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Donison V, Feng G, Parthipan M, Toledano N, Breunis H, Emmenegger U, Soto-Perez-de-Celis E, Matthew A, Alibhai S, Puts M. Symptom experiences of older men undergoing hormonal treatment for metastatic castrate resistant prostate cancer (mCRPC). J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00389-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Vassantachart A, Cao Y, Gribble M, Guzman S, Ye J, Hurth K, Matthew A, Zada G, Fan Z, Chang E, Yang W. Automatic Differentiation of Grade I and II Meningioma on Magnetic Resonance Image Using an Asymmetric Convolutional Neural Network. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Matthew A, Robinson J, Ellis J, Elliott S, Singal R, McLeod D, Elterman D, Petrella A, Yang G, Jamnicky L, Finelli A, Fleshner N, Perlis N, Walker L, Bender J, Fergus K, Wassersug R. 160 Canadian TrueNTH Sexual Health and Rehabilitation eClinic (SHAReClinic) for Prostate Cancer Patients: Results of a Feasibility Study. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2019.11.106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Matthew A, Robinson J, McLeod D, Elliott S, Ellis J, Singal R, Elterman D, Gentile A, Yang G, Walker L, Wassersug R, Fergus K, Gajewski J, Brock G, Bender J, Jamnicky L, Berlin A, Perlis N, Fleshner N, Finelli A. 048 Canadian TrueNTH Sexual Health and Rehabilitation eClinic (SHAReClinic): Online Education and Support for Prostate Cancer Patients and their Partners. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Matthew A, Lutzky-Cohen N, Jamnicky L, Currie K, Gentile A, Mina DS, Fleshner N, Finelli A, Hamilton R, Kulkarni G, Jewett M, Zlotta A, Trachtenberg J, Yang Z, Elterman D. The Prostate Cancer Rehabilitation Clinic: a biopsychosocial clinic for sexual dysfunction after radical prostatectomy. ACTA ACUST UNITED AC 2018; 25:393-402. [PMID: 30607114 DOI: 10.3747/co.25.4111] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose The most prevalent intervention for localized prostate cancer (pca) is radical prostatectomy (rp), which has a 10-year relative survival rate of more than 90%. The improved survival rate has led to a focus on reducing the burden of treatment-related morbidity and improving the patient and partner survivorship experience. Post-rp sexual dysfunction (sdf) has received significant attention, given its substantial effect on patient and partner health-related quality of life. Accordingly, there is a need for sdf treatment to be a fundamental component of pca survivorship programming. Methods Most research about the treatment of post-rp sdf involves biomedical interventions for erectile dysfunction (ed). Although findings support the effectiveness of pro-erectile agents and devices, most patients discontinue use of such aids within 1 year after their rp. Because side effects of pro-erectile treatment have proved to be inadequate in explaining the gap between efficacy and ongoing use, current research focuses on a biopsychosocial perspective of ed. Unfortunately, there is a dearth of literature describing the components of a biopsychosocial program designed for the post-rp population and their partners. Results In this paper, we detail the development of the Prostate Cancer Rehabilitation Clinic (pcrc), which emphasizes multidisciplinary intervention teams, active participation by the partner, and a broad-spectrum medical, psychological, and interpersonal approach. Conclusions The goal of the pcrc is to help patients and their partners achieve optimal sexual health and couple intimacy after rp, and to help design cost-effective and beneficial rehabilitation programs.
