Institution
University of Manitoba
Education•Winnipeg, Manitoba, Canada•
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.
Papers published on a yearly basis
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University of Calgary1, University of Milan2, Semmelweis University3, University of Mainz4, Queen Mary University of London5, University of California, San Diego6, Goethe University Frankfurt7, Pennsylvania State University8, University of Toronto9, Laval University10, University of Alberta11, University of British Columbia12, St. John's University13, McMaster University14, Dalhousie University15, Ottawa Hospital16, Université de Montréal17, Halifax18, Queen's University19, University of Manitoba20, University of Auckland21, University of Cincinnati22, Odense University Hospital23, Duke University24, University of Tromsø25, Tel Aviv University26, University of Bern27, Peking Union Medical College Hospital28
TL;DR: Consensus approach is only an interim guide to a complex disorder such as HAE and should be replaced as soon as possible with large phase III and IV clinical trials, meta analyses, and using data base registry validation of approaches.
Abstract: C1 inhibitor deficiency (hereditary angioedema [HAE]) is a rare disorder for which there is a lack of consensus concerning diagnosis, therapy, and management, particularly in Canada. European initiatives have driven the approach to managing HAE with 3 C1-INH Deficiency Workshops held every 2 years in Hungary starting in 1999, with the third Workshop having recently been held in May 2003. The European Contact Board has established a European HAE Registry that will hopefully advance our knowledge of this disorder. The Canadian Hereditary Angioedema Society/Societe d'Angioedeme Hereditaire du Canada organized a Canadian International Consensus Conference held in Toronto, Ontario, Canada, on October 24 to 26, 2003, to foster consensus between major European and North American HAE treatment centers. Papers were presented by investigators from Europe and North America, and this consensus algorithm approach was discussed. There is a paucity of double-blind placebo-controlled trials in the treatment of HAE, making levels of evidence to support the algorithm less than optimal. Enclosed is the consensus algorithm approach recommended for the diagnosis, therapy, and management of HAE and agreed to by the authors of this article. This document is only a consensus algorithm approach and requires validation. As such, participants agreed to make this a living 2003 algorithm (ie, a work in progress) and agreed to review its content at future international HAE meetings. The consensus, however, has strength in that it was arrived at by the meeting of patient-care providers along with patient group representatives and individual patients reviewing information available to date and reaching agreement on how to approach the diagnosis, therapy, and management of HAE circa 2003. Hopefully evidence to support approaches to the management of HAE will approach the level of meta-analysis of randomized controlled trials in the near future.
575 citations
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University of Tampere1, University of Helsinki2, University of New Mexico3, Chulalongkorn University4, Royal Children's Hospital5, Telethon Institute for Child Health Research6, Universidade Federal do Rio Grande do Sul7, Mexican Social Security Institute8, National Taiwan University9, Central Manchester University Hospitals NHS Foundation Trust10, State University of Campinas11, University of the Philippines12, Queen Mary University of London13, University of Alberta14, University of Manitoba15, University of Würzburg16, Katholieke Universiteit Leuven17, Federal University of Paraná18, University of Sydney19, GlaxoSmithKline20
TL;DR: End-of-study results show excellent vaccine efficacy against CIN3+ and AIS irrespective of HPV DNA in the lesion, suggesting population-based vaccination that incorporates the HPV-16/18 vaccine and high coverage of early adolescents might have the potential to substantially reduce the incidence of cervical cancer.
Abstract: Summary Background Cervical intraepithelial neoplasia grade 2 or greater (CIN2+) is the surrogate endpoint used in licensure trials of human papillomavirus (HPV) vaccines. Vaccine efficacy against CIN3+, the immediate precursor to invasive cervical cancer, is more difficult to measure because of its lower incidence, but provides the most stringent evidence of potential cancer prevention. We report vaccine efficacy against CIN3+ and adenocarcinoma in situ (AIS) in the end-of-study analysis of PATRICIA (PApilloma TRIal against Cancer In young Adults). Methods Healthy women aged 15–25 years with no more than six lifetime sexual partners were included in PATRICIA, irrespective of their baseline HPV DNA status, HPV-16 or HPV-18 serostatus, or cytology. Women were randomly assigned (1:1) to receive an HPV-16/18 AS04-adjuvanted vaccine or a control hepatitis A vaccine via an internet-based central randomisation system using a minimisation algorithm to account for age ranges and study sites. The patients and study investigators were masked to allocated vaccine. The primary endpoint of PATRICIA has been reported previously. In the present end-of-study analysis, we focus on CIN3+ and AIS in the populations of most clinical interest, the total vaccinated cohort (TVC) and the TVC-naive. The TVC comprised all women who received at least