Sunnybrook Health Science Centre

High Yield of Pharmacogenetic Testing for Clopidogrel Resistance in a Canadian Outpatient Stroke Population

BACKGROUND: Clopidogrel is commonly prescribed for secondary stroke prevention, but routine pharmacogenetic testing is not typically performed. As the CYP2C19 enzyme activates clopidogrel into its effective form, clopidogrel-treated patients who carry CYP2C19 loss-of-function all...

Use of Telestroke Prior to Endovascular Stroke Treatment in Canada: Results from the OPTIMISE Registry

BACKGROUND: Telestroke allows rapid assessment of acute stroke patients for intravenous thrombolysis and endovascular thrombectomy (EVT). While its safety and efficacy for thrombolysis are well established, evidence regarding EVT decision-making via telestroke is scarce. METHODS:...

Trends in Dispensing of Opioids and Benzodiazepines Among Older Adults Admitted for an Acute Hip Fracture Between 2008 and 2024 in Ontario, Canada

INTRODUCTION: Opioids and benzodiazepines (BZDs) are commonly prescribed for managing pain, anxiety, and sleep-related problems following a hip fracture. Both opioids and BZDs carry risks of persistent dependence, falls, and mortality with long-term use. Despite these risks, Cana...

Development and Validation of a Tool to Measure Documented Health Care Encounter Time

Importance Time toxicity, defined as the time patients spend receiving cancer treatment and interacting with health care systems, is an emerging treatment-related burden. Existing studies typically quantify time toxicity using health care contact days, which may inadequately capt...

Multivariate analysis identifies distinct latent components and highlights the contribution of motor cortex neurochemistry to clinical variance in amyotrophic lateral sclerosis

Abstract Amyotrophic lateral sclerosis (ALS) is marked by substantial clinical heterogeneity across motor and extramotor domains, yet how different neuroimaging modalities jointly relate to this heterogeneity remains poorly understood. Prior ALS neuroimaging studies have largely...

Blood proteomics of menopause map to brain aging and dementia risk

Abstract Menopause is a hallmark process in biological aging that has been implicated in later neurodegenerative risk, but the pathways underlying this connection remain unclear. Here we used blood proteomics data from several cohorts to identify biological changes associated wit...

Summary of Research: HER2CLIMB-05: A Phase III Study of Tucatinib Versus Placebo in Combination with Trastuzumab and Pertuzumab as First-Line Maintenance Therapy for HER2+ Metastatic Breast Cancer

This is a summary of a research article reporting the findings of the HER2CLIMB-05 trial (NCT05132582), a randomized, double-blind, placebo-controlled, international, phase III trial. The HER2CLIMB-05 trial was conducted to compare the efficacy and safety of adding tucatinib vers...

Optimized Brain Functional MRI for Patients With Deep Brain Stimulation Systems

BACKGROUND AND OBJECTIVES: Deep brain stimulation (DBS) is an established neuromodulation therapy for Parkinson disease and other neurological disorders. Active DBS–functional MRI (fMRI) enables visualization of circuit engagement and may provide objective biomarkers of therapeut...

Personalized Ultrafractionated Stereotactic Adaptive Radiotherapy in Lung Cancer and Lung Metastases: A Systematic Review

Background/Objectives: Personalized ultrafractionated stereotactic adaptive radiotherapy (PULSAR) delivers high-dose stereotactic radiation as temporally separated pulses, permitting interval response assessment, adaptive replanning, and integration with systemic therapy. Its rol...

Readability and Quality of Online Patient Education Materials: Thyroid Radiofrequency Ablation

OBJECTIVE: To assess the readability and quality of online patient education materials regarding thyroid radiofrequency ablation. METHODS: Google searches were conducted using six search terms related to thyroid radiofrequency ablation, and the top 50 webpages from each search we...

Assessing Challenges and Barriers to Effective Wound Care in Rural Indigenous Communities

OBJECTIVE: To explore the lived experiences of patients with chronic wounds from a remote Indigenous community in Northern Manitoba, Canada, focusing on challenges in wound management, the impact on quality of life, barriers to wound care access, and the role of traditional heali...

Global inequitable distribution of seminal studies of chemotherapy-induced nausea and vomiting

BACKGROUND: Chemotherapy-induced nausea and vomiting (CINV) remains one of the most quality of life limiting toxicities of cancer therapy. Decades of trials have produced robust antiemetic evidence, but their applicability to resource-limited settings where guideline-recommended...

Considerations for optimal team-based rheumatology care: a qualitative study exploring the experiences of rheumatology health professionals

Interdisciplinary team-based rheumatology care models are a promising solution for improving access to high quality, equitable care for people with rheumatic and musculoskeletal disorders. There is limited understanding on health professionals’ perspectives on their needs to deli...

A process evaluation of a randomized clinical trial of selective decontamination of the digestive tract in ventilated adults admitted to intensive care: the SuDDICU PE study

The SuDDICU trial evaluated the effectiveness of selective digestive decontamination (SDD), a prophylactic antibiotic regimen comprising oral, gastric and intravenous (IV) components in ventilated adults admitted to intensive care. The trial recruited 9289 participants in 26 clus...

Data-driven mapping of known and novel fluid biomarker progression profiles in genetic frontotemporal lobar degeneration

Abstract Introduction Recent proteomic studies have identified both established and novel proteins in genetic frontotemporal lobar degeneration (FTLD). However, it remains unclear at what point in the disease these proteins deviate from normal levels and how their trajectories re...

The diagnosis to surgery interval and overall survival in patients with cervical cancer

Importance Evidence regarding the association of the diagnosis to treatment interval (DTI) and survival can inform clinical care and health policy. Data in this regard are currently lacking for cervical cancer. Objective To examine the relationship between the DTI and overall sur...

Janus kinase inhibitors combined with 308‐nm excimer laser for vitiligo: A systematic review

The data that supports the findings of this study are available in the external repository (https://data.mendeley.com/datasets/6rh8dcvmfv/1) of this article.

Understanding the impact of meeting performance measures on the outcomes of joint replacement in rheumatoid arthritis: a population-based study in British Columbia, Canada

Objective Canadian performance measures (PMs) evaluate the quality of rheumatoid arthritis (RA) care; however limited evidence exists linking these process measures to long-term patient outcomes. This research evaluated the impact of meeting PMs in early RA on 10-year risk of tot...

Team-Based Outpatient Rheumatology Care: A Scoping Review of Terminology, Team Composition, and Impact on Advancing the Quintuple Aim

Objectives Team-based models of rheumatology care, in which rheumatologists and interdisciplinary healthcare professionals (IHPs) collaborate in care delivery, are increasingly recognized to improve outcomes across all domains of the Quintuple Aim (population health, patient expe...