BEN-NOUN, LIUBOV (LOUBA), EZRA SOHAR, AND ARIE LAOR. Neck circumference as a simple screening measure for identifying overweight and obesity patients. Obes Res. 2001;9:470 -477. Objective: There are numerous methods of assessing overweight and obesity. We undertook an observational study to test a method of identifying overweight or obese patients solely by measuring the circumference of the neck. Research Methods and Procedures:A test sample and a second validation sample included 979 subjects (460 men and 519 women), who visited a family medicine clinic in a southern Israeli urban district for any reason between the randomly chosen months of January and September 1998. Main outcome included neck, waist, and hip circumferences; body mass index (BMI); and waist:hip ratio measures. Results: Pearson's correlation coefficients indicated a significant association between neck circumference (NC) and: BMI (men, r ϭ 0.83; women, r ϭ 0.71; each, p Ͻ 0.0001), age (men, r ϭ 0.33; women, r ϭ 0.36; each, p Ͻ 0.0001), weight (men, r ϭ 0.7; women, r ϭ 0.81; each, p Ͻ 0.0001), waist circumference (men, r ϭ 0.86; women, r ϭ 0.85; each, p Ͻ 0.0001), hip circumference (men, r ϭ 0.62; women, r ϭ 0.56; each, p Ͻ 0.0001), and waist:hip ratio (men, r ϭ 0.66; women, r ϭ 0.87; each, p Ͻ 0.0001). NC Ն37 cm for men and Ն34 cm for women were the best cutoff levels for determining the subjects with BMI Ն25.0 kg/m 2 using the receiver output curve analysis. In the validation unrelated group, the test characteristics were excellent with 98% sensitivity, 89% specificity, and 94% accuracy for men, and 100% sensitivity, 98% specificity, and 99% accuracy for women. NC Ն39.5 cm for men and Ն36.5 cm for women were the best cutoff levels for determining the subjects with BMI Ն30 kg/m 2 using the receiver output curve analysis. In the validation unrelated group, the test characteristics were excellent with 93% sensitivity, 90% specificity, and 91% accuracy for men, and 93% sensitivity, 98% specificity, and 97% accuracy for women. Discussion: NC measurement is a simple and time-saving screening measure that can be used to identify overweight and obese patients. Men with NC Ͻ37 cm and women with NC Ͻ34 cm are not to be considered overweight. Patients with NC Ն37 cm for men and Ն34 cm for women require additional evaluation of overweight or obesity status.

BEN-NOUN, LIUBOV (LOUBA) AND ARIE LAOR.Relationship of neck circumference to cardiovascular risk factors. Obes Res. 2003;11:226 -231. Objective: To determine a relationship between neck circumference (NC) and risk factors for coronary heart disease by evaluating the components of the metabolic syndrome. Research Methods and Procedures:The study group included 561 subjects (231 men and 330 women) who had no known major medical conditions and were not receiving any medication therapy. The subjects were those who attended a family health clinic for any reason between 1998 and December 2001. Main indicators studied included NC, waist circumference, waist-to-hip ratio, body mass index, blood pressure, and lipoprotein, glucose, and uric acid levels. Results: Pearson's correlation coefficients indicated a significant association between NC and body mass index (men, r ϭ 0.71; women, r ϭ 0.81; each, p Ͻ 0.0001), waist circumference (men, r ϭ 0.75; women, r ϭ 0.79; each, p Ͻ 0.0001), waist-to-hip ratio (men, r ϭ 0.56; women, r ϭ 0.63; each, p Ͻ 0.0001), total cholesterol (men, r ϭ 0.50; women, r ϭ 0.66; each, p Ͻ 0.0001), low-density lipoprotein-cholesterol (men, r ϭ 0.42; women, r ϭ 0.60; each, p Ͻ 0.0001), triglycerides (men, r ϭ 0.48; women, r ϭ 0.49; each, p Ͻ 0.0001), glucose (men, r ϭ 0.21, p Ͻ 0.001; women, r ϭ 0.44; p Ͻ 0.0001), uric acid (men, r ϭ 0.50, p Ͻ 0.0001; women, r ϭ 0.60, p Ͻ 0.001), and systolic (men, r ϭ 0.53; women, r ϭ 0.69; each, p Ͻ 0.0001), and diastolic (men, r ϭ 0.55; women, r ϭ 0.65; each, p Ͻ 0.0001) blood pressure. Discussion: Higher NC is correlated positively with the factors of the metabolic syndrome; therefore, it is likely to increase the risk of coronary heart disease.

