Institution
Trillium Health Centre
Healthcare•Mississauga, Ontario, Canada•
About: Trillium Health Centre is a healthcare organization based out in Mississauga, Ontario, Canada. It is known for research contribution in the topics: Health care & Population. The organization has 94 authors who have published 111 publications receiving 2768 citations.
Papers published on a yearly basis
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University of Toronto1, Montreal Neurological Institute and Hospital2, University of British Columbia3, Mount Sinai Hospital, Toronto4, University of Calgary5, Wellcome Trust Centre for Human Genetics6, Boston Children's Hospital7, Alberta Children's Hospital8, Centre Hospitalier Universitaire de Sherbrooke9, McMaster Children's Hospital10, Montreal Children's Hospital11, Children's Hospital of Eastern Ontario12, Queen's University13, Saint John Regional Hospital14, Halifax15, Royal University Hospital16, Janeway Children's Health and Rehabilitation Centre17, Trillium Health Centre18, Dalhousie University19, University of Manitoba20
TL;DR: Risk of multiple sclerosis in children can be stratified by presence of HLA-DRB1*15 alleles, remote Epstein-Barr virus infection, and low serum 25-hydroxyvitamin D concentrations, suggesting established disease.
Abstract: Summary Background HLA-DRB1*15 genotype, previous infection with Epstein-Barr virus, and vitamin D insufficiency are susceptibility factors for multiple sclerosis, but whether they act synergistically to increase risk is unknown. We aimed to assess the contributions of these risk factors and the effect of established precursors of multiple sclerosis, such as brain lesions on MRI and oligoclonal bands in CSF at the time of incident demyelination, on development of multiple sclerosis in children. Methods In our prospective national cohort study, we assessed children who presented with incident CNS demyelination to any of the 16 paediatric health-care facilities or seven regional health-care facilities in Canada. We did univariate and multivariable analyses to assess contributions of HLA-DRB1*15 , Epstein-Barr virus, vitamin D status, MRI evidence of brain lesions, and CSF oligoclonal bands as determinants of multiple sclerosis. We used classification and regression tree analyses to generate a risk stratification algorithm for clinical use. Findings Between Sept 1, 2004, and June 30, 2010, we screened 332 children of whom 302 (91%) were eligible and followed-up for a median of 3·14 years (IQR 1·61–4·51). 63 (21%) children were diagnosed with multiple sclerosis after a median of 127 days (99–222). Although the risk of multiple sclerosis was increased with presence of one or more HLA-DRB1*15 alleles (hazard ratio [HR] 2·32, 95% CI 1·25–4·30), reduced serum 25-hydroxyvitamin D concentration (HR per 10 nmol/L decrease 1·11, 1·00–1·25), and previous Epstein-Barr-virus infection (HR 2·04, 0·99–4·20), no interactions between these variables were detected on multivariate analysis. Multiple sclerosis was strongly associated with baseline MRI evidence of one or more brain lesion (HR 37·9, 5·26–273·85) or CSF oligoclonal bands (6·33, 3·35–11·96), suggesting established disease. One patient diagnosed with multiple sclerosis had a normal MRI scan, and therefore sensitivity of an abnormal MRI scan for multiple sclerosis diagnosis was 98·4%. Interpretation Risk of multiple sclerosis in children can be stratified by presence of HLA-DRB1*15 alleles, remote Epstein-Barr virus infection, and low serum 25-hydroxyvitamin D concentrations. Similar to previous studies in adults, brain lesions detected on MRI and CSF oligoclonal bands in children are probable precursors to the clinical onset of multiple sclerosis. Children with a normal MRI are very likely to have a monophasic illness. Funding Canadian Multiple Sclerosis Scientific Research Foundation.
282 citations
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TL;DR: Crizotinib exerted a potent antitumor activity with durable responses in advanced, heavily pretreated ALK+ lymphoma patients, with a benign safety profile.
Abstract: Anaplastic lymphoma kinase (ALK)-positive lymphomas respond to chemotherapy, but relapses, which bear a poor prognosis, occur. Crizotinib inhibits ALK in vitro and in vivo and was administered as monotherapy to 11 ALK+ lymphoma patients who were resistant/refractory to cytotoxic therapy. The overall response rate was 10 of 11 (90.9%; 95% confidence interval [CI] = 58.7% to 99.8%). Disease status at the latest follow-up is as follows: four patients are in complete response (CR) (months >21, >30, >35, >40) under continuous crizotinib administration; 4 patients had progression of disease (months 1, 2, 2, 2); 1 patient obtained CR on crizotinib, received an allogeneic bone marrow transplant, and is in CR; 2 patients (treated before and/or after allogeneic bone marrow transplant) obtained and are still in CR but they have stopped crizotinib. Overall and progression-free survival rates at 2 years are 72.7% (95% CI = 39.1% to 94.0%) and 63.7% (95% CI = 30.8% to 89.1%), respectively. ALK mutations conferring resistance to crizotinib in vitro could be identified in relapsed patients. Crizotinib exerted a potent antitumor activity with durable responses in advanced, heavily pretreated ALK+ lymphoma patients, with a benign safety profile.
