Prevalence of Lumbosacral Transitional Vertebra in Individuals with Low Back Pain: Evaluation Using Plain Radiography and Magnetic Resonance Imaging

Study DesignDescriptive cross-sectional study.PurposeTo determine the frequency of lumbosacral transitional vertebrae (LSTV) in patients with low back pain (LBP) and the role of iliolumbar ligament (ILL) origin from L5 in LSTV cases.Overview of LiteratureTransitional vertebrae are developmental variants of the spine. LSTV is a common congenital abnormality, and failure to recognize this anomaly may result in serious consequences during surgery.MethodsAll patients aged 11–90 years of either gender with LBP for any duration, who presented for X-ray and magnetic resonance imaging (MRI) of the lumbosacral spine, were included. X-rays of the lumbosacral spine in anteroposterior and lateral views were acquired. In addition, T1- and T2-weighted sagittal and axial MRI was performed. Images were evaluated on a workstation.ResultsOf 504 patients, transitional vertebrae were observed in 75 patients (15%). Among them, 39 (52%) patients had Castellvi type III and 36 (48%) patients had Castellvi type II. However, on MRI, 42 (56%) patients had O'Driscoll type II, 18 (24%) patients had O'Driscoll type IV, and 15 patients (20%) had O'Driscoll type III. ILL origin from L5 was significantly higher (n=429, 100%) among patients with a normal lumbosacral junction than among patients with a transitional lumbosacral junction (n=22, 29.3%) (p<0.001).ConclusionsLSTV occurs at a high frequency in patients with LBP. Furthermore, in the presence of LSTV, the ILL is not a reliable marker for the identification of L5

Epigenome-wide meta-analysis of blood DNA methylation in newborns and children identifies numerous loci related to gestational age

Background Preterm birth and shorter duration of pregnancy are associated with increased morbidity in neonatal and later life. As the epigenome is known to have an important role during fetal development, we investigated associations between gestational age and blood DNA methylation in children. Methods We performed meta-analysis of Illumina's HumanMethylation450-array associations between gestational age and cord blood DNA methylation in 3648 newborns from 17 cohorts without common pregnancy complications, induced delivery or caesarean section. We also explored associations of gestational age with DNA methylation measured at 4-18 years in additional pediatric cohorts. Follow-up analyses of DNA methylation and gene expression correlations were performed in cord blood. DNA methylation profiles were also explored in tissues relevant for gestational age health effects: fetal brain and lung. Results We identified 8899 CpGs in cord blood that were associated with gestational age (range 27-42 weeks), at Bonferroni significance, P <1.06 x 10(- 7), of which 3343 were novel. These were annotated to 4966 genes. After restricting findings to at least three significant adjacent CpGs, we identified 1276 CpGs annotated to 325 genes. Results were generally consistent when analyses were restricted to term births. Cord blood findings tended not to persist into childhood and adolescence. Pathway analyses identified enrichment for biological processes critical to embryonic development. Follow-up of identified genes showed correlations between gestational age and DNA methylation levels in fetal brain and lung tissue, as well as correlation with expression levels. Conclusions We identified numerous CpGs differentially methylated in relation to gestational age at birth that appear to reflect fetal developmental processes across tissues. These findings may contribute to understanding mechanisms linking gestational age to health effects.Peer reviewe

Effets sur la santé des perturbateurs endocriniens pendant la grossesse et l'enfance

