Faculté de médecine – Travaux et publications
URI permanent de cette collectionhttps://hdl.handle.net/1866/19699
Cette collection accueille les publications savantes et d’autres types de travaux d’auteur.e.s associé.e.s à cette unité. Voir aussi les collections Thèses et mémoires et Production étudiante de l'unité.
Parcourir
Dépôts récents
Item Accès libre Athletes’ lived experiences recovering from and returning to sport following a sport-related concussion : a meta-synthesis of qualitative studiesCadotte, Gabrielle; Duncan, Lindsay R.; Caron, Jeffrey; Université de Montréal. Faculté de médecine (Taylor and Francis, 2024-11-25)A small, but growing body of qualitative studies have explored athletes’ lived experiences with sport-related concussions (SRCs). For this meta-synthesis, we reviewed and synthesized qualitative, peer-reviewed studies on athletes’ lived experiences during recovery from and/or return to sport following SRC. Following PRISMA guidelines, we initially identified 5062 articles through PsycINFO, Embase, MedLine, SportDiscus, and Web of Science. After eliminating duplicates, screening titles, abstracts and full texts, 33 peer-reviewed articles matched our inclusion criteria. Subsequently, the authors appraised the quality of the included articles using the Critical Appraisal Skills Program. We followed guidelines for thematic synthesis, in which we initially developed 16 descriptive themes, each rooted in the original data extracted from the 33 articles. Subsequently, we developed four analytical themes that were informed by the descriptive themes and existing models and frameworks in the sport and exercise literature: (a) SRC characteristics: Identifying SRC features, (b) SRC consequences: Understanding the impact of the injury, (c) SRC outcomes: Discovering paths to recovery, and (d) Influential factors: Exploring the contextual factors affecting SRC consequences and outcomes. Our findings offer a comprehensive description of qualitative evidence on athletes’ lived experiences with SRC, including gaps in knowledge and insights for future research in the field.Item Accès libre Leaving the mark : FMOs as an emerging class of cytokinetic regulatorsLacroix, Léa; Goupil, Eugénie; Smith, Matthew James; Labbé, Jean-Claude; Université de Montréal. Faculté de médecine. Département de pathologie et biologie cellulaire (Taylor and Francis, 2025-04-08)Posttranslational modification of proteins plays a fundamental role in cell biology. It provides cells a means to regulate the signaling, enzymatic or structural properties of proteins without continuous cycles of synthesis and degradation, offering multiple distinct functions to individual proteins in a rapid and reversible manner. Modifications can include phosphorylation, ubiquitination or methylation, which are widespread and simple to detect using current approaches. More challenging to identify, one modification of growing significance is the direct oxidation of cysteine and methionine side chains. Protein oxidation has long been known to occur spontaneously upon the accumulation of cellular reactive oxygen species (ROS), but new data are providing insight into the targeted oxidation of proteins by flavin-containing monooxygenases (FMOs). Here, we review how oxidation of cellular proteins can modulate their activity and consider potential roles for FMOs in the targeted modification of proteins shaping cell division, with a particular focus on two families of FMOs: MICAL and OSGIN.Item Accès libre Impact of expressive intentions on upper-body kinematics in two expert pianistsTurner, Craig; Mailly, Robin; Dal Maso, Fabien; Verdugo, Felipe; Université de Montréal. Faculté de médecine. École de kinésiologie et des sciences de l'activité physique (Frontiers Media, 2025-01-13)Introduction: Expression is a key aspect of music performance. Studies on pianists’ gestures and expression have mainly documented the impact of their expressive intentions on proximal segments and head linear kinematics. It remains unclear how pianists’ expressive intentions influence joint angular kinematics as well as exposure to risk factors of injury, such as poor overall posture and distal jerky movements, two kinematic factors linked to injury. The first objective of this exploratory case study was to analyze the influence of pianists’ expressive intentions on proximal and distal joint range of motion (ROM) across different musical contexts. The second objective was to evaluate the impact of expressive intentions on the posture of joints that are commonly injured in pianists, as well as distal joint angular jerk. Methods: Two expert pianists (P1 and P2) performed six musical excerpts (E1–E6) in two experimental conditions: normal condition (including expressive intentions) and the control condition (strictly playing the composer’s notations written in the score with no subjective interpretation). An inertial measurement unit system recorded upper body kinematics. Methods: Two expert pianists (P1 and P2) performed six musical excerpts (E1–E6) in two experimental conditions: normal condition (including expressive intentions) and the control condition (strictly playing the composer’s notations written in the score with no subjective interpretation). An inertial measurement unit system recorded upper body kinematics. Results and discussion: Both