Windsor Regional Hospital

Windsor, Canada

Windsor Regional Hospital

Windsor, Canada
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Ferraiuolo R.-M.,University of Windsor | Tubman J.,University of Windsor | Tubman J.,Acenzia Inc | Sinha I.,Acenzia Inc | And 3 more authors.
Oncotarget | Year: 2017

The Ras/Raf/MEK/ERK pathway conveys growth factor and mitogen signalling to control the phosphorylation of a plethora of substrates regulating proliferation, survival, and migration. The Ras signalling pathway is frequently associated with poor prognosis and drug resistance in various cancers including those of the blood, breast and prostate. Activation of the downstream effector ERK does not always occur via a linear cascade of events; complicating the targeting of this pathway therapeutically. This work describes a novel positive feedback loop where the cell cycle regulatory factor Spy1 (RINGO; gene SPDYA) activates ERK1/2 in a MEK-independent fashion. Spy1 was originally isolated for the ability to stimulate Xenopus oocyte maturation via a MAPK-signalling pathway and is known to override apoptosis triggered by the DNA damage response. We demonstrate that mammalian Spy1-mediated ERK activation increases ligand-independent phosphorylation and activation of estrogen receptor a, correlating with a decrease in tamoxifen sensitivity. This could define a novel druggable mechanism driving proliferation and resistance in select cancers.

Jasra S.K.,University of Windsor | Badian C.,University of Windsor | Macri I.,Windsor Regional Hospital | Ra P.,Windsor Regional Hospital
Journal of Forensic Sciences | Year: 2012

The diagnosis of early myocardial infarction (MI) after death, especially in the first few hours (c. 6h) after the onset of MI, poses a challenge to the forensic pathologists. During this time, the damaged myocardium does not show grossly identifiable morphological changes and may not be recognized even with routine histological microscopic examination. However, the infarcted cardiac tissue releases certain chemicals that can be detected microscopically, two of these being cardiac troponin-I (CT-I) and complement C9 (C9). This study utilizes the importance of these two biomarkers immunohistochemically in an attempt to identify this early phase of MI. This study reveals that the early phase of MI of <6h duration may be detected through immunohistochemical staining with CT-I and C9. The ischemic/infarcted cardiac myofibers in the <6h group display reduced/absent CT-I staining as well as positive C9 staining. © 2012 American Academy of Forensic Sciences.

Ward A.,University of Windsor | Morettin A.,University of Windsor | Shum D.,Windsor Regional Hospital | Hudson J.W.,University of Windsor
BMC Cancer | Year: 2011

Background: Hepatocellular carcinoma (HCC), one of the most common cancers world-wide occurs twice as often in men compared to women. Predisposing conditions such as alcoholism, chronic viral hepatitis, aflatoxin B1 ingestion, and cirrhosis all contribute to the development of HCC.Methods: We used a combination of methylation specific PCR and bisulfite sequencing, qReal-Time PCR (qPCR), and Western blot analysis to examine epigenetic changes for the Polo-like kinases (Plks) during the development of hepatocellular carcinoma (HCC) in Plk4 heterozygous mice and murine embryonic fibroblasts (MEFs).Results: Here we report that the promoter methylation of Plk4 CpG islands increases with age, was more prevalent in males and that Plk4 epigenetic modification and subsequent downregulation of expression was associated with the development of HCC in Plk4 mutant mice. Interestingly, the opposite occurs with another Plk family member, Plk1 which was typically hypermethylated in normal liver tissue but became hypomethylated and upregulated in liver tumours. Furthermore, upon alcohol exposure murine embryonic fibroblasts exhibited increased Plk4 hypermethylation and downregulation along with increased centrosome numbers and multinucleation.Conclusions: These results suggest that aberrant Plk methylation is correlated with the development of HCC in mice. © 2011 Ward et al; licensee BioMed Central Ltd.

PubMed | Windsor Regional Hospital
Type: | Journal: Case reports in neurological medicine | Year: 2017

Meningiomas have long been known to be associated with sexual hormones. We discuss here the case of a woman with a huge meningioma that rapidly grew over the course of a couple years while the patient was simultaneously taking fertility treatments. There is substantial evidence suggesting that fertility treatments can fuel the growth of meningiomas. The potential risks should be considered in women with a previous or family history of meningiomas who plan to undergo fertility treatment. These patients need to be evaluated and a screening imaging of brain MRI (Magnetic Resonant Imaging) should be offered in the middle or toward the end of such a treatment to control and prevent complications of these meningiomas.