All humans are exposed to chemicals in everyday life, from food, indoor environment, cosmetics and other products that surround us at home and at work. Endocrine disruptors (EDCs) are man-made compounds that can bind to cell receptors and mimic or block the functions of natural hormones potentially resulting in adverse health effects. In recent years, hypotheses have been put forward that EDCs may contribute also to the development of allergic and respiratory diseases. In addition, it is likely that EDCs could act already during pregnancy by causing gestational diabetes mellitus and pregnancy induced hypertension, which may also trigger to develop hypertension and diabetes mellitus later in life. This dissertation provides evidence that maternal exposure to phthalates and heavy metals (Lead, Cadmium and Manganese) during pregnancy may be associated with gestational diabetes mellitus, pregnancy induced hypertension and later eczema/atopic dermatitis in children. We used ongoing French EDEN-mother child cohort data for our three studies. Our results add new suggestive evidence on the relationship between EDCs (phthalates and heavy metals we studied) and maternal and children health, that prenatal exposure to certain phthalates and heavy toxic metals may play a role in the development of gestational diabetes mellitus and pregnancy induced hypertension during pregnancy and later eczema in early childhood. Future research focusing on larger populations and addressing multiple exposures assessed prenatally and postnatally are required to provide more evidence on possible contributions of emerging pollutants to study the role of phthalates and heavy metals.Les perturbateurs endocriniens (PE) sont des composés synthétiques capables de se lier aux récepteurs cellulaires et d'imiter ou de bloquer le fonctionnement des hormones naturelles, pouvant ainsi entraîner des effets néfastes sur la santé. Ces dernières années, des hypothèses ont été émises selon lesquelles les PE pourraient également contribuer au développement de maladies allergiques et respiratoires. En outre, il est probable que les PE pourraient déjà agir pendant la grossesse en provoquant un diabète gestationnel (DG) et une hypertension induite par la grossesse, pouvant également provoquer une hypertension et un diabète plus tard dans la vie. Ce travail de thèse a permis de mettre en évidence que l'exposition maternelle aux phtalates et aux métaux lourds (plomb, cadmium et manganèse) pendant la grossesse pourrait être associée au diabète gestationnel, à l'hypertension induite par la grossesse et à l'eczéma/dermatite atopique chez l'enfant. Nous avons utilisé les données de la cohorte Française de naissance mère-enfant, EDEN (Étude des déterminants pré et post-natals du développement de la santé de l’enfant) pour examiner les hypothèses de ce travail de thèse. Nos résultats apportent de nouvelles preuves potentielles sur la relation entre les perturbateurs endocriniens (phtalates et métaux lourds étudiés) et la santé de la mère et de l’enfant, selon lesquelles l’exposition prénatale à certains phtalates et métaux toxiques lourds pourrait jouer un rôle dans le développement du diabète gestationnel et de l’hypertension induite par la grossesse pendant la grossesse et, ultérieurement, un eczéma pendant la petite enfance

Loss to follow-up pattern in TB patients in Rawalpindi, Pakistan

Background: Tuberculosis is a serious global public health, social and economical problem that affects millions of people particularly in low income countries. The aim of this study was to see the loss to follow up pattern in Tuberculosis patients in district Rawalpindi, Pakistan. Materials and method: A cross-sectional study was conducted in district Rawalpindi between August and October 2010. All sputum smear positive Tuberculosis patients diagnosed and treated in public sector, urban and rural diagnostic centers of the district Rawalpindi during the year 2008 were included in the study.All cases other (smear negative pulmonary and extra-pulmonary) than sputum smear positive and all private hospitals were excluded. Results: A total of 451 patients were enrolled in the study. Majority of the patients (89.6%) were provided with the treatment support. Geographically dropout rate was observed higher in urban patients than in rural 18.7% vs. 10.5%. On the other hand by patient gender, drop out was seen more in male patients than in females 16.5% vs. 13.1%. By patients age groups, interestingly patients under the childhood age group all the patients completed the treatment while drop out was observed more in older age group. Conclusions: Loss to follow up pattern was seen more in urban patients, by gender more in male patients and by age groups observed more in older patients

