Prevalence of physical activity and sedentary-related behaviors among adolescents: data from the Qatar National School Survey.

OBJECTIVES: To investigate the prevalence of physical activity (PA) and sedentary behaviors among adolescents in Qatar by selected demographic characteristics. STUDY DESIGN: Cross-sectional study. METHODS: A total of 5862 students (2938 boys and 2924 girls) in the age group 12-17 years were included in the analyses. PA and sedentary-related measures were obtained from the self-reported survey questions. RESULTS: Only 35.4% of students were performing 60 min of PA ≥3 days/week. The proportion of students with >2 hr screentime ranged from 43% to 57% (weekdays) and 50% to 62.5% (weekends). Girls had less odds of being physically active than the boys (odds ratio [OR] = 0.61, P < 0.001). Qatari students were less likely to be physically active than non-Qataris (OR = 0.79, P < 0.001). Age was inversely correlated with PA ([r = -0.113, P < 0.001 for participation with sports team] and [r = -0.139, P < 0.001 for school physical education classes]). Participation in sports teams positively correlated with 60 min of PA number of days in a week (r = 0.317, P < 0.001). CONCLUSIONS: The study describes insufficient PA among youth as a public health issue of concern in the State of Qatar that requires multipronged health promotion initiatives.

Does a 5-day course of antibiotics in elderly patients with community-acquired pneumonia achieve the established criteria of clinical stability?

OBJECTIVE: We aimed to determine the proportion of elderly patients hospitalised for community-acquired pneumonia (CAP) in whom a 5-day antibiotic therapy would achieve clinical stability according to American Thoracic Society (ATS) criteria. METHODS: Patients aged≥75 years, hospitalised for CAP between November 2018 and August 2019, were analysed retrospectively. The American Thoracic Society (ATS) clinical stability criteria (temperature≤37°C, heart rate≤100/min, respiratory rate≤24/min, systolic blood pressure≥90mmHg, oxygen saturation≥90% in room air) were assessed after five days of antibiotic therapy. RESULTS: Seventy-five patients (mean age 88 years, 49% requiring oxygen therapy) were included. Six died, and at day 5, 36/69 (52%) fulfilled 4/5 stability criteria. The median duration of treatment was 9 days. In 28 patients (41%), it was ≤7 days. CONCLUSION: In 52% of elderly patients with CAP, a 5-day treatment regimen resulted in clinical stability.

Medical management of obesity: an update.

Obesity is rapidly growing global epidemic with monumental impact on health and economics. It is associated with multiple adverse health consequences including hypertension, diabetes, dyslipidemia, coronary heart disease, heart failure and stroke to name a few. It is also associated with premature death. The economic impact of obesity is also striking and represents up to 6% of the total healthcare expenditure worldwide. Therefore, effective therapeutic strategies are desperately needed to curb the rising epidemic of obesity. In this review, we present the underlying cause of obesity, together with pathophysologic insights necessary for the practicing physician as basis for the medical therapeutic options available, that are presented in more details. We also discuss promising therapeutic agents that are under different stages of development.

Hyperactivation of the silencing proteins, Sir2p and Sir3p, causes chromosome loss.

The SIRgene products maintain transcriptional repression at the silent mating type loci and telomeres in Saccharomyces cerevisiae, although no enzymatic or structural activity has been assigned to any of the Sir proteins nor has the role of any of these proteins in transcriptional silencing been clearly defined. We have investigated the functions and interactions of the Sir2, Sir3, and Sir4 proteins by overexpressing them in yeast cells. We find that Sir2p and Sir3p are toxic when overexpressed, while high Sir4p levels have no toxic effect. Epistasis experiments indicate that Sir2p-induced toxicity is diminished in strains lacking the SIR3 gene, while both Sir2p and Sir4p are required for Sir3p to manifest its full toxic effect. In addition, the effects of Sir2 or Sir3 overexpression are exacerbated by specific mutations in the N-terminus of the histone H4 gene. These results are consistent with a model in which Sir2p, Sir3p and Sir4p function as a complex and interact with histones to modify chromatin structure. We find no evidence that toxicity from high levels of the Sir proteins results from widespread repression of transcription. Instead, we find that high levels of Sir2p and/or Sir3p cause a profound decrease in chromosome stability. These results can be appreciated in the context of the effects of Sir2p in histone acetylation and of chromatin structure on chromosome stability.

The Use of Intraoperative Traction in Pediatric Scoliosis Surgery: A Systematic Review.

