Skip header and navigation

Refine By

78 records – page 1 of 8.

Active surveillance for prostate cancer: a review.

https://arctichealth.org/en/permalink/ahliterature143951
Source
Curr Urol Rep. 2010 May;11(3):165-71
Publication Type
Article
Date
May-2010
Author
Laurence Klotz
Author Affiliation
Division of Urology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, #MG408, Toronto, ON, M4N 3M5, Canada. Laurence.klotz@sunnybrook.ca
Source
Curr Urol Rep. 2010 May;11(3):165-71
Date
May-2010
Language
English
Publication Type
Article
Keywords
Biopsy - methods
Canada - epidemiology
Humans
Male
Mass Screening - methods
Morbidity
Population Surveillance - methods
Prostate-Specific Antigen - blood
Prostatic Neoplasms - blood - diagnosis - epidemiology
Risk Assessment - methods
Risk factors
United States - epidemiology
Abstract
Active surveillance is a solution to the widely acknowledged problem of overdiagnosis and overtreatment of clinically insignificant disease which accompanies early detection of prostate cancer using prostate-specific antigen (PSA) and biopsy. It is an approach to the management of favorable-risk prostate cancer which uses the opportunity provided by the long natural history of the disease to incorporate a period of initial observation into patient management. The basic concept is that most men diagnosed with low-grade, small-volume disease are not destined to have any clinical manifestations of the condition during their lifetime. However, a subset of patients with favorable-risk prostate cancer is at risk, due to either the presence of higher-risk disease not apparent at diagnosis or progression to a more aggressive phenotype over time. These patients can be identified with reasonable accuracy by close follow-up, including serial PSAs and biopsies, and treated effectively in most cases. The rationale, patient selection, method of follow-up, triggers for intervention, and recent results of this approach will be reviewed.
PubMed ID
20425623 View in PubMed
Less detail

Adherence to guidelines for surveillance colonoscopy in patients with ulcerative colitis at a Canadian quaternary care hospital.

https://arctichealth.org/en/permalink/ahliterature148080
Source
Can J Gastroenterol. 2009 Sep;23(9):613-7
Publication Type
Article
Date
Sep-2009
Author
Dan Kottachchi
Derek Yung
John K Marshall
Author Affiliation
Department of Internal Medicine, McMaster University, Hamilton, ON, Canada.
Source
Can J Gastroenterol. 2009 Sep;23(9):613-7
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Biopsy - statistics & numerical data
Canada - epidemiology
Cell Transformation, Neoplastic - pathology
Colitis, Ulcerative - complications - diagnosis
Colon - pathology
Colonic Neoplasms - epidemiology - etiology - prevention & control
Colonic Polyps - epidemiology - etiology - pathology
Colonoscopy - statistics & numerical data
Female
Gastroenterology - standards
Guideline Adherence - statistics & numerical data
Hospitals, University - statistics & numerical data
Humans
Intestinal Mucosa - pathology
Male
Mass Screening - methods
Middle Aged
Physician's Practice Patterns - standards
Practice Guidelines as Topic
Precancerous Conditions - epidemiology - etiology - pathology
Retrospective Studies
Severity of Illness Index
Abstract
Patients with ulcerative colitis (UC) are at high risk of colonic dysplasia. Therefore, surveillance colonoscopy to detect early dysplasia has been endorsed by many professional organizations.
To determine whether gastroenterologists at Hamilton Health Sciences (Hamilton, Ontario) adhere to recommendations for UC surveillance issued by the Canadian Association of Gastroenterology and to retrospectively assess the incidence and type of dysplasia found and the subsequent outcome of patients with dysplasia (ie, colorectal cancer [CRC], colectomy, dysplasia recurrence).
A retrospective chart review of all patients with UC undergoing colonoscopy screening at Hamilton Health Sciences from January 1980 to January 2005, was performed. Patients were classified by the extent of colonic disease: limited left-sided colitis (LSC), pancolitis and any disease extent with concurrent primary sclerosing cholangitis.
A total of 141 patients fulfilled eligibility criteria. They underwent 921 endoscopies, including 453 for surveillance, which were performed by 20 endoscopists. Overall, screening was performed on 90% of patients, and surveillance at the appropriate time in 74%. There was a statistically significant increase in the mean number of biopsies per colonoscopy after the guidelines were published (P
Notes
Cites: Gastroenterology. 1993 Aug;105(2):418-248335197
Cites: Gastroenterology. 1994 Oct;107(4):934-447926483
Cites: Am J Gastroenterol. 1999 Apr;94(4):1047-5210201481
Cites: Inflamm Bowel Dis. 2005 Mar;11(3):314-2115735438
Cites: Br J Surg. 2005 Aug;92(8):928-3616034807
Cites: Curr Opin Gastroenterol. 2005 Sep;21(5):585-816093774
Cites: Scand J Gastroenterol. 2005 Sep;40(9):1076-8016211714
Cites: Am J Gastroenterol. 2005 Dec;100(12):2724-916393226
Cites: Clin Gastroenterol Hepatol. 2006 Mar;4(3):335-4216527697
Cites: Gastroenterology. 2006 Apr;130(4):1030-816618396
Cites: Gastroenterology. 2006 Apr;130(4):1039-4616618397
Cites: N Engl J Med. 2006 Dec 14;355(24):2551-717167138
Cites: Aliment Pharmacol Ther. 2007 Mar 15;25(6):657-6817311598
Cites: Int J Clin Pract. 2007 Mar;61(3):510-317313621
Cites: Gastrointest Endosc. 2007 Jun;65(7):998-100417451704
Cites: Dig Dis. 2007;25(3):267-917827953
Cites: Gastrointest Endosc. 2000 Feb;51(2):123-810650251
Cites: Cancer. 2001 Feb 15;91(4):854-6211241255
Cites: Gut. 2001 Apr;48(4):526-3511247898
Cites: Gut. 2002 Oct;51 Suppl 5:V10-212221032
Cites: Gastroenterology. 2003 Feb;124(2):544-6012557158
Cites: Gut. 2003 Aug;52(8):1127-3212865270
Cites: Br J Cancer. 2003 Oct 6;89(7):1232-614520452
Cites: Can J Gastroenterol. 2004 Feb;18(2):93-914997217
Cites: Gastroenterology. 2004 May;126(6):1634-4815168373
Cites: Gastrointest Endosc. 2004 Sep;60(3):334-915332019
Cites: N Engl J Med. 1990 Nov 1;323(18):1228-332215606
PubMed ID
19816624 View in PubMed
Less detail

