Atrial structure and function in middle-aged, physically-active males and females: A cardiac magnetic resonance study.

Recent studies have reported on an association between endurance sport, atrial enlargement and the development of lone atrial fibrillation in younger, male cohorts. The atrial morphology and function of middle-aged, physically-active males and females have not been well studied. We hypothesized that middle-aged males would demonstrate larger left atrium (LA) and right atrium (RA) volumes compared to females, but atrial function would not differ. LA and RA volume and function were evaluated at rest in healthy adults, using a standardized 3.0Tesla cardiac magnetic resonance protocol. Physical activity, medical history, and maximal oxygen consumption ( V ˙ O 2 peak ) were also assessed. Physically-active, middle-aged men (n = 60; 54 ± 5 years old) and women (n = 30; 54 ± 5 years old) completed this study. Males had a higher body mass index, systolic blood pressure, and V ˙ O 2 peak than females (p < .05 for all), despite similar reported physical activity levels. Absolute and BSA and height-indexed LA and RA maximum volumes were higher in males relative to females, despite no differences in ejection fractions (p < .05 for all). In multivariable regression, male sex p < .001) and V ˙ O 2 peak (p = .004) were predictors of LA volume (model R2  = 0.252), whereas V ˙ O 2 peak (p < .001), male sex (p = .03), and RV EF (p < .05) were predictors of RA volume (model R2  = 0.377). While middle-aged males exhibited larger atrial volumes relative to females, larger, prospective studies are needed to explore the magnitude of physiologic atrial remodeling and functional adaptations in relation to phenotypic factors.

Evaluating Trends in COVID-19 Research Activity in Early 2020: The Creation and Utilization of a Novel Open-Access Database.

Introduction The coronavirus disease 2019 (COVID-19) pandemic has been unprecedented in recent history. The rapid global spread has demonstrated how the emergence of a novel pathogen necessitates new information to advise both healthcare systems and policy-makers. The directives for the management of COVID-19 have been limited to infection control measures and treatment of patients, which has left physicians and researchers alone to navigate the massive amount of research being published while searching for evidence-based strategies to care for patients. To tackle this barrier, we launched CovidReview.ca, an open-access, continually updated, online platform that screens available COVID-19 research to determine higher quality publications. This paper uses data from this review process to explore the activity and trends of COVID-19 research worldwide over time, while specifically looking at the types of studies being published. Materials and Methods The literature search was conducted on PubMed. Search terms included "COVID-19", "severe acute respiratory syndrome coronavirus 2", "coronavirus 19", "SARS-COV-2", and "2019-nCoV". All articles captured by this strategy were reviewed by a minimum of two reviewers and categorized by type of research, relevant medical specialties, and type of publication. Criteria were developed to allow for inclusion or exclusion to the website. Due to the volume of research, only a level 1 (title and abstract) screen was performed. Results The time period for the analysis was January 17, 2020, to May 10, 2020. The total number of papers captured by the search criteria was 10,685, of which 2,742 were included on the website and 7,943 were excluded. The greatest increase in the types of studies over the 16 weeks was narrative review/expert opinion papers followed by case series/reports. Meta-analyses, systematic reviews, and randomized controlled trials remained the least published types of studies. Conclusions The surge of research that accompanied the COVID-19 pandemic is unparalleled in recent years. From our analysis, it is clear that case reports and narrative reviews were the most widely published, particularly in the earlier days of this pandemic. Continued research that falls higher on the evidence pyramid and is more applicable to clinical settings is warranted.

Scholarly activity as a selection criterion in the Canadian Residency Matching Service (CaRMS): A review of published criteria by internal medicine, family medicine, and pediatrics programs.

