bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health Care Utilization by Preterm Infants with Respiratory Complications in Quebec
Authors: Landry Jennifer S , Croitoru Dan , Jin Yulan , Schwartzman Kevin , Benedetti Andrea , Menzies Dick 
Published: March 2016

INTRODUCTION: Despite notable advances in prenatal and neonatal care, respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) remain important complications of preterm births, and their long‐term sequelae are poorly understood.OBJECTIVE: To describe health care utilization and costs over a 16‐ to 25‐year follow‐up period in a cohort of preterm infants with respiratory complications.METHODS: Using provincial health administrative databases from Quebec, a cohort of individuals who were born prematurely with complications of RDS and/or BPD between 1983 and 1992 were identified. From these databases, which cover all Quebec residents, health services use, medication prescriptions, associated diagnoses and costs were tabulated.RESULTS: A total of 3442 subjects with respiratory complications following preterm birth were identified, of whom 773 had been diagnosed with BPD and 2669 had RDS without BPD. Asthma was diagnosed twice as frequently (1.7 to 2.4 times) in the BPD group compared with the RDS group, with more frequent hospital readmission, and outpatient and emergency room visits. Although respiratory causes remained the main reason for consultation in both groups, 3.7% and 3.4% of the outpatient visits were for mental or psychological ailments, such as depression, attention deficit hyperactivity disorder or dysthymia for the BPD and RDS groups, respectively.CONCLUSION: BPD patients experienced more hospital admissions, outpatient and emergency rooms visits, and were more likely to suffer from respiratory illnesses and to use respiratory drugs than RDS patients. Neurological and psychiatric complications occurred at a high frequency in both RDS and BPD subjects, and were associated with significant use of antipsychotic and antidepressant medications.
Reliability of the Conditioned Pain Modulation Paradigm to Assess Endogenous Inhibitory Pain Pathways
Authors: Lewis Gwyn N , Luke Heales , Rice David A , Rome Keith , McNair Peter J 
Published: March 2016

BACKGROUND: Conditioned pain modulation paradigms are often used to assess the diffuse noxious inhibitory control (DNIC) system. DNICs provide one of the main supraspinal pain inhibitory pathways and are impaired in several chronic pain populations. Only one previous study has examined the psychometric properties of the conditioned pain modulation technique and this study did not evaluate intersession reliability.OBJECTIVES: To evaluate and compare the intra‐ and intersession reliability of two conditioned pain modulation paradigms using different conditioning stimuli, and to determine the time course of conditioned pain inhibition following stimulus removal.METHODS: An electronic pressure transducer was used to determine the pressure‐pain threshold at the knee during painful conditioning of the opposite hand using the ischemic arm test and the cold pressor test. Assessments were completed twice on one day and repeated once approximately three days later.RESULTS: The two conditioning stimuli resulted in a similar increase in the pressure‐pain threshold at the knee, reflecting presumed activation of the DNIC system. Intrasession intraclass correlation coefficients for the cold pressor (0.85) and ischemic arm tests (0.75) were excellent. The intersession intraclass correlation coefficient for the cold pressor test was good (0.66) but was poor for the ischemic arm test (−0.4). Inhibition of the pressure‐pain threshold remained significant at 10 min following conditioning, but returned to baseline by 15 min.CONCLUSIONS: Within‐session reliability of DNIC assessment using conditioned pain modulation paradigms was excellent, but the applicability of assessing pain modulation over multiple sessions was influenced by the conditioning stimulus. The cold pressor test was the superior technique.
Pleural Mesothelioma Surveillance: Validity of Cases from a Tumour Registry
Authors: Labrèche France , Case Bruce W , Ostiguy Gaston , Chalaoui Jean , Camus Michel , Siemiatycki Jack 
Published: March 2016

