-
[show abstract]
[hide abstract]
ABSTRACT: Age-standardized rates of hip fracture in Canada declined during the period 1985 to 2005. We investigated whether this incidence pattern is explained by period effects, cohort effects or both. All hospitalizations during the study period with primary diagnosis of hip fracture were identified. Age- and sex-specific hip fracture rates were calculated for nineteen 5-years age groups and four 5-years calendar periods, resulting in twenty births cohorts. The effect of age, calendar period, and birth cohort on hip fracture rates was assessed using age-period-cohort models as proposed by Clayton and Schiffers. From 1985 to 2005, a total of 570,872 hospitalizations for hip fracture were identified. Age-standardized rates for hip fracture have progressively declined for females and males. The annual linear decrease in rates per 5 year period were 12% for females and 7% for males (both p<0.0001). Significant birth cohort effects were also observed for both sexes (p<0.0001). Cohorts born prior to 1950 had a higher risk of hip fracture, while those born after 1954 had a lower risk. After adjusting for age and constant annual linear change (drift term common to both period and cohort effects), we observed a significant nonlinear birth cohort effect for males (p=0.0126) but not for females (p=0.9960). In contrast, the nonlinear period effect, after adjustment for age and drift term was significant for females (p=0.0373) but not for males (p=0.2515). For males, we observed no additional nonlinear period effect after adjusting for age and birth cohort whereas for females, we observed no additional nonlinear birth cohort effect after adjusting for age and period. Although hip fracture rates decreased in both sexes, different factors may explain these changes. In addition to the constant annual linear decrease, non-linear birth cohort effects were identified for males and calendar period effects were identified for females as possible explanations. © 2013 American Society for Bone and Mineral Research.
Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research 02/2013; · 6.04 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Heart failure (HF) is a leading morbid cause of hospitalization and death. HF is often accompanied by comorbid conditions, increasing the health care burden. This study describes hospital mortality and identifies comorbid conditions associated with HF.
Acute care hospital separations in 2005-2006, with a diagnosis of HF I50, I500, I501, I509 (The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Canada [ICD-10-CA]) were identified from all Canadian jurisdictions except Québec.
A total of 2,457,527 hospital separations among 1,812,923 individuals, identifying 8,212,869 diagnoses were reported. Among those, a total of 33,693 (1.9%) of all hospitalized individuals had a most responsible diagnosis of HF, accounting for 42,399 hospital separations. Further, HF was coded 77,049 times as a comorbid diagnosis, altogether occurring in 4.9% of all hospitalizations. The most common primary diagnoses associated with comorbid HF were acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), and pneumonia. Seniors had a much higher hospitalization rate due to HF. Hospitalized individuals with a primary diagnosis of HF had an almost 3-fold higher 30-day in-hospital mortality rate and nearly double the mean hospital stay than that for all causes. On average, hospitalizations with a primary diagnosis of HF had 3.9 comorbidities, most commonly chronic ischemic heart disease (IHD), atrial fibrillation and flutter, diabetes, renal failure, etc.; 1.7 times greater for HF than for all causes.
HF has a high in-hospital mortality rate particularly among the elderly and is associated with many cardiac and noncardiac conditions. HF necessitates long hospital stays, which increases the burden on the health care system in Canada.
The Canadian journal of cardiology 08/2011; 28(1):74-9. · 3.36 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Hip fractures are a public health concern because they are associated with significant morbidity, excess mortality, and the majority of the costs directly attributable to osteoporosis.
To examine trends in hip fracture rates in Canada.
Ecologic trend study using nationwide hospitalization data for 1985 to 2005 from a database at the Canadian Institute for Health Information. Data for all patients with a hospitalization for which the primary reason was a hip fracture (570,872 hospitalizations) were analyzed.
Age-specific and age-standardized hip fracture rates.
There was a decrease in age-specific hip fracture rates (all P for trend <.001). Over the 21-year period of the study, age-adjusted hip fracture rates decreased by 31.8% in females (from 118.6 to 80.9 fractures per 100,000 person-years) and by 25.0% in males (from 68.2 to 51.1 fractures per 100,000 person-years). Joinpoint regression analysis identified a change in the linear slope around 1996. For the overall population, the average age-adjusted annual percentage decrease in hip fracture rates was 1.2% (95% confidence interval, 1.0%-1.3%) per year from 1985 to 1996 and 2.4% (95% confidence interval, 2.1%-2.6%) per year from 1996 to 2005 (P < .001 for difference in slopes). Similar changes were seen in both females and males with greater slope reductions after 1996 (P < .001 for difference in slopes for each sex).
