bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Seroepidemiology of Toxoplasmosis in the Lower Fraser Valley of British Columbia
Authors: Proctor Eileen M , Banerjee Satyendra N 
Published: March 2016

Objective: To determine the seroprevalence of toxoplasmosis in vegetarian and nonvegetarian members of different ethnic communities in the lower Fraser Valley of British Columbia.Design: Serum samples were collected from 2027 participants drawn from various ethnic groups and tested by elisa for the presence of immunoglobulin (Ig) G and IgM antibodies to Toxoplasma gondii. Coded questionnaires requesting information relevant to the study were completed by each participant. The study population comprised 1334 females and 693 males; ages ranged from 17 to 102 years.Main Results: Four hundred and nineteen (20.7%) individuals were IgG positive with titres ranging from 1:100 to 1:3200. IgM antibodies were detected in only four individuals. The seroprevalence rose with increase in age but there was no significant difference between males and females. A positive correlation was shown between ingestion of meat and between consumption of unpasteurized milk and antibodies to T gondii. Eighty per cent of females between the ages of 17 and 40, of all ethnic origins, were seronegative. Seropositivity did not differ between cat owners and non‐cat owners.Conclusions: Women of childbearing age are at risk of acquiring toxoplasmosis during pregnancy and of transmitting the infection transplacentally. Consumption of undercooked meat and unpasteurized milk may result in the acquisition of toxoplasmosis. Data suggest that acquisition of toxoplasmosis is more likely via environmental oocysts or cysts in food source animals than by direct contact with cats.
An Assessment of the Anaerobic Vial of Paired NR 6A and NR 7N Bactec Blood Cultures
Authors: Forward Kevin R , Kerr Elizabeth , Dalton Maurice 
Published: March 2016

Objective: To determine the number of obligate anaerobes recovered in anaerobic blood culture vials and to determine if their recovery had a significant impact on patient care.Design: Retrospective review.Setting: Tertiary care teaching hospital.Main Results: Six thousand nine hundred and five pairs of Bactec blood cultures were submitted (each set consisted of one 6A and one 7N vial). Of these, 690 sets were culture‐positive in at least one of the vials (10% of pairs). Both vials were positive in 406 (58.8%). The aerobic vial alone was positive in 176 (25.5%) and the anaerobic vial alone was positive in 107 (15.5%). Of these, most were facultative anaerobes; however, 20 blood culture sets from 18 patients were positive for obligate anaerobes. In five of the 18, the isolate was judged to be a contaminant. In 11 of 13 patients, the clinically significant obligate anaerobic bacteremia might have been predicted on clinical grounds, and in eight patients, empirical antianaerobic antibiotics had been started before the results of blood cultures were known.Conclusions: Clinical laboratories should carefully examine the use of the routine anaerobic blood culture and consider its replacement with larger volume aerobic blood culture vials.
Treatment of Hypersensitivity Pneumonitis: Contact Avoidance versus Corticosteroid Treatment
Authors: Cormier Yvon , Desmeule Marc 
Published: March 2016

OBJECTIVE: To compare the early response to oral corticosteroid treatment with contact avoidance in patients with acute hypersensitivity pneumonitis.DESIGN: Prospective evaluation of patients with hypersensitivity pneumonitis. who chose either contact avoidance or low dose corticosteroid treatment.STUDY POPULATION: Twenty‐eight patients with acute hypersensitivity pneumonitis.INTERVENTIONS: Each subject had a clinical evaluation, chest radiographs. lung function measurements and a bronchoalveolar lavage at diagnosis and after one month of either form of treatment (contact avoidance or oral prednisone 20 mg daily).RESULTS: Nineteen subjects (all with farmer′s lung) chose the
corticosteroid arm and nine chose the contact avoidance arm (three
farmer′s lung, four humidifier lung and two bird fancier′s lung).
Initially subjects in both groups had similar disease severity
(single breath carbon dioxide diffusion capacity [DLCO] 61.4±3.9
and 60.7±18.9% predicted. respeclively [mean ± SD]. total
bronchoalveolar lavage cells 101X106 versus 119x106.
All subjects improved with either treatment. and 10 subjects considered
themselves back to normal. DLCO increased from the above
values to 74.6±21.9 and 77.1±18.5. respectively. Bronchoalveolar
lavage lymphocytos is remained unchanged after one month of
either treatment.CONCLUSIONS: Both low dose oral corticosteroids and contact avoidance provided adequate initial treatment of acute hypersensitivity
pneumonitis. Bronchoalveolar lavage cellular findings remained
abnormal despite clinical improvements; this technique did
not provide useful clinical information in the follow‐up of hypersensitivity pneumonitis.
Randomized Comparison of Two Spacer Devices in Subjects with Reversible Airflow Limitation
Authors: Clarke Fred W , Montgomery Leslie L , Stubbing David G 
Published: March 2016

