The global prevalence of screen-based disordered eating and associated risk factors among high school students: systematic review, meta-analysis, and meta-regression.

OBJECTIVE: Estimate the prevalence, and associated risk factors, of high school students who are considered at risk for an eating disorder based on screening measures. METHODS: An electronic search of nine databases was completed from their inception until 1st September 2022. A random-effects meta-analysis was conducted, and confounder (moderator) analyses and meta-regressions examined whether the overall prevalence estimate for of screen-based disordered eating (SBDE) was moderated by student age, BMI, or gender, as well as culture and type of SBDE assessment. RESULTS: The mean estimate of the prevalence of SBDE among high school students (K = 42 (66 datapoints), N = 56282] in the sample of 25 countries was 13% ([95% CI] = 10.0-16.8%, I2 = 99.0%, Cochran's Q p = 0.001). This effect was not moderated by features of the samples such as gender, BMI, or age. Among cultures, non-Western countries had a higher prevalence of SBDE prevalence than Western countries, but the difference was not significant. There was considerable variability in the prevalence estimates as a function of the assessment measure, but no meaningful pattern emerged. CONCLUSION: The estimated figure of 1 in 8 high school students with SBDE-unmoderated by gender and BMI-stands out as a problem in need of attention from public health officials, psychologists, psychiatrists, pediatricians, parents, and educators. There is a great need for innovative, integrated policy and program development all along the spectrum of health promotion and universal, selective, and indicated prevention. Further research is also needed to validate and refine this estimate by (a) conducting basic research on the accuracy of eating disorder screening measurements in samples ages 14 through 17; (b) examining representative samples in more countries in general and Latin American countries in particular; (c) clarifying the relationships between SBDE and age throughout the different phases of late childhood, adolescence, and emerging adulthood; and (d) investigating whether there are meaningful forms of disordered eating and whether these are associated with variables such as gender, ethnicity, and BMI.

We searched nine databases to identify studies of high school students that yielded an estimate of disordered eating based on screening measures such as the Eating Attitudes Test. Forty-two 42 studies (N = 56282 students) from 25 countries met the selection criteria. A random effects meta-analysis indicated that across those countries the best estimate of the prevalence of screen-based disordered eating is 13%. This estimate was not significantly moderated by BMI, gender, age, and whether the country was Western or non-Western. There was considerable variability in the prevalence estimates as a function of the assessment measure, but no meaningful pattern emerged. The estimated figure of 1 in 8 high school students with disordered eating is a problem deserving of attention from public health officials, psychologists, psychiatrists, pediatricians, parents, educators, and leaders committed to prevention and early identification of eating disorders and referral for treatment. Further research in many more countries is also needed to validate this estimate and to explore its relationship with development throughout adolescence and with variables that can help us to refine prevention and effective early identification and treatment of eating disorders.

Association between IRS-1, PPAR-γ and LEP genes polymorphisms and growth traits in rabbits.

Single nucleotide polymorphisms are commonly associated with changes in quantitative traits, and have been considered useful markers for improving different traits in livestock. The current study aimed to explore the effect of three SNPs located in Insulin receptor substrate (IRS-1), Peroxisome proliferator-activated receptor γ (PPAR-γ), and Leptin (LEP) genes on the growth traits of rabbits. Individuals from three rabbit breeds were genotyped using RFLP-PCR. The IRS-1 variant (c.189T > G) was associated with post-weaning body weight, and body weight gains, However, the effect on growth rates was insignificant in Baladi Red and V-line rabbits. The PPAR-γ variant (c.207A > C) was significantly associated with 8-wk body weights in V-line rabbits, 10-wk body weights, and growth rates from 8 to 10 weeks of age in New Zealand rabbits. However, the differences between genotypes were insignificant for body weight gains and average daily gain. The LEP gene mutation (g.16079636C > G) had significant effects on body weights at 6 and 8 weeks of age in New Zealand White rabbits and 8 weeks of age in Baladi Red rabbits were associated with the presence of the C allele. Concludingly, the results stressed the importance of the IRS-1 gene in post-weaning growth and suggested the existence of breed-specific effects for PPAR-γ and LEP.

