Publications by authors named "Rimmer E"

Introduction: Daratumumab is an anti-CD38 monoclonal antibody used in the treatment of myeloma and other related disorders. To mitigate the risk of infusion related reactions with IV Daratumumab the product monograph suggested a slow administration schedule that extends over several hours. This leads to a significant burden for the outpatients' treatment administration units and indirect costs to the patients such as time toxicity.

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Infections are a significant cause of morbidity and mortality in myelodysplastic syndrome (MDS). Precise estimates of infection frequency and severity with modern therapies are uncertain. We conducted a retrospective analysis of a prospective cohort enrolled in a Canadian MDS registry and characterized the frequency and severity of infectious complications.

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Myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) are severe myeloid disorders associated with significant morbidity and mortality. Because of patient and disease factors, many older adults are treated as outpatients with less-intensive therapy. Optimal supportive care strategies to minimize bleeding and infectious complications in this patient population have not been systematically evaluated.

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  • The study investigates the effects of blocking interleukin-10 (IL-10) and PD-1 on controlling HIV/SIV viral rebound after stopping antiretroviral therapy (ART).
  • In a trial with rhesus macaques, a combination treatment of anti-IL-10 and anti-PD-1 led to sustained control of viral levels in 9 out of 10 monkeys for over 24 weeks post-treatment interruption.
  • Outcomes indicated that specific immune responses, such as increased memory T cells and changes in cytokine levels, could predict successful viral control after ART cessation.
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  • Community-acquired pneumonia (CAP) can lead to serious inflammatory and thrombotic responses, and the use of antiplatelet agents may positively influence patient outcomes, although their impact on non-COVID-19 CAP is unclear.
  • A systematic review and meta-analysis examined the effects of antiplatelet agents on mortality in hospitalized patients with non-COVID-19 CAP, analyzing data from observational studies and randomized controlled trials (RCTs).
  • The findings suggest that antiplatelet agents are linked to lower mortality in observational studies, but the evidence from RCTs is inconclusive and overall trust in the results is low due to potential biases.
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Mesothelioma is an aggressive cancer of the mesothelial layer associated with an extensive fibrotic response. The latter is in large part mediated by cancer-associated fibroblasts which mediate tumour progression and poor prognosis. However, understanding of the crosstalk between cancer cells and fibroblasts in this disease is mostly lacking.

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Barrett's oesophagus (BO) is a pathological condition in which the squamous epithelium of the distal oesophagus is replaced by an intestinal-like columnar epithelium originating from the gastric cardia. Several somatic mutations contribute to the intestinal-like metaplasia. Once these have occurred in a single cell, it will be unable to expand further unless the altered cell can colonise the surrounding squamous epithelium of the oesophagus.

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  • Acquired haemophilia A (AHA) is a rare bleeding disorder caused by autoantibodies against factor VIII, with a population-based incidence of 1.78 cases per million per year found in a study in Manitoba, Canada.
  • The study identified 34 patients over 15 years, most commonly presenting at an average age of 76, with 97% experiencing bleeding, often major, leading to delayed diagnoses and a need for haemostatic therapy.
  • Treatment involved immunosuppressive therapy in 88% of cases, yielding an encouraging 79% remission rate, with relatively low treatment-related mortality and morbidity noted.
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Objective: The aim of this study was to identify the percentage of patients that were transferred from rural hospitals and who received an investigation or intervention at an urban hospital that was not readily available at the rural hospital.

Methods: A retrospective observational study.

Design: Patients were randomly selected and clinical records were reviewed.

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Background: Immune thrombocytopenia (ITP) is a diagnosis of exclusion that can resemble other thrombocytopenic disorders.

Objectives: To develop a clinical prediction model (CPM) for the diagnosis of ITP to aid hematogists in investigating patients presenting with undifferentiated thrombocytopenia.

Methods: We designed a CPM for ITP diagnosis at the time of the initial hematology consultation using penalized logistic regression based on data from patients with thrombocytopenia enrolled in the McMaster ITP registry (n = 523) called the Predict-ITP Tool.

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Purpose: Septic shock is associated with a mortality of 20-40%. The white blood cell count (WBC) at hospital admission correlates with prognosis in septic shock. Here, we explore whether the trajectory of WBC after admission provides further information about outcomes.

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Pancreatic ductal adenocarcinoma remains an aggressive cancer with a low 5-year survival rate. Although gemcitabine has been a standard treatment for advanced pancreatic cancer, patients often develop resistance to this therapeutic. We have previously shown that treating pancreatic cancer cells in vitro with a combination of gemcitabine and the cytokine TRAIL significantly reduced both cell viability and survival.

