Medical Specialties Commons^™

Vitamin D Levels In Peanut Allergic Children, Adam Fowlie, Laura Kim, Trefford Simpson, Harold Kim

Department of Medicine Presentations

Background

The prevalence of peanut allergy is increasing. The reasons for this are not entirely known. A factor may be vitamin D (Vit D).

Methods

This study was performed in a referral allergist’s office in Ontario. Prospectively, all patients (<18 years old) with peanut allergy who were tested for peanut specific IgE (PN IgE) also had Vit D measured. All measurements were done between December 2010 and May 2011. The Vit D measure was 25-hydroxy vitamin D. Patients were divided into three groups: deficient (less than 25 nmol/L), insufficient (25-75 nmol/L) and sufficient (75-250 nmol/L). Vit D levels were compared to PN IgE, sex, age, body mass index (BMI) and other allergies.

Results

Fifty peanut allergic patients were included. The mean Vit D level of the patients was 73.8 nmol/L and the 95% confidence interval was 69.6 - 75.7 nmol/L. One patient (2%) had deficient and thirty-one (62%) of the patients had insufficient Vit D levels. Nineteen (38%) had Vit D levels in the sufficient range. There was no correlation between Vit …

Culture Medium, Gas Atmosphere And Mapk Inhibition Affect Regulation Of Rna-Binding Protein Targets During Mouse Preimplantation Development., Michele D Calder, Patricia H Watson, Andrew J Watson

Obstetrics & Gynaecology Publications

During oogenesis, mammalian oocytes accumulate maternal mRNAs that support the embryo until embryonic genome activation. RNA-binding proteins (RBP) may regulate the stability and turnover of maternal and embryonic mRNAs. We hypothesised that varying embryo culture conditions, such as culture medium, oxygen tension and MAPK inhibition, affects regulation of RBPs and their targets during preimplantation development. STAU1, ELAVL1, KHSRP and ZFP36 proteins and mRNAs were detected throughout mouse preimplantation development, whereas Elavl2 mRNA decreased after the two-cell stage. Potential target mRNAs of RBP regulation, Gclc, Slc2a1 and Slc7a1 were detected during mouse preimplantation development. Gclc mRNA was significantly elevated in embryos …

Causes Of Death In Canadian Forces Members Deployed To Afghanistan And Implications On Tactical Combat Casualty Care Provision., D Pannell, R Brisebois, M Talbot, V Trottier, J Clement, N Garraway, Vivian Mcalister, H Tien

Data and Test Instruments

BACKGROUND: As part of its contribution to the Global War on Terror and North Atlantic Treaty Organization's International Security Assistance Force, the Canadian Forces deployed to Kandahar, Afghanistan, in 2006. We have studied the causes of deaths sustained by the Canadian Forces during the first 28 months of this mission. The purpose of this study was to identify potential areas for improving battlefield trauma care. METHODS: We analyzed autopsy reports of Canadian soldiers killed in Afghanistan between January 2006 and April 2008. Demographic characteristics, injury data, location of death within the chain of evacuation, and cause of death were determined. …

The Role 3 Multinational Medical Unit At Kandahar Airfield 2005-2010., R Brisebois, P Hennecke, R Kao, Vivian Mcalister, J Po, R Stiegelmar, H Tien

Data and Test Instruments

In late 2005, Canadian Forces Health Services (CFHS) was tasked with the command of the NATO Role 3 Multinational Medical Unit (R3MMU) on Kandahar Airfield in southern Afghanistan. Preparations drew on past experience and planning. Eight complete hospital contingents were trained and deployed in rotation. Near-reality simulation training was undertaken with the combat brigade, including complete deployment of the field hospital in the exercise area. Standard operating procedures (SOP) were developed and applied by each rotation so successfully that they were adopted by the new command in late 2009. The Canadian period at R3MMU had the highest survival rate ever …

Utilization Profile Of The Trauma Intensive Care Unit At The Role 3 Multinational Medical Init At Kandahar Airfield Between May 1 And Oct. 15, 2009., Sha K, Pirie S, Compton L, Vivian Mcalister, Brian Church, Ray Kao

Data and Test Instruments

Background: In the war against the Taliban, Canada was the lead North Atlantic Treaty Organization (NATO) nation to provide medical and surgical care to NATO soldiers, Afghanistan National Army soldiers, Afghanistan Nation Police, civilians working in and outside Kandahar Airfield and Afghanistan civilians at the Role 3 Multinational Medical Unit (R3MMU) from February 2006 to October 2009. Methods: We obtained data from the Joint Theatre Trauma Registry between May 1 and Oct. 15, 2009; 188 patients were admitted to the R3MMU intensive care unit (ICU). We analyzed the ICU data according to types and causes of trauma, mechanical ventilation prevalence, …

