Cardiometabolic risk factors among children and adolescents with overweight and Class 1 obesity: A cross-sectional study. Insights from stratification of Class 1 obesity.

Context: Severe childhood obesity is associated with increased prevalence of cardiometabolic risk factors (CMRFs). Among children with Class 1 obesity, higher BMI may indicate greater cardiometabolic risk. Class 1 obesity reflects a wide spectrum of BMI values. Each 10% increase in BMI above the 95th percentile is equivalent to an average increase of 2.15 kg/m2 and 2.75 kg/m2 in BMI among children and adolescents, respectively. Such increments may be of clinical importance. Objectives: The study aimed to determine the prevalence and clustering of CMRFs in children and adolescents with BMI 110%-119% of the 95th BMI percentile. Methods: A cross-sectional analysis of data, from an Israeli health maintenance organization, of children and adolescents (5-17 years) with overweight or Class 1 obesity, and at least one measurement of lipid profile during Jan/2020-May/2021. CMRFs were defined as abnormal lipid profile, elevated alanine aminotransferase, hypertension, and prediabetes or diabetes. Study groups included overweight and Class 1 Obesity-A (BMI < 110%) and Obesity-B (BMI ≥ 110%) of the 95th BMI percentile. Results: Of 7211 subjects included, 40.2% were overweight, 50.3% obesity-A, and 9.5% obesity-B. Multivariable analyses showed that children and adolescents from the Obesity-B group had increased odds for higher triglycerides, LDL cholesterol, and ALT levels; and lower HDL cholesterol levels, as compared to Obesity-A. The odds of prediabetes (insignificant) tended to be higher in the Obesity-B group, which was associated with increased CMRFs clustering. Conclusions: Among children and adolescents with Class 1 obesity, BMI ≥ 110% of the 95th percentile was associated with higher prevalence and clustering of CMRFs.

Long-Term Health Impacts of Wildfire Exposure: A Retrospective Study Exploring Hospitalization Dynamics Following the 2016 Wave of Fires in Israel.

BACKGROUND: Climate-related events, including wildfires, which adversely affect human health, are gaining the growing attention of public-health officials and researchers. Israel has experienced several disastrous fires, including the wave of fires in November 2016 that led to the evacuation of 75,000 people. The fires lasted six days (22-27 November) with no loss of life or significant immediate health impacts. The objective of this study is to explore the long-term hospitalization dynamics in a population exposed to this large-scale fire, including the effects of underlying morbidity and socio-economic status (SES). METHODS: This is a retrospective crossover study, conducted in 2020, analyzing the electronic medical records of residents from areas exposed to a wildfire in northern Israel. The study spans from one year before exposure to two years after it (22 November 2015-27 November 2018). The hospitalization days during the study period were analyzed using the Poisson regression model. The rate of hospitalization days along with 95% confidence intervals (CIs) were plotted. RESULTS: The study included 106,595 participants. The median age was 37 (IQR = 17-56), with a mean socio-economic ranking of 6.47 out of 10 (SD = 2.01). Analysis revealed that people with underlying morbidity were at greater risk of experiencing long-term effects following fires, which was manifested in higher hospitalization rates that remained elevated for two years post-exposure. This was also evident among individuals of low socio-economic status without these background illnesses. CONCLUSIONS: Healthcare services should prepare for increased hospitalization rates during the two years following wildfires for populations with underlying morbidity and those of low socio-economic status. Implementing preventive-medicine approaches may increase the resiliency of communities in the face of extreme climate-related events and prevent future health burdens. Additional research should focus on the specific mechanisms underpinning the long-term effects of wildfire exposure.

Hospital Operation During a Disaster - Hospital Multi-Component Emergency Center (HMCEC).

A hospital's operating modes can be divided into three main levels of operation: routine, mass-casualty, and interim states that require procedures and resources beyond the routine capacity.Regardless of the nature of the event and the needs, the medical staff has to be prepared for a sudden increase in demand for service that could overwhelm the functional capacity and safety standards of the hospital.In any sort of an emergency event, the hospital has to fulfill two goals: First is to be able to sustain itself against the sudden rise in demand for medical support; the aid given depends on the nature of the disaster. The second goal is to continue supporting the essential routine duties for patients already hospitalized and for others arriving at the hospital regardless of the disaster.The aim of this paper is to describe the principles and the methods for hospital operation in case of a disaster-level event. The paper describes the structure and methods for handling prolonged disaster-level events and the adjustments that can be made in the case of lower intensity events.