5,304 results match your criteria: "Vancouver General Hospital.[Affiliation]"

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.

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Cytokine storm syndromes such as hemophagocytic lymphohistiocytosis (HLH), Adult-onset Still's disease (AOSD), and COVID-19 cytokine storm (CCS) are characterized by markedly elevated inflammatory cytokines. However clinical measurement of serum cytokines is not widely available. This study examined the clinical utility of C-reactive protein (CRP) and ferritin, two inexpensive and widely available inflammatory markers, for distinguishing HLH from AOSD and CCS.

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Background: Immunotherapy, including the use of immune checkpoint inhibitors such as nivolumab, is increasingly common in cancer treatment and can lead to various immune-related adverse effects, including rare cases of diabetic ketoacidosis. This case report highlights an unique instance of nivolumab-induced diabetic ketoacidosis in a patient without prior history of diabetes, emphasizing the importance of careful monitoring even in those without traditional risk factors.

Case Presentation: We report a case of a 70-year-old Caucasian male with metastatic esophageal adenocarcinoma who developed diabetic ketoacidosis 3 weeks after stopping nivolumab therapy.

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Purpose: Although the provision of a survivorship care plan (SCP) has been recommended after prostate cancer (PCa) treatment, there have been no randomized controlled trials to examine their impact. The objective of this study was to evaluate the effect of a tailored PCa-SCP intervention provided to early-stage PCa survivors.

Materials And Methods: A prospective, parallel 1:1 randomized controlled trial was conducted at 3 sites across Canada.

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Background: There is a dearth of information on the effects of bone conductive devices on temporal processing in individuals with single-sided deafness (SSD). This study investigates the effect of an adhesive bone conductive device on temporal processing in adults with SSD.

Methods: A prospective cohort study of temporal processing in adults with SSD was undertaken.

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Native Valve and Native Neo-Sinus Remodeling Following Transcatheter Aortic Valve Replacement.

Circ Cardiovasc Interv

December 2024

Cardiovascular Translational Laboratory, Providence Research and Centre for Heart Lung Innovation, Vancouver, British Columbia, Canada (J.Y., H.G., J.J., A.L., J.G.W., J.S., D.M., S.L.S.).

Background: Transcatheter aortic valve replacement (TAVR) pushes aside the diseased native aortic valve and creates a native neo-sinus bordered by the aortic root wall and the displaced native valve. There are limited data on the progression of native valve disease post-TAVR and no previous analysis of the native neo-sinus.

Methods: Native aortic valves and native neo-sinus explants obtained post-TAVR were evaluated histologically (hematoxylin and eosin, Movat pentachrome, and Martius Scarlet Blue stains) and by immunohistochemistry (TGF-β1 [transforming growth factor-beta 1], FAP [fibroblast activation protein], and ALP [alkaline phosphatase]) to assess disease mechanisms.

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Aims: Mesonephric-like adenocarcinoma (MLA) of the endometrium is often a diagnostic challenge, due to its morphological resemblance to other more common Müllerian neoplasms. This study aimed to retrospectively identify overlooked MLA in a large endometrial carcinoma cohort, using a combination of immunohistochemistry (IHC), morphology and KRAS sequencing.

Methods And Results: IHC was conducted on 1094 endometrial carcinomas, identifying 16 potential MLA cases based on GATA3+ and/or TTF1+ and ER- staining patterns, which subsequently underwent detailed histological review, KRAS sequencing and ProMisE molecular classification.

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In the last three decades, ablation of atrial fibrillation (AF) has become an evidence-based safe and efficacious treatment for managing the most common cardiac arrhythmia. In 2007, the first joint expert consensus document was issued, guiding healthcare professionals involved in catheter or surgical AF ablation. Mounting research evidence and technological advances have resulted in a rapidly changing landscape in the field of catheter and surgical AF ablation, thus stressing the need for regularly updated versions of this partnership which were issued in 2012 and 2017.

