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This article aims to bridge existing knowledge gaps that impact clinical cardiovascular care and outcomes for women in Canada. The authors discuss various aspects of women’s heart health, emphasizing the efficacy of multidisciplinary care in promoting women’s well-being. The article also identifies the impact of national women’s heart health campaigns and the value of peer support in improving outcomes. The article addresses the particular risks that women face, such as pregnancy-related complications and hormone replacement therapy, all of which are associated with cardiovascular events, and highlights the differences in ischemic symptoms between men and women. Despite improvements in acute event outcomes, challenges persist in accessing timely ambulatory care, particularly for women. Canada has responded to these challenges by introducing Women Heart Programs, which offer tailored programs, support groups, and specialized testing. However, these programs remain few in number and are found only in urban settings. Overall, this review identifies sex and gender factors related to women’s heart health, underscoring the importance of specialized programs and multidisciplinary care in improving women’s cardiovascular health. RÉsumÉ: Cet article vise à répondre aux incertitudes actuelles qui se répercutent sur les soins cardiovasculaires et les issues cliniques chez les femmes au Canada. Les auteurs abordent différents aspects de la santé cardiaque des femmes, mettant l’accent sur l’efficacité des soins multidisciplinaires pour améliorer le bien-être des femmes. L’article présente également l’effet des campagnes nationales sur la santé cardiaque des femmes et l’importance de l’entraide entre collègues pour améliorer les résultats. L’article traite des risques particuliers touchant les femmes, comme les complications liées à la grossesse et l’hormonothérapie substitutive, qui sont toutes associées à des événements cardiovasculaires, et il souligne les différences entre les hommes et les femmes pour ce qui est des symptômes ischémiques. Bien que des améliorations aient été observées quant à l’issue des événements aigus, des difficultés persistent sur le plan de l’accès rapide à des soins ambulatoires, surtout pour les femmes. Le Canada a répondu à ces difficultés en créant des programmes pour la santé cardiaque des femmes, qui offrent des services adaptés, des groupes de soutien et des analyses spécialisées. Cependant, ils sont encore peu nombreux et accessibles seulement en milieu urbain. Dans l’ensemble, cette analyse définit les facteurs liés au sexe et au genre qui interviennent dans la santé cardiaque des femmes, soulignant l’importance de mettre en place des programmes spécialisés et des soins multidisciplinaires pour améliorer la santé cardiovasculaire des femmes.

BackgroundWhile lymph node metastasis is among the strongest predictors of disease-free and overall survival for patients with breast cancer, the immunological nature of tumor-draining lymph nodes is often ignored, and may provide additional prognostic information on clinical outcome.Methods and findingsWe performed immunohistochemical analysis of 47 sentinel and 104 axillary (nonsentinel) nodes from 77 breast cancer patients with 5 y of follow-up to determine if alterations in CD4, CD8, and CD1a cell populations predict nodal metastasis or disease-free survival. Sentinel and axillary node CD4 and CD8 T cells were decreased in breast cancer patients compared to control nodes. CD1a dendritic cells were also diminished in sentinel and tumor-involved axillary nodes, but increased in tumor-free axillary nodes. Axillary node, but not sentinel node, CD4 T cell and dendritic cell populations were highly correlated with disease-free survival, independent of axillary metastasis. Immune profiling of ALN from a test set of 48 patients, applying CD4 T cell and CD1a dendritic cell population thresholds of CD4 > or = 7.0% and CD1a > or = 0.6%, determined from analysis of a learning set of 29 patients, provided significant risk stratification into favorable and unfavorable prognostic groups superior to clinicopathologic characteristics including tumor size, extent or size of nodal metastasis (CD4, p < 0.001 and CD1a, p < 0.001). Moreover, axillary node CD4 T cell and CD1a dendritic cell populations allowed more significant stratification of disease-free survival of patients with T1 (primary tumor size 2 cm or less) and T2 (5 cm or larger) tumors than all other patient characteristics. Finally, sentinel node immune profiles correlated primarily with the presence of infiltrating tumor cells, while axillary node immune profiles appeared largely independent of nodal metastases, raising the possibility that, within axillary lymph nodes, immune profile changes and nodal metastases represent independent processes.ConclusionThese findings demonstrate that the immune profile of tumor-draining lymph nodes is of novel biologic and clinical importance for patients with early stage breast cancer.

