Pacinioma of Lumbosacral Skin in Closed Spinal Dysraphism.

Closed spinal dysraphism (CSD) is a congenital condition caused by a failure in secondary neurulation during embryogenesis. CSD is associated with characteristic cutaneous stigmata often identified clinically. Rarely, such stigmata have been reported to occur with complex congenital intraspinal lipomas containing Pacinian corpuscle hyperplasia.

Fit-for-Purpose Ki-67 Immunohistochemistry Assays for Breast Cancer.

New therapies are being developed for breast cancer, and in this process, some "old" biomarkers are reutilized and given a new purpose. It is not always recognized that by changing a biomarker's intended use, a new biomarker assay is created. The Ki-67 biomarker is typically assessed by immunohistochemistry (IHC) to provide a proliferative index in breast cancer.

Post Stroke Visual Impairment: Interdisciplinary Collaborative Program - Canadian Perspective.

Post-stroke visual impairment (PSVI) affects more than 60% of the people who have a stroke but visual function is not routinely assessed in most stroke units. Recent high-quality research in this field has produced evidence-based assessment and management practices for PSVI. Orthoptists have integrated into the stroke care team in the United Kingdom (UK) to provide this valuable service.

Synchrotron X-ray methods in the study of mercury neurotoxicology.

In situ methods are valuable in all fields of research. In toxicology, the importance of dose is well known, elevating the need for in situ techniques to measure levels of toxicants and their byproducts in precise anatomically identifiable locations. More recently, additional emphasis has been placed on the value of techniques which can detect chemical form or speciation, which is equally important in the toxicology of a chemical compound.

Canadian Association of Radiologists Breast Disease Imaging Referral Guideline.

The Canadian Association of Radiologists (CAR) Breast Disease Expert Panel consists of breast imaging radiologists, a high-risk breast clinician, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 20 clinical/diagnostic scenarios, a systematic rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 30 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) for guidelines framework were used to develop 69 recommendation statements across the 20 scenarios.

OCTA changes following loading phase with intravitreal aflibercept for DME.

Objective: To quantify changes in optical coherence tomography angiography (OCTA) parameters following intravitreal anti-vascular endothelial growth factor treatment for diabetic macular edema (DME), and to assess associations between pretreatment OCTA parameters and visual outcomes.

Design: Prospective cohort study.

Methods: Twenty-nine patients with DME received 5 monthly intravitreal injections of aflibercept.

Light Color and the Commercial Broiler: Effect on Ocular Health and Visual Acuity.

Light is a critical management factor for broiler production, and the wavelength spectrum, one of its components, can affect bird physiology, behavior and production. Among all the senses, sight is important to birds, and their visual system possess several adaptations that allow them to perceive light differently from humans. Therefore, it is critical to consider whether the exposure to monochromatic light colors influences broiler visual ability, which could affect behavioral expression.

Musculoskeletal ultrasound in hemophilia: Results and recommendations from a global survey and consensus meeting.

Introduction: For persons with hemophilia, optimization of joint outcomes is an important unmet need. The aim of this initiative was to determine use of ultrasound in evaluating arthropathy in persons with hemophilia, and to move toward consensus among hemophilia care providers regarding the preferred ultrasound protocols for global adaptation.

Methods: A global survey of hemophilia treatment centers was conducted that focused on understanding how and why ultrasound was being used and endeavored to move toward consensus definitions of both point-of-care musculoskeletal ultrasound (POC-MSKUS) and full diagnostic ultrasound, terminology to describe structures being assessed by ultrasound, and how these assessments should be interpreted.

Is Call Karma Real? Resident After-Hours On-Call Imaging at the University of Saskatchewan: An Assessment of Call Volumes Including Inter-Resident Variability.

Purpose: Quantify resident caseload during call and determine if there are consistent differences in call volumes for individuals or resident subgroups.

Methods: Accession codes for after-hours computed tomography (CT) cases dictated by residents between July 1, 2012 and January 9, 2017 were reviewed. Case volumes by patient visits and body regions scanned were determined and categorized according to time period, year, and individual resident.

The 20 Prism Diopter Base Out Prism Test in Pseudostrabismus.

The 20 Base Out Prism Test is one of the artillery of fusion tests used in vision and strabismus screening, and in daily pediatric strabismus practice. Its use has been described in textbooks as early as 1958, but the test has not yet been validated.We present a cohort of esotropic cases formerly diagnosed with pseudostrabismus who were tested with the 20BO test, and explore the possible explanations for their positive response rate of 100%.

Artificial intelligence-based imaging analytics and lung cancer diagnostics: Considerations for health system leaders.

Lung cancer is a leading cause of cancer death in Canada, and accurate, early diagnosis are critical to improving clinical outcomes. Artificial Intelligence (AI)-based imaging analytics are a promising healthcare innovation that aim to improve the accuracy and efficiency of lung cancer diagnosis. Maximizing their clinical potential while mitigating their risks and limitations will require focused leadership informed by interdisciplinary expertise and system-wide insight.

Comparison of p53 immunohistochemical staining in differentiated vulvar intraepithelial neoplasia (dVIN) with that in inflammatory dermatoses and benign squamous lesions in the vulva.