OBJECTIVE: To assess a new spacer device. the ACE. by comparing
it with the Aerochamber in subjects with reversible airflow
limilation and assessing the change in lung function after inhaled bronchodilator.DESIGN: A randomized single‐blind cross‐over trial was performed.SETTING: Hospital‐based pulmonary function laboratory.
POPULATION STUDIED: Thirty subjects with reversible airflow
limitation. Mean forced expired volume in Is (FEV1) was 1.37 L.
range O.8 to 3.3 L. All subjects had previously shown at least 15% reversibility after inhaled bronchodilator.
All inhaled bronchodilators were witheld for 6 h. Subjects were studied on two separate days.
Four subjects were excluded from the final analysis because
baseline FEV1 varied by greater than 10% between the two study
days. Maximum expiratory fow rates were used as the primary
outcome measure· Change in heart rate was assessed for adverse
effects.INTERVENTIONS: The change in maximum expiratory flow rates
was assessed 15 mins after two, three and four pulls of inhaled
salbutamol delivered via one or the spacer devices. The use of
spacer was randomized.RESULTS: Data from 26 subjects were analyzed. Baseline FEV1
was similar on the two study days: 1.37±0.13 L (ACE) and
1.38±0.14 L. (Aerochamber). The change in FEV1 was similar on
both study days. The change in all the maximum expiratory flow
rates was similar with both spacer devices. FEV1 after four pulls
of salbutamol was 1.7±0.16 L. (ACE) and I.71 ±0.16 L (Aerochamber).CONCLUSION: The bronchodilation achieved was similar with
both spacers. Because the ACE is cheaper. it may offer cost
savings to individuals or institutions.
Validation of the Pain Beliefs and Perceptions Inventory
Authors: Mikail Samuel F , D′Eon Joyce L , Gagné Théo A De 
Published: March 2016

OBJECTIVE: To examine the test‐retest reliability, construct validity and factor structure of the Pain Beliefs and Perceptions Inventory (PBPI).DESIGN: A sample of 195 individuals attending a chronic pain clinic completed the PBPI along with a preclinic assessment battery. A subset of this sample completed the assessment package two to four weeks and four to six months later in order to examine the test‐retest reliability of the PBPI.RESULTS: Confirmatory factor analysis revealed a four‐factor solution: pain constancy, self‐blame, mystery and understanding of chronicity. Internal consistency estimates ranged from 0.63 to 0.75. Pain constancy and understanding of chronicity had good test‐retest reliability, while test‐retest reliability of the remaining subscales was not adequate. These results differ from those reported in the initial development of the PBPI. Construct validity was determined through examination of correlations between the PBPI and the Beck Depression Inventory, the McGill Pain Questionnaire, the Multidimensional Pain Inventory and a self‐blame questionnaire.CONCLUSIONS: The results of this investigation are consistent with the findings of recent investigations that revealed a four‐factor solution to the PBPI. However, the subscales of this instrument were not found to be uniformly stable over time. These results suggest that further examination and refinement of item content for two of the subscales are required before the instrument is suitable for clinical use.
Pulmonary Kaposi′s Sarcoma: Diagnostic Features and Natural History in Patients with Acquired Immuneodeficiency Syndrome
Authors: Tsai Willis , Chan Charles K , Shepherd Frances , Sawka Carol 
Published: March 2016

