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Michael Gdalevich

Publications and source records attributed to Michael Gdalevich.

10 recordsLinked to original sources
PubMed2006

Appropriateness of US and international BMI-for-age reference curves in defining adiposity among Israeli school children.

Effective surveillance of trends in paediatric overweight and obesity requires the establishment of valid cutoff values to identify children at risk. In Israel, standard values for childhood BMI-for-age are currently based on growth charts published by the US Centers for Disease Control and Prevention. However, the appropriateness of using US reference values in populations outside the US is questionable, due to inherent differences in ethnicity, culture and socioeconomic status. We recorded data from 9,988 children aged 6-12 selected by random cluster sampling within the framework of school-based health surveys conducted in Israel during the years 1997 and 2000. We constructed population-specific centile BMI-for-age curves valid for Israeli children, and compared these curves to current standard US and international reference values. Curves were constructed using LMS statistical curve smoothing methods. The data set of Israeli schoolchildren produced reference centiles substantially different than those based on US children. Israeli reference values were closer to centile curves published by the International Obesity Task Force. In conclusion, local and national health planners should recognize the intrinsic limitations associated with the use of "standard" reference values in defining paediatric overweight and obesity in dissimilar populations. The results of this large population-based study highlight the need for population-specific BMI-for-age reference values, in order to accurately describe the prevalence of paediatric overweight and obesity.

Body Mass Index↗
PubMed2006

Parental smoking and education as determinants of overweight in Israeli children.

INTRODUCTION: Obesity is a well-recognized risk factor for many chronic diseases. Pediatric overweight is an especially severe problem because its childhood onset increases the overall length of exposure to the detrimental effects of overweight, accelerates the onset of chronic disease, and affects children's physical, psychological, and social development. Several parental traits have been shown to be associated with an increased risk for childhood overweight. In our study, we quantified the mutual effects of parental education and smoking on the risk of filial overweight in a large population-based sample of Israeli schoolchildren, adjusting for the effects of age, sex, and immigration status. METHODS: Data were collected in 1997 and 2000 from 8623 Israeli schoolchildren aged 8 to 13 years in two cross-sectional samples. Overweight was defined as body mass index (BMI) of greater than the 85th percentile for age and sex, and severe overweight was defined as BMI greater than the 95th percentile for age and sex. RESULTS: Mean BMI was positively associated with number of parental smokers for a child. Parental smoking was an independent risk factor for both overweight and severe overweight, with a dose-response relationship between the number of parental smokers and the risk of filial overweight. Children whose parents did not attend college were at increased risk for overweight (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.03-1.42) and severe overweight (OR, 1.49; 95% CI, 1.09-2.05) compared with children whose parents both attended college. Children with one college-educated parent were at increased risk for severe overweight (OR, 1.31; 95% CI, 1.004-1.71) compared with children whose parents both attended college. CONCLUSION: Parental education and smoking are independent risk factors for filial overweight. Children of less-educated, smoking parents should be targeted for overweight prevention and intervention efforts. These findings should also be included as key messages in adult smoking prevention and cessation campaigns. Parents who smoke should be warned that not only is their own health at stake, but their children are also at increased risk for overweight and its associated diseases.

Adolescent↗
PubMed2006

Ten-year trends in obesity among Israeli schoolchildren: 1990-2000.

AIM: To analyze trends in childhood body mass index (BMI) in Israel between 1990 and 2000, and to determine the proportion of obese children using US and population-specific reference values. METHODS: Cross-sectional data from 13 284 second- and fifth-grade schoolchildren were collected, including age, sex, height, weight, country of birth, and time since immigration. Age- and sex-specific BMI means and centiles were calculated, and the prevalence of obesity was determined using Israeli and US reference values. RESULTS: BMI values at the 95th centile increased monotonously over time in all age and sex categories. Between 1990 and 2000, 95th centile values increased by 12.7% and 11.8% among second-grade boys and girls, respectively. Among fifth-grade children, 95th centile values increased by 10.2% and 8.4%, respectively. Among second graders in 2000, 11.4% of both boys and girls exceeded the BMI value recorded at the 95th centile in 1990. Among fifth-graders in 2000, 10.7% of boys and 11.1% of girls exceeded the 1990 BMI reference value (p for all comparisons < 0.001). The proportion of obese children increased over time using both Israeli and US reference values. CONCLUSION: This substantial increase in childhood obesity poses a serious health threat, and requires implementation of suitable public health interventions.

