Aeroallergen-related Diseases Predate the Diagnosis of Inflammatory Bowel Disease.

Objective: This study aimed to determine whether having a diagnosis of asthma or allergic rhinitis (AR) increased the risk of being diagnosed with inflammatory bowel disease (IBD) and whether there was increased incidence of these diseases after a diagnosis of IBD.

Design: This is a retrospective, historical cohort-based study. We used the administrative data of Manitoba Health and the population-based University of Manitoba IBD Epidemiology Database.

Decision tree-based rules outperform risk scores for childhood asthma prognosis.

Background: There are no widely accepted prognostic tools for childhood asthma; this is in part due to the multifactorial and time-dependent nature of mechanisms and risk factors that contribute to asthma development. Our study objective was to develop and evaluate the prognostic performance of conditional inference decision tree-based rules using the Pediatric Asthma Risk Score (PARS) predictors as an alternative to the existing logistic regression-based risk score for childhood asthma prediction at 7 years in a high-risk population.

Methods: The Canadian Asthma Primary Prevention Study data were used to develop, compare, and contrast the prognostic performance (area under the curve [AUC], sensitivity, and specificity) of conditional inference tree-based decision rules to the pediatric asthma risk score for the prediction of childhood asthma at 7 years.

Reassessing access to intensive care using an estimate of the population incidence of critical illness.

Background: The consistently observed male predominance of patients in intensive care units (ICUs) has raised concerns about gender-based disparities in ICU access. Comparing rates of ICU admission requires choosing a normalizing factor (denominator), and the denominator usually used to compare such rates between subpopulations is the size of those subpopulations. However, the appropriate denominator is the number of people whose medical condition warranted ICU care.

Assessing Symptoms, Concerns, and Quality of Life in Noncancer Patients at End of Life: How Concordant Are Patients and Family Proxy Members?

Context: It has become commonplace to use family caregivers as proxy responders where patients are unable to provide information about their symptoms and concerns to health care providers.

Objectives: The objective of this study was to determine the degree of concordance between patients' and family members' reports of patient symptoms and concerns at end of life.

Methods: Sample dyads included a mix of patients residing at home, in a nursing home, in a long-term care facility, or in hospice.

Correction: Dignity and Distress towards the End of Life across Four Non-Cancer Populations.

[This corrects the article DOI: 10.1371/journal.pone.

Dignity and Distress towards the End of Life across Four Non-Cancer Populations.

Objective: The purpose of this study was to identify four non-cancer populations that might benefit from a palliative approach; and describe and compare the prevalence and patterns of dignity related distress across these diverse clinical populations.

Design: A prospective, multi-site approach was used.

Setting: Outpatient clinics, inpatient facilities or personal care homes, located in Winnipeg, Manitoba and Edmonton, Alberta, Canada.

A population-based observational study of intensive care unit-related outcomes. With emphasis on post-hospital outcomes.

Rationale: Many studies of critical illness outcomes have been restricted to short-term outcomes, selected diagnoses, and patients in one or a few intensive care units (ICUs).

Objectives: Evaluate a range of relevant outcomes in a population-based cohort of patients admitted to ICUs.

Methods: Among all adult residents of the Canadian province of Manitoba admitted to ICUs over a 9-year period, we assessed ICU, hospital, 30-day, and 180-day mortality rates; ICU and hospital lengths-of-stay; Post-hospital use of hospital care, ICU care, outpatient physician care, medications, and home care; and Post-hospital residence location.

Distinct determinants of long-term and short-term survival in critical illness.

Purpose: To identify the determinants of short-term and long-term survival in adult patients admitted to intensive care units (ICUs).

Methods: This population-based, observational cohort study included all eleven adult ICUs in the Winnipeg Health Region of Manitoba, Canada, analyzing initial ICU admissions during the period 1999-2010 of all Manitobans ≥17 years old. Analysis included Kaplan-Meier survival curves and multivariable regression models of 30-day mortality and post-90-day survival among those who survived to day 90.

Probiotic supplementation during pregnancy or infancy for the prevention of asthma and wheeze: systematic review and meta-analysis.

Objective: To evaluate the association of probiotic supplementation during pregnancy or infancy with childhood asthma and wheeze.

Design: Systematic review and meta-analysis of randomised controlled trials.

Data Sources: Medline, Embase, and Central (Cochrane Library) databases from inception to August 2013, plus the World Health Organization's international clinical trials registry platform and relevant conference proceedings for the preceding five years.

A population-based analysis of leaving the hospital against medical advice: incidence and associated variables.

Background: Prior studies of patients leaving hospital against medical advice (AMA) have been limited by not being population-based or assessing only one type of patient.

Methods: We used administrative data at the Manitoba Centre for Health Policy to evaluate all adult residents of Manitoba, Canada discharged alive from acute care hospitals between April 1, 1990 and February 28, 2009. We identified the rate of leaving AMA, and used multivariable logistic regression to identify socio-demographic and diagnostic variables associated with leaving AMA.