proximal and distal joint ROM increased when pianists incorporated expressive intentions. Participants exhibited more static, non-neutral wrist postures when incorporating expressive intentions (right and left wrist for P1 and P2, respectively), suggesting an increased risk of distal injury. On the contrary, the thorax exhibited more dynamic, neutral flexion postures, suggesting a reduced risk of proximal injury. These results suggest that expressive intentions may impact proximal and distal postures differently. Incorporating expressive intentions also led to jerkier, less smooth wrist movements in lyrical, non-virtuosic musical excerpts (E1–E4). However, in more virtuosic excerpts (E5–E6), there were generally no differences between conditions. Spatiotemporal constraints might explain these discrepancies between non-virtuosic and virtuosic musical excerpts. These results provide evidence of the impact of expressive intentions on the entire kinematic chain, while highlighting the implications of the subjective dimension of music expression in relation to exposure to risk factors of injury.Item Accès libre Chromatin dynamics and DNA replication roadblocksHammond-Martel, Ian; Verreault, Alain; Wurtele, Hugo; Université de Montréal. Faculté de médecine (Elsevier, 2021)A broad spectrum of spontaneous and genotoxin-induced DNA lesions impede replication fork progression. The DNA damage response that acts to promote completion of DNA replication is associated with dynamic changes in chromatin structure that include two distinct processes which operate genome-wide during S-phase. The first, often referred to as histone recycling or parental histone segregation, is characterized by the transfer of parental histones located ahead of replication forks onto nascent DNA. The second, known as de novo chromatin assembly, consists of the deposition of new histone molecules onto nascent DNA. Because these two processes occur at all replication forks, their potential to influence a multitude of DNA repair and DNA damage tolerance mechanisms is considerable. The purpose of this review is to provide a description of parental histone segregation and de novo chromatin assembly, and to illustrate how these processes influence cellular responses to DNA replication roadblocks.Item Accès libre p75NTR modulation prevents cellular, cortical activity and cognitive dysfunctions caused by perinatal hypoxiaChattopadhyaya, Bidisha; Lee, Karen K. Y .; Carreño-Muñoz, Maria Isabel; Paris-Rubianes, Andrea; Lavertu-Jolin, Marisol; Berryer, Martin; Longo, Frank M.; Di Cristo, Graziella; Université de Montréal. Faculté de médecine. Département de neurosciences (Oxford University Press, 2025-03-04)Children who experienced moderate perinatal hypoxia are at risk of developing long-lasting subtle cognitive and behavioural deficits, including learning disabilities and emotional problems. Understanding the underlying mechanisms is an essential step for designing targeted therapy. Fast-spiking, parvalbumin-positive (PV) GABAergic interneurons modulate the generation of gamma oscillations, which in turn regulate many cognitive functions including goal-directed attentional processing and cognitive flexibility. Due to their fast-firing rate, PV cell function requires high levels of energy, which may render them highly vulnerable to conditions of metabolic and oxidative stress caused by perinatal hypoxia. Here, we show that adult mice that experienced moderate perinatal hypoxia (MPH) have decreased cortical PV expression levels in addition to specific impairments in social behaviour, recognition memory and cognitive flexibility. We further found that the expression level of the neurotrophin receptor p75NTR, which limits PV cell maturation during the first postnatal weeks, is increased in MPH mice. Genetic deletion of p75NTR in GABAergic neurons expressing the transcription factor Nkx2.1, which include PV cells, protects mice from PV expression loss and the long-term cognitive effects of MPH. Finally, treatment with a p75NTR inhibitor starting after MPH and lasting for a week, prevented PV expression loss and the occurrence of cognitive and cortical activity deficits in adult mice. Altogether our data reveals p75NTR-mediated signaling, as a potential molecular target, for the treatment of the cognitive alterations caused by MPH.Item Accès libre Participation at home of adults with multiple disabilities and influencing factors from their parents' perspectiveCutnam, Gabrielle; Iavorova Kroumova, Elisa; Rochette, Annie; Université de Montréal. Faculté de médecine. École de réadaptation (Taylor and Francis, 2025-02-03)To understand participation at home of adults with multiple disabilities and the indicatorsof their engagement from the parents’ perspective as well as to explore the influencing environmentalfactors.Methods: A qualitative, descriptive design was used. Participants had to be the parent of an adultpresenting multiple disabilities aged between 21 and 65 with no degenerative diagnosis. Semi-structuredinterviews were conducted using an interview guide, anchored in the Human Development Model –Disability Creation Process and developed through an iterative process. Data were analyzed using a6-step qualitative analysis process.Results: The majority (5/8) of participating parents were aged between 56 and 61 years and were