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Affiliation(s)
- A Matthew
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - N Lutzky-Cohen
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - L Jamnicky
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - K Currie
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - A Gentile
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - D Santa Mina
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - N Fleshner
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - A Finelli
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - R Hamilton
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - G Kulkarni
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - M Jewett
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - A Zlotta
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - J Trachtenberg
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - Z Yang
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - D Elterman
- Department of Surgical Oncology, University Health Network, Toronto, ON
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Giuliani M, Quartey N, Catton C, D’souza A, Kucharski E, Maganti M, Matthew A, Papadakos J. Exploring the Role of Prostate Cancer Survivors in Managing Survivorship Care. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Matthew A, Jamnicky L, Currie K, Gentile A, Trachtenberg J, Alibhai S, Finelli A, Fleshner N, Yang G, Osqui L, Davison J, Elterman D. 320 Prostate Cancer Rehabilitation: Outcomes of a Sexual Health Clinic. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2017.11.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Loblaw A, Souter LH, Canil C, Breau RH, Haider M, Jamnicky L, Morash R, Surchin M, Matthew A. Follow-up Care for Survivors of Prostate Cancer - Clinical Management: a Program in Evidence-Based Care Systematic Review and Clinical Practice Guideline. Clin Oncol (R Coll Radiol) 2017; 29:711-717. [PMID: 28928084 DOI: 10.1016/j.clon.2017.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 07/11/2017] [Accepted: 07/19/2017] [Indexed: 11/26/2022]
Abstract
AIMS This clinical practice guideline was developed to provide evidence-based guidance on the frequency by which prostate-specific antigen (PSA) levels should be tested in men after curative-intent treatment for prostate cancer and to define the most appropriate diagnostic testing if biochemical recurrence occurs. MATERIALS AND METHODS An electronic search using OVID was used to systematically search the MEDLINE and EMBASE databases for systematic reviews and primary literature. A systematic review and practice guideline was written, reviewed and approved by the Guideline Development Group (GDG) and Program in Evidence-Based Care Report Approval Panel. External review by three prostate experts was completed, as well as an online consultation with healthcare professionals who were intended users of the guideline. RESULTS Three systematic reviews and seven primary studies were included in the evidence base. All identified literature reported on diagnostic imaging properties of diagnostic tests following biochemical recurrence. CONCLUSIONS Due to a lack of empirical research, few evidenced-based recommendations could be made with respect to a follow-up schedule of PSA testing for prostate cancer survivors following curative-intent treatment, or detailing diagnostic testing upon detection of biochemical recurrence. Accordingly, the GDG focused substantial effort on critical examination of the identified evidence, existing clinical practice guidelines and on obtaining clinical expertise consensus using a modified Delphi method. Overall, the recommendations embedded in this guideline reflect the best practice to date for the efficient and effective clinical follow-up care of prostate cancer survivors.
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Affiliation(s)
- A Loblaw
- Odette Cancer Centre, Toronto, Ontario, Canada
| | - L H Souter
- Program in Evidence-Based Care, Cancer Care Ontario, Toronto, Ontario, Canada; Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - C Canil
- Ottawa Hospital Cancer Centre, Ottawa, Ontario, Canada
| | - R H Breau
- Ottawa Hospital Research Institution, Ottawa, Ontario, Canada
| | - M Haider
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - L Jamnicky
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - R Morash
- Ottawa Hospital Cancer Centre, Ottawa, Ontario, Canada
| | | | - A Matthew
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
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Barbera L, Zwaal C, Elterman D, McPherson K, Wolfman W, Katz A, Matthew A. Interventions to address sexual problems in people with cancer. Curr Oncol 2017; 24:192-200. [PMID: 28680280 PMCID: PMC5486385 DOI: 10.3747/co.24.3583] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Sexual dysfunction in people with cancer is a significant problem. The present clinical practice guideline makes recommendations to improve sexual function in people with cancer. METHODS This guideline was undertaken by the Interventions to Address Sexual Problems in People with Cancer Expert Panel, a group organized by the Program in Evidence-Based Care (pebc). Consistent with the pebc standardized approach, a systematic search was conducted for existing guidelines, and the literature in medline and embase for the years 2003-2015 was systematically searched for both systematic reviews and primary literature. Evidence found for men and for women was evaluated separately, and no restrictions were placed on cancer type or study design. Content and methodology experts performed an internal review of the resulting draft recommendations, which was followed by an external review by targeted experts and intended users. RESULTS The search identified 4 existing guidelines, 13 systematic reviews, and 103 studies with relevance to the topic. The present guideline provides one overarching recommendation concerning the discussion of sexual health and dysfunction, which is aimed at all people with cancer. Eleven additional recommendations made separately for men and women deal with issues such as sexual response, body image, intimacy and relationships, overall sexual functioning and satisfaction, and vasomotor and genital symptoms. CONCLUSIONS To our knowledge this clinical practice guideline is the first to comprehensively evaluate interventions for the improvement of sexual problems in people with cancer. The guideline will be a valuable resource to support practitioners and clinics in addressing sexuality in cancer survivors.
