The development and validation of a decision aid to enhance shared decision-making for the management of actinic keratosis.

Actinic keratoses (AKs) are common pre-malignant lesions. There are numerous management options including active surveillance, multiple topical therapies, cryotherapy, curettage and cautery, and photodynamic therapy, each with their own risks, benefits and efficacy. Best practice currently involves shared decision-making between patient and clinician, particularly in the setting of multiple management options.

Using virtual reality-based neurocognitive testing and eye tracking to study naturalistic cognitive-motor performance.

Natural human behavior arises from continuous interactions between the cognitive and motor domains. However, assessments of cognitive abilities are typically conducted using pen and paper tests, i.e.

Seminoma in 46, XY Gonadal Dysgenesis: Rare Presentation and Review of the Literature.

Swyer syndrome is a rare congenital condition that serves as a risk factor for developing germ cell tumors. The condition belongs to the group of 46, XY disorders of sexual development, is characterized by complete gonadal dysgenesis (CGD) and is mostly manifested as delayed puberty and primary amenorrhea during adolescence. Individuals with Swyer syndrome are known to be phenotypically female with normal internal and external female genitalia at birth.

The development and validation of a decision aid to facilitate patient choice of surgery versus radiotherapy for high-risk basal cell carcinoma.

Basal cell carcinoma (BCC) is an increasingly common cancer. For high-risk BCCs, there are several treatment options, with similar efficacies. The current best practice in deciding upon a particular treatment is for a patient-centred approach.

Return of (gypsy moth): A case report.

An invasive moth, , also known as the gypsy moth, originates from Europe and first came to Ontario, Canada, in 1969. The moth is a defoliator which feeds on oak and other deciduous trees, and less commonly, conifers. Outbreaks of moth infestation occur every 7-10 years with rapid expansion of the population until there is a natural collapse due to pathogens and predators.

Quality of life in sinonasal tumors: an up-to-date review.

Purpose Of Review: To assess the impact of benign and malignant sinonasal tumors and their management on patients' Quality of Life (QOL) as measured by Patient Reported Outcome Measures (PROMS).

Recent Findings: Although there is a growing consensus that endoscopic surgical management in carefully selected patients with sinonasal tumors is at least as (and probably more) effective than open resection, it is not clear to what extent this translates to better QOL outcomes. Earlier studies reported better outcomes in the emotional and physical function domains after endoscopic resection, and it seems that postsurgical morbidity is less in endoscopic compared to open approaches.

Clinicians for CARE: A Systematic Review and Meta-Analysis of Interventions to Support Caregivers of Patients With Heart Disease.

Background Caregivers provide critical support for patients with chronic diseases, including heart disease, but often experience caregiver stress that negatively impacts their health, quality of life, and patient outcomes. We aimed to inform health care teams on an evidence-based approach to supporting the caregivers of patients with heart disease. Methods and Results We conducted a systematic review and meta-analysis of randomized controlled trials written in English that evaluated interventions to support caregivers of patients with heart disease.

Mitral valve paravalvular leaks: Comprehensive review of literature.

Background: Mitral paravalvular leaks (mPVL) are a recognized complication for patients with mitral valve prostheses. Although clinically insignificant for many patients, it may pose life-threatening haemolysis and regurgitation-induced heart failure, and so clinicians should have a high index of suspicion in the presence of new symptoms.

Aims: This review discusses the pathogenesis, clinical features, diagnosis, imaging and treatment of mPVLs.

Comparative analysis of histopathological subtypes of renal cell carcinoma in the Middle East compared to other world regions.

Introduction: Renal cell carcinoma (RCC) has various histopathological tumor subtypes which have a significant implication on the oncological outcome of these patients. We aimed to evaluate the distribution of RCC subtypes presenting at a tertiary care center in the Middle East, in comparison to the distribution reported in different geographic areas worldwide.

Methods: A retrospective chart review was conducted on all patients who underwent partial or radical nephrectomy for RCC at the American University of Beirut Medical Center between January 2012 and January 2018.

Vision Affects Gait Speed but not Patterns of Muscle Activation During Inclined Walking-A Virtual Reality Study.

