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PubMed1990

Future prospects and strategies for academic medicine in Quebec.

Complete reorganization of the Quebec health and social services system, as envisaged by a new bill to be studied by the provincial government, is of major importance for the future of academic medicine since it includes all aspects of the training of health care professionals. While the bill aims to stimulate fundamental and applied research to the highest standards of academic medicine, its clearly stated spending limitations are a major concern to academic physicians. With the proposed centralization of all health care institutions, the role of medical schools and universities will be significantly diminished. Scientific programs of international standing and high levels of teaching and training of medical students and residents, on the other hand, can only be achieved with the development of appropriate structures. Effective prioritization, planning and representation of academic institutions must therefore be given as much consideration as the equally important functions of health care, teaching, and research. Programs oriented toward personnel support and the development of research centres and institutes should continue to be fostered. The future of academic medicine, particularly in its clinical components, is closely linked to the health care system. Academic physicians must become involved in the strategic planning of health care delivery since the development of academic medicine will otherwise not flourish.

Academic Medical Centers↗
PubMed1990

Seroprevalence of Actinobacillus (Haemophilus) pleuropneumoniae serotype-1 infection in swine herds in Quebec.

Seroprevalence of Actinobacillus (Haemophilus) pleuropneumoniae serotype-1 infection was evaluated in pigs on 7 farms in Quebec. Commercial cross-bred herds A to G, ranging from 110 to 235 sows and infected with A pleuropneumoniae serotype-1 were selected. Five pigs/litter were selected at random and were identified (group 1). Blood samples were obtained from group-1 pigs at 2 to 4, 14, 28, 42, and 56 days of age. Blood also was obtained from group-1 pigs remaining in the postweaning unit at 70 days of age, and from 20 to 40 sows 1 to 3 times. To determine prevalence of seropositive pigs in all age groups for the entire study period in herds C to G, blood samples were obtained from 20 pigs/age group (group 2) selected at random at 28, 42, and 56 days of age at each visit. Group-1 pigs were included when they reached 28, 42, and 56 days of age. Pigs were serologically monitored in herds A and B for 3 months and in herds C to G for 5 to 6 months. Serologic status of pigs at 2 to 4 days of age was not statistically associated with status at 42 days (P = 0.6293) and at 56 days (P = 0.3098) of age for the same pigs. Therefore, seronegative pigs 2 to 4 days old did not seroconvert earlier than did those with detectable maternal antibodies at 2 to 4 days old. Only about 50% of the 70-day-old pigs were seropositive at 56 days. Seemingly, pigs seroconverted late in the postweaning period.(ABSTRACT TRUNCATED AT 250 WORDS)

Actinobacillosis↗
PubMed1990

Total and coronary heart disease mortality in relation to major risk factors--Quebec cardiovascular study.

The relationships of blood pressure, smoking, serum cholesterol and education levels on total and coronary artery disease (CAD) mortality were evaluated in 4576 Quebec men aged 35 to 64 years, free from overt CAD at entry and followed for 12 years. From January 1974 to January 1986, there were 417 deaths, 131 due to CAD. A progressive increase in total and CAD mortality was observed from quintile 3 to 5 for both systolic and diastolic blood pressure. In comparison to quintile 1, the adjusted relative risks of quintiles 4 and 5 for systolic blood pressure were significantly elevated (2 P less than 0.01), being 1.5 and 2.0 for total mortality, and 2.6 and 3.5 for CAD mortality, respectively. The relative risks of quintiles 4 and 5 for diastolic blood pressure were also significantly elevated (2 P less than 0.04), being 1.5 and 1.6 for total mortality and 1.9 and 2.7 for CAD mortality, respectively. In comparison to those who never smoked, the relative risks of smoking one to 20, and 21 and more cigarettes per day, were 2.1 (2 P less than 0.003) and 3.1 (2 P less than 0.0001) for overall mortality, and 2.2 (2 P less than 0.08) and 3.5 (2 P less than 0.002) for CAD mortality. Men who had discontinued smoking at least one year before the study, had a relative risk not different from those who had never smoked. Serum cholesterol and education levels were not significantly associated with total or CAD mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[The impact of the hospitalization site on length of stay in short-stay hospitals in Quebec].