256 citations
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University of Copenhagen1, Stanford University2, University of Texas at San Antonio3, Medical College of Wisconsin4, University of Cincinnati5, Detroit Medical Center6, University of Arizona7, University of Iowa8, University of Kansas9, University of Miami10, Grady Memorial Hospital11, Main Line Health12, University of Pittsburgh13, Veterans Health Administration14, Rochester General Health System15, Washington University in St. Louis16, University of Colorado Denver17, University of Pennsylvania18, University of Texas Medical Branch19, Vanderbilt University20, University of Maryland, Baltimore21, North Shore-LIJ Health System22, LSU Health Sciences Center Shreveport23, Women & Children's Hospital of Buffalo24, NorthShore University HealthSystem25, Cleveland Clinic26, University Medical Center27, Tufts University28, University of Toledo29, University of California, Davis30, Rhode Island Hospital31, University of South Alabama32, McGill University33, Foothills Medical Centre34, Université de Montréal35, Trillium Health Centre36, University of Alberta37, Laval University38, University of Western Ontario39, University of British Columbia40, Innsbruck Medical University41, University of Helsinki42, University of Eastern Finland43, Uppsala University44, University of Paris45, Lille University of Science and Technology46, Centre Hospitalier Universitaire de Nice47, Heidelberg University48, University of Cologne49, Ruhr University Bochum50, Charité51, University of Duisburg-Essen52, Ludwig Maximilian University of Munich53, University of Münster54, University of Genoa55, University of Perugia56, University of Groningen57, Erasmus University Rotterdam58, University of Lausanne59, University of Bern60, University of Zurich61, University of Dundee62, Aberdeen Royal Infirmary63, Nottingham City Hospital64, Western Infirmary65, University of Lisbon66, University of Coimbra67, University of Barcelona68, Autonomous University of Barcelona69, Complutense University of Madrid70, University of Melbourne71, Royal Melbourne Hospital72, Alfred Hospital73, North Shore Hospital74, Christchurch Hospital75, Auckland City Hospital76, Stellenbosch University77
TL;DR: The SPARCL Study is a prospective, multi-centre, double-blind, randomised, placebo-controlled trial designed to evaluate the effect of statin treatment in secondary stroke prevention.
Abstract: Evidence suggests that statin therapy reduces the risk of stroke in patients with coronary heart disease (CHD), but its benefit for patients with cerebrovascular disease and no history of CHD remains
169 citations
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University of Toronto1, Montreal Heart Institute2, Women's College Hospital3, St. Joseph's Healthcare Hamilton4, Trillium Health Centre5, St. Michael's Hospital6, Toronto General Hospital7, Queen Elizabeth II Health Sciences Centre8, University of Alberta9, Université de Montréal10, University of British Columbia11, McMaster University12
TL;DR: Recommendations are provided regarding pharmacologic interactions that may occur during combination therapy with warfarin, clopidogrel and proton-pump inhibitors, or acetylsalicylic acid and nonsteroidal anti-inflammatory drugs, as well as for the management of bleeding complications.
129 citations
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TL;DR: There is insufficient evidence to support the use of high-dose methylprednisolone within eight hours following an acute closed spinal cord injury as a treatment standard or as a guideline for treatment.
Abstract: Background: A systematic review of the evidence pertaining to methylprednisolone infusion following acute spinal cord injury was conducted in order to address the persistent confusion about the utility of this treatment. Methods: A committee of neurosurgical and orthopedic spine specialists, emergency physicians and physiatrists engaged in active clinical practice conducted an electronic database search for articles about acute spinal cord injuries and steroids, from January 1, 1966 to April 2001, that was supplemented by a manual search of reference lists, requests for unpublished additional information, translations of foreign language references and study protocols from the author of a Cochrane systematic review and Pharmacia Inc. The evidence was graded and recommendations were developed by consensus. Results: One hundred and fifty-seven citations that specifically addressed spinal cord injuries and methylprednisolone were retrieved and 64 reviewed. Recommendations were based on one Cochrane systematic review, six Level I clinical studies and seven Level II clinical studies that addressed changes in neurological function and complications following methylprednisolone therapy. Conclusions: There is insufficient evidence to support the use of high-dose methylprednisolone within eight hours following an acute closed spinal cord injury as a treatment standard or as a guideline for treatment. Methylprednisolone, prescribed as a bolus intravenous infusion of 30 mg per kilogram of body weight over fifteen minutes within eight hours of closed spinal cord injury, followed 45 minutes later by an infusion of 5.4 mg per kilogram of bodyweight per hour for 23 hours, is only a treatment option for which there is weak clinical evidence (Level I- to II-1). There is insufficient evidence to support extending methylprednisolone infusion beyond 23 hours if chosen as a treatment option.
123 citations
Authors
Showing all 96 results
Name | H-index | Papers | Citations |
---|---|---|---|
Donald E. Low | 88 | 359 | 24384 |
Cristina Messa | 55 | 175 | 9876 |
Sara McEwen | 21 | 57 | 1813 |
H. S. Smyth | 16 | 25 | 1268 |
Charles Lazzam | 11 | 11 | 1796 |
Miller MacPherson | 10 | 32 | 321 |
Claire Coire | 9 | 10 | 203 |
Heather Ead | 7 | 17 | 177 |
Anil Gupta | 7 | 9 | 443 |
Hossam El Beheiry | 6 | 12 | 634 |
Andre G. Douen | 5 | 8 | 321 |
Mehreen Sabih | 5 | 7 | 63 |
Cyril J Serrick | 4 | 4 | 89 |
Susan Bisaillon | 4 | 7 | 79 |
Mary Scholz | 4 | 4 | 89 |