University of Western Ontario medical journal最新文献_第2页

Student-led clinic in the Windsor-Essex region can help close healthcare gaps in vulnerable populations 学生主导的诊所在温莎-埃塞克斯地区可以帮助缩小弱势群体的医疗差距

University of Western Ontario medical journal Pub Date : 2023-03-16 DOI: 10.5206/uwomj.v90i2.14833

Alex Zhou, Abdelhady Osman, Lotus Alphonsus

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Social Determinants Influencing Pregnancy and Preterm Birth 影响妊娠和早产的社会决定因素

University of Western Ontario medical journal Pub Date : 2023-01-29 DOI: 10.5206/uwomj.v90i2.14740

Piali Bhati

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Isolated small bowel disease and multiple lung nodules: an unusual initial presentation of pediatric Crohn’s disease 孤立性小肠疾病和多发肺结节:儿童克罗恩病的不寻常的初始表现

University of Western Ontario medical journal Pub Date : 2023-01-29 DOI: 10.5206/uwomj.v90i2.14593

Nicole Wiebe

{"title":"Isolated small bowel disease and multiple lung nodules: an unusual initial presentation of pediatric Crohn’s disease","authors":"Nicole Wiebe","doi":"10.5206/uwomj.v90i2.14593","DOIUrl":"https://doi.org/10.5206/uwomj.v90i2.14593","url":null,"abstract":"Crohn’s disease (CD) is a chronic idiopathic inflammatory disorder of the gastrointestinal tract characterized by transmural inflammation, skip lesions, and architectural changes. Isolated small bowel involvement is seen in approximately 1% of patients with CD at diagnosis. Extraintestinal manifestations can occur, with pulmonary involvement seen in <1% of all CD. We report an unusual case of a previously healthy 12-year old male who presented to hospital with acute abdominal pain, emesis, and fever. He had microcytic anemia, thrombocytosis, elevated C-reactive protein, hypoalbuminemia, digital clubbing, and poor growth. Interestingly, initial upper endoscopy and ileocolonoscopy were unremarkable. Pathology revealed colonic nonnecrotizing granulomas without inflammation. He incidentally was found to have multiple lung nodules despite the absence of respiratory symptoms, and MRE revealed five small bowel strictures. This prompted work-up for alternative etiologies including infectious and rheumatologic, which were negative. Ultimately, five months later, double balloon enteroscopy revealed ileal ulcerations at the strictures and several small aphthous ulcers in the transverse and sigmoid colon. Biopsies showed active ileitis and chronic active colitis with nonnecrotizing granulomas. He developed perianal disease, confirmed on MR pelvis, and a diagnosis of CD was made. The patient started infliximab therapy and is clinically in remission. This is a rare and unique phenotype of CD with initial presentation of multiple lung nodules and isolated small bowel disease. This case highlights the importance of recognizing that pulmonary manifestations should be considered in the absence of respiratory symptoms and that a normal first endoscopy does not preclude a diagnosis of CD.","PeriodicalId":87852,"journal":{"name":"University of Western Ontario medical journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77380623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Impact of the Canadian Tobacco and Vaping Products Act on e-cigarette use and perceived risk in adolescents 加拿大烟草和电子烟产品法案对青少年电子烟使用和感知风险的影响

University of Western Ontario medical journal Pub Date : 2023-01-19 DOI: 10.5206/uwomj.v90i1.14003

