4,519 results match your criteria: "Canada §§Royal Victoria Hospital[Affiliation]"

Background: This study experimentally validated a computationally optimized screw number and screw distribution far cortical locking distal femur fracture plate and compared the results to traditional implants.

Methods: 24 artificial femurs were osteotomized with a 10 mm fracture gap 60 mm proximal to the intercondylar notch. Three fixation constructs were used.

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Objectives: Female otolaryngologist-head and neck surgeons (OHNS) confront unique barriers. This study examines the influence of home life, especially gendered division of household labor, on leadership, productivity, and burnout.

Methods: A survey was distributed through social media and national society list-serv.

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This review explores the intricacies of evaluating cirrhotic patients for liver resection while exploring how to extend surgical intervention to those typically excluded by the Barcelona Clinic Liver Cancer (BCLC) criteria guidelines by focusing on the need for robust preoperative assessment and innovative surgical strategies. Cirrhosis presents unique challenges and complicates liver resection due to the altered physiology of the liver, portal hypertension, and liver decompensation. The primary objective of this review is to discuss the current approaches in assessing the suitability of cirrhotic patients for liver resection and aims to identify which patients outside of the BCLC criteria can safely undergo liver resection by highlighting emerging strategies that can improve surgical safety and outcomes.

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Article Synopsis
  • Pediatric acute otitis media (AOM) is common in children, leading to concerns about overdiagnosis and overtreatment, prompting the need for specific quality indicators (QIs).
  • An expert panel, utilizing the RAND/UCLA methodology, evaluated candidate indicators and ultimately agreed on 8 QIs related to antimicrobial management, referrals, and counseling for tympanostomy tubes.
  • These QIs aim to address the inconsistent care in AOM diagnosis and management, enhancing adherence to guidelines and improving patient outcomes.
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Pregnancy, delivery, and neonatal outcomes among women with PCOS and endometriosis: a population database cohort.

Arch Gynecol Obstet

August 2024

Department of Obstetrics and Gynecology, McGill University Health Center, Royal Victoria Hospital (Glen Site), 1001 Boul. Decarie, Quebec D05.2553, Montreal, H4A 3J1, Canada.

Article Synopsis
  • The study investigates the pregnancy, delivery, and neonatal outcomes of women with both polycystic ovary syndrome (PCOS) and endometriosis compared to those with PCOS alone.
  • Researchers analyzed data from a large U.S. database between 2004 and 2014, finding significant differences in demographics and pregnancy complications.
  • Women with both conditions were more likely to be white, of lower socioeconomic status, and experienced higher rates of complications like placental abruption and cesarean sections, indicating a need for better clinical management and patient counseling.
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Background: Thin-cap fibroatheroma (TCFA) lesions are associated with a high risk of future major adverse cardiovascular events. However, the impact of other optical coherence tomography-detected vulnerability features (OCT-VFs) and their interplay with TCFA in predicting adverse events remains unknown.

Aims: We aimed to evaluate the individual as well as the combined prognostic impact of OCT-VFs in predicting the incidence of the lesion-oriented composite endpoint (LOCE) in non-ischaemic lesions in patients with diabetes mellitus (DM).

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Study Design: In-vitro cadaveric biomechanical study.

Objectives: Long posterior spinal fusion is a standard treatment for adult spinal deformity. However, these rigid constructs are known to alter motion and stress to the adjacent non-instrumented vertebrae, increasing the risk of proximal junctional kyphosis (PJK).

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Article Synopsis
  • Radiotherapy is an important cancer treatment, but research in low-income countries has some tough problems.
  • A 2022 survey provided new information on how these countries are dealing with radiotherapy and the funding they get.
  • The paper talks about new technology and ideas that can help improve cancer treatment in places that struggle with resources and emphasizes the need for more trained researchers in this field.
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We aimed to determine the surgical output for patients from Nunavik undergoing transfer to an urban centre for hysteroscopy, and associated costs. We performed a retrospective chart review of all patients from the 14 villages of Nunavik transferred for hysteroscopic surgery from 2016 to 2021. Diagnoses, surgical intervention, and nature of the procedure were all extracted from the patient charts, and costs/length of stay obtained from logisticians and administrators servicing the Nunavik region.

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COVID-19 breakthrough infection (BTI) can occur despite vaccination. Using a multi-centre, prospective, observational Canadian cohort of people with HIV (PWH) receiving ≥2 COVID-19 vaccines, we compared the SARS-CoV-2 spike (S) and receptor-binding domain (RBD)-specific IgG levels 3 and 6 months post second dose, as well as 1 month post third dose, in PWH with and without BTI. BTI was defined as positivity based on self-report measures (data up to last study visit) or IgG data (up to 1 month post dose 3).

