2,793 results match your criteria: "IWK Health Centre[Affiliation]"

Pregnancy loss has been linked to poorer mental and relationship well-being. Given that strong sexual well-being is associated with better mental and physical health, understanding sexual well-being following a recent pregnancy loss may contribute to education and treatment models. Yet, little research has examined the effects of pregnancy loss on both couple members' sexual well-being.

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Purpose: National Wilms Tumor Study-5 (NWTS-5) and AREN0321 evaluated the outcomes of children with rhabdoid tumor of the kidney (RTK) and malignant rhabdoid tumor of soft tissues (MRT).

Patients And Methods: Eligible patients with RTK were enrolled prospectively on NWTS-5 (1995-2002) and treated with carboplatin and etoposide alternating with cyclophosphamide (Regimen RTK). Patients with RTK or MRT were enrolled on AREN0321 (2005-2012) and received vincristine, doxorubicin, and cyclophosphamide alternating with carboplatin, cyclophosphamide, and etoposide (Regimens UH-1 or dose-reduced Revised UH-1).

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Introduction to immunology and immune disorders.

Allergy Asthma Clin Immunol

December 2024

Department of Pediatrics, Division of Allergy, Dalhousie University, IWK Health Centre, Halifax, NS, Canada.

The body has a collection of physical barriers to prevent infection, but once these are overcome, we rely on our immune systems to protect us against a wide variety of infections. The complex mechanisms through which this is achieved are grouped into two lines of defense called the "innate" and "adaptive" immune systems. The innate immune system provides a rapid and tailored response to infection or injury often associated with inflammation.

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Non-immunoglobulin E-mediated food allergy.

Allergy Asthma Clin Immunol

December 2024

Division of Allergy, Department of Pediatrics, Dalhousie University, IWK Health Centre, Halifax, NS, Canada.

Non-immunoglobulin E (IgE)-mediated food allergies are characterized by delayed gastrointestinal (GI) manifestations that occur after exposure to an inciting food protein; they include food protein-induced allergic proctocolitis (FPIAP), food protein-induced enteropathy (FPE), and food protein-induced enterocolitis syndrome (FPIES). Although the exact mechanisms underlying these disorders are not well understood, non-IgE-mediated food allergies likely represent a spectrum of disease with shared pathophysiological processes. Typically, these non-IgE-mediated food allergies begin in infancy or early childhood, although FPIES can present across the lifespan, with increasing reports in adults in recent years.

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Primary prevention of food allergy: beyond early introduction.

Allergy Asthma Clin Immunol

December 2024

Department of Pediatrics, Division of Allergy, Dalhousie University, IWK Health Centre, Halifax, NS, Canada.

Food allergy typically begins early in life and persists as a lifelong condition. Delayed introduction of allergenic foods followed by years of hesitancy to introduce these foods early may have contributed to the increase in food allergy prevalence in recent decades. Most infant feeding guidelines focus on the importance of early introduction of allergenic foods in infants at around age 4-6 months.

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Eosinophilic esophagitis.

Allergy Asthma Clin Immunol

December 2024

Division of Allergy, Department of Pediatrics, Dalhousie University, IWK Health Centre, Halifax, NS, Canada.

Eosinophilic esophagitis (EoE) is an atopic condition of the esophagus that has become increasingly recognized. Diagnosis of the disorder is dependent on the patient's clinical manifestations and must be confirmed by histologic findings on esophageal mucosal biopsies. The epidemiology, pathophysiology, diagnosis, treatment, and prognosis of EoE are discussed in this review.

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Background: The ductus arteriosus is a blood vessel connecting the main pulmonary artery and the proximal descending aorta. After birth, the ductus arteriosus usually closes completely. However, sometimes it remains patent in the neonate, which is called patent ductus arteriosus (PDA).

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Importance: The American Academy of Pediatrics (AAP) higher-risk criteria for brief resolved unexplained events (BRUE) have a low positive predictive value (4.8%) and misclassify most infants as higher risk (>90%). New BRUE prediction rules from a US cohort of 3283 infants showed improved discrimination; however, these rules have not been validated in an external cohort.

