Agreement between questionnaire report of allergy-related outcomes in school-age children and objective measures of atopy: the Saskatchewan rural health study.

BACKGROUND AND OBJECTIVES: In population-based studies, questionnaires remain the most efficient tool to assess the presence of allergy and atopic conditions, but the quality of the information obtained needs to be validated. We sought to evaluate the agreement and predictive values of a questionnaire to assess atopy in rural children, an understudied population with regard to atopy and allergic disease. METHODS: A total of 480 schoolchildren (grades 1-8) from rural Saskatchewan completed a questionnaire report of allergy and atopic outcomes and participated in skin prick testing (SPT). SPT for 6 common allergens (local grasses, wheat dust, cat dander, house dust mite mixed, Alternaria, and Cladosporium) was completed. Subjects with at least one positive SPT (≥ 3 mm) compared to the negative control were considered to be atopic. We considered per cent concordance, Kappa, sensitivity, specificity, and the positive predictive value and negative predictive value (NPV, PPV) of reported allergies or allergic conditions in comparison with SPT as the gold standard. RESULTS: We found that 25.0% of children reported a history of any allergy and 19.4% were atopic based on SPT. The agreement between questionnaire report of allergic triggers and atopy measured by SPT was high (83.0-89.5%). The agreement between atopy and report of allergic conditions ranged from 67.1% to 79.6%. Individual allergic conditions demonstrated high specificity but low sensitivity. The questionnaire report of any allergy had a low PPV in detecting atopy (47.3%) and high NPV (86.3%). The PPV of reported allergic conditions was low (24.8-43.9%), but the NPV was again high (82.0-82.9%). CONCLUSIONS: We found that the standardized questionnaire report of allergy and atopic conditions was shown not to efficiently and reliably predict atopy. However, given the good specificity and the NPV, the questionnaire may be an efficient tool for epidemiological studies that involve the differential inclusion of subjects without atopy.

Prevalence and determinants of atopy and allergic diseases among school-age children in rural Saskatchewan, Canada.

BACKGROUND: There have been few investigations of farming-related activities or specific characteristics resulting in the associations between those exposures and atopic disease. OBJECTIVE: To study the associations between farm-associated exposures and atopic diseases. METHODS: As part of a longitudinal study of lung health in rural residents, a cross-sectional baseline study was conducted in rural Saskatchewan, Canada. This included an initial survey phase followed by a clinical testing phase. A subsample of 584 children (grades 1-8) completed skin prick testing to assess atopic status. Atopy was defined as a positive reaction to any of 6 allergens (local grasses, wheat dust, cat dander, house dust mite, Alternaria species, or Cladosporium species) of at least 3 mm compared with the negative control. RESULTS: Of those who completed clinical testing, the prevalence of atopy was 19.4%, that of hay fever was 8.8%, and that of eczema was 27.4%. Based on skin prick testing, sensitization was highest for cat dander (8.6%) followed by local grasses (8.2%) and house dust mite (5.1%). After adjustment for potential confounders, home location (farm vs non-farm) was not associated with atopic status. However, livestock farming was protective against atopy (adjusted odds ratio 0.38, 95% confidence interval 0.17-0.88). In contrast, current residence on a farm was associated with an increase in the likelihood of hay fever in these children (adjusted odds ratio 3.68, 95% confidence interval 1.29-10.45). Also, regular farming activities in the past year were associated with an increased risk of hay fever. CONCLUSION: In children, livestock exposure has a protective effect on skin prick test positivity, whereas farm living and activities increase the risk of hay fever.

Cigarette smoking and risk of Hodgkin lymphoma and its subtypes: a pooled analysis from the International Lymphoma Epidemiology Consortium (InterLymph).

