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PubMed1991

Unrelated bone marrow transplantation in Canada, the national experience.

The Canadian Unrelated Bone Marrow Donor Registry (UBMDR) of the Canadian Red Cross Society (CRCS) Blood Transfusion Service (BTS) was officially funded as of April 1, 1989 for an initial three year period with a mandate to recruit 50,000 unrelated bone marrow donors and conduct the search activities for unrelated bone marrow donors worldwide on behalf of Canadian patients (1). All provinces of Canada agreed to fund the Registry and it was unanimously adopted to locate the Canadian National Coordinating Centre (CNCC) of the Registry in Vancouver. Since February of 1988, 64 unrelated bone marrow transplants have been carried out in Canada. Over half of the unrelated donors have come from other countries. Canada has established working relationships with the United States, the United Kingdom and France. Recruitment of unrelated bone marrow donors is now established in twelve Canadian cities with more to follow. It is anticipated that the size of the registries world wide will continue to increase, that their ethnic makeup will become diversified and that the indications for unrelated bone marrow transplantation will broaden in the years to come.

Bone Marrow Transplantation↗
PubMed1990

Life expectancy in Canada--an overview.

At 73 years for men and more than 80 years for women, Canada's life expectancy at birth compares favourably with other developed countries; Japan currently leads the world with 75.6 years for men and 81.4 years for women. In 1920-1922, fewer than six out of ten Canadians could expect to survive to their 65th birthday; by 1985-1987, this had risen to eight out of ten. At the oldest ages, the increases in survival are even more striking. In 1920-1922, just over one in ten Canadians could expect to reach their 85th birthday; by 1985-1987, this had increased to more than three out of ten. Since the 1920s, life expectancy has been higher in the Western provinces and lower in Atlantic Canada and Quebec. In 1950-1952, for example, a person born in Saskatchewan could expect to live four years longer than a person born in Quebec. By 1985-1987, this difference had been reduced to just over one year. Women have made much greater gains in life expectancy than men. In 1920-1922, women had an advantage in life expectancy over men of less than two years; by 1970-1972, this had more than tripled to seven years. Married men and women have a distinct advantage in longevity over other marital status categories. Married men may expect to live over eight years longer than never-married men, and more than ten years longer than widowed men. Married women can expect to live three years longer than never-married women, and four years longer than women who are either divorced or widowed. As of 1986, a boy born in highest-income quintile area in urban Canada can expect to live almost six years longer than a boy born in a lowest-income quintile area. For girls, the difference is almost two years. However, this socio-economic differential narrowed from 1971 to 1986.

Aged↗
PubMed1990

Divorces in Canada, 1988.

In 1988, a total of 79,872 divorces were granted in Canada. This was a 12.2% decrease from the 1987 total of 90,985, the highest ever in Canada. Divorce levels have been generally high in the late 1980s, but data for several more years are required before the impact of the 1985 Divorce Act can be accurately assessed. The 1988 divorce rate in Canada for married women aged 15 and over was 1,256 per 100,000. The highest rates occurred in Alberta (1,498) and British Columbia (1,407), and the lowest in Newfoundland (669) and Prince Edward Island (844). The average duration of marriages ending in divorce was 12.5 years. The largest number of divorces occurred after five years, followed by six and four years. Among divorces granted in 1988 under the 1985 divorce law, separation for not less than one year was cited as the grounds in almost nine out of ten cases. Of all children affected by custody orders for divorces granted under the 1985 law, 76% were awarded to the wife, 12% to the husband, 11% to joint custody, and fewer than 1% to a person other than the husband or wife.

Adolescent↗
PubMed1990

Susceptibility of Haemophilus influenzae to antimicrobial agents used in Canada. Canadian Study Group.

