Rapid COVID-19 testing: Speed, quality and cost. Can you have all three?

KEY MESSAGES.

Designing Biomaterials to Modulate Notch Signaling in Tissue Engineering and Regenerative Medicine.

The design of cell-instructive biomaterials for tissue engineering and regenerative medicine is at a crossroads. Although the conventional tissue engineering approach is top-down (cells seeded to macroporous scaffolds and mature to form tissues), bottom-up tissue engineering strategies are becoming appealing. With such developments, we can study cell signaling events, thus enabling functional tissue assembly in physiologic and diseased models.

Teaching family medicine residents about care of adults with intellectual and developmental disabilities.

Problem Addressed: Adults with intellectual and developmental disabilities (IDD), a group with complex health problems and inequities in access to health care, look to family physicians for primary care.

Objective Of Program: To enable residents to learn and demonstrate competencies that are unique to the care of adults with IDD with minimal extra time and resources required of the residency program.

Program Description: In their regular family medicine teaching practices, residents undertake planned encounters with adults with IDD involving comprehensive health assessments with physical examinations.

Step Rate and Worsening of Patellofemoral and Tibiofemoral Joint Osteoarthritis in Women and Men: The Multicenter Osteoarthritis Study.

Objective: To determine the association of self-selected walking step rate with worsening of cartilage damage in the patellofemoral (PF) joint and tibiofemoral (TF) joint compartments at a 2-year follow-up visit.

Methods: The Multicenter Osteoarthritis Study (MOST) is a prospective cohort of men and women with or at risk of knee osteoarthritis. Self-selected step rate was measured using an instrumented GAITRite walkway (CIR Systems) at the 60-month visit.

Fecal Calprotectin Responses Following Induction Therapy With Vedolizumab in Moderate to Severe Ulcerative Colitis: A Post Hoc Analysis of GEMINI 1.

Background: In patients with ulcerative colitis (UC), fecal calprotectin (FC) concentrations correlate with endoscopic inflammation evidence. This study investigated the effect of vedolizumab induction on FC concentrations and whether FC concentrations could be a reliable surrogate measure of disease status.

Methods: Data from the placebo-controlled, phase 3 trial GEMINI 1 were used to evaluate week-6 relationships between outcomes (including clinical remission, mucosal healing [MH], and endoscopic remission) and both absolute FC concentration values and relative FC concentration changes from baseline (%FC0-6).

Adipose-Derived Stem Cells in a Resilient In Situ Forming Hydrogel Modulate Macrophage Phenotype.

Injectable hydrogels have the potential to enhance stem cell-based therapies by improving cell localization, retention, and survival after transplantation. The inflammatory response to both the hydrogel and the encapsulated cells is a critical aspect of this strategy, with macrophages being highly involved in the process of hydrogel remodeling, angiogenesis, and tissue regeneration. As a step toward the development of a cell-based strategy for therapeutic angiogenesis, this work compared the intramuscular injection of allogeneic rat adipose-derived stem/stromal cells (rASCs) in an in situ gelling hydrogel with the injection of the hydrogel alone and rASCs in saline in an immunocompetent rat model by immunohistochemical analysis over 4 weeks.

Durability and survival are similar after elective endovascular and open repair of abdominal aortic aneurysms in younger patients.

Objective: The role of endovascular repair (EVAR) of aortic aneurysms in young patients is controversial. The purpose of this study was to determine the long-term outcomes and reintervention rates in patients 60 years of age or younger who underwent elective open or endovascular repair of an abdominal aortic aneurysm.

Methods: Retrospective review of a prospectively collected vascular surgery database at a university-affiliated medical center was performed to identify all patients who underwent elective repair of an abdominal aortic aneurysm between 2000 and 2013 and were 60 years of age or younger at the time of the repair.

Natural history of minimal aortic injury following blunt thoracic aortic trauma.

Background: Endovascular repair of blunt traumatic thoracic aortic injuries (BTAI) is common at most trauma centres, with excellent results. However, little is known regarding which injuries do not require intervention. We reviewed the natural history of untreated patients with minimal aortic injury (MAI) at our centre.

Late conversion of endovascular to open repair of abdominal aortic aneurysms.

Background: Failure of endovascular repair (EVAR) of an abdominal aortic aneurysm can result in significant risk of morbidity and mortality. We review our experience with late conversions to open repair.

Methods: We conducted a retrospective database review to identify all EVAR procedures performed between 1997 and 2010 and the number converted to open repair at our university-affiliated medical centre.

Trends in management of abdominal aortic aneurysms.

Objective: The purpose of this study was to evaluate patients undergoing elective repair of infrarenal abdominal aortic aneurysms (AAAs) and the longitudinal trends in surgical management (open repair vs endovascular aneurysm repair [EVAR]), factors associated with the choice of surgical technique, and differences in the rate of in-hospital mortality at a single large-volume Canadian center.

Methods: This retrospective cohort study used data from a prospectively collected vascular surgery database and reviewed all patients undergoing elective repair of an infrarenal AAA over a recent 10-year period (June 2000-May 2010). Information was reviewed regarding surgical techniques, patient demographics, and short-term outcomes.

