University of Manitoba

About: University of Manitoba is a education organization based out in Winnipeg, Manitoba, Canada. It is known for research contribution in the topics: Population & Health care. The organization has 31888 authors who have published 66592 publications receiving 2095493 citations.

Practice guideline recommendations summary: Disease-modifying therapies for adults with multiple sclerosis: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology

Abstract: Objective To develop recommendations for disease-modifying therapy (DMT) for multiple sclerosis (MS). Methods A multidisciplinary panel developed DMT recommendations, integrating findings from a systematic review; followed an Institute of Medicine–compliant process to ensure transparency and patient engagement; and developed modified Delphi consensus–based recommendations concerning starting, switching, and stopping DMTs pertinent to people with relapsing-remitting MS, secondary progressive MS, primary progressive MS, and clinically isolated syndromes of demyelination. Recommendations were supported by structured rationales, integrating evidence from one or more sources: systematic review, related evidence (evidence not from the systematic review), principles of care, and inference from evidence. Results Thirty recommendations were developed: 17 on starting DMTs, including recommendations on who should start them; 10 on switching DMTs if breakthrough disease develops; and 3 on stopping DMTs. Recommendations encompassed patient engagement strategies and individualization of treatment, including adherence monitoring and disease comorbidity assessment. The panel also discussed DMT risks, including counseling about progressive multifocal leukoencephalopathy risk in people with MS using natalizumab, fingolimod, rituximab, ocrelizumab, and dimethyl fumarate; and made suggestions for future research to evaluate relative merits of early treatment with higher potency DMTs vs standard stepped-care protocols, DMT comparative effectiveness, optimal switching strategies, long-term effects of DMT use, definitions of highly active MS, and effects of treatment on patient-specified priority outcomes. This guideline reflects the complexity of decision-making for starting, switching, or stopping MS DMTs. The field of MS treatment is rapidly changing; the Academy of Neurology development process includes planning for future updates.

Pathogen survival in swine manure environments and transmission of human enteric illness--a review.

Abstract: The influence of zoonotic pathogens in animal manure on human health and well-being as a direct or indirect cause of human enteric illness is examined. Available international data are considered, but the study is focused on the developing situation in western Canada, where it is certain there will be further rapid growth in livestock numbers, particularly hogs. Major pathogens considered are Escherichia coli O157:H7, Salmonella, Campylobacter, Yersinia, Cryptosporidium, and Giardia. Canada is now the leading exporter of pork internationally, but recent increases in production contrast with constant domestic levels of pork consumption and declining levels of foodborne illness caused by pork. Effects of increased levels of manure production are not quantifiable in terms of effects on human health. The presence of major pathogens in manure and movement to human food sources and water are considered on the basis of available data. Survival of the organisms in soil, manure, and water indicate significant variability in resistance to environmental challenge that are characteristic of the organisms themselves. Generally, pathogens survived longer in environmental samples at cool temperatures but differences were seen in liquid and solid manure. Based on actual data plus some data extrapolated from cattle manure environments, holding manure at 25 degrees C for 90 d will render it free from the pathogens considered above.

Immunization with modified vaccinia virus Ankara-based recombinant vaccine against severe acute respiratory syndrome is associated with enhanced hepatitis in ferrets.

Abstract: Severe acute respiratory syndrome (SARS) caused by a newly identified coronavirus (SARS-CoV) is a serious emerging human infectious disease. In this report, we immunized ferrets (Mustela putorius furo) with recombinant modified vaccinia virus Ankara (rMVA) expressing the SARS-CoV spike (S) protein. Immunized ferrets developed a more rapid and vigorous neutralizing antibody response than control animals after challenge with SARS-CoV; however, they also exhibited strong inflammatory responses in liver tissue. Inflammation in control animals exposed to SARS-CoV was relatively mild. Thus, our data suggest that vaccination with rMVA expressing SARS-CoV S protein is associated with enhanced hepatitis.