274 results match your criteria: "Health Sciences and McMaster University[Affiliation]"

Background: Delirium is an acute state of confusion associated with adverse postoperative outcomes. Delirium is diagnosed clinically using screening tools; most cases go undetected. Identifying a delirium biomarker would allow for accurate diagnosis, application of therapies, and insight into causal pathways.

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Background And Aims: The Malaysian government has implemented various antismoking measures to reduce the incidence of unhealthy lifestyles within the population. This study analyzes the baseline data of the Prospective Urban Rural Epidemiology (PURE) study to establish the prevalence of sociodemographic factors that are associated with smoking habits among Malaysian adults.

Methods: This study was carried out in urban and rural communities with adults aged between 35 and 70 years using purposive sampling.

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Background: About 25% of patients with acute ischemic stroke have lacunar infarct on follow-up imaging. In this secondary analysis from the AcT (Alteplase Compared With Tenecteplase) trial, we assessed if there is variation in safety or efficacy of intravenous thrombolysis by infarct type in patients with no visible occlusion. We also determined if this effect differed between tenecteplase and alteplase.

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Association of Vascular Risk With Severe vs Non-Severe Stroke: An Analysis of the INTERSTROKE Study.

Neurology

December 2024

From the HRB Clinical Research Facility Galway (C.R., M.C., C.J., M.J.O.), School of Medicine, University of Galway; Wellcome Trust-HRB (C.R.), Irish Clinical Academic Training, Dublin, Ireland; Institute of Health Informatics (C.R.), University College London, United Kingdom; Perron Institute Chair in Stroke Research (G.J.H.), Medical School, The University of Western Australia; Perron Institute for Neurological and Translational Science (G.J.H.), Perth, Australia; Rush Alzheimer Disease Research Center (S.O.), Rush University Medical Center, Chicago, IL; Academic Section of Geriatric Medicine (P.L.), Glasgow Royal Infirmary, University of Glasgow, United Kingdom; Beijing Hypertension League Institute (X.W.), China; Health and Medical Sciences (H.K.I.), University of Copenhagen, Denmark; Faculty of Medicine (F.L.), Universidad de La Frontera, Temuco, Chile; King Saud University (F.A.-H.), Riyadh, Saudi Arabia; Institute of Psychiatry and Neurology (A.C.), Warsaw, Poland; Department of Internal Medicine (A.O.), Faculty of Medicine, Istanbul Medeniyet University, Turkey; Sahlgrenska University Hospital and Sahlgrenska Academy (A.R.), University of Gothenburg, Sweden; St Johns Medical College and Research Institute (D.X.), Bangalore, India; and Population Health Research Institute (S.Y., M.J.O.), Hamilton Health Sciences and McMaster University, Ontario, Canada.

Background And Objectives: Acute stroke is associated with a spectrum of functional deficits. The objective of this analysis was to explore whether the importance of individual risk factors differ by stroke severity, which may be of relevance to public health strategies to reduce disability.

Methods: INTERSTROKE is an international case-control study of risk factors of first acute stroke (recruitment 2007-August 2015) in 32 countries.

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The standard treatment for patients with confirmed Venous Leg Ulcers (VLUs) is compression therapy to improve the function of the calf muscle pump. There is a significant cohort of patients who are unable to tolerate optimal compression therapy or indeed any level of compression therapy. In addition, there is a cohort of patients who can tolerate compression whose ulcers show little or no evidence of healing.

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Article Synopsis
  • Complete revascularization is the standard treatment for older STEMI patients with multivessel disease, offering benefits shown in the FIRE trial, though long-term effects remain uncertain.
  • A meta-analysis of several randomized clinical trials analyzed data from 1733 patients aged 75 and older, comparing complete versus culprit-only revascularization strategies.
  • Results indicated that complete revascularization significantly reduced the risk of cardiovascular death or myocardial infarction in the long term, but did not show a difference in overall death rates compared to culprit-only revascularization.
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Background: GLP-1 (glucagon-like peptide-1) receptor agonists and SGLT2 (sodium-glucose cotransporter 2) inhibitors both improve cardiovascular and kidney outcomes in people with type 2 diabetes. We conducted a systematic review and meta-analysis to assess the effects of GLP-1 receptor agonists on clinical outcomes with and without SGLT2 inhibitors.

Methods: We searched MEDLINE and Embase databases from inception until July 12, 2024, for randomized, double-blind, placebo-controlled outcome trials of GLP-1 receptor agonists in type 2 diabetes that reported treatment effects by baseline use of SGLT2 inhibitors, with findings supplemented by unpublished data.

