Wilma M Hopman

Queen's University Belfast, Béal Feirste, Northern Ireland, United Kingdom

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Publications (161)463.49 Total impact

  • M Deforest · J Grabell · S Albert · J Young · A Tuttle · W M Hopman · P D James
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    ABSTRACT: Our aim was to generate, optimize and validate a self-administered bleeding assessment tool (self-BAT) for von Willebrand disease (VWD). In Phase 1, medical terminology in the expert-administered International Society on Thrombosis and Haemostasis (ISTH)-BAT was converted into a Grade 4 reading level to produce the first version of the Self-BAT which was then optimized to ensure agreement with the ISTH-BAT. In Phase 2, the normal range of bleeding scores (BSs) was determined and test-retest reliability analysed. In Phase 3, the optimized Self-BAT was tested as a screening tool for first time referrals to the Haematology clinic. Bleeding score from the final optimized version of the Self-BAT showed an excellent intra-class correlation coefficient (ICC) of 0.87 with ISTH-BAT BS in Phase 1. In Phase 2, the normal range of BSs for the optimized Self-BAT was determined to be 0 to +5 for females and 0 to +3 for males and excellent test-retest reliability was shown (ICC = 0.95). In Phase 3, we showed that a positive Self-BAT BS (≥6 for females, ≥4 for males) has a sensitivity of 78%, specificity of 23%, positive predictive value (PPV) of 0.15 and negative predictive value (NPV) of 0.86 for VWD; these figures improved when just the females were analysed; sensitivity of 100%, specificity of 21%, PPV = 0.17 and NPV = 1.0. We show an optimized Self-BAT can generate comparable BS to the expert-administered ISTH-BAT and is a reliable, effective screening tool to incorporate into the assessment of individuals, particularly women, referred for a possible bleeding disorder. © 2015 John Wiley & Sons Ltd.
    Haemophilia 07/2015; DOI:10.1111/hae.12747 · 2.47 Impact Factor
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    ABSTRACT: The Consolidated Standards of Reporting Trials statement requires detailed reporting of interventions for randomized controlled trials. We hypothesized that there was variable reporting of chemotherapy compliance in published randomized controlled trials in breast cancer, and therefore surveyed the literature to assess this parameter and determine the study characteristics associated with reporting quality. Published Phase III randomized controlled trials (January 2005-December 2011; English language) evaluating chemotherapy in breast cancer were identified through a systematic literature search. Articles scored 1 point each for reporting of the four measures: number of chemotherapy cycles, dose modification, early treatment discontinuation and relative dose intensity. Logistic regression identified study characteristics associated with reporting quality score of ≥2. Of the 115 eligible randomized controlled trials, 79 (69%) were published in high-impact journals, 66 (57%) were published since 2008, 43 (37%) reported advanced-stage disease and 37 (32%) were industry sponsored. Relative dose intensity, number of cycles, dose modification and early treatment discontinuation were reported in 70 (61%), 53 (46%), 65 (57%) and 81 (70%) articles, respectively. Eighty-two (71%) articles showed a quality score of ≥2; 25 (22%) articles reported all four compliance measures. Articles published since 2008 (P = 0.035) and those reporting advanced-stage disease (P < 0.001) showed significantly higher quality of compliance. Our results demonstrate variable reporting of chemotherapy compliance in published randomized controlled trials with a modest improvement noted in recent years. Incorporating standards for reporting chemotherapy compliance in scientific guidelines or the journal peer review process may decrease the variability and improve the quality of reporting. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
    Japanese Journal of Clinical Oncology 06/2015; 45(6):520-6. DOI:10.1093/jjco/hyv043 · 1.75 Impact Factor
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    ABSTRACT: Background: Obstructive Sleep Apnea (OSA) results in intermittent hypoxia leading to atrial remodeling, which, among other things, facilitates development of atrial fibrillation. While much data exists on the macrostructural changes in cardiac physiology induced by OSA, there is a lack of studies looking for histologic changes in human atrial tissue induced by OSA which might lead to the observed macrostructural changes. Methods: A case control study was performed. Patients undergoing coronary artery bypass grafting (CABG) were evaluated for OSA and categorized as high-risk or low-risk. The right atrial tissue samples were obtained during CABG and both microscopic histological analysis and Sirius Red staining were performed. Results: 18 patients undergoing CABG were included; 10 high-risk OSA and 8 low-risk OSA in evenly matched populations. No statistically significant difference between the two groups was observed in amount of myocytolysis ( p= 0.181), nuclear hypertrophy ( p= 0.671), myocardial inflammation ( p= n/a), amyloid deposition ( p= n/a), or presence of thrombi ( p= n/a), as measured through routine H&E staining. As well, no statistically significant difference in interstitial and epicardial collagen was observed, as measured by Sirius Red staining (for total tissue: p= 0.619: for myocardium: p= 0.776). Conclusions: In this pilot study there were no observable histological differences in human right atrial tissue from individuals at high- and low-risk for OSA. Further investigation would be required for more definitive results.
