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Malas T, Chaudry S, Sohmer B, Ruel M, Mesana T, Boodhwani M. Is Aortic Valve Repair Reproducible? Analysis of the Learning Curve for Aortic Valve Repair. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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52
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Blackburn N, Sofrenovic T, Kuraitis D, Ahmadi A, McEwan K, Padavan D, McNeill B, Rayner K, Ruel M, Suuronen E. Time of Delivery Influences the Efficacy of Collagen Matrix Therapy for Myocardial Infarction. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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53
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Tiwari-Pandey R, Toeg H, Seymour R, Ahmadi A, Crowe S, Vulesevic B, Suuronen E, Ruel M. Effects and Mechanistic Correlates of Using a Liquefied, Injectable Porcine Submucosa Extracellular Matrix, With Or Without Angiogenic Cells, in a Myocardial Scar Model. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Elmistekawy E, Ahrari A, Ruel M, Mesana T, Chan V. Valve Prosthesis Selection in Patients With Left-Sided Endocarditis. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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55
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Fitzpatrick M, Latham N, Tilokee E, Wells G, Lam K, Ruel M, Davis D. The Regenerative Capacity of Cardiac Stem Cells Inversely Correlates With Risk Factors for Coronary Artery Disease. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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56
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Une D, Armstrong S, Ruel M, David TE. 068 * TWENTY-YEAR DURABILITY OF THE AORTIC HANCOCK II BIOPROSTHESIS IN YOUNG PATIENTS: IS IT DURABLE ENOUGH? Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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57
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Chan V, Ruel M, Elmistekawy E, Mesana T. Determinants of postoperative left ventricle dysfunction in patients with chronic asymptomatic severe mitral regurgitation due to myxomatous degeneration. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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58
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Chan V, Ruel M, Elmistekawy E, Mesana T. Impact of mitral valve repair on late postoperative left ventricular function in patients with non-ischemic cardiomyopathy. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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59
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Elmistekawy E, Rubens F, Hudson C, McDonald B, Ruel M, Lam K, Mesana TG, Boodhwani M. Preoperative anaemia is a risk factor for mortality and morbidity following aortic valve surgery. Eur J Cardiothorac Surg 2013; 44:1051-5; discussion 1055-6. [DOI: 10.1093/ejcts/ezt143] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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60
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Kuraitis D, Ebadi D, Zhang P, Rizzuto E, Vulesevic B, Padavan DT, Al Madhoun A, McEwan KA, Sofrenovic T, Nicholson K, Whitman SC, Mesana TG, Skerjanc IS, Musarò A, Ruel M, Suuronen EJ, Suuronen EJ. Injected matrix stimulates myogenesis and regeneration of mouse skeletal muscle after ischaemic injury. Eur Cell Mater 2012; 24:175-95; discussion 195-6. [PMID: 22972509 DOI: 10.22203/ecm.v024a13] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Biomaterial-guided regeneration represents a novel approach for the treatment of myopathies. Revascularisation and the intramuscular extracellular matrix are important factors in stimulating myogenesis and regenerating muscle damaged by ischaemia. In this study, we used an injectable collagen matrix, enhanced with sialyl LewisX (sLeX), to guide skeletal muscle differentiation and regeneration. The elastic properties of collagen and sLeX-collagen matrices were similar to those of skeletal muscle, and culture of pluripotent mESCs on the matrices promoted their differentiation into myocyte-like cells expressing Pax3, MHC3, myogenin and Myf5. The regenerative properties of matrices were evaluated in ischaemic mouse hind-limbs. Treatment with the sLeX-matrix augmented the production of myogenic-mediated factors insulin-like growth factor (IGF)-1, and IGF binding protein-2 and -5 after 3 days. This was followed by muscle regeneration, including a greater number of regenerating myofibres and increased transcription of Six1, M-cadherin, myogenin and Myf5 after 10 days. Simultaneously, the sLeX-matrix promoted increased mobilisation and engraftment of bone marrow-derived progenitor cells, the development of larger arterioles and the restoration of tissue perfusion. Both matrix treatments tended to reduce maximal forces of ischaemic solei muscles, but sLeX-matrix lessened this loss of force and also prevented muscle fatigue. Only sLeX-matrix treatment improved mobility of mice on a treadmill. Together, these results suggest a novel approach for regenerative myogenesis, whereby treatment only with a matrix, which possesses an inherent ability to guide myogenic differentiation of pluripotent stem cells, can enhance the endogenous vascular and myogenic regeneration of skeletal muscle, thus holding promise for future clinical use.
