Achieving Procedural Competence during Nephrology Fellowship Training: Current Requirements and Educational Research.

Concerns have previously been raised as to whether training programs are ensuring that nephrology fellows achieve competence in the procedural skills required for independent practice. We sought to review the current requirements for procedural training as well as educational research pertaining to achieving competence in the core nephrology procedures of nontunneled (temporary) hemodialysis catheter insertion and percutaneous kidney biopsy. At this time, there is no universal approach to procedural training and assessment during nephrology fellowship.

Selecting SNPs informative for African, American Indian and European Ancestry: application to the Family Investigation of Nephropathy and Diabetes (FIND).

Background: The presence of population structure in a sample may confound the search for important genetic loci associated with disease. Our four samples in the Family Investigation of Nephropathy and Diabetes (FIND), European Americans, Mexican Americans, African Americans, and American Indians are part of a genome- wide association study in which population structure might be particularly important. We therefore decided to study in detail one component of this, individual genetic ancestry (IGA).

Longitudinal Evaluation of Trial Outcome Index Scores in Patients With Esophageal Cancer.

Background: The purpose of this study was to use the Trial Outcome Index (TOI) to longitudinally assess the effects of treatment for esophageal cancer.

Methods: Patients with esophageal cancer treated with curative intent therapy (N = 84) were evaluated with Functional Assessment of Cancer Therapy-Esophageal Cancer subscale (FACT-E) questionnaires, which were scheduled at baseline and at 1, 3, 6, 9, 12, 18, 24, and 36 months after completion of treatment. Patients treated with preoperative therapy also completed questionnaires 6 to 8 weeks after starting treatment and after completion of induction treatment (12-14 weeks) just before the operative procedure.

The initiation of a multidisciplinary bladder cancer clinic and the uptake of neoadjuvant chemotherapy: A time-series analysis.

Introduction: While level 1 evidence supports the use of neoadjuvant chemotherapy (NAC) for patients with muscle-invasive bladder cancer (MIBC), its uptake has been underwhelming, even in academic centres. Our aim was to determine if the initiation of a multidisciplinary bladder cancer clinic (MDBCC) in 2008 at our institution, where patients are assessed simultaneously by bladder cancer-focused urologists and radiation oncologists with easy access to a medical oncologist, was associated with an increased use of NAC.

Methods: Patients with MIBC initiating treatment between July 2000 and June 2013 were identified and classified by academic year (July 1 to June 30).

Risk of Cerebral Venous Thrombosis in Obese Women.

Importance: Obesity is a risk factor for deep vein thrombosis of the leg and pulmonary embolism. To date, however, whether obesity is associated with adult cerebral venous thrombosis (CVT) has not been assessed.

Objective: To assess whether obesity is a risk factor for CVT.

The role of biopsy for small renal masses.

The incidence of small renal masses (SRMs) has been increasing due to the more liberal use of abdominal imaging. This increased detection has driven the attention of clinicians to the characterization of these lesions and toward a better understanding of their natural history. To this end, renal tumour biopsies (RTBs) have a crucial role as they provide vital pathological information.

Technical Note: Method to correlate whole-specimen histopathology of radical prostatectomy with diagnostic MR imaging.

Purpose: Validation of MRI-guided tumor boundary delineation for targeted prostate cancer therapy is achieved via correlation with gold-standard histopathology of radical prostatectomy specimens. Challenges to accurate correlation include matching the pathology sectioning plane with the in vivo imaging slice plane and correction for the deformation that occurs between in vivo imaging and histology. A methodology is presented for matching of the histological sectioning angle and position to the in vivo imaging slices.

Indications for biopsy and the current status of focal therapy for renal tumours.

The increased detection of small renal masses (SRMs) has focused attention on their uncertain natural history. The development of treatment alternatives and the discovery of biologically targeted drugs have also raised interest. Renal mass biopsies (RMBs) have a crucial role as they provide the pathological, molecular and genetic information needed to classify these lesions and guide clinical management.

Intracranial vessel wall MRI.

There are many different methods of imaging the intracranial arteries; however, the vast majority of currently used techniques are based on luminal imaging. Although this is useful, it does have limitations as many different pathological processes can produce the same appearance. Therefore, directly imaging the site of the pathology - the vessel wall itself - offers the hope of discriminating between different disease processes.

Testicular germ cell tumours.

Testicular germ cell tumours are at the crossroads of developmental and neoplastic processes. Their cause has not been fully elucidated but differences in incidences suggest that a combination of genetic and environment factors are involved, with environmental factors predominating early in life. Substantial progress has been made in understanding genetic susceptibility in the past 5 years on the basis of the results of large genome-wide association studies.

High-Resolution Vessel Wall Magnetic Resonance Imaging in Angiogram-Negative Non-Perimesencephalic Subarachnoid Hemorrhage.

Purpose: Standard magnetic resonance imaging (MRI) rarely identifies the cause of hemorrhage in patients with an angiogram-negative, non-perimesencephalic subarachnoid hemorrhage (SAH). Yet up to 10 % of these patients have recurrent hemorrhage. The aim of the study was to explore the potential role of high-resolution contrast-enhanced 3-Tesla vessel wall-MRI in patients with angiogram-negative SAH.

Active Surveillance for Renal Neoplasms with Oncocytic Features is Safe.

