The role of C-reactive protein and ferritin in the diagnosis of HLH, adult-onset still's disease, and COVID-19 cytokine storm.

Cytokine storm syndromes such as hemophagocytic lymphohistiocytosis (HLH), Adult-onset Still's disease (AOSD), and COVID-19 cytokine storm (CCS) are characterized by markedly elevated inflammatory cytokines. However clinical measurement of serum cytokines is not widely available. This study examined the clinical utility of C-reactive protein (CRP) and ferritin, two inexpensive and widely available inflammatory markers, for distinguishing HLH from AOSD and CCS.

Association between emergency medical services' response times, low socioeconomic status, and poorer outcomes in out-of-hospital cardiac arrest: the MEDIC multicenter retrospective cohort study for disparities in access to prehospital critical care in the Paris metropolitan area.

Background And Importance: Prolonged emergency medical services' response times (EMS-RT) are associated with poorer outcomes in out-of-hospital cardiac arrest (OHCA). The patient access time interval (PATI), from vehicle stop until contact with patient, may be increased in areas with low socioeconomic status (SES).

Objectives: The objective of this study is to identify predictors of prolonged EMS-RT intervals, and to evaluate associations with clinical outcomes in OHCAs occurring in the largest metropolitan area in France.

Effect of depressive symptoms on health services utilization in the HIV and hepatitis C co-infected population in Canada.

Depression is common among people living with HCV and HIV, which contributes to health services utilization (HSU). It is unknown whether successful HCV treatment affects this. We examined depressive symptoms and HSU in people co-infected with HIV-HCV and their association with sustained virologic response (SVR) during the direct-acting antiviral era.

Magnitude of infection and associated factors in open tibial fracture treated operatively, in Addis Ababa burn emergency and trauma center.

Background: Due to the specific anatomical features of the tibia (limited soft tissue coverage), more than a quarter of its fractures are classified as open, representing the most common open long-bone injuries. Open tibial fractures frequently cause significant bone comminution, periosteal stripping, soft tissue loss, contamination and are prone to bacterial entry with biofilm formation, which increases the risk of deep bone infection. The main objective of this study was to determine prevalence of infection and its associated factors in surgically treated open tibial fracture, at Addis Ababa Burn Emergency and Trauma (AaBET) hospital.

Comparative lipidomic and metabolomic profiling of mdx and severe mdx-apolipoprotein e-null mice.

Despite its notoriously mild phenotype, the dystrophin-deficient mdx mouse is the most common model of Duchenne muscular dystrophy (DMD). By mimicking a human DMD-associated metabolic comorbidity, hyperlipidemia, in mdx mice by inactivating the apolipoprotein E gene (mdx-ApoE) we previously reported severe myofiber damage exacerbation via histology with large fibro-fatty infiltrates and phenotype humanization with ambulation dysfunction when fed a cholesterol- and triglyceride-rich Western diet (mdx-ApoE). Herein, we performed comparative lipidomic and metabolomic analyses of muscle, liver and serum samples from mdx and mdx-ApoE mice using solution and high-resolution-magic angle spinning (HR-MAS) H-NMR spectroscopy.

Cutaneous involvement of light chain deposition disease: A case report.

Light chain deposition disease is a rare condition associated with plasma cell dyscrasia and other lymphoproliferative disorders in which there is overproduction and deposition of non-amyloid light chains in various organs, leading to organ dysfunction. It is well-established that the majority of patients with light chain deposition disease exhibit renal involvement. Although awareness of extrarenal manifestations is increasing, cutaneous involvement has rarely been reported.

Diagnostic and therapeutic hysteroscopy in Ethiopia: a retrospective study on practice and outcomes.

Background: Hysteroscopy is considered the standard for evaluating the uterine cavity. Limited data exists regarding hysteroscopy in Ethiopia. Therefore, the objective of the study was to describe the diagnostic and operative hysteroscopic procedures at St.