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Tiwari-Pandey R, Toeg H, Seymour R, Crowe S, Vulesevic B, Suuronen E, Ruel M. 209 Evaluation of a New, Clinically Relevant Biopolymer Matrix For Vasculogenesis And Myogenesis In The Setting Of Acute Myocardial Infarction. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Tilokee E, Mayfield A, Jackson R, Lam B, Ruel M, Suuronen E, Courtman D, Stewart D, Davis D. 775 Encapsulation of Ex Vivo Proliferated Human Cardiac Stem Cells Within Matrix Supplemented Hydrogel Enhances Survival by Preventing Detachment Induced Apoptosis. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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63
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Chan V, Ruel M, Mesana T. 412 Natural History of Pulmonary Hypertension Regression in Patients Following Mitral Valve Repair of Regurgitation Due to Degenerative Disease. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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64
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Struthers C, Eastwood K, Montoya L, Labinaz M, Ruel M. N061 Do All TAVI Patients Require Telehome Monitoring Follow-up After Discharge From Hospital? Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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65
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Ramirez F, Hibbert B, Simard T, Pourdjabbar A, Wilson K, Hibbert R, Kazmi M, Hawken S, Ruel M, Labinaz M, O'Brien E. 012 Natural History and Management of Aortocoronary Saphenous Vein Graft Aneurysms: A Systematic Review of Published Cases. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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66
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Khatri P, Webb J, Rodés-Cabau J, Fremes S, Ruel M, Lau K, Guo H, Wijeysundera H, Ko D. 567 Adverse Effects Associated With Transcatheter Aortic Valve Implantation: A Meta-Analysis of Contemporary Studies. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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67
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Petrosyan A, Chan V, Mesana T, Ruel M. 556 Functional Significance of Recurrent Mitral Regurgitation After Mitral Valve Repair for Ischemic Mitral Regurgitation. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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68
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McNeill B, Ruel M, Suuronen E. 308 Collagen Matrices Enhance CD34+ Circulating Angiogenic Cell Function Through The Integrin Receptors. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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69
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Ruel M, Shariff M, Lapierre H, Sohmer B, McGinn J. 254 Mid-Term Results of 800 Minimally Invasive Coronary Bypass Operations. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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70
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Chan V, Ruel M, Chaudry S, Nicholson D, Mesana T. 555 Mitral Regurgitation Lesion Type Impacts Outcomes Following Mitral Valve Repair in Patients With Non-Ischemic Cardiomyopathy and Severe Left Ventricle Dysfunction. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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71
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Sofrenovic T, Blackburn N, Ahmadi A, Kuraitis D, McEwan K, Ruel M, Suuronen E. 211 Evaluation Of An Enhanced (sialyl LewisX) Collagen Matrix for Neovascularization And Cardiomyogenesis in a Mouse Model Of Myocardial Infarction. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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72
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Elmistekawy E, Chan V, Lam B, Mesana T, Ruel M. 744 Double Valve Replacement: Biological Versus Mechanical Protheses. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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73
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Grimaldi-Bensouda L, Viallard JF, Aubrun E, Leighton P, Fain O, Ruel M, Machet L, Le Guern V, Kone-Paut I, Abenhaim L, Costedoat-Chalumeau N. La vaccination est-elle associée au risque de survenue d’un lupus systémique ? Résultat d’une étude prospective multicentrique cas–témoins utilisant le registre PGRx-Lupus. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Daneluzzi V, Zeghidi H, Velten L, Gilles S, Ruel M. La neuro-syphilis est de plus en plus fréquente en France : ouvrons l’œil ! Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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75
