Publications by authors named "Winston B"

Background: Traumatic brain injury (TBI) is a major public health concern worldwide, contributing to high rates of injury-related death and disability. Severe traumatic brain injury (sTBI), although it accounts for only 10% of all TBI cases, results in a mortality rate of 30-40% and a significant burden of disability in those that survive. This study explored the potential of metabolomics in the diagnosis of sTBI and explored the potential of metabolomics to examine probable primary and secondary brain injury in sTBI.

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  • The study investigates differences in thrombo-inflammatory responses and outcomes between non-COVID-19 community-acquired pneumonia (CAP) and COVID-19 CAP in hospitalized adults in Canada.
  • Non-COVID-19 CAP patients displayed lower 28-day mortality rates and fewer complications compared to those with COVID-19, indicating a more effective immune response developed over time against bacterial infections.
  • The findings suggest that the complexities of the immune response to COVID-19 resulted in higher mortality rates, highlighting the challenges posed by emerging viruses compared to known pathogens.
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Background: In 2019, SARS-CoV-2, the novel coronavirus, entered the world scene, presenting a global health crisis with a broad spectrum of clinical manifestations. Recognizing the significance of metabolomics as the omics closest to symptomatology, it has become a useful tool for predicting clinical outcomes. Several metabolomic studies have indicated variations in the metabolome corresponding to different disease severities, highlighting the potential of metabolomics to unravel crucial insights into the pathophysiology of SARS-CoV-2 infection.

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Background: Most Canadians receive their care in community hospitals, yet most clinical research is conducted in academic hospitals. This study aims to compare patients with community acquired pneumonia (CAP) treated in academic and community hospitals with respect to their demographics, clinical characteristics, treatments and outcomes.

Methods: This nested observational cohort substudy of the Community Acquired Pneumonia: Toward InnoVAtive Treatment (CAPTIVATE) trial included 1,329 hospitalized adults with CAP recruited between March 1st, 2018 and September 31st, 2023 from 15 Canadian hospitals.

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  • Researchers investigated the effect of losartan, an angiotensin receptor blocker, on 28-day mortality in hospitalized COVID-19 patients compared to usual care, due to its potential impact on angiotensin levels.
  • The study was stopped early due to safety concerns, showing that adverse events and hypotension were significantly higher in the losartan group (39.8% SAEs and 30.4% hypotension) versus the control group (27.2% SAEs and 15.3% hypotension).
  • There was no significant difference in 28-day mortality (6.5% for losartan vs. 5.9% for usual care), indicating that ARBs should be used cautiously in this patient population to
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Freshwater fishes are among the most biodiverse vertebrate groups and among the most threatened by anthropogenic activities. Many occur in small and geographically restricted populations that are increasingly subject to catastrophic events (hurricanes, wildfires, extreme floods and droughts), but it has rarely been possible to assess the impacts of such events. Here we document the decline and recovery of a regularly monitored, small shoal bass (Micropterus cataractae) population in the Chipola River, Florida following a catastrophic hurricane disturbance.

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Background: The Berlin definition of acute respiratory distress syndrome (ARDS) includes only clinical characteristics. Understanding unique patient pathobiology may allow personalized treatment. We aimed to define and describe ARDS phenotypes/endotypes combining clinical and pathophysiologic parameters from a Canadian ARDS cohort.

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  • ARDS (Acute Respiratory Distress Syndrome) is a critical condition linked mainly to infections like COVID-19, influenza, and bacterial pneumonia, and research is focused on its mechanisms and treatment options.
  • The study aims to compare metabolic profiles of ARDS caused by COVID-19, H1N1 influenza, and bacterial pneumonia to understand their unique metabolic pathways.
  • Results showed distinct metabolic differences based on the infection type, indicating different underlying mechanisms in ARDS associated with each infectious cause.
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Background: In preclinical studies, mesenchymal stromal cells (MSCs), including umbilical cord-derived MSCs (UC-MSCs), demonstrate the ability to modulate numerous pathophysiological processes related to sepsis; however, a systematic synthesis of the literature is needed to assess the efficacy of UC-MSCs for treating sepsis.

