Predictive Validity of a QT Interval Prolongation Risk Score in the Intensive Care Unit.

Background: Torsade de pointes is a form of polymorphic ventricular tachycardia associated with heart rate-corrected QT (QT ) interval prolongation. With approximately 24-61% of critically ill patients experiencing QT interval prolongation, a predictive tool to identify high-risk patients could assist in the monitoring and management in the intensive care unit (ICU). The Tisdale et al.

The Role of Emergency Radiology in COVID-19: From Preparedness to Diagnosis [Formula: see text].

Emergency trauma radiology, although a relatively new subspecialty of radiology, plays a critical role in both the diagnosis/triage of acutely ill patients, but even more important in providing leadership and taking the lead in the preparedness of imaging departments in dealing with novel highly infectious communicable diseases and mass casualties. This has become even more apparent in dealing with COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, first emerged in late 2019. We review the symptoms, epidemiology, and testing for this disease.

Long-term outcomes following salvage surgery for locally recurrent rectal cancer: A 15-year follow-up study.

Background: Locally recurrent rectal cancer (LRRC) is a complex problem requiring multidisciplinary consultation and specialized surgical care. Given the paucity of published longer-term survival data, skepticism persists regarding the benefit of major extirpative surgery. We investigated ultra-long-term (~15 years) outcomes following radical resection of LRRC and sought relevant clinicopathologic prognostic variables.

Continuation of Buprenorphine to Facilitate Postoperative Pain Management for Patients on Buprenorphine Opioid Agonist Therapy.

Background: Acute pain management in patients on buprenorphine opioid agonist therapy (BOAT) can be challenging. It is unclear whether BOAT should be continued or interrupted for optimization of postoperative pain control.

Objectives: To determine an evidence-based approach for pain management in patients on BOAT in the perioperative setting, particularly whether BOAT should be continued or interrupted with or without bridging to another mu opioid agonist and to identify benefits and harms of either perioperative strategy.

Successful same day discharge after immediate post-mastectomy alloplastic breast reconstruction: A single tertiary centre retrospective audit.

Background: Immediate Post-Mastectomy Alloplastic Breast Reconstruction (IPMABR) traditionally requires a post-operative overnight stay. Recent initiatives have identified same day discharge as a safe option.

Methods: A retrospective audit of all cases at a tertiary breast cancer centre was performed.

Institution of Code Neurointervention and Its Impact on Reaction and Treatment Times.

Background/objective: Various strategies have been implemented to reduce acute stroke treatment times. Recent studies have shown a significant benefit of acute endovascular therapy. The JFK Comprehensive Stroke Center instituted Code Neurointervention (NI) on May 1, 2014 for the purpose of rapidly assembling the NI team and rapidly providing acute endovascular therapy.

Sex differences in the relative heterogeneity of frailty in relation to age, frailty, health protection, and five-year mortality.

Background: Previous studies have suggested that the relative heterogeneity of frailty declines with increases in age and the level of the frailty index (FI). In this study, we investigated the sex difference in the relative heterogeneity of frailty and its response to health-protective factors, in a Chinese community sample.

Methods: Data used for this secondary analysis were obtained from the Beijing Longitudinal Study of Aging that involved 3257 community-dwelling Chinese people aged 55 years and older at baseline.

Self-Managed Surveillance for Breast Cancer-Related Upper Body Issues: A Feasibility and Reliability Study.

Background: Early identification of breast cancer-related upper body issues is important to enable timely physical therapist treatment.

Objective: This study evaluated the feasibility and reliability of women performing self-managed prospective surveillance for upper body issues in the early postoperative phase as part of a hospital-based physical therapy program.

Design: This was a prospective, single-site, single-group feasibility and reliability study.

Stress Ulcer Prophylaxis in Critically Ill Children: A Multicenter Observational Study.

Objective: To describe current stress ulcer prophylaxis practice in Canadian PICUs.

Design: Multicenter cohort study. We defined stress ulcer prophylaxis as the use of a proton-pump inhibitor, histamine-2 receptor antagonist, or sucralfate within the first 2 PICU days among children who had not been on these medications at home and had no evidence of gastrointestinal bleeding.

Rare SUZ12 variants commonly cause an overgrowth phenotype.

The Polycomb repressive complex 2 is an epigenetic writer and recruiter with a role in transcriptional silencing. Constitutional pathogenic variants in its component proteins have been found to cause two established overgrowth syndromes: Weaver syndrome (EZH2-related overgrowth) and Cohen-Gibson syndrome (EED-related overgrowth). Imagawa et al.

White Matter fMRI Activation Cannot Be Treated as a Nuisance Regressor: Overcoming a Historical Blind Spot.

Despite past controversies, increasing evidence has led to acceptance that white matter activity is detectable using functional magnetic resonance imaging (fMRI). In spite of this, advanced analytic methods continue to be published that reinforce a historic bias against white matter activation by using it as a nuisance regressor. It is important that contemporary analyses overcome this blind spot in whole brain functional imaging, both to ensure that newly developed noise regression techniques are accurate, and to ensure that white matter, a vital and understudied part of the brain, is not ignored in functional neuroimaging studies.

Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Manifestations of Sepsis: A Diagnostic Study.

Background: Administering antimicrobial agents before obtaining blood cultures could potentially decrease time to treatment and improve outcomes, but it is unclear how this strategy affects diagnostic sensitivity.

Objective: To determine the sensitivity of blood cultures obtained shortly after initiation of antimicrobial therapy in patients with severe manifestations of sepsis.

