Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Differentiation between sarcoidosis and Hodgkin's lymphoma based on mediastinal lymph node involvement pattern : evaluation using spiral CT scan

Background: The purpose of this study was to determine the specific and detailed anatomic sites and morphologic characteristics of mediastinal lymph nodes on spiral computed tomography for the purpose of differentiation between sarcoidosis and Hodgkin's lymphoma. Material/Methods: Anatomical distribution of mediastinal lymph nodes on spiral CT was reviewed in 39 patients with sarcoidosis and 37 patients with Hodgkin's lymphoma using the International Association for the Study of Lung Cancer (IASLC) lymph node map. Other morphologic features such as lymph node calcification or coalescence of adjacent lymph nodes were also compared. Results: Zone 10 was involved more often in sarcoidosis than in Hodgkin's lymphoma. On the other hand, there was a higher tendency for presence of zone 1 and 3 as well as retrocrural and internal mammary lymphadenopathy in Hodgkin's lymphoma than in sarcoidosis. Sarcoidosis presented with intranodal calcifications more often than Hodgkin's lymphoma. Coalescence, pressure effect on adjacent structures and central cavitations were significantly more common in Hodgkin's lymphoma. Conclusions: Findings of the present study indicate that specific anatomical distribution and morphological patterns of mediastinal lymph nodes, as demonstrated on spiral CT, can be useful in differentiating sarcoidosis from Hodgkin's lymphoma

3D printing-assisted fabrication of a patient-specific antibacterial radial head prosthesis with high periprosthetic bone preservation

We present a novel fabrication and surgical approach for anatomical reconstruction of a fractured radial head using a patient-specific radial head prosthesis (RHP) made of polymethylmethacrylate (PMMA) bone cement. To this end, the use of PMMA bone cement for prosthesis fabrication was initially investigated using computational modeling and experimental methods. The RHP was fabricated through casting of PMMA bone cement in a silicone mold in the operating room before implantation. To enhance the precision of bony preparation for replacement of the radial head, a patient-specific surgical guide for accurate resection of the radial neck with the desired length was developed. Post-surgical clinical examinations revealed biomechanical restoration of elbow function, owing to the use of the patient-specific RHP and surgical guide. Importantly, follow-up radiographs after a mean follow-up of 18 months revealed bone preservation at the bone–prosthesis interface without any signs of erosion of the capitellum. Taken together, our method demonstrated the safety and efficacy of the PMMA RHP in restoring elbow biomechanics. This also provides a very safe and cost-effective method for making various patient-specific prostheses with localized antibacterial delivery and close mechanical properties to native bone for improved periprosthetic bone regeneration. The clinical trial of this study was registered at Mashhad University of Medical Sciences under the trial registration number 970493

Cerebral venous sinus thrombosis associated with SARS-CoV-2; a multinational case series

10.1016/j.jns.2020.117183JOURNAL OF THE NEUROLOGICAL SCIENCES41

Risk of stroke in hospitalized SARS-CoV-2 infected patients: A multinational study

Background: There is an increased attention to stroke following SARS-CoV-2. The goal of this study was to better depict the short-term risk of stroke and its associated factors among SARS-CoV-2 hospitalized patients

SARS-CoV-2 and Stroke Characteristics: A Report From the Multinational COVID-19 Stroke Study Group

International audienceBackground and Purpose: Stroke is reported as a consequence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in several reports. However, data are sparse regarding the details of these patients in a multinational and large scale. Methods: We conducted a multinational observational study on features of consecutive acute ischemic stroke, intracranial hemorrhage, and cerebral venous or sinus thrombosis among SARS-CoV-2–infected patients. We further investigated the risk of large vessel occlusion, stroke severity as measured by the National Institutes of Health Stroke Scale, and stroke subtype as measured by the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria among patients with acute ischemic stroke. In addition, we explored the neuroimaging findings, features of patients who were asymptomatic for SARS-CoV-2 infection at stroke onset, and the impact of geographic regions and countries’ health expenditure on outcomes. Results: Among the 136 tertiary centers of 32 countries who participated in this study, 71 centers from 17 countries had at least 1 eligible stroke patient. Of 432 patients included, 323 (74.8%) had acute ischemic stroke, 91 (21.1%) intracranial hemorrhage, and 18 (4.2%) cerebral venous or sinus thrombosis. A total of 183 (42.4%) patients were women, 104 (24.1%) patients were <55 years of age, and 105 (24.4%) patients had no identifiable vascular risk factors. Among acute ischemic stroke patients, 44.5% (126 of 283 patients) had large vessel occlusion; 10% had small artery occlusion according to the TOAST criteria. We observed a lower median National Institutes of Health Stroke Scale (8 [3–17] versus 11 [5–17]; P =0.02) and higher rate of mechanical thrombectomy (12.4% versus 2%; P <0.001) in countries with middle-to-high health expenditure when compared with countries with lower health expenditure. Among 380 patients who had known interval onset of the SARS-CoV-2 and stroke, 144 (37.8%) were asymptomatic at the time of admission for SARS-CoV-2 infection. Conclusions: We observed a considerably higher rate of large vessel occlusions, a much lower rate of small vessel occlusion and lacunar infarction, and a considerable number of young stroke when compared with the population studies before the pandemic. The rate of mechanical thrombectomy was significantly lower in countries with lower health expenditures

MAPPING LOCAL PATTERNS OF CHILDHOOD OVERWEIGHT AND WASTING IN LOW- AND MIDDLE-INCOME COUNTRIES BETWEEN 2000 AND 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic