Prevalence of Coxiella burnetii seropositivity and shedding in farm, pet and feral cats and associated risk factors in farm cats in Quebec, Canada.

Cats represent a potential source of Coxiella burnetii, the aetiological agent of Q fever in humans. The prevalence and risk factors of C. burnetii infection in farm, pet and feral cats were studied in Quebec, Canada, using a cross-sectional study. Serum samples were tested using a specific enzyme-linked immunosorbent assay (ELISA) for the presence of antibodies against C. burnetii, whereas rectal swabs were assayed using real-time quantitative polymerase chain reaction (qPCR) for the molecular detection of the bacteria. Potential risk factors for farm cats were investigated using clinical examinations, questionnaires and results from a concurrent study on C. burnetii farm status. A total of 184 cats were tested: 59 from ruminant farms, 73 pets and 52 feral cats. Among farm cats, 2/59 (3.4%) were ELISA-positive, 3/59 (5.1%) were ELISA-doubtful and 1/59 (1.7%) was qPCR-positive. All pets and feral cats were negative to C. burnetii ELISA and qPCR. Farm cat positivity was associated with a positive C. burnetii status on the ruminant farm (prevalence ratio = 7.6, P = 0.03). Our results suggest that although pet and feral cats do not seem to pose a great C. burnetii risk to public health, more active care should be taken when in contact with cats from ruminant farms.

Development of training for medicines-oriented policymakers to apply evidence.

BACKGROUND: Health systems globally promote appropriate prescribing by healthcare providers and safe and effective medicine use by consumers. Rx for Change, a publicly available database, provides access to systematic reviews regarding best practices for prescribing and using medicines. Despite the value of the database for improving prescribing and medicine use, its use remains suboptimal. This study aimed to develop a training program for five medicine-focused organisations in Canada and Australia to facilitate the use and understanding of the Rx for Change database. METHODS: Four steps were undertaken: 1) key informant interviews were completed across all organisations to understand the knowledge user perspective; 2) a directed content analysis was completed of the interview transcripts and proposed training was developed; 3) a second round of feedback on the proposed training by knowledge users was gathered; and 4) feedback was integrated to develop the final training. RESULTS: Sixteen key informant interviews with knowledge users were conducted. Themes for training content included the scope of, navigation and strategies for using Rx for Change (generic content) and practical examples on incorporating evidence within their workplace context (tailored content). The final training consisted of an informational video, a 60-minute face-to-face workshop and two post-training reminders. CONCLUSIONS: A method of engaging knowledge users in the development of a training program to improve the use of an on-line database of systematic reviews was established and used to design training. Next steps include the delivery and evaluation of the training.

Harvested white-tailed deer as sentinel hosts for early establishing Ixodes scapularis populations and risk from vector-borne zoonoses in southeastern Canada.

Due to recent establishment of the blacklegged tick, Ixodes scapularis Say, in southeastern Canada, tick-borne zoonoses (Lyme disease, human granulocytotropic anaplasmosis, and babesiosis) are of growing concern for public health. Using white-tailed deer (Odocoileus virginianus) culled in southwestern Quebec during 2007-2008, we investigated whether hunter-killed deer could act as sentinels for early establishing tick populations and for tick-borne pathogens. Accounting for environmental characteristics of culling sites, and age and sex of deer, we investigated whether their tick infestation levels could identify locations of known tick populations detected in active surveillance, presumed tick populations detected by passive surveillance, or both. We also used spatial cluster analyses to identify spatial patterns of tick infestation and occurrence of tick-borne zoonoses infection in ticks collected from the deer. Adult ticks were found on 15% of the 583 deer examined. Adult male deer had the greatest number (approximately 90%) of adult ticks. Overall, 3, 15, and 0% of the ticks collected were polymerase chain reaction (PCR)-positive for Borrelia burgdorferi, Anaplasma phagocytophilum, and Babesia microti, respectively. Our statistical analyses suggest that sex and age of deer, temperature, precipitation, and an index of tick dispersion by migratory birds were significantly associated with tick infestation levels. Cluster analysis identified significant clusters of deer carrying ticks PCR-positive for A. phagocytophilum, and for deer carrying two or more I. scapularis. Our study suggests that hunter-killed deer may be effective as sentinels for emerging areas of tick-borne anaplasmosis. They may have limited use as sentinels for early emerging I. scapularis tick populations and emerging Lyme disease risk.