We evaluated the incidence of Haemophilus influenzae resistance to selected antimicrobials used in Canada. From 1985 to 1987, 2503 H. influenzae isolates obtained in 14 hospitals across Canada were sent to the Centre hospitalier de l'université Laval (CHUL) for identification, serotyping, biotyping and testing for beta-lactamase production. Susceptibility tests were done with the use of 12 antibiotics. Of the strains 424 (16.9%) produced beta-lactamase; the proportion varied from 12.8%, in Newfoundland, to 19.6%, in Ontario. Of the strains 18.3% were type b; 19.4% of those produced beta-lactamase. Almost 82% of the strains were not type b. The proportion of beta-lactamase-producing strains varied according to the isolation site, from 15.3% in the respiratory tract to 25.6% in the blood. The overall level of resistance was 19.3% to ampicillin, 24.2% to erythromycin, 3.8% to trimethoprim-sulfamethoxazole, 1.7% to amoxicillin-potassium clavulanate, 1.4% to cefaclor, 1.3% to tetracycline, 1.0% to rifampin, 0.7% to cefuroxime and 0.1% to cefamandole. Disc diffusion susceptibility testing revealed 64 strains (2.6%) that did not produce beta-lactamase but were resistant to ampicillin and 9 (0.4%) that produced beta-lactamase but were susceptible to ampicillin. The results of beta-lactamase production tests were identical regardless of whether the tests were done by the CHUL or by the other hospitals, but there was a marked difference in the susceptibility test results between the CHUL and the other centres. Our results suggest that the level of resistance of H. influenzae to antibiotics is increasing in Canada and that the initial choice of drug therapy may have to be modified.

Amoxicillin↗
PubMed1989

Changes in mortality by income in urban Canada from 1971 to 1986.

The reduction of socio-economic inequities in health is now an explicit objective of health policy in Canada. This study examines changes in mortality by income in urban Canada from 1971 to 1986 in terms of both relative and absolute differences between income groups. Street address information as shown on death certificates was used to code census tract of usual place of residence for deaths occurring to residents of Canada's Census Metropolitan Areas (CMAs) in 1971 and 1986. After exclusion of residents of health care institutions, 73,995 deaths were included in the study for 1971, and 88,129 for 1986. These deaths were analyzed by income quintile (based on census tract incidence of low income), age, sex, and cause of death. In 1971, the difference in life expectancy at birth between the highest and lowest income quintiles was 6.3 years for men and 2.8 years for women. By 1986, these differences had decreased to 5.6 years for men and 1.8 years for women. However, relative mortality (lowest compared to highest income quintile) at most ages changed only slightly over the 15 years. Relative infant mortality, for example, was 1.97 in 1971 and 1.82 in 1986. In 1986, 21% of total potential years of life lost (PYLL) prior to age 75 could be attributed to differences in quintile death rates compared to rates for the highest income quintile. Approximately 45% of this "excess" PYLL was for persons under 45 years of age. In 1971, the comparable figure was 67%. In 1986, the major causes of death contributing to income inequalities in mortality were: circulatory diseases, accounting for 25% of excess PYLL related to quintile differences; accidents, poisonings and violence, accounting for about 17%; and neoplasms, accounting for 15%. Respiratory diseases, ill-defined conditions, metabolic diseases and perinatal conditions each contributed 6-7% of excess PYLL. From 1971 to 1986, in terms of age-standardized morality rates (ASMRs) for all ages, certain causes of death showed increased mortality together with greater inequality by income, especially for males: these causes included lung cancer, suicide, metabolic diseases other than diabetes, and ill-defined conditions. Other causes of death showed either little change or less inequality by income but higher ASMRs: these included breast cancer, colon and rectal cancer, arterial diseases, alcoholism, mental disorders, and diseases of the nervous system.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1989

Tuberculosis in Canada 1987.

In 1987, 1,957 new or reactivated cases of tuberculosis were reported in Canada, an 8.8% drop from 1986. This corresponds to an overall decline of almost 50% in Canada's tuberculosis rates over the past decade. This article examines tuberculosis rates by sex, age and province, and identifies four high risk groups. The first group, comprising North American Indians and Inuit, has a rate five to ten times higher than the Canadian population. Poor inner city residents have rates up to four times higher, and foreign-born Canadians up to three times higher. For all Canadians, risk increases with age, and thus the elderly comprise the fourth risk group. A fifth group, males aged 25 to 44 infected with Human Immunodeficiency Virus (HIV) and who later develop Acquired Immune Deficiency Syndrome (AIDS), has emerged in the United States although no increased risk is at yet seen in Canada.

Adolescent↗
PubMedDate not supplied

An historical prospective mortality study of the Sarnia Division of Dow Chemical Canada Inc., Sarnia, Ontario (1950-1984).