Cui Q.,McMaster University | Robinson L.,Windsor Regional Hospital | Elston D.,McMaster University | Smaill F.,McMaster University | And 7 more authors.
AIDS Patient Care and STDs | Year: 2012

The prevalence of smoking in HIV-infected subjects is high. As a smoking cessation aid, varenicline (Champix ®, Pfizer, Saint-Laurent, QC, Canada or Chantix ®, Pfizer, Mission, KS) has not been previously evaluated in HIV-infected smokers. In this multicenter pilot open label study, varenicline 1.0 mg was used twice daily for 12 weeks with dose titration in the first week. Adverse events (AEs) during the treatment period were recorded. Changes from baseline in laboratory tests, vital signs, daily cigarette consumption, nicotine dependence, and withdrawal were measured through week 24. Self-reported abstinence was validated by serum cotinine at week 12. We enrolled 36 subjects with a mean of 29 pack-years of smoking and a minimum of 4 cigarettes per day. All but 1 were male, 33 (92%) were white. The most frequently reported AEs were nausea (33%), abnormal dreams (31%), affect lability (19%), and insomnia (19%). Six (17%) subjects discontinued varenicline due to AEs. No grade 3/4 laboratory abnormalities or serious AEs occurred during the study. There was no significant change in HIV viral load. CD4 counts increased by 69 cells/mm 3 (p=0.001) at week 24. Serum cotinine-verified 4-week continuous abstinence rate through weeks 9-12 was 42% (95% confidence interval [CI]: 26-58%). AEs and abstinence rates were comparable to those in published randomized controlled trials conducted in generally healthy HIV-negative smokers. Varenicline was safe and appears effective among HIV-infected smokers in this exploratory study, although AEs were common. The most common AE was nausea, with no adverse effect on HIV treatment outcome. Close monitoring of liver enzymes and blood pressure is recommended for HIV-positive smokers taking varenicline. © 2012, Mary Ann Liebert, Inc.

Agapito J.,Windsor Regional Hospital
Medical Dosimetry | Year: 2013

To assess, using clinical cases, the potential of a hybrid technique for the treatment of non-small cell lung cancer (NSCLC)-blending volumetric-modulated arc therapy (VMAT) and conformal radiation therapy (CRT) fields, and to consider potential issues with implementation of such a technique. Eight clinical cases already treated with CRT were used for a planning study comparing target coverage and organs at risk (OAR) sparing between CRT and hybrid VMAT (VMATh). Quality assurance (QA) implications of the resultant hybrid plans are discussed. The hybrid technique resulted in superior target conformity or improved sparing of OAR or both. The hybrid technique shows promise, but the QA implications of motion at treatment need careful consideration. © 2013 American Association of Medical Dosimetrists.

Valensi P.,Paris Nord University | Shaban J.A.,Windsor Regional Hospital | Bushnell D.M.,Health Research Associates | Christensen T.L.,Novo Nordisk AS
Quality of Life Research | Year: 2010

Purpose: Understanding treatment satisfaction (TS) for diabetes is increasingly important as treatment options increase. This study examines treatment satisfaction with NovoMix® 30 in an observational study in patients with type 2 diabetes. Methods: The DiabMedSat assesses Overall, Treatment Burden, Symptom and Efficacy Treatment Satisfaction. The impact of type of pretreatment variables on TS was examined by ANOVA at baseline and week 26. Satisfaction at week 26 was examined by t-test and effect size. Linear regression models examined impact of prior treatment factors (age, gender, duration of diabetes, type of prior treatment and diabetes-related comorbidities) and current treatment factors (weight gain, hypoglycemic events, reaching therapeutic goal) on TS. Results: The data set comprised 17,488 persons. Prior treatment with insulin had a more positive impact on baseline satisfaction. At week 26, there were no differences between type of prior treatment groups in Overall, Symptoms and Burden TS. Current treatment with NovoMix 30 significantly improved TS. Regression analyses examining the combined effect of pretreatment factors and current treatment factors found that all factors except for age-impacted TS although the domains impacted varied. Conclusions: Patients treated with NovoMix 30 reported improved treatment satisfaction, and the improvement is considered clinically meaningful to patients. © 2010 The Author(s).

