Losartan increases bone mass and accelerates chondrocyte hypertrophy in developing skeleton.

Angiotensin receptor blockers (ARBs) are a group of anti-hypertensive drugs that are widely used to treat pediatric hypertension. Recent application of ARBs to treat diseases such as Marfan syndrome or Alport syndrome has shown positive outcomes in animal and human studies, suggesting a broader therapeutic potential for this class of drugs. Multiple studies have reported a benefit of ARBs on adult bone homeostasis; however, its effect on the growing skeleton in children is unknown.

Treatment of the stress positive ligamentous SE4 ankle fracture: incidence of syndesmotic injury and clinical decision making.

Objectives: The objective of the study was to review our experience with the treatment of stress positive (+) supination and external pattern injuries using shared decision making with the patients.

Design: Retrospective case review.

Setting: Level 1 trauma center.

The darker side of randomized trials: recruitment challenges.

Randomized trials are thought to provide optimal evidence if carried out correctly. Their application to important questions is the best guide to clinical decision-making. However, these trials are expensive to complete and have a variety of challenges in design and application.

Combined intravitreal bevacizumab with phacoemulsification in visually significant cataract and visually significant exudative maculopathy.

Purpose: We investigated the visual outcome of combined phacoemulsification with intravitreal bevacizumab, in eyes with dense cataract and visually significant exudative maculopathy.

Materials And Methods: Prospective longitudinal pilot study of consecutive patients treated by two surgeons in 2006, using intravitreal bevacizumab at the end of phacoemulsification. The historical control group consisted of consecutive subjects with exudative maculopathy and dense cataract treated by the same surgeons with the help of phacoemulsification without intravitreal bevacizumab prior to 2006.

Anabolic agents and bone quality.

Background: The definition of bone quality is evolving particularly from the perspective of anabolic agents that can enhance not only bone mineral density but also bone microarchitecture, composition, morphology, amount of microdamage, and remodeling dynamics.

Questions/purposes: This review summarizes the molecular pathways and physiologic effects of current and potential anabolic drugs.

Methods: From a MEDLINE search (1996-2010), articles were identified by the search terms "bone quality" (1851 articles), "anabolic agent" (5044 articles), "PTH or parathyroid hormone" (32,229 articles), "strontium" or "strontium ranelate" (283 articles), "prostaglandin" (77,539 articles), and "statin" or "statins" (14,233 articles).

Seasonal variation of retinal detachment in Lebanon.

Background: The literature remains controversial regarding seasonal variation of rhegmatogenous retinal detachment (RRD).

Methods: In this retrospective chart review, seasonal variation of RRD was examined based on the records of 211 consecutive patients operated for idiopathic RRD in one referral medical center over a 13-year period.

Results: The number of eyes with RRD recorded per season was 46 in autumn, 46 in winter, 62 in spring and 57 in summer.

Violent behavior among adolescents in post-war Lebanon: the role of personal factors and correlation with other problem behaviors.

Background: Adolescent violence is a significant public health problem. The primary objective of this study is to assess the prevalence and correlates of violent behavior among adolescent students in Lebanon.

Methods: A cross-sectional study was conducted among a representative sample of 827 secondary students enrolled in public and private schools in Beirut.

Comparison of domestic and war ocular injuries during the Lebanese Civil War.

Objective: To examine the differences between war and domestic ocular injuries during the Lebanese Civil War in terms of baseline characteristics, treatment provided and prognosis.

Methods: We retrospectively reviewed the charts of subjects with traumatic ocular injuries referred to a major medical center from 1980 to 1996. The variables were tabulated according to the international classification of ocular trauma.

Infectious Collet-Sicard syndrome in the differential diagnosis of cerebrovascular accident: a case of head-to-neck dissociation with skull-based osteomyelitis.

Background Context: Collet-Sicard syndrome (CSS) is a rare condition that includes palsies of cranial nerves IX, X, XI, and XII. There are multiple reported causes in the literature, although infection is particularly unusual.

Purpose: To report an unusual case of CSS as a result of infection causing head-to-neck dissociation with involvement of the upper cervical spine.

Internal decapitation: survival after head to neck dissociation injuries.

Study Design: Case series.

Objective: To describe survival and outcomes after occipitocervical dissociation injuries.

Summary Of Background Data: Historically, occipitocervical dissociation injuries have a high rate of associated neurologic deficit with a relatively high incidence of mortality.

De novo three-way chromosome translocation 46,XY,t(4;6;21)(p16;p21.1;q21) in a male with cleidocranial dysplasia.

Cleidocranial dysplasia (CCD) is an autosomal dominant skeletal dysplasia associated with cranial, clavicular, and dental anomalies. It is caused by mutations in the RUNX2 gene, which encodes an osteoblast-specific transcription factor and maps to chromosome 6p21. We report clinical and molecular cytogenetic studies in a patient with clinical features of CCD including wormian bones, delayed fontanel closure, hypoplastic clavicles and pubic rami, and supernumerary dentition.

A positive or a negative confounding variable? A simple teaching aid for clinicians and students.

Anticipating the direction of a confounding variable can be problematic especially to introductory students. Using elementary rules of mathematics, we describe below a simple instructional tool for deriving the direction of confounding bias. The tool is illustrated with examples and a heuristic mathematical justification is also described.

Prevalence of coronary artery calcium among asymptomatic men and women in a developing country: comparison with the USA data.

Background: Coronary artery calcium score (CACS) correlates with atherosclerotic burden and predicts cardiac events. Most of the published data have been derived from the USA population.

Objective: To study the prevalence of coronary calcium in an asymptomatic population from the eastern Mediterranean region and compare it to data obtained from a large population study in the USA.

Ethnic differences in weight loss behavior among secondary school students in Beirut: the role of weight perception.

Objectives: Assessing the prevalence of weight loss attempts in Beirut, Lebanon, a country characterized by a diversity of ethnic and religious groups and examining the interplay between ethnicity, body mass index (BMI) and weight perception and their relationship to weight loss behavior.

Methods: A school-based survey of risk behaviors conducted among secondary students (grade 10-12) in 1997. Subjects consisted of 827 boys and girls, aged 15 to 23 years, the majority of whom were Moslems (65.