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Verma A.,Regina QuAppelle Health Region | St. Onge J.,Research and Performance Support | Dhillon K.,Prostate Assessment Center | Chorneyko A.,Prostate Assessment Center
Canadian Journal of Urology | Year: 2014

Introduction: Prostate-specific antigen (PSA) and the digital rectal exam (DRE) have moderate sensitivity but low specificity for cancer diagnosis, potentially causing unnecessary treatment complications with prostate biopsy. Transrectal ultrasound (TRUS) to evaluate prostate size and calculate PSA density can improve the specificity of PSA in predicting cancer. We evaluated the sensitivity and specificity of different pre-biopsy tests to detect prostate cancer. Materials and methods: Pre-biopsy data were collected from 521 men referred for biopsy from January-December 2011 and cancer aggressiveness data from 96 men who had radical prostatectomy. Model predictors included total PSA, DRE, the ratio of free to total PSA (PSAf/t), and PSA density. We used logistic regression and ROC curve analyses to compare the accuracy of different models to predict positive biopsy. Results: The area under the curve (AUC) for model A (PSA total, DRE, PSAf/t) was moderate, but significant (AUC = .59, p < .05); only PSAf/t was a significant independent predictor of positive biopsy (OR = .002, p < .05). In model B (PSAf/t and PSA density; AUC= .66, p < .05), PSA density was the only strong predictor (OR = 1067.93, p < .05). Both models had comparable sensitivity (74% versus 72%) but model B had greater specificity (44% versus 61%). PSA density was also a significant predictor of different indices of aggressive cancer. Conclusions: PSA density has discriminative predictive power for prostate cancer. It had similar sensitivity, but greater specificity compared to using PSA total, DRE and PSAf/t. These results support the value of using PSA density to improve prediction of prostate cancer and reduce unnecessary biopsies. © The Canadian Journal of Urology™.


Young F.,Surrey Memorial Hospital | Bolt J.,Regina quAppelle Health Region
Journal of Clinical Pharmacy and Therapeutics | Year: 2013

What is known and objective Complementary medicines are commonly used by many patients. Caesium, a complementary therapy said to be of benefit for cancer treatment, has been associated with cardiac arrhythmias in the literature. We report a case of caesium-induced torsades de pointes and provide an evidence review. Case summary A 46-year-old woman with syncope experienced torsades de pointes and cardiac arrest. Upon admission her QTc was 620 ms. The patient had taken caesium carbonate 10 g daily for 1 month prior to admission. The patient was successfully resuscitated and discharged home after 35 days in hospital. What is new and conclusion Ten cases of caesium-induced cardiac arrhythmias have previously been reported in the literature. Treatment strategies differed significantly among the cases. However, all patients recovered from the event. Complementary and alternative medicines should not be overlooked as a potential cause of serious adverse events. © 2013 Blackwell Publishing Ltd.


Fenton T.R.,University of Calgary | Nasser R.,Regina QuAppelle Health Region | Eliasziw M.,Tufts University | Kim J.H.,University of California at San Diego | And 2 more authors.
BMC Pediatrics | Year: 2013

Background: Current fetal-infant growth references have an obvious growth disjuncture around 40 week gestation overlapping where the fetal and infant growth references are combined. Graphical smoothening of the disjuncture to connect the matching percentile curves has never been validated. This study was designed to compare weight gain patterns of contemporary preterm infants with a fetal-infant growth reference (derived from a meta-analysis) to validate the previous smoothening assumptions and inform the revision of the Fenton chart.Methods: Growth and descriptive data of preterm infants (23 to 31 weeks) from birth through 10 weeks post term age were collected in three cities in Canada and the USA between 2001 and 2010 (n = 977). Preterm infants were grouped by gestational age into 23-25, 26-28, and 29-31 weeks. Comparisons were made between the weight data of the preterm cohort and the fetal-infant growth reference.Results: Median weight gain curves of the three preterm gestational age groups were almost identical and remained between the 3rd and the 50th percentiles of the fetal-infant-growth-reference from birth through 10 weeks post term. The growth velocity of the preterm infants decreased in a pattern similar to the decreased velocity of the fetus and term infant estimates, from a high of 17-18 g/kg/day between 31-34 weeks to rates of 4-5 g/kg/day by 50 weeks in each gestational age group. The greatest discrepancy in weight gain velocity between the preterm infants and the fetal estimate was between 37 and 40 weeks; preterm infants grew more rapidly than the fetus. The infants in this study regained their birthweight earlier compared to those in the 1999 National Institute of Child Health and Human Development report.Conclusion: The weight gain velocity of preterm infants through the period of growth data disjuncture between 37 and 50 weeks gestation is consistent with and thus validates the smoothening assumptions made between preterm and post-term growth references. © 2013 Fenton et al.; licensee BioMed Central Ltd.


