1
|
Russell K, Walld R, Bolton JM, Chateau D, Ellis MJ. Incidence of Subsequent Mental Health Disorders and Social Adversity Following Pediatric Concussion: A Longitudinal, Population-Based Study. J Pediatr 2023; 259:113436. [PMID: 37088182 DOI: 10.1016/j.jpeds.2023.113436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 02/28/2023] [Accepted: 03/31/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVE To determine the long-term risk of new adverse psychosocial outcomes among adolescents diagnosed with a concussion compared with those not diagnosed. STUDY DESIGN A retrospective, population-based cohort study was conducted. Adolescents (10-18 years) with a physician-diagnosed concussion between 2000 and 2005 were matched on neighborhood and age with 5 controls without concussion from the general population. New-onset mental health disorders, medication use, social, and justice outcomes were extracted using datasets linked to the population data repository. Adolescents were followed for 11-16 years. Adjusted hazard ratios (95% CIs) were estimated. RESULTS In total, 2082 adolescents with a concussion were matched to 10 510 without. Adolescents with a concussion had an increased risk of any mental health disorder (HR 1.34; 95% CI 1.25-1.45), mood disorder (HR 1.30; 95% 1.18-1.43), psychosis (HR 1.43; 95% CI 1.18-1.74), substance abuse disorder (HR 1.67; 95% 1.31-2.14), and receiving a psychotropic prescription (HR 1.31; 95% CI 1.20-1.42). Female adolescents had an increased risk of ADHD following concussion (HR 1.89; 95% CI 1.17-3.05). Adolescents with a concussion had an increased risk of being accused (HR 1.22; 95% CI 1.11-1.34), victim (HR 1.29; 95% CI 1.11-1.48), or witness (HR 1.16; 95% CI 1.01-1.32) of a crime, or contact with Child and Family Services (HR 1.33; 95% CI 1.10-1.62). There was no association between concussion and attempting or completing suicide, receiving housing support, or collecting income support. CONCLUSIONS Concussion was associated with an increased risk for multiple adverse psychosocial outcomes. Future work should focus on early identification of those at risk of these outcomes to help optimize longitudinal medical care and support.
Collapse
Affiliation(s)
- Kelly Russell
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada; Excellence in Neurodevelopment and Rehabilitation Research in Child Health Research Theme - Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.
| | - Randy Walld
- Manitoba Center for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
| | - James M Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Daniel Chateau
- Manitoba Center for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada; National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Michael J Ellis
- Department of Surgery, Section of Neurosurgery, University of Manitoba, Winnipeg, Manitoba, Canada; Pan Am Concussion Program, Winnipeg, Manitoba, Canada
| |
Collapse
|
2
|
Nickel NC, Sanguins J, Ekuma O, Taylor C, Eze N, Balogun OD, Casidsid H, Brownell M, Chartier M, Chartrand F, Chateau D, Driedger M, Enns J, Katz A, Klos O, Lix L, Mahar A, Neault R, Urquia M. Experiences of Red River Métis Accessing COVID Vaccines: A partnership-based, whole-population linked administrative data study. Int J Popul Data Sci 2022. [DOI: 10.23889/ijpds.v7i3.1944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
ObjectivesRed River Métis are Indigenous people hailing from the Canadian Prairies who have historically experienced poor health outcomes due to colonial practices. Researchers from the Manitoba Métis Federation (MMF) partnered with health services researchers to test whether MMF-led COVID initiatives were associated with access to COVID-19 testing and vaccines.
ApproachWe linked the Métis Population Data-Base from the MMF (to identify Red River Métis) with whole-population COVID testing and vaccination data and health and social services administrative data (for information on sociodemographics and confounders) to complete this retrospective cohort study. We used restricted mean survival time models to test whether COVID-19 vaccination differed between Métis and all other Manitobans (AOM); models adjusted for demographics, comorbidities, and other characteristics (age, socioeconomic status, urbanicity, and mental health status). Data were stratified by sex and subsequent effect modification analyses tested whether associations differed by sex and physical health comorbidities.
ResultsCOVID testing rates were lower during the first year of the pandemic among Métis than among AOM. During the second year of the pandemic, this finding was reversed - Métis accessed tests at higher rates. There was no difference between Métis and AOM in accessing first vaccine doses before implementation of MMF-led initiatives. After initiatives were put in place, Métis received their second COVID vaccine, on average, 1.3 (95% CI 1.9-0.6) days sooner than AOM, after adjusting for confounders. Effect modification analyses showed this relationship was concentrated among females – female Métis received their second vaccine 1.7 (2.6-0.8) days sooner than female AOM; differences were non-significant for males. Métis with 2+ comorbidities received their vaccine second 2.9 (5.3-0.5) days sooner than AOM with 2+ comorbidities.
ConclusionPublic health initiatives prioritizing Métis for vaccines improved uptake. Initiatives led by Métis to improve COVID outcomes were critical to supporting Métis during the course of the pandemic. Public health response efforts need to operate from a standpoint that honours Indigenous sovereignty in their design and implementation.
Collapse
|
3
|
Garland A, Marrie RA, Wunsch H, Yogendran M, Chateau D. Administrative Data Is Insufficient to Identify Near-Future Critical Illness: A Population-Based Retrospective Cohort Study. Front Epidemiol 2022; 2:944216. [PMID: 38455278 PMCID: PMC10910992 DOI: 10.3389/fepid.2022.944216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 06/13/2022] [Indexed: 03/09/2024]
Abstract
Background Prediction of future critical illness could render it practical to test interventions seeking to avoid or delay the coming event. Objective Identify adults having >33% probability of near-future critical illness. Research Design Retrospective cohort study, 2013-2015. Subjects Community-dwelling residents of Manitoba, Canada, aged 40-89 years. Measures The outcome was a near-future critical illness, defined as intensive care unit admission with invasive mechanical ventilation, or non-palliative death occurring 30-180 days after 1 April each year. By dividing the data into training and test cohorts, a Classification and Regression Tree analysis was used to identify subgroups with ≥33% probability of the outcome. We considered 72 predictors including sociodemographics, chronic conditions, frailty, and health care utilization. Sensitivity analysis used logistic regression methods. Results Approximately 0.38% of each yearly cohort experienced near-future critical illness. The optimal Tree identified 2,644 mutually exclusive subgroups. Socioeconomic status was the most influential variable, followed by nursing home residency and frailty; age was sixth. In the training data, the model performed well; 41 subgroups containing 493 subjects had ≥33% members who developed the outcome. However, in the test data, those subgroups contained 429 individuals, with 20 (4.7%) experiencing the outcome, which comprised 0.98% of all subjects with the outcome. While logistic regression showed less model overfitting, it likewise failed to achieve the stated objective. Conclusions High-fidelity prediction of near-future critical illness among community-dwelling adults was not successful using population-based administrative data. Additional research is needed to ascertain whether the inclusion of additional types of data can achieve this goal.
Collapse
Affiliation(s)
- Allan Garland
- Department of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Ruth Ann Marrie
- Department of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Hannah Wunsch
- Department of Anesthesia, University of Toronto, Toronto, ON, Canada
| | - Marina Yogendran
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Daniel Chateau
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
| |
Collapse
|
4
|
Strumpf E, Austin N, Lang A, Derksen S, Bolton J, Brownell M, Gregory P, Chateau D, Heaman M. The effects of early pregnancy loss on health outcomes and health care utilization and costs. Health Serv Res 2022; 57:786-795. [PMID: 35076944 PMCID: PMC9264463 DOI: 10.1111/1475-6773.13941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/21/2021] [Accepted: 12/29/2021] [Indexed: 12/03/2022] Open
Abstract
Objective To evaluate the effects of early pregnancy loss on subsequent health care use and costs. Data Sources Linked administrative health databases from Manitoba, Canada. Study Design This was a population‐based cohort study. The exposure of interest was first recorded ectopic pregnancy or miscarriage (EPM). Outcomes included visits to all ambulatory care providers, family physicians (FPs), specialists, and hospitals, as well as the costs associated with these visits. We also assessed the impact of EPM on a global measure of health service utilization and the incidence and costs of psychotropic medications. Data Collection/Extraction Methods We identified women who experienced their first recorded loss (EPM) from 2003–2012 and created a propensity score model to match these women to women who experienced a live birth, with outcome measures available through 31 December 2014. We used a difference in differences approach with multivariable negative binomial models and generalized estimating equations (GEE) to assess the impact of EPM on the aforementioned health care utilization indicators. Principal Findings EPM was associated with a short‐term increase in visits to, and costs associated with, certain ambulatory care providers. These findings were driven in large part by increased visits/costs to FPs (rate difference [RD]: $19.92 [95% CI: $16.33, $23.51]) and obstetrician‐gynecologists (OB‐GYNs) (RD $9.41 [95% CI: $8.42, $10.40]) in the year immediately following the loss, excluding care associated with the loss itself. We also detected an increase in hospital stays and costs and a decrease in the use of psychotropic medications relative to matched controls. Conclusion Pregnancy loss may lead to subsequent increases in certain types of health care utilization. While the absolute costs associated with post‐EPM care are relatively small, the observed patterns of service utilization are informative for providers and policy makers seeking to support women following a loss.
Collapse
Affiliation(s)
- E. Strumpf
- Department of Epidemiology, Biostatistics, and Occupational Health & Department of Economics. Leacock Building McGill University Montreal QC Canada
| | - N. Austin
- School of Health Administration Dalhousie University Halifax Nova Scotia Canada
| | - A. Lang
- School of Nursing McGill University Quebec Canada
| | - S. Derksen
- University of Manitoba, Manitoba Centre for Health Policy Manitoba Canada
| | - J. Bolton
- Department of Psychiatry and Manitoba Centre for Health Policy University of Manitoba Winnipeg Manitoba Canada
| | - M. Brownell
- Department of Community Health Sciences & Manitoba Centre for Health Policy, Max Rady College of Medicine, Community Health Sciences University of Manitoba Winnipeg Manitoba Canada
| | - P. Gregory
- Red River College, Nursing Department School of Health Sciences and Community Services Winnipeg Manitoba Canada
| | - D. Chateau
- Department of Community Health Sciences & Manitoba Centre for Health Policy University of Manitoba Manitoba Canada
| | - M. Heaman
- College of Nursing & Department of Obstetrics, Gynecology and Reproductive Sciences, College of Nursing, Rady Faculty of Health Sciences, University of Manitoba University of Manitoba Winnipeg Manitoba Canada
| |
Collapse
|
5
|
Daneman N, Chateau D, Dahl M, Zhang J, Fisher A, Sketris IS, Quail J, Marra F, Ernst P, Bugden S. Fluoroquinolone use for uncomplicated urinary tract infections in women: a retrospective cohort study. Clin Microbiol Infect 2019; 26:613-618. [PMID: 31655215 DOI: 10.1016/j.cmi.2019.10.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 10/04/2019] [Accepted: 10/15/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The United States Food & Drug Administration released an advisory in 2016 that fluoroquinolones be relegated to second-line agents for uncomplicated urinary tract infections (UTIs) given reports of rare but serious side effects; similar warnings have followed from Health Canada and the European Medicines Agency. The objective was to determine whether alternative non-fluoroquinolone agents are as effective as fluoroquinolones in the treatment of UTIs. METHODS We conducted a retrospective population-based cohort study using administrative health data from six Canadian provinces. We identified women (n = 1 585 997) receiving antibiotic treatment for episodes of uncomplicated UTIs (n = 2 857 243) between January 1 2005 and December 31 2015. Clinical outcomes within 30 days from the initial antibiotic dispensation were compared among patients treated with a fluoroquinolone versus non-fluoroquinolone agents. High-dimensional propensity score adjustments were used to ensure comparable treatment groups and to minimize residual confounding. RESULTS Fluoroquinolone use for UTI declined over the study period in five of six Canadian provinces and accounted for 22.3-48.5% of treatments overall. The pooled effect across the provinces indicated that fluoroquinolones were associated with fewer return outpatient visits (OR 0.89, 95%CI 0.87-0.92), emergency department visits (OR 0.74, 95%CI 0.61-0.89), hospitalizations (OR 0.83, 95%CI 0.77-0.88), and repeat antibiotic dispensations (OR 0.77, 95%CI 0.75-0.80) within 30 days. CONCLUSIONS Fluoroquinolones are associated with improved clinical outcomes among women with uncomplicated UTIs. This benefit must be weighed against the risk of fluoroquinolone resistance and rare but serious fluoroquinolone side effects when selecting first-line treatment for these patients.
Collapse
Affiliation(s)
- N Daneman
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada; Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - D Chateau
- Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - M Dahl
- Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - J Zhang
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - A Fisher
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - I S Sketris
- College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - J Quail
- Health Quality Council, Saskatoon, Saskatchewan, Canada; Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - F Marra
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - P Ernst
- Centre for Clinical Epidemiology, Lady Davis Institute - Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - S Bugden
- School of Pharmacy, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada; College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
| | | |
Collapse
|
6
|
Dart AB, McGavock J, Sharma A, Chateau D, Schwartz GJ, Blydt-Hansen T. Estimating glomerular filtration rate in youth with obesity and type 2 diabetes: the iCARE study equation. Pediatr Nephrol 2019; 34:1565-1574. [PMID: 31049718 DOI: 10.1007/s00467-019-04250-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 02/14/2019] [Accepted: 03/26/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The validity of pediatric estimated glomerular filtration rate equations (eGFRs) in early stages of CKD including hyperfiltration is unknown. The purpose of this study was to develop an eGFR equation for adolescents with obesity and type 2 diabetes (T2D). METHODS eGFRs were developed from iohexol-derived GFRs (iGFRs) in 26 overweight/obese (BMI > 85th percentile) youth and 100 with T2D from the iCARE (Improving renal Complications in Adolescents with T2D through REsearch) cohort. Twenty percent of the cohort was withheld as a validation dataset. Linear regression analyses were used to develop the best formula based on body size, sex, creatinine, urea, ± cystatin C. Comparable validity of commonly used eGFR equations was assessed. RESULTS Mean age 15.4 + 2.4 years, BMI Z-score 2.5 + 1.2, 61% female, and mean iGFR 129.0 + 27.7 ml/min/ 1.73 m2. The best adjusted eGFR formula (ml/min/1.73 m2) was 50.7 × BSA0.816 × (height (cm)/creatinine)0.405 × 0.8994 if sex = female | 1 otherwise. It resulted in 53.8% of eGFRs within 10% of measured iGFR and 96.2% within 30%. Bland-Altman 95% limits of agreement in the external dataset were - 37.6 to 45.5 ml/min/1.73m2 (bias = 3.96), and the correlation was 0.62. This equation performed better than all previously published creatinine-based eGFRs. cystatin C did not significantly improve results; however, some other cystatin C formulas also performed well. CONCLUSIONS The iCARE equation provides a more accurate creatinine-based eGFR in obese youth with and without T2D. Further studies are warranted to evaluate within-subject variability and applicability to lower GFRs and other populations.
