OBJECTIVES: To investigate the surgical outcomes of different uvulopalatopharyngoplasty (UPPP). METHODS: All subjects underwent overnight polysomnography and were evaluated using the Epworth sleepiness scale (ESS), the Quebec sleep questionnaire and the snoring scale at the baseline and 3 and 12 months following operation. The primary endpoint was the overall effective rate representing the sum of the surgical success rate and effective rate. RESULTS: The overall effective rate at 12 months post surgery was 55.6% for simple UPPP, 95.8% for UPPP+GA, and 92.3% for UPPP+TBA. The surgical success rate at 3 and 12 months postoperation for UPPP+GA or UPPP+TBA was significantly higher than simple UPPP (P<0.05). Marked improvement was observed in all patients in the snoring scale score and the ESS score 3 and 12 months following surgery compared to the baseline (P<0.05 in all). CONCLUSION: UPPP, UPPP+GA, and UPPP+TBA are all effective in improving the surgical outcome of obstructive sleep apnea hypopnea syndrome (OSAHS) patients with multilevel obstruction. UPPP+TBA appears to be the most effective in treating OSAHS patients.
Humans ; Polysomnography ; Prospective Studies* ; Quebec ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Tongue* ; Surveys and Questionnaires

A Wide variety of non-operative treatments are advocated in management of lumbar disc herniations. Unfortunately the multiplicity of treatment methods implies the absence of a clearly superior treatment program. Because of the great expense created by the chaotic array of conservative care measures and arbitrary selection of these measures by different subspecialist, Quebec Task Force, the Agency for Health Care Policy and Research, AAOS/NASS spine Algorithm Task Force developed the guidelines for conservative treatments. It is generally accepted that past medical recommendations may have been overly cautious in returning patients to activity to their possible detriment, thereby slowing recovering and worsening prognosis were resulted. Therefore there is a shifts towards more active therapy with involvement of the patient in various excercise programs recently. In this articles various conservative treatments were reviewed in order to help in managing the patient with lumbar disc herniation.
Advisory Committees ; Humans ; Prognosis ; Quebec ; Spine ; United States Agency for Healthcare Research and Quality

OBJECTIVES: The purpose of this study was to identify the association between satisfaction with assistive technology devices and psychosocial impact among some mentally or physically disabled children. METHODS: The study subjects were 120 disabled children and their primary caregivers who were using rental assistive technology devices in Gwangju and Jeollanam-Do. Data were collected by structured questionnaire composed of general characteristics of subjects, characteristics related with using assistive devices. Quebec User Evaluation of Satisfaction with assistive Technology 2.0 (QUEST 2.0) and Psychosocial Impact of Assistive Device Scale (PIADS). The statistical analysis were performed by descriptive statistics, t-test, ANOVA and Pearson's correlational analysis. RESULTS: The total mean score for QUEST 2.0 was 4.08±0.66 (satisfaction with devices, 4.01±0.70; satisfaction with the assistive devices service, 4.14±0.90) and the mean of PIADS was 1.00±0.75 (ability, 0.99±0.78; adaptability, 1.04±0.86; self-respect, 0.99±0.74). The scores of PIADS was statistically significant difference according to usage time of assistive devices. The PIADS was significantly positive correlated with QUEST 2.0 CONCLUSIONS: The mentally or physically disabled children reported that the higher level of satisfaction and the more positive impact of psychosocial aspect with assistive technology devices. It would be necessary to perform further studies for addressing the effects of assistive technology devices.
Caregivers ; Child* ; Disabled Children ; Disabled Persons* ; Gwangju ; Humans ; Jeollanam-do ; Quebec ; Self-Help Devices*

