1,040 results match your criteria: "Sunnybrook Health Sciences center[Affiliation]"

Harnessing Placebo Effects for the Treatment of Functional Cognitive Disorder: A Feasibility Pilot Study.

J Neuropsychiatry Clin Neurosci

July 2024

Neuropsychiatry Program, Department of Psychiatry, and Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Center, University of Toronto, Toronto (Burke); Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto (Burke); Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology (Burke, Cappon, Santarnecchi) and Program in Placebo Studies (Burke), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston; Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Center for Memory Health, Hebrew SeniorLife, Boston (Cappon, Pascual-Leone); Department of Neurology, Harvard Medical School, Boston (Cappon, Pascual-Leone, Santarnecchi); Departments of Neurology and Psychiatry (Perez) and Precision Neuroscience and Neuromodulation Program, Gordon Center for Medical Imaging (Santarnecchi), Massachusetts General Hospital and Harvard Medical School, Boston; Guttmann Brain Health Institute, Barcelona, Spain (Pascual-Leone).

Objective: Limited research has directly investigated whether and how placebo effects can be harnessed for the treatment of functional neurological disorder (FND), despite a long-standing and controversial history of interest in this area.

Methods: A small exploratory study was conducted with adults with a cognitive subtype of FND recruited from a single cognitive neurology center in the United States. Participants were given the expectation of receiving cranial stimulation that could benefit their memory symptoms; however, the intervention was sham transcranial magnetic stimulation (placebo).

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Background And Objectives: Withdrawal of life-sustaining treatment (WLST) in severe traumatic brain injury (TBI) is complex, with a paucity of standardized guidelines. We aimed to assess the variability in WLST practices between trauma centers in North America.

Methods: This retrospective study used data from trauma centers through the American College of Surgeons Trauma Quality Improvement Program between 2017 and 2020.

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Purpose: Early administration and protocolization of massive hemorrhage protocols (MHP) has been associated with decreases in mortality, multiorgan system failure, and number of blood products used. Various prediction tools have been developed for the initiation of MHP, but no single tool has demonstrated strong prediction with early clinical data. We sought to develop a massive transfusion prediction model using machine learning and early clinical data.

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Objective: To examine the association of anesthesiologist sex on postoperative outcomes.

Background: Differences in patient postoperative outcomes exist, depending on whether the primary surgeon is male or female, with better outcomes seen among patients treated by female surgeons. Whether the intraoperative anesthesiologist's sex is associated with differential postoperative patient outcomes is unknown.

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Spreading depolarization suppression from inter-astrocytic gap junction blockade assessed with multimodal imaging and a novel wavefront detection scheme.

Neurotherapeutics

January 2024

Department of Physiology, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada; Division of Genetics and Development, Krembil Research Institute, 60 Leonard Ave., Toronto, Ontario M5T 2S8, Canada; Krembil Neuroscience, Krembil Research Institute, 60 Leonard Ave., Toronto, Ontario M5T 2S8, Canada; The Institute Biomedical Engineering, University of Toronto, 164 College St., Toronto, Ontario M5S 3G9, Canada.

Spreading depolarizations (SDs) are an enigmatic and ubiquitous co-morbidity of neural dysfunction. SDs are propagating waves of local field depolarization and increased extracellular potassium. They increase the metabolic demand on brain tissue, resulting in changes in tissue blood flow, and are associated with adverse neurological consequences including stroke, epilepsy, neurotrauma, and migraine.

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Common data elements (CDEs) for concussion, as established by international bodies, are not being widely used in Ontario, resulting in significant variability in the data being assessed and collected across clinics. CDEs support standardization of care as well as large-scale data sharing for high impact research. A collaborative network - - comprised of health care professionals, researchers, members from advocacy groups, and patients was formed to establish and implement CDEs for concussion care and research.