We examined the mortality experience of 3,479 male Dow Canada employees who were employed at Sarnia Division for at least 12 continuous months during the years 1945 through 1983, utilizing the Canadian Mortality Data Base maintained by Statistics Canada, covering 1950-1984. We analyzed cause-specific mortality using male, age and calendar-year-adjusted death rates for Canada and Ontario. Total mortality was significantly below expectation whether the entire follow-up period (240 observed vs. 366.9 expected) or a 15-year latency period (171 observed vs. 290.4 expected) was considered. Statistically significant fewer observed deaths were found for all respiratory cancer, cancer of the bronchus and lung, circulatory disease, ischemic heart disease, cerebrovascular disease, digestive disease, cirrhosis and other liver disease and deaths due to accidents, poisonings and violence. The observation of three deaths due to mesothelioma, a rare cancer often associated with asbestos exposure, was a significant finding as was a statistically significant elevation of observed deaths in the category "other forms of heart disease".

Adult↗
PubMed1989

Benzodiazepine use and abuse in Canada.

Benzodiazepines are frequently prescribed, yet the extent of their use in Canada has not been described. Such data would be valuable in assessing patient exposure to benzodiazepines and would provide a context to estimate the risk-benefit ratio of these drugs. Analysis of benzodiazepine sales in 1978-87 in Canada, expressed as the defined daily dose (DDD) per 1000 inhabitants per day, showed that the use of these drugs was stable during the first half of the decade, at 33 DDD/1000 inhabitants per day, then steadily increased from 1983 to 1987, reaching 48 DDD/1000 inhabitants per day in 1987. The total use of slowly eliminated benzodiazepines declined, whereas the overall use of rapidly eliminated benzodiazepines increased linearly. In 1978-83 Canada had the second-lowest total benzodiazepine use among several Western countries. The patterns of use and abuse of rapidly eliminated benzodiazepines in 1978-84 showed a close correlation. Our findings indicate that data on drug use can be monitored and linked to clinical data, providing a mechanism for monitoring the relation between use and related illness.

Benzodiazepines↗
PubMed1988

The future of general surgery in Canada.

Manpower studies carried out by the Canadian Association of General Surgeons revealed a need for approximately 70 new general surgeons to enter practice each year to replace those who will discontinue practice for various reasons. The Royal College of Physicians and Surgeons of Canada certifies about 70 general surgeons each year; however, two-thirds of these pursue further specialty training, leaving only 20 to 25 to continue in general surgery. Training programs in Canada are of variable length and content. Less than half the trainees have substantial research experience. Programs designed to train the comprehensive community general surgeon are lacking in Canadian medical schools and reductions in residency training posts and other governmental constraints may worsen the anticipated shortage of general surgeons. Strong leadership is needed to bring together organized medicine, the surgical specialties, universities and government to address the training and manpower requirements for general surgeons in Canada.

Canada↗
PubMed1986

Regulation of animal experimentation: Canada's program of voluntary control.

The Canadian Council on Animal Care (CCAC), is an autonomous advisory and supervisory body responsible for surveillance of experimental animal care and use in Canada's universities, government laboratories and pharmaceutical houses. Its 20-organization membership includes representatives of government, industry, academia and the humane movement. CCAC's voluntary peer review program depends heavily on institutional animal care committees who evaluate the ethical aspects of animal study protocols, and provide day-to-day surveillance of animal care. Its scientific teams, each of which also includes an appointee of the Canadian Federation of Humane Societies (CFHS), conduct assessments based on CCAC's "Guide to the Care and Use of Experimental Animals" (Volume 1, 1980; Volume 2, 1984). Canada's two major funding agencies, the Medical Research Council (MRC) and the Natural Sciences and Engineering Research Council (NSERC), have recently stated that, in the event of an institution's continued non-compliance with CCAC requirements, sanctions may include the "freezing or withdrawal of any or all research programs funded by either or both Research Councils in an institution". This presentation describes the CCAC program of voluntary peer review and examines historic aspects of animal issues in Canada, from that country's early reliance on the fur trade, to today's almost defunct harp seal fishery, from Banting and Best's discovery of insulin, to development of the pacemaker.

