bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low Prevalence of Gastrointestinal Colonization with Antimicrobial‐Resistant Bacteria in High Risk Units in a Canadian Tertiary Care Centre
Authors: Embil John M , Kabani Amin , Zhanel George , Nicolle Lindsay E 
Published: March 2016

OBJECTIVE: To determine the prevalence of antimicrobial‐resistant bacteria among patients receiving care in high risk units in a Canadian tertiary care centre.DESIGN: Prevalence study over a four‐month period in 1995 with rectal swab or freshly passed stool specimen collected from each patient included in study. Standardized record data extraction for selected patient variables was used.SETTING: Units at high risk for antimicrobial‐resistant organisms at the Health Sciences Centre, Winnipeg, including neonatal (NICU), pediatric (PICU), surgical (SICU) and medical intensive care units (MICU), central dialysis unit (CDU), and the in‐patient oncology ward (ONC).PATIENTS: One hundred and fifty‐seven patients admitted to the high risk care units for at least 72 h were screened. Ward distribution was NICU 13 (8.3%), PICU nine (5.7%), SICU 24 (15.3%), MICU 19 (12.1%), CDU 62 (39.5%) and ONC 30 (19.1%). Fifty‐one of 157 (32.5%) patients had urinary drainage devices, 108 (68.8%) had invasive vascular devices, and 57 (36.3%) had had a surgical procedure within the month before specimen collection. In the month before sampling, 114 (72.6%) had received antimicrobial therapy, including 21 (13.3%) who had received vancomycin, and 81 (51.5%) were receiving antimicrobials, seven (10.8%) vancomycin, on the day of sampling.RESULTS: Antimicrobial susceptibilities were performed on 371 bacterial isolates. There were no vancomycin‐resistant enterococci or methicillin‐resistant Staphylococcus aureus. Eleven (10.8%) enterococci were resistant to ampicillin, none of which were β‐lactamase producers, 19 (18.6%) and five (4.9%) demonstrated high level resistance to gentamicin and streptomycin, respectively. One (0.7%) Escherichia coli was resistant to ciprofloxacin and another to gentamicin. Six (20.7%) Enterobacter cloacae samples were resistant to cefotaxime. One (2.4%) Klebsiella species was resistant to ciprofloxacin and another to cefotaxime. Two (16.6%) Citrobacter species were resistant to cefotaxime. One of 11 (9%) Pseudomonas aeruginosa isolates was resistant to ceftazidime; none were resistant to piperacillin, aminoglycosides, ciprofloxacin or imipenem.CONCLUSIONS: The prevalence of antimicrobial‐resistant organisms colonizing the gastrointestinal tract in patients in these high risk units is low. The reasons for this low prevalence of antimicrobial resistance require further exploration.
Socioeconomic Status and Childhood Atopy
Authors: Demissie Kitaw , Ernst Pierre , Becklake Margaret R 
Published: March 2016

BACKGROUND: Variation in the prevalence of allergic disorders among socioeconomic groups could be due either to differences in the type of allergens encountered or to actual differences in susceptibility to sensitization to any particular antigen.OBJECTIVE: To examine the relationship of skin test positivity to inhaled aeroallergens and socioeconomic status (SES).METHODS: A total of 989 Montreal elementary school children were studied. A short questionnaire was completed by parents, and the children performed spirometry before and after a free‐running exercise challenge. A subsample of 309 children underwent allergy skin prick tests to common inhaled aeroallergens. SES was established using parental occupation.RESULTS: Higher social class was associated with an increased likelihood of having positive skin tests to cat and trees, while there was a trend towards an inverse relationship between SES and skin test sensitivity to cockroach and moulds. Reported history of asthma, hay fever or eczema were unrelated to SES.CONCLUSIONS: The results of this study suggest differences in levels of exposure to different allergens by social class. From the public health point of view, community‐based allergen avoidance measures need to be adapted to social class.
Concentration‐Effect Relationship after Intravenous Hydromorphone Administration: Use of An Effect Compartment Model and System Analysis to Minimize Hysteresis of Effects
Authors: Westerling D , Hoglund P 
Published: March 2016