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Background: The current standard of care (SoC) for the initial treatment of unresectable or metastatic well-differentiated gastroenteropancreatic neuroendocrine tumours (GEP-NET) requires initiation of first-generation somatostatin receptor ligand (SRL) therapy, octreotide and lanreotide, which provide safe and efficacious tumour/symptom control in most patients. However, disease progression can occur with SoC SRL treatment and the optimal dose response of SRL remains unknown. Octreotide subcutaneous depot (CAM2029) is a novel, long-acting, high-exposure formulation that has shown greater bioavailability and improved administration than octreotide long-acting release (LAR) with a well-tolerated safety profile.

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Surgical stabilization of rib fractures for flail chest: Analysis of center-based variability in practice and outcomes.

J Trauma Acute Care Surg

June 2024

From the Division of General Surgery Department of Surgery, (M.H.), Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC; Department of Surgery, St. Michael's Hospital-Unity Health and the Temerty Faculty of Medicine (D.G.), Tory Trauma Program, Sunnybrook Health Sciences Center and the Temerty Faculty of Medicine (B.T., B.H., A.N.), University of Toronto; Division of Respirology and Critical Care Medicine, Department of Medicine, University Health Network (B.T.), Toronto, ON, Canada.

Background: Given the lack of high-quality data on patient selection for surgical stabilization of rib fractures (SSRF), significant variability in practice likely exists across trauma centers. We aimed to determine whether centers with a more liberal approach to SSRF had improved outcomes.

Methods: We performed a retrospective cohort study of adult patients with flail chest admitted to Level I or II trauma centers participating in the American College of Surgeons' Trauma Quality Improvement Program.

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Introduction: The COVID-19 pandemic has caused over 6 million deaths worldwide and is a significant cause of mortality. Mortality dynamics vary significantly by country due to pathogen, host, social and environmental factors, in addition to vaccination and treatments. However, there is limited data on the relative contribution of different explanatory variables, which may explain changes in mortality over time.

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Importance: The decision to withdraw life-sustaining treatment for pediatric patients with severe traumatic brain injury (TBI) is challenging for clinicians and families with limited evidence quantifying existing practices. Given the lack of standardized clinical guidelines, variable practice patterns across trauma centers seem likely.

Objective: To evaluate the factors influencing decisions to withdraw life-sustaining treatment across North American trauma centers for pediatric patients with severe TBI and to quantify any existing between-center variability in withdrawal of life-sustaining treatment practices.

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Objectives: Mothers with a history of adverse childhood experiences (ACE) are at elevated risk for postpartum mental illness and impairment in the mother-infant relationship. Interventions attending to maternal-infant interactions may improve outcomes for these parents and their children, but barriers to accessing in-person postpartum care limit uptake. We adapted a postpartum psychotherapy group for mothers with mental illness (e.

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Objective: To systematically review and meta-analyse the effect of late surfactant administration versus placebo in reducing the incidence of death or bronchopulmonary dysplasia (BPD) in preterm infants.

Design: PubMed, EMBASE, CINAHL and Cochrane CENTRAL were searched until 30 May 2023, for randomised controlled trials (RCTs) comparing administration of surfactant after 48 hours of age versus placebo in preterm ventilator-dependent neonates. The primary outcome was incidence of death or BPD at 36 weeks' postmenstrual age (PMA).

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Background And Objectives: Central cord syndrome (CCS) is expected to become the most common traumatic spinal cord injury, yet its optimal management remains unclear. This study aimed to evaluate variability in nonoperative vs operative treatment for CCS between trauma centers in the American College of Surgeons Trauma Quality Improvement Program, identify patient- and hospital-level factors associated with treatment, and determine the association of treatment with outcomes.

Methods: Adults with CCS were identified from the Trauma Quality Improvement Program database (2014-2016).

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Outcomes for people with respiratory failure in the United States vary by patient race and ethnicity. Invasive ventilation is an important treatment initiated based on expert opinion. It is unknown whether the use of invasive ventilation varies by patient race and ethnicity.

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Introduction: Individuals with chronic kidney disease (CKD) are at increased risk of adverse pregnancy outcomes and are susceptible to disempowerment and decisional burden when receiving reproductive counseling and considering pregnancy. Nephrologists do not frequently counsel about reproductive health, and no tools exist to support patient-centered reproductive counseling for those with CKD.