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Affiliation(s)
- L. Barbera
- Department of Radiation Oncology, University of Toronto, Toronto
| | - C. Zwaal
- Program in Evidence-Based Care, Cancer Care Ontario, Hamilton
| | - D. Elterman
- Department of Surgery, Division of Urology, University of Toronto, Toronto
| | - K. McPherson
- Patient and Family Advisory Council, Cancer Care Ontario, Hamilton; and
| | - W. Wolfman
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON; and
| | - A. Katz
- CancerCare Manitoba, Winnipeg, MB
| | - A. Matthew
- Department of Surgery, Division of Urology, University of Toronto, Toronto
| | - The Interventions to Address Sexual Problems in People with Cancer Guideline Development Group
- Department of Radiation Oncology, University of Toronto, Toronto
- Program in Evidence-Based Care, Cancer Care Ontario, Hamilton
- Department of Surgery, Division of Urology, University of Toronto, Toronto
- Patient and Family Advisory Council, Cancer Care Ontario, Hamilton; and
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON; and
- CancerCare Manitoba, Winnipeg, MB
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Barbera L, Zwaal C, Elterman D, Wolfman W, Katz A, McPherson K, Matthew A. EP-1415: Interventions to Address Sexual Problems in People with Cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31850-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Matthew A, Kupittayanant S, Burdyga T, Wray S. Characterization of Contractile Activity and Intracellular Ca2+ Signalling in Mouse Myometrium. ACTA ACUST UNITED AC 2016; 11:207-12. [PMID: 15120693 DOI: 10.1016/j.jsgi.2003.10.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To characterize the contractile responses of mouse myometrium, the associated calcium (Ca2+) changes and the role of the sarcoplasmic reticulum (SR), and to better understand excitation contraction coupling in this tissue. METHODS Strips of longitudinal myometrium were used, and Ca2+ was measured after loading with Indo-1. RESULTS Intracellular Ca2+ transients, produced by Ca2+ entry, preceded phasic spontaneous contractions. Depolarization with high potassium concentration significantly increased the amplitude of the contractions and transformed the pattern of activity from phasic to tonic, with accompanying changes in intracellular Ca2+ concentration ([Ca2+]i). Oxytocin significantly stimulated contractile activity and [Ca2+]i above the level occurring spontaneously. Thus all forms of contractile activity were closely correlated with Ca2+. When the SR was emptied using a blocker of the SR calcium-adenosinetriphosphatase, cyclopiazonic acid, spontaneous Ca2+ and force transients increased greatly in frequency and amplitude. Ryanodine, a blocker of Ca(2+)-induced Ca2+ release (CICR), did not impair activity. In the absence of external Ca2+, oxytocin was able to release Ca2+ from the SR through IP3 but produced only a small increase in force, demonstrating a requirement for Ca2+ entry as part of the mechanism of agonist action. CONCLUSION Mouse myometrium, (1) produces contractile activity reflecting changes in [Ca2+]i irrespective of the stimulus, (2) has a significant SR Ca2+ content releasable by agonists but not CICR, (3) has an SR acting to inhibit spontaneous activity, and (4) behaves qualitatively similarly to human and rat myometrium in major aspects of excitation contraction coupling and is therefore a useful model tissue.