If the influence of age or disease on the length of stay is evident, this is not the case for the impact of the distance between the site of hospitalization and the residence of the patient. In addressing this issue, the study analyzes the length of stay of four groups of patients: patients aged 45-64 with cardiovascular problems; patients aged 45-64 with rheumatismal problems; patients aged 65 and over with cardiovascular problems; and patients aged 65 and over with rheumatismal problems. Hospitalization sites are grouped under four categories: (i) within the "Departement de Santé Communitaire" (DSC) of patients' residence; (ii) outside the DSC of patients' residence but within their "région socio-sanitaire"; (iii) outside the DSC of patients' residence and outside their "région socio-sanitaire"; and (iv) outside the DSC of patients' residence but within Greater Montreal or Greater Quebec. The Student test is used.

Aged↗
PubMedDate not supplied

[The demand for health services: a geographic analysis in Quebec].

Nearly one quarter of the people surveyed in Quebec have seen a health professional during the two previous weeks. One third of these visits have been to GPs. Females have paid more visits than males, widows more than married people, the elderly more than the young. Moreover, two groups have had a higher demand: the poor, wherever they are, and the rich in the big cities and metropolitan areas. When grouped into homogeneous areas, the growth of demand is correlated with available services and perceived illness or ailments. When a group increases its demand for services, which are nearly free of charge, the consumption level of the group goes beyond need, and the availability of services becomes increasingly the main determinant.

Delivery of Health Care↗
PubMed1990

[Hip dislocation in Indians of Quebec].

The prevalence of congenital dislocation of the hip in the Cree Indian population of Canada is very high. On 3 separate occasions, from 1973 to 1976, the author had the opportunity to conduct 3 missions in Quebec Northern Territories with the objective of training the medical personnel for carrying out examination of the hips in the neonatal period for the early diagnosis of congenital dislocation of the hip and the application of simple and efficient methods of treatment. The author reports his observations on the use of the tihkinakan cradle board, the high incidence of ligamentous hyperlaxity and how it may affect the clinical findings, the result of treatment of the older child and the clinical and radiological findings of the untreated dislocation in the adults. Most dislocations of the hip in the Cree Indians are now diagnosed early and a large number of them treated locally with braces and harnesses.

Adult↗
PubMed1989

Gonotrophic status, sperm presence and sugar feeding patterns in southwestern Quebec tabanid (Diptera) populations.

Parity, stage of follicular development, sperm and fructose presence were determined for 6 tabanid species from southwestern Quebec during 2 consecutive years. Females were collected in canopy traps baited with or without carbon dioxide. Based on the presence or absence of host-seeking nulliparous flies (nullipars), Hybomitra epistates, H. nitidifrons nuda, H. sodalis, Tabanus lineola and T. similis were classified as being anautogenous. Hybomitra frontalis was classified as autogenous for its first ovarian cycle. Sperm was found in 88% and fructose was detected in 84% of the 700 specimens dissected. In anautogenous species, sperm and fructose prevalence was higher in pars than in nullipars.

Animals↗
PubMed1989

Cochlear implantation in Quebec city: auditory performance in a recently trained patient.

The Quebec Cochlear Implant Research Program has implanted nine patients since 1984. At the same time, we have been developing some original rehabilitative material for these French speaking patients. This paper reports the results obtained with our last adult patient. With his implant, J-P.F. has clearly improved his auditory response to sounds. After the training period, he demonstrated good abilities in detection, discrimination, identification and comprehension of sounds, phonemes, words and sentences. His lipreading has improved. The performance observed with this patient is comparable with the data reported in other studies using the same implant device.

Adult↗
PubMed1989

Eastern equine encephalitis in Quebec and Connecticut, 1972: introduction by infected mosquitoes on the wind?

In 1972 there were outbreaks of eastern equine encephalitis in the Eastern Townships, Quebec, Canada and in Connecticut, USA. Climatic data including Northern Hemisphere synoptic charts were examined. The findings indicate that the virus could have been brought to Lac Brome by infected mosquitoes carried on surface winds from Meriden, Connecticut, on the night of August 22-23, 1972. The distance of 400 km would have been covered in 14-16 h at a speed of 25-30 km h-1 and at a temperature of 15 degrees C and higher. The first case was recorded 13 days later on September 5, 1972. The outbreak at Meriden, Connecticut started on August 21, 1972. On August 7, 1972 southwesterly winds blew along the Atlantic coast at heights up to 1.5 km. Infected mosquitoes could have been carried on the wind from Cape May, New Jersey, Delaware-Maryland-Virginia peninsula, North Carolina or Georgia. Flights would have been at 17 degrees-20 degrees C and lasted 5-6, 9-10, 14-16 and 20-26 h depending on the origin. The arrival on August 8, 1972 coincided with a cold front moving from the northwest through Connecticut. Culiseta melanura is regarded as the mosquito species most likely to have been involved in the transmission of infection.

