2,570 results match your criteria: "Department of Orthopaedics University of British Columbia; V anada. brian.kwon@vch.ca[Affiliation]"

The local molecular signature of human peripheral neuropathic pain.

Pain

November 2024

Nuffield Department of Clinical Neuroscience, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom.

Focal nerve injuries are often associated with neuropathic pain. Preclinical research suggests altered neuroimmune signalling underlies such neuropathic pain; however, its cause remains poorly understood in humans. In this multicentre cohort study, we describe the local cellular and molecular signature of neuropathic pain at the lesion site, using Morton's neuroma as a human model system of neuropathic pain (n = 22; 18 women) compared with nerves from participants without nerve injury (n = 11; 4 women).

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Article Synopsis
  • * Researchers analyzed MRI scans from 501 stroke patients to assess regional brain-PAD and lesion loads, discovering that larger stroke lesions correlate with older brain-PAD in the affected areas and younger brain-PAD in the opposite hemisphere.
  • * The findings highlight that the severity of stroke damage is linked to poorer motor function, with machine learning models identifying specific brain regions and lesion characteristics as key predictors of motor outcomes.
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Introduction: Complex regional pain syndrome (CRPS) is a common complication following distal radius fractures that is difficult to diagnose and can lead to permanent disability. While various proposed prophylaxis and treatment modalities exist, high-quality evidence guiding practice is limited. This survey of Orthopaedic Trauma Association (OTA) and Canadian Orthopaedic Association (COA) members was conducted with the primary aim of assessing practice patterns in distal radius fractures complicated with CRPS.

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Background: Family-centred care (FCC) emphasizes a partnership approach to care between healthcare providers (HCPs), patients, and families. FCC provides significant benefits to both children and families; however, challenges exist in implementing FCC into practice. This study aimed to explore HCPs' FCC behaviours in multidisciplinary specialty clinics at a tertiary pediatric health care center in Canada.

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A Scoping Review of Mental Practice in Athletes: How can Surgeons Learn?

J Surg Educ

January 2025

Division of Otolaryngology-Head & Neck Surgery, University of British Columbia, Vancouver, BC, Canada. Electronic address:

Introduction: Mental imagery is a dynamic mental state involving the cognitive visualization and rehearsal of motor movements or positions without overt motor output. Mental imagery is known to have numerous benefits for skill acquisition within athletic performance and is often incorporated into elite athletic training programs. The literature on the effects of mental imagery in surgery, which shares many of the high-performance qualities of elite athletics, remains limited.

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Multicentre analysis of severe perioperative adverse events in children undergoing surgery who were infected with SARS-CoV-2: a propensity score-adjusted analysis.

Br J Anaesth

November 2024

Department of Anesthesiology and Pain Management, University of Texas Southwestern and Children's Health, Dallas, TX, USA; Department of Outcomes Research, Cleveland Clinic, Cleveland, OH, USA.

Background: The incidence of severe adverse events in children with SARS-CoV-2 undergoing anaesthesia has not been well established. We examined the relationship between SARS-CoV-2 infection and severe perioperative adverse events in children.

Methods: This multicentre (21 North American institutions), retrospective cohort study included children <18 years old, with American Society of Anesthesiologists physical status (ASA PS) of 1-4 and non-severe SARS-CoV-2, who underwent general anaesthesia between April 1, 2020, and March 31, 2021.

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Purpose: Proximal junctional kyphosis is an infrequent complication in AIS; however, equipoise remains on the effects of ending a fusion proximally at the C7-T1 junction on the future development of PJK. The purpose of this study was to determine the rate of PJK in patients with AIS who had a UIV of T1 vs those with a UIV of T2 at 5 years of follow-up.

Methods: A query was performed of a prospective, multi-center AIS database of patients who received a PSF with at least 5 years of follow-up.

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Compensatory thoracic curve correction in lumbar anterior vertebral body tether (VBT) versus lumbar posterior spinal fusion (PSF).

Spine Deform

November 2024

Department of Orthopaedic Surgery, Seattle Children's Hospital, University of Washington, 4800 Sand Point Way NE, Seattle, WA, 98105, USA.

Purpose: Anterior vertebral body tethering (VBT) is a non-fusion surgical option for skeletally immature patients with idiopathic scoliosis. Prior studies demonstrated compensatory correction of the thoracic curve after lumbar posterior spinal fusion (PSF); however, no studies have examined thoracic curve correction after lumbar VBT.

Methods: Patients with Lenke 5 + 6 lumbar scoliosis who underwent VBT and at least 2 years' follow-up were compared to matched lumbar PSF patients.

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Introduction: There is undocumented and unjustified variability in orthopaedic surgery training between countries. This study compares and contrasts the main features of orthopaedic training in Australia, New Zealand, the United Kingdom, United States, and Canada.

Methods: Comparisons included: competition for, and selection into, training; training pathway structures; training requirements, and; training length.

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Granzyme B cleaves tenascin-C to release its C-terminal domain in rheumatoid arthritis.

JCI Insight

October 2024

International Collaboration on Repair Discoveries (ICORD) Centre, British Columbia Professional Firefighters' Burn and Wound Healing Group, Vancouver Coastal Health Research Institute, and.