Principles Of Combat Surgical Care In A Staged Evacuation System, Vivian Mcalister, Rob Stiegelmar, Brian Church, Ray Kao

Data and Test Instruments

Background: The NATO hospital classification of hospitals describes an orderly transfer of patients with severe injuries through a series of increasingly sophisticated hospitals as they are brought from the point of injury to their home hospital. Forward hospital surgery is restricted to damage control and resuscitation while definitive surgery is performed at home by the destination surgical team. In reality many patients enter the hospital chain higher up and some receive definitive surgery as they proceed through the chain of evacuation. The purpose of this paper is to determine if clear doctrine exists to guide the performance of surgery on …

Master Transcription Factors Determine Cell-Type-Specific Responses To Tgf-Β Signaling, Alan C. Mullen, David A. Orlando, Jamie J. Newman, Jakob Lovén, Roshan M. Kumar, Steve Bilodeau, Jessica Reddy, Matthew G. Guenther, Rodney P. Dekoter, Richard A. Young

Paediatrics Publications

Transforming growth factor beta (TGF-β) signaling, mediated through the transcription factors Smad2 and Smad3 (Smad2/3), directs different responses in different cell types. Here we report that Smad3 co-occupies the genome with cell-type-specific master transcription factors. Thus, Smad3 occupies the genome with Oct4 in embryonic stem cells (ESCs), Myod1 in myotubes, and PU.1 in pro-B cells. We find that these master transcription factors are required for Smad3 occupancy and that TGF-β signaling largely affects the genes bound by the master transcription factors. Furthermore, we show that induction of Myod1 in nonmuscle cells is sufficient to redirect Smad3 to Myod1 sites. We …

The Effect Of Intermittent Umbilical Cord Occlusion On Elastin Composition In The Ovine Fetus., Jennifer A Thompson, Sarah A Gimbel, Bryan S Richardson, Robert Gagnon, Timothy Regnault

Paediatrics Publications

This study aimed to determine the effect of varying degrees of intermittent umbilical cord occlusion (UCO) on arterial elastin composition. Over 4 days, chronically catheterized late gestation fetal sheep received 5 total UCO per day lasting 1 min/h (mild group: n = 6), 2 min/h (moderate group: n = 4), 3 min/h (severe group; n = 6); or no occlusion (control group: n = 7). Each group was evaluated for elastin content of the carotid and superior mesenteric artery (SMA), the arterial pressure response to UCO, and plasma cortisol concentration. Elastin content of the carotid artery was significantly increased by …

The Role Of Surgery In Building Resilience To Blast Attacks, Vivian Mcalister

Data and Test Instruments

Blast attacks are the commonest form of terrorist attack on civilians. Blast often causes injury from industrial accidents. Blast injury is the most common cause of injury and death in modern combat. A recent review of Canadian fatal casualties in Afghanistan found 81% to have been caused by blast, almost four times the number killed by gun shot wounds. Improvised explosive devices (IED) caused 78% of the blasts with another 20% being due to rocket propelled grenades (RPG).1 The purpose of this review is to outline the mechanisms of injury, to define the surgical response and to understand the implications …

The Authors Reply:, Ajay P. Sharma, Guido Filler, Prabo Dwight, William F. Clark

Paediatrics Publications

No abstract provided.

A Comparison Of Two Headless Compression Screws For Operative Treatment Of Scaphoid Fractures, Ruby Grewal, Joseph Assini, David Sauder, Louis Ferreira, Jim Johnson, Kenneth Faber

Surgery Publications

PURPOSE: The purpose of this study was to compare the interfragmentary compression force across a simulated scaphoid fracture by two commonly used compression screw systems; the Acutrak 2 Standard and the 3.0 mm Synthes headless compression screw.

METHODS: Sixteen (8 pairs; 6 female, 2 male) cadaver scaphoids were randomly assigned to receive either the Acutrak 2 or Synthes screw with the contralateral scaphoid designated to receive the opposite. Guide wires were inserted under fluoroscopic control. Following transverse osteotomy, the distal and proximal fragments were placed on either side of a custom load cell, to measure interfragmentary compression. Screws were placed …

Integrin-Linked Kinase: A Scaffold Protein Unique Among Its Ilk, Lina Dagnino

Paediatrics Publications

Integrin-linked kinase (ILK) is a scaffolding protein with central roles in tissue development and homeostasis. Much debate has focused on whether ILK is a bona fide or a pseudo- kinase. This aspect of ILK function has been complicated by the large volumes of conflicting observations obtained from a wide variety of experimental approaches, from in vitro models, to analyses in invertebrates and in mammals. Key findings in support or against the notion that ILK is catalytically active are summarized. The importance of ILK as an adaptor protein is well established, and defining its role as a signaling hub will be …

