The Regie de 1'assurance maladie du Quebec (RAMQ) health insurance databases have been demonstrated to be a valuable research tool for certain illnesses. The purpose of this study was to examine which data from the RAMQ administrative database could be used to accurately diagnose COPD patients, and classify their severity and comorbidity. Methods . Patients with physician-diagnosed COPD were selected using hospital discharge and outpatient records. Information collected from medical chart was compared to information on the same patients from medical service and prescription drug databases. Results. The ICD-9 respiratory diagnostic codes were found to have a sensitivity of 93% identifying COPD in 151 cases and 94% specificity within a group of similar-aged asthmatic patients. The number of prednisone prescriptions over one year accurately separated severe from moderate patients. As well, diagnostic codes showed moderate reliability for indicating the presence of comorbidity. Conclusions. The diagnostic codes of the medical service database were accurate at identifying COPD patients and the prescription drug data was useful for classifying their severity.

Despite the benefits of coronary artery bypass graft surgery (CABG), graft closure can still occur and lead to the development of unstable angina, myocardial infarction (MI) and death. Secondary prevention is thus greatly needed in order to prevent future cardiovascular events in the post-CABG patient. Few studies have examined the benefits of cardiac medical therapy specifically among CABG patients. A review of randomized controlled trials (RCT's) was first conducted in order to understand what constitutes appropriate cardiac medical therapy in the post-CABG patient. / The use of aspirin, clopidogrel, coumadin, anti-lipid agents, anti-ischemic medications (beta-blockers, CCB's, nitrates) and ACE inhibitors was then examined among patients enrolled in the Routine versus Selective Exercise Treadmill Testing After Coronary Artery Bypass Graft Surgery (ROSETTA-CABG) Study. We examined the use of these medications among all patients as well as patients with various co-morbidities.

The MicroTactus is an instrument designed to detect signals arising from the interaction of a tip with soft or hard objects and to magnify them for haptic and auditory reproduction. An enhanced arthroscopic surgical probe was developed using an accelerometer and a custom-designed actuator for haptic feedback. Measurements were made to characterize the device and the results showed that numerous factors such as gripping method and gripping force influenced the system response in a complicated manner. The device was tested with the task of detecting surface defects of a cartilage-like material. Subjects were asked to detect the cuts of different depths under four conditions: no amplification, with haptic feedback, with sound feedback, and with passive touch. Both haptic and auditory feedback was found to significantly improve detection performance, which demonstrated that an enhanced arthroscopic probe provided useful information for the detection of small cuts in tissue-like materials.

Retinoic acid (RA), the principal biologically active retinoid, is essential for normal differentiation of a wide variety of cell types. Vitamin A deficiency predisposes to certain cancers and it has since been discovered that retinoids display antitumorigenic activity in many models. Keratinocytes with a null mutation in the RARgamma and RARalphagamma genes are predisposed to tumorigenesis in vivo. This outcome is reversed by the re-introduction of a functional RAR, suggesting that some retinoid-target gene(s) are implicated in tumour formation in this model. Suppressive subtractive hybridization techniques have been used to isolate RA-responsive genes no longer regulated in RAR-null keratinocytes. This work led to the cloning of gas3, a member of the growth arrest-specific gene family. Our studies have demonstrated that gas3 expression is regulated by RA and is greatly reduced following tumor promotion, indicating that this gene could potentially inhibit epidermal tumorigenesis elicited by retinoids.

Lung transplantation is a therapeutic option for patients affected with end-stage lung diseases. However, several complications may arise following the procedure, such as Bronchiolitis Obliterans (BO). This condition, characterized by small airway fibrosis, remains a major cause of morbidity and mortality in patients following lung transplantation. It is thought to be a manifestation of chronic rejection within the airways, with hallmark inflammation and fibroproliferation. TGF-beta and other cytokines, including IL-1, IFN-gamma and PDGF, have been implicated in the pathogenesis of fibrosis, mostly in animal models. IL-11 and IL-17 are novel profibrotic cytokines that induce fibroblasts and epithelial cells to produce excess extracellular matrix. They have recently been identified as having a role in tissue remodelling and induction of tissue fibrosis. We hypothesize that IL-11 and IL-17 are involved in chronic lung rejection (Bronchiolitis Obliterans) and that their expression could be a predictive and prognostic marker of chronic lung rejection. / The objectives of the study were to investigate the expression of IL-11 and IL-17 (mRNA and protein) in endobronchial biopsies from lung transplant patients and to define the correlation between the expression of IL-11 and IL-17 and the development of chronic rejection.

