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Biomedical subjects

N Burke

Publications and source records attributed to N Burke.

12 recordsLinked to original sources
PubMed2005

The economic burden of schizophrenia in Canada in 2004.

OBJECTIVE: To estimate the financial burden of schizophrenia in Canada in 2004. METHODS: A prevalence-based cost-of-illness (COI) approach was used. The primary sources of information for the study included a review of the published literature, a review of published reports and documents, secondary analysis of administrative datasets, and information collected directly from various federal and provincial government programs and services. The literature review included publications up to April 2005 reported in MedLine, EMBASE and PsychINFO. Where specific information from a province was not available, the method of mean substitution from other provinces was used. Costs incurred by various levels/departments of government were separated into healthcare and non-healthcare costs. Also included in the analysis was the value of lost productivity for premature mortality and morbidity associated with schizophrenia. Sensitivity analysis was used to test major cost assumptions used in the analysis. Where possible, all resource utilization estimates for the financial burden of schizophrenia were obtained for 2004 and are expressed in 2004 Canadian dollars (CAN dollars). RESULTS: The estimated number of persons with schizophrenia in Canada in 2004 was 234 305 (95% CI, 136 201-333 402). The direct healthcare and non-healthcare costs were estimated to be 2.02 billion CAN dollars in 2004. There were 374 deaths attributed to schizophrenia. This combined with the high unemployment rate due to schizophrenia resulted in an additional productivity morbidity and mortality loss estimate of 4.83 billion CAN dollars, for a total cost estimate in 2004 of 6.85 billion CAN dollars. By far the largest component of the total cost estimate was for productivity losses associated with morbidity in schizophrenia (70% of total costs) and the results showed that total cost estimates were most sensitive to alternative assumptions regarding the additional unemployment due to schizophrenia in Canada. CONCLUSIONS: Despite significant improvements in the past decade in pharmacotherapy, programs and services available for patients with schizophrenia, the economic burden of schizophrenia in Canada remains high. The most significant factor affecting the cost of schizophrenia in Canada is lost productivity due to morbidity. Programs targeted at improving patient symptoms and functioning to increase workforce participation has the potential to make a significant contribution in reducing the cost of this severe mental illness in Canada.

Adolescent↗
PubMed2002

Comparison of outcomes of untreated carpal tunnel syndrome and asymptomatic controls in meat packers.

Our objectives were to determine the reporting of symptoms, the medical outcome and the work status of meat plant workers diagnosed with clinical carpal tunnel syndrome (CTS). Forty-seven cases of CTS were identified from a previously reported study, and were matched by age, gender and hand use. Cases and controls were followed up for 24 months. The Provincial Workers' Compensation Board and company health records were used to determine the reporting of symptoms, interventions and work status. Thirty-one study cases and all control cases were followed for the full 24 months (16 study cases were lost to follow-up). In total, 12 cases reported symptoms of CTS during the 24 months (eight study cases and four controls). Of the eight study cases, one required surgical release of the carpal tunnel. After a period of work modification, five of the eight study cases returned to regular duty and the remainder were placed on permanent job restrictions. Of the four controls, one subject had a surgical release and returned to regular work, two subjects' jobs were permanently modified, and the fourth returned to regular duty. Occupation-related CTS in meat packers appears to be transient and responsive to conservative measures, with a surgical rate comparable to other occupations.

Adult↗
PubMed2000

Persistent activation of ERK contributes to glutamate-induced oxidative toxicity in a neuronal cell line and primary cortical neuron cultures.

Oxidative stress can trigger neuronal cell death and has been implicated in several chronic neurological diseases and in acute neurological injury. Oxidative toxicity can be induced by glutamate treatment in cells that lack ionotrophic glutamate receptors, such as the immortalized HT22 hippocampal cell line and immature primary cortical neurons. Previously, we found that neuroprotective effects of geldanamycin, a benzoquinone ansamycin, in HT22 cells were associated with a down-regulation of c-Raf-1, an upstream activator of the extracellular signal-regulated protein kinases (ERKs). ERK activation, although often attributed strictly to neuronal cell survival and proliferation, can also be associated with neuronal cell death that occurs in response to specific insults. In this report we show that delayed and persistent activation of ERKs is associated with glutamate-induced oxidative toxicity in HT22 cells and immature primary cortical neuron cultures. Furthermore, we find that U0126, a specific inhibitor of the ERK-activating kinase, MEK-1/2, protects both HT22 cells and immature primary cortical neuron cultures from glutamate toxicity. Glutamate-induced ERK activation requires the production of specific arachidonic acid metabolites and appears to be downstream of a burst of reactive oxygen species (ROS) accumulation characteristic of oxidative stress in HT22 cells. However, inhibition of ERK activation reduces glutamate-induced intracellular Ca(2+) accumulation. We hypothesize that the precise kinetics and duration of ERK activation may determine whether downstream targets are mobilized to enhance neuronal cell survival or ensure cellular demise.

Animals↗
PubMed1991

Surgical correction of the Wolff-Parkinson-White syndrome.

The results of corrective surgery in 75 consecutive patients with Wolff-Parkinson-White (WPW) syndrome are reported. There were 47 male and 28 female patients with a median age of 27 years. Intraoperative mapping disclosed 88 accessory pathways, of which 83 were successfully divided at the primary operation without mortality. Two patients underwent successful reoperation at three days and two years respectively. Patient success rates were 93% and 96% for first and total operations. Complications, usually minor, occurred in 20 patients, including permanent pacemaker implantation in two. Surgical correction of WPW syndrome is recommended as a safe alternative to lifelong medical treatment.

Adolescent↗
PubMed1991

Operations for Wolff-Parkinson-White syndrome.