Age Distribution↗
PubMed2005

Familial mycosis fungoides: report of 6 kindreds and a study of the HLA system.

BACKGROUND: The familial occurrence of mycosis fungoides (MF) has been reported only in 8 families. Recently, the HLA class II alleles DRB1* 11 and DQB1* 03 have been found to be significantly increased for patients with sporadic MF, suggesting a possible immunogenetic basis for the pathogenesis of this malignancy. OBJECTIVE: We sought to detect familial occurrences of MF, to describe familial features, and to investigate the possible association or linkage with the HLA system in such cases. METHODS: The files of 300 patients with MF were reviewed to search for familial occurrence in at least two first-degree relatives. A group of 252 healthy unrelated individuals served as control subjects. Tissue typing for HLA class I was performed using the microlymphocytotoxicity technique. DNA-based analysis for DRB1* and DQB1* alleles was performed using polymerase chain reaction amplification. RESULTS: Six families comprising 12 Jewish patients (9 male and 3 female) were detected: in 5, two first-degree relatives had MF; and in one, one member had MF and another had parapsoriasis en plaque. There were 5 families with two affected siblings and one family with a parent-child pair. In all but one family, the age of onset, clinical features, and response to therapy were similar to those in sporadic MF. One family, however, was exceptional: both affected siblings were children and both exhibited a similar but unusual morphology in the form of a hypopigmented variant of MF in conjunction with a psoriasiform variant. The allele frequency of HLA DQB1* 03 was found to be significantly greater among the patients than in the control group (66.7% vs 33%, respectively; P = .027), supporting an association of this allele with familial MF. Analysis of the HLA typing in the affected sibling pairs, when grouped together, did not support linkage to the HLA locus because no segregation distortion could be demonstrated ( P = .76). CONCLUSIONS: Familial aggregation of MF among Israeli Jews may not be as rare as is reflected in the literature. This familial clustering, together with the detection of certain HLA class II alleles with this malignancy (sporadic and familial), suggests that genetic factors may play a role in MF.

Adolescent↗
PubMed2004

Morbidity and mortality after hip fracture: the impact of operative delay.

INTRODUCTION: The relationship between the timing of surgery after hip fracture and the subsequent survival of the patient has been studied extensively, yet still remains a controversy. This study aims to assess the impact of operative delay on the 1-year survival of patients and on the rate of complications during the postoperative hospital stay. MATERIALS AND METHODS: Medical and demographic data were extracted from the hospital records of 651 consecutive hip fracture patients over 60 years old. Information on mortality was obtained by cross-linkage with the Department of Interior population files. The multivariate survival analysis model was utilized to assess the association between the time from fracture incident to surgery and the outcome (1-year survival and postoperative complications). RESULTS: The hazard ratio (HR) of 1-year mortality for postponing surgery beyond 48 h was 1.63 (95%CI 1.11-2.40), as derived by the Cox proportional hazards model. Other variables found to be independently associated with decreased survival are: male gender (HR=1.54), mental deterioration (HR=2.94), postoperative mobility (HR=2.45), and severity of pre-existing diseases (HR=1.96). Occurrence of general complications during the postoperative hospital stay was a significant predictor of decreased 1-year survival (HR=1.83). CONCLUSION: These findings suggest that early (within 48 h) surgical treatment of hip fractures is associated with improved 1-year survival.

Aged↗
PubMed2003

Vitamin A supplementation and childhood morbidity from diarrhea and respiratory infections: a meta-analysis.

