Publications by authors named "Stuart Skinner"

Article Synopsis
  • Women make up about one-third of people who inject drugs in the US and Canada, yet little is known about their health outcomes related to injection drug use complications, particularly infective endocarditis (IE).
  • This study focuses on identifying the clinical characteristics and outcomes of IE in women who inject drugs, using data from five hospitals in Canada between 2007 and 2018, comparing findings based on gender.
  • Results indicated that women with IE were younger and more likely to have right-sided infections than men, with urban women experiencing higher mortality rates; those receiving substance use counseling in inpatient settings had better survival outcomes.
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First Nation people residing in rural and remote communities have limited primary healthcare access, which often affects chronic disease management leading to poor health outcomes. Individuals with lived experiences of chronic disease and substance use, along with health directors, advocated for improved services. Subsequently, an urban healthcare team in partnership with four First Nation communities developed an Outreach clinic to address healthcare access barriers.

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Despite high prevalence of hepatitis C virus (HCV), linkage to care and treatment for Indigenous people is low. In an Indigenous community in Saskatchewan, Canada a retrospective review identified 200 individuals (∼12% prevalence) had HCV antibodies though majority lacked ribonucleic acid (RNA) testing, and few received treatment despite availability of an effective cure. Following Indigenous oral traditions, focus group discussions were held with key community members and leadership.

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Background: Infectious complications of injection drug use (IDU) often require lengthy inpatient treatment. Our objective was to identify the number of admissions related to IDU in Regina, Canada, as well as describe patient demographics and comorbidities, yearly mortality, readmission rate, and cumulative cost of these hospitalizations between January 1 and December 31, 2018. Additionally, we sought to identify factors that increased risk of death or readmission.

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Alveolar echinococcosis (AE) is a life-threatening parasitic disease caused by the zoonotic cestode Echinococcus multilocularis. Our goals were to confirm infection, identify species, and analyze biogeographical origin of metacestode tissues from a suspected human AE case in Saskatchewan, Canada. We conducted polymerase chain reaction (PCR) targeting the nad1 mitochondrial gene for E.

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During 2011-16, HIV outbreaks occurred among people who inject drugs (PWID) in Canada (southeastern Saskatchewan), Greece (Athens), Ireland (Dublin), Israel (Tel Aviv), Luxembourg, Romania (Bucharest), Scotland (Glasgow), and USA (Scott County, Indiana). Factors common to many of these outbreaks included community economic problems, homelessness, and changes in drug injection patterns. The outbreaks differed in size (from under 100 to over 1000 newly reported HIV cases among PWID) and in the extent to which combined prevention had been implemented before, during, and after the outbreaks.

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Despite a dramatic decrease in vertical transmission of HIV in the developed world, maternal HIV infection acquired after negative prenatal screening still leaves a window of vulnerability. Through quality assurance programs in two Canadian Provinces, five cases where perinatal HIV transmission occurred despite negative prenatal screening were identified between 2005 and 2015. Maternal risk factors such as intravenous drug use, high-risk sexual behavior, hepatitis C virus co-infection, and belonging to high prevalence minority groups were common.

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Background: Exophiala dermatitidis is a melanized fungus isolated from many environmental sources. Infections caused by Exophiala species are typically seen in immunocompromised hosts and manifest most commonly as cutaneous or subcutaneous disease. Systemic infections are exceedingly rare and associated with significant morbidity and mortality CASE PRESENTATION: A 28-year-old female originally from India presented with fevers, chills, weight loss and increasing back pain.

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The nature of the HIV epidemic in the United States and Canada has changed with a shift toward rural areas. Socioeconomic factors, geography, cultural context, and evolving epidemics of injection drug use are coalescing to move the epidemic into locations where populations are dispersed and health care resources are limited. Rural-urban differences along the care continuum demonstrate the implications of this sociogeographic shift.

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Objective: To assess the impact of clinical and social factors unique to HIV-infected adults in Saskatoon, Saskatchewan, regarding the rate of CD4(+) count change, and to identify factors associated with a risk of CD4(+) count decline.

Methods: A retrospective longitudinal cohort study from medical chart reviews at two clinics was conducted in Saskatoon. Univariate and multivariate linear mixed effects models were used to assess the impact of selected factors on CD4(+) count change.

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Objective: To characterize and identify determinants of HIV disease progression among a predominantly injection drug use (IDU) HIV population in the highly active antiretroviral therapy era.

Methods: The present retrospective study was based on 343 HIV patients diagnosed from 2005 to 2010 from two clinics in Saskatoon, Saskatchewan. Disease progression was defined as the time from diagnosis to immunological AIDS (CD4 count <200 cells/μL) and death.

