13,877 results match your criteria: "Sunnybrook Health Sciences Centre.[Affiliation]"
Hospital antimicrobial stewardship funding and resourcing impact on broad-spectrum antibiotic use: a cross-sectional study.
Antimicrob Steward Healthc Epidemiol
December 2024
Public Health Ontario, Dalla Lana School of Public Health, Toronto, ON, Canada.
Background: Antimicrobial stewardship programs (ASPs) aim to mitigate antimicrobial resistance (AMR) by optimizing antibiotic use including reducing unnecessary broad-spectrum therapy. This study evaluates the impact of ASP funding and resources on the use of broad-spectrum antibiotics in Ontario hospitals.
Methods: We conducted a cross-sectional study of antimicrobial use (AMU) across 63 Ontario hospitals from April 2020 to March 2023.
Preferred labels and language to improve communication about lesions at low risk of progressing to cancer: qualitative interviews with patients and physicians.
BMJ Open
January 2025
Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
Objectives: We explored how to improve communication about low-risk lesions including labels, language and other strategies.
Design: Qualitative description and thematic analysis to examine the transcripts of telephone interviews with patients who had low-risk lesions and physicians; and mapping to Communication Accommodation Theory to interpret themes.
Setting: Canada PARTICIPANTS: 15 patients: 6 (40%) bladder, 5 (33%) prostate and 4 (27%) cervix lesions; and 13 physicians: 7 (54%) cervix, 3 (23%) bladder and 3 (23%) prostate lesions.
International Consensus Guidance for the Management of Glucocorticoid Related Complications in Neuromuscular Disease.
Muscle Nerve
January 2025
Neurology Quality and Innovation Lab, Division of Neurology, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.
Introduction/aims: Glucocorticoid (GC)-related adverse reactions and risks are commonly seen during the treatment of immune-mediated and inflammatory neuromuscular disorders. There is wide variation in the management of associated complications. The aim of this study is to develop international consensus guidance on the management of GC-related complications in neuromuscular disorders.
View Article and Find Full Text PDFStratifying vascular disease patients into homogeneous subgroups using machine learning and FLAIR MRI biomarkers.
Npj Imaging
December 2024
Department of Electrical, Computer and Biomedical Engineering, Toronto Metropolitan University, Toronto, ON Canada.
This study proposes a framework to stratify vascular disease patients based on brain health and cerebrovascular disease (CVD) risk using regional FLAIR biomarkers. Intensity and texture biomarkers were extracted from FLAIR volumes of 379 atherosclerosis patients. K-Means clustering identified five homogeneous subgroups.
View Article and Find Full Text PDFIdentifying mild traumatic brain injury in the post-acute polytrauma setting: a scoping review of diagnostic approaches and screening tools.
Brain Inj
January 2025
St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Objective: Mild traumatic brain injury (mTBI) is frequently overlooked in polytrauma patients due to the overshadowing of more severe injuries, a fact that makes its identification in post-acute settings challenging since symptoms overlap with other conditions and no validated diagnostic tools exist. To address this gap, this scoping review explored the literature on mTBI diagnosis in post-acute civilian polytrauma settings.
Methods: By utilizing the Arksey and O'Malley framework and PRISMA-ScR guidelines, the review focused on studies from 2010 to 2024 related to delayed mTBI diagnosis in adults.
Comparison of Renal Adverse Events Between Intravitreal Anti-Vascular Endothelial Growth Factor Agents: A Meta-Analysis.
Am J Ophthalmol
December 2024
Department of Ophthalmology and Vision Sciences (M.B., M.M.P., P.J.K., R.H.M.), University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology (R.H.M.), St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada. Electronic address:
Purpose: To compare the risk of renal adverse events, particularly acute kidney injury (AKI), between intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents.
Design: Meta-analysis.
Methods: A systematic literature search was conducted on Ovid Medline, Embase, and the Cochrane Library for randomized controlled trials (RCTs) published from January 2005 to February 2024 involving adult patients receiving anti-VEGF intravitreal injections for age-related macular degeneration, diabetic macular edema, and macular edema secondary to retinal vein occlusion.
Tranexamic Acid and Blood Transfusion in Liver Resection-Reply.