The Ages and Stages Questionnaires: feasibility of use as a screening tool for children in Canada.

https://arctichealth.org/en/permalink/ahliterature159267
Source
Can J Rural Med. 2008;13(1):9-14
Publication Type
Article
Date
2008
Author
Jorina Elbers
Andrew Macnab
Elaine McLeod
Faith Gagnon
Author Affiliation
Department of Pediatrics, University of British Columbia, Vancouver, BC.
Source
Can J Rural Med. 2008;13(1):9-14
Date
2008
Language
English
Publication Type
Article
Keywords
British Columbia - epidemiology
Canada - epidemiology
Child
Child, Preschool
Developmental Disabilities - diagnosis - epidemiology - etiology
Feasibility Studies
Humans
Infant
Mass Screening - methods
Questionnaires
Sensitivity and specificity
Abstract
To determine the accuracy and feasibility of a monitoring tool completed by parents for screening at-risk and community infants and children for developmental problems.
We assessed 43 children following open-heart surgery and 68 community children (aged 4-36 mo) at prescribed intervals using the Ages and Stages Questionnaires (ASQ). Subjects were followed 3 years later (at age 5-6 yr) via telephone interview with their parents concerning developmental delay identified by physicians. Responses were confirmed by telephone interviews with family physicians. We then compared the results of the ASQ with the physician assessments.
Nine at-risk and 9 community children were lost to follow-up. The ASQ identified 4 of the 25 at-risk children as having developmental delay, while 2 of the 6 children assessed by a neurologist were identified as having developmental delay. The ASQ identified 2 of the 59 community children as having developmental delay, 1 of whom was assessed by a neurologist as having developmental delay. The ASQ had sensitivities of 75% in the at-risk group and 100% in the community group, and specificities of 95% and 90%, respectively. The parents were unanimous in their willingness to complete the assessments.
The ASQ is feasible, inexpensive, easy to use, and was appreciated by the parents. It is a sufficiently sensitive and specific monitoring tool that its use in cardiac follow-up programs and in community programs for healthy children is warranted. Although this tool should not be used to replace clinical assessment, it can be used to rationalize access to specialist developmental assessment services.
PubMed ID
18208647 View in PubMed
Less detail

An epidemiological survey of chlamydial and gonococcal infections in a Canadian arctic community.

