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[PMID]:29185358
[Au] Autor:Pisa J; Gousseau M; Mowat S; Westerberg B; Unger B; Hochman JB
[Ad] Endereço:1 Surgical Hearing Implant Program, Department of Otolaryngology-Head and Neck Surgery, Health Sciences Centre, Winnipeg, Manitoba, Canada.
[Ti] Título:Simplified Summative Temporal Bone Dissection Scale Demonstrates Equivalence to Existing Measures.
[So] Source:Ann Otol Rhinol Laryngol;127(1):51-58, 2018 Jan.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Emphasis on patient safety has created the need for quality assessment of fundamental surgical skills. Existing temporal bone rating scales are laborious, subject to evaluator fatigue, and contain inconsistencies when conferring points. To address these deficiencies, a novel binary assessment tool was designed and validated against a well-established rating scale. METHODS: Residents completed a mastoidectomy with posterior tympanotomy on identical 3D-printed temporal bone models. Four neurotologists evaluated each specimen using a validated scale (Welling) and a newly developed "CanadaWest" scale, with scoring repeated after a 4-week interval. RESULTS: Nineteen participants were clustered into junior, intermediate, and senior cohorts. An ANOVA found significant differences between performance of the junior-intermediate and junior-senior cohorts for both Welling and CanadaWest scales ( P < .05). Neither scale found a significant difference between intermediate-senior resident performance ( P > .05). Cohen's kappa found strong intrarater reliability (0.711) with a high degree of interrater reliability of (0.858) for the CanadaWest scale, similar to scores on the Welling scale of (0.713) and (0.917), respectively. CONCLUSION: The CanadaWest scale was facile and delineated performance by experience level with strong intrarater reliability. Comparable to the validated Welling Scale, it distinguished junior from senior trainees but was challenged in differentiating intermediate and senior trainee performance.
[Mh] Termos MeSH primário: Dissecação/educação
Educação de Pós-Graduação em Medicina/métodos
Internato e Residência
Otolaringologia/educação
Impressão Tridimensional
Osso Temporal/anatomia & histologia
Osso Temporal/cirurgia
[Mh] Termos MeSH secundário: Competência Clínica
Simulação por Computador
Avaliação Educacional
Feminino
Seres Humanos
Masculino
Manitoba
Curva ROC
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171130
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417745090


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[PMID]:29216254
[Au] Autor:Yang S; Lix LM; Yan L; Hinds AM; Leslie WD
[Ad] Endereço:Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China.
[Ti] Título:International Classification of Diseases (ICD)-coded obesity predicts risk of incident osteoporotic fracture.
[So] Source:PLoS One;12(12):e0189168, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:International Classification of Diseases (ICD) codes have been used to ascertain individuals who are obese. There has been limited research about the predictive value of ICD-coded obesity for major chronic conditions at the population level. We tested the utility of ICD-coded obesity versus measured obesity for predicting incident major osteoporotic fracture (MOF), after adjusting for covariates (i.e., age and sex). In this historical cohort study (2001-2015), we selected 61,854 individuals aged 50 years and older from the Manitoba Bone Mineral Density Database, Canada. Body mass index (BMI) ≥30 kg/m2 was used to define measured obesity. Hospital and physician ICD codes were used to ascertain ICD-coded obesity and incident MOF. Average cohort age was 66.3 years and 90.3% were female. The sensitivity, specificity and positive predictive value for ICD-coded obesity using measured obesity as the reference were 0.11 (95% confidence interval [CI]: 0.10, 0.11), 0.99 (95% CI: 0.99, 0.99) and 0.79 (95% CI: 0.77, 0.81), respectively. ICD-coded obesity (adjusted hazard ratio [HR] 0.83; 95% CI: 0.70, 0.99) and measured obesity (adjusted HR 0.83; 95% CI: 0.78, 0.88) were associated with decreased MOF risk. Although the area under the receiver operating characteristic curve (AUROC) estimates for incident MOF were not significantly different for ICD-coded obesity versus measured obesity (0.648 for ICD-coded obesity versus 0.650 for measured obesity; P = 0.056 for AUROC difference), the category-free net reclassification index for ICD-coded obesity versus measured obesity was -0.08 (95% CI: -0.11, -0.06) for predicting incident MOF. ICD-coded obesity predicted incident MOF, though it had low sensitivity and reclassified MOF risk slightly less well than measured obesity.
