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Tyler J OʼNeill, Janet M Raboud, Jill Tinmouth, Sean B Rourke, Sergio Rueda, Trevor A Hart, Curtis Cooper, Anita Rachlis, Ann N Burchell
BACKGROUND: The prevalence of self-reported gastrointestinal (GI) symptoms and distress is high, but few studies have quantified their impact on health-related quality of life (HRQoL). METHODS: We conducted a prospective cohort study of patients with HIV in care in Ontario, Canada (2007-2014). General linear mixed models were used to assess the impact of GI symptoms (diarrhea/soft stool, nausea/vomiting, bloating/painful abdomen, loss of appetite, weight loss/wasting) and distress (range: 0-4) on physical and mental HRQoL summary scores (range: 0-100) measured by the Medical Outcomes Survey SF-36...
May 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Leonard K Seibold, Peter E DeWitt, Miranda E Kroehl, Malik Y Kahook
PURPOSE: To determine the 24-h effects of brinzolamide/brimonidine tartrate 1%/0.2% fixed combination (BBFC) on intraocular pressure (IOP), ocular perfusion pressure (OPP), blood pressure (BP), and heart rate (HR). METHODS: Sixty subjects with open angle glaucoma (OAG) or ocular hypertension (OHTN) were admitted overnight for 24-h monitoring of IOP, BP, and HR. All subjects underwent the first, baseline 24-h study after washout of all medications, if necessary. Subjects were then randomized to receive either (1) timolol maleate 0...
April 2017: Journal of Ocular Pharmacology and Therapeutics
Beth Rachlis, Ann N Burchell, Sandra Gardner, Lucia Light, Janet Raboud, Tony Antoniou, Jean Bacon, Anita Benoit, Curtis Cooper, Claire Kendall, Mona Loutfy, Wendy Wobeser, Frank McGee, Anita Rachlis, Sean B Rourke
Continuous HIV care supports antiretroviral therapy initiation and adherence, and prolongs survival. We investigated the association of social determinants of health (SDH) and subsequent retention in HIV care in a clinical cohort in Ontario, Canada. The Ontario HIV Treatment Network Cohort Study is a multi-site cohort of patients at 10 HIV clinics. Data were collected from medical charts, interviews, and via record linkage with the provincial public health laboratory for viral load tests. For participants interviewed in 2009, we used three-category multinomial logistic regression to identify predictors of retention in 2010-2012, defined as (1) continuous care (≥2 viral loads ≥90 days in all years; reference category); (2) discontinuous care (only 1 viral load/year in ≥1 year); and (3) a gap in care (≥1 year in 2010-2012 with no viral load)...
December 27, 2016: AIDS Care
Samantha Robinson, Sandra Gardner, Mona Loutfy, Lucia Light, Wangari Tharao, Sean B Rourke, Ann N Burchell
Understanding the sexual activities and partnerships of women living with human immunodeficiency virus (HIV) remains important to promote healthy sexuality and to reduce the transmission of HIV and other sexually transmitted infections. We described sexual behaviors of women living with HIV enrolled in an ongoing study in Ontario, Canada. Data were available from 582 women who self-completed a sexual behavior questionnaire between 2010 and 2012. Nearly half (46.1%) of women reported a sexual partner in the preceding three months; women less likely to be sexually active were older, Black/African, separated, divorced, widowed, single, and unemployed...
May 2017: AIDS Care
Tyler J O'Neill, Janet M Raboud, Jill Tinmouth, Sean B Rourke, Sandra Gardner, Curtis Cooper, Sergio Rueda, Trevor A Hart, Anita Rachlis, Ann N Burchell
In the modern antiretroviral (ARV) era, there is limited knowledge about the prevalence and risk factors for HIV patient-reported gastrointestinal (GI) symptoms (diarrhoea/soft stool, nausea/vomiting, bloating/painful abdomen, loss of appetite, and weight loss/wasting) and distress. We prospectively analysed data (2007-2014) on distressing GI symptoms from the Ontario HIV Treatment Network Cohort Study, which follows people attending HIV clinics. Using generalized estimating equations with a logit link, we estimated the associations of psychosocial, demographic, behavioural, and clinical factors with each GI symptoms compared to asymptomatic and non-bothersome symptoms...