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Implementation of infant pain practice change (ImPaC) is a multifaceted web-based resource to support pain practice change in neonatal intensive care unit (NICU). We evaluated the (1) intervention effectiveness and (2) implementation effectiveness of ImPaC using a hybrid type 1 effectiveness-implementation study (ie, cluster randomized controlled trial and longitudinal descriptive study). Eligible level 2 and 3 Canadian NICUs were randomized to intervention (INT) or waitlisted to usual care (UC) for 6 months.

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Atopic dermatitis.

Allergy Asthma Clin Immunol

December 2024

Division of Allergy, IWK Health Centre, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.

Atopic dermatitis (AD) is a common, chronic skin disorder that can significantly impact the quality of life (QoL) of affected individuals as well as their families. Although the pathogenesis of the disorder is not yet completely understood, it appears to result from the complex interplay between defects in skin barrier function, environmental and infectious agents, and immune dysregulation. There are no diagnostic tests for AD; therefore, the diagnosis is based on specific clinical criteria that take into account the patient's history and clinical manifestations.

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Urticaria.

Allergy Asthma Clin Immunol

December 2024

Division of Allergy, Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, NS, Canada.

Urticaria (hives) is a common disorder that may be associated with angioedema (swelling that occurs beneath the skin). It is generally classified as acute or chronic, and chronic urticaria is further classified as spontaneous or inducible Second-generation, non-sedating histamine type 1 (H1)-receptor antihistamines represent the mainstay of therapy for both acute and chronic urticaria. Second-line treatment for uncontrolled chronic urticaria includes omalizumab (a monoclonal anti-immunoglobulin E [IgE] antibody).

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tp53 R217H and R242H mutant zebrafish exhibit dysfunctional p53 hallmarks and recapitulate Li-Fraumeni syndrome phenotypes.

Biochim Biophys Acta Mol Basis Dis

December 2024

Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada; Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada. Electronic address:

Li-Fraumeni syndrome (LFS) is a hereditary cancer predisposition syndrome associated with a highly penetrant cancer spectrum characterized by germline TP53 mutations. We characterized the first LFS zebrafish hotspot mutants, tp53 R217H and R242H (human R248H and R273H), and found these mutants exhibit partial-to-no activation of p53 target genes, have defective cell-cycle checkpoints, and display partial-to-full resistance to apoptosis, although the R217H mutation has hypomorphic characteristics. Spontaneous tumor development histologically resembling human sarcomas was observed as early as 6 months.

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The Canadian Association of Radiologists (CAR) Pediatric Expert Panel is made up of pediatric physicians from the disciplines of radiology, emergency medicine, endocrinology, gastroenterology, general surgery, neurology, neurosurgery, respirology, orthopaedic surgery, otolaryngology, urology, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 50 clinical/diagnostic scenarios, a rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 32 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop 133 recommendation statements across the 50 scenarios.

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This article examines the complicated terrain of immunization acceptance and access among Indigenous peoples in northern Ontario by drawing on conversations held prior to 2019 that explored knowledge about Haemophilus influenzae type a (Hia) infection specifically and attitudes toward vaccines more broadly. In the decade preceding COVID-19, Hia emerged as a leading cause of morbidity and mortality in Indigenous communities in northern Canada. Before developing new vaccines, it is imperative to hold conversations with the communities most affected and to learn more about Indigenous peoples' perceptions of and knowledge about vaccines, both generally and Hia specifically.

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Article Synopsis
  • - This study examines how symptoms from sport-related concussions (SRC) and non-SRC recover in young children aged 5 to 12 years over a period of 12 weeks.
  • - The research included 1,747 children from various pediatric emergency departments and analyzed their symptom changes using a standardized inventory to gather self-reported and parent-reported data.
  • - The findings aim to provide insights into the differences in symptom recovery trajectories between younger children and highlight any variations based on the type of injury experienced.
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Child maltreatment mortality in Canada: An analysis of coroner and medical examiner data.