[Mh] Termos MeSH primário: Classificação Internacional de Doenças
Obesidade/complicações
Fraturas por Osteoporose/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Estudos de Casos e Controles
Estudos de Coortes
Feminino
Seres Humanos
Masculino
Manitoba/epidemiologia
Meia-Idade
Fraturas por Osteoporose/etiologia
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189168


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[PMID]:27770672
[Au] Autor:Hammond E; Shu E; Sawchuk K; Myal Y; Raouf A; Klonisch T; Hombach-Klonisch S; Leygue E; Kung S; Safneck J; Mowat M; Xu W; Murphy L; Pitz M
[Ad] Endereço:Rady Faculty of Health Sciences, University of Manitoba, Canada.
[Ti] Título:Population-based analysis of breast cancer treatment by intrinsic sub-type in Manitoba, Canada.
[So] Source:Cancer Epidemiol;45:82-90, 2016 12.
[Is] ISSN:1877-783X
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Few descriptive epidemiological studies on the incidence, treatment and survival can accurately reflect a whole population. Manitoba, Canada has an accurate cancer registry, a drug information program network and a breast screening program since 1995. This combined with a stable population provides true population data that can accurately describe the region. METHODS: Using a retrospective cohort design all Breast Cancer cases were obtained from 2004-2010 (N=5399) and grouped by Intrinsic sub-type. Identifiable co-morbidities, prescribed endocrine therapy, staging, surgery, treatment and overall and disease-free survival by intrinsic sub-type were evaluated. RESULTS: Prevalence of Luminal A (41.7%), Luminal B HER2- (15.6%), Luminal B HER2+ (8.9%), Basal-like(10.8%), and HER2+ non-luminal (5.1%) were consistent with other descriptive studies in Canada and Spain. Over this time period the number of lumpectomies increased 1.7% per year (P=0.007). There was a steady increase of 3.4% per year in the use of aromatase inhibitors (P=0.005). Pre-menopausal patients had an increased proportion of HER2+ and Basal-like sub-types. The 7year overall/disease-free survival percentages for Luminal A, Luminal B HER2-, Luminal B HER2+, Basal-like, and HER2+ non-luminal were 88.7%/83.6, 78.2%/73.0, 81.5%/73.3%, 67.7%/63.2%, 70.4%/65.6% respectively. CONCLUSIONS: Reasons for variability in the prevalence of intrinsic sub-type by region is not fully understood. Manitoba is unique due the stability of the population, completeness of the registry and length of breast cancer screening program. Few true population-based studies grouped by intrinsic sub-type are available. IMPACT: Descriptive epidemiological studies guide future research by identifying factors that can affect treatment, recurrence, and survival.
[Mh] Termos MeSH primário: Biomarcadores Tumorais/metabolismo
Neoplasias da Mama/patologia
Neoplasias da Mama/terapia
Recidiva Local de Neoplasia/patologia
Recidiva Local de Neoplasia/terapia
[Mh] Termos MeSH secundário: Idoso
Neoplasias da Mama/epidemiologia
Neoplasias da Mama/metabolismo
Terapia Combinada
Feminino
Seres Humanos
Manitoba/epidemiologia
Meia-Idade
Recidiva Local de Neoplasia/epidemiologia
Recidiva Local de Neoplasia/metabolismo
Estadiamento de Neoplasias
Prognóstico
Receptor ErbB-2/metabolismo
Receptores Estrogênicos/metabolismo
Receptores de Progesterona/metabolismo
Estudos Retrospectivos
Taxa de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 0 (Receptors, Estrogen); 0 (Receptors, Progesterone); EC 2.7.10.1 (Receptor, ErbB-2)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE


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[PMID]:28930037
[Au] Autor:Kreindler SA; Siragusa L; Bohm E; Rudnick W; Metge CJ
[Ad] Endereço:From the Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man. (Kreindler, Bohm, Metge); the George and Fay Yee Centre for Healthcare Innovation, University of Manitoba and Winnipeg Regional Health Authority, Winnipeg, Man. (Kreindler, Bohm,
[Ti] Título:Regional consolidation of orthopedic surgery: impacts on hip fracture surgery access and outcomes.
