Trends of abdominal adiposity in white, black, and Mexican-American adults, 1988 to 2000.

OBJECTIVE: To describe changes in the distribution of waist circumference (WC) and abdominal obesity (AO) in white, black, and Mexican-American adults from 1988 through 2000. RESEARCH METHODS AND PROCEDURES: Nationally representative cross-sectional surveys of adults 20 to 79 years of age were examined using data from U.S. National Health and Nutrition Examination Surveys of 1988 to 1994 and 1999 to 2000. AO was defined as WC > or =102 cm in men and > or 88 cm in women. RESULTS: There was a gradient of increasing WC and AO with increasing age in both study periods in whites and blacks. In men, the average increase between the study periods in overall WC in whites, blacks, and Mexican Americans were 3, 3.3, and 3.4 cm, respectively. The corresponding values in women were 2.4, 5.3, and 3.7 cm, respectively. In men, the percentage change in prevalence of AO between 1988 and 2000 ranged from 5.5% in Mexican-American men to 8.2% in white men. In women, there was a 1.7% decrease in AO in Mexican Americans, whereas there was an increase of 6.3% for whites and 7% for blacks. DISCUSSION: Despite increased understanding of the need for screening and treatment for obesity, this study indicates increasing prevalence of AO in white and black Americans. Without concerted effort to reduce the prevalence of overall obesity, the increasing prevalence of AO is likely to lead to increased prevalence of metabolic syndromes in the United States. Our results highlight the need to design evidence-based programs that show promise for long-term health behavior changes to facilitate the prevention of AO and related comorbidities.

Otitis media in the Republic of Palau. A case-series study.

Race is a known epidemiologic determinant for the development of otitis media. This study assessed the severity of otitis media in a subpopulation (N = 73; mean age, 13.2 years) receiving care from the ear clinic in the Republic of Palau, a US Trust Territory, through a questionnaire and an otologic examination. The mean age of patients with otorrhea (2.5 years) was found to be significantly different from the mean age at which they began to swim (4 years). Otitis media-related sequelae were found to involve more than half of ears or subjects examined. No statistical difference was noted when various patient characteristics were compared with the severity of disease. Our clinical impression is that this subpopulation is severely affected by otitis media and its sequelae. Prospective studies are required to identify risk factors present in the population at large.

A epidemiologia na administraçäo dos serviços de saúde / Epidemiology in health services management

A premissa básica é a de que os hospitais e outras organizaçöes ligadas à saúde necessitam dos instrumentos básicos da epidemiologia para que possam tomar decisöes seguras quanto à política de saúde baseada em evidência epidemiológica. É preciso conhecer e compreender a epidemiologia e como ela se relaciona com a utilizaçäo dos serviços. Para isto, é preciso compreender também os princípios e métodos específicos da epidemiologia e disciplinas correlatas, que têm que ser aplicados às áreas de política e administraçäo da instituiçäo de saúde. Estes vários aspectos da epidemiologia na administraçäo dos serviços de saúde säo detalhadamente discutidos.