Thrombosis is a vascular pathological process which frequently affects the veins of the lower limbs, and embolisation of thrombotic material is common. Thromboembolic disease is a common cause of death in Western societies, predominantly affecting the elderly. Numerous risk factors and co-morbidities have been identified. Safe and effective means of prophylaxis are available but are underutilised. Anticoagulant drugs are very effective in preventing thromboembolic disease, but their effects on the evolution of the thrombotic process remain poorly documented. These drugs are difficult to use, and treatment errors and treatment failures are common. The factors which determine the embolisation of deep vein thrombosis are poorly understood. When such embolisation occurs it is usually asymptomatic. Symptomatic pulmonary embolism presents in 3 general ways-pleuritic pain, shortness of breath, or collapse. Tachypnea is the commonest sign. Tests which are available to assist in the diagnosis of thromboembolic disease include the ventilation perfusion lung scan, ultrasound of the lower limbs, pulmonary angiography and echocardiography. The commonest investigation requested in this context is the lung scan. Although the results are often inconclusive, this is frequently the only specific investigation which is performed. The accurate interpretation of lung scans requires consideration of the pretest probability of pulmonary embolism. The D-dimer assay is another test which may be useful. The finding of a normal D-dimer level substantially reduces the probability of thromboembolic disease and may render a lung scan unnecessary. / Subscription resource available via Digital Dissertations only.

Thrombosis is a vascular pathological process which frequently affects the veins of the lower limbs, and embolisation of thrombotic material is common. Thromboembolic disease is a common cause of death in Western societies, predominantly affecting the elderly. Numerous risk factors and co-morbidities have been identified. Safe and effective means of prophylaxis are available but are underutilised. Anticoagulant drugs are very effective in preventing thromboembolic disease, but their effects on the evolution of the thrombotic process remain poorly documented. These drugs are difficult to use, and treatment errors and treatment failures are common. The factors which determine the embolisation of deep vein thrombosis are poorly understood. When such embolisation occurs it is usually asymptomatic. Symptomatic pulmonary embolism presents in 3 general ways-pleuritic pain, shortness of breath, or collapse. Tachypnea is the commonest sign. Tests which are available to assist in the diagnosis of thromboembolic disease include the ventilation perfusion lung scan, ultrasound of the lower limbs, pulmonary angiography and echocardiography. The commonest investigation requested in this context is the lung scan. Although the results are often inconclusive, this is frequently the only specific investigation which is performed. The accurate interpretation of lung scans requires consideration of the pretest probability of pulmonary embolism. The D-dimer assay is another test which may be useful. The finding of a normal D-dimer level substantially reduces the probability of thromboembolic disease and may render a lung scan unnecessary. / Subscription resource available via Digital Dissertations only.

Thrombosis is a vascular pathological process which frequently affects the veins of the lower limbs, and embolisation of thrombotic material is common. Thromboembolic disease is a common cause of death in Western societies, predominantly affecting the elderly. Numerous risk factors and co-morbidities have been identified. Safe and effective means of prophylaxis are available but are underutilised. Anticoagulant drugs are very effective in preventing thromboembolic disease, but their effects on the evolution of the thrombotic process remain poorly documented. These drugs are difficult to use, and treatment errors and treatment failures are common. The factors which determine the embolisation of deep vein thrombosis are poorly understood. When such embolisation occurs it is usually asymptomatic. Symptomatic pulmonary embolism presents in 3 general ways-pleuritic pain, shortness of breath, or collapse. Tachypnea is the commonest sign. Tests which are available to assist in the diagnosis of thromboembolic disease include the ventilation perfusion lung scan, ultrasound of the lower limbs, pulmonary angiography and echocardiography. The commonest investigation requested in this context is the lung scan. Although the results are often inconclusive, this is frequently the only specific investigation which is performed. The accurate interpretation of lung scans requires consideration of the pretest probability of pulmonary embolism. The D-dimer assay is another test which may be useful. The finding of a normal D-dimer level substantially reduces the probability of thromboembolic disease and may render a lung scan unnecessary. / Subscription resource available via Digital Dissertations only.

Thrombosis is a vascular pathological process which frequently affects the veins of the lower limbs, and embolisation of thrombotic material is common. Thromboembolic disease is a common cause of death in Western societies, predominantly affecting the elderly. Numerous risk factors and co-morbidities have been identified. Safe and effective means of prophylaxis are available but are underutilised. Anticoagulant drugs are very effective in preventing thromboembolic disease, but their effects on the evolution of the thrombotic process remain poorly documented. These drugs are difficult to use, and treatment errors and treatment failures are common. The factors which determine the embolisation of deep vein thrombosis are poorly understood. When such embolisation occurs it is usually asymptomatic. Symptomatic pulmonary embolism presents in 3 general ways-pleuritic pain, shortness of breath, or collapse. Tachypnea is the commonest sign. Tests which are available to assist in the diagnosis of thromboembolic disease include the ventilation perfusion lung scan, ultrasound of the lower limbs, pulmonary angiography and echocardiography. The commonest investigation requested in this context is the lung scan. Although the results are often inconclusive, this is frequently the only specific investigation which is performed. The accurate interpretation of lung scans requires consideration of the pretest probability of pulmonary embolism. The D-dimer assay is another test which may be useful. The finding of a normal D-dimer level substantially reduces the probability of thromboembolic disease and may render a lung scan unnecessary. / Subscription resource available via Digital Dissertations only.

Thesis (Ph.D.)--Pacific Graduate School of Psychology, 1991. / Source: Dissertation Abstracts International, Volume: 52-05, Section: B, page: 2775. Co-Chairs: Karl Mueller; Wayne K. Detloff.