BACKGROUND: Undergraduate medical students seek as much information as possible as to how residency programs select candidates. The Canadian Residency Matching Service (CaRMS) website is one of their primary sources of information. Students may be more competitive in the match if they know whether scholarly activity is used in the selection process by their preferred programs, as described on the CaRMS website. METHODS: For all 17 Canadian faculties of medicine, 2019 R1 entry internal medicine, family medicine and pediatrics program descriptions were reviewed on the CaRMS website looking for keywords related to scholarly activity. RESULTS: Forty-one percent of family medicine, 65% of internal medicine and 71% of pediatric programs explicitly stated having interest in applicants with scholarly experience. In Western Canada, 80% of internal medicine and 60% of pediatrics programs included scholarly activity in their CaRMS description of criteria considered in ranking applications. Similarly, in Ontario, 66% of internal medicine and 83% of pediatrics programs mentioned scholarly activity as a valuable quality. In Quebec 100% of family medicine and 50% of pediatrics programs include scholarly activity in their descriptions. Pediatrics and family medicine programs (100%) in Atlantic Canada mentioned scholarly activities but neither of the two Atlantic Canada internal medicine programs mentioned scholarly activities. CONCLUSION: Undergraduate medical students can use this project to prioritize extracurricular activities and scholarly work to be competitive for application to family medicine, internal medicine and pediatrics residency programs.

CONTEXTE: Les étudiants de premier cycle en médecine cherchent autant de renseignements que possible sur la manière dont les programmes de résidence sélectionnent les candidats. Le site Web du Service canadien de jumelage des résidents (CaRMS) représente l'une de leur principale source de renseignements. Les étudiants peuvent être plus compétitifs dans le jumelage s'ils savent comment les activités d'érudition sont utilisées dans le processus de sélection par leurs programmes préférés, comme il est décrit sur le site Web de CaRMS. MÉTHODES: Pour l'ensemble des 17 facultés de médecine canadiennes, les descriptions des programmes d'entrée R1 de 2019 en médecine interne, en médecine familiale et en pédiatrie ont été examinées sur le site Web du CaRMS pour la recherche de mots clés liés aux activités d'érudition. RÉSULTATS: 41 % des programmes de médecine familiale, 65 % de ceux en médecine interne et 71 % de ceux en pédiatrie énonçaient explicitement avoir un intérêt pour les candidats avec une expérience en érudition. Dans l'Ouest canadien, 80 % des programmes en médecine interne et 60 % de ceux en pédiatrie comportaient une activité d'érudition dans leur description CaRMS des critères dont ils tenaient compte dans le classement des demandes. De même, en Ontario, 66 % des programmes en médecine interne et 83 % de ceux en pédiatrie mentionnaient que les activités d'érudition représentaient une qualité importante. Au Québec, 100 % des programmes en médecine familiale et 50 % de ceux en pédiatrie présentent une activité d'érudition dans leur description. Les programmes de pédiatrie et de médecine familiale (100 %) dans le Canada atlantique mentionnent les activités scientifiques, mais aucun des deux programmes de médecine interne du Canada atlantique ne mentionnait des activités scientifiques. CONCLUSION: Les étudiants de premier cycle en médecine peuvent utiliser le présent projet pour prioriser leurs activités extracurriculaires et le travail d'érudition pour être compétitifs lors de leurs applications dans des programmes de médecine familiale, de médecine interne et de pédiatrie.

Myalgia and Hematuria in Association with Clonidine and Arginine Administration for Growth Hormone Stimulation Tests.

Growth hormone deficiency (GHD) in children has significant impacts on growth and metabolism. Two-agent GH stimulation tests are commonly used to diagnose GHD, and these tests are generally considered safe. We report the case of a 5-year 5-month-old boy with a history of anaplastic ependymoma who underwent GH stimulation testing for growth deceleration using clonidine and arginine. He developed bilateral calf myalgia and gross hematuria within 24 hours of the tests. Myalgia and hematuria resolved spontaneously. Importantly, the literature review and database searches for hematuria identified 6 cases with clonidine and 20 cases with arginine. This case highlights an unusual combination of adverse reactions to clonidine and arginine in children undergoing GH stimulation testing to assess for GHD. Pediatric endocrinologists need to be aware of the potential for these side effects to allow appropriate management, and further studies are needed to clarify the mechanisms and frequency of these side effects. We recommend that patients and families need to be counselled about hematuria as an association of GH testing with these medications.