Metabolically Healthy Obesity and High Carotid Intima-Media Thickness in Children and Adolescents: International Childhood Vascular Structure Evaluation Consortium.

OBJECTIVE: It has been argued that metabolically healthy obesity (MHO) does not increase cardiovascular disease (CVD) risk. This study examines the association of MHO with carotid intima-media thickness (cIMT), a proxy of CVD risk, in children and adolescents. RESEARCH DESIGN AND METHODS: Data were available for 3,497 children and adolescents aged 6-17 years from five population-based cross-sectional studies in Brazil, China, Greece, Italy, and Spain. Weight status categories (normal, overweight, and obese) were defined using BMI cutoffs from the International Obesity Task Force. Metabolic status (defined as "healthy" [no risk factors] or "unhealthy" [one or more risk factors]) was based on four CVD risk factors: elevated blood pressure, elevated triglyceride levels, reduced HDL cholesterol, and elevated fasting glucose. High cIMT was defined as cIMT ≥90th percentile for sex, age, and study population. Logistic regression model was used to examine the association of weight and metabolic status with high cIMT, with adjustment for sex, age, race/ethnicity, and study center. RESULTS: In comparison with metabolically healthy normal weight, odds ratios (ORs) for high cIMT were 2.29 (95% CI 1.58-3.32) for metabolically healthy overweight and 3.91 (2.46-6.21) for MHO. ORs for high cIMT were 1.44 (1.03-2.02) for unhealthy normal weight, 3.49 (2.51-4.85) for unhealthy overweight, and 6.96 (5.05-9.61) for unhealthy obesity. CONCLUSIONS: Among children and adolescents, cIMT was higher for both MHO and metabolically healthy overweight compared with metabolically healthy normal weight. Our findings reinforce the need for weight control in children and adolescents irrespective of their metabolic status.

Indicadores de prescrição médica nas unidades básicas de Saúde da Família no município de Campina Grande, PB / Prescription indicators in Family Health basic units of the municipal district of Campina Grande, PB

INTRODUÇÃO: O Sistema Unico de Saúde (SUS) assegura o acesso aos medicamentos, mediante a garantia da execução integral da Assistência Farmacêutica. A Organização Mundial de Saúde (OMS) desenvolveu os Indicadores do Uso de Medicamentos com o intuito de descrever e avaliar aspectos que afetam a prática farmacêutica nos centros de saúde. OBJETIVO: Conhecer a(s) classes terapêuticas mais prescritas, segundo os indicadores de prescrição médica nas Unidades de Saúde da Família (UBSF) do município de Campina Grande. MÉTODOS: O estudo baseou-se nos Indicadores de Prescrição de Medicamentos propostos pela OMS. Os medicamentos foram classificados segundo a Anatomical Therapeutic Chemical Classification (ATC) e os dados analisados utilizando-se os programas EpiInfo 2000 e Excel. RESULTADOS: Foi prescrita uma média de 1,5 medicamentos por receita médica. A porcentagem de antibióticos prescritos foi de 21,1 por cento. Os medicamentos foram prescritos pelo nome genérico em 84,2 por cento das prescrições e apenas 1,1 por cento eram injetáveis. Faziam parte da lista de medicamentos padronizados 91,9 por cento dos prescritos. O grupo farmacológico mais prescrito foi o de antibióticos (21,0 por cento), seguido dos antiparasitários (18,4 por cento), analgésicos e antipiréticos (15,4 por cento), medicamentos para o aparelho digestivo (9,5 por cento) e respiratório (9,2 por cento). CONCLUSÕES: Percebe-se a importância de conhecer as principais demandas da comunidade, a fim de que os serviços possam planejar e realizar intervenções pertinentes às necessidades da população. Os indicadores apresentaram bons índices, demonstrando possível conseqüência da Política Nacional de Medicamentos e da realização da Conferência Municipal de Medicamentos e Assistência Farmacêutica.

INTRODUCTION: The "Sistema Unico de Saúde" (Unified National Health System - SUS) ensures access to medication through the guarantee of integral pharmaceutical care. The World Health Organization (WHO) developed Indicators on the Utilization of Drugs with the intention of describing and evaluating aspects that affect pharmaceutical practices in health centers. OBJECTIVES: To learn which are the most commonly prescribed therapeutic groups, according to Prescription Indicators in the Family Health Program of the municipal district of Campina Grande. METHODS: The study was based on the Prescription Indicators proposed by the WHO. Drugs were classified according to the Anatomical Therapeutic Chemical Classification (ATC) and data were analyzed using EpiInfo 2000 and Excel programs. RESULTS: An average of 1.5 drugs were prescribed per prescription. The percentage of antibiotics prescribed was 21.1 percent. Medication was prescribed by its generic name in 84.2 percent of prescriptions and only 1.1 percent was parenteral. 91.9 percent of the medications prescribed were part of the list of standard drugs. The most frequently prescribed pharmacologic group was antibiotics (21.0 percent), followed by anti-parasites (18.4 percent), analgesics and anti-thermals (15.4 percent), and drugs for the digestive (9.5 percent) and respiratory (9.2 percent) systems. CONCLUSIONS: It is important to know the community's main demands, so that policy-makers can plan and carry out appropriate activities to meet the needs of the population. Indicators presented good indexes, possibly as a consequence of the National Drug Policy and the accomplishment of the Municipal Conference on Medication and Pharmaceutical Care.