Choosing Wisely Canada rhinology recommendations.

The Choosing Wisely Canada campaign is an initiative that aims to involve physicians and patients in collaborative decision making to avoid unnecessary tests and treatments. The Rhinology Subspecialty Group of the Canadian Society of Otolaryngology - Head & Neck Surgery developed a list of five evidence-based recommendations for the management of acute rhinosinusitis and nasal fractures: (1) don't prescribe antibiotics to patients with acute sinusitis who do not meet the diagnostic criteria for acute bacterial rhinosinusitis; (2) don't order a CT scan for uncomplicated acute rhinosinusitis; (3) don't order plain film sinus x-rays; (4) don't swab the nasal cavity as part of the work up for rhinosinusitis; and (5) don't order a plain film x-ray in the evaluation of nasal fractures.

Accessory anterolateral talar facet: analysis of the morphologic features on MRI.

Purpose: To analyze the morphologic features of accessory anterolateral talar facet (AALTF) on MRI that can assist in detecting this entity, identify any associated structural changes and also define its MRI prevalence.

Methods: Two radiologists retrospectively evaluated 140 ankle MRI scans for the presence of AALTF, complimentary anterior calcaneal extension facet and angle of Gissane measurement. One observer evaluated the scans for other structural details including AALTF length, cartilage thickness, bone marrow edema, hind foot coalition and talar beaking.

Predictors of adherence to positive airway pressure therapy in children: a systematic review and meta-analysis.

Background: While positive airway pressure (PAP) is effective for treating sleep-disordered breathing (SDB) in children, adherence is poor. Studies evaluating predictors of PAP adherence have inconsistent findings, and no rigorous reviews have been conducted. This systematic review aims to summarize the literature on predictors of PAP therapy adherence in children.

Prolonged versus brief balloon inflation during arterial angioplasty for de novo atherosclerotic disease: a systematic review and meta-analysis.

Objective: Angioplasty is a fundamental treatment for atherosclerotic disease and may be performed as the sole therapy in small vessel disease. However, the ideal duration of balloon inflation has not yet been identified. Our study investigated whether prolonged inflation of at least 1-min duration, when compared with brief inflation, affects residual stenosis after arterial angioplasty.

Diagnostic accuracy of dual-energy computed tomography (DECT) to differentiate uric acid from non-uric acid calculi: systematic review and meta-analysis.

Background: Uric acid stone diagnosis is presently done primarily with in vitro analysis of stones. In vivo diagnosis with dual-energy CT (DECT) would allow earlier initiation of therapy with urine alkalinization and avoid surgical intervention.

Objective: To evaluate if DECT, using stone analysis as reference standard, is sufficiently accurate to replace stone analysis for diagnosis of uric acid stones.

Publication bias in diagnostic imaging: conference abstracts with positive conclusions are more likely to be published.

Objective: To evaluate whether imaging diagnostic test accuracy conference abstracts with positive conclusions or titles are more likely to reach full-text publication than those with negative (or neutral) conclusions or titles.

Methods: Diagnostic accuracy research abstracts were included if they were presented at the 2011 or 2012 Radiological Society of North America conference. Full-text publication status at 5 years post conference abstract submission was determined.

Patients' expectations of spine surgery for degenerative conditions: results from the Canadian Spine Outcomes and Research Network (CSORN).

Background: Understanding patient expectations is a critical component of patient-centered care; however, little is known about which expectation(s) are most important to patients as they relate to their sense of postoperative success.

Purpose: To investigate patient's preoperative expectations of change in symptoms, function, and well-being resulting from surgical intervention and to examine the associations between sociodemographic, lifestyle, health status, and clinical characteristics with patient outcome expectations STUDY DESIGN: Observational cross-sectional study.

Sample: Preoperative data from the Canadian Spine Outcomes and Research Network national registry of patients of patients (n=4,333) undergoing surgery for degenerative spinal conditions between 2012 and 2017.

Radiographic/MR Imaging Correlation of the Wrist.

In this review article, the authors discuss the imaging features of the most common pathologic conditions of the wrist by putting the emphasis on radiographic and MR imaging correlations. A topographic approach based on the 3 functional columns of the wrist (radial, central, and ulnar) serves as a framework. The pathologic conditions are classified, based on the structures involved, as fractures, ligament injuries, arthropathies, bone abnormalities, and tendinopathies.

Survey on Barriers to Critical Care and Palliative Care Integration.

Purpose: It has been shown that integrating palliative care (PC) in intensive care unit (ICU) improves end-of-life care (EOLC), but very few Canadian hospitals have adopted this practice. Our study aims to evaluate the perceived quality of EOLC at participating institutions and explore barriers toward ICU-PC integration.

Materials And Methods: A self-administered questionnaire was developed by a multidisciplinary team.

Treatment failure definitions for non-purulent skin and soft tissue infections: a systematic review.

Objective: There is currently no uniform definition for antimicrobial treatment failure for adults with non-purulent skin and soft tissue infections (SSTIs). The objective of this systematic review was to identify treatment failure definitions and their common components in the literature.

Methods: Five electronic databases were searched from inception to March 2019.

Steps toward more complete reporting of systematic reviews of diagnostic test accuracy: Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy (PRISMA-DTA).

Reporting standards in biomedical research have been shown to be suboptimal. The publication of the PRISMA statement has improved the completeness of reporting of systematic reviews, but several issues specific to diagnostic test accuracy are not included in the PRISMA statement. Therefore, a diagnostic test accuracy extension of the PRISMA statement, PRISMA-DTA, was created.