An anesthesiology-led perioperative outreach service: experience from a Canadian centre and a focused narrative literature review.

Approximately 320 million surgeries occur annually worldwide, increasingly performed on an ageing, comorbid population in whom postoperative complications contribute significantly to mortality. While anesthesiologists have led advances in perioperative care, the optimal structure of the provision of postoperative care has lacked discourse. In this article, we describe the implementation, structure, role, and benefits of an Anesthesiology Perioperative Outreach Service (APOS) at a Canadian tertiary hospital, providing proactive daily review and management of high-risk surgical patients.

The misclassification of depression and anxiety disorders in the multiple sclerosis prodrome: A probabilistic bias analysis.

Background: Studies suggest that depression/anxiety form part of the multiple sclerosis (MS) prodrome. However, several biases have not been addressed. We re-examined this association after correcting for: (i) misclassification of individuals not seeking healthcare, (ii) differential surveillance of depression/anxiety in the health system, and (iii) misclassified person-time from using the date of the first MS-related diagnostic claim (i.

Laminar Fluid Ejection for Olfactory Drug Delivery: A Proof of Concept Study.

Focal intranasal drug delivery to the olfactory cleft is a promising avenue for pharmaceuticals targeting the brain. However, traditional nasal sprays often fail to deliver enough medication to this specific area. We present a laminar fluid ejection (LFE) method for precise delivery of medications to the olfactory cleft.

Five Year Outcomes in Low-Risk Patients Undergoing Surgery in the PARTNER 3 Trial.

Background: Surgery remains an important treatment for low-risk patients with severe symptomatic aortic stenosis (AS). We evaluated 5-year outcomes in low-risk patients undergoing isolated surgical aortic valve replacement (SAVR) or SAVR with concomitant procedures within the randomized PARTNER 3 trial.

Methods: In the PARTNER 3 trial, 454 patients underwent surgery for severe, symptomatic, tri-leaflet AS and were followed for 5 years.

Relationship Between Severity of Ischemia and Coronary Artery Disease for Different Stress Test Modalities in the ISCHEMIA Trial.

Background: The relationship between the extent and severity of stress-induced ischemia and the extent and severity of anatomic coronary artery disease (CAD) in patients with obstructive CAD is multifactorial and includes the intensity of stress achieved, type of testing used, presence and extent of prior infarction, collateral blood flow, plaque characteristics, microvascular disease, coronary vasomotor tone, and genetic factors. Among chronic coronary disease participants with site-determined moderate or severe ischemia, we investigated associations between ischemia severity on stress testing and the extent of CAD on coronary computed tomography angiography.

Methods: Clinically indicated stress testing included nuclear imaging, echocardiography, cardiac magnetic resonance imaging, or nonimaging exercise tolerance test.

Native Valve and Native Neo-Sinus Remodeling Following Transcatheter Aortic Valve Replacement.

Background: Transcatheter aortic valve replacement (TAVR) pushes aside the diseased native aortic valve and creates a native neo-sinus bordered by the aortic root wall and the displaced native valve. There are limited data on the progression of native valve disease post-TAVR and no previous analysis of the native neo-sinus.

Methods: Native aortic valves and native neo-sinus explants obtained post-TAVR were evaluated histologically (hematoxylin and eosin, Movat pentachrome, and Martius Scarlet Blue stains) and by immunohistochemistry (TGF-β1 [transforming growth factor-beta 1], FAP [fibroblast activation protein], and ALP [alkaline phosphatase]) to assess disease mechanisms.

Cardiac CT, MRI, and PET in 2023: Exploration of Key Articles across Imaging and Multidisciplinary Journals.

In this review, the authors examine recent advancements in noninvasive cardiac imaging, focusing on cardiac CT, MRI, and PET, reviewing key publications from imaging and multidisciplinary journals from 2023. The authors discuss the increasing adoption of photon-counting CT and its applications in coronary and structural imaging, and explore various aspects of plaque and functional assessment, emphasizing their clinical implications. Radiation exposure analysis from the SCOT-HEART (Scottish Computed Tomography of the Heart) trial is also discussed.

