The effects of the first wave of COVID-19 restrictions on physical activity: a longitudinal study from "step into health" program in Qatar.

Introduction: The COVID-19 pandemic led to restrictions that prevented physical activity in public places. This study sought to conduct a comprehensive longitudinal analysis of how lockdown policies in an Arabian Gulf country influenced the patterns of physical activity during first wave. Methods: In a longitudinal study design, members of the ongoing "Step into health" community-based health promotion program who provided valid pedometer data from January to August 2020, covering pre, during and post-covid first wave period met the inclusion criteria. Results: 420 (76.7% men, 13.8% ≤40 years) were included in the study. Overall, significant decline in daily step counts was recorded (-1,130 ± SE302) after the implementation of lockdown policies (p < 0.001). When the restrictions were removed, the steps per day were still lower compared to pre-covid for men (-910 ± SE610, p = 0.017) and among individuals with normal BMI (-1,304 ± SE409, p = 0.004). The lockdown in Qatar did not significantly affect women and individuals with obesity who already had lower daily steps pre-covid. Discussion: The present study confirms immediate decline in daily steps imposed indirectly through the COVID-19 lockdown measures. Participants with higher physical activity levels pre-covid experienced significant decline in step count during and even after restrictions were uplifted.

Does tranexamic acid effectively minimise blood loss in cleft palate repair? A rigorous assessment through comprehensive systematic review and meta-analysis.

Cleft palate repair is a common reconstructive procedure that can involve significant blood loss. Tranexamic acid (TXA) has been proposed to minimise blood loss during various surgical procedures, but its effectiveness in cleft palate repair remains unclear. This systematic review and meta-analysis aimed to assess the effectiveness of TXA to reduce postoperative blood loss. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive search across multiple databases, including PubMed, Cochrane, and Web of Science, to identify relevant studies published up to September 2023. Only randomised controlled trials (RCTs) were included. Primary outcomes measured were total blood loss, transfusion rates, and postoperative complications. We identified four relevant RCTs, which included 275 cleft palate patients with a mean (range) age of 28.7 (6-65) months. The pooled analysis found no significant difference in duration of surgery (MD -18.40 minutes, p = 0.09), preoperative haemoglobin (MD 0.46 g/dl, p = 0.27), or postoperative haemoglobin (MD 0.07 g/dl, p = 0.86) between TXA and control groups. Intraoperative blood loss was lower with TXA, but with TXA, the difference was not statistically significant (MD -16.63 ml, p = 0.15). TXA significantly improved surgical field visibility (p = 0.004). No adverse events occurred with its use. While no significant differences were found in surgical outcomes with TXA, surgical field visibility significantly improved, and TXA showed a promising safety profile. Larger and higher-quality RCTs are still needed to validate these preliminary findings before TXA can be considered as a standard treatment.

Case report: Refractory cardiac arrest supported with veno-arterial-venous extracorporeal membrane oxygenation and left-ventricular Impella CP®-Physiological insights and pitfalls of ECMELLA.

Introduction: To the best of our knowledge, this is the first case report which provides insights into patient-specific hemodynamics during veno-arterio-venous-extracorporeal membrane oxygenation (VAV ECMO) combined with a left-ventricular (LV) Impella® micro-axial pump for therapy-refractory cardiac arrest due to acute myocardial infarction, complicated by acute lung injury (ALI). Patient presentation: A 54-year-old male patient presented with ST-segment elevation acute coronary syndrome complicated by out-of-hospital cardiac arrest with ventricular fibrillation upon arrival of the emergency medical service. As cardiac arrest was refractory to advanced cardiac life support, the patient was transferred to the Cardiac Arrest Center for immediate initiation of extracorporeal cardiopulmonary resuscitation (ECPR) with peripheral VA ECMO and emergency percutaneous coronary intervention using drug eluting stents in the right coronary artery. Due to LV distension and persistent asystole after coronary revascularization, an Impella® pump was inserted for LV unloading and additional hemodynamic support (i.e., "ECMELLA"). Despite successful unloading by ECMELLA, post-cardiac arrest treatment was further complicated by sudden differential hypoxemia of the upper body. This so called "Harlequin phenomenon" was explained by a new onset of ALI, necessitating escalation of VA ECMO to VAV ECMO, while maintaining Impella® support. Comprehensive monitoring as derived from the Impella® console allowed to illustrate patient-specific hemodynamics of cardiac unloading. Ultimately, the patient recovered and was discharged from the hospital 28 days after admission. 12 months after the index event the patient was enrolled in the ECPR Outpatient Care Program which revealed good recovery of neurologic functions while physical exercise capacities were impaired. Conclusion: A combined mechanical circulatory support strategy may successfully be deployed in complex cases of severe cardio-circulatory and respiratory failure as occasionally encountered in clinical practice. While appreciating potential clinical benefits, it seems of utmost importance to closely monitor the physiological effects and related complications of such a multimodal approach to reach the most favorable outcome as illustrated in this case.

