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David Moore

Publications and source records attributed to David Moore.

41 records · Page 3Linked to original sources
PubMedDate not supplied

The clinical characteristics and impact of laryngopharyngeal reflux disease on health-related quality of life.

BACKGROUND AND OBJECTIVES: Although it is accepted that reflux of stomach acid causes gastroesophageal reflux disease (GERD), it is less well understood that it also contributes to the clinical signs and symptoms of laryngitis in the form of laryngopharyngeal reflux (LPR). Study objectives were to identify what is known about the impact of LPR on health-related quality of life (HRQL) compared with the impact of GERD on HRQL and to assess whether currently available HRQL instruments adequately measure this impact or if a new disease-specific instrument should be recommended. METHODS: The authors combined a systematic literature review with prospective patient evaluation via focus groups. The review, using MEDLINE, focused on clinical characteristics and HRQL measurement and impact. Focus groups involving a total of 30 patients with LPR provided input on clinical manifestations of the disease and its HRQL impact. RESULTS: Information gleaned from the literature indicates that less than 40% of patients presenting with symptoms of laryngitis directly attributable to reflux also report experiencing the classic symptoms of heartburn and acid regurgitation associated with GERD. Reflux laryngitis is thus a distinct clinical entity from GERD and may have a unique impact on HRQL. Although multiple instruments are available to assess the impact of GERD on HRQL, no specific instruments are available for LPR. Focus group discussions identified voice problems, chronic cough, throat clearing, and swallowing difficulties to be key concerns of patients with LPR. These manifestations negatively impact HRQL as described by the focus group participants, notably in role functioning, physical well-being, and emotional well-being. CONCLUSIONS: A disease-specific instrument to assess the impact of LPR on HRQL would contribute to clinical care and the evaluation of new therapies. This instrument would ideally be sensitive to the variety of LPR's symptomatic presentations.

Focus Groups↗
PubMedDate not supplied

The role of nuclear envelope calcium in modifying nuclear pore complex structure.

Some of the most important trafficking processes in cells involve transport across the nuclear envelope. Whether it is the import of transcription factors or the export of RNA, the only known portal across the double lipid bilayer that forms the nuclear envelope are the macromolecular pores known as nuclear pore complexes (NPCs). Understanding how signals influence the conformation of the NPC is important for testing models of, and perhaps modifying, transport across the nuclear envelope. Here we summarize high-resolution atomic force microscopy studies of NPC structure following manipulation of nuclear envelope calcium stores of nuclei from Xenopus laevis oocytes. The results show that the release of calcium from these stores through the specific activation of inositol 1,4,5-trisphosphate receptors leads to changes in NPC structure observable from both sides of the nuclear envelope. The diameter of the NPC is also sensitive to these calcium stores and increases upon calcium release. Western blot analysis reveals the presence of ryanodine receptors in the nuclear envelope of X. laevis oocytes, although in low abundance. Activation of these calcium channels also leads to the displacement of the central mass and changes in NPC diameter. This change in structure may involve a displacement of the cytoplasmic and nuclear rings of the NPC towards each other, leading to the apparent emergence of the central mass from both sides of the NPC. The changes in conformation and diameter of the NPC may alter cargo access and binding to phenylalanine-glycine repeats lining the pore, thus altering transport.

Adenosine↗
PubMedDate not supplied

Assessing the health implications for healthcare workers of regulatory changes eliminating locally developed occupational exposure limits in favor of TLVs: an evidence-based bipartite approach.

In response to the intention of the Workers' Compensation Board of British Columbia (WCB of BC) to eliminate made-in-BC occupational exposure limits (OELs) and adopt threshold limit values (TLVs), this study assessed the potential health impacts on healthcare workers (HCWs) of the proposed change, by (1) reviewing the processes used to establish the OELs and TLVs, (2) selecting of substances of health concern for HCWs, (3) identifying chemicals with discordances between existing OELs and the 2002 TLVs, and 4) reviewing the discordances and assessing the potential health implications. Differences in philosophies, policies and processes that influenced the setting of OELs and TLVs were substantial. The TLV process involves U.S. and international priorities; in BC, a tripartite committee determined OELs taking into consideration how OELs should be interpreted in the local context. 47 chemicals of concern to BC HCWs were discordant, with significant discordances totalling 57; 15 compounds had BC 8-hour OELs lower than their respective TLVs and three TLVs were lower than the 8-hour BC OELs. Review of six chemicals with discordances suggested a potential for increased risks of adverse health effects. Eliminating the local capacity and authority to set OELs is unlikely to cause major health problems in the short run, but as chemicals in use locally may not have up-to-date TLVs, eliminating the capacity for local considerations should be undertaken with great caution. While the WCB of BC did implement the change, the present report resulted in procedural changes that will provide better protection for the workforce.

British Columbia↗
PubMedDate not supplied

Population health effects of air quality changes due to forest fires in British Columbia in 2003: estimates from physician-visit billing data.

BACKGROUND: Major forest fires near populated areas during 2003 exacted a huge economic toll on communities in British Columbia. We designed a study to examine associations between PM2.5 and PM10 levels and physician visits in two affected communities. METHODS: Measurements of 24-hour averages of particulate matter (PM10 and PM2.5) obtained from the monitoring network of the BC Ministry of Water, Land and Air Protection were used to define weeks where forest fires resulted in increases in ambient PM. Weekly rates of physician visits for respiratory (ICD-9 codes 460-519), cardiovascular (390-459) and mental illnesses (290-319) obtained through the Medical Services Plan of BC, were compared for 2003 and aggregates of the 10 previous years. RESULTS: Both the Kelowna and Kamloops regions experienced five weeks of elevated 24-hour average PM levels, although maximum levels in Kelowna were greater. In the Kelowna region, increases in physician visits for respiratory diseases of between 46 and 78% above 10-year mean rates were observed for three weeks during the forest fire period. Similar effects were not observed in Kamloops. Effects on visits for cardiovascular diseases or mental disorders were not seen in either community. INTERPRETATION: Forest fire smoke was associated with an excess of respiratory complaints in Kelowna area residents. The lack of a similar effect in Kamloops is likely due to the population being exposed to lower levels of PM. The absence of apparent cardiovascular health effects may be due to selective effects of forest fire smoke on respiratory tract disease.

Air Pollution↗