Yvan St-Pierre

Inadvertent exposures in children with peanut allergy

To cite this article: Nguyen‐Luu NU, Ben‐Shoshan M, Alizadehfar R, Joseph L, Harada L, Allen M, St‐Pierre Y, Clarke A. Inadvertent exposures in children with peanut allergy. Pediatr Allergy Immunol 2011: Doi: 10.1111/j.1399‐3038.2011.01235.x

Counterbalancing Patient Demands With Evidence: Results From a Pan-Canadian Randomized Clinical Trial of Brief Supportive-Expressive Group Psychotherapy for Women With Systemic Lupus Erythematosus

Objective: To evaluate the effect of Brief Supportive-Expressive Group Psychotherapy as an adjunct to standard medical care in reducing psychological distress, medical symptoms, and health care costs and improving quality of life in women with systemic lupus erythematosus (SLE). Methods: A randomized clinical trial was conducted with 133 SLE female patients from 9 clinics across Canada. Clinical and psychosocial measures were taken at baseline, posttreatment, and 6 and 12 months posttreatment. Outcomes assessed were psychological distress, quality of life, disease activity, health service utilization, and diminished productivity. Results: Intention-to-treat analyses revealed that there were no clinically important group differences on any of the outcome measures. Conclusion: Although both groups improved over time on several measures (e.g., decreases in psychological distress, stress, and emotion-oriented coping), these changes could not be attributed to the psychotherapeutic intervention. Thus, evidence does not support the referral of these patients to this type of intervention.

A majority of parents of children with peanut allergy fear using the epinephrine auto-injector

Prompt epinephrine administration is crucial in managing anaphylaxis, but epinephrine auto‐injectors (EAIs) are underutilized by patients and their families. Children with peanut allergy were recruited from the Allergy Clinics at the Montreal Childrens Hospital, food allergy advocacy organizations and organizations providing products to allergic individuals. Parents of children who had been prescribed an EAI were queried on whether they were fearful of using it and on factors that may contribute to fear. A majority of parents (672/1209 = 56%) expressed fear regarding the use of the EAI. Parents attributed the fear to hurting the child, using the EAI incorrectly or a bad outcome. Parents whose child had longer disease duration or a severe reaction and parents who were satisfied with the EAI training or found it easy to use were less likely to be afraid. Families may benefit from simulation training and more education on the recognition and management of anaphylaxis.

Cigarette smoking and cutaneous damage in systemic lupus erythematosus.

Objective. To evaluate the association between cigarette smoking and cutaneous damage in systemic lupus erythematosus (SLE). Methods. Our study was performed in SLE clinic registry cohort patients, all of whom fulfilled revised American College of Rheumatology criteria for SLE; patients are followed prospectively with annual assessments that include collection of demographic variables, smoking history, disease activity (SLE Disease Activity Index version 2000, SLEDAI-2K), medications, and damage scores (Systemic Lupus International Collaborating Clinics/ACR Damage Index). Cumulative cutaneous damage scores were used for the primary analyses. Logistic and logit regression models were performed to examine potential associations between current smoking and cutaneous damage, controlling for age, sex, race, lupus disease duration, antimalarial or immunosuppressant use, and anti-DNA and anti-SSA antibody status. Results. Of our sample (N = 276), 92% were women and 73.7% were Caucasian; the mean age was 45.1 years, mean disease duration 13.5 years, and 17.5% were current smokers. In the regression analyses, current cigarette smoking was associated with total cutaneous damage (OR 2.73, 95% CI 1.10, 6.81) and with scarring (OR 4.70, 95 CI 1.04, 21.2). In additional analyses, current smoking was also associated with active lupus rash (OR 6.18, 95% CI 1.63, 23.3). Conclusions. Current cigarette smoking may be associated with cutaneous damage and active lupus rash in SLE, suggesting another reason to emphasize smoking cessation in patients with SLE.

Healthcare Cost and Loss of Productivity in a Canadian Population of Patients with and without Lupus Nephritis

Objective. To compare the healthcare cost and loss of productivity in patients with systemic lupus erythematosus (SLE) with (LN) and without lupus nephritis (lupus nephritis-negative, LNN). Method. Patients were classified into those with active (ALN and ALNN) and inactive disease (ILN and ILNN). Patients reported on visits to healthcare professionals and use of diagnostic tests, medications, assistive devices, alternative treatments, hospital emergency visits, surgical procedures, and hospitalizations as well as loss of productivity in the 4 weeks preceding enrollment. Results. Enrollment was 141 patients, 79 with LN and 62 LNN. Patients with LN were more likely to visit rheumatologists and nephrologists, undergo diagnostic tests, and had higher costs for medications than patients who were LNN. The annual healthcare cost averaged

A population-based assessment of live births in women with systemic lupus erythematosus

CAN 12,597 ± 9946 for patients with LN and

The use of incentives in vulnerable populations for a telephone survey: a randomized controlled trial

10,585 ± 13,149 for patients who were LNN, a difference of

Management of anaphylaxis in schools: Evaluation of an epinephrine auto-injector (EpiPen®) use by school personnel and comparison of two approaches of soliciting participation

2012 (95% CI –

Timing of total joint replacement affects clinical outcomes among patients with osteoarthritis of the hip or knee.

2075,

What is the impact of adolescent arthritis and rheumatism? Evidence from a national sample of Canadians.

6100). Patients with ALN had more diagnostic tests and surgical procedures, contributing to a significantly higher annual direct cost (