Melanoma of the penis is an uncommon cancer. We present the case of a 73-year-old male with penile melanoma and non palpable lymph nodes. Lymphoscintigraphy was applied to locate the sentinel lymph nodes for dissection. His lymph nodes were negative for melanoma and he has been disease-free for 1 year with careful surveillance.

Byline: Denise Johnson McManus, Charles A. Snyder Data warehousing is believed to be a competitive necessity. The management of knowledge supports the competitive advantage of organisations. Therefore, the effective use of data warehousing to store knowledge can be instrumental in supporting the competitive advantage of companies. 'Ongoing management of the data warehouse with minimal adjustments to the data architecture and business users excited about their data are true indicators of project success'. Data warehousing can be used as a repository, which is considered a gateway to managerial information or the expert's knowledge, i.e. the Knowledge Management (KM) concept. Corporations can enhance their ability to share information by utilising data warehousing and KM. This study examines how companies are extracting valuable information by utilising a data warehouse. This article presents an exploratory study of three industries that have effectively implemented and utilised data warehousing and knowledge management. These case studies examine the corporate expectations of data warehousing and its support for storing and retrieving the expert's knowledge.

The case study presented involved an 87-year-old Hispanic man who was transferred to the emergency department (ED) of an acute care hospital. The patient was complaining of left hip pain and hitting his head. The patient had fallen backward upon standing from a wheelchair, lost his balance, and suffered an occipital laceration with hematoma. There was a brief loss of consciousness after hitting his head. An external pelvic stabilizer was placed on the patient's pelvis in an attempt to stabilize the comminuted pelvic fractures. Because of the patient's comorbidities and unstable condition, the consulting physician specialists determined that the patient was not a surgical or interventional candidate. Self-tamponed of retroperitoneal bleeding occurred without intervention of angiogram with embolization or laparotomy. A decision was made among the patient, the patient's stepchildren, and the attending physicians for a do-not-resuscitate order. The patient was then transferred to a palliative care unit outside the hospital. This case discusses the physiological changes in geriatric patients and the management of geriatric patients with pelvic trauma and retroperitoneal bleeding. [ABSTRACT FROM AUTHOR]

The concept of site selection has received extensive attention throughout history. Although plant location decision issues have always been important to US manufacturing finns, the impact of global competition has increased recognition of their importance. To successfully compete globally, manufacturers must have an effective global supply chain infrastructure, which requires effective communications. However, plant location strategies change over time, because of the dynamic nature of the variables that determine a location decision. This study was conducted to extend the location decision taxonomy by including telecommunications. The research included a specification of telecommunications attributes that impact site selection, the importance of telecommunications as a location decision criterion and the differences in location decision criteria between domestic (US) and foreign sites. The telecommunications- specific attributes determined in this study include: telecommunications infrastructure, cost, reliability, bandwidth, personnel, local and US government restrictions, and local and US government regulations on exporting and importing data. The conclusions of this study not only present evidence that telecommunications is influencing decision-makers in site selection, but also provides a list of criteria that are critical to site selection. [ABSTRACT FROM AUTHOR]

Modern organizations face increasing pressure to find new ways to compete effectively in a dynamic global market. Many firms are turning to E-commerce and virtual structures, such as virtual organizations and virtual teams, to improve organizational agility and to expand globally. These solutions elevate the importance of information flow within the firm and among firm partners. New technologies are emerging at a rapid pace to support this increased flow of information. As organizations grow to depend upon these new technologies, their opportunities to expand into new geographic regions might be limited by the ability of the remote information infrastructure to support the organization's modernized requirements. Thus, firms seeking to improve their ability to compete globally might actually impede future expansion. [ABSTRACT FROM AUTHOR]

This is a randomised cross-over study designed to access the effect of position on urodynamic investigation of women with urinary incontinence. Women were investigated in the supine and sitting positions. There was small, not statistically significant difference in total bladder volume. Total bladder volume was nearer to women’s actual bladder capacity in the sitting position. There was no difference in bladder volume at first sensation or normal desire in both positions. There was a small, not statistically significant difference in bladder volume at strong desire and urgency. Women felt strong desire and urgency at lower bladder volumes in the sitting position. [ABSTRACT FROM AUTHOR]