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Affiliation(s)
- A Matthew
- Department of Physiology, The University of Liverpool, United Kingdom
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Matthew A, Burns N, Mair F, O'Donnell K. Exploring how asylum seeking/refugee women perceive and respond to preventive health care: cervical screening as a case study. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku161.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abdullah A, Omar AN, Mulcahy R, Clapp A, Tullo E, Carrick-Sen D, Newton J, Hirst B, Krishnaswami V, Foster A, Vahidassr D, Chavan T, Matthew A, Trolan CP, Steel C, Ellis G, Ahearn DJ, Lotha K, Shukla P, Bourne DR, Mathur A, Musarrat K, Patel A, Nicholson G, Nelson E, McNicholl S, McKee H, Cuthbertson J, Nelson E, Nicholson G, McNicholl S, McKee H, Cuthbertson J, Lunt E, Lee S, Okeke J, Daniel J, Naseem A, Ramakrishna S, Singh I, Barker JR, Weatherburn AJ, Thornton L, Daniel J, Okeke J, Holly C, Jones J, Varanasi A, Verma A, Singh I, Foster JAH, Carmichael C, Cawston C, Homewood S, Leitch M, Martin J, McDicken J, Lonnen J, Bishop-Miller J, Beishon LC, Harrison JK, Conroy SP, Gladman JRF, Sim J, Byrne F, Currie J, Ollman S, Brown S, Wilkinson M, Manoj A, Hussain F, Druhan A, Thompson M, Tsang J, Soh J, Offiah C, Coughlan T, O'Brien P, McCabe DJH, Murphy S, McManus J, O'Neill D, Collins DR, Warburton K, Maini N, Cunnington AL, Mathew P, Hoyles K, Lythgoe M, Brewer H, Western-Price J, Colquhoun K, Ramdoo K, Bowen J, Dale OT, Corbridge R, Chatterjee A, Gosney MA, Richardson L, Daunt L, Ali A, Harwood R, Beveridge LA, Harper J, Williamson LD, Bowen JST, Gosney MA, Wentworth L, Wardle K, Ruddlesdin J, Baht S, Roberts N, Corrado O, Morell J, Baker P, Whiller N, Wilkinson I, Barber M, Maclean A, Frieslick J, Reoch A, Thompson M, Tsang J, McSorley A, Crawford A, Sarup S, Niruban A, Edwards JD, Bailey SJ, May HM, Mathieson P, Jones H, Ray R, Prettyman R, Gibson R, Heaney A, Hull K, Manku B, Bellary S, Ninan S, Chhokar G, Sweeney D, Nivatongs W, Wong SY, Aung T, Kalsi T, Babic-Illman G, Harari D, Aljaizani M, Pattison AT, Pattison AT, Aljaizani M, Fox J, Reilly S, Chauhan V, Azad M, Youde J, Lagan J, Cooper H, Komrower D, Price V, von Stempel CB, Gilbert B, Bouwmeester N, Jones HW, Win T, Weekes C, Hodgkinson R, Walker S, Le Ball K, Muir ZN. Clinical effectiveness. Age Ageing 2013. [DOI: 10.1093/ageing/aft096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
OBJECTIVE To assess the extent to which in vitro measurements of myometrial contractility reflect the clinical indication for caesarean section. DESIGN A prospective, observational hypothesis-generating study. SETTING Women were recruited from Liverpool Women's NHS Foundation Trust and experiments were performed in the Physiology Department at the University of Liverpool. POPULATION Myometrial samples were taken from women undergoing a caesarean section during labour (n = 50) or from women having a repeat nonlabouring caesarean section (n = 70). METHODS The demographic characteristics of the women and indications for current and previous caesarean sections were recorded. The force, frequency and duration of spontaneous contractions of myometrial strips, and changes in the intracellular calcium concentration of the strips, were measured. Kruskall-Wallis and post hoc tests were used to assess the significance of differences between groups. RESULTS Samples from women whose caesarean section was for fetal distress/acidosis (scalp pH <7.2) contracted with more force than those from women whose caesarean section was for delay in the first stage of labour (P < 0.001). For repeat, nonlabouring caesarean sections, samples from women whose first caesarean section was for fetal distress/acidosis also contracted with more force than did samples from women whose first caesarean section was for delay in the first stage of labour (P = 0.03). CONCLUSIONS These findings suggest that the myometrium contracts with greater force in women who have a caesarean section for fetal distress.