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Hypovolaemic phlebotomy in patients undergoing hepatic resection at higher risk of blood loss (PRICE-2): a randomised controlled trial.

Lancet Gastroenterol Hepatol

February 2025

Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; Canadian Blood Services, Ottawa, ON, Canada.

Background: Blood loss and subsequent red blood cell transfusions are common in liver surgery. Hypovolaemic phlebotomy is associated with decreased red blood cell transfusion in observational studies. This trial aimed to investigate whether hypovolaemic phlebotomy is superior to usual care in reducing red blood cell transfusions in patients undergoing liver resection.

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A mouse model for the study of diet-induced changes in intestinal microbiome composition on renal calcium oxalate crystal formation.

Urolithiasis

December 2024

The Stone Centre at Vancouver General Hospital, Department of Urologic Sciences, University of British Columbia, Jack Bell Research Centre, 2660 Oak Street, Vancouver, BC, V6H 3Z6, Canada.

Currently available animal models for calcium oxalate kidney stones are limited in their translational potential. Particularly with increasing interest in gut microbiota involvement in kidney stone disease, there are limited animal models which can be used. As such, we have developed a novel diet-induced hyperoxaluria murine model which addresses some of the shortcomings of other currently available models.

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The purpose of this study was to determine the necessity and cost-effectiveness of radiologists' interpretation of plain hand radiographs for diagnosing and managing different hand pathologies in the plastic surgery outpatient clinic setting. Through a retrospective cohort study, we identified new patient encounters from January 2021 to December 2022 in an outpatient hand clinic. We included patients with radiology reports that were submitted subsequent to the surgeon's consult note in clinic.

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Objectives: Venovenous extracorporeal membrane oxygenation (ECMO) is a life-preserving intervention for patients with respiratory failure refractory to conventional mechanical ventilation. Intracranial hemorrhage (ICH) and ischemic stroke are life-threatening complications associated with venovenous ECMO. Despite this, little is known regarding the prognostic factors associated with these adverse neurologic events.

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Background: T-cell-redirecting therapies, such as bispecific antibodies and chimeric antigen receptor T-cells, exploit the cytotoxic capabilities of the immune system to destroy cells expressing specific surface antigens, including malignant cells. These therapies have demonstrated unprecedented rates, depth, and duration of responses in relapsed and refractory multiple myeloma. However, there are significant challenges in implementing these therapies into practice, which require multidisciplinary and multicenter coordination and significant healthcare resources to effectively manage these patients.

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Liberal or Restrictive Transfusion Strategy in Aneurysmal Subarachnoid Hemorrhage.

