Haim Bibi

The Relationship Between Asthma and Obesity in Children: Is It Real or a Case of Over Diagnosis?

Objective: To determine whether obesity among children is associated with an increased incidence of asthma. Design and Method: Five thousand nine hundred eighty‐four children participated in a lung health study in the Ashkelon region, Israel. A lung health questionnaire was completed and they underwent spirometry. Body mass index (BMI) was then calculated for each child. Results: Three hundred two children (5.05%) were above the 95th percentile for BMI and considered obese. Obese children tended to wheeze more than the non‐obese children 14.5% vs. 10.5%, respectively (p < 0.038). Asthma (physician diagnosis) was diagnosed more often among obese children than non‐obese 7.2% vs. 3.9%, respectively (p < 0.008). Inhaler use was more prevalent among obese children than non‐obese 15.9% vs. 8.8%, respectively (p < 0.001). Bronchial hyperreactivity was significantly greater among the non‐obese asthmatic children compared with their obese counterparts, 352 (51.4%) vs. 10 (27.8%), respectively (p < 0.001). Chest symptoms and asthma were more frequent in obese than non‐obese boys. Conclusion: Asthma, wheezing, and inhaler use were more common in obese children than in non‐obese children. Symptoms were more prevalent among obese boys. Increasing BMI among children is a risk factor for asthma, which may in reality be obesity‐related chest symptoms that mimic asthma.

Comparison of positive allergy skin tests among asthmatic children from rural and urban areas living within small geographic area

BACKGROUNDnEvidence of increased asthma and allergic response among urban versus rural residents has been reported.nnnOBJECTIVEnTo evaluate the prevalence of allergic response among asthmatic children from urban and rural areas living within close proximity.nnnMETHODSnIn all, 448 asthmatic children from urban (363) and rural (85) areas were studied. The study group consisted of 234 9-year-olds and 214 12-year-olds. A health questionnaire was completed on each child who subsequently underwent allergic skin prick tests (SPTs).nnnRESULTSnThere was significantly more positive SPT response to house-dust mite, mold, cat, and cypress among asthmatic children from urban areas compared with children living in rural areas: 58.3% versus 37.6%, 46.1% versus 31.8%, 17.45 versus 5.9%, and 26.2% versus 15.3%, respectively. Positive SPT for indoor allergens were significantly greater among asthmatic urban residents than asthmatic rural residents: 63.3% versus 45.5%, respectively (P < 0.02). Positive SPT response to all the allergens checked was higher among the 12-year-old age group when compared with the 9-year-olds, 34.6% versus 22.7%, respectively (P = 0.05).nnnCONCLUSIONSnAllergic response measured by SPT is significantly more common among asthmatic children from urban areas as opposed to rural, even though both areas are within small distance of one another. Further, asthmatic children living in urban areas demonstrated more allergic response to both indoor and outdoor allergens. The allergic response tends to increase with increased age in both urban and rural asthmatic children.

Rare jatropha multifida intoxication in two children

Two children were admitted to the Emergency Department (ED) after ingesting a large amount of fruit of a plant identified as Jatropha multifida. They were mildly obtunded, had intractable vomiting, and seemed dehydrated. Intravenous fluid replacement and urine alkalinization were initiated. After stabilization, their 5-day hospital stays were uneventful except for a subclinical rise of liver enzymes. Jatropha species contain the toxalbumin ricin, which causes severe vomiting and diarrhea, dehydration, shock, and renal and hepatic impairment. Ricin also has cardiotoxic and hemolytic effects and several deaths have been documented. Children are attracted by the shape and the color of the Jatropha fruits. Mortality can be prevented by immediate fluid and electrolyte replacement.

Differences in lung function among school children in communities in Israel.