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Affiliation(s)
- S Quenby
- Clinical Sciences Research Institute, University of Warwick, Coventry, UK.
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15
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Brown L, Ritvo P, Howlett R, Cotterchio M, Matthew A, Rosen B, Murphy J, Mai V. Attitudes toward HPV testing: interview findings from a random sample of women in Ontario, Canada. Health Care Women Int 2008; 28:782-98. [PMID: 17907007 DOI: 10.1080/07399330701563061] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
As most women diagnosed with cervical carcinoma have been "inadequately screened," improvements in screening are critical. After abnormal Pap test findings (through liquid-based cytology), residual specimens now can be tested simultaneously for oncogenic types of Human Papilloma virus (HPV). If these "reflex" HPV tests are negative, Pap tests need not be repeated for 12 months. Women with positive oncogenic HPV tests, however, can be referred immediately for colposcopy. There has been concern that "stigma" issues could be associated with positive HPV status (because of its sexual transmission) that might cause women to avoid this reflex HPV testing. We addressed this concern by assessing whether stigma issues surface in relation to HPV testing. We randomly selected 20 women and administered to them semistructured telephone interviews that included responses to a scenario of reflex HPV-DNA testing. Interview transcripts were analyzed qualitatively. Highly limited knowledge levels were found about HPV, but, following education about screening options, there was no rejection of HPV testing. In conclusion, it appears that women favor reflex HPV testing due to its "convenience" and perceptions that it is "the least intrusive option more definitive than Pap testing."
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Affiliation(s)
- L Brown
- Cancer Care Ontario, Toronto, Ontario, Canada
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Ritvo P, Irvine J, Naglie G, Tomlinson G, Bezjak A, Matthew A, Trachtenberg J, Krahn M. Reliability and Validity of the PORPUS, a Combined Psychometric and Utility-Based Quality-of-Life Instrument for Prostate Cancer. J Urol 2006. [DOI: 10.1016/s0022-5347(05)00548-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- P. Ritvo
- York University and Cancer Care Ontario, Division of Preventive Oncology, Toronto, Ontario, Canada
| | - J. Irvine
- York University and Cancer Care Ontario, Division of Preventive Oncology, Toronto, Ontario, Canada
| | - G. Naglie
- York University and Cancer Care Ontario, Division of Preventive Oncology, Toronto, Ontario, Canada
| | - G. Tomlinson
- York University and Cancer Care Ontario, Division of Preventive Oncology, Toronto, Ontario, Canada
| | - A. Bezjak
- York University and Cancer Care Ontario, Division of Preventive Oncology, Toronto, Ontario, Canada
| | - A. Matthew
- York University and Cancer Care Ontario, Division of Preventive Oncology, Toronto, Ontario, Canada
| | - J. Trachtenberg
- York University and Cancer Care Ontario, Division of Preventive Oncology, Toronto, Ontario, Canada
| | - M. Krahn
- York University and Cancer Care Ontario, Division of Preventive Oncology, Toronto, Ontario, Canada
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Abstract
Control of smooth muscle is vital for health. The major route to contraction is a rise in intracellular [Ca2+], determined by the entry and efflux of Ca2+ and release and re-uptake into the sarcoplasmic reticulum (SR). We review these processes in myometrium, to better understand excitation-contraction coupling and develop strategies for preventing problematic labours. The main mechanism of elevating [Ca2+] is voltage-gated L-type channels, due to pacemaker activity, which can be modulated by agonists. The rise of [Ca2+] produces Ca-calmodulin and activates MLCK. This phosphorylates myosin and force results. Without Ca2+ entry uterine contraction fails. The Na/Ca exchanger (NCX) and plasma membrane Ca-ATPase (PMCA) remove Ca2+, with contributions of 30% and 70% respectively. Studies with PMCA-4 knockout mice show that it contributes to reducing [Ca2+] and relaxation. The SR contributes to relaxation by vectorially releasing Ca2+ to the efflux pathways, and thereby increasing their rates. Agonists binding produces IP3 which can release Ca from the SR but inhibition of SR Ca2+ release increases contractions and Ca2+ transients. It is suggested that SR Ca2+ targets K+ channels on the surface membrane and thereby feedback to inhibit excitability and contraction.