JAMA
January 2025
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Outcomes among patients with coronary artery bypass grafts presenting with acute coronary syndrome: impact of revascularization.
Ther Adv Cardiovasc Dis
January 2025
Section of Cardiology, Department of Internal Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, MB, Canada Y3006 - 409, Tache Avenue, St. Boniface Hospital, Winnipeg, MB R2H 2A6, Canada.
Background: Patients post-coronary artery bypass graft (CABG) can re-present with acute coronary syndrome (ACS); however, culprit lesion identification, as well as revascularization, is often challenging. Furthermore, the impact of revascularization in this patient group is relatively unknown.
Objectives: The purpose of our study was to evaluate the efficacy of percutaneous coronary intervention (PCI) in patients with previous CABG surgery presenting with ACS.
Delayed Postoperative Radiotherapy in Head & Neck Cancers-A Systematic Review and Meta-Analysis.
Laryngoscope
January 2025
Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Objectives: To evaluate the impact of delayed postoperative radiotherapy (PORT) on overall survival (OS) in patients with head and neck cancers (HNC).
Data Sources: A systematic review and meta-analysis were conducted by searching MEDLINE, Embase, CENTRAL, Web of Science, and CINAHL databases.
Review Methods: Studies assessing the impact of delayed PORT in adult HNC patients were included.
Predefined and data-driven CT radiomics predict recurrence-free and overall survival in patients with pulmonary metastases treated with stereotactic body radiotherapy.
PLoS One
December 2024
Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Background: This retrospective study explores two radiomics methods combined with other clinical variables for predicting recurrence free survival (RFS) and overall survival (OS) in patients with pulmonary metastases treated with stereotactic body radiotherapy (SBRT).
Methods: 111 patients with 163 metastases treated with SBRT were included with a median follow-up time of 927 days. First-order radiomic features were extracted using two methods: 2D CT texture analysis (CTTA) using TexRAD software, and a data-driven technique: functional principal components analysis (FPCA) using segmented tumoral and peri-tumoural 3D regions.
The association between neighbourhood marginalization and SARS-CoV-2 outcomes in patients presenting to emergency departments.
Can J Public Health
December 2024
Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Objective: Social and economic marginalizations have been associated with inferior health outcomes in Canada. Our objective was to describe the relationship between neighbourhood marginalization and COVID-19 outcomes among patients presenting to Canadian emergency departments (ED).
Methods: We conducted an observational study among consecutive COVID-19 patients recruited from 47 hospitals participating in the Canadian COVID-19 ED Rapid Response Network (CCEDRRN) between March 3, 2020, and July 24, 2022.
Transfabric Leaks After Percutaneous Left Atrial Appendage Occlusion Procedures with the WATCHMAN FLX Device.
CJC Open
December 2024
Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Background: Cardiac computed tomography imaging with contrast is being used increasingly to image left atrial appendage occlusion (LAAO) devices. Contrast flow across a device, also known as a transfabric leak (TFL), may indicate a lack of complete LAAO-device endothelialization. The data on the rate, predictors, and clinical events associated with TFL are limited.
View Article and Find Full Text PDFPrimary care follow-up improves outcomes in older adults following emergency general surgery admission.
J Trauma Acute Care Surg
October 2024
From the Sunnybrook Health Sciences Centre, Division of General Surgery (M.P.G.), Toronto Ontario, Canada; Institute of Health Policy, Management, and Evaluation (M.P.G., B.W.T., A.B.N., S.E.B., B.H.), Department of Surgery (M.P.G., A.B.N., B.H.), and Interdepartmental Division of Critical Care Medicine, Department of Medicine (B.W.T., B.H.), University of Toronto; Sunnybrook Research Institute (A.B.N., S.E.B., L.J., B.H., M.P.G.), Toronto, Ontario, Canada; Trauma Quality Improvement Program, American College of Surgeons (A.B.N.), Chicago, Illinois; and ICES (A.B.N., S.E.B., R.S., L.J., A.H., B.H.), Toronto, Ontario, Canada.