[So] Source:Can J Surg;60(5):349-354, 2017 Sep.
[Is] ISSN:1488-2310
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Timely access to orthopedic trauma surgery is essential for optimal outcomes. Regionalization of some types of surgery has shown positive effects on access, timeliness and outcomes. We investigated how the consolidation of orthopedic surgery in 1 Canadian health region affected patients requiring hip fracture surgery. METHODS: We retrieved administrative data on all regional emergency department visits for lower-extremity injury and all linked inpatient stays from January 2010 through March 2013, identifying 1885 hip-fracture surgeries. Statistical process control and interrupted time series analysis controlling for demographics and comorbidities were used to assess impacts on access (receipt of surgery within 48-h benchmark) and surgical outcomes (complications, in-hospital/30-d mortality, length of stay). RESULTS: There was a significant increase in the proportion of patients receiving surgery within the benchmark. Complication rates did not change, but there appeared to be some decrease in mortality (significant at 6 mo). Length of stay increased at a hospital that experienced a major increase in patient volume, perhaps reflecting challenges associated with patient flow. CONCLUSION: Regionalization appeared to improve the timeliness of surgery and may have reduced mortality. The specific features of the present consolidation (including pre-existing interhospital performance variation and the introduction of daytime slates at the referral hospital) should be considered when interpreting the findings.
[Mh] Termos MeSH primário: Serviço Hospitalar de Emergência/estatística & dados numéricos
Acesso aos Serviços de Saúde/organização & administração
Acesso aos Serviços de Saúde/estatística & dados numéricos
Fraturas do Quadril/cirurgia
Mortalidade Hospitalar
Tempo de Internação/estatística & dados numéricos
Procedimentos Ortopédicos/estatística & dados numéricos
Avaliação de Resultados (Cuidados de Saúde)/estatística & dados numéricos
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Fraturas do Quadril/mortalidade
Seres Humanos
Manitoba
Procedimentos Ortopédicos/mortalidade
Complicações Pós-Operatórias/mortalidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171005
[Lr] Data última revisão:
171005
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170921
[St] Status:MEDLINE


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[PMID]:28816143
[Au] Autor:Cooke AL; Diaz-Abele J; Hayakawa T; Buchel E; Dalke K; Lambert P
[Ad] Endereço:Department of Radiation Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada; University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: acooke1@cancercare.mb.ca.
[Ti] Título:Radiation Therapy Versus No Radiation Therapy to the Neo-breast Following Skin-Sparing Mastectomy and Immediate Autologous Free Flap Reconstruction for Breast Cancer: Patient-Reported and Surgical Outcomes at 1 Year-A Mastectomy Reconstruction Outcomes Consortium (MROC) Substudy.
[So] Source:Int J Radiat Oncol Biol Phys;99(1):165-172, 2017 Sep 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To determine whether adjuvant radiation therapy (RT) is associated with adverse patient-reported outcomes and surgical complications 1 year after skin-sparing mastectomy and immediate autologous free flap reconstruction for breast cancer. METHODS AND MATERIALS: We compared 24 domains of patient-reported outcome measures 1 year after autologous reconstruction between patients who received adjuvant RT and those who did not. A total of 125 patients who underwent surgery between 2012 and 2015 at our institution were included from the Mastectomy Reconstruction Outcomes Consortium study database. Adjusted multivariate models were created incorporating RT technical data, age, cancer stage, estrogen receptor, chemotherapy, breast size, body mass index, and income to determine whether RT was associated with outcomes. RESULTS: At 1 year after surgery, European Organisation for Research and Treatment of Cancer (EORTC) Breast Cancer-Specific Quality of Life Questionnaire breast symptoms were significantly greater in 64 patients who received RT (8-point difference on 100-point ordinal scale, P<.0001) versus 61 who did not receive RT in univariate and multivariate models. EORTC arm symptoms (20-point difference on 100-point ordinal scale, P=.0200) differed on univariate analysis but not on multivariate analysis. All other outcomes-including Numerical Pain Rating Scale, BREAST-Q (Post-operative Reconstruction Module), Patient-Report Outcomes Measurement Information System Profile 29, McGill Pain Questionnaire-Short Form (MPQ-SF) score, Generalized Anxiety Disorder Scale, and Patient Health Questionnaire-were not statistically different between groups. Surgical complications were uncommon and did not differ by treatment. CONCLUSIONS: RT to the neo-breast compared with no RT following immediate autologous free flap reconstruction for breast cancer is well tolerated at 1 year following surgery despite patients undergoing RT also having a higher cancer stage and more intensive surgical and systemic treatment. Neo-breast symptoms are more common in patients receiving RT by the EORTC Breast Cancer-Specific Quality of Life Questionnaire but not by the BREAST-Q. Patient-reported results at 1 year after surgery suggest RT following immediate autologous free flap breast reconstruction is well tolerated.