OBJECTIVE: To compare the effectiveness of extracorporeal shock wave therapy (ESWT) and trigger point injection (TPI) for the treatment of myofascial pain syndrome in the quadratus lumborum. METHODS: In a retrospective study at our institute, 30 patients with myofascial pain syndrome in the quadratus lumborum were assigned to ESWT or TPI groups. We assessed ESWT and TPI treatment according to their affects on pain relief and disability improvement. The outcome measures for the pain assessment were a visual analogue scale score and pain pressure threshold. The outcome measures for the disability assessment were Oswestry Disability Index, Roles and Maudsley, and Quebec Back Pain Disability Scale scores. RESULTS: Both groups demonstrated statistically significant improvements in pain and disability measures after treatment. However, in comparing the treatments, we found ESWT to be more effective than TPI for pain relief. There were no statistically significant differences between the groups with respect to disability. CONCLUSION: Compared to TPI, ESWT showed superior results for pain relief. Thus, we consider ESWT as an effective treatment for myofascial pain syndrome in the quadratus lumborum.
Back Pain ; Humans ; Myofascial Pain Syndromes* ; Outcome Assessment (Health Care) ; Pain Measurement ; Quebec ; Retrospective Studies ; Shock* ; Trigger Points*

STUDY DESIGN: Interventional research with a 6-month follow-up period. PURPOSE: We aimed to establish the effectiveness of a multidisciplinary workplace intervention on reduction of work-related low back pain (WRLBP), using ergonomic posture training coupled with an educational program based on social cognitive theory. OVERVIEW OF LITERATURE: WRLBP is a major occupational problem among healthcare workers, who are often required to lift heavy loads. Patient handling is a particular requirement of nurse aides, and has been reported as the main cause of chronic WRLBP. METHODS: We included 125 nursing assistants from two hospitals affiliated to Qom University of Medical Sciences from May to December 2015. There was an intervention hospital with a number of 63 nursing assistants who received four multidisciplinary educational sessions for 2 hours each plus ergonomic posture training over two days and a control hospital with a number of 62 nursing assistants who didn't receive educational intervention about low back pain. The outcomes of interest were reductions in WRLBP intensity and disability from baseline to the follow up at 6 months, which were measured using a visual analog scale and the Quebec Disability Scale. Descriptive and analytical statistics were used to analyze the data. RESULTS: The comparison tests showed significant change from baseline in reduction of WRLBP intensity following the multidisciplinary program, with scores of 5.01±1.97 to 3.42±2.53 after 6 months on the visual analog scale in the intervention group (p<0.001) and no significant change in control groups. There was no significant difference in the disability scores between the two groups (p=0.07). CONCLUSIONS: We showed that our multidisciplinary intervention could reduce the intensity of WRLBP among nurse aides, making them suitable for implementation in programs to improve WRLBP among nursing assistants working in hospitals.
Delivery of Health Care ; Follow-Up Studies ; Humans ; Iran* ; Low Back Pain* ; Moving and Lifting Patients ; Nurses' Aides ; Nursing* ; Posture ; Quebec ; Visual Analog Scale

BACKGROUND AND PURPOSE: Patients with nonvalvular atrial fibrillation (NVAF) who survive an intracranial hemorrhage (ICH) have an increased risk of ischemic stroke and systemic embolism (IS/SE). We investigated whether starting oral anticoagulants (OACs) among older NVAF patients after an ICH was associated with a lower risk of IS/SE and mortality but offset by an increase in major bleeding. METHODS: We assembled a patient cohort from the Quebec Régie de l'Assurance Maladie du Québec (RAMQ) and Med-Echo administrative databases. We identified older adults with NVAF from 1995 to 2015. All patients with incident ICH and discharged in community were included. Patients were categorized according to OAC exposure. Outcomes included IS/SE, all-cause mortality, recurrent ICH and major bleeding after a quarantine period of 6 weeks. Crude event rates were calculated at 1-year of follow-up, and Cox proportional hazard models with a time-dependent binary exposure were used to assess adjusted hazard ratios (AHRs). RESULTS: The cohort of 683 NVAF patients with ICH aged 83 years on average. The rates (per 100 person-years) for IS/SE, death, ICH and major bleeding were 3.3, 40.6, 11.4, and 2.7 for the no OAC group; and 2.6, 16.3, 5.2, and 5.2 for OAC group, respectively. The AHR for IS/SE and death was 0.10 (95% confidence interval [CI], 0.05 to 0.21), 0.43 (95% CI, 0.19 to 0.97) for recurrent ICH and 1.73 (95% CI, 0.71 to 4.20) for major extracranial bleeding comparing OAC exposure to non-exposed. CONCLUSIONS: Initiating OAC after ICH in older individuals with NVAF is associated with a reduction of IS/SE and mortality and a trend in recurrent ICH supporting its use after ICH.
Adult ; Anticoagulants ; Atrial Fibrillation ; Cohort Studies ; Embolism ; Follow-Up Studies ; Hemorrhage ; Humans ; Intracranial Hemorrhages ; Mortality ; Proportional Hazards Models ; Quarantine ; Quebec ; Stroke