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Kuraitis D, Zhang P, Zhang Y, Padavan DT, McEwan K, Sofrenovic T, McKee D, Zhang J, Griffith M, Cao X, Musarò A, Ruel M, Suuronen EJ, Suuronen EJ. A stromal cell-derived factor-1 releasing matrix enhances the progenitor cell response and blood vessel growth in ischaemic skeletal muscle. Eur Cell Mater 2011; 22:109-23. [PMID: 21892805 DOI: 10.22203/ecm.v022a09] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Although many regenerative cell therapies are being developed to replace or regenerate ischaemic muscle, the lack of vasculature and poor persistence of the therapeutic cells represent major limiting factors to successful tissue restoration. In response to ischaemia, stromal cell-derived factor-1 (SDF-1) is up-regulated by the affected tissue to stimulate stem cell-mediated regenerative responses. Therefore, we encapsulated SDF-1 into alginate microspheres and further incorporated these into an injectable collagen-based matrix in order to improve local delivery. Microsphere-matrix impregnation reduced the time for matrix thermogelation, and also increased the viscosity reached. This double-incorporation prolonged the release of SDF-1, which maintained adhesive and migratory bioactivity, attributed to chemotaxis in response to SDF-1. In vivo, treatment of ischaemic hindlimb muscle with microsphere-matrix led to increased mobilisation of bone marrow-derived progenitor cells, and also improved recruitment of angiogenic cells expressing the SDF-1 receptor (CXCR4) from bone marrow and local tissues. Both matrix and SDF-1-releasing matrix were successful at restoring perfusion, but SDF-1 treatment appeared to play an earlier role, as evidenced by arterioles that are phenotypically older and by increased angiogenic cytokine production, stimulating the generation of a qualitative microenvironment for a rapid and therefore more efficient regeneration. These results support the release of implanted SDF-1 as a promising method for enhancing progenitor cell responses and restoring perfusion to ischaemic tissues via neovascularisation.
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Elmistekawy E, Chan V, Bourke M, Dupuis J, Rubens F, Mesana T, Ruel M. 102 OPCAB is not associated with better postoperative renal function compared to CABG. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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77
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Kuraitis D, Ebadi D, Zhang P, Vulesevic B, Al-Madhoun A, Sofrenovic T, Mesana T, Skerjanc I, Ruel M, Suuronen E. 196 Injectable matrix activates myogenic differentiation in embryonic stem cells and regenerates muscle in ischemic tissue. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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78
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Chan V, Ruel M, Chaudry S, Grisoli D, Tran A, Ressler L, Hynes M, Mesana T. 475 Larger left ventricle size negatively impacts late postoperative left ventricle function following mitral valve repair. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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79
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Ahmadi A, Vulesevic B, Toeg H, DaSilva J, Kordos M, Thorn S, Renaud J, Mesana T, Beanlands R, deKemp R, Ruel M, Suuronen E. 182 An Integrin-Linked Kinase Mechanism is Associated with Improved Perfusion, Viability, and Function of Infarcted Myocardium Following Cell-Matrix Therapy. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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80
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Elmistekawy E, Tran D, Dupuis J, McDonald B, Ruel M, Mesana T, Lam B. 601 The value of risk algorithms in predicting outcomes for octogenarians undergoing Aortic valve replacement with or without CABG. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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81
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Elmistekawy E, Lapierre H, Tran D, Ruel M, Mesana T, Lam B. 625 Impact of patient-prothesis mismatch on octogenerian after aortic valve replacement. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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82
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Giordano C, Thorn S, Suuronen E, Renaud J, Al-Atassi T, Boodhwani M, Zhang P, Ascah K, deKemp R, Beanlands R, Ruel M. 604 Pre-clinical evaluation of biopolymer-delivered endothelial progenitor cells in hibernating myocardium. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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83
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Ruel M, Grenon J, Boodhwani M, Mielniczuk L, Rubens F, Haddad H, Lam B, Davies R, Veinot J, Lapierre H, Ressler L, Pipe A, Struthers C, Pugliese C, Mesana T, Hendry P, Masters R. 422 Results of 461 orthotopic heart transplantations at the University of Ottawa Heart Institute: Follow-up data to 25 years. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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84