Erica Ai Li, Jeffrey N. Gutierrez, Ahmad Yasir Omar

{"title":"Impact of the Canadian Tobacco and Vaping Products Act on e-cigarette use and perceived risk in adolescents","authors":"Erica Ai Li, Jeffrey N. Gutierrez, Ahmad Yasir Omar","doi":"10.5206/uwomj.v90i1.14003","DOIUrl":"https://doi.org/10.5206/uwomj.v90i1.14003","url":null,"abstract":"Introduction: Canada enacted the Tobacco and Vaping Products Act (TVPA) in 2018, which prohibited the sale of e-cigarettes to individuals under 18. However, this law increased the distribution and sale of e-cigarettes to individuals over 18. Presently, there is limited evidence on the impact of the TVPA on adolescents’ use of e-cigarettes. The aim of this study is to assess adolescents’ prevalence and perception of e-cigarette use before and after enactment of the TVPA. \u0000Methods: The Canadian Tobacco, Alcohol and Drugs Survey for 2017 and the Canadian Student Tobacco, Alcohol and Drugs Survey for 2015, 2017, and 2019 were obtained. Using RStudio, we conducted two-way ANOVA with Tukey’s post hoc test. We reported the goodness of fit of each model through its multiple R-squared values and conducted likelihood ratio tests. Results were presented as the mean with 95% confidence intervals. \u0000Results: We found that e-cigarette use was more prevalent in adolescents compared to adults prior to enactment of the TVPA. Interestingly, e-cigarette use in adolescents increased even after enactment of the TVPA, and this law did not impact adolescents’ perceived risk of e-cigarette and conventional cigarette use. Furthermore, e-cigarette use in adolescents was highest in Saskatchewan and Newfoundland and lowest in Quebec and Ontario. \u0000Conclusion: Although the TVPA aimed to reduce e-cigarette use in adolescents, this study demonstrates that the TVPA generated the opposite effect. These findings highlight the need for improved public education and stricter e-cigarette sale regulations.","PeriodicalId":87852,"journal":{"name":"University of Western Ontario medical journal","volume":"88 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88965781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Hand Hygiene Compliance Among the Public and in Ontario Hospitals 安大略省公立医院和医院的手部卫生遵守情况

University of Western Ontario medical journal Pub Date : 2022-12-20 DOI: 10.5206/uwomj.v90i1.13514

Corina DeKraker, Zahra Taboun

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Women’s Health: Atypical Presentation of Myocardial Infarction 妇女健康:心肌梗塞的非典型表现

University of Western Ontario medical journal Pub Date : 2022-11-18 DOI: 10.5206/uwomj.v90i1.13956

Piali Bhati, M. Wunder

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The Independent Inventions of General Anesthesia in 19th century Japan and United States 19世纪日本和美国全身麻醉的独立发明

University of Western Ontario medical journal Pub Date : 2022-09-19 DOI: 10.5206/uwomj.v90i1.14004

Arjun Patel

{"title":"The Independent Inventions of General Anesthesia in 19th century Japan and United States","authors":"Arjun Patel","doi":"10.5206/uwomj.v90i1.14004","DOIUrl":"https://doi.org/10.5206/uwomj.v90i1.14004","url":null,"abstract":"In October of 1804, surgeon Hanaoka Seishū performed the first documented surgery using general anesthesia. Hanaoka’s formulation, a mixture of plant extracts called tsūsensan, was commonly used in Japan, but it had minimal influence elsewhere. It was not until the 1840s that general anesthesia was used outside of Japan. In the eastern United States, four individuals, including dentist William Morton, were independently experimenting with the use of diethyl ether and nitrous oxide as general anesthetics. Unlike Hanaoka’s invention, Morton’s successful use of diethyl ether in a neck tumour removal surgery sparked the rapid development and proliferation of new anesthetic technologies and compounds throughout the world. This paper examines why Hanaoka’s work was not significantly influential outside of Japan, while the later American discoveries achieved global prominence despite being four decades later. Additionally, historical context behind both stories is included. Reasons for this disparity include Japan’s isolationist policy at the time (sakoku) and differences in 19th century Western and Japanese approaches to medical education and research.","PeriodicalId":87852,"journal":{"name":"University of Western Ontario medical journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78398291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Presenilin 1 gene mutations: a potential marker to help diagnose early onset Alzheimer’s disease 早老素1基因突变:帮助诊断早发性阿尔茨海默病的潜在标志物

University of Western Ontario medical journal Pub Date : 2022-09-19 DOI: 10.5206/uwomj.v90i1.13513