BACKGROUND: The etiology of Hodgkin lymphoma (HL) remains incompletely characterized. Studies of the association between smoking and HL have yielded ambiguous results, possibly due to differences between HL subtypes. PATIENTS AND METHODS: Through the InterLymph Consortium, 12 case-control studies regarding cigarette smoking and HL were identified. Pooled analyses on the association between smoking and HL stratified by tumor histology and Epstein-Barr virus (EBV) status were conducted using random effects models adjusted for confounders. Analyses included 3335 HL cases and 14 278 controls. RESULTS: Overall, 54.5% of cases and 57.4% of controls were ever cigarette smokers. Compared with never smokers, ever smokers had an odds ratio (OR) of HL of 1.10 [95% confidence interval (CI) 1.01-1.21]. This increased risk reflected associations with mixed cellularity cHL (OR = 1.60, 95% CI 1.29-1.99) and EBV-positive cHL (OR = 1.81, 95% CI 1.27-2.56) among current smokers, whereas risk of nodular sclerosis (OR = 1.09, 95% CI 0.90-1.32) and EBV-negative HL (OR = 1.02, 95% CI 0.72-1.44) was not increased. CONCLUSION: These results support the notion of etiologic heterogeneity between HL subtypes, highlighting the need for HL stratification in future studies. Even if not relevant to all subtypes, our study emphasizes that cigarette smoking should be added to the few modifiable HL risk factors identified.

Should noncurative resection of the primary tumour be performed in patients with stage iv colorectal cancer? A systematic review and meta-analysis.

PURPOSE: Surgical resection of the primary tumour in patients with advanced colorectal cancer (crc) remains controversial. This review compares survival in patients with advanced crc who underwent surgical resection of the primary tumour with that in patients not undergoing resection, and determines rates of post-operative mortality and nonfatal complications, the primary tumour complication rate, the non-resection surgical procedures rate, and quality of life (qol). METHODS: Reports in the central, medline, and embase databases were searched for relevant studies, which were selected using pre-specified eligibility criteria. The search was also restricted to publication dates from 1980 onward, the English language, and studies involving human subjects. Screening, evaluation of relevant articles, and data abstraction were performed in duplicate, and agreement between the abstractors was assessed. Articles that met the inclusion criteria were assessed for quality using the Newcastle-Ottawa Scale. Data were collected and synthesized per protocol. RESULTS: From among the 3379 reports located, fifteen retrospective observational studies were selected. Of the 12,416 patients in the selected studies, 8620 (69%) underwent surgery. Median survival was 15.2 months (range: 10-30.7 months) in the resection group and 11.4 months (range: 3-22 months) in the non-resection group. Hazard ratio for survival was 0.69 [95% confidence interval (ci): 0.61 to 0.79] favouring surgical resection. Mean rates of postoperative mortality and nonfatal complications were 4.9% (95% ci: 0% to 9.7%) and 25.9% (95%ci: 20.1% to 31.6%) respectively. The mean primary tumour complication rate was 29.7% (95% ci: 18.5% to 41.0%), and the non-resection surgical procedures rate in the non-resection group was 27.6% (95 ci: 15.4% to 39.9%). No study provided qol data. CONCLUSIONS: Although this review supports primary tumour resection in advanced crc, the results have significant biases. Randomized trials are warranted to confirm the findings.

Body mass index versus waist circumference as predictors of mortality in Canadian adults.

BACKGROUND: Elevated body mass index (BMI) and waist circumference (WC) are associated with increased mortality risk, but it is unclear which anthropometric measurement most highly relates to mortality. We examined single and combined associations between BMI, WC, waist-hip ratio (WHR) and all-cause, cardiovascular disease (CVD) and cancer mortality. METHODS: We used Cox proportional hazard regression models to estimate relative risks of all-cause, CVD and cancer mortality in 8061 adults (aged 18-74 years) in the Canadian Heart Health Follow-Up Study (1986-2004). Models controlled for age, sex, exam year, smoking, alcohol use and education. RESULTS: There were 887 deaths over a mean 13 (SD 3.1) years follow-up. Increased risk of death from all-causes, CVD and cancer were associated with elevated BMI, WC and WHR (P<0.05). Risk of death was consistently higher from elevated WC versus BMI or WHR. Ascending tertiles of each anthropometric measure predicted increased CVD mortality risk. In contrast, all-cause mortality risk was only predicted by ascending WC and WHR tertiles and cancer mortality risk by ascending WC tertiles. Higher risk of all-cause death was associated with WC in overweight and obese adults and with WHR in obese adults. Compared with non-obese adults with a low WC, adults with high WC had higher all-cause mortality risk regardless of BMI status. CONCLUSION: [corrected] BMI and WC predicted higher all-cause and cause-specific mortality, and WC predicted the highest risk for death overall and among overweight and obese adults. Elevated WC has clinical significance in predicting mortality risk beyond BMI.