Jabs C.,Regina QuAppelle Health Region | Carleton E.,Saint Mary's University, Halifax
Journal of Obstetrics and Gynaecology Canada | Year: 2013

Objective: To determine the efficacy of intradetrusor injections of botulinum toxin A for non-neurogenic urinary urge incontinence. Methods: We conducted a six-month, randomized, double-blind controlled trial involving women with urinary urge incontinence. Participants received intradetrusor injections of either botulinum toxin (100U in 10 mL) via cystoscopy or a placebo control (saline injection). The primary outcome was maximum bladder capacity at cystoscopy. Secondary outcomes included quality-of-life measures, 24-hour leakage rate, patients' subjective assessment, and safety data. Results: There were 21 participants: 11 in the botulinum toxin (treated) group and 10 in the placebo (control) group. There were no significant differences between the groups at baseline. After six months the mean maximum bladder capacity at cystoscopy was 161.6 mL greater in the treated group than in the control group (P. =. 0.018). There were no differences in diary data or quality-of- life measures. The 24-hour pad test (a measure of leakage) after three months showed significant improvement in the treated group (difference 272.12 g, P. =. 0.016); treated subjects also showed subjective benefit at three months (difference 1.29, P. =. 0.007) and at six months (difference 1.16, P. =. 0.01). There was no significant difference in rates of urinary tract infection between groups. There was one serious adverse event (a perioperative cardiac event) in the botulinum toxin group. Conclusion: Botulinum toxin increased bladder capacity at cystoscopy and reduced urinary incontinence on 24-hour pad testing in adult females with urinary urge incontinence. There was one adverse event in the group treated with botulinum toxin. © 2013 Society of Obstetricians and Gynaecologists of Canada.


Carleton R.N.,University of Regina | Thibodeau M.A.,University of Regina | Teale M.J.N.,University of Regina | Welch P.G.,University of Regina | And 3 more authors.
PLoS ONE | Year: 2013

Background: The Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977) is a commonly used freely available self-report measure of depressive symptoms. Despite its popularity, several recent investigations have called into question the robustness and suitability of the commonly used 4-factor 20-item CES-D model. The goal of the current study was to address these concerns by confirming the factorial validity of the CES-D. Methods and Findings: Differential item functioning estimates were used to examine sex biases in item responses, and confirmatory factor analyses were used to assess prior CES-D factor structures and new models heeding current theoretical and empirical considerations. Data used for the analyses included undergraduate (n = 948; 74% women), community (n = 254; 71% women), rehabilitation (n = 522; 53% women), clinical (n = 84; 77% women), and National Health and Nutrition Examination Survey (NHANES; n = 2814; 56% women) samples. Differential item functioning identified an item as inflating CES-D scores in women. Comprehensive comparison of the several models supported a novel, psychometrically robust, and unbiased 3-factor 14-item solution, with factors (i.e., negative affect, anhedonia, and somatic symptoms) that are more in line with current diagnostic criteria for depression. Conclusions: Researchers and practitioners may benefit from using the novel factor structure of the CES-D and from being cautious in interpreting results from the originally proposed scale. Comprehensive results, implications, and future research directions are discussed. © 2013 Carleton et al.


Ong-Tone L.,Regina quAppelle Health Region | Bell A.,Regina quAppelle Health Region | Tan Y.Y.,Regina quAppelle Health Region
Canadian Journal of Ophthalmology | Year: 2011

Objective: To establish the cataract surgery practice patterns of the members of the Canadian Ophthalmological Society (COS). Study Design: Web-based questionnaire. Methods: In January 2010, an email with a link to SurveyMonkey was sent from the COS office to its 305 members who had indicated their practice focus is cataract surgery. A reminder email was sent 2 weeks later. All responses were collected anonymously. Results: There was a 32.5% response rate (99 responses), compared with 20.7% in 2009. Two respondents volunteered that they no longer performed cataract surgery and 1 response was incomplete; therefore, 96 responses were analyzed. The results of the 2010 survey were compared to those of the 2009 survey. Conclusions: While the majority of the practice patterns analyzed were unchanged between the 2009 and 2010 surveys, there appears to be a trend to start nonsteroidal anti-inflammatory drug eye drops earlier preoperatively and an increase in the use of one-piece hydrophobic acrylic, aspheric, and blue-blocking intraocular lenses. The use of the fourth generation fluoroquinolone antibiotic gatifloxacin has increased at the expense of older antibiotics.


