bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Gastrointestinal Infection among International Travellers Returning to Canada
Authors: Russell Margaret L , Love Edgar J , Temple Larissa KF 
Published: March 2016

Objective: To describe the prevalence of parasitic and bacterial gastrointestinal infection (excluding enterotoxigenic Escherichia coli) among international travellers attending the International Travel Clinic at The University of Calgary.Methods: Data were abstracted from the records of the first visit after travel of all persons making a post travel visit between January 1, 1986 and March 31, 1990.Results: Data were available for 886 first visits (840 persons). Stools were submitted by 692 travellers. The frequency of stool submission varied by the duration of travel abroad, and the frequency of diarrhea either during or after the trip was greater among those who had submitted a stool specimen. The prevalence of stools positive for ova, parasites or pathogenic bacteria was 41.2%. When only pathogenic organisms were considered, the prevalence of infection was 19.4%. The most commonly isolated pathogenic parasites were Dientamoeba fragilis, Giardia lamblia, and Entamoeba histolytica. The most commonly isolated bacteria were Campylobacter species and Salmonella species.Conclusions: Although the prevalence of positive stool screens among returned travellers in this population was high, only about one‐fifth of persons tested were positive for pathogens.
Changing Pattern of Clinical Illness in Children with Group A Streptococcal Bacteremia
Authors: Burrows Kim J , Halperin Scott A , Swift Margaret , Bortolussi Robert 
Published: March 2016

Objective: To test the hypothesis that bacteremia caused by group A streptococci (gas) has become more common and the presentation of the infection more severe in the Izaak Walton Killam Hospital for Children during the past decade.Design: Retrospective analysis by laboratory log and chart review.Setting: A pediatric teaching hospital providing primary and tertiary care.Results: There was no difference in the frequency of detection of gas bacteremia between the two periods studied (1980 to 1988 and 1988 to 1991). However, severe gas infection with deep tissue invasion was more common in the last three‐year period (77% versus 11%, P=0.01). Severity, as measured by length of hospital stay, was also greater in the recent group (17.9 days versus 3.3 days, P=0.03). A recent group of four children was identified with a unique clinical syndrome of rash, severe myalgias, hyperesthesia, and refusal to bear weight.Conclusion: The number of cases of severe gas disease has increased in the past several years, and gas infection should be included in the differential diagnosis of seriously ill children, gas infection must be managed aggressively with vigilance for additional deep tissue involvement, even while on appropriate antimicrobial therapy.
A prospective Comparison of Porta‐Sonic and Fisoneb Ultrasonic Nebulizers for Administering Aerosol Pentamidine
Authors: McIvor Andrew , Flood Diane , Lee-Pack Leslie , Rachlis Anita , Berger Philip , Chan Charles K , Favell Kim , Lewis Carmen , Moore Margaret , Rawji Mustafa , the Toronto Aerosolized Pentamidine Study (TAPS) group  
Published: March 2016

Objective: To report patient acceptability and overall therapeutic effectiveness of two different ultrasonic nebulizers, Fisoneb and Porta‐sonic, for the administration of aerosol pentamidine for Pneumocysitis carinii prophylaxis in human immunodeficiency virus (hiv)‐infected individuals.Design: Prospective assessment of a random subgroup of 174 individuals from an inception cohort of 1093 patients attending a central aerosol pentamidine treatment centre in Toronto, Ontario.Methods: One hundred and seventy‐four patients who had been receiving aerosolized pentamidine for more than 10 weeks using Fisoneb at 60 mg every two weeks were switched to Porta‐sonic. Subjective evaluation included three standard 10 cm visual analogue scales rating cough/wheeze, aftertaste and overall preference. The individuals were also asked to compare the duration of time spent on the aerosol treatments. Objective evaluation included spirometry performed immediately before and 15 mins after pentamidine administration. Prospective surveillance of the entire cohort was preformed to record and document episodes of breakthrough P carinii pneumonia.Results: Porta‐sonic was the overall preferred nebulizer in 82% of patients. Less time was spent on aerosol treatment using the Porta‐sonic nebulizer compared with the Fisoneb in 66% of patients. The Porta‐sonic nebulizer system produced less aftertaste compared with Fisoneb. Both nebulizers produced significant but modest reduction in flow rates. During the study period there was no statistically significant difference in the rates of breakthrough P carinii pneumonia between the two groups. A total of 91 episodes occurred, at a rate of 0.5 episodes per patient‐month on Porta‐sonic compared with 0.7 episodes per patient‐month on Fisoneb (P=0.2536).Discussion: Aerosol pentamidine remains the proven second‐line prophylaxis against P carinii pneumonia in hiv/aids for those intolerant to trimethoprim‐sulphamethoxazole. Cough, bronchospasm and poor taste are side effects that may limit patient tolerance and acceptability. The results of this study show that the Porta‐sonic nebulizer system significantly reduces some of these side effects and increases patient preference.Conclusion: This study suggests that Porta‐sonic, the newer nebulizer system, with more ideal in vitro characteristics may become a favoured device in clinical practice.
What do Parents Learn by Reading a DPT Vaccine Information Form?
Authors: Gold Ronald , Bjornson Gordean L 
Published: March 2016

