Age‐ and gender‐specific reference intervals for serum lipid levels (measured with an Advia 1650 analyzer) in school children

Background: Due to the lack of country‐specific norms in Saudi Arabia, age‐ and gender‐specific lipid reference intervals are needed to be established for Saudi children. Methods: Blood samples were collected from 1168 children aged 6–16 years: 500 boys (43%) and 668 girls (57%), and were analyzed for cholesterol, high‐density lipoprotein (HDL) and low‐density lipoprotein (LDL). Reference intervals were established by calculating the mean and the 2.5th and 97.5th percentiles. Results: There were significant differences between boys at each Tanner stage with respect to cholesterol (P < 0.001); and HDL (P < 0.0001) but not LDL (P < 0.06) among girls. There were significant differences between boys and girls during puberty with respect to cholesterol (P < 0.0001), HDL (P < 0.0001), and LDL (P < 0.001). There was a significant positive correlation between total cholesterol levels, LDL and HDL levels at all Tanner stages in both genders. In girls, the only significant inverse correlation was at stage I (r=?0.243, P= 0.001); there was no significant correlation at other stages. Conclusions: Unlike children in other developing countries, Saudi children do not have lower serum cholesterol than their Western counterparts. These findings reflect changing dietary habits and increasing affluence in Saudi Arabia. These reference intervals may be used to aid in the early assessment of cardiovascular risk in Saudi pediatric populations.     

Prevalence of antibodies against hepatitis C virus among blood donors in Lebanon, 1997–2000

Chronic hepatitis C virus (HCV) infection in many individuals is asymptomatic and the prevalence of antibodies to hepatitis C virus (anti‐HCV) among blood donors in Lebanon is scarce. This study aimed to address the prevalence of anti‐HCV in 8700 blood donors, the data obtained was compared to other world regions. Between 1997 and 2000, 8700 blood donors were screened for the presence of anti‐HCV in their sera. Initially reactive specimens were retested in duplicate, and repeatedly positive samples were subsequently retested by a third generation microplate enzyme immunoassay. Of the 8700 blood donors screened, 51 were confirmed positive for anti‐HCV, giving a prevalence rate of 0.6%. While there was no difference in anti‐HCV prevalence in relation to age or gender, higher rates were seen in non‐Lebanese compared to Lebanese subjects (6.17% vs. 0.48%, P < 0.001). None of the anti‐HCV positive individuals had an identifiable risk factor for contracting HCV (intravenous drug user, prior transfusion, etc.), and their transaminases were comparable to anti‐HCV‐negative donors, suggesting that HCV‐positive donors were asymptomatic. These results demonstrate low prevalence of anti‐HCV among Lebanese blood donors, which was comparable to those established for Western countries.     

Effect of narghile and cigarette smoking on newborn birthweight

Objective  To assess the effect of narghile smoking on the weight of newborns.
Design  Historical retrospective cohort.
Setting  Six major hospitals in Greater Beirut, Lebanon.
Population  Consecutive singleton newborns delivered from August 2000 to August 2003.
Methods  Obstetric and nursery charts were reviewed to obtain information about maternal and neonatal variables. Information concerning initiation of smoking, dose of smoking, smoking habits during pregnancy, and socio-demographic characteristics was collected through interviews with mothers.
Main outcome measures  Low birthweight and newborn birthweight.
Results  Exclusive narghile smokers constituted 4.4% (378/8592) of women. Multiparas were significantly more likely to smoke cigarettes and narghile. Mothers smoking narghile more than once per day were at 2.4 increased odds of having low birthweight infants compared with nonsmoking mothers (OR 2.4; 95% CI 1.2–5.0) after adjusting for confounding variables. No difference was noted between women smoking narghile in the first trimester and those initiating smoking in subsequent trimesters regarding low birthweight.
Conclusions  Narghile smoking more than once per day increases the odds of low birthweight by a 2.4-fold compared with nonsmokers, although to a lesser extent than cigarette smoking.     

Evolução e Estado Atual das Práticas de Implante Transcateter de Válvula Aórtica na América Latina – Estudo WRITTEN LATAM

