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1.
PLoS One ; 15(10): e0239886, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33006990

RESUMO

BACKGROUND: Syndromic surveillance through web or phone-based polling has been used to track the course of infectious diseases worldwide. Our study objective was to describe the characteristics, symptoms, and self-reported testing rates of respondents in three different COVID-19 symptom surveys in Canada. METHODS: This was a cross-sectional study using three distinct Canada-wide web-based surveys, and phone polling in Ontario. All three sources contained self-reported information on COVID-19 symptoms and testing. In addition to describing respondent characteristics, we examined symptom frequency and the testing rate among the symptomatic, as well as rates of symptoms and testing across respondent groups. RESULTS: We found that over March- April 2020, 1.6% of respondents experienced a symptom on the day of their survey, 15% of Ontario households had a symptom in the previous week, and 44% of Canada-wide respondents had a symptom in the previous month. Across the three surveys, SARS-CoV-2-testing was reported in 2-9% of symptomatic responses. Women, younger and middle-aged adults (versus older adults) and Indigenous/First nations/Inuit/Métis were more likely to report at least one symptom, and visible minorities were more likely to report the combination of fever with cough or shortness of breath. INTERPRETATION: The low rate of testing among those reporting symptoms suggests significant opportunity to expand testing among community-dwelling residents of Canada. Syndromic surveillance data can supplement public health reports and provide much-needed context to gauge the adequacy of SARS-CoV-2 testing rates.


Assuntos
Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Autorrelato/estatística & dados numéricos , Vigilância de Evento Sentinela , Adulto , Idoso , Canadá/epidemiologia , Infecções por Coronavirus/diagnóstico , Estudos Transversais , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Prevalência , Telefone
2.
Can J Surg ; 63(5): E393-E394, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33009900

RESUMO

SUMMARY: The impact of waiting for surgery on the mental health of patients usually receives little attention. Because of the coronavirus disease 2019 (COVID-19) pandemic, the waits for elective surgery have been lengthening, potentially inducing or exacerbating mental health burdens. Provinces' health systems need to provide better support to assess not only patients' physical health, but also their mental health, and provide them with timely access to care based on need. A stepped care approach is needed to mitigate negative mental health effects associated with prolonged waits for elective operations. To provide the best care possible, we need to recognize and address both the physical and mental health problems of our waiting patients.


Assuntos
Infecções por Coronavirus/prevenção & controle , Procedimentos Cirúrgicos Eletivos/psicologia , Controle de Infecções/normas , Saúde Mental , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Cuidados Pré-Operatórios/métodos , Betacoronavirus/patogenicidade , Canadá/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Procedimentos Cirúrgicos Eletivos/normas , Acesso aos Serviços de Saúde/normas , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Fatores de Tempo , Tempo para o Tratamento , Listas de Espera
3.
Can J Surg ; 63(5): E418-E421, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33009901

RESUMO

SUMMARY: The Canadian Network for International Surgery (CNIS) hosted a workshop in May of 2020 with a goal of critically evaluating Trauma Team Training courses. The workshop was held virtually because of the coronavirus disease 2019 (COVID-19) pandemic. Twenty-three participants attended from 8 countries: Canada, Guyana, Kenya, Nigeria, Switzerland, Tanzania, Uganda and the United States. More participants were able to attend the virtual meeting than the traditional in-person meetings. Web-based videoconference software was used, participants presented prerecorded PowerPoint videos, and questions were raised using a written chat. The review proved successful, with discussions and recommendations for improvements surrounding course quality, lecture content, skills sessions, curriculum variations and clinical practical scenarios. The CNIS's successful experience conducting an online curriculum review involving international participants may prove useful to others proceeding with collaborative projects during the COVID-19 pandemic.


