Childhood obesity and associated factors in a rural Greek island.

INTRODUCTION: Childhood obesity has increased dramatically in the past few decades both in developed and developing countries. The objectives of this study were to estimate the prevalence of increased weight in children and adolescents on a remote Greek island in the Aegean Sea, and to assess the factors influencing this phenomenon. METHODS: A cross-sectional study was conducted involving children and adolescents aged 8-16 years, resident on the island of Kalymnos, Greece. Their height and weight were measured in the school environment. Information about the children's leisure habits, a plain dietary history, whether they were exposed to tobacco smoke at home, parental nutritional status and socioeconomic status were collected via a written questionnaire. Obesity was defined according to the International Obesity Task Force curves. Univariable and multivariable logistic regression analysis were conducted in order to identify any factor correlated to increased weight. RESULTS: In total, 232 children took part in the study (91.6% participation), and 20.6% (n=48) were classified as overweight while 8.1% (n=19) were obese. The majority of the children (85.9%) had been breastfed and 45.6% (n=106) were exposed to smoke at home. In the multivariable analysis, statistically significant terms associated with childhood increased weight were: maternal obesity, maternal occupation and weekly consumption of sugar-sweetened soft drinks. CONCLUSIONS: The high prevalence of increased weight in children and adolescents on this remote island is part of the major global public health problem. The evidence suggests that maternal nutritional status and occupation, together with children's dietary habits, are associated with childhood body weight.

Predictors of mortality in patients with bloodstream infections caused by KPC-producing Klebsiella pneumoniae and impact of appropriate antimicrobial treatment.

Bloodstream infections (BSIs) caused by Klebsiella pneumoniae carbapenemases (KPC)-producing K. pneumoniae (KPC-KP) are associated with high mortality rates. We investigated outcomes, risk factors for mortality and impact of appropriate antimicrobial treatment in patients with BSIs caused by molecularly confirmed KPC-KP. All consecutive patients with KPC-KP BSIs between May 2008 and May 2010 were included in the study and followed-up until their discharge or death. Potential risk factors for infection mortality were examined by a case-control study. Case-patients were those who died from the BSI and control-patients those who survived. Appropriate antimicrobial therapy was defined as treatment with in vitro active antimicrobials for at least 48 h. A total of 53 patients were identified. Overall mortality was 52.8% and infection mortality was 34%. Appropriate antimicrobial therapy was administered to 35 patients; mortality due to infection occurred in 20%. All 20 patients that received combination schemes had favourable infection outcome; in contrast, seven of 15 patients given appropriate monotherapy died (p 0.001). In univariate analysis, risk factors for mortality were age (p <0.001), APACHE II score at admission and infection onset (p <0.001) and severe sepsis (p <0.001), while appropriate antimicrobial treatment (p 0.003), combinations of active antimicrobials (p 0.001), catheter-related bacteraemia (p 0.04), prior surgery (p 0.014) and other therapeutic interventions (p 0.015) were significantly associated with survival. Independent predictors of mortality were age, APACHE II score at infection onset and inappropriate antimicrobial treatment. Among them, appropriate treatment is the only modifiable independent predictor of infection outcome.