Multilocular Lipoma in the Middle and Index Fingers: A Case Report.

Lipomas are the most common type of soft tissue tumor, and 95% of them are benign. While lipomas can present anywhere on the body, 1% of them are found in the fingers. The ultimate goal of management is surgical excision of the mass with preservation of the neurovascular surroundings. Here, we present the case of a 24-year-old, morbidly obese Saudi female patient complaining of large non-tender lumps in the index and middle fingers involving the palmar and dorsal surfaces of the left non-dominant hand. The lumps were associated with paresthesia and tingling sensations. The article aims to report and highlight the satisfactory outcomes after total excision of such lipomas and restoring the function as well as the cosmetic results of the hand.

Carbetocin vs. oxytocin at elective caesarean delivery: a double-blind, randomised, controlled, non-inferiority trial of low- and high-dose regimens.

Carbetocin or oxytocin are given routinely as first-line uterotonic drugs following delivery of the neonate during caesarean delivery to prevent postpartum haemorrhage. Low doses may be as effective as high doses with a potential reduction in adverse effects. In this double-blind, randomised, controlled, non-inferiority trial, we assigned low-risk patients undergoing elective caesarean delivery under spinal anaesthesia to one of four groups: carbetocin 20 µg; carbetocin 100 µg; oxytocin 0.5 IU bolus + infusion; and oxytocin 5 IU bolus + infusion. The study drug was given intravenously after delivery of the neonate. Uterine tone was assessed by the obstetrician 2, 5 and 10 minutes after study drug administration according to an 11-point verbal numerical rating scale (0 = atonic, 10 = excellent tone). The primary outcome measure was uterine tone 2 min after study drug administration. The pre-specified non-inferiority margin was 1.2 points on the 11-point scale. Secondary outcomes included uterine tone after 5 and 10 minutes, use of additional uterotonics, blood loss and adverse effects. Data were available for 277 patients. Carbetocin 20 µg resulting in uterine tone of (median (IQR [range])) 8 (7-8 [1-10]) was non-inferior to carbetocin 100 µg with tone 8 (7-9 [3-10]), median (95%CI) difference 0 (-0.44-0.44). Similarly, oxytocin 0.5 IU with tone 7 (6-8 [3-10]) was non-inferior to oxytocin 5 IU with tone 8 (6-8 [2-10]), median (95%CI) difference 1 (0.11-1.89). Carbetocin 20 µg was also non-inferior to oxytocin 5 IU, and oxytocin 0.5 IU was non-inferior to carbetocin 100 µg. Uterine tone after 5 and 10 minutes, use of additional uterotonics, blood loss and adverse effects were similar in all groups.

Effects of COVID-19 Lockdown on Physical Activity, Sedentary Behavior, and Satisfaction with Life in Qatar: A Preliminary Study.