Gait assessment in mild cognitive impairment and Alzheimer's disease: the effect of dual-task challenges across the cognitive spectrum.

Gait impairment is a prominent falls risk factor and a prevalent feature among older adults with cognitive impairment. However, there is a lack of comparative studies on gait performance and fall risk covering the continuum from normal cognition through mild cognitive impairment (MCI) to Alzheimer's disease (AD). We evaluated gait performance and the response to dual-task challenges in older adults with AD, MCI and normal cognition without a history of falls.

miR-146a-Mediated extracellular matrix protein production in chronic diabetes complications.

Objective: MicroRNAs (miRNAs), through transcriptional regulation, modulate several cellular processes. In diabetes, increased extracellular matrix protein fibronectin (FN) production is known to occur through histone acetylator p300. Here, we investigated the role of miR-146a, an FN-targeting miRNA, on FN production in diabetes and its relationship with p300.

Prospective evaluation of consultant surgeon sleep deprivation and outcomes in more than 4000 consecutive cardiac surgical procedures.

Objective: To determine the effect of consultant surgeon sleep hours on patient outcomes in cardiac surgery.

Design: Prospective observational cohort study.

Subjects: Between January 2004 and December 2009, we prospectively collected sleep hours of 6 consultant surgeons, ranging in age from 32 to 55 years, working in a tertiary care academic institution.

The role of platelet-rich plasma in inguinal wound healing in vascular surgery patients.

The objective was to determine whether incision application of platelet-rich plasma (PRP) will decrease postoperative wound complications in vascular surgery patients. A prospective, randomized trial randomized 81 incisions in 51 patients who underwent femoral artery exposure for elective revascularization procedures or endovascular abdominal aneurysm repairs. Incidence of diabetes, chronic renal failure, prosthetic grafts, body mass index (BMI), and steroid use did not differ.

Patient attitudes towards the arteriovenous fistula: a qualitative study on vascular access decision making.

Background: The use of arteriovenous fistulas (AVFs) among hemodialysis (HD) patients has been consistently associated with lower rates of morbidity and mortality; however, up to 30% of eligible patients refuse the creation or cannulation of an AVF. We aimed to understand the attitudes, beliefs, preferences and values of patients who refused creation or use of an AVF.

Methods: With qualitative methodology, we conducted semi-structured interviews with 13 HD patients (Canada, 2009), who previously refused creation or use of an AVF.

A validation study of the Canadian Organ Replacement Register.

Background And Objectives: Accurate and complete documentation of patient characteristics and comorbidities in renal registers is essential to control bias in the comparison of outcomes across groups of patients or dialysis facilities. The objectives of this study were to assess the quality of data collected in the Canadian Organ Replacement Register (CORR) compared with the patient's medical charts.

Design, Setting, Participants, & Measurements: This cohort study of a representative sample of adult, incident patients registered in CORR in 2005 to 2006 examined the prevalence, sensitivity, specificity, positive and negative predictive values, and κ of comorbid conditions and agreement in coding of patient demographics and primary renal disease between CORR and the patient's medical record.

Midterm results of the Zenith endograft in relation to neck length.

Background: Successful endovascular repair of abdominal aortic aneurysms (AAAs) requires specific infrarenal neck anatomy to allow for a durable seal and fixation. This is a single-center study reviewing outcomes in relation to neck length after placement of a Zenith endograft.

Methods: Retrospective single-center review of all AAAs electively repaired with a Zenith endograft during a recent 5-year period.

Early mortality following endovascular versus open repair of ruptured abdominal aortic aneurysms.

Purpose: To determine whether endovascular repair (EVAR) offers a survival advantage over open repair (OAR) with ruptured abdominal aortic aneurysms (RAAA).

Methods: Retrospective analysis of RAAA patients treated between 2003 and 2008. Univariate and multivariate analyses were performed.

The measurement of hemodialysis access blood flow by a conductivity step method.

Background And Objectives: Measurement of blood flow rate (Qa) is used to monitor dialysis access, AV fistulas, and grafts. Indicator dilution measurements of the recirculation (R) induced by reversal of hemodialysis blood lines are commonly used. This plus the dialysis circuit flow (Qb) allows calculation of Qa.

Economic evaluation of open vs endovascular repair of blunt traumatic thoracic aortic injuries.

Objectives: During the last decade, endovascular repair (EV) has replaced open surgical repair (OSR) as the preferred method of treatment of blunt traumatic thoracic aortic injuries (BTAIs) at many trauma centers. This has resulted in reductions in mortality, length of stay, and major complications, including paraplegia, with the added expense of the initial endograft, subsequent surveillance, and reinterventions. The purpose of this study was to conduct an economic evaluation comparing these two methods of repair.

Informed consent: what level of risk to disclose with carotid artery endarterectomy?

You are asked to see a 65-year-old man with an asymptomatic high-grade carotid artery stenosis. He is otherwise quite healthy, is receiving appropriate medical management, and has no contraindications for surgery. You recommend a carotid endarterectomy (CEA) as the best prophylactic measure against stroke.