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Affiliation(s)
- A Matthew
- Department of Physiology, The University of Liverpool, Liverpool L69 3BX, UK
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18
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Wray S, Jones K, Kupittayanant S, Li Y, Matthew A, Monir-Bishty E, Noble K, Pierce SJ, Quenby S, Shmygol AV. Calcium signaling and uterine contractility. J Soc Gynecol Investig 2003; 10:252-64. [PMID: 12853086 DOI: 10.1016/s1071-5576(03)00089-3] [Citation(s) in RCA: 144] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Changes in Ca(2+) signals within the myometrium have important functional consequences, as they determine contractility. We show that the basic phasic nature of uterine contractions, which is essential for successful labor, is critically dependent on Ca(2+) influx through voltage-gated L-type Ca(2+) channels, and hence in turn, on membrane potential. Thus changes in ion channel expression around term will play an important role in governing uterine excitability and contractility. There remains uncertainty about which channels are present in human myometrium and the nature of the pacemaker mechanism that initiates the action potential. The sarcoplasmic reticulum may augment, to a small extent, the necessary increase in [Ca(2+)] for contraction when agonists stimulate the uterus, but its main role appears to be to control excitability, acting as a negative feedback mechanism to limit contractions. Myosin light chain kinase activity and phosphorylation of myosin are essential components in the pathway of uterine contraction, once Ca(2+) has been elevated. Modulation of myosin light chain phosphatase activity can also influence contractions, but the effects are small compared with those modulating myosin light chain kinase. Ca(2+)-sensitizing pathways may not be utilized much in modulating normal phasic uterine activity, and caution is needed in extrapolating from in vitro experiments to in vivo conditions, especially because there may be redundant pathways. There is a need to study appropriate physiologic preparations, but these are not always available (eg, preterm laboring myometrium) and to combine functional studies with modern molecular approaches, to advance our understanding to a new level, from which better therapeutics will be developed.
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Affiliation(s)
- Susan Wray
- Department of Physiology, The University of Liverpool, Liverpool, United Kingdom.
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19
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Ritvo P, Irvine J, Robinson G, Brown L, Murphy KJ, Matthew A, Rosen B. Psychological adjustment to familial-genetic risk assessment for ovarian cancer: predictors of nonadherence to surveillance recommendations. Gynecol Oncol 2002; 84:72-80. [PMID: 11748980 DOI: 10.1006/gyno.2001.6461] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate whether self-report measures of psychological distress and perceived risk were associated with nonadherence to recommended ovarian cancer surveillance. METHODS Eighty-three patients attending the Familial Ovarian Cancer Clinic (FOCC) at Princess Margaret Hospital were assessed psychosocially prior to and during initial familial-genetic assessment and then monitored for adherence with recommended follow-up surveillance over a period of 12-18 months. The assessment protocol included an investigator-designed clinic questionnaire, the State-Trait Anxiety Inventory (STAI), Center for Epidemiologic Studies Depression Scale (CESD), Life Orientation Test (LOT), Medical Outcomes Study Social Support Survey (MOSSS), Texas Inventory of Grief, and the COPE. Nonadherence was measured in terms of unexplained absences at one or two recommended and scheduled surveillance appointments following the familial-genetic assessment. RESULTS Univariate tests revealed a significant association between higher perception of ovarian cancer risk, as assessed immediately after the familial-genetic risk assessment in the clinic and nonadherence to physician-recommended surveillance (chi2 (2, N = 83) = 9.75, P < 0.008). Empirically based estimates of risk, conveyed by the clinic team to subjects, were not significantly associated with nonadherence (chi2 (2, N = 83) = 0.19, P = 0.91). Logistic regression analysis revealed that subjects who perceived themselves to be at high ovarian cancer risk were five times more likely to be nonadherent than participants who perceived themselves to be at low or medium ovarian cancer risk. CONCLUSIONS These results suggest that higher self-perceived risk may predict adherence difficulties to recommended surveillance in women attending a familial-genetic risk clinic.
