703 results match your criteria: "and Dalhousie University[Affiliation]"

Background: Childhood obesity can result in adverse health outcomes. The objectives of this study were to describe the prevalence of obesity and determine the association between obesity at cancer diagnosis and event-free survival (EFS) and overall survival (OS) in children diagnosed with cancer in Canada.

Methods: The authors conducted a retrospective cohort study using the Cancer in Young People in Canada database, including all children with newly diagnosed cancer aged 2-18 years across Canada from 2001 to 2020.

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Background: Delirium is a common and serious syndrome of acute brain dysfunction associated with negative outcomes. Melatonin may have a role in delirium prevention for critically ill adults based on data from non-critically ill patient populations. Our objective was to assess the feasibility of a multi-centre, randomized, placebo-controlled trial testing the hypothesis that low-dose melatonin prevents delirium in critically ill adults.

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Guidelines suggest the Liver Imaging Reporting and Data System (LI-RADS) may not be applicable for some populations at risk for hepatocellular carcinoma (HCC). However, data assessing the association of HCC risk factors with LI-RADS major features are lacking. To evaluate whether the association between HCC risk factors and each CT/MRI LI-RADS major feature differs among individuals at-risk for HCC.

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Objectives: To assess the natural history of incidental pancreatic cystic lesions (PCLs) and the sensitivity of surveillance guidelines to detect malignancy.

Materials And Methods: We performed a single-center retrospective analysis of incidental PCLs discovered between 2012 and 2017. Patients were identified by searching radiology reports for relevant keywords, then search results were manually reviewed to exclude patients with < 5 years of follow-up, non-incidental PCLs, known pancreatic cancer, or pancreatitis.

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Mimics of pancreatic neoplasms at cross-sectional imaging: Pearls for characterization and diagnostic work-up.

Curr Probl Diagn Radiol

December 2024

Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre and Dalhousie University. Victoria General Building, 3rd floor, 1276 South Park Street, Halifax, Nova Scotia B3H 2Y9, Canada. Electronic address:

Interpreting imaging examinations of the pancreas can be a challenge. Several different entities can mimic or mask pancreatic neoplasms, including normal anatomic variants, non-pancreatic lesions, and both acute and chronic pancreatitis. It is important to distinguish these entities from pancreatic neoplasms, as the management and prognosis of a pancreatic neoplasm, particularly adenocarcinoma, have considerable impact on patients.

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The crisis of the third day in intracranial pressure dynamics following traumatic brain injury, fact or fiction?

Brain Spine

November 2024

Department of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the Netherlands.

Introduction: In 1960, Lazorthes and Campman introduced the concept of a which gained prominence in the field of traumatic brain injury (TBI), where it relates to neurological deterioration on the third day after injury. However, evidence regarding this phenomenon remains scarce.

Research Question: This study aimed to analyze posttraumatic intracranial pressure (ICP) patterns in a large European cohort to investigate the existence of a third-day crisis and its impact on 12-month functional outcomes.

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To compare the incremental prognostic value of pupillary reactivity captured as part of the Glasgow Coma Scale-Pupils (GCS-P) score or added as separate variable to the GCS+P, in traumatic brain injury (TBI). We analyzed patients enrolled between 2014 and 2018 in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI, = 3521) and the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI, = 1439) cohorts. Logistic regression was utilized to quantify the prognostic performances of GCS-P (GCS minus number of unreactive pupils) and GCS+P versus GCS alone according to Nagelkerke's .

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Dr. Roberts et al reply.

J Rheumatol

December 2024

Alexandra Legge, MD, MSc, Division of Rheumatology and Department of Medicine, QEII Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia; Arthritis Research Canada, Richmond, British Columbia, Canada.

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Molecular-Guided Therapy for Melanoma in Canada: Overview of Current Practices and Recommendations.

J Cutan Med Surg

December 2024

Department of Diagnostic and Molecular Pathology, Memorial University of Newfoundland, Health Sciences Centre, St. John's, NL, Canada.

The emergence of pathologist-driven molecular reflex testing for tumoural biomarkers is a significant advancement in cancer diagnostics, facilitating targeted cancer therapy for our patients. Based on our experience, the Canadian landscape of pathologist-driven reflex biomarker testing for melanoma lacks standardization and is plagued by a lack of awareness by pathologists and clinicians. This paper comprehensively examines the approaches to reflex biomarker testing for melanoma patients across Canada, highlighting the regional variations in the criteria for initiating molecular testing, the biomarkers tested, and the molecular techniques employed.

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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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Background: The long-term effects of catheter ablation (CA) compared with medical therapy on cardiovascular outcomes for atrial fibrillation (AF) remain undetermined.

Objective: Using a population-based cohort, we sought to determine what the association between CA and medical therapy was on these outcomes.

Methods: By use of Alberta administrative data, patients with AF as the primary diagnosis during hospitalization, emergency department visit, or physician visit were included between October 1, 2008, and March 31, 2018.

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Article Synopsis
  • Traumatic brain injury (TBI) is a significant health issue, particularly in low- and middle-income countries like India, which presents different epidemiological trends and care practices compared to Europe.
  • Data from studies in India (CINTER-TBI) and Europe (CENTER-TBI) reveal that patients in India tend to be younger and more severely injured than those in Europe, with falls being the main cause in Europe and traffic incidents in India.
  • Access to pre-hospital care is markedly higher in Europe, with Indian patients more likely to receive certain surgical interventions for severe TBI, indicating differences in acute care responsiveness between the regions.
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Background: Contemporary surgical practices for traumatic brain injury (TBI) remain unclear. We describe the clinical profile of an 18-centre US TBI cohort with cranial surgery.

