Determinants of cervical spine disorders in military pilots: a systematic review.

BACKGROUND: Neck pain and cervical spine disorders are widespread among military cockpit aircrew pilots and are often recognized as occupational stressors. AIMS: This systematic review aimed to identify significant determinants for military pilot neck pain and cervical spine disorders determined through multivariable logistic regression studies. METHODS: This systematic review was conducted according to the recommendations of the Statement of Systematic Review and Meta-analysis Protocols (Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA]-P). The following databases were searched for literature: Medline and Embase. We included studies that studied neck pain, cervical spine disorders, and/or radiological abnormalities and associated exposures (adjusted odds ratios, ORadj) in military cockpit aircrew. The trustworthiness, relevance and results of the published papers were evaluated using the Joanna Briggs Institute critical checklist. RESULTS: A total of three studies quantified the strength of the correlations between exposures and outcomes. Significant determinants/risk factors of neck pain, cervical spine disorders and radiological abnormalities were identified as age (ORadj: 1.092 [95% CI 1.054, 1.132]), fighter type (ORadj: 3.9 [95% CI 1.1, 13.9]) and absolute rotation angle of C2-7 (ARA) (ORadj: 0.91 [CI 0.85, 0.98]). The following variables were unable to demonstrate statistical significance: flying hours, body height and body mass index. CONCLUSIONS: Military cockpit aircrew's frequent neck pain after a flight raises concerns about cervical spine disorders. Age, fighter type and ARA C2-7 are strong predictors of neck pain and cervical spine disorders. More research is needed on occupational determinants and risk factors for neck pain and cervical spine disorders in military cockpit aircrew.

Socioeconomic risk factors for low birth weight newborns: A population-based study.

Low birth weight (LBW) is an important indicator of maternal health and poverty. This study explored the socioeconomic factors associated with LBW. METHODS: Data was collected from a 4-year maternal-newborn registry. RESULTS: There were 5,316 LBW and 54,029 normal birth weight (NBW). The prevalence of LBW was 9%. The Native women in the LBW group compared to non-native women were 10.4% (1784/5316) vs. 8.4% (3532/5316) with a P-value of 0.001. There were more illiterate mothers in the LBW compared to the NBW, respectively: 8.1% (1597/19497) vs. 7.5% (1763/23230) with a P-value of 0.001. Working mothers tend to have more LBW infants compared to mothers with NBW, 8.4% (1588/17217) vs. 7.9% (2532/31891) and P-value 0.001. Young mothers (<20 years old) with early childbearing had more LBW compared to older mothers, respectively 12.7% (180/1414) vs. 8.9% (5149/52919) P-value <0.001. Women with no antenatal care reported a high rate of LBW compared to women with regular antenatal care: 14.2% (516/3696) vs. 8.6% (4741/55691) P-value <0.001. LBW babies were born more from assisted conception pregnancies (38% compared to 8.4% of normal pregnancies) P-value <0.001. Smoking mothers scored higher with LBW at 13.6% vs. 8.3% and a P-value of 0.001. There were no differences between the two groups regarding religion, consanguinity, marital status, or family income. CONCLUSION: Risk factors for low birth weight can be improved by providing antenatal care, smoking cessation, optimizing high-risk pregnancy care, and governing assisted reproduction regulations.

Prolonged empiric antibiotics and time to full enteral feed in preterm infants less than 29 weeks of gestational age.

BACKGROUND: Early empiric antibiotic exposure appears to negatively influence feeding tolerance in preterm infants. However, the effect of prolonged antibiotic treatment is unknown. The objective of this study was to investigate whether prolonged antibiotics impact the time to full enteral feed in infants less than 29 weeks of gestational age with negative blood cultures. METHODS: Retrospective data for infants less than 29 weeks gestation age were retrieved from the PEARL-Peristat perinatal registry in Qatar. Exclusion criteria were major congenital anomalies, conditions requiring surgery in the first 10 days of life, positive blood cultures in the first 48 hours of life, and death within the first week of life. Antibiotic courses were categorized as prolonged if continued more than 48 hours. The primary outcome was the duration of total parenteral nutrition. RESULTS: Of 199 study infants, 185 (92.9%) underwent antibiotic treatment for > 48 hours despite negative blood cultures. The median duration of parenteral nutrition was not significantly different between the prolonged and short antibiotic groups (25 and 22 days, respectively; p = 0.139). Infants with prolonged antibiotic courses experienced non-significantly higher levels of necrotizing enterocolitis (7.1% and 18.4%, respectively), bronchopulmonary dysplasia (28.6% and 45.4%, respectively), and retinopathy of prematurity (14.3% and 38.4%, respectively). There were no differences in the late-onset sepsis rate (78.6% and 82.1%, respectively) and the in-hospital death rate (7.1% and 7.6%, respectively). CONCLUSIONS: Prolonged antibiotic treatment in infants less than 29 weeks gestation with negative blood cultures has no significant impact on the time to full enteral feed.