Rac1 Activation Induces Tumour Necrosis Factor-Α Expression And Cardiac Dysfunction In Endotoxemia, Ting Zhang, Xiangru Lu, Frank Beier, Qingping Feng

Paediatrics Publications

Induction of tumour necrosis factor-α (TNF-α) expression leads to myocardial depression during sepsis. However, the underlying molecular mechanisms are not fully understood. The aim of this study was to investigate the role of Rac1 in TNF-α expression and cardiac dysfunction during endotoxemia and to determine the involvement of phosphoinositide-3 kinase (PI3K) in lipopolysaccharide (LPS)-induced Rac1 activation. Our results showed that LPS-induced Rac1 activation and TNF-α expression in cultured neonatal mouse cardiomyocytes. The response was inhibited in Rac1 deficient cardiomyocytes or by a dominant-negative Rac1 (Rac1N17). To determine whether PI3K regulates Rac1 activation, cardiomyocytes were treated with LY294002, a PI3K selective …

Deletion Of Glycogen Synthase Kinase-3Β In Cartilage Results In Up-Regulation Of Glycogen Synthase Kinase-3Α Protein Expression, J. R. Gillespie, V. Ulici, H. Dupuis, A. Higgs, A. Dimattia, S. Patel, J. R. Woodgett, Frank Beier

Paediatrics Publications

The rate of endochondral bone growth determines final height in humans and is tightly controlled. Glycogen synthase kinase-3 (GSK-3) is a negative regulator of several signaling pathways that govern bone growth, such as insulin/IGF and Wnt/β-catenin. The two GSK-3 proteins, GSK-3 and GSK-3β, display both overlapping and distinct roles in different tissues. Here we show that pharmacological inhibition of GSK-3 signaling in a mouse tibia organ culture system results in enhanced bone growth, accompanied by increased proliferation of growth plate chondrocytes and faster turnover of hypertrophic cartilage to bone. GSK-3 inhibition rescues some, but not all, effects of phosphatidylinositide 3-kinase …

Maternal Protein Restriction Elevates Cholesterol In Adult Rat Offspring Due To Repressive Changes In Histone Modifications At The Cholesterol 7Α-Hydroxylase Promoter, Gurjeev Sohi, Kelly Marchand, Andrew Revesz, Edith Arany, Daniel B. Hardy

Paediatrics Publications

Adverse events in utero, such as intrauterine growth restriction (IUGR), can permanently alter epigenetic mechanisms leading to the metabolic syndrome, which encompasses a variety of symptoms including augmented cholesterol. The major site for cholesterol homeostasis occurs via the actions of hepatic cholesterol 7α-hydroxylase (Cyp7a1), which catabolizes cholesterol to bile acids. To determine whether posttranslational histone modifications influence the long-term expression of Cyp7a1 in IUGR, we used a protein restriction model in rats. This diet during pregnancy and lactation led to IUGR offspring with decreased liver to body weight ratios, followed by increased circulating and hepatic cholesterol levels in both sexes …

Pregnant Women As Research Participants: Why Is Additional Protection Required?, Kyoko Wada

Research Day (Arts & Humanities, FIMS, and Education)

Today, blanket exclusion of pregnant women from research participation is not endorsed; however, a tendency still remains to exclude pregnant women from participating in research. This exclusion results in insufficient data to guide clinical practice for pregnant women, and hence adds risks to pregnant women and fetuses (Lyerly et al. 2007, 2008, 2009; Baylis 2010; Goldkind et al. 2010).

Human Spinal Cord Injury Causes Specific Increases In Surface Expression Of Beta Integrins On Leukocytes, Feng Bao, Christopher S. Bailey, Kevin R. Gurr, Stewart I. Bailey, M. Patricia Rosas-Arellano, Arthur Brown, Gregory A. Dekaban, Lynne C. Weaver

Paediatrics Publications

Spinal cord injury (SCI) activates circulating leukocytes that migrate into the injured cord and bystander organs using adhesion molecule-mediated mechanisms. These cells cause oxidative damage, resulting in secondary injury to the spinal cord, as well as injury to bystander organs. This study was designed to examine, over a 6-h to 2-week period, changes in adhesion molecule surface expression on human peripheral leukocytes after SCI (9 subjects), using as controls 10 uninjured subjects and 6 general trauma patients (trauma controls, TC). Both the percentage of cells expressing a given adhesion molecule and the average level of its expression was quantified for …

