141 results match your criteria: "Surgical Outcomes Research Centre (SOURCE) and McMaster University;[Affiliation]"

Nonsurgical Knee Osteoarthritis Treatments for Reducing Inflammation as Measured on MRI Scans: A Systematic Review of Randomized Controlled Trials.

Orthop J Sports Med

December 2024

Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Background: Knee osteoarthritis (OA) is a debilitating condition, and synovitis is a structural marker of disease progression that can be identified on magnetic resonance imaging (MRI). Nonsurgical therapies have been developed with the goal of targeting this inflammation to reduce pain and slow disease progression.

Purpose: To review current randomized controlled trials (RCTs) that measured changes in pain outcomes and synovitis on MRI scans after nonsurgical treatment for persons with knee OA.

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Article Synopsis
  • The text discusses the importance of forecasting future health issues in the USA for effective planning and public awareness regarding disease and injury burdens.
  • It describes the methodology for predicting life expectancy, cause-specific mortality, and disability-adjusted life-years (DALYs) from 2022 to 2050 using the Global Burden of Diseases framework.
  • The forecasting includes various scenarios to assess the potential impacts of health risks and improvements across the country, focusing on demographic trends and health-related risk factors.
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A consensus definition of creativity in surgery: A Delphi study protocol.

PLoS One

December 2024

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Article Synopsis
  • Clear definitions of creativity are crucial in scientific fields, especially in complex domains like surgery, where creativity can enhance problem-solving and innovation.* -
  • The study aims to establish a consensus definition of creativity in surgery through the insights of experienced surgeons and existing literature, addressing the unique challenges of the profession.* -
  • Methods include focus group discussions to explore surgeons' perceptions, rating existing definitions, and considering essential components of creativity beyond novelty and effectiveness.*
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Background: To meaningfully understand outcomes of gender-affirming care, patient-reported outcome measures (PROMs) that are grounded in what matters to individuals seeking care are urgently needed. The objective of this study was to develop a comprehensive PROM to assess outcomes of gender-affirming care in clinical practice, research, and quality initiatives (the GENDER-Q).

Methods: Internationally established guidelines for PROM development were used to create a field test version of the GENDER-Q.

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Reevaluating antibiotic prophylaxis: insights from a network meta-analysis on dry socket and surgical site infections.

Evid Based Dent

December 2024

Centre for Biostatistics, School of Health Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.

Data Sources: Three databases (MEDLINE, Cochrane Library, and Scopus) were searched in December 2021 for 16 Randomised Clinical Trials (RCTs).

Study Selection: Three reviewers reviewed the articles on oral antibiotic prophylaxis (ABP) for the prevention of surgical site infection (SSI) and dry socket (DS) after lower third molar (L3M) extraction using the PICO framework. From 1999 to 2021, RCTs involving healthy patients undergoing L3M extraction with ABP, placebo, or no therapy were included.

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Background: Unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) are treatment options for patients with medial spontaneous osteonecrosis of the knee (SONK).

Purpose: To compare the clinical outcomes after UKA and HTO in patients with SONK.

Study Design: Cohort study; Level of evidence, 3.

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Surgical Predictors of Clinical Outcome 6 Years After Revision ACL Reconstruction.

Am J Sports Med

November 2024

Luminis Health Orthopedics, Pasadena, MD, USA.

Background: Revision anterior cruciate ligament (ACL) reconstruction has been documented to have inferior outcomes compared with primary ACL reconstruction. The reasons why remain unknown.

Purpose: To determine whether surgical factors performed at the time of revision ACL reconstruction can influence a patient's outcome at 6-year follow-up.

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Purpose: Movement restrictions and assistive devices have traditionally been recommended to prevent hip dislocation after total hip arthroplasty (THA). Considering the advancements in THA surgery, a review of treatment recommendations is worthwhile. The aim of this study was to investigate whether unrestricted protocol (without movement restrictions and assistive devices) should be recommended for THA patients.