Collapse
Affiliation(s)
- A B Dart
- Department of Pediatrics and Child Health, Section of Nephrology, Children's Hospital Research Institute of Manitoba, Diabetes Research Envisioned and Accomplished in Manitoba Research Team, University of Manitoba, FE009 - 840 Sherbrook Street, Winnipeg, MB, R3A 1S1, Canada.
| | - J McGavock
- Department of Pediatrics and Child Health, University of Manitoba, FE009 - 840 Sherbrook Street, Winnipeg, MB, R3A 1S1, Canada
| | - A Sharma
- Department of Pediatrics and Child Health, University of Manitoba, FE009 - 840 Sherbrook Street, Winnipeg, MB, R3A 1S1, Canada
| | - D Chateau
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - G J Schwartz
- University of Rochester Medical Center, Rochester, NY, USA
| | - T Blydt-Hansen
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| |
Collapse
|
7
|
Kustra J, Martin E, Chateau D, Lerouge F, Monnereau C, Andraud C, Sitarz M, Baldeck PL, Parola S. Two-photon controlled sol–gel condensation for the microfabrication of silica based microstructures. The role of photoacids and photobases. RSC Adv 2017. [DOI: 10.1039/c7ra08608c] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Two-photon excitation of photobases is used to induce pH changes and control the condensation step of the sol–gel process at the focal point of a laser beam in a confocal configuration.
Collapse
Affiliation(s)
- J. Kustra
- Laboratoire de Chimie
- Ecole Normale Supérieure de Lyon
- CNRS
- Université Claude Bernard Lyon 1
- UMR 5182
| | - E. Martin
- Laboratoire de Chimie
- Ecole Normale Supérieure de Lyon
- CNRS
- Université Claude Bernard Lyon 1
- UMR 5182
| | - D. Chateau
- Laboratoire de Chimie
- Ecole Normale Supérieure de Lyon
- CNRS
- Université Claude Bernard Lyon 1
- UMR 5182
| | - F. Lerouge
- Laboratoire de Chimie
- Ecole Normale Supérieure de Lyon
- CNRS
- Université Claude Bernard Lyon 1
- UMR 5182
| | - C. Monnereau
- Laboratoire de Chimie
- Ecole Normale Supérieure de Lyon
- CNRS
- Université Claude Bernard Lyon 1
- UMR 5182
| | - C. Andraud
- Laboratoire de Chimie
- Ecole Normale Supérieure de Lyon
- CNRS
- Université Claude Bernard Lyon 1
- UMR 5182
| | - M. Sitarz
- AGH University of Science and Technology
- Faculty of Materials Science and Ceramics
- 30-059 Cracow
- Poland
| | - P. L. Baldeck
- Laboratoire de Chimie
- Ecole Normale Supérieure de Lyon
- CNRS
- Université Claude Bernard Lyon 1
- UMR 5182
| | - S. Parola
- Laboratoire de Chimie
- Ecole Normale Supérieure de Lyon
- CNRS
- Université Claude Bernard Lyon 1
- UMR 5182
| |
Collapse
|
8
|
Russell K, Hutchison MG, Selci E, Leiter J, Chateau D, Ellis MJ. Academic Outcomes in High-School Students after a Concussion: A Retrospective Population-Based Analysis. PLoS One 2016; 11:e0165116. [PMID: 27764223 PMCID: PMC5072608 DOI: 10.1371/journal.pone.0165116] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 10/06/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Many concussion symptoms, such as headaches, vision problems, or difficulty remembering or concentrating may deleteriously affect school functioning. Our objective was to determine if academic performance was lower in the academic calendar year that students sustain a concussion compared to the previous year when they did not sustain a concussion. METHODS Using Manitoba Health and Manitoba Education data, we conducted a population-based, controlled before-after study from 2005-2006 to 2010-2011 academic years. Grade 9-12 students with an ICD9/10 code for concussion were matched to non-concussed controls. Overall changes in grade point average (GPA) were compared for the academic year prior to the concussion to the academic year the concussion occurred (or could have occurred among non-concussed matched students). RESULTS Overall, 8240 students (1709 concussed, 6531 non-concussed students) were included. Both concussed and non-concussed students exhibited a lower overall GPA from one year to the next. Having sustained a concussion resulted in a -0.90% (95% CI: -1.88, 0.08) reduction in GPA. Over the same period, non-concussed matched students' GPA reduced by -0.57% (95% CI: -1.32, 0.19). Students who sustained a concussion during high school were just as likely to graduate within four years as their non-concussed peers (ORadj: 0.84; 95% CI: 0.73, 1.02). CONCLUSIONS We found that, at a population level, a concussion had minimal long-term effects on academic performance during high school. While academic accommodations and Return-to-Learn programs are an important component of pediatric concussion management, research is needed to identify risk factors for poor academic performance after a concussion and who should receive these programs.
Collapse
Affiliation(s)
- Kelly Russell
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
- Canada North Concussion Network, Winnipeg, Canada
| | - Michael G. Hutchison
- Faculty of Kinesiology and Physical Education, University of Toronto, Ontario, Canada
| | - Erin Selci
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Jeff Leiter
- Canada North Concussion Network, Winnipeg, Canada
- Department of Surgery, University of Manitoba, Winnipeg, Canada
| | - Daniel Chateau
- Manitoba Center for Health Policy, University of Manitoba, Winnipeg, Canada
| | - Michael J. Ellis
- Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
- Canada North Concussion Network, Winnipeg, Canada
- Department of Surgery, Section of Neurosurgery, University of Manitoba, Winnipeg, Canada
| |
Collapse
|
9
|
Alessi-Severini S, Bolton JM, Enns MW, Dahl ME, Chateau D, Collins DM, Sareen J. Sustained Use of Benzodiazepines and Escalation to High Doses in a Canadian Population. Psychiatr Serv 2016; 67:1012-8. [PMID: 27133727 DOI: 10.1176/appi.ps.201500380] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE "Antibenzodiazepine" campaigns have been conducted worldwide to limit the prescribing of these drugs because of concerns about inappropriate use and addiction. The causal relationship between long-term use and escalation to high doses has not been proven. This study assessed the extent of dose escalation among individuals who were long-term users of benzodiazepines or Z-hypnotics. METHODS A population-based study was conducted in the Canadian province of Manitoba using administrative health databases. Sustained use was defined as continuous use for at least two years (N=12,598). Dose escalation, measured in diazepam milligram equivalents (DMEs) per day and observed at six-month intervals, was assessed by using latent-class trajectory analysis. Characteristics of individuals with sustained use were described. RESULTS The analysis revealed four distinct groups. Two groups (<8% of the cohort) showed escalation to high doses (over 40 DMEs). More than 55% of high-dose escalators were in the 0- to 44-year age group, 75% lived in urban areas, and approximately 75% had a diagnosis of depression. Clonazepam was the drug most commonly involved with dose escalation; among individuals escalating to doses higher than 60 DMEs, 91% were using clonazepam. Rates of "doctor shopping" and "pharmacy hopping" were higher among younger adults, compared with older adults. Younger adults also had higher rates of concomitant antidepressant therapy. CONCLUSIONS A limited segment of a population that received benzodiazepine prescriptions was classified as sustained users, and a small proportion of that group escalated to doses higher than those recommended by product monographs and clinical guidelines.
Collapse
Affiliation(s)
- Silvia Alessi-Severini
- Dr. Alessi-Severini and Dr. Collins are with the College of Pharmacy, and Dr. Bolton, Dr. Enns, and Dr. Sareen are with the Department of Psychiatry, College of Medicine, all in the Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (e-mail: ). Dr. Alessi-Severini is also with the Manitoba Centre for Health Policy, Winnipeg, where Mr. Dahl and Dr. Chateau are affiliated. Dr. Bolton, Dr. Enns, Dr. Chateau, and Dr. Sareen are also with the Department of Community Health, College of Medicine, Faculty of Health Sciences, University of Manitoba
| | - James M Bolton
- Dr. Alessi-Severini and Dr. Collins are with the College of Pharmacy, and Dr. Bolton, Dr. Enns, and Dr. Sareen are with the Department of Psychiatry, College of Medicine, all in the Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (e-mail: ). Dr. Alessi-Severini is also with the Manitoba Centre for Health Policy, Winnipeg, where Mr. Dahl and Dr. Chateau are affiliated. Dr. Bolton, Dr. Enns, Dr. Chateau, and Dr. Sareen are also with the Department of Community Health, College of Medicine, Faculty of Health Sciences, University of Manitoba
| | - Murray W Enns
- Dr. Alessi-Severini and Dr. Collins are with the College of Pharmacy, and Dr. Bolton, Dr. Enns, and Dr. Sareen are with the Department of Psychiatry, College of Medicine, all in the Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (e-mail: ). Dr. Alessi-Severini is also with the Manitoba Centre for Health Policy, Winnipeg, where Mr. Dahl and Dr. Chateau are affiliated. Dr. Bolton, Dr. Enns, Dr. Chateau, and Dr. Sareen are also with the Department of Community Health, College of Medicine, Faculty of Health Sciences, University of Manitoba
| | - Matthew E Dahl
- Dr. Alessi-Severini and Dr. Collins are with the College of Pharmacy, and Dr. Bolton, Dr. Enns, and Dr. Sareen are with the Department of Psychiatry, College of Medicine, all in the Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (e-mail: ). Dr. Alessi-Severini is also with the Manitoba Centre for Health Policy, Winnipeg, where Mr. Dahl and Dr. Chateau are affiliated. Dr. Bolton, Dr. Enns, Dr. Chateau, and Dr. Sareen are also with the Department of Community Health, College of Medicine, Faculty of Health Sciences, University of Manitoba
| | - Daniel Chateau
- Dr. Alessi-Severini and Dr. Collins are with the College of Pharmacy, and Dr. Bolton, Dr. Enns, and Dr. Sareen are with the Department of Psychiatry, College of Medicine, all in the Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (e-mail: ). Dr. Alessi-Severini is also with the Manitoba Centre for Health Policy, Winnipeg, where Mr. Dahl and Dr. Chateau are affiliated. Dr. Bolton, Dr. Enns, Dr. Chateau, and Dr. Sareen are also with the Department of Community Health, College of Medicine, Faculty of Health Sciences, University of Manitoba
| | - David M Collins
- Dr. Alessi-Severini and Dr. Collins are with the College of Pharmacy, and Dr. Bolton, Dr. Enns, and Dr. Sareen are with the Department of Psychiatry, College of Medicine, all in the Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (e-mail: ). Dr. Alessi-Severini is also with the Manitoba Centre for Health Policy, Winnipeg, where Mr. Dahl and Dr. Chateau are affiliated. Dr. Bolton, Dr. Enns, Dr. Chateau, and Dr. Sareen are also with the Department of Community Health, College of Medicine, Faculty of Health Sciences, University of Manitoba
| | - Jitender Sareen
- Dr. Alessi-Severini and Dr. Collins are with the College of Pharmacy, and Dr. Bolton, Dr. Enns, and Dr. Sareen are with the Department of Psychiatry, College of Medicine, all in the Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (e-mail: ). Dr. Alessi-Severini is also with the Manitoba Centre for Health Policy, Winnipeg, where Mr. Dahl and Dr. Chateau are affiliated. Dr. Bolton, Dr. Enns, Dr. Chateau, and Dr. Sareen are also with the Department of Community Health, College of Medicine, Faculty of Health Sciences, University of Manitoba
| |
Collapse
|
10
|
Roizblatt D, Eamer G, Roberts D, Ball C, Banfield J, Greene B, Veigas P, Moore L, Schellenberg M, Ali J, Ali J, Xiao J, Babul S, Goeres P, Babsail AM, Rice T, MacGillivray S, Addioui A, Tardif PA, Porgo TV, Matar M, Tze N, Rae R, Alali A, Da Luz LT, Vogt K, Da Luz LT, Murphy P, Ali J, Mador B, Muakkassa F, Faidim S, Kirkpatrick A, Kirkpatric A, Laviolette M, Taylor S, Engels P, Hossri S, Snider C, Kortbeek J, Green R, Green R, Green R, Snider C, Green R, Lee C, Green R, Driedger M, Clement J, Charan NKD, Sowers N, Neuhaus N, Hardy I, Younus M, Ibrahim-Zada I, Marrer AMP, Bailey K, Bennett S, Gillman L, Hossri S, Cyr K, Yanchar N, Hinton M, Bernal E, Chisholm A, Hogan A, Watson I, Hogan A, Hogan A, Hewitson L, Rouse C, Rouse C, Al-Thani H, Masson-Trottier M, Mydeen MF, Sne N, Peralta R, Bracco D, Bracco D, Bekdache O, Bracco D, Bracco D, Padim P, Omar M, Yazdani S, Hussein Z, Zargaran E, Fong D, Almaawali A, Tien H, Alshlwi S, Moffat B, Biswas S, Hassan ME, Biswas S, Biswas S, LaLande A, Al Rawahi A, Min A, Phelan B, Harrington J, Mucciaccio M, Alhinai F, Knight H, Young D, Alam A, Waggott M, McKee J, Al-Masrouri S, Al Hinai A, McKee J, Mckee J, Semprun C, Collins D, Kim D, Grenier T, Curtis S, Dufrsne P, Curtis S, Khan S, Curtis S, Appel J, Appel J, Stewart TC, Keenan A, Thakore J, Younus A, Marrero AMP, Mapiour D, Hamadani F, Nascimento B, McGowan M, Kokoski C, Logsetty S, Lawless B, McBeth P, Di Battista A, Rao J, Alhabboubi M, Neto JR, Alhabboubi M, Neto JR, Rao J, Neto JR, Menezes A, Gillard K, Almansoori K, Nash N, Babsail A, Alhabboubi M, Hamadani F, Benyayer D, Malo C, Deckelbaum D, Khwaja K, Beckett A, Razek T, Fata P, Bratu I, Craig J, Faris P, Ball C, Tiruta C, Xiao J, McBeath P, Kubes P, Doig C, Kirkpatrick A, Lampron J, Rizoli S, Callum J, Nascimento B, Da Luz LT, Lauzier F, Berthelot S, Stelfox HT, Kortbeek J, Simons R, Bourgeois G, Clement J, Stevens K, Mehmood A, Gautam S, Zafarm I, Sorvari A, Adam R, Ondiveeran H, Bedaysie H, Ali E, Sorvari A, Briggs S, Wilson C, Robertson HL, Roberts D, Kirkpatrick A, Zeiler F, Unger B, Gillman L, Alhadhrami B, Elhusseini M, Alhalbboubi M, Abdulla M, Chughtai T, Fata P, Khwaja K, Razek T, Beckett A, Sne N, Rice J, Reid S, Li J, Baillie F, Somers A, Robinson T, Boone A, Sandhu N, Wishart I, Saint-Vil D, Crevier L, Beaudinn M, Moore L, Moore L, Lavoie A, Nshimyumukiza L, Turgeon A, Bourgeois G, Lapointe J, Cisse B, Duplantie J, Tran A, Margie O, Yelle JD, Pagliarello G, Lampron J, Grenier T, Lampron J, Bakry H, Malla A, Faidi S, Coates A, Engels P, Neto AC, DaCosta LD, Inaba K, Rhind S, Nascimento B, Rizoli S, Moffat B, Leeper W, Charyk-Stewart T, Malthaner R, Gray D, Parry N, Pena CES, Tien H, Nathens A, Nascimento B, Parry N, Sothilingam N, Vogt K, Moffat B, Gray D, Batey B, Charyk-Stewart T, Sovari A, Henry S, Nascimento B, Rizoli S, Marley R, Salvator A, Yetmar Z, Horattas I, Erck D, Landry BA, Coates A, Patlas M, Tien H, LaPorta A, McKee J, Wright-Beatty H, Keillorn J, Brien S, Roberts D, Wong J, Beckett A, Mador B, Ball C, Louw D, McKee I, McKee J, Panebianco N, Parfitt RJ, Roberts D, Hamilton D, Sevcik B, Lampron J, Waggott M, Stelfox HT, Boyd J, Erdogan M, Widder S, Butler M, Kureshi N, Martin K, Green R, Fasanya C, Barrett N, Cyr K, Camorlinga P, Quigley S, Kureschi N, Erdogan M, Butler M, Kureshi N, Erdogan M, Butler M, Kureshi N, Erdogan M, Longsetty S, Jian D, Fergusson D, Turgeon A, McIntyre L, Kovacs G, Griesdale D, Butler M, McLeod S, Klingel M, Van Aarsen K, Franc J, Peddle M, Fergusson D, Turgeon A, McIntyre L, Kovacs G, Griesdale D, Butler M, Gupta A, Wells B, Dixon E, Ball C, Moore L, Rajaram K, Froese P, Erdogan M, Green R, Younus M, Torres D, Widom K, Leonard D, Baro S, Dove J, Blansfield J, Shabahang M, Timmons S, Wild J, McFaull S, Beaudin M, Saint-Vil D, Torres D, Widom K, Leonard D, Baro S, Dove J, Blansfield J, Shabahang M, Wild J, Friese R, Rhee P, Veercruysse G, Joseph B, Wang A, Coates A, Pelletier H, Calligan D, Amath A, Knight H, Lampron J, Brindley P, Paton-Gay D, Engels P, Park J, Widder S, Fasanya C, Snider C, Barrett N, Cheng A, Mikrogianakis A, Dhanani