BACKGROUND: Pleural mesothelioma is a rare tumour associated with exposure to asbestos fibres. Fewer than than one-quarter of cases registered in the Quebec Tumour Registry (QTR) have been compensated as work-related. While establishing a surveillance system, this led to questioning as to whether there has been over-registration of cases that are not authentic pleural mesotheliomas in the QTR.OBJECTIVE: To assess whether registered cases of pleural mesothelioma could be confirmed.METHODS: A medical chart review was designed to assess the proportion of mesothelioma cases newly registered in the QTR in 2001/2002 that could be confirmed. For each registered case, clinical, medical imaging and pathology information were sought and, occasionally, additional immunohistochemistry staining was obtained. Three specialists – a chest physician, a radiologist and a pathologist – reviewed the available information and material, coding each mesothelioma case as to degree of certainty of the mesothelioma diagnosis.RESULTS: The QTR reported 190 incident cases of mesothelioma (81% males) for the period. The specialists classified 81% of charts as ‘certain/probable’or ‘possible’ mesotheliomas, 8% as ‘unlikely to be a mesothelioma’ and 11% as ‘not a mesothelioma’. After excluding chart summaries of unsatisfactory quality, 87% to 88% of the charts were classified as ‘certain/probable’ or ‘possible’ mesotheliomas, and 9% to 11% were still considered ‘not a mesothelioma’.CONCLUSION: Tumour registry data are a valid source of information for mesothelioma surveillance. While there is some over-registration of mesothelioma cases in the QTR, a significant majority of registered cases appeared to be authentic. Over-registration cannot explain the greater proportion of cases that were not compensated.
A Survey of Digital Rectal Examination Training in Canadian Medical Schools
Authors: Nensi Alysha , Chande Nilesh 
Published: March 2016

BACKGROUND: The digital rectal examination (DRE) is important for the diagnosis of a variety of gastrointestinal, urological and gynecological disorders. However, it appears that Canadian medical students may not be adequately taught nor provided the opportunity to practice their skills often enough. The present study was an analysis of the current practices in DRE teaching and evaluation in undergraduate medicine programs across Canada.METHODS: Clinical skills coordinators from the 14 English-speaking medical schools in Canada were invited to participate in the survey and to respond to questions regarding DRE teaching at their respective schools.RESULTS: Thirteen of the 14 schools (93%) responded to the survey. The DRE is taught in various ways: 69% of schools use anatomical rectal models, 62% use video tutorials and 62% involve physician instruction. Most schools (85%) offer one formal teaching session before clerkship. Generally, there is no formal DRE teaching session during clerkship. Preclerkship students in 62% of the schools perform ≤1 DRE during their training, and clinical skills coordinators in 85% of the schools expected that clerkship students perform ≤2. The training is evaluated in a variety of ways, with most schools (77%) only requiring mandatory attendance.DISCUSSION: Although a variety of techniques are used to teach and evaluate DRE training in Canadian medical schools, students are performing very few DREs before graduation. Medical schools should objectively evaluate proficiency to give meaningful feedback and improve competence in their students as well as provide more opportunities for students to obtain the necessary experience performing DREs during their clinical training.
The Information Needs and Preferences of Persons with Longstanding Inflammatory Bowel Disease
Authors: Wong Samantha , Walker John R , Carr Rachel , Graff Lesley A , Clara Ian , Promislow Stephen , Rogala Linda , Miller Norine , Rawsthorne Patricia , Bernstein Charles N 
Published: March 2016