theparents of an adult with multiple disabilities aged between 21 and 41. Two themes for participationwere generated: communication to build relationships, and they are disabled, but not so much whereasfour themes relating to environmental factors were generated: context as a determinant of meaningfulactivity, the effects of the caregiver’s attitude on social participation, the importance of the relationship oftrust, and facilitating participation through adaptations.Conclusion: Non-verbal communication and context of realization of activities of adults with multipledisabilities should be considered as they contribute to making participation meaningful.Item Accès libre Perceived training needs of municipal stakeholders in Quebec (Canada) relating to universal design action plansRochette, Annie; Vermeulen, Perrine; Boucher, Normand; Roussel, Nathalie; Simard, Nathalie; Grondin-Gravel, Gabrielle; Morissette, A.; Lamontagne, Michel; Fougeyrollas, Patrick; Université de Montréal. Faculté de médecine. École de réadaptation (Taylor and Francis, 2025-02-21)Quebec (Canada) municipalities with ≥15 000 inhabitants are legally required to produce an annual action plan to reduce barriers encountered by person with disabilities. Actual tools for universal design are diverse and not harmonised between cities, leading to important training needs. We thus aimed to identify priority training needs among municipalities of all sizes. We use a two-phase sequential descriptive design starting with an online survey (Phase 1) anchored into dimensions of inclusive access followed by focus group discussions (Phase 2). Descriptive statistics and a semi-inductive content analysis for qualitative data were used. A total of n = 114 municipalities responded to Phase 1 including nearly half (37/78) of municipalities with a population ≥15 000 inhabitants. The top five priority needs were 1) Needs assessment, 2) General knowledge, 3) Practical and organisational knowledge, 4) Design/planning phase and 5) Know-how, attitudes, mentalities, culture of the municipalities. Participants (n = 10) to Phase 2 insisted on their needs for practical knowledge, including authentic, contextualised examples coming from other cities. No major differences in needs to prioritise emerged when contrasting larger and smaller size’s municipalities. Results highlighted a variety of training needs, including the importance of prioritising practical contextualised knowledge anchored in authentic experience.Item Accès libre Attenuating hyperammonemia preserves protein synthesis and muscle mass via restoration of perturbed metabolic pathways in bile duct-ligated ratsBosoi, Cristina R.; Kumar, Avinash; Oliveira, Mariana M.; Welch, Nicole; Clément, Marc-André; Tremblay, Mélanie; Ten-Have, Gabriella A. M.; Engelen, Marielle P. K. J.; Bémeur, Chantal; Deutz, Nicolaas E. P.; Dasarathy, Srinivasan; Rose, Christopher; Université de Montréal. Faculté de médecine. Département de médecine (Springer, 2025-01-23)Sarcopenia and hepatic encephalopathy (HE) are complications of chronic liver disease (CLD), which negatively impact clinical outcomes. Hyperammonemia is considered to be the central component in the pathogenesis of HE, however ammonia's toxic effects have also been shown to impinge on extracerebral organs including the muscle. Our aim was to investigate the effect of attenuating hyperammonemia with ornithine phenylacetate (OP) on muscle mass loss and associated molecular mechanisms in rats with CLD. Six-week bile duct-ligated (BDL) rats and Sham-operated controls were treated with OP (1 g/kg, oral) for 5 weeks. Body composition, assessed by EchoMRI, and muscle protein fractional synthesis rate were evaluated. Signalling mechanisms regulating protein homeostasis, ATP content and metabolic intermediates in the tricarboxylic acid cycle (TCA) in skeletal muscle were quantified. OP treatment attenuated hyperammonemia, prevented brain edema and improved locomotor activity in BDL rats. Increased muscle ammonia, reduction in lean body mass, decreased muscle protein synthesis rate and ATP content were restored in OP-treated versus saline-treated BDL rats. TCA cycle intermediary metabolite, α-ketoglutarate, alterations of molecular markers regulating protein homeostasis including mTOR signalling and autophagy, were also preserved in muscle of OP-treated BDL rats. OP attenuated hyperammonemia, preserved muscle protein synthesis and prevented muscle mass loss in a preclinical model of CLD through restoration of perturbed signalling responses and altered TCA intermediary metabolites. Ammonia-lowering strategies have the potential for rapid clinical translation for simultaneous neuroprotection and sarcopenia prevention in patients with CLD.Item Accès libre How have neck muscle vibration effects on visuospatial behavior and spatial neglect been explored? A scoping reviewDuclos, Noémie C.; Sorita, Eric; Poncet, Frédérique; Duclos, Cyril; Jamal, Karim; Université de Montréal. Faculté de médecine. École de réadaptation (Taylor and Francis, 2024-11-28)Introduction: Neck muscle vibration (NMV) has been proposed as a bottom-up intervention toenhance visuospatial exploration in post-stroke patients with unilateral spatial neglect (USN). Whilesome studies report enlarged visual exploration during NMV application, others find no significantimpact, highlighting