OBJECTIVE: To investigate the concentration‐effect relationship of hydromorphone by using two different methods to minimize the hysteresis between concentration and effects.DESIGN: Open study.SUBJECTS: Twelve healthy volunteers.MEASUREMENTS: The analgesic effect of hydromorphone, evaluated as pressure pain thresholds (PPTs), and nonanalgesic effects, miosis and reduction of saliva production, were related to the concentration of the opioid, analyzed by high performance liquid chromatography. Hysteresis between the concentration and the measured effects of hydromorphone was minimized by a link model and system analysis.RESULTS: Parameter estimation was successful using both methods of hysteresis minimization. According to the link model, the mean concentration of hydromorphone at steady state (Css50) producing 50% of the Emax for reduction of saliva production was 6.7±3.0 nmol/L and the mean Emax, given as the fraction of baseline salivation, was ‐1.1±0.2. Mean Css50 for reduction of pupil size was 15±20 nmol/L, and mean Emax was ‐0.8±0.2. For analgesia, mean Css50 was 68±42 nmol/L and mean Emax was 1.8±2.2. Similar results were obtained by using system analysis.CONCLUSION: Hydromorphone demonstrated a high intrinsic activity, producing miosis and dryness of the mouth. The analgesic effect of hydromorphone at the dose used in this laboratory setting was transient but significant. The link model and system analysis were equally efficient at evaluating the relation between concentration, and analgesic and nonanalgesic effects of hydromorphone, and gave similar results. Both methods may be useful in the study of pharmacodynamics of opioids.
Salmeterol and Airway Response to Allergen
Authors: Cockcroft Donald W , Swystun Veronica A , Bhagat Rajesh , Kalra Sanjay 
Published: March 2016

BACKGROUND: Regular treatment with inhaled salbutamol (seven to 14 days) increases airway responsiveness to allergen.OBJECTIVE: To assess the effect of salmeterol 50 µg twice daily for six days on the early asthmatic response to allergen (PC15).DESIGN: Double‐blind, randomized, crossover trial comparing salmeterol with placebo (twice daily over six days) with one week or more washout. Forced expiratory volume in 1 s (FEV1) and allergen PC15 were measured 36 h after each treatment was discontinued.SETTING: Tertiary care out‐patient bronchoprovocation laboratory.SUBJECTS: Fourteen atopic asthmatics well controlled with (n=5) or without (n=9) inhaled corticosteroids. Subjects did not use inhaled beta‐agonists for at least two weeks before and during the trial.RESULTS: FEV1 was slightly but significantly lower 36 h after the last dose of salmeterol versus placebo (3.28±0.83 versus 3.40±0.88 L, P=0.032). Airway responsiveness to allergen increased by about half a doubling concentration (log10 PC15 2.71±0.61 versus 2.85±0.61, P=0.047).CONCLUSION: A six‐day treatment course of salmeterol 50 μg twice daily resulted in a slight decline in FEV1 and a modest increase in airway response to allergen at 36 h.
Economic Benefits of a Routine Second Dose of Combined Measles, Mumps and Rubella Vaccine in Canada
Authors: Rivière Marc , Tretiak Roma , Levinton Carey , Fitzsimon Catherine , Leclerc Caroline 
Published: March 2016

OBJECTIVE: To evaluate the potential economic benefits of a program for a second routine dose of combined measles, mumps and rubella (MMR) vaccine, administered to children in Canada.DESIGN: Both published and unpublished data from the United States and Canada were incorporated into a linear model. This information was supplemented with opinions on probability and resource use from interviews with a Canadian panel of physicians and practitioners. The province of Quebec was used as a model for resource use and costs.MATERIAL AND METHODS: Data were based on a vaccination program for Canadian children at 18 months, with an estimated annual birth cohort of 400,000. Further data were also collected for the lifetime costs of complications arising from these diseases or from vaccination, for both patients and family caregivers.OUTCOME MEASURES: Outcomes were reviewed from the perspectives of a provincial ministry of health (direct medical costs) and of society (all direct and indirect medical and nonmedical costs).RESULTS: It was estimated that a second dose of MMR vaccine administered at 18 months of age would prevent 9200 cases of measles, 6120 cases of mumps and 1960 cases of rubella, producing a savings of $6.34 for every dollar spent from the ministry of health perspective, and $3.25 from the societal perspective.CONCLUSIONS: A routine second dose immunization with MMR vaccine would result in considerable cost savings in Canada.
Coping and Self‐Medication in a Community Sample of Junior High School Students
Authors: Bedard Geneviève Bianca V , Reid Graham J , McGrath Patrick J , Chambers Christine T 
Published: March 2016