The prevalence and risk factors of screen-based disordered eating among university students: a global systematic review, meta-analysis, and meta-regression.

PURPOSE: The purpose of this review was to estimate the prevalence of screen-based disordered eating (SBDE) and several potential risk factors in university undergraduate students around the world. METHODS: An electronic search of nine data bases was conducted from the inception of the databases until 1st October 2021. Disordered eating was defined as the percentage of students scoring at or above established cut-offs on validated screening measures. Global data were also analyzed by country, research measure, and culture. Other confounders in this review were age, BMI, and sex. RESULTS: Using random-effects meta-analysis, the mean estimate of the distribution of effects for the prevalence of SBDE among university students (K = 105, N = 145,629) was [95% CI] = 19.7% [17.9%; 21.6%], I2 = 98.2%, Cochran's Q p value = 0.001. Bayesian meta-analysis produced an estimate of 0.24, 95% credible intervals [0.20, 0.30], τ = 92%. Whether the country in which the students were studying was Western or non-Western did not moderate these effects, but as either the mean BMI of the sample or the percentage of the sample that was female increased, the prevalence of SBDE increased. CONCLUSIONS: These findings support previous studies indicating that many undergraduate students are struggling with disordered eating or a diagnosable eating disorder, but are neither receiver effective prevention nor accessing accurate diagnosis and available treatment. It is particularly important to develop ever more valid ways of identifying students with high levels of disordered eating and offering them original or culturally appropriate and effective prevention or early treatment. LEVEL OF EVIDENCE: I, systematic review and meta-analysis.

Exploring agendas of patients attending family medicine clinics in Jordan. A qualitative content analysis study.

OBJECTIVES: To explore concerns, beliefs, and expectations of patients who attend Family Medicine clinics in  the University of Jordan Hospital, Amman, Jordan. Methods: A qualitative descriptive design was used. Semi-structured interviews were conducted with 143 patients (84% females, mean age 45.3±17.8 years) between September and December 2016. A validated patient's agenda form included open-ended questions on patients' main concerns, beliefs, and expectations was used. A qualitative content analysis of answers was completed by coding answers into categories. Results: A good aggregate inter-rater reliability for coding categories was found (κ-values ranging from 0.76-0.88). The most common concern of participants were the need to receive treatment for an acute illness, followed by the desire for clarification on health condition. Forty percent of participants believed that their symptoms were caused by a health condition rather than lifestyle, while 32.5% had no speculations related to the causes behind their symptoms. The highest percentage of patients expected doctors to provide information related to their health condition. Conclusion: The most prominent needs of participants were the need for information and explanation regarding health condition. Family doctors are encouraged to use agenda forms to enhance patient communications and improve outcomes of consultations.

Clinical and histopathologic prognostic implications of the expression of cytokeratins 8, 10, 13, 14, 16, 18 and 19 in oral and oropharyngeal squamous cell carcinoma.

OBJECTIVES: To identify cytokeratins (CK) of significant correlations with clinical and histopathologic prognostic parameters in oral and oropharyngeal squamous cell carcinoma (SCC). DESIGN: The sample consisted of 100 cases retrieved from the archives of the Pathology Department/ King Hussein Cancer Center/Amman/ Jordan. Recorded data included: age, gender, location, grade, depth of invasion, the presence of epithelial dysplasia, tumor size, lymph node metastasis, number of positive lymph nodes, distant metastases, clinical stage, local recurrence, treatment modalities and 5-year survival rate. Immunohistochemical staining of 7 cytokeratins: 8, 10, 13, 14, 16, 18, and 19 was performed using standard protocols. Stained sections were digitized and analyzed using ImageJ-color deconvolution to identify the percentage of cytokeratin-positive area (score). Statistical tests used were: student t-test, analysis of variance, bivariate analysis and logistic regression. RESULTS: Lower CK8,18, 19 scores correlated with lower 5-year survival rate. Higher CK19 and lower CK 10, 14, 16 scores were associated with distant metastasis. Increased CK8, 18, 19 scores correlated with higher stage and with higher depth of invasion. Increased CK18 scores correlated with increased local recurrence. Higher CK10, 13, 16 scores correlated with well-differentiated grade. Higher CK19 and lower CK16 scores were associated with adjacent epithelial dysplasia. Regression analysis showed that better 5-year survival rate was significantly correlated with increased CK16, decreased CK18 and 19 scores. CONCLUSION: Expression scores of a panel of cytokeratin are potential prognostic indicators for 5-year survival and correlates with other prognostic parameters.

