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Biomedical subjects

N MacDonald

Publications and source records attributed to N MacDonald.

At least 55 records · Page 3Linked to original sources
PubMed1996

Prevalence of Dientamoeba fragilis antibodies in children and recognition of a 39 kDa immunodominant protein antigen of the organism.

Dientamoeba fragilis, a common intestinal protozoan parasite in Canada, has been associated with diarrhoea and abdominal pain in some patients. Seroprevalence of this organism has not been reported previously. In the present study sera from three symptomatic patients, 12 age- and sex-matched controls, and 189 randomly selected healthy individuals (age 6 months to 19 years) were tested for antibodies against Dientamoeba fragilis by an indirect immunofluorescence (IIF) assay. All three symptomatic patients infected with Dientamoeba fragilis had positive IIF titres of 80, and all 12 matched controls had positive titres ranging 20 to 160 (geometric mean titre 48). Of the 189 healthy children, 172 (91%) were positive at a serum dilution of 1:10 or higher. The specificity of the IIF assay was reinforced by immunoblotting 20 representative serum samples against Dientamoeba fragilis. In all 17 IIF-positive serum samples, a 39 kDa protein band of Dientamoeba fragilis was identified, the same band recognized by a mouse monoclonal antibody raised in our laboratory. Findings over a five-year period indicate that Dientamoeba fra-gilis was the most common protozoan, followed closely by Giardia lamblia and more distantly by Cryptosporidium parvum. The high seropositivity of 91% for Dientamoeba fragilis compares reasonably well with serologic data obtained by IIF and reported previously for Giardia lamblia (85.6%) and Cryptosporidium parvum (86%).

Adolescent↗
PubMed1996

A comparison of Culture-Free Self-Esteem Scale means from different child and adolescent groups.

The Culture-Free Self-Esteem Inventory (CFSEI-2) was administered to 7 groups of children: 84 White Catholic school students from a New Orleans suburb, 78 White rural public school students from Virginia, 62 Hispanic Migrant student from Florida, 90 Aboriginal and White students from an isolated Canadian community, 199 African American students attending an inner city school, 60 Hispanic and White international students from Venezuela, and 61 Innuit students from isolated community in Labrador. The four elder groups also wrote three words to describe themselves (the Adjective Generation Technique [AGT]). Significant differences in responding between groups were found on all CFSEI-2 scales and for AGT favorability means. Although several possible reasons for these results are discussed, we conclude that the CFSEI-2 is not culture-free. Recommendations are: change the title of the test to avoid misrepresentation, limit test usage to elementary school children, develop an adolescent version with age appropriate language, and construct local norms before using the CFSEI-2 to make decisions about a child's self-esteem. To determine relevance of scores, a team of professionals and lay persons should review items from this or any test given to children who may be different from the normative or standardization group.

Adolescent↗
PubMed1995

The Brandes-Friesen case reports: how should we interpret the news?

In this issue (see pages 561 to 566 two case reports by Lorne J. Brandes and Linda A. Friesen illustrate a temporal relation between the discontinuation or initiation of therapy with certain non-antineoplastic agents (lithium, carbamazepine and an H1-antihistamine) and the clinical course of cancer. Only an accumulation of similar case reports and the results of epidemiologic and controlled clinical studies will show whether the temporal relation observed in these cases is also a causal one. In the absence of strong, let alone conclusive, evidence that antidepressants or antihistamines promote the growth of tumours in human beings, a recommendation to stop using these medications would be premature. The news about these case reports and about animal studies on the tumour-promoting potential of some antidepressants and antihistamines is likely to spread through the media. The realistic and responsible option for physicians and clinical investigators is to help patients and prospective participants in clinical trials to interpret this information in a balanced and reasonable fashion.

Carbamazepine↗
PubMed1995

Diffusion of standards of care for cancer pain.