OBJECTIVES: To perform an updated meta-analysis of the effect of vitamin A supplementation on childhood morbidity from respiratory tract infections and diarrhea. Study design A comprehensive search of the 1966 to 2000 MEDLINE database and review of the reference lists of relevant articles identified 9 randomized controlled trials dealing with morbidity from respiratory infections and diarrhea in children 6 months to 7 years of age and provided "intention-to-treat" data. RESULTS: The combined results indicated that vitamin A supplementation has no consistent overall protective effect on the incidence of diarrhea (relative risk, 1.00; 95% CI, 0.94-1.07) and that it slightly increases the incidence of respiratory tract infections (relative risk, 1.08; 95% CI, 1.05-1.11). CONCLUSIONS: High-dose vitamin A supplements are not recommended on a routine basis for all preschool children and should be offered only to individuals or populations with vitamin A deficiency.

Child↗
PubMed2002

Adult infection with hepatitis A despite declining endemicity; in favor of adult vaccination.

Seropositivity against hepatitis A was examined among 4806 standing army personnel (4497 males and 309 females) during 1998-1999. Each bi-annual birth cohort examined showed a decline in seropositivity compared to the previous one. When compared with a study performed in 1989, however, for each of the 1961-1962, 1963-1964, 1965-1966, 1967-1968 and 1969-1970 birth cohorts examined, the 1998-1999 study showed 5-15% higher seropositivity. This trend remained after controlling for differences between the two studies in ethnic origin, sibship size and level of education. The overall seroconversion rate is estimated as 1.15% per year and the clinical to subclinical ratio as 1:14. Thus, hepatitis A infection continues to occur in the young adult age group and vaccination of this group should be considered.

Adult↗
PubMed2002

Incidental asthma prevention by immune serum globulin.

BACKGROUND: After a case of hepatitis A in a food handling worker in a military base, the entire exposed population was vaccinated with immune serum globulin (ISG). We analyzed the potential effects of ISG on asthma attacks and respiratory infections. METHODS: The base population was observed for asthma exacerbation for the 3 months after the immunization and was compared with the population of the same base a year earlier. Rates were tested using chi2 statistics. RESULTS: The vaccinated population had a highly significant decrease in the incidence of asthma attacks (rate ratio [RR] = 0.2, 95% confidence interval [CI] 0.09 to 0.45), sinusitis (RR = 0.34, 95% CI 0.2 to 0.58), and pneumonia (RR = 0.41, 95% CI 0.17 to 0.99). No significant difference was observed in the incidence rates of upper respiratory infections between the two groups. CONCLUSIONS: A single administration of ISG significantly reduces the rate of asthma attacks and respiratory infections.

Adolescent↗
PubMed2002

Measles antibody prevalence rates among young adults in Israel.

BACKGROUND: In Israel, vaccination coverage against measles is high, yet seroepidemiologic studies have shown that more than 15% of the 18-year-old population were unprotected against the disease. A 2-dose program of vaccination against measles, mumps, and rubella at the ages of 1 and 6 years was begun in 1990, supplemented by a measles catch-up plan for all 13-year-olds. The aim of this study was to assess the prevalence of antimeasles antibodies at induction to the Israel Defense Forces in the first doubly vaccinated birth-cohort. METHODS: In 1996, serum samples of 540 recruits, 339 men and 201 women, were tested for measles virus antibody. Findings were compared with surveys conducted in 1987 and 1990. RESULTS: Measles antibodies were present in 95.6% (95% CI, 93.5-97.1) of the recruits. Antibody prevalence was higher in women than in men (99% vs 93.5%; P =.0096). A slightly lower seroprevalence was found in recruits born in the former Soviet Union. The results were substantially higher than the seroprevalence rates found in 1987 (73.3%) and 1990 (84.6%). CONCLUSIONS: The high prevalence of antimeasles antibodies in the young adult population in Israel points to the success of the double-vaccination policy in promoting immunity against the disease.

Adolescent↗