Surveillance of laboratory exposures to human pathogens and toxins: Canada 2016.

BACKGROUND: Canada recently enacted legislation to authorize the collection of data on laboratory incidents involving a biological agent. This is done by the Public Health Agency of Canada (PHAC) as part of a comprehensive national program that protects Canadians from the health and safety risks posed by human and terrestrial animal pathogens and toxins. OBJECTIVE: To describe the first year of data on laboratory exposure incidents and/or laboratory-acquired infections in Canada since the Human Pathogens and Toxins Regulations came into effect. METHODS: Incidents that occurred between January 1 and December 31, 2016 were self-reported by federally-regulated parties across Canada using a standardized form from the Laboratory Incident Notification Canada (LINC) surveillance system. Exposure incidents were described by sector, frequency of occurrence, timeliness of reporting, number of affected persons, human pathogens and toxins involved, causes and corrective actions taken. Microsoft Excel 2010 was used for basic descriptive analyses. RESULTS: In 2016, 46 exposure incidents were reported by holders of 835 active licences in Canada representing 1,352 physical areas approved for work involving a biological agent, for an overall incidence of 3.4%. The number of incidents was highest in the academic (n=16; 34.8%) and hospital (n=12; 26.1%) sectors, while the number of reported incidents was relatively low in the private industry sector. An average of four to five incidents occurred each month; the month of September presented as an outlier with 10 incidents.​: A total of 100 people were exposed, with no reports of secondary exposure. Four incidents led to suspected (n=3) or confirmed (n=1) cases of laboratory-acquired infection. Most incidents involved pathogens classified at a risk group 2 level that were manipulated in a containment level 2 laboratory (91.3%). Over 22 different species of human pathogens and toxins were implicated, with bacteria the most frequent (34.8%), followed by viruses (26.1%). Eleven (23.9%) incidents involved a security sensitive biologic agent. Procedure breaches (n=15) and sharps-related incidents (n=14) were the most common antecedents to an exposure. In 10 (21.7%) cases, inadvertent possession (i.e., isolation of an unexpected biological agent during routine work) played a role. Possible improvements to standard operating procedures were cited in 71.7% of incidents. Improvements were also indicated for communication (26.1%) and management (23.9%). CONCLUSIONS: The Laboratory Incident Notification Canada is one of the first surveillance systems in the world to gather comprehensive data on laboratory incidents involving human pathogens and toxins. Exposure incidents reported in the first year were relatively rare, occurring in less than 4% of containment zones within laboratory settings.

Methodology of the 2009 Survey on Living with Chronic Diseases in Canada--hypertension component.

INTRODUCTION: The Survey on Living with Chronic Diseases in Canada--hypertension component (SLCDC-H) is a 20-minute cross-sectional telephone survey on hypertension diagnosis and management. Sampled from the 2008 Canadian Community Health Survey (CCHS), the SLCDC-H includes Canadians (aged ≥ 20 years) with self-reported hypertension from the ten provinces. METHODS: The questionnaire was developed by Delphi technique, externally reviewed and qualitatively tested. Statistics Canada performed sampling strategies, recruitment, data collection and processing. Proportions were weighted to represent the Canadian population, and 95% confidence intervals (CIs) were derived by bootstrap method. RESULTS: Compared with the CCHS population reporting hypertension, the SLCDC-H sample (n = 6142) is slightly younger (SLCDC-H mean age: 61.2 years, 95% CI: 60.8-61.6; CCHS mean age: 62.2 years, 95% CI: 61.8-62.5), has more post-secondary school graduates (SLCDC-H: 52.0%, 95% CI: 49.7%-54.2%; CCHS: 47.5%, 95% CI: 46.1%-48.9%) and has fewer respondents on hypertension medication (SLCDC-H: 82.5%, 95% CI: 80.9%-84.1%; CCHS: 88.6%, 95% CI: 87.7%-89.6%). CONCLUSION: Overall, the 2009 SLCDC-H represents its source population and provides novel, comprehensive data on the diagnosis and management of hypertension. The survey has been adapted to other chronic conditions--diabetes, asthma/chronic obstructive pulmonary disease and neurological conditions. The questionnaire is available on the Statistics Canada website; descriptive results have been disseminated by the Public Health Agency of Canada.