OBJECTIVE: To examine differences between high and low catastrophizers in terms of pain, self‐medication, coping, age and sex.DESIGN: Data were collected from 651 junior high students. Coping was assessed in response to pain in general. Pain (intensity and frequency) and self‐medication were assessed in response to five types of pain: headache, stomach, muscle and/or joint and/or back, ear and/or throat, and menstrual pains.RESULTS: Catastrophizing groups were formed based on scores from the upper and lower thirds of a catastrophizing scale. The high catastrophizing group had higher levels of pain intensity and frequency for all five types of pain, and self‐medicated more for headache, and ear and/or throat pain, compared with the low catastrophizing group. High catastrophizers reported taking over‐the‐counter (OTC) medication more frequently than low catastrophizers. High catastrophizers used information seeking, problem solving, social support seeking, positive self‐statements and externalization more often than low catastrophizers. Low catastrophizers used behavioural and cognitive distraction more often than high catastrophizers. High catastrophizers perceived themselves to have more difficulty in dealing with pain and less control over their emotions when in pain than low catastrophizers. There were no significant differences between high and low catastrophizers in terms of controllability of pain. There was a higher percentage of catastrophizers in grade 9 than in grades 7 or 8 and a higher percentage of girls catastrophizing than boys.CONCLUSIONS: More frequent use of coping strategies while experiencing greater pain intensity and frequency may reflect catastrophizers′ general inability to reduce pain. Greater use of OTC medications by catastrophizers is likely due to their experiences of more frequent and intense pain.
Lack of Evidence for Age Differences in Pain Beliefs
Authors: Gagliese Lucy , Melzack Ronald 
Published: March 2016

OBJECTIVE: To assess, in two studies, whether there are any age differences in beliefs about the role of psychological, organic and ageing factors in the experience of chronic pain.SUBJECTS: Healthy adults free from chronic pain ranging in age from 18 to 86 years (first study); adults with chronic pain due to arthritis, fibromyalgia or other rheumatological disorders ranging in age from 27 to 79 years (second study).MATERIALS: In both studies, subjects completed the Pain Beliefs Questionnaire which was modified to measure beliefs about the relationship between pain and ageing. In addition, subjects completed various self‐assessments of health, pain intensity and depression. Those with chronic pain also completed the Arthritis Self‐Efficacy Scale.RESULTS: There was no evidence of any age differences in beliefs about pain in either the pain‐free or chronic pain samples. There was some evidence that elderly patients may report less pain, but there were no age differences found on measures of depression or self‐efficacy.CONCLUSIONS: The elderly were no more likely than younger persons to associate pain with the normal ageing process than with organic factors such as tissue damage, nor were they more likely to deny the importance of psychological factors to the pain experience.
Amino Acid Levelsin the Brain of Rats with Peripheral Nerve Constriction or Section
Authors: Bianchi Mauro , Ferrario Paolo , Clavenna Antonio , Biella Gabriele , Sotgiu Maria Luisa 
Published: March 2016

BACKGROUND: Both excitatory and inhibitory amino acids modulate central neuronal activity following peripheral nerve tissue injury.OBJECTIVE: To establish whether mononeuropathy induced by chronic constriction injury or by sectioning of the sciatic nerve affects neurotransmitter amino acid levels in the rat brain areas.METHODS: Glutamine, glutamic acid, gamma‐aminobutyric acid (GABA) and aspartic acid in the hindbrain, midbrain and hypothalamus of rats were measured by high performance liquid chromatography 14 days after surgery.RESULTS: After monolateral nerve ligation an increase in glutamine and a decrease in GABA levels in all brain areas were observed, with no side preference. The section of the sciatic nerve did not cause any modification in amino acid levels.CONCLUSIONS: The results allow one to differentiate more clearly classic models of mononeuropathy from a biochemical point of view. Moreover, results indicate that continuous neuronal stimulation induced by nerve constriction is able to modify some amino acid pathways at a supraspinal level.
Age Differences in the Quality of Chronic Pain: A Preliminary Study
Authors: Gagliese Lucia , Melzack Ronald 
Published: March 2016