    03/2015; 6:71-75. DOI:10.1016/j.ijcha.2015.01.008
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    ABSTRACT: A significant proportion of patients develop atrial fibrillation (AF) following cavotricuspid isthmus (CTI) ablation for typical atrial flutter (AFl). The objective of this study was to assess whether the presence of advanced interatrial block (aIAB) was associated with an elevated risk of AF after CTI ablation in patients with typical AFl and no prior history of AF. This study included patients with typical AFl and no prior history of AF that were referred for CTI ablation. Patients were excluded when they had received repeat ablations or did not demonstrate a bidirectional block. In all patients, a post-ablation electrocardiogram (ECG) in sinus rhythm was evaluated for the presence of aIAB, defined as a P-wave duration ≥120 ms and biphasic morphology in the inferior leads. New-onset AF was identified from 12-lead ECGs, Holter monitoring, and device interrogations. The cohort comprised 187 patients (age 67 ± 10.7 years; ejection fraction 55.8 ± 11.2%). Advanced interatrial block was detected in 18.2% of patients, and left atrium was larger in patients with aIAB compared with those without aIAB (46.2 ± 5.9 vs. 43.1 ± 6.0 mm; P = 0.01). Over a median follow-up of 24.2 months, 67 patients (35.8%) developed new-onset AF. The incidence of new-onset AF was greater in patients with aIAB compared with those without aIAB (64.7 vs. 29.4%; P < 0.001). After a comprehensive multivariate analysis, aIAB emerged as the strongest predictor of new-onset AF [odds ratio (OR) 4.2, 95% confidence interval (CI): 1.9-9.3; P < 0.001]. Advanced interatrial block is a key predictor for high risk of new-onset AF after a successful CTI ablation in patients with typical AFl. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.
    Europace 02/2015; DOI:10.1093/europace/euu379 · 3.05 Impact Factor
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    Katya M. Herman · Wilma M. Hopman · Catherine M. Sabiston
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    ABSTRACT: Physical activity (PA) and screen time (ST) are associated with self-rated health (SRH) in adults; however, SRH has been less studied among youth, and information about self-rated mental health (SRMH) is lacking. This study examined the associations of PA and ST with SRH and SRMH among adolescents.
    Preventive Medicine 02/2015; 73. DOI:10.1016/j.ypmed.2015.01.030 · 2.93 Impact Factor
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    ABSTRACT: Advanced interatrial block (aIAB) on the surface electrocardiogram (ECG), defined as a P-wave duration ≥120 milliseconds with biphasic (±) morphology in inferior leads, is frequently associated with atrial fibrillation (AF). The aim of this study was to determine whether preoperative aIAB could predict new-onset AF in patients with severe congestive heart failure (CHF) requiring cardiac resynchronization therapy (CRT). Retrospective analysis of consecutive patients with CHF and no prior history of AF undergoing CRT for standard indications. A baseline 12-lead ECG was obtained prior to device implantation and analyzed for the presence of aIAB. ECGs were scanned at 300 DPI and maximized 8×. Semiautomatic calipers were used to determine P-wave onset and offset. The primary outcome was the occurrence of AF identified through analyses of intracardiac electrograms on routine device follow-up. Ninety-seven patients were included (74.2% male, left atrial diameter 45.5 ± 7.8 mm, 63% ischemic). Mean P-wave duration was 138.5 ± 18.5 milliseconds and 37 patients (38%) presented aIAB at baseline. Over a mean follow-up of 32 ± 18 months, AF was detected in 29 patients (30%) and the incidence was greater in patients with aIAB compared to those without it (62% vs 28%; P < 0.003). aIAB remained a significant predictor of AF occurrence after multivariate analysis (OR 4.1; 95% CI, 1.6-10.7; P < 0.003). The presence of aIAB is an independent predictor of new-onset AF in patients with severe CHF undergoing CRT. © 2015 Wiley Periodicals, Inc.