Squamous cell carcinoma presenting as multiple discharging sinuses on the chin.

Squamous cell carcinoma (SCC) usually presents as a raised, firm, pink to skin-coloured keratotic papule, plaque or ulcer, arising on sun-exposed skin. We report an unusual case of a 65-year-old male patient who presented with a 1-year history of multiple discharging sinuses on his chin, which on investigation was found to be an SCC. A malignancy should be considered in the differential diagnoses of patients presenting with multiple discharging sinuses on the chin. We discuss other possible diagnoses for sinuses presenting on the face.

Statistical modelling of mental distress among rural and urban seniors.

The senior population is growing rapidly in Canada. Consequently, there will be an increased demand for health care services for seniors who have mental illness. Seniors are more likely to live in rural areas than younger people; therefore, it is important to identify the differences between rural and urban seniors in order to design and deliver mental health services. The main objective of this paper was to use the National Population Health Survey (NPHS) to examine the differences with regard to mental distress between rural and urban seniors (i.e. 55 years and older). The other objectives were to investigate the long-term association between smoking and mental health and the long-term association between unmet health care needs and the mental health of seniors in rural and urban areas. The mental distress measure was examined as a binary outcome. The analysis was conducted using a generalized estimating equation approach that accounted for the complexity of a multi-stage survey design. Rural seniors reported a higher proportion of mental distress [OR=1.16; 95% CI: 0.98, 1.37] with a borderline statistical significance than urban seniors. This finding was based on a final multivariate model to study the relationship between mental distress and location of residence(i.e. rural or urban) as well as between smoking and self-perceived unmet health care needs, adjusting for other important covariates and missing outcome values. A significant correlation was noted between smoking and mental health problems among seniors after adjusting for other covariates [OR = 1.26; 95% CI: 1.00, 1.60]. Participants who reported self-perceived unmet health care needs reported a higher proportion of mental distress [OR = 1.72; 95% CI: 1.38, 2.13] compared to those who were satisfied with their health care.

The hefty fetal phenotype hypothesis revisited: high birth weight, type 2 diabetes and gestational diabetes in a Saskatchewan cohort of First Nations and non-First Nations women.

Although low birth weight (LBW) increases the risk for type 2 diabetes (T2DM), the relationship between high birth weight (HBW) and T2DM is less definitive and largely confined to North American Indigenous populations. We re-examined the relationship between LBW (4000 g) and both T2DM and gestational diabetes (GDM) among First Nations and non-First Nations women in Saskatchewan. We analyzed new data for female subjects from a 2001 case-control study that led to our hefty fetal phenotype hypothesis. Using survival analysis techniques and a validated algorithm for identifying diabetes in health care administrative data, we followed a 1950-1984 birth cohort of 2003 women until March 31, 2013. Cox regression analysis determined the time to occurrence of first episode of GDM and diagnosis of T2DM by birth weight and ethnicity. First Nations women with HBW demonstrated a greater risk for developing both T2DM [hazard ratios (HR) 1.568; 95% confidence interval (CI) 1.188, 2.069] and GDM (HR 1.468; 95% CI 1.016, 2.121) than those with normal birth weight (NBW). Non-First Nations women with LBW had a greater risk of developing GDM than those with NBW (HR 1.585; 95% CI 1.001, 2.512). HBW is a risk factor for GDM and T2DM among First Nations women. This is likely due to exposure of these women to their own mothers' diabetic pregnancies or gestational impaired glucose tolerance. This inter-generational amplification of T2DM risk mediated through prenatal exposures appears to play a substantial role in the epidemic of T2DM among First Nations peoples.