Animal Testing Alternatives↗
PubMed1986

The prevalence of antibody to delta virus in western Canada.

To assess the prevalence and pathological role of hepatitis D virus (HDV) infection in western Canada, we tested a total of 310 sera from the province of Alberta, Yukon and Northwest Territories for antibody to HD (anti-HDV) by commercial solid phase radioimmunoassay. Two hundred and forty-five sera were hepatitis B surface antigen (HBsAg) positive. These were classified on the basis of clinical and biochemical data as either acute hepatitis, chronic hepatitis or in the healthy carrier phase of infection Sixty-five HBsAg negative sera from patients with other forms of chronic liver diseases served as controls. Anti-HDV was detected in only four of the HBsAg positive sera (1.6%) and in none of the controls. The prevalence of anti-HDV was significantly higher in patients with chronic hepatitis, three of twenty-two (13.6%) than in patients with acute hepatitis (0%) (p less than 0.05) or healthy carriers (0%) (p less than 0.005). Two of the four anti-HDV positive sera were obtained from patients with a history of parenteral drug abuse. These results indicate that HDV infection is uncommon in western Canada but, when it does occur, is more likely to be associated with chronic inflammatory liver disease. Parenteral drug abuse appears to be the major risk factor for HDV infection in western Canada at this time.

Acute Disease↗
PubMed1972

Influenza in Canada geese.

The role of wild avian species in the natural history of influenza is unknown. A serological study was carried out to ascertain the prevalence, distribution, and types of influenza antibody in several wild Canada goose populations. Geese were trapped and blood samples were obtained in each of 4 consecutive years, 1966-69. Antibody to influenzavirus was found in 66 (4.7%) of the 1 401 Canada geese tested by the haemagglutination inhibition (HI) test. Antiribonucleoprotein antibody was found in 8 of 1 359 sera tested by the agar gel precipitation (AGP) test. An increase in the percentage of reactors was seen each year. This increase was greater in two refuges with nonmigratory flocks. HI antibody was found against the turkey/Wisconsin/66, turkey/Wisconsin/68, turkey/Canada/63, and turkey/Alberta/6962/66, or closely related viruses. No antibody was found against duck/Ukraine/1/63 or human A/Hong Kong/68 virus at a time when the latter was prevalent in human populations, suggesting that Canada geese played no direct role in spreading the virus.Canada geese were experimentally exposed to turkey/Wisconsin/66 and turkey/Wisconsin/68 viruses; mallard ducks were exposed to turkey/Wisconsin/66 virus. HI antibody developed in 75% of the geese and 40% of the ducks but was generally short-lived. Anti-RNP antibody was detected in 15% of the exposed geese but in none of the ducks. Virus was recovered from 3 of 10 adult ducks but not from geese. None of the birds showed signs of disease.

Animals↗
PubMed1979

A comparative study of involutional depressive patients in French Canada and in Hungary.

The data dealing with 200 involutional depressive patients who were treated in Quebec City and in Budapest are presented. A questionnaire prepared for this purpose is produced and evaluated. Half of the Canadian and 80% of the Hungarian patients were personally interviewed by the author. Those patients with organic brain syndromes were not included in the population studied. Besides many similarities between the two groups, there were also symptomatological differences observed, e.g. the agitated type of involutional melancholy occurred twice as often in Canada as in Hungary, the apathetic cases were rarer in Canada, and the illness began earlier among Canadian women. Self-blame in Canada was often linked to religious observation. Two typical syndromes in male and female patients are detailed as special disease patterns. The symptomatology of this disorder has become identical in the last few years in both countries, therefore it is improbable that a similar study in the future could point out the differences described here.

Aged↗
PubMed1979

Lassa fever, Marburg and Ebola virus diseases and other exotic diseases: is there a risk to Canada?

There are seven exotic diseases of concern; three of these, the most unpredictable and least understood, are Lassa fever, Marburg virus disease and Ebola virus disease. In this article the epidemiologic aspects of these diseases are discussed, with particular emphasis on exportation from their indigenous areas in Africa and on the occurrence of secondary cases. Any of these conditions could be brought into Canada either by aeromedical evacuation or inadvertently. Between 1972 and 1978 there were seven occasions when Canada could have been involved with handling cases of Lassa fever. The Government of Canada has purchased several containment bed and transit isolators. These units, with filtered air under negative pressure, accommodate infectious patients being transported and cared for without contaminating medical attendants or the environment.