Mortality and morbidity peaks modeling: An extreme value theory approach.

Hospitalizations and deaths belong to the most studied health variables in public health. Those variables are usually analyzed through mean events and trends, based on the whole dataset. However, this approach is not appropriate to comprehend health outcome peaks which are unusual events that strongly impact the health care network (e.g. overflow in hospital emergency rooms). Peaks can also be of interest in etiological research, for instance when analyzing relationships with extreme exposures (meteorological conditions, air pollution, social stress, etc.). Therefore, this paper aims at modeling health variables exclusively through the peaks, which is rarely done except over short periods. Establishing a rigorous and general methodology to identify peaks is another goal of this study. To this end, the extreme value theory appears adequate with statistical tools for selecting and modeling peaks. Selection and analysis for deaths and hospitalizations peaks using extreme value theory have not been applied in public health yet. Therefore, this study also has an exploratory goal. A declustering procedure is applied to the raw data in order to meet extreme value theory requirements. The application is done on hospitalization and death peaks for cardiovascular diseases, in the Montreal and Quebec metropolitan communities (Canada) for the period 1981-2011. The peak return levels are obtained from the modeling and can be useful in hospital management or planning future capacity needs for health care facilities, for example. This paper focuses on one class of diseases in two cities, but the methodology can be applied to any other health peaks series anywhere, as it is data driven.

Structure and magnetism in LaCoO3.

The temperature dependence of the hexagonal lattice parameter c of single crystal LaCoO3(LCO) with H = 0 and 800 Oe, as well as LCO bulk powders with H = 0, was measured using high-resolution x-ray scattering near the transition temperature To ≈35 K. The change of c(T) is well characterized by a power law in T − To for T>To and by a temperature independent constant for T

How American oncologists treat breast cancer: an assessment of the influence of clinical trials.

The present study was designed to assess the preferred methods of treatment of breast cancer by American oncologists, and the impact of clinical trials on their practice. We mailed 465 questionnaires to surgical, radiation, or medical oncologists. The questionnaire described five hypothetic patients with breast cancer, and respondents were asked to select their preferred treatment for each patient. For primary breast cancer, most physicians would offer the choice of local excision followed by radiation therapy or modified radical mastectomy. About 80% of physicians would prescribe adjuvant chemotherapy for a premenopausal woman with estrogen receptor-negative, axillary node negative breast cancer, and for a postmenopausal woman with estrogen receptor-negative, node-positive disease. This policy was favored by male and female physicians of each specialty. Almost all respondents would treat a young woman with inflammatory breast cancer with initial chemotherapy followed by radiation and/or surgery, and about 60% would recommend chemotherapy to a postmenopausal patient with estrogen receptor-negative disease and minimally symptomatic bone metastases. Clinical trials have compared treatment strategies that could be applied to patients described in our questionnaire. Preferred treatments for primary breast cancer, and for inflammatory breast cancer are supported by the results of clinical trials. Recommendation of adjuvant chemotherapy for node-negative breast cancer is not based on a consistent demonstration of improvement in survival, although randomized trials with short follow-up have shown delay to recurrence. Recommendation of adjuvant chemotherapy for a postmenopausal woman with node-positive breast cancer is contrary to the results of large randomized controlled trials (and to a meta-analysis), which have shown that this policy does not lead to improved survival. Our report suggests that even large randomized clinical trials may have a minimal impact on practice if their results run counter to belief in the value of the treatment.

Biochemical reference ranges for groups of ewes of different ages.

Reference biochemical ranges for young adult and adult ewes in mid-gestation were derived from 83 pooled serum samples taken from 30 flocks in the Province of Québec, Canada. In each flock the samples were pooled into three age categories and each category contained between six and 10 samples. The blood samples were taken by jugular venepuncture in December 1999. All the values were within the normal published ranges. As the age of the ewes increased there were slight increases in the concentrations of globulin and total protein and decreases in the concentrations of calcium, phosphorus, creatinine, glucose and albumin, and in the activities of alkaline phosphatase and glutathione peroxidase.

The unusual magnetism of nanoparticle LaCoO3.