February 2017: AIDS Care
Stephanie K Y Choi, Eleanor Boyle, John Cairney, Sandra Gardner, Evan J Collins, Jean Bacon, Sean B Rourke
BACKGROUND: Major depression can profoundly impact clinical and quality-of-life outcomes of people living with HIV, and this disease is underdiagnosed and undertreated in many HIV-positive individuals. Here, we describe the prevalence of publicly funded primary and secondary mental health service use and antidepressant use, as well as mental health care for depression in accordance with existing Canadian guidelines for HIV-positive patients with depression in Ontario, Canada. METHODS: We conducted a prospective cohort study linking data from the Ontario HIV Treatment Network Cohort Study with administrative health databases in the province of Ontario, Canada...
2016: PloS One
Ramandip Grewal, Vanessa G Allen, Sandra Gardner, Veronika Moravan, Darrell H S Tan, Janet Raboud, Ahmed M Bayoumi, Rupert Kaul, Tony Mazzulli, Frank McGee, Sean B Rourke, Ann N Burchell
OBJECTIVES: Rates of chlamydia and gonorrhoea have been rising in urban centres in Canada, particularly among HIV-positive men who have sex with men (MSM). Our objective was to identify behavioural risk factors for diagnosis with chlamydia and gonorrhoea in this population, with a focus on the HIV status of sexual partners. METHODS: The OHTN Cohort Study follows people in HIV care across Ontario. We restricted the analysis to 1997 MSM who completed questionnaires in 2010-2013 at one of seven clinics that submit all chlamydia and gonorrhoea tests to the provincial public health laboratory; we obtained test results via record linkage...
February 2017: Sexually Transmitted Infections
Jill M Wecht, Joseph P Weir, Stephanie Martinez, Mastanna Eraifej, William A Bauman
PURPOSE: Abnormal blood pressure (BP) response to orthostatic maneuvers may predict adverse health outcomes. Orthostatic hypotension (OH) is defined as a fall in BP of ≥20/10 mmHg, and orthostatic hypertension (OHTN) is defined as an increase in systolic BP (SBP) of ≥20 mmHg, with standing. Herein, we document the prevalence of OH and OHTN in American veterans. METHODS: The influence of demographic characteristics, life habits, co-incident medical conditions, and prescription medication use on these prevalence rates and associations between abnormal orthostatic BP responses and severity of self-reported symptoms of fatigue, dizziness, trouble concentrating, and head and neck discomfort were determined...
February 2016: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Stephanie K Y Choi, Eleanor Boyle, Ann N Burchell, Sandra Gardner, Evan Collins, Paul Grootendorst, Sean B Rourke
OBJECTIVE: Major depression affects up to half of people living with HIV. However, among HIV-positive patients, depression goes unrecognized 60-70% of the time in non-psychiatric settings. We sought to evaluate three screening instruments and their short forms to facilitate the recognition of current depression in HIV-positive patients attending HIV specialty care clinics in Ontario. METHODS: A multi-centre validation study was conducted in Ontario to examine the validity and accuracy of three instruments (the Center for Epidemiologic Depression Scale [CESD20], the Kessler Psychological Distress Scale [K10], and the Patient Health Questionnaire depression scale [PHQ9]) and their short forms (CESD10, K6, and PHQ2) in diagnosing current major depression among 190 HIV-positive patients in Ontario...
2015: PloS One
Bláithín Ní Bhuachalla, Christine A McGarrigle, Kwadwo Owusu Akuffo, Tunde Peto, Stephen Beatty, Rose Anne Kenny
BACKGROUND: Manifestations of neurocardiovascular instability (NCVI), including orthostatic hypotension (OH) orthostatic hypertension (OHTN) and impaired blood pressure variability (BPV), have been associated with cardiovascular (CV) events. The eye is highly vascular and we propose an ideal target end organ to investigate pathological implications of NCVI. OBJECTIVE: To identify and define clinically applicable phenotypes of orthostatic blood pressure (BP) behaviour, analogous to OH, OHTN, and orthostatic BPV and to investigate their relationship to vision...