Prevention of agricultural injuries: an evaluation of an education-based intervention.

OBJECTIVE: To evaluate the effectiveness of an agricultural health and safety program in reducing risks of injury. DESIGN: Cross-sectional survey. SETTING: 50 rural municipalities in the Province of Saskatchewan, Canada. INTERVENTION: The Agricultural Health and Safety Network (AHSN), a mainly educational program that administered 112 farm safety interventions over 19 years. SUBJECTS: 5292 farm people associated with 2392 Saskatchewan farms. Farms and associated farm people were categorized into three groups according to years of participation in the AHSN. IMPACT: self-reported prevalence of: (1) farm safety practices; (2) physical farm hazards. OUTCOME: (1) self-reported agricultural injuries. RESULTS: After adjustment for group imbalances and clustering at the rural municipality level, the prevalence of all impact and outcome measures was not significantly different on farms grouped according to years of AHSN participation. To illustrate, the adjusted relative risk of reporting no rollover protection on tractors among farms with none (0 years) versus high (>8 years) levels of AHSN participation was 0.95 (95% CI 0.69 to 1.30). The adjusted relative risk for agricultural injuries (all types) reported for the year before the survey was 0.99 (95% CI 0.74 to 1.32). CONCLUSIONS: Educational interventions delivered via the AHSN program were not associated with observable differences in farm safety practices, physical farm hazards, or farm-related injury outcomes. There is a need for the agricultural sector to extend the scope of its injury prevention initiatives to include the full public health model of education, engineering, and regulation.

Opposing trends in the prevalence of health professional-diagnosed asthma by sex: a Canadian National Population Health Survey study.

BACKGROUND: The prevalence of asthma is on the rise worldwide, with large variations in prevalence existing between and within countries. Little is known regarding the variation in asthma prevalence in adults living in rural and urban settings. OBJECTIVES: Using questionnaire data from the Canadian National Population Health Survey, the prevalence of asthma at four time periods (1994/1995 [cycle 1], 1996/1997 [cycle 2], 1998/1999 [cycle 3] and 2000/2001 [cycle 4]) was compared between rural and urban populations stratified by sex, smoking status and age group. Asthma was defined as a positive response to the question: "Do you have asthma diagnosed by a health professional?" METHODS: To account for the complexity of the survey design, the bootstrap method was used to calculate prevalences and 95% CIs. RESULTS: Overall, the prevalence of asthma increased from 7.3% (cycle 1) to 7.5% (cycle 4). After stratifying by sex, the asthma prevalence decreased among men, but in women, there was a steady increase. Asthma prevalence increased for both the rural population and the urban population. After stratifying each cycle by sex and location (rural or urban), both rural and urban men showed a decrease in asthma prevalence. On dividing according to age groups (0 to 14 years, 15 to 34 years, 35 to 64 years, and 65 years and older), the prevalence of asthma was greatest in the 15- to 34-year age group of urban and rural women. CONCLUSIONS: Asthma prevalence increased among rural and urban women. The prevalence of asthma was highest among female smokers and male nonsmokers when stratified by smoking status. Based on these findings, the rate of increase in asthma prevalence is different for men and women.

Non-Hodgkin's lymphoma and specific pesticide exposures in men: cross-Canada study of pesticides and health.