Assuntos
Congressos como Assunto/organização & administração , Infecções por Coronavirus/prevenção & controle , Currículo , Cirurgia Geral/educação , Cooperação Internacional , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus/patogenicidade , Canadá/epidemiologia , Congressos como Assunto/normas , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Cirurgia Geral/métodos , Guiana/epidemiologia , Humanos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Quênia/epidemiologia , Nigéria/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Suíça/epidemiologia , Tanzânia/epidemiologia , Uganda/epidemiologia , Estados Unidos/epidemiologia , Comunicação por Videoconferência/organização & administração , Comunicação por Videoconferência/normas , Ferimentos e Lesões/cirurgia
4.
Artigo em Inglês | MEDLINE | ID: mdl-32987764

RESUMO

Background: This cross-sectional online survey investigates the prevalence of obsessive-compulsive disorder (OCD) symptoms at an early stage of the COVID-19 pandemic in Canada. Methods: OCD symptoms, moderate/high stress, likely generalized anxiety disorder (GAD) and likely major depressive disorder (MDD) were assessed with the Brief Obsessive-Compulsive Scale (BOCS), Perceived Stress Scale (PSS), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9) scale, respectively. Results: Out of 32,805 individuals subscribed to Text4Hope, 6041 completed an online survey; the response rate was 18.4%. Overall, 60.3% of respondents reported onset of OCD symptoms and 53.8% had compulsions to wash hands during the COVID-19 pandemic. Respondents who showed OCD symptoms only since the start of COVID-19 were significantly more likely to have moderate/high stress (z = 6.4, p < 0.001), likely GAD (z = 6.0, p < 0.001), and likely MDD (z = 2.7, p < 0.01). Similarly, respondents who engaged in compulsive hand washing were significantly more likely to have moderate/high stress (z = 4.6, p < 0.001) and likely GAD (z = 4.6 p < 0.001), but not likely MDD (z = 1.4, p = 0.16). Conclusion: The prevalence of OCD symptoms increased during the COVID-19 pandemic, at a rate significantly higher than pre-pandemic rates reported for the sample population. Presenting with OCD symptoms increased the likelihood of presenting with elevated stress, likely GAD, and likely MDD.


Assuntos
Transtornos de Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Transtorno Depressivo Maior/epidemiologia , Saúde Mental , Transtorno Obsessivo-Compulsivo/epidemiologia , Pneumonia Viral/psicologia , Betacoronavirus , Canadá/epidemiologia , Estudos Transversais , Humanos , Pandemias , Prevalência , Estresse Psicológico/epidemiologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-32882922

RESUMO

BACKGROUND: The spread of COVID-19 along with strict public health measures have resulted in unintended adverse effects, including greater levels of distress, anxiety, and depression. This study examined relative presentations of these psychopathologies in different age groups in a Canadian cohort during the COVID-19 pandemic. METHODOLOGY: Participants were subscribers to the Text4Hope program, developed to support Albertans during the COVID-19 pandemic. A survey link was used to gather demographic information and responses on several self-report scales, such as Perceived Stress Scale (PSS), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9). RESULTS: There were 8267 individuals who completed the survey, giving a response rate of 19.4%. Overall, 909 (11.0%) respondents identified as ≤25 years, 2939 (35.6%) identified as (26-40) years, 3431 (41.5%) identified as (41-60) years, 762 (9.2%) identified as over 60 years, and 226 (2.7%) did not identify their age. Mean scores on the PSS, GAD-7, and PHQ-9 scales were highest among those aged ≤25 and lowest amongst those aged >60 years old. CONCLUSIONS: The finding that the prevalence rates and the mean scores for stress, anxiety, and depression on standardized scales to decrease from younger to older subscribers is an interesting observation with potential implications for planning to meet mental health service needs during COVID-19.


Assuntos
Distribuição por Idade , Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/epidemiologia , Pneumonia Viral/psicologia , Adulto , Betacoronavirus , Canadá/epidemiologia , Humanos , Pessoa de Meia-Idade , Pandemias
8.
PLoS One ; 15(9): e0239253, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32946479