Tony Jung, Aileen Liang

{"title":"Presenilin 1 gene mutations: a potential marker to help diagnose early onset Alzheimer’s disease","authors":"Tony Jung, Aileen Liang","doi":"10.5206/uwomj.v90i1.13513","DOIUrl":"https://doi.org/10.5206/uwomj.v90i1.13513","url":null,"abstract":"Alzheimer’s disease is a prevalent neurodegenerative disorder that affects millions of people worldwide with a substantial healthcare expenditure of almost $500 billion dollars. Alzheimer’s is primarily considered a disease of the aging population, with 95% of cases being diagnosed in patients over 65. Alzheimer’s in patients under 65 years of age are termed early onset Alzheimer’s disease (EOAD). The clinical presentation and disease mechanism of EOAD are quite distinct from typical Alzheimer’s. For example, EOAD patients often experience more rapid cognitive decline and have cortical region atrophy as opposed to temporal region atrophy. The atypical nature of EOAD frequently leads to delayed diagnosis and treatment. This delay is especially problematic for EOAD patients because they are at a stage of life with significant responsibilities such as maintaining their careers and families. This case study examines a previously healthy 32-year-old man that was mistakenly suspected of having frontotemporal dementia. Alzheimer’s was not considered as a correct diagnosis due to the atypical symptoms and weak family history for the disease. For these reasons, genetic analysis was not used to help make a diagnosis. The patient died at the age of 36 and autopsy revealed markers of Alzheimer’s including neuritic plaques and tau neurofibrillary tangles. Genetic analysis revealed no presenilin 1 (PSEN1) mutations which has been associated with EOAD. However, this patient may have had deletion mutations that could not be investigated due to the lack of frozen tissue for RNA analysis. This case illustrates the importance of genetic testing for EOAD diagnosis.","PeriodicalId":87852,"journal":{"name":"University of Western Ontario medical journal","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83193924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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The War Within: Mental Health and COVID-19 内心的战争:心理健康和COVID-19

University of Western Ontario medical journal Pub Date : 2022-09-19 DOI: 10.5206/uwomj.v89is.13975

Lotus Alphonsus, N. Alphonsus

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Necessity of Diagnostic Imaging and its Lacking Availability 诊断成像的必要性及其缺乏可用性

University of Western Ontario medical journal Pub Date : 2022-09-19 DOI: 10.5206/uwomj.v90i1.13506

A. Kassay, Amalka De Silva

{"title":"Necessity of Diagnostic Imaging and its Lacking Availability","authors":"A. Kassay, Amalka De Silva","doi":"10.5206/uwomj.v90i1.13506","DOIUrl":"https://doi.org/10.5206/uwomj.v90i1.13506","url":null,"abstract":"The World Health Organization (WHO) states that 50-75% of people across the globe do not have adequate access to basic diagnostic imaging such as ultrasound and X-ray. Studies have shown that ultrasound and X-ray can address 80-90% of imaging needs in developing countries. A proper understanding of what access to diagnostic imaging means is important to provide equitable and effective solutions. It is not enough to be geographically located near a hospital that has diagnostic imaging, but the imaging must also address the local need, be affordable to the country, and be scientifically valid. No matter the location, whether it be in developed or developing countries, access to diagnostic imaging is a necessity and a problem that needs a solution. Potential solutions exist such as the WHO’s technical review titled “The Needs Assessment for Medical Devices” which demonstrates how to calculate gaps in access to medical technologies specifically by cataloguing what type of diagnostic imaging is available and what should be available. Other solutions include non-profit organizations, such as “RAD-AID”, which are working towards increasing radiology services in developing countries. Finally, donating diagnostic imaging devices is another potential solution to address the need for this technology in places that lack it. However, there are many important factors to consider before making a donation. Overall, diagnostic imaging, such as X-ray and ultrasound, have an important role in patient care and are needed in countries that cannot access any other imaging modalities.","PeriodicalId":87852,"journal":{"name":"University of Western Ontario medical journal","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87412645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0