Hypercholesterolemia is a potential risk factor for asthma independent of obesity.

Morbidly obese asthma patients have a higher degree of insulin resistance compared to morbidly obese non-asthma patients. We speculate that the pro-inflammatory state of insulin resistance may contribute to the pathogenesis of asthma in obese patients. Future prospective studies should address insulin resistance as a possible risk factor for asthma in obese children and adolescents.

To report our experience in identification and treatment of acute otitis media (AOM) with otorrhea secondary to community-acquired methicillinresistant Staphylococcus aureus (CA-MRSA), which is seen in children at increasing rates.

Study Objectives: The impact of vitamin D on human health including sleep has been well described in adults. Its deficiency has been associated with multiple sleep disorders such as decrease in sleep duration, worsening of sleep quality, and even OSA. Such correlation is less evident in the pediatric population.In the current study, we examined the relationship between sleep architecture and vitamin D status in children referred to a sleep clinic. Methods: This was a retrospective-cohort study in a tertiary care children's hospital over a 1-year period. Children who underwent an in-laboratory overnightpolysomnogram and had a 25-hydroxy vitamin D level obtained within 120 days of the sleep study were included. Patients with OSA or central sleep apnea were excluded. Data from polysomnograms and Pediatric Sleep Questionnaires were collected and analyzed. Results: A total of 39 patients (mean age, 6.6 years; 46% female) were included in the study. Twenty (51%) patients had vitamin D deficiency (25-hydroxy vitamin D level < 30 ng/mL). Children with vitamin D deficiency had less total sleep time (470.3 minutes ± 35.6 vs 420.3 minutes ± 61.7; P =.004) and poorer sleep efficiency (91.9% ± 5.6% vs 84.5% ± 9.5%; P = .015) compared with children with sufficient vitamin D. In addition, children with vitamin D deficiency had later weekday bedtimes (21:02 PM ± 1:01 vs 20:19 PM ± 0:55; P =.037) and later weekend bedtimes (21:42 PM ± 0:59 vs 20:47 PM ± 1:08; P =.016) than children with sufficient vitamin D, with a tendency for later wake time that did not reach statistical significance. The remainder of the polysomnogram findings and Pediatric Sleep Questionnaire data were not different between the 2 groups. Conclusions: Vitamin D deficiency in children was associated with objectively measured decreased sleep duration and poorer sleep efficiency. Furthermore, vitamin D deficiency was associated with delayed bedtimes, suggesting that vitamin D and circadian rhythm could be related. Future prospective studies in children would be helpful to learn if vitamin D deficiency leads to sleep disturbance or vice versa.