Introduction: Urgent, tailored and equitable action is needed to address the alarming rise in syphilis rates in Canada. In the last decade, the rates of infectious syphilis have increased by 345% in Ontario, Canada. Underserved populations-people who use drugs, un(der)housed individuals and those living in rural and remote areas-face unique social and healthcare challenges that increase their vulnerability to syphilis infections and hinder their access to timely diagnosis and treatment.
View Article and Find Full Text PDFBackground: The practice of patient self-collected swab specimens for Neisseria gonorrhoeae and Chlamydia trachomatis is supported in the literature.
Local Problem: Health care providers observed that patients sometimes performed their self-swabs incorrectly resulting in cancelled or invalid specimens.
Methods: The clinic's outdated visual aids were replaced with new visual aids.
Background: In Canada, HIV transmission continues to disproportionately affect the same communities of gay men, bisexual men and men who have sex with men (gbMSM); members of African, Caribbean or Black communities (ACB); people who use injection drugs; Indigenous people; and women who belong to the aforementioned groups. While primary care is an ideal location for HIV testing for members of these groups, many people do not have access to such healthcare services. In response, we launched GetaKit to distribute HIV self-tests.
View Article and Find Full Text PDFBackground: In Canada, HIV transmission continues to disproportionately affect the same communities of gay men, bisexual men and men who have sex with men (gbMSM); members of African, Caribbean or Black communities (ACB); people who use injection drugs; Indigenous people; and women who belong to the aforementioned groups. While primary care is an ideal location for HIV testing for members of these groups, many people do not have access to such healthcare services. In response, we launched GetaKit to distribute HIV self-tests.
View Article and Find Full Text PDFHIV PrEP is over 99% effective in preventing HIV when medication adherence is high. Despite this, uptake and retention in PrEP care remains less than optimal. We investigated whether gbMSM with objective risk factors for HIV who were automatically offered PrEP would have higher uptake and retention in PrEP care.
View Article and Find Full Text PDFIntroduction: The Nepal Family Cohort study uses a life course epidemiological approach to collect comprehensive data on children's and their parents' environmental, behavioural and metabolic risk factors. These factors can affect the overall development of children to adulthood and the onset of specific diseases. Among the many risk factors, exposure to air pollution and lifestyle factors during childhood may impact lung development and function, leading to the early onset of respiratory diseases.
View Article and Find Full Text PDFImportance: The optimal inhaled reliever therapy for asthma remains unclear.
Objective: To compare short-acting β agonists (SABA) alone with SABA combined with inhaled corticosteroids (ICS) and with the fast-onset, long-acting β agonist formoterol combined with ICS for asthma.
Data Sources: The MEDLINE, Embase, and CENTRAL databases were searched from January 1, 2020, to September 27, 2024, without language restrictions.
Background: Cough severity represents an important endpoint to assess the impact of therapies for patients with refractory chronic cough (RCC).
Objective: To develop a new patient-reported outcome measure addressing cough severity in patients with RCC.
Methods: Phase 1 (item generation): A systematic survey, focus groups, and expert consultation generated 51 items.
Background: Diabetes is a risk factor for the development of vascular disease, chronic kidney disease, retinopathy, and neuropathy. Diabetes is a co-morbid condition commonly present in patients with respiratory disorders but the extent to which it influences ventilatory capacity, gas exchange, and functional capacity is not well known. Research question Does the presence of diabetes contribute to impairment in spirometry, gas transfer, and exercise capacity?
Methods: Retrospective analysis of all subjects who performed incremental cardio-pulmonary exercise testing (CPET) between 1988 and 2012 at McMaster University Medical Centre.
Background: Atopic dermatitis (AD) is a skin barrier dysfunction characterized by tissue eosinophilia.
Objective: In patients with AD, we evaluated the effect of eosinophil depletion with benralizumab on markers of inflammation in skin after intradermal allergen challenge.
Methods: A total of 20 patients with moderate-to-severe AD completed a randomized, double-blind, placebo-controlled parallel-group study comparing 3 doses of benralizumab (30 mg each) administered subcutaneously every 4 weeks (n = 9) with placebo (n = 11).
Spaces produced in healthcare settings and research institutions tend to perpetuate marginalized populations' state of social otherness. We believe nurses from are best suited to walk between dominant (striated) spaces and margins in healthcare settings. is a liminal space where multiple identities, places, cultures, paradigms, or ways of thinking intersect.
View Article and Find Full Text PDFCan Fam Physician
August 2024
Objective: To provide a guide on appropriate sexually transmitted infection (STI) testing for primary care providers to use with patients who identify as men who have sex with men (MSM).
Sources Of Information: Canadian guidelines for STI testing and enteric and protozoan infections; Ontario guidelines for HIV screening and mpox; and US guidelines for STI testing.