Awareness of oral medicine among medical practitioners, evidence of the unbridged interdisciplinary gap.

RATIONALE, AIMS, AND OBJECTIVES: Inadequate awareness of oral health and related disciplines appears to be common among medical practitioners. This study was designed to evaluate the awareness of oral medicine (OM) specialty and its scope of practice among Jordanian medical practitioners and to outline potential strategies for improvement where appropriate. METHOD: A specially designed questionnaire was electronically distributed to Jordanian medical practitioners and thereafter via personal interviews to improve the response rate. The questionnaire comprised nine questions and covered demographical details and characteristics of participants, in addition to their awareness of OM and agreement to refer a group of common oral and dental conditions to OM specialists. Pearson Chi-square tests were used to examine the significance of association between the variables of respondents and awareness of OM. Significance level was set at P values < 0.05. RESULTS: A total of 1492 respondents completed the questionnaire, of which 779 (52.2%) were aware of OM as an independent specialty. Age group, higher degrees in medicine, country of graduation, and the specialty type were significant determinants of OM awareness level. Oral ulceration and other mucosal pathology, including fungal infections, were the most likely conditions to be referred to OM specialists while participants had apparent problems separating the scope of practice of OM from other dental disciplines. CONCLUSION: This study provides evidence on the profound interdisciplinary gap between medicine and dentistry and highlights the importance of more focused education and training in oral health-related disciplines to be provided to clinicians and medical trainees as described.

[Prescription of antimalarial drugs in the pediatric ward of the National Hospital of Lamordé, in Niamey]. / Prescription d'antipaludiques dans le service de pédiatrie de l'Hôpital national de Lamordé, à Niamey.

In Niger, malaria is a major public health problem, due to the high number of deaths that are attributable to it and because of its heavy weight and socioeconomic status. The objective of this study was to contribute to the inventory of medical practices to rationalize the use of medicines and minimize the resistance phenomenon. This is a prospective study, which took place from May 1 to July 31, 2009, in the pediatric ward of the National Hospital of Lamordé. It concerned children aged from 0 to 14 years hospitalized and having received one or more antimalarial drugs during at least 24 h. During the 3 months of the study, 1,248 children had been admitted in the department. Among them, 881 children received antimalarial treatment, i.e., 70.5% with prescriptions. Malaria was confirmed by microscopy in 410 children, i.e., 46.5% of the sick children received antimalarial treatment. Prescription control was deemed noncompliant in 258 patients, i.e., 29.3% of the total. Treatments based on microscopic diagnosis are one of the strategies that will help to streamline the use of antimalarial drugs to improve their effectiveness and efficiency and also to reduce the risk of emergence of resistance.

[Mortal poisoning by bee stings in a child: Study of a case observed in the regional hospital of Maradi (Niger)]. / Envenimation mortelle par piqûres d'abeilles chez l'enfant : à propos d'un cas observé au centre hospitalier régional de Maradi (Niger).

We report a fatal case due to a massive attack by a swarm of bees in a nine-year-old child. The accident was fatal because of two aggravating factors: the cephalic location and the large number of stings (about 300). Complications were coagulopathy, anemia, hemorrhage, coma, and oligoanuria. Support was symptomatic at a facility second level. The outcome was fatal within 14 days. In view of the encountered difficulties, we recommend to build written protocols for the management of envenomation in any health training reference.

Immunohistochemical expression of keratins 6, 7, 8, 14, 16, 18, 19, and MNF-116 pancytokeratin in primary and metastatic melanoma of the head and neck.