Hyperfiltration Affects Accuracy Of Creatinine Egfr Measurement, Shih Han S. Huang, Ajay P. Sharma, Abeer Yasin, Robert M. Lindsay, William F. Clark, Guido Filler

Paediatrics Publications

Background and objectives: Surrogate markers such as creatinine, cystatin C (CysC), and beta trace protein (BTP) have been used to estimate GFR (eGFR). The accuracy of eGFR may be altered with hyperfiltration and differences in filtration fraction (FF). It is hypothesized that the accuracy of creatinine for eGFR may be affected by hyperfiltration and different effective renal plasma flow (ERPF). Design, setting, participants, & measurements: A total of 127 pediatric patients with various renal diseases underwent simultaneous measurements of GFR using 51Cr-EDTA renal scan and ERPF ( 131I-hippurate clearance) to calculate the FF (FF = GFR/ERPF). The eGFRs were calculated …

Mass Casualty Training Exercise At The Canadian Surgery Forum

Data and Test Instruments

On September 18, 2011 second year Schulich School of Medicine and Dentistry students helped run the first mass casualty training exercise, directed by Dr. Vivian McAlister, Division of General Surgery, at the Canadian Surgery Forum held this year at the London Convention Centre.

Composite Tissue Allotransplantation To Treat Veterans With Complex Amputation Injuries, Vivian Mcalister, Ray Kao, Brian Church, Markus Besemann, Rob Stiegelmar

Data and Test Instruments

Amputee rehabilitation may be limited by complexity of injury (e.g. bilateral arm amputation), associated injury (e.g. colostomy) or by the level of amputation (e.g. high above knee). Our objective is to assess the potential for composite tissue allotransplantation (CTA) to overcome these barriers. Medical literature was searched and programs were surveyed regarding the current status of CTA. Results CTA remains an experimental reconstructive option that involves a large collaborative (physiatry, orthopaedic, plastic and transplant surgeons). Limb transplantation has evolved out of limb reimplantation surgery and organ transplantation. Approximately 10 programs world wide, with almost a decade of experience, report 90% …

Histamine Deficiency Promotes Inflammation-Associated Carcinogenesis Through Reduced Myeloid Maturation And Accumulation Of Cd11b +Ly6g+ Immature Myeloid Cells, Xiang Dong Yang, Walden Ai, Samuel Asfaha, Govind Bhagat, Richard A. Friedman, Guangchun Jin, Heuijoon Park, Benjamin Shykind, Thomas G. Diacovo, Andras Falus, Timothy C. Wang

Paediatrics Publications

Histidine decarboxylase (HDC), the unique enzyme responsible for histamine generation, is highly expressed in myeloid cells, but its function in these cells is poorly understood. Here we show that Hdc-knockout mice show a high rate of colon and skin carcinogenesis. Using Hdc-EGFP bacterial artificial chromosome (BAC) transgenic mice in which EGFP expression is controlled by the Hdc promoter, we show that Hdc is expressed primarily in CD11b +Ly6G+ immature myeloid cells (IMCs) that are recruited early on in chemical carcinogenesis. Transplant of Hdc-deficient bone marrow to wild-type recipients results in increased CD11b + Ly6G + cell mobilization and reproduces the …

Ouabain Stimulates A Na+/K+-Atpase-Mediated Sfk-Activated Signalling Pathway That Regulates Tight Junction Function In The Mouse Blastocyst., Holly Giannatselis, Michele Calder, Andrew J Watson

Obstetrics & Gynaecology Publications

The Na(+)/K(+)-ATPase plays a pivotal role during preimplantation development; it establishes a trans-epithelial ionic gradient that facilitates the formation of the fluid-filled blastocyst cavity, crucial for implantation and successful pregnancy. The Na(+)/K(+)-ATPase is also implicated in regulating tight junctions and cardiotonic steroid (CTS)-induced signal transduction via SRC. We investigated the expression of SRC family kinase (SFK) members, Src and Yes, during preimplantation development and determined whether SFK activity is required for blastocyst formation. Embryos were collected following super-ovulation of CD1 or MF1 female mice. RT-PCR was used to detect SFK mRNAs encoding Src and Yes throughout preimplantation development. SRC and …

Learning From Mistakes: Improving Initial Fingertip Force Scaling By Observing Lifting Errors, Gavin Buckingham, Minnie Tang, Paul Gribble, Melvyn A. Goodale

Psychology Presentations

• When lifting objects that are lighter or heaver than we expect them to be, individuals typically misapply forces in a way that reflects their prior expectations of heaviness.