Main Message: Across Canada rates of sexually transmitted bacterial, enteric, protozoan, and systemic infections-including HIV and mpox-have been steadily increasing among cisgender and transgender MSM.
Background: Benralizumab induces rapid and near-complete depletion of eosinophils from blood and lung tissue. We investigated whether benralizumab could attenuate the allergen-induced late asthmatic response (LAR) in participants with allergic asthma.
Methods: Participants with allergic asthma who demonstrated increased sputum eosinophils and LAR at screening were randomised to benralizumab 30 mg or matched placebo given every 4 weeks for 8 weeks (3 doses).
Background: Treatment of allergic bronchopulmonary aspergillosis (ABPA) is challenging. Biological therapies have been reported as adjunctive treatments for ABPA, primarily in case series or case reports. This study aimed to analyze the efficacy of biologics for managing ABPA both qualitatively and quantitatively.
View Article and Find Full Text PDFIntroduction: The rates of gonorrhea and chlamydia have been increasing in the years preceding the COVID19 pandemic. Because most gonorrhea and chlamydia infections are located in the oropharynx and rectum for men who have sex with men (MSM), and because at-home self-collected swabs for these infections are not licensed by Health Canada or the United States Food and Drug Administration, decreased accessed to in-person care during and since the COVID19 pandemic potentially means missed case findings.
Objectives: To evaluate the performance of at-home self-collected pharyngeal and rectal swabs for gonorrhea and chlamydia nucleic acid amplification testing.
Introduction: Immunoglobulins play a vital role in host immune response and in the pathogenesis of conditions like asthma. Therapeutic agents such as monoclonal antibodies target specific elements of the asthmatic inflammatory cascade. Decisions to utilize these medications are often based on systemic inflammatory profiling without direct insight into the airway inflammatory profile.
View Article and Find Full Text PDFThis issue highlights and details the program and scientific presentations at the International Eosinophil Society's 12th biennial symposium, which was held in Hamilton, Ontario, Canada, in July 2023. The meeting included sessions on regulation of eosinophil development; cell death, stress, and autophagy in eosinophils; local immunity interactions of eosinophils with multiple cell types; eosinophils in host defense; eosinophils and mast cells in gastrointestinal disorders; reciprocal interactions between eosinophils and the microbiome in homeostasis and dysbiosis; and eosinophils in tissue injury and repair and in tumor biology and cancer therapy. There was a mixture of special invited lectures and cutting-edge abstracts on specific aspects of eosinophil science, as well as enlivened pro-con debates on targeting eosinophils with biologics.
View Article and Find Full Text PDFAm J Respir Crit Care Med
September 2024
In asthma, sputum group 2 innate lymphoid cells (ILC2s) are activated within 7 hours after allergen challenge. Neuroimmune interactions mediate rapid host responses at mucosal interfaces. In murine models of asthma, lung ILC2s colocalize to sensory neuronal termini expressing the neuropeptide neuromedin U (NMU), which stimulates type 2 (T2) cytokine secretion by ILC2s, with additive effects to alarmins .
View Article and Find Full Text PDFJ Assoc Nurses AIDS Care
June 2024
Clinical trials of pre-exposure prophylaxis (PrEP) to prevent HIV infection have established its efficacy as upwards of 99%. Despite this, the effectiveness of this medication has been shown to be diminished by individual factors, such as medication adherence. We completed a systematic review to identify and describe interventions to improve oral PrEP adherence.
View Article and Find Full Text PDFCurrent international HIV testing guidelines recommend that HIV negative persons from HIV priority groups complete repeat screening every 3-6 months; local guidelines in our jurisdiction recommend that such retesting should occur every 3 months. Such an approach allows for timely HIV diagnosis and linkage to care - and aligns with the UNAIDS 95-95-95 targets to have 95% of undiagnosed persons be aware of their HIV status. To meet these aims, new approaches to HIV testing have been developed, including our HIV self-testing initiative, GetaKit.
View Article and Find Full Text PDFBackground: We sought to evaluate if increased uptake of HIV pre-exposure prophylaxis (PrEP) correlated to population-level changes in human immunodeficiency virus (HIV) epidemiology, in a setting with an integrated PrEP delivery system centred on a public health nurse-led PrEP clinic and referral process.
Methods: This study was conducted in Ottawa, Canada, where all positive HIV test results are reported to the public health units. Risk factor information is also collected by nurses and subsequently entered into a provincial database.
Background: In Ontario, Canada we developed and implemented an online screening algorithm for the distribution of HIV self-tests, known as GetaKit. During the COVID pandemic, we adapted the GetaKit algorithm to screen for COVID based on population and infection data and distributed COVID rt-LAMP self-tests (using the Lucira Check-It®) to eligible participants.
Methods: GetaKit/COVID was a prospective observational study that occurred over a 7-month period from September 2021 to April 2022.