S, Bhanji F, Lalani A, Al-Harthi F, Mehta S, Wolf S, Arnoldo B, Kowalske K, Phelan H, Benjamin S, Hogan A, Woodford S, Watson I, Woodford S, Watson I, Hogan A, Woodford S, Chisholm A, Louis R, St. Pierre E, Louis R, Woodford S, Watson I, Atkinson P, Mekwan J, Verheul G, Lewis D, Hayre J, French J, Watson I, Benjamin S, Fraser J, Chisholm A, Sealy B, Erdogan M, Green R, Atkinson P, Hayre J, French J, Watson I, Benjamin S, Fraser J, Chisholm A, Sealy B, Erdogan M, Green R, Atkinson P, El-Menyar A, Consunji R, Zarour A, Abdulrahman H, Parchani A, Peralta R, Cyr CE, Arbour C, Gosselin N, Marcotte K, Johnson A, Rice T, Rice J, Passos E, Fan J, Baillie F, Jichici D, Healey A, Consunji R, El Menyar A, Shaltout H, Abdi H, Tarakieh H, Abdulrahman H, Parchani A, Zarour A, Al Thani H, Deckelbaum D, Grenier T, Razek T, Boniface R, Museru L, Lalande A, Deckelbaum D, Razek T, Deckelbaum D, Grenier T, Razek T, Marcoux J, Maleki M, Deckelbaum D, Razek T, Canestrini S, Tuma M, McFarlan A, Neto JR, Veigas P, Rizoli S, Belmont CCG, Moore L, Tardif PA, Dufresne P, Bonaventure PL, McFarlan A, Veigas P, Neto JR, Rizoli S, Lakha N, Simons R, Ramsey D, Hameed M, Nicol A, Spence R, Navsaria P, Lakha N, Hussein Z, Wong H, Martinez R, Shangguan E, Asselstine J, Nascimento B, Brenneman F, Alhadhrami B, Bracco D, Razek T, Grush J, Vogt K, Ahghari M, Parry N, MacDonald R, Gray D, Iqbal S, Fong N, Grushka J, Deckelbaum D, St-Laurent L, Eckert E, Razek T, Khwaja K, Boniface R, Munthali V, Bracco D, Deckelbaum D, Museru L, Razek T, Kirkpatrick A, Roberts D, Doig C, Alhinai F, Xiao J, Kortbeek J, Rizoli S, Perez A, Shek P, Grodecki R, Veigas P, Peng H, Fraser J, Pishe T, Middeton J, Chisholm A, Benjamin S, Watson I, Atkinson P, Stewart TC, Penney A, McLeod S, Klingel M, Van Aarsen K, Hedges C, Dukelow A, Bradford P, Levy D, Kirkpatrick A, Doig C, Roberts D, Xiao J, Al Rawahi A, Keenan A, Waggott M, Lally S, Xiao J, Rados A, Williams A, Vis C, Perlman R, Callum J, Nascimento B, Tien H, Keenan A, Knight H, Tien H, Wright-Beatty H, Keillor J, LaPorta A, Brien S, Roberts D, Ball C, Louw D, Kirkpatrick A, Garraway N, Smith T, Simons R, Hameed M, Ball C, Roberts D, Filips D, Kirkpatrick A, Mckee I, Bouclin M, Atkinson I, Roberts D, McKee I, Kirkpatrick A, Tien H, Alam A, Nathens A, Nascimento B, Kim G, Putnam B, de Virgilio C, Maciel J, Neville A, Bongard F, Bricker S, Plurad D, Tze N, Odenbach J, Grokiert R, Falconer C, Courchesne C, Campbell S, Newton A, Moore L, Clement J, Falconer C, Sevcik B, VanRiper L, Wilkes H, Hussein A, Newton A, Alisc E, Hoysted C, Landolt M, Parri N, Lytle M, Stanley R, Kharbanda A, Babl F, Kassam-Adams N, Fichter K, Rao J, Harris Y, Nahachewsky D, Rao J, Parry N, Batey B, Fleiszer T, Fraser DD, Klassen B, Waggott M, Briereley Y, McMillan J, Robinson S, Williams D, Wild J, Widder S, Qosa H, Khwaja K, Razek T, Perez A, Rizoli S, Trpcic S, Adhikari N, Lamontagne F, Cumyn A, Burns K, Scales D, Duffett M, Henry B, McFarlan A, Zakrison T, Young A, MacKinnon D, Dainty K, Denbok J, Mcgowan M, Blight A, Bakker A, Barratt L, Butorac E, Gaunt K, Gawaziuk J, Lim S, Chateau D, Khan S, Doupe M, Sareen J, Sekhon M, Hameed M, Schuurman N, Dodek P, Ayas N, Vu E, Griesdale D, Rhind S, Hassan S, Perez A, Topolovec-Vranic J, Da Luz LT, Kenjilnaba, Neto AC, Trpcic S, Da Costa LD, Baker A, Rizoli S, Appel J, Lyster K, Grushka J, Hassan ME, Baabsail A, Khwaja K, Deckelbaum D, Razek T, Fata P, Ahmed N, Rotstein O, Rizoli S, Gao ZH, Duong M, Deckelbaum D, Razek T, Shum-Tim D, Khwaja K, Rizoli S, Abreu E, Rotstein O, Appel J, Fichter K, Abreu E, Machado C, Neto MP, Godinho J, Bernardes A, Rizoli S, Fry N, Liang M, Khwaja K, Brenneman F, Bleszynski M, Buczkowski A, Parry N, Martindale R, Evans D, Fraser S, Stephens M, Rao J, Kirkpatrick A, Knowlton L, Hameed M, Almansorri D, Mutiso V, Saleh A, Hawes H, Hogan J, Kromm J, Menon M, Benns M. Trauma Association of Canada Annual Scientific Meeting, Westin Calgary Calgary, Alberta, Apr. 10–11, 2015Outcomes and opportunities for improvement in self-inflicted blunt and penetrating traumaAbdominal compartment syndrome in the childActive negative pressure peritoneal therapy after abbreviated laparotomy: The intraperitoneal vacuum randomized controlled trialUse of a novel combined RFA/saline energy instrument for arresting ongoing hemorrhage from solid organ injuriesHealth care costs of burn patients from homes without fire sprinklersPenetrating trauma in eastern Ontario: a descriptive analysisThresholds of rotational thrombelastometry (ROTEM) used for the diagnosis and management of bleeding trauma patients: a systematic reviewA quality indicator to measure hospital complications for injury admissionsThromboelastography (TEG) in the management of trauma: implications for the developing worldPotential role of the rural trauma team development course (RTTDC) in the United Arab Emirates (UAE)Applicability of the advanced disaster medical response (ADMR) course, Trinidad and TobagoInflammatory mediators in intra-abdominal sepsis or injury: a scoping reviewEvaluation of the online Concussion Awareness Training Toolkit (CATT) for parents, players and coachesUltrasound assessment of optic nerve sheath diameter (ONSD) in healthy volunteersThe benefits of epidural analgesia in flail chest injuriesMandatory reporting rates of injured alcohol-impaired drivers with suspected alcohol dependence in a level 1 Canadian trauma centre: a single institution’s experienceSimulation implementation in a new pediatric residency program in Haiti: trauma specificsManagement of skull fractures in children younger than 1 year of ageResource use in patients who have sustained a traumatic brain injury within an integrated Canadian trauma system: a multicentre cohort studyResource use intensity in a mature, integrated Canadian trauma system: a multicentre cohort studyRates and determinants of unplanned emergency department visits and readmissions within 30 days following discharge from the trauma service — the Ottawa Hospital experienceAlcohol — screening, brief intervention and referral to treatment (SBIRT): Is it readily available in Canadian trauma centres?Management of traumatic occult hemothorax: a survey among trauma providers in CanadaAn audit of venous thromboembolism prophylaxis: a quality assurance project at our level 1 trauma centreCatecholamines as outcome markers in traumatic brain injuryAre we missing the missed injury? The burden of traumatic missed injuries diagnosed after hospital dischargeThe use of fibrinogen concentrate in trauma: a descriptive systematic reviewVery early initiation of chemical venous thromboembolism prophylaxis after solid organ injury is safe: a call for a national prospective multicentre studyThe 2 student to 1 faculty (2:1) model of teaching the Advanced Trauma Operative Management (ATOM) courseTrauma transfusion in the elderlyCocaine and benzodiazepines are more predictive of an injury severity score greater than 15 compared to alcohol or tetrahydrocannabinol in trauma patients under 18 years oldAre we missing traumatic bowel and mesenteric injuries?The marriage of surgical simulation and telementoring for damage control surgical training of operational first-respondersAdding remote ultrasound control to remote just-in-time telementored trauma ultrasound: a pilot studyDescriptive analysis of morbidity and mortality associated with falls at a level 1trauma centreDevelopment of an ICU transition questionnaire: evaluating the transfer process from ICU, ward, and patient/family stakeholder perspectivesUse of IO devices in trauma: A survey of trauma practitioners in Canada, Australia and New ZealandTime to reversal of medication-induced coagulopathy in traumatic intracranial hemorrhageMeta-analysis of randomized control trials of hospital based violence interventions on repeat intentional injuryBlunt injury of a horseshoe kidney, case report and review of the literatureLegal consequences for alcohol-impaired drivers involved in motor vehicle collisions: a systematic reviewA characterization of major adult sport-related trauma in Nova Scotia, 2000–2013Is hockey the most dangerous pediatric sport? An evaluation of pediatric sport-related injuries treated in Nova ScotiaInterim results of a pilot randomized control trial of an ED-based violence intervention programPre-intubation resuscitation by Canadian physicians: results of a national surveyFirst-responder accuracy using SALT during mass-casualty incident simulationEmergent endotracheal intubation: medications and device choices by Canadian resuscitation physicians“Oh the weather outside is frightful”: Severe injury secondary to falls while installing residential Christmas lightsCan we speak the same language? Understanding Quebec’s inclusive trauma systemAn unusual segmental clavicle fracture treated with titanium elastic nailImpact of the age of stored blood on trauma patient mortality: a systematic reviewInterhospital transfer of traumatic brain injury: utilization of helicopter transportCheerleading injuries: a Canadian perspectivePre-hospital mode of transport in a rural trauma system: air versus groundAnalysis of 15 000 patient transfers to level 1 trauma centre: Injury severity does not matter — just drive, drive, drive!The effects of legislation on morbidity and mortality associated with all-terrain vehicle and motorcycle crashes in Puerto RicoAssessing how pediatric trauma patients are supported nutritionally at McMaster Children’s HospitalOutcomes of conservative versus operative management of stable penetrating abdominal traumaS.T.A.R.T.T. — Evolution of a true multidisciplinary trauma crisis resource management simulation courseDevelopment of criteria to identify traumatic brain injury patients NOT requiring intensive care unit monitoringAssigning costs to visits for injuries due to youth violence — the first step in a cost-effectiveness analysisThere’s no TRIK to it — development of the Trauma Resuscitation in Kids courseResilient despite childhood trauma experiencesA five-year, single-centre review of toxic epidermal necrolysis managementAll in the family: creating and implementing an inclusive provincial trauma registryLessons learned from a provincial trauma transfer systemThe NB Trauma Program: 5 years laterProvincial coordination of injury prevention: the New Brunswick (NB) experienceImproving access and uptake of trauma nursing core course (TNCC): a provincial approachULTRASIM: ultrasound in trauma simultation. Does the use of ultrasound during simulated trauma scenarios improve diagnostic abilities?Traumatic tale of 2 cities, part 1: Does being treated by different EMS affect outcomes in trauma patients destined for transport to level 1 trauma centres in Halifax and Saint John?Traumatic tale of 2 cities, part 2: Does being treated by different hospitals affect outcome in trauma patients destined for transport to Level 1trauma centres in Halifax and Saint John?Protective devices use in road traffic injuries in a developing countryFunctional and anatomical connectivity and communication impairments in moderate to severe traumatic brain injuryCaring and communicating in critical cases: Westlock trauma form, a resource for rural physiciansMonitoring of ocular nerve sheath in traumatic raised intracranial pressure (Moonstrip Study): a prospective blinded observational trialEstablishing an alcohol screening and brief intervention for trauma patients in a multicultural setting in the Middle East: challenges and opportunitiesThe poor compliance to seat belt use in Montréal: an 18 461 road user iPhone-based studyAn iPad-based data acquisition for core trauma registry data in 6 Tanzanian hospitals: 1 year and 13 462 patients later“The Triple-Q Algorithm”: a practical approach to the identification of liver topographyA pan-Canadian bicycle helmet use observational studyDoor to decompression: the new benchmark in trauma craniotomiesAre missed doses of pharmacological thromboprophylaxis a risk factor for thromboembolic complications?Complications following admission for traumatic brain injuryExcessive crystalloid infusion in the first 24 hours is not associated with increased complications or mortalitySBIRT: plant, tend, growReal time electronic injury surveillance in an African trauma centreSBIRT in concert: establishing a new initiativeReview of the current knowledge of the pathophysiology of acute traumatic coagulopathy: implications for current trauma resuscitation practicesFactors associated with primary fascial closure rates in patients undergoing damage control laparotomyFree intraperitoneal fluid on CT abdomen in blunt trauma: Is hospital admission necessary?The need for speed — the time cost of off-site helipadsEndovascular management of penetrating Zone III retroperitoneal injuries in selective patients: a case reportMeasured resting energy expenditure in patients with open abdomens: preliminary data of a prospective pilot studyTraumatic inferior gluteal artery pseudoaneurysm: case report and review of literaturePancreatico duodenectomy, SMA, SMV repair and delayed reconstruction following blunt abdominal trauma. A case report with discussion of trauma whipple and complex pancreatico duodenal injuriesA retrospective evaluation of the effect of the Trauma Team Training program in TanzaniaDoes procalcitonin measurement predict clinical outcomes in critically ill/injured adults managed with the open abdomen technique?In trauma, conventional ROTEM and TEG results are not interchangeable but are similar in clinical applicabilitySevere trauma in the province of New Brunswick: a descriptive epidemiological studyPartnering for success — a road safety strategy for London and regionEvaluation of a patient safety initiative of rapid removal of backboards in the emergency departmentActive negative pressure peritoneal therapy and C-reactive protein levels after abbreviated laparotomy for abdominal trauma or intra-abdominal sepsisA comparison of outcomes: Direct admissions vs. interhospital transfers April 2009–March 2014YEE HA or YEE OUCH! A 5-year review of large animal-related incidentsEarly goal-directed therapy for prevention of hypothermia-related transfusion, morbidity and mortality in severely injured trauma patientsImproving care of adolescent trauma patients admitted to adult trauma centres by fostering collaboration between adult and pediatric partnersExpediting operational damage control laparotomy closure: iTClam v. suturing during damage control surgical simulation trainingAre conventional coagulation tests inadequate in the assessment of acute traumatic coagulopathy?Predictors of long-term outcomes in patients admitted to emergency general surgery services: a systematic review of literatureUse of the iTClamp versus standard suturing techniques for securing chest tubes: A randomized cadaver studyiTClamp application for control of simulated massive upper extremity arterial hemorrhage by tactical policeAssessing performance in the trauma roomThe deadly need for methadone/opiate educationTrends in the management of major abdominal vascular injuries: 2000–2014Addressing high school seniors’ risky behaviours through a hospital-based and peer teaching outreach programScreening for risk of post-traumatic stress disorder after injury in acutely injured children: a systematic reviewThe impact of trauma centre designation levels on surgical delay, mortality and complications: a multicentre cohort studyHow many acutely injured children report subsequent stress symptoms?The frequency of coagulopathy and its significance in an emergency neurotrauma facilityPsychosocial care for injured