Background: While preoperative optimization improves outcomes for older adults undergoing major elective surgery, no such optimization is possible in the emergent setting. Surgeons must identify postoperative interventions to improve outcomes among older emergency general surgery (EGS) patients. The objective of this cohort study was to examine the association between early follow-up with a primary care physician (PCP) and the risk of nursing home acceptance or death in the year following EGS admission among older adults.
View Article and Find Full Text PDFAccelerated growth and local progression of radiorecurrent prostate cancer in an orthotopic bioluminescent mouse model.
Sci Rep
December 2024
Department of Medical Biophysics, University of Toronto, Toronto, Canada.
Globally, prostate cancer is the second most common malignancy in males, with over 400 thousand men dying from the disease each year. A common treatment modality for localized prostate cancer is radiotherapy. However, up to half of high-risk patients can relapse with radiorecurrent prostate cancer, the aggressive clinical progression of which remains severely understudied.
View Article and Find Full Text PDFTowards a histological diagnosis of childhood small vessel CNS vasculitis.
Pediatr Rheumatol Online J
December 2024
Section of Rheumatology, Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Canada.
Background: Primary small vessel CNS vasculitis (sv-cPACNS) is a challenging inflammatory brain disease in children. Brain biopsy is mandatory to confirm the diagnosis. This study aims to develop and validate a histological scoring tool for diagnosing small vessel CNS vasculitis.
View Article and Find Full Text PDFA Remote Management-Centric Postdischarge Pathway for Patients Admitted to GIM with Heart Failure.
Am J Med
December 2024
Department of Medicine, University of Toronto, Toronto, Ontario, Canada; HoPingKong Centre for Excellence in Education and Practice, University Health Network, Toronto, Ontario, Canada; Division of General Internal Medicine and Geriatrics, University Health Network, Toronto, Ontario, Canada.
Background: Few GIM-specific heart failure transition of care (TOC) programs exist. We thus piloted a TOC program for heart failure patients discharged from GIM that incorporates a remote patient management program, Medly.
Methods: This single-centre, prospective proof-of-concept study described sociodemographic and medical characteristics of included patients, and computed summary statistics to describe clinical and workload outcomes.
Development of a National Colorectal Cancer Screening Research Agenda: An Initiative of the Canadian Screening for Colorectal Cancer Research Network (CanSCCRN).
Curr Oncol
December 2024
Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada.
The Canadian Screening for Colorectal Cancer Research Network (CanSCCRN) recently set out to develop a national CRC screening research agenda and identify priority research areas. The specific objectives were to (1) identify evidence gaps relevant to CRC screening and the barriers and facilitators to evidence generation and uptake by CRC screening programs, (2) establish high-priority collaborative research ideas to inform best CRC screening practices, and (3) identify one to two research topics for grant development and submission within 12 to 18 months. Three focus groups were conducted with network members and relevant parties ( = 15) to identify evidence gaps, barriers, and facilitators to evidence generation and uptake.
View Article and Find Full Text PDFA Randomized Control Trial of a Virtually Delivered Program for Increasing Upper Limb Activity After Stroke.
Neurorehabil Neural Repair
December 2024
Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
Background: Upper limb activity following stroke is low, which may limit recovery. We investigated whether a virtually-delivered upper limb program, that included a wearable device with reach-to-grasp feedback, would increase upper limb activity after stroke.
Methods: This was a parallel-group, assessor-blinded, randomized control trial conducted at 6 sites across 5 provinces of the CanStroke Recovery Trials Platform between 2020 to 2022.
Bilateral Lesions in Parkinson's Disease: Gaps and Controversies.
Mov Disord
December 2024
Grenoble Alpes University, CHU of Grenoble, Division of Neurology, Grenoble Institute of Neurosciences, INSERM, Grenoble, France.
Bilateral lesions of the basal ganglia using termocoagulation or radiation for improving tremor, bradykinesia, and rigidity in people with Parkinson's disease (PD) have been performed starting several decades ago, especially when levodopa and deep brain stimulation (DBS) surgery were not available. However, because of unclear additional benefit compared to unilateral lesion, and particularly to the evidence of increased adverse events occurrence, bilateral lesions were basically abandoned at the end of the 20th century. Therefore, bilateral DBS has become the standard procedure to treat PD.