BACKGROUND: Understanding the information needs and preferred vehicles of information delivery to patients with inflammatory bowel disease (IBD) will enhance their care.OBJECTIVE: To survey persons with longstanding IBD as to their information needs and preferred vehicles of information delivery.METHODS: The population-based Manitoba IBD Cohort (n=271, mean disease duration 11 years) was surveyed to assess its information needs across 23 issues, both retrospectively at the time of diagnosis and currently.RESULTS: Most participants (64%) were initially diagnosed by a gastroenterologist, or otherwise by a family physician (19%) or surgeon (12%). Recalling time of diagnosis, at least 80% rated as very important information about common symptoms of IBD, possible complications, long-term prognosis, medication side effects, self management of symptoms and when to involve the doctor, yet only 10% to 36% believed they received the right amount of information about these issues. Dietary guidance was also regarded as important by 80% to 89%, yet only 8% to 16% received the correct amount of information. Regarding current needs, a large proportion believed it would be very helpful to have more information about long-term prognosis (66%) and diet considerations (60% to 68%). The following information sources were regarded as very acceptable: medical specialist (81%); brochure (79%); family doctor (64%); and website (64%), with 51% ranking the medical specialist as the first choice. In a comparison of the responses of this cohort to those of a recently diagnosed sample, there was remarkable consistency in the information needs and most desired sources of information.DISCUSSION: In the present population-based cohort with longstanding disease, dietary information was regarded as the least adequately addressed. There was clear openness to receiving information through other routes than just the medical specialist, suggesting that optimizing brochures and websites would be an important adjunct source of information.CONCLUSION: Approximately 10 years after diagnosis, only a small percentage of persons with IBD believed they received the correct amount of information about the issues they regarded as most important to have discussed at diagnosis.
Vascular Compromise and Hemodynamics in Pulmonary Arterial Hypertension: Model Predictions
Authors: Bshouty Zoheir 
Published: March 2016

A previously validated computer model of the normal pulmonary circulation is adapted to simulate pulmonary arterial hypertension (PAH) in humans. Model predictions are used to explore the suitability of currently accepted criteria for diagnosing PAH by correlating hemodynamic data with the degree of vascular compromise (disease severity).Model predictions demonstrate a hyperbolic relationship between vascular compromise, mean pulmonary artery pressure (PAPm) and pulmonary vascular resistance (PVR). PAPm and PVR change very little from disease initiation until a vascular compromise of 65% to 70% (surface area of 0.35 to 0.3 of baseline, respectively) is reached. Following that, further compromise is associated with a steep rise in PAPm and PVR.The relationship between vascular compromise and hemodynamics may explain the relative stability of cardiac output early in this disease process and, therefore, the lack of symptoms. It also explains the rapid deterioration following diagnosis if the disease remains untreated.Model predictions demonstrate the inadequacy of the current hemodynamic criteria for diagnosing PAH over a wide range of left atrial pressure and cardiac output combinations and for early detection of disease. The model provides an alternative approach to diagnosing PAH by translating hemodynamic data to degree of vascular compromise.
Wet Laboratory Versus Computer Simulation for Learning Endobronchial Ultrasound: A Randomized Trial
Authors: Stather David R , MacEachern Paul , Chee Alex , Dumoulin Elaine , Hergott Christopher A , Tremblay Alain 
Published: March 2016

BACKGROUND: Linear endobronchial ultrasound with transbronchial needle aspiration (EBUS‐TBNA) is a revolutionary bronchoscopic procedure that is challenging to learn.OBJECTIVES: To compare two methods used to teach EBUS‐TBNA: wet laboratory (lab) versus computer EBUS‐TBNA simulation.METHODS: A prospective, randomized study of respirologists, thoracic surgeons and trainees learning EBUS‐TBNA at a two‐day continuing medical education course. All subjects received education via a series of lectures and live cases, followed by randomization to learn EBUS‐TBNA predominantly either by wet lab simulation (n=6) or computer simulation (n=6). All subjects then completed testing of their EBUS‐TBNA skills via a previously validated method using simulated cases on EBUS‐TBNA simulators and questionnaires evaluating learner preferences.RESULTS: There were no significant differences between the computer EBUS‐TBNA simulator group and the wet lab group in procedure time (25.3±6.1 min versus 25.2±2.5 min; P=0.984) and percentage of successful biopsies (81.3±14.9% versus 74.0±17.3%; P=0.453). The computer simulator group performed significantly better than the wet lab group in the percentage of lymph nodes correctly identified (70.4±16.7% versus 42.9±19.9%; P=0.002). Wet lab simulation was associated with increased learner confidence with operating the real EBUS‐TBNA bronchoscope. All subjects responded that wet lab and computer EBUS‐TBNA simulation offered important complementary learning opportunities.DISCUSSION: Computer EBUS‐TBNA simulation leads to improved skill at correctly identifying lymph nodes, while wet lab simulation provided increased learner confidence due to increased realism.CONCLUSION: Computer EBUS‐TBNA simulation and wet lab simulation are effective methods of learning basic EBUS‐TBNA skills and appeared to be complementary.
The Determinants of Chronic Bronchitis in Aboriginal Children and Youth
Authors: Hossain Alomgir , Konrad Stephanie , Dosman James A , Senthilselvan Ambikaipakan , McCrosky Jesse , Pahwa Punam 
Published: March 2016