children: The views of 2500 emergency department physicians and nurses from around the worldDevelopment of the Trauma Electronic Document (TED)Development of trauma team activation criteria for an urban trauma centreBrains and brawn: evaluation of a sports skills and concussion awareness campRegional trauma networks: a tale of 2 pilotsContinuous data quality improvement in a provincial trauma registryDoes the Rural Trauma Team Development Course shorten transfer time?Epidemiology of trauma in Puerto RicoCT scans facilitate early discharge of trauma patientsFeasibility of data collection in a conflict zone to assess the impact on emergency health care deliveryConsent for Emergency Research (CONfER): a national survey of Canadian research ethics board practicesMaking handover safer for our trauma patients through the lens of trauma team leadersChallenges and opportunities to improve trauma transitions of care from emergency to intensive care nursingPhysical disorder following major injury: a population-based studyToward an inclusive trauma system: regional trauma system development in OntarioTraumatic brain injury in British Columbia: current incidence, injury patterns and risk factorsAcute cytokine and chemokine profiles in brain-injured patients: relationship to sympathetic activation and outcomeMultidisciplinary trauma simulation training in a tertiary care centreNon-operative management of blunt splenic injuries: routine radiologic follow-up may reduce the time of activity restrictionModified triple layer peritoneal-aponeurotic transposition: a new strategy to close the open abdomenMesenchymal stem cells locate and differentiate to the trauma site in a blunt rat liver trauma model: preliminary resultsThree indications for the “open abdomen”, anatomical, logistical and physiological: How are they different?Development of an urban trauma centre using lean methodologyThe impact of standardized care in 191 patients with chest tube thoracostomyComplex abdominal wall reconstruction: recommendations from the Canadian Abdominal Wall Reconstruction GroupCompensatory behaviours and cognitions in persons with history of traumaDevelopment of the Kenyatta National Hospital — University of Alberta Orthopedic Trauma Assessment Tool: phase 1 resultsRisk-taking behaviour negatively affects outcome in burn patients. Can J Surg 2015. [DOI: 10.1503/cjs.003415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
11
|
Chateau D, Liotta A, Vadcard F, Navarro JRG, Chaput F, Lermé J, Lerouge F, Parola S. From gold nanobipyramids to nanojavelins for a precise tuning of the plasmon resonance to the infrared wavelengths: experimental and theoretical aspects. Nanoscale 2015; 7:1934-43. [PMID: 25530122 DOI: 10.1039/c4nr06323f] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Anisotropic gold nanoparticles and in particular with shapes exhibiting tips are known to present an extremely strong localized electromagnetic field. This field is mostly located at the top of the tips and can be used in various optical applications. Moreover, as a consequence of their anisotropy, they present two plasmon resonance bands corresponding to the transverse and longitudinal resonance modes. Tuning the aspect ratio it becomes possible to display SPR bands near the near infrared region. This was particularly investigated in the case of nanorods and also for bipyramids. In this paper we report a high yield synthesis approach that allows one to precisely control the aspect ratio of bipyramids and to elongate the structure until they adopt a javelin-like aspect. We were able to prepare nano-javelins with surface plasmon resonances up to 1850 nm, opening important perspectives in terms of optical applications in the NIR and IR regions. The synthetic methods are fully reported and the optical properties were correlated with the theoretical approach, taking into consideration not only the aspect ratio but also the truncation of the nano-objects.
Collapse
Affiliation(s)
- D Chateau
- Ecole Normale Supérieure de Lyon, CNRS, Université Lyon 1, Laboratoire de Chimie UMR 5182, 46, allée d'Italie, F-69364, Lyon cedex 07, France.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Brownell M, Nickel N, Chateau D, Martens P, Taylor C, Crockett L, Katz A, Sarkar J, Burland E, Goh C. Long-term benefits of full-day kindergarten: a longitudinal population-based study. Early Child Dev Care 2015; 185:291-316. [PMID: 25632172 PMCID: PMC4299551 DOI: 10.1080/03004430.2014.913586] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 04/07/2014] [Indexed: 06/04/2023]
Abstract
In the first longitudinal, population-based study of full-day kindergarten (FDK) outcomes beyond primary school in Canada, we used linked administrative data to follow 15 kindergarten cohorts (n ranging from 112 to 736) up to grade 9. Provincial assessments conducted in grades 3, 7, and 8 and course marks and credits earned in grade 9 were compared between FDK and half-day kindergarten (HDK) students in both targeted and universal FDK programmes. Propensity score matched cohort and stepped-wedge designs allowed for stronger causal inferences than previous research on FDK. We found limited long-term benefits of FDK, specific to the type of programme, outcomes examined, and subpopulations. FDK programmes targeted at low-income areas showed long-term improvements in numeracy for lower income girls. Our results suggest that expectations for wide-ranging long-term academic benefits of FDK are unwarranted.
Collapse
Affiliation(s)
- M.D. Brownell
- Department of Community Health Sciences, University of Manitoba, Manitoba, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - N.C. Nickel
- Department of Community Health Sciences, University of Manitoba, Manitoba, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - D. Chateau
- Department of Community Health Sciences, University of Manitoba, Manitoba, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - P.J. Martens
- Department of Community Health Sciences, University of Manitoba, Manitoba, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - C. Taylor
- Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - L. Crockett
- Department of Community Health Sciences, University of Manitoba, Manitoba, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - A. Katz
- Department of Community Health Sciences, University of Manitoba, Manitoba, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - J. Sarkar
- Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - E. Burland
- Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - C.Y. Goh
- Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| |
Collapse
|
13
|
Bolton JM, Walld R, Chateau D, Finlayson G, Sareen J. Risk of suicide and suicide attempts associated with physical disorders: a population-based, balancing score-matched analysis. Psychol Med 2015; 45:495-504. [PMID: 25032807 DOI: 10.1017/s0033291714001639] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The association between physical disorders and suicide remains unclear. The aim of this study was to examine the relationship between physical disorders and suicide after accounting for the effects of mental disorders. METHOD Individuals who died by suicide (n = 2100) between 1996 and 2009 were matched 3:1 by balancing score to general population controls (n = 6300). Multivariate conditional logistic regression compared the two groups across physician-diagnosed physical disorders [asthma, chronic obstructive pulmonary disease (COPD), ischemic heart disease, hypertension, diabetes, cancer, multiple sclerosis and inflammatory bowel disease], adjusting for mental disorders and co-morbidity. Secondary analyses examined the risk of suicide according to time since first diagnosis of each physical disorder (1-90, 91-364, ⩾ 365 days). Similar analyses also compared individuals with suicide attempts (n = 8641) to matched controls (n = 25 923). RESULTS Cancer was associated with increased risk of suicide [adjusted odds ratio (AOR) 1.40, 95% confidence interval (CI) 1.03-1.91, p < 0.05] even after adjusting for all mental disorders. The risk of suicide with cancer was particularly high in the first 90 days after initial diagnosis (AOR 4.10, 95% CI 1.71-9.82, p < 0.01) and decreased to non-significance after 1 year. Women with respiratory diseases had elevated risk of suicide whereas men did not. COPD, hypertension and diabetes were each associated with increased odds of suicide attempts in adjusted models (AORs ranged from 1.20 to 1.73). CONCLUSIONS People diagnosed with cancer are at increased risk of suicide, especially in the 3 months following initial diagnosis. Increased support and psychiatric involvement should be considered for the first year after cancer diagnosis.
Collapse
Affiliation(s)
- J M Bolton
- Department of Psychiatry,University of Manitoba,Winnipeg, Manitoba,Canada
| | - R Walld
- Manitoba Centre for Health Policy,Winnipeg, Manitoba,Canada
| | - D Chateau
- Manitoba Centre for Health Policy,Winnipeg, Manitoba,Canada
| | - G Finlayson
- Manitoba Centre for Health Policy,Winnipeg, Manitoba,Canada
| | - J Sareen
- Department of Psychiatry,University of Manitoba,Winnipeg, Manitoba,Canada
| |
Collapse
|
14
|
Wall-Wieler E, Roos LL, Chateau D. EARLY CHILDHOOD IS OVERRATED—A LIFE COURSE PERSPECTIVE USING SIBLINGS AND POPULATIONS. Br J Soc Med 2015. [DOI: 10.1136/jech-2014-205217.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
15
|
Chateau D, Géminard JC. Fracture path in an anisotropic material in the light of a friction experiment. Phys Rev E 2013; 88:033202. [PMID: 24125375 DOI: 10.1103/physreve.88.033202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 06/17/2013] [Indexed: 11/07/2022]
Abstract
A slider is pulled by means of a flexible link on a flat solid surface which exhibits anisotropic frictional properties. The resulting trajectory of the slider is assessed experimentally. First, we check that the experimental results are in excellent agreement with a theoretical description of the problem based on an expression of the frictional forces. Second, we point out that the trajectory of the slider can be recovered by the use of a "maximum of energy release rate" criterion which is generally used to predict the path of a fracture even if the validity of the principle is difficult to verify in the latter complex systems.
Collapse
Affiliation(s)
- D Chateau
- Laboratoire de Physique, Ecole Normale Supérieure de Lyon, CNRS, Université de Lyon, 46 Allée d'Italie, 69364 Lyon Cedex, France
| | | |
Collapse
|
16
|
Garland A, Ramsey CD, Fransoo R, Olafson K, Chateau D, Yogendran M, Kraut A. Rates of readmission and death associated with leaving hospital against medical advice: a population-based study. CMAJ 2013; 185:1207-14. [PMID: 23979869 DOI: 10.1503/cmaj.130029] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Leaving hospital against medical advice may have adverse consequences. Previous studies have been limited by evaluating specific types of patients, small sample sizes and incomplete determination of outcomes. We hypothesized that leaving hospital against medical advice would be associated with increases in subsequent readmission and death. METHODS In a population-based analysis involving all adults admitted to hospital and discharged alive in Manitoba from Apr. 1, 1990, to Feb. 28, 2009, we evaluated all-cause 90-day mortality and 30-day hospital readmission. We used multivariable regression, adjusted for age, sex, socioeconomic status, year of hospital admission, patient comorbidities, hospital diagnosis, past frequency of admission to hospital, having previously left hospital against medical advice and data clustering (patients with multiple admissions). For readmission, we assessed both between-person and within-person effects of leaving hospital against medical advice. RESULTS Leaving against medical advice occurred in 21 417 of 1 916 104 index hospital admissions (1.1%), and was associated with higher adjusted rates of 90-day mortality (odds ratio [OR] 2.51, 95% confidence interval [CI] 2.18-2.89), and 30-day hospital readmission (within-person OR 2.10, CI 1.99-2.21; between-person OR 3.04, CI 2.79-3.30). In our additional analyses, elevated rates of readmission and death associated with leaving against medical advice were manifest within 1 week and persisted for at least 180 days after discharge. INTERPRETATION Adults who left the hospital against medical advice had higher rates of hospital readmission and death. The persistence of these effects suggests that they are not solely a result of incomplete treatment of acute illness. Interventions aimed at reducing these effects may need to include longitudinal interventions extending beyond admission to hospital.
Collapse
|
17
|
Decker KM, Turner D, Demers AA, Martens PJ, Lambert P, Chateau D. Evaluating the Effectiveness of Cervical Cancer Screening Invitation Letters. J Womens Health (Larchmt) 2013; 22:687-93. [DOI: 10.1089/jwh.2012.4203] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kathleen M. Decker
- Screening Programs, CancerCare Manitoba, Winnipeg Manitoba, Canada
- Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg Manitoba, Canada
| | - Donna Turner
- Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg Manitoba, Canada
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg Manitoba, Canada
| | - Alain A. Demers
- Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg Manitoba, Canada
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg Manitoba, Canada
| | - Patricia J. Martens
- Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg Manitoba, Canada
| | - Pascal Lambert
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg Manitoba, Canada
| | - Daniel Chateau
- Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg Manitoba, Canada
| |
Collapse
|
18
|
Fransoo R, Bucklaschuk J, Prior H, Burland E, Chateau D, Martens P. Social gradients in surgical sterilization rates: opposing patterns for males and females. J Obstet Gynaecol Can 2013; 35:454-460. [PMID: 23756276 DOI: 10.1016/s1701-2163(15)30936-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to analyze population-based rates of surgical sterilization by sex, income, age group, and location of residence (urban, rural, or remote) among a universally insured population. METHODS The study included all 1.2 million residents of Manitoba. Data from comprehensive hospital and medical visit records were used to calculate rates of vasectomy and tubal ligation among the population aged 20 to 55 years. Analyses were carried out with generalized linear modelling, using administrative data housed at the Manitoba Centre for Health Policy. RESULTS There were significant income-related gradients in sterilization rates for both sexes (P < 0.001), but the trends were in opposite directions for males and females. Tubal ligation rates were highest in low-income areas, and decreased with income, whereas vasectomy rates were lowest in low-income areas and increased with income. Rates also varied considerably by age and area of residence (urban, rural, or remote). CONCLUSION These results are potentially worrying because tubal ligation is more invasive, associated with higher risks, and more costly than vasectomy. It would therefore be expected to be less common than vasectomy among all groups, not just those in higher income areas. The results contribute unique population-based procedure rates, which are not subject to biases that can affect survey-based studies. The findings may reflect underlying differences across income groups in decision-making regarding reproductive health issues.
