Healing journey: Experiences of First Nations individuals with recovery from opioid use.

Objective: To understand experiences of recovery from opioid use among First Nations individuals living in a small remote community.

Design: Qualitative phenomenologic study.

Setting: Northwestern Ontario.

Progression From Gestational Diabetes Mellitus to Type 2 Diabetes Mellitus Among First Nations Women in Northwest Ontario: A Retrospective Cohort Study.

Objective: Our aim in this study was to identify the incidence of type 2 diabetes mellitus among First Nations women in northwest Ontario with a history of gestational diabetes mellitus (GDM).

Methods: This work was a retrospective cohort study of women diagnosed with GDM using a 50-gram oral glucose challenge test or a 75-gram oral glucose tolerance test from January 1, 2010, to December 31, 2017, at the Sioux Lookout Meno Ya Win Health Centre. Outcomes were assessed based on glycated hemoglobin (A1C) measurements performed between January 1, 2010, and December 31, 2019.

Systematic review of the use of metformin compared to insulin for the management of gestational diabetes: Implications for low-resource settings.

Introduction: This systematic review examines the effectiveness of metformin treatment compared to insulin treatment for gestational diabetes within the context of a low-resource environment.

Methods: Electronic data searches of Medline, EMBASE, Scopus and Google scholar databases from 1 January, 2005 to 30 June, 2021 were performed using medical subject headings: 'gestational diabetes or pregnancy diabetes mellitus' AND 'Pregnancy or pregnancy outcomes' AND 'Insulin' AND 'Metformin Hydrochloride Drug Combination/or Metformin/or Hypoglycemic Agents' AND 'Glycemic control or blood glucose'. Randomized controlled trials were included if: participants were pregnant women with gestational diabetes mellitus (GDM); the interventions were metformin and/or insulin.

Social Inequities Contributing to Gestational Diabetes in Indigenous Populations in Canada: A Scoping Review.

The prevalence of gestational diabetes mellitus (GDM) is dramatically higher in Indigenous compared with non-Indigenous populations in Canada. In this scoping review, we synthesize the existing literature regarding GDM among Indigenous peoples in Canada, including social and structural determinants that contribute to its higher prevalence in this population. Seven themes related to GDM in Indigenous populations emerged from a synthesis of the 44 included articles.

Demographics of mental healthcare presentations in a northwest Ontario emergency department.

Objectives: Providing emergency mental health services for populations in remote rural areas of Canada is challenging. Program needs are distinct. We describe the emergency mental health workload and service needs at the Sioux Lookout Meno Ya Win Health Centre (SLMHC) in northwest Ontario.

The development of a community-based public health response to an outbreak of post-streptococcal glomerulonephritis in a First Nations community.

Background: Post-streptococcal glomerulonephritis (PSGN) is a rare immune-mediated condition that typically occurs in children as a result of group A streptococcus (GAS) infection. PSGN is not considered a disease of public health significance, or reportable, in Canada. Higher incidence of PSGN has been described among Indigenous people in Canada.

Intravenous iron therapy in a rural hospital: A retrospective chart review.

Introduction: Intravenous iron infusion therapy is commonly delivered in rural hospitals, but there are no common guidelines for dosing or choice of agent. The objective of the study was to understand present practice and alternate therapies and develop practical recommendations for small hospital use.

Methods: This was a retrospective chart review of all non-dialysis patients aged 15 years or older who received iron replacement therapy at Sioux Lookout Meno Ya Win Health Centre from May 2013 to May 2019 and a literature review of available iron preparations.

Demographics, prevalence and outcomes of diabetes in pregnancy in NW Ontario.

Introduction: Diabetes in pregnancy confers increased risk. This study examines the prevalence and birth outcomes of diabetes in pregnancy at the Sioux Lookout Meno Ya Win Health Centre (SLMHC) and other small Ontario hospitals.

Methods: This was a retrospective study of maternal profile: age, parity, comorbidities, mode of delivery, neonatal birth weight, APGARS and complications.