This study examined the effects of home confinement on physical activity (PA) and life satisfaction during the COVID-19 outbreak in Qatar. A total of 1144 subjects participated (male: n = 588; female: n = 556; age: 33.1 ± 11.1 years; mass: 76.1 ± 16.4 kg; height: 1.70 ± 0.11 m; body mass index (BMI): 26.1 ± 4.44  kg/m2). Online survey questions considered "before" and "during" confinement. Confinement reduced all PA intensities (ηp2 = 0.27-0.67, p < 0.001) and increased daily sitting time from 3.57 ± 1.47 to 6.32 ± 1.33 h per weekday (ηp2 = 0.67, p < 0.001). The largest reduction was detected for the sum parameter all physical activity (minutes per week, ηp2 = 0.67, p < 0.001; MET (metabolic equivalent of task)-minutes/week, ηp2 = 0.69, p < 0.001). Life satisfaction decreased, with the score for "I am satisfied with my life" (ηp2 = 0.76, p < 0.001) decreasing from 28.1 ± 4.81 to 14.2 ± 6.41 arbitrary units (AU). Concerning life satisfaction, the largest change was detected for the statement "the conditions of my life are excellent" (dmale = 7.93). For all parameters, time effects were indicative of large negative effects in both genders. In terms of magnitude, the difference between gender was greatest for the parameter "the conditions of my life are excellent" (difference between groups, d = 4.84). In conclusion, COVID-19 confinement decreased PA, increased sitting time, and decreased life satisfaction in Qatar. These precautionary findings explicate the risk of psychosocial impairment and the potential physical harm of reducing physical activity during early COVID-19 confinement in 2020.

Excess mortality during the COVID-19 pandemic: a geospatial and statistical analysis in Aden governorate, Yemen.

BACKGROUND: The burden of COVID-19 in low-income and conflict-affected countries remains unclear, largely reflecting low testing rates. In parts of Yemen, reports indicated a peak in hospital admissions and burials during May-June 2020. To estimate excess mortality during the epidemic period, we quantified activity across all identifiable cemeteries within Aden governorate (population approximately 1 million) by analysing very high-resolution satellite imagery and compared estimates to Civil Registry office records. METHODS: After identifying active cemeteries through remote and ground information, we applied geospatial analysis techniques to manually identify new grave plots and measure changes in burial surface area over a period from July 2016 to September 2020. After imputing missing grave counts using surface area data, we used alternative approaches, including simple interpolation and a generalised additive mixed growth model, to predict both actual and counterfactual (no epidemic) burial rates by cemetery and across the governorate during the most likely period of COVID-19 excess mortality (from 1 April 2020) and thereby compute excess burials. We also analysed death notifications to the Civil Registry office over the same period. RESULTS: We collected 78 observations from 11 cemeteries. In all but one, a peak in daily burial rates was evident from April to July 2020. Interpolation and mixed model methods estimated ≈1500 excess burials up to 6 July, and 2120 up to 19 September, corresponding to a peak weekly increase of 230% from the counterfactual. Satellite imagery estimates were generally lower than Civil Registry data, which indicated a peak 1823 deaths in May alone. However, both sources suggested the epidemic had waned by September 2020. DISCUSSION: To our knowledge, this is the first instance of satellite imagery being used for population mortality estimation. Findings suggest a substantial, under-ascertained impact of COVID-19 in this urban Yemeni governorate and are broadly in line with previous mathematical modelling predictions, though our method cannot distinguish direct from indirect virus deaths. Satellite imagery burial analysis appears a promising novel approach for monitoring epidemics and other crisis impacts, particularly where ground data are difficult to collect.

Excess mortality during the COVID-19 pandemic in Aden governorate, Yemen: a geospatial and statistical analysis

