Economic implications of endovenous great saphenous ablation in a public health care system.

Background: In mid-2007, endovenous ablation (EVA) of the great saphenous vein was introduced into the publicly funded health care system in Saskatchewan, Canada. We hypothesize that the introduction of EVA resulted in a decrease in use of high ligation and stripping (HL/S), decreased costs to the health care system, and increased demand of patients for great saphenous vein ablative procedures.

Methods: We retrospectively reviewed administrative data to capture cases of HL/S between 2003 and 2014 and cases of EVA of the great saphenous vein (endovenous laser treatment and radiofrequency ablation) between 2007 and 2014.

Open Family Presence Adoption: Role of Patient and Family Advisors.

The philosophy of patient- and family-centred care is widely being adopted in Canada. Critical to this philosophy is the engagement of patients and families as full partners in healthcare. Saskatchewan has successfully adopted a provincial policy that eliminates restrictive visiting hours in hospitals and other healthcare facilities that support partnership with patients and families.

Hemothorax due to Ruptured Mycotic Aneurysm of Intercostal Arteries Associated with Infective Endocarditis.

We present a case of hemothorax due to ruptured mycotic aneurysm in three intercostal arteries in a 40-year-old male with methicillin-resistant infective endocarditis (IE) due to intravenous drug use. Microcoil embolization and thoracotomy successfully achieved hemostasis. Mycotic aneurysm is a rare complication of IE and is usually found in the intracranial vessels.

Protein purification and analysis: next generation Western blotting techniques.

Western blotting is one of the most commonly used techniques in molecular biology and proteomics. Since western blotting is a multistep protocol, variations and errors can occur at any step reducing the reliability and reproducibility of this technique. Recent reports suggest that a few key steps, such as the sample preparation method, the amount and source of primary antibody used, as well as the normalization method utilized, are critical for reproducible western blot results.

Glomerular Endothelium and its Impact on Glomerular Filtration Barrier in Diabetes: Are the Gaps Still Illusive?

Background: Glomerular capillaries are lined with highly specialized fenestrated endothelium which are primarily responsible to regulate high flux filtration of fluid and small solutes. During filtration, plasma passes through the fenestrated endothelium and basement membrane before it reaches the slit diaphragm, a specialized type of intercellular junction that connects neighbouring podocytes.

Methods: A PubMed search was done for recent articles on components of the glomerular filtration barrier such as glomerular endothelial cells, podocytes and glomerular basement membrane, and the effect of diabetes on these structures.

Integrated genome and transcriptome sequencing identifies a noncoding mutation in the genome replication factor as the cause of microcephaly-micromelia syndrome.

While next-generation sequencing has accelerated the discovery of human disease genes, progress has been largely limited to the "low hanging fruit" of mutations with obvious exonic coding or canonical splice site impact. In contrast, the lack of high-throughput, unbiased approaches for functional assessment of most noncoding variants has bottlenecked gene discovery. We report the integration of transcriptome sequencing (RNA-seq), which surveys all mRNAs to reveal functional impacts of variants at the transcription level, into the gene discovery framework for a unique human disease, microcephaly-micromelia syndrome (MMS).

Development of a program theory for shared decision-making: a realist review protocol.

Background: The practicality of applying evidence to healthcare systems with the aim of implementing change is an ongoing challenge for practitioners, policy makers, and academics. Shared decision- making (SDM), a method of medical decision-making that allows a balanced relationship between patients, physicians, and other key players in the medical decision process, is purported to improve patient and system outcomes. Despite the oft-mentioned benefits, there are gaps in the current literature between theory and implementation that would benefit from a realist approach given the value of this methodology to analyze complex interventions.

Endoscopic Clip MRI Screening: A Canada-Wide Policy Survey.

Objective: Not all endoscopically placed clips are MRI compatible, so screening for endoscopic clips before MRI is recommended. The purpose of this study was to assess endoscopic clip screening practices at Canadian MRI centers, including number of centers that screen, specific screening methods, perceived safety of endoscopic clip models, and practices for dealing with confirmed gastrointestinal endoscopic clips.

Materials And Methods: A bilingual online survey was distributed to Canadian MRI centers to assess site demographics, endoscopic clip screening practices, safety considerations for different endoscopic clip models, protocols for dealing with patients with endoscopic clips, and the perceived value of screening.

Clinical, genetic, and structural basis of congenital adrenal hyperplasia due to 11β-hydroxylase deficiency.

Congenital adrenal hyperplasia (CAH), resulting from mutations in , a gene encoding 11β-hydroxylase, represents a rare autosomal recessive Mendelian disorder of aberrant sex steroid production. Unlike CAH caused by 21-hydroxylase deficiency, the disease is far more common in the Middle East and North Africa, where consanguinity is common often resulting in identical mutations. Clinically, affected female newborns are profoundly virilized (Prader score of 4/5), and both genders display significantly advanced bone ages and are oftentimes hypertensive.

