Parental feeding practices in relation to low diet quality and obesity among LSES children.

OBJECTIVE: To examine the relationships between parental feeding practices, diet quality, overweight, and obesity among low-socioeconomic status (LSES) preschoolers. RESEARCH METHODS AND PROCEDURES: A cohort of preschool children (aged 5-6) and their mothers was recruited from November 2009 to December 2009. To overcome seasonal and personal variation in dietary intake, 3 replications of the Food Frequency Questionnaire (FFQ) and a parental Feeding Practices Questionnaire (CFPQ) were obtained in person at baseline, 3 months from baseline, and 6 months from baseline. Anthropometric measurements were attained at preschool class on the same dates. Scores of the 12 factors of the CFPQ were calculated and related to dietary intake. Correlation coefficients between the mean energy and fat intake and CFPQ factors' scores were calculated. One-way analysis of variance with post hoc analyses was used to compare nutrient intake and anthropometric measures across CFPQ tertiles. RESULTS: Preschoolers (n = 63), aged 64.4 ± 5.0 months (47% boys), were recruited. Unhealthy feeding practices including food as a reward for good behavior and food restriction for promoting health were associated with increased consumption of junk food, sweets, and snacks. Among healthy feeding practices, encouraging balance and food variety and healthy eating modeled by parents were associated with increased vegetable consumption and smaller waist circumference. Weight was negatively associated with factors that reflect parental pressure and food restriction for weight control. CONCLUSIONS: Our data showed that certain feeding practices relate to a higher diet quality and lower weight and waist circumference. These practices may be encouraged in order to improve diet quality and prevent overweight and obesity.

Possible association between in vitro fertilization technologies and offspring neoplasm.

OBJECTIVE: To study the association among fertility treatments, treatment protocol, and offspring neoplasm risk up to the age of 18 years. DESIGN: A population-based retrospective cohort. SETTING: Soroka University Medical Center (SUMC), the single tertiary medical center and in vitro fertilization (IVF) unit in southern Israel. PATIENT(S): All offspring born at the SUMC between the years 1995 and 2018 after IVF treatment (the exposed group) and offspring conceived spontaneously (the unexposed group). INTERVENTION(S): The study was performed at the SUMC, the single tertiary medical center and IVF unit in southern Israel. The exposed and unexposed were matched with a ratio of 1:4, based on maternal age and calendar month of delivery. Data collection included a summary of the couple's medical records, delivery data, and offspring neoplasm diagnoses. MAIN OUTCOME MEASURE(S): Offspring neoplasm of any kind and time to diagnosis in each of the groups. RESULT(S): A total of 1,583 exposed and 5,874 offspring were included in the study. The incidences of offspring benign neoplasm were 14 (0.9%) versus 21 (0.4%), and the incidences of malignancies were 17 (1.1%) versus 29 (0.5%) among offspring of the IVF and spontaneous groups, respectively. The association between mode of conception and offspring neoplasm risk remained significant after adjusting for confounders, including mode of delivery and pregnancy complications such as hypertensive disorder, gestational diabetes mellitus, and preterm delivery compared with spontaneously conceived offspring. Among the IVF group, the increased risk for neoplasm was found among offspring who were transferred as fresh embryos, at an earlier stage of development (cleavage stage), or after three or more aspirated oocytes. CONCLUSION(S): IVF treatment is associated with offspring neoplasm risk; specifically, the risk was greater among offspring who were returned as fresh embryos, at an earlier embryotic stage (cleavage stage), or after three or more aspirated oocytes.

Factor analysis of the Beer Sheva Psoriasis Severity Score (BPSS).

BACKGROUND: The Beer Sheva Psoriasis Severity Score is a novel instrument for the assessment of psoriasis severity, designed for use in routine clinical conditions. OBJECTIVE: To identify the main factors of the BPSS. METHODS: The sample used to study the BPSS comprised 70 patients with psoriasis vulgaris treated by climatotherapy at the Dead Sea. Psoriasis severity was assessed using BPSS and PASI (Psoriasis Area and Severity Index). Factor analysis was used to identify the main factors of BPSS. Internal consistency analysis was performed. Correlation matrices were generated to compare BPSS factors. RESULTS: Factor analysis demonstrated that BPSS included six factors that explained 74.0% of the variance as follows: patient assessment 26.0%; physician assessment 13.2%; palms and soles involvement 11.9%; genitals, nails, and pruritus 9.0%; face involvement 7.3%; and scalp involvement 6.6%. Total scale Cronbach's alpha was 0.76; alpha for the factors ranged between 0.39 and 0.81. CONCLUSIONS: The major factors of BPSS were identified. BPSS may be used as a comprehensive tool for measuring psoriasis severity.

Respiratory deterioration following laparoscopic adjustable gastric banding: A three-year follow-up of over 3,000 subjects.