Internet Use and Its Addiction Among Medical Students in Hyderabad, Pakistan

Background: With the advances in information and technology, internet addiction appears as a serious obsessive condition that has numerous dreadful effects on human physical and mental health. The objective of the study was to determine the level of internet addiction among medical undergraduate students of Isra University, Hyderabad. Methods: A cross-sectional survey was conducted at the Isra University, Hyderabad from August to December 2019. All medical (MBBS) undergraduate students of either sex were included. A stratified sampling technique was used for the selection of participants. A structured 5-point Likert scale questionnaire for the internet addiction test was adopted from Dr. Kimberly Young and used for the collection of participant’s information and measurement of their level of addiction. Results: A total of 263 undergraduate medical students participated in the study. The majority (56.65%) were males while 51.71% were from the age group 21-22 years. Over two-thirds (85.17%) of participants were found to be internet addicts. Of these internet addicts, 63.84% were mild or minimal internet addicts while 12.05% were severely addicted participants. A statistically significant difference (p&lt;0.05) was observed between gender, age groups, year of study, and current residential status of participants. Conclusion: Internet addiction was highly prevalent among undergraduate medical students, specially in the age group (19-20) years, hostlers, 2nd year of study and male

The association between maternal urinary phthalate metabolites concentrations and pregnancy induced hypertension: Results from the EDEN Mother-Child Cohort

International audienceBackground: Studies have suggested that exposure to endocrine disruptors such as phthalates that are widelyused in our daily life (food wrapping, cosmetics, toys, medical devices, polyvinyl chloride flooring, and building materials) might be related to raised blood pressure and increased risk of cardiovascular diseases. Phthalates might induce a pro-inflammatory response and increased oxidative stress and may be a cause ofpregnancy induced hypertension.Methods: We evaluated the association between maternal exposure to phthalates during pregnancy andpregnancy induced hypertension. 604 pregnant women were included and eleven phthalate metaboliteswere quantified in spot maternal urine samples collected between the 23rd and 28th week of gestation in aFrench EDEN mother-child cohort. The associations were assessed by applying multiple logistic regressionanalysis.Results: Twenty nine (4,8%) mothers developed pregnancy induced hypertension. Two low molecular weightphthalate metabolites: Monoethyl phthalate (MEP) and Mono-n‑butyl phthalate (MBP) were positively associated with pregnancy induced hypertension in crude (Odds Ratio: 1.43, 95% Confidence Interval: 1.04−1.96,p-value = 0.02 and 1.48, 1.10−2.01, p-value =0.01) and in adjusted (1.47, 1.01−2.14, p-value = 0.04 and 1.66,1.11−2.47, p-value = 0.01) models respectively.Conclusion: Our data suggest that prenatal exposure to some phthalates, including MEP and MBP, might playa role in pregnancy induced hypertension

Prenatal Exposure to Phthalates and the Development of Eczema Phenotypes in Male Children : Results from the EDEN Mother-Child Cohort Study

BACKGROUND: Contradictory results exist regarding the importance of early-life exposure to phthalates for development of childhood eczema. OBJECTIVES: We evaluated the association between maternal urinary concentrations of phthalate metabolites between the 24th and 28th week of gestation and occurrence of eczema in their sons up to 5 y of age, according to allergic sensitization as assessed by total immunoglobulin E (IgE) in a subsample of individuals. METHODS: Data on health outcomes and background factors were collected using five standardized annual questionnaires completed by parents at the children's ages of 1-5 y, and their associations with phthalate metabolite urinary concentrations were assessed in 604 mother son pairs with adjusted multiple logistic regression and Cox's survival model. Several eczema phenotypes were considered. Atopic status was assessed at 5 y of age in 293 boys through total IgE assessment. RESULTS: At 5 y of age, the prevalence of ever eczema was 30.4%. Metabolites of di-isobutyl phthalate, (DiBP) and di-isononyl phthalate (DiNP) were positively associated with early-onset (0-24 mo of age) eczema (15.7%) and late-onset (24-60 mo of age) eczema (14.7%). Applying the Cox's model showed a significant association of occurrence of eczema in the first 5 y of life with DiBP and DINP metabolites. Among IgE-sensitized boys, metabolites of di-n-butyl phthalate (DBP) and DiBP were significantly associated with ever eczema {hazard ratio (HR) = 1.67 [95% confidence, interval (CI): 1.10, 2.54], p = 0.01 and HR = 1.87 (95% CI: 1.01, 3.48), p = 0.04, respectively]. CONCLUSIONS: Occurrence of eczema in early childhood may be influenced by prenatal exposure to certain phthalates in boys. Further investigations are needed to confirm this observation