2,421 results match your criteria: "Kingston General Hospital.[Affiliation]"

Background: Diffuse intrinsic pontine glioma (DIPG) stands as the predominant type of brainstem glioma. It is characterized by a notably brief median survival period, with the majority of patients experiencing disease progression within six months following radiation therapy. This systematic review and meta-analysis aims to assess the efficacy and safety of hypofractionated radiotherapy (HFRT) compared to conventionally fractionated radiotherapy (CFRT) in DIPG treatment.

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Patients' considerations of time toxicity when assessing cancer treatments with marginal benefit.

Oncologist

November 2024

Cancer Care and Epidemiology, Sinclair Cancer Research Institute, Queen's University, Kingston, ON K7L3N6, Canada.

Background: Effective techniques for eliciting patients' preferences regarding their own care, when treatment options offer marginal gains and different risks, is an important clinical need. We sought to evaluate the association between patients' considerations of the time burdens of care ("time toxicity") with decisions about hypothetical treatment options.

Methods: We conducted a secondary analysis of a multicenter, mixed-methods study that evaluated patients' attitudes and preferences toward palliative-intent cancer treatments that delayed imaging progression-free survival (PFS) but did not improve overall survival (OS).

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Purpose: Standard-of-care first-line treatment for recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) is pembrolizumab plus platinum and fluorouracil (FU). However, FU is associated with potential challenges (continuous 4-day infusion, high administration costs, and cardiovascular and gastrointestinal toxicities), creating a clinical need for alternative chemotherapy combinations. We evaluated the efficacy and safety of first-line pembrolizumab plus carboplatin and paclitaxel for R/M HNSCC in the open-label, single-arm, phase IV KEYNOTE-B10 study (ClinicalTrials.

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Stereotactic ablative radiotherapy for locally advanced non-small cell lung cancer: A systematic review and meta-analysis.

Radiother Oncol

December 2024

Latin America Cooperative Oncology Group (LACOG), Porto Alegre, Brazil; Department of Oncology - Division of Radiation Oncology, Kingston General Hospital, Queen's University, Kingston, ON, Canada.

Introduction: To evaluate the feasibility, efficacy and safety of stereotactic ablative radiotherapy (SABR) to the primary tumor and lymph nodes in patients with locally advanced non-small cell lung cancer (LA-NSCLC) who are ineligible for or refused concomitant chemoradiation.

Materials And Methods: In accordance with the PRISMA and MOOSE guidelines, a systematic review with meta-analysis was conducted. The study included reports that assessed the outcomes of SABR treatment in patients with LA-NSCLC.

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Background: Ultra-low-field magnetic resonance imaging (ULF-MRI) has emerged as an alternative with several portable clinical applications. This review aims to comprehensively explore its applications, potential limitations, technological advancements, and expert recommendations.

Methods: A review of the literature was conducted across medical databases to identify relevant studies.

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Article Synopsis
  • - Significant advances in managing large laterally spreading tumors (LSTs) in colorectal polyps exist, but management practices vary globally, prompting the need for an international consensus.
  • - A Delphi study involving 43 experts from 18 countries led to 42 statements reaching consensus regarding training, evaluation, resection techniques, and post-resection care for LSTs.
  • - The resulting expert consensus aims to standardize practices and provide clear guidance for evaluating, resecting, and following up on LSTs worldwide.
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Purpose: Medical errors may be occasionally explained by inattentional blindness (IB), i.e., failing to notice an event/object that is in plain sight.

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Sex- and age-adjusted reference values for dynamic inspiratory constraints during incremental cycle ergometry.

Respir Physiol Neurobiol

September 2024

Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston General Hospital, Connell 2-200. 102 Stuart St., Kingston, ON K7L 2V7, Canada. Electronic address:

Activity-related dyspnea in chronic lung disease is centrally related to dynamic () inspiratory constraints to tidal volume expansion. Lack of reference values for exertional inspiratory reserve (IR) has limited the yield of cardiopulmonary exercise testing in exposing the underpinnings of this disabling symptom. One hundred fifty apparently healthy subjects (82 males) aged 40-85 underwent incremental cycle ergometry.

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Ten-Year Review of the Postpartum Maternal Health Clinic at the Kingston Health Sciences Centre.

J Obstet Gynaecol Can

August 2024

Queen's University Department of Obstetrics and Gynaecology, Kingston General Hospital, Kingston, ON. Electronic address:

Objectives: The postpartum Maternal Health Clinic (MHC) sees patients who have experienced pregnancy complications identified as pregnancy-related cardiovascular disease (CVD) risk indicators (hypertensive disorders of pregnancy, gestational diabetes, placental abruption, idiopathic preterm delivery, and intrauterine growth restriction) at 6 months postpartum for CVD risk screening. This project aimed to summarise the past 10 years of the MHC and identify trends in patient characteristics, patient CVD risk assessments, and clinic attendance over time.

Methods: Patients included in this study have experienced 1 or more pregnancy-related CVD risk indicator(s) and have delivered between April 2011 and April 2021.

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Implications of GLP-1 agonist use on airway management.

Am J Emerg Med

August 2024

Department of Anesthesiology, São Luiz Hospital, Itaim / Rede D'Or - CMA Anesthesia Team, São Paulo, Brazil.

