31 results match your criteria: "IWK Hospital[Affiliation]"

AI-PEDURO - Artificial intelligence in pediatric urology: Protocol for a living scoping review and online repository.

J Pediatr Urol

October 2024

Division of Urology, The Hospital for Sick Children, Toronto, ON, Canada; Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada. Electronic address:

Background: Artificial intelligence (AI) and machine learning (ML) methods are increasingly being applied in pediatric urology across a growing number of settings, with more extensive databases and wider interest for use in clinical practice. More than 30 ML models have been published in the pediatric urology literature, but many lack items required by contemporary reporting frameworks to be high quality. For example, most studies lack multi-institution validation, validation over time, and validation within the clinical environment, resulting in a large discrepancy between the number of models developed versus the number of models deployed in a clinical setting, a phenomenon known as the AI chasm.

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Neuropsychological complications of hypoprolactinemia.

Rev Endocr Metab Disord

December 2024

Division of Endocrinology and Metabolism, Department of Medicine, Dalhousie University, Halifax, NS, B3H 2Y9, Canada.

Prolactin (PRL) is primarily produced by the pituitary lactotrophic cells and while initially named for its role in lactation, PRL has several other biological roles including immunomodulation, osmotic balance, angiogenesis, calcium metabolism, and appetite regulation. Most of the PRL-related literature has traditionally focused on hyperprolactinemia, whereas hypoprolactinemia has received little attention. There is evidence to suggest that PRL receptors are widely distributed within the central nervous system including the limbic system.

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Pathogenic FLNA variants affecting the hinge region of filamin A are associated with male survival.

Am J Med Genet A

October 2024

Department of Women's and Children's Health, Dunedin School of Medicine, Otago University, Dunedin, New Zealand.

Article Synopsis
  • Pathogenic variants in the FLNA gene lead to various X-linked developmental disorders, influenced by either increased or decreased filamin A protein levels, which can be understood as gain- or loss-of-function issues.
  • Embryonic lethality is typically associated with hemizygosity for deletions or truncating variants in FLNA, but the study reveals that three specific variants involving the hinge-1 region result in distinct clinical conditions without causing embryonic death in affected males.
  • The findings suggest that while hinge-1 typically provides flexibility to filamin A and is involved in important cellular signaling, its impairment can lead to viable, albeit varied, phenotypes instead of lethal outcomes in male patients.
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Review of current best practices for human milk banking.

Matern Child Nutr

June 2024

Department of Pediatrics, Sinai Health, Toronto, Ontario, Canada.

Mother's/parent milk is the optimal way to feed infants and when unavailable, supplemental donor human milk is preferred. A safe supply of donor human milk should be available for all low birthweight infants for whom it has been shown to reduce morbidity. Human milk banking has been in existence for more than a century, although largely shut down during the 1980s, primarily due to fears of human immunodeficiency virus transmission.

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As the number of people with dementia admitted to hospitals is expected to grow, now is the time to identify methods to improve nursing care of this population. We conducted an environmental scan to identify and describe interventions in Canadian hospitals to improve the nursing care of people with dementia, how they are being evaluated and what issues influence the success of interventions. Methods included a search of published and unpublished literature and key stakeholder interviews.

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Introduction: Vesicoureteral reflux (VUR) is commonly diagnosed in the workup of urinary tract infections or hydronephrosis in children. Traditionally, VUR severity is graded subjectively based on voiding cystourethrogram (VCUG) imaging. Herein, we characterized the association between age, sex, and indication for VCUG, by employing standardized quantitative features.

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Article Synopsis
  • Vesicoureteral reflux grading is subjective and has low reliability, prompting research into improving it through machine learning focused on features like ureteral tortuosity and dilatation.
  • A total of 1,492 kidneys and ureters were analyzed through voiding cystourethrograms, revealing low inter-rater reliability and confirming that higher measured features correlate with higher reflux grades.
  • The machine learning model qVUR demonstrated improved reliability and accuracy in grading reflux, outperforming traditional methods by 3.6-fold, and showed consistent performance across multiple data sets.
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We report on a 57 year old female patient who presented in acute respiratory failure with severe generalized weakness. She was previously misdiagnosed for over three decades as polymyositis. She was treated with enzyme replacement therapy (ERT) for over five years, after being diagnosed with late onset Pompe Disease (LOPD).

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The phenotypic spectrum of AMER1-related osteopathia striata with cranial sclerosis: The first Canadian cohort.

Am J Med Genet A

December 2021

Division of Clinical and Metabolic Genetics, Department of Pediatrics, London Health Sciences, Schulich School of Medicine, Western University, London, Ontario, Canada.

Osteopathia striata with cranial sclerosis (OSCS; OMIM# 300373) is a rare X-linked disorder caused by mutations of the AMER1 gene. OSCS is traditionally considered a skeletal dysplasia, characterized by cranial sclerosis and longitudinal striations in the long bone metaphyses. However, OSCS affects many body systems and varies significantly in phenotypic severity between individuals.

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This clinical consensus document addresses the assessment, selection, and fitting considerations for non-surgical bone conduction hearing devices (BCHD) for children under the age of 5 years identified as having unilateral or bilateral, permanent conductive or mixed hearing losses. Children with profound unilateral sensorineural hearing losses are not addressed. The document was developed based on evidence review and consensus by The Paediatric Bone Conduction Working Group, which is composed of audiologists from North America who have experience working with BCHDs in children.

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Background: Although cure rates for Wilms tumours (WT) are high, many patients receive therapy with attendant long-term complications. Our goal was to stratify WT using genome-wide analyses to identify candidate molecular features for patients who would benefit from a reduction in therapy.