Abstract Differences in lung functions of school-age children who lived near two electrical power plants in the Ashkelon district of Israel were studied. Lung-function tests were performed, and the American Thoracic Society questionnaire was administered in three study periods during the following years: (1) 1990, (2) 1994, and (3) 1997. Measurements of air pollutants (i.e., sulfur dioxide, nitric oxides, ozone) were also taken during the aforementioned study periods. Statistical analysis included an estimation of a series of fixed-effects regression models. A total of 2,455, 1,613, and 4,346 observations were included in the analyses for study years 1990, 1994, and 1997, respectively. The authors controlled for age, sex, height, weight, parents education and smoking status, and being born out of Israel, and, consequently, substantial differences in lung function across the different communities and study periods were demonstrated in the study area. No robust association with air pollution was demonstrated. The cause of these differences in the respiratory health of children remains unknown.

Zn/Ga−DFO iron–chelating complex attenuates the inflammatory process in a mouse model of asthma

Background Redox-active iron, a catalyst in the production of hydroxyl radicals via the Fenton reaction, is one of the key participants in ROS-induced tissue injury and general inflammation. According to our recent findings, an excess of tissue iron is involved in several airway-related pathologies such as nasal polyposis and asthma. Objective To examine the anti-inflammatory properties of a newly developed specific iron–chelating complex, Zn/Ga−DFO, in a mouse model of asthma. Materials and methods Asthma was induced in BALBc mice by ovalbumin, using aluminum hydroxide as an adjuvant. Mice were divided into four groups: (i) control, (ii) asthmatic and sham-treated, (iii) asthmatic treated with Zn/Ga−DFO [intra-peritoneally (i/p) and intra-nasally (i/n)], and (iv) asthmatic treated with Zn/Ga−DFO, i/n only. Lung histology and cytology were examined. Biochemical analysis of pulmonary levels of ferritin and iron-saturated ferritin was conducted. Results The amount of neutrophils and eosinophils in bronchoalveolar lavage fluid, goblet cell hyperplasia, mucus secretion, and peri-bronchial edema, showed markedly better values in both asthmatic-treated groups compared to the asthmatic non-treated group. The non-treated asthmatic group showed elevated ferritin levels, while in the two treated groups it returned to baseline levels. Interestingly, i/n-treatment demonstrated a more profound effect alone than in a combination with i/p injections. Conclusion In this mouse model of allergic asthma, Zn/Ga−DFO attenuated allergic airway inflammation. The beneficial effects of treatment were in accord with iron overload abatement in asthmatic lungs by Zn/Ga−DFO. The findings in both cellular and tissue levels supported the existence of a significant anti-inflammatory effect of Zn/Ga−DFO.

The Association Between Psychological Distress and Decision Regret During Armed Conflict Among Hospital Personnel.

The association between psychological distress and decision regret during armed conflict among hospital personnel is of interest. The objective of this study was to learn of the association between psychological distress and decision regret during armed conflict. Data was collected from 178 hospital personnel in Barzilai Medical Center in Ashkelon, Israel during Operation Protective Edge. The survey was based on intranet data collection about: demographics, self-rated health, life satisfaction, psychological distress and decision regret. Among hospital personnel, having higher psychological distress and being young were associated with higher decision regret. This study adds to the existing knowledge by providing novel data about the association between psychological distress and decision regret among hospital personnel during armed conflict. This data opens a new venue of future research to other potentially detrimental factor on medical decision making and medical error done during crisis.

Young Infants' Morbidity and Exposure to Fine Particles in a Region with Two Power Plants

Abstract This study investigated the effect of fine particulate matter (PM2.5) in ambient air on hospital admissions and emergency room (ER) visits among young children (0–3 yr) residing in 4 communities in southern Israel, within an area 5–25 km from the 2 power plants, which operate within 25 km of each other. Daily records of hospitalizations and ER visits for respiratory diseases at the 3 hospitals serving the region were examined for 9 mo, October 1, 2000-June 30, 2001. Mean PM2.5 concentrations for the four communities ranged from 11.6 to 28.1 μmlg/m3. Time series analysis revealed a statistically significant association (p < 0.05) between the numbers of hospitalizations and ER visits for respiratory symptoms and concentrations of PM2.5. This effect was evaluated for 0–3 lag days, directly, and for interactions with temperatures and seasonal parameters. The respiratory health of young children may be affected by 24 hr concentrations of PM2.5 < 60 μmlg/m3, the threshold proposed by both Israel and the United States.