OBJECTIVE: To investigate the immunohistochemical expression (IHCE) of selected keratins in primary cutaneous and mucosal melanoma (pM), and metastatic melanoma (metsM) of the head and neck and to compare their expression to a group of undifferentiated/poorly differentiated tumors of the same anatomic region. STUDY DESIGN: IHCE of K6, K7, K8, K14, K16, K18, and K19 were studied in 29 melanomas and 70 cases of non-melanoma tumors of the same anatomic region (neuroendocrine carcinoma, neuroblastoma, olfactory neuroblastoma, sinonasal undifferentiated carcinoma, undifferentiated nasopharyngeal carcinoma, anaplastic large cell lymphoma, poorly differentiated squamous cell carcinoma (PDSCC), and Ewing sarcoma). MNF-116 pancytokeratin was investigated in melanoma. RESULTS: All studied keratins, except K6, were expressed in melanoma. IHCE of MNF-116, K8, and K18 was higher in metsM compared with pM. K14 and K16 expression was highest in PDSCC. CONCLUSIONS: metsM expresses keratins more than pM, specifically K8, K18, and MNF-116. Keratin positivity in an undifferentiated or poorly differentiated neoplasm does not necessarily exclude the diagnosis of melanoma.

[Tuberculosis in children: 29 cases in two hospitals of Niamey and at the national tuberculosis center]. / La tuberculose chez l'enfant: a propos de 29 cas colliges dans deux hopitaux de Niamey et au centre national antituberculeux.

In 2013, the WHO considered that worldwide, the annual incidence of the tuberculosis is of 9 million cases, and prevalence at 14 million. The diagnosis of tuberculosis in children is difficult and can be at the origin of a delay of care and an under estimation of the amount of cases. The purpose of this study was to analyze the epidemiological and diagnostic aspects of tuberculosis in children. It was a multicenter study taking place from October 1st, 2009 until June 1st, 2011. The average age of children was of 4.6 years, with a sex-ratio of 1.43. 65, 52% of patients were inoculated with BCG; 86, 21% arose from family from a low socio-economic level; 55% suffered from malnutrition. Extrapulmonary effects are more frequent than pulmonary (62.07% versus 37.93%). IDR was positive in 85.71% of the children; the sedimentation speed was high in 88.89% of them. The HIV serology tests were administered to 27.59% of the children, all were seronegative. The fight against tuberculosis has to intensify, through the combination of several strategies, such as vaccination, active screening, the adequate care of the cases, improvement of socioeconomic conditions of the populations and research for a new more effective vaccine, news methods of diagnostic and antituberculosis drugs successful.

INTRODUCTION: En 2013, l'OMS a estimé qu'à travers le monde, l'incidence annuelle de la tuberculose était de 9 millions de cas, et la prévalence de 14 millions. Le diagnostic chez l'enfant est difficile et cela est à l'origine de retard de prise en charge et d'une sous estimation des cas. MÉTHODE: Cette étude a été réalisée dans le but d'analyser les aspects épidémiologiques et diagnostiques de la tuberculose chez l'enfant. Il s'agit d'une étude multicentrique prospective qui s'est déroulée d'octobre 2009 à juin 2011, à Niamey dans les deux hôpitaux nationaux et au Centre National Antituberculeux. RÉSULTATS: L'âge moyen des enfants était de 4,6 ans, et le sex-ratio était de 1,4. Soixante cinq virgule cinq pourcent des patients étaient vaccinés au BCG; 86, 2% étaient issus de famille à bas niveau socio-économique; 55% d'entre eux souffraient de malnutrition. Les atteintes extra-pulmonaires étaient plus fréquentes que les formes pulmonaires (62,1% versus 37,9%). L'IDR était positive chez 85,7% des enfants; la vitesse de sédimentation était élevée chez 88,9% d'entre eux. Le test sérologique pour le VIH a été fait chez 27,6% des enfants; tous étaient séronégatifs. CONCLUSION: La lutte contre la tuberculose doit s'intensifier, à travers la combinaison de plusieurs stratégies, telles que la vaccination, le dépistage actif, la prise en charge adéquate des cas, l'amélioration des conditions socio-économiques des populations et la recherche d'un nouveau vaccin, ainsi que de nouvelles méthodes de diagnostic.