Validity of self-reported weight and height among 13-14 year old schoolchildren in Israel.

BACKGROUND: Data regarding the validity of self-reported weight and height in adolescents are conflicting. OBJECTIVES: To evaluate the validity of self-reported weight and height among 13-14 year olslddren. METHODS: We conducted a cross-sectional study of 517 schoolchildren aged 13-14 years and compared self-reported and measured weight and height by gender, population group, parental education and crowdedness. RESULTS: Females under-reported their weight on average by 0.79 +/- 5.46 kg (P = 0.03), resulting in underestimation of the body mass index with borderline significance (mean difference 0.28 +/- 2.26 kg/m2, P = 0.06). Males over-reported their height on average by 0.75 +/- 5.81 cm (P = 0.03). Children from less crowded homes (< or = 1 person per room) overestimated their height more than children from more crowded homes, resulting in a significant underestimation of BMI (mean difference between reported BMI and measured values was 0.30 +/- 2.36 kg/m2, P = 0.04). Measured BMI was a significant predictor of the difference between self-reported and measured BMI, adjusted for gender, population group, parents' education, and crowdedness (beta = -0.3, P < 0.0001). As a result of this reporting bias, only 54.9% of children with overweight and obesity (BMI > or = 85th percentile) were classified correctly, while 6.3% of children were wrongly classified as overweight and obese. The largest difference in BMI was observed in obese females (4.40 +/- 4.34) followed by overweight females (218 +/- 1.95) and underweight females (-1.38 +/- 13.75). Similar findings were observed for males, where the largest difference was found among obese males (2.83 +/- 3.44). CONCLUSIONS: Studies based on self-reported weight and height in adolescents may be biased. Attempts should be made to correct this bias, based on the available data for each population.

A food-borne outbreak of streptococcal pharyngitis.

BACKGROUND: Food-borne pharyngitis outbreaks causing substantial morbidity have been documented. OBJECTIVES: To investigate an outbreak of food-borne Streptococcus beta hemolyticus group A pharyngitis among employees of a hitech company. METHODS: We received a report on an unusually high rate of morbidity among employees of a company in September 2003. The Tel Aviv District Health Office conducted an epidemiological investigation of the outbreak. RESULTS: Among the 278 people who attended a company party, 83 became ill. The overall attack rate was 29.8%. Information was available on 174 of 193 employees and family members who attended the party and worked in the Tel Aviv district. Forty-six of them became ill (attack rate 26.4%). The secondary attack rate was 3.8%. Most cases developed symptoms 24-48 hours following the event. Seven cases had throat cultures positive for Streptococcus beta hemolyticus group A. Three items were significantly associated with becoming sick: spring chicken (odds ratio 2.26, 95% confidence interval 1.11-4.63, P = 0.02), vegetable salad (OR 2.88 95% CI 1.40-5.94, P = 0.003) and corn (OR 7.73, 95% CI 3.18-18.80, P < 0.001). Eating corn remained significantly associated with pharyngitis after controlling for other food items consumed. CONCLUSIONS: We describe the epidemiological investigation of a large food-borne outbreak of Streptococcus beta hemolyticus group A pharyngitis most probably transmitted by corn. No previous publication has implicated corn. Food handlers and the public should be aware that they can transmit diseases to others. Physicians should be aware that streptococcal pharyngitis could be a foodborne disease and that outbreaks in a non-confined setting may be easily missed.

Air transportation of corneal tissue: experience with local compared to transatlantic donor corneas.

PURPOSE: To compare the outcome of corneas obtained at the same hospital in which they were transplanted (group 1) to that of corneas obtained in the United States and grafted in Israel (group 2). METHODS: One hundred twenty-six patients undergoing corneal grafting in Israel during the years 1995 to 1998 were included in a retrospective, nonrandomized clinical trial. Group 1 included 31 procedures, and group 2 included 95. Data regarding preoperative condition, tissue characteristics, and postoperative outcome were collected from hospital charts. Statistically significant difference between groups was considered as P < 0.05. RESULTS: Follow-up time was 796 +/- 523 days for group 1 (mean +/- SD) and 815 +/- 510 days for group 2. Donor age and gender, recipient age and gender, graft size, and length of follow-up were similar. Time from preservation to transplantation was longer for group 2 (8.8 +/- 2.29 days) compared with in group 1 (3.13 +/- 2.38 days). Graft clarity was similar between groups 1 and 2 at 1 year (79% versus 71%) and at last follow-up visit (57% versus 62%). Visual acuity, intraocular pressure, and incidence of complications such as rejection (32% versus 38%), failure (35% versus 28%), secondary glaucoma (35% versus 43%), corneal ulcer (13% versus 6%), and regrafts (13% versus 7%) showed no difference between the groups. CONCLUSIONS: Air transport of corneal tissue, including loss of time due to travel and handling, did not compromise corneal transplantation success rate.

Effectiveness of the Oka/GSK attenuated varicella vaccine for the prevention of chickenpox in clinical practice in Israel.

BACKGROUND: The varicella Oka/Merck vaccine has been shown to be very effective in clinical practice; however, several recent studies reported reduced effectiveness. The varicella Oka/GSK vaccine (Varilrix; GlaxoSmithKline Biologicals), which has been subjected to fewer effectiveness studies, was licensed in Israel for voluntary use in 2000. This study was planned to estimate the effectiveness of the varicella Oka/GSK vaccine among children 1-5 years of age. METHODS: Recent reports of varicella were retrieved from the Tel Aviv Health District. Two age-matched control subjects who attended the same day-care center and/or resided in the same neighborhood and had not contracted varicella in the past were recruited for each varicella case. The parents of case and control subjects were interviewed regarding the history of varicella vaccination and the severity of illness. RESULTS: A total of 151 case subjects (mean age, 2.9 +/-1.1 years) and 298 control subjects (mean age, 3.0 +/-1.1 years) were recruited. Vaccination rates for case and control subjects were 6.6% and 38.3%, respectively (P < 0.001). Disease among vaccinated children was significantly milder, as measured by several indices, including parental perception of the illness, presence of fever, time until the lesions dried and days of day care missed. Vaccine effectiveness against varicella of any severity with these figures was 88% (95% confidence interval, 77-94%), and effectiveness against moderate/severe illness was 100%. CONCLUSIONS: Our data demonstrate that the varicella Oka/GSK vaccine used in clinical practice is highly effective in prevention of varicella (especially moderate/severe disease) among children, including those attending day-care centers.

Interferon-alpha-associated bilateral simultaneous ischemic optic neuropathy.

The authors describe one patient with essential thrombocytosis and one with chronic hepatitis C infection who developed bilateral simultaneous anterior ischemic optic neuropathy within 3 months of starting treatment with interferon-alpha. One patient had several typical risk factors for conventional AION; the other did not. These cases are the fourth and fifth reported examples of this phenomenon. Interferon-alpha treatment may cause or aggravate the risk of developing anterior ischemic optic neuropathy. Vulnerable patients should be advised of this potential complication, assisted in reducing risk factors, and monitored for optic nerve and retinal vascular complications.