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Article Synopsis
  • The KNEES-ACL is a 41-item patient-reported outcome measure created for individuals with ACL deficiencies and post-reconstruction, proving more effective than other similar measures in clinical studies.
  • The study aimed to translate and adapt this measure from Danish to North American English to make it more accessible.
  • The translation involved a bilingual panel and focus groups to ensure wording fit everyday language, followed by cognitive interviews with ACL injury patients to refine the content to be relevant and understandable.
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  • Researchers studied strokes from 1990 to 2021 to understand how many people get them and how they are affected around the world.
  • In 2021, strokes caused about 7.3 million deaths and were a major cause of health problems, especially in specific regions like Southeast Asia and Oceania.
  • There are differences in stroke risks based on where people live and their age, and some areas actually saw more strokes happening since 2015.
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Despite surgical resection, many patients with muscle invasive urothelial carcinoma (MIUC) experience recurrence. Adjuvant immune checkpoint inhibition (ICI) following radical resection in patients with MIUC demonstrates disparate outcomes among phase III randomized controlled trials (RCTs). Our objective was to synthesize available data regarding the disease-free survival (DFS) benefit of adjuvant ICIs for patients with MIUC and evaluate the overall safety profile of ICIs in this setting.

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Background: In recent years a broader range of immunomodulatory and immunosuppressive treatment options have emerged for people with progressive forms of multiple sclerosis (PMS). While consensus supports these options as reducing relapses, their relative benefit and safety profiles remain unclear due to a lack of direct comparison trials.

Objectives: To compare through network meta-analysis the efficacy and safety of alemtuzumab, azathioprine, cladribine, cyclophosphamide, daclizumab, dimethylfumarate, diroximel fumarate, fingolimod, fludarabine, glatiramer acetate, immunoglobulins, interferon beta 1-a and beta 1-b, interferon beta-1b (Betaferon), interferon beta-1a (Avonex, Rebif), laquinimod, leflunomide, methotrexate, minocycline, mitoxantrone, mycophenolate mofetil, natalizumab, ocrelizumab, ofatumumab, ozanimod, pegylated interferon beta-1a, ponesimod, rituximab, siponimod, corticosteroids, and teriflunomide for PMS.

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Osteochondroplasty with or without labral repair is more cost-effective than arthroscopic lavage with or without labral repair for treatment of young adults with femoroacetabular impingement: A cost-utility analysis based on data from a randomized controlled trial.

J ISAKOS

December 2024

Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada; Department of Surgery, Division of Orthopaedic Surgery, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada. Electronic address:

Objectives: The objective of this study was to conduct a cost-utility analysis of osteochondroplasty with or without labral repair compared to arthroscopic lavage with or without labral repair for femoroacetabular impingement (FAI) from a Canadian public payer perspective.

Methods: A Markov model was constructed to compare the lifetime quality-adjusted life years (QALYs) and costs of the two treatment strategies. The target population was surgical FAI patients aged 36 years.

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Perioperative Transfusion Practices in Adults Having Noncardiac Surgery.

Transfus Med Rev

July 2024

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada; Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.

Surgical patients are often transfused to manage bleeding and anemia. Best practices for red blood cell (RBC) transfusion administration in patient having noncardiac surgery remains controversial and a robust evaluation and description of perioperative transfusion practices is lacking. We characterized perioperative hemoglobin concentrations and transfusion practices from the prospective VISION cohort which included 39,222 patients aged ≥45 years who had inpatient noncardiac surgery.

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Article Synopsis
  • * A pilot randomized trial will involve 90 donors and 324 organ recipients across nine hospitals in Ontario and Québec, with participants receiving either tacrolimus or a placebo before organ retrieval.
  • * Researchers will assess the trial's feasibility, including donor enrollment and recipient consent, while monitoring graft function and survival; findings will be shared publicly through publications and conferences.
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Objectives: Embolic Stroke of Undetermined Source (ESUS) is a distinct stroke entity that disproportionately affects young adults. We sought to describe characteristics, workup and outcomes of young adult ESUS patients who underwent thrombectomy, and compare outcomes to those reported in different age groups.

