Autonomic dysreflexia (AD) is a medical emergency that is characterized by hypertension as an autonomic response to noxious stimuli in patients with a history of spinal cord injury at the level of T6 or above. We present the case of a 31-year-old Caucasian male with a history of spinal cord injury at the level of C3-C4, with symptoms described as recurring episodes of hypertension with flushing and sweating above the level of the lesion for the past five to six years. His symptoms are triggered by bowel distention, excitement, a bumpy car ride, or a simple turning of the neck to the left. Physical examination and laboratory studies ruled out other possible differentials (e.g., migraines, pheochromocytoma). As a result, AD was diagnosed.

The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on the mental health and wellbeing of Ontario's youth. Our study investigated the psychological impacts of COVID-19 on the pediatric population of Ontario, using a survey derived from the Revised Children's Anxiety and Depression Scale (RCADS) system to identify children who may benefit from seeking professional help. Our cross-sectional study examined the potential risk factors that contributed to worsening mental health and wellbeing in children, including changes in sleep patterns, appetite, and physical activity levels, as well as the diagnosis of a family member with COVID-19. Our study found that 24%, 9.4%, and 15.5% of participants exhibited symptoms of depression, anxiety, and obsessive-compulsive disorder (OCD), respectively, according to the RCADS system. Furthermore, there were significant associations between the presence of symptoms and the diagnosis of a family member with COVID-19 or a frontline worker in the family. This suggests a need to create interventions to support the families of frontline workers and those directly affected by a COVID-19 diagnosis.

Background: Spontaneous intestinal perforation (SIP) affects very low birth weight preterm neonates and accounts for 44% of gastrointestinal perforations. Commonly used medications such as indomethacin, ibuprofen and acetaminophen for PDA closure, increases the risk of intestinal perforation. Unfortunately, the majority of the data combine SIP with those affected by necrotizing enterocolitis (NEC) despite them being separate entities. This systematic review aims to explore the association between the use of common medications and SIP in the premature infant cohort independently from NEC. Methods: Our study will focus on preterm infants with exposure to either indomethacin, ibuprofen or acetaminophen where SIP is a reported outcome. A health science librarian will search Medline and Medline in Process via OVID, Embase Classic + Embase via OVID, the LILACS database, the ScIELO database and the Cochrane Library including EBM Reviews - Cochrane Central Register of Controlled Trials. Search dates for each database will be from their respective dates of inception to March 2022. All articles will undergo screening by two independent reviewers, and if selected, data extraction with risk of bias assessment by two independent reviewers. A third reviewer will settle any disagreements that may occur. Incidence of SIP will be measured as a proportion. Individual proportions will be pooled using a random effects logistic regression model. The comparative incidence of SIP by treatment group will be measured using the odds ratio. Odds ratios will be pooled using the DerSimonian and Laird random effects model for meta-analysis. PROSPERO Registration: CRD42017058603