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Classical dogma holds that epistaxis is more common in winter months but there is significant variability reported in the literature. No study has yet examined the effect of season, humidity and temperature on epistaxis in a location with as severe weather extremes as seen in Alberta, Canada. The objective of the study is to evaluate for an effect of these meteorological factors on the incidence of epistaxis in Alberta. Method A retrospective review of consecutive adult patients presenting to the Emergency room (ER) in Edmonton and Calgary, Alberta over a three-year period was performed. Daily temperature and humidity data was recorded from the respective airports. Statistical analysis with Pearson's correlation coefficient was performed. Results 4315 patients presented during the study period. Mean daily temperatures ranged from a low of -40°C to a high of +23°C. A significant negative correlation was found for mean monthly temperature with epistaxis (Pearson's r = -0.835, p = 0.001). A significant correlation was also present for daily temperature and epistaxis presentation (Pearson's r = -0.55, p = 0.018, range 1.8 to 2.2 events/day). No correlation was identified with humidity and no significant seasonal variation was present. Conclusions A negative correlation was found to exist for both daily and mean monthly temperature with rates of epistaxis. A seasonal variation was seen in Edmonton but not in Calgary. No correlation was found for humidity when compared to both presentation rates and admissions. [ABSTRACT FROM AUTHOR]

Background Many published epidemiologic studies confirm a marked increase in the prevalence of asthma and allergic rhinitis. The link between allergic rhinitis and asthma has been extensively studied and approximately 75% of patients with asthma have allergic rhinitis. The proportion of patients with asthma in populations of allergic rhinitis patients has not been well studied. Objective The purpose of this study is to estimate the prevalence of undiagnosed asthma in a specific population of patients presenting to an Otolaryngologist with symptoms of allergic rhinitis. Study design Prospective cohort study Methods: Patients presenting with symptoms of allergic rhinitis to two tertiary care Rhinology practices in Northern Alberta were asked to undergo allergy skin testing, serum IgE quantification, and pulmonary functional testing. Patients with previous asthma screening or known history of reactive airway disease or asthma were excluded. Results 107 patients with allergic rhinitis symptoms were recruited between September 2010 to January 2013. Patients predominantly had perennial or persistent rhinitis (64.5%) with moderate-severe symptoms (50.5%). While only 14.9% of patients had abnormal IgE levels, 68.8% had positive skin testing. Abnormal pulmonary function tests were obtained in 35.1% of patients and 24.5% of patients were diagnosed with asthma. Conclusions There is a high prevalence of undiagnosed asthma in patients presenting to tertiary Rhinology care with moderate to severe allergic rhinitis symptoms. Screening lung function testing should be considered in this patient population. [ABSTRACT FROM AUTHOR]

Background: Comprehensive School Health (CSH) is an internationally recognized framework that holistically addresses school health by transforming the school culture. It has been shown to be effective in enhancing health behaviours among students while also improving educational outcomes. Despite this effectiveness, there is a need to focus on how CSH is implemented. Previous studies have attempted to uncover the conditions necessary for successful operationalization, but none have described them in relation to a proven best practice model of implementation that has demonstrated positive changes to school culture and improvements in health behaviours.Methods: The purpose of this research was to identify the essential conditions of CSH implementation utilizing secondary analysis of qualitative interview data, incorporating a multitude of stakeholder perspectives. This included inductive content analysis of teacher (n = 45), principal (n = 46), and school health facilitator (n = 34) viewpoints, all of whom were employed within successful CSH project schools in Alberta, Canada between 2008 and 2013.Results: Many themes were identified, here called conditions, that were divided into two categories: 'core conditions' (students as change agents, school-specific autonomy, demonstrated administrative leadership, dedicated champion to engage school staff, community support, evidence, professional development) and 'contextual conditions' (time, funding and project supports, readiness and prior community connectivity). Core conditions were defined as those conditions necessary for CSH to be successfully implemented, whereas contextual conditions had a great degree of influence on the ability for the core conditions to be obtained. Together, and in consideration of already established 'process conditions' developed by APPLE Schools (assess, vision, prioritize; develop and implement an action plan; monitor, evaluate, celebrate), these represent the essential conditions of successful CSH implementation.Conclusions: Overall, the present research contributes to the evidence-base of CSH implementation, ultimately helping to shape its optimization by providing school communities with a set of understandable essential conditions for CSH implementation. Such research is important as it helps to support and bolster the CSH framework that has been shown to improve the education, health, and well-being of school-aged children. [ABSTRACT FROM AUTHOR]

Purpose: Steroids, inhaled and systemic, are used to treat airway inflammation in patients with asthma; however, steroids are recognized to cause a number of side effects, including osteoporosis. We evaluated the prevalence of osteopenia/osteoporosis in patients with moderate-severe asthma managed through the Edmonton Regional Severe Asthma Centre., Methods: We performed a retrospective chart review and analyzed 57 charts on patients with moderate-severe asthma followed through the specialty clinic, and recorded their bone mineral density (BMD). Steroid use was reviewed and the frequency of osteopenia/osteoporosis was compared in patients requiring continuous systemic steroids (Group 1, n=15), intermittent systemic steroids (Group 2, n=15) or inhaled steroids only (Group 3, n=27)., Results: The mean age (mean±SD) was 50±14.8 years. Cumulative systemic steroid dose of prednisone equivalent was higher in Group 1 (12.5 mg/day) than Group 2 (3.2 mg/day) (p=0.002). The frequency of osteopenia / osteoporosis was not significantly different between patients in Group 1(67%) and Group 2 (53%, p=0.46) but was significantly greater in patients from Group 1 in comparison with Group 3 (33%, p=0.038)., Conclusion: Patients with moderate-severe asthma have a high prevalence of reduced bone density. Many patients treated with intermittent systemic steroids for exacerbations, or who were stable on inhaled steroids, had either osteopenia or osteoporosis before the age of 50. National and international osteoporosis guidelines should emphasize earlier screening for asthma patients; and increase awareness of the detrimental effects of short-term systemic steroids and inhaled steroids on BMD, especially when started at an early age and in northern climates.

Objective: To identify the common non-otolaryngological diagnoses (N-OD) encountered by a pediatric otolaryngologist in surgical patients. This information may help in educating otolaryngologists on relevant pediatric conditions among their patients., Design/setting: Cross-sectional, retrospective database review of entries from 2006 to 2008 at a tertiary pediatric centre involving the patient case load of a busy pediatric otolaryngologist., Main Outcome Measures: The main outcome of this study was to identify the common (N-OD) encountered by a pediatric otolaryngologist. Conditions excluded from the analysis were surgical complications and diagnoses managed primarily by otolaryngologists (sleep disordered breathing and allergic rhinitis)., Results: 1357 pediatric surgical entries were identified. Of these, 524 (38.6%) entries contained N-OD and underwent surgery. A total of 580 N-OD were identified for these 524 patients. The N-OD were identified and categorized into the following subheadings: syndromes/associations, respiratory and cardiac, gastrointestinal, developmental, metabolic, and miscellaneous conditions. The most common N-OD are gastro-esophageal reflux disease, obesity, history of prematurity, congenital heart disease, asthma developmental delay and Down syndrome. The commonest categories encountered were developmental (138), cardio-respiratory (114) and gastro-intestinal (114)., Conclusions: This paper identifies the common N-OD encountered by a pediatric otolaryngologist in children managed at a tertiary level. The highlighted N-OD may help as a guide on curriculum content for training residents and fellows and continued medical education., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)