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Zhang Y, Kuraitis D, Burgon P, Crowe S, Vulesevic B, Thorn S, Wu J, DaSilva J, deKemp R, Beanlands R, Suuronen E, Ruel M. 705 Development of reporter gene PET imaging techniques for long-term assessment of transplanted human circulating progenitor cells. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.08.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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85
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Mastrobuoni S, Gawad N, Chan V, Ruel M, Mesana T, Rubens F. 114 Use of bilateral internal thoracic artery during coronary artery bypass graft surgery in Canada: The BITA Survey. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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86
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McGinn JT, Usman S, Lapierre H, Pothula VR, Mesana TG, Ruel M. Minimally Invasive Coronary Artery Bypass Grafting: Dual-Center Experience in 450 Consecutive Patients. Circulation 2009; 120:S78-84. [DOI: 10.1161/circulationaha.108.840041] [Citation(s) in RCA: 143] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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87
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Kulik A, Lam BK, Rubens FD, Hendry PJ, Masters RG, Goldstein W, Bédard P, Mesana TG, Ruel M. Gender differences in the long-term outcomes after valve replacement surgery. Heart 2008; 95:318-26. [PMID: 18653574 DOI: 10.1136/hrt.2008.146688] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To compare the long-term outcomes in women and men after valve replacement surgery. DESIGN Observational study. SETTING Postoperative aortic valve replacement (AVR) or mitral valve replacement (MVR). PATIENTS 3118 patients (1261 women, 1857 men) who underwent AVR or MVR between 1976 and 2006 (2255 AVR, 863 MVR), with mean follow-up of 5.6 (4.5) years. MAIN OUTCOME MEASURES The independent effect of gender on the risk of long-term complications (reoperation, stroke and death) after valve replacement surgery using multivariate actuarial methods. RESULTS After implantation of an aortic valve bioprosthesis, women had a significantly lower rate of reoperation compared to men (comorbidity-adjusted hazard ratio (HR) 0.4; 95% confidence intervals (CI) 0.2 to 0.9). In contrast, if an aortic mechanical prosthesis had been implanted, women were more at risk for late stroke compared to men (HR 1.7; CI 1.1 to 2.7). After adjustment for age and co-morbidities, women had significantly better long-term survival compared to men after bioprosthetic AVR (HR 0.5; CI 0.3 to 0.6), but there was no survival difference between genders after mechanical AVR. Trends existed towards better survival for women after bioprosthetic MVR (HR 0.6; CI 0.4 to 1.0) and mechanical MVR (HR 0.8; CI 0.5 to 1.1). CONCLUSION The long-term outcomes after valve replacement surgery differ between women and men. Although women have more late strokes after valve replacement, they undergo fewer reoperations and have better overall long-term survival compared to men.
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Zucman D, De Truchis P, Ruel M, Berthe H, Olivier C. M-02 Guérison spontanée de l’hépatite chronique C chez 4 patients co-infectés par le VIH et le VHC : rôle de la restauration immunitaire sous trithérapie et de l’arrêt de la consommation d’alcool. Med Mal Infect 2008. [DOI: 10.1016/s0399-077x(08)73175-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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89
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Randolph TF, Schelling E, Grace D, Nicholson CF, Leroy JL, Cole DC, Demment MW, Omore A, Zinsstag J, Ruel M. Invited review: Role of livestock in human nutrition and health for poverty reduction in developing countries. J Anim Sci 2007; 85:2788-800. [PMID: 17911229 DOI: 10.2527/jas.2007-0467] [Citation(s) in RCA: 201] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Livestock keeping is critical for many of the poor in the developing world, often contributing to multiple livelihood objectives and offering pathways out of poverty. Livestock keeping also affects an indispensable asset of the poor, their human capital, through its impact on their own nutrition and health. This paper outlines the linkages between livestock keeping and the physical well-being of the poor, and examines a number of commonly held beliefs that misrepresent livestock development issues related to these linkages. These beliefs limit the scope of intervention programs to promote livestock and limit their potential contribution to poverty reduction. Recognition of the complexity of the role livestock play in household decision-making and of the opportunities foregone due to these misconceptions can enhance the ability of livestock to contribute to human well-being in the developing world.
