Can school health check-ups serve as screening tool for growth anomalies and obesity in children?

OBJECTIVE: To evaluate the prevalence of growth disorders and obesity in schoolchildren and determine whether school health check-ups are effective in their screening. Subjects-methods: Analysis of anonymized growth and body mass index (BMI) data from 2887 children attending the 3rd grade from 2008 to 2009 after selection of 75 elementary schools in Paris. RESULTS: Linear growth velocity was abnormal in 198 children. Height and weight were above the French reference values (+ 0.9 ± 1.2 SD and + 1 ± 1.7 SD, respectively). BMI was higher, compared to reference values (+ 0.4 ± 1.4 SD). At their last check-up, 20.9% of children had a BMI > + 2 SD. CONCLUSIONS: School health check-ups constitute a good screening tool for growth and obesity. However, further work is needed to determine the most effective modality. The reference values currently used in France are no longer suitable and new reference charts need to be established. The high prevalence of obesity in schoolchildren remains a public health challenge.

Suspected community-acquired pneumonia in an ambulatory setting (CAPA): a French prospective observational cohort study in general practice.

BACKGROUND: Few studies have addressed the pragmatic management of ambulatory patients with suspected community-acquired pneumonia (CAP) using a precise description of the disease with or without chest X-ray (X-ray) evidence. AIMS: To describe the characteristics, clinical findings, additional investigations and disease progression in patients with suspected CAP managed by French General Practitioners (GPs). METHODS: The patients included were older than 18 years, with signs or symptoms suggestive of CAP associated with recent-onset unilateral crackles on auscultation or a new opacity on X-ray. They were followed for up to 6 weeks. Descriptive analyses of all patients and according to their management with X-rays were carried out. RESULTS: From September 2011 to July 2012, 886 patients have been consulted by 267 GPs. Among them, 278 (31%) were older than 65 years and 337 (38%) were at increased risk for invasive pneumococcal disease. At presentation, the three most common symptoms, cough (94%), fever (93%), and weakness or myalgia (81%), were all observed in 70% of patients. Unilateral crackles were observed in 77% of patients. Among patients with positive radiography (64%), 36% had no unilateral crackles. A null CRB-65 score was obtained in 62% of patients. Most patients (94%) initially received antibiotics and experienced uncomplicated disease progression regardless of their management with X-rays. Finally, 7% of patients were hospitalised and 0.3% died. CONCLUSIONS: Most patients consulting GPs for suspected CAP had the three following most common symptoms: cough, fever, and weakness or myalgia. More than a third of them were at increased risk for invasive pneumococcal disease. With or without X-rays, most patients received antibiotics and experienced uncomplicated disease progression.

A new experimental method for measuring skin's natural tension.

PURPOSE: The precise determination of skin's mechanical properties is still an open question. When performing an in vivo test, the piece of skin tested is not as well defined as it is in material testing. Moreover, the body zone and the body posture imply an initial stress on the skin. Consequently, a precise mechanical analysis needs a precise measurement of the natural skin tension. METHODS: A new method and the relative device are presented. It is based on an extensiometry test. Skin is tested not only in traction but also in compression. The tested skin sample is well defined and protected from surrounding effects by follower tabs. The size and shape of the device have been optimised by a finite element modelisation. RESULTS: The method was tested with elastomers pre-tensioned at different loads. It is shown that the initial tension can be retrieved with good precision. Tests were then performed in vivo on the forearm for different arm positions. It is shown that initial tension could be only clearly determined for the highest skin tension, although the skin presented very different traction behaviour with different arm positions. CONCLUSION: It is shown how body posture influences measurements. An innovative method for easily determining initial tension is presented. Nevertheless, further tests and device improvements are needed to apply this skin tension measurement for different body zones and body postures.