Collapse
Affiliation(s)
- Randall Fransoo
- Community Health Sciences, University of Manitoba, Winnipeg MB; Manitoba Centre for Health Policy, University of Manitoba, Winnipeg MB
| | | | - Heather Prior
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg MB
| | - Elaine Burland
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg MB
| | - Daniel Chateau
- Community Health Sciences, University of Manitoba, Winnipeg MB; Manitoba Centre for Health Policy, University of Manitoba, Winnipeg MB
| | - Patricia Martens
- Community Health Sciences, University of Manitoba, Winnipeg MB; Manitoba Centre for Health Policy, University of Manitoba, Winnipeg MB
| |
Collapse
|
19
|
Hoit G, Hinkewich C, Tiao J, Porgo V, Moore L, Moore L, Tiao J, Wang C, Moffatt B, Wheeler S, Gillman L, Bartens K, Lysecki P, Pallister I, Patel S, Bradford P, Bradford P, Kidane B, Holmes A, Trajano A, March J, Lyons R, Kao R, Rezende-Neto J, Leblanc Y, Rezende-Neto J, Vogt K, Alzaid S, Jansz G, Andrusiek D, Andrusiek D, Bailey K, Livingston M, Calthorpe S, Hsu J, Lubbert P, Boitano M, Leeper W, Williamson O, Reid S, Alonazi N, Lee C, Rezende-Neto J, Aleassa E, Jennings P, Jennings P, Mador B, Hoffman K, Riley J, Vu E, Alburakan A, Alburakan A, Alburakan A, Mckee J, Bobrovitz N, Gabbe B, Gabbe B, Hodgkinson J, Hodgkinson J, Ali J, Ali J, Grant M, Roberts D, Holodinsky J, Cooper C, Santana M, Kruger K, Hodgkinson J, Waggott M, Da Luz L, Banfield J, Santana M, Dorigatti A, Birn K, Bobrovitz N, Zakirova R, Davies D, Das D, Gamme G, Pervaiz F, Almarhabi Y, Brainard A, Brown R, Bell N, Bell N, Jowett H, Jowett H, Bressan S, Hogan A, Watson I, Woodford S, Hogan A, Boulay R, Watson I, Howlett M, Atkinson P, Chesters A, Hamadani F, Atkinson P, Azzam M, Fraser J, Doucet J, Atkinson P, Muakkassa F, Sathivel N, Chadi S, Joseph B, Takeuchi L, Bradley N, Al Bader B, Kidane B, Harrington A, Nixon K, Veigas P, Joseph B, O’Keeffe T, Bracco D, Rezende-Neto J, Azzam M, Lin Y, Bailey K, Bracco D, Nash N, Alhabboubi M, Slobogean G, Spicer J, Heidary B, Joos E, Berg R, Berg R, Sankarankutty A, Zakrison T, Babul S, Lockhart S, Faux S, Jackson A, Lee T, Bailey K, Pemberton J, Green R, Tallon J, Moore L, Turgeon A, Boutin A, Moore L, Reinartz D, Lapointe G, Turgeon A, Stelfox H, Turgeon A, Nathens A, Neveu X, Stelfox H, Turgeon A, Nathens A, Neveu X, Moore L, Turgeon A, Bratu I, Gladwin C, Voaklander D, Lewis M, Vogt K, Eckert K, Williamson J, Stewart TC, Parry N, Gray D, L’Heureux R, Ziesmann M, Kortbeek J, Brindley P, Hicks C, Fata P, Engels P, Ball C, Paton-Gay D, Widder S, Vogt K, Hernandez-Alejandro R, Gray D, Vanderbeek L, Forrokhyar F, Anatharajah R, Howatt N, Lamb S, Sne N, Kahnamoui K, Lyons R, Walters A, Brooks C, Pinder L, Rahman S, Walters A, Kidane B, Parry N, Donnelly E, Lewell M, Mellow R, Hedges C, Morassutti P, Bulatovic R, Morassutti P, Galbraith E, McKenzie S, Bradford D, Lewell M, Peddle M, Dukelow A, Eby D, McLeod S, Bradford P, Stewart TC, Parry N, Williamson O, Fraga G, Pereira B, Sareen J, Doupe M, Gawaziuk J, Chateau D, Logsetty S, Pallister I, Lewis J, O’Doherty D, Hopkins S, Griffiths S, Palmer S, Gabbe B, Xu X, Martin C, Xenocostas A, Parry N, Mele T, Rui T, Abreu E, Andrade M, Cruz F, Pires R, Carreiro P, Andrade T, Lampron J, Balaa F, Fortuna R, Issa H, Dias P, Marques M, Fernandes T, Sousa T, Inaba K, Smith J, Okoye O, Joos E, Shulman I, Nelson J, Parry N, Rhee P, Demetriades D, Ostrofsky R, Butler-Laporte G, Chughtai T, Khwaja K, Fata P, Mulder D, Razek T, Deckelbaum D, Bailey K, Pemberton J, Evans D, Anton H, Wei J, Randall E, Sobolev B, Scott BB, van Heest R, Frankfurter C, Pemberton J, McKerracher S, Stewart TC, Merritt N, Barber L, Kimmel L, Hodgson C, Webb M, Holland A, Gruen R, Harrison K, Hwang M, Hsee L, Civil I, Muizelaar A, Baillie F, Leeper T, Stewart TC, Gray D, Parry N, Sutherland A, Hart M, Gabbe B, Tuma F, Coates A, Farrokhyar F, Faidi S, Gastaldo F, Paskar D, Reid S, Faidi S, Petrisor B, Bhandari M, Loh WL, Ho C, Chong C, Rodrigues G, Gissoni M, Martins M, Andrade M, Cunha-Melo J, Rizoli S, Abu-Zidan F, Cameron P, Bernard S, Walker T, Jolley D, Fitzgerald M, Masci K, Gabbe B, Simpson P, Smith K, Cox S, Cameron P, Evans D, West A, Barratt L, Rozmovits L, Livingstone B, Vu M, Griesdale D, Schlamp R, Wand R, Alhabboubi M, Alrowaili A, Alghamdi H, Fata P, Essbaiheen F, Alhabboubi M, Fata P, Essbaiheen F, Chankowsky J, Razek T, Stephens M, Vis C, Belton K, Kortbeek J, Bratu I, Dufresne B, Guilfoyle J, Ibbotson G, Martin K, Matheson D, Parks P, Thomas L, Kirkpatrick A, Santana M, Kline T, Kortbeek J, Stelfox H, Lyons R, Macey S, Fitzgerald M, Judson R, Cameron P, Sutherland A, Hart M, Morgan M, McLellan S, Wilson K, Cameron P, Sorvari A, Chaudhry Z, Khawaja K, Ali A, Akhtar J, Zubair M, Nickow J, Sorvari A, Holodinsky J, Jaeschke R, Ball C, Blaser AR, Starkopf J, Zygun D, Kirkpatrick A, Roberts D, Ball C, Blaser AR, Starkopf J, Zygun D, Jaeschke R, Kirkpatrick A, Santana M, Stelfox H, Stelfox H, Rizoli S, Tanenbaum B, Stelfox H, Redondano BR, Jimenez LS, Zago T, de Carvalho RB, Calderan TA, Fraga G, Campbell S, Widder S, Paton-Gay D, Engels P, Ferri M, Santana M, Kline T, Kortbeek J, Stelfox H, Nathens A, Lashoher A, McFarlan A, Ahmed N, Booy J, McDowell D, Nasr A, Wales P, Roberts D, Mercado M, Vis C, Kortbeek J, Kirkpatrick A, Lall R, Stelfox H, Ball C, Niven D, Dixon E, Stelfox H, Kirkpatrick A, Kaplan G, Hameed M, Ball C, Qadura M, Sne N, Reid S, Coates A, Faidi S, Veenstra J, Hennecke P, Gardner R, Appleton L, Sobolev B, Simons R, van Heest R, Hameed M, Sobolev B, Simons R, van Heest R, Hameed M, Palmer C, Bevan C, Crameri J, Palmer C, Hogan D, Grealy L, Bevan C, Palmer C, Jowett H, Boulay R, Chisholm A, Beairsto E, Goulette E, Martin M, Benjamin S, Boulay R, Watson I, Boulay R, Watson I, Watson I, Savoie J, Benjamin S, Martin M, Hogan A, Woodford S, Benjamin S, Chisholm A, Ondiveeran H, Martin M, Atkinson P, Doody K, Fraser J, Leblanc-Duchin D, Strack B, Naveed A, vanRensburg L, Madan R, Atkinson P, Boulva K, Deckelbaum D, Khwaja K, Fata P, Razek T, Fraser J, Verheul G, Parks A, Milne J, Nemeth J, Fata P, Correa J, Deckelbaum D, Bernardin B, Al Bader B, Khwaja K, Razek T, Atkinson P, Benjamin S, Sproul E, Mehta A, Galarneau M, Mahadevan P, Bansal V, Dye J, Hollingsworth-Fridlund P, Stout P, Potenza B, Coimbra R, Madan R, Marley R, Salvator A, Pisciotta D, Bridge J, Lin S, Ovens H, Nathens A, Abdo H, Dencev-Bihari R, Parry N, Lawendy A, Ibrahim-Zada I, Pandit V, Tang A, O’Keeffe T, Wynne J, Gries L, Friese R, Rhee P, Hameed M, Simons R, Taulu T, Wong H, Saleem A, Azzam M, Boulva K, Razek T, Khwaja K, Mulder D, Deckelbaum D, Fata P, Plourde M, Chadi S, Forbes T, Parry N, Martin G, Gaunt K, Bandiera G, Bawazeer M, MacKinnon D, Ahmed N, Spence J, Sankarankutty A, Nascimento B, Rizoli S, Ibrahim-Zada I, Aziz H, Tang A, Friese R, Wynne J, O’keeffe T, Vercruysse G, Kulvatunyou N, Rhee P, Sakles J, Mosier J, Wynne J, Kulvatunyou N, Tang A, Joseph B, Rhee P, Khwaja K, Fata P, Deckelbaum D, Razek T, Dias P, Issa H, Fortuna R, Sousa T, Abreu E, Bracco D, Khwaja K, Fata P, Deckelbaum D, Razek T, Bracco D, Khwaja K, Fata P, Deckelbaum D, Razek T, Norman D, Li J, Pemberton J, Al-Oweis J, Khwaja K, Fata P, Deckelbaum D, Razek T, Albuz O, Karamanos E, Vogt K, Okoye O, Talving P, Inaba K, Demetriades D, Elhusseini M, Sudarshan M, Deckelbaum D, Fata P, Razek T, Khwaja K, MacPherson C, Sun T, Pelletier M, Hameed M, Khalil MA, Azzam M, Valenti D, Fata P, Deckelbaum D, Razek T, Brown R, Simons R, Evans D, Hameed M, Inaba K, Vogt K, Okoye O, Gelbard R, Moe D, Grabo D, Demetriades D, Inaba K, Karamanos E, Okoye O, Talving P, Demetriades D, Inaba K, Karamanos E, Pasley J, Teixeira P, Talving P, Demetriades D, Fung S, Alababtain I, Brnjac E, Luz L, Nascimento B, Rizoli S, Parikh P, Proctor K, Murtha M, Schulman C, Namias N, Goldman R, Pike I, Korn P, Flett C, Jackson T, Keith J, Joseph T, Giddins E, Ouellet J, Cook M, Schreiber M, Kortbeek J. Trauma Association of Canada (TAC) Annual Scientific Meeting. The Westin Whistler Resort & Spa, Whistler, BC, Thursday, Apr. 11 to Saturday, Apr. 13, 2013Testing the reliability of tools for pediatric trauma teamwork evaluation in a North American high-resource simulation settingThe association of etomidate with mortality in trauma patientsDefinition of isolated hip fractures as an exclusion criterion in trauma centre performance evaluations: a systematic reviewEstimation of acute care hospitalization costs for trauma hospital performance evaluation: a systematic reviewHospital length of stay following admission for traumatic injury in Canada: a multicentre cohort studyPredictors of hospital length of stay following traumatic injury: a multicentre cohort studyInfluence of the heterogeneity in definitions of an isolated hip fracture used as an exclusion criterion in trauma centre performance evaluations: a multicentre cohort studyPediatric trauma, advocacy skills and medical studentsCompliance with the prescribed packed red blood cell, fresh frozen plasma and platelet ratio for the trauma transfusion pathway at a level 1 trauma centreEarly fixed-wing aircraft activation for major trauma in remote areasDevelopment of a national, multi-disciplinary trauma crisis resource management curriculum: results from the pilot courseThe management of blunt hepatic trauma in the age of angioembolization: a single centre experienceEarly predictors of in-hospital mortality in adult trauma patientsThe impact of open tibial fracture on health service utilization in the year preceding and following injuryA systematic review and meta-analysis of the efficacy of red blood cell transfusion in the trauma populationSources of support for paramedics managing work-related stress in a Canadian EMS service responding to multisystem trauma patientsAnalysis of prehospital treatment of pain in the multisystem trauma patient at a community level 2 trauma centreIncreased mortality associated with placement of central lines during trauma resuscitationChronic pain after serious injury — identifying high risk patientsEpidemiology of in-hospital trauma deaths in a Brazilian university teaching hospitalIncreased suicidality following major trauma: a population-based studyDevelopment of a population-wide record linkage system to support trauma researchInduction of hmgb1 by increased gut permeability mediates acute lung injury in a hemorrhagic shock and resuscitation mouse modelPatients who sustain gunshot pelvic fractures are at increased risk for deep abscess formation: aggravated by rectal injuryAre we transfusing more with conservative management of isolated blunt splenic injury? A retrospective studyMotorcycle clothesline injury prevention: Experimental test of a protective deviceA prospective analysis of compliance with a massive transfusion protocol - activation alone is not enoughAn evaluation of diagnostic modalities in penetrating injuries to the cardiac box: Is there a role for routine echocardiography in the setting of negative pericardial FAST?Achievement of pediatric national quality indicators — an institutional report cardProcess mapping trauma care in 2 regional health authorities in British Columbia: a tool to assist trauma sys tem design and evaluationPatient safety checklist for emergency intubation: a systematic reviewA standardized flow sheet improves pediatric trauma documentationMassive transfusion in pediatric trauma: a 5-year retrospective reviewIs more better: Does a more intensive physiotherapy program result in accelerated recovery for trauma patients?Trauma care: not just for surgeons. Initial impact of implementing a dedicated multidisciplinary trauma team on severely injured patientsThe role of postmortem autopsy in modern trauma care: Do we still need them?Prototype cervical spine traction device for reduction stabilization and transport of nondistraction type cervical spine injuriesGoing beyond organ preservation: a 12-year review of the beneficial effects of a nonoperative management algorithm for splenic traumaAssessing the construct validity of a global disability measure in adult trauma registry patientsThe mactrauma TTL assessment tool: developing a novel tool for assessing performance of trauma traineesA quality improvement approach to developing a standardized reporting format of ct findings in blunt splenic injuriesOutcomes in geriatric trauma: what really mattersFresh whole blood is not better than component therapy (FFP:RBC) in hemorrhagic shock: a thromboelastometric study in a small animal modelFactors affecting mortality of chest trauma patients: a prospective studyLong-term pain prevalence and health related quality of life outcomes for patients enrolled in a ketamine versus morphine for prehospital traumatic pain randomized controlled trialDescribing pain following trauma: predictors of persistent pain and pain prevalenceManagement strategies for hemorrhage due to pelvic trauma: a survey of Canadian general surgeonsMajor trauma follow-up clinic: Patient perception of recovery following severe traumaLost opportunities to enhance trauma practice: culture of interprofessional education and sharing among emergency staffPrehospital airway management in major trauma and traumatic brain injury by critical care paramedicsImproving patient selection for angiography and identifying risk of rebleeding after angioembolization in the nonoperative management of high grade splenic injuriesFactors predicting the need for angioembolization in solid organ injuryProthrombin complex concentrates use in traumatic brain injury patients on oral anticoagulants is effective despite underutilizationThe right treatment at the right time in the right place: early results and associations from the introduction of an all-inclusive provincial trauma care systemA multicentre study of patient experiences with acute and postacute injury carePopulation burden of major trauma: Has introduction of an organized trauma system made a difference?Long-term functional and return to work outcomes following blunt major trauma in Victoria, AustraliaSurgical dilemma in major burns victim: heterotopic ossification of the tempromandibular jointWhich radiological modality to choose in a unique penetrating neck injury: a differing opinionThe Advanced Trauma Life Support (ATLS) program in CanadaThe Rural Trauma Team Development Course (RTTDC) in Pakistan: Is there a role?Novel deployment of BC mobile medical unit for coverage of BMX world cup sporting eventIncidence and prevalence of intra-abdominal hypertension and abdominal compartment syndrome in critically ill adults: a systematic review and meta-analysisRisk factors for intra-abdominal hypertension and abdominal compartment syndrome in critically ill or injured adults: a systematic review and meta-analysisA comparison of quality improvement practices at adult and pediatric trauma centresInternational trauma centre survey to evaluate content validity, usability and feasibility of quality indicatorsLong-term functional recovery following decompressive craniectomy for severe traumatic brain injuryMorbidity and mortality associated with free falls from a height among teenage patients: a 5-year review from a level 1 trauma centreA comparison of adverse events between trauma patients and general surgery patients in a level 1 trauma centreProcoagulation, anticoagulation and fibrinolysis in severely bleeding trauma patients: a laboratorial characterization of the early trauma coagulopathyThe use of mobile technology to facilitate surveillance and improve injury outcome in sport and physical activityIntegrated knowledge translation for injury quality improvement: a partnership between researchers and knowledge usersThe impact of a prevention project in trauma with young and their learningIntraosseus vascular access in adult trauma patients: a systematic reviewThematic analysis of patient reported experiences with acute and post-acute injury careAn evaluation of a world health organization trauma care checklist quality improvement pilot programProspective validation of the modified pediatric trauma triage toolThe 16-year evolution of a Canadian level 1 trauma centre: growing up, growing out, and the impact of a booming economyA 20-year review of trauma related literature: