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  1. Article: Point-of-care ultrasound Usage and accuracy within a Canadian urology division.

    van der Leek, Aaron P / Metcalfe, Peter

    Canadian Urological Association journal = Journal de l'Association des urologues du Canada

    2023  Volume 18, Issue 2, Page(s) 48–54

    Abstract: Introduction: This research evaluates the utility and precision of point-of-care ultrasound (POCUS) in urology, inspired by recent affirmations of its feasibility and value.1,2 Our study provides valuable insights for urologists about POCUS's practical ... ...

    Abstract Introduction: This research evaluates the utility and precision of point-of-care ultrasound (POCUS) in urology, inspired by recent affirmations of its feasibility and value.1,2 Our study provides valuable insights for urologists about POCUS's practical usage.
    Methods: A prospective study assessed POCUS usage and accuracy in the University of Alberta's Division of Urology using data from April 4, 2022, to April 4, 2023. Data include POCUS indications, findings, and correlation with the final diagnosis/gold standard. Additionally, a qualitative survey was conducted among urologists and residents about POCUS's pros, cons, and barriers to integration.
    Results: Thirty-three patients underwent POCUS examinations, mainly for suspected hydronephrosis (27%, n=9). Other indications included urinary retention, testicular mass, torsion, cryptorchidism, renal mass, extended focused assessment with sonography in trauma (eFAST ) exams, nephrostomy tube placement confirmation, and scrotal hematomas. POCUS findings matched the final diagnosis in most cases, showing 86% sensitivity, with an average exam time of 1-5 minutes. POCUS showed potential for suprapubic tube insertions. Residents (60%, n=20) were the most frequent users, followed by staff (33%, n=10), and students (6%, n=2). The surveyed urologists and residents expressed comfort with POCUS but cited time, cost, and practicality as barriers.
    Conclusions: POCUS proves accurate and beneficial in urology, particularly for hydronephrosis. Most findings align with the gold standard, and the average exam time is brief. Barriers include time and cost. Further research is necessary to evaluate cost-effectiveness and POCUS's impact on patient outcomes in routine urologic practice.
    Language English
    Publishing date 2023-11-06
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2431403-1
    ISSN 1911-6470
    ISSN 1911-6470
    DOI 10.5489/cuaj.8513
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: The Kynurenine Pathway As a Novel Link between Allergy and the Gut Microbiome.

    Van der Leek, Aaron P / Yanishevsky, Yarden / Kozyrskyj, Anita L

    Frontiers in immunology

    2017  Volume 8, Page(s) 1374

    Abstract: In the past few decades, the indoleamine 2,3 dioxygenase (IDO) subset of the kynurenine (KYN) pathway of tryptophan (TRP) metabolism has been the subject of much research in the area of immune tolerance. In this review, we aim to incorporate new findings ...

    Abstract In the past few decades, the indoleamine 2,3 dioxygenase (IDO) subset of the kynurenine (KYN) pathway of tryptophan (TRP) metabolism has been the subject of much research in the area of immune tolerance. In this review, we aim to incorporate new findings on this pathway in relation to allergy and the gut microbiome, while providing a comprehensive overview of the pathway itself. Stimulated by interferon gamma, IDO acts as a tolerogenic, immunosuppressive enzyme to attenuate allergic responses by the induction of the KYN-IDO pathway, resultant depletion of TRP, and elevation in KYN metabolites. Acting through the aryl hydrocarbon receptor, KYN metabolites cause T-cell anergy and apoptosis, proliferation of Treg and Th17 cells, and deviation of the Th1/Th2 response, although the outcome is highly dependent on the microenvironment. Moreover, new evidence from germ-free mice and human infants shows that gut microbiota and breast milk are key in determining the functioning of the KYN-IDO pathway. As such, we recommend further research on how this pathway may be a critical link between the microbiome and development of allergy.
    Language English
    Publishing date 2017
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2606827-8
    ISSN 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2017.01374
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Maternal Distress During Pregnancy and Recurrence in Early Childhood Predicts Atopic Dermatitis and Asthma in Childhood.

    van der Leek, Aaron P / Bahreinian, Salma / Chartier, Mariette / Dahl, Matthew E / Azad, Meghan B / Brownell, Marni D / Kozyrskyj, Anita L

    Chest

    2020  Volume 158, Issue 1, Page(s) 57–67

    Abstract: Background: Early-life stress is becoming an important determinant of immune system programming. Maternal prenatal distress is found to be associated with atopic disease in offspring but the separate effects of postnatal distress are not well-studied.!## ...