inconsistencies in the literature. The diversity in NMV application methodsand the variation in visuospatial outcome measures may contribute to these conflicting findings.This study aimed to overview the methodological approaches used to investigate NMV’s effects onvisuospatial behavior in USN patients, focusing on aspects beyond sample size and study design.Methods: Among the seven databases, studies that applied NMV and assessed visual or perceptualoutcomes were included in the analysis. Two independent reviewers screened titles and abstractsto select the studies to analyze. Data about the publication, population, modalities of application,and outcomes were extracted and synthesized.Results: Twenty-five publications from 1988 to 2023 were included, involving a total of 512participants, of whom 114 (22.3%) had USN. The presence of USN was assessed based on paper-and-pencil tests. The frequency of NMV was set between 80 and 125 hz. In 22 studies, NMV wereapplied on the left side of the neck muscles. Six studies proposed multiple NMV sessions, lastingbetween 5 and 50 minutes/day, 3–5 times/week, for 2–4 weeks. One study included a follow-upperiod of up to 1.4 years. The tasks during NMV often involved indicating the subjective straightahead (SSA, n = 8), pointing out targets, or no specific activity (n = 7, each). The SSA and cancella-tion tests were the most frequent outcomes.Conclusions: NMV application modalities varied widely across studies, with only vibration fre-quency showing consistency. The tasks performed during NMV and the outcome measures werediverse and generally unrelated to activities of daily living. Therefore, NMV effects during moreecologically valid tasks should be explored.Item Accès libre Effect of a whole-group intervention on children’s participation in interactive book readingMcMahon-Morin, Paméla; Nasri, Bouchra; Verduyckt, Ingrid; Rezzonico, Stefano; Gingras, Marie-Pier; Université de Montréal. Faculté de médecine. École d'orthophonie et d'audiologie (Taylor and Francis, 2024-09-12)This study examined the effects of an SLP-delivered whole-class interactive book reading intervention and a professional development program on children’s self-initiated participation. Eleven kindergarten teachers and the children in their classes participated in this quasi-experimental study. They were filmed during book reading at pre- and post-intervention, and follow-up. Children’s types of spontaneous comments appeared to be more diverse after the intervention, and the types that increased or emerged were consistent with the language targets of the interactive book reading. Nonparametric statistical tests were conducted. Significant changes were found in the number of hands raised by children to make a spontaneous comment and in the number of spontaneous comments after the intervention and at follow-up. Results for child-initiated interaction sequences were mitigated. This study invites school-based SLPs to foster children’s self-initiated participation in their tier-1 intervention and to support teachers in using children’s spontaneous comments to further scaffold children’s learning.Item Accès libre Improving pelvic floor muscle training with AI : a novel quality assessment system for pelvic floor dysfunctionEl-Sayegh, Batoul; Dumoulin, Chantal; Leduc-Primeau, François; Sawan, Mohamad; Université de Montréal. Faculté de médecine. École de réadaptation (MDPI, 2024-10-29)The first line of treatment for urinary incontinence is pelvic floor muscle (PFM) training, aimed at reducing leakage episodes by strengthening these muscles. However, many women struggle with performing correct PFM contractions or have misconceptions about their contractions. To address this issue, we present a novel PFM contraction quality assessment system. This system combines a PFM contraction detector with a maximal PFM contraction performance classifier. The contraction detector first identifies whether or not a PFM contraction was performed. Then, the contraction classifier autonomously quantifies the quality of maximal PFM contractions across different features, which are also combined into an overall rating. Both algorithms are based on artificial intelligence (AI) methods. The detector relies on a convolutional neural network, while the contraction classifier uses a custom feature extractor followed by a random forest classifier to predict the strength rating based on the modified Oxford scale. The AI algorithms were trained and tested using datasets measured by vaginal dynamometry, combined in some cases with digital assessment results from expert physiotherapists. The contraction detector was trained on one dataset and then tested on two datasets measured with different dynamometers, achieving 97% accuracy on the first dataset and 100% accuracy on the second. For the contraction performance classifier, the results demonstrate that important clinical features can be extracted automatically with an acceptable error. Furthermore, the contraction classifier is able to predict the strength rating within a ±1 scale point with 97% accuracy. These results demonstrate the system’s potential to enhance PFM training and rehabilitation by enabling women to monitor and improve their PFM contractions autonomously.Item Accès libre Management of physical impairments, activity limitations and participation