View Article and Find Full Text PDFAssociation Between Serum Thyrotropin and Cancer Recurrence in Differentiated Thyroid Cancer: A Population-Based Retrospective Cohort Study.
Thyroid
December 2024
Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Levothyroxine to suppress thyrotropin (TSH) to <0.5 mIU/L following thyroidectomy in differentiated thyroid cancer (DTC) may reduce recurrence in higher-risk DTC. However, there is limited evidence to support guideline recommendations to maintain TSH in the low-normal range of 0.
View Article and Find Full Text PDFsegcsvd: A Convolutional Neural Network-Based Tool for Quantifying White Matter Hyperintensities in Heterogeneous Patient Cohorts.
Hum Brain Mapp
December 2024
SEB Centre for Brain Resilience & Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada.
White matter hyperintensities (WMH) of presumed vascular origin are a magnetic resonance imaging (MRI)-based biomarker of cerebral small vessel disease (CSVD). WMH are associated with cognitive decline and increased risk of stroke and dementia, and are commonly observed in aging, vascular cognitive impairment, and neurodegenerative diseases. The reliable and rapid measurement of WMH in large-scale multisite clinical studies with heterogeneous patient populations remains challenging, where the diversity of imaging characteristics across studies adds additional complexity to this task.
View Article and Find Full Text PDFThe molecular epidemiology of respiratory syncytial virus in Ontario, Canada from 2022-2024 using a custom whole genome sequencing assay and analytics package.
J Clin Virol
December 2024
Division of Microbiology, Kingston Health Sciences Centre, Kingston, ON, Canada; Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada; Infectious Disease Sequencing Laboratory, Kingston Health Sciences Centre, Kingston, ON, Canada; Gastrointestinal Disease Research Unit, Department of Medicine, Queen's University, Kingston, ON, Canada.
Background: Respiratory Syncytial Virus (RSV) infections are a cause of significant morbidity and mortality in children and the elderly. Despite the clinical burden of disease, very little is known about the inter- and intra-seasonal genomic variability of RSV. Furthermore, the recent approval of vaccines and monoclonal antibody therapies will likely lead to higher selective pressure on RSV.
View Article and Find Full Text PDFPerspectives of Canadian Plastic Surgeons on the Surgical Management of Pressure Injuries.
Plast Surg (Oakv)
December 2024
Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Pressure injuries, particularly among patients with spinal cord injuries and the elderly, significantly contribute to morbidity, mortality, and financial sequelae. Surgical interventions, including debridement and flaps, may improve outcomes, especially for stage 3 and 4 pressure injuries. This survey assesses Canadian plastic surgeons' perspectives and practices regarding the surgical management of these injuries.
View Article and Find Full Text PDFDEK :: AFF2 Fusion Sinonasal and Skull Base Nonkeratinizing Squamous Cell Carcinoma : A Clinical Outcome Study Compared With Conventional Sinonasal Squamous Cell Carcinoma.
Am J Surg Pathol
February 2025
Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center.
DEK :: AFF2 fusion nonkeratinizing squamous cell carcinoma (NKSCC) is an emerging entity in the sinonasal tract, temporal bone, and skull base. However, the clinical behavior of these tumors has not been well studied. Here, we report the largest cohort of DEK :: AFF2 carcinomas to determine if morphology, mitotic rate, and/or Ki-67 IHC are associated with patient outcomes, including a comparison with high-risk human papillomavirus (HPV)-associated and independent patients.
View Article and Find Full Text PDFRisk of bleeding with the concurrent use of amiodarone and DOACs: A systematic review and meta-analysis.
Eur Heart J Cardiovasc Pharmacother
December 2024
Cardiology Department, Health Sciences North, Northern Ontario School of Medicine University, Sudbury, Ontario, Canada.
Background And Aims: Amiodarone is frequently prescribed alongside direct oral anticoagulants (DOACs) in atrial fibrillation (AF). There are concerns regarding drug-drug interactions (DDIs) between amiodarone and DOACs. The literature is conflicting on the clinical implications of this DDI, hence we conducted a meta-analysis to compare bleeding risk among patients receiving DOACs, with and without concurrent amiodarone.
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