[Mh] Termos MeSH primário: Neoplasias da Mama/radioterapia
Mamoplastia/métodos
Mastectomia/métodos
Tratamentos com Preservação do Órgão/métodos
[Mh] Termos MeSH secundário: Fatores Etários
Análise de Variância
Índice de Massa Corporal
Mama/patologia
Neoplasias da Mama/química
Neoplasias da Mama/patologia
Neoplasias da Mama/cirurgia
Feminino
Seres Humanos
Renda
Manitoba
Meia-Idade
Estadiamento de Neoplasias
Tamanho do Órgão
Medidas de Resultados Relatados pelo Paciente
Complicações Pós-Operatórias
Estudos Prospectivos
Qualidade de Vida
Dosagem Radioterapêutica
Radioterapia Adjuvante/métodos
Receptores Estrogênicos
Retalhos Cirúrgicos
Inquéritos e Questionários
Fatores de Tempo
Transplante Autólogo
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Receptors, Estrogen)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE


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[PMID]:28754564
[Au] Autor:Cloutier JM; Liu S; Hiebert B; Tam JW; Seifer CM
[Ad] Endereço:University of Manitoba, Section of Cardiology, Winnipeg, Manitoba, Canada.
[Ti] Título:Relationship of Extreme Cold Weather and Implantable Cardioverter Defibrillator Shocks.
[So] Source:Am J Cardiol;120(6):1002-1007, 2017 Sep 15.
[Is] ISSN:1879-1913
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cold weather to 0°C has been implicated as a risk factor for ventricular arrhythmias and implantable cardioverter defibrillator (ICD) shocks. The effect of more extreme cold weather on the risk of ventricular arrhythmias and ICD shocks is unknown. We sought to describe the relationship between extreme cold weather and the risk of ICD shocks. We retrospectively identified patients seen at the Pacemaker and Defibrillator Clinic at St. Boniface Hospital in Winnipeg, Manitoba, Canada between 2010 and 2015 with an ICD shock. We excluded multiple shocks occurring on the same day in a single patient. We collected weather data, and evaluated the relationship between ICD shocks and weather on the same day as the shock using Negative Binomial regression. Three hundred and sixty patients experienced a total of 1,355 shocks. When excluding multiple shocks occurring in a single patient on the same day, there were 756 unique shocks. The daily high (DH) was the strongest predictor of receiving an ICD shock. Compared with the warmest days (DH above 10°C), shocks were 25% more common on the coldest days (DH below -10°C), and 8% more common on cold days (DH between -10°C and 10°C). This linear trend was statistically significant, with a p-value of 0.04. In conclusion, we found an association between extreme cold weather and ICD shocks.
[Mh] Termos MeSH primário: Arritmias Cardíacas/terapia
Desfibriladores Implantáveis
Cardioversão Elétrica/instrumentação
Frio Extremo/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Arritmias Cardíacas/mortalidade
Causas de Morte/tendências
Feminino
Seres Humanos
Masculino
Manitoba/epidemiologia
Meia-Idade
Estudos Retrospectivos
Fatores de Risco
Taxa de Sobrevida/tendências
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170730
[St] Status:MEDLINE


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[PMID]:28709393
[Au] Autor:Agnello M; Marques J; Cen L; Mittermuller B; Huang A; Chaichanasakul Tran N; Shi W; He X; Schroth RJ
[Ad] Endereço:1 School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA.