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Suuronen EJ, Muzakare L, Doillon CJ, Kapila V, Li F, Ruel M, Griffith M. Promotion of angiogenesis in tissue engineering: developing multicellular matrices with multiple capacities. Int J Artif Organs 2007; 29:1148-57. [PMID: 17219355 DOI: 10.1177/039139880602901208] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
One of the aims of tissue engineering is to be able to develop multi-tissue organs in the future. This requires the optimization of conditions for the differentiation of multiple cell types and maintenance of the differentiated phenotype within complex engineered tissues. The goal of this study was to develop prototype tissue engineered matrices to support the simultaneous growth of different cell types with a particular focus on the angiogenic process. We examined two different matrix compositions for the promotion of blood vessel and tube formation. A fibrin-based matrix with the addition of a combination of growth factors supported vascular growth and the invasion of inflammatory cells. Using this fibrin matrix, in combination with a collagen-based hydrogel, a simple in vitro model of the cornea with adjacent sclera was developed that was complete with innervation and vascular structures. In addition, we showed that collagen-based matrices were effective in delivering mononuclear endothelial progenitor cells to ischemic tissue in vivo, and allowing these cells to incorporate into vascular structures. It is anticipated that with further development, these matrices have potential for use as delivery matrices for cell transplantation and for in vitro study purposes of multiple cell types.
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91
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Ramlawi B, Khan T, Ruel M, Voisine P, Bianchi C, Boodhwani M, Sellke F. Gene Expression Profiles following Cardiac Surgery in Diabetic Patients and Their Clinical Correlation. J Investig Med 2006. [DOI: 10.1177/108155890605402s135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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92
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Ramlawi B, Khan TA, Ruel M, Voisine P, Bianchi C, Boodhwani M, Sellke FW. 56 GENE EXPRESSION PROFILES FOLLOWING CARDIAC SURGERY IN DIABETIC PATIENTS AND THEIR CLINICAL CORRELATION. J Investig Med 2006. [DOI: 10.2310/6650.2005.x0015.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Choinière A, Girard F, Boudreault D, Ruel M, Girard DC. Voluntary hyperventilation before a rapid-sequence induction of anesthesia does not decrease postintubation PaCO2. Anesth Analg 2001; 93:1277-80. [PMID: 11682414 DOI: 10.1097/00000539-200111000-00050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
UNLABELLED To prevent hypercapnia, voluntary hyperventilation is recommended for patients with increased intracranial pressure before the induction of general anesthesia. We sought to determine whether this maneuver results in a lower PaCO2 than breathing 3 min of oxygen 100% by face mask (preoxygenation) after intubation. Thirty patients requiring general anesthesia were randomly assigned to breathe either 3 min of oxygen 100% by face mask (Group P) or 1 min of oxygen 100% followed by 2 min of voluntary hyperventilation with oxygen 100% (Group H). All patients received a standard rapid-sequence induction of anesthesia followed by a 90-s period of apnea. Patients were then tracheally intubated and mechanically ventilated. Five arterial blood gas samples were taken: with room air, after preoxygenation or hyperventilation, after 60 and 90 s of apnea, and after tracheal intubation. Voluntary hyperventilation decreased PaCO2 before rapid-sequence induction (hyperventilation, 30.0 +/- 3.5 mm Hg versus preoxygenation, 37.9 +/- 5.2 mm Hg; P < 0.0001), but after 60 s of apnea, both groups had similar PaCO2 (hyperventilation, 36.1 +/- 3.3 mm Hg versus preoxygenation, 35.6 +/- 3.4 mm Hg; P = 0.673), and no benefit was found after intubation (hyperventilation, 40.5 +/- 3.9 mm Hg versus preoxygenation, 41.4 +/- 2.7 mm Hg; P = 0.603). We conclude that voluntary hyperventilation before rapid-sequence induction does not provide protection against potential hypercapnia during intubation. IMPLICATIONS Voluntary hyperventilation before anesthesia induction is recommended for patients with increased intracranial pressure to prevent hypercapnia. This randomized, prospective study demonstrated that this maneuver does not result in a lower postintubation PaCO2 than standard preoxygenation.
