[Association between screen time and sleep habits in 11-to-12-year-old French middle school students]. / Associations entre les temps d'écran et les habitudes de sommeil chez des jeunes collégiens.

BACKGROUND: Screen media usage has become increasingly commonplace in daily life with children initiating themselves to screen media at an early age. Given the high prevalence of screen viewing among children worldwide, its impact on children's health has become a cause for concern. Unfortunately, little information on the independent association between sleep habits and screen time in French children is currently available. The main aim of this study was to assess possible relationships between screen time and sleep habits (quality, duration, etc.) among young middle school students in France. METHODS: A total of 448 (55 % girls) 11-to-12-year-olds from 5 schools were included. Body weight and height were measured according to standard procedures and BMI percentiles were determined based on international reference values. Sleep parameters were obtained by sleep diaries and visual estimations. A sleep diary was maintained for one week to record sleeping and waking times and related information. Information on lifestyle habits (sedentary behaviours, physical activity, and dietary intake) was obtained via standardised questionnaires. RESULTS: Participants were 11.5 (±0.4) years of age. From total sample, 25.5 % reported screen time ≥2hours/d during school days and 62.7 % during school-free days. High screen time was associated with significantly poorer sleep habits and these results remained valid after adjustment for several confounding factors (body mass index, sex, center and parental level of educational attainment) (P<0.05). CONCLUSION: This study highlights an association between longer screen time and shorter sleep duration in French middle school students aged 11 to 12 years. Preventive measures on use of and exposure to screens are called for. Further studies are necessary to confirm our findings.

Extra-target low-risk prostate cancer: implications for focal high-intensity focused ultrasound of clinically significant prostate cancer.

PURPOSE: To analyse the impact of the presence of extra-target non-clinically significant cancer (NCSC) after high-intensity focused ultrasound (HIFU) hemiablation on oncological results. To analyse radical treatment free survival (RTFS) rates at 2-3 years follow-up. METHODS: Retrospective single-centre study of 55 patients treated by primary HIFU hemiablation from 2010 to 2016. Inclusion criteria were unilateral MRI detected CSC, stage ≤ T2b, Gleason score (GS) ≤ 7, at least 6 mm distant from prostate apex. MRI with systematic and targeted biopsies was performed at diagnosis. Follow-up included clinical examination, PSA every 6 month, MRI and biopsies at 1 year and in case of PSA elevation. HIFU retreatment was possible. Whole-gland treatment was indicated in case of positive biopsies with GS ≥ 7 or maximum cancer core length > 5 mm, any GS. RESULTS: Mean follow-up was 33 months (SD: 17-49 months). Presence or not of an extra-target NCSC in the untreated part of the gland had no impact on RTFS at univariate analysis (p = 0.29). 10 (18%) patients had a salvage whole-gland treatment after a median follow-up of 26 months (IQR 17-28). RTFS at 2 and 3 years were 92% and 80%. CONCLUSION: Presence or not of an extra-target NCSC in the untreated part of the gland had no impact on RTFS. NCSC lesion can be left untreated and actively monitored. RTFS was 80% at 3 years which support the concept of focal/partial treatment as a treatment option of CSC prostate cancer.

Cryptogenic haemoptysis in smokers: angiography and results of embolisation in 35 patients.

The aim of the present study was to describe angiographic findings and embolisation results in smokers with haemoptysis. We retrospectively reviewed the clinical data and angiographic findings from 35 patients with smoking-related bronchopulmonary disease and no associated comorbidity, who were referred for embolisation for mild (n = 6), moderate (n = 14) and severe (n = 15) haemoptysis. Spirometric classification subdivided our population into: 16 patients with chronic bronchitis but no airflow limitation; and 19 patients with chronic obstructive pulmonary disease (COPD) (stage I: n = 12; stage II: n = 5; stage III: n = 2). Bronchoscopy depicted focal submucosal vascular abnormalities in three patients and only endobronchial inflammation in 32 (91%) patients. Bronchial artery angiography revealed moderate (n = 18) or severe (n = 10) hypervascularisation in 28 (80%) patients, and normal vascularisation in seven (20%). No statistically significant difference was observed between the angiographic findings and the severity of COPD, tobacco consumption or the amount of bleeding. Cessation of bleeding was obtained by embolisation in 29 out of the 34 technically successful procedures (85%), requiring surgery in three out of five patients with recurrence. Follow-up (mean duration 7 yrs) demonstrated no recurrence of bleeding in 32 (94%) out of 34 patients and excluded late endobronchial malignancy. Smokers with various stages of COPD severity may suffer from haemoptysis that is efficiently treatable by endovascular treatment.

Epidemiology of patients with MSSA versus MRSA infections of orthopedic implants: Retrospective study of 115 patients.