N Engl J Med

December 2024

From Ottawa Hospital Research Institute, Ottawa (S.W.E., D.A.F., A.T., I.W., T.R., R.M., D.D., S.C.M., L.M.); the Department of Medicine, Division of Critical Care, Faculty of Medicine, University of Ottawa, Ottawa (S.W.E., L.M.); School of Epidemiology and Public Health University of Ottawa, Ottawa (S.W.E., D.A.F., L.M.); Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa (D.A.F., D.D., S.C.M.); George Institute for Global Health, Sydney (A.D., F.B., N.H., C.R.A., P.T.); Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, St. Leonards, NSW, Australia (A.D., N.H., C.R.A., E.F.); the Faculty of Medicine and Health, University of Sydney Northern Clinical School, St. Leonards, NSW, Australia (A.D., C.R.A.); Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (A.D., A.U.); the Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montreal (M. Chassé); the Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal (M. Chassé); the Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada (A.F.T., F.L.); Population Health and Optimal Health Practice Research Unit, Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada (A.F.T., F.L.); the Department of Anesthesia, Critical Care Medicine Service, Hôpital de L'Enfant-Jésus, Centre Hospitalier Universitaire de Québec-Université Laval, Quebec, QC, Canada (A.F.T., F.L.); the Department of Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada (F.L.); the Department of Neurology and Neurosurgery, Division of Neurocritical Care, Emory University School of Medicine, Emory University Hospital and Grady Memorial Hospital, Atlanta (O.S.); the Department of Medicine, Division of Critical Care Medicine, Faculty of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada (D.E.G.); the Division of Neurosurgery, Vancouver General Hospital, Vancouver, BC, Canada (G.R.); the Division of Neurosurgery, Department of Surgery, the University of British Columbia, Vancouver, Canada (G.R.); Neurocritical Care and Anesthesia, Sunnybrook Health Sciences Centre and Sunnybrook Research Institute, Toronto (M. Chapman); McGill University, Montreal (M.H.); the Departments of Critical Care Medicine and Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada (A.K.); Nepean Clinical School, University of Sydney, Sydney (I.S.); the Department of Clinical Medicine, Macquarie University, Sydney (I.S.); the Critical Care and Trauma Division, the George Institute for Global Health, Sydney (I.S.); the Department of Intensive Care and Hyperbaric Medicine, the Alfred, Melbourne, VIC, Australia (A.U.); the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada (D.J.K.); the Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada (R.Z.); the Department of Medical Oncology/Hematology and the Paul Albrechtsen Research Institute, Cancer Care Manitoba, Winnipeg, Canada (R.Z.); the Department of Anesthesiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada (F.D.); Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada (F.D.); the Department of Medicine, Division of Neurology, School of Medicine, Queen's University, Kingston, ON, Canada (J.G.B.); Department of Critical Care Medicine, School of Medicine, Queen's University, Kingston, ON, Canada (J.G.B.); the Intensive Care Unit, Prince of Wales Hospital, Randwick, NSW, Australia (G.S.); the Department of Intensive Care, Royal Brisbane and Women's Hospital, Herston, QLD, Australia (J.B.); University of Queensland, Brisbane, Australia (J.B.); the Department of Adult Intensive Care, Island Health Authority, Victoria, BC, Canada (G.W.); University of Colorado School of Medicine, Aurora (L.C.); the Department of Surgery, Division of Neurosurgery, Dalhousie University, Halifax, NS, Canada (G.P.); QEII Health Sciences Centre, Halifax, NS, Canada (G.P.); Lewis Katz School of Medicine, Temple University, Philadelphia (L.K.); Rush University Medical Center, Chicago (L.K.); Royal North Shore Hospital, Sydney (F.B.); the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto (D.C.S.); the Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto (D.C.S.); the Kirby Institute, University of New South Wales, Kensington, Australia (C.R.A.); the Department of Surgery, Division of Neurosurgery, Faculty of Medicine, University of Ottawa, Ottawa (J.S.); Canadian Blood Services, Edmonton, AB, Canada (J.A.); the Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada (J.A.); and Physical Medicine and Rehabilitation, Bruyere Continuing Care, Ottawa (S.C.M.).

Background: The effect of a liberal red-cell transfusion strategy as compared with a restrictive strategy in patients during the critical care period after an aneurysmal subarachnoid hemorrhage is unclear.

Methods: We randomly assigned critically ill adults with acute aneurysmal subarachnoid hemorrhage and anemia to a liberal strategy (mandatory transfusion at a hemoglobin level of ≤10 g per deciliter) or a restrictive strategy (optional transfusion at a hemoglobin level of ≤8 g per deciliter). The primary outcome was an unfavorable neurologic outcome, defined as a score of 4 or higher on the modified Rankin scale (range, 0 to 6, with higher scores indicating greater disability) at 12 months.

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Perspectives on Long-Term Follow-Up among Living Kidney Donors.

Clin J Am Soc Nephrol

December 2024

Division of Nephrology, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada.

Key Points: In a survey of 685 previous living kidney donors, donors wanted lifelong annual follow-up with a primary care provider. Living donors wanted information on clinical and laboratory assessment and health reassurance. Donors also wanted access to specialized care in the event of hospitalization or change in health.