Duggleby W.,University of Alberta | Doell H.,Saskatchewan Cancer Agency | Cooper D.,Regina QuAppelle Health Region | Thomas R.,University of Ottawa | Ghosh S.,University of Alberta
Cancer Nursing | Year: 2014

Background: The quality of life of male spouses of partners with breast cancer may determine the support they are able to give their wives. Little is known about the factors associated with their quality of life. Objective: The purpose of this study was to examine the relationship of the quality of life of male spouses of partners with breast cancer with the following factors: (a) demographic variables of male spouses and their partners, (b) levels of hope of male spouses and their partners, (c) self-efficacy and loss and grief of male spouses, and (d) quality of life of partners with breast cancer. Methods: Six hundred surveys were mailed to women with breast cancer (stage 1-3) and their male spouses. A total of 110 surveys were completed. Results: With the use of generalized linear modeling, participating male spouses with higher quality of life scores: (a) were older (P = .01), (b) had higher hope scores (P = .01), (c) had lower feelings of guilt scores (P < .01) (subscale of loss and grief), (d) had higher general self-efficacy scores (P < .01), and (e) had partners with breast cancer with higher quality of life scores (P < .01). Conclusions: Hope, self-efficacy, feelings of guilt, age, and their partners' quality of life were significantly related to quality of life of the male spouses of women with breast cancer. Implications for practice: The findings underscore the importance of assessing for and fostering hope and self-efficacy as well as decreasing guilt in male spouses of women with breast cancer to improve their quality of life. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Rehman H.U.,Regina quAppelle Health Region
Canadian Respiratory Journal | Year: 2012

Birt-Hogg-Dubé syndrome is an autosomal dominant genodermatosis caused by germline mutations in the folliculin gene and characterized by facial papules, pulmonary cysts, kidney tumours and recurrent pneumothoraces. Several distinct mutations in the folliculin gene resulting in a truncated protein have been described. The present report describes a new mutation, which has not been reported in individuals with Birt-Hogg- Dubé syndrome but is of a type predicted to cause disease. ©2012 Pulsus Group Inc. All rights reserved.


Ong-Tone L.,Regina quAppelle Health Region | Bell A.,Regina quAppelle Health Region | Tan Y.Y.,Regina quAppelle Health Region
Canadian Journal of Ophthalmology | Year: 2012

Objective: To establish the practice patterns of the members of the Canadian Ophthalmological Society (COS) in cataract surgery. Design: Web-based questionnaire. Participants: Members of the COS indicating practice focus to be cataract surgery. Methods: In January 2011 an e-mail with a link to Fluid Surveys was sent from the COS office to the 292 members who had indicated their practices' focus to be cataract surgery. A reminder e-mail was sent 3 weeks later. Approval for the survey was obtained from the Regina Qu'Appelle Health Region Research Ethics Board. All responses were collected anonymously. Results: There were 92 responses (31.5%). In 2009, the response rate was 20.7%, and in 2010 it was 32.5%. The results of the 3 surveys were compared. There was a gradual increase in the use of topical-only anaesthesia, in the number of days during which the nonsteroidal anti-inflammatory drug (NSAID) eye drops were used preoperatively, and in the use of multifocal and toric intraocular lenses. Postoperatively, the use of an NSAID eye drop alone remained unchanged, but there was a decrease in the use of steroid eye drops alone and a corresponding increase in the use of a combination steroid and NSAID eye drop. Conclusions: Over the past 3 years the majority of the practice patterns in cataract surgery by the members of the Canadian Ophthalmological Society have remained unchanged. However, there were certain areas where definite trends were noted. © 2012 Canadian Ophthalmological Society.


Duggleby W.,University of Alberta | Ghosh S.,University of Alberta | Cooper D.,Regina quAppelle Health Region | Dwernychuk L.,Saskatchewan Cancer Agency
Journal of Pain and Symptom Management | Year: 2013

Context: Hope is important to cancer patients as it helps them deal with their diagnosis. Little is known about hope in newly diagnosed cancer patients. Objectives: Based on the Transcending Possibilities conceptual model of hope, the purpose of this study was to examine the relationship of hope with pain, energy, and psychological and demographic characteristics in newly diagnosed adult oncology outpatients. Methods: Data from 310 New Patient Assessment Forms from cancer outpatients' health records were collected. Health records from the first six months of 2009 were reviewed and data were collected on hope, energy, pain, depression, anxiety, feeling overwhelmed, and demographic variables. A generalized linear modeling approach was used to study the relationship of hope scores with these variables. Hypothesized variables and variables that were significant at the P = 0.01 level from the univariate analysis were entered into the multivariate model, with hope scores as the dependent variable. Results: Hope scores were significantly negatively related to age (P = 0.02). More specifically, oncology patients who were 65 years of age or older had significantly less hope than those under the age of 65 years (P = 0.01). Gender (P = 0.009) also was a significant factor, with men having higher hope scores than women. No other variables were significant. Conclusion: Older adults comprise the majority of persons in Canada with cancer. The lower hope scores found in this age group compared with their younger counterparts underscore the importance of further research. This study provides a foundation for future research in this important area for oncology patients. © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

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