STUDY DESIGN: Systematic review. OBJECTIVE: To study the morbidity and the potential benefits of using intraoperative skeletal traction as an adjunct method for correcting scoliosis. SUMMARY OF BACKGROUND DATA: Cotrel et al., used intraoperative skeletal traction in all patients in their original series of segmental spinal instrumentation for scoliosis correction (Cotrel et al., Clin Orthop Relat Res 1988;227:10-23). However, the use of intraoperative traction may introduce other forms of surgical morbidity, which has not been systematically studied. METHODS: Two independent reviewers searched MEDLINE (1948-current) and EMBASE (1980-current) using the keywords scoliosis, intraoperative, and traction in all fields, combined with AND. Studies were subject to full-text assessment against specific inclusion and exclusion criteria; discrepancies between the reviewers were resolved by a third independent reviewer. Data were extracted into standardized extraction tables and papers were critically appraised papers with regards to their relative strengths and weaknesses, with particular attention to the study objective. RESULTS: Nine papers were included: case report (n = 1), retrospective case series (n = 2), retrospective case-control (n = 6), and studies included both adolescent idiopathic scoliosis (AIS) and neuromuscular scoliosis. Seven studies reported positive effects of intraoperative skeletal traction on diverse outcome measures, such as correction of pelvic obliquity, Cobb angle, and axial plane deformity, as well as precluding the need for an anterior release preceding posterior instrumentation for large curves. Overall, there was only one reported postoperative traction-related complication (anterosuperior iliac spine pressure sore). One paper reported that intraoperative traction may evoke neuromonitoring signal changes in a large proportion of patients undergoing AIS surgery. These changes were responded to intraoperatively by decreasing or removing weight and none of the patients had postoperative neurologic deficits. CONCLUSION: Isolated intraoperative skeletal traction may be a low-morbidity adjunct to facilitate scoliosis surgery. Further studies are needed to compare outcomes of scoliosis surgery with or without intraoperative skeletal traction.

A cluster of pediatric metallic mercury exposure cases treated with meso-2,3-dimercaptosuccinic acid (DMSA)

Nine children and their mother were exposed to vapors of metallic mercury. The source of the exposure appears to have been a 6-oz vial of mercury taken from a neighbor's home. The neighbor reportedly operated a business preparing mercury-filled amulets for practitioners of the Afro-Caribbean religion Santeria. At diagnosis, urinary mercury levels in the children ranged from 61 to 1,213 microg/g creatinine, with a geometric mean of 214.3 microg/m creatinine. All of the children were asymptomatic. To prevent development of neurotoxicity, we treated the children with oral meso-2,3-dimercaptosuccinic acid (DMSA). During chelation, the geometric mean urine level rose initially by 268% to 573.2 microg mercury/g creatinine (p<0.0005). At the 6-week follow-up examination after treatment, the geometric mean urine mercury level had fallen to 102.1 microg/g creatinine, which was 17.8% of the geometric mean level observed during treatment (p<0.0005) and 47.6% of the original baseline level (p<0.001). Thus, oral chelation with DMSA produced a significant mercury diuresis in these children. We observed no adverse side effects of treatment. DMSA appears to be an effective and safe chelating agent for treatment of pediatric overexposure to metallic mercury.

Image design: generation of a prescribed image at the output of a band-limited system.

Image design involves determining the object distribution which produces a prescribed image at the output of a given imaging system. We solve the problem of generating two parallel lines at the output of an imaging system that is modeled by a linear band-limited system foliowed by a point nonlinearity of the hardlimiting type. It is shown that a solution always exists whatever the system's bandwidth. In principle, infinite two-line resolution is achievable. In practice, resolution much higher than the conventional resolution of the imaging system is possible.

Recognizing and treating social anxiety disorder.

Social anxiety disorder is the third most common psychiatric disorder in the United States. Patients strive to avoid stress-inducing situations, or they may endure them with marked psychological distress and physical reactions, including sweating and tachycardia. Social anxiety disorder can be diagnosed by a careful history and can be treated successfully with medications or psychosocial interventions.

An in vivo model of femtosecond laser intrastromal refractive surgery.

BACKGROUND AND OBJECTIVE: To develop an animal model for evaluation of femtosecond laser intrastromal refractive surgery. METHODS: Intrastromal photodisruption was performed in New Zealand Albino rabbits using a femtosecond laser system. This surgical pattern consisted of a 100 microm-tick pyramid of laser pulses starting 180 microm below the corneal surface. Animals underwent serial slit lamp examinations and corneal thickness measurements at 1,3,7,14, and 28 days, then monthly up to 1 year. RESULTS: Approximately 70 microm of central corneal thinning were seen at 1 week, remaining stable up to 7 months. CONCLUSIONS: Intrastromal photodisruption with femtosecond lasers produced consistent changes in corneal thickness without loss of corneal transparency. These changes were more stable than those produced with excimer laser procedures in a similar animal model.

[Recurrent traumatic posterior luxation of the hip with defect of the sphericity of the femoral head. Value of x-ray computed tomography]. / Luxation traumatique récidivante postérieure de la hanche avec défaut de sphéricité de la tête fémorale. Intérêt de la tomodensitométrie.

The authors report a case of traumatic recurrent posterior dislocation of the hip. The cause of the recurrence was related to flattening of the femoral head on its anterior aspect with incongruity between the head and the anterior wall of the acetabulum. The diagnosis was made by tomodensitometry.

[Transverse fracture of the body of C2. Apropos of a case]. / Fracture séparation sagittale transcorporéale de C2. A propos d'un cas.