Factors that predict the occurrence of a surgical site infection due to methicillin-resistant Staphylococcus aureus (MRSA) are not well known; however this information could be used to modify the recommended antimicrobial prophylaxis. We carried out a retrospective study of S. aureus infections on orthopedic implants to determine: (1) whether epidemiological factors can be identified that predict a MRSA infection, (2) the impact of these factors as evidenced by the odds ratio (OR). HYPOTHESIS: Risk factors for a MRSA infection can be identified from a cohort of patients with S. aureus infections. MATERIALS AND METHODS: We identified 244 patients who experienced a S. aureus surgical site infection (SSI) in 2011-2012 documented by intraoperative sample collection. Of these 244 patients, those who had a previous SSI (n=44), those with a SSI but no orthopedic implant (n=80) or those who had the infection more than 1-year after the initial surgery (n=5) were excluded. This resulted in 115 patients (53 arthroplasty, 62 bone fixation) being analyzed for this study. There were 24 MRSA infections and 91 MSSA infections. The following factors were evaluated in bivariate and multifactorial analysis: age, sex, type of device (prosthesis/bone fixation), predisposition (diabetes, obesity, kidney failure), and environmental factors (hospitalization in intensive care unit within past 5 years, nursing home stay). RESULTS: Two factors were correlated with the occurrence of MRSA infections. (1) Nursing home patients had a higher rate of MRSA infections (67% vs. 18%, P=0.017) with an OR of 8.42 (95% CI: 1.06-66.43). (2) Patients who had undergone bone fixation had a lower rate of MRSA infections than patients who had undergone arthroplasty (13% vs. 30%, P=0.023), OR 0.11 (95% CI: 0.02-0.56). Although the sample size was too small to be statistically significant, all of the patients with kidney failure (n=4) had a MRSA infection. DISCUSSION: Since these MRSA infection risk factors are easy to identify, the antimicrobial prophylaxis could be adapted in these specific patient groups.

Single- and dual-source chest CT protocols: Levels of radiation dose in routine clinical practice.

PURPOSE: To establish the radiation dose level for single- and dual-source thoracic CT scans in daily practice. MATERIALS AND METHODS: The dose levels delivered during 634 consecutive examinations over a period of 2 months were recorded. The CT scans were performed using: (a) a standard protocol (single source, single energy [group 1]: n=266; dual source, single energy [group 2]: n=276; (b) with prospective ECG synchronisation [group 3]: n=13; or (c) with dual energy [group 4]: n=79. All the acquisitions included kilovoltage selection depending on the weight and automatic milliamperage modulation. RESULTS: The mean DLP of the standard protocols was 97.12 mGycm (group 2; BMI=23.1kg/m(2)) and 211.1 mGycm (group 1; BMI=27.3kg/m(2)), the choice of protocol depending on the diameter of the thorax relative to the diameter of the field of the second source, and therefore on the patient's morphotype. When imaging included examination of the proximal and middle coronary arteries (group 3), the mean DLP was 105.5 mGycm. Morphological and functional imaging (group 4) was obtained with a mean DLP of 404.3 mGycm. CONCLUSION: Depending on the objective of the protocol, the mean DLP varied from 97.12 to 404.3 mGycm.

Low-dose ECG-gated 64-slices helical CT angiography of the chest: evaluation of image quality in 105 patients.

The purpose of this study was to evaluate image quality of low-dose electrocardiogram (ECG)-gated multislice helical computed tomography (CT) angiograms of the chest. One hundred and five consecutive patients with a regular sinus rhythm (72 men; 33 women) underwent ECG-gated CT angiographic examination of the chest without administration of beta blockers using the following parameters: (a) collimation 32 x 0.6 mm with z-flying focal spot for the acquisition of 64 overlapping 0.6-mm slices, rotation time 0.33 s, pitch 0.3; (b) 120 kV, 200 mAs; (c) use of two dose modulation systems, including adjustment of the mAs setting to the patient's size and anatomical shape and an ECG-controlled tube current. Subjective and objective image quality was evaluated by two radiologists in consensus on 3-mm-thick scans reconstructed at 55% of the response rate (RR) interval. The population and protocol characteristics included: (a) a mean [+/-standard deviation (SD)] body mass index (BMI) of 24.47 (+/-4.64); (b) a mean (+/-SD) heart rate of 72.04 (+/-15.76) bpm; (c) a mean (+/-SD) scanning time of 18.3 (+/-2.73) s; (d) a mean (+/-SD) dose-length product (DLP) value of 260.57 (+/-83.67) mGy/cm; (e) an estimated average effective dose of 4.95 (+/-1.59) mSv. Subjective noise was depicted in a total of nine examinations (8.5%), always rated as mild. Objective noise was assessed by measuring the standard deviation of pixel values in a homogeneous region of interest within the trachea and descending aorta; SD was 15.91 HU in the trachea and 22.16 HU in the descending aorta, with no significant difference in the mean value of the standard deviations between the four categories of BMI except for obese patients, who had a higher mean SD within the aorta. Interpolation artefacts were depicted in 22 patients, with a mean heart rate significantly lower than that of patients without interpolation artifacts, rated as mild in 11 patients and severe in 11 patients. The severity of interpolation artefacts was significantly linked to a low heart rate in affected patients. The overall image quality of CT scans was rated as diagnostic in 94 patients (89.5%) while 11 examinations (10.5%) were found to be partially nondiagnostic owing to the cyclic presence of severe interpolation artefacts, which can be compensated for by additional reconstructions at a different temporal window. In these cases, interpolation artefacts could have been avoided by reducing the pitch from 0.3 to 0.2 at the expense of increased patient dose. Low-dose ECG-gated CT angiograms of the chest can be obtained in routine clinical practice with 64-slice CT technology without altering the diagnostic value of CT scans.