    Annals of Noninvasive Electrocardiology 02/2015; DOI:10.1111/anec.12258 · 1.13 Impact Factor
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  • Natalia M Pittman · Wilma M Hopman · Mihaela Mates
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    ABSTRACT: Curative chemotherapy for breast cancer is associated with significant toxicities including emergency room (ER) visits and hospital admissions (HAs), events that are underreported in clinical trials. This study examined the reasons for, and factors associated with, ER visits and HA after curative chemotherapy for breast cancer in a tertiary Ontario hospital. A retrospective study of all patients who completed at least one cycle of curative chemotherapy for breast cancer in 2011 and 2012 was conducted. We recorded ER visits and HAs within 30 days of any chemotherapy. We collected demographics, comorbidities, surgical data, tumor characteristics, chemotherapy type and cycles, and use of granulocyte colony-stimulating factors (G-CSF). A total of 149 patients underwent curative chemotherapy. Mean age was 58.6 years. Adjuvant chemotherapy was received by 85% of patients and G-CSF by 88.6%. At least one ER visit occurred in 53% of patients, and 13% required HA. The most common causes of ER visits were fever without neutropenia (23.3%), pain (12.8%), and febrile neutropenia (9%). Stage of breast cancer was the only factor statistically significantly associated with ER visits (P = .045); tumor size (P = .019), adjuvant chemotherapy (P = .045), and lower number of chemotherapy cycles (P = .005) were significantly associated with HA. Future research should focus on identifying the patient, provider, and health system factors associated with ER visits and HAs after chemotherapy for breast cancer, to minimize them and lessen the burden on the health care system. Copyright © 2015 by American Society of Clinical Oncology.
    Journal of Oncology Practice 01/2015; 11(2). DOI:10.1200/JOP.2014.000257
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    ABSTRACT: Background: Chronic pain is of major concern to global health and one of the top reasons for a patient to seek physician care. The prevalence of chronic pain in the civilian population has been well documented, as has chronic pain with certain injuries commonly seen in veterans; however little is known about the burden of chronic pain in the general population of veterans. Objectives: The objective of this review is to summarize the evidence on the prevalence of chronic pain and related risk factors in military veterans. Inclusion criteria: Types of participants; International studies that included military veterans. Focus of the review; Studies that evaluated the prevalence of and/or related risk factors associated with chronic pain in the general military veteran population. Types of studies; Analytical and descriptive epidemiological studies including prospective and retrospective cohort studies, and cross sectional studies. Search strategy: The search strategy targeted both published and unpublished studies. An initial limited search of MEDLINE and CINAHL was undertaken, followed by an analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second search in MEDLINE, CINAHL, Embase, PsycINFO and Web of Science included all identified keywords and index terms. Reference lists were hand searched. Inclusion criteria were English language studies published between 1996 and 2013. The search for unpublished studies included: Dissertations and theses, MedNar, Centers for Disease Control and Prevention (CDC). All identified studies were assessed for relevance based on information provided in the title, abstract and subject terms. Full papers were retrieved for studies that satisfied the inclusion criteria, or if there was uncertainty regarding relevance. Studies identified from reference list searches of included studies were assessed for relevance based on the title. Data collection: Two independent reviewers extracted data from the selected papers using the standardized data extraction tool from Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Data synthesis: Meta-analysis was not possible due to methodological and statistical heterogeneity of the studies. Hence study findings are presented in narrative form. Results: A total of 4829 citations were located by the search strategy. Of this set, 1218 were duplicates, 3536 were off-topic and 73 did not meet inclusion criteria. Twelve studies were included in this systematic review. The prevalence of pain ranged from 25% to 72%. The prevalence of moderate to severe chronic pain of at least three months duration was 27.4%. Factors associated with chronic pain included sex, being married, lower levels of education, smoking, emotional distress, rank, type of service and being younger. Conclusions: There is a significant burden of chronic pain in veterans, and it appears to be higher than in civilian populations. However, the current evidence is limited by the paucity of available studies and the variability in study design and pain measurement. Implications for research: The findings of this review may be useful for clinician and policy decisions to improve the care of veterans and to target veterans with a high burden of chronic pain.