Publication Bias: Association of Diagnostic Accuracy in Radiology Conference Abstracts with Full-Text Publication.

Background Recent investigations have identified a faster time to publication for imaging studies with higher diagnostic test accuracy (DTA), but it is unknown whether such studies are more likely to be published. A higher probability of full-text publication for studies with higher DTA could have negative consequences on clinical decision making and patient care. Purpose To evaluate the proportion of imaging diagnostic accuracy studies presented as conference abstracts that reach full-text publication and to identify whether there is an association between diagnostic accuracy and full-text publication in peer-reviewed journals within 5 years after abstract submission.

Selective Citation Practices in Imaging Research: Are Diagnostic Accuracy Studies With Positive Titles and Conclusions Cited More Often?

The purpose of this study was to examine the existence of selective citation practices in the imaging literature by assessing whether diagnostic accuracy studies with positive titles or conclusions are cited more frequently than those with negative (or neutral) titles or conclusions. MEDLINE was searched for meta-analyses of diagnostic accuracy studies published in imaging journals from January 2005 to April 2016. Primary studies from the meta-analyses were screened for eligibility.

Surgical Exploration and Discovery Program: Early Exposure to Surgical Subspecialties and Its Influence on Student Perceptions of a Surgical Career.

Objective: Interest in pursuing a surgical career has been declining among North American medical students. Numerous factors are known to influence student interest in pursuing surgery as a career, such as prestige, income potential, and overall lifestyle. Given that many of these factors are rooted in bias, it may be possible to properly address several of these stereotypes through first-hand, early exposure to the field of surgery via the Surgical Exploration and Discovery (SEAD) Program.

Comparative reviews of diagnostic test accuracy in imaging research: evaluation of current practices.

Purpose: The purpose of this methodological review was to determine the extent to which comparative imaging systematic reviews of diagnostic test accuracy (DTA) use primary studies with comparative or non-comparative designs.

Methods: MEDLINE was used to identify DTA systematic reviews published in imaging journals between January 2000 and May 2018.

Inclusion Criteria: systematic reviews comparing at least two index tests (one of which was imaging-based); review characteristics were extracted.

Reporting Guidelines for Imaging Research.

Suboptimal reporting in the publication of imaging research studies is a growing concern. Deficient and incomplete reporting prevents the evaluation of the validity, replicability, and the overall quality of the research. Reporting guidelines are checklists designed to guide researchers about the minimum information to be provided in research studies to allow for adequate quality appraisal and to assess generalizability.

The effect of post mastectomy radiation therapy on breast reconstruction with and without acellular dermal matrix: a systematic review and meta-analysis protocol.

Background: The widespread implementation of acellular dermal matrix (ADM) has broadened the reconstructive repertoire for alloplastic breast reconstruction. ADM's role in the context of postoperative radiation therapy remains unclear. The present review will evaluate whether ADM reduces complication rates in patients undergoing post-mastectomy radiation therapy (PMRT).

Prolonged versus brief balloon inflation during arterial angioplasty for de novo atherosclerotic disease: protocol for a systematic review.

Background: Angioplasty is a fundamental treatment for atherosclerotic disease in the cardiac, cerebrovascular, and peripheral vascular beds. However, the optimal duration of balloon inflation has not been identified. Our study will investigate whether prolonged angioplasty balloon inflation of at least 1 min duration, when compared with brief inflation, affects residual stenosis after arterial angioplasty.

Diagnostic Accuracy of Dual-Energy CT for Evaluation of Renal Masses: Systematic Review and Meta-Analysis.

Objective: The purpose of this study is to determine the diagnostic accuracy of dual-energy CT (DECT) using quantitative iodine concentration in patients with renal masses using histopathologic analysis or follow-up imaging as the reference standard. The secondary objective is to compare the accuracy of DECT (using iodine concentration) to that of conventional CT (using Hounsfield unit measurements).

Materials And Methods: We searched the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases for studies evaluating the accuracy of DECT for renal mass characterization (1947-2018).

Municipal transportation policy as a population health intervention: estimating the impact of the City of Ottawa Transportation Master Plan on diabetes incidence.

Intervention: Physical inactivity is an important behavioral risk factor for chronic disease in Canada. Individual-level strategies are used in clinical medicine to target individuals for preventive intervention based on one or more risk factors. In contrast, this study examines the impact of a population-level intervention: a municipal policy outside the healthcare sector that influences the built and social environment.

Differentiation of pancreatic neuroendocrine tumors from pancreas renal cell carcinoma metastases on CT using qualitative and quantitative features.

Purpose: To assess qualitative and quantitative imaging features on enhanced CT that may differentiate pancreatic neuroendocrine tumors (PNETs) from pancreatic renal cell carcinoma (RCC) metastases.

Methods: This IRB-approved multi-center retrospective case-control study compared 43 resected PNETs and 28 resected RCC metastases with pre-operative enhanced CT identified consecutively between 2003 and 2017. Two blinded radiologists (R1/R2) independently assessed tumor location, attenuation (relative to pancreas), composition (solid/cystic/mixed), homogeneity (homogeneous/heterogeneous), calcification, multiplicity, and for main pancreatic duct (MPD) dilation.

Stability of Tranexamic Acid Mouth Rinse.

Tranexamic acid is an antifibrinolytic agent that inhibits the conversion of plasminogen to plasmin and is used to treat fibrinolytic hemorrhages. Tranexamic acid mouth rinse was compounded using active pharmaceutical ingredient powder or commercial tablets. The bitter taste was masked by using either cherry-vanilla or peppermint and mint flavoring and aspartame.