404 results match your criteria: "St Michaels' Hospital[Affiliation]"

Article Synopsis
  • Drug-coated balloon (DCB) catheters are a new option for treating coronary issues, delivering drugs directly to blood vessel walls without the need for permanent stents.
  • Recent evidence supports their use not only in recurrent restenosis but also in treating new coronary diseases and chronic total occlusions (CTO).
  • A case study showed successful use of a DCB-only strategy in a 49-year-old male with multivessel occlusions, highlighting the need for more research on the long-term effectiveness of DCBs in these scenarios.
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Background: As dissemination and implementation (D&I) research increases, we must continue to expand training capacity and research networks. Documenting, understanding, and enhancing advice networks identifies key connectors and areas where networks are less established. In 2012 Norton et al.

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N-acetyl-aspartate (NAA) and myo-inositol (mI) are neurometabolites reflecting neuronal viability and astrocyte activity, respectively. These are quantified using proton magnetic resonance spectroscopy (1H-MRS) and may be biomarkers for Alzheimer's disease dementia (AD). Our objectives were: 1) Compare dorsolateral prefrontal cortex (DLPFC) NAA and mI levels between AD and cognitively healthy control participants (HC) 2) assess if NAA/mI ratio can distinguish groups, and 3) explore the relationship between metabolites and cognition.

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Advancing excellence: a national peer-coaching program for advanced laparoscopic HPB techniques.

HPB (Oxford)

November 2024

Division of General Surgery, University of Toronto, Toronto, Canada; HPB Surgery Service, St. Joseph's Health Centre, Unity Health Toronto, Toronto, Canada; Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Canada. Electronic address:

Article Synopsis
  • * The program involved educational sessions and hands-on coaching, with positive outcomes reported, including a 34.9% increase in surgeons' comfort with laparoscopic HPB surgeries.
  • * Participants recognized challenges in adopting surgical coaching, emphasizing the need for teamwork, respect, and a willingness to learn to effectively implement these changes in practice.
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Article Synopsis
  • The study examines the long-term outcomes of patients in Ontario, Canada, who were managed non-operatively for acute appendicitis (AA) between 2004-2019.
  • A total of 13,200 adults were included, and findings revealed a 33% chance of needing additional medical intervention within one year and a 36% chance within five years.
  • The results suggest that while the rates of emergency and scheduled surgeries were significant, they were lower than what previous studies had reported, indicating that non-operative management can be a viable option for some patients.
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Unlabelled: Self-diagnosis of retrograde cricopharyngeus dysfunction (RCPD) or abelchia has been increasing over the past 5 years with patients seeking treatment for lifelong symptoms of inability to burp, neck gurgling, bloating, and flatulence. There is a distinct paucity of objective data in diagnosis and underlying pathophysiology of this disorder.

Objective: The purpose of this study was to prospectively evaluate patients with abelchia using standardized investigations to explore possible underlying mechanisms.

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Introduction: Artificial intelligence (AI) has the potential to improve healthcare quality when thoughtfully integrated into clinical practice. Current evaluations of AI solutions tend to focus solely on model performance. There is a critical knowledge gap in the assessment of AI-clinician interactions.

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Background: The assessment of serum neurofilament light chain (sNfL) concentration in multiple sclerosis (MS) is a useful tool for predicting clinical outcomes and assessing treatment response. However, its use in clinical practice is still limited. We aimed to assess how measurement of sNfL influences neurologists' treatment decisions in MS.

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The use of intrathecal (IT) dexamethasone during subarachnoid block (SAB) has not been evaluated. There are no pooled data available to decide on the optimal regimen of IT dexamethasone during SAB, irrespective of the type of surgery. There is uncertainty about its dosage, effectiveness, and safety, and a need to establish clear guidelines on its use.

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Article Synopsis
  • The COMET trial aims to determine if whole-body hypothermia can improve cognitive development in neonates with mild hypoxic ischemic encephalopathy, a condition linked to learning difficulties.
  • It is a phase III multicenter randomized controlled trial involving 426 neonates, comparing hypothermia treatment (33.5°C) to normothermia (37.0°C) within the first six hours of birth.
  • The primary goal is to evaluate cognitive outcomes at two years using the Bayley scales, while also ensuring the trial's safety and assessing healthcare resource utilization.
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Calibrating Shock Strength for Cardioversion in Atrial Fibrillation: Less Is More or More Is More?

Can J Cardiol

November 2024

Sunnybrook Research Institute and Department of Emergency Services, Sunnybrook Health Science Centre, Toronto, Ontario, Canada; Department of Family and Community Medicine, Division of Emergency Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.

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Individuals with disabilities may require specific medications in pregnancy. The prevalence and patterns of medication use, overall and for medications with known teratogenic risks, are largely unknown. This population-based cohort study in Ontario, Canada, 2004-2021, comprised all recognized pregnancies among individuals eligible for public drug plan coverage.

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Therapeutic hypothermia improves outcomes following neonatal hypoxic-ischaemic encephalopathy, reducing cases of death and severe disability such as cerebral palsy compared with normothermia management. However, when cooled children reach early school-age, they have cognitive and motor impairments which are associated with underlying alterations to brain structure and white matter connectivity. It is unknown whether these differences in structural connectivity are associated with differences in functional connectivity between cooled children and healthy controls.

