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Institution

Sunnybrook Health Sciences Centre

HealthcareToronto, Ontario, Canada
About: Sunnybrook Health Sciences Centre is a healthcare organization based out in Toronto, Ontario, Canada. It is known for research contribution in the topics: Population & Breast cancer. The organization has 7689 authors who have published 15236 publications receiving 523019 citations. The organization is also known as: Sunnybrook.


Papers
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Journal ArticleDOI
TL;DR: Empiric data from diverse meta-analyses demonstrate similar treatment effects and no large differences in heterogeneity of RoM compared with difference-based methods.

152 citations

Journal ArticleDOI
TL;DR: HTN, diabetes, and dyslipidemia have independent and dose-response associations with incident AS in an unselected population of older individuals, and together accounted for approximately one-third of the incidence of severe AS.

152 citations

Journal ArticleDOI
TL;DR: Evidence-based recommendations for the diagnosis and treatment of Ventilator-associated pneumonia are presented and implementation of these recommendations into clinical practice may lessen the morbidity and mortality of patients who develop VAP.

152 citations

Journal ArticleDOI
TL;DR: A systematic approach to prevention and treatment of MVO in different clinical settings is advocated, requiring a better understanding of intracellular cardioprotective pathways such as the blockade of the mitochondrial permeability transition pore.
Abstract: Microvascular obstruction (MVO) commonly occurs following percutaneous coronary interventions (PCI), may lead to myocardial injury, and is an independent predictor of adverse outcome. Severe MVO may manifest angiographically as reduced flow in the patent upstream epicardial arteries, a situation that is termed “no-reflow.” Microvascular obstruction can be broadly categorized according to the duration of myocardial ischemia preceding PCI. In “interventional MVO” (e.g., elective PCI), obstruction typically involves myocardium that was not exposed to acute ischemia before PCI. Conversely “reperfusion MVO” (e.g., primary PCI for acute myocardial infarction) occurs within a myocardial territory that was ischemic before the coronary intervention. Interventional and reperfusion MVO have distinct pathophysiological mechanisms and may require individualized therapeutic approaches. Interventional MVO is triggered predominantly by downstream embolization of atherosclerotic material from the epicardial vessel wall into the distal microvasculature. Reperfusion MVO results from both distal embolization and ischemia-reperfusion injury within the subtended ischemic tissue. Management of MVO and no-reflow may be targeted at different levels: the epicardial artery, microvasculature, and tissue. The aim of the present report is to advocate a systematic approach to prevention and treatment of MVO in different clinical settings. Randomized clinical trials have studied strategies for prevention of MVO and no-reflow; however, the efficacy of measures for reversing MVO once no-reflow has been demonstrated angiographically is unclear. New approaches for prevention and treatment of MVO will require a better understanding of intracellular cardioprotective pathways such as the blockade of the mitochondrial permeability transition pore.

151 citations

Journal ArticleDOI
TL;DR: In this paper, the authors used the Alberta Stroke Program Early CT Score (ASPECTS) to predict the infarct size in the absence of major neurologic improvement.
Abstract: BACKGROUND AND PURPOSE: Qualitative CT perfusion (CTP) assessment by using the Alberta Stroke Program Early CT Score (ASPECTS) allows rapid calculation of infarct extent for middle cerebral artery infarcts. Published thresholds exist for noncontrast CT (NCCT) ASPECTS, which may distinguish outcome/complication risk, but early ischemic signs are difficult to detect. We hypothesized that different ASPECTS thresholds exist for CTP parameters versus NCCT and that these may be superior at predicting clinical and radiologic outcome in the acute setting. MATERIALS AND METHODS: Thirty-six baseline acute stroke NCCT and CTP studies within 3 hours of symptoms were blindly reviewed by 3 neuroradiologists, and ASPECTS were assigned. Treatment response was defined as major neurologic improvement when a ≥8-point National Institutes of Health Stroke Scale improvement at 24 hours occurred. Follow-up NCCT ASPECTS and 90-day modified Rankin score (mRS) were radiologic and clinical reference standards. Receiver operating characteristic curves derived optimal thresholds for outcome. RESULTS: Cerebral blood volume and NCCT ASPECTS had similar radiologic correlations (0.6 and 0.5, respectively) and best predicted infarct size in the absence of major neurologic improvement. A NCCT ASPECT threshold of 7 and a cerebral blood volume threshold of 8 discriminated patients with poor follow-up scans ( P P = .0001) and mRS ≤2 ( P = .001 and P P = .02). Interobserver agreement was substantial (intraclass correlation coefficient, 0.69). Cerebral blood volume ASPECTS sensitivity, specificity, positive predictive value, and negative predictive value for clinical outcome were 60%, 100%, 100%, and 45%, respectively. No patients with cerebral blood volume ASPECTS CONCLUSION: Cerebral blood volume ASPECTS is equivalent to NCCT for predicting radiologic outcome but may have an additional benefit in predicting patients with major neurologic improvement.

151 citations


Authors

Showing all 7765 results

NameH-indexPapersCitations
Gordon B. Mills1871273186451
David A. Bennett1671142109844
Bruce R. Rosen14868497507
Robert Tibshirani147593326580
Steven A. Narod13497084638
Peter Palese13252657882
Gideon Koren129199481718
John B. Holcomb12073353760
Julie A. Schneider11849256843
Patrick Maisonneuve11858253363
Mitch Dowsett11447862453
Ian D. Graham11370087848
Peter C. Austin11265760156
Sandra E. Black10468151755
Michael B. Yaffe10237941663
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
202324
2022103
20211,627
20201,385
20191,171
20181,044