Air Movements↗
PubMed1989

[The prevalence of malocclusion problems and orthodontic treatment needs in 13 and 14-year old Quebec school children in 1983-1984].

This article details the problems related to occlusion of 13-14 year old Quebec students. The data was derived from a province wide probability sample of 1201 children in 1983-84 using Granger's Orthodontic Treatment Priority Index (TPI). The principal conclusion are: 32% of the children are in Angle's class II; 18% have an overjet of 5 mm and over; 50% have one or more teeth in minor or major displacement; treatment is mandatory or highly desirable for 13.7% and only 2.9% of the students are under treatment. The results are compared to 6 surveys of the same nature.

Adolescent↗
PubMed1989

Incidence of cancers of the brain, the lymphatic tissues, and of leukemia and the use of pesticides among Quebec's rural farm population, 1982-1983.

Massive use of pesticides in agriculture poses risks for the environment and for human health. Pesticides are toxic substances and the suggestion that some may be carcinogenic has been the source of much controversy. In this article we focus on the relation between the use of pesticides in agriculture and the incidence of cancers of the lymphatic tissues, the brain, and of leukemia in the rural farm population in 34 major drainage basins in the province of Quebec (Canada) for the period 1982-1983. The basins were grouped into three categories (low, intermediate and high exposure) based upon the amount of pesticide sold. The study of highly exposed basins shows an excessive incidence of leukemia (SMR = 1.69, p less than or equal to 0.05) for men in rural farm areas in the Yamaska river basin. This specific group's relative risk (RR) of incidence as compared to the urban male population is 2.27 (p less than or equal to 0.05). The RR is also high and statistically significant among the men in municipalities that draw their drinking water from wells (RR = 2.07, p less than or equal to 0.05) as compared to those where water is drawn from rivers. Most municipalities using wells are in the rural farm areas. These results suggest that there may be a relationship between leukemia and the use of pesticides in this drainage basin, and this hypothesis could be verified at the individual level in epidemiological studies.

Brain Neoplasms↗
PubMedDate not supplied

[Could the Quebec Tumor Registry be used to identify risks of occupational cancers?].

Many countries have used their tumor registries to conduct studies on cancer and occupation. In the past, the Quebec Tumor Registry (QTR) has collected information on occupation of cases. The form currently in use has a space to include this information but it is not mandatory to do so. Among male cases of naso-sinusal, pleural and ocular cancer, diagnosed between 1975 and 1979, and aged 16 to 64, 72% had information on occupation. The occupation registered at the QTR and the occupation given by the case himself during epidemiological studies on bladder cancer and leukemia are respectively the same in 64% and 69% of cases. The association between mesothelioma and work in asbestos related industries was not found in the present study. Explanations and recommendations are given.

Adolescent↗
PubMed1988

Viral agents associated with outbreaks of diarrhea in turkey flocks in Quebec.

The relative importance of various enteric viruses associated with diarrhea of turkey poults was investigated by an evaluation of specimens received since 1982. Specimens originated from one to eight week old turkey poults, with mild to severe diarrhea, from 114 flocks in 42 commercial operations located in southern Quebec. The acute phase of enteritis occurred usually in poults between two and four weeks of age. Clarified intestinal contents were examined by direct electron microscopy and enzyme immunoassays. Enzyme-linked immunosorbent assays were performed with antisera to bovine rotavirus group antigen, avian reovirus types 1 to 5, and the prototype strain of the turkey enteric coronavirus. The presence of viruses could be demonstrated by electron microscopy in 55.3% of the specimens, and at least five different viruses were incriminated either alone or in combination. The coronavirus was by far the most common enteric virus with a prevalence of 47.5%. By enzyme-linked immunosorbent assay, rotavirus, reovirus and turkey coronavirus were detected in 14.5%, 18.1% and 61.4% of the specimens, respectively. By electron microscopy, 56.6% of these cases were positive for at least one virus.

Animals↗
PubMed1987

Importance and economic burden of occupational back pain: a study of 2,500 cases representative of Quebec.