    JBI Database of Systematic Reviews and Implementation Reports 12/2014; 12(10):152-186. DOI:10.11124/jbisrir-2014-1720
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    The Canadian journal of cardiology 10/2014; 30(10):S311. DOI:10.1016/j.cjca.2014.07.555 · 3.94 Impact Factor
  • Sarah Ferrara · Wilma M. Hopman · Michael Leveridge
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    ABSTRACT: Introduction We assess how urologists are rated online by patients and which factors influence these ratings. Methods We created an anonymous database of urologists’ ratings from Ontario, Canada using a popular rating website (RateMDs.com). Comments were assessed for mention of diagnosis, bedside manner and nonlinguistic emphasis devices, and the impact of these variables was analyzed. Results A total of 3,288 ratings were identified for 224 urologists (median 15 ratings per urologist, range 1 to 35), representing 75.4% of practicing urologists in the province. Mean rating was 3.96/5 (median 4.75, range 1 to 5). Overall 2,215 ratings (67.4%) were 4/5 or greater. Comment on good bedside manner was associated with higher ratings (mean 4.74 vs 3.92, p <0.001) and comment on poor bedside manner was associated with lower ratings (mean 2.45 vs 4.01, p <0.001). Patients mentioning surgery rated urologists higher than those who did not (4.28 vs 3.85, p <0.001). A specific diagnosis was mentioned in 1,056 cases (32.1%). Mean rating was highest for kidney cancer (4.67) and lowest for vasectomy (3.77, p <0.001). Comments with at least 1 word in full capital letters and those with a word or phrase in quotation marks were accompanied by lower ratings (mean 3.11 vs 4.03 and 3.13 vs 4.02, respectively, p <0.001). Longer comments were also associated with lower ratings (word count 1 to 50—mean rating 4.24, word count 51 to 100—mean rating 3.88, word count greater than 100—mean rating 3.29; p <0.001). Conclusions Urologists are reviewed favorably online. Patients who note surgery, a cancer diagnosis or good bedside manner rate urologists highly, while longer comments, the use of all caps or quotation marks, or mention of a poor bedside manner are associated with lower ratings.
    Urology Practice 09/2014; DOI:10.1016/j.urpr.2014.05.005
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    ABSTRACT: Adjuvant chemotherapy (AC) improves survival among patients with colon cancer (CC). Two meta-analyses have demonstrated a decrease in survival with increasing time to AC (TTAC). Here, we examine the predominant factors leading to delay in TTAC.
    Journal of Oncology Practice 08/2014; 11(1). DOI:10.1200/JOP.2014.001531
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    ABSTRACT: BACKGROUND: High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010. METHODS: We used data for exposure to risk factors by country, age group, and sex from pooled analyses of population-based health surveys. We obtained relative risks for the effects of risk factors on cause-specific mortality from meta-analyses of large prospective studies. We calculated the population attributable fractions for each risk factor alone, and for the combination of all risk factors, accounting for multicausality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific population attributable fractions by the number of disease-specific deaths. We obtained cause-specific mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the final estimates. FINDINGS: In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After accounting for multicausality, 63% (10·8 million deaths, 95% CI 10·1-11·5) of deaths from these diseases in 2010 were attributable to the combined effect of these four metabolic risk factors, compared with 67% (7·1 million deaths, 6·6-7·6) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country level, age-standardised death rates from these diseases attributable to the combined effects of these four risk factors surpassed 925 deaths per 100 000 for men in Belarus, Kazakhstan, and Mongolia, but were less than 130 deaths per 100 000 for women and less than 200 for men in some high-income countries including Australia, Canada, France, Japan, the Netherlands, Singapore, South Korea, and Spain. INTERPRETATION: The salient features of the cardiometabolic disease and risk factor epidemic at the beginning of the 21st century are high blood pressure and an increasing effect of obesity and diabetes. The mortality burden of cardiometabolic risk factors has shifted from high-income to low-income and middle-income countries. Lowering cardiometabolic risks through dietary, behavioural, and pharmacological interventions should be a part of the global response to non-communicable diseases.