Materials And Methods: Young-ESUS is a multicenter longitudinal cohort study that enrolled consecutive patients aged 21-50 years at 41 stroke centers in 13 countries between 2017- 2019.

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  • Concerns have emerged regarding the effectiveness of renin-angiotensin system (RAS) blockers in treating heart failure in Black patients compared to non-Black patients with reduced ejection fraction.
  • A study analyzed randomized trials involving both Black and non-Black adults with heart failure to see how RAS blockers affect cardiovascular outcomes between these two groups.
  • Results indicated that Black patients had higher rates of death and hospitalization for heart failure than non-Black patients, with less impactful effects of RAS blockers observed in Black patients, particularly concerning hospitalizations for heart failure.
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  • The study aimed to evaluate the effectiveness and safety of physical rehabilitation and mobilization (PR&M) for adult patients on extracorporeal life support (ECLS), analyzing various studies comparing PR&M approaches with standard care.
  • Seventeen studies with nearly 1,000 patients were reviewed, primarily focusing on those undergoing venovenous and venoarterial ECMO in the ICU; however, the analysis lacked sufficient data for a meta-analysis, leading to a narrative summary.
  • Overall, the findings indicate an uncertain impact of high-intensity PR&M on patient outcomes like mortality and quality of life compared to low-intensity methods, with very low certainty in the evidence due to serious biases and im
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Importance: Catheter ablation is associated with reduced heart failure (HF) hospitalization and death in select patients with atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF). However, the benefit in patients with HF with preserved ejection fraction (HFpEF) is uncertain.

Objective: To investigate whether catheter ablation for AF is associated with reduced HF-related outcomes according to HF phenotype.

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Background: The Global increase in colonization by multidrug-resistant (MDR) bacteria poses a significant concern. The precise impact of MDR colonization in solid organ transplant recipients (SOTR) remains not well established.

Objectives: To assess the impact of MDR colonization on SOTR's mortality, infection, or graft loss.

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  • The study investigates whether ticagrelor or clopidogrel monotherapy is as effective as dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in preventing major adverse cardiovascular events like death, myocardial infarction (MI), or stroke.
  • Researchers conducted a systematic review using data from various sources, analyzing patient information from randomized trials to compare the outcomes of the different treatments.
  • The analysis included data from 25,960 PCI patients, showing that the efficacy and safety of ticagrelor or clopidogrel monotherapy were evaluated against DAPT to determine their noninferiority regarding adverse clinical outcomes.
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Aims: The Saudi Urolithiasis Guidelines are a set of recommendations for diagnosing, evaluating, and treating urolithiasis in the Saudi population. These guidelines are based on the latest evidence and expert consensus to improve patient outcomes and optimize care delivery. They cover the various aspects of urolithiasis, including risk factors, diagnosis, medical and surgical treatments, and prevention strategies.

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  • Type 2 diabetes (T2D) is a complex disease influenced by various genetic factors and molecular mechanisms that vary by cell type and ancestry.
  • In a large study involving over 2.5 million individuals, researchers identified 1,289 significant genetic associations linked to T2D, including 145 new loci not previously reported.
  • The study categorized T2D signals into eight distinct clusters based on their connections to cardiometabolic traits and showed that these genetic profiles are linked to vascular complications, emphasizing the role of obesity-related processes across different ancestry groups.
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Background: High tibial osteotomy (HTO) is a successful joint-preserving procedure for the treatment of medial compartment osteoarthritis. Long-term survivorship of HTO ranges from 40% to 85%. There are consistent factors that predict failure.

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Rationale: Clinical deterioration of patients hospitalized outside the ICU is a source of potentially reversible morbidity and mortality. To address this, some acute care hospitals have implemented systems aimed at detecting and responding to such patients.

Objectives: To provide evidence-based recommendations for hospital clinicians and administrators to optimize recognition and response to clinical deterioration in non-ICU patients.

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