Paced P-wave morphology templates to guide atrial tachycardia localization: A derivation and validation study.

Background: Surface ECG is a useful tool to guide mapping of focal atrial tachycardia (AT).

Objectives: We aimed to construct 12-lead ECG templates for P-wave morphology (PWM) during endocardial pacing from different sites in both atria in patients with no apparent structural heart disease (derivation cohort), with the goal of creating a localization algorithm, which could subsequently be validated in a cohort of patients undergoing catheter ablation of focal AT (validation cohort).

Methods: We prospectively enrolled consecutive patients who underwent electrophysiology study, had no structural heart disease and no atrial enlargement.

Cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC) for peritoneal mesothelioma: Canadian practices and outcomes.

Introduction: Peritoneal mesothelioma (PM) is a rare malignancy originating from the peritoneal lining. Cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC) is the standard-of-care for patients with isolated PM. Due to a paucity of prospective data there are several different HIPEC protocols.

Rationale and design for the myocardial ischemia and transfusion (MINT) randomized clinical trial.

Background: Accumulating evidence from clinical trials suggests that a lower (restrictive) hemoglobin threshold (<8 g/dL) for red blood cell (RBC) transfusion, compared with a higher (liberal) threshold (≥10 g/dL) is safe. However, in anemic patients with acute myocardial infarction (MI), maintaining a higher hemoglobin level may increase oxygen delivery to vulnerable myocardium resulting in improved clinical outcomes. Conversely, RBC transfusion may result in increased blood viscosity, vascular inflammation, and reduction in available nitric oxide resulting in worse clinical outcomes.

Treating Insulin Resistance With Metformin as a Strategy to Improve Clinical Outcomes in Treatment-Resistant Bipolar Depression (the TRIO-BD Study): A Randomized, Quadruple-Masked, Placebo-Controlled Clinical Trial.

Therapeutic options are limited for treatment-resistant bipolar depression (TRBD). Insulin resistance (IR) confers increased risk for TRBD. We investigated metformin, an insulin sensitizer, to reverse IR and improve clinical outcomes in TRBD.

Evaluating Targeted Next-Generation Sequencing Assays and Reference Materials for NTRK Fusion Detection.

Neurotrophic tyrosine receptor kinase (NTRK1/2/3) fusions are oncogenic drivers in approximately 0.3% of solid tumors. High-quality testing to identify patients with NTRK fusion-positive tumors who could benefit from tropomyosin receptor kinase inhibitors is recommended, but the current NTRK testing landscape, including next-generation sequencing (NGS), is fragmented and availability of assays varies widely.

Symptom and Disability Measurement by Common Foot and Ankle-Specific Outcome Rating Scales.

Background: Well-designed foot and ankle clinical outcomes research requires region-specific subjective outcome measures. Many foot and ankle-specific instruments are now available. Determining which instruments to choose is daunting.

BioAdvance Patient Support Program Survey: Positive Perception of Intravenous Infusions of Infliximab.

Purpose: To understand the perception of intravenous infusions in patients receiving infliximab (Remicade) within the BioAdvance patient support program (PSP).

Design: Intravenous infusion of infliximab occurs at approximately 200 clinics across Canada and is managed via the BioAdvance PSP. Patients were invited to complete a 28-question survey on demographics, disease/treatment characteristics, health rating, lifestyle, employment, and perception of intravenous infusions and the BioAdvance program.

LVIS Jr 'shelf' technique: an alternative to Y stent-assisted aneurysm coiling.

Wide-necked bifurcation intracranial aneurysms have traditionally not been amenable to coil embolization with the use of a single stent due to the high risk of coil prolapse. Y-configuration double stent-assisted coil embolization ('Y-stenting') of this aneurysm type has been shown to have generally good clinical outcomes, although the technique is complex with various challenges described in the literature. The compliant and flexible closed-cell design of braided stents such as the LVIS Jr allows for the creation of a 'shelf' across the aneurysm neck sufficient to prevent coil prolapse.

Transfemoral aortic valve implantation for severe aortic stenosis in a patient with dextrocardia situs inversus.

Transcatheter aortic valve implantation (TAVR) has grown rapidly over the past 10 years. Device and delivery catheter systems have evolved to facilitate the procedure and reduce the risk of associated complications, including those related to vascular access. It is important to understand the utility of the TAVR equipment in patients with more challenging anatomy to select the most appropriate technique for this complex procedure.

Differential entrainment distinguishes atrioventricular nodal reentry tachycardia from atrioventricular reentrant tachycardia.

Background: Entrainment from the right ventricular (RV) apex and the base has been used to distinguish atrioventricular reentrant tachycardia (AVRT) from atrioventricular nodal reentry tachycardia (AVNRT). The difference in the entrainment response from the RV apex in comparison with the RV base has not been tested.

Methods: Fifty-nine consecutive patients referred for ablation of supraventricular tachycardia (SVT) were included.

Malignant rhabdoid tumor of the vulva: case report and review of the literature with emphasis on clinical management and outcome.

Background: Malignant extrarenal rhabdoid tumors (ERTs) of the vulva are rare but aggressive neoplasms. We describe the eighth reported case and the first to have long-term survival despite initial rapid recurrence.

Case: A 40-year-old woman presented with a painless lump on the mons pubis.

Focal segmental glomerulosclerosis in one of two "en bloc" pediatric transplanted kidneys.

Focal segmental glomerulosclerosis (FSGS) is thought to have several causes, including hypertension, reduction of nephron mass, or immunologic processes. Experimental studies have underlined the role of glomerular adaptation to capillary pressure in the growing kidney after partial nephrectomy. We report here the occurrence of FSGS in one of two "en bloc" pediatric kidneys transplanted in an adult recipient.