While walking, our locomotion is affected by and adapts to the environment based on vision- and body-based (vestibular and proprioception) cues. When transitioning to downhill walking, we modulate gait by braking to avoid uncontrolled acceleration, and when transitioning to uphill walking, we exert effort to avoid deceleration. In this study, we aimed to measure the influence of visual inputs on this behavior and on muscle activation.

The role of simulation in training breast surgeons: a systematic review.

Background: As surgical education has evolved, most curricula have favoured a competency-based approach over traditional apprenticeship models. Surgical simulation can be a useful aide in the training of both oncological and reconstructive breast surgery trainees. This review investigates the extent to which simulation of breast surgery procedures has been validated as a training tool.

Using the loading response peak for defining gait cycle timing: A novel solution for the double-belt problem.

Unlabelled: Split-belt treadmills (SBTM) contain force plates under each belt that measure ground reaction force (GRF). Initial contact (IC) detection for each gait cycle obtained from the GRF is used for calculating temporal gait parameters (e.g.

Sedative drugs modulate the neuronal activity in the subthalamic nucleus of parkinsonian patients.

Microelectrode recording (MER) is often used to identify electrode location which is critical for the success of deep brain stimulation (DBS) treatment of Parkinson's disease. The usage of anesthesia and its' impact on MER quality and electrode placement is controversial. We recorded neuronal activity at a single depth inside the Subthalamic Nucleus (STN) before, during, and after remifentanil infusion.

Review of migraine incidence and management in obstetrics and gynaecology.

Purpose: Migraines are the third most prevalent disorder, and seventh-highest specific cause of disability worldwide. Migraines have a multitude of underlying aetiologies; the pathology may come as a result of hormonal treatment or as a sole symptom during menstrual cycle or pregnancy, with variable intensity and duration. In addition, clinicians should be fully aware of the potential complications and well-versed in management options.

Association between Brain-Derived Neurotrophic Factor (BDNF) Levels in 2 Trimester Amniotic Fluid and Fetal Development.

The development of the fetal nervous system mirrors general fetal development, comprising a combination of genetic resources and effects of the intrauterine environment. Our aim was to assess the 2 trimester amniotic fluid levels of brain-derived neurotrophic factor (BDNF) and to investigate its association with fetal growth. In accordance with our study design, samples of amniotic fluid were collected from women who had undergone amniocentesis early in the 2 trimester.

Transoral Robotic Surgery and the Unknown Primary.

Carcinoma of unknown primary (CUP) comprises approximately 1%-5% of all head and neck malignancies. Primary site detection rates for metastatic cervical squamous cell carcinoma (SCC) remain variable, with current diagnostic imaging unable to identify all tumours. Prevailing evidence suggests that most head and neck CUP are located in the oropharynx.

Position effect, cryptic complexity, and direct gene disruption as disease mechanisms in de novo apparently balanced translocation cases.

The majority of apparently balanced translocation (ABT) carriers are phenotypically normal. However, several mechanisms were proposed to underlie phenotypes in affected ABT cases. In the current study, whole-genome mate-pair sequencing (WG-MPS) followed by Sanger sequencing was applied to further characterize de novo ABTs in three affected individuals.

Hypothyroidism conversion to hyperthyroidism: it's never too late.

Unlabelled: Primary hypothyroidism is a common endocrine condition, most commonly caused by autoimmune thyroiditis (Hashimoto's disease) while Graves' disease is the most common cause of hyperthyroidism. Hypothyroidism is usually a permanent condition in most patients requiring lifelong levothyroxine treatment. Transformation from Hashimoto's disease to Graves' disease is considered rare but recently been increasingly recognised.

Challenges of pain management in neurologically injured patients: systematic review protocol of analgesia and sedation strategies for early recovery from neurointensive care.

Background: A recent paradigm shift within the intensive care discipline has led to implementation of protocols to drive early recovery from the intensive care unit (ICU). These protocols belong to a large knowledge, translation and quality improvement initiative lead by the Society of Critical Care Medicine, aiming to "liberate" patients from the ICU. They "bundle" evidence-based elements shown to lower ICU stay and mortality and optimize pain management.

Benign and malignant pathology of the uterus.

The diagnosis of a uterine myoma size and location can be very precise when a 3D sonograph and knowledge are available. The majority of fibroids are asymptomatic, and expectant management is recommended. In young patients, fibroids cause infertility and in middle-aged women, abnormal uterine bleedings.