Our objective in the study was to investigate the putative associations of specific pesticides with non-Hodgkin's Lymphoma [NHL; International Classification of Diseases, version 9 (ICD-9) 200, 202]. We conducted a Canadian multicenter population-based incident, case (n = 517)-control (n = 1506) study among men in a diversity of occupations using an initial postal questionnaire followed by a telephone interview for those reporting pesticide exposure of 10 h/year or more, and a 15% random sample of the remainder. Adjusted odds ratios (ORs) were computed using conditional logistic regression stratified by the matching variables of age and province of residence, and subsequently adjusted for statistically significant medical variables (history of measles, mumps, cancer, allergy desensitization treatment, and a positive history of cancer in first-degree relatives). We found that among major chemical classes of herbicides, the risk of NHL was statistically significantly increased by exposure to phenoxyherbicides [OR, 1.38; 95% confidence interval (CI), 1.06-1.81] and to dicamba (OR, 1.88; 95% CI, 1.32-2.68). Exposure to carbamate (OR, 1.92; 95% CI, 1.22-3.04) and to organophosphorus insecticides (OR, 1.73; 95% CI, 1.27-2.36), amide fungicides, and the fumigant carbon tetrachloride (OR, 2.42; 95% CI, 1.19-5.14) statistically significantly increased risk. Among individual compounds, in multivariate analyses, the risk of NHL was statistically significantly increased by exposure to the herbicides 2,4-dichlorophenoxyacetic acid (2,4-D; OR, 1.32; 95% CI, 1.01-1.73), mecoprop (OR, 2.33; 95% CI, 1.58-3.44), and dicamba (OR, 1.68; 95% CI, 1.00-2.81); to the insecticides malathion (OR, 1.83; 95% CI, 1.31-2.55), 1,1,1-trichloro-2,2-bis (4-chlorophenyl) ethane (DDT), carbaryl (OR, 2.11; 95% CI, 1.21-3.69), aldrin, and lindane; and to the fungicides captan and sulfur compounds. In additional multivariate models, which included exposure to other major chemical classes or individual pesticides, personal antecedent cancer, a history of cancer among first-degree relatives, and exposure to mixtures containing dicamba (OR, 1.96; 95% CI, 1.40-2.75) or to mecoprop (OR, 2.22; 95% CI, 1.49-3.29) and to aldrin (OR, 3.42; 95% CI, 1.18-9.95) were significant independent predictors of an increased risk for NHL, whereas a personal history of measles and of allergy desensitization treatments lowered the risk. We concluded that NHL was associated with specific pesticides after adjustment for other independent predictors.

Prognostic significance of the onset mode in parkinsonism.

Early recognition of the prognosis in parkinsonism is important for both the management and studies aimed at preventing progression of disease. Less favorable prognosis is reported in early-onset postural instability and gait difficulty (PIGD) than in the tremor-onset cases, but the reasons for this are unknown. In 70 autopsy-verified cases, 11 (15.7%) had PIGD, and 34 (49%) had tremor onset. Improvement on levodopa was more common in the tremor-than the PIGD-onset cases (p < 0.05). The majority of tremor-onset cases had Lewy body disease, while the majority of PIGD-onset cases had other forms of pathology. Survival was shorter in the PIGD- than the tremor-onset cases (p < 0.05).

Deep brain stimulation of the Vim nucleus of the thalamus for the treatment of tremor.

The surgical treatment of tremor has evolved considerably in the past few years. Of the several conditions associated with severe tremor, the most common are Parkinson's disease (PD) and essential tremor (ET). Levodopa therapy reduced drastically the number of patients with PD who require surgery because of inadequate control. However, there remains a small number of "tremor dominant" PD patients for whom surgical treatment is often the best option. The ventralis intermediate nucleus (Vim) of the thalamus has been the preferred surgical target for the treatment of parkinsonian tremor for many years, but this is now challenged by the subthalamic nucleus (STN). Deep brain stimulation (DBS) of either target possesses high therapeutic efficacy against tremor in PD. ET may be difficult to treat pharmacologically. Thalamotomy is an effective surgical procedure for ameliorating ET but may be associated with persistent neurologic deficits. DBS of the thalamus is also a highly effective means of reducing ET. DBS appears to be safer than thalamotomy and is now the recommended surgical procedure.