Objective: To examine the effects of UC-MSCs on overall mortality (primary outcome) as well as on organ dysfunction, coagulopathy, endothelial permeability, pathogen clearance, and systemic inflammation (secondary outcomes) at prespecified time intervals in preclinical models of sepsis.

Methods: A systematic search was conducted on Embase, Ovid MEDLINE, and Web of Science up to June 20, 2023.

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  • * Researchers analyzed protein levels in 74 patients at three different time points after diagnosis, using a method called multiple reaction monitoring on 269 peptides, alongside routine lung function tests.
  • * The study found increases in proteins linked to lipid-related pathways over time, while those related to immune responses decreased; it also noted significant differences in protein concentrations between males and females affecting lung function.
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Sepsis is the result of an uncontrolled host inflammatory response to infection that may lead to septic shock with multiorgan failure and a high mortality rate. There is an urgent need to improve early diagnosis and to find markers identifying those who will develop septic shock and certainly a need to develop targeted treatments to prevent septic shock and its high mortality. Herein, we explore metabolic alterations due to mesenchymal stromal cell (MSC) treatment of septic shock.

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Background: Diagnosis and prognostication of severe traumatic brain injury (sTBI) continue to be problematic despite years of research efforts. There are currently no clinically reliable biomarkers, though advances in protein biomarkers are being made. Utilizing Omics technology, particularly metabolomics, may provide new diagnostic biomarkers for sTBI.

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Background: Omicron is the current predominant variant of concern of SARS-CoV-2. We hypothesized that vaccination alters outcomes of patients hospitalized with COVID-19 during the Omicron wave and that these patients have different characteristics and outcomes than in previous waves.

Methods: This is a substudy of the Host Response Mediators in Coronavirus (COVID-19) Infection (ARBs CORONA I) trial, which included adults admitted to hospital with acute COVID-19 up to July 2022 from 9 hospitals in British Columbia, Ontario and Quebec.

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Background: Prognostication is very important to clinicians and families during the early management of severe traumatic brain injury (sTBI), however, there are no gold standard biomarkers to determine prognosis in sTBI. As has been demonstrated in several diseases, early measurement of serum metabolomic profiles can be used as sensitive and specific biomarkers to predict outcomes.

Methods: We prospectively enrolled 59 adults with sTBI (Glasgow coma scale, GCS ≤ 8) in a multicenter Canadian TBI (CanTBI) study.

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  • Aspirin is effective and safe for preventing venous thromboembolism (VTE) after total knee (TKA) and total hip arthroplasty (THA), even in higher-risk patients.
  • A study analyzed data from over 107,000 surgeries and found that aspirin was comparable to other anticoagulants like low-molecular-weight heparin (LMWH) and warfarin for VTE prevention, although it did not show noninferiority against factor Xa inhibitors.
  • Overall, the research suggests that aspirin can be a suitable option for VTE prophylaxis in most total joint replacement patients.
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The lung naturally resists () in healthy individuals, but multiple conditions can disrupt this resistance, leading to lethal invasive infections. Core processes of natural resistance and its breakdown are undefined. We investigated three distinct conditions predisposing to lethal aspergillosis-severe SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection, influenza A viral pneumonia, and systemic corticosteroid use-in human patients and murine models.

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Introduction: With the advent of endovascular technique and the emergence of vascular surgery as a separate branch distinct from general surgery, there is a decrease in exposure of open vascular technique to general surgery resident. Vascular access surgery is a vascular subspecialty area and not all residents get similar exposure during training, and this has implications if one becomes a vascular consultant in the future and have to undertake access surgery. There is no established protocol or duration, following which a surgical resident can be named as "trained" in vascular anastomosis.

