Brain Function Outcomes of Recent and Lifetime Cannabis Use.

Importance: Cannabis use has increased globally, but its effects on brain function are not fully known, highlighting the need to better determine recent and long-term brain activation outcomes of cannabis use.

Objective: To examine the association of lifetime history of heavy cannabis use and recent cannabis use with brain activation across a range of brain functions in a large sample of young adults in the US.

Design, Setting, And Participants: This cross-sectional study used data (2017 release) from the Human Connectome Project (collected between August 2012 and 2015).

Staging at Diagnosis and Survival of Hematologic Neoplasms in Children and Adolescents in Mato Grosso, Brazil: A Population-based Study.

Objective: To apply the Toronto Childhood Cancer Staging Guidelines (TG) and Estimate the Observed Survival Probabilities for Pediatric Patients with Leukemia and Lymphoma.

Methods: Staging at diagnosis was conducted according to tier 2 of the TG. The study cohort included patients aged 0 -19 years from the Population-Based Cancer Registry (PBCR) of Mato Grosso, diagnosed with leukemia and lymphoma between 2008 and 2017, with follow-up until December 31, 2022.

The role of circular RNAs in autoimmune diseases: Potential diagnostic biomarkers and therapeutic targets.

With the emergence of high-quality sequencing technologies, further research on transcriptomes has become possible. Circular RNA (circRNA), a novel type of endogenous RNA molecule with a covalently closed circular structure through "back-splicing," is reported to be widely present in eukaryotic cells and participates mainly in regulating gene and protein expression in various ways. It is becoming a research hotspot in the non-coding RNA field.

In vitro evaluation of antimicrobial photodynamic therapy with photosensitizers and calcium hydroxide on bond strength, chemical composition, and sealing of glass-fiber posts to root dentin.

Investigate the impact of antimicrobial photodynamic therapy (aPDT) using different photosensitizers (PSs) such as indocyanine green (IG), curcumin (CC), and methylene blue (MB), with or without intracanal application of calcium hydroxide (CH), on the push-out bond strength of glass-fiber posts (GFPs) to intraradicular dentin, the chemical composition of the root substrate, and the sealing of the adhesive interface across different thirds of intraradicular dentin. A total of 112 bovine teeth underwent biomechanical preparation and were divided into eight experimental groups (n = 14 each): Negative control with deionized water; positive control with deionized water + CH; IG group with indocyanine green and infrared laser; IG + CH group; CC group with curcumin and blue LED; CC + CH group; MB group with methylene blue and red laser; and MB + CH group. The push-out bond strength was measured using a universal testing machine (n = 8), and scanning electron microscopy characterized the fracture patterns.

Use of AI in Cardiac CT and MRI: A Scientific Statement from the ESCR, EuSoMII, NASCI, SCCT, SCMR, SIIM, and RSNA.

Artificial intelligence (AI) offers promising solutions for many steps of the cardiac imaging workflow, from patient and test selection through image acquisition, reconstruction, and interpretation, extending to prognostication and reporting. Despite the development of many cardiac imaging AI algorithms, AI tools are at various stages of development and face challenges for clinical implementation. This scientific statement, endorsed by several societies in the field, provides an overview of the current landscape and challenges of AI applications in cardiac CT and MRI.

Should Low-Risk Pregnant Patients be Screened for Asymptomatic Bacteriuria?

AbstractScreening and treatment of asymptomatic bacteriuria is generally not recommended due to a lack of clinical benefit and potential harm. A notable exception is the recommendation for routine screening during pregnancy. In this Tomorrow's Trial, the authors review the relevant evidence and propose a trial to address the question, "should low-risk pregnant patients be screened for asymptomatic bacteriuria?"

Efficacy and Safety of Mechanical Thrombectomy in Distal Medium Middle Cerebral Artery Occlusion Ischemic Stroke Patients on Low-Dose Aspirin.

Background: Acute ischemic stroke (AIS) from distal medium vessel occlusion (DMVO) presents unique treatment challenges. Mechanical thrombectomy (MT) is emerging as a viable option for these patients, yet the role of pre-stroke aspirin treatment is unclear. This study evaluates the impact of pre-stroke low-dose aspirin on outcomes in DMVO patients undergoing MT.

Effectiveness of Anti-Inflammatory Agents to Prevent Atrial Fibrillation After Cardiac Surgery: A Systematic Review and Network Meta-Analysis.

Background: Preventing postoperative atrial fibrillation (POAF) as one of the most significant complications of cardiovascular surgeries remains a major clinical challenge. We conducted a systematic review with network meta-analysis of randomized controlled trials, to identify the most effective and safe anti-inflammatory drugs to prevent new-onset POAF.

Methods: MEDLINE, Embase, Web of Science, and Cochrane Library were searched without language or publication-date restriction on August 8, 2022 (updated on August 8, 2023).

Management of Patients with Myocardial Injury After Noncardiac Surgery: A Retrospective Chart Review.

Background: Myocardial injury after noncardiac surgery (MINS) is associated with an increased incidence of cardiac morbidity and mortality. Little is known about how these patients are managed.

Methods: We performed a single-centre retrospective chart review of patients referred to a postoperative clinic with the diagnosis of MINS.

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Background: Out-of-hospital cardiac arrest (OHCA) remains a prominent medical concern worldwide. Epidemiologic metrics and trends over time for OHCA cases in Canada are not well defined. This study evaluated geographic differences in the incidence and outcomes of OHCA patients admitted to hospitals across Canada, during the period 2013-2017.

Implementation of a Sudden Cardiac Death Risk Prediction Tool in Clinical Practice Through Electronic Health Records (INSERT-HCM Study Design).