BackgroundThe burden of COVID-19 in low-income and conflict-affected countries is still unclear, largely reflecting low testing rates. In parts of Yemen, reports indicated a peak in hospital admissions and burials during May-June 2020. To estimate excess mortality during the epidemic period, we quantified activity across all identifiable cemeteries within Aden governorate in Yemen (population approximately one million) by analysing very high-resolution satellite imagery, and compared estimates to Civil Registry office records from the city. MethodsAfter identifying active cemeteries through remote and ground information, we applied geospatial analysis techniques to manually identify new grave plots and measure changes in burial surface area over a period from July 2016 to September 2020. After imputing missing grave counts using surface area data, we used alternative approaches, including simple interpolation and a generalised additive mixed growth model, to predict both actual and counterfactual (no epidemic) burial rates by cemetery and across the governorate during the most likely period of COVID-19 excess mortality (from 1 April 2020), and thereby compute excess burials. We also analysed death notifications to the Civil Registry office during April-July 2020 and in previous years. ResultsWe collected 78 observations from 11 cemeteries, of which 10 required imputation from burial surface area. Cemeteries ranged in starting size from 0 to 6866 graves. In all but one a peak in daily burial rates was evident from April to July 2020. Interpolation and mixed model methods estimated {approx} 1500 excess burials up to 6 July, and 2120 up to 19 September, corresponding to a peak weekly increase of 230% from the counterfactual. Satellite imagery estimates were generally lower than Civil Registry data, which indicated a peak 1823 deaths in May alone. However, both sources suggested the epidemic had waned by September 2020. DiscussionTo our knowledge this is the first instance of satellite imagery being used for population mortality estimation. Findings suggest a substantial, under-ascertained impact of COVID-19 in this urban Yemeni governorate, and are broadly in line with previous mathematical modelling predictions, though our method cannot distinguish direct from indirect virus deaths. Satellite imagery burial analysis appears a promising novel approach for monitoring epidemics and other crisis impacts, particularly where ground data are difficult to collect.

Decreased Subcortical T2 FLAIR Signal Associated with Seizures.

Abnormally decreased T2/T2 FLAIR signal can be seen on brain imaging of patients who are experiencing clinical or subclinical seizures and can be associated with various intracranial pathologies. We identified 29 such patients. The abnormal signal was unilateral in 75.9% of patients. It affected various lobes of the brain, but only in the anterior circulation. In 28 patients (96.6%), there was corresponding decreased signal on DWI. The ADC was normal in all cases. In 26 patients (89.7%), there was corresponding low signal on SWI/gradient recalled-echo; 44.8% of patients underwent contrast-enhanced scans, and there was no abnormal enhancement. Twenty-two (75.9%) patients had documented clinical seizures on the day of imaging. The most frequent concomitant pathology was a subdural hematoma. Electroencephalograms obtained within 24 hours of imaging were available in 65.5%. Findings of all of these electroencephalograms were abnormal, and these electroencephalogram changes were either localized to the area of the abnormal MR imaging signal (where the signal was unilateral) or were bilateral (where the MR imaging changes were bilateral). In summary, decreased white matter T2/T2 FLAIR signal changes can be seen in patients with remarkably similar clinical findings (particularly seizures). These changes are often correlated with abnormal electroencephalogram activity localized to the involved lobes.

Effect of a pedometer-based walking challenge on increasing physical activity levels amongst hospital workers.

BACKGROUND: More than 50% of Qatari adults are physically inactive. The workplace is an excellent environment to implement cost-effective, efficient behavioural physical activity (PA) interventions to increase PA. This study evaluated whether a pedometer-based walking challenge would increase PA levels amongst hospital workers. METHODS: A pedometer-based workplace walking intervention was implemented in April-August 2017. Amongst 800 recruited full-time hospital workers, a cross-sectional sample of 212 workers completed the online questionnaires Quality of Life Questionnaire, International Physical Activity Questionnaire (IPAQ), and Workforce Sitting Questionnaire. A sub-sample of participants (n = 54) wore a pedometer for 3 months. They recorded their daily step count through an online web platform linked to the pedometer. Another cross-sectional sample (n = 194) in the same target population completed online questionnaires at post intervention. RESULTS: The IPAQ assessed physical activity at post-intervention was higher compared to pre-intervention. In a sub-sample (n = 54) that provided pedometer data, workers' step count during intervention was significantly higher (9270) from pre-intervention (7890) (p = 0.048). CONCLUSIONS: Although self-reported PA was higher post-intervention, the subsample showed objectively assessed physical activity did not exceed the threshold recommended for optimal health. Therefore, encouraging participation and maintaining motivation amongst workers in a work-based PA programme is challenging.

Palmitoylation of Ca2+ channel subunit CaVß2a induces pancreatic beta-cell toxicity via Ca2+ overload.