[Ti] Título:Microbiome Associated with Severe Caries in Canadian First Nations Children.
[So] Source:J Dent Res;96(12):1378-1385, 2017 Nov.
[Is] ISSN:1544-0591
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Young Indigenous children in North America suffer from a higher degree of severe early childhood caries (S-ECC) than the general population, leading to speculation that the etiology and characteristics of the disease may be distinct in this population. To address this knowledge gap, we conducted the first microbiome analysis of an Indigenous population using modern molecular techniques. We investigated the caries-associated microbiome among Canadian First Nations children with S-ECC. Thirty First Nations children <72 mo of age with S-ECC and 20 caries-free children were recruited in Winnipeg, Canada. Parents or caregivers completed a questionnaire on general and dental health, diet, and demographics. The plaque microbiome was investigated by sequencing the 16S rRNA gene. Sequences were clustered into operational taxonomic units and taxonomy assigned via the Human Oral Microbiome Database, then analyzed at the community level with alpha and beta diversity measures. Compared with those who were caries free, children with S-ECC came from households with lower income; they were more likely to live in First Nations communities and were more likely to be bottle-fed; and they were weaned from the bottle at a later age. The microbial communities of the S-ECC and caries-free groups did not differ in terms of species richness or phylogenetic diversity. Beta diversity analysis showed that the samples significantly clustered into groups based on caries status. Twenty-eight species-level operational taxonomic units were significantly different between the groups, including Veillonella HOT 780 and Porphyromonas HOT 284, which were 4.6- and 9-fold higher, respectively, in the S-ECC group, and Streptococcus gordonii and Streptococcus sanguinis, which were 5- and 2-fold higher, respectively, in the caries-free group. Extremely high levels of Streptococcus mutans were detected in the S-ECC group. Overall, First Nations children with S-ECC have a significantly different plaque microbiome than their caries-free counterparts, with the S-ECC group containing higher levels of known cariogenic organisms.
[Mh] Termos MeSH primário: Cárie Dentária/epidemiologia
Cárie Dentária/microbiologia
Índios Norte-Americanos
Microbiota
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Inquéritos de Saúde Bucal
Feminino
Seres Humanos
Lactente
Masculino
Manitoba/epidemiologia
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:170716
[St] Status:MEDLINE
[do] DOI:10.1177/0022034517718819


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[PMID]:28700669
[Au] Autor:Tangri N; Ferguson TW; Whitlock RH; Rigatto C; Jassal DS; Kass M; Toleva O; Komenda P
[Ad] Endereço:Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.
[Ti] Título:Long term health outcomes in patients with a history of myocardial infarction: A population based cohort study.
[So] Source:PLoS One;12(7):e0180010, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Myocardial infarction (MI) is associated with high morbidity and mortality, particularly in the first 12 months post-event. Interventions such as dual antiplatelet therapy can reduce the risk of major adverse cardiovascular events (MACE), but the duration of the high-risk time interval and the optimal prescription time frame for these interventions remains unknown. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: We performed a retrospective cohort study using data from medical services and hospitalizations in Manitoba, Canada for patients admitted with a MI between April 2006 and March 2010, and followed until Nov 30, 2014. We used survival analysis to determine the cumulative incidence of death, subsequent MI, or stroke, and used Cox proportional hazards models to assess factors associated with these endpoints. RESULTS: There were 8,493 patients in Manitoba admitted to hospital for a MI during the study period. Of those, 6,749 (79.5%) survived for at least 1 year without a recurrent MI or stroke. In the following year, this population remained at high risk, with 372 (5.5%) of the remaining patients dying in the next twelve months (48.1% cardiovascular deaths), 244 (3.6%) having a recurrent MI, and 74 (1.1%) having a stroke. Older age, male sex, diabetes, prior stroke, prior heart failure, prior unstable angina, and absence of revascularization were associated with worse long-term prognosis. CONCLUSIONS: The risk of MACE remains elevated among post-MI patients after the first year. Interventions to more intensively monitor, evaluate, and treat these patients should be considered beyond the first year following myocardial infarction.