TITRE: Méthodologie de l'Enquête sur les personnes ayant une maladie chronique au Canada ­ composante de l'hypertension de 2009. INTRODUCTION: L'Enquête sur les personnes ayant une maladie chronique au Canada ­ composante de l'hypertension (EPMCC-H) est une enquête téléphonique transversale de 20 minutes sur le diagnostic et la prise en charge de l'hypertension. L'échantillon de l'EPMCC-H, sélectionné à partir des répondants à l'Enquête sur la santé dans les collectivités canadiennes (ESCC) de 2008, était composé de Canadiens (de 20 ans et plus) des dix provinces ayant déclaré avoir reçu un diagnostic d'hypertension. MÉTHODOLOGIE: Le questionnaire a été élaboré au moyen de la technique Delphi et a fait l'objet d'un examen externe ainsi que de tests qualitatifs. Statistique Canada s'est chargé des stratégies d'échantillonnage, du recrutement, de la collecte et du traitement des données. Les proportions ont été pondérées afin de représenter la population canadienne et les intervalles de confiance (IC) à 95 % ont été calculés au moyen de la méthode de rééchantillonnage bootstrap. RÉSULTATS: Si on le compare à la population de l'ESCC ayant déclaré souffrir d'hypertension, l'échantillon de l'EPMCC-H (n = 6 142) est légèrement plus jeune (âge moyen des répondants à l'EPMCC-H : 61,2 ans, IC à 95 % : 60,8 à 61,6; âge moyen des répondants à l'ESCC : 62,2 ans, IC à 95 % : 61,8 à 62,5), comporte plus de détenteurs d'un diplôme d'études postsecondaires (EPMCC-H : 52,0 %, IC à 95 %: 49,7 % à 54,2 %; ESCC : 47,5 %, IC à 95 % : 46,1 % à 48,9 %) et moins de répondants prenant un médicament pour l'hypertension (EPMCC-H : 82,5 %, IC à 95 % : 80,9 % à 84,1 %; ESCC : 88,6 %, IC à 95 % : 87,7 % à 89,6 %). CONCLUSION: Dans l'ensemble, l'EPMCC-H de 2009 est représentatif de sa population source et fournit des données nouvelles et exhaustives sur le diagnostic et la prise en charge de l'hypertension. L'enquête a été adaptée à d'autres maladies chroniques ­ diabète, asthme/maladie pulmonaire obstructive chronique et troubles neurologiques. Le questionnaire est accessible à partir du site Web de Statistique Canada; des résultats descriptifs ont été publiés par l'Agence de la santé publique du Canada.

Report summary. Diabetes in Canada: facts and figures from a public health perspective.

"Diabetes in Canada: facts and figures from a public health perspective" is the first comprehensive diabetes surveillance report published by the Public Health Agency of Canada. The report aims to support public health professionals and organizations in developing effective, evidence-based public health policies and programs to prevent and manage diabetes and its complications. The report, developed in collaboration with provincial and territorial governments, the Canadian Diabetes Association, Juvenile Diabetes Research Foundation, CNIB, Health Canada and the academic community, uses data from national health surveys and vital statistics, as well as population-based administrative data from the Canadian Chronic Disease Surveillance System (CCDSS). For the first time, the CCDSS contains data from all 13 Canadian jurisdictions. Using CCDSS data representing cases of diagnosed diabetes among Canadians aged one year and older, Diabetes in Canada presents prevalence and incidence national rates from the fiscal year 2008/2009 and national trends from 1998/1999 onwards. The report also outlines sub-populations at higher risk, ways of reducing the risks of developing the disease and its complications, and estimates of related economic costs. In addition, it contains sections on specific populations, including children and youth and First Nations, Inuit and Métis populations.

Perception of uncontrolled blood pressure and behaviours to improve blood pressure: findings from the 2009 Survey on Living with Chronic Diseases in Canada.

Individuals with hypertension should lower and maintain their blood pressure levels through lifestyle modification and/or pharmacotherapy. To determine whether perception of blood pressure control is related to behaviours and intentions for improving blood pressure, data from 6142 Canadians age 20+ years with self-reported hypertension were analysed. Relationships between perception of control, current behaviours for blood pressure control and intentions to improve these behaviours were examined. Although individuals who reported uncontrolled blood pressure were equally likely to report engaging in lifestyle behaviours for blood pressure control, they were more likely to indicate an intention to improve their health, compared with those who reported well-controlled/low blood pressure. These individuals were also less likely to report having enough information to control their blood pressure. In addition, they were less likely to report having been advised to take antihypertensive medication, and to be taking and adhering to medications. Individuals who perceive their blood pressure as uncontrolled have intentions to make health-enhancing changes but may lack the information to do so. The study highlights the potential need for programmes/services to help those with uncontrolled blood pressure make lifestyle changes and/or take appropriate medication.

[Sonographic control of wound healing after caesarean section in cattle]. / Sonographische Verlaufskontrolle der Wundheilung nach Sectio caesarea beim Rind.