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The treatment effect across ASPECTS in acute ischemic stroke: Analysis from the AcT trial.

Int J Stroke

January 2025

Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Background: Early ischemic changes on baseline imaging are commonly evaluated for acute stroke decision-making and prognostication.

Aims: We assess the association of early ischemic changes on clinical outcomes and whether it differs between intravenous tenecteplase and Alteplase.

Methods: Data are from the phase 3, Alteplase compared to Tenecteplase (AcT) trial.

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Stereoelectroencephalography (SEEG) has emerged as a transformative tool in epilepsy surgery, shedding light on the complex network dynamics involved in focal epilepsy. This review explores the role of SEEG in elucidating the role of deep brain structures, namely the basal ganglia and thalamus, in epilepsy. SEEG advances understanding of their contribution to seizure generation, propagation, and control by permitting precise and minimally invasive sampling of these brain regions.

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A Clinical Diagnostic Test for Calcium Release Deficiency Syndrome.

JAMA

July 2024

Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada.

Article Synopsis
  • - The text discusses Calcium Release Deficiency Syndrome (CRDS), a serious genetic heart condition that can cause sudden cardiac arrest without clear reasons and is not detectable through standard tests.
  • - The study aimed to analyze electrocardiogram (ECG) responses after brief periods of fast heart rates followed by pauses in order to develop a diagnostic test for CRDS.
  • - Findings showed that patients with CRDS had a significantly greater change in T-wave amplitude on their ECG after a pause compared to control groups, indicating a potential diagnostic marker for this syndrome.
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Markers of periodontal disease and risk of stroke: INTERSTROKE case-control study.

J Stroke Cerebrovasc Dis

August 2024

HRB Clinical Research Facility Galway, School of Medicine, University of Galway, Galway, Ireland; Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada.

Article Synopsis
  • Periodontal disease, specifically lost teeth, is linked to an increased risk of stroke in a large international study involving over 26,000 participants from 32 countries.
  • Symptoms like painful teeth and gums did not show a significant association alone, but combined symptoms increased the odds further.
  • This research suggests that managing periodontal disease could be an important way to reduce stroke risk.
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Article Synopsis
  • Cognitive decline is a major concern with aging, linked to higher risks of dementia and stroke, though the exact causes are unclear.
  • A study of 1160 proteins in plasma found five that are associated with cognitive function, specifically in a test called DSST, with two proteins (NCAN and CDCP1) showing consistent results in a follow-up group.
  • The research indicates that some proteins may influence brain health and stroke risk, suggesting avenues for future research and potential drug treatments to help mitigate cognitive decline and related risks.
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Article Synopsis
  • The study examines the link between blood pressure variability during the initial stages of acute stroke and patients' functional outcomes after one month, aiming to identify factors that could modify this variability.
  • Data from 13,206 participants revealed that higher systolic and diastolic blood pressure variability is significantly associated with poorer functional outcomes, particularly when measured by standard deviation (SD).
  • Factors such as age, female sex, high body mass index, and certain lifestyle habits contribute to increased blood pressure variability, indicating that managing these factors could improve outcomes for stroke patients.
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Limb Outcomes With Ticagrelor Plus Aspirin in Patients With Diabetes Mellitus and Atherosclerosis.

J Am Coll Cardiol

April 2024

French Alliance for Cardiovascular Trials, Département Hospitalo-Universitaire FIRE, Hôpital Bichat, Université de Paris, INSERM Unité 1148, Paris, France.

Article Synopsis
  • Ticagrelor, when added to aspirin, was found to reduce major adverse cardiovascular events (MACE) but also increased the risk of bleeding in patients with type 2 diabetes mellitus (T2DM) and coronary artery disease.
  • In a study involving 19,220 patients over a median of 3 years, those with peripheral artery disease (PAD) who received the placebo had significantly higher risks of both MACE and limb events compared to those on ticagrelor.
  • While ticagrelor demonstrated a reducing effect on limb events such as revascularization and acute limb ischemia, the overall bleeding risk also increased; further studies are necessary to explore the balance of benefits and risks in various patient groups.
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Genetic Determinants of Vascular Dementia.