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Affiliation(s)
- P Ritvo
- Toronto General Hospital, Ontario Cancer Institute/University Health Network, Toronto, Ontario, M5G 2C4, Canada.
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Ritvo P, Robinson G, Irvine J, Brown L, Matthew A, Murphy KJ, Stewart DS, Styra R, Wang C, Mullen M, Cole D, Rosen B. Psychological adjustment to familial genetic risk assessment: differences in two longitudinal samples. Patient Educ Couns 2000; 40:163-172. [PMID: 10771370 DOI: 10.1016/s0738-3991(99)00082-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Heritable cancer risk assessment is an increasingly common method of deriving valuable information relevant to deciding on appropriate screening regimens and preventive treatments. Assessments of heritable risk typically include familial-genetic evaluation, where analyses relate family pedigree to cancer risk, and DNA testing, where analyses indicate genetic mutations associated with cancer risk (e.g., BRCA1/BRCA2 mutations) or their absence. In this paper we report on the psychological responses of women given familial-genetic evaluations for ovarian cancer risk. The baseline and 6 to 12 follow-up assessments of an initial clinic-attending cohort of 65 women are compared with the baseline and 9 to 12 follow-up assessments of a second clinic-attending cohort of 60 women. Sizeable differences were found in the prevalence of clinically significant depression in these two physician or self-referred populations, as assessed by the Center for Epidemiological Studies Depression scale and in the mean scores. Hypotheses accounting for these differences are discussed.
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Affiliation(s)
- P Ritvo
- Research Unit, Division of Preventive Oncology, Cancer Care Ontario, Toronto, Canada
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Abstract
The motivations of cancer patients in seeking complementary therapies are, fundamentally, self-healing motivations which, when engaged appropriately, can contribute to the patient's psychological and physical well being. In this paper, we apply a theoretical model, the Risk Adaptation Model, to furthering the clinical understanding of the motivations of cancer patients in seeking complementary therapies. The model identifies six discrete cognitive processes which, in combination, are hypothesized to play a central role in therapy seeking. Emphasis in this model is placed on the patient's need to maintain positive expectancies (optimism) when faced with the risk and uncertainty of cancer. This understanding of complementary-therapy seeking is grounded in the perspective that clinicians must respect the autonomy of cancer patients in their quest for appropriate therapies, and assist rather than direct their process of therapy-seeking.
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Affiliation(s)
- P Ritvo
- Division of Preventive Oncology, Cancer Care Ontario, Toronto, Ontario, Canada
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Katz R, Stephen J, Shaw BF, Matthew A, Newman F, Rosenbluth M. The East York Health Needs Study. I: Prevalence of DSM-III-R psychiatric disorder in a sample of Canadian women. Br J Psychiatry 1995; 166:100-6. [PMID: 7894856 DOI: 10.1192/bjp.166.1.100] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND This study reports the prevalence of psychiatric disorder in women from a Canadian community. The GHQ and the CES-D were compared for their utility. METHOD A thousand women over the age of 18 were mailed the GHQ and the CES-D. Our return rate was 44.4%; 24% were personally interviewed by interviews blind to screening information. The CIDI was used to establish DSM-III-R diagnoses. Four versions of the GHQ and one version of the CES-D were calibrated against the CIDI. RESULTS The prevalence of general psychiatric disorder was estimated as between 15% and 19%, anxiety disorders between 10% and 13%, and depression occurring with anxiety between 3% and 4%. The calibrated GHQ was the most reliable instrument. CONCLUSIONS Prevalence of DSM-III-R psychiatric disorder can be reliably determined with the calibrated GHQ. Anxiety disorders are most prevalent in this community, and were best detected using calibrated versions of the longer form GHQ.