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  • The study aimed to assess if angiotensin receptor blockers (ARBs) or ACE inhibitors improve outcomes for hospitalized COVID-19 patients based on sex, while also investigating sex-related differences in the renin-angiotensin system (RAS).
  • The research involved a prospective cohort study of 1,686 hospitalized patients across 10 Canadian urban hospitals, measuring baseline characteristics and clinical outcomes related to ARB/ACE inhibitor use.
  • Findings revealed that males on ARBs showed reduced need for ventilation and vasopressors compared to those who weren’t on these medications, while no significant benefits were found for females, highlighting a notable sex difference in treatment response.
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Follicular lymphoma (FL) is a cancer of B-cells, representing the second most common type of non-Hodgkin lymphoma and typically diagnosed at advanced stage in older adults. In contrast to the wide range of available molecular genetic data, limited data relating the metabolomic features of follicular lymphoma are known. Metabolomics is a promising analytical approach employing metabolites (molecules < 1 kDa in size) as potential biomarkers in cancer research.

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Acute respiratory distress syndrome (ARDS) is a lung injury characterized by noncardiogenic pulmonary edema and hypoxic respiratory failure. The purpose of this study was to investigate the effects of therapeutic hypothermia on short-term experimental ARDS. Twenty adult female Yorkshire pigs were divided into four groups (n = 5 each): normothermic control (C), normothermic injured (I), hypothermic control (HC), and hypothermic injured (HI).

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Background: There have been multiple waves in the COVID-19 pandemic in many countries. We sought to compare mortality and respiratory, cardiovascular and renal dysfunction between waves in 3 Canadian provinces.

Methods: We conducted a substudy of the ARBs CORONA I study, a multicentre Canadian pragmatic observational cohort study that examined the association of pre-existing use of angiotensin receptor blockers with outcomes in adults admitted to hospital with acute COVID-19 up to April 2021 from 9 community and teaching hospitals in 3 Canadian provinces (British Columbia, Ontario and Quebec).

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The host response to COVID-19 pathophysiology over the first few days of infection remains largely unclear, especially the mechanisms in the blood compartment. We report on a longitudinal proteomic analysis of acute-phase COVID-19 patients, for which we used blood plasma, multiple reaction monitoring with internal standards, and data-independent acquisition. We measured samples on admission for 49 patients, of which 21 had additional samples on days 2, 4, 7, and 14 after admission.

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Background: Acute kidney injury (AKI) is a potentially fatal complication of Coronavirus Disease-2019 (COVID-19). Binding of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, to its viral receptor, angiotensin converting enzyme 2 (ACE2), results in viral entry and may cause AKI.

Objectives: We performed a systematic review and meta-analysis of the frequencies of AKI and renal replacement therapy (RRT) in critically ill COVID-19 patients and compared those frequencies with patients who were infected by respiratory viruses that bind or downregulate ACE2 (ACE2-associated viruses) and viruses that do not bind nor downregulate ACE2 (non-ACE2-associated viruses).

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Objective: Although the right ventricle (RV) to pulmonary artery conduit in stage 1 Norwood operation results in improved interstage survival, the long-term effects of the ventriculotomy used in the traditional technique remain a concern. The periscopic technique (PT) of RV to pulmonary artery conduit placement has been described as an alternative technique to minimize RV injury. A retrospective study was performed to compare the effects of traditional technique and PT on ventricular function following Norwood operation.

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Background: Neurological injury can alter the systemic immune system, modifying the functional capacity of immune cells and causing a dysfunctional balance of cytokines, although mechanisms remain incompletely understood. The objective of this study was to assess the temporal relationship between changes in the activation status of circulating invariant natural killer T (iNKT) cells and the balance of plasma cytokines among critically ill patients with neurological injury.

Methods: We conducted an exploratory prospective observational study of adult (18 years or older) intensive care unit (ICU) patients with acute neurological injury (n = 20) compared with ICU patients without neurological injury (n = 22) and healthy controls (n = 10).

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