Biomedical subjects

R Pong

Publications and source records attributed to R Pong.

5 recordsLinked to original sources

PubMed2000

Pregnancy outcome and ovarian antibodies in infertility patients undergoing controlled ovarian hyperstimulation.

PROBLEM: Several endocrine markers are well-established, but not absolute, predictors of successful outcomes following controlled ovarian hyperstimulation. Another potential predictor for success may be a marker of ovarian autoimmunity. Ovarian antibodies (OVAB) are detected in women with unexplained infertility. We tested the hypothesis that women with OVAB have a poorer pregnancy outcome in in vitro fertilization (IVF). METHOD OF STUDY: Serum samples (n = 47) were assessed by a previously described immunoassay for OVAB in a cross-sectional, retrospective study design. RESULTS: Women who became pregnant had a lower frequency of OVAB than women who did not become pregnant (25.0% [4/16] vs. 58.1% [18/31], respectively; P = 0.03). There was no significant difference in day 3 estradiol, amount of human menopausal gonadotropin given, peak estradiol, the number of follicles observed, or the number of eggs retrieved between women who achieved pregnancy and those who did not. CONCLUSIONS: Together with other information such as reproductive hormone levels and measures of follicle growth, OVAB may contribute additional information for prediction of successful IVF outcomes.

Adult↗

PubMed1999

Rural background and clinical rural rotations during medical training: effect on practice location.

BACKGROUND: Providing health care services in rural communities in Canada remains a challenge. What affects a family medicine resident's decision concerning practice location? Does the resident's background or exposure to rural practice during clinical rotations affect that decision? METHODS: Cross-sectional mail survey of 159 physicians who graduated from the Family Medicine Program at Queen's University, Kingston, Ont., between 1977 and 1991. The outcome variables of interest were the size of community in which the graduate chose to practise on completion of training (rural [population less than 10,000] v. nonrural [population 10,000 or more]) and the size of community of practice when the survey was conducted (1993). The predictor or independent variables were age, sex, number of years in practice, exposure to rural practice during undergraduate and residency training, and size of hometown. RESULTS: Physicians who were raised in rural communities were 2.3 times more likely than those from nonrural communities to choose to practise in a rural community immediately after graduation (95% confidence interval 1.43-3.69, p = 0.001). They were also 2.5 times more likely to still be in rural practice at the time of the survey (95% confidence interval 1.53-4.01, p = 0.001). There was no association between exposure to rural practice during undergraduate or residency training and choosing to practise in a rural community. INTERPRETATION: Physicians who have roots in rural Canada are more likely to practise in rural Canada than those without such a background.

Adult↗

PubMed1999

Ovarian autoimmunity: greater frequency of autoantibodies in premature menopause and unexplained infertility than in the general population.

The objective of this study was to: (1) assess the relative prevalence of ovarian, thyroid, nuclear, and cardiolipin antibodies associated with premature menopause and unexplained infertility and (2) compare ovarian and thyroid antibodies in premature menopause, unexplained infertility, and the general population. Autoantibodies were evaluated in women with premature menopause (n = 30), unexplained infertility with (n = 38) or without (n = 15) prior gonadotropin-induced ovulation, and normal cycling controls (n = 12) and in a population of women obtained from a blood bank (n = 53). Antibodies to ovary (OVAB), thyroid (THYAB; thyroid peroxidase and thyroglobulin), cardiolipin, and eight nuclear antigens were assessed by enzyme immunoassay. Organ-specific antibodies (ovary and thyroid) were present with significantly greater frequency than non-organ-specific antibodies (nuclear and cardiolipin) in premature menopause and unexplained infertility (60% (50/83) vs 16% (13/83) respectively; P < 0.0001). OVAB (53%, 44/83) were significantly more frequent than THYAB (30%, 25/83) in premature menopause and unexplained infertility (P = 0.0030). THYAB did not differ among all groups (P = 0.78). In premature menopause and treated or untreated unexplained infertility OVAB frequencies were 53, 61, and 33%, respectively, and were significantly more frequent than in the population (17%) (P = 0.0001). In unexplained infertility, individuals with no prior gonadotropin-induced ovulation had a lower frequency of OVAB than treated individuals (P = 0.07). The frequency distribution of optical density values for OVAB was significantly higher for premature menopause and unexplained infertility than for population or normal cycling women (P < 0.0001). Thus, only ovarian antibodies were significantly more frequent than other antibody markers of autoimmunity in premature menopause and unexplained infertility.

Adult↗

PubMed1998

Practice choices of graduating family medicine residents.

OBJECTIVE: To examine the types of practices family medicine residents chose during the first 2 years after residency, and how these choices have changed over a 15-year period. DESIGN: Mailed survey. SETTING: Areas served by graduates of the Queen's University family medicine residency program. PARTICIPANTS: Two hundred thirty (76%) of the 303 graduates from 1977 to 1991 of the Queen's University family medicine residency program responded to the questionnaire. MAIN OUTCOME MEASURES: Type of practices residents entered immediately out of residency: whether they began full-time, part-time, locum tenens, or other type of practice; length of time spent in the first practice situation; and proportion of residents who had settled into a full-time practice within 2 years of completing residency. RESULTS: Residents who graduated before 1985 were significantly more likely to go into full-time practice immediately out of residency (P = .0001). The earlier residents had graduated from the program, the more likely they were to go immediately into full-time practice. This finding was not affected by residents' age, sex, size of community of origin, exposure to rural teaching sites, marital status, or how well prepared for practice they felt. Residents graduating before 1985 were also more likely to be in full-time practice within 2 years of completing their residency program (P = .003). CONCLUSIONS: Recent family medicine residents did not enter full-time practice immediately out of residency as often as those who had graduated earlier, nor did they commit to full-time practice within 2 years of graduating as often as residents graduating before 1985 did.

Career Choice↗

PubMedDate not supplied

Predicting future long-term-care needs in a community.

Under current financial restraints, planning for the future long-term-care needs of older Canadians is coming under increasing scrutiny. Even though health care is moving to a community-based system (i.e., deinstitutionalization), this is not necessarily the most cost-effective strategy for severely disabled older adults. Three models are used in the present paper to estimate the number of severely disabled (two or more ADL disabilities abilities) older adults expected in the next 5 to 10 years in a small community in Northern Ontario. While mortality and disability rates are the main predictors, it was also necessary to consider additional factors particular to the community in question. It is suggested that for long-term-care planning to be effective and economically sound, similar strategies will be needed throughout Canada.

Activities of Daily Living↗