What have we done and where are we going?Management of traumatic flail chest: a systematic review of the literatureOperative versus nonoperative management of flail chestEmergency department performance of a clinically indicated and technically successful emergency department thoracotomy and pericardiotomy with minimal equipment in a New Zealand institution without specialized surgical backupBritish Columbia’s mobile medical unit — an emergency health care support resourceRoutine versus ad hoc screening for acute stress: Who would benefit and what are the opportunities for trauma care?A geographical analysis of the Early Development Instrument (EDI) and childhood injuryDevelopment of a pediatric spinal cord injury nursing course“Kids die in driveways” — an injury prevention campaignEpidemiology of traumatic spine injuries in childrenA collaborative approach to reducing injuries in New Brunswick: acute care and injury preventionImpact of changes to a provincial field trauma triage tool in New BrunswickEnsuring quality of field trauma triage in New BrunswickBenefits of a provincial trauma transfer referral system: beyond the numbersThe field trauma triage landscape in New BrunswickImpact of the Rural Trauma Team Development Course (RTTDC) on trauma transfer intervals in a provincial, inclusive trauma systemTrauma and stress: a critical dynamics study of burnout in trauma centre healthcare professionalsUltrasound-guided pediatric forearm fracture reduction with sedation in the emergency departmentBlock first, opiates later? The use of the fascia iliaca block for patients with hip fractures in the emergency department: a systematic reviewRural trauma systems — demographic and survival analysis of remote traumas transferred from northern QuebecSimulation in trauma ultrasound trainingIncidence of clinically significant intra-abdominal injuries in stable blunt trauma patientsWake up: head injury management around the clockDamage control laparotomy for combat casualties in forward surgical facilitiesDetection of soft tissue foreign bodies by nurse practitioner performed ultrasoundAntihypertensive medications and walking devices are associated with falls from standingThe transfer process: perspectives of transferring physiciansDevelopment of a rodent model for the study of abdominal compartment syndromeClinical efficacy of routine repeat head computed tomography in pediatric traumatic brain injuryEarly warning scores (EWS) in trauma: assessing the “effectiveness” of interventions by a rural ground transport service in the interior of British ColumbiaAccuracy of trauma patient transfer documentation in BCPostoperative echocardiogram after penetrating cardiac injuries: a retrospective studyLoss to follow-up in trauma studies comparing operative methods: a systematic reviewWhat matters where and to whom: a survey of experts on the Canadian pediatric trauma systemA quality initiative to enhance pain management for trauma patients: baseline attitudes of practitionersComparison of rotational thromboelastometry (ROTEM) values in massive and nonmassive transfusion patientsMild traumatic brain injury defined by GCS: Is it really mild?The CMAC videolaryngosocpe is superior to the glidescope for the intubation of trauma patients: a prospective analysisInjury patterns and outcome of urban versus suburban major traumaA cost-effective, readily accessible technique for progressive abdominal closureEvolution and impact of the use of pan-CT scan in a tertiary urban trauma centre: a 4-year auditAdditional and repeated CT scan in interfacilities trauma transfers: room for standardizationPediatric trauma in situ simulation facilitates identification and resolution of system issuesHospital code orange plan: there’s an app for thatDiaphragmatic rupture from blunt trauma: an NTDB studyEarly closure of open abdomen using component separation techniqueSurgical fixation versus nonoperative management of flail chest: a meta-analysisIntegration of intraoperative angiography as part of damage control surgery in major traumaMass casualty preparedness of regional trauma systems: recommendations for an evaluative frameworkDiagnostic peritoneal aspirate: An obsolete diagnostic modality?Blunt hollow viscus injury: the frequency and consequences of delayed diagnosis in the era of selective nonoperative managementEnding “double jeopardy:” the diagnostic impact of cardiac ultrasound and chest radiography on operative sequencing in penetrating thoracoabdominal traumaAre trauma patients with hyperfibrinolysis diagnosed by rotem salvageable?The risk of cardiac injury after penetrating thoracic trauma: Which is the better predictor, hemodynamic status or pericardial window?The online Concussion Awareness Training Toolkit for health practitioners (CATT): a new resource for recognizing, treating, and managing concussionThe prevention of concussion and brain injury in child and youth team sportsRandomized controlled trial of an early rehabilitation intervention to improve return to work Rates following road traumaPhone call follow-upPericardiocentesis in trauma: a systematic review. Can J Surg 2013. [DOI: 10.1503/cjs.005813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
20
|
Sisler JJ, Seo B, Katz A, Shu E, Chateau D, Czaykowski P, Wirtzfeld D, Singh H, Turner D, Martens P. Concordance with ASCO guidelines for surveillance after colorectal cancer treatment: a population-based analysis. J Oncol Pract 2012. [PMID: 23181004 DOI: 10.1200/jop.2011.000396] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
PURPOSE Intensive surveillance after curative treatment of colorectal cancer (CRC) is associated with improved overall survival. This study examined concordance with the 2005 ASCO surveillance guidelines at the population level. METHODS A cohort of 250 patients diagnosed with stage II or III CRC in 2004 and alive 42 months after diagnosis was identified from health administrative data in Manitoba, Canada. Colonoscopy, liver imaging, and carcinoembryonic antigen (CEA) testing were assessed over 3 years. Guidelines were met if patients had at least one colonoscopy in 3 years and at least one liver imaging test and three CEA tests annually. Multivariate logistic regression assessed the effect of patient and physician characteristics and disease and treatment factors on guideline concordance. RESULTS Guidelines for colonoscopy, liver imaging, and CEA were met by 80.4%, 47.2%, and 22% of patients, respectively. Guideline concordance for colonoscopy was predicted by annual contact with a surgeon, higher income, and the diagnosis of colon (rather than rectal) cancer. Adherence was lower in those older than 70 years and with higher comorbidity. For liver imaging, significant predictors were annual contact with an oncologist, receipt of chemotherapy, and diagnosis of colon cancer. Concordance with CEA guidelines was higher with annual contact with an oncologist and high levels of family physician contact, and lower in urban residents, in those older than 70, and in those with stage II disease. CONCLUSION Completion of recommended liver imaging and CEA testing fall well below guidelines in Manitoba, whereas colonoscopy is better provided. Addressing this gap should improve outcomes for CRC survivors.
Collapse
|
21
|
Decker K, Demers A, Chateau D, Musto G, Nugent Z, Lotocki R, Harrison M. Papanicolaou test utilization and frequency of screening opportunities among women diagnosed with cervical cancer. Open Med 2009; 3:e140-7. [PMID: 21603052 PMCID: PMC3090124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2007] [Revised: 06/15/2007] [Accepted: 06/26/2008] [Indexed: 11/05/2022]
Abstract
BACKGROUND Although the importance of Papanicolaou (Pap) smear test screening in reducing the incidence of cervical cancer is well established, in 1994-95 one in 4 women in Manitoba aged 18 to 69 years reported never having had a Pap test or not having had a Pap test in the last 3 years. The objectives of this study were to examine the screening history of women in Manitoba diagnosed with invasive cervical cancer and to explore whether opportunities for screening were missed. METHODS In this case-control study women aged 18 years and older who resided in Manitoba and were diagnosed with invasive cervical cancer between 1989 and 2001 were each matched by age and area of residence to 5 controls, (N = 4009). Conditional logistic regression analyses were used to examine the association between Pap test utilization and the likelihood of diagnosis with invasive cervical cancer. Generalized linear models using the negative binomial distribution were used to assess the association between cancer status and rates of prior Pap testing and of opportunities to be screened. Logistic generalized estimating equation models were used for the analysis of physician characteristics. RESULTS Forty-six percent of women in Manitoba diagnosed with invasive cervical cancer and 67% of the control group had received a Pap test in the 5 years before the case's diagnosis. After adjustment for age, income and residence, the rate of Pap testing was significantly higher in the control group (rate ratio [RR] = 1.57, 95% confidence interval [CI] 1.44-1.73). Conversely, when cervical cancer was the outcome, women who had not had Pap tests were more likely to be diagnosed with invasive cervical cancer (odds ratio [OR] = 2.77, 95% CI 2.30-3.30) than women who did have a Pap test. Although women diagnosed with invasive cervical cancer had fewer Pap tests, they had had as many opportunities to be screened as controls (RR = 1.04, 95% CI 0.96-1.12). Compared with urban family physicians, rural family physicians were less likely to provide Pap tests (OR = 0.68, 95% CI 0.58-0.80) and specialists were more likely to provide Pap tests (OR = 1.70, 95% CI 1.30-2.22). CONCLUSIONS Women who were diagnosed with invasive cervical cancer in the province of Manitoba, Canada, had fewer Pap tests but the same frequency of opportunities to be screened as matched controls. These results reinforce the need to educate women about cervical cancer screening and the importance of receiving Pap tests.
Collapse
|
22
|
Chateau D, Kauffmann MT, Aron C. Are the Amygdaloid Projections to the Hypothalamic Ventromedial Nucleus Involved in Estrous Rhythm Regulation in the Female Rat? Exp Clin Endocrinol Diabetes 2009; 83:303-9. [PMID: 6540699 DOI: 10.1055/s-0029-1210345] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The aim of this investigation was to determine whether the corticomedial amygdaloid nucleus (CMA) and its projections to the hypothalamic ventromedial nucleus (VMN) were involved in the regulation of estrous rhythm by the VMN in the rat. It is known (Carrer et al., 1973-1974) that partial VMN lesions caused the occurrence of either 5-day or alternate 4- or 5-day cycles in about 50% of 4-day cyclic female rats and that large lesions induced cycle prolongation in most of the operated animals while hypothalamic dorsomedial nucleus (DMN) lesions left estrous rhythm unmodified. CMA lesions in 4-day cyclic female rats caused the occurrence of either 5-day or alternate cycles with sequence of 4, 5, 4 days, more frequently than in their sham operated counterparts (15/20 vs 3/20). Stria terminalis (ST) lesions placed at its emergence from the CMA or at its horizontal course over the internal capsule induced a higher proportion (10/14 and 9/16, respectively) of females to display changes in cycle duration than did sham operated and unoperated controls as well (10/32 and 7/29, respectively). Combined partial VMN and ST lesions resulted in a 24 hours cycle prolongation or alternate 4- and 5-day cycles in a greater number of females than in those bearing small VMN lesions only (15/18 vs 22/40). A noticeable proportion of CMA, ST and ST + small VMN lesioned females offered more or less prolonged diestrous periods immediately following surgery before resuming estrous cyclicity. It was suggested that the CMA neurons which project fibers to the VMN via the ST are implicated in estrous rhythm regulation in the rat.
Collapse
|
23
|
Sisler JJ, McCormack-Speak P, Chateau D. Integrating primary care and the cancer system: Program evaluation of the UPCON Network in Manitoba, Canada. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.6605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
24
|
Brownell MD, Mayer T, Chateau D. The incidence of methylphenidate use by Canadian children: what is the impact of socioeconomic status and urban or rural residence? Can J Psychiatry 2006; 51:847-54. [PMID: 17195604 DOI: 10.1177/070674370605101306] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To examine socioeconomic, demographic, and behavioural factors that influence the incidence of methylphenidate use among children aged 4 to 13 years. METHOD A total of 11,316 children, aged 2 through 11 years, from Cycle 1 (1994-95) of the National Longitudinal Survey of Children and Youth were followed up 2 years later in Cycle 2 (1996-97). The outcome measure was methylphenidate use in Cycle 2. Individual-level explanatory variables included sex, age, socioeconomic status (SES), mother's age at birth of child, lone-parent family status, parental working status, and hyperactivity-impulsivity and inattention probabilities. Area-level explanatory variables included income and rural or urban residence. We used hierarchical linear modelling to examine individual- and area-level factors that predicted methylphenidate use. RESULTS The strongest predictors of methylphenidate use were behavioural: children with high hyperactive-impulsive and (or) inattention behaviours in 1994, compared with children low on these behaviours, were 4.5 to 6 times more likely to use methylphenidate 2 years later. SES remained a significant predictor of the incidence of methylphenidate use, even when other significant predictors were held constant, with lower SES being associated with higher use. Area-level income also predicted methylphenidate use. CONCLUSION Even when children with similar behavioural symptoms and demographic characteristics were compared, socioeconomic factors had a significant impact on incidence of methylphenidate use.
Collapse
|
25
|
Decker KM, Harrison M, Chateau D. Influence of direct referrals on time to diagnosis after an abnormal breast screening result. ACTA ACUST UNITED AC 2005; 28:361-7. [PMID: 15542262 DOI: 10.1016/j.cdp.2004.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2004] [Accepted: 07/06/2004] [Indexed: 10/26/2022]
Abstract
This study examined the influence of a direct referral process implemented by a population-based provincial breast screening program on the time from screening to first procedure, first procedure to diagnosis, and screening to diagnosis following an abnormal breast screening result. The direct referral process shifted the responsibility for the coordination of diagnostic follow-up procedures from the family physician to the screening program. Three cohorts of women were included: a control cohort (screened prior to the initiation of a direct referral process, n = 1347), a usual care cohort (screened after the initiation of a direct referral process but for whom permission to refer was denied by the family physician, n = 1225), and a direct referral cohort (screened after the initiation of the direct referral process and for whom permission to refer was given by the family physician, n = 1232). The direct referral cohort was subdivided into women referred to a breast health centre (BHC group) (n = 606) and women referred to a diagnostic facility (diagnostic group) (n = 626). The direct referral cohort completed all three time intervals significantly faster than the other two cohorts (P < 0.0001). The diagnostic group experienced a significantly lower time from screening to the first procedure than the other cohorts or the BHC group (P < 0.0001). However, the BHC group had a significantly lower time from first procedure to diagnosis than the other cohorts or the diagnostic group (P < 0.0001). The control and the usual care cohorts were not significantly different from each other (P = 0.6250). The direct referral process significantly reduced the time to diagnosis after an abnormal screening result.