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We report the results of a joint human-animal health investigation in a Dene community in northern Saskatchewan, where residents harvest wildlife (including moose, bear, elk, and fish), live in close contact with free roaming dogs, and lack access to permanent veterinary services. Fecal analysis of owned and free-roaming dogs over two consecutive years (N = 92, 103) identified several parasites of public health concern, including Toxocara canis, Diphyllobothrium spp., Echinococcus/Taenia, Cryptosporidium spp.

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Article Synopsis
  • The study examined HIV-positive patients in care from 2003 to 2007 across Manitoba, Saskatchewan, and southern Alberta, revealing a total of 2,263 patients by the end of 2007.
  • There was a notable 12% annual increase in new cases, with males experiencing a higher rate of increase compared to females, and Aboriginal people comprising about 36% of new cases.
  • Heterosexual contact was the primary risk factor for HIV acquisition, but significant risks from injection drug use and men who have sex with men were also identified, highlighting the need for improved early testing and healthcare access to address rising numbers and late diagnoses.
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Background: The lower limit of detection of the original Roche Amplicor HIV plasma viral load (pVL) assay (50 copies/mL) has defined HIV treatment success. The Amplicor assay, however, has been replaced by the Roche TaqMan assay(s). Changes to the limits of detection and calibration have not been validated for clinical utility.

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Blastomyces dermatitidis, a thermally dimorphic fungus endemic to areas of North America, causes a granulomatous infection which may affect any organ system. Since limited clinical data exist about pediatric blastomycosis, we conducted a retrospective review of medical records of pediatric patients with a laboratory-confirmed diagnosis of blastomycosis treated during a 30-year period at a tertiary care center. Thirty-four pediatric patients with blastomycosis were identified (20 [59%] male), with a mean age at diagnosis of 10 ± 5 years.

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Article Synopsis
  • - Five genera of zoonotic bacteria and parasites were found in fecal samples from a remote indigenous community in Northern Saskatchewan, Canada, including Toxocara canis and Giardia duodenalis.
  • - Notably high levels of Giardia spp. and Campylobacter spp. were detected, with 75% of samples containing at least one species of Campylobacter and significant average concentrations of C. jejuni and Giardia cysts.
  • - The findings indicate that canine feces may pose a serious health risk to residents of rural and remote indigenous communities in Canada due to the presence of these zoonotic organisms.
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Article Synopsis
  • In a remote Canadian Indigenous community, a study found that 11% of people had antibodies indicating exposure to Echinococcus granulosus, a parasite.
  • Echinococcus granulosus eggs were also found in 6% of dog fecal samples collected from the environment.
  • The research suggests that the exposure mainly occurs through indirect contact with dog feces rather than direct activities like dog ownership or hunting, and recommends restricting free-roaming dogs from consuming deer remains to reduce human risk.
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Article Synopsis
  • - The introduction of the Hib vaccine has significantly reduced invasive Hib disease, but there is a concerning rise in nontypeable H. influenzae (NT Hi) infections.
  • - Analysis of 125 NT Hi isolates showed they lack the characteristics of serotypeable strains, confirming they are nonencapsulated, and revealed genetic diversity with two main clusters present among both invasive and respiratory cases.
  • - A notable percentage of invasive NT Hi isolates exhibited resistance to ampicillin and the demographic shift indicates that invasive Hi disease is increasingly affecting adults and infants rather than just children.
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Clinical evidence for failure with beta-lactam therapy has been lacking for patients with borderline oxacillin-resistant Staphylococcus aureus (BORSA) infections. We describe a failure of cloxacillin for a patient with endocarditis due to BORSA. The isolate also had false-negative thermonuclease and coagulase test results.

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Article Synopsis
  • - Myiasis in humans, caused by bot flies from animals, is uncommon but might be on the rise.
  • - The best treatment options include laser photocoagulation or vitrectomy, along with removing the larvae and using intraocular steroids.
  • - Ophthalmomyiasis from Hypoderma spp. can lead to vision loss but it is important to note that it may be reversible.
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Article Synopsis
  • A study collected 122 isolates of Haemophilus influenzae from Manitoba between 2000 and 2006 to analyze their serotypes, antibiotic resistance, and genetic diversity.
  • Over half of the isolates (56.6%) were nonserotypeable (NST), which exhibited significant diversity, while the serotypeable isolates were more genetically similar.
  • The study found that antibiotic resistance was more prevalent in NST strains (37.7%) compared to serotypeable strains (15%), indicating a potential shift in infection patterns since the introduction of the Hib vaccine, and highlighted the need for ongoing surveillance of all types of isolates.
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