André E. Lalonde

Canadian Consensus Conference on Osteoporosis, 2006 Update

OBJECTIVE To provide guidelines for the health care provider on the diagnosis and clinical management of postmenopausal osteoporosis. OUTCOMES Strategies for identifying and evaluating high-risk individuals, the use of bone mineral density (BMD) and bone turnover markers in assessing diagnosis and response to management, and recommendations regarding nutrition, physical activity, and the selection of pharmacologic therapy to prevent and manage osteoporosis. EVIDENCE MEDLINE and the Cochrane database were searched for articles in English on subjects related to osteoporosis diagnosis, prevention, and management from March 2001 to April 2005. The authors critically reviewed the evidence and developed the recommendations according to the Journal of Obstetrics and Gynaecology Canadas methodology and consensus development process. VALUES The quality of evidence is rated using the criteria described in the report of the Canadian Task Force on the Periodic Health Examination. Recommendations for practice are ranked according to the method described in this report. SPONSORS The development of this consensus guideline was supported by unrestricted educational grants from Berlex Canada Inc., Lilly Canada, Merck Frosst, Novartis, Novogen, Novo Nordisk, Proctor and Gamble, Schering Canada, and Wyeth Canada.

Canadian Consensus Conference on Menopause, 2006 Update

OBJECTIVE To provide guidelines for health care providers on the management of menopause in asymptomatic healthy women as well as in women presenting with vasomotor symptoms, urogenital, sexual, and mood and memory concerns and on specific medical considerations, and cardiovascular and cancer issues. OUTCOMES Prescription medications, complementary and alternative medicine (CAM), and lifestyle interventions are presented according to their efficacy in treating menopausal symptoms. EVIDENCE MEDLINE and the Cochrane database were searched for articles from March 2001 to April 2005 in English on subjects related to menopause, menopausal symptoms, urogenital and sexual health, mood and memory, hormone therapy, CAM, and on specific medical considerations that affect the decision of which intervention to choose. VALUES The quality of evidence is rated using the criteria described in the report of the Canadian Task Force on the Periodic Health Examination. Recommendations for practice are ranked according to the method described in this report (see Table 1). SPONSORS The development of this consensus guideline was supported by unrestricted educational grants from Berlex Canada Inc, Lilly Canada, Merck Frosst, Novartis, Novogen, Novo Nordisk, Proctor and Gamble, Schering Canada, and Wyeth Canada.

Hepburn intrusive suite: Peraluminous plutonism within a closing back-arc basin, Wopmay orogen, Canada

Within the Hepburn metamorphic-plutonic internal zone of the Wopmay orogen (Northwest Territories, Canada) there are two chronologically and petrologically distinct plutonic associations. The more voluminous of the two, the older 1.885 Ga Hepburn intrusive suite, includes rocks ranging in composition from gabbro to granite, peraluminous granite dominating. The younger 1.855 Ga neighboring Bishop intrusive suite (also gabbro to granite) represents the waning stages of a well-documented calc-alkaline arc, the Great Bear magmatic zone. The petrological distinctions between the two suites are all late-acquired features imposed primarily by contrasting environments of emplacement. Hepburn magmas were intruded within a closing, dominantly sedimentary, back-arc basin. Magma emplacement was synchronous with crustal imbrication, regional metamorphism, and translation of the basin-fill units onto Archean crust. Significant assimilation of sedimentary host rocks by the rising Hepburn magmas occurred, whereas the postregional metamorphism emplacement of the Bishop magmas precluded similar assimilation. The gabbroic contribution observed in the Hepburn intrusive suite is interpreted to reflect a mantle-derived precursor inherited from the back-arc rifting event that immediately preceded emplacement of the suite.

Accuracy of ferric/ferrous determinations in micas: A comparison of Mössbauer spectroscopy and the Pratt and Wilson wet-chemical methods

We compare ferric/ferrous determinations in mica granules and powders, as obtained by the Pratt and Wilson wet chemical (WC) methods and by Mössbauer spectroscopy (MS). The Pratt method is accurate whereas the Wilson method is not but both have the same precision (σ = 1.2 wt.% FeO). Assuming that the Pratt WC method gave accurate ferric/ferrous ratios leads to a calculated ferric/ferrous ratio of MS recoilless fractions at room temperature for a given biotite sample of f3+/f2+ = 1.009(5). Also, the Mica-Fe and Mica-Mg international standards are shown to be unsuitable, with significant size-fraction dependencies of their oxidation states. These results are discussed in the general context of evaluating accuracy and precision of WC methods by comparisons with MS and of the special problems related to accuracy and precision with MS itself.

Canadian Consensus Guidelines on Human Papillomavirus

OBJECTIVE To serve as a guideline for health care providers on the use of continuous and extended combined hormonal contraception regimens, to prevent pregnancy, and to delay menses that affect health-related quality of life. OPTIONS All combined hormonal contraceptive methods available in Canada that may be used in a continuous or extended regimen are reviewed, and the implications are discussed. OUTCOMES Efficacy of cited regimens and assessment of their side effects, patient safety, medical usage and non-contraceptive benefits, cost-effectiveness, and availability in Canada. Indications for patient counselling are also provided. EVIDENCE Medline, PubMed, and Cochrane Database were searched for articles published in English between 1977 and May 2007. Relevant publications and position papers from appropriate reproductive health and family planning organizations were also reviewed. VALUES The quality of evidence is rated using the criteria described by the Canadian Task Force on Preventive Health Care (Table 1). BENEFITS, HARMS, AND COSTS The guideline is intended to help reduce unintended pregnancies and improve health-related quality of life in women who find their menses problematic. Increased awareness and empowerment of women, their partners, and health care professionals will improve their ability to make appropriate choices between continuous or extended and cyclic usage of these regimens. SPONSORS The development of this guideline has been supported by unrestricted grants from Bayer HealthCare Pharmaceuticals, Janssen Ortho, Organon Canada Ltd., Paladin Labs Inc., Pfizer Canada Inc., and Wyeth Pharmaceuticals.Objective: To promote guidelines for health care providers on the key aspects of HPV infection and the management of HPV-related disease in the new era of vaccine availability.