RESUMO

PURPOSE: To examine the psychological impact of fertility treatment suspensions resulting from the COVID-19 pandemic and to clarify psychosocial predictors of better or worse mental health. METHODS: 92 women from Canada and the United States (ages 20-45 years) whose fertility treatments had been cancelled were recruited via social media. Participants completed a battery of questionnaires assessing depressive symptoms, perceived mental health impact, and change in quality of life related to treatment suspensions. Potential predictors of psychological outcomes were also examined, including several personality traits, aspects of social support, illness cognitions, and coping strategies. RESULTS: 52% of respondents endorsed clinical levels of depressive symptoms. On a 7-point scale, participants endorsed a significant decline in overall quality of life (M(SD) = -1.3(1.3), p < .0001) as well as a significant decline in mental health related to treatment suspensions on a scale from -5 to +5 (M(SD) = -2.1(2.1), p < .001). Several psychosocial variables were found to positively influence these outcomes: lower levels of defensive pessimism (r = -.25, p < .05), greater infertility acceptance (r = .51, p < .0001), better quality social support (r = .31, p < .01), more social support seeking (r = .35, p < .001) and less avoidance of infertility reminders (r = -.23, p = .029). CONCLUSION: Fertility treatment suspensions have had a considerable negative impact on women's mental health and quality of life. However, these findings point to several protective psychosocial factors that can be fostered in the future to help women cope.


Assuntos
Betacoronavirus , Infecções por Coronavirus/psicologia , Infertilidade/tratamento farmacológico , Pneumonia Viral/psicologia , Suspensão de Tratamento , Adulto , Canadá/epidemiologia , Feminino , Fármacos para a Fertilidade Feminina/provisão & distribução , Fármacos para a Fertilidade Feminina/uso terapêutico , Humanos , Infertilidade/psicologia , Saúde Mental , Pessoa de Meia-Idade , Pandemias , Qualidade de Vida/psicologia , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
9.
BMC Public Health ; 20(1): 1453, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32977776

RESUMO

BACKGROUND: This study examines the relationships between childhood food allergy and parental unhealthy food choices for their children across attitudes towards childhood obesity as mediators and parental gender, income and education as potential moderators. METHODS: We surveyed parents with at least one child between the ages of 6 and 12 living in Canada and the United States. We received 483 valid responses that were analysed using structural equation modelling approach with bootstrapping to test the hypothetical path model and its invariance across the moderators. RESULTS: The analysis revealed that pressure to eat fully mediated the effects of childhood food allergy and restriction on parental unhealthy food choices for their children. Finally, we found that parental gender moderated the relationship between childhood food allergy and the pressure to eat. CONCLUSIONS: The paper contributes to the literature on food allergies among children and the marginalisation of families with allergies. Our explorative model is a first of its kind and offers a fresh perspective on complex relationships between variables under consideration. Although our data collection took place prior to Covid-19 outbreak, this paper bears yet particular significance as it casts light on how families with allergies should be part of the priority groups to have access to food supply during crisis periods.


Assuntos
Hipersensibilidade Alimentar/epidemiologia , Preferências Alimentares/psicologia , Relações Pais-Filho , Pais/psicologia , Canadá/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Modelos Psicológicos , Obesidade Pediátrica/epidemiologia , Inquéritos e Questionários , Estados Unidos/epidemiologia
11.
Eur Rev Med Pharmacol Sci ; 24(15): 8232-8238, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32767355

RESUMO

OBJECTIVE: The COVID-19 pandemic has caused a global public health crisis with social, psychological and long-lasting economical damages. Weather-related dynamics have an impact on the pattern of human health and disease. The present study aimed to investigate the impact of heat and humidity on daily basis incidence and mortality due to COVID-19 pandemic in ten of the world's hottest countries compared to ten of the coldest ones. MATERIALS AND METHODS: Worldwide, we selected 20 countries; 10 hottest countries with the highest temperatures and 10 coldest countries with the lowest temperature. The selection of the countries was based on the daily basis mean temperature from the date of appearance of the initial cases of COVID-19, Dec 29, 2019 to May 12, 2020. In the world's 10 hottest countries, the mean temperature was (26.31±1.51) and humidity (44.67±4.97). However, in the world's 10 coldest countries the mean temperature was (6.19±1.61) and humidity (57.26±2.35). The data on the global outbreak of COVID-19, daily new cases and deaths were recorded from World Health Organization, and daily information on temperature and humidity was obtained from metrological web "Time and Date". RESULTS: In countries with high temperatures and low humidity, the mean daily cases incidence were (407.12±24.33); cumulative cases (9094.34±708.29); and cumulative deaths (452.84±43.30) were significantly low compared to countries with low temperatures and high humidity: daily cases (1876.72±207.37); cumulative cases (44232.38±5875.11); and cumulative deaths (2008.29±310.13). Moreover, COVID-19 cases and deaths per million population were significantly low in countries with high temperatures (cases 711.23, and deaths 16.27) compared to countries with low temperatures (cases 1685.99; and deaths 86.40). Furthermore, in hottest countries, a 1% increase in humidity reduced number of cases and deaths by (ß = -5.40, p<0.001) and (ß = -0.187, p=0.004) respectively. A similar trend was seen with a 1°C increase in temperature, reducing the number of deaths by (ß = -1.35. p<0.001). CONCLUSIONS: The results revealed a significant decrease in incidence of daily cases and deaths in countries with high temperatures and low humidity (warmest countries), compared to those countries with low temperatures and high humidity (coldest countries). The findings could be of interest to the policymakers and the health officials on the epidemiological trends of COVID-19 pandemic and weather changes.