Aims: Differentiated vulvar intraepithelial neoplasia (dVIN), the precursor lesion to human papillomavirus-independent vulvar squamous cell carcinoma (VSCC), can be difficult to distinguish from vulvar inflammatory dermatoses. Our goal was to determine if p53 could be a useful biomarker for dVIN, by characterizing p53 percentage, intensity and patterns of staining in dVIN and its histological mimics.

Methods And Results: We studied p53 immunohistochemical staining patterns in 16 dVIN cases and 46 vulvar non-neoplastic squamous lesions [12 lichen sclerosus (LS); seven lichen simplex chronicus; three lichen planus (LP); six psoriasis; 13 spongiotic dermatitis (SPO); and five candidiasis].

Use of ultrasound for assessment of musculoskeletal disease in persons with haemophilia: Results of an International Prophylaxis Study Group global survey.

Aim: The objective of this survey was to understand the global trends of imaging assessments in persons with haemophilia, focusing on point-of-care ultrasound (POCUS). Insights into the barriers impeding its widespread proliferation as a frontline imaging modality were obtained.

Methods: The survey opened in September of 2017 and closed in May of 2018.

Amplification of a calcium channel subunit CACNG4 increases breast cancer metastasis.

Background: Previously, we found that amplification of chromosome 17q24.1-24.2 is associated with lymph node metastasis, tumour size, and lymphovascular invasion in invasive ductal carcinoma.

Eccentric Fixation and Inverse Occlusion: Renewing Our Interest?

The use of inverse occlusion and pleoptics came into favor in Europe and then in North America in the late 1940's, and fell out of favor less than 25 years later. Introduced as a method of promoting foveal fixation, and improving binocularity and vision in cases of eccentric fixation, it did not outperform conventional occlusion prescribed at an earlier age.In this issue, Godts and Mathysen provide a case series of 11 contemporary patients treated with inverse occlusion after patching failure.

Nurse managers implementing the lean management system: A qualitative study in Western Canada.

Aim: This study explores the perceptions and experiences of nurse managers involved in implementing the Lean management system in a Western Canadian province.

Background: The provincial government of Saskatchewan, Canada, implemented a multimillion-dollar investment in the Lean management system to transform health care delivery by reducing waste and increasing efficiency of processes and outcomes.

Methods: This qualitative exploratory study employed semi-structured interviews with 14 nurse managers in urban and rural health regions in one Canadian province.

National consensus recommendations on patient-centered care for ductal carcinoma in situ.

Purpose: The purpose of this research was to generate recommendations on strategies to achieve patient-centered care (PCC) for ductal carcinoma in situ (DCIS).

Methods: Thirty clinicians (surgeons, medical/radiation oncologists, radiologists, nurses, navigators) who manage DCIS and 32 DCIS survivors aged 18 or older were nominated. Forty-six recommendations to support PCC for DCIS were derived from primary research, and rated in a two-round Delphi process from March to June 2018.

Reduced prevalence of small-for-gestational-age and preterm birth for women of low socioeconomic position: a population-based cohort study comparing antenatal midwifery and physician models of care.

Objective: Our aim was to investigate if antenatal midwifery care was associated with lower odds of small-for-gestational-age (SGA) birth, preterm birth (PTB) or low birth weight (LBW) compared with general practitioner (GP) or obstetrician (OB) models of care for women of low socioeconomic position.

Setting: This population-level, retrospective cohort study used province-wide maternity, medical billing and demographic data from British Columbia, Canada.

Participants: Our study included 57 872 pregnant women, with low socioeconomic position, who: were residents of British Columbia, Canada, carried a singleton fetus, had low to moderate medical/obstetric risk, delivered between 2005 and 2012 and received medical insurance premium assistance.

Spasm of the Near Reflex: Literature Review and Proposed Management Strategy.

Background And Purpose: Spasm of the near reflex (SNR) can be a variable, unpredictable condition. There is no standard management strategy. The purpose of this paper is to summarize the pertinent information from a literature review to better identify, explain, and manage this condition.

A Comparison of GATA3, TTF1, CD10, and Calretinin in Identifying Mesonephric and Mesonephric-like Carcinomas of the Gynecologic Tract.

Mesonephric carcinomas of the gynecologic tract are neoplasms that are often under-recognized due to their varied morphologic appearances. Recently, GATA3 and TTF1 have been reported to be useful immunohistochemical markers for distinguishing mesonephric carcinomas from its morphologic mimics. Herein, we compared the performance of GATA3 and TTF1 to the traditional markers used for mesonephric carcinomas, CD10 and calretinin.

Structure of health-care dyad leadership: an organization's experience.

Purpose This study aims to explore the structural aspects (roles, responsibilities and reporting) of dyad leadership in one health-care organization (HCO). Design/methodology/approach The perceptions of 32 leaders (17 physician leaders and 15 dyad co-leaders) in formal leadership positions (six first-level with formal authority limited to teams or divisions, 23 middle-level with wider departmental or program responsibility and three senior-level with institution-wide authority) were obtained through focus groups and surveys. In addition, five senior leaders were interviewed.