restrictions in survivors of childhood acute lymphoblastic leukemia: perspectives from physiotherapistsBrochu, Annie; Hébert, Luc J.; Fiscaletti, Melissa; Kairy, Dahlia; Université de Montréal. Faculté de médecine. École de réadaptation (Lippincott, 2024-10-04)Background: Survivors of childhood acute lymphoblastic leukemia (cALL) present a high risk of long-term neuromusculoskeletal (NMSK) sequelae. Clinical guidelines for specific management of these complications are still lacking. The aim of this study is to (1) describe current physiotherapy practice with cALL survivors at one of Canada’s specialized pediatric oncology centers, (2) explore perceived optimal management of long-term NMSK sequelae by physiotherapists, and (3) identify the barriers and facilitators for its in-clinic implementation. Methods: This qualitative descriptive study with a focus group using a semi-structured interview guide was conducted with physiotherapists (n = 6) from one of Canada’s specialized pediatric oncology centers. We performed a hybrid analysis including both a deductive and an inductive approach using the International Classification of Functioning, Disability, and Health and Consolidated Framework for Implementation Research. Results: Even though the participants were experts in managing NMSK sequelae in survivors of cALL, standardized management of these patients is lacking. Physiotherapists described their perceived optimal management of NMSK sequelae as systematic and interdisciplinary. Barriers (eg, relative priority and availability of resources) and facilitators (eg, relative benefit and commitment) for implementing this perceived optimal management were identified. Conclusion: Physiotherapy management could improve care and services offered to survivors of cALL. The identification of barriers and facilitators to best practice offers relevant potential solutions to explore in order to improve and optimize management of this patient group.Item Accès libre Physical impairments, activity limitations, and participation restrictions of childhood acute lymphoblastic leukemia survivors with and without hip osteonecrosis : a PETALE cohort studyBrochu, Annie; Kairy, Dahlia; Alos, Nathalie; Laverdière, Caroline; Sinnett, Daniel; Sultan, Serge; Curnier, Daniel; Miron, Marie-Claude; Ramy, El-Jalbout; Fiscalett, Melissa; Hébert, Luc J.; Université de Montréal. Faculté de médecine. École de réadaptation (Springer, 2024-04-02)Purpose Long-term musculoskeletal complications represent a growing burden for survivors of childhood acute lymphoblastic leukemia (cALL). This study aimed to describe physical impairments, activity limitations, and participation restrictions in a high-risk subgroup of cALL survivors of the PETALE cohort. Methods This cross-sectional study, using observational data from the PETALE cohort, included a subgroup of survivors who presented high-risk criteria for late effects. Outcomes measures consisted of hip magnetic resonance imaging, maximal isometric muscle strength (MIMS) or torque (MIMT), range of motion (ROM), Near Tandem Balance (NTB), 6-Minute Walk Test (6MWT), Five Time Sit-to-Stand Test (FTSST), and health-related quality of life. Descriptive statistics and regression analyses were performed. Results Survivors (n = 97, 24.2 ± 6.7 years old) showed limited grip strength, FTSST, and NTB performance compared to reference values (p < 0.001). Thirteen participants (14.6%, 18 hips) had hip osteonecrosis (ON) (53.8% male). Higher severity hip ON was found in female survivors (66.7% vs. 22.2%). Survivors with hip ON had reduced hip external rotation ROM compared to those without (p < 0.05). Relationships were found between MIMS and ROM outcomes (r = 0.32, p < 0.01) and with 6MWT (r = 0.39–0.41, p < 0.001). Our multiple linear regression model explained 27.6% of the variance of the 6MWT. Conclusions Survivors in our subgroup had clinically significant physical impairments and activity limitations, and those with hip ON showed worst hip impairment outcomes. Implications for Cancer Survivors These findings emphasize the importance of long-term follow-up including physical therapy assessment to help early identification and management of physical impairments and activity limitations in survivors of cALL.Item Accès libre Trajectories of opioid consumption as predictors of patient-reported outcomes among individuals attending multidisciplinary pain treatment clinicsAngarita-Fonseca, Adriana; Lacasse, Anaïs; Choinière, Manon; Kaboré, Jean-Luc; Sylvestre, Marie-Pierre; Tchouangue Dinkou, Gillis Delmas; Bruneau, Julie; Martel, Marc Olivier; Hovey, Richard; Motulsky, Aude; Rahme, Elham; Pagé, Gabrielle; Université de Montréal. Faculté de médecine. Département d'anesthésiologie et de médecine de la douleur (Wiley, 2023-10-06)Purpose This study aimed to identify opioid consumption trajectories among persons living with chronic pain (CP) and put them in relation to patient-reported outcomes 6 months after initiating multidisciplinary pain treatment. Methods This study used data from the Quebec Pain Registry (2008–2014) linked to longitudinal Quebec health insurance databases. We included adults diagnosed with CP and covered by the Quebec public prescription drug insurance plan. The daily cumulative opioid doses in the first 6 months after initiating multidisciplinary pain treatment were