Assuntos
Clima , Infecções por Coronavirus/epidemiologia , Temperatura Alta , Umidade , Pneumonia Viral/epidemiologia , Argélia/epidemiologia , Áustria/epidemiologia , Betacoronavirus , Canadá/epidemiologia , Infecções por Coronavirus/mortalidade , Estônia/epidemiologia , Finlândia/epidemiologia , Gana/epidemiologia , Humanos , Incidência , Índia/epidemiologia , Irã (Geográfico)/epidemiologia , Cazaquistão/epidemiologia , Kuweit/epidemiologia , México/epidemiologia , Mortalidade , Noruega/epidemiologia , Omã/epidemiologia , Paquistão/epidemiologia , Pandemias , Pneumonia Viral/mortalidade , Análise de Regressão , República de Belarus/epidemiologia , Federação Russa/epidemiologia , Arábia Saudita/epidemiologia , Suécia/epidemiologia , Emirados Árabes Unidos/epidemiologia , Estados Unidos/epidemiologia
12.
BMC Infect Dis ; 20(1): 553, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32736606

RESUMO

BACKGROUND: We examined cytokine immune response profiles among contacts to tuberculosis patients to identify immunologic and epidemiologic correlates of tuberculosis. METHODS: We prospectively enrolled 1272 contacts of culture-confirmed pulmonary tuberculosis patients at 9 United States and Canadian sites. Epidemiologic characteristics were recorded. Blood was collected and stimulated with Mycobacterium tuberculosis culture filtrate protein, and tumor necrosis factor (TNF-α), interferon gamma (IFN-γ), and interleukin 10 (IL-10) concentrations were determined using immunoassays. RESULTS: Of 1272 contacts, 41 (3.2%) were diagnosed with tuberculosis before or < 30 days after blood collection (co-prevalent tuberculosis) and 19 (1.5%) during subsequent four-year follow-up (incident tuberculosis). Compared with contacts without tuberculosis, those with co-prevalent tuberculosis had higher median baseline TNF-α and IFN-γ concentrations (in pg/mL, TNF-α 129 versus 71, P < .01; IFN-γ 231 versus 27, P < .001), and those who subsequently developed incident tuberculosis had higher median baseline TNF-α concentrations (in pg/mL, 257 vs. 71, P < .05). In multivariate analysis, contact age < 15 years, US/Canadian birth, and IFN or TNF concentrations > the median were associated with co-prevalent tuberculosis (P < .01 for each); female sex (P = .03) and smoking (P < .01) were associated with incident tuberculosis. In algorithms combining young age, positive skin test results, and elevated CFPS TNF-α, IFN-γ, and IL-10 responses, the positive predictive values for co-prevalent and incident tuberculosis were 40 and 25%, respectively. CONCLUSIONS: Cytokine concentrations and epidemiologic factors at the time of contact investigation may predict co-prevalent and incident tuberculosis.