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Nguyen A, Girard F, Boudreault D, Fugère F, Ruel M, Moumdjian R, Bouthilier A, Caron JL, Bojanowski MW, Girard DC. Scalp nerve blocks decrease the severity of pain after craniotomy. Anesth Analg 2001; 93:1272-6. [PMID: 11682413 DOI: 10.1097/00000539-200111000-00048] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED Up to 80% of patients report moderate to severe pain after craniotomy. In this study, we assessed the efficacy of scalp block for decreasing postoperative pain in brain surgery. Thirty patients scheduled for supratentorial craniotomy were enrolled. They were randomly divided into two groups: Ropivacaine (scalp block with 20 mL of ropivacaine 0.75%) and Saline (scalp block with 20 mL of saline 0.9%). Anesthesia was standardized. The scalp block was performed after skin closure and before awakening. Postoperative pain was assessed at 4, 8, 12, 16, 20, 24, and 48 h by using a 10-cm visual analog scale. Analgesia was provided with sub- cutaneous codeine as requested by the patient. Average visual analog scale scores were higher in the Saline group as compared with Ropivacaine (3.7 +/- 2.4 vs 2.0 +/- 1.6; P = 0.036). The total dose of codeine did not differ, nor did the duration of time before the first dose of codeine was required in the Ropivacaine (571 +/- 765 min) versus Saline (319 +/- 409 min; P = 0.17) group. In conclusion, we found that postoperative scalp block decreases the severity of pain after craniotomy and that this effect is long lasting, possibly through a preemptive mechanism. IMPLICATIONS Up to 80% of patients report moderate to severe pain after craniotomy. This randomized double-blinded study demonstrated that ropivacaine scalp block decreases the severity of pain after supratentorial craniotomy.
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95
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Ruel M, Bedard P, Morash CG, Hynes M, Barber GG. Resection of right atrial tumor thrombi without circulatory arrest. Ann Thorac Surg 2001; 71:733-4. [PMID: 11235750 DOI: 10.1016/s0003-4975(00)02317-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Resectable retroperitoneal tumors with right atrial tumor thrombus extension have been excised previously using cardiopulmonary bypass and deep hypothermic circulatory arrest. We have used a technique involving clamping of the descending aorta with avoidance of deep hypothermic circulatory arrest in 6 patients. The approach provided a virtually bloodless field and allowed complete resection to be performed with low morbidity.
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Bhutta ZA, Bird SM, Black RE, Brown KH, Gardner JM, Hidayat A, Khatun F, Martorell R, Ninh NX, Penny ME, Rosado JL, Roy SK, Ruel M, Sazawal S, Shankar A. Therapeutic effects of oral zinc in acute and persistent diarrhea in children in developing countries: pooled analysis of randomized controlled trials. Am J Clin Nutr 2000; 72:1516-22. [PMID: 11101480 DOI: 10.1093/ajcn/72.6.1516] [Citation(s) in RCA: 309] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Zinc deficiency is prevalent in children in developing countries. Supplemental zinc provides therapeutic benefits in diarrhea. OBJECTIVE We sought to measure the effect of supplemental zinc given with oral rehydration therapy during recovery from acute or persistent diarrhea. DESIGN We conducted pooled analyses including all available published and unpublished randomized controlled trials of the effects of supplementary oral zinc in children aged <5 y with acute or persistent diarrhea. We used Cox survival regression analysis to evaluate the overall effect of zinc on continuation of diarrhea and possible differential effects in subgroups divided by sex, age, weight-for-height, and initial plasma zinc concentration. Dichotomous outcomes were analyzed by logistic regression. To assess the effects of excluding studies without original data from the pooled analyses, effect-size was estimated for all studies by using random-effects models. RESULTS Zinc-supplemented children had a 15% lower probability of continuing diarrhea on a given day (95% CI: 5%, 24%) in the acute-diarrhea trials and a 24% lower probability of continuing diarrhea (95% CI: 9%, 37%) and a 42% lower rate of treatment failure or death (95% CI: 10%, 63%) in the persistent-diarrhea trials. In none of the subgroup analyses were the 2 subgroups of each pair significantly different from each other; however, in persistent diarrhea there tended to be a greater effect in subjects aged <12 mo, who were male, or who had wasting or lower baseline plasma zinc concentrations. CONCLUSION Zinc supplementation reduces the duration and severity of acute and persistent diarrhea.