transformed into morphine milligram equivalents. An individual-centered approach involving principal factor and cluster analyses applied to longitudinal statistical indicators of opioid use was conducted to classify trajectories. Multivariate regression models were applied to evaluate the associations between trajectory group membership and outcomes at 6-month follow-up (pain intensity, pain interference, depression, and physical and mental health-related quality of life). Results We identified three trajectories of opioid consumption: “no or very low and stable” opioid consumption (n = 2067, 96.3%), “increasing” opioid consumption (n = 40, 1.9%), and “decreasing” opioid consumption (n = 39, 1.8%). Patients in the “no or very low and stable” trajectory were less likely to be current smokers, experience polypharmacy, use opioids or benzodiazepine preceding their first visit, or experience pain interference at treatment initiation. Patients in the “increasing” opioid consumption group had significantly greater depression scores at 6-month compared to patients in the “no or very low and stable” trajectory group. Conclusion Opioid consumption trajectories do not seem to be important determinants of most PROs 6 months after initiating multidisciplinary pain treatment.Item Accès libre A prospective cohort study of acute pain and in-hospital opioid consumption after cardiac surgery : associations with psychological and medical factors and chronic postsurgical painPagé, Gabrielle; Ganty, Praveen; Wong, Dorothy; Rao, Vivek; Khan, James; Ladha, Karim S.; Hanlon, John; Miles, Sarah; Katznelson, Rita; Wijeysundera, Duminda; Katz, Joel; Clarke, Hance; Université de Montréal. Faculté de médecine. Département d'anesthésiologie et de médecine de la douleur (Lippincott, Williams & Wilkins, 2024-01-31)BACKGROUND: Understanding the association of acute pain intensity and opioid consumption after cardiac surgery with chronic postsurgical pain (CPSP) can facilitate implementation of personalized prevention measures to improve outcomes. The objectives were to (1) examine acute pain intensity and daily mg morphine equivalent dose (MME/day) trajectories after cardiac surgery, (2) identify factors associated with pain intensity and opioid consumption trajectories, and (3) assess whether pain intensity and opioid consumption trajectories are risk factors for CPSP. METHODS: Prospective observational cohort study design conducted between August 2012 and June 2020 with 1-year follow-up. A total of 1115 adults undergoing cardiac surgery were recruited from the preoperative clinic. Of the 959 participants included in the analyses, 573 completed the 1-year follow-up. Main outcomes were pain intensity scores and MME/day consumption over the first 6 postoperative days (PODs) analyzed using latent growth mixture modeling (GMM). Secondary outcome was 12-month CPSP status. RESULTS: Participants were mostly male (76%), with a mean age of 61 ± 13 years. Three distinct linear acute postoperative pain intensity trajectories were identified: “initially moderate pain intensity remaining moderate” (n = 62), “initially mild pain intensity remaining mild” (n = 221), and “initially moderate pain intensity decreasing to mild” (n = 251). Age, sex, emotional distress in response to bodily sensations, and sensitivity to pain traumatization were significantly associated with pain intensity trajectories. Three distinct opioid consumption trajectories were identified on the log MME/day: “initially high level of MME/day gradually decreasing” (n = 89), “initially low level of MME/day remaining low” (n = 108), and “initially moderate level of MME/day decreasing to low” (n = 329). Age and emotional distress in response to bodily sensations were associated with trajectory membership. Individuals in the “initially mild pain intensity remaining mild” trajectory were less likely than those in the “initially moderate pain intensity remaining moderate” trajectory to report CPSP (odds ratio [95% confidence interval, CI], 0.23 [0.06–0.88]). No significant associations were observed between opioid consumption trajectory membership and CPSP status (odds ratio [95% CI], 0.84 [0.28–2.54] and 0.95 [0.22–4.13]). CONCLUSIONS: Those with moderate pain intensity right after surgery are more likely to develop CPSP suggesting that those patients should be flagged early on in their postoperative recovery to attempt to alter their trajectory and prevent CPSP. Emotional distress in response to bodily sensations is the only consistent modifiable factor associated with both pain and opioid trajectories.Item Accès libre Virtual group psychotherapy for chronic pain : exploring the impact of the virtual medium on participants’ experiencesMoore, Emily; Paré, Catherine; Carde, Estelle; Pagé, Gabrielle; Université de Montréal. Faculté de médecine. Département d'anesthésiologie et de médecine de la douleur (Oxford University Press, 2023-09-21)Background Virtual psychotherapy for chronic pain (CP) has been shown to be feasible, efficacious, and acceptable; however, little is known about how virtual delivery of group psychotherapy affects participants’ experiences. This study aimed to explore the impact of a virtual medium during the coronavirus disease 2019 (COVID-19) pandemic on social interactions and therapeutic processes in the context of group psychotherapy for CP