Assuntos
Interferon gama/sangue , Interleucina-10/sangue , Tuberculose/diagnóstico , Fator de Necrose Tumoral alfa/sangue , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Canadá/epidemiologia , Criança , Pré-Escolar , Busca de Comunicante , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tuberculose/sangue , Estados Unidos/epidemiologia , Adulto Jovem
13.
Healthc Q ; 23(2): 16-17, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32762814

RESUMO

As a chief nurse in Ontario during the severe acute respiratory syndrome (SARS) outbreak in 2003, I never thought I would experience anything even remotely similar, let alone exponentially worse, in my lifetime. Seventeen years and almost 17,000 km later, the COVID-19 crisis feels eerily similar in many ways, and completely different in others.


Assuntos
Infecções por Coronavirus , Surtos de Doenças/prevenção & controle , Pandemias , Pneumonia Viral , Síndrome Respiratória Aguda Grave , Austrália/epidemiologia , Betacoronavirus , Canadá/epidemiologia , Administração Hospitalar , Humanos , Administração em Saúde Pública/métodos , Quarentena/organização & administração
14.
Healthc Policy ; 16(1): 112-124, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32813643

RESUMO

To inform Canada's research response to COVID-19, the Canadian Institutes of Health Research's Institute of Health Services and Policy Research (IHSPR) conducted a rapid-cycle priority identification process. Seven COVID-19 priorities for health services and policy research were identified: system adaptation and organization of care; resource allocation decision-making and ethics; rapid synthesis and comparative policy analysis of the COVID-19 response and outcomes; healthcare workforce; virtual care; long-term consequences of the pandemic; and public and patient engagement. Three additional cross-cutting themes were identified: supporting the health of Indigenous Peoples and vulnerable populations, data and digital infrastructure, and learning health systems and knowledge platforms. IHSPR hopes these research priorities will contribute to the broader ecosystem for collective research investment and action.


Assuntos
Infecções por Coronavirus/prevenção & controle , Assistência à Saúde/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pesquisa , Canadá/epidemiologia , Infecções por Coronavirus/epidemiologia , Política de Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Pneumonia Viral/epidemiologia
15.
Can J Public Health ; 111(4): 469-472, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32761546

RESUMO

COVID-19 has led to disruption in routine immunization programs around the globe and here in Canada. The National Advisory Committee on Immunization (NACI) in Canada has indicated that this sets the stage for serious outbreaks of vaccine-preventable diseases. The World Health Organization has evidence-based guidance on how to address missed opportunities for vaccination, albeit predominately applicable for low- and middle-income countries. In Canada, immunization applies beyond infant and childhood immunization, with immunization across the life course being recommended by NACI. Three components stand out and must be integrated and used concurrently for best effect on catch-up in Canada: (1) Identify who has been missed across the life course; (2) detect delivery gaps, adapt and adjust, and develop multipronged tailored strategies for catch-up; and (3) communicate, document, evaluate and readjust the immunization programs. All must be adapted to the reality of the evolving COVID-19 pandemic. We cannot go back to a pre-COVID-19 world. However, ensuring that routine immunization and catch-up programs are done well during this pandemic strengthens the immunization foundation in Canada for when COVID-19 vaccines become available.


Assuntos
Infecções por Coronavirus/epidemiologia , Programas de Imunização/organização & administração , Imunização/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Canadá/epidemiologia , Criança , Humanos , Lactente , Pandemias
16.
Can J Public Health ; 111(4): 462-465, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32767271

RESUMO

COVID-19 mitigation strategies have led to widespread school closures around the world. Initially, these were undertaken based on data from influenza outbreaks in which children were highly susceptible and important in community-wide transmission. An argument was made that school closures were necessary to prevent harm to vulnerable adults, especially the elderly. Although data are still accumulating, the recently described complication, pediatric multisystem inflammatory syndrome, is extremely rare and children remain remarkably unaffected by COVID-19. We also do not have evidence that children are epidemiologically important in community-wide viral spread. Previous studies have shown long-term educational, social, and medical harms from school exclusion, with very young children and those from marginalized groups such as immigrants and racialized minorities most affected. The policy and ethical implications of ongoing mandatory school closures, in order to protect others, need urgent reassessment in light of the very limited data of public health benefit.