Extent of pulmonary tuberculosis in patients diagnosed by active compared to passive case finding.

OBJECTIVE: To compare the extent of pulmonary tuberculosis amongst patients detected by screening (active case finding) with that in patients detected by symptoms (passive case finding), and to identify early symptoms of pulmonary tuberculosis. SUBJECTS AND METHOD: In this cross-sectional study, Tuberculosis Control Program records were reviewed for method of detection and extent of disease in Canadian Plains Aborigines between 1 January 1991 and 30 June 1999. RESULTS: Among 903 cases, method of detection was active in 450 (49.8%) and passive in 453 (50.2%). Cough and fever were the most common symptoms in both methods of detection, and were significantly more frequent in passive detection (P < 0.05). Cough was present in 59% and fever in 19% of actively detected cases compared to 84% and 47%, respectively, of passively detected cases. Age was significantly different between the two methods of detection. Hemoptysis, weight loss and method of detection were associated with increased risk of infectiousness among those < or = 19 years, while cough, hemoptysis and weight loss were associated among those >19 years. CONCLUSION: Method of detection rather than age contributed to infectiousness in children and adolescents. Daily cough for more than 1 month and unexplained fever for more than 1 week should raise the suspicion for TB.

Quality-of-life issues in patients with ovarian cancer and their caregivers: a review.

UNLABELLED: Significant progress has been made towards the treatment of ovarian cancer resulting in longer median survival despite a persistent low cure rate. Relatively few studies have examined the impact of the cancer and its treatment on the patients and their caregivers due to the difficulty in the definition and measurement of the Quality of Life (QOL) concept. A review of the literature revealed significant alterations in the quality of life of ovarian cancer patients during treatment and long term follow ups. For the caregivers, it is important for health care providers to realize that: 1) caregivers are being asked to assume an increasing number of complex care giving tasks at home, 2) there exists a high proportion of unmet caregiver needs, 3) the care giving experience includes both positive and negative elements and, 4) perception of caregivers' burden is positively linked to negative reactions to care giving. Supportive programs for patients and caregivers should be designed with these needs in mind. Future research should study the best way to incorporate results of quality of life assessments into routine treatment decision-making. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader should be able to outline the current data on QOL issues in patients with ovarian cancer, and to describe potential working definitions of QOL.

Predictors of onset of wheezing in grain elevator workers.

A longitudinal study of Canadian grain elevator workers over a 12-year period was conducted. Data on respiratory symptoms and pulmonary function tests were collected once every three years as part of the Grain Dust Medical Surveillance Program started by Labour Canada in 1978; each three-year interval was called a 'cycle'. Of workers who had two or more observations, 1848 subjects (67.2%) were free of respiratory symptoms (wheeze, dyspnea, cough or sputum) at the baseline (cycle II). Predictors of first episode of wheezing were examined in these symptoms-free grain workers. Baseline mean age +/- SD of the grain workers was 34.0 +/- 11.4 years and mean duration of work in the industry was 9.9 +/- 8.7 years. Of the 1848 symptoms-free grain workers at cycle II, 203 (11.0%) subsequently reported wheezing during the study. Cox's proportional hazards model for analysis of survival data was used to determine significant predictors of first episode of wheezing. Significant predictors for first episode of wheezing were current smoking (relative risk [RR] 2.33; 95% CI 1.63 to 3.33; P<0.0001) and baseline forced expiratory volume in 1 s to forced vital capacity ratio [RR 0.02; 95% CI 0.003 to 0.20; P<0.0001). Baseline pulmonary function measurements and smoking habits appear to be important predictors of future development of asthma-like symptoms in grain elevator workers.

Quality of life evaluations of caregivers of ovarian cancer patients during chemotherapy treatment.