Early Gestational Diabetes Mellitus Screening With Glycated Hemoglobin: A Systematic Review.

Objective: This review sought to examine the association of HbA levels <6.5% in early pregnancy with the subsequent development of gestational diabetes mellitus (GDM) and adverse pregnancy outcomes.

Methods: A search of Medline and EMBASE was conducted for the period of January 1, 2000 to July 9, 2019 and the terms: "gestational diabetes or pregnancy diabetes mellitus" and "glycosylated hemoglobin or glycated hemoglobin A" and "pregnancy trimester, first, or first-trimester pregnancy," "screening or prenatal screening," "prenatal diagnosis or early diagnosis or prediction," "retrospective studies or prospective studies.

Screening for gestational diabetes in pregnancy in Northwestern Ontario.

Introduction: We estimate the screening and prevalence of gestational diabetes mellitus (GDM) in a primarily first nations obstetrical population in Northwestern Ontario.

Methods: The study is an 8-year retrospective analysis of all gestational glucose challenge and tolerance tests performed at the Sioux Lookout Meno Ya Win Health Centre (SLMHC) laboratory from 1 January, 2010 to 31 December, 2017. Test, gestational timing and completion rate of screening were recorded, and GDM prevalence was calculated on the tested population.

Outcomes of Pregnancies Affected by Gestational Diabetes and Type 2 Diabetes in a Rural First Nations Obstetrical Program in Northwest Ontario.

Objectives: In this work, we describe diabetes prevalence and birth outcomes in a primarily First Nations obstetrical population in northwest Ontario.

Methods: This retrospective, observational study of maternal and neonatal characteristics and birth outcomes was performed at the Sioux Lookout Meno Ya Win Health Centre between April 1, 2012 and March 31, 2017.

Results: The prevalence of pre-existing type 2 diabetes mellitus was 3.

Cesarean Delivery and Vaginal Birth After Cesarean Delivery Rates in a First Nations Community-Based Obstetrical Program in Northwestern Ontario.

Objective: To examine rates of cesarean delivery (CD) and vaginal birth after cesarean delivery (VBAC) and the patient profile in a community-based obstetrical practice.

Methods: Retrospective data from 2012 to 2017 for the Sioux Lookout Meno Ya Win Health Centre (SLMHC) were compared to data from the 30 hospitals providing the same level of services (Maternity 1b: maternity care by family physicians/midwives with CD and VBAC capacity) and Ontario. SLMHC VBAC patients were then compared to the general SLMC obstetrical population.

Women and Their Microbes: The Unexpected Friendship.

Communities of microbiota have been associated with numerous health outcomes, and while much emphasis has been placed on the gastrointestinal niche, there is growing interest in the microbiome specific for female reproductive health and the health of their offspring. The vaginal microbiome plays an essential role not only in health and dysbiosis, but also potentially in successful fertilization and healthy pregnancies. In addition, microbial communities have been isolated from formerly forbidden sterile niches such as the placenta, breast, uterus, and Fallopian tubes, strongly suggesting an additional microbial role in women's health.

[An unusual cause of sinusitis].

Background: Larvae of the sheep botfly (Oestrus ovis) normally have sheep or goats as host. In humans the larvae can survive for a short time in the nose or under the eyelids, after which they die or are sneezed out.

Case Description: We describe a 47-year-old woman who during a stay in the Cape Verde Islands developed symptoms of sneezing, a swollen face and an itchy feeling in her nose.

Effect of micronutrient and probiotic fortified yogurt on immune-function of anti-retroviral therapy naive HIV patients.

Background: Micronutrient supplementation has been shown to reduce the progression of HIV but does not have an effect on the intestinal barrier or the intestinal microbiota of HIV patients. Studies have suggested that probiotics could potentially complement micronutrients in preserving the immune-function of HIV patients.

Objective: Assess the impact of micronutrient supplemented probiotic yogurt on the immune function of HIV patients.

Probiotic yogurt consumption may improve gastrointestinal symptoms, productivity, and nutritional intake of people living with human immunodeficiency virus in Mwanza, Tanzania.