BACKGROUND: Obesity is considered a global epidemic. Until recently, laparoscopic adjustable gastric binding (LAGB) was routinely offered as a means of weight reduction for selected patient populations. Previous case series have documented several pulmonary complications following LAGB. In the current study, we explored the rate of long-term respiratory deterioration associated with LAGB. METHODS: The study is a historical cohort study of medical records of subjects who underwent LAGB at Soroka University Medical Center in Israel between January 1997 and July 2008. After the exclusion of short-term respiratory events, respiratory morbidity during the three years following the operation was compared with that three years prior to the operation. Subjects whose respiratory status worsened following surgery were further compared with those whose status either remained unchanged or improved. RESULTS: The final analysis included 3084 subjects, of whom 709 (22.9%) had documented respiratory morbidity following surgery. Compared to pre-operative respiratory status, respiratory deterioration following LAGB was found in 590 subjects (19.1%). Risk factors associated with the worsening of respiratory status were age ≤28 or ≥46 years (odds ratio [OR] = 1.32, 95% confidence interval [CI]: 1.02-1.71 and OR = 1.42, 95% CI: 1.09-1.85, respectively), female gender (OR = 1.31, 95% CI: 1.06-1.63), and pre-operative documentation of respiratory morbidity. CONCLUSIONS: The rate of deterioration in the respiratory status observed among subjects who underwent LAGB was high. Consequently, physicians should be aware of the possible link, even years after the surgery, between respiratory symptoms and a history of LAGB.

Effectiveness of climatotherapy at the Dead Sea for psoriasis vulgaris: A community-oriented study introducing the 'Beer Sheva Psoriasis Severity Score'.

BACKGROUND: Climatotherapy at the Dead Sea (CDS) is a therapeutic modality for moderate to severe psoriasis vulgaris. OBJECTIVE: To evaluate the effectiveness of CDS in patients with psoriasis, using the PASI score and a novel simplified tool for the assessment of psoriasis - the Beer Sheva Psoriasis Severity Score (BPSS). METHODS: A total of 70 patients with psoriasis vulgaris were treated by CDS. In all patients, the severity of psoriasis was assessed before and after CDS using PASI score and BPSS. BPSS includes eight items that are recorded by the physician (total severity of the disease, and seven items relating to the physical distribution of the disease) and eight items that are recorded by the patient (total severity, physical and psychological severity, pruritus and assessment of involvement in the face, nails, palms and soles and genital regions). RESULTS: The study included 70 patients (40 men, 30 women; age 19-78 years). There was a 75.9% reduction in PASI score, from a mean of 16.6+/-11.0 before treatment to 4.0+/-4.2 after treatment (p<0.001). There was a 57.5% reduction in BPSS, from a mean of 72.8+/-19.6 before treatment to 31.0+/-21.2 after treatment (p<0.001). PASI score significantly correlated with BPSS before CDS treatment (r = 0.59, p<0.001) and after CDS treatment (r = 0.53, p<0.001). CONCLUSION: CDS is an effective therapy for patients with psoriasis, as evaluated by either PASI score or BPSS. BPSS was considered shorter and more user-friendly by the participating physicians.

Drug exposure and psoriasis vulgaris: case-control and case-crossover studies.

Intake of drugs is considered a risk factor for psoriasis. The aim of this study was to investigate the association between drugs and psoriasis. A case-control study including 110 patients who were hospitalized for extensive psoriasis was performed. A control group (n = 515) was defined as patients who had undergone elective surgery. A case-crossover study included 98 patients with psoriasis. Exposure to drugs was assessed during a hazard period (3 months before hospitalization) and compared to a control period in the patient's past. Data on drug sales were extracted by data mining techniques. Multivariate analyses were performed by logistic regression and conditional logistic regression. In the case-control study, psoriasis was associated with benzodiazepines (OR 6.9), organic nitrates (OR 5.0), angiotensin-converting enzyme (ACE) inhibitors (OR 4.0) and non-steroidal anti-inflammatory drugs (NSAIDs) (OR 3.7). In the case-crossover study, psoriasis was associated with ACE inhibitors (OR 9.9), beta-blockers (OR 9.9), dipyrone (OR 4.9) and NSAIDs (OR 2.1). Extensive psoriasis may be associated with intake of ACE inhibitors, NSAIDs or beta-blockers.

Anemia as a risk factor for infectious diseases in infants and toddlers: results from a prospective study.

Anemia due to iron deficiency is the most prevalent form of micronutrient malnutrition in the world, however, the causal relationship between anemia and infection remains unclear. We examined prospectively, the association between anemia and infection among Bedouin infants. We recruited 293 families and newborns from the Bedouin population, which is ongoing major lifestyle changes, during the periods of 1989-1992 and 1994-1997 and followed them to age 18 months. The number of diarrhea and respiratory disease episodes as well as total days of diarrhea were ascertained weekly. Hemoglobin levels were obtained at age 6 months. Additional data on feeding practices, environmental, household and demographic characteristics were obtained throughout the 18 months. Diarrhea before 6 months of age was found to be a risk factor for diarrhea after that age. After controlling for early morbidity < 6 months, anemia (Hb < 11 g/dl) at 6 months was an independent risk factor for diarrhea and respiratory illness from 7 to 18 months of age. This associations remained significant even after controlling, in addition, for environmental and socio-economic factors. In the multivariable models, anemia at age 6 months increased the risk for diarrhea after that age by 2.9-fold (95% confidence interval 1.6 - 5.3; p = 0.001) and that of respiratory disease by 2-fold (1.1 - 3.7; p = 0.03). Our findings suggest that anemia may increase the rates of infections in toddlers. The possibility that reducing anemia in infants may be a preventive measure to lower disease burden from infectious disease in this and other vulnerable populations should be tested in further studies.