Bulk and nanoparticle powders of LaCoO3 (LCO) were synthesized and their magnetic and structural properties were studied using SQUID magnetometry and neutron diffraction. The bulk and large nanoparticles exhibit weak ferromagnetism (FM) below T ≈ 85 K and a crossover from strong to weak antiferromagnetic (AFM) correlations near a transition expressed in the lattice parameters, To≈40 K. This crossover does not occur in the smallest nanoparticles; instead, the magnetic behavior is predominantly ferromagnetic. The amount of FM in the nanoparticles depends on the amount of Co3O4 impurity phase, which induces tensile strain on the LCO lattice. A core-interface model is introduced, with the core region exhibiting the AFM crossover and with FM in the interface region near surfaces and impurity phases.

The effects of Co3O4 on the structure and unusual magnetism of LaCoO3.

Bulk La(w)CoO(3) particles with w = 1.1, 1.0, 0.9, 0.8, and 0.7 were synthesized using starting materials with varying molar ratios of La(2)O(3) and Co(3)O(4). The resulting particles are characterized as LaCoO(3) crystals interfaced with a crystalline Co(3)O(4) phase. X-ray and neutron scattering data show little effect on the average structure and lattice parameters of the LaCoO(3) phase resulting from the Co(3)O(4) content, but magnetization data indicate that the amount of Co(3)O(4) strongly affects the ferromagnetic ordering at the interfaces below TC ≈ 89 K. In addition to ferromagnetic long-range order, LaCoO(3) exhibits antiferromagnetic behavior with an unusual temperature dependence. The magnetization for fields 20 Oe ⩽ H ⩽ 5 kOe is fit to a combination of a power law ((T - TC)/TC)(ß) behavior representing the ferromagnetic long-range order and sigmoid-convoluted Curie-Weiss-like behavior representing the antiferromagnetic behavior. The critical exponent ß = 0.63 ± 0.02 is consistent with 2D (surface) ordering. Increased Co(3)O(4) correlates well to increased ferromagnetism. The weakening of the antiferromagnetism below T ≈ 40 K is a consequence of the lattice reaching a critical rhombahedral distortion as T is decreased for core regions far from the Co(3)O(4) interfaces. We introduce a model that describes the ferromagnetic behavior of the interface regions and the unusual antiferromagnetism of the core regions.

Use of a physician-directed questionnaire to define a consensus about management of breast cancer: implications for assessing costs and benefits of treatment.

The present study was designed to assess the preferred methods of treatment of early breast cancer by United States oncologists, to define the impact of published clinical trials on their practice, and to define questions related to clinical decision making that should be subjected to further research. A questionnaire was mailed to 405 oncologists of all three disciplines (medical, radiation, and surgical oncology) and to 60 oncology nurses who practice in the United States. The questionnaire included clinical scenarios of: (a) a patient with primary breast cancer; (b) a premenopausal woman with node-negative breast cancer; and (c) a postmenopausal woman with estrogen receptor (ER)-negative, node-positive breast cancer. Respondents were asked to describe their preferred management for each scenario. Our study demonstrates a consensus that modified radical mastectomy, or partial mastectomy plus radiation therapy, should be offered as equal options to selected patients with primary breast cancer; this consensus is supported by results of clinical trials. We also found agreement that adjuvant chemotherapy should be offered to premenopausal women with node-negative, ER-negative breast cancer. There was a similar consensus in favor of adjuvant chemotherapy for postmenopausal patients with ER-negative, node-positive breast cancer, despite the absence of improvement in overall survival in large, mature, controlled randomized trials (and in a meta-analysis). We suggest that further research be undertaken into factors that influence decision making by oncologists when they consider the administration of adjuvant chemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Allogeneic transplantation for multiple myeloma: further evidence for a GVHD-associated graft-versus-myeloma effect.