Assuntos
Infecções por Coronavirus/prevenção & controle , Política de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Prática de Saúde Pública/ética , Instituições Acadêmicas/organização & administração , Canadá/epidemiologia , Criança , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia
20.
PLoS Med ; 17(8): e1003281, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32797086

RESUMO

BACKGROUND: Prostate cancer (PC) is the most frequently diagnosed cancer in North American men. Pathologists are in critical need of accurate biomarkers to characterize PC, particularly to confirm the presence of intraductal carcinoma of the prostate (IDC-P), an aggressive histopathological variant for which therapeutic options are now available. Our aim was to identify IDC-P with Raman micro-spectroscopy (RµS) and machine learning technology following a protocol suitable for routine clinical histopathology laboratories. METHODS AND FINDINGS: We used RµS to differentiate IDC-P from PC, as well as PC and IDC-P from benign tissue on formalin-fixed paraffin-embedded first-line radical prostatectomy specimens (embedded in tissue microarrays [TMAs]) from 483 patients treated in 3 Canadian institutions between 1993 and 2013. The main measures were the presence or absence of IDC-P and of PC, regardless of the clinical outcomes. The median age at radical prostatectomy was 62 years. Most of the specimens from the first cohort (Centre hospitalier de l'Université de Montréal) were of Gleason score 3 + 3 = 6 (51%) while most of the specimens from the 2 other cohorts (University Health Network and Centre hospitalier universitaire de Québec-Université Laval) were of Gleason score 3 + 4 = 7 (51% and 52%, respectively). Most of the 483 patients were pT2 stage (44%-69%), and pT3a (22%-49%) was more frequent than pT3b (9%-12%). To investigate the prostate tissue of each patient, 2 consecutive sections of each TMA block were cut. The first section was transferred onto a glass slide to perform immunohistochemistry with H&E counterstaining for cell identification. The second section was placed on an aluminum slide, dewaxed, and then used to acquire an average of 7 Raman spectra per specimen (between 4 and 24 Raman spectra, 4 acquisitions/TMA core). Raman spectra of each cell type were then analyzed to retrieve tissue-specific molecular information and to generate classification models using machine learning technology. Models were trained and cross-validated using data from 1 institution. Accuracy, sensitivity, and specificity were 87% ± 5%, 86% ± 6%, and 89% ± 8%, respectively, to differentiate PC from benign tissue, and 95% ± 2%, 96% ± 4%, and 94% ± 2%, respectively, to differentiate IDC-P from PC. The trained models were then tested on Raman spectra from 2 independent institutions, reaching accuracies, sensitivities, and specificities of 84% and 86%, 84% and 87%, and 81% and 82%, respectively, to diagnose PC, and of 85% and 91%, 85% and 88%, and 86% and 93%, respectively, for the identification of IDC-P. IDC-P could further be differentiated from high-grade prostatic intraepithelial neoplasia (HGPIN), a pre-malignant intraductal proliferation that can be mistaken as IDC-P, with accuracies, sensitivities, and specificities > 95% in both training and testing cohorts. As we used stringent criteria to diagnose IDC-P, the main limitation of our study is the exclusion of borderline, difficult-to-classify lesions from our datasets. CONCLUSIONS: In this study, we developed classification models for the analysis of RµS data to differentiate IDC-P, PC, and benign tissue, including HGPIN. RµS could be a next-generation histopathological technique used to reinforce the identification of high-risk PC patients and lead to more precise diagnosis of IDC-P.


Assuntos
Carcinoma Intraductal não Infiltrante/diagnóstico por imagem , Aprendizado de Máquina/normas , Microscopia Óptica não Linear/normas , Neoplasias da Próstata/diagnóstico por imagem , Idoso , Canadá/epidemiologia , Carcinoma Intraductal não Infiltrante/epidemiologia , Carcinoma Intraductal não Infiltrante/patologia , Estudos de Casos e Controles , Estudos de Coortes , Humanos , Masculino , Pessoa de Meia-Idade , Microscopia Óptica não Linear/métodos , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/patologia , Reprodutibilidade dos Testes , Estudos Retrospectivos
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