In this study, the use of transcutaneous ultrasonography for the post-operative control of wound healing after caesarean section in cattle was investigated. In 20 cows, admitted to our clinic because of dystocia, a caesarean section was performed via the left flank. Post-operatively, the laparotomy wound was checked with a 5.0 and a 7.5 MHz linear probe every three days until the animal was discharged. In 10 animals, accumulation of fluid was detected ultrasonographically before fluctuation could be palpated in the peri-incision area. The fluid was aspirated after punctuation of the skin and was submitted for microbiological analysis. In 5 cases, sterile haemato-seromas were diagnosed and resorption of the process was followed by repeated ultrasonographic examination. In 5 animals, bacteria could be cultured and in 4 of these cases, development of an abscess was detected with repeated ultrasonography. In one cow, an infected heamatoma was found which remained unchanged, both ultrasonographically and clinically until the animal was discharged. In conclusion, ultrasonography does add important findings to the clinical evaluation of the laparotomy wound after caesarean section and can be used for early diagnosis of a disturbed healing process.

[Sex-specific changes in body composition during weight reduction]. / Geschlechtsspezifische Anderung der Körperzusammensetzung bei Gewichtsreduktion.

The aim of this study was to ascertain whether overweight men and women of comparable age, body surface area and weight would display any differences in weight loss or changes in body composition while receiving identical calorie intakes. 15 men and 15 women of mean age 46.7 (26-57) years with obesity (body mass index 29-36 kg/m2) were given a reducing diet containing 700 kcal/d for 4 weeks. The two groups were identical in age, body weight and height. The change in body composition was studied by means of ultrasound and nitrogen balance. The women had thicker layers of subcutaneous fat (241 +/- 8 mm) over all parts of the body than the men (137 +/- 10 mm) (summated measurements at 14 points). Among the men body weight fell from 93.1 +/- 2.1 to 83.8 +/- 2.0 kg, but the women declined only from 92.9 +/- 2.0 to 84.7 +/- 1.9 kg. Although men achieved a greater weight loss (13%; P less than 0.001) the decrease in their subcutaneous fat layer was 33% less (to 117 +/- 9 mm) than in the women (211 +/- 8 mm). Cumulative nitrogen balance among the men was 4.7 times more negative than in women (-104 +/- 14 g versus -22 +/- 11 g); this points to accentuated muscle breakdown. More fat was mobilized in the women than in the men, chiefly from the regions of the limbs and hips.

Loss and restoration of preoptic thermoreactiveness after lesions of the rostral raphe nuclei.

Preoptic neurons, extracellularly recorded in the rat's brain, were tested for their responses to thermal stimulation of the scrotal and abdominal skin before and after electrolytic lesions of about 1 mm3 in the area of the rostral raphe nuclei, nucleus raphe dorsalis and centralis (NRD/NRC). All analyzed neurons were of the switching type, i.e. they changed their firing rates to a higher or lower level when a threshold of the peripheral stimulation temperature was exceeded. When major parts of NRD or NRC were destroyed, the preoptic neurons no longer changed their firing rates after thermal stimulation, whereas transmission of noxious information in most cases was not impeded. Smaller lesions in NRD or NRC did not abolish the responses, but brought about essentially modified responses compared to those before the lesions. Lesions lateral to NRD or NRC had no effect. If the lesions were effective and the neurons could be observed for a longer period after the lesions, the response was restored in many cases. As the noxious response had often not been abolished and the lateral lesions were without any effect, it might be that the lesion effects and the restoration of responses involve short-term plasticity. However, temporary block of input to the neurons by unspecific effects cannot be excluded.

The significance of nucleus raphe dorsalis and centralis for thermoafferent signal transmission to the preoptic area of the rat.

Neuronal spike-trains were recorded extracellularly within the preoptic area, which is generally considered the center of information processing for thermoregulation. The neuronal responses were tested by thermal stimulation of the scrotal and abdominal skin of the rat. After a neuron had been identified as warm responsive, electrical stimulation and/or lesion were applied in medial midbrain to test the influence on the preoptic neurons. Post-stimulus-histograms were determined by using 600 single shocks. Furthermore a small area of the medial midbrain was electrolytically lesioned and the thermal response of the neuron was tested again. All lesion, stimulation and recording sites were examined histologically. Electrical stimulation of either nucleus raphe dorsalis or centralis influenced the responsiveness of the recorded preoptic neurons. The post-stimulus-histograms predominantly reveal polysynaptic ascending pathways. Lesion of either nucleus raphe dorsalis or centralis abolished the responsiveness of the recorded preoptic neurons. Lesions lateral to these nuclei were ineffective. By this it is concluded that both nucleus raphe dorsalis and centralis are essentially involved in the thermal signal transmission to the preoptic area.