Management of primary hepatic pregnancy: A case report.

Hepatic pregnancy, an exceedingly rare subtype of abdominal ectopic pregnancy, remains clinically challenging due to its infrequency, diverse presentations, and diagnostic difficulties. We report the clinical course, diagnostic journey and treatment of a woman with a primary hepatic pregnancy. The patient presented with acute pain in the right hypochondrium and vomiting.

Real-world experience and long-term outcomes of a mandatory non-medical switch of adalimumab originator to biosimilars in inflammatory bowel disease.

Background: Over the last decade, the treatment options for inflammatory bowel disease (IBD) have significantly progressed with the emergence of new medications designed to target various immune pathways and mitigate inflammation. Adalimumab (ADA) is a tumor necrosis factor alpha antagonist and stands as an effective treatment for IBD. In April 2021, the province of British Columbia implemented a mandatory non-medical switch policy of the ADA originator Humira to ADA biosimilars.

Comparison of SARS-CoV-2 RNA detection in different types of clinical specimens among suspected COVID-19 patients in Addis Ababa, Ethiopia.

Unlabelled: Although nasopharyngeal swabs (NPSs) are superior to saliva specimens, saliva can be used as an alternative specimen for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. Moreover, studies have reported contradicting findings on whether SARS-CoV-2 can be detected in urine or not. Thus, we aimed to evaluate the diagnostic utility of NPSs, saliva and urine specimens in suspected COVID-19 patients.

Readmissions after next-day discharge following transcatheter aortic valve implantation.

Background: No data compare newer-generation transcatheter heart valves (THVs) in terms of next-day discharge (NDD) following transfemoral (TF) transcatheter aortic valve implantation (TAVI).

Aims: We aimed to evaluate the safety of NDD in unselected patients who received ACURATE (neo/neo2), Evolut (PRO/PRO+/FX) and the SAPIEN (3/Ultra) THVs.

Methods: This multicentre registry included patients who underwent TF-TAVI without a preprocedural permanent pacemaker implantation (PPI) and were discharged the next day without a new PPI.

Adverse changes in close social ties in aging women and men: A population-based longitudinal study of the CLSA (2011-2021).

Close social ties are important for health but these can decline as people age. Moreover, losses of close social ties may be worse for women, older age and low socioeconomic groups. We characterized alterations in both marital status or living arrangement over 6 years by gender, and assessed patterns by age, country of origin, geographic location, education, wealth, and household income.

"There was no services that I could access so I just stayed on the street…using until I went into labour.": A qualitative study of accessibility and cultural safety of services for perinatal substance use in British Columbia, Canada.

Background: Perinatal substance use is a critical public health challenge, impacting both mother and fetus. Its prevalence has increased in British Columbia, Canada, disproportionately impacting First Nations people. For specialized perinatal substance use services to be effective, they must be accessible and safe.

Oncologic safety and technical feasibility of completion transanal total mesorectal excision after local excision; a cohort study from the International TaTME Registry.

Background: As part of an organ sparing strategy, a surgical local excision may be performed in patients with early-stage rectal cancer or following neoadjuvant (chemo)radiotherapy. In selected cases, a completion total mesorectal excision may be recommended which can be more complex because of the preceding local excision. A transanal approach to perform completion total mesorectal excision may offer an advantage through the better visualization of the surgical field in the distal rectum and less forceful retraction for exposure.

Urethral clear cell adenocarcinoma in an adult female: A rare case report.

Clear cell adenocarcinoma of the urethra is an extremely rare malignancy with a poor outcome, mainly affecting females in old age. We present the case of a 42-year-old female patient who presented with progressively worsening lower urinary tract symptoms, leading to a cystoscopy-guided core needle biopsy diagnosis of clear cell adenocarcinoma of the urethra. We will mainly discuss the cross-sectional imaging and pathological aspects of the case.