Can J Cardiol

August 2024

Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada; Department of Pathology and Molecular Medicine, McMaster University, Michael G. DeGroote School of Medicine, Hamilton, Ontario, Canada; Thrombosis and Atherosclerosis Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton, Ontario, Canada. Electronic address:

Vascular dementia (VaD) is a prevalent form of cognitive impairment with underlying vascular etiology. In this review, we examine recent genetic advancements in our understanding of VaD, encompassing a range of methodologies including genome-wide association studies, polygenic risk scores, heritability estimates, and family studies for monogenic disorders revealing the complex and heterogeneous nature of the disease. We report well known genetic associations and highlight potential pathways and mechanisms implicated in VaD and its pathological risk factors, including stroke, cerebral small vessel disease, and cerebral amyloid angiopathy.

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Aims: Guidelines recommend extended dual pathway inhibition (DPI) with aspirin and rivaroxaban in patients with chronic coronary syndrome (CCS) at high ischaemic risk. The CHADS-P2A2RC score improves risk prediction and enables antithrombotic treatment allocation in these patients. This study evaluated the net clinical benefit of DPI treatment according to baseline risk as classified by the CHADS-P2A2RC score in patients with CCS included in the COMPASS (Cardiovascular Outcomes for People Using Anticoagulation Strategies) trial.

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Article Synopsis
  • Type 2 diabetes (T2D) is a complex disease influenced by various genetic factors and molecular mechanisms that vary by cell type and ancestry.
  • In a large study involving over 2.5 million individuals, researchers identified 1,289 significant genetic associations linked to T2D, including 145 new loci not previously reported.
  • The study categorized T2D signals into eight distinct clusters based on their connections to cardiometabolic traits and showed that these genetic profiles are linked to vascular complications, emphasizing the role of obesity-related processes across different ancestry groups.
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A method to estimate the contribution of rare coding variants to complex trait heritability.

Nat Commun

February 2024

Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada.

It has been postulated that rare coding variants (RVs; MAF < 0.01) contribute to the "missing" heritability of complex traits. We developed a framework, the Rare variant heritability (RARity) estimator, to assess RV heritability (h) without assuming a particular genetic architecture.

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Patients with end-stage kidney disease (ESKD) experience a high thrombotic risk but are also at increased risk of bleeding. There is an unmet need for safer antithrombotic therapy in patients with ESKD on hemodialysis. Factor XI (FXI) represents an attractive therapeutic target for anticoagulation because of the potential to mitigate the bleeding risks associated with currently approved anticoagulants, especially in patients at high risk of bleeding.

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To evaluate the performance accuracy and workload savings of artificial intelligence (AI)-based automation tools in comparison with human reviewers in medical literature screening for systematic reviews (SR) of primary studies in cancer research in order to gain insights on improving the efficiency of producing SRs. Medline, Embase, the Cochrane Library, and PROSPERO databases were searched from inception to November 30, 2022. Then, forward and backward literature searches were completed, and the experts in this field including the authors of the articles included were contacted for a thorough grey literature search.

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Article Synopsis
  • The study examines waist circumference (WC) as a measure of abdominal obesity for predicting major cardiovascular events (MACE) and diabetes in a Colombian cohort, highlighting the need for region-specific cut-off points rather than relying on Asian population data.
  • Data from 6,580 participants over 12 years revealed mean WC values of 85.2 cm for women and 88.3 cm for men, with optimal cut-off points determined to be 88.85 cm for men and 85.65 cm for women for predicting health outcomes.
  • The findings suggest that using these specific cut-off values (89 cm for men and 86 cm for women) can help identify individuals at higher risk for
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Background: Rivaroxaban plus aspirin compared with aspirin alone reduced major cardiac and ischemic limb events after lower extremity revascularization (LER) in the VOYAGER PAD (Vascular Outcomes Study of ASA Along With Rivaroxaban in Endovascular or Surgical Limb Revascularization for Peripheral Artery Disease) trial. The effect has not been described in patients undergoing endovascular LER.

Methods: The VOYAGER PAD trial randomized 6564 patients with symptomatic peripheral artery disease to a double-blinded treatment with 2.

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Individual- and supply-level macronutrient intakes are well correlated over a 50-year period (1961-2011) in 18 countries in Asia, North America, and Europe.

Nutr Res

November 2023

Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, L8L 2X2, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, L8S 4L8, Canada.

Reliable information on dietary trends is essential. We compared individual-level dietary estimates for total energy, carbohydrate, fat, and protein intake over time with national supply data from the Global Expanded Nutrient Supply Model (186 paired estimates from 1961 to 2011, 18 countries). We hypothesized that supply data would overestimate individual measures and that the two measures would be weakly correlated.

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