OBJECTIVE: This retrospective descriptive study was undertaken to highlight the diagnostic features and natural history of pulmonary Kaposi′s sarcoma (KS).METHODS: Thirty‐three patients with symptomatic pulmonary KS were assembled from a cohort of 239 patient with KS. Pulmonary KS was diagnosed by visualization of endobronchial lesions at bronchoscopy or based on clinical‐radiological correlation and exclusion of opportunistic infections.RESULTS: The median time from initial presentation with KS to the development of pulmonary involvement was nine months. Dyspnea (79%) and dry cough (79%) were the most common presenting symptoms. Oral palatal involvement was present in 58% of patients with pulmonary KS. Pulmonary nodules (58%) were the most common radiological finding, but an interstitial pattern was noted in 42% of patients. Pleural effusion was present in 39%. Radiological patterns were not static, as 50% of patients with an initial interstitial pattern progressed to develop poorly formed nodules in the peripheral lung fields. Endobronchial lesions were noted on bronchoscopy in 23 patients. A presumptive diagnosis of pulmonary KS was made in 10 patients, with autopsy confirmation in four. Chemotherapy completely resolved symptoms in nine of 25 treated (36%) patients, and a further nine (36%) experienced a significant reduction in symptoms. Radiological improvement was noted in two of the clinical responders. Median survival from the time of diagnosis of pulmonary KS was only eight months, and symptoms relapsed within six weeks of achieving the best clinical response with chemotherapy.CONCLUSIONS: Pulmonary KS presents a difficult diagnostic challenge due to a nonspecific constellation of symptoms and radiological findings. Bronchoscopy is diagnostic when endobronchial lesions are visualized but, more important, it can exclude opportunistic infections. In some patients, even with a negative bronchoscopy, the diagnosis may still be established using clinical‐radiographic correlation, particularly if there is radiological evolution to a nodular pattern over time. Multidrug chemotherapeutic regimens appear to have some symptomatic benefit, but radiological improvement is extremely limited. Progression of disease occurs in virtually all patients, and the median survival is only eight months from the point of recognition of pulmonary KS.
Evaluation of Non‐HIV‐Related, Drug‐Sensitive Cluster Outbreaks of Tuberculosis with PCR‐based DNA Fingerprinting
Authors: FitzGerald JM , Black WA , Kunimoto D 
Published: March 2016

OBJECTIVES: To characterize two cluster outbreaks of tuberculosis by DNA fingerprinting and to evaluate the possibility of their association with human immunodeficiency virus (HIV) infection and multiple drug‐resistant Mycobacterium tuberculosis.SETTING: Two clusters of tuberculosis cases in adjoining aboriginal Canadian reserves and a control population.METHODS: All cases of tuberculosis diagnosed in the two communities and a number of control isolates were fingerprinted using a novel simplified DNA‐based technique. Demographic data, purified protein derivative (PPD) skin test response to 5TU PPD, type of disease and HIV serology were also evaluated. Positive cultures were assessed for susceptibility to antituberculous drugs.RESULTS: Two distinct clusters with five cases in one community and 21 cases in the second were identified. Isolates from both communities differed in their DNA pattern but were identical within communities. Thirteen cases had bacteriologically proven disease and grew susceptible organisms. Serological analysis for HIV infection was carried out in 15 of 18 adults, and all were negative.CONCLUSIONS: The study shows the potential for the rapid transmission of tuberculosis infection in HIV‐negative subjects with susceptible organisms. It further highlights the usefulness of DNA fingerprinting for molecular epidemiology in evaluating particular outbreaks.
Lung Function in Preteenaged Canadian School Children: Comparison with Two Standard Prediction Equations and Examination of the Effect of Weight
Authors: Leech Judith A , Bartlett Sheryl , Walker Michael , Raizenne Mark 
Published: March 2016