Objective: Information forms are commonly used to inform parents about childhood vaccination. This study assessed the knowledge of mothers about pertussis and pertussis vaccine before and after reading a form about diphtheria‐pertussis‐tetanus (dpt) vaccine.Design: A test was administered to mothers before and after the first vaccination of their infant. By random allocation, one‐half of the mothers received the form (study group) in addition to the routine counselling by a public health nurse given to the others (control group).Setting: Public health immunization clinics in suburban Vancouver, British Columbia.Subjects: One hundred and fifty‐one mothers who were scheduled to bring their infant for the first dpt immunization were recruited, of whom 145 (96%) completed the study.Interventions: A test consisting of 20 true/false questions was administered by telephone two weeks before and two weeks after the first dpt vaccination. Additional data about sources of vaccine information, maternal education, number of children and maternal age were obtained.Outcome Measures: Mean scores and mean change in scores on test.Results: The mean changes in scores between tests 1 and 2 in study and control groups were +22.2% and +6.9%, respectively, on the disease‐related questions (P<0.001) and +14.6% and +10.7%, respectively, on the vaccine‐related questions (P=0.16). The forms were considered to be very useful by the mothers and clearly enabled them to score higher on a test of their knowledge of pertussis and pertussis vaccine.Conclusions: Reading a dpt vaccine form enabled mothers to improve their knowledge of pertussis and pertussis vaccine.
Trends and Rural‐Urban Differences in Asthma Hospitalizations in Saskatchewan 1970‐1989
Authors: Senthilselvan A 
Published: March 2016

OBJECTIVE: To examine the trends in hospitalization rates for
atsthma in Saskatchewan from 1970 to 1989 and to investigate the
differences in asthma hospitalization rates between rural and urban
dwellers.DESIGN: Asthma hospitalization rates were calculated for the age
groups O to 4, 5 to 9. 10 to 14, 15 to 24. 25 to 34. 35 to 49 and 50
to 64 years for the period between 1970 and 1989. Only the first
admission in each year for each person was included in the analysis. As the classification of asthma changed in 1978.
trends in asthma hospitalization rates were investigated separately for the
periods 1970 to 1978 and 1979 to 1989. respectively. Rate ratios
were obtained for male/female and rural/urban comparisons by
fitting Poisson regression models.SETTING: The hospitalization data for respiratory diseases for the
province of Saskatchewan were examined by age group, sex and
place or residence.RESULT: No significant increases were observed in asthma hospitalization rates lrorn 1970 to 1978. In the period 1979 to 1989.
asthma hospitalization rates increased significantly among children under four years from 4.31/1000 in 1979 to 7.04/1000 in
1989. Among children under 14 years. asthma hospitalization rates
were greater in boys than in girls . The converse was true for adults
aged 15 and above, with women having a higher hospitalization
rate for asthma than men . In adults aged 35 and above. rural
dwellers had higher hospitalization rates for asthma than urban
dwellers throughout the study period. In other age groups, although
rural dwellers had higher asthma hospitalization rates than
did urban dwellers during 1970 to 1984. the differences disappered duri ng 1985 to 1989.CONCLUSION: Further studies are required to find reasons for the
increase in asthma hospitalizations among young children under
four years old and for the differences between rural and urban
dwellers in the age group 35 years and above.
Comparison of Culture, Cytotoxin Assay and Two Eia Tests with Clinical Diagnosis of Clostridium difficile‐Associated Diarrhea
Authors: Binning Marilyn , John Michael A , Schieven Berend C , Austin Thomas W , Lannigan Robert , Hussain Zafar 
Published: March 2016