High blood glucose triggers the release of insulin from pancreatic beta cells, but if chronic, causes cellular stress, partly due to impaired Ca2+ homeostasis. Ca2+ influx is controlled by voltage-gated calcium channels (CaV) and high density of CaV in the plasma membrane could lead to Ca2+ overload. Trafficking of the pore-forming CaVα1 subunit to the plasma membrane is regulated by auxiliary subunits, such as the CaVß2a subunit. This study investigates, using Ca2+ imaging and immunohistochemistry, the role of palmitoylation of CaVß2a in maintaining Ca2+ homeostasis and beta cell function. RNA sequencing data showed that gene expression of human CACNB2, in particular CACNB2A (CaVß2a), is highest in islets when compared to other tissues. Since CaVß2a can be regulated through palmitoylation of its two cysteines, CaVß2a and its mutant form were overexpressed in pancreatic beta cells. Palmitoylated CaVß2a tethered to the plasma membrane and colocalized with CaV1.2 while the mutant form remained in the cytosol. Interestingly, CaVß2a overexpression raised basal intracellular Ca2+ and increased beta cell apoptosis. Our study shows that palmitoylation of CaVß2a is necessary for CaVα1 trafficking to the plasma membrane. However, excessive number of palmitoylated CaVß2a leads to Ca2+ overload and beta cell death.

Building Capability for Clinical Pharmacology Research in Sub-Saharan Africa.

A strong scientific rationale exists for conducting clinical pharmacology studies in target populations because local factors such as genetics, environment, comorbidities, and diet can affect variability in drug responses. However, clinical pharmacology studies are not widely conducted in sub-Saharan Africa, in part due to limitations in technical expertise and infrastructure. Since 2012, a novel public-private partnership model involving research institutions and a pharmaceutical company has been applied to developing increased capability for clinical pharmacology research in multiple African countries.

Efficacy and safety of early tacrolimus conversion to sirolimus after kidney transplantation: Long-term results of a prospective randomized study.

We report a prospective, open-label, randomized study to evaluate the safety and efficacy of converting patients with a stable renal function from tacrolimus (Tac)-based regimen to a sirolimus (SRL)-based regimen after kidney transplantation. Fifty-eight low-risk renal allograft recipients who receiving Tac 6 months posttransplant, were randomly assigned to continue Tac (n = 29) or convert to SRL (n = 29). We evaluated the 3-year outcomes including patient and graft survival, graft function, and safety profile. Three-year patient and graft survival in SRL and Tac groups were 93.1% versus 100% (P = 0.32), and 89.7% versus 100% (P = 0.11), respectively. However, the SRL group had a significantly better renal function, from the 2nd year posttransplant until the last follow-up. Four (13.8%) patients in the SRL group and 3 (10.3%) in the Tac group (P = 0.5) developed biopsy-proven acute rejection. Mean urinary protein excretion increased significantly after SRL conversion. Diastolic blood pressure was significantly lower at the end of the study in patients who eliminated Tac (80.4 vs. 75.6 mmHg in Tac and SRL group, respectively) (P = 0.03). Mean hemoglobin concentrations decreased after SRL conversion and remained significantly lower from 12 months to 36 months (P = 0.01). The mean serum cholesterol (540 ± 44 mg/dl) and triglyceride (177 ± 27 mg/dl) increased significantly in the SRL group, compared to Tac group (487 ± 62 mg/dl) (P = 0.03) and (141 ± 26 mg/dl) (P = 0.04). Our experience demonstrates that conversion to SRL from calcineurin inhibitors-based therapy may result in better renal function and blood pressure control in renal transplant recipients without an increased risk of acute rejection. However, these benefits have not resulted in a growing advantage in graft or patient survival.

Effectiveness of "Step into Health" program in Qatar: a pedometer-based longitudinal study.

BACKGROUND: This study examines the impact of a one-year pedometer-based intervention on increasing the physical activity level among adult population in Qatar. METHODS: This longitudinal study was conducted over a one-year period and included a total of 268 adults aged between 18-64 years old. Data were extracted and used from the "Step into Health" (SIH) program, a community-based program launched in 2012, as an approach to improve physical activity in Qatar. Walking intervention encouraged members of SIH to accumulate 10,000 steps or more per day and monitor their progress through a pedometer supported by a self-monitoring online account and a reinforcement system. RESULTS: This study shows a significant increase in average daily steps from 3933±3240 steps/day at baseline into 7507±5416 steps/week at the 12th month (P<0.001). It was found that 18.6% of participants met the daily target of 10,000 steps or more; however, there was a considerable increase of 39.2% by the 12th month. Females showed an increase in their physical activity; still, they remain less active than males. It was found that non-Arabs subgroup were more active than Arabs. Interestingly, older members (≥50 years old) were more active throughout the study period. CONCLUSIONS: Pedometer program was found to be effective in increasing the level of physical activity among participants. A decline in physical activity has been observed during hot weather, while re-enforcement campaign had a positive impact on the number of steps/day.