BACKGROUND: Recent studies of the relationship between age and the intensity of chronic pain report increases, decreases or no change in pain intensity as a function of age. These inconsistencies may be due in part to the pain assessment tools employed and their appropriateness with different age groups.OBJECTIVES: To assess age differences in chronic pain by using several measures of pain intensity and a multidimensional measure of pain qualities in the same sample; to assess the consistency of pain intensity estimates obtained from different scales within age groups; to determine whether the failure rates for appropriately completing the scale (such as choosing more than one descriptor or making more than one mark on the Visual Analog Scale [VAS]) differ among age groups.SUBJECTS: Seventy‐nine adults aged 27 to 79 years with chronic arthritis pain.MEASUREMENTS: The unidimensional pain intensity scales used were the VAS, the Verbal Descriptor Scale and the Behavioural Rating Scale. The multidimensional pain scale used was the short form McGill Pain Questionnaire (SF‐MPQ). The Beck Depression Inventory was also administered.RESULTS: Age‐related decreases were found in the sensory and affective dimensions of chronic pain as measured with the SF‐MPQ. No age differences in pain intensity were measured with any of the unidimensional scales. These results were maintained after controlling for the effects of concurrent depressive symptomatology. Pain intensity estimates differed within groups, with verbal descriptors yielding the most consistent estimates in the elderly group. The elderly were significantly more likely to fail on the VAS than younger subjects. There were no age differences on any other measure.CONCLUSIONS: There may be age‐related changes in the quality but not in the intensity of chronic arthritis pain. Implications for clinical pain assessment in the elderly are discussed.
Does Vibrio Vulnificus Present a Health Threat to Canadians?
Authors: Stavric Stanislava , Buchanan Barbara 
Published: March 2016

OBJECTIVE: To review recent data on Vibrio vulnificus and its properties, characteristics of disease and epidemiology, sources of infection, population at risk, infectious dose, documented cases of infection and health risk from V vulnificus infection in Canada.DATA SOURCE: A MEDLINE and CURRENT CONTENTS search (1981 through September 1996) using the main heading ‘Vibrio vulnificus’, ‘Vibrio species’, ‘seafood’, etc. Relevant articles were also selected from the literature collection in the authors’ laboratory.STUDY SELECTION AND DATA EXTRACTION: The authors judged articles relevant to the objective of the paper and selected them for a review.DATA SYNTHESIS: V vulnificus, an important cause of septicemia, wound infections and gastroenteritis, is considered to be one of the most invasive and rapidly lethal human pathogens. Molluscan shellfish concentrate this organism from warm seawater and present the greatest danger to consumers. Infections with this pathogen have been reported throughout the world. Most deaths have resulted from the consumption of raw or undercooked oysters, fewer from contact with seawater. Individuals with underlying disease, particularly those with liver diseases and iron overload, are the most susceptible.CONCLUSION: The two reported cases of V vulnificus wound infection in Canada might not represent the real situation. Infection with this organism may go unrecognized, unreported or simply may not occur. Medical professionals need to become aware of this pathogen and the dire consequences of infection in individuals with underlying disease.
Smoking and Non‐Neoplastic Lung Disease in Canadian Men and Women
Authors: Ashley Mary Jane , Choi Bernard CK , Pak Anita WP 
Published: March 2016

MAIN OBJECTIVE: To document and assess the current health impact of non‐neoplastic lung disease (NNLD) in Canadian men and women that is attributable to smoking.DESIGN: Comparison of three recent studies providing estimates of smoking‐attributable deaths, potential years of life lost, hospital separations and hospital days due to NNLD in Canada. Review of recent epidemiological studies providing relative risk estimates of smoking‐attributable mortality and morbidity for chronic obstructive pulmonary disease and pneumonia, including a meta‐analysis.MAIN RESULTS: Each year at least 6700 Canadian men and women die from NNLD attributable to smoking. Smoking‐attributable NNLD deaths in men outnumber those in women by about 2 to 1. The majority of these deaths are due to chronic obstructive pulmonary disease, which is exceeded in importance as a smoking‐attributable cause of death only by lung cancer and ischemic heart disease. NNLD accounts for about 20% of all smoking‐attributable deaths in Canada, 14% of the potential years of life lost due to smoking, and 22% and 25% of all smoking‐attributable hospital separations and hospital days, respectively. Long term follow‐up assessments of large cohorts suggest that the impact of smoking on health has been underestimated. Recent studies also suggest that women may be more susceptible than men to the adverse effects of smoking on lung function.CONCLUSION: NNLD caused by smoking has an important health impact in Canada. Tobacco control strategies must be enhanced.
Myofibroblasts in Nasal Polyposis: Regulation by Topical Steroids
Authors: Tremblay Guy M , Nonaka Manabu , Särnstrand Bengt , Dolovich Jerry , Gauldie Jack , Jordana Manel 
Published: March 2016