OBJECTIVES: (1) To examine the quality of life (QOL) of caregivers of women undergoing chemotherapy for advanced ovarian cancers, and (2) to correlate the QOL measures of caregivers to those of the women undergoing chemotherapy. METHODS: Over a 9-month period, all women undergoing chemotherapy for ovarian cancer at the Saskatoon Cancer Centre, and their caregivers, were offered participation. Two well-validated instruments were used to measure the "quality of life" concept. Women with ovarian cancer completed the Functional Assessment of Cancer Therapy--Ovarian (FACT-O) questionnaire in the clinic prior to each course of chemotherapy. Each caregiver completed a Caregiver Quality of Life Index--Cancer (CQOL-C) questionnaire at home at the start and conclusion of each chemotherapy regimen (cycle 1 and after the last chemotherapy treatment). The demographics of the caregivers were described. A paired t test was used to detect changes to caregivers' QOL scores before and after chemotherapy treatment. Correlation analysis was carried out to examine the relationship between the caregivers' total QOL scores and the various subscale and total scores of the FACT-O questionnaires completed by the women with ovarian cancer. Multivariate regression models were constructed to examine the relative importance of each of the QOL domain measures of the woman with cancer in predicting the effect on her caregiver's QOL. RESULTS: Thirty different patient-caregiver pairs participated in the study, providing 50 separate assessments since not all pairs had completed the post-chemotherapy assessments. There was improvement (P <.05) in the caregiver's QOL scores at the conclusion of the chemotherapy treatment compared to the baseline assessments. The improvement was unrelated to the performance status or response to chemotherapy of the woman undergoing treatment. There was also a correlation (P <.05) between an increase in a caregiver's distress and worsening scores in the "emotional," "functional," and "concerns" QOL domain assessments of the woman undergoing treatment. Stepwise regression analysis showed the "concerns" score, measuring specific ovarian cancer-related symptoms, to be the only predictor of a caregiver's distress (P <.05). CONCLUSIONS: Standard chemotherapy for ovarian cancer does not worsen a caregiver's QOL. There is a direct relationship between the QOL of women with cancer and that of their caregivers. Future research is required to identify how best to integrate the results of QOL assessments in cancer treatment protocols and to examine the long-term effects of ovarian cancer and its treatment on both caregivers and the women for whom they care.

Effect of periodontal therapy on lactoferrin levels in gingival crevicular fluid.

BACKGROUND: The aim of this study was to evaluate lactoferrin quantification as a sensitive and objective method of detecting the degree of periodontal inflammation, oxidative stress and to monitor the effects of periodontal therapy. METHODS: Fifty subjects were divided into two groups based on gingival index, probing pocket depth, clinical attachment loss and alveolar bone loss: healthy group and periodontitis group with generalized chronic periodontitis. Non-surgical periodontal therapy was rendered and crevicular fluid samples collected at baseline and four weeks after therapy for lactoferrin quantification using enzyme linked immunosorbent assay. The correlation between clinical parameters and lactoferrin levels was drawn and analysed for both groups. RESULTS: The mean level of crevicular lactoferrin in the periodontitis group was 1857.21 ng/ml. The mean level decreased to 1415.03 ng/ml after treatment. The lowest lactoferrin concentration was seen in the healthy group (75.34 ng/ml). All clinical parameters correlated positively with lactoferrin levels. CONCLUSIONS: The lactoferrin level was higher in the periodontitis group compared to the healthy group, and reduced with periodontal therapy. Higher levels were associated with higher values of clinical parameters, both before and after therapy. The data indicates that Lactoferrin plays an important role in periodontal disease and crevicular lactoferrin quantification can be a marker for detecting periodontal inflammation, oxidative stress and monitoring periodontal therapy.

Protective effect of Alpinia galanga in STZ induced diabetic nephropathy.