INTRODUCTION: A new fracture of the body of C2 is described. The mechanism is an axial compression producing a body sagittal fracture spreading to the posterior arch with a separation effect. CASE REPORT: A 29 years old female fell from the second floor. Examination showed a head injury and upper neck stiffness. Specific radiological signs was reported on the standard X-ray. The fracture involved the body and the lamina of C2 with a sagittal separation. No neurological abnormality was detected. CT scan provided additional information and allowed the survey of bone healing. Non operative treatment was undertaken by minerva jacket for four months carying complete recovery. DISCUSSION: The mechanism of this fracture seems to be similar to Jefferson's fracture. Review of the literature showed that fractures of the body of C2 are uncommon. Their different types are discussed.

[Simultaneous traumatic dislocations of the index finger. Apropos of a case with review of the literature]. / Luxation étagée traumatique de l'index. A propos d'un cas avec revue de la littérature.

A new case of simultaneous dislocation of the proximal and distal interphalangeal joints on the same digit is reported. This injury is uncommon in the index. The forces were applied to the finger tip in hyperextension position. Closed treatment provided a good result with full range of motion. Therapeutic options are discussed.

[Atlanto-axial Pott's disease. Apropos of a case with review of the literature]. / Mal de Pott atloïdo-axoidien. A propos d'un cas avec revue de la littérature.

INTRODUCTION: A new case of sub-occipital Potts disease is reported. CASE REPORT: A 26 years old female from Senegal was admitted for cervical pain of three months duration, neck stiffness and left nasal obstruction with Arnold neuralgia. Radiological studies found a C1-C2 rotatory subluxation with an osteolytic erosion of the lateral mass of the atlas and destruction of the left atlanto-axial joint. CT scan and magnetic resonance imaging provided important diagnostic clues. Culture of sinus biopsies showed a mycobacterium tuberculosis. Progressive reduction of the dislocation and immobilization by minerva jacket for six months with prolonged antituberculous chemotherapy provided successful end result. DISCUSSION: A review of the literature found 95 cases reported since the beginning of this century. The mean age was 20-30 years old. A finding of acid resistant bacilli is necessary for diagnosis and requires culture of gastric secretion, expectoration, retro pharyngeal mass puncture and other upper respiratory tract foci. Radiological signs are discussed. Chemotherapy is the mainstay of treatment with immobilization following reduction of the dislocation when present. The removal of abscess is discussed as well as bone grafting by an anterior or more commonly by posterior approach in case of instability.

[Bipolar luxation of the 5th metacarpal bone]. / Luxation bipolaire du cinquième métacarpien.

A case of post-traumatic double dislocation of the fifth metacarpal is reported. No reference has been found in the literature. Both were dorsal dislocations, mechanism appears as an axial compression on the metacarpal distal extremity, as first phalanx is hyperextended. Only the carpo-metacarpal-joint was reduced by close technic with percutaneous fixation; the metacarpo-phalangeal dislocation required surgery using a palmar approach. Normal function of the joint was recovered three months later.

Restoration of partially coherent images by use of a second-degree nonlinear filter.

A partially coherent imaging system distorts images nonlinearly. We investigate the restoration of such images by use of a second-degree nonlinear filter which is optimum for low-contrast images. The performance of this filter is shown to be better than that of a linear inverse filter, especially as the imaging becomes more coherent.

Ultrasonic prediction of discordant growth in twin pregnancies.

In this prospective study conducted from 1984 through 1987, the ability to correctly predict growth discordancy in twin gestations by ultrasonic estimated fetal weights is examined. Discordancy was defined as an intertwin birth weight difference of 25% or greater. This method resulted in a sensitivity rate of 77% and a specificity rate of 92%. The positive predictive value of an abnormal test (i.e. discordant growth) was 67% and the negative predictive value of a normal test (i.e. concordant growth) was 95%. The perinatal mortality rate of 217/1,000 in discordant twin fetuses was significantly higher than 29/1,000 in the concordant twins in this study population (p < 0.01) and even more of a contrast to the rate of 10/1,000 in our singleton population. Accurate prediction of discordant twin pregnancies which are at high risk for poor outcome opens the opportunity for potential in utero treatment modalities.

Ultrasound diagnosis of intrauterine growth retardation.

Intrauterine growth retardation is associated with increased perinatal morbidity and mortality. Assuming an accurately dated pregnancy, ultrasonic estimations of fetal weight can be used to predict intrauterine growth retardation. Antenatal detection of this condition will have an impact on management and ideally may improve outcome.

An apparent balanced translocation [t(9;11)(p21.2;p14.2)] in a neonate with dysmorphic features.

The role of so called balanced translocations in human morphogenesis remains puzzling. An eleven month old hispanic female was referred for neurological evaluation. The major dysmorphic features include: epicanthal folds, flat nasal bridge, small mouth, micrognathia, low set ears and cleft-palate. The cytogenetic findings by multiple banding techniques revealed an apparent balanced translocation involving chromosomes 9p and 11p i.e. 46,XX,t(9;11)(p21.2;p14.2) which, according to the authors, has not been previously reported.