Impact of Climatic Conditions on Physical Activity: A 2-Year Cohort Study in the Arabian Gulf Region.

BACKGROUND: Little is known about the effects that climatic conditions, especially extreme heat, have on physical activity (PA) levels. The aim of this 2-year cohort analysis undertaken in the Arabian Gulf region was to assess changes in objectively-assessed PA as a result of changes in climatic conditions. METHODS: A total of 2088 adults (1390 men and 698 women) from many regions of the world were enrolled in a community health program in Qatar, were included in this study. For 2 years participants recorded daily step count using an Omron HJ-720 ITC pedometer. Daily climate parameters included temperature, relative humidity and other conditions. RESULTS: From linear mixed model analysis it was evident that higher average temperature and humidity, and the Wet bulb Globe Temperature (WbGT), resulted in a reduction of the number of steps taken per day. Analysis of interaction effects also revealed that the effects of heat stress were equivalent across gender, age, and the region participants came from according to a World Health Organization classification scheme. CONCLUSIONS: Increased temperature and humidity are associated with a reduction in the number of steps taken per day. Community-based PA programs in hot hot/humid climates should consider novel approaches to increase PA levels.

Nutrient intake of infants and toddlers in the United Arab Emirates: the Feeding Infants and Toddlers Study.

This descriptive study evaluated the nutrient adequacy of the diet of infants (aged 6-11.9 months) and toddlers (aged 12-24 months) in the United Arab Emirates. A random sample of 1000 infants and toddlers was recruited from 2 cities (Al Ain and Dubai) from March 2011 to February 2012 and their usual nutrient intake was determined using 24-hour recall. In all, 54.2% of infants and 25.2% of toddlers were breastfeeding. Mean energy intake of infant girls in Al Ain and Dubai was 747 (SD 189) kcal and 773 (SD 215) kcal respectively and 810.5 (SD 232.2) kcal and 821.9 (SD 262) kcal for boys. In toddlers, mean energy intake for girls in Al Ain and Dubai was 1032.8 (SD 252) kcal and 1013 (SD 339.1) kcal respectively and 1057.2 (SD 201.8) kcal and 1030.3 (SD 341.7) kcal for boys. Iron intake was low in both groups. Mean body mass index and body weight and height were similar to World Health Organization figures but significant numbers of infants and toddlers of both sexes were over- or underweight. Although mean energy and macronutrient intakes were comparable to the RDA, significant numbers were over- or underfed.

Elevated Basal Insulin Secretion in Type 2 Diabetes Caused by Reduced Plasma Membrane Cholesterol.

Elevated basal insulin secretion under fasting conditions together with insufficient stimulated insulin release is an important hallmark of type 2 diabetes, but the mechanisms controlling basal insulin secretion remain unclear. Membrane rafts exist in pancreatic islet cells and spatially organize membrane ion channels and proteins controlling exocytosis, which may contribute to the regulation of insulin secretion. Membrane rafts (cholesterol and sphingolipid containing microdomains) were dramatically reduced in human type 2 diabetic and diabetic Goto-Kakizaki (GK) rat islets when compared with healthy islets. Oxidation of membrane cholesterol markedly reduced microdomain staining intensity in healthy human islets, but was without effect in type 2 diabetic islets. Intriguingly, oxidation of cholesterol affected glucose-stimulated insulin secretion only modestly, whereas basal insulin release was elevated. This was accompanied by increased intracellular Ca2+ spike frequency and Ca2+ influx and explained by enhanced single Ca2+ channel activity. These results suggest that the reduced presence of membrane rafts could contribute to the elevated basal insulin secretion seen in type 2 diabetes.