Design: Patient-level, single-group, diagnostic study.

Hospital Pharmacists' Perceptions and Decision-Making Related to Drug-Drug Interactions.

Background: Pharmacists often overlook drug interaction alerts because of limitations in clinical decision support (CDS) software systems intended to detect evidence-based, clinically significant drug-drug interactions (DDIs). Alert fatigue, which occurs when pharmacists become desensitized to an overload of DDIs, may also contribute.

Objectives: To gain a better understanding of how pharmacists assess common DDIs and the extent to which computerized drug alerts affect their decision-making, as background for initiatives to overcome alert fatigue and improve detection of DDIs.

Expanding the role of pharmacy technicians to facilitate a proactive pharmacist practice.

Purpose: This study describes a change in pharmacy practice to expand pharmacy technician roles to allow dispensing without a pharmacist check, thereby enhancing the pharmacist role in direct patient care.

Summary: In an effort to optimize patient care with limited resources, we set out to change our pharmacy practice model. We transferred duties that did not require clinical judgment in the dispensary from the pharmacist to the regulated technician.

Asymptomatic Pharyngeal Carriage of Kingella kingae Among Young Children in Vancouver, British Columbia, Canada.

Background: Kingella kingae has emerged as a significant cause of osteoarticular infections in young children. Pharyngeal colonization is considered a prerequisite for invasive K. kingae infection.

Mediators and moderators of change in mindfulness-based stress reduction for painful diabetic peripheral neuropathy.

Painful diabetic peripheral neuropathy (PDPN) is a chronic pain condition with modest response to pharmacotherapy. Participation in mindfulness-based stress reduction (MBSR) leads to improvements in pain-related outcomes but the mechanisms of change are unknown. The present study examined the mediators and moderators of change in 62 patients with PDPN who participated in a randomized controlled trial comparing MBSR to waitlist.

Barriers and Strategies for Transition from Student to Successful Hospital Pharmacist.

Background: Many health care professionals experience a process of transition when entering the workforce. Various barriers have been documented in the literature, including a lack of confidence, challenging interactions with patients and colleagues, workload, increased responsibility, and a fear of making mistakes. Strategies to overcome these barriers, such as orientation and support programs, have been proposed.

Assessment of Empiric Vancomycin Regimen in the Neonatal Intensive Care Unit.

Background: Vancomycin is used to treat serious gram-positive infections in neonates. Currently, there is no consensus on the preferred empiric dosing regimen or target trough vancomycin levels for neonates. The current Fraser Health empiric dosing regimen, implemented in 2010, was designed to achieve target trough levels of 5 to 15 mg/L.

What Is the Evidence for Co-trimoxazole, Clindamycin, Doxycycline, and Minocycline in the Treatment of Methicillin-Resistant (MRSA) Pneumonia?

To review the evidence for trimethoprim-sulfamethoxazole (TMP-SMX), clindamycin, doxycycline, and minocycline in the treatment of methicillin-resistant (MRSA) pneumonia. MEDLINE, PubMed, EMBASE, Google, Google Scholar, Cochrane Central Register of Controlled Trials from 1946 to May 20, 2019. The search was performed with the keywords methicillin-resistant , MRSA, , pneumonia, trimethoprim, sulfamethoxazole drug combination, trimethoprim, sulfamethoxazole, TMP-SMX, co-trimoxazole, clindamycin, doxycycline, and minocycline.

Age-Related Whole-Brain Structural Changes in Relation to Cardiovascular Risks Across the Adult Age Spectrum.

: The brain atrophy and lesion index (BALI) has been developed to assess whole-brain structural deficits that are commonly seen on magnetic resonance imaging (MRI) in aging. It is unclear whether such changes can be detected at younger ages and how they might relate to other exposures. Here, we investigate how BALI scores, and the subcategories that make the total score, compare across adulthood and whether they are related to the level of cardiovascular risks, in both young and old adulthood.

Obesity prevention in corticosteroid-treated patients: Use and effectiveness of strategies for weight management.

We conducted a systematic review to identify the use and effectiveness of clinical interventions to prevent or mitigate weight gain in patients using systemic corticosteroids. We independently searched nine bibliometric databases for reviews and longitudinal studies published up to 26 October 2018, and assessed the quality of studies meeting inclusion criteria. We identified 3893 records and screened 3037 eligible studies, read four full-texts and extracted data from three randomized control trials.

Evaluation of Pharmacist Intervention on Discharge Medication Reconciliation.

Background: Discharge medication reconciliation (Discharge MedRec) was implemented on one unit at a large urban teaching hospital, and was to be expanded across the rest of the hospital and the health authority's various sites by the end of 2018. Clinical pharmacists on the Acute Care for the Elderly unit carried out discharge planning and led Discharge MedRec during a pilot period, to inform the future implementation.

Objectives: The primary objective was to examine the number and type of medication discrepancies before and after implementation of Discharge MedRec.

Switching to Clopidogrel in Patients With Acute Coronary Syndrome Managed With Percutaneous Coronary Intervention Initially Treated With Prasugrel or Ticagrelor: Systematic Review and Meta-analysis.

To evaluate the effects of switching from ticagrelor or prasugrel to clopidogrel in acute coronary syndrome (ACS) patients managed with percutaneous coronary intervention on major adverse cardiovascular events (MACEs) and bleeding. We searched MEDLINE, EMBASE, CENTRAL, bibliographies of relevant articles, and clinicaltrials.gov for eligible articles published from inception to January 27, 2019.