The activity of the alcoholic extract of the rhizomes of Alpinia galanga was studied for the treatment of diabetes-induced nephropathy in rats. Wistar rats received a single intraperitoneal streptozotocin injection (60 mg kg(-1) b.wt.) to induce diabetes. Rats were considered diabetic if blood glucose concentration increased up to 200 or more mg dL(-1). The rats were orally administered alcoholic extract of Alpinia galanga (50, 100 and 200 mg kg(-1)), once daily for 40 days. Body weight, blood glucose, urinary albumin, glycosylated haemoglobin, Blood Urea Nitrogen (BUN), creatinine, lipids profile, Malondialdehyde (MDA), Superoxide Dismutase (SOD), Glutathione (GSH) and Catalase (CAT) were then evaluated. After 40 days of treatment, Alpinia galanga significantly (p<0.05) decreased glycaemia, Blood Urea Nitrogen (BUN), urinar albumin and increased body weight in diabetes-nephropathic rats. The extract (200 mg kg(-1)) decreased MDA significantly (p<0.01); GSH (p<0.05), increased SOD (p<0.05) and CAT (p<0.05) in the rats, compared with nephropathic control. The extract (100 and 200 mg kg(-1), respectively) lowered (p<0.05) total cholesterolemia, blood triglycerides (p<0.05), blood LDL cholesterol (p<0.05), but increased blood HDL cholesterol (p<0.01). Overall, atherogenic index was decreased significantly (p<0.05). In the present study, the rhizomes of Alpinia galanga demonstrated significant nephro-protective activities in the tested models. The alcoholic extract of the rhizomes of Alpinia galanga holds promise for the development of a standardized phytomedicine for diabetes mellitus and kidney disease treatment.

Chronic bronchitis in Aboriginal people--prevalence and associated factors.

INTRODUCTION: Knowledge about chronic bronchitis (CB) among Aboriginal people in Canada is limited. The aim of this study was to determine the prevalence of CB and its associated factors among Aboriginal people aged 15 years plus. METHODS: Logistic regression analysis was used on data from the cross-sectional 2006 Aboriginal Peoples Survey to determine risk factors associated with CB. RESULTS: CB prevalence was 6.6% among First Nations, 6.2% among Métis and 2.4% among Inuit. Prevalence was higher among females than males (7.2% versus 5.0%). Individuals with CB were more likely to be older, living at a lower income, with a lower educational attainment and residing in rural areas. Smoking status and body mass index were also significantly associated with CB, but their effect differed by sex. Obesity was particularly significantly associated with CB among females compared with males, and current smoking and non-smoking status was significantly associated with CB among females but not males. CONCLUSION: These findings identify factors associated with CB among Aboriginal people. As such, they may represent potentially preventable risk factors that can inform health promotion and disease prevention practices.

TITRE: La bronchite chronique chez les Autochtones ­ prévalence et facteurs associés. INTRODUCTION: On sait peu de choses sur la bronchite chronique (BC) chez les Autochtones au Canada. Le but de cette étude était de déterminer la prévalence de la BC et des facteurs qui lui sont associés chez les Autochtones de 15 ans et plus. MÉTHODOLOGIE: Une analyse de régression logistique a été appliquée à des données tirées de l'Enquête auprès des peuples autochtones de 2006 (enquête transversale) afin de déterminer les facteurs de risque associés à la BC. RÉSULTATS: La prévalence de la BC était de 6,6 % au sein des membres des Premières nations, de 6,2 % chez les Métis et de 2,4 % chez les Inuits. Elle était plus élevée chez les femmes que chez les hommes (7,2 % contre 5,0 %). Les individus atteints de BC étaient en général plus âgés et plus nombreux à avoir un revenu et un niveau d'instruction plus faibles et à habiter en milieu rural. Le tabagisme et l'indice de masse corporelle étaient également associés de façon significative à la BC, mais leur effet différait selon le sexe. L'obésité était associée de manière particulièrement significative à la BC chez les femmes, et le fait d'être fumeur ou de n'avoir jamais fumé était aussi associé de façon significative à la BC chez les femmes. CONCLUSION: Ces constatations permettent de déterminer les facteurs associés à la BC chez les Autochtones. Ce sont peut-être à ce titre des facteurs de risque potentiellement évitables qui peuvent éclairer les pratiques en matière de promotion de la santé et de prévention des maladies.