The gut-associated lymphoid tissue is a major site of human immunodeficiency virus (HIV) activity and significantly influences disease prognosis. Reducing immune activation due to gastroenteritis may thus help slow disease progression. Probiotic microorganisms have considerable immunomodulatory effects at the level of the gut-associated lymphoid tissue.

Vaginal microbiome and epithelial gene array in post-menopausal women with moderate to severe dryness.

After menopause, many women experience vaginal dryness and atrophy of tissue, often attributed to the loss of estrogen. An understudied aspect of vaginal health in women who experience dryness due to atrophy is the role of the resident microbes. It is known that the microbiota has an important role in healthy vaginal homeostasis, including maintaining the pH balance and excluding pathogens.

Probiotics and prebiotics to combat enteric infections and HIV in the developing world: a consensus report.

Infectious disease in the developing world continues to represent one of the greatest challenges facing humanity. Every year over a million children suffer and die from the sequela of enteric infections, while in 2008 it is estimated almost 2.7 million (UNAIDS 2009 update) adults and children became infected with human immunodeficiency virus (HIV).

Effect of 25 weeks probiotic supplementation on immune function of HIV patients.

Introduction: Studies with a follow-up of < 8 weeks have indicated immune-preserving effects of yogurt probiotic supplementation among HIV patients. To evaluate the impact of 25 weeks use of probiotics, a randomized, double blind, controlled study was undertaken on 65 women who were naïve to anti-retroviral treatment.

Results: Ten participants were excluded post-randomization due to non-eligibility.

Guide to designing, conducting, publishing and communicating results of clinical studies involving probiotic applications in human participants.

The heterogeneity of human clinical trials to assess the effectiveness of probiotics presents challenges regarding interpretation and comparison. Evidence obtained from clinical trials among a population with a disease or specific risk factors may not be generalizable to healthy individuals. The evaluation of interventions in healthy persons requires careful selection of outcomes due to the absence of health indicators and the low incidence of preventable conditions.

Probiotic strategies for the treatment and prevention of bacterial vaginosis.

Importance Of The Field: Urogenital infections are on average the number-one reason for women to visit the doctor. Yet, treatment and preventive strategies have gone unchanged for close to 50 years. With prevalence rates for bacterial vaginosis at more than 29%, depending on the population, and similarly high incidences of vulvo-vaginal candidiasis and urinary tract infections, plus HIV, new therapies are urgently needed to improve the health of women around the world.

Microbiome profiling by illumina sequencing of combinatorial sequence-tagged PCR products.

We developed a low-cost, high-throughput microbiome profiling method that uses combinatorial sequence tags attached to PCR primers that amplify the rRNA V6 region. Amplified PCR products are sequenced using an Illumina paired-end protocol to generate millions of overlapping reads. Combinatorial sequence tagging can be used to examine hundreds of samples with far fewer primers than is required when sequence tags are incorporated at only a single end.

Altered host-microbe interaction in HIV: a target for intervention with pro- and prebiotics.

The intestinal immune system is severely affected by HIV and circulating microbial products from the intestinal tract that provide an ongoing source of systemic inflammation and concomitant viral replication. In addition, HIV-infected individuals can have a deregulated immune response that may hamper the anti-viral capacity of the host. Various probiotic organisms and prebiotic agents have been shown to enhance intestinal epithelial barrier functions, reduce inflammation, and support effective Th-1 responses.

Lactobacillus rhamnosus GR-1 and L. reuteri RC-14 to prevent or cure bacterial vaginosis among women with HIV.

Objective: To assess, among women with HIV, whether long-term oral Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 supplementation can prevent bacterial vaginosis (BV) and enhance the cure rate of metronidazole among those with BV.

Methods: A randomized, double-blind, placebo-controlled trial conducted among 65 HIV-infected women with an aberrant microbiota (Nugent score 4-10) who were randomized to receive daily probiotics or placebo for 6 months. Those with BV (Nugent score 7-10) additionally received metronidazole for 10 days (400 mg twice daily).