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Introduction: Since 2022, all Canadian post-graduate medical programs have transitioned to a Competence by Design (CBD) model within a Competency-Based Medical Education (CBME) framework. The CBME model emphasized more frequent, formative assessment of residents to evaluate their progress towards predefined competencies in comparison to traditional medical education models. Faculty members therefore have increased responsibility for providing assessments to residents on a more regular basis, which has associated challenges.

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Objectives: The aim of this study was to study the prevalence of exocrine pancreas insufficiency (EPI) at a population level and the subsequent risk of pancreatic ductal adenocarcinoma (PDAC).

Materials And Methods: Using TriNetX (a database of over 79 million US residents), we included patients ≥18 years with EPI (identified via ICD-10 codes) and continuous follow-up from 2016-2022. Patients with prior pancreas resection and PDAC before an EPI diagnosis were excluded.

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Effect of neurosurgical residency programs on neurosurgical patient outcomes in a single health care system: a cohort study.

Can J Surg

May 2024

From the Division of Neurosurgery, Department of Surgery, Kingston General Hospital, Kingston, Ont. (Taslimi, Cook, Levy); the Department of Surgery, Queen's University, Kingston, Ont. (Brogly); ICES Queen's, Kingston, Ont. (Li); the Faculty of Medicine, University of British Columbia, Kelowna, B.C. (Rodger); the Department of Life Sciences, Queen's University, Kingston, Ont. (Rodger); and the Department of Neurosurgery, McMaster University, Hamilton, Ont. (Kasper).

Background: The evidence on the benefits and drawbacks of involving neurosurgical residents in the care of patients who undergo neurosurgical procedures is heterogeneous. We assessed the effect of neurosurgical residency programs on the outcomes of such patients in a large single-payer public health care system.

Methods: Ten population-based cohorts of adult patients in Ontario who received neurosurgical care from 2013 to 2017 were identified on the basis of procedural codes, and the cohorts were followed in administrative health data sources.

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Despite major biomedical advancements in various realms of oncology, the benefits of these developments are not equitably distributed, particularly in underresourced settings. Although much work has described the challenges and systemic barriers in global cancer control, in this article we focus on success stories. This article describes clinical care delivered at Rwanda's Butaro Cancer Center of Excellence, the cancer research collaborations under India's National Cancer Grid, and the efforts of Latin America's Institute of Cancer of São Paulo in advancing cancer care and training.

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Purpose: Point-of-care ultrasound (POCUS) allows for rapid bedside assessment and guidance of patient care. Recently, POCUS was included as a mandatory component of Canadian anesthesiology training; however, there is no national consensus regarding the competencies to guide curriculum development. We therefore aimed to define national residency competencies for basic perioperative POCUS proficiency.

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Objectives: While substantial progress has been made in engineering cartilaginous constructs for animal models, further research is needed to translate these methodologies for human applications. Evidence suggests that cultured autologous chondrocytes undergo changes in phenotype and gene expression, thereby affecting their proliferation and differentiation capacity. This study was designed to evaluate the expression of chondrogenic markers in cultured human articular chondrocytes from passages 3 (P3) and 7 (P7), beyond the current clinical recommendation of P3.

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Background: Obesity and chronic pain (CP) represent serious, interrelated global public health concerns that have a profound impact on individuals and society. Bariatric surgery is increasing in popularity and has been proven safe and efficacious, providing long-term weight loss and improvements in many obesity-related co-morbidities. A decrease in CP is often a motivation for bariatric surgery.

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Background And Objectives: Nasal intermittent positive pressure ventilation (NIPPV) has been shown to be superior to nasal continuous positive airway pressure (CPAP) postextubation in preterm neonates. However, studies have not permitted high CPAP pressures or rescue with other modes. We hypothesized that if CPAP pressures >8 cmH2O and rescue with other modes were permitted, CPAP would be noninferior to NIPPV.

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Sedentary behavior does not predict low BMD nor fracture-population-based Canadian Multicentre Osteoporosis Study.

J Bone Miner Res

April 2024

Division of Endocrinology, Department of Medicine, Centre for Menstrual Cycle and Ovulation Research, University of British Columbia, Vancouver, BC V5Z 1M9, Canada.

Article Synopsis
  • Sedentary behavior (SB), or prolonged sitting, has been linked to various health issues, particularly regarding bone health, but there is a lack of population-based data on its long-term impact on bone density and fracture risk.
  • The study assessed the relationship between daily sitting time, bone mineral density (BMD) measured via DXA, and the incidence of low-trauma fractures in a diverse group of over 8,000 participants in Canada aged 25 to 80+.
  • The findings indicated that while increased SB was associated with lower baseline BMD in certain groups, it did not correlate with significant changes in BMD or an increased risk of fractures over a 10-year period.
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Analgesia for rib fractures: a narrative review.

Can J Anaesth

April 2024

Department of Anesthesiology & Perioperative Medicine, Queen's University, Kingston General Hospital, Victory 2 Wing, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.

Purpose: Rib fracture(s) is a common and painful injury often associated with significant morbidity (e.g., respiratory complications) and high mortality rates, especially in the elderly.

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High-resolution manometry (HRM) is used to evaluate the esophageal motor function. Unfortunately, there are times when testing cannot be performed accurately. Our study aimed to quantify the occurrence of failed HRM and identify the associated risk factors.

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