https://arctichealth.org/en/permalink/ahliterature90552
Source
Sex Transm Dis. 2009 Feb;36(2):79-83
Publication Type
Article
Date
Feb-2009
Author
Steenbeek Audrey
Tyndall Mark
Sheps Samuel
Rothenberg Richard
Author Affiliation
School of Nursing, Dalhousie University, NS, Canada. a.steenbeek@dal.ca
Source
Sex Transm Dis. 2009 Feb;36(2):79-83
Date
Feb-2009
Language
English
Publication Type
Article
Keywords
Adult
Canada - epidemiology
Chlamydia Infections - epidemiology - ethnology - prevention & control
Chlamydia trachomatis
Contact Tracing
Cross-Sectional Studies
Female
Gonorrhea - epidemiology - ethnology - prevention & control
Humans
Interviews as Topic
Inuits
Male
Mass Screening - methods
Neisseria gonorrhoeae
Prevalence
Sexually Transmitted Diseases, Bacterial - epidemiology - ethnology - prevention & control
Young Adult
Abstract
BACKGROUND: Sexually transmitted infections are leading causes of morbidity for Canadian Aboriginal women. To date, very few initiatives have been successful in screening, treating, and limiting these infections among these populations. OBJECTIVES: To evaluate the efficacy of universal screening, treatment and contact tracing as a means of capturing a more accurate count of chlamydia and gonorrhea prevalence and limiting transmission among Inuit communities. METHODS: 181 participants were screened for chlamydia and gonorrhea and interviewed in a cross-sectional survey (Aug-Sept/03). Information was collected on demographics, use of health services, sexual histories and STI knowledge among others. A random sample (n = 100) from the cross-sectional group was selected for the longitudinal cohort. Individuals were followed every two months post baseline for four visits (Oct/03-May/04). At each visit, participants were screened for chlamydia/gonorrhea. All positive cases and their partners were treated and contact tracing completed. Logistic Regression analysis and the McNemar Test of Correlated Proportions were used to analyze the data. RESULTS: Overall, 35 cases of chlamydia were detected, with 21 detected at baseline and 14 during follow-up. The baseline prevalence was 11.6% in comparison with 2.7% that was previously estimated. No gonorrhea was detected. The strongest factor associated with a positive chlamydia was having recent STI (OR 9.82, CI: 2.70, 35.77). CONCLUSIONS: Consistent with the literature, the results support the use of universal screening followed by prompt treatment and contact tracing in populations with greater than 10% chlamydia prevalence.
PubMed ID
19125145 View in PubMed
Less detail

Association of sexually transmitted disease-related stigma with sexual health care among women attending a community clinic program.

https://arctichealth.org/en/permalink/ahliterature157562
Source
Sex Transm Dis. 2008 Jun;35(6):553-7
Publication Type
Article
Date
Jun-2008
Author
Melanie Rusch
Jean Shoveller
Susan Burgess
Karen Stancer
David Patrick
Mark Tyndall
Author Affiliation
Division of International Health and Cross Cultural Medicine, University of California, San Diego, La Jolla, California 92093-0622, USA. mrusch@ucsd.edu
Source
Sex Transm Dis. 2008 Jun;35(6):553-7
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Adult
Ambulatory Care
Canada - epidemiology
Community Health Services - utilization
Female
Humans
Mass Screening - methods
Papanicolaou test
Patient Acceptance of Health Care
Sexually Transmitted Diseases - diagnosis - epidemiology - prevention & control - psychology
Stereotyping
Vaginal Smears
Abstract
The objective of this study was to assess the association of sexually transmitted disease (STD)-related stigma on sexual health care behaviors, including Papanicolaou smears and STD testing/treatment, among women from a high-risk community.
Descriptive statistics were used to assess the association of demographics, sexual and drug-related risk behaviors, and 3 measures of STD-stigma (internal, social, and tribal stigma, the latter referring to "tribes" of womanhood) with sexual health care in the past year. Pearson's chi-square test and Mann-Whitney test were used to assess significance. Multivariate logistic models were used to determine the association of STD-stigma with sexual health care after controlling for other factors.
Lower internal stigma score was marginally associated with reporting an STD test in the past year [median score (interquartile range) for those reporting and not reporting an STD test were 0.79 (0.30-1.59) and 1.35 (0.67-1.93), respectively]. In an adjusted model, internal stigma retained a negative association with reporting of STD testing in the past year (adjusted odds ratio, 0.92; 95% confidence interval, 0.85-0.99).
Most women had received a Papanicolaou smear in the past year, and none of the STD-stigma scales were associated with reporting this behavior. Internal stigma retained an association with not having any STD test or treatment. Although sexual stigma is a deeply rooted social construct, paying attention to how prevention messages and STD information are delivered may help remove one barrier to sexual health care.
PubMed ID
18434941 View in PubMed
Less detail