[Mh] Termos MeSH primário: Infarto do Miocárdio/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Manitoba
Meia-Idade
Infarto do Miocárdio/mortalidade
Infarto do Miocárdio/terapia
Análise de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170713
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180010


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[PMID]:28676579
[Au] Autor:Sawatsky L; Halipchuk J; Wicklow B
[Ad] Endereço:Health Sciences Centre Winnipeg (Sawatsky, Halipchuk); Department of Pediatrics and Child Health (Wicklow), Rady Faculty of Health Sciences, University of Manitoba; The Children's Hospital Research Institute of Manitoba (Wicklow), Winnipeg, Man. Lsawatsky2@hsc.mb.ca.
[Ti] Título:Type 2 diabetes in a four-year-old child.
[So] Source:CMAJ;189(26):E888-E890, 2017 07 04.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 2/diagnóstico
Diabetes Mellitus Tipo 2/etiologia
Índios Norte-Americanos
[Mh] Termos MeSH secundário: Pré-Escolar
Diabetes Mellitus Tipo 2/tratamento farmacológico
Seres Humanos
Masculino
Manitoba
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170706
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.170259


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[PMID]:28661825
[Au] Autor:Martin RK; Hrubeniuk TJ; Witiw CD; MacDonald P; Leiter J
[Ad] Endereço:Pan Am Clinic, Winnipeg, Manitoba, Canada.
[Ti] Título:Concussions in Community-Level Rugby: Risk, Knowledge, and Attitudes.
[So] Source:Sports Health;9(4):312-317, 2017 Jul/Aug.
[Is] ISSN:1941-0921
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Rugby is a popular collision sport where participants are at risk of sustaining concussions. Most research focuses on elite-level or youth divisions. Comparatively, little is known about adult community rugby. The aim of this research was to estimate the risk of sustaining a concussion during participation in community-level rugby and summarize the collective knowledge and attitudes toward concussions. HYPOTHESIS: Concussion symptoms will be reported frequently among community-level rugby players and a substantial proportion will report a willingness to continue participation despite the risk. STUDY DESIGN: Cross-sectional analysis. LEVEL OF EVIDENCE: Level 3. METHODS: An anonymous, voluntary survey was administered to all 464 senior rugby players registered in the province of Manitoba in 2015. Two primary domains were assessed: (1) concussion history from the preceding season including occurrence, symptomatology, and impact on daily activities and (2) knowledge and attitudes toward concussion risks and management. RESULTS: In total, 284 (61.2%) rugby players responded. Concussive symptoms were reported by 106 (37.3%). Of those, 87% were formally diagnosed with a concussion and 27% missed school and/or work as a result. The danger of playing while symptomatic was recognized by 93.7% of participants, yet 29% indicated they would continue while symptomatic. Furthermore, 39% felt they were letting others down if they stopped playing due to a concussion. CONCLUSION: Concussive symptoms were common among the study cohort and had a notable impact on daily activities. A high proportion of players were willing to continue while experiencing symptoms despite recognizing the danger. The observed discord between knowledge and attitudes implicates a culture of "playing injured." CLINICAL RELEVANCE: Understanding the risk of injury may affect an individual's decision to participate in community-level rugby. Moreover, evidence of discord between the knowledge and attitudes of players may direct future research initiatives and league governance.
[Mh] Termos MeSH primário: Concussão Encefálica/epidemiologia
Futebol Americano/lesões
Conhecimentos, Atitudes e Prática em Saúde
[Mh] Termos MeSH secundário: Absenteísmo
Adulto
Concussão Encefálica/diagnóstico
Estudos Transversais
Feminino
Seres Humanos
Masculino
Manitoba/epidemiologia
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170801
[Lr] Data última revisão:
170801
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170630
[St] Status:MEDLINE
[do] DOI:10.1177/1941738117695777



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