Collapse
Affiliation(s)
- Kathleen M Decker
- Manitoba Breast Screening Program, CancerCare Manitoba, 5-25 Sherbrook St., Winnipeg, MB, Canada.
| | | | | |
Collapse
|
26
|
Kue Young T, Chateau D, Zhang M. Factor analysis of ethnic variation in the multiple metabolic (insulin resistance) syndrome in three Canadian populations. Am J Hum Biol 2002; 14:649-58. [PMID: 12203819 DOI: 10.1002/ajhb.10083] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
This study describes and compares the pattern of risk factor clustering in multiple metabolic (insulin resistance) syndrome (MMS) in three Canadian ethnic groups (Indians, Inuit, non-Aboriginal Canadians). Three cross-sectional, population-based sample surveys in three contiguous regions of Canada were conducted during the late 1980s and early 1990s (Ontario, Manitoba, Northwest Territories). The combined dataset consists of 873 Cree-Ojibwa Indians from northern Ontario and Manitoba, 387 Inuit from the Northwest Territories, and 2,670 non-Aboriginal Canadians (predominantly of European origin) in the province of Manitoba. The samples are representative of the noninstitutionalized, adult population of their respective catchment areas. Factor analysis transformed 10 anthropometric and metabolic variables into three uncorrelated factors. Three factors, which together account for 64.3% of the variance, can be identified: an "obesity factor" (factor loadings for weight, height, waist and hip girth, and HDL-cholesterol); a "blood pressure factor" (factor loadings for mean systolic and diastolic BP and total cholesterol); and a "lipid/glucose factor" (factor loadings for triglycerides, total cholesterol, HDL, and fasting plasma glucose). Fasting insulin is available for only a subset of the data and separate analysis shows that it groups with glucose. Factor scores generated by the factor analysis differ according to ethnic group, diabetes status, and sex on multivariate analysis of variance. Indians have the highest scores for all three factors. Inuit have the lowest obesity scores and are not significantly different from non-Aboriginal people with regard to the other two factors. MMS is prevalent in diverse ethnic groups but varies in the pattern of phenotypic expression, with some components more prominent in some groups.
Collapse
Affiliation(s)
- T Kue Young
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada R3E 0W3.
| | | | | |
Collapse
|
27
|
Ferreiro A, Estournet B, Chateau D, Romero NB, Laroche C, Odent S, Toutain A, Cabello A, Fontan D, dos Santos HG, Haenggeli CA, Bertini E, Urtizberea JA, Guicheney P, Fardeau M. Multi-minicore disease--searching for boundaries: phenotype analysis of 38 cases. Ann Neurol 2000; 48:745-57. [PMID: 11079538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Multi-minicore disease (MmD) is a congenital myopathy morphologically defined by the presence of multiple small zones of sarcomeric disorganization and lack of oxidative activity ("minicores") in muscle fibers. The dinical expression of MmD is considered to be greatly variable, and the morphological lesions are nonspecific; therefore, its boundaries are poorly defined, and its molecular bases are not known. To better define the phenotypic characteristics of MmD, we analyzed a large series of 38 patients with multiple minicores in muscle fibers in the absence of any other potential cause. According to clinical features, 4 subgroups were identified. Most patients (30 cases) shared a common highly consistent phenotype marked by the axial predominance of muscle weakness and a high occurrence of severe respiratory insufficiency and scoliosis ("classical" form). Other forms were characterized by pharyngolaryngeal involvement and total lack of head control (2 cases), antenatal onset with arthrogryposis (3 cases), and slowly progressive weakness with marked hand amyotrophy (3 cases). Type 1 fiber predominance and hypotrophy as well as centrally located nuclei were found in every subgroup. MmD is thus phenotypically heterogeneous, but a typical recognizable phenotype does exist. This phenotype classification should be helpful when undertaking research into the molecular defects that cause MmD.
Collapse
Affiliation(s)
- A Ferreiro
- INSERM U523/Institut de Myologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Bakker A, Barthélémy C, Frachon P, Chateau D, Sternberg D, Mazat JP, Lombès A. Functional mitochondrial heterogeneity in heteroplasmic cells carrying the mitochondrial DNA mutation associated with the MELAS syndrome (mitochondrial encephalopathy, lactic acidosis, and strokelike episodes). Pediatr Res 2000; 48:143-50. [PMID: 10926287 DOI: 10.1203/00006450-200008000-00005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Most mitochondrial DNA (mtDNA) alterations associated with human disorders are heteroplasmic, i.e. mutant mtDNA molecules coexist with normal ones within the cell. We addressed the possibility of intermitochondrial exchanges through histologic analyses of cybrid clones with increasing proportion of the MELAS (A3243G) mtDNA transfer RNA point mutation. MtDNA-dependent cytochrome c oxidase activity and protein composition as well as mitochondrial membrane potential appeared heterogeneous in individual cells from clonal heteroplasmic cell populations on the basis of confocal and electron microscopy. The number of defective cells increased with increasing mutation load. We conclude that in the presence of a heteroplasmic mtDNA mutation in the cell type that we studied, intermitochondrial molecular exchanges cannot provide an efficient even distribution of the complementing molecules such as wild-type mtDNA, transfer RNA, or protein. Mitochondria in these heteroplasmic cells cannot, therefore, be considered a single functional unit.
Collapse
Affiliation(s)
- A Bakker
- INSERM UR523, Institut de Myologie, Paris, France
| | | | | | | | | | | | | |
Collapse
|
29
|
Fardeau M, Vicart P, Caron A, Chateau D, Chevallay M, Collin H, Chapon F, Duboc D, Eymard B, Tomé FM, Dupret JM, Paulin D, Guicheney P. [Familial myopathy with desmin storage seen as a granulo-filamentar, electron-dense material with mutation of the alphaB-cristallin gene]. Rev Neurol (Paris) 2000; 156:497-504. [PMID: 10844369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Two familial cases of a myopathy remarkable by the presence of a granulo-filamentar, electron dense material were reported in 1978. In a second step, in 1988, it was demonstrated that this material contained an abnormally-phosphorylated desmin. During the last twenty years, the occurrence of new cases in this family confirmed the autosomal dominant inheritance of the disease, and made it potentially informative for molecular genetics studies. This allowed first to map the disease on chromosome11q21-23, and afterwards to identify a mutation within a gene coding for a chaperone protein, alphaBcrystallin. An extensive clinical, pathological and genetic study of this princeps family is herein reported in detail. First, it showed the possible detection of histopathological changes in presymptomatic patients. Second, it allowed to demonstrate the simultaneous occurrence of both alphaBcrystallin and desmin in the granulo-filamentar aggregates. Third, this study provided a precise knowledge of the evolution rate of the disease. The analysis of similar observations reported in the literature clearly shows the clinical, pathological and genetic heterogeneity of this new neuro-muscular disorder.
Collapse
Affiliation(s)
- M Fardeau
- Unité INSERM 523 et Institut de Myologie, Hôpital de la Salpêtrière, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Abstract
The effect of exposure to print on the efficiency of phonological and orthographic word recognition processes was examined by comparing two groups of university students having similar reading comprehension scores but different levels of exposure to print. Participants with a high level of exposure to print were faster and more accurate in naming pseudowords, in choosing the correct member of a homophone pair, and in making lexical decisions when nonwords were pseudohomophones. In the lexical decision task, low-print-exposure participants were more sensitive to the frequency of the orthographic patterns in the stimuli. The results of a form priming task demonstrated that high-print-exposure participants more quickly and strongly activated the orthographic representations of common words and subsequently more strongly activated the corresponding phonological representations. Even among successful students, differences in exposure to print produce large differences in the efficiency of both orthographic and phonological word recognition processes.
Collapse
Affiliation(s)
- D Chateau
- University of Western Ontario, London, Canada
| | | |
Collapse
|
31
|
Abstract
We report the case of a 28 year-old woman with left scapuloperoneal syndrome since the age of 24. The course was slowly progressive and diffuse weakness was observed 4 years later. Serum creatine kinase levels were moderately elevated (x3 normal value) and EMG showed mixed neurogenic and myogenic patterns. Muscle biopsy showed type I predominance and numerous reducing bodies in muscle fibers. Reducing bodies were strongly immunoreactive with antibodies to dystrophin, alpha-sarcoglycan, vimentin and ubiquitin. Desmin immunoreactivity was increased at the periphery of some reducing bodies but alphaB crystallin, alpha actinin, titin and nebulin were negative. Western blot analysis showed an increase in dystrophin, vimentin and desmin expression. Ultrastructurally, reducing bodies were composed of tubulofilamentous material, 17 nm in diameter, and immunoreactive with anti-Dys 2 antibody. Granulofilamentous material, immunoreactive with anti-desmin antibody was observed at the periphery of some reducing bodies. This report further highlights the proteinic composition of reducing bodies and shows that late onset reducing body myopathy may occur.
Collapse
Affiliation(s)
- D Figarella-Branger
- Laboratoire de Biopathologie Nerveuse et Musculaire, Faculté de Médecine, Marseille, France
| | | | | | | | | | | | | |
Collapse
|
32
|
Aissaoui A, Klingel-Schmitt I, Couderc J, Chateau D, Romagne F, Jambou F, Vincent A, Levasseur P, Eymard B, Maillot MC, Galanaud P, Berrih-Aknin S, Cohen-Kaminsky S. Prevention of autoimmune attack by targeting specific T-cell receptors in a severe combined immunodeficiency mouse model of myasthenia gravis. Ann Neurol 1999; 46:559-67. [PMID: 10514092 DOI: 10.1002/1531-8249(199910)46:4<559::aid-ana3>3.0.co;2-s] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Myasthenia gravis (MG) is an autoimmune disease targeting the skeletal muscle acetylcholine receptor. We have previously demonstrated a selection bias of CD4+ T cells expressing the Vbeta5.1 T-cell receptor gene in the thymus of HLA-DR3 patients with MG. To evaluate the pathogenicity of these cells, severe combined immunodeficiency mice engrafted with MG thymic lymphocytes were treated with anti-Vbeta5.1 antibody. Signs of pathogenicity (eg, acetylcholine receptor loss and complement deposits at the muscle end plates of chimeric mice) were prevented in anti-Vbeta5.1-treated severe combined immunodeficiency chimeras. Pathogenicity was mediated by autoantibodies against acetylcholine receptor. Thymic cells depleted of Vbeta5.1-positive cells in vitro before cell transfer were nonpathogenic, indicating that Vbeta5.1-positive cells are involved in the production of pathogenic autoantibodies. Acetylcholine receptor loss was prevented by Vbeta5.1 targeting in HLA-DR3 patients only, demonstrating specificity for HLA-DR3-peptide complexes. The action of the anti-Vbeta5.1 antibody involved both the in vivo depletion of Vbeta5.1-expressing cells and an increase in the interferon-gamma/interleukin-4 ratio, pointing to an immune deviation-based mechanism. This demonstration that a selective and specific T-helper cell population is involved in controlling pathogenic autoantibodies in MG holds promise for the treatment of MG.
Collapse
Affiliation(s)
- A Aissaoui
- CNRS ESA 8078, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Donger C, Krejci E, Serradell AP, Eymard B, Bon S, Nicole S, Chateau D, Gary F, Fardeau M, Massoulié J, Guicheney P. Mutation in the human acetylcholinesterase-associated collagen gene, COLQ, is responsible for congenital myasthenic syndrome with end-plate acetylcholinesterase deficiency (Type Ic). Am J Hum Genet 1998; 63:967-75. [PMID: 9758617 PMCID: PMC1377491 DOI: 10.1086/302059] [Citation(s) in RCA: 125] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Congenital myasthenic syndrome (CMS) with end-plate acetylcholinesterase (AChE) deficiency is a rare autosomal recessive disease, recently classified as CMS type Ic (CMS-Ic). It is characterized by onset in childhood, generalized weakness increased by exertion, refractoriness to anticholinesterase drugs, and morphological abnormalities of the neuromuscular junctions (NMJs). The collagen-tailed form of AChE, which is normally concentrated at NMJs, is composed of catalytic tetramers associated with a specific collagen, COLQ. In CMS-Ic patients, these collagen-tailed forms are often absent. We studied a large family comprising 11 siblings, 6 of whom are affected by a mild form of CMS-Ic. The muscles of the patients contained collagen-tailed AChE. We first excluded the ACHE gene (7q22) as potential culprit, by linkage analysis; then we mapped COLQ to chromosome 3p24.2. By analyzing 3p24.2 markers located close to the gene, we found that the six affected patients were homozygous for an interval of 14 cM between D3S1597 and D3S2338. We determined the COLQ coding sequence and found that the patients present a homozygous missense mutation, Y431S, in the conserved C-terminal domain of COLQ. This mutation is thought to disturb the attachment of collagen-tailed AChE to the NMJ, thus constituting the first genetic defect causing CMS-Ic.
Collapse
Affiliation(s)
- C Donger
- INSERM U153, Group Hospitalier Pitié-Salpêtrière, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Abstract
A distal myopathy characterised by an autosomal dominant inheritance, with clinical onset around the age of 60, early involvement of posterior leg and thigh muscles, and normal or slightly-elevated creatine kinase levels was identified in three members of a French kindred. Tibialis anterior muscles were involved only in the most severely-affected sibling. Histological features included large multiple nonrimmed vacuolation and focal intrasarcoplasmic masses which immunoreacted with the anti-desmin antibody. Cytoplasmic and intranuclear tubulofilamentous inclusions were observed by electron microscopy. The condition of this familial syndrome is discussed in relation to previously-identified autosomal dominant distal myopathies and inclusion body myopathies.
Collapse
|
35
|
Vicart P, Caron A, Guicheney P, Li Z, Prévost MC, Faure A, Chateau D, Chapon F, Tomé F, Dupret JM, Paulin D, Fardeau M. A missense mutation in the alphaB-crystallin chaperone gene causes a desmin-related myopathy. Nat Genet 1998; 20:92-5. [PMID: 9731540 DOI: 10.1038/1765] [Citation(s) in RCA: 787] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Desmin-related myopathies (DRM) are inherited neuromuscular disorders characterized by adult onset and delayed accumulation of aggregates of desmin, a protein belonging to the type III intermediate filament family, in the sarcoplasma of skeletal and cardiac muscles. In this paper, we have mapped the locus for DRM in a large French pedigree to a 26-cM interval in chromosome 11q21-23. This region contains the alphaB-crystallin gene (CRYAB), a candidate gene encoding a 20-kD protein that is abundant in lens and is also present in a number of non-ocular tissues, including cardiac and skeletal muscle. AlphaB-crystallin is a member of the small heat shock protein (shsp) family and possesses molecular chaperone activity. We identified an R120G missense mutation in CRYAB that co-segregates with the disease phenotype in this family. Muscle cell lines transfected with the mutant CRYAB cDNA showed intracellular aggregates that contain both desmin and alphaB-crystallin as observed in muscle fibers from DRM patients. These results are the first to identify a defect in a molecular chaperone as a cause for an inherited human muscle disorder.
