Medicine and Health Sciences Commons^™

Evidence For Using Immunosuppressive Treatments When Treating Idiopathic Non-Infectious Uveitis: A Systematic Review And Meta-Analysis, Hargurinder Singh

Electronic Thesis and Dissertation Repository

Idiopathic non-infectious uveitis is the spontaneous inflammation of the eye, which can lead to blindness if not treated correctly. Due to long-term side effects of corticosteroids, 4 classes of off-label immunosuppressive treatments are sometimes used (alkylating agents, inhibitors of T-lymphocyte signalling, antimetabolites and biological modifiers). We conducted a systematic review and meta-analysis to assess the effectiveness of different treatment classes on uveitis patients with similar characteristics. Results of the systematic review concurred with the conclusions from the meta-analysis, which found that all immunosuppressive treatments improved patient vision, with a statistically significant change in logMAR of -0.11 (95% CI of -0.152 …

Physical Exertion As A Risk Factor For Ventricular Arrhythmia: A Prospective Cohort Study, Harpreet S. Chahal

Electronic Thesis and Dissertation Repository

Episodes of physical exertion are associated with an immediately higher risk of cardiovascular events while physical activity over the long-term is cardioprotective. To assess the transient and long-term risk of ventricular arrhythmia (VA), we conducted a nested case-crossover study within a prospective cohort of 97 patients with implantable cardioverter-defibrillators (ICD). Within an hour of episodes of exertion, the risk of VA was 5.3 (95% CI 2.7 – 10.6) times greater compared to periods of rest. The association was higher among patients with aerobic fitness below the median (RR[relative risk]=17.5, 95% 5.2 – 58.5) than for patients with aerobic fitness above …

Survival Outcomes And Treatment Utilization Among Patients With Known And Unknown Primary Tumours In Ontario., Chong Sung Kim

Electronic Thesis and Dissertation Repository

I identify two cohorts of cancer patients with known and unknown primary tumours. Cancer of unknown primary (CUP) is defined by the presence of pathologically identified metastatic disease without clinical or radiological evidence of a primary tumour. Using the Ontario Cancer Registry, Same Day Surgery/Discharge Abstract Database and Ontario Health Insurance Plan, a novel linkage strategy was developed to cross-validate diagnoses. I found CUP patients represent a significant portion of all metastatic cancers. CUP patients with histological confirmed disease, squamous cell histology, or metastases localized to nodal regions had significantly better survival than other CUP patients. Knowledge of the primary …

Risk Of Arrhythmia And Mortality From Macrolide Antibiotic Prescription: A Population-Based Cohort Study, Mai H. Trac

Electronic Thesis and Dissertation Repository

Many respiratory tract infections are treated with macrolide antibiotics. Regulatory agencies warn that these antibiotics increase the risk of ventricular arrhythmia. This population-based retrospective cohort study examined the 30-day risk of a hospital encounter with ventricular arrhythmia and all-cause mortality in 503,612 matched pairs of older adults who received a new outpatient prescription for an oral macrolide antibiotic and those prescribed referent antibiotics from 2002 to 2013 in Ontario. Conditional logistic regression was used to measure the association between macrolide exposure and outcomes. Macrolide antibiotics compared with referent antibiotics were not associated with a higher 30-day risk of ventricular arrhythmia …

The Association Between The Neighbourhood Food Environment And Prevalence Of Three Chronic Diseases In Urban Canada: A Cross-Sectional Analysis, Jagraj Singh Pandher

Electronic Thesis and Dissertation Repository

Research on the association between the neighbourhood food environment and prevalence of chronic diseases is very limited in Canada. The objective of this thesis was to investigate: (i) the associations between the neighbourhood food environment and prevalence of type II diabetes, cardiovascular disease and hypertension among Canadian adults living in urban areas; and (ii) whether or not dietary patterns, obesity and physical activity mediate such associations. Self-reported diagnosis of three chronic diseases, and individual-level socio-demographic and lifestyle variables were taken from the 2009-2010 Canadian Community Health Survey; neighbourhood-level socio-economic data were taken from the 2011 National Household Survey; and the …

Does Satisfaction With Perinatal Health Care Influence Postpartum Weight Retention?, Andreea Bente

Electronic Thesis and Dissertation Repository

The primary aim of this thesis is to identify whether satisfaction with perinatal health care encounters is associated with lower postpartum weight retention (PPWR). PPWR is the difference between postpartum and pre-pregnancy weight. Principal components analysis confirmed the validity of a summed satisfaction score representing six dimensions: information, compassion, competency, privacy, respect and decision-making. Confounders were identified using a directed acyclic graph. Multivariable linear regression models were constructed using blocks, and backwards elimination. Results reflect a mean PPWR of 2.5 kg, and high satisfaction, with more than 90% of respondents being very satisfied or satisfied on each dimension. The multivariable …

Epidemiology Of Fracture In Adults With Kidney Disease, Kyla L. Naylor

Electronic Thesis and Dissertation Repository

Fractures are a global health concern, leading to morbidity and mortality. Individuals with reduced kidney function experience bone mineral metabolism changes which can increase fracture risk. Yet, there is little consensus on the fundamentals: prediction, incidence, risk factors, and screening of fractures in kidney disease patients. This thesis addressed these critical areas helping decrease the health burden of fracture in this unique population.

This research used data from the Canadian Multicentre Osteoporosis Study (CaMos) to examine individuals with chronic kidney disease (CKD) (n=320). CaMos is a national longitudinal study designed to collect information on fractures. To examine kidney transplant recipients …

Maternal Fat Intake During Pregnancy And Breastfeeding Initiation, Rachel Man

Electronic Thesis and Dissertation Repository

Introduction: Breast milk provides health benefits for both mother and child. Prominent reasons for not initiating breastfeeding include lactation problems and perceived insufficient milk supply. Animal studies have shown that a high fat diet is associated with negative changes in the lactation process, while omega-3 supplementation appears to have positive effects. Hypothesis: 1. High maternal fat intake during pregnancy is associated with breastfeeding non-initiation. 2. Long-chain omega-3 fatty acid intake (EPA+DHA) is associated with breastfeeding initiation. 3. Maternal EPA+DHA intake modifies the relationship between total fat intake during pregnancy and breastfeeding initiation. Materials and Methods: The data for this study …