Objective: The most common etiology of infectious diarrhea in hospitalized patients is Clostridium difficile. No single laboratory test yields a definitive diagnosis. Four methods were evaluated for their sensitivity and specificity in patients who had clinically defined C difficile‐associated diarrhea.Methods: Clinical criteria for C difficile‐associated diarrhea were defined. All adult in‐hospital patients whose stools were tested for C difficile were prospectively followed. Stools were examined with culture on a selective medium, a commercial cytotoxicity assay (cta), and two commercially available enzyme immunoassays (eias) for toxin A (Meridian) and toxin AB (cbc).Results: During the study period 235 stool specimens from 185 patients were tested. Fifty‐one patients were positive for C difficile or its markers, cta was most sensitive (80%), whereas cbc-eia was most specific (98%). Differences in the sensitivities of cta and Meridian‐eia were minor (80% versus 73.3%) and they were equally specific (95.5%).Conclusions: The sensitivity and specificity of eia for toxin A is similar to other tests. However, due to rapidity and ease of performance, it may be a more practical test for the diagnosis of C difficile‐associated diarrhea, especially if the cytotoxin assay is not available.
Airways Hyperresponsiveness and Atopy: A Comparison of Inuit and Montreal Schoolchildren
Authors: Hemmelgarn Brenda , Loozen Esther , Saralegui Sheila , Chatwood Susan , Ernst Pierre 
Published: March 2016

OBJECTIVE: To compare the prevalence ol exercise induced bronchial hyperresponsiveness in Inuit children with that or children in Montreal, and to identify possible genetic and environmental determinants of the differences observed.DESIGN: Cross‐sectional survey.SETTING: Salluit, an isolated Inuit community in northern Quebec, and Montreal.POPULATION STUDIED: All children attending school in Salluit in grades 2 to 6 were eligible to participate. For the Montreal study, 18 schools were selected and from each of these one class from each of grades 1, 3 and 5 were chosen.MEASUREMENTS: Data collection for both locations included an exercise challenge test to assess exercise induced bronchial hyperresponsiveness (EIBH), allergy skin testing, a questionnaire for parents regarding details or the home environment as well as the child’s history of respiratory symptoms, and collection of dust samples from the bedroom floor and mattress for the presence of house dust mite.RESULTS: The prevalence or EIBH (defincd as a decline of 15% or more between pre‐exercise forced expiratory volume in 1 s [FEV1] and that at 5 or 10 mins postexercise) was 19.5% (23 of 118) among the Inuit children, compared with 8.8% (87 of 989) among the Montreal children. In contrast. only 8.6% of the Inuit children had a positive allergy skin test compared with 34% in Montreal.CONCLUSIONS: A higher prevalence of EIBH was found in Inuit schoolchildren compared with children of similar age in Montreal, although the prevalence of atopy was considerably lower.
Fibreoptic Bronchoscopy in the Diagnosis of Pulmonary Disease in the Immunocompromised Host in Northern Alberta
Authors: Crocket Jennifer A , Chaput Michelle R , Lien Dale C 
Published: March 2016

OBJECTIVES: To determine the diagnostic utility of bronchoscopy in a population of immunocompromised hosts in northern Alberta.PATIENTS AND METHODS: Results from bronchoscopy in 86 immunocompromised patients who underwent a total of 101 procedures were retrospectively reviewed.RESULTS: The overall diagnostic yield was 57% with the highest yield in patients on immunosuppressive drug therapy (80%) and the lowest yield in the group of bone marrow transplant patients (27%).CONCLUSIONS: Bronchoscopy is a valuable tool for the evaluation of pulmonary disease in the immunocompromised host. Overall diagnostic yield of 57% is comparable with that reported in the literature.
Emergence of Penicillin‐Resistant Streptococcus Pneumoniae in Southern Ontario, 1993–94
Authors: Simor Andrew E , Rachlis Anita , Louie Lisa , Goodfellow Janet , Louie Marie 
Published: March 2016