    Abstract Background: Early-life stress is becoming an important determinant of immune system programming. Maternal prenatal distress is found to be associated with atopic disease in offspring but the separate effects of postnatal distress are not well-studied.
    Research question: Does the likelihood of asthma and atopic dermatitis in children increase when they are exposed to maternal distress pre- and postnatally in a sex-specific manner?
    Study design and methods: Using data from a provincial newborn screen and health-care database for 12,587 children born in 2004, maternal distress (depression or anxiety) was defined as prenatal, self-limiting, recurrent, or late-onset postpartum. Atopic dermatitis (AD) and asthma at ages 5 years and 7 years of age were diagnosed by using hospitalization, physician visit, or prescription records. Associations between maternal distress and childhood asthma and AD were determined by using multiple logistic regression.
    Results: After adjusting for risk factors, a significant association between maternal prenatal (OR, 1.27; 95% CI, 1.11-1.46), recurrent postpartum (OR, 1.28; 95% CI, 1.11-1.48), and late-onset postpartum (OR, 1.19, 95% CI, 1.06-1.34) distress was found with AD at age 5 years. Asthma at age 7 years was also associated with maternal prenatal distress (OR, 1.57; 95% CI, 1.29-1.91) and late-onset postnatal distress (OR, 1.22; 95% CI, 1.01-1.46). Self-limiting postnatal distress was not found to be a risk factor for either atopic condition. Associations with AD or asthma were of a similar magnitude in boys and girls; the exception was recurrent postnatal distress, which increased risk for asthma in boys only.
    Interpretation: This population-based study provides evidence for sex-specific associations between maternal prenatal and postnatal distress, as well as the development of AD and asthma. The findings support recommendations for greater psychosocial support of mothers during pregnancy and early childhood to prevent childhood atopic disease.
    MeSH term(s) Adult ; Age Factors ; Asthma/diagnosis ; Asthma/epidemiology ; Child ; Child, Preschool ; Cohort Studies ; Dermatitis, Atopic/diagnosis ; Dermatitis, Atopic/epidemiology ; Female ; Humans ; Male ; Pregnancy ; Pregnancy Complications/epidemiology ; Pregnancy Complications/psychology ; Prevalence ; Recurrence ; Sex Factors ; Stress, Psychological/complications ; Stress, Psychological/epidemiology ; Young Adult
    Language English
    Publishing date 2020-03-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2020.01.052
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  4. Article ; Online: Sanitization of Early Life and Microbial Dysbiosis

    Shelly Jun / Kelsea Drall / Brittany Matenchuk / Cara McLean / Charlene Nielsen / Chinwe V. Obiakor / Aaron van der Leek / Anita Kozyrskyj

    Challenges, Vol 9, Iss 2, p

    2018  Volume 43

    Abstract: Childbearing and infant care practices have dramatically evolved since the 15th century. Shifting away from traditional home-based experiences, with the emergence of the microbial aware era and the hospital as a quintessential sanitizing machine, early ... ...

    Abstract Childbearing and infant care practices have dramatically evolved since the 15th century. Shifting away from traditional home-based experiences, with the emergence of the microbial aware era and the hospital as a quintessential sanitizing machine, early life has now long been characterized as a condition to be medically managed. Paradoxically, this ‘germ-free’ march towards a healthier early life environment has opened the door to greater microbial susceptibility and dysbiosis. Many studies have now established that infant exposure to excessive sanitation and hygiene regimens are associated with an increased risk for and onset of childhood immune system diseases. In this paper, we explore the ways in which biomedical-centered efforts to enhance early life have come at a cost to planetary health, in relation to infant microbial succession. We examine three major areas of early life that have been subject to the ‘ripple effect’ of hygiene and sanitation concerns—childbirth, home environment, and breastfeeding.
    Keywords antibiotics ; birth ; breastfeeding ; caesarean section ; cleaning products ; microbial succession ; planetary health ; sanitation ; Technology ; T ; Science (General) ; Q1-390
    Subject code 300
    Language English
    Publishing date 2018-12-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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