management. Methods This qualitative, interview-based study collected data on 18 individuals who participated in virtual group psychotherapy in a tertiary care pain management unit. Results Results of the thematic analysis showed 4 themes. First, the ability to participate and connect was modified by not meeting in person. Connections also occurred differently as the usual patterns of interactions changed. Participants described important shifts in how emotions are communicated and subsequent experience of empathy. Finally, the commonality of chronic pain experience was identified as a central driver of connection between participants. Conclusions Mixed impacts of the virtual medium on group psychotherapy dynamics and processes were found. Future research could explore ways to mitigate the negative impacts.Item Accès libre One-year opioid consumption trajectories among individuals receiving multidisciplinary postsurgical care : a single-center observational study from the Toronto General Hospital Transitional Pain ServicePagé, Gabrielle; Katz, Joel; Darville, Rasheeda; Gabriel, Gretchen; Ladha, Karim S.; Huang, Alexander; Ganty, Praveen; Katznelson, Rita; Tamir, Diana; Fiorellino, Joseph; Kahn, Michael; Tao, Leeping; Slepian, Maxwell; Wieskopf, Jeffrey; Clarke, Hance; Université de Montréal. Faculté de médecine. Département d'anesthésiologie et de médecine de la douleur (BMJ Publishing Group, 2024-07-30)Introduction The Transitional Pain Service (TPS) is an innovative, personalized approach to postsurgical opioid consumption and pain management. The objectives of this study were to identify trajectories of opioid consumption and pain intensity within 12 months after initiating treatment through the TPS, identify biopsychosocial factors associated with trajectory membership, and examine the relationship between trajectory membership and other outcomes of interest over the same 12-month period. Methods Consecutive patients referred to the TPS were included in the present study (n=466). After providing informed consent, they completed self-report questionnaires at the initial visit at the TPS (either pre surgery or post surgery) and at every TPS visit until 12 months. Growth mixture modeling was used to derive trajectories and identify associated factors. Results Results showed three distinct opioid consumption trajectories for both presurgical opioid consumers and opioid-naïve patients. These trajectories all decreased over time and among those who were consuming opioids before surgery that returned to presurgical levels. Being man, having a substance use disorder, or reporting higher levels of pain interference were associated with higher daily opioid consumption for presurgical opioid consumers. For presurgical opioid-naïve individuals, higher opioid consumption trajectories were associated with higher levels of psychological distress. Five pain intensity trajectories were identified, and there were no significant association between opioid consumption and pain intensity trajectories. Conclusions Results suggest that opioid consumption and pain intensity trajectories mostly decrease after surgery in a high-risk population enrolled in a TPS. Results also show heterogeneity in postsurgical recovery and highlight the importance of using personalized interventions to optimize individual trajectories. Data availability statement No data are available. Data are available on reasonable request. No data are available for sharing as consent was not obtained from participants for this purpose.Item Accès libre Associations between weight loss attempts, weight-related stress and body image during childhood and adolescence in children with parental obesityHarnois-Leblanc, Soren; Van Hulst, Andraea; Lucibello, Kristen M.; Harbec, Marie-Josée; Sabiston, Catherine M.; Maximova, Katerina; Sylvestre, Marie-Pierre; Henderson, Mélanie; Université de Montréal. Faculté des arts et des sciences. École de psychoéducation; Université de Montréal. Faculté de médecine. Département de pédiatrie; Université de Montréal. École de santé publique. Département de médecine sociale et préventive (Mary Ann Liebert, 2024-09-06)Background: Few longitudinal studies have investigated the role of weight-loss attempts or weight-related stress on body image during childhood. We examined whether weight-loss attempts and weight-related stress are associated with weight misperception and body dissatisfaction across childhood and adolescence. Methods: Data were drawn from the Quebec Adipose and Lifestyle InvesTigation in Youth (QUALITY) cohort of Canadian children with parental obesity (8–10 years: n = 630; 10–12 years: n = 564; 15–17 years: n = 377). We assessed weight-loss attempts and weight-related stress at baseline and first follow-up, and perceived and desired silhouettes at first and second follow-up with questionnaires. Weight misperception consisted of the difference in BMI z-score (zBMI) from the perceived silhouette and the measured zBMI. Body dissatisfaction consisted of the discordance between perceived and desired silhouettes. We estimated multivariable mixed-effects regression models adjusting for age, sex, pubertal stage, parental BMI and education, and sport-based teasing. Results: Weight loss attempts were associated with a higher weight misperception score (ever tried, beta [95% confidence intervals; CI]: 