Objective: To determine the prevalence of resistance of Streptococcus pneumoniae to penicillin and other antimicrobial agents in metropolitan Toronto.Design: Consecutive pneumococcal isolates from different patients were obtained from two private community‐based laboratories and from patients assessed in the emergency department of a tertiary‐care teaching hospital in Toronto, Ontario between June and December 1993, and between March and October 1994. In vitro susceptibility testing was done by broth microdilution in accordance with National Committee for Clinical Laboratory Standards guidelines.Results: Twenty (7.3±3.1%) of 274 pneumococcal isolates were resistant to penicillin; six (30%) isolates had high‐level resistance (minimal inhibitory concentration [mic] 2.0 μg/mL or greater); and 14 isolates had intermediate resistance (mic 0.1 to 1.0 μg/mL). Penicillin‐resistant strains were also frequently resistant to tetracycline (55%), cotrimoxazole (50%), erythromycin (40%) and cefuroxime (35%). Resistant strains comprised several serotypes: 19F (six isolates), 9V (three), 23F (three), and one each of 6A, 6B, 14, and 19A; four isolates were nontypeable.Conclusions: There has been a recent emergence of penicillin‐resistant S pneumoniae in southern Ontario. National and regional surveillance is warranted to determine the extent of the problem elsewhere in Canada.
The Lung Health Study
Authors: Manfreda J , Anthonisen NR , The Lung Health Study Research Group  
Published: March 2016

OBJECTIVE: To determine whether smoking intervention and use of an inhaled bronchodilator can slow the rate of decline in forced expiratory volume in 1 s (FEV1) in smokers with mild obstructive pulmonary disease.DESIGN: Randomized clinical trial: participants randomized to one of three groups: smoking intervention plus inhaled bronchodilator (Atrovent; ipratropium bromide) (SIA): smoking intervention plus placebo (SIP); or no intervention (usual care, UC).SETTING: Ten centres in the United States and Canada.PARTICIPANTS: A total of 5887 smokers, aged 35 to 60 years, with FEV1 55 to 90% predicted and FEV1/forced vital capacity (FVC) less than 70%.INTERVENTIONS: Smoking intervention: intensive program combining behaviour modification and use or nicotine gum, with a subsequent maintenance program to prevent relapse. Bronchodilator: ipratropium bromide, two puffs three times daily from a metered dose inhaler.MAIN OUTCOME MEASURES: Change in FEV1 over a five‐year period.RESULTS: Sustained smoking cessation was achieved in 22% of both intervention groups (SIA, SIP), compared with 5% in UC. Both SIA and SIP groups showed significantly smaller declines in postbronchodilator FEV1 over the five years of the study ‐ 184 mL and 209 mL, respectively. compared with 267 mL in UC. This difference was accounted for by an increase in FEV1 in the SIA (+39 mL) and SIP (+11 mL) groups in the first year of the study, compared with a decline in UC (‐34 mL). Those who achieved sustained smoking cessation experienced the greatest benefit, evident for the five years of study. There was a small noncumulative benefit associated with use of the active bronchodilator, which disappeared after the bronchodilator was discontinued.CONCLUSIONS: An effective smoking intervention program significantly reduced decline in FEV1 in smokers with mild airways obstruction. Use of an inhaled anticholinergic bronchodilator did not influence the long term decline of FEV1.
Inclusion of Peak Expiratory Flow for Selection of the ′Best′ Forced Vital Capacity Manoeuvre
Authors: Di Pede Francesco , Pistelli Francesco , Viegi Giovanni , Paoletti Paolo , Celi Alessandro , Carrozzi Laura , Vellutini Mariella , Pistelli Giuseppe , Giuntini Carlo 
Published: March 2016

