Leadership component of type A behavior predicts physical activity in early midlife

Background  

Research on the long-term effects of Type A behavior and its components in the prediction of physical activity in adulthood is scarce and there is a lack of prospective data that are able to show such an association.     

Cardio-Facio-Cutaneous syndrome: Three additional cases and review of the literature

We report on 3 patients with the cardio-faciocutaneous (CFC) syndrome. Each of them was a sporadic case in the family. The severity of the psychomotor retardation varied from mild to severe. Skin manifestations were often minimal, but each patient had abnormally curly and brittle hair. A skin biopsy from one of the patients showed vellus hair cysts filled with keratin, and the hair follicles were surrounded by unusually thick fibrotic sheaths. © 1992 Wiley-Liss, Inc.     

The effect of incidental dural lesions on outcome after decompression surgery for lumbar spinal stenosis: results of a multi-center study with 800 patients

Purpose

Incidental durotomy is one of the most common complications in lumbar spine surgery. There are conflicting reports whether a dural lesion is associated with an inferior outcome after lumbar decompression. This study analyzed the effect of incidental durotomy in this specific group of patients (Dura+) and compared the results with the remaining cohort without dural laceration (Dura?).

Methods

This prospective multi-center study included 800 patients with lumbar spinal stenosis who underwent exclusive decompression surgery. All procedures were performed as part of a multi-center investigation at three highly specialized spine clinics. Outcome measures (ODI, EQ5D, VAS_{back pain} and VAS_{leg pain}) were obtained preoperatively as well as 3 and 12 months after surgery. The effect of an incidental durotomy on the clinical outcomes was analyzed statistically between the two cohorts.

Results

An intraoperative dura lesion was recorded in 6.5 % (n = 52/800) of all cases. Both cohorts (Dura+ and Dura?) did not reveal any differences regarding patient demographics, risk factors, or co-morbidities at baseline. The length of the hospital stay was significantly longer for the Dura+ cohort (8.0 vs. 6.4 days; p < 0.01). After 12 months, the Dura? cohort demonstrated a significantly greater improvement in VAS_{back pain} in comparison to the Dura+ cohort (Δ21.4 vs. Δ7.2 points; p < 0.05). The differences for the remaining outcome measures were not statistically significant (p > 0.05).

Conclusions

The results of this study reveal that an incidental durotomy was associated with a significant increase in the patient’s length of stay, and risk for re-intervention for the treatment of persisting CSF leakage. In contrast to previous reports which have investigated the effects of incidental durotomies on the clinical outcome after lumbar decompression surgery, our data further suggest a possible inferior outcome in terms of low back pain improvement in the Dura+ cohort, which became clinically apparent at the 12-month follow-up period. Future studies should investigate whether a more pronounced decompression required for adequate exposure and repair of a dural laceration may, ultimately, result in increased segmental instability and in clinically undesirable low back pain.

     

Seasonal and weather variation of sleep and physical activity in 12–14-year-old children

Background: Understanding variation in physical activity (PA) and sleep is necessary to develop novel intervention strategies targeting adolescents’ health behaviors. We examined the extent to which PA and sleep vary by aspects of the physical environment. Participants: We performed a cross-sectional analysis of 669 adolescents in the Project Viva cohort. Methods: We estimated total PA, sleep duration, sleep efficiency, and sleep midpoint timing from wrist accelerometers. We used multivariable linear regression models and generalized estimated equations to assess associations of PA and sleep with season and daily weather conditions obtained from the National Oceanic and Atmospheric Administration archive. Results: Mean age was 12.9 (SD 0.6) years; 51% were female and 68% were white. Mean sleep duration was 466 (SD 42) min per night and total PA was 1,652 (SD 431) counts per min per day. Sleep midpoint time was 41 (95% CI: 27 to 54) min later in summer, 28 (95% CI: ?41 to ?14) min earlier in spring, and 29 (95% CI: ?43 to ?15) min earlier in autumn compared to winter. Higher temperature and longer day length both were associated with small reductions of nightly sleep duration. Adolescents were less physically active during winter and on rainy and short sunlight days. There was an inverse U-shaped relationship between PA and mean temperature. Conclusions: Season was associated with large changes in sleep timing, and smaller changes in other sleep and PA measurements. Given the importance of sleep and circadian alignment, future health behavioral interventions may benefit by targeting “season-specific” interventions.     

Upper airway dimensions in Class II malocclusion. Effects of headgear treatment

OBJECTIVE: To study the effects of cervical headgear treatment of Class II division 1 malocclusion on upper airway structures in children. MATERIALS AND METHODS: Forty children aged 9.1 (7.2-11.5) years with Class II division 1 malocclusion were treated using a cervical headgear as the only treatment appliance. The headgear consisted of a long outer bow bent 15 degrees upward and a large inner bow expanded 10 mm larger than the intermolar distance. Lateral cephalograms were taken before and after the treatment. Upper airway structures were estimated from the cephalograms. The results were compared to cross-sectional data of 80 age-matched controls with a Class I molar relationship. RESULTS: A Class I molar relationship was achieved in all treated children. The mean treatment time was 1.6 (0.3-3.1) years. The Class II malocclusion was accompanied by a similar or wider nasopharyngeal space than in the controls but narrower oro- and hypopharyngeal spaces. The retropalatal area was widened by the treatment (P < .05), whereas the rest of the oropharynx and hypopharynx remained narrower than in the controls. Before the treatment, the mandibular plane was in a more horizontal position than in the controls, but during the treatment, it rotated to a position similar to that of the controls. CONCLUSION: Class II division 1 malocclusion is associated with a narrower upper airway structure even without retrognathia. Headgear treatment is associated with an increase in the retropalatal airway space.