Age-standardized rates of hip fracture have steadily declined in Canada since 1985 and more rapidly during the later study period. The factors primarily responsible for the earlier reduction in hip fractures are unknown.
JAMA The Journal of the American Medical Association 09/2009; 302(8):883-9. · 30.03 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: HEALTH ISSUE: Overweight and obesity have been recognized as major public health concern in Canada and throughout the world. Lack of physical activity, through its impact on energy balance, has been identified as an important modifiable risk factor for obesity. Physical activity and obesity are also important risk factors for a variety of chronic diseases. This chapter provides an overview of the current state of physical activity and overweight/obesity among Canadian women. KEY FINDINGS: For all ages combined more women (57%) than men (50%) are physically inactive (energy expenditure <1.5 KKD). Physical activity increases as income adequacy and educational level decrease. Physical inactivity also varies by ethnicity. The prevalence of both overweight (BMI 25.0 - 29.9 kg/m2) and obese (BMI >/= 30 kg/m2) Canadian women has increased 7% since 1985. Obesity increases with age and is highest among women reporting low and lower middle incomes and lower levels of education. The prevalence of obesity is highest among Aboriginal women and men (28% and 22% respectively). DATA GAPS AND RECOMMENDATIONS: There is currently no surveillance system in Canada to monitor the level of physical activity among children, those performing activity at work, at school or in the home. There is a gap in the knowledge surrounding socio-cultural and ecological determinants of physical activity and obesity and the associations of these to chronic disease among women and minority populations. Multi-sectoral policy interventions that act to decrease the broad systemic barriers to physical activity and healthy weights among all women are needed.
BMC Women s Health 08/2004; 4 Suppl 1:S6.
-
[show abstract]
[hide abstract]
ABSTRACT: To characterize interstitial lung diseases (ILDs) and evaluate use of keyhole lung biopsy for diagnosis of ILDs in dogs and cats.
Retrospective study.
11 dogs and 2 cats.
Medical records of dogs and cats undergoing keyhole lung biopsy to confirm ILDs were reviewed. Signalment, clinical signs, results of thoracic radiography and other respiratory diagnostic tests, postoperative complications, and patient outcome were analyzed.
Clinical respiratory signs included cough, tachypnea, exercise intolerance, and hemoptysis. Thoracic radiographic abnormalities included interstitial, alveolar, and bronchointerstitial patterns and multiple discrete pulmonary nodules. Lung biopsy and histologic examination revealed interstitial pulmonary fibrosis, bronchiolitis obliterans with organizing pneumonia, or unclassified lesions. Outcome after biopsy included no response to treatment, euthanasia, partial or complete remission while receiving medication, and cure.
Recognition and classification of ILDs in dogs and cats are likely to be important in guiding appropriate treatment and providing accurate prognostic information. Ancillary respiratory diagnostic tests are beneficial in ruling out infectious and neoplastic disorders that may mimic ILDs; however, their present use in the diagnosis of ILDs is limited. Results suggest that keyhole lung biopsy is an effective means for obtaining a specimen for histologic diagnosis in dogs and cats with ILDs.
Journal of the American Veterinary Medical Association 12/2002; 221(10):1453-9. · 1.79 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Metallic hemoclips or surgical staples were inserted in 16 tumor-bearing dogs at the time of surgical resection of the tumor. Orthogonal radiographs were taken immediately postoperatively and after wound healing to visualize the location and number of hemoclips or metallic staples. A shift in hemoclip/staple position was identified in nine dogs, mainly from positioning during radiography. In three dogs, an absolute shift in marker position was identified. Based on this study, it appears that the placement of surgical clips is potentially useful in identifying the tumor bed, which may be of benefit in establishing radiation treatment fields.
Journal of the American Animal Hospital Association 40(4):300-8. · 0.96 Impact Factor
