49 research outputs found

    Impact du virus du Nil occidental sur les caractéristiques de la population de corneilles au Québec

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    ThÚse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

    Morphological Description of American Crow, Corvus brachyrhynchos, Populations in Southern Quebec

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    The American Crow has always been a much scrutinized bird in North America but, since the emergence of West Nile Virus (WNV) in North America in 1999, public health authorities’ attention to it has been raised another notch. In QuĂ©bec, like everywhere else in North America, part of the WNV surveillance programme was based on detection of WNV mortality in crow populations. During the summer of the 2005 surveillance season, we followed an age and gender determination protocol, as well as a morphological measurement protocol, on dead crows sent in for WNV status determination, to improve our knowledge of the crow population in QuĂ©bec. Statistical analysis of the measurements revealed that age and gender were important factors in the morphological characterisation of the American Crow. Bill depth and head-to-bill length appeared as the most important morphological variables for gender prediction through a discriminant function analysis. We also realized that, in adult age groups, our WNV positive carcasses had lower mean weights than carcasses that tested negative for WNV, in adult age groups.Depuis toujours, la corneille d’AmĂ©rique est un oiseau trĂšs Ă©tudiĂ©, mais, depuis l’apparition du virus du Nil occidental (VNO) en AmĂ©rique du Nord en 1999, l’attention des autoritĂ©s en santĂ© publique sur cet oiseau a encore augmentĂ©. Au QuĂ©bec, comme ailleurs en AmĂ©rique du Nord, une part importante du programme de surveillance pour la dĂ©tection du VNO a Ă©tĂ© basĂ©e sur la dĂ©tection des mortalitĂ©s liĂ©es au VNO dans les populations de corneilles. Pour amĂ©liorer notre connaissance de cette espĂšce au QuĂ©bec, nous avons mis Ă  profit la rĂ©colte des carcasses au cours de l’étĂ© 2005 dans le cadre du programme de surveillance en instaurant un protocole de dĂ©termination de l’ñge, du genre ainsi qu’une prise des mesures morphologiques sur ces mĂȘmes carcasses. L’analyse statistique des rĂ©sultats a montrĂ© qu’à la fois l’ñge et le genre Ă©taient des facteurs importants dans la caractĂ©risation morphologique de la corneille d’AmĂ©rique. À l’aide de l’analyse discriminante, il est apparu que la profondeur du bec ainsi que la distance tĂȘte-bec Ă©taient les mesures les plus importantes pour prĂ©dire le genre de l’oiseau. Nos analyses nous ont Ă©galement permis d’observer que, dans les groupes d’oiseaux adultes, les carcasses positives pour le VNO Ă©taient en moyenne moins lourdes que les carcasses nĂ©gatives

    Long-term outcome after mitral valve repair: a risk factor analysis

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    Objective: Mitral valve repair is the gold standard to restore mitral valve function and is now known to have good long-term outcome. In order to help perioperative decision making, we analyzed our collective to find independent risk factors affecting their outcome. Methods: We retrospectively studied our first 175 consecutive adult patients (mean age: 64±10.4 years; 113 males) who underwent primary mitral valve repair associated with any other cardiac procedures between January 1986 and December 1998. Risk factors influencing reoperations and late survival were plotted in a uni- and multivariate analyses. Results: Operative mortality was 3.4% (6 deaths, 0-22nd postoperative day (POD)). Late mortality was 9.1% (16 deaths, 3rd-125th POM). Reoperation was required in five patients. Kaplan-Meier actuarial analysis demonstrated a 96±1% 1-year survival, 88±3% 5-year survival and a 69±8% 10-year survival. Freedom from reoperations was 99% at 1 year after repair, 97±2% after 5 years and 88±6% after 10 years. Multivariate analysis demonstrated that residual NYHA class III and IV (p=0.001, RR 4.55, 95% CI: 1.85-14.29), poor preoperative ejection fraction (p=0.013, RR 1.09, 95% CI: 1.02-1.18), functional MR (p=0.018, RR 4.17, 95% CI: 1.32-16.67), and ischemic MR (p=0.049, RR 3.13, 95% CI: 1.01-10.0) were all independent predictors of late death. Persistent mitral regurgitation at seventh POD (p=0.005, RR 4.55, 95% CI: 1.56-20.0), age below 60 (p=0.012, RR 8.7, 95% CI: 2.44-37.8), and absence of prosthetic ring (p=0.034, RR 4.76, 95% CI: 1.79-33.3) were all independent risk factors for reoperation. Conclusions: Mitral valve repair provides excellent survival. However, long-term outcome can be negatively influenced by perioperative risk factors. Risk of reoperation is higher in younger patients with a residual mitral regurgitation and without ring annuloplast

