Assessing the feasibility of a randomised, double-blinded, placebo-controlled trial to investigate the role of intraperitoneal ropivacaine in gastric bypass surgery: a protocol.

Introduction: Postoperative pain control remains a major challenge for surgical procedures, including laparoscopic gastric bypass. Pain management is particularly relevant in obese patients who experience a higher number of cardiovascular and pulmonary events. Effective pain management may reduce their risk of serious postoperative complication, such as deep vein thrombosis and pulmonary emboli.

Phase II study of accelerated hypofractionated three-dimensional conformal radiotherapy for stage T1-3 N0 M0 non-small cell lung cancer: NCIC CTG BR.25.

Background: A multi-institutional phase II trial was performed to assess a hypofractionated accelerated radiotherapy regimen for early stage non-small cell lung cancer (NSCLC) in an era when stereotactic body radiotherapy was not widely available.

Methods: Eighty patients with biopsy-proven, peripherally located, T1-3 N0 M0 NSCLC were enrolled. Eligible patients received 60 Gy in 15 fractions using a three-dimensional conformal technique without inhomogeneity correction.

Reservoir alternate surgical implantation technique: preliminary outcomes of initial PROPPER study of low profile or spherical reservoir implantation in submuscular location or traditional prevesical space.

Purpose: Alternative reservoir site placement has become an accepted technique for patients who require an inflatable penile prosthesis. To our knowledge there has been no prospective evaluation of this technique, which is currently off label. We performed a prospective, multicenter, multinational, internal review board approved study to evaluate the effectiveness and safety of alternative reservoir site placement.

Management of pregnancy associated venous-thromboembolism: a survey of practices.

Introduction: Low-molecular-weight heparin (LMWH) is frequently recommended for the treatment of pregnancy associated venous thromboembolism (PAVTE). Given that prior reports have suggested a wide variation in dosing of LMWH in pregnancy and the use of anti-Xa monitoring in pregnancy, the principal aim of this survey was to assess current practices for the management of PAVTE.

Methods: An electronic survey was conducted.

Vital signs after cardiac arrest following withdrawal of life-sustaining therapy: a multicenter prospective observational study.

Objective: Controversies regarding the process and timing of the determination of death for controlled organ donation after circulatory death persist. This study assessed the feasibility of conducting a prospective, observational study of continuous monitoring of vital signs for 30 minutes after the clinical determination of death in five Canadian ICUs. Waveform data were analyzed.

Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism: the ADJUST-PE study.

Importance: D-dimer measurement is an important step in the diagnostic strategy of clinically suspected acute pulmonary embolism (PE), but its clinical usefulness is limited in elderly patients.

Objective: To prospectively validate whether an age-adjusted D-dimer cutoff, defined as age × 10 in patients 50 years or older, is associated with an increased diagnostic yield of D-dimer in elderly patients with suspected PE.

Design, Settings, And Patients: A multicenter, multinational, prospective management outcome study in 19 centers in Belgium, France, the Netherlands, and Switzerland between January 1, 2010, and February 28, 2013.

Circulating angiogenic cell dysfunction in patients with hereditary hemorrhagic telangiectasia.

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant vascular disorder. Circulating angiogenic cells (CACs) play an important role in vascular repair and regeneration. This study was designed to examine the function of CACs derived from patients with HHT.

Efficacy and safety of weight-adjusted heparin prophylaxis for the prevention of acute venous thromboembolism among obese patients undergoing bariatric surgery: a systematic review and meta-analysis.

Background: The bariatric surgical population is a particularly high risk population for VTE. It is unclear if standard (i.e.

Maxillary sinus atelectasis (silent sinus syndrome): treatment with balloon sinuplasty.

Introduction: Maxillary sinus atelectasis is a form of chronic rhinosinusitis of uncertain aetiology. Previously, the conventional treatment for this condition has been standard endoscopic surgery. There are no reports in the literature of successful treatment using balloon sinuplasty.

From scourge to cure: tumour-selective viral pathogenesis as a new strategy against cancer.

Tumour mutations corrupt cellular pathways, and accumulate to disrupt, dysregulate, and ultimately avoid mechanisms of cellular control. Yet the very changes that tumour cells undergo to secure their own growth success also render them susceptible to viral infection. Enhanced availability of surface receptors, disruption of antiviral sensing, elevated metabolic activity, disengagement of cell cycle controls, hyperactivation of mitogenic pathways, and apoptotic avoidance all render the malignant cell environment highly supportive to viral replication.

Impact of imaging guidelines on X-ray use among American provider network chiropractors: interrupted time series analysis.

Background Context: Overuse and misuse of spine X-ray imaging for nonspecific back and neck pain persists among chiropractors. Distribution of educational materials among physicians results in small-to-modest improvements in appropriate care, such as ordering spine X-ray studies, but little is known about its impact among North American chiropractors.

Purpose: To evaluate the impact of web-based dissemination of a diagnostic imaging guideline on the use of spine X-ray images among chiropractors.

Self-Reported Preconception Care of HIV-Positive Women of Reproductive Potential: A Retrospective Study.

Objectives: We determined the proportion and correlates of self-reported pregnancy planning discussions (that is preconception counseling) that HIV-positive women reported to their family physicians (FPs), HIV specialists, and obstetrician/gynecologists (OB/Gyns).

Methods: In a cross-sectional substudy, HIV-positive women of reproductive potential were asked whether their care providers discussed pregnancy planning. Logistic regression was used to calculate odds ratios for the correlates of preconception counseling.

Embracing the certainty of uncertainty: implications for health care and research.