Influenza and endemic viral pneumonia.

Viruses are a common and important cause of severe community-acquired pneumonia, and may lead to severe respiratory disease and admission to the intensive care unit. Influenza is the most common virus associated with severe viral pneumonia, although other important causes include respiratory syncytial virus, adenovirus, metapneumonia virus, and coronaviruses. Viral pneumonias tend to have a seasonal predilection and are often preceded by a typical viral prodrome.

Epidemiology of critically ill patients in intensive care units: a population-based observational study.

Introduction: Epidemiologic assessment of critically ill people in Intensive Care Units (ICUs) is needed to ensure the health care system can meet current and future needs. However, few such studies have been published.

Methods: Population-based analysis of all adult ICU care in the Canadian province of Manitoba, 1999 to 2007, using administrative data.

Rates of readmission and death associated with leaving hospital against medical advice: a population-based study.

Background: Leaving hospital against medical advice may have adverse consequences. Previous studies have been limited by evaluating specific types of patients, small sample sizes and incomplete determination of outcomes. We hypothesized that leaving hospital against medical advice would be associated with increases in subsequent readmission and death.

High screen time is associated with asthma in overweight Manitoba youth.

Objective: Low physical activity and high sedentary behavior are associated with adverse health outcomes, including asthma. The purposes were to (1) determine if low physical activity and/or high screen time increase the risk of asthma and airway hyperresponsiveness (AHR) in youth and (2) determine if weight status modifies these associations.

Methods: This is a prospective cohort study of healthy weight and overweight Canadian youth.

Low vegetable intake is associated with allergic asthma and moderate-to-severe airway hyperresponsiveness.

Background: In recent decades, children's diet quality has changed and asthma prevalence has increased, although it remains unclear if these events are associated.

Objective: To examine children's total and component diet quality and asthma and airway hyperresponsiveness (AHR), a proxy for asthma severity.

Methods: Food frequency questionnaires adapted from the Nurses' Health Study and supplemented with foods whose nutrients which have garnered interest of late in relation to asthma were administered.

"Asthma isn't an excuse, it's just a condition": youths' perceptions of physical activity and screen time.

Objective: During puberty, physical activity patterns begin to decline, while sedentary time increases. These changes may be confounded by asthma. The purpose of this study was to gain insight into youths' perceptions of screen time and physical activity by asthma status.

Sedation and analgesia usage in severe pandemic H1N1 (2009) infection: a comparison to respiratory failure secondary to other infectious pneumonias.

Background: During the 2009 H1N1 pandemic (pH1N1), patients requiring mechanical ventilation for respiratory failure received high doses of sedation and analgesia.

Objective: To examine sedation and analgesia use among patients with respiratory failure due to severe pH1N1 infection compared to other infectious pneumonias.

Methods: In this observational cohort study of intensive care unit (ICU) patients with respiratory failure, we compared doses of sedatives and analgesics administered to patients with pH1N1, non-pH1N1 viral pneumonia, and adult respiratory distress syndrome (ARDS) secondary to bacterial pneumonia, on days 1, 3, 7, 14, and 28 of ICU admission.

The challenge of asthma in minority populations.

The burden and disparity of asthma in race/ethnic minorities present a significant challenge. In this review, we will evaluate data on asthma epidemiology in minorities, examine potential reasons for asthma disparities, and discuss strategies of intervention and culturally sensitive care.

Ventilator management for hypoxemic respiratory failure attributable to H1N1 novel swine origin influenza virus.

Novel H1N1 swine origin influenza virus has led to a worldwide pandemic. During the pandemic, a significant number of patients became critically ill primarily because of respiratory failure. Most of these patients required intubation and mechanical ventilation and were treated with conventional modes of mechanical ventilation using a lung-protective strategy with low tidal volumes, plateau pressures <30 to 35 cm H2O, and optimal positive end-expiratory pressure.

Exposure to dust mite allergen and endotoxin in early life and asthma and atopy in childhood.

Background: There has been no longitudinal study of the relation between concurrent exposure to dust mite allergen and endotoxin in early life and asthma and atopy at school age.

Objectives: To examine the relation between exposure to dust mite allergen and endotoxin at age 2 to 3 months and asthma, wheeze, and atopy in high-risk children.

Methods: Birth cohort study of 440 children with parental history of atopy in the Boston metropolitan area.

Respiratory illnesses in early life and asthma and atopy in childhood.

Background: The relation between respiratory illnesses in early life and the development of asthma and atopy in childhood is incompletely understood.

Objective: We sought to examine the relationship between respiratory illnesses in early life and atopic diseases at school age.

Methods: We performed a prospective birth cohort study of the relationship between respiratory illnesses in the first year of life and asthma, atopy (sensitization to >or=1 allergen), and allergic rhinitis at school age in 440 children with a parental history of atopy.