Background:Transcatheter aortic valve replacement (TAVR) is a worldwide adopted procedure with rapidly evolving practices. Regional and temporal variations are expected to be found.Objective:To compare TAVR practice in Latin America with that around the world and to assess its changes in Latin America from 2015 to 2020.Methods:A survey was applied to global TAVR centers between March and September 2015, and again to Latin-American centers between July 2019 and January 2020. The survey consisted of questions addressing: i) center’s general information; ii) pre-TAVR evaluation; iii) procedural techniques; iv) post-TAVR management; v) follow-up. Answers from the 2015 survey of Latin-American centers (LATAM15) were compared with those of other centers around the world (WORLD15) and with the 2020 updated Latin-American survey (LATAM20). A 5% level of significance was adopted for statistical analysis.Results:250 centers participated in the 2015 survey (LATAM15=29; WORLD15=221) and 46 in the LATAM20. Combined centers experience accounted for 73 707 procedures, with WORLD15 centers performing, on average, 6- and 3-times more procedures than LATAM15 and LATAM20 centers, respectively. LATAM centers performed less minimalistic TAVR than WORLD15 centers, but there was a significant increase in less invasive procedures after 5 years in Latin-American centers. For postprocedural care, a lower period of telemetry and maintenance of temporary pacing wire, along with less utilization of dual antiplatelet therapy was observed in LATAM20 centers.Conclusion:Despite still having a much lower number of procedures, many aspects of TAVR practice in Latin-American centers have evolved in recent years, followingthe trend observed in developed country centers.     

Impact of maternal age on preterm delivery and low birthweight: a hospital-based collaborative study of nulliparous Lebanese women in Greater Beirut.

OBJECTIVES: To analyze the impact of maternal age at first childbirth on the incidence of preterm delivery and low birthweight among single live births delivered to nulliparous Lebanese women in Greater Beirut. STUDY DESIGN: Eligible subjects were selected from a consecutive sample of neonatal admissions to nine National Collaborative Perinatal Network participating hospitals over a three-year period (April 1, 1999 to March 31, 2002). Chi-square tests and logistic regression analyses were applied. RESULTS: Out of 5556 nulliparous mothers, 5.4% had a preterm delivery and 5.2% a low-birthweight infant. In the multivariate analysis, preterm delivery was not significantly affected by old maternal age. Mothers aged 25 years or more remained a high-risk group for low birthweight even after controlling for potentially confounding characteristics. CONCLUSIONS: Maternal age at first childbirth above 25 years is an independent risk factor for low birthweight, but not for preterm delivery, an outcome influenced mainly by obstetric complications.     

Investigating indoor concentrations of PM<Subscript>10</Subscript> in an underground loading dock in Malaysia

Risky air contaminants including PM₁₀ can accumulate inside underground confined loading docks because of the enclosed nature and limited contacts of loading docks with ambient air. Exposure to PM₁₀ can increase morbidity and mortality rates. Hence, this study aimed to investigate and model PM₁₀ concentrations in an underground loading dock located at Kuala Lumpur city center, Malaysia. For this purpose, a real-time air quality monitoring instrument was used for measuring PM₁₀ concentrations for 20 consecutive weeks starting from November 8, 2014. After that, the Statistical Package for Social Sciences (SPSS) software was used to analyze measured PM₁₀ concentrations through series of statistical analyses, whereas MATLAB R2013a was employed for developing prediction models of future PM₁₀ concentrations. Moreover, PM₁₀ temporal variation was examined using time series plots. The results showed that short-term PM₁₀ concentrations did not exceed the Malaysian indoor allowable limit of 150 μg/m³. Despite that, PM₁₀ had 8 % probability of exceedance of WHO standard concentration of 50 μg/m³. This indicates that the occupants will be under the risk of prolonged exposure to PM₁₀ even at low concentrations. The results confirmed a strong correlation between PM₁₀ concentrations and diesel-powered vehicles flow. Contrarily, the flow of gasoline-powered vehicles was poorly correlated. Finally, future daily-averaged PM₁₀ concentrations were predicted for the three weekdays that followed the measurement period using single exponential smoothing. The obtained accuracy was at 70 % of measured PM₁₀ concentrations. Future hourly-averaged PM₁₀ concentrations were estimated using single linear regression with an accuracy of 53 %.     

Rapid hematoma growth triggers spreading depolarizations in experimental intracortical hemorrhage

Recurrent waves of spreading depolarization (SD) occur in brain injury and are thought to affect outcomes. What triggers SD in intracerebral hemorrhage is poorly understood. We employed intrinsic optical signaling, laser speckle flowmetry, and electrocorticography to elucidate the mechanisms triggering SD in a collagenase model of intracortical hemorrhage in mice. Hematoma growth, SD occurrence, and cortical blood flow changes were tracked. During early hemorrhage (0–4 h), 17 out of 38 mice developed SDs, which always originated from the hematoma. No SD was detected at late time points (8–52 h). Neither hematoma size, nor peri-hematoma perfusion were associated with SD occurrence. Further, arguing against ischemia as a trigger factor, normobaric hyperoxia did not inhibit SD occurrence. Instead, SDs always occurred during periods of rapid hematoma growth, which was two-fold faster immediately preceding an SD compared with the peak growth rates in animals that did not develop any SDs. Induced hypertension accelerated hematoma growth and resulted in a four-fold increase in SD occurrence compared with normotensive animals. Altogether, our data suggest that spontaneous SDs in this intracortical hemorrhage model are triggered by the mechanical distortion of tissue by rapidly growing hematomas.