OBJECTIVE: To assess four different criteria for selecting the ′best′ forced vital capacity (FVC) manoeuvre to be used for clinical diagnostic purposes.DESIGN: Criterion standard.SETTING: General population survey performed in 1980‐82.PATIENTS: One thousand, two hundred and eighty‐three subjects (age range eight to 64 years) were first stratified into five mutually exclusive groups according to the following criteria: simultaneous largest FVC, forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF) (group 1; n=481); isolated largest FVC (group 2; n=223); isolated largest FEV1 (group 3; n=144); isolated largest PEF (group 4; n=299); and overlapping criteria (group 5; n=136).INTERVENTION: Subjects performed spirometry following American Thoracic Society (ATS) protocol and filled out a standardized respiratory questionnaire.MAIN OUTCOME MEASURES: Spirograms were analyzed by examining the frequency of spirometry abnormalities with regard to the presence of respiratory symptoms, first within mutually exclusive groups of subjects and then within the whole sample. The hypothesis of the role of PEF in ′best test′ selection was formulated after data collection.MAIN RESULTS: When the isolated largest PEF criterion was used, the following data were obtained: the highest prevalence of spirometric abnormalities for each FVC parameter in each mutually exclusive group; the highest predictive value for mean and instantaneous expiratory flows in separating symptomatic from asymptomatic subjects; and finally, using the whole sample, higher levels of sensitivity and similar specificity to other criteria for all test parameters (all over 90%, except for PEF).CONCLUSIONS: While maintaining the current ATS criteria of acceptability and variability for FVC trials, it is proposed that the curve that better reflects maximal expiratory effort, ie, that with the largest PEF, be recorded and analyzed for spirometric variables.
Antibody Response in Seropositive Multiple Sclerosis Patients Vaccinated with Attenuated Live Varicella Zoster Virus
Authors: Ross RT , Dawood MR , Cheang Mary , Nicolle Lindsay E 
Published: March 2016

OBJECTIVE: To determine the safety and effectiveness of live attenuated varicella zoster virus (VZV) vaccine (OKA/Merck) on 50 patients with chronic progressive multiple sclerosis (MS), based on the hypothesis that VZV might be the antigen or antigen mimic of MS plus the fact that repeated high antigen doses have produced ‘antigen paralysis’ in experimental allergic encephalomyelitis mice.DESIGN: Fifty patients were randomly selected without controls. They were assessed clinically at entry and on four other occasions over 14 months. Enhanced cranial magnetic resonance imaging (MRI) was performed at entry and at six and 12 months post entry. All were vaccinated after initial assessment and again six weeks later.SETTING: All clinical and laboratory assessments were performed at the Health Sciences Centre, Winnipeg, in the out‐patient department. All MRI examinations were performed at the St Boniface General Hospital, Winnipeg, Manitoba. Both are tertiary care hospitals.POPULATION STUDIED: Fifty randomly selected patients with chronic progressive MS, age 18 to 60 years, and a disability status scale of 2.0 or greater were included. Forty‐five patients completed the study.INTERVENTIONS: Two vaccinations with attenuated live VZV six weeks apart.RESULTS: All patients were VZV seropositive at entry and all showed an increased antibody level following vaccination. No one was harmed by the vaccine. There may have been some changes in the MS of 15 patients.CONCLUSIONS: It may be reasonable and safe to challenge the process of MS using large doses of the immunogenic proteins of the VZV to induce ‘immune paralysis’.
Association of Human Lymphocyte Antigens with Obstructive Airways Disease after Bone Marrow Transplantation
Authors: Spaner David , Lipton Jeffrey , Chan Charles K 
Published: March 2016

BACKGROUND: Obstructive airways disease (OAD) is a known complication of allogeneic bone marrow transplantation. The etiology of OAD is unknown but is probably multifactorial. The identification of a significant human lymphocyte antigen (HLA) association with the development of OAD might offer some insight into its pathogenesis and serve as a marker to identify prospectively patients at risk for developing OAD.OBJECTIVE: The major histocompatibility antigen (MHC) associations of OAD post‐allogeneic bone marrow transplantation were studied to determine whether particular subsets of patients are more susceptible to this syndrome.POPULATION: Twenty‐one of 244 consecutive patients with allogeneic transplants performed between 1980 and 1987 were identified as developing OAD after having had normal pulmonary function tests before transplant. Thirty‐nine controls were selected on the basis of normal pulmonary function tests pre‐ and post‐transplant and comparable follow‐up periods.METHODS: The study was a retrospective case‐control study. Gene frequencies of the HLA‐A and ‐B types in the patients and controls were compared and a relative risk of OAD with a given HLA allele was calculated.RESULTS: There was a significant correlation of the development of OAD with the presence of the MHC antigen, HLA‐B12 (44,45).CONCLUSIONS: These data support the idea that patients who express the HLA‐B12 (44,45) antigen are at higher risk for the development of OAD post bone marrow transplantation. However, the findings are based on retrospective analysis and accordingly should be considered tentative until followed by larger and preferably prospective studies to confirm the findings.