DETERMINATION OF CIS AND TRANS FE2+ POPULATIONS IN 2M1 MUSCOVITE BY MOSSBAUER SPECTROSCOPY

Specimens of muscovite from Siluro-Devonian Appalachian granites of the Gander zone in New Brunswick were studied by 57Fe Mössbauer spectroscopy, microprobe analysis and X-ray powder diffractometry. Chemical compositions, corresponding structural formulae and powder patterns indicate that they are dioctahedral true micas of 2M1 polytype. Mössbauer spectroscopy shows that these muscovites fall into two groups having distinct spectra, despite an absence of systematic differences in their chemical compositions, X-ray patterns, unit-cell parameters, and Fe3+/Fetotal ratios. In the first group, two distinct and well-resolved viFe2+ spectral contributions occur whereas, in the second group, a single but broader viFe2+ contribution occurs. All spectra from both groups have viFe3+ contributions. These observations are confirmed by quadrupole splitting distribution (QSD) analyses of the spectra. Spectra from the first group clearly show a bimodal distribution of quadrupole splittings for Fe2+, with a dominant contribution at ~3.0 mm/s and a minor one at ~2.1 mm/s. In the second group, the spectra show a broad unimodal distribution of QSDs for Fe2+. We attribute the 3.0 and 2.1 mm/s QSD components to Fe2+ in cis and trans octahedral sites, respectively. Muscovites from our second group may have Fe2+ in both cis and trans sites but these cannot be resolved, as is usually the case, for example, with trioctahedral micas. In group one, cis/trans populations provide measures of the degree of cation order and of the density of vacancies on the cis sites. Simple models based on average unit cell site dimensions are found not to hold. Local effects seem to dominate, with Fe2+ showing no systematic preference for cis or trans sites.

Statement on Wait Times in Obstetrics and Gynaecology

OBJECTIVE To develop benchmarks for wait times for obstetrics and gynaecology. METHODS An expert panel reviewed the literature published from 1995 to September 30, 2007, and provided recommendations. EVIDENCE The benchmarks in this document were recommended by the SOGC ad hoc Committee on Wait Times, which includes members with expertise in obstetrics, gynaecology, urogynaecology, and gynaecologic oncology. A literature review was conducted on wait times and access to care, and existing clinical practice guidelines and standards of care documents were reviewed. This policy, developed by the SOGC ad hoc Committee on Wait Times, was adopted by the SOGC Council at its meeting on November 10, 2007. The SOGC Council includes representatives from all regions of Canada, experts from all areas of practice in obstetrics and gynaecology, family physicians, nurses, midwives, program directors, and residents, as well as a public representative. OUTCOMES Development through consensus of recommended wait times in obstetrics and gynaecology.

Upper limit of the tetrahedral rotation angle and factors affecting octahedral flattening in synthetic and natural 1M polytype C2/m space group micas

Abstract We have used recently developed quantitative crystal chemical models and a simple structural free-energy model to examine and interpret: (1) previously reported powder X-ray diffraction data for several trioctahedral mica solid solution series (64 synthetic powder samples between the Mg, Co, Ni, and Fe end-members, with different degrees of oxidation, vacancy contents, and Al/Si ratios; indexed as 1M polytype, space group C2/m; supplemented here by 57Fe Mössbauer spectroscopy to obtain accurate iron-site populations of IVFe3+, VIFe3+, and VIFe2+), and (2) 175 previously published single-crystal refinements comprising 138 natural and 37 synthetic 1M mica samples refined in space group C2/m. The crystal chemical models were validated by comparisons between predicted and measured relations between structural parameters, and needed model parameters and their uncertainties were extracted, using the single-crystal refinements. Two main results arise. First, an observed limit value of the b lattice parameter in certain synthetic solid solution series is shown to correspond to an upper limit value for the tetrahedral rotation angle α of αmax = 9.5° for AlSi3 tetrahedral sheets in K-rich micas. This upper limit is also clearly seen in the single-crystal refinement data for those Krich single-crystals that have near-AlSi3 tetrahedral compositions. We argue that the (tetrahedral sheet composition dependent) upper limit of tetrahedral rotation is an intrinsic property of the tetrahedral sheet (presumably corresponding to an intra-tetrahedral-sheet bond-bending limit) rather than arising either from interactions with the interlayer cations or from an octahedral sheet lateral-contraction limit. Second, we find that, except in the extreme cases where one approaches the lower (α = 0°) or upper (α = αmax) tetrahedral rotation limits, the magnitude of the octahedral flattening angle ψ is predominantly determined by octahedral cation stereo-chemical bonding requirements (and other intra-octahedral-sheet properties such as intra-sheet bond bending and intra-sheet electrostatic forces) rather than arising from tetrahedral-octahedral inter-sheet interactions (as generally argued or assumed). In addition, we corroborate a previously reported difference in the crystal chemical behaviors of trivalent octahedral cation (Fe3+, Al3+) and vacancy-bearing trioctahedral micas relative to samples that contain only divalent octahedral cations (e.g., Fe-Mg, Fe-Ni, Mg-Ni, and Co-Mg synthetic series); their b vs. average octahedral metal-oxygen bond-length behaviors are dramatically different, a result that is consistent with our proposed dominant stereo-chemical control of ψ.