• Because we lift in this predictive way, large and small cubes elicit these characteristic errors even when they are adjusted to have equal mass. Lifters will apply too much force to a large cube and substantially less force to a small cube – errors that are rapidly corrected with repeated lifts (Flanagan & Beltzner, 2000).

• When watching others lift objects, an observer’s motor system automatically reacts in a way …

Integrin-Linked Kinase Is Required For Tgf-_1 Induction Of Dermal Myofibroblast Differentiation, Linda Vi, Cristina De Lasa, Gianna M. Diguglielmo, Lina Dagnino

Paediatrics Publications

Cutaneous repair after injury requires activation of resident dermal fibroblasts and their transition to myofibroblasts. The key stimuli for myofibroblast formation are activation of transforming growth factor-b (TGF-b) receptors and mechanotransduction mediated by integrins and associated proteins. We investigated the role of integrin-linked kinase (ILK) in TGF-b1 induction of dermal fibroblast transition to myofibroblasts. ILK-deficient fibroblasts treated with TGF-b1 exhibited attenuation of Smad 2 and 3 phosphorylation, accompanied by impaired transcriptional activation of Smad targets, such as a-smooth muscle actin. These alterations were not limited to Smad-associated TGF-b1 responses, as stimulation of noncanonical mitogenactivated protein kinase pathways by this growth …

Chest Compressions And Epinephrine During Resuscitation Of Infants Born At The Border Of Viability: Yes, No Or Maybe?, Gregory P. Moore, Thierry Daboval, Kevin W. Coughlin

Paediatrics Publications

Neonatology, in large part due to its population of babies born at the edge of viability, is rife with bioethical issues. This unique population is at high risk of mortality and considerable neurodevelopmental morbidity. One contentious, ongoing debate concerns whether these extremely low birth weight infants born at the border of viability should, if required by the Neonatal Resuscitation Program guidelines, receive chest compressions and epinephrine as part of their delivery room resuscitation. The present article, through a case presentation and discussion based on the ethical framework of principlism, provides readers with a thoughtful approach to the controversial issue of …

Nitric Oxide And Osteoporosis: What A Gas!, Sophie Jamal

Canadian Centre for Activity and Aging Presentations

No abstract provided.

Do Older Patients Utilize Excess Health Care Resources After Liver Transplantation?, Neil Shankar, Mamoon Albashir, Paul Marotta, William Wall, Vivian Mcalister, Natasha Chandok

Data and Test Instruments

INTRODUCTION: Liver transplantation is a highly effective treatment for end-stage liver disease. However, there is debate over the practice of liver transplantation in older recipients (age ≥ 60 years) given the relative shortage of donor grafts, worse post-transplantation survival, and concern that that older patients may utilize excess resources postoperatively, thus threatening the economic feasibility of the procedure. AIM: To determine if patients ≥ 60 years of age utilize more health resources following liver transplantation compared with younger patients. MATERIAL AND METHODS: Consecutive adult patients who underwent primary liver transplantation (n = 208) at a single center were studied over …

Review Of “Noted Surgeon, Fine Citizen”: The Life Of Archibald E Malloch, Md 1844–1919 By Charles G. Roland, Chloe Mcalister, Vivian Mcalister

Data and Test Instruments

No abstract provided.

2010 Newsmakers: Celebrating Our Own, Paul Mayne, Jason Winders

Data and Test Instruments

How will we remember 2010? Probably through these faces. This year, the Western News starts a new, if not wholly original, tradition. Our Newsmakers 2010 section celebrates the best of research, academia and volunteer spirit that we have to offer on this campus. We spotlight, in brief words and striking images, the accomplishments of some of our favourites from the last year. One of the most powerful women in Canada. A student with an eye for the greater good. And a man who would do anything, including posing with a zebra, for the United Way. A football coach. A ground-breaking …

A Pioneer Of Urologic Surgery From A Small Town In Ontario, Canada: A Tribute To Abraham Groves (1847-1935)., Yves Caumartin, Vivian Mcalister, Patrick Luke

Data and Test Instruments

Background: Abraham Groves worked as a general practitioner and surgeon in the small town of Fergus, Ontario, Canada. Several priority claims have been attributed to Groves’ life in surgery, including aseptic surgery (1874), appendectomy (1883) and the use of surgical gloves (1885). He was also an early practitioner of urological surgery. Objective: The purpose of this paper is to describe and objectively assess his contributions as a pioneer in urological surgery. Methods: A systematic search of contemporary journals was made for articles by or about Groves. These articles and his 1934 autobiography were reviewed. The information was assessed not only …