The objectives of the study were to estimate the rate of 1-year incidence of occupational back pain, describe the duration of absence from work, and assess medical and economic aspects of this problem. A total of 2,523 files of occupational back pain, representative of the Province of Quebec for the year 1981, were examined by a multidisciplinary team. Census data from 1981 were used for the denominators. The overall 1-year incidence in 1981 was 1.37%. The age-specific incidence rates show an increase-decrease pattern that could be interpreted as a "healthy worker effect". The male to female relative risks by age range from 5.6 (20 to 24 years old) to 1.8 (55 to 64 years old). In the 1-year follow-up, 74% of the workers were absent for less than 1 month. The 7.4% of cases who were absent from work for more than 6 months accounted for nearly 75% of lost days, medical costs, and indemnity payments. We pinpoint some methodologic issues of studies on occupational back pain.

Absenteeism↗
PubMed1988

Working disability due to occupational back pain: three-year follow-up of 2,300 compensated workers in Quebec.

A cohort of 2,342 cases constituting a random sample of all occupational back injuries compensated in Quebec (Canada) during 1981 was observed prospectively for 3 years to study associations between cumulative duration of absence from work and sex, age, site of symptoms (cervical, thoracic, and lumbar), and occupation. Of the cohort members, 227 (9.7%) cumulated 6 months of absence or more. A logistic regression model showed age and site of symptoms to be the two most important risk factors associated with absences of 6 months or more. No association was found with sex or occupation. The results showed discrepancies between measures of frequency distribution of back injuries and duration of absence from work, an important finding in terms of identifying health priorities.

Absenteeism↗
PubMed1985

Epizootiological survey of parainfluenza-3, reovirus-3, respiratory syncytial and infectious bovine rhinotracheitis viral antibodies in sheep and goat flocks in Quebec.

A serological survey was conducted in an attempt to detect antibodies against bovine respiratory viruses in sheep and goats from seven geographical areas of Quebec. Sera from 10% of the animals in 182 sheep flocks and 40 goat flocks were collected and specific antibodies against parainfluenza-3, reovirus type 3, respiratory syncytial and infectious bovine rhinotracheitis viruses were detected by hemagglutination-inhibition tests for the former viruses and complement fixation and seroneutralization assays for the latter viruses. Results showed prevalence rates of serological reaction to parainfluenza-3, reovirus type 3 and respiratory syncytial viruses of 28, 72 and 35% in sheep and 26, 64 and 36% in goats, respectively. No antibodies in infectious bovine rhinotracheitis virus were detected in sheep or goats tested. Prevalence rates varied according to the geographical area. No relationships were detected between age, sex, breed, size of flock and prevalence rates of different antibodies except that parainfluenza-3 antibodies were more common in large goat flocks and in sheep flocks with total confinement housing. A relationship between presence of clinical signs in the flocks and prevalence rates of antibodies was only demonstrated for parainfluenza-3 infection in goat flocks.

Animals↗
PubMed1986

Distinct serotypes of porcine rotavirus associated with diarrhea in suckling piglets in southern Quebec.

Cytopathic rotavirus strains were isolated in cell cultures from the intestinal contents of diarrheic piglets on Quebec pig farms where repeated outbreaks of enteritis occurred. All the isolates shared the common group antigens of rotaviruses as revealed by immunofluorescence and counterimmunoelectrophoresis. A hemagglutinating activity was demonstrated with human group O, porcine and guinea pig erythrocytes. At least one of the isolates was clearly distinguished from the American prototype of porcine rotavirus (strain OSU) by neutralization and hemagglutination inhibition tests; a third serotype was also suspected. By polyacrylamide gel electrophoresis of RNA, it was not possible to differentiate these isolates.

Animals↗
PubMed1988

[Relation between blood pressure and smoking in a population of Quebec workers].

Relations between blood pressure and cigarette smoking were investigated on the basis of a health survey conducted in a population of 3034 mine workers from Quebec Province. Blood pressure was found to be lower among smokers than among non-smokers, the difference between these two groups being: systolic pressure 2.3 mmHg, diastolic pressure 3.0 mmHg. After adjustment for age and bodyweight this relation persisted but only as far as diastolic pressure was concerned. The prevalence of hypertension was 1.5 times higher in non-smokers than in smokers. On the other hand, the number of cigarette-smoking years and the number of cigarettes smoked per day seemed to have little effect on mean arterial pressure.

Adult↗