Ehlers-Danlos Syndrome (EDS) are a heterogeneous group of genetic connective tissue disorders, and typically manifests as weak joints that subluxate/dislocate, stretchy and/or fragile skin, organ/systems dysfunction, and significant widespread pain. Historically, this syndrome has been poorly understood and often overlooked. As a result, people living with EDS had difficulty obtaining an accurate diagnosis and appropriate treatment, leading to untold personal suffering as well as ineffective health care utilization. The GoodHope EDS clinic addresses systemic gaps in the diagnosis and treatment of EDS. This paper describes a leap forward—from lack of awareness, diagnosis, and treatment—to expert care that is tailored to meet the specific needs of patients with EDS. The GoodHope EDS clinic consists of experts from various medical specialties who work together to provide comprehensive care that addresses the multi-systemic nature of the syndrome. In addition, EDS-specific self-management programs have been developed that draw on exercise science, rehabilitation, and health psychology to improve physical and psychosocial wellbeing and overall quality of life. Embedded into the program are research initiatives to shed light on the clinical presentation, underlying mechanisms of pathophysiology, and syndrome management. We also lead regular educational activities for community health care providers to increase awareness and competence in the interprofessional management of EDS beyond our doors and throughout the province and country.
The heterogeneity of diseased tissue causes major challenges in the detection and treatment of disease. Such challenges have motivated the development of tools for single-cell isolation and analysis. However, many cell isolation methods in microfluidics rely on the use of cell-labeling steps or expose cells to potentially harmful forces. Here, we present a microfluidic method for label-free control of cell-encapsulating biocompatible droplets using negative magnetophoresis. Our system is distinguished from previous microfluidic diamagnetic sorting approaches by the encapsulation of the cells inside droplets, which isolates the cells from the magnetic continuous phase. The droplet phase is comprised of cells suspended in their growth culture medium, and all of the magnetic content is contained in the oil-based continuous phase. At a flow-focusing junction, empty droplets and cell-encapsulating droplets are both generated and surrounded by the magnetic continuous phase. Cell encapsulation produces a size distinction between empty droplets and cell-encapsulated droplets. Through the application of a permanent magnet to the system, diamagnetic size-based sorting of empty droplets from cell-encapsulated droplets is achieved with a purity of ∼84% in a single pass. Additionally, since the encapsulated cells are completely isolated from the magnetic content in the continuous phase, 88% cell-viability is observed after a two-hour incubation period. If combined with a single-cell assay, this system can provide label-free isolation of viable cells at a high purity for subsequent downstream analysis.
Hyperbaric oxygen therapy (HBOT) is widely used to treat several pathologies. The hemodynamic changes during HBOT, particularly the magnitude of arterial blood pressure (ABP) increase, are not completely understood. No clinical predictors for HBOT-induced ABP increase have been described. The purpose of this study was to quantify ABP changes in patients undergoing HBOT and to examine their predictors. This retrospective longitudinal cohort study examined 3291 elective HBOT sessions. Non-invasive ABP was recorded before and after each session. The primary outcome was to quantify the HBOT-induced ABP rise. The secondary outcome was to determine the ABP-rise predictors among demographic and clinical variables. Overall, ABP increased significantly after HBOT; this finding was more evident in the hypertensive subgroup compared to the normotensive one (+6 vs. +16.2 mmHg). Clinical predictors of significant post-HBOT ABP change were history of hypertension and pre-session baseline ABP classification. This study demonstrates an absolute HBOT-induced ABP rise. This change is clinically relevant in patients with history of hypertension. A higher baseline ABP seems a risk factor for clinically relevant ABP change. Pre-session ABP should be used clinically as an indicator for strict ABP monitoring during HBOT; future studies are recommended to explore the ABP optimization before starting an HBO treatment.
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