Methods: The prospective, observational Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (2014-2018; ClinicalTrials.

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Article Synopsis
  • The study compares the effectiveness and toxicity of two treatments, rituximab (RTX) and cyclophosphamide (CYC), for pediatric patients with granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA).
  • It analyzes data from 104 patients and finds no significant difference in remission rates or severe adverse events between the two treatment groups.
  • Limitations of the study include the lack of standardized treatment protocols and the retrospective nature of the analysis.
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Article Synopsis
  • The study evaluates the cost-effectiveness of using molecular testing for indeterminate thyroid nodules versus traditional management in Nova Scotia.
  • Despite molecular testing showing higher effectiveness (89%) compared to current strategies (64%), it incurs a higher average cost ($8414 vs. $6431).
  • The incremental cost-effectiveness ratio indicates that routine molecular testing results in an additional cost of $7876 for each surgery avoided, highlighting a trade-off between effectiveness and cost.
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Article Synopsis
  • A customized version of the QUADAS-2 tool was developed to assess the risk of bias and applicability in 37 studies related to LI-RADS, a classification system for diagnosing liver cancer.
  • The studies, published between 2017 and 2022, focused on the diagnostic accuracy of imaging methods like CT, MRI, and ultrasound for Hepatocellular Carcinoma (HCC), and two experienced reviewers independently evaluated the risk of bias.
  • Findings revealed that 31 of the 37 studies had a high risk of bias, with issues particularly in patient selection and study flow, highlighting the need for improved research practices to enhance the validity of LI-RADS studies.
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Outcomes of relapsed favorable-histology Wilms tumor in non-clinical trial setting.

Pediatr Blood Cancer

January 2025

Department of Pediatrics, Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, Texas, USA.

Article Synopsis
  • The study reviews the outcomes of patients with relapsed favorable-histology Wilms tumor (FHWT) treated outside clinical trials between 2002 and 2018 at six North American institutions.
  • A total of 94 patients were analyzed, categorized into standard-risk (SRR), high-risk (HRR), and very high-risk (VHRR) groups, with varying treatment regimens affecting their 4-year event-free survival (EFS) and overall survival (OS) rates.
  • Results indicate that while SRR had relatively good survival rates, HRR and VHRR patients had poorer outcomes, highlighting the urgent need for better treatment strategies for these higher-risk groups.
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Article Synopsis
  • This study examines the differences in PD-L1 scores between fresh and archived tissue samples from lung cancer patients, highlighting significant variability over a six-month period.
  • The results indicate that advanced cancer stages show increased PD-L1 expression, with implications for survival rates depending on the presence of driver mutations.
  • The findings suggest that PD-L1 scores can influence treatment outcomes, particularly with immunotherapy, indicating a need for careful assessment of tissue samples in clinical decision-making.
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Case 30-2024: A 45-Year-Old Woman with Kidney Lesions and Lytic Bone Disease.

N Engl J Med

September 2024

From the Department of Medicine, University of British Columbia, Vancouver, and Dalhousie University, Halifax, NS - both in Canada (L.Y.C.C.); and the Departments of Radiology (A.J.H.), Medicine (J.H.S.), and Pathology (J.A.F.), Massachusetts General Hospital, and the Departments of Radiology (A.J.H.), Medicine (J.H.S.), and Pathology (J.A.F.), Harvard Medical School - both in Boston.

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The likelihood of exposure to overheated indoor environments is increasing as climate change is exacerbating the frequency and severity of hot weather and extreme heat events (EHE). Consequently, vulnerable populations will face serious health risks from indoor overheating. While the relationship between EHE and human health has been assessed in relation to outdoor temperature, indoor temperature patterns can vary markedly from those measured outside.

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Introduction: Acute subdural hematoma (ASDH) due to traumatic brain injury (TBI) constitutes an increasing global health problem, especially in the elderly population. Treatment decisions on surgical versus conservative management pose a neurosurgical dilemma. Large practice variation exists between countries, hospitals, and individual neurosurgeons, illustrating the presence of 'clinical equipoise'.

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Introduction: The incidence of varicella in Canada has decreased by almost 99% since vaccination was introduced. However, variation in the timing and eligibility of vaccination programs across the country has resulted in some cohorts being under-vaccinated and therefore potentially susceptible to infection.

Methods: We used nationally representative specimens from the Biobank of Statistics Canada's Canadian Health Measures Survey (CHMS) as well as residual specimens from Ontario collected between 2009-2014 to estimate population immunity across age-groups and geography, and identify any groups at increased risk of varicella infection.

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Nova Scotia Health COVID-19 Non-severe Therapy Consult Service: Lessons from a Hospital Pharmacy-Based Model.

Can J Hosp Pharm

August 2024

MD, PhD, FRCPC, is a Clinician Scientist, Division of Infectious Diseases, Nova Scotia Health, and Assistant Professor, Division of Infectious Diseases, Department of Medicine, Dalhousie University, Halifax, Nova Scotia.

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Molecular dissection of cobra venom highlights heparinoids as an antidote for spitting cobra envenoming.

Sci Transl Med

July 2024

Charles Perkins Centre, Dr. John and Anne Chong Lab for Functional Genomics, and School of Life and Environmental Sciences, University of Sydney, Camperdown, NSW 2006, Australia.

Snakebites affect about 1.8 million people annually. The current standard of care involves antibody-based antivenoms, which can be difficult to access and are generally not effective against local tissue injury, the primary cause of morbidity.

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