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Questions remain concerning the long-term efficacy, safety, and site(s) of transgene expression following adeno-associated vector (AAV) therapy. We report a long-term follow-up of 8 (male = 4, hemizygous, and female = 4, homozygous) dogs with severe hemophilia A treated with a single portal vein infusion of a B-domain-deleted (BDD)-canine FVIII (cFVIII) AAV vector (median dose = 1.25 × 1013 vg/kg, AAV2 = 4, AAV6 = 3, and AAV8 = 1).

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  • Interleukin-10 (IL-10) is an immunosuppressive cytokine that aids in T follicular helper (Tfh) cell differentiation and germinal center formation, influencing SIV persistence in infected macaques.
  • Elevated IL-10 levels were found during SIV infection and remained high even after antiretroviral therapy (ART), correlating with SIV-DNA content in CD4+ memory cells, particularly Tfh cells.
  • Neutralizing IL-10 in ART-treated macaques disrupted the maintenance of B cell follicles and reduced memory CD4+ T cell populations, suggesting that targeting IL-10 could help improve immune response and reduce viral persistence in people living with HIV.
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Aims: Orthopaedic surgeries are complex, frequently performed procedures associated with significant haemorrhage and perioperative blood transfusion. Given refinements in surgical techniques and changes to transfusion practices, we aim to describe contemporary transfusion practices in orthopaedic surgery in order to inform perioperative planning and blood banking requirements.

Methods: We performed a retrospective cohort study of adult patients who underwent orthopaedic surgery at four Canadian hospitals between 2014 and 2016.

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Purpose: Intravenous immune globulin (IVIG) may improve survival in people with septic shock. Current utilization patterns of IVIG are unknown. We sought to characterize adult patients with septic shock requiring vasopressors who received IVIG, describes IVIG regimens, and evaluate determinants of IVIG use in patients with septic shock.

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Background: Tranexamic acid (TXA) reduces transfusion in a wide range of surgical populations, although its real-world use in non-cardiac surgeries has not been well described. The objective of this study was to describe prophylactic TXA use in non-cardiac surgeries at high risk for transfusion.

Methods: This is a retrospective cohort study of all adult patients undergoing major non-cardiac surgery at ≥5% risk of perioperative transfusion at five Canadian hospitals between January 2014 and December 2016.

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Purpose: This national survey evaluated the perceived efficacy and safety of intravenous immune globulin (IVIG) in septic shock, self-reported utilization patterns, barriers to use, the population of interest for further trials and willingness to participate in future research of IVIG in septic shock.

Methods: We conducted a cross-sectional survey of critical care and infectious diseases physicians across Canada. We summarized categorical item responses as counts and proportions.

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Purpose: Tranexamic acid (TXA) reduces red blood cell transfusion in various orthopedic surgeries, yet the degree of practice variation in its use among anesthesiologists and surgeons has not been described. To target future knowledge transfer and implementation strategies, and to better understand determinants of variability in prophylactic TXA use, our primary objective was to evaluate the influence of surgical team members on the variability of prophylactic TXA administration.

Methods: This was a retrospective cohort study of all adult patients undergoing primary total hip arthroplasty (THA), hip fracture surgery, and spine fusion ± vertebrectomy at two Canadian hospitals between January 2014 and December 2016.

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Background: Daratumumab is used in the treatment of relapsed multiple myeloma. Daratumumab infusion-related reactions can occur with the highest incidence on the first infusion.

Methods: A retrospective review of all daratumumab infusions used as part of the DVd and DRd regimens for relapsed multiple myeloma was undertaken.

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Perioperative bleeding is a major indication for red blood cell (RBC) transfusion, yet transfusion data in many major noncardiac surgeries are lacking and do not reflect recent blood conservation efforts. We aim to describe transfusion practices in noncardiac surgeries at high risk for RBC transfusion. We completed a retrospective cohort study to evaluate adult patients undergoing major noncardiac surgery at 5 Canadian hospitals between January 2014 and December 2016.

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Tranexamic acid (TXA) reduces transfusion requirements in cardiac surgery and total hip and knee arthroplasty, where it has become standard of care. Our objective is to determine the efficacy and safety of TXA in other surgeries associated with a high risk for red blood cell (RBC) transfusion. We identified randomized controlled trials in Medline, Embase, CENTRAL, and CAB abstracts from inception to June 2019.

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