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Pediatric CNS Inflammation and Infection: A Review of Immunopathology and Radiology.

Can J Neurol Sci

May 2024

Division of Neuroradiology, Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Toronto, ON, Canada.

The innate and adaptive immune systems are critical in defense against pathogens and ensuring homeostasis. The central nervous system (CNS) was initially considered to be impermeable to immune cells due to the blood-brain barrier. However, this has now been debunked, with modern research delineating immune cell trafficking within the CNS, ensuring constant immune surveillance.

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Article Synopsis
  • This clinical practice guideline from the European Society of Intensive Care Medicine focuses on the choice of resuscitation fluids for critically ill adult patients, with two more parts planned to address fluid volume and removal.
  • An international panel of experts used the GRADE methodology to assess the evidence and guide their recommendations.
  • The guideline offers conditional recommendations favoring crystalloids over albumin in various patient scenarios, while also addressing specific cases with varying levels of evidence certainty, such as traumatic brain injury and cirrhosis.
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Tenecteplase versus standard of care for minor ischaemic stroke with proven occlusion (TEMPO-2): a randomised, open label, phase 3 superiority trial.

Lancet

June 2024

Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Background: Individuals with minor ischaemic stroke and intracranial occlusion are at increased risk of poor outcomes. Intravenous thrombolysis with tenecteplase might improve outcomes in this population. We aimed to test the superiority of intravenous tenecteplase over non-thrombolytic standard of care in patients with minor ischaemic stroke and intracranial occlusion or focal perfusion abnormality.

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Osteosarcopenia and Mortality in Older Adults Undergoing Transcatheter Aortic Valve Replacement.

JAMA Cardiol

July 2024

Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Québec, Canada.

Article Synopsis
  • Osteosarcopenia is a new syndrome in older adults that combines muscle and bone deterioration, which has not been thoroughly studied in patients undergoing transcatheter aortic valve replacement (TAVR).
  • The study aimed to explore the link between osteosarcopenia and adverse outcomes post-TAVR, analyzing data from a multicenter cohort of patients aged 70 and older.
  • Results showed that 15% of patients had osteosarcopenia and exhibited higher rates of frailty and negative health outcomes, highlighting the syndrome’s importance in this clinical context.
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Effect of Endovascular Thrombectomy for Acute Ischemic Stroke on Cognitive Outcomes: A Secondary Analysis of the ESCAPE Trial.

Neurology

May 2024

From the Division of Neurology (R.A.J.), Hamilton Health Sciences, McMaster University & Population Health Research Institute, Hamilton, Ontario; Department of Clinical Neurosciences (E.E.S., B.K.M., A.G., P. Barber, S.B.C., A.D., M.G., M.D.H.), Hotchkiss Brain Institute, Departments of Radiology (E.E.S., B.K.M., A.G., A.D., M.G., M.D.H.), and Medicine (M.D.H.), Cumming School of Medicine, and Department of Community Health Sciences (E.E.S., B.K.M., A.G., M.D.H.), University of Calgary, Alberta; Department of Clinical Neurological Sciences (J.M.), Western University and London Health Sciences Center, Ontario; Departments of Radiology (J.L.R.), and Medicine (Neurology) (A.S.), University of Alberta Hospital, Edmonton, Canada; Department of Radiology (J.T.), Beaumont Hospital, Dublin, Ireland; Department of Radiology (D.R.), Université de Montréal, Centre Hospitalier de l'Université de Montréal (CHUM), Québec, Canada; Department of Neurology (T.G.J.), Cooper University Health Care, Camden, NJ; Department of Medicine (Neurology) (D.D.), University of Ottawa, Ottawa Hospital, Ontario, Canada; Radiology Imaging Associates (D.F.F.), Swedish Medical Centre, Englewood, CO; Division of Neurology (F.L.S.), Department of Medicine and Department of Radiology (A.B.), University of Toronto, St. Michael's Hospital, Ontario; Department of Neurosciences (A.P.), Université de Montréal, Centre Hospitalier de l'Université de Montréal (CHUM), Québec; Department of Neurology (J.S.T.), Montreal Neurological Institute, Québec, Canada; Department of Neurology (D.W.), Royal College of Surgeons Ireland, Beaumont Hospital, Dublin; Department of Neurology (O.Y.B.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Providence Neurological Specialties (B.L.S.), Providence Health Care, Portland, OR; Department of Neuroradiology (P. Burns), Royal Victoria Hospital, Belfast, United Kingdom; Department of Neuroradiology (H.C.), Community Regional Medical Centre, Fresno, CA; Department of Neurology (J.-H.H.), Severance Medical Centre, Yonsei University, Seoul, South Korea; Department of Surgery (Neurosurgery) (M.E.K.), University of Saskatoon, Royal Saskatoon Hospital, Saskatchewan, Canada; St. Louis University (G.L.), Souers Stroke Institute, MO; Department of Radiology (J.J.S.), University of Manitoba, Health Sciences Centre, Winnipeg, Canada; Department of Neurology (S.-I.S.), Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, South Korea; and Department of Medicine (Neurology) (R.H.S.), University of Toronto, Sunnybrook Health Sciences Centre, Ontario, Canada.