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Cardiac arrest (CA) is associated with high incidence and mortality rates. Among patients who survive the acute phase, brain injury stands out as a primary cause of death or disability. Effective intensive care management, including targeted temperature management, seizure treatment and maintenance of normal physiological parameters, plays a crucial role in improving survival and neurological outcomes.

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Human papillomavirus (HPV) integration has been implicated in transforming HPV infection into cancer. To resolve genome dysregulation associated with HPV integration, we performed Oxford Nanopore long-read sequencing on 72 cervical cancer genomes from an Ugandan dataset that was previously characterized using short-read sequencing. We found recurrent structural rearrangement patterns at HPV integration events, which we categorized as: del(etion)-like, dup(lication)-like, translocation, multibreakpoint, or repeat region integrations.

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Liquid biopsy is increasingly being used in oncology for tumor molecular characterization. CHIP is a common incidental finding in cfDNA, and its prevalence increases with age. This study builds on growing evidence of common CHIP variants in patients with solid tumors.

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Immune Dysregulation in a Child With SOD1-Related Neurological Disease.

Am J Med Genet A

December 2024

Department of Medical Genetics, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.

Article Synopsis
  • Spastic tetraplegia and axial hypotonia (STAHP) is a rare neurological disorder in children linked to biallelic SOD1 deficiency, marked by progressive symptoms starting before age 2.
  • Five studies have reported nine cases, primarily related to a common genetic variant in SOD1 that disrupts enzyme function, with one case involving a novel SOD1 variant in a 19-year-old male.
  • The patient exhibited significant neurological decline and MRI findings of cerebellar atrophy, plus new symptoms including immune dysregulation and physical anomalies not previously associated with STAHP.
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Purpose: Chronic rhinosinusitis (CRS) often requires endoscopic sinus surgery (ESS) for symptom control. However, there is currently a high reported revision rate. The introduction of biologics offers an alternative treatment, but patient criteria are ambiguous, particularly regarding the definition of "previous ESS.

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Article Synopsis
  • The study investigates differences in thrombo-inflammatory responses and outcomes between non-COVID-19 community-acquired pneumonia (CAP) and COVID-19 CAP in hospitalized adults in Canada.
  • Non-COVID-19 CAP patients displayed lower 28-day mortality rates and fewer complications compared to those with COVID-19, indicating a more effective immune response developed over time against bacterial infections.
  • The findings suggest that the complexities of the immune response to COVID-19 resulted in higher mortality rates, highlighting the challenges posed by emerging viruses compared to known pathogens.
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Midterm survival, clinical, and hemodynamic outcomes of a novel mechanical mitral valve prosthesis.

J Thorac Cardiovasc Surg

November 2024

Division of Cardiothoracic Surgery, Mount Sinai Saint Luke's, New York, NY.

Objective: To evaluate the midterm survival, clinical, and hemodynamic outcomes of the On-X mechanical mitral valve, based on the 5-year results of the Prospective Randomized On-X Anticoagulation Clinical Trial (PROACT).

Method: PROACT Mitral was a multicenter study evaluating 401 patients who underwent mitral valve replacement (MVR) with either Standard or Conform-X On-X mitral valves, comparing low-dose and standard-dose warfarin. Here we report prespecified secondary outcomes of survival, New York Heart Association (NYHA) functional classification, and valve hemodynamics as assessed by core lab-adjudicated echocardiography at 1, 3, and 5 years in the pooled population.

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Purpose: The time from article submission to publication in peer-reviewed scientific journals is variable and can be prolonged, which slows the dissemination of research and can influence the academic progress of authors. This study evaluated the publication times for articles in radiology journals, in particular the relationship between turnaround times and journal impact factors (IFs).

Methods: Bibliometric data was obtained from Journal Citation Reports to conduct a comparative analysis of radiology journals against those in other disciplines of clinical medicine using highest IF, median IF, cited half-life, immediacy index, and number of journals.

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