Synergistic Interaction Between Heme Oxygenase (HO) and Nuclear-Factor E2- Related Factor-2 (Nrf2) against Oxidative Stress in Cardiovascular Related Diseases.

Background: Nuclear factor-erythroid related factor-2 (Nrf2) is a master regulator of transcriptional activation of anti-oxidants in cells. Similarly, heme oxygenase (HO) is a cytoprotective protein with anti-oxidant effects. This review article will shed more light on the interaction between Nrf2 and HO.

Comments on Public Health Aspects of Paediatric Dental Treatment under General Anaesthesia. Dent. J. 2016, 4, 20.

I would like to comment on an article by Thomson [1] recently published in Dentistry Journal.[..

Interprofessional Skills Learning Guide: A Multimedia E-Book for Small-Group or Individual Learning.

Introduction: Redefining learning space beyond physical classrooms with fixed resources is necessary to address challenges of interprofessional learning in a clinical setting. This multimedia e-book introduces recognized team skills of shared mental models, situational awareness, and the SBAR (situation, background, assessment, and recommendation) communication tool for individual or small-group learning. The e-book was derived from work done to develop an interprofessional small-group interactive learning tool for use in a clinical environment where resources, including meeting space, time, and facilitators, were limited.

The Upstream Hospital Leader: Taking Action to Improve Population Health.

Canadian hospital leaders face numerous barriers when they seek to work upstream in an effort to improve population health. A noted challenge is lack of role clarity. We introduce the concept of an "upstream hospital leader" in an attempt to address this challenge, and suggest behaviours for how this role can advance population health at the individual, organizational and health system levels.

Heme oxygenase in cardiac repair and regeneration.

The incidence of cardiac complications such as myocardial infarction and congestive heart failure is increasing. Once congestive heart failure emerges, little can be done to improve long-term cardiac function. The cellular basis of this downward spiral may be the dramatic loss of viable cardiomyocytes following acute ischemia and/or chronic apoptosis/necrosis which are not adequately replaced.

The 5Cs of Consultation: Training Medical Students to Communicate Effectively in the Emergency Department.

Background: Effective communication is critical for health care professionals, particularly in the Emergency Department (ED). However, currently, there is no standardized consultation model that is consistently practiced by physicians or used for training medical graduates. Recently, the 5Cs of Consultation model (Contact, Communicate, Core Question, Collaborate, and Close the Loop) has been studied in Emergency Medicine residents using simulated consultation scenarios.

Patient and observer scar assessment scores favour the late appearance of a transverse cervical incision over a vertical incision in patients undergoing carotid endarterectomy for stroke risk reduction.

Background: Carotid endarterectomy (CEA) is a very common operation, but there is no agreement on the appropriate orientation of the surgical incision.

Methods: We retrospectively reviewed the charts of patients who had undergone CEA between Jul. 1, 2010, and Dec.

Critical care capacity in Canada: results of a national cross-sectional study.

Introduction: Intensive Care Units (ICUs) provide life-supporting treatment; however, resources are limited, so demand may exceed supply in the event of pandemics, environmental disasters, or in the context of an aging population. We hypothesized that comprehensive national data on ICU resources would permit a better understanding of regional differences in system capacity.

Methods: After the 2009-2010 Influenza A (H1N1) pandemic, the Canadian Critical Care Trials Group surveyed all acute care hospitals in Canada to assess ICU capacity.

Heme Oxygenase Improves Renal Function by Potentiating Podocyte-Associated Proteins in Nω-Nitro-l-Arginine-Methyl Ester (l-NAME)-Induced Hypertension.

Background: Although heme-oxygenase (HO) is cytoprotective, its effects on podocyte regulators like podocalyxin, podocin, CD2-associated protein (CD2AP) in renal dysfunction in N (ω)-nitro-l-arginine-methyl ester (l-NAME) hypertension are largely unclear.

Methods: Hypertension was induced in normotensive Sprague Dawley rats by administering l-NAME for 4 weeks. Enzyme immunoassay, enzyme-linked immunosorbent, histology/morphology, spectrophotometry, and western immunoblotting were used.

Mechanisms by which heme oxygenase rescue renal dysfunction in obesity.

Obesity and excessive inflammation/oxidative stress are pathophysiological forces associated with kidney dysfunction. Although we recently showed that heme-oxygenase (HO) improves renal functions, the mechanisms are largely unclear. Moreover, the effects of the HO-system on podocyte cytoskeletal proteins like podocin, podocalyxin, CD2-associated-protein (CD2AP) and proteins of regeneration/repair like beta-catenin, Oct3/4, WT1 and Pax2 in renal tissue from normoglycemic obese Zucker-fatty rats (ZFs) have not been reported.