December 2015: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Ann N Burchell, Vanessa G Allen, Sandra L Gardner, Veronika Moravan, Darrell H S Tan, Ramandip Grewal, Janet Raboud, Ahmed M Bayoumi, Rupert Kaul, Tony Mazzulli, Frank McGee, Sean B Rourke
BACKGROUND: The re-emergence of syphilis among HIV-positive gay and other men who have sex with men (MSM) requires vigilance. We estimated incidence of and risk factors for first and subsequent syphilis diagnoses among MSM in HIV care in Ontario, Canada. METHODS: We analyzed data from 2,280 MSM under follow-up from 2006 to 2010 in the Ontario HIV Treatment Network Cohort Study (OCS), a multi-site clinical cohort. We obtained syphilis serology results via record linkage with the provincial public health laboratory...
2015: BMC Infectious Diseases
Denise Jaworsky, Anita Benoit, Janet Raboud, Doe O'Brien-Teengs, Sandra Blitz, Sean B Rourke, Ann N Burchell, Mona R Loutfy
Complex historical and cultural factors have contributed to the HIV epidemic among Aboriginal populations in Canada. This study assesses social supports, adaptive and maladaptive coping mechanisms, stress, and mastery of Canadian-born Aboriginal and Canadian-born Caucasian people living with HIV in Ontario and posits that coping and social support are important micro- and meso-level factors associated with the epidemic. This cross-sectional analysis included questionnaire data collected from 2007 to 2011 at HIV clinics in Toronto...
2016: AIDS Care
Ling Shen, Ronald B Melles, Ravikanth Metlapally, Lisa Barcellos, Catherine Schaefer, Neil Risch, Lisa J Herrinton, Christine Wildsoet, Eric Jorgenson
PURPOSE: To evaluate the association between refractive error and the prevalence of glaucoma by race or ethnicity. DESIGN: Cross-sectional study. PARTICIPANTS: Kaiser Permanente Northern California Health Plan members with refractive error measured at 35 years of age or older between 2008 and 2014 and with no history of cataract surgery, refractive surgery, or a corneal disorder. METHODS: We identified 34 040 members with glaucoma or ocular hypertension (OHTN; cases) and 403 398 members without glaucoma (controls)...
January 2016: Ophthalmology
Nazlee Zebardast, Jason F Solus, Harry A Quigley, Divya Srikumaran, Pradeep Y Ramulu
BACKGROUND: Previous studies suggest there are large variations in adherence of ophthalmologists with the American Academy of Ophthalmology's Preferred Practice Patterns (PPPs). The purpose of this study was to compare rates of compliance with glaucoma care guidelines between resident and glaucoma faculty physicians at a single institution. METHODS: Charts of resident continuity clinic or glaucoma faculty patients with primary open angle glaucoma (POAG), ocular hypertension (OHTN), or suspicion of glaucoma were reviewed during the 2005-6 academic year...
2015: BMC Ophthalmology
Ann N Burchell, Ramandip Grewal, Vanessa G Allen, Sandra L Gardner, Veronika Moravan, Ahmed M Bayoumi, Rupert Kaul, Frank McGee, Margaret Peggy E Millson, Robert S Remis, Janet Raboud, Tony Mazzulli, Sean B Rourke
OBJECTIVES: We described patterns of testing for chlamydia and gonorrhoea infection among persons in specialty HIV care in Ontario, Canada, from 2008 to 2011. METHODS: We analysed data from 3165 participants in the OHTN Cohort Study attending one of seven specialty HIV care clinics. We obtained chlamydia and gonorrhoea test results via record linkage with the provincial public health laboratory. We estimated the proportion of participants who underwent testing annually, the positivity rate among those tested and the proportion diagnosed with chlamydia or gonorrhoea among all under observation...