BACKGROUND: There is limited knowledge concerning chronic bronchitis (CB) in Canadian Aboriginal peoples.OBJECTIVE: To determine the prevalence (crude and adjusted) of CB and its associated risk factors in Canadian Aboriginal children and youth six to 14 years of age.METHODS: Data from the cross-sectional Aboriginal Peoples Survey were analyzed in the present study. Logistic regression analysis was used to determine risk factors influencing the prevalence of CB among Aboriginal children and youth. The balanced repeated replication method was used to compute standard errors of regression coefficients to account for clustering inherent in the study design. The outcome of interest was based on the question: “Have you been told by a doctor, nurse or other health professional that you have chronic bronchitis?” Demographics, environment and population characteristics (predisposing and enabling resources) were tested for an association with CB.RESULTS: The prevalence of CB was 3.1% for boys and 2.8% for girls. Other significant risk factors of CB were age (OR 1.38 [95% CI 1.24 to 1.52] for 12 to 14 year olds versus six to eight year olds), income (OR 2.28 [95% CI 2.02 to 2.59] for income category <$25,000/year versus ≥$85,000/year), allergies (OR 1.96 [95% CI 1.78 to 2.16] for having allergies versus no allergies), asthma (OR 7.61 [ 95% CI 6.91 to 8.37] for having asthma versus no asthma) and location of residence (rural/urban and geographical location). A significant two-way interaction between sex and body mass index indicated that the relationship between the prevalence of CB and body mass index was modified by sex.DISCUSSION: The prevalence of CB was related to well-known risk factors among adults, including older age and lower annual income.
Community‐Onset Bloodstream Infection during the ‘After Hours’ Is not Associated with an increased Risk for Death
Authors: Laupland Kevin B , Kibsey Pamela C , Galbraith John C 
Published: March 2016

BACKGROUND/OBJECTIVE: Patients admitted to hospital during the ‘after hours’ (weekends and evenings) may be at increased risk for adverse outcome. The objective of the present study was to assess whether community‐onset bloodstream infections presenting in the after hours are associated with death.METHODS: All patients in the Victoria area of British Columbia, who had first admissions with community‐onset bloodstream infections between 1998 and 2005 were included. The day of admission to hospital, the day and time of culture draw, and all‐cause, in‐hospital mortality were ascertained.RESULTS: A total of 2108 patients were studied. Twenty‐six per cent of patients were admitted on a weekend. Blood cultures were drawn on a weekend in 27% of cases and, in 43%, 33%, and 25% of cases, cultures were drawn during the day (08:00 to 17:59), the evening (18:00 to 22:59) and night (23:00 to 07:59), respectively. More than two‐thirds (69%) of index cultures were drawn during the after hours (any time Saturday or Sunday and weekdays 18:00 to 07:59). The overall in‐hospital case fatality rate was 13%. No difference in mortality was observed in relation to the day of the week of admission or time period of sampling. After‐hours sampling was not associated with mortality in a multivariable logistic regression model examining factors associated with death.CONCLUSION: Presentation with community‐onset, bloodstream infection during the after hours does not increase the risk of death.
A Systematic Review of Early Prognostic Factors for Persistent Pain Following Acute Orthopedic Trauma
Authors: Clay Fiona J , Watson Wendy L , Newstead Stuart V , McClure Roderick J 
Published: March 2016