OBJECTIVES: To compare prediction curves for forced vital capacity (FVC) in children from a large population sample with the standard prediction curves currently in clinical use. A secondary objective was to assess the contribution of weight to the prediction of lung function in preteenagers.DESIGN: The data used for this analysis were from a prospective cohort study of health effects of air pollution on children in 10 Canadian communities, five in Saskatchewan and five in Ontario.PARTICIPANTS: A 96% response rate among a target population of 4935 boys and girls aged seven to 11 years was attained. After exclusion of non‐Caucasians and asthmatics there remained 3142 children.ANALYSIS: FVC prediction curves for each sex were compared with the two standard prediction curves most frequently used in children′s hospitals in Canada with respect to mean values and the lower limits of normal. A random subsample of 500 subjects was selected and their values were interpreted as normal or abnormal by the three prediction equations. Rates of abnormalcy between prediction methods were compared by the uncertainty coefficient statistic. Regression equations within each sex were examined for the effect of weight in addition to height.MAIN RESULTS: Prediction curves from this large population sample were not statistically different from two widely used prediction curves in the mean or lower limits of normal in boys or girls. In 1575 boys a small but significant effect of weight was demonstrated (r=0.024, P=0.001) after age, height and square of height were added to the model (overall r2=0.725). Similarly, a significant effect of weight was seen in girls (r=0.022, P=0.001, overall r2=0.756).CONCLUSIONS: A large sample of nonsmoking Canadian children offers no further advantage in mean or lower limits of normal over standard predictions based on smaller convenience samples in generating prediction curves for normal FVC. In the youngest children who can perform pulmonary function tests, weight should be taken into account in epidemiological studies of pulmonary function. Although the effect may be small it is of the order of magnitude anticipated due to a number of different pneumotoxins (ie, air pollutants).
Sex Differences in Predictors of Response to Multidisciplinary Treatment of Chronic Pain
Authors: Burns John W , Johnson Barbara J , Mahoney Neil , Derleth Martha , Pawl Ronald 
Published: March 2016

BACKGROUND: Multidisciplinary programs for treatment of chronic pain are generally effective, yet many patients fail to show significant improvement. The search for predictors of outcome has not explicitly considered sex.OBJECTIVE: To examine mediation and moderation pathways through which sex may predict outcome.DESIGN: Correlational outcome, exploratory, archival study.PARTICIPANTS: A total of 156 chronic pain patients.SETTING: Four‐week multidisciplinary pain program.PREDICTOR AND OUTCOME MEASURES: Predictor variables of pain level, activity interference and perceived pain helplessness were culled from patient charts. Outcome was assessed with staff ratings of patient progress.RESULTS: While men responded to treatment more poorly than women, regressions suggested that the greater number of surgeries for men mediated this link. Further analyses revealed that sex acted as a moderator. Among women, perceived pain helplessness was negatively related to outcome, while married women with dissatisfying marriages responded more poorly than unmarried women and women with satisfying marriages. These variables were not significant predictors of outcome among men.CONCLUSIONS: Men and women may be differentially characterized by various risk factors for treatment failure. Moreover, relationships between pretreatment psychosocial factors and outcome may depend on sex.
Seasonal Patterns in Asthma Hospitalization in Saaskatchewan, 1979 to 1989
Authors: Meleth Sreelatha , Senthilselvan A 
Published: March 2016

OBJECTIVES: To determine whether monthly asthma hospitalization rates in Saskatchewan exhibited a seasonal pattern. Rates were studied from January 1979 to December 1989.PATIENTS: The age groups studied were aged birth to four years, aged five to 14 years, 15 to 34 years, 35 to 49 years and 50 to 65 years. Sex differences in seasonal patterns in asthma hospitalization rates were also investigated.METHODS: The hospitalization data for asthma were obtained for the province of Saskatchewan from 1979 to 1989, inclusive. The time series was decomposed into its trend, seasonal and error component, using an additive model. Significance of the components was tested using a two‐way ANOVA.RESULTS: Seasonal variations were observed in the monthly asthma hospitalization rates among Saskatchewan residents. Increases in asthma hospitalization rates were observed in the spring and fall months among children, in summer months among young adults aged 15 to 34 years and in winter months among the older age groups. Seasonal patterns in asthma hospitalization rates were similar for males and females in children and in adults aged 50 to 64 years. In young adults aged 15 to 34 years, increased asthma hospitalization rates were observed in spring months among men and in both spring and fall months among women. The 35‐ to 49‐year‐old men did not exhibit a statistically significant seasonal pattern, whereas the women did. No sex differences in seasonal patterns of asthma hospitalization rates were statistically significant.CONCLUSIONS: Seasonal patterns were observed in asthma hospitalization rates for residents of Saskatchewan. Asthma hospitalizations were greater in spring and fall seasons for children and in winter for the older adults. More studies are required to examine possible reasons for these seasonal differences in asthma hospitalizations.
Apoptosis: Molecular Mechanisms, Regulation and Role in Pathogenesis
Authors: Hung Ryan Wei Yan , Chow Anthony W 
Published: March 2016