one vaccine dose, approximating catch-up populations and including sexually active women (vaccine n=9319; control=9325). The TVC-naive comprised women with no evidence of oncogenic HPV infection at baseline, approximating early adolescent HPV exposure (vaccine n=5824; control=5820). This study is registered with ClinicalTrials.gov, number NCT00122681. Findings Vaccine efficacy against CIN3+ associated with HPV-16/18 was 100% (95% CI 85·5–100) in the TVC-naive and 45·7% (22·9–62·2) in the TVC. Vaccine efficacy against all CIN3+ (irrespective of HPV type in the lesion and including lesions with no HPV DNA detected) was 93·2% (78·9–98·7) in the TVC-naive and 45·6% (28·8–58·7) in the TVC. In the TVC-naive, vaccine efficacy against all CIN3+ was higher than 90% in all age groups. In the TVC, vaccine efficacy against all CIN3+ and CIN3+ associated with HPV-16/18 was highest in the 15–17 year age group and progressively decreased in the 18–20 year and 21–25 year age groups. Vaccine efficacy against all AIS was 100% (31·0–100) and 76·9% (16·0–95·8) in the TVC-naive and TVC, respectively. Serious adverse events occurred in 835 (9·0%) and 829 (8·9%) women in the vaccine and control groups, respectively; only ten events (0·1%) and five events (0·1%), respectively, were considered to be related to vaccination. Interpretation PATRICIA end-of-study results show excellent vaccine efficacy against CIN3+ and AIS irrespective of HPV DNA in the lesion. Population-based vaccination that incorporates the HPV-16/18 vaccine and high coverage of early adolescents might have the potential to substantially reduce the incidence of cervical cancer. Funding GlaxoSmithKline Biologicals.
573 citations
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TL;DR: It is found that periods of increased freshwater flow to the North Atlantic occurred at the same time as reductions in the formation of North Atlantic Deep Water, thus providing a mechanism for observed climate variability that may be generally characteristic of times of intermediate global ice volume.
Abstract: Large millennial-scale fluctuations of the southern margin of the North American Laurentide Ice Sheet occurred during the last deglaciation, when the margin was located between about 43° and 49°N. Fluctuations of the ice margin triggered episodic increases in the flux of freshwater to the North Atlantic by rerouting continental runoff from the Mississippi River drainage to the Hudson or St. Lawrence Rivers. We found that periods of increased freshwater flow to the North Atlantic occurred at the same time as reductions in the formation of North Atlantic Deep Water, thus providing a mechanism for observed climate variability that may be generally characteristic of times of intermediate global ice volume.
573 citations
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TL;DR: Handgrip strength was lower in subjects with ICUAP and had good test performance for diagnosingICUAP, and handgrip dynamometry is also independently associated with poor hospital outcome and may serve as a simple test to identify ICU AP.
Abstract: Rationale: ICU-acquired paresis (ICUAP) is common in survivors of critical illness. There is significant associated morbidity, including prolonged time on the ventilator and longer hospital stay. However, it is unclear whether ICUAP is independently associated with mortality, as sicker patients are more prone and existing studies have not adjusted for this.Objectives: To test the hypothesis that ICUAP is independently associated with increased mortality. Secondarily, to determine if handgrip dynamometry is a concise measure of global strength and is independently associated with mortality.Methods: A prospective multicenter cohort study was conducted in intensive care units (ICU) of five academic medical centers. Adults requiring at least 5 days of mechanical ventilation without evidence of preexisting neuromuscular disease were followed until awakening and were then examined for strength.Measurements and Main Results: We measured global strength and handgrip dynamometry. The primary outcome was in-hospita...
570 citations
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TL;DR: There are clinically relevant differences among H1-antihistamines in their pharmacology and safety profiles in allergic rhinoconjunctivitis and chronic urticaria.
Abstract: Histamine has an important role as a chemical messenger in physiologic responses, neurotransmission, allergic inflammation, and immunomodulation by way of the H1-receptor. Most H1-antihistamines, which are useful in treating these effects, possess similar efficacy in allergic rhinoconjunctivitis and chronic urticaria. However, there are clinically relevant differences among them in their pharmacology and safety profiles.
570 citations
Authors
Showing all 32123 results
Name | H-index | Papers | Citations |
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George Davey Smith | 224 | 2540 | 248373 |
Peer Bork | 206 | 697 | 245427 |
David A. Weitz | 178 | 1038 | 114182 |
Yang Yang | 171 | 2644 | 153049 |
Robert E. W. Hancock | 152 | 775 | 88481 |
Peter B. Jones | 145 | 1857 | 94641 |
Peter Lang | 140 | 1136 | 98592 |
James J. Gross | 139 | 529 | 100206 |
Steven J.M. Jones | 137 | 594 | 146609 |
Rajkumar Buyya | 133 | 1066 | 95164 |
Jeff A. Sloan | 129 | 656 | 65308 |
Dafna D. Gladman | 129 | 1036 | 75273 |
Murray B. Stein | 128 | 745 | 89513 |
Robert W. Heath | 128 | 1049 | 73171 |
Jürgen Rehm | 126 | 1132 | 116037 |