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Tattevin P, Egmann G, Casalino E, Fleury L, Ruel M, Bouvet E. [Development of a predictive model for respiratory isolation of patients suspected of having pulmonary tuberculosis]. Rev Med Interne 2000; 21:533-41. [PMID: 10909153 DOI: 10.1016/s0248-8663(00)89229-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION As numerous nosocomial outbreaks of pulmonary tuberculosis have been reported during the last two decades, prompt identification and effective isolation of contagious patients should be made a priority in tuberculosis control policies. There is a need to develop a predictive model which would allow prompt recognition and isolation of smear-positive patients. CURRENT KNOWLEDGE AND KEY POINTS Various authors have attempted to improve the respiratory isolation policies for patients suspected of having pulmonary tuberculosis. A French multicenter prospective study of 211 patients suspected of having pulmonary tuberculosis established that: 1) the current respiratory isolation policy of suspected pulmonary tuberculosis needs improvement (sensitivity = 71.4%; i.e., 28.6% of smear-positive patients are admitted without isolation) and 2) better interpretation of clinical and radiological data available on patient admission could improve the adequacy of respiratory isolation. Univariate analysis showed that predictive factors of pulmonary tuberculosis were chest X-rays (P < 0.00001), symptoms (P = 0.0004), age (mean: 40.8 years for TB vs. 47.5 for non-TB, P = 0.04), HIV infection (10.6% vs. 28.7%, P = 0.01), immigrant (72% vs. 55%, P = 0.03) and BCG status (P = 0.025), while multivariate analysis demonstrated that chest X-ray pattern (P < 0.00001), HIV infection (P = 0.002) and symptoms (P = 0.009) were independent predictive factors. FUTURE PROSPECTS AND PROJECTS From these data, a model was proposed and evaluated in the derivation cohort using the receiver operating characteristics (ROC) curve. We retrospectively studied the predictive model in two populations different from the one from which it was derived. The model would have improved sensitivity of the respiratory isolation policy from 71.4% (current respiratory isolation policy) to 82.4% and 91.1%, respectively. Prospective, multicenter studies are requested to establish the value of such a predictive model in improving the respiratory isolation policy for patients suspected of having pulmonary tuberculosis.
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Salvaggio J, Jacob C, Schmitt C, Orizet C, Ruel M, Lambert H. [Abuse of flunitrazepam in opioid addicts]. ANNALES DE MEDECINE INTERNE 2000; 151 Suppl A:A6-9. [PMID: 10855371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Fifty-three heroin addicts, nineteen of them methadone treated, were asked about their use of flunitrazepam. Drug abuse began after a medical prescription in 50% of cases; flunitrazepam was taken per os, but also i.v. in 19% of cases. The mean daily dose was about 20 mg/day, often associated with other psychotropic drugs, alcohol, opiates or cocaine. Attention is focused on the amnesia and increased feeling of power (11% of cases), often resulting in serious violent offenses.