Methods: We generated DNA methylation and exome sequencing data on WT-kidney pairs (n = 57) and unpaired tumours (n = 27) collected either at our centre or by the Children's Oncology Group.

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This study aims to identify predictors of treatment outcome in young children with ASD within a European context, where service provision of intervention remains sporadic. We investigated whether a child's age at baseline, intensity of the intervention provided, type of intervention, child's level of social orienting and cognitive skills at baseline predicted changes in autistic symptoms and cognitive development after 1 year of intervention, in a sample of 60 children with ASD. Our results strongly support early and intensive intervention.

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Objective: Nanotechnology is a promising field with numerous applications across various branches of medicine. The unique innate physical, chemical, and biological properties of nanoparticles enable them to serve as appropriate agents performing diverse functions at cellular and subcellular levels. Spinal pathologies constitute one major field where its applications are being explored.

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Parkinson's disease (PD) is a progressive neurological disorder characterized by motor symptoms as well as severe deficits in olfactory function and microstructural changes in olfactory brain regions. Because of the evidence of asymmetric neuropathological features in early-stage PD, we examined whether lateralized microstructural changes occur in olfactory brain regions and the substantia nigra in a group of early-stage PD patients. Using diffusion tensor imaging (DTI) and the University of Pennsylvania Smell Identification Test (UPSIT), we assessed 24 early-stage PD patients (Hoehn and Yahr stage 1 or 2) and 26 healthy controls (HC).

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Occlusion of one eye of kittens (monocular deprivation) results in a severe and permanent loss of visual acuity in that eye, which parallels closely the vision loss characteristic of human amblyopia. We extended earlier work to demonstrate that amblyopic vision loss can be either blocked or erased very fast by a 10 day period of total darkness following a period of monocular deprivation that begins near birth and extends to at least 8 weeks of age. The parameters of darkness were strict because no visual recovery was observed after 5 days of darkness.

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Introduction: Haemophilia A treatment with factor VIII concentrates requires frequent venipunctures; a central venous access device (CVAD) may be required to facilitate reliable venous access, especially in young children. While CVADs provide reliable venous access, complications such as infection and thrombosis may occur.

Aim: The aim of this study was to assess CVAD use in the Canadian Hemophilia Primary Prophylaxis Study (CHPS), a single-arm, multi-centre prospective study whereby factor use is tailored to individual prophylactic need.

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Objective: To determine the proportion and characteristics of children presenting with childhood absence epilepsy (CAE) who were not taking anti-epileptic drugs (AEDs) and were seizure-free over the last year of long-term follow-up.

Methods: For case finding, centralized EEG records for the province of Nova Scotia allowed identification of all children with typical CAE diagnosed between 1977 and 1985. Follow-up was done in 1994 to 1995.

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The value of laboratory monitoring for children with epilepsy.

Semin Pediatr Neurol

December 1994

Neurology Division, IWK Hospital for Children, Halifax, Nova Scotia.

Routine serum antiepileptic (AED) drug levels and laboratory monitoring for drug toxicity have crept into clinical practice. The value of these routines is uncertain. Serum drug levels do not clearly improve seizure control, predict adverse effects, or influence compliance.

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The elimination of cyclosporin A was assessed in eight pediatric renal transplant patients who received calcium channel blockers concomitantly with their immunosuppressive therapy. In three children, verapamil decreased the rate of elimination of cyclosporin A. In five children who received nifedipine, cyclosporin A elimination was also impaired, which contrasts with the reports in adult patients indicating that this calcium channel blocker has no effect on cyclosporin A elimination.

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Hemodynamic effects of peritoneal dialysis in three children following open heart surgery.

Pediatr Cardiol

January 1992

Department of Pediatrics and Anesthesia, IWK Hospital for Children, Halifax, Nova Scotia, Canada.

We studied the hemodynamic responses of peritoneal dialysis (PD) in three children following open heart surgery. Hemodynamic measurements were made prior to a dialysis run, following the instillation of dialysis solution (20 ml/kg), and immediately prior to and 5 min after drainage of the peritoneal cavity. The same protocol was repeated 48 h later.

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Estimation of pulmonary vascular resistance in patients with ventricular septal defects by echo-Doppler cardiography.

Clin Physiol

July 1991

Department of Pediatric Cardiology, IWK Hospital for Children, Dalhousie University, Halifax, Canada.

The pulmonary vascular resistance is one of the parameters considered in the evaluation of patients with ventricular septal defects. We describe a new method to estimate resistance. The method estimates the systolic resistance in the pulmonary circulation and we assume that there is a linear relation between this resistance and the traditional resistance in which a continuous flow in systole and diastole is assumed.

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Social validation of psychoeducational assessment reports.

J Learn Disabil

October 1990

Psychology Department, IWK Hospital for Children, Halifax, Nova Scotia, Canada.

The present study obtained written feedback concerning psychoeducational reports about youngsters referred to a pediatric hospital for known or suspected learning difficulties. A total of 269 questionnaires, with reference to 80 reports, were sent to parents and professionals. The results indicated that the reports were rated favorably in terms of understandability, explanatory value, and usefulness.

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Left ventricular thrombus following repair of truncus arteriosus.

Pediatr Cardiol

January 1990

Department of Pediatrics, IWK Hospital for Children, Halifax, Nova Scotia, Canada.

A 6-month-old infant developed a left ventricular thrombus in association with low antithrombin-III activity following the repair of a truncus arteriosus. Conservative management was associated with spontaneous resolution of the clot. The significance of this association is discussed.

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