Collapse
Affiliation(s)
- P Vicart
- Institut Pasteur, Paris, France.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Uyama E, Uchino M, Chateau D, Tomé FM. Autosomal recessive oculopharyngodistal myopathy in light of distal myopathy with rimmed vacuoles and oculopharyngeal muscular dystrophy. Neuromuscul Disord 1998; 8:119-25. [PMID: 9608566 DOI: 10.1016/s0960-8966(98)00002-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We investigated two Japanese siblings presenting with oculopharyngodistal myopathy, whose healthy parents were consanguineous. To clarify their disease characteristics, we compared them with four patients with distal myopathy with rimmed vacuoles linked to chromosome 9p1-q1, and 36 patients with oculopharyngeal muscular dystrophy linked to 14q11.2-q13. The first symptom in the patients with autosomal recessive oculopharyngodistal myopathy was weakness of the tibialis anterior muscle. Their biceps muscles showed initial and advanced myogenic changes, with rimmed vacuoles in 3% and 6% of the muscle fibers, respectively. In contrast, patients with distal myopathy with rimmed vacuoles revealed many rimmed vacuoles, on average in 20% of the fibers, and their oculopharyngeal muscles were spared. None of the patients with oculopharyngeal muscular dystrophy showed distal dominant weakness and the occurrence of rimmed vacuoles was rare. Ultrastructural studies in groups of autosomal recessive oculopharyngodistal myopathy and distal myopathy with rimmed vacuoles disclosed a collection of cytoplasmic filaments of 16-18 nm, but oculopharyngeal muscular dystrophy-specific intranuclear inclusions of 8.5 nm were not found. Thus, the phenotype of autosomal recessive oculopharyngodistal myopathy is distinct from distal myopathy with rimmed vacuoles and oculopharyngeal muscular dystrophy, but shares some ultrastructural characteristics with distal myopathy with rimmed vacuoles and hereditary inclusion body myopathy.
Collapse
Affiliation(s)
- E Uyama
- Department of Neurology, Kumamoto University School of Medicine, Japan.
| | | | | | | |
Collapse
|
37
|
Abstract
The study of muscle biopsies of 29 cases of oculopharyngeal muscular dystrophy (OPMD) showed the two main morphological features of this disease: rimmed vacuoles (in 26 cases) and intranuclear inclusions (in all cases). These inclusions are made of 8.5 nm tubular filaments and the areas occupied by them are lighter than the surrounded nucleoplasm. This can be seen by light microscopy, facilitating the detection of the tubulo-filamentous inclusions which can only be identified with certitude by electron microscopy. In a given ultrathin section the area occupied by these inclusions varied from 2% to 5% of the nuclei. The intranuclear inclusions are the morphological marker of OPMD and their finding in a muscle biopsy allows the exact diagnosis of this disease. The origin and biochemical nature of the intranuclear inclusions is unknown.
Collapse
Affiliation(s)
- F M Tomé
- Unité de Recherche de Développement, Pathologie et Régénération Neuromusculaires, INSERM U. 153, Hôpital de la Salpêtrière, Paris, France
| | | | | | | |
Collapse
|
38
|
Abstract
Oculopharyngeal muscular dystrophy (OPMD) in the European population has been frequently diagnosed, but except for one black family, the occurrence in other ethnic groups is uncertain. We identified two unrelated OPMD Japanese families, including 34 affected individuals. Major clinical manifestations were bilateral ptosis and dysphagia starting after age 40. Histologic studies of limb muscles revealed mild myogenic changes, occasional rimmed vacuoles, and small angulated fibers. By contrast, cricopharyngeal muscle showed a marked loss of fibers and massive proliferation of connective tissue. Intranuclear tubulofilamentous inclusions (ITFI) of 8.5 nm outer diameter were observed in 2-5% of the nuclei in four different biopsied muscles. One patient with recurrent aspirations underwent successful cricopharyngeal myotomy. Aerodynamic examination was useful to evaluate velopharyngeal closure function. Our investigations revealed that OPMD is a geographically widespread disorder, and ITFI may be the specific morphologic hallmark.
Collapse
Affiliation(s)
- E Uyama
- Department of Neurology, Kumamoto University School of Medicine, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Abstract
In rats, vaginal epithelium shows cyclic changes with an alternating pattern of keratinization under estrogen control and mucification under progesterone control. Since retinoids suppress keratinizing differentiation, in this paper we studied the expression of the major retinoid receptors normally present in keratinizing squamous epithelia: RAR alpha, RAR gamma and RXR alpha. In cyclic rats and steroid-treated ovariectomized rats, RXR alpha and RAR gamma were detected in basal and suprabasal cells while RAR alpha was mainly localized in suprabasal cells. No changes in RAR gamma expression were observed in correlation with ovarian steroids. During diestrus and in ovariectomized rats, the superficial cuboid cells expressed the three receptors. In the uterine epithelium, RAR alpha, RAR gamma and RXR alpha expression was induced by estrogens. Retinoic acid treatment did not modify retinoid receptor expression in vaginal and uterine epithelia. These data suggest specific roles for the different receptors in the complex process of vaginal epithelium proliferation and differentiation under estrogens and retinoic acid control.
Collapse
Affiliation(s)
- N Boehm
- Institut d'Histologie, Faculté de Médecine, Strasbourg, France
| | | | | |
Collapse
|
40
|
Uyama E, Tokunaga M, Chateau D, Tomé F, Brais B, Uchino M. Autosomal recessive oculopharyngodistal myopathy in a Japanese family: investigations in light of distal myopathy with rimmed vacuoles and OPMD. Neuromuscul Disord 1997. [DOI: 10.1016/s0960-8966(97)87309-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
41
|
Laforêt P, Eymard B, Lombès A, Duboc D, Jehenson P, Rocchiccioli F, Chaussain M, Chateau D, Brunet P, Fardeau M. [Exercise intolerance caused by muscular phosphorylase kinase deficiency. Contribution of in vivo metabolic studies]. Rev Neurol (Paris) 1996; 152:458-64. [PMID: 8944243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A 33 year old man has been presenting since childhood an exertional muscle pain syndrome without myoglobinuria. Muscle biopsy revealed a vacuolar myopathy with glycogen excess in subsarcolemmal and intermyofibrillar spaces which was confirmed by electron microscopy. Plasma production of ammonia was abnormally high during exercise on a bicycle ergometer while the raise of lactate was normal. NMR spectroscopy showed an increased muscle glycogen content, with a slight and delayed drop of the pH during exercise. Phosphorylase b kinase activity was undetectable in muscle specimen whereas activities of others enzymes of carbohydrate metabolism were normal. Clinical presentation of our patient is compared to that of the reported cases of phosphorylase b kinase deficiency.
Collapse
Affiliation(s)
- P Laforêt
- Service de Neurologie (Pr Brunet), Hôpital de la Salpêtrière, Paris
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Chateau D, Boehm N. Regulation of differentiation and keratin 10 expression by all-trans retinoic acid during the estrous cycle in the rat vaginal epithelium. Cell Tissue Res 1996; 284:373-81. [PMID: 8646757 DOI: 10.1007/s004410050598] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In rodents, the vaginal epithelium shows cyclic changes with an alternating pattern of keratinization under estrogen control and mucification under progesterone control. Retinoids are powerful regulators of cell differentiation, an excess of retinoids suppressing the keratinizing differentiation of keratinocytes. Here, we have examined the vaginal epithelium during the estrous cycle and compare the effects of retinoids on both types of hormonally induced differentiation, i.e. keratinization and mucification. All-trans retinoic acid was administered either by daily injections during the estrous cycle or by a single injection before the estrogen rise; these two protocols gave similar results. Retinoic acid suppressed estrogen-induced vaginal keratinization and cytokeratin K10 expression (a biochemical marker of terminal differentiation). Progesterone-induced mucification was not impaired; however, retinoic acid impeded mucous cell desquamation, suggesting an effect of retinoic acid on cell adhesiveness. Retinoic acid induced the appearance of apoptotic-like cells, as revealed by immunocytochemical staining of DNA fragmentation.
Collapse
Affiliation(s)
- D Chateau
- Institut d'Histologie, Faculté de Médecine, Strasbourg, France
| | | |
Collapse
|
43
|
Uyama E, Nohira O, Chateau D, Tokunaga M, Uchino M, Okabe T, Ando M, Tome FM. Oculopharyngeal muscular dystrophy in two unrelated Japanese families. Neurology 1996; 46:773-8. [PMID: 8618681 DOI: 10.1212/wnl.46.3.773] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The occurrence of oculopharyngeal muscular dystrophy (OPMD) in Orientals is uncertain. We identified two unrelated Japanese families, including 30 affected individuals (14 men, 16 women, mean age 58 years) of OPMD through four generations, with complete penetrance. Their major clinical manifestations were late-onset bilateral ptosis and dysphagia. Histologic studies of slightly affected muscles reveal mild myogenic changes, occasional rimmed vacuoles, and small angulated fibers. By contrast, the severely involved cricopharyngeal muscle showed marked loss of fibers and massive proliferation of connective tissue. Ultrastructural studies of four different biopsied muscles disclosed subsarcolemmal intranuclear tubulofilamentous inclusions, identical to those of non-Japanese OPMD patients.
Collapse
Affiliation(s)
- E Uyama
- Department of Neurology, Kumamoto University School of Medicine, Kumamoto, Japan
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Chateau D, Geiger JM, Samama B, Boehm N. Vaginal keratinization during the estrous cycle in rats: a model for evaluating retinoid activity. Skin Pharmacol 1996; 9:9-16. [PMID: 8868028 DOI: 10.1159/000211385] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A model is described for evaluating the activity of a retinoid based on its effect on the keratinization of the vaginal epithelium that occurs on estrus (day 4) of a 4-day cycle in female rats. This keratinization process is dependent on the endogenous estradiol (E2) secreted between the evening of diestrus 2 (day 2) and that of proestrus (day 3). Various doses of all-transretinoic acid (tRA) were injected at different time points during the estrous cycle and the vaginal keratinization was assessed by microscope examination of unstained native or Papanicolaou-stained smear preparations. Additionally, the preovulatory E2 secretion was measured and ovaries were histologically examined. A single injection of 10 mg/kg tRA either on diestrus 2 (evening) or on proestrus (early morning) was able to induce a complete inhibition of the vaginal keratinization in more than 80% of the cases. This can be considered as a direct effect on the vaginal epithelial differentiation since neither the E2 secretion nor the ovulatory process were affected. The inhibition of vaginal keratinization can be used as a rapid and convenient in vivo model for screening retinoid candidates with antikeratinizing activity.
Collapse
Affiliation(s)
- D Chateau
- Institute of Histology, Faculty of Medicine, Strasbourg, France
| | | | | | | |
Collapse
|
45
|
Uyama E, Uchino M, Ando M, Chateau D, Tomé FM. [Oculopharyngeal muscular dystrophy specific intranuclear tubulofilamentous inclusions]. Rinsho Shinkeigaku 1995; 35:817-8. [PMID: 8777812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
46
|
Villanova M, Louboutin JP, Chateau D, Eymard B, Sagniez M, Tomé FM, Fardeau M. X-linked vacuolated myopathy: complement membrane attack complex on surface membrane of injured muscle fibers. Ann Neurol 1995; 37:637-45. [PMID: 7755359 DOI: 10.1002/ana.410370514] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We describe a probable recessive X-linked myopathy characterized by the presence of vacuolated muscle fibers. Four males and their shared maternal grandfather were affected. Clinical characteristics include juvenile onset, very slow progression, and predominant proximal muscle involvement. The clinical picture and the morphological findings are compared with those previously described in a family. By immunofluorescence, all histologically abnormal muscle fibers, in particular those vacuolated, showed a strong deposition of the complement C5b-9 membrane attack complex over the whole muscle fiber surface. Weak immunostaining for membrane attack complex was also found in endomysial capillaries and perimysial vessel walls. Muscle fibers showed sarcolemmal immunolabeling with anti-major histocompatibility complex I, which was also present on the margins of many vacuoles. All vacuoles were stained by antidystrophin antibody, which colocalized in most of them with antilaminin immunostaining. Taken together, these results suggest that the deposition of membrane attack complex on the damaged cell surface membrane could be important in the pathogenesis of this muscle disorder, and that the membrane-bounded vacuoles could be a consequence of sarcolemmal invagination.
Collapse
|
47
|
Abstract
Expression of NADPH-diaphorase (NADPH-d) was studied in the rat telencephalon and diencephalon from embryonic day 15 (E15) to postnatal day 30 (P30). The study has focused on the first appearance of NADPH-d staining in some areas which show high expression during adult life. The time of appearance ranged from E15 to the first days following birth, depending on the location of the cells. In many regions, neuronal processes, when staining appeared, were observed in close relationship with cerebral vessels. A possible role for nitric oxide in brain development should be explored.
Collapse
Affiliation(s)
- B Samama
- Institut d'Histologie, Faculté, de Médecine, Strasbourg, France
| | | | | |
Collapse
|
48
|
Chateau D, Aron C. Peripheral anosmia and display of lordosis behaviour in the male rat. Behav Processes 1990; 22:33-40. [DOI: 10.1016/0376-6357(90)90005-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/1990] [Indexed: 10/27/2022]
|
49
|
Abstract
The aim of the experiment was to study the effects of stereotaxic lesions of the anterior and the posterior regions of the corticomedial amygdaloid nucleus (CMN) on the display of lordosis behavior by the male rat. Animals were orchidectomized as adults and given estradiol benzoate and progesterone (P) sequentially. Sexual behavior testing was performed by 9 +/- 1 hr after P injection. Lesions placed into the posterior region of the CMN significantly decreased the proportion of animals showing lordosis behavior as compared to sham-operated and control animals. By contrast lesions in the anterior region of the CMN did not cause any changes in the proportion of animals displaying lordosis but markedly increased the lordosis quotient (LQ) of responding animals. The CMN was then concluded to exert a dual control in the display of lordosis behavior in the male rat with a posterior region regulating the willingness of animals to display lordosis behavior and rostral region subserving inhibitory mechanisms related to the sexual performance (LQ values).
Collapse
Affiliation(s)
- D Chateau
- Institute of Histology, Faculty of Medicine, University Louis Pasteur, Strasbourg, France
| | | |
Collapse
|
50
|
Abstract
Previous studies showed that different amygdaloid nuclei are involved in the control of lordosis behavior in female rats. The objective of the present study was to determine whether these nuclei played a role in the control of lordosis behavior in the male rat. Lesions were placed into different amygdaloid nuclei in male rats castrated as adults and primed with ovarian hormones. Lesions in the corticomedial amygdaloid nucleus completely suppressed lordosis behavior as expressed by the number of animals displaying lordosis responses to male mounts. By contrast extended lesions placed into the lateral amygdaloid nucleus (LN) remained without effects. Lesions placed in the very posterior part of the LN produced "hypersexuality" with a rise in the number of animals displaying lordosis responses and high LQ values. Lesions in the anterior part of the LN induced a decrease in the number of animals showing lordosis responses. The amygdala was then concluded to represent a functionally heterogeneous structure with different regions exerting opposite effects on the display of lordosis behavior in the male rat.
Collapse
Affiliation(s)
- D Chateau
- Institute of Histology, Faculty of Medicine, University Louis Pasteur, Strasbourg, France
| | | |
Collapse
|