0.13 [0.01–0.24]) and with 2.13 times higher desire to be thinner (95% CI: 1.39–3.26) at the subsequent follow-up. Similarly, children stressed by their weight had a higher misperception score (beta [95% CI]: 0.15 [0.02–0.27]) and greater desire to be thinner at the next follow-up (odds ratio [95% CI]: 1.73 [0.999–3.00]). Conclusions: Weight-loss attempts and weight-related stress in children and adolescents are associated with weight misperception and body dissatisfaction, supporting empowerment and counseling focusing on healthy eating behaviors and a positive body image.Item Embargo The association between depressive symptoms and overweight or obesity in prepubertal children: findings from the QUALITY cohortBonin, Sarah; Harnois-Leblanc, Soren; Béland, Mélanie; Simoneau, Gabrielle; Mathieu, Marie-Ève; Barnett, Tracie A.; Sabiston, Catherine M.; Henderson, Mélanie; Université de Montréal. Faculté de médecine. Département de pédiatrie; Université de Montréal. Faculté de médecine. École de kinésiologie et des sciences de l'activité physique; Université de Montréal. École de santé publique. Département de médecine sociale et préventive (Elsevier, 2024-08-24)Background: Youth obesity and depression are public health concerns. Although metaanalyses suggest a positive association between those conditions in adults and adolescents, evidence remains unclear in prepubertal children. We examined the bidirectional associations between levels of depressive symptoms and weight status in 8-10-year-old children with a parental history of obesity, over two years, and whether they differ by sex. Methods: Data were drawn from QUebec Adipose and Lifestyle InvesTigation in Youth Cohort Study’s baseline and first follow-up evaluations (n=558). Depressive symptoms were assessed using the 12-item Center for Epidemiological Studies Depression scale and weight status using body mass index z-scores based on World Health Organization standards. Linear and logistic regression models were used to test the directionality and magnitude of the associations, adjusting for age, sex, physical activity, screen time, parental education, alcohol and cigarette use, and baseline outcome measure. Results: Children with higher levels of depressive symptoms at baseline were not more likely to have overweight/obesity at follow-up (odds ratio [95% Coefficient Interval] = 0.95[0.88;1.02]). Baseline overweight/obesity was not associated with subsequent higher levels of depressive symptoms (beta coefficient [95% Coefficient Interval] = 0.20 [-0.47;0.87]). No sex differences emerged. Limitations: Selection bias may have occurred due to loss at followup (10% attrition) and exclusion of 6 participants taking mood disorder medication. Conclusions: Unlike in adults and adolescents, no association between weight status and depressive symptoms was observed in childhood over two years. Underlying mechanisms linking both conditions later in life may not apply as early as prepubertal childhood.Item Embargo Adiposity and cardiac autonomic function in children with a family history of obesitySaade, Marie-Béatrice; Holden, Samuel; Lisa, Kakinami; McGrath, Jennifer J.; Mathieu, Marie-Ève; Poirier, Paul; Barnett, Tracie A.; Beaucage, Pierre; Henderson, Mélanie; Université de Montréal. Faculté de médecine. Département de pédiatrie; Université de Montréal. Faculté de médecine. École de kinésiologie et des sciences de l'activité physique; Université de Montréal. École de santé publique. Département de médecine sociale et préventive (Springer, 2024-09-21)Purpose Data on associations between adiposity and heart rate variability (HRV) in pre-pubertal children are limited. We examined the associations between adiposity indices and HRV, independent of lifestyle behaviors, comparing multiple indicators of adiposity, and explored differences between boys and girls. Methods Data stem from 469 participants of the QUALITY cohort (630 children aged 8-10 yrs with a parental history of obesity). Adiposity indices included waist-to-height ratio, body mass index (BMI) percentiles and categories (overweight, obesity), dual-energy x-ray absorptiometry (DEXA) defined fat mass percentage and android/gynoid ratio. HRV indices in the frequency and the spectral domain were derived from a daytime 3-hr Holter recording. Multivariable linear regression models were adjusted for age, sex, Tanner stage, physical activity, screen time, and fitness. Interactions between sex and adiposity were tested. Results Greater adiposity was associated with decreased parasympathetic modulation and increased sympathetic dominance. Waist-to-height ratio was associated with lower parasympathetic activity: RMSSD (B=-23.32 [-42.42, -4.22]), pNN50 (B=-16.93 [-28.58, -5.27]), LF/HF ratio (B=1.83 [0.97, 2.70]). Patterns of association were similar for android/gynoid ratio. Overweight was not associated with altered HRV. Obesity was negatively associated with RMSSD and pNN50 and positively with LF/HF ratio. Greater fat mass percentage was associated with lower RMSSD, pNN50 and HF, and increased LF/HF ratio. There were no differences between boys and girls. Conclusion Specific markers of adiposity relate to altered HRV in childhood, with waist-to-height ratio being potentially a more relevant marker of HRV than BMI and more pragmatic than percent body fat. NCT03356262, November 11, 2017.