    The Lancet Diabetes & Endocrinology 08/2014; 2(8):634-47. DOI:10.1016/S2213-8587(14)70102-0 · 9.19 Impact Factor
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    The Canadian journal of cardiology 08/2014; 30(12). DOI:10.1016/j.cjca.2014.08.023 · 3.94 Impact Factor
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    ABSTRACT: BACKGROUND Interferon-gamma release assays (IGRAs) may be useful in diagnosing latent tuberculous infection (LTBI) in inmates; however, published experience in these settings is limited. OBJECTIVE To identify variables associated with IGRA positivity among Canadian federal inmates with positive tuberculin skin test (TST) results. DESIGNOn intake, TST-positive (10 mm) inmates were offered an IGRA (QuantiFERON®-TB Gold), and demographic and historical data were collected. IGRA-positive and -negative inmates were compared using the χ2 test and multivariable logistic regression; the final model's goodness of fit was assessed using Hosmer-Lemeshow test and area under the receiver operating characteristic curve (AUC). RESULTSOf 96 TST-positive inmates, 31 (32.3%) were IGRA-positive. Variables associated with positive IGRA were age >45 years (11/20 vs. 20/75, P = 0.016) and previous LTBI treatment (9/20 vs. 13/55, P = 0.032) in univariate analysis, and being from a country with a moderate or high estimated tuberculosis (TB) incidence (OR 3.5, 95%CI 1.3–9.4, P = 0.013) and absence of bacille Calmette-Guérin (BCG) vaccination (OR 3.3, 95%CI 1.2–9.0, P = 0.017) in multivariable analysis. The data fit the model well, classifying the group better than chance alone (AUC 0.67, P = 0.007). CONCLUSION High discordance with TST, particularly among BCG-vaccinated inmates and those from low TB incidence countries, suggest that IGRA may be useful in Canadian federal penitentiary screening programmes.
    The International Journal of Tuberculosis and Lung Disease 07/2014; 18(7):787-92. DOI:10.5588/ijtld.13.0816 · 2.76 Impact Factor
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    ABSTRACT: A significant proportion of hemodialysis patients have functional, but modifiable, vitamin K deficiency. To determine the correlates of poor vitamin K status in hemodialysis patients. Cross-sectional study. Hemodialysis units at Kingston General Hospital and its satellite centres, Ontario, Canada. Patients undergoing outpatient hemodialysis for end-stage kidney disease. Serum concentrations of phylloquinone, undercarboxylated prothrombin, also known as protein induced by vitamin K absence or antagonism - factor II (PIVKA-II), and the percentage of undercarboxylated osteocalcin (%ucOC). Vitamin K status was determined in fasting blood samples of hemodialysis patients. Bivariate relationships were examined using parametric and non-parametric statistics as appropriate. Multivariable linear regression models were applied to identify predictors of vitamin K status. Among 44 HD patients, criteria for subclinical vitamin K deficiency were met in 13.6% (phylloquinone < 0.4 nmol/L), 51% (%ucOC > 20%) and 90.9% (PIVKA-II > 2.0 nmol/L) of subjects. Phylloquinone levels were positively associated with total cholesterol, triglyceride levels and non-smoking status. Higher %ucOC was associated with increased calcium-phosphate product. Increased PIVKA-II levels were observed with advancing age, reduced dialysis adequacy, lower HDL and a history of coronary artery disease. There were no associations found among the individual biomarkers of vitamin K status. In a multi-variable model, triglycerides were the only significant predictor of phylloquinone levels, while increasing phosphate and decreasing PTH were independent predictors of %ucOC. PIVKA-II levels increased by 0.54 nmol/L for every 10-year increase in age. Observational study; small sample size. A significant proportion of HD patients met criteria for subclinical vitamin K deficiency. Of the biomarkers measured, PIVKA-II may be superior given its independence of renal function or dyslipidemia, both of which may confound the other vitamin K biomarkers. Studies in patients with ESKD linking biomarkers of vitamin K status to important patient outcomes, including cardiovascular disease, nutritional status and mortality, are required in order to determine the optimal biomarker for evaluating vitamin K status in this particular population.