Velehorschi C.,Windsor Regional Hospital | Velehorschi C.,University of Western Ontario | Bleau P.,McGill University | Vermani M.,START Clinic for Mood and Anxiety Disorders | And 3 more authors.
Psychiatry Research | Year: 2014

Major depressive disorder (MDD) is a common disorder with a lifetime prevalence of 16.2% and the fourth highest cause of disability globally. It is hypothesized to be a syndromatic manifestation of multiple pathological processes leading to similar clinical manifestation. MDD is associated with at least three categories of peripheral hormone-type factors including neurotrophic factors, proinflammatory cytokines, and processes that impair regulation of the hypothalamic-pituitary-adrenocortical axis. Neuroimaging studies have identified functional abnormalities including subcortical systems associated with reward and emotion processing, medial prefrontal and anterior cingulate cortical regions and the lateral prefrontal cortical systems involved in cognitive control and voluntary emotion regulation. Studies investigating the effects of psychotherapy and pharmacotherapy on functional brain measures show normalization of brain function with return to euthymia. Nevertheless, approximately 50% of patients with MDD will not respond sufficiently and 60 to 70% will not achieve full remission with first-line pharmacotherapy, therefore clinicians strive to improve patient responses through the use of adjunct therapies. This review discusses recent research in the various biological processes associated with MDD as well as recent data in support of the use of adjunctive non-pharmacological therapies including psychotherapy, bibliotherapy, Internet therapy, "natural" or herbal approaches, exercise therapy, and somatic therapies. © 2014 Elsevier Ireland Ltd.

Matthews J.I.,University of Western Ontario | Zok A.V.,University of Western Ontario | Quenneville E.P.M.,Windsor Regional Hospital | Dworatzek P.D.N.,University of Western Ontario
Canadian Journal of Public Health | Year: 2014

Objectives: The FRESH (Food Resources and Education for Student Health) peer nutrition education program engages undergraduate and graduate students in experiential learning to improve the campus food and nutrition environment and promote healthy behaviours among university students. Target Population: University students in general, and graduate and undergraduate food and nutrition students as program designers and peer educators, respectively. Setting: Large university campus in southwestern Ontario. Intervention: A peer nutrition education program, utilizing multiple population strategies and intersectoral partnerships, was created by and for university students with faculty and food service personnel as mentors. The population health strategies employed were building awareness and program branding; developing personal skills through peer nutrition education and hands-on cooking demonstrations; and creating supportive environments through incentive programs for fruit and dairy as well as point-of-purchase menu labelling. Outcomes: The program has reached students, staff and faculty through over 60 interactive FRESH displays and education sessions. Website and social media have also had a significant reach with over 4,000 website visits and 277 Facebook "likes". FRESH has also improved the food environment for over 5,000 students in residence, e.g., 1,931 FRESH Fruit/Dairy Cards have been returned for free fruit/milk cartons. Graduate students in Foods and Nutrition continue to participate every year (cumulative n=60) in ongoing program development. Peer educators have developed enhanced leadership, public speaking and group facilitation skills, and the ability to creatively apply what they have learned in the classroom to new contexts. Conclusion: Increased nutrition knowledge and an improved food environment could, over the long term, support improved university student health. © Canadian Public Health Association, 2014. All rights reserved.

PubMed | Memorial University of Newfoundland, Windsor regional Hospital, Bliss Murphy Cancer Center, Family Medicine. and 2 more.
Type: Journal Article | Journal: Family practice | Year: 2016

Primary care practitioners are familiar with the frail elderly and commonly have to deal with their multi-morbidity and their functional decline, both physically and mentally. However, there are well elderly with high quality of life and very few co-morbidities who seldom seek medical care.To determine if a nurse-based program of home-delivered care, linked directly with the primary care practitioner or primary care team, would improve quality of life, symptoms, satisfaction with care and utilization of community and medical services, in independent community living old elderly.Randomized controlled trial.St. Johns, Newfoundland, Canada.Two hundred and thirty-six independent, community-dwelling, cognitively functioning, people aged 80 years and older.A nurse-based program of care, carried out in the patients home, that involved a detailed assessment of needs, the development of a plan to meet the needs, and up to eight visits to the patients home during a 1-year period to facilitate the meeting of those needs.Usual careQuality of Life measured using the SF-36 and the CASP-19 scales; symptomology using the Comorbidity Symptom Scale; patient satisfaction using the PSQ-18; and assessment of health care services (community services, emergency room visits, hospitalizations, use of diagnostic services and family doctor visits) through patient recall, family physician chart review and assessment of hospitalization records.There were no statistical or meaningful differences between the intervention and control groups in any of the outcomes measured.The intensive, home-delivered, program of care for the well old elderly did not have an impact on the outcomes measured.

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