"Uncertainty" is the ongoing realization that we cannot predict the future, and "surprise" reminds us lest we forget. Despite the fact that uncertainty is an undeniable fact of everyday experiences, in particular when providing care to patients, it is ignored and under-evaluated scientifically. Understandably and appropriately, medical science seeks knowledge, certainty, and prediction; however, the fundamental truth of intrinsic irreducible uncertainty remains neglected.

Do older females store more heat than younger females during exercise in the heat?

Introduction: Aging is associated with a reduction in the body's capacity to dissipate heat. To date, few studies have examined age-related changes in thermoregulatory function during short exercise periods in the heat in older females.

Purpose: This study aimed to investigate the effects of age on whole-body heat loss during intermittent exercise in the heat in young and older females.

Performance of multinomial designs in comparison with response-based designs in non-randomized phase II trials of targeted cancer agents.

Background: In phase II trials of cytotoxic agents, a multinomial phase II design incorporating early progression and response end points was shown to perform more efficiently than designs based only on response. We undertook a study to evaluate the performance of these designs in trials of targeted agents using the actual phase II data.

Patients And Methods: Using best response data from sequentially enrolled patients in 15 NCIC Clinical Trials Group and 7 European Organization for Research and Treatment of Cancer trials of targeted agents, we determined that trials would have been stopped at the end of stage I of accrual by applying rules generated by the multinomial and Fleming designs.

Vesicular storage of glycine in glutamatergic terminals in mouse hippocampus.

Glycine acts as a neuromodulator to regions rich in glutamatergic synapses, such as the forebrain. However, recent evidences for synaptic release of glycine in hippocampal cultured neurons and synaptosomes argue for the existence of functional glycinergic synapses in the hippocampus. It is well established that GABA and glycine act in concert at inhibitory synapses, while the existence of synapses which utilize both glutamate and glycine is less common.

Resistance to two heterologous neurotropic oncolytic viruses, Semliki Forest virus and vaccinia virus, in experimental glioma.

Attenuated Semliki Forest virus (SFV) may be suitable for targeting malignant glioma due to its natural neurotropism, but its replication in brain tumor cells may be restricted by innate antiviral defenses. We attempted to facilitate SFV replication in glioma cells by combining it with vaccinia virus, which is capable of antagonizing such defenses. Surprisingly, we found parenchymal mouse brain tumors to be refractory to both viruses.

The diagnosis of venous thromboembolism.

Venous thromboembolism (VTE) is a serious and potentially fatal medical condition. Correct diagnosis and early treatment of VTE with anticoagulant drugs are critical steps in preventing further complications and recurrence. Evidence suggests that patients with suspected deep vein thrombosis (DVT) or pulmonary embolism (PE) should be managed with a diagnostic strategy that includes clinical pretest probability assessment, D-dimer test, and imaging.

Cardiac glycoside toxicity: more than 200 years and counting.

Digitalis toxicity produces a toxidrome characterized by gastrointestinal, neurologic, electrolyte, and nonspecific cardiac manifestations. Chronic toxicity remains much more difficult to recognize compared with an acute presentation because of the nonspecific manifestations; therefore, serum glycoside levels are essential for diagnosis in this population. The mainstay of management continues to be rapid toxidrome identification followed by digoxin-specific antibody fragment therapy with supportive care.

Risk estimation of metabolic syndrome at one and three years after a pregnancy complicated by preeclampsia.

Background: Our goal was to determine the prevalence of metabolic syndrome in women following a pregnancy complicated by preeclampsia and to determine whether this changes between one- and three-years postpartum.

Methods: We recruited women into a longitudinal prospective cohort following a pregnancy with or without preeclampsia. The prevalence of cardiometabolic factors were assessed at one- and three-years postpartum.

Ten-year, thirty-year, and lifetime cardiovascular disease risk estimates following a pregnancy complicated by preeclampsia.

Objective: To calculate the cardiovascular disease (CVD) risk estimates for women following a pregnancy with or without preeclampsia.

Methods: We calculated 10-year, 30-year, and lifetime CVD risk estimates at one year postpartum for women recruited into the Pre-Eclampsia New Emerging Team's prospective cohort.

Results: Complete CVD risk screening data were obtained from 118 control women and 99 preeclamptic women.

Differentiation and characterization of dendritic cells from human embryonic stem cells.

Human embryonic stem cells (hESCs) offer great hope in regenerative medicine. Their ability to give rise to almost any type of cell present in the adult body makes them an invaluable tool in finding cures for a variety of diseases. While considerable protocols have been devised to efficiently differentiate hESCs into various cells types including cells of hematopoietic origin, this protocol will focus on the derivation of dendritic cells (DC), a potent antigen-presenting cell.

Urgent readmission rates can be used to infer differences in avoidable readmission rates between hospitals.

Objective: Most of the urgent readmissions are unavoidable. This study developed a method that used observed urgent readmission rates to compare the latent avoidable readmission rates between the two hospitals.

Study Design And Setting: To compare two hospitals, we identified all proportions of urgent readmissions deemed avoidable at each hospital making their avoidable readmission rates significantly different.

A national survey of endoscopic practice among gynaecologists in Canada.

Objective: To assess the current status of endoscopic gynaecological surgery in Canada, as well as the attitudes, perceptions, and educational preferences regarding endoscopy among Canadian obstetrician-gynaecologists.

Methods: An electronic online survey was sent to 630 obstetrician-gynaecologists in Canada through the Society of Obstetricians and Gynaecologists of Canada electronic mailing list. Survey respondents were asked about demographic variables, level of training and current practice of endoscopic procedures, reasons for and barriers to performing endoscopy, and interest in continuing surgical education in laparoscopy and hysteroscopy.