Background and objectives of the U.S. Preventive Services Task Force.

https://arctichealth.org/en/permalink/ahliterature228463
Source
J Gen Intern Med. 1990 Sep-Oct;5(5 Suppl):S11-3
Publication Type
Article
Author
J M McGinnis
S H Woolf
Author Affiliation
Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, Washington, DC 20201.
Source
J Gen Intern Med. 1990 Sep-Oct;5(5 Suppl):S11-3
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Humans
Mass Screening - methods
Physical Examination - utilization
Preventive Health Services
Preventive Medicine
United States - epidemiology
United States Dept. of Health and Human Services
Abstract
Clinical preventive services have always been recognized by clinicians as an important part of primary care medicine, but for many years there has been some uncertainty as to the effectiveness of these maneuvers in preventing disease and exactly how and when they should be performed. The recent report of the U.S. Preventive Services Task Force provides a comprehensive review of the science base for preventive services and offers specific recommendations for clinicians on the appropriate delivery of screening tests, counseling interventions, immunizations, and other preventive services. The recommendations provide guidance on how to design an appropriate package of services based on the medical history and risk profile of each patient. This article describes the historical background behind the formation of the task force, its methodology and rationale, and the format of the final report, the "Guide to Clinical Preventive Services." The potential implications of this report and its limitations are also discussed.
PubMed ID
2231051 View in PubMed
Less detail
Source
Can Fam Physician. 1999 Aug;45:1937-9, 1942-4
Publication Type
Article
Date
Aug-1999
Source
Can Fam Physician. 1999 Aug;45:1937-9, 1942-4
Date
Aug-1999
Language
English
French
Publication Type
Article
Keywords
Age Distribution
Aged
Breast Neoplasms - epidemiology - genetics - prevention & control
Canada - epidemiology
Female
Humans
Mammography
Mass Screening - methods
Middle Aged
Primary prevention - methods
Notes
Cites: Annu Rev Public Health. 1996;17:47-678724215
Cites: Medicine (Baltimore). 1998 May;77(3):208-269653432
Cites: Lancet. 1998 Jul 11;352(9122):93-79672273
Cites: J Natl Cancer Inst. 1998 Sep 16;90(18):1371-889747868
Cites: Am J Hum Genet. 1993 Apr;52(4):678-7018460634
Cites: J Natl Cancer Inst. 1993 Oct 20;85(20):1644-568105098
Cites: JAMA. 1995 Jan 11;273(2):149-547799496
Cites: Lancet. 1998 Jul 11;352(9122):98-1019672274
PubMed ID
10463094 View in PubMed
Less detail

Building clinical capacity for fetal alcohol spectrum disorder diagnoses in western and northern Canada.

https://arctichealth.org/en/permalink/ahliterature156780
Source
Can J Clin Pharmacol. 2008;15(2):e223-37
Publication Type
Article
Date
2008
Author
Sterling K Clarren
Jan Lutke
Author Affiliation
The Canada Northwest Fetal Alcohol Spectrum Disorder Research Network Centre for Community Child Health Research, Vancouver, British Columbia.
Source
Can J Clin Pharmacol. 2008;15(2):e223-37
Date
2008
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Child
Community Health Services - methods - supply & distribution
Female
Fetal Alcohol Spectrum Disorders - diagnosis - economics - epidemiology
Health Services Accessibility
Humans
Mass Screening - methods
Patient care team
Pregnancy
Abstract
Fetal alcohol syndrome and fetal alcohol spectrum disorder are common problems. In response to this problem the Canada Northwest FASD Research Network was established in 2005 by the Canada Northwest FASD Ministerial Partnership. This study was conducted to determine the FASD clinical activity in Canada Northwest.
The Network identified all clinical programs via Internet sites, provincial postings and professional word of mouth references that purported to do FASD assessments regularly using a multidisciplinary assessment team. Each of these programs was sent a questionnaire asking about clinical capacity, aggregate diagnostic results, team composition, time of clinical assessment and cost of assessment.
Of the 27 programs identified to receive the questionnaire 15 programs responded. These programs were determined to have evaluated about 85% of the patients evaluated by all the programs. The total 7 jurisdictional capacity for FASD diagnosis was 816 evaluations in 2005 and projected to be 975 in 2006. Selection methods for appointing patients for assessment seemed excellent as 23% of those assessed were found to have FAS or pFAS and another 44% had other forms of FASD. The most common professionals to participate in the team evaluations were Paediatricians, Clinical Psychologists, Speech and Language Pathologists and Occupational Therapists.
Clinics are developing in western and northern Canada to diagnose patients with FASD. Comparing the experiences of these clinics can help to determine the continued need to increase diagnostic capacity, standardize diagnostic approaches to assure consistency of approach and diagnosis across the sites and appropriately staff and fund the programs. Key words: FASD; diagnosis; Canada; clinics.
PubMed ID
18544794 View in PubMed
Less detail