We report a series of 37 consecutive patients with multiple myeloma (MM) who received an allograft between 1990 and 2000 at our institution. Median age was 47 years, and nearly 70% of patients were Durie-Salmon stage III. A median of five cycles of chemotherapy were given before transplant, with a median interval between diagnosis and transplant of 9.3 months. We report a nonrelapse mortality rate of 22% with a median follow-up period of 40 months, whereas complete remission (CR) rate at 12 months is estimated at 57%. Treatment failure rate and overall survival at 40 months are estimated at 52% and 32%, respectively. The number of chemotherapy cycles prior to allotransplantation achieved borderline statistical significance as a poor prognosis factor for overall survival (P = 0.05), while the presence of chronic graft-versus-host disease (cGVHD) was significantly correlated with CR achievement (P = 0.036). Our study confirms that early allografting in MM can yield toxicity rates significantly lower than those associated with historical cohorts, and supports the hypothesis that cumulative chemotoxicity has a negative influence on mortality and survival rates. More importantly, our study clearly demonstrates an association between cGVHD and CR and brings further evidence in favor of a graft-versus-myeloma effect.

Optimization of a polypyrrole glucose oxidase biosensor.

An amperometric glucose biosensor was fabricated by the electrochemical polymerization of pyrrole onto a platinum electrode in the presence of the enzyme glucose oxidase in a KCl solution at a potential of +0.65 V versus SCE. The enzyme was entrapped into the polypyrrole film during the electropolymerization process. Glucose responses were measured by potentiostating the enzyme electrode at a potential of +0.7 V versus SCE in order to oxidize the hydrogen generated by the oxidation of glucose by the enzyme in the presence of oxygen. Experiments were performed to determine the optimal conditions of the polypyrrole glucose oxidase film preparation (pyrrole and glucose oxidase concentrations in the plating solution) and the response to glucose from such electrodes was evaluated as a function of film thickness, pH and temperature. It was found that a concentration of 0.3 M pyrrole in the presence of 65 U/ml of glucose oxidase in 0.01 M KCl were the optimal parameters for the fabrication of the biosensor. The optimal response was obtained for a film thickness of 0.17 microns (75 mC/cm2) at pH 6 and at a temperature of 313 K. The temperature dependence of the amperometric response indicated an activation energy of 41 kJ/mole. The linearity of the enzyme electrode response ranged from 1.0 mM to 7.5 mM glucose and kinetic parameters determined for the optimized biosensors were 33.4 mM for the Km and 7.2 microA for the Imax. It was demonstrated that the internal diffusion of hydrogen peroxide through the polypyrrole layer to the platinum surface was the main limiting factor controlling the magnitude of the response of the biosensor to glucose. The response was directly related to the enzyme loading in the polypyrrole film. The shelf life and the operational stability of the optimized biosensor exceed 500 days and 175 assays, respectively. The substrate specificity of the entrapped glucose oxidase was not altered by the immobilization procedure.

Two different schedules for integrating filgrastim as adjuvant therapy in the treatment of patients with advanced stage Hodgkin's lymphoma receiving MOPP/ABV hybrid chemotherapy.

PURPOSE: Management of advanced-stage Hodgkin's disease with a MOPP/ABV hybrid regimen (mechlorethamine, vincristine, procarbazine, prednisone, Adriamycin, bleomycin and vinblastine) has yielded a high complete response rate (75-85%). However, myelosuppression can limit delivery of treatment. Filgrastim has been shown to reduce chemotherapy-related neutropenia and allow for on-time administration of planned doses of chemotherapeutic agents. The objective of this study was to find the best way to integrate filgrastim with the MOPP/ABV hybrid regimen. METHODS: Enrolled in this study were 24 patients (aged 18-52 years) with newly diagnosed, histologically documented Hodgkin's disease. In schedule I, patients received filgrastim (5 microg/kg s.c. daily) beginning on day 9, 24 h after administration of ABV. In schedule II, patients received filgrastim concomitantly with procarbazine on days 2-7 (starting 24 h after day-1 MOPP administration and stopping 24 h before ABV administration) as well as after ABV beginning on day 9. Filgrastim after ABV administration was administered until two consecutive ANC readings of 10 x 10(9)/l were achieved. RESULTS: All patients were able to complete all six cycles of therapy. There was a trend to fewer dose reductions in schedule II (0.76%) as compared to schedule I (4.2%) with a P-value of 0.077 (chi-squared test). Specifically, 11.6% of MOPP courses and 5.5% of ABV courses were dose-reduced in schedule I versus 1.7% and 1.4%, respectively, in schedule II. CONCLUSION: In conclusion, filgrastim was effective in supporting the delivery of the MOPP/ABV chemotherapy. Concomitant administration of filgrastim with procarbazine (days 2-7) appears to be safe and allows the maximum dose intensity of this therapy.