Child Abuse Negl

January 2025

Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1A 0K9, Canada; School of Arctic and Subarctic Studies, Labrador Campus, Memorial University, 171 Hamilton River Road, Happy Valley-Goose Bay, NL A0P 1E0, Canada. Electronic address:

Background: Fatalities are the most severe consequence of child maltreatment, but there are gaps in what is known about the epidemiology of such deaths in Canada.

Objectives: The objectives of this study were to: (1) identify child maltreatment deaths among those classified as homicide or undetermined manner; (2) estimate rates of child maltreatment mortality by sex, age, geography, and year; and (3) measure differences between rates of child maltreatment mortality and homicide mortality.

Methods: We used a cross-sectional design and analyzed mortality data from the Canadian Coroner and Medical Examiner Database for a ten-year period (2007 to 2016).

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Objectives: We aimed to study the disease course, outcomes, and predictors of outcome in pediatric-onset anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) affecting the kidneys.

Methods: Patients eligible for this study had a diagnosis of granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), or ANCA positive pauci-immune glomerulonephritis, were ≤ 18 years at diagnosis, had renal disease defined by biopsy or dialysis dependence, and had clinical data at diagnosis and either 12- or 24-months. Ambispective data from the ARChiVE/PedVas Registry was used.

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: There remains a lack of compelling objective evidence on whether stereopsis is necessary for an ophthalmic surgical career. It is also unclear if high-grade stereoacuity correlates with better surgical performance. The present study attempts to address this question by comparing the simulated surgical performance of subjects with different levels of stereoacuity using a virtual reality (VR) intraocular surgical simulator (EYESi, VRmagic, Mannheim, Germany).

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Article Synopsis
  • Paediatric hypertrophic cardiomyopathy (HCM) is linked to a higher risk of sudden cardiac death, leading to restrictions on physical activity; this inactivity, combined with rising youth obesity, may negatively impact cardiovascular health in these patients.* -
  • The study involved 56 Canadian HCM patients aged 10-19 and evaluated their cardiovascular health using standardized questionnaires; results showed that many had poor health scores similar to those of the general Canadian youth population.* -
  • Findings indicate a significant number of HCM patients have intermediate or poor cardiovascular health, underscoring the need for targeted interventions to encourage healthier lifestyles and improve overall cardiovascular wellbeing.*
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Article Synopsis
  • The study examines the effects of e-cigarette use on lung function among young adults aged 18 to 24, comparing those exposed to e-cigarettes with those who are not.
  • Participants were categorized based on their history of e-cigarette use, ranging from unexposed to heavy users, with ventilation distribution assessed using the lung clearance index (LCI).
  • Results indicated that e-cigarette users, particularly heavy users, had higher LCI measures compared to unexposed individuals, suggesting that LCI could be a valuable biomarker for detecting early lung function impairment related to e-cigarette use.
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Background/objectives: Despite strong evidence that breastfeeding, skin-to-skin care, and sucrose reduce pain in newborns during minor painful procedures, these interventions remain underutilized in practice. To address this knowledge-to-practice gap, we produced a five-minute parent-targeted video demonstrating the analgesic effects of these strategies and examined whether the use of newborn pain treatment increased in maternal-newborn care settings following the introduction of the video by nurses.

Methods: The design was a pre-post outcome evaluation.

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[Not Available].

CMAJ

November 2024

Canadian Center for Vaccinology (Abu-Raya, Langley), Dalhousie University, IWK Health Centre et Nova Scotia Health Authority; Départements de pédiatrie (Abu-Raya, Langley), de microbiologie et d'immunologie (Abu-Raya), et de santé communautaire et épidémiologie (Langley), Dalhousie University, Halifax, N.-É.; Département de pédiatrie (Lavoie), University of British Columbia, Vancouver, C.-B.

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[Not Available].

CMAJ

November 2024

Canadian Center for Vaccinology (Abu-Raya, Langley), Dalhousie University, IWK Health Centre et le Nova Scotia Health Authority; Départements de pédiatrie (Abu-Raya, Langley), de microbiologie et immunologie (Abu-Raya), et de santé communautaire et épidémiologie (Langley), Dalhousie University, Halifax, N.-É.; Département de pédiatrie (Lavoie), University of British Columbia, Vancouver, C.-B.

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