Objectives Anemia and iron deficiency (ID) are frequent among Indigenous children of Canada, but few data are available in Quebec. The present study aimed to characterize anemia and ID prevalence and associated protective and risk factors among First Nations youth in Quebec. Methods The 2015 First Nations (JES!-YEH!) pilot study was conducted among children and adolescents (3 to 19 years; n = 198) from four First Nations communities in Quebec. Blood and urine samples and anthropometric measurements were collected. Hemoglobin (Hb), serum ferritin (SF), plasma hs-CRP, and urinary cotinine levels were measured. Factors associated with anemia and ID (including traditional and market food consumption) were assessed using an interview-administered food frequency questionnaire, based on which nutritional intakes were calculated. Structural equation models were used to test associations. Results The prevalence of anemia and ID was elevated (16.8% and 20.5% respectively). Traditional meat, fruit, and fruit juice (natural and powdered)-via their positive association with vitamin C intake-were the only food variables positively associated with SF (coefficient [95%

BACKGROUND Prevalence of anemia and iron deficiency (ID) are higher among indigenous children in Canada, although few data are available in Quebec. Iron is metal that interact with the absorption of manganese (Mn) and Lead (Pb) cobalt (Co). ID is known to upregulate these metals, thereby increasing their absorption, concentration inside the body and their toxicity. OBJECTIVES The objectives of the present study are to: (i) Characterize ID and anemia prevalence and their protective/risk factors; and (ii) Study associations between blood Mn, Pb and iron status biomarkers. DESIGN/METHODS Data from The 2015 First Nation Youth Health and Environment Pilot Study was conducted among children (3 to 19 y, n = 198) from four First Nations communities in Quebec will be used in these study where, blood samples and anthropometric measures were collected, hemoglobin was measured on site using an Hemocue analyser. Protective/risk factors including education, food security, housing conditions and lifestyle and dietary habits were documented using interview-administered questionnaire to children’ parents. Serum ferritin and blood Pb, Mn, Co, Zn and Ca were measured by Modular P analyser and ICPMS. Descriptive and multiple regression statistical analyses adjusting for relevant co-variables were used. RESULTS Results showed ID and anemia prevalence of 20.7% and 17.6% respectively, among which 8.8% presented iron deficiency anemia. Moreover, up to 11.9% had elevated blood Mn (median = 15.9 µg/L, range 7.1 to 31.9 µg/L) of which 27.5% presented ID. However, blood Pb was low (median = 5.4 µg/L, range 1.8 to 50.8 µg/L). Multiple logistic regression analysis showed that crystal juice intake was associated with lower ID and anemia (OR (95%): 0.50 (0.30 - 0.82) and 0.47 (0.26 - 0.87) respectively) in girls. Likewise, the presence of hunter in the household was associated with lower anemia in girls (0.09 (0.02 - 0.53)). No factors were associated with ID in boys, and for anemia, lower serum ferritin and older age was associated with higher prevalence of anemia (1.08 (1.01 - 1.14) and 1.23 (1.02 - 1.48) respectively). In adjusted models, blood Mn was negatively associated with serum ferritin concentrations (ß = -0.05; p < 0.02) in girls and positively associated with blood Co (ß = 8.50; p < 0.01) in boys. CONCLUSION Findings on high prevalence of ID, anemia and elevated blood Mn among children form these First Nation communities support that, community and family activities increasing traditional foods consumption improve nutritional status and suggest that foods and beverages naturally rich in vitamin C - but lower in added sugar than crystal juice - would improve iron intake in girls, which would contribute to improve their iron status, decrease anemia and restore normal Mn blood levels.

Background/Aims: Given that their traditional lifestyle and diet still relies on fish and other marine species for sustenance, the Inuit are highly exposed to polychlorinated biphenyls (PCBs) and PCBs are increasingly linked to obesity. However, evidence is not consistent regarding which periods of exposure are most relevant. In this study, we examine whether in utero, childhood, and adolescent exposure to PCBs are related to physical growth at adolescence. Method: Inuit adolescents from Canada (N=212) enrolled in a prospective longitudinal cohort study since birth were assessed for height, weight, body mass index (BMI), fat mass index (FMI) and fat free mass index (FFMI) at 18 years of age. PCB 153 concentrations were quantified in blood samples obtained at birth (umbilical cord), 11, and 18 years of age. Maternal anthropometrics were measured and those for the newborns collected from medical records. Data on biological mothers and participants' sociodemographic characteristics and food security were collected using interviews.Multiple linear regression analyses were used to test associations between PCB 153 concentrations and adolescent anthropometric measures.Results: Cord PCB 153 was not related to height or FFMI at adolescence. By contrast, analyses showed that cord PCB 153 was related to higher BMI, FMI and marginally to weight in girls but not boys.Child PCB 153 was not related to height, weight or FFMI in adolescence. Child PCB 153 was related to lower BMI and FMI at adolescence in both sexes, particularly among those considered overweight or obese during childhood. Adolescent PCB 153 was not associated with any outcome. Conclusion:This study suggests that prenatal exposure to PCBs may have a long-term effect on growth in early adulthood among girls and identifies the peri-pubertal period as another window of sensitivity for the action of PCBs. Our findings also suggest that exposure to PCBs and body size be documented in multiple time periods from infancy to adulthood.

Objective: To demonstrate the efficiency and safety of Harmonic scalpel in comparison with electrocautery for gallbladder dissection and hemostasis in laparoscopic cholecystectomy. Patients and methods: A prospective comparative, study was done at Al-Jamhori Teaching Hospital in Mosul, during the period from 1 st of January 2010 to 1 st of January 2012. Three hundred and twenty patients underwent laparoscopic cholecystectomy, the following criteria were applied for selection: they had chronic cholecystitis, no complaint at time of operation, age between 25 to 50 years, normal body weight, with American Score of Anesthesia (ASA) of 1 or 2, no previous upper abdominal operation, no, or well controlled hypertension or diabetes, gall bladder wall thickness with less than 6 mm by preoperative ultrasonography and all the patients were operated by the authors. The patients were divided into two groups according to the instrument used for dissection of gall bladder from its bed, the first group with electrocautery and second group with harmonic scalpel. The time needed for complete dissection and hemostasis started from spreading of Calot's triangle till removal of gall bladder totally from its bed, was recorded. Any intra operative complications: bleeding, gallbladder perforation, slipped stones, or conversion were recorded. Results: The study included 320 patients, 172 patients belonged to the first group (electrocautery) and 148 patients belonged to second group (harmonic). For the first group, the median time was 17 minutes, the mean time was 17.7 minutes and the mode was 13 minutes, while that for second group, the median time was 14 minutes, with a mean time of 16 minutes and a mode of 14 minutes. Intra-operative bleeding was recorded in 34 (20%) for the first group and 17 (11%) for the second one. Gallbladder perforation was recorded in 26 (15%) patients and slipped stone in 12 (7%) patients in the electrocautery group and 13(9%) and 5 (3%) respectively in the harmonic group. No common bile duct injury was recorded in either group. Conversion was needed in 4 patients (1.3%), 3 (2%) patients belonged to the first group and one (06%) to the second group. Conclusion: Harmonic scalpel is very safe and effective instrument for dissection of gall bladder and hemostasis in laparoscopic cholecystectomy and can replace electrocautery for this purpose if available at operative theater.

No abstract