Infectious mononucleosis is caused by Epstein-Barr virus and can lead to complications, including hepatitis and hematological abnormalities, in a subset of patients. The authors of this article assessed measures of illness severity as well as viral load at presentation and six weeks later among a cohort of individuals <25 years of age for the purpose of informing the management of patients with infectious mononucleosis.

INTRODUCTION:Understanding the spectrum and frequencies of Epstein-Barr virus (EBV) complications and markers of illness severity in immunocompetent patients with primary EBV infection will inform management of patients with EBV-related illnesses. OBjECTIVES: To determine the clinical and laboratory correlates of illness severity among infants, children and youth with infectious mononucleosis (IM). METHODS: Study subjects with confirmed IM were prospectively enrolled. Illness severity was assessed at baseline and at six weeks using a scoring tool. Peripheral blood viral loads served as a measure of viral burden. RESULTS: Among 32 children and young adults with IM, the median age was 16 years (range two to 24 years). 19%]). With respect to symptoms or signs that persisted to at least six weeks after illness onset, the predominant complaint was lymphadenopathy in 35% of subjects available for reassessment. Deranged liver function tests were present at presentation in up to 44% of subjects. Patients with the highest viral loads at presentation had significantly higher illness severity scores associated with fatigue (P=0.02). Other than the scores associated with fatigue, viral load values were not significantly correlated with the illness severity scores at baseline and at six weeks. CONCLUSION: In IM, viral loads are not necessarily correlated with illness severity, with the exception of fatigue. EBV-related hepatitis is common in IM, confirming the status of this virus as a relatively common cause of transient hepatitis in children and youth. This entity is not necessarily a marker of disease severity. Key Words: Epstein-Barr virus; Hepatitis; Mononucleosis; Viral loadDes corrélats de la gravité de la maladie en cas de mononucléose infectieuse

Background: Asthma is one of the most common chronic health conditions, affecting 900,000 Ontarians and 2.4 million Canadians. Research evidence indicates that pharmacists can play a critical role in the management of asthma yet there is a paucity of studies which focus on community-based pharmacist asthma interventions on adults in Ontario, Canada. Purpose: The aim of this study is to evaluate an asthma-specific pharmacist-led intervention over a 12-month period in relation to patient health outcomes and patient satisfaction. Methods: This prospective cluster randomized controlled study required trained intervention pharmacists to identify asthma patients, deliver medication reviews and educate patients in order to improve asthma measures. The validated measures selected for the study were adherence to medication, asthma knowledge and peak expiratory flow rate. 12 pharmacies in and around Toronto, Ontario were recruited. Results: A total of 81 patients were identified by pharmacists as potential participants over the course of the program. Of these, 19 consented to participate and 14 completed the program. The intervention group saw a statistically significant improvement of asthma knowledge scores (p=0.02). In both groups, all patients had improved medical adherence scores after completion of the program. Diurnal variation between control and intervention groups was found to be significantly different. Control patients had significantly more days of high variability than the intervention group. Conclusion: The implementation of a pharmacist-provided comprehensive education program in a community pharmacy setting had a positive impact on patients’ diurnal variation, asthma related knowledge and adherence to medication. While the target sample size was not achieved and results cannot be generalized, this study is an important step towards understanding the benefits of a pharmacist-delivered intervention in asthma management.

Background: Asthma is one of the most common chronic health conditions, affecting 900,000 Ontarians and 2.4 million Canadians. Research evidence indicates that pharmacists can play a critical role in the management of asthma yet there is a paucity of studies which focus on community-based pharmacist asthma interventions on adults in Ontario, Canada. Purpose: The aim of this study is to evaluate an asthma-specific pharmacist-led intervention over a 12-month period in relation to patient health outcomes and patient satisfaction. Methods: This prospective cluster randomized controlled study required trained intervention pharmacists to identify asthma patients, deliver medication reviews and educate patients in order to improve asthma measures. The validated measures selected for the study were adherence to medication, asthma knowledge and peak expiratory flow rate. 12 pharmacies in and around Toronto, Ontario were recruited. Results: A total of 81 patients were identified by pharmacists as potential participants over the course of the program. Of these, 19 consented to participate and 14 completed the program. The intervention group saw a statistically significant improvement of asthma knowledge scores (p=0.02). In both groups, all patients had improved medical adherence scores after completion of the program. Diurnal variation between control and intervention groups was found to be significantly different. Control patients had significantly more days of high variability than the intervention group. Conclusion: The implementation of a pharmacist-provided comprehensive education program in a community pharmacy setting had a positive impact on patients’ diurnal variation, asthma related knowledge and adherence to medication. While the target sample size was not achieved and results cannot be generalized, this study is an important step towards understanding the benefits of a pharmacist-delivered intervention in asthma management.