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3.  Management of occupational back pain: the Sherbrooke model. Results of a pilot and feasibility study. 
OBJECTIVES--The aim was to combat occurrence of chronic occupational back pain. METHODS--A multidisciplinary model to manage back pain that includes both clinical and ergonomic approaches has been developed. Early detection, early clinical and ergonomic evaluations, and early active treatment make up the cornerstone of management. Detection of cases starts after four weeks of absence from work. An ergonomic intervention is implemented at six weeks. A medical specialist is involved at eight weeks. If return to work is not possible after 12 weeks, a functional recovery therapy followed by a therapeutic return to work is implemented. A multidisciplinary team decides if return to original or modified work is possible or if vocational rehabilitation is necessary. This model has been implemented by the investigators in the Sherbrooke (Quebec, Canada) area, and is presently being evaluated through a randomised trial in 31 industrial settlements (about 20,000 workers). A cluster randomisation of industries and workers will allow separate testing of ergonomic and clinical interventions. RESULTS--One year after implementation, 31 of 35 of the eligible industrial sites participated in the study and 79 of 88 of the eligible workers affected by recent back pain had agreed to participate. Ergonomic and clinical interventions have been implemented as planned. Only three workers dropped out. Hence this global clinical and ergonomic management programme has been shown to be feasible in a general population. CONCLUSION--A global management programme of back pain joining ergonomic and clinical intervention with a multidisciplinary approach has not been tested yet. Linking these two strategies in a same multidisciplinary team represents a systemic approach to this multifactorial ailment. During the first year of this trial we did not find any conflict between these two interventions from the employer's or worker's point of view.
PMCID: PMC1128053  PMID: 7951791
5.  Effect of aluminum ions on chemical and immunological properties of meningococcal group B polysaccharide. 
Infection and Immunity  1985;49(3):587-592.
Soluble salts of aluminum were examined for their capacity to complex with purified meningococcal group B polysaccharide. The formation of the complexes resulted, first, in a markedly reduced rate of internal esterification at acid pH and, consequently, prolonged stability of the antigen as measured by its reactivity with antibody at pH 4 and, second, in an increased resistance to neuraminidase. Al3+ complexes of B polysaccharides were tested for immunogenicity in mice and found to be no better than the purified polysaccharide in the Na+ or Ca2+ form. However, when Neisseria meningitidis type 6 protein (outer membrane) complexed to B polysaccharide was tested, a substantial increase in anti-B titers was detected, whereas antiprotein titers remained unchanged. The possibility of using combinations of metal-polysaccharide-outer membrane protein complexes as vaccines for humans is discussed.
PMCID: PMC261215  PMID: 3928492
6.  Immunity and protection of mice against Neisseria meningitidis group B by vaccination, using polysaccharide complexed with outer membrane proteins: a comparison with purified B polysaccharide. 
Infection and Immunity  1985;47(2):527-533.
A methodology for preparing outer membrane proteins (type specific) complexed to group B polysaccharide of Neisseria meningitidis is described. These complexes, low in nucleic acid and lipopolysaccharide content, were immunogenic in mice with induction of humoral antigroup B and antiprotein responses. Immunized mice were also protected against challenge with N. meningitidis group B strains of the same or a different type from that used for vaccination. Both immunity and protection were enhanced when the mice received a secondary immunization with the protein-polysaccharide complex. Additional data have shown the capacity of purified B polysaccharide to induce immunological memory, even though it is incapable of inducing a humoral response when given alone.
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PMCID: PMC263203  PMID: 3917979
7.  Deforming arthritis in systemic lupus erythematosus. 
Annals of the Rheumatic Diseases  1981;40(2):124-126.
Of 45 patients in the McGill Lupus Registry 6 were found to have Jaccoud's deformities. One of these 6 and 4 others had fixed flexion contractures of the elbows. Those with Jaccoud's deformities were similar to the other patients with systemic lupus erythematosus in all respects except that those with Jaccoud's syndrome had had their disease and their arthritis significantly longer. It is concluded that Jaccoud's deformities are the result of longstanding arthritis and that elbow contractures occur via a different mechanism.
PMCID: PMC1000692  PMID: 7224685
8.  Vascular involvement in relapsing polychondritis. 
Canadian Medical Association Journal  1977;116(9):1019-1022.
Review of four cases of relapsing polychondritis (RP) seen at one hospital in the 12-year period 1963 to 1974 revealed that one patient had aortic insufficiency with large artery involvement, two others had involvement of medium and large arteries and the fourth may have had mucocutaneous vasculitis. Valvular disease has occurred in 9% of all cases of RP reported in the literature and, if vasculitis beyong the aortic root is included, 25% of cases of RP manifested inflammatory vascular disease. The frequency of pseudotumour of the orbit and cochlear-labyrinthine dysfunction is also high and may be a manifestation of vasculitis.
PMCID: PMC1879066  PMID: 870159

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