Adult↗
PubMed1966

A census of residents in Canadian hospitals approved for training by the Royal College of Physicians and Surgeons of Canada, April 1965.

A census taken in April 1965 revealed that there were 3162 residents training in Canadian hospitals approved by the Royal College of Physicians and Surgeons of Canada. Thirty-one of the 151 approved hospitals had no residents in training, and another 43 hospitals each having 20 or more residents accounted for 85% of all residents training in Canada. Fifty-seven per cent of the residents in Canada were Canadian citizens, 19% were landed immigrants, and 24% were foreign trainees. Major teaching hospitals contained 65% of all residents; 70% of Canadian graduates and 60% of non-Canadian graduates were training in major teaching hospitals. Hospitals approved for full training in the specialty of the trainee contained 57% of all residents; 64% of Canadian graduates and 48% of foreign graduates were in such hospitals.

Canada↗
PubMed1982

Experience with measles in Canada and the United States.

The United States is attempting to eliminate indigenous measles by October 1982. Progress in this effort appears to be related largely to the fact that all children must now be vaccinated before starting school and that unvaccinated children are not allowed to attend school during epidemics. Canada has not yet made a similar concerted effort to eliminate measles. The epidemiologic features of the disease in Canada and the United states have generally been similar, but some differences have emerged in recent years: Canadian rates are currently about 10 times higher, and the highest incidence in Canada is still in children 5 to 9 years of age, whereas in the United States the highest incidence is now in children aged 10 to 14 years, the result of intensive vaccination programs for preschool and early school-aged children.

Adolescent↗
PubMed1980

Legal abortions among teenagers in Canada, 1974 through 1978.

Between August 1969, when the amendment to the Criminal Code went into effect, and December 1978 about 397 000 legal abortions were performed in hospitals with therapeutic abortion committees in Canada. During the 5-year period 1974-78 abortions in females under 20 years of age accounted for 30.9% of all the legal abortions performed in Canada on Canadian residents, and the abortion rate per 1000 women aged 15 to 19 years increased from 13.6 to 16.3. During 1974-77 the proportion of women in whom the gestation period was more than 12 weeks at the time of abortion was 25.3% for teenagers (females under 20 years of age) but only 14.6% for women aged 20 years or over. In 1976 the teenage abortion rate was lower in Canada (14.5) than in the United States (36.2%), Sweden (28.5), Hungary (26.4), Denmark (26.0), Norway (22.7), Finland (20.3), and England and Wales (15.4).

Abortion, Legal↗
PubMed1981

Cardiovascular disease mortality in Canada.

During the past two decades approximately one half of all deaths in Canada were due to cardiovascular diseases. Ischemic heart disease and cerebrovascular disease caused more than 60% and 20% of those deaths respectively. The mortality rates for ischemic heart disease in males increased slightly until 1965 and then dropped substantially, whereas the rates for females, which were declining at least since the early 1960s, accelerated in their decline. As a consequence, the rates for males remain almost twice as high as those for females. The reductions were initially observed in males 25 to 34 years old and in all age groups of females, but became apparent in a wider range of ages in the second period reviewed (1969 through 1977). The mortality of cerebrovascular disease has gradually diminished for both sexes since the 1950s, but the decline has been more pronounced among females, who originally had the higher rate. Marked geographic differences in mortality rates still exist in Canada despite the decline in death rates for both ischemic heart disease and cerebrovascular disease in all regions of the country. Surprising regional differences in times of onset of these declines have been demonstrated. For ischemic heart disease Ontario maintains the highest and the Prairies the lowest mortality rates. Quebec, despite a sustained decline, still ranks third, while the Pacific region shows the second-lowest rates in the country. The Atlantic region showed the lowest rates of decline in the period reviewed. The reduction in the mortality of ischemic heart disease in Canada (16.4% between 1969 and 1977) must be considered real for a variety of reasons. Direct evidence is not available to elucidate whether the reduction is the consequence of reduced incidence, increased survival or a combination of the two factors. The potential role of various factors that may have contributed to this decline is briefly discussed in this article.

Adult↗