Article Synopsis
  • The study investigated the impact of endovascular therapy (EVT) on cognitive outcomes following a large vessel occlusion stroke, using data from the ESCAPE trial.
  • Cognitive assessments were performed 90 days post-stroke and included various tests to evaluate memory and cognitive function, with results indicating that EVT significantly improved cognitive outcomes across all tests.
  • Findings showed that EVT was associated with better cognitive performance (higher odds ratios for favorable outcomes), and both final infarct volume and cognitive function had notable correlations, suggesting that both factors influence recovery.
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(1) Background: Despite advances in surgical technique and systemic chemotherapy, some patients with multifocal, bilobar colorectal liver metastases (CRLM) remain unresectable. These patients may benefit from surgical debulking of liver tumors in combination with chemotherapy compared to chemotherapy alone. (2) Methods: A retrospective study including patients evaluated for curative intent resection of CRLM was performed.

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Background: Although speaking up is lauded as a critical patient safety strategy, it remains exceptionally challenging for team members to enact. Existing efforts to address the problem of silence among interprofessional teams involve training low-authority members to use direct language and unambiguous challenge scripts. The role or value of indirect communication in preventing medical error remains largely unexplored despite its pervasiveness among interprofessional teams.

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Background And Aims: Diagnostic criteria for metabolic dysfunction-associated steatotic liver disease (MASLD) have been proposed but not yet validated. This study aimed to compare the diagnostic accuracy of the MASLD definition with the existing criteria for metabolic dysfunction-associated fatty liver disease (MAFLD) in identifying patients with significant fibrosis.

Methods: The analysis included a total of 8317 individuals who had complete biochemical and liver ultrasonography data from the National Health and Nutrition Examination Survey (2017-2020).

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Discordance among apoB, non-high-density lipoprotein cholesterol, and triglycerides: implications for cardiovascular prevention.

Eur Heart J

July 2024

Mike and Valeria Rosenbloom Centre for Cardiovascular Prevention, Department of Medicine, McGill University Health Centre-Royal Victoria Hospital, 1001 Boulevard Décarie, Montreal, Québec H4A 3J1, Canada.

Background And Aims: Despite growing evidence that apolipoprotein B (apoB) is the most accurate marker of atherosclerotic cardiovascular disease (ASCVD) risk, its adoption in clinical practice has been low. This investigation sought to determine whether low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (HDL-C), and triglycerides are sufficient for routine cardiovascular care.

Methods: A sample of 293 876 UK Biobank adults (age: 40-73 years, 42% men), free of cardiovascular disease, with a median follow-up for new-onset ASCVD of 11 years was included.

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Objective: Ischemic mitral regurgitation (MR) is generally associated with very poor outcomes and disappointing results, despite a seemingly perfect initial repair and optimal revascularization. We previously published our intermediate-term results of posterior leaflet augmentation without follow-up extending beyond 4 years. Our objective is to assess long-term durability of the repair, survival, and the causes of late mortality.

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Bone fracture plates are usually made from steel or titanium, which are much stiffer than cortical bone. This may cause bone 'stress shielding' (i.e.

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Antibody-Drug Conjugates in the Treatment of Genitourinary Cancers: An Updated Review of Data.

Curr Oncol

April 2024

Division of Medical Oncology, Department of Oncology, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada.

The treatment landscape of genitourinary cancers has significantly evolved over the past few years. Renal cell carcinoma, bladder cancer, and prostate cancer are the most common genitourinary malignancies. Recent advancements have produced new targeted therapies, particularly antibody-drug conjugates (ADCs), due to a better understanding of the underlying oncogenic factors and molecular mechanisms involved.

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CD44 and RHAMM Are Microenvironmental Sensors with Dual Metastasis Promoter and Suppressor Functions.

Adv Biol (Weinh)

June 2024

Cancer Research Laboratory Program, Lawson Health Research Institute, Victoria Hospital, London, ON, N6A 5W9, Canada.

The progression of primary tumors to metastases remains a significant roadblock to the treatment of most cancers. Emerging evidence has identified genes that specifically affect metastasis and are potential therapeutic targets for managing tumor progression. However, these genes can have dual tumor promoter and suppressor functions that are contextual in manifestation, and that complicate their development as targeted therapies.

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