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Systemic mastocytosis (SM) is a rare haematological neoplasm associated with the gain of function mutation KIT D816V in 90% of adult patients. Classically, cytogenetic aberrations are not common except in cases of SM associated with another haematological neoplasm. We highlight here an unusual clinical presentation of SM and demonstrate the utility of advanced cytogenetic analysis (optical genome mapping, OGM) in detecting a novel cytogenetic abnormality resulting in an unusual mechanism of DNMT3A and TET2 loss of function.

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Objective: Current guidelines recommend that patients presenting with ST-elevation myocardial infarction (STEMI) to hospitals not capable of performing primary percutaneous coronary intervention (PCI) be transferred to a PCI-capable hospital if reperfusion can be accomplished within 120 min. Most STEMI patients are accompanied by an advanced care paramedic (ACP, equivalent to EMT-P), nurse, or physician who can manage complications should they arise. In our region, stable STEMI patients are transported by primary care paramedics (PCPs, similar scope of practice to advanced EMT) in cases where a nurse, physician, or ACP paramedic is not available.

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Olfactory bulb anomalies in KBG syndrome mouse model and patients.

BMC Med

April 2024

Department of Medical Genetics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 2H7, Canada.

ANKRD11 (ankyrin repeat domain 11) is a chromatin regulator and the only gene associated with KBG syndrome, a rare neurodevelopmental disorder. We have previously shown that Ankrd11 regulates murine embryonic cortical neurogenesis. Here, we show a novel olfactory bulb phenotype in a KBG syndrome mouse model and two diagnosed patients.

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Background: Rhinological procedures demand a high degree of technical expertise and anatomical knowledge. Because of limited surgical opportunities, ethical considerations and the complexity of these procedures, simulation-based training has become increasingly important. This review aimed to evaluate the effectiveness of simulation models used in rhinology training.

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Background: The DOSE VF randomized controlled trial (RCT) employed a pragmatic definition of refractory ventricular fibrillation (VF after three successive shocks). However, it remains unclear whether the underlying rhythm during the first three shocks was shock-refractory or recurrent VF.

Objective: To explore the relationship between alternate defibrillation strategies employed during the DOSE VF RCT and the type of VF, either shock-refractory VF or recurrent VF, on patient outcomes.

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Ventilator Weaning and Extubation.

Crit Care Clin

April 2024

Department of Critical Care, Ottawa Hospital, Ottawa, Ontario, Canada; Division of Thoracic Surgery, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.

Increasing evidence supports specific approaches to liberate patients from invasive ventilation including the use of liberation protocols, inspiratory assistance during spontaneous breathing trials (SBTs), early extubation of patients with chronic obstructive pulmonary disease to noninvasive ventilation, and prophylactic use of noninvasive support strategies after extubation. Additional research is needed to elucidate the best criteria to identify patients who are ready to undergo an SBT and to inform optimal screening frequency, the best SBT technique and duration, extubation assessments, and extubation decision-making. Additional clarity is also needed regarding the optimal timing to measure and report extubation success.

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Background And Purpose: To assess cost-effectiveness of late time-window endovascular treatment (EVT) in a clinical trial setting and a "real-world" setting.

Methods: Data are from the randomized ESCAPE trial and a prospective cohort study (ESCAPE-LATE). Anterior circulation large vessel occlusion patients presenting > 6 hours from last-known-well were included, whereby collateral status was an inclusion criterion for ESCAPE but not ESCAPE-LATE.

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Heterogeneity of Cognition in Older Adults with Remitted Major Depressive Disorder: A Latent Profile Analysis.

Am J Geriatr Psychiatry

July 2024

Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Toronto Dementia Research Alliance (TKR, BHM), University of Toronto, Toronto, ON, Canada. Electronic address:

Objectives: To identify data-driven cognitive profiles in older adults with remitted major depressive disorder (rMDD) with or without mild cognitive impairment (MCI) and examine how the profiles differ regarding demographic, clinical, and neuroimaging measures.

Design: Secondary cross-sectional analysis using latent profile analysis.

Setting: Multisite clinical trial in Toronto, Canada.

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Differences in methylation profiles between long-term survivors and short-term survivors of IDH-wild-type glioblastoma.

Neurooncol Adv

January 2024

Department of Medicine, Divisions of Neurology and Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.

Background: Patients with glioblastoma (GBM) have a median overall survival (OS) of approximately 16 months. However, approximately 5% of patients survive >5 years. This study examines the differences in methylation profiles between long-term survivors (>5 years, LTS) and short-term survivors (<1 year, STS) with isocitrate dehydrogenase (IDH)-wild-type GBMs.

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Introduction: We examine trends in inguinal hernia repairs with respect to the COVID-19 pandemic and secular trends in Ontario, Canada.

Methods: This was a retrospective cohort study. Hernia repairs performed January 1, 2010-December 31, 2022 were captured from health administrative inpatient and outpatient databases.

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