17,075 results match your criteria: "Toronto Western Hospital & University of Toronto[Affiliation]"

Introduction: Low Anterior Resection Syndrome (LARS) describes bowel dysfunction post-restorative proctectomy (RP) and is associated with poor quality of life (QoL). The aim of this study was to assess the impact of an interactive online informational and peer support App on participants' QoL (primary outcome), LARS, and emotional distress (secondary outcomes).

Methods: A multicentre, randomized, parallel-group trial was conducted across five Canadian colorectal surgery practices.

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Stroke endovascular thrombectomy related subarachnoid hyperdensity: incidence, predictive factors, and a proposed sub-classification.

Neuroradiology

January 2025

Division of Neuroradiology, University Medical Imaging and Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada.

Background: Subarachnoid hyperdensity (SAH) after endovascular thrombectomy is a well-known phenomenon. Nevertheless, the clinical significance and natural history of this phenomenon is not well described. In addition, we test previously postulated hypotheses of distal occlusions sites and antithrombotic use to SAH prevalence and extent.

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Background: The Montreal Cognitive assessment (MoCA) is a well-validated global cognitive screening instrument. Its validity in progressive supranuclear palsy (PSP) has not been assessed.

Objectives: To evaluate the MoCA as an outcome measure in PSP clinical trials.

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Epigenetic therapies facilitate transcription of immunogenic repetitive elements that cull cancer cells through 'viral mimicry' responses. Paradoxically, cancer-initiating events also facilitate transcription of repetitive elements. Contributions of repetitive element transcription towards cancer initiation, and the mechanisms by which cancer cells evade lethal viral mimicry responses during tumor initiation remain poorly understood.

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Background: Predicting complete liberation from mechanical ventilation (MV) is still challenging. Electrical impedance tomography (EIT) offers a non-invasive measure of regional ventilation distribution and could bring additional information.

Research Question: Whether the display of regional ventilation distribution during a Spontaneous Breathing Trial (SBT) could help at predicting early and successful liberation from MV.

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Engaging dystonia networks with subthalamic stimulation.

Proc Natl Acad Sci U S A

January 2025

Center for Brain Circuit Therapeutics, Department of Neurology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115.

Deep brain stimulation is an efficacious treatment for dystonia. While the internal pallidum serves as the primary target, recently, stimulation of the subthalamic nucleus (STN) has been investigated. However, optimal targeting within this structure and its surroundings have not been studied in depth.

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CAR/CSAR Practice Statement on Pelvic MRI for Endometriosis.

Can Assoc Radiol J

January 2025

Department of Radiology, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.

The Canadian Association of Radiologists (CAR) Endometriosis Working Group was tasked with providing guidance and benchmarks to ensure the quality of technique and interpretation for advanced imaging modalities associated with diagnosing endometriosis. Advanced pelvic ultrasound is essential in diagnosing and mapping pelvic endometriosis, but pelvic MRI serves as an excellent imaging tool in instances where access to advanced ultrasound is limited, or an alternative imaging modality is required. Despite the known utility of MRI for endometriosis, there is no consensus on imaging protocol and patient preparation in Canada.

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Urinary tract dilations (UTDs) are the most frequent prenatal renal anomaly. The spectrum of etiologies causing UTD ranges from mild spontaneously resolving obstruction to severe upper and lower urinary tract obstruction or reflux. The early recognition and management of these anomalies allows for improved renal endowment prenatally and ultimately better outcome for the child.

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Background/objectives: Cardiac arrest may cause significant hypoxic-ischemic injury leading to coma, seizures, myoclonic jerks, or status epilepticus. Mortality is high, but accurate prognostication is challenging. A multimodal approach is employed, in which electroencephalography (EEG) forms a key part with several recognised patterns of prognostic significance.

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Objective: To examine factors associated with high intensity physician-based mental health care services in a population-based sample of children and youth in Ontario, Canada.

Methods: Data from the 2014 Ontario Child Health Study (OCHS) were linked at the person-level to longitudinal health administrative databases containing physician contacts in outpatient settings, emergency departments and hospitals. Our analytical sample (15.

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Bleomycin sclerotherapy for venous vascular malformations of the tongue.

J Neurointerv Surg

January 2025

Division of Neuroradiology, Toronto Western Hospital, Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Background: Venous vascular malformations (VVMs) are congenital vascular anomalies, often impacting quality of life due to discomfort, swelling, and functional impairments. This study evaluates the efficacy of bleomycin sclerotherapy as a treatment for symptomatic VVMs of the tongue.

Methods: We conducted a retrospective review of all patients treated with this method in our institution between 2004 and 2024.

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Prominent Head and Arm Tremor in Late-Onset Pelizaeus-Merzbacher-Like Disease 1.

Mov Disord Clin Pract

January 2025

Division of Neurology University of Toronto, Movement Disorder Clinic, Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Ontario, Canada.

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Tumor burden with AFP improves survival prediction for TACE-treated patients with HCC: An international observational study.

JHEP Rep

January 2025

State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.

Background & Aims: Current prognostic models for patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) are not extensively validated and widely accepted. We aimed to develop and validate a continuous model incorporating tumor burden and biology for individual survival prediction and risk stratification.

Methods: Overall, 4,377 treatment-naive candidates for whom TACE was recommended, from 39 centers in five countries, were enrolled and divided into training, internal validation, and two external validation datasets.