OBJECTIVES: To compare numbers of myofibroblasts, a fibroblast phenotype associated with chronically inflamed tissue, in nasal polyp tissues from untreated and corticosteroid‐treated subjects. To study whether corticosteroids can directly affect myofibroblast differentiation in vitro.PATIENTS AND METHODS: Immunolocalization of alpha‐smooth muscle actin (alpha‐SMA) as a marker of myofibroblast differentiation, vimentin and transforming growth factor (TGF)‐beta in nasal polyp tissues from nine patients who had taken no steroids for at least a month before polypectomy and from eight patients who had received intranasal budesonide or beclomethasone dipropionate continuously for four to 12 months before polypectomy. Cultured nasal polyp fibroblasts were exposed to budesonide for six days and alpha‐SMA expression was determined by immunocytochemistry.RESULTS: Nasal polyp tissues from untreated subjects were characterized by the presence of a substantial number of myofibroblasts compared with tissues from corticosteroid‐treated subjects. The median percentages of alpha‐SMA positive cell areas per total area for the two groups were 6.4% (0.5 to 11.5) and 1.3% (0.1 to 4.7), respectively. This difference in alpha‐SMA staining between the two groups was not due to a decrease in fibroblast numbers (vimentin‐positive spindle‐shape cells). Numbers of TGF‐beta positive cells were similar in the two groups of subjects. In vitro, budesonide treatment decreased the number of alpha‐SMA positive fibroblasts in primary lines in a dose dependent manner.CONCLUSIONS: The difference in myofibroblast numbers between nasal polyp tissues from untreated and corticosteroid‐treated subjects, as shown by immunolocalization of alpha‐SMA, suggests a new therapeutic effect of nasal topical corticosteroids in nasal polyposis. This could be a direct effect of the drug on fibroblast differentiation and/or modulation of cytokine production.
Influenza Vaccine Match with Circulating Strains and Indicators of Influenza Strain Impact ‐ Canada 1980 to 1992
Authors: Ellis Edward , Weber John M , Cuff Wilf , Mackenzie Susan G 
Published: March 2016

OBJECTIVES: To determine the similarity between influenza vaccine antigens and viruses associated with laboratory‐confirmed infections by virus type/subtype, strain and influenza season; to correlate pneumonia and influenza hospitalization and mortality rates with the number of laboratory‐confirmed influenza infections in an influenza season; and to develop predictive indicators of the likely incidence of current strains in the following season.DESIGN: Ecological study using national laboratory, pneumonia and influenza hospitalization and mortality data.SETTING: Canada, influenza seasons from 1980 to 1992.POPULATION STUDIED: Individuals with laboratory‐confirmed influenza infections, pneumonia and influenza hospitalizations or deaths.INTERVENTION: Influenza immunization.MAIN RESULTS: Similarity of circulating strains and vaccine antigens was 99% for A(H1N1), 65% for A(H3N2) and 65% for B strains. During outbreaks, pneumonia and influenza hospitalization, and mortality rates increased 19% or less and 21% or less for A(H1N1), respectively; 28% or less and 51% or less for A(H3N2), and 19% or less and 16% or less for B strains. There were usually fewer than 25 laboratory‐confirmed A(H1N1) infections with a particular strain in a season if there had been more than 25 infections with similar strains the previous season. For A(H3N2), the figure was 100, and for B it was 150.CONCLUSIONS: Matches were excellent for A(H1N1) and good for A(H3N2) plus B strains. Hospitalization and mortality rates increased substantially during outbreaks, eg, estimated 1609 excess deaths during a widespread A(H3N2) outbreak. This study identifies relationships that provide some ability to predict the incidence of a particular influenza strain in a coming season based on the incidence of strains similar to it in the previous season.