BACKGROUND: As of now, the impact of low back pain (LBP) and its chronic state, chronic low back pain (CLBP), on mental health-related quality of life (HRQOL) has never been investigated among police officers. The present investigation aims at studying this relationship using a biopsychosocial model. METHODS: Between May and October 2014, a Web-based cross-sectional study was conducted among Quebec police officers (Quebec, Canada). Mental HRQOL was measured using the role emotional (RE) and the mental health (MH) domains of the SF-12v2 Health Survey. The impact of CLBP on mental HRQOL (as opposed to acute/subacute LBP or no LBP) was studied with a multivariate linear regression model. RESULTS: Of the 3,589 police officers who participated in the study, 1,013 (28.4%) reported CLBP. The mean age of respondents was 38.5 ± 8.7 years, and 32.0% were females. The RE (44.1/100) and MH (49.0/100) mean scores of the CLBP group were comparable with the scores found in populations suffering from cancer or heart diseases. Compared to officers without LBP, the presence of CLBP was significantly associated with lower RE (β: −0.068; p = 0.003) and MH (β: −0.062; p = 0.002) scores. These relationships were not found in the acute/subacute LBP group. CONCLUSION: Our results underscore how frequent CLBP is among police officers and how burdensome it is. Considering the importance of good physical and mental health for this occupational population, police organizations should be aware of this issue and contribute to the efforts toward CLBP prevention and management in the workplace.
Cross-Sectional Studies ; Female ; Health Surveys ; Heart Diseases ; Humans ; Linear Models ; Low Back Pain ; Mental Health ; Police ; Quality of Life ; Quebec ; Surveys and Questionnaires

BACKGROUND AND PURPOSE: There is a variety of stroke risk factors, and engaging individuals in reducing their own personal risk is hugely relevant and could be an optimal dissemination strategy. The aim of the present study was to estimate the stroke risk for specific combinations of health- and lifestyle-related factors, and to develop a personalized stroke-risk assessment tool for health professionals and the general population (called the MyRisk_Stroke Calculator). METHODS: This population-based, longitudinal study followed a historical cohort formed from the 1992 or 1998 Sante Quebec Health Surveys with information for linkage to health administrative databases. Stroke risk factors were ascertained at the time of survey, and stroke was determined from hospitalizations and death records. Cox proportional hazards models were used, modeling time to stroke in relationship to all variables. RESULTS: A total of 358 strokes occurred among a cohort of 17805 persons (men=8181) who were followed for approximately 11 years (i.e., -200000 person-years). The following regression parameters were used to produce 10-year stroke-risk estimates and assign risk points: for age (1 point/year after age 20 years), male sex (3 points), low education (4 points), renal disease (8 points), diabetes (7 points), congestive heart failure (5 points), peripheral arterial disease (2 points), high blood pressure (2 points), ischemic heart disease (1 point), smoking (8 points), >7 alcoholic drinks per week (3 points), low physical activity (2 points), and indicators of anger (4 points), depression (4 points), and anxiety (3 points). According to MyRisk_Stroke Calculator, a person with <50, 75, and 90 risk points has a 10-year stroke risk of <3%, 28%, and >75%, respectively. CONCLUSIONS: The MyRisk_Stroke Calculator is a simple method of disseminating information to the general population about their stroke risk.
Alcoholics ; Anger ; Anxiety ; Cohort Studies ; Death Certificates ; Depression ; Education ; Health Occupations ; Health Surveys ; Heart Failure ; Hospitalization ; Humans ; Hypertension ; Longitudinal Studies ; Male ; Methods ; Motor Activity ; Myocardial Ischemia ; Peripheral Arterial Disease ; Proportional Hazards Models ; Quebec ; Risk Assessment* ; Risk Factors ; Smoke ; Smoking ; Stroke*