Sudden cardiac death is a leading cause of mortality in children with hypertrophic cardiomyopathy (HCM). The PRecIsion Medicine in CardiomYopathy consortium developed a validated tool (PRIMaCY) for sudden cardiac death risk prediction to help with implantable cardioverter defibrillator shared decision-making, as recommended by clinical practice guidelines. The mplemeting a udden Cardiac Dath isk Assessment ool in hildhood (INSERT-HCM) study aims to implement PRIMaCY into electronic health records (EHRs) and assess implementation determinants and outcomes.

The Canadian Heart Failure (CAN-HF) Registry: A Canadian Multicentre, Retrospective Study of Outpatients with Heart Failure.

Background: Guideline-directed medical therapy (GDMT) reduces events in patients with heart failure (HF) with reduced ejection fraction (HFrEF). Despite this impact, underutilization of GDMT persists. This report sought to describe HF management in Canadian outpatients treated at specialized HF clinics (HFCs).

Cardiovascular Implications of Non-steroidal Anti-inflammatory Drugs: A Comprehensive Review, with Emphasis on Patients with Rheumatoid Arthritis.

This review examines the cardiovascular risks associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs), both traditional NSAIDs and cyclooxygenase-2 selective inhibitors (COXIBs). It describes the history of traditional NSAIDs and the development of COXIBs to explain why their cardiovascular side effects were unnoticed for many decades. Further, the review presents the mechanism of action of NSAIDs, to elucidate the possible underlying basis for why they are associated with an increased risk of cardiovascular disease.

Engaging older adults in diagnostic safety: implementing a diagnostic communication note sheet in a primary care setting.

Introduction: Adults over the age of 65 are at a higher risk for diagnostic errors due to a myriad of reasons. In primary care settings, a large contributor of diagnostic errors are breakdowns in information gathering and synthesis throughout the patient-provider encounter. Diagnostic communication interventions, such as the Agency for Healthcare Research and Quality's "Be the Expert on You" note sheet, may require adaptations to address older adults' unique needs.

Striving for early effective glycaemic and weight management in type 2 diabetes: A narrative review.

Despite the recognition by key guidelines that achieving early glycaemic control has important benefits in individuals with type 2 diabetes (T2D) and that addressing excess adiposity is one of the central components of comprehensive person-centred T2D care, a substantial proportion of individuals with T2D do not meet their metabolic treatment goals. Prior treatment paradigms were limited by important treatment-associated risks such as hypoglycaemia and body weight gain. Therefore, a more conservative, sequential approach to treatment was typically utilized.

Association between prescribed stimulant medications and overdose among individuals receiving opioid agonist therapy: A retrospective cohort study from British Columbia, Canada.

Aims: We measured the association between prescribed stimulant medications and overdose among individuals receiving opioid agonist therapy (OAT) for opioid use disorder.

Design: Retrospective cohort study using the British Columbia Provincial Overdose Cohort, a linked administrative database.

Setting: We used data from British Columbia, Canada, from January 2015 through February 2020.

Population-Based Analysis of the Risk of Mycobacterial Infections Associated With Immune Checkpoint Inhibitors.

In this population-based study, we examined the risk of nontuberculous mycobacterial disease associated with immune checkpoint inhibitors among people with cancer. Using a nested case-control design, we identified 184 cases and 714 matched controls; there was no significant association on conditional logistic regression (adjusted odds ratio, 0.51 [95% confidence interval, .

Peritoneal dialysis and kidney transplantation: Your questions answered.

Peritoneal dialysis (PD) and kidney transplantation are important therapeutic options in patients with advanced kidney disease. This article delineates the relationship between PD and kidney transplantation in several key domains, including: (1) Comparative merits and limitations of PD versus center-based hemodialysis prior to kidney transplantation, (2) Patient outcomes after kidney transplantation in individuals receiving PD prior to kidney transplantation, (3) Perioperative management strategies of patients receiving PD at the time of kidney transplantation, and (4) The relative advantages and clinical outcomes of PD use following kidney allograft failure compared to other modalities. This article aims to provide comprehensive guidance for optimizing care across the PD-kidney transplant transitions continuum.

Robotic surgery for paediatric neurogenic lower urinary tract dysfunction: a systematic review.

Objective: To evaluate in a systematic review the outcomes, benefits, and limitations of robot-assisted surgeries for paediatric neurogenic lower urinary tract dysfunction (LUTD), as robot-assisted techniques have emerged as a potential alternative, offering enhanced precision, dexterity, and visualisation.

Methods: This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO identifier CRD42023464849) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included studies of paediatric patients (aged <18 years) with neurogenic LUTD undergoing robot-assisted continence surgery, assessing safety and efficacy.

Perioperative and periprocedural management of GLP-1 receptor-based agonists and SGLT2 inhibitors: narrative review and the STOP-GAP and STOP DKA-2 algorithms.

The GLP-1 receptor-based agonists (GLP-1RAs) and SGLT2 inhibitors (SGLT2i) are major 21 century breakthroughs in diabetes and obesity medicine but there are important safety considerations regarding the perioperative and periprocedural management of individuals who are treated with these agents. GLP-1RAs have been linked to an increased risk of retained gastric contents and pulmonary aspiration while SGLT2i can be associated with diabetic ketoacidosis. This manuscript provides a narrative review of the available evidence for perioperative and periprocedural risks in people prescribed GLP-1RAs and SGLT2i.

Secondary Immunodeficiency.

The field of medicine is constantly changing and, as healthcare providers, we are fortunate to be practicing in a time when patients are living longer and novel therapeutic options continue to evolve. However, these new advances may be associated with adverse effects that practitioners need to be aware of. Some of these impair the immune system leading to secondary immunodeficiencies (SID) that increase host susceptibility to infections and other complications.