A processing plant survey of external lesions of American eels (Anguilla rostrata) from Lake Ontario and the St. Lawrence River, Canada.

Signs of decreasing landing and recruitment were observed in the last decade in American eels (Anguilla rostrata) from the St. Lawrence River basin, Canada. In order to verify if the declines were associated with high prevalence of diseases among commercial catches, a total of 12243 eels captured in five commercial fishing sites were inspected at two processing plants in 1992. They were all examined for external lesions and palpated to detect vertebral deformities. Eels from Lakes Ontario, Saint-François and Saint-Pierre were mainly resident eels, while those from the Richelieu River and the St. Lawrence Estuary at Kamouraska were mainly mature migrating eels. Prevalences of every lesion observed were low (< or = 1%) at every site. Scratches all over the body were found only on eels from Kamouraska. Cutaneous ulcers were observed more frequently in the Richelieu River. Higher prevalences of vertebral deformities were found in mature migrating eels captured in Kamouraska and in the Richelieu River. Vertebral deformities were also observed more frequently among eels captured at the end of the 1992 fishing season in Kamouraska. Higher length, weight and/or age of mature migrating eels may be associated with higher prevalences of vertebral deformities among this group. These results do not indicate that the health of the American eels commercially captured in the St. Lawrence basin is severely impaired. However, the magnitude of diseases among the biological population is probably underestimated by such a survey.

A telephone survey of eel fishermen regarding external lesions and mortalities of American eels (Anguilla rostrata) from Lake Ontario and the St. Lawrence River basin, Canada.

Signs of decreasing landings and recruitment have been observed during the last decade in American eels (Anguilla rostrata) from the St. Lawrence River basin, Canada. A study was undertaken to examine whether important manifestational diseases among commercial catches could be associated with these declines. During this survey, 56 fishermen from Lakes Ontario, Saint-François and Saint-Pierre, the Richelieu River, the Québec City area and the St. Lawrence Estuary were interviewed. Most fishermen from every area reported decreasing catches since the 1980s. Eel mortalities were reported from 1990 to 1992 in Lake Saint-François, Lake Saint-Pierre and the Québec City area, but in apparently lower magnitude than in the past decades. The lesions observed on dead eels in Lake Saint-François indicated that the cause of the mortalities might be associated with the upstream hydroelectric dam. Eels with 'scratches all over the body' were only observed in the St. Lawrence Estuary. Fishermen from almost every area reported that they had observed eels with 'crooked tail', 'humpback' and 'cut tail' in low frequency in 1992. The questionnaire data were validated by comparing some of the results of the questionnaire survey and a processing plant survey in 1992. The use of questionnaires for assessing fish diseases in commercial species is discussed. The results of this survey do not indicate that the health of the American eels from the St. Lawrence River basin is severely impaired. However, the magnitude of diseases and mortalities was probably underestimated.

Indicators for a sustainable society.

This study presents a set of 20 indicators that could be suitable for monitoring the progress of our society on the path to sustainable development. Based on the concept of a sustainable society, which explicitly links the four aspects of health, social equity, economy and environment, these indicators are meant for large administrative areas, and use mostly already available data. The approach is global and symbolic in order to be able to facilitate the integration of the four aspects in the public's mind. It is information for action that could be used in a systematic way for presentation to the general public and to decision-makers, in the manner of everyday economic or weather indicators.

[Drugs, Poverty and HIV: results regarding a provincial needle exchange program in Point de Repères, Quebec]. / Drogues, pauvreté et VIH: données en provenance du programme d'échange de seringues Point de Repères, Québec.

In this study (n = 200), the characteristics of IDUs participating in a provincial needle exchange program (NEP) for more than 2 years (> 2 years) were compared with those of IDUs having participated for less than 2 years (< or = 2 years). Compared to the < or = 2 years, the > 2 years were more often recipients of welfare (RC: 4.7), especially among the HIV-positive (RC: 62.0); tried quitting drugs more frequently (RC: 3.8); more often recommended the NEP to other IDUs (RC: 3.1); and more often requested being given shelter and longer opening hours (RC: 3.6). These results highlight the urgent need to improve and develop transitional and support services for the > 2 years. Preventive interventions that would reach out to the < or = 2 years where they live should also be implemented in close collaboration with organizations involved in mental health and drug use prevention.

