ABSTRACT
Patient-Reported Outcome Measures (PROMs) are important clinical devices for evaluating injuries and surgeries of the hand. However, some of the most widely used questionnaires, such as the MHQ and bMHQ, are currently unavailable in French, which prevents them from being used in the French Canadian province of Quebec as well as in other French-speaking nations. We therefore intend to develop valid and culturally adapted French translations of the afore-mentioned questionnaires. Two independent bilingual translators converted all English questionnaires to French. Two distinct translators then translated the French versions back to English in reverse-blinded fashion. Discrepancies between the original and second English versions were examined by a committee of four bilingual healthcare professionals before final French translations of all documents were produced. Thirty patients bilingual in French and English were then asked to complete the original and French versions of the MHQ and bMHQ. Their answers were compared in order to assess the accuracy of our translation. In light of these findings, revised French versions were produced. French versions of the MHQ and bMHQ questionnaires produced metrological qualities of validity and fidelity with an inter-class correlation superior to 0.90 and a kappa coefficient of 0.81 to 1. Clinical applicability revealed the distribution of scores according to disease process was reproducible between the English and French versions. PROM translation requires a rigorous process in order to achieve strong metrological qualities in both the original and translated versions. We produced French translations of the MHQ and bMHQ by abiding to the Beaton method of cross-cultural adaptation of self-reported measures.
Subject(s)
Disability Evaluation , Hand Injuries/physiopathology , Musculoskeletal Diseases/physiopathology , Surveys and Questionnaires , Female , Humans , Male , Middle Aged , Patient Reported Outcome Measures , Psychometrics , Quebec , Reproducibility of Results , TranslationsABSTRACT
SUMMARY: Spontaneous dissecting aneurysms (SDAs) seldom involve the intradural vertebral artery VA, the posterior cerebral, basilar or postero inferior cerebellar arteries (PICAs), where they produce subarachnoid haemorrhage and/or ischaemia. These lesions may develop spontaneously or occasionally after minor trauma and occur in young people in whom there is no underlying abnormality to explain the appearance of the dissection in most cases. Spontaneous dissecting aneurysm of the PICA is rare and its natural history is not well understood. Surgery or endovascular treatment for PICA dissection remain controversial because they suggest vessel occlusion. Only in a few cases is the bypass between the occipital artery and the PICA possible with trapping of the dissected segment. Reinforcement of the arterial wall does not seem efficient and the surgical approach per se with sole exclusion of the aneurysm may be disastrous. We describe two cases of SDA of PICA that presented with subarachnoid haemorrhage (SAH), treated conservatively, with spontaneous cure of the lesions, angiographically confirmed at mid-time follow-up of five and four months. These favourable spontaneous thromboses, like 11 other similar case reported in the literature, did not show any rebleed. The possibility of a benign clinical course of this lesion exists; clinical and angiographic management of the patient before a decision for a aggressive treatment is proposed.
ABSTRACT
PURPOSE: To evaluate the effects of sotalol in patients with nonsustained ventricular tachyarrhythmia (NSVT). METHODS: Ninety patients were enrolled. Patients were submitted to a double-blind crossover randomized study (placebo x 320 ms/po/d/sotalol; 4 weeks, after a wash-out control period. Holter recordings were performed in control (Ct), placebo (Pb) and drug (Dg) periods. Eligible patients had > 50/h isolated ventricular premature beats (VPB), in control, with or without pairs (P) or nonsustained VT (NSVT; > 3 beats, > 100bpm). Drug efficacy criteria were; > or = 75% reduction in isolated VPB, reduction > or = 90% of P and NSVT. The effects of the Dg were evaluated in the global population, in patients with Chagas' disease, idiopathic arrhythmias and ischemic/hypertensive patients. RESULTS: Differences between control and placebo were NS. Isolated VPB; Dg was effective in 42% (38/90 patients) with a mean of Pb and Dg respectively of 11,770 +/- 13,818 and 1,043 +/- 1,554 (p < 0.001). Pairs: drug was effective in 48% (32/67 patients) with a mean of Pb and Dg respectively of 439 +/- 586 and 27 +/- 52 (p < 0.001). NSVT: drug effectiveness was 53% (19/36 patients) with a mean of Pb and Dg respectively of 445 +/- 1,148 and 2.5 +/- 5.8 (p < 0.102). In patients with Chagas' disease, the reduction in VPB was 33% (13/39 patients), in pairs was 42+ (14/34) and in NSVT was 64% (12/22). In idiopathic patients the reduction of VPB was 53% (17/32 patients), in pairs was 50% (10/20) and in NSVT was 36% (4/11). In ischemic and hypertensive patients the reduction of VPB was 47% (7/15 patients) and 73% in pairs (8/11). CONCLUSION: In the present study, sotalol was effective in the control of nonsustained ventricular tachyarrhythmia, with minimal side-effects.
Subject(s)
Anti-Arrhythmia Agents/pharmacology , Anti-Arrhythmia Agents/therapeutic use , Arrhythmias, Cardiac/drug therapy , Sotalol/therapeutic use , Tachycardia, Ventricular/drug therapy , Administration, Oral , Adult , Aged , Analysis of Variance , Double-Blind Method , Electrocardiography , Female , Humans , Male , Middle Aged , Prospective Studies , Sotalol/administration & dosage , Sotalol/pharmacologyABSTRACT
Objetivo - Avaliar através de ensaio clínico prospectivo, randomizado, duplo-cego cruzado contra placebo, a eficácia do sotalol na dose oral de 320 miligramas diários em reduzir taquiarritmias ventriculares näo sustentadas (TVNS). Métodos - Foram avaliados em condiçöes de controle (Ct), placebo (Pb) e droga (Dg), 90 portadores de um número médio maior ou igual a 50 extra-sístole horárias (EV), com ou sem respostas pareadas (RP) e TVNS, registradas no Holter. Considerou-se a droga como efetiva, fren a uma reduçäo maior ou igual a 75 por cento das EV e maior ou igual a 90 por cento das RP e TVNS. Avaliaram-se os resultados globais e os observados em doenças específicas, incluindo a cardiopatia chagásica crônica, arritmias ventriculares idiopáticas e doença coronariana e hipertensiva sistêmica. Resultados - Näo ocorreram diferenças significativas entre Ct e Pb. Globalmente, a droga reduziu as EV em 42 por cento (38/90 pacientes), as RP em 48 por cento (32/67 e as TVNS em 53 por cento (19/36), com méis respectivas entre Pb e Dg de 11.770 mais ou menos 13.818 para 1.043 mais ou menos 1.554 nas EV (p menor a 0,001); de 439 mais ou menos 586 para 27 mais ou menos 52 nas RP (p menor a 0,001) e de 445 mais ou menos 1.147 para 2,5 mais ou menos 5,8 nas TVNS (p menor a 0,102). Nos chagásicos, reduçäo das EV de 33 por cento (13/39 pacientes), das RP em 42 por cento (14/34) e das TVNS em 64 por cento (12/22). Nos indiopáticos, a reduçäo das EV foi de 53 por cento (17/32 pacientes), das RP de 50 por cento (0/0) e das TVNS de 36 por cento (4/11). Nos isquêmicos e/ou hipertensos, a reduçào das EV foi de 47 por cento (7/15 pacientes) e de 73 por cento nas RP (8/11). Conclusäo - Na populaçäo estudada e na dose indicada, o sotalol mostrou ser um fármaco efetivo para controle de TVNS, apresentando mínimos efeitos colaterais.