Methods: A total of 30 patients aged 18 to 45 years with CKD stages 1 to 5 who were assigned female sex at birth and 12 nephrologists from a single academic medical center participated in semistructured qualitative interviews.

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Importance: Prior research has shown differences in postoperative outcomes for patients treated by female and male surgeons. It is important to understand, from a health system and payer perspective, whether surgical health care costs differ according to the surgeon's sex.

Objective: To examine the association between surgeon sex and health care costs among patients undergoing surgery.

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Introduction: Resuscitative thoracotomy (RT) is a critical procedure performed in certain trauma patients in extremis, with extremely low survival rates. Currently, there is a paucity of data pertaining to prehospital variables and their predictive role in survival outcomes in traumatic cardiac arrest (TCA) patients requiring RT. The aim of the study was to determine the impact of prehospital intubation and out-of-hospital time (OOHT) on return of spontaneous circulation (ROSC) and survival in TCA requiring RT.

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Cusp overlap method for self-expanding transcatheter aortic valve replacement.

Catheter Cardiovasc Interv

January 2024

Schulich Heart Program, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada.

Article Synopsis
  • Background: Permanent pacemaker (PPM) implantation is a frequent issue after transcatheter aortic valve replacement (TAVR) with self-expanding valves, prompting a comparison of two implantation techniques to assess their impact on PPM rates.
  • Aims: The study aimed to compare the rates of new PPM implantation and complete heart block in patients undergoing TAVR with self-expanding valves using either the conventional three-cusp technique or the cusp-overlap technique.
  • Results: The cusp-overlap technique significantly reduced in-hospital and 30-day rates of new complete heart block (9.4% vs. 23.4%) and PPM implantation (8% vs. 21%) compared to the standard
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Importance of Direct Exposure in Continuing Medical Education: Primary Care Physician Learning Through Patients With Transcatheter Aortic Valve Implantation.

Can J Cardiol

April 2024

Department of Cardiology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.

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Objective: To determine whether patient-surgeon gender concordance is associated with mortality of patients after surgery in the United States.

Design: Retrospective observational study.

Setting: Acute care hospitals in the US.

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Firearm injuries in Missouri.

PLoS One

November 2023

Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada.

Firearm deaths continue to be a major public health problem, but the number of non-fatal firearm injuries and the characteristics of patients and injuries is not well known. The American College of Surgeons Committee on Trauma, with support from the National Collaborative on Gun Violence Research, leveraged an existing data system to capture lethal and non-lethal injuries, including patients treated and discharged from the emergency department and collect additional data on firearm injuries that present to trauma centers. In 2020, Missouri had the 4th highest firearm mortality rate in the country at 23.

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Introduction: Pulmonary vein isolations (PVI) are being performed using a high-power, short-duration (HPSD) strategy. The purpose of this study was to compare the clinical efficacy and safety outcomes of an HPSD versus low-power, long-duration (LPLD) approach to PVI in patients with paroxysmal atrial fibrillation (AF).

Methods: Patients were grouped according to a HPSD (≥40 W) or LPLD (≤35 W) strategy.

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Importance: Merkel cell carcinoma (MCC) is an aggressive cutaneous neuroendocrine carcinoma. Due to its relatively low incidence and limited prospective trials, current recommendations are guided by historical single-institution retrospective studies.

Objective: To evaluate the overall survival (OS) of patients in Canada with head and neck MCC (HNMCC) according to American Joint Committee on Cancer 8th edition staging and treatment modalities.

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Article Synopsis
  • A study compared the quality of life (QoL) effects of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients, using various standard questionnaires to measure outcomes over time.
  • The analysis included over 10,000 patients from five trials, showing that both procedures significantly improved patients' angina frequency and QoL, with some advantages for CABG at certain follow-up points, like QoL at 12 months.
  • Overall, both CABG and PCI were effective in enhancing long-term disease-specific and general QoL, but CABG showed better results at 6, 12, and 36-60 months in several measures.
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