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Bhutta ZA, Black RE, Brown KH, Gardner JM, Gore S, Hidayat A, Khatun F, Martorell R, Ninh NX, Penny ME, Rosado JL, Roy SK, Ruel M, Sazawal S, Shankar A. Prevention of diarrhea and pneumonia by zinc supplementation in children in developing countries: pooled analysis of randomized controlled trials. Zinc Investigators' Collaborative Group. J Pediatr 1999; 135:689-97. [PMID: 10586170 DOI: 10.1016/s0022-3476(99)70086-7] [Citation(s) in RCA: 429] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This study assessed the effects of zinc supplementation in the prevention of diarrhea and pneumonia with the use of a pooled analysis of randomized controlled trials in children in developing countries. STUDY DESIGN Trials included were those that provided oral supplements containing at least one half of the United States Recommended Daily Allowance (RDA) of zinc in children <5 years old and evaluated the prevention of serious infectious morbidity through household visits. Analysis included 7 "continuous" trials providing 1 to 2 RDA of elemental zinc 5 to 7 times per week throughout the period of morbidity surveillance and 3 "short-course" trials providing 2 to 4 RDA daily for 2 weeks followed by 2 to 3 months of morbidity surveillance. The effects on diarrhea and pneumonia were analyzed overall and in subgroups defined by age, baseline plasma zinc concentration, nutritional status, and sex. The analysis used random effects hierarchical models to calculate odds ratios (OR) and 95% CIs. RESULTS For the zinc-supplemented children compared with the control group in the continuous trials, the pooled ORs for diarrheal incidence and prevalence were 0.82 (95% CI 0.72 to 0.93) and 0.75 (95% CI 0.63 to 0.88), respectively. Zinc-supplemented children had an OR of 0.59 (95% CI 0.41 to 0.83) for pneumonia. No significant differences were seen in the effects of the zinc supplement between the subgroups examined for either diarrhea or pneumonia. In the short-course trials the OR for the effects of zinc on diarrheal incidence (OR 0.89, 95% CI 0.62 to 1.28) and prevalence (OR 0.66, 95% CI 0.52 to 0.83) and pneumonia incidence (OR 0.74, 95% CI 0.40 to 1.37) were similar to those in the continuous trials. CONCLUSIONS Zinc supplementation in children in developing countries is associated with substantial reductions in the rates of diarrhea and pneumonia, the 2 leading causes of death in these settings.
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Couture P, Denault AY, Carignan S, Boudreault D, Babin D, Ruel M. Intraoperative detection of segmental wall motion abnormalities with transesophageal echocardiography. Can J Anaesth 1999; 46:827-31. [PMID: 10490149 DOI: 10.1007/bf03012970] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To compare two methods of analysis of regional wall-motion (RWM) using transesophageal echocardiography (TEE). METHODS Thirty patients undergoing coronary artery bypass surgery were studied. The transgastric short axis view at the mid-papillary level was recorded before and after cardiopulmonary bypass. All images were reviewed by an anesthesiologist trained in TEE and an echocardiographer. Regional wall motion was graded: 1 normal, 2 hypokinetic, 3 akinetic, and 4 dyskinetic. The left ventricle was evaluated according to the guidelines of the American Society of Echocardiography using 6-segment, and 4-segment models. Agreement between observers (interobservers), and for one observer at two different moments (intraobservers), for grading each segment was defined as RWM abnormality scores within 1 grade. A wall-motion score index (WMSI), which is the sum of individual scores divided by the number of segments visualized, was calculated. A Bland Altman analysis was used to assess interobserver variability. RESULTS Agreement between observers occurred in 96% and 94% of the examined segments, using 4- and 6-segment models respectively. Intraobserver agreement was 99% and 97% for the 4- and 6-segment models. The mean differences (bias) of the interobserver variability in grading the segments were 0.04 +/- 0.79 and 0 +/- 0.72 using a 4- or 6-segment model. The mean difference of the interobserver variability in WMSI were -0.05 +/- 0.42 and 0.05 +/- 0.37 using a 4- or a 6-segment model. CONCLUSION Both methods, using either a 4- or a 6-segment model, result in a high intraobserver and interobserver agreement, and a low interobserver variability.
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