In a prospective study of risk factors for lateral ankle sprain among 390 male Israeli infantry recruits, a 18% incidence of lateral ankle sprains was found in basic training. There was no statistically significant difference in the incidence of lateral ankle sprains between recruits who trained in modified basketball shoes or standard lightweight infantry boots. By multivariate stepwise logistic regression a statistically significant relationship was found between body weight x height (a magnitude which is proportional to the mass moment of inertia of the body around a horizontal axis through the ankle), a previous history of ankle sprain, and the incidence of lateral ankle sprains. Recruits who were taller and heavier and thus had larger mass moments of inertia (P = 0.004), and those with a prior history of ankle sprain (P = 0.01) had higher lateral ankle sprain morbidity in basic training.

Background. An increased incidence of cancer, especially hematopoietic in origin, has long been suspected but never established in patients with Gaucher disease. Methods. To determine whether patients with Gaucher disease have an increased risk of cancer, the authors conducted a retrospective cohort study, comparing the incidence and type of cancer in 48 patients with Gaucher disease with those of 511 control subjects without the disease. Results. Among patients with Gaucher disease, 10 of 48 (20.8%) had cancer, as compared with 35 of 511 (6.8%) of the control group (P = 0.0027; relative risk, 3.6; 95% confidence interval, 1.7–7.5). As compared with the control group, patients with Gaucher disease had a 14.7‐fold risk of having cancer of hematopoietic origin (10.4% [5 of 48] versus 0.78% [4 of 511], respectively; P = 0.00037; 95% confidence interval, 5.2–41.7). The mean age at cancer diagnosis in the group with Gaucher disease was 57 ± 18 years. Conclusions. The authors conclude that patients with Gaucher disease have a significantly increased risk of cancer, occurring in late adulthood. Of all the cancers, hematologic cancers are significantly more prevalent. Cancer 1993; 72:219–24.

OBJECTIVE:To determine the efficacy of blue versus blue-green phototherapy using new light sources with narrow luminous spectra. The devices made of highintensity gallium nitride light-emitting diodes (LEDs) were also compared to conventional halogen-quartz bulbs phototherapy. DESIGN:Prospective open randomized study. PARTICIPANTS:A total of 114 jaundiced, but otherwise healthy term infants who met the entry criteria for phototherapy set by the American Academy of Pediatrics' Practice Parameter. MAIN OUTCOME MEASURES:The duration of phototherapy and the rate of decrease in total serum bilirubin (TSB). RESULTS:The mean TSB concentrations at initiation and termination of treatment, as well as the duration of phototherapy and the rate of decrease in TSB, were not statistically different in newborns receiving blue LED, blue-green LED or conventional phototherapy. The average rate of decrease in TSB (slope), after adjustment by a linear regression analysis for confounding factors, was À3.61 mmol/hour (95% confidence limits À5.47, À1.75) in the 25 newborns receiving blue LED phototherapy compared with À2.57 mmol/hour (À4.32, À0.82) in the 22 newborns treated with bluegreen LED phototherapy and À3.42 mmol/hour (À5.02, À1.81) in the 57 newborns who received conventional phototherapy. CONCLUSIONS:When using low light irradiance, there was no statistically significant difference in the effectiveness of phototherapy using blue-green LEDs, blue LEDs or conventional halogen-quartz bulbs.

No abstract

Objective-To investigate the influence of maternal pre-eclampsia on the blood pressure, physique and intelligence of the offspring at the age of 17 years. Design-Data obtained at the age of 17 during assessment for drafting to the Israel Defence Forces and from the records of the mothers' pregnancies from the Jerusalem Perinatal Study.Subjects-Study subjects were 145 girls and 283 boys whose mothers had had pre-eclampsia and controls were 12 701 girls and 20 416 boys whose mothers did not have pre-eclampsia.Main outcome measures-Systolic and diastolic blood pressure, weight, height and intelligence scores at the age of 17 were related to birthweight and the occurrence of pre-eclampsia during their mothers' pregnancies. Results-Systolic blood pressure was >140 mmHg in 6.9 and 11-0% of the study girls and boys, compared with 2.9 and 9.9% of the control girls and boys. The study boys but not the girls had a higher mean body mass index than the controls (P140 mmHg was 2.30 (95% CI 1.80-4-46) for the study girls but was not significantly increased for the study boys. Conclusion-Maternal pre-eclampsia does not impair growth and cognitive performance in the children who reach late adolescence but may be associated with hypertension.Pre-eclampsia is a disease of obscure aetiology (Sibai 1990), although there is considerable evidence which supports a significant genetic con-

Objective: To assess the effect of size at birth, maternal nutrition, and body mass index on blood pressure in late adolescence.