Persistent or chronic pain is prevalent in many developed countries, with estimates ranging from 10% to higher than 50%, and is a major economic burden to individuals and societies. However, the variation in pain outcomes after acute orthopedic trauma and treatment confronts treating physicians with uncertainty in providing prognostic advice regarding long‐term recovery. Although several previous reviews have addressed the determinants of chronic pain outcomes secondary to acute trauma, they have primarily focused on specific injury samples and, furthermore, lack consistency with respect to the important prognostic factors, which limits the generalizability of findings. This review, however, aimed specifically to identify the early prognostic factors associated with variation in persistent pain outcomes following acute orthopedic trauma presenting with a spectrum of pathologies.BACKGROUND: Acute orthopedic trauma contributes substantially to the global burden of disease.OBJECTIVES: The present systematic review aimed to summarize the current knowledge concerning prognostic factors for the presence of persistent pain, pain severity and pain‐related disability following acute orthopedic trauma involving a spectrum of pathologies to working‐age adults.METHODS: The Ovid MEDLINE and EMBASE databases were searched for level II prognostic studies published between January 1996 and October 2010. Studies that were longitudinal and reported results with multivariate analyses appropriate for prognostic studies were included. Studies that addressed two specific injury types that have been the subject of previous reviews, namely, injuries to the spinal column and amputations, were excluded.RESULTS: The searches yielded 992 studies; 10 studies met the inclusion criteria and were rated for methodological quality. Seventeen factors were considered in more than one cohort. There was strong evidence supporting the association of female sex, older age, high pain intensity, preinjury anxiety or depression, and fewer years of education with persistent pain outcomes. There was moderate evidence supporting the association between postinjury depression or anxiety with persistent pain, and that injury severity was not a risk factor for ongoing pain.CONCLUSION: Many individuals experience persistent pain following acute trauma. Due to the lack of studies, the use of different constructs to measure the same factor and the methodological limitations associated with many of the studies, the present review was only able to reliably identify a limited set of factors that predicted persistent pain. Recommendations for the conduct of future methodologically rigorous studies of persistent pain are provided.
The Effect of Endogenous Angiotensin II on Alveolar Fluid Clearance in Rats with Acute Lung Injury
Authors: Deng Jia , Wang Dao-xin , Deng Wang , Li Chang-yi , Tong Jin 
Published: March 2016

BACKGROUND: In acute lung injury (ALI), angiotensin II (Ang II) plays a vital role in the stimulation of pulmonary permeability edema formation through the angiotensin type 1 (AT1) receptor. The effect of Ang II on alveolar fluid clearance (AFC) in ALI remains unknown.METHODS: Sprague Dawley rats were anesthetized and intratracheally injected with 1 mg/kg lipopolysaccharide (LPS), while control rats received saline. The AT1 receptor antagonist ZD7155 was injected intraperitoneally (10 mg/kg) 30 min before LPS administration. The lungs were isolated for AFC measurement, and alpha‐epithelial sodium channel (ENaC) messenger RNA and protein expression were detected by reverse‐transcription polymerase chain reaction and Western blot.RESULTS: LPS‐induced ALI caused an increase in Ang II levels in plasma and lung tissue but a decrease in AFC. The time course of Ang II levels paralleled that of AFC. Pretreatment with ZD7155 prevented ALI‐induced reduction of AFC. ZD7155 also reversed the ALI‐induced reduction of beta‐ENaC and gamma‐ENaC levels, and further decreased alpha‐ENaC levels.CONCLUSIONS: These findings suggest that endogenous Ang II inhibits AFC and dysregulates ENaC expression via AT1 receptors, which contribute to alveolar filling and pulmonary edema in LPS‐induced ALI.