Canadian colorectal cancer screening initiatives and barriers.

https://arctichealth.org/en/permalink/ahliterature155452
Source
J Am Coll Radiol. 2008 Sep;5(9):951-7
Publication Type
Article
Date
Sep-2008
Author
Ania Z Kielar
Robert H El-Maraghi
Author Affiliation
Department of Diagnostic Imaging, The Ottawa Hospital, Ottawa, Ontario, Canada. aniakielar@gmail.com
Source
J Am Coll Radiol. 2008 Sep;5(9):951-7
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada - epidemiology
Colorectal Neoplasms - mortality - prevention & control
Female
Humans
Male
Mass Screening - methods - organization & administration - statistics & numerical data
Middle Aged
Prevalence
PubMed ID
18755433 View in PubMed
Less detail

The Canadian National Breast Screening Study-1: breast cancer mortality after 11 to 16 years of follow-up. A randomized screening trial of mammography in women age 40 to 49 years.

https://arctichealth.org/en/permalink/ahliterature188743
Source
Ann Intern Med. 2002 Sep 3;137(5 Part 1):305-12
Publication Type
Article
Date
Sep-3-2002
Author
Anthony B Miller
Teresa To
Cornelia J Baines
Claus Wall
Author Affiliation
University of Toronto, Toronto, Canada. a.miller@dkfz-heidelberg.de
Source
Ann Intern Med. 2002 Sep 3;137(5 Part 1):305-12
Date
Sep-3-2002
Language
English
Publication Type
Article
Keywords
Adult
Breast Neoplasms - diagnosis - mortality - prevention & control
Breast Self-Examination - standards
Canada - epidemiology
Female
Follow-Up Studies
Humans
Mammography - standards
Mass Screening - methods - standards
Middle Aged
Physical Examination - standards
Preventive Health Services - standards
Abstract
The efficacy of breast cancer screening in women age 40 to 49 years remains controversial.
To compare breast cancer mortality in 40- to 49-year-old women who received either 1) screening with annual mammography, breast physical examination, and instruction on breast self-examination on 4 or 5 occasions or 2) community care after a single breast physical examination and instruction on breast self-examination.
Individually randomized, controlled trial.
15 Canadian centers.
50 430 volunteers age 40 to 49 years, recruited from January 1980 to March 1985, who were not pregnant, had no previous breast cancer diagnosis, and had not had mammography in the preceding 12 months.
Breast physical examination and instruction on breast self-examination preceded random assignment of 25 214 women to receive mammography and annual mammography, breast physical examination, and breast self-examination and 25 216 women to receive usual community care with annual follow-up.
Verified breast cancer incidence and cohort mortality through 31 December 1993 and deaths from breast cancer through 30 June 1996.
The 105 breast cancer deaths in the mammography group and 108 breast cancer deaths in the usual care group yielded a cumulative rate ratio, adjusted for mammography done outside the study, of 1.06 (95% CI, 0.80 to 1.40). A total of 592 cases of invasive breast cancer and 71 cases of in situ breast cancer were diagnosed by 31 December 1993 in the mammography group compared with 552 and 29 cases, respectively, in the usual care group. The expected proportions of nonpalpable and small invasive tumors were detected on mammography.
After 11 to 16 years of follow-up, four or five annual screenings with mammography, breast physical examination, and breast self-examination had not reduced breast cancer mortality compared with usual community care after a single breast physical examination and instruction on breast self-examination. The study data show that true effects of 20% or greater are unlikely.
Notes
Comment In: Cancer Treat Rev. 2003 Feb;29(1):55-712633581
Comment In: Ann Intern Med. 2002 Sep 3;137(5 Part 1):361-212204022
Comment In: ACP J Club. 2003 Mar-Apr;138(2):38-3912614123
SummaryForPatientsIn: Ann Intern Med. 2002 Sep 3;137(5 Part 1):I2812204045
PubMed ID
12204013 View in PubMed
Less detail

78 records – page 1 of 8.