OBJECTIVE: To review the current state of knowledge of apoptosis, with an emphasis on identifying potential and established roles for apoptosis in the pathogenesis of infectious diseases.DATA SOURCES: MEDLINE and the University of British Columbia library system were searched using the search subject, “apoptosis”, for the years 1992 to 1996. Further search terms (eg, “pathogenesis”) were used to narrow the results. These review articles and reference books were used as the basis for locating original articles on particular studies.DATA SELECTION: Approximately 40 studies were reviewed, with the criterion for selection being the relevance to either the molecular mechanisms behind apoptosis or roles for apoptosis in the pathogenesis of infectious diseases.DATA EXTRACTION: Relevant information from each study was collated into categories specific to morphological and biochemical characterization, and the regulation and molecular mechanisms of apoptosis and its role in the pathogenesis of infectious diseases.DATA SYNTHESIS AND CONCLUSIONS: Apoptosis is characterized by distinct morphological and biochemical changes that distinguish it from cell necrosis. Different signal transduction events and transcription factors can promote or inhibit apoptosis, although where and how these tie into the cell death pathway is still poorly understood. Apoptosis has been implicated in the pathogenesis of infectious diseases in two distinct ways: first, multicellular organisms use apoptosis to combat viral infections; and second, pathogens can alter the normal process of apoptosis in host cells by abnormal upregulation or downregulation. Many diseases have been shown to implicate apoptosis in their pathogenesis, raising the possibility of novel treatments for some disorders by therapeutically altering the occurrence and course of apoptosis. Therefore, further study of apoptosis in both health and disease needs to be rigorously pursued.
Lactate Kinetics during Exercise in Chronic Obstructive Pulmonary Disease
Authors: Maltais François , Bernard Sarah , Jobin Jean , Belleau Roger , LeBlanc Pierre 
Published: March 2016

OBJECTIVES: To examine whether the lactate kinetics during exercise are abnormal in patients with chronic obstructive pulmonary disease (COPD) and to evaluate the relationship of lactate kinetics with functional status.POPULATION: Fifty‐four patients with COPD (forced expiratory volume in 1 s [FEV1] [mean ± SD] 36±12% predicted, range 19 to 70) and 10 healthy, age‐matched normal men were included in this study.INTERVENTION: Each subject performed a stepwise exercise test up to maximal capacity during which five‐breath averages of oxygen uptake (VO2) were obtained. Arterial plasma lactate (La) concentration was also measured at each one‐minute exercise step. The La/VO2 relationship during exercise was fitted by an exponential function where b represents the steepness of the relationship. Patients′ functional status was classified according to the peak VO2 : more than 16 mL/min/kg and 20 mL/min/kg or less indicated mild to moderate impairment (class B, n=15); more than 10 mL/min/kg and 16 or less mL/min/kg, moderate to severe impairment (class C, n=31); and more than 6 mL/min/kg and 10 mL/min/kg or less, severe impairment (class D, n=8). An average La/VO2 relationship was constructed for each functional class with the La and VO2 data obtained from each individual at each exercise step.RESULTS: Parameter b was obtained in all normal subjects and in 46 of 54 patients with COPD. It averaged 2.66±0.47 and 4.49±1.72 in normal subjects and COPD patients, respectively (P<0.005). In 30 of 46 patients, parameter b was greater than the upper value obtained in the normal group. The rise in arterial lactate concentration during exercise became progressively greater with the worsening of functional status.CONCLUSIONS: Lactate kinetics are frequently abnormal in patients with moderate to severe COPD compared with age‐matched normal subjects. Reduction in functional status from class B to D was associated with a progressively greater increase in arterial blood lactate during exercise.