Paediatric vertebral marrow signal: defining a normal reference range for the marrow-to-disc signal ratio.

AIM: To establish a normal reference range of bone marrow from birth to 16 years of age. MATERIALS AND METHODS: Two independent observers performed region-of-interest measurements of the magnetic resonance imaging (MRI) signal on sagittal non-contrast T1-weighted images of the spine of paediatric patients collected from a 12-year picture archiving and communication system (PACS) archive. The mean signal of the bone marrow and adjacent intervertebral disc were recorded. The mean marrow signal of the L1-L5 vertebrae was expressed as a ratio to the mean signal from the adjacent disc. RESULTS: Two hundred and ninety-seven MRI studies (149 males, 148 females) met inclusion criteria. The ratio of the signal from the vertebral marrow to disc increased with age. The normal reference range was calculated for each of six age groups and defined as two standard deviations above and below the mean. The lower limit of the reference range crossed the isointense line at the age of 2 years. CONCLUSION: The ratio of disc to marrow signal increases until the age of 2 years, after which it remains stable. It can be normal to see a bright disc on T1 below the age of 1 year, but after the age of 2 years a hyperintense disc on T1 is outside the 95% reference range.

Nutrient intake of infants and toddlers in the United Arab Emirates: the Feeding Infants and Toddlers Study

This descriptive study evaluated the nutrient adequacy of the diet of infants [aged 6-11.9 months] and toddlers [aged 12-24 months] in the United Arab Emirates. A random sample of 1000 infants and toddlers was recruited from 2 cities [Al Ain and Dubai] from March 2011 to February 2012 and their usual nutrient intake was determined using 24-hour recall. In all, 54.2% of infants and 25.2% of toddlers were breastfeeding. Mean energy intake of infant girls in Al Ain and Dubai was 747 [SD 189] kcal and 773 [SD 215] kcal respectively and 810.5 [SD 232.2] kcal and 821.9 [SD 262] kcal for boys. In toddlers, mean energy intake for girls in Al Ain and Dubai was 1032.8 [SD 252] kcal and 1013 [SD 339.1] kcal respectively and 1057.2 [SD 201.8] kcal and 1030.3 [SD 341.7] kcal for boys. Iron intake was low in both groups. Mean body mass index and body weight and height were similar to World Health Organization figures but significant numbers of infants and toddlers of both sexes were over- or underweight. Although mean energy and macronutrient intakes were comparable to the RDA, significant numbers were over- or underfed

La présente étude descriptive avait pour objectif d'évaluer la valeur nutritionnelle de l'alimentation des nourrissons [6 à 11,9 mois] et des jeunes enfants [12 à 24 mois] aux Emirats arabes unis. Un échantillon aléatoire de 1000 nourrissons et de jeunes enfants a été sélectionné dans deux villes [Al-Aïn et Dubaï] entre mars 2011 et février 2012, et leur apport nutritionnel habituel a été déterminé au moyen du rappel des 24h. Au total, 54,2% des nourrissons et 25,2% des jeunes enfants étaient allaités au sein. L'apport énergétique moyen des nourrissons de sexe féminin à Al-Aïn et Dubaï était de 757 kcal [ET 189] et de 773 kcal [ET 215] respectivement, et de 810,5 kcal [ET 232,2] et de 821,9 kcal [ET 262] pour les nourrissons de sexe masculin. Concernant les jeunes enfants, l'apport énergétique moyen des petites filles à Al-Aïn et Dubaï était de 1032,8 kcal [ET 252] et de 1013 kcal [ET 339,1] respectivement, et de 1057,2 kcal [ET 201,8] et de 1030,3 kcal [ET 341,7] pour les petits garçons. L'apport en fer était faible dans les deux groupes. L'index de masse corporelle ainsi que le poids corporel et la taille moyens étaient similaires aux chiffres de l'Organisation mondiale de la Santé, mais un nombre important de nourrissons et de jeunes enfants des deux sexes étaient en surpoids ou souffraient au contraire d'insuffisance pondérale. Bien que l'apport énergétique et l'apport en macronutriments moyens étaient comparables aux apports journaliers recommandés, un nombre important des sujets étaient sur ou sous-alimentés