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Background: Intracerebral hemorrhage (ICH) causes prominent deposition of extracellular matrix molecules, particularly the chondroitin sulphate proteoglycan (CSPG) member neurocan. In tissue culture, neurocan impedes the properties of oligodendrocytes. Whether therapeutic reduction of neurocan promotes oligodendrogenesis and functional recovery in ICH is unknown.

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Updates on Recent Advances in the Therapy of Adult Psoriatic Disease.

Curr Rheumatol Rev

January 2025

University of Toronto, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada.

Psoriatic arthritis (PsA) is a heterogeneous inflammatory disease with various joint and skin manifestations and multiple associated comorbidities. The management of PsA is important not only in controlling disease activity and preventing subsequent damage but also in improving the quality of life and reducing mortality. Over the years, numerous drugs have been introduced into the therapeutic armamentarium of the disease.

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Purpose Of Review: To highlight recent research on antidepressant use and weight change and explore best clinical practices for reducing weight gain and obesity risk in individuals with depression.

Recent Findings: Research on antidepressant use and weight gain suggests that genetic and biological factors including metabolizer phenotypes and inflammation can help to predict an individual's threshold for weight change among specific agents. For individuals with increased susceptibility to metabolic complications, medications including bupropion, fluoxetine, and newer agents (e.

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Objective: Malalignment following cervical spine deformity (CSD) surgery can negatively impact outcomes and increase complications. Despite the growing ability to plan alignment, it remains unclear whether preoperative goals are achieved with surgery. The objective of this study was to assess how good surgeons are at achieving their preoperative goal alignment following CSD surgery.

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Purpose: Continuous EEG (cEEG) monitoring is increasingly used in the management of neonates with seizures. There remains debate on what clinically relevant information can be gained from cEEG in neonates with suspected seizures, at high risk for seizures, or with definite seizures, as well as the use of cEEG for prognosis in a variety of conditions. In this guideline, we address these questions using American Clinical Neurophysiology Society structured methodology for clinical guideline development.

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Article Synopsis
  • The study aimed to determine effective cutoff scores for the Psoriatic Arthritis Impact of Disease questionnaire (PsAID12) based on disease activity measures in patients with PsA.
  • Using data from the ReFlaP study, researchers analyzed scores to define disease states such as remission and varying impact levels, employing statistical methods to establish these cutoffs.
  • Results indicated that the PsAID12 score had high diagnostic performance against established benchmarks, but further validation and expert consensus are needed to confirm the proposed cutoffs for clinical use.
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When should the tricuspid valve be repaired during mitral valve repair?

Curr Opin Cardiol

December 2024

Division of Cardiac Surgery, Department of Surgery, Western University, London, Ontario, Canada.

Purpose Of Review: Management of tricuspid regurgitation and annular dilation during mitral valve repair remains controversial. We review the latest evidence on indications to repair the tricuspid valve during mitral valve repair and discuss surgical strategies and complications.

Recent Findings: Concomitant tricuspid valve repair of moderate tricuspid regurgitation is effective in reducing tricuspid regurgitation progression at 2 years, but has not shown benefit to late survival, quality of life, or functional benefit, and is associated with increased permanent pacemaker implantation (PPM) rates, which is associated with reduced late survival.

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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.

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Objective: This study examined the lived employment experiences of young adults with childhood and adult-onset systemic lupus erythematosus (SLE).

Methods: Participants were recruited from three Canadian lupus clinics and asked to complete, semi-structured, qualitative video/phone interviews. Interviews were transcribed verbatim and analyzed using thematic analysis.

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Genetic variants of accessory proteins and G proteins in human genetic disease.

Crit Rev Clin Lab Sci

January 2025

Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, West Midlands, UK.

We present a series of three articles on the genetics and pharmacogenetics of G protein- coupled receptors (GPCR). In the first article, we discuss genetic variants of the G protein subunits and accessory proteins that are associated with human phenotypes; in the second article, we build upon this to discuss "G protein-coupled receptor (GPCR) gene variants and human genetic disease" and in the third article, we survey "G protein-coupled receptor pharmacogenomics". In the present article, we review the processes of ligand binding, GPCR activation, inactivation, and receptor trafficking to the membrane in the context of human genetic disease resulting from pathogenic variants of accessory proteins and G proteins.

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Prediction of good neurological outcome after return of circulation following paediatric cardiac arrest: A systematic review and meta-analysis.

Resuscitation

December 2024

Department of Critical Care Medicine, Hospital for Sick Children, Department of Paediatrics, University of Toronto, Neurosciences and Mental Health Program, Research Institute Toronto, ON, Canada.

Aim: To evaluate the ability of blood-biomarkers, clinical examination, electrophysiology, or neuroimaging, assessed within 14 days from return of circulation to predict good neurological outcome in children following out- or in-hospital cardiac arrest.

Methods: Medline, EMBASE and Cochrane Trials databases were searched (2010-2023). Sensitivity and false positive rates (FPR) for good neurological outcome (defined as either 'no, mild, moderate disability or minimal change from baseline') in paediatric survivors were calculated for each predictor.

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Systemic sclerosis-associated Raynaud phenomenon (SSc-RP) confers poor outcomes, including ulceration, gangrene, autoamputation, and hand disability. Prostaglandin analogues (PG) are a group of prostacyclin-derived drugs with properties that may address underlying complex mechanisms of SSc-RP. This systematic review and meta-analysis evaluated the efficacy and tolerability of PGs in SSc-RP.

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