    06/2014; 1:13. DOI:10.1186/2054-3581-1-13
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    ABSTRACT: To prospectively assess changes in health-related quality of life (HRQOL) over 10 years, by age and sex, and to compare measured within-person change to estimates of change based on cross-sectional data. Participants in the Canadian Multicentre Osteoporosis Study completed the 36-item short form (SF-36) in 1995/1997 and 2005/2007. Mean within-person changes for domain and summary components were calculated for men and women separately, stratified by 10-year age groups. Projected changes based on published age- and sex-stratified cross-sectional data were also calculated. Mean differences between the two methods were then estimated, along with the 95 % credible intervals of the differences. Data were available for 5,569/9,423 (59.1 %) of the original cohort. Prospectively collected 10-year changes suggested that the four physically oriented domains declined in all but the youngest group of men and women, with declines in the elderly men exceeding 25 points. The four mentally oriented domains tended to improve over time, only showing substantial declines in vitality and role emotional in older women, and all four domains in older men. Cross-sectional estimates identified a similar pattern of change but with a smaller magnitude, particularly in men. Correspondence between the two methods was generally high. Changes in HRQOL may be minimal over much of the life span, but physically oriented HRQOL can decline substantially after middle age. Although clinically relevant declines were more evident in prospectively collected data, differences in 10-year age increments of cross-sectional data may be a reasonable proxy for longitudinal changes, at least in those under 65 years of age. Results provide additional insight into the natural progression of HRQOL in the general population.
    Quality of Life Research 06/2014; 23(10). DOI:10.1007/s11136-014-0733-5 · 2.86 Impact Factor
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    ABSTRACT: Objective-Sequence variations in the gene(s) encoding vitamin K epoxide reductase complex subunit 1 (VKORC1), the enzyme target of warfarin, have been associated with increased cardiovascular disease in the general population. Coronary artery calcification (CAC) is a prevalent form of cardiovascular disease in chronic kidney disease. We tested the hypothesis that the VKORC1 rs8050894 CC genotype would be associated with mortality and progression of CAC <= 4 years. Approach and Results-This study is an observational, prospective study of 167 individuals with stages 3 to 5 chronic kidney disease. Survival <= 4 years was assessed in all participants, and CAC progression was measured in a subset of 86 patients. Participants with the CG/GG genotype of VKORC1 had higher baseline CAC scores (median score, 112 versus 299; P=0.036). Of those 86 patients who had a 4-year CAC score, those with the CG/GG genotype had an increased risk of progressive CAC (adjusted for age, diabetes mellitus, estimated glomerular filtration rate, and hypertension) compared with those with the CC genotype. Four-year mortality risk was 4 times higher for individuals with the CG/GG genotypes compared with individuals with the CC genotype (odds ratio, 3.8; 95% confidence interval, 1.2-12.5; P=0.02), adjusted for age, sex, diabetes mellitus, estimated glomerular filtration rate, baseline CAC, and hypertension. Conclusions-Patients with the CG/GG genotype of VKORC1 had a higher risk of CAC progression and a poorer survival. These data provide new perspectives on the potential extrahepatic role of VKORC1 in individuals with chronic kidney disease.
    Arteriosclerosis Thrombosis and Vascular Biology 05/2014; 34(7). DOI:10.1161/ATVBAHA.114.303211 · 5.53 Impact Factor
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    ABSTRACT: This study aimed to collect and analyze CO levels as an indirect measure of smoke exposure in pregnant adolescents.
    Journal of Pediatric and Adolescent Gynecology 04/2014; 27(2):e26–e27. DOI:10.1016/j.jpag.2014.01.015 · 1.81 Impact Factor
  • NM Pittman · M. Mates · WM Hopman
    Cancer Research 03/2014; 73(24 Supplement):P6-06-56-P6-06-56. DOI:10.1158/0008-5472.SABCS13-P6-06-56 · 9.28 Impact Factor

Publication Stats

4k Citations
463.49 Total Impact Points


  • 2015
    • Queen's University Belfast
      Béal Feirste, Northern Ireland, United Kingdom
  • 1999–2015
    • Kingston General Hospital
      Kingston, Ontario, Canada
  • 1996–2015
    • Queen's University
      • • Division of Cardiology
      • • Department of Community Health and Epidemiology
      • • Department of Medicine
      Kingston, Ontario, Canada
  • 2014
    • University of Ottawa
      Ottawa, Ontario, Canada
  • 2009–2013
    • Queens University of Charlotte
      New York, United States
  • 2007
    • Beverly Hospital, Boston MA
      BVY, Massachusetts, United States