December 2014: Sexually Transmitted Infections
Kinda Aljassem, Janet M Raboud, Trevor A Hart, Anita Benoit, DeSheng Su, Shari L Margolese, Sean B Rourke, Sergio Rueda, Ann Burchell, John Cairney, Paul Shuper, Mona R Loutfy
This study investigates the differences in severity and correlates of depression symptoms among 1069 men and 267 women living with HIV in Ontario, Canada, who completed the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). Women had higher CES-D scores than that of men (median [interquartile range]: 13 [5-26] versus 9 [3-20], P=.0004). More women had total CES-D scores>15 (mild-moderate depression; 44% versus 33%, P=.002) and >21 (severe depression; 31% versus 23%, P=.003). Unlike men, at age 40, women's scores increased yearly (0...
January 2016: Journal of the International Association of Providers of AIDS Care
Jennifer Gillis, Marek Smieja, Angela Cescon, Sean B Rourke, Ann N Burchell, Curtis Cooper, Janet M Raboud
BACKGROUND: The increased risk for cardiovascular disease (CVD) in HIV is well established. Despite high prevalence of viral hepatitis coinfection with HIV, there are few studies on the risk of CVD amongst antiretroviral therapy (ART)-treated coinfected patients. METHODS: Ontario HIV Treatment Network Cohort Study participants who initiated ART without prior CVD events were analysed. HBV and HCV coinfection were identified by serology and RNA test results. CVD was defined as any of: coronary artery disease including atherosclerosis, chronic ischaemic heart disease and arteriosclerotic vascular disease; myocardial infarction; congestive heart failure; cerebrovascular accident or stroke; coronary bypass; angioplasty; and sudden cardiac death...
2014: Antiviral Therapy
Denise Jaworsky, Laverne Monette, Janet Raboud, Doe O'Brien-Teengs, Christina Diong, Sandra Blitz, Sean B Rourke, Mona R Loutfy
BACKGROUND: Studies have found that Aboriginal people living with HIV/AIDS (APHAs) are more likely than non-APHAs to receive suboptimal HIV care, yet achieve similar clinical outcomes with proper care. OBJECTIVE: To compare the proportions of individuals diagnosed late with HIV between APHAs and non-APHAs within the Ontario HIV Treatment Network Cohort Study (OCS). METHODS: The analysis included OCS participants who completed the baseline visit by November 2009...
2012: Canadian Journal of Infectious Diseases & Medical Microbiology
Anita C Benoit, Lucia Light, Ann N Burchell, Sandra Gardner, Sean B Rourke, Wendy Wobeser, Mona R Loutfy
The concept of psychological distress includes a range of emotional states with symptoms of depression and anxiety and has yet to be reported in HIV-positive women living in Ontario, Canada, who are known to live with contributing factors. This study aimed to determine the prevalence, severity, and correlates of psychological distress among women accessing HIV care participating in the Ontario HIV Treatment Network Cohort Study using the Kessler Psychological Distress Scale (K10). The K10 is a 10-item, five-level response scale...
2014: AIDS Care
Ann N Burchell, Vanessa G Allen, Veronika Moravan, Sandra Gardner, Janet Raboud, Darrell H S Tan, Ahmed M Bayoumi, Rupert Kaul, Tony Mazzulli, Frank McGee, Peggy Millson, Robert S Remis, Sean B Rourke
BACKGROUND: Since 2000, reported syphilis cases increased ten-fold in Canada, particularly among men who have sex with men (MSM) co-infected with HIV. We characterized temporal patterns of of syphilis testing in a large cohort of HIV patients in Ontario, Canada. METHODS: We analyzed data from a multi-site cohort of people in HIV care from 2000 to 2009. Data were obtained from medical charts, interviews and record linkage with the syphilis test database at the Public Health Ontario Laboratories...
2013: BMC Infectious Diseases
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