The authors report the results of a symposium on improving the standards of care for patients with cancer pain. The symposium was sponsored by the Advisory Committee on Cancer Control of the National Cancer Institute of Canada and was held Apr. 8 to 10, 1994, in Toronto. Participants included experts on control of cancer pain and on diffusion techniques, patients with cancer and representatives of regulatory agencies. They suggested the following strategies to improve outcomes in patients with cancer pain. Processes for accreditation of health care institutions should require documentation of cancer pain, its treatment and its outcome. Tertiary care facilities that provide cancer treatment should have expert, subspecialty, multidisciplinary programs for pain control and should provide adequate psychosocial support to patients suffering cancer pain. The Canadian Cancer Society should conduct a public-education campaign to encourage patients to report pain to health care providers. The National Cancer Institute of Canada should foster research on cancer pain by restructuring its process for review of pain-research protocols. Examinations for professionals who care for patients with cancer should include a defined number of questions concerning pain and symptom control. Provincial programs to monitor prescribing through the use of triplicate prescription pads should have an educational as well as regulatory purpose.

Administration, Oral↗
PubMed1995

Cachexia-anorexia-asthenia.

The National Cancer Institute (Canada) sponsored a workshop on symptom control in Banff, Alberta, in October 1993. This article reports on the workshop recommendations for research on one symptom complex, the cachexia-anorexia-asthenia syndrome. In addition to encouraging study generation, the recommendations provide a baseline for assessing the scope and strength of future Canadian research initiatives on cachexia-anorexia-asthenia.

Anorexia↗
PubMed1995

Occult infection as a cause of hip pain in a patient with metastatic breast cancer.

A 39-year-old woman with breast cancer metastatic to bone presented with acute hip pain marginally responsive to escalating doses of opioid analgesics. Pathologic pelvic fractures were present and there were minimal clinical indicators of infection, but the severity and intractable nature of the pain prompted further investigation. Computed tomography revealed a pelvic abscess. Antibiotic therapy and drainage of the abscess resulted in markedly improved pain control, decreased analgesic requirements, and improved quality of life. We suggest that, in patients with malignancy, the diagnosis of occult infection should be aggressively pursued as a potentially reversible cause of intractable pain.

Abscess↗
PubMed1995

A proposed matrix for organisational changes to improve quality of life in oncology.

Educational and institutional changes are needed to improve the care of dying patients. There are four phases to a cancer control programme, and each phase stresses prevention. The fourth phase of a cancer control programme is concerned with the prevention of suffering, through impeccable management of physical and psychosocial distress. In practice, cancer control is usually addressed primarily as a biological problem, with less emphasis placed on behavioural aspects and the alleviation of suffering. The principles of symptom control and the management of psychosocial issues have been defined by the palliative care movement. However, this body of knowledge tends to be cocooned within palliative care programmes and associated journals and textbooks. As exemplified by recent advances in cancer pain management, symptom control research is a promising area for development. However, the promise is not matched by priority assignment and idea implementation. This article offers proposals for specific changes in the structure of university and cancer programmes, and revision of legislative policies which will enhance the care of patients who depend upon our interest in the fourth phase of cancer control, the prevention and relief of suffering.

Humans↗
PubMed1995

Incidence and pathogenicity of Arcanobacterium haemolyticum during a 2-year study in Ottawa.

Arcanobacterium haemolyticum has been described as a rare cause of systemic invasive disease and is occasionally isolated from throat swabs. We describe a 2-year study of the incidence and clinical features of A. haemolyticus infection in a pediatric and adolescent population. A total of 11,620 throat swabs were examined for A. haemolyticum with use of a locally developed selective medium. Controls (2,241) were healthy students who were recruited from a separate study. A. haemolyticum was isolated from 42 patients, with the maximum incidence in the 15 to 18-year-old age group; in this subset the incidence was 2.5%. There were no isolates of A. haemolyticum found in the healthy controls, and the difference in incidence between patients and controls in the 15 to 18-year-old age group was highly significant (P < .01). Approximately half of the patients infected with A. haemolyticum had a rash. In 5 patients, A. haemolyticum was associated with a positive monospot test. The organism was highly susceptible to erythromycin and less susceptible to penicillin. The evidence from this study suggests that A. haemolyticum may be a pathogen with maximum incidence in the 15 to 18-year-old age group.

Actinomycetaceae↗
PubMed1995

Desert disaster.

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Accidents, Traffic↗