Rheumatoid arthritis (RA) is a common autoimmune disorder characterized by exacerbated joint inflammation. Despite the well-documented accumulation of the serine protease granzyme B (GzmB) in RA patient biospecimens, little is understood pertaining to its role in pathobiology. In the present study, tenascin-C (TNC) - a large, pro-inflammatory extracellular matrix glycoprotein - was identified as a substrate for GzmB in RA.

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Mitigating Medical Adverse Events Following Spinal Surgery: The Effectiveness of a Postoperative Quality Improvement (QI) Care Bundle.

Qual Manag Health Care

October 2024

Author Affiliations: Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedic Surgery, University of British Columbia, Vancouver, British Columbia, Canada. (Drs Moskven, Craig, Banaszek, Inglis, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, and Street, and Mrs Belanger,); Arthritis Research Canada, Richmond, British Columbia, Canada. (Dr Sayre), and Division of Critical Care Medicine, University of British Columbia, Vancouver, British Columbia, Canada. (Drs Chittock, and Griesdale).

Article Synopsis
  • Spine surgery often leads to postoperative medical adverse events (AEs), primarily minor ones, which can be costly and impact patient outcomes; a study aimed to assess the effectiveness of a quality improvement (QI) care bundle in reducing these events.
  • The research spanned 14 years and compared outcomes before and after implementing the QI care bundle, analyzing nearly 13,500 patients to evaluate changes in AEs and associated costs.
  • Results indicated a significant reduction in several types of AEs, such as cardiac and pulmonary issues, following QI implementation; however, some AEs, like delirium, did not show improvement.
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Article Synopsis
  • The study analyzed global, regional, and national trends in injury burden and identified risk factors contributing to injuries using data from the GBD 2019.
  • In 2019, there were approximately 713.9 million injury incidents and 4.3 million injury-related deaths globally, with low bone mineral density emerging as the leading risk factor.
  • The findings emphasize the need for effective global injury prevention policies by highlighting the persistent impact of injuries on global health.
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Paper 5: a methodological overview of methods and interventions.

J Clin Epidemiol

December 2024

RTI International, Research Triangle Park, NC, USA.

Article Synopsis
  • The study evaluated systematic reviews of interventions aimed at improving racial health equity among racialized populations, particularly those published between January 2020 and January 2023.
  • Analysis of 157 reviews revealed that only 14% addressed the role of racism in health disparities, and 67% merely summarized studies without proper synthesis, with many using biased methods for effect sizes.
  • The findings highlight a need for better research quality, comprehensive examination of racism, and a focus on structural interventions to enhance opportunities for racialized groups in addressing health inequities.
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  • The study aims to explore hip problems in individuals with developmental central hypotonia, focusing on various rare genetic disorders while excluding Down syndrome.
  • It analyzed 89 articles, ultimately including 79 that covered 544 subjects aged from infancy to 63 years, revealing that many of these syndromes are linked to hip structural or stability issues starting from birth, which worsen over time.
  • The findings suggest that children with notable hypotonia should undergo specific ultrasound screenings and regular orthopedic evaluations to monitor and address potential hip issues that might not be detected through standard neonatal assessments.
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Who gets better after surgery for degenerative cervical myelopathy? A responder analysis from the multicenter Canadian Spine Outcomes and Research Network.

Spine J

February 2025

Division of Neurosurgery, Department of Surgery, University of Toronto, 149 College Street, 5th Floor, Toronto, Ontario, M5T 1P5, Canada; Institute of Health Policy Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, Ontario, M5T 3M6, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria St, Toronto, Ontario, M5B 1T8, Canada. Electronic address:

Background Context: Degenerative cervical myelopathy (DCM) is the most common cause of acquired nontraumatic spinal cord injury worldwide. Surgery is a common treatment for DCM; however, outcomes often vary across patients.

Purpose: To inform preoperative education and counseling, we performed a responder analysis to identify factors associated with treatment response.

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Objective: Despite efforts toward achieving gender-based equality in clinical trial enrollment, females are frequently underrepresented and gender-specific data analysis is lacking. Identifying and addressing gender bias in medical decision-making and outcome reporting may facilitate more equitable healthcare delivery. This study aimed to determine if gender differences exist in the clinical evaluation and surgical management of patients with degenerative lumbar conditions.

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Article Synopsis
  • This study compared two different surgical approaches for addressing stiffness after knee replacement: liner exchange (LE) and component revision (CRev).
  • A total of 129 patients who had revision surgery for stiffness were analyzed, showing that both methods provided similar improvements in range of motion and long-term success rates.
  • Although both techniques were effective, CRev involved longer surgery times, more blood loss, and longer hospital stays compared to LE, suggesting that LE may be a better option for selected patients with stiffness after knee replacement.
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Introduction: Developmental dysplasia of the hip (DDH) includes a spectrum of clinical and imaging findings at birth or early infancy. The circumstances in which this condition is detected and managed may be heterogeneous in Brazil owing to its large territory and regional socio-economic differences. Mapping DDH perspectives in a country is fundamental for designing guidelines and strategies for public policy.

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Article Synopsis
  • This study investigates the role of paraspinal muscle dysfunction in spinal degeneration by examining surgical patients with varying degrees of spinal imbalance.
  • Twelve patients were divided into three groups based on their sagittal balance and compensatory mechanisms, with muscle biopsies taken to assess contractile properties.
  • The findings reveal that patients with sagittal imbalance show impaired muscle force generation, and all patients demonstrate abnormal muscle structure, shedding light on the underlying issues of muscle weakness in spinal degeneration.
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