Purpose: Oncocytomas are benign tumors often diagnosed incidentally on imaging. Small case series have suggested that the growth kinetics of oncocytomas are similar to those of malignant renal tumors. Biopsy material may be insufficient to exclude a diagnosis of chromophobe renal cell carcinoma.

Genome-Wide Association and Trans-ethnic Meta-Analysis for Advanced Diabetic Kidney Disease: Family Investigation of Nephropathy and Diabetes (FIND).

Diabetic kidney disease (DKD) is the most common etiology of chronic kidney disease (CKD) in the industrialized world and accounts for much of the excess mortality in patients with diabetes mellitus. Approximately 45% of U.S.

The effect of metformin on cancer-specific survival outcomes in diabetic patients undergoing radical cystectomy for urothelial carcinoma of the bladder.

Purpose: Metformin, a first-line oral therapy for diabetes, has anticancer properties. Our objective was to evaluate the association between metformin use and oncologic outcomes in diabetic patients undergoing radical cystectomy (RC) for bladder cancer (BC).

Methods: A single-institution retrospective cohort (January 1997-June 2013) of diabetic patients undergoing RC was assembled.

CT and MR imaging of non-cavernous cranial dural arteriovenous fistulas: Findings associated with cortical venous reflux.

Purpose: To compare the conventional CT and MR findings of DAVFs in relation to the venous drainage pattern on digital subtraction angiography (DSA).

Materials And Methods: Cross-sectional imaging findings (CT and/or MR) in 92 patients were compared to the presence of cortical venous reflux (CVR) on DSA.

Results: Imaging features significantly more prevalent in patients with CVR included: abnormally dilated and tortuous leptomeningeal vessels (92% vs.

Renal Tumor Biopsy for Small Renal Masses: A Single-center 13-year Experience.

Background: Renal tumor biopsy (RTB) for the characterization of small renal masses (SRMs) has not been widely adopted despite reported safety and accuracy. Without pretreatment biopsy, patients with benign tumors are frequently overtreated.

Objective: To assess the diagnostic rate of RTBs, to determine their concordance with surgical pathology, and to assess their impact on management.

Dermatoses among returned Canadian travellers and immigrants: surveillance report based on CanTravNet data, 2009-2012.

Background: There is a lack of multicentre analyses of the spectrum of dermatologic illnesses acquired by Canadian travellers and immigrants. Our objective for this study was to provide a comprehensive, Canada-specific surveillance summary of travel-related dermatologic conditions in a cohort of returned Canadian travellers and immigrants.

Methods: Data for Canadian travellers and immigrants with a primary dermatologic diagnosis presenting to CanTravNet sites between September 2009 and September 2012 were extracted and analyzed.

Chronic Larva Currens Following Tourist Travel to the Gambia and Southeast Asia Over 20 Years Ago.

Larva currens is the cutaneous manifestation of human infection with the geotropic helminth Strongyloides stercoralis. Strongyloidiasis is a lifelong infection unless treated. A high index of suspicion is needed to prevent chronic symptoms of strongyloidiasis (eg, larva currens, eosinophilia, abdominal discomfort) and to prevent fatal dissemination.

Placebo effect of medication cost in Parkinson disease: a randomized double-blind study.

Objective: To examine the effect of cost, a traditionally "inactive" trait of intervention, as contributor to the response to therapeutic interventions.

Methods: We conducted a prospective double-blind study in 12 patients with moderate to severe Parkinson disease and motor fluctuations (mean age 62.4 ± 7.

Practice patterns and perceptions of survivorship care in Canadian genitourinary oncology: A multidisciplinary perspective.

Introduction: There is little knowledge of survivorship care specific to genitourinary (GU) cancers. To improve care delivery to this patient population, we need to clearly define physician perceptions of survivorship care. We therefore conducted a study to determine the challenges to GU cancer survivorship care in Canada.

Perioperative aspirin and clonidine and risk of acute kidney injury: a randomized clinical trial.

Importance: Acute kidney injury, a common complication of surgery, is associated with poor outcomes and high health care costs. Some studies suggest aspirin or clonidine administered during the perioperative period reduces the risk of acute kidney injury; however, these effects are uncertain and each intervention has the potential for harm.

Objective: To determine whether aspirin compared with placebo, and clonidine compared with placebo, alters the risk of perioperative acute kidney injury.

Travel-acquired infections in Canada: CanTravNet 2011-2012.

Background: Important gaps remain in our knowledge of the infectious diseases people acquire while travelling and the impact of pathogens imported by Canadian travellers.

Objective: To provide a surveillance update of illness in a cohort of returned Canadian travellers and new immigrants.

Methods: Data on returning Canadian travellers and new immigrants presenting to a CanTravNet site between September 2011 and September 2012 were extracted and analyzed by destination, presenting symptoms, common and emerging infectious diseases and disease severity.

Active MR-temperature feedback control of dynamic interstitial ultrasound therapy in brain: in vivo experiments and modeling in native and coagulated tissues.

Purpose: The recent clinical emergence of minimally invasive image-guided therapy has demonstrated promise in the management of brain metastasis, although control over the spatial pattern of heating currently remains limited. Based on experience in other organs, the delivery of high-intensity contact ultrasound energy from minimally invasive applicators can enable accurate spatial control of energy deposition, large treatment volumes, and high treatment rate. In this acute study, the feasibility of active MR-Temperature feedback control of dynamic ultrasound heat deposition for interstitial thermal ablation in brain was evaluatedin vivo.