Forty-six patients with symptomatic tachycardia underwent operations to divide 55 atrioventricular accessory pathways. Mean age was 29 years (range 11 to 63). Ten patients (22%) had associated cardiac disease, including two with a congenital diverticulum of the coronary sinus and six (13%) who had concomitant surgical procedures. A bipolar hand-held electrode was used in 22 operations, and simultaneous multisite mapping in the last 24 operations. Ten patients (22%) had multiple accessory pathways. A modified endocardial approach was used. The overall patient success rate was 93% with 91% to 93% of accessory pathways successfully divided. The perioperative morbidity was 17%. There were two reoperations. There were no early or late deaths. Patients have been followed up for a mean of 16 months. There were five recurrences of preexcitation (two early, three late). Two of these patients (both with a congenital diverticulum of the coronary sinus) had reoperation. One patient had late recurrence of atrial fibrillation. Operation for the Wolff-Parkinson-White syndrome has a high probability of success with a low operative risk.

Adolescent↗
PubMed1987

Cotinine validation of self-reported smoking in commercially run community surveys.

A validation study was carried out on self-reported smoking for 1177 people in Sydney and Melbourne in 1983. Because of its long half life and the fact that smoking is its only source in body fluids, saliva cotinine was chosen as the validation measure. Cotinine levels above 250 nmol/l were used to classify people as smokers. The sensitivity of self-reported smoking was 92.6% and the specificity was 93.4%. There was some evidence that people in the process of changing their smoking status might be slow in updating their self-classification. The smoking prevalence estimate based on cotinine levels was found to be 1.7% lower than that for self-reported smoking status. The small proportion of false negatives and false positives suggests that commercially collected data banks can be valid sources of prevalence data. Correlation between cotinine level and reported cigarette consumption was not affected by sample volume, and was similar to that achieved for carbon monoxide and thiocyanate at a low 0.34. Regression analysis using self-reported cigarette consumption filter/non-filter cigarettes, and time since last cigarette as predictors, explained 13.6% of the variance in cotinine level.

Adolescent↗
PubMed1986

Evaluation of the Sydney "Quit. For Life" anti-smoking campaign. Part 2. Changes in smoking prevalence.

Between June and November 1983, the "Quit. For Life" media campaign was conducted in Sydney to reduce the prevalence of smoking. Surveys on a cross-sectional sample of the Sydney population were conducted before and after the campaign, and similar measures were undertaken in the rest of Australia for comparison. The sample sizes for both the Sydney and control areas comprised more than 4000 subjects. In addition, a cohort of 949 residents of Sydney and Melbourne were followed for changes in the prevalence of smoking during the year of the campaign. The cross-sectional survey results for 1984 and 1983 demonstrated decreases in the prevalence of smoking of approximately 1% for both men and women in Sydney compared with the rest of Australia. In the cohort study there was a 3.4% decrease in smoking prevalence in Sydney compared with a 0.8% increase in Melbourne. The pooled estimate of the difference in smoking prevalence attributable to the campaign was 2.8% (95% confidence interval, 0.5%-5.1%).

Adolescent↗
PubMed1986

Evaluation of the Sydney "Quit. For Life" anti-smoking campaign. Part 1. Achievement of intermediate goals.

The "Quit. For Life" campaign was a media-based programme that was aimed at reducing the prevalence of smoking in Sydney. The programme committee set four intermediate goals which it felt had to be met for such a change in prevalence to occur. From households selected at random in Sydney and Melbourne, 5713 people were interviewed to assess whether the campaign attained these goals. The television commercials that were designed for the campaign, their frequency and the timing of their screening produced a higher recall of the commercial's message and the use of campaign back-up services than were specified originally in the goals. During the campaign there was a progressive increase in the number of smokers in Sydney who reported that they were likely to quit; this was significantly different from Melbourne data by the end of the campaign and thus fulfilled another campaign goal. However, shortly after the campaign ended, the proportion of smokers who intended to quit smoking was the same in the two cities. A cohort study of 949 people from the baseline study showed that, during the 12-month period of follow-up, 66% of Sydney smokers tried to stop or to reduce their smoking. In the control city, Melbourne, 60% of smokers reported making such attempts. Of the original smokers, 23% in Sydney and 9% in Melbourne quit during the follow-up period--a statistically significant difference. As well, 10% of the original ex-smokers in Sydney and 11% in Melbourne relapsed, while 4% of nonsmokers in both cities began smoking by the end of the second survey.

Adolescent↗
PubMedDate not supplied

Alternative methods for newborn urine sample collection.

PURPOSE: To investigate the accuracy of laboratory results of urine samples collected from cotton balls as compared with paired samples collected from catheterization, Preemie Pampers, and Newborn Pampers. METHOD: Urine samples were collected from 30 infants by aspirating urine from a cotton ball placed over the meatus. An additional urine sample was obtained from the same infants by aspiration from the diaper. The samples were tested by labstik analysis and results were compared by t-test. An additional sample of 20 infants had urine collected by cotton ball and catheterization for detection of Group B strep antigen and the results were correlated. FINDINGS: Samples obtained from cotton balls and Preemie Pampers yielded equivalent results. Significant differences were found in the pH and specific gravity of Newborn Pampers and Preemie Pampers. No redness nor skin breakdown was observed with the cotton ball application. Three positive Group B strep results were detected by both methods of urine collection. The remainder of the samples were negative by both methods. CONCLUSIONS: Urine samples collected by the cotton ball method were accurate for pH and specific gravity and were atraumatic to the skin of newborns. The sample size of positive Group B strep antigen was small (n = 3) and results should be replicated with further research.

Female↗