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Affiliation(s)
- R Katz
- Department of Psychiatry, University of Toronto, Canada
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Abstract
Presents an evaluation of a TQM initiative which was designed to help the general level of awareness and knowledge within general practices and to encourage the implementation of TQM in primary care. The purposes of the initiative were to assess the effectiveness of the TQM approach used, not only in terms of tangible results but also in terms of cost effectiveness suitability and workability; and to check the transferability of the model used and its replicability with similar levels of benefits in other general practices on a nationwide basis.
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Affiliation(s)
- M Zairi
- Bradford University Management Centre, UK
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Abstract
Over a 2-year period, 151 outpatients with a palpable breast lump requiring needle core biopsy were randomized to a Tru-Cut 14-G (T14), Bioptycut 14-G (B14) or Bioptycut 18-G (B18) needle. Use of a Biopty gun resulted in less pain than a Tru-Cut needle. An inadequate sample was obtained after two needle passes in 11 of 49 (T14), none of 51 (B14) and two of 51 (B18) patients (chi 2 = 14.6, 2 d.f., P = 0.0007). Tissue samples were assessed by a single pathologist for tissue volume and overall diagnostic value; the B14 group scored better than the B18 and T14 for both of these parameters (P < 0.003). The sensitivities were 68 (T14), 88 (B14) and 96 (B18) per cent (overall chi 2 = 7.3, 2 d.f., P = 0.026). The Biopty gun with a 14-G needle results in a higher sampling success rate, greater diagnostic sensitivity and a better specimen quality than the Tru-Cut, and is much easier to use.
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Affiliation(s)
- A J McMahon
- Department of Surgery, Dumfries and Galloway Royal Infirmary, UK
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Abstract
The relationship of coronary artery disease to plasma lipoproteins was examined in 43 men admitted to our unit with suspected ischemic heart disease. Coronary arteriography was performed, and a score reflecting the severity of disease was assigned to the angiogram. Plasma, obtained after a 12-h overnight fast, was assayed for triglycerides, total cholesterol, high-density lipoprotein (HDL) cholesterol, and HDL-3 cholesterol. HDL-2 cholesterol was found by subtraction. The cholesterol contents of very low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) were quantitated by the Freidwald equation. Men with high coronary scores tended to be older, and subjects with moderate coronary disease had significantly higher total and LDL cholesterol values than those with minimal disease. Age was the only factor to be significantly associated with coronary score and there was no significant association between coronary score and total LDL and HDL cholesterol or its subfractions when the age factor was taken into account.
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Affiliation(s)
- J J O'Sullivan
- Department of Cardiology, Cork Regional Hospital, Wilton, Ireland
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Switonski M, Ansari HA, Matthew A, Jung HR, Stranzinger G. Synaptonemal complex analysis in primary spermatocytes of cattle x zebu hybrids (Bos taurus × Bos indicus). J Anim Breed Genet 1990. [DOI: 10.1111/j.1439-0388.1990.tb00030.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Matthew A, Duggan PF. Stability of high-density lipoprotein subfractions in stored plasma. Clin Chem 1988; 34:425-6. [PMID: 3342524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- A Matthew
- Biochem. Lab., Regional Hospital, Cork, Ireland
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Affiliation(s)
- A Matthew
- Biochem. Lab., Regional Hospital, Cork, Ireland
| | - P F Duggan
- Biochem. Lab., Regional Hospital, Cork, Ireland
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Fischer DS, Russo DW, Matthew A, Conway DF. Nurse-run "PAP" smear hospital screening. Conn Med 1977; 41:143-5. [PMID: 837684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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