiopulmonary complications during procedures. Procedural cancelations are common, regardless of the drug type, recency of use, and total dosage consumed.

Factors affecting hospitalization, imaging severity, and complications in posterior reversible encephalopathy syndrome.

Purpose: Assess factors in posterior reversible encephalopathy syndrome (PRES) related to intensive care unit (ICU) admissions, mechanical ventilation, and length of stay (LoS).

Methods: Retrospectively, we collected clinical, biochemical, and imaging data of PRES patients. MRI studies were assessed for imaging severity, and complications, including restricted diffusion and hemorrhage.

Development of a Multiparametric Renal CT Algorithm for Diagnosis of Clear Cell Renal Cell Carcinoma Among Small (≤ 4 cm) Solid Renal Masses.

The MRI clear cell likelihood score predicts the likelihood that a renal mass is clear cell renal cell carcinoma (ccRCC). A CT-based algorithm has not yet been established. The purpose of our study was to develop and evaluate a CT-based algorithm for diagnosing ccRCC among small (≤ 4 cm) solid renal masses.

Rapid detection of bacteria using gold nanoparticles in SERS with three different capping agents: Thioglucose, polyvinylpyrrolidone, and citrate.

The increase in outbreaks of emerging and re-emerging bacterial infections over the last few decades calls for their rapid detection and treatment. Surface-enhanced Raman spectroscopy (SERS) is a technique that can be applied to develop fast screening systems for bacterial presence in biological samples. Optimizing the capping agents in nanoparticle synthesis is important because capping agents are responsible for controlling the morphological features and chemical properties of the nanoparticles that are essential for SERS.

Co-Designing an Integrated Care Network with People Living with Parkinson's Disease: A Heterogeneous Social Network of People, Resources and Technologies.

As part of the iCARE-PD project, a multinational and multidisciplinary research endeavour to address complex care in Parkinson's disease, a Canadian case study focused on gaining a better understanding of people living with Parkinson's disease (PwP) experiences with health and medical services, particularly their vision for a sustainable, tailored and integrated care delivery network. The multifaceted nature of the condition means that PwP must continuously adapt and adjust to every aspect of their lives, and progressively rely on support from care partners (CP) and various health care professionals (HCP). To envision the integrated care delivery network from the perspective of PwP, the study consisted of designing scenarios for an integrated care delivery network with patients, their CP and their HCP, as well as identifying key requirements for designing an integrated care delivery network.

Coping Styles in Patients with Parkinson's Disease: Consideration in the Co-Designing of Integrated Care Concepts.

Integrated care models may help in designing care for Parkinson's disease (PD) that is more efficient and patient-centered. However, in order to implement such models successfully, it is important to design these models around patients' needs and preferences. Personality traits and coping styles play a well-studied important role in patients' disease perception and their utilization of medical and social services to cope with their disease.

Evolving Role of Risk Tailored Therapy in Early Stage HER2-Positive Breast Cancer: A Canadian Perspective.

The advent of HER2-targeted therapies has led to an important shift in the management of HER2-positive early breast cancer. However, initial treatment approaches apply uniform treatment regimens to all patients, with significant treatment-related and financial toxicities for both the patient and the health care system. Recent data demonstrates that for many patients, the chemotherapy backbone, duration and nature (mono- versus dual-targeted therapy) of the HER2 blockade can be better targeted to an individual patient's risk of recurrence.

Changes in Positive Airway Pressure Use in Adults with Sleep-Related Breathing Disorder During the COVID-19 Pandemic: A Cross-Sectional National Community-Based Survey.

Purpose: To better understand: (i) a positive airway pressure (PAP) therapy use during the pandemic, (ii) how PAP use may relate to sleep, health, and COVID-19-related outcomes, and (iii) factors associated with PAP use during the pandemic.

Methods: This study is based on data collected between Apr 2020 and Jan 2021 as part of an online cross-sectional national community-based survey. The included participants were located in North America, 18 years and older, with self-reported sleep-related breathing disorder (SBD) and usage of a PAP device in the last month before the COVID-19 pandemic.

Disparities and Factors Associated with Coronavirus Disease-2019-Related Public Stigma: A Cross-Sectional Study in Thailand.

Coronavirus disease 2019 (COVID-19)-related public stigma is a major challenge, with scarce available evidence. This study aimed to determine the disparities and factors associated with COVID-19-related public stigma in the Thai population. We conducted a cross-sectional study involving a voluntary online survey in Thailand from 21 April 2020 to 4 May 2020.

Evaluation of the T2-weighted (T2W) adrenal MRI calculator to differentiate adrenal pheochromocytoma from lipid-poor adrenal adenoma.

Objectives: To evaluate the T2-weighted (T2W) MRI calculator to differentiate adrenal pheochromocytoma from lipid-poor adrenal adenoma.

Methods: Twenty-nine consecutive pheochromocytomas resected between 2010 and 2019 were compared to 23 consecutive lipid-poor adrenal adenomas. Three blinded radiologists (R1, R2, R3) subjectively evaluated T2W signal intensity and heterogeneity and extracted T2W signal intensity ratio (SIR) and entropy.