Determination of gestational age in sheep and goats using transrectal ultrasonographic measurement of placentomes.

Three experiments were conducted to determine gestational age in the ewe and doe by measuring placentomes with a B-mode ultrasonograph and a 5 MHz transducer. Transrectal measurements were obtained by placing the female over a bale of hay. In Experiment 1, ewes (n = 12) and does (n = 15) were examined by transrectal ultrasonography every week from breeding to parturition to determine the growth pattern of placentomes during pregnancy. In Experiment 2, placentomes from 132 ewes and 169 does were measured between 30 and 90 d of gestation. A linear regression relationship between fetal age in days and placentome size in mm was calculated and adjusted for does (gestational age = 28.74 + 1.80PL + e, r(2) = 70.34) and for ewes (age = 47.98 + 0.62PL + e, r(2) = 15.59). In Experiment 3, the placentomes of 63 does were measured to validate this relationship by using linear regression. Gestational age was determined correctly in 66% of the does, with a range of +/- 7 d and in 96% with a margin of +/- 14 d. In conclusion, transrectal ultrasonography allowed for the measurement of placentome size, which increased rapidly during the first 70 to 90 d of gestation in ewes and does. In ewes, however, there was a poor correlation of placentome size with gestational age, while in goats, measurement of placentomes could be used along with pregnancy diagnosis by transrectal ultrasonography as an indication of gestation age.

Radiographic, high detail radiographic, microangiographic and histological findings of the distal portion of the tarsus in weanling, young and adult horses.

Clinical radiographic (LM and D35L-P1MO views), high detail radiographic, microangiographic and histological findings of the distal portion of the tarsus of 16 horses (five weanling, four young and six adult), without known clinical histories, were evaluated to determine the sensitivity of clinical radiographs for the detection of abnormalities in the distal tarsus and the prevalence of abnormalities in this population. Clinical radiographic and high detail radiographic abnormalities were observed in at least 30 per cent of the tarsi examined. Statistical agreement between observations from clinical radiographs and corresponding post mortem high detail radiographs was not good for subchondral bone plate irregularities and joint margin changes. Three patterns of sclerosis of the medullary spongiosa were visualised on high detail radiographs: thickening of the subchondral bone plate was seen commonly in the weanling group, whereas arching and bridging patterns were more prevalent in the young and adult groups. Bone production on the dorsal cortex of the central and third tarsal bones did not increase with age. Abnormalities in vascular perfusion and articular cartilage histology were observed in association with subchondral bone plate irregularities and focal regions of osteopenia observed on high detail radiographs.

Importance of Escherichia coli in young beef calves from northwestern Quebec.

The objectives of this study were: (i) to investigate the prevalence of Escherichia coli producing F5 (K99), F41, or F165 fimbriae and STa enterotoxin; (ii) to determine serum antibody levels against these fimbriae; (iii) and to examine the association between bacteriological and serological results and the presence of diarrhea, in beef calves from northwestern Quebec. A total of 373 live three to four week old calves and 27 dead calves were sampled between January and March 1991. No isolates positive for F5 were detected in live calves, and only one E. coli producing STa and F41 was isolated. Escherichia coli producing F41-like surface antigens or F165 fimbriae were isolated from 17.43% and 5.63% of live calves, respectively. Antibodies against F5, F41 and F165 were low. Escherichia coli isolates positive for F41-like surface antigen were most often observed in calves born between January and March. No association was found between bacteriological and serological findings, nor between these findings and diarrhea. Calves born from dams vaccinated against E. coli had higher median antibody levels than those born from unvaccinated dams. No E. coli positive for F5 or F41 fimbriae were isolated from dead calves. Escherichia coli with F41-like surface antigen or F165 were found in 55.56% and 11.11% of ileal samples; 4% and 16% of cecal samples, and 0% and 7.4% of colon samples, respectively. Escherichia coli positive for F41-like surface antigen were detected significantly more frequently in the ileum (chi (2)2df = 31.01, p < 0.001).