    Bird species involved in west nile virus epidemiological cycle in southern Québec

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    Despite many studies on West Nile Virus (WNV) in the US, including the reservoir role of bird species and the summer shifts of the Culex mosquito, feeding from birds to mammals, there have been few equivalent studies in the neighboring regions of Canada where WNV is endemic. Here, a priority list of bird species likely involved in WNV transmission in the greater MontrĂ©al area is constructed by combining three sources of data: (i) from WNV surveillance in wild birds (2002–2015); (ii) blood meal analysis of Culex pipiens–restuans (CPR), the primary enzootic vectors of WNV in the region, collected from surveillance in 2008 and 2014; (iii) literature review on the sero-prevalence/host competence of resident birds. Each of these data sources yielded 18, 23 and 53 species, and overall, 67 different bird species were identified as potential WNV amplifiers/reservoirs. Of those identified from CPR blood meals, Common starlings, American robins, Song sparrows and House sparrows ranked the highest and blood meal analysis demonstrated a seasonal shift in feed preference from birds to mammals by CPR. Our study indicates that there are broad similarities in the ecology of WNV between our region and the northeastern US, although the relative importance of bird species varies somewhat between regions

    A survey of fertility preservation options available to cancer patients around the globe

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    Purpose: Oncofertility focuses on providing fertility and endocrine-sparing options to patients who undergo life-preserving but gonadotoxic cancer treatment. The resources needed to meet patient demand often are fragmented along disciplinary lines. We quantify assets and gaps in oncofertility care on a global scale. Methods: Survey-based questionnaires were provided to 191 members of the Oncofertility Consortium Global Partners Network, a National Institutes of Health–funded organization. Responses were analyzed to measure trends and regional subtleties about patient oncofertility experiences and to analyze barriers to care at sites that provide oncofertility services. Results: Sixty-three responses were received (response rate, 25%), and 40 were analyzed from oncofertility centers in 28 countries. Thirty of 40 survey results (75%) showed that formal referral processes and psychological care are provided to patients at the majority of sites. Fourteen of 23 respondents (61%) stated that some fertility preservation services are not offered because of cultural and legal barriers. The growth of oncofertility and its capacity to improve the lives of cancer survivors around the globe relies on concentrated efforts to increase awareness, promote collaboration, share best practices, and advocate for research funding. Conclusion: This survey reveals global and regional successes and challenges and provides insight into what is needed to advance the field and make the discussion of fertility preservation and endocrine health a standard component of the cancer treatment plan. As the field of oncofertility continues to develop around the globe, regular assessment of both international and regional barriers to quality care must continue to guide process improvements

    Survey of Third-Party Parenting Options Associated With Fertility Preservation Available to Patients With Cancer Around the Globe

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    Purpose: In the accompanying article, “Analysis of Fertility Preservation Options Available to Patients With Cancer Around the Globe,” we showed that specific fertility preservation services may not be offered at various sites around the world because of cultural and legal barriers. We assessed global and regional experiences as well as the legal status of third-party reproduction and adoption to serve as a comprehensive international data set and resource for groups that wish to begin oncofertility interventions. Methods: We provide data on the legalities of third-party assisted reproductive technologies and other family-building options in the 28 oncofertility-practicing countries surveyed. Results: We found regional and country differences that will be important in the development of tailored resources for physicians and for patient brochures that are sensitive to these local restrictions and cultural norms. Conclusion: Because many patients first consult Web-based materials, the formal assessment of the availability of these options provides members of the global oncofertility community with data to which they might otherwise not have ready access to better serve their patients

    Survey of third-party parenting options associated with fertility preservation available to patients with cancer around the globe

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    bstract PURPOSE In the accompanying article, “Survey of Fertility Preservation Options Available to Patients With Cancer Around the Globe,” we showed that specific fertility preservation services may not be offered at various sites around the world because of cultural and legal barriers. We assessed global and regional experiences as well as the legal status of third-party reproduction and adoption to serve as a comprehensive international data set and resource for groups that wish to begin oncofertility interventions. METHODS We provide data on the legalities of third-party assisted reproductive technologies and other familybuilding options in the 28 oncofertility-practicing countries surveyed. RESULTS We found regional and country differences that will be important in the development of tailored resources for physicians and for patient brochures that are sensitive to these local restrictions and cultural norms. CONCLUSION Because many patients first consult Web-based materials, the formal assessment of the availability of these options provides members of the global oncofertility community with data to which they might otherwise not have ready access to better serve their patients

    Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

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    Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
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