Prevalencia de obesidad a los 14 años en cuatro consultas de atención primaria. Evolución desde los dos años / Prevalence of obesity in 14-year-olds in four primary care centers. Trendsin weight changes since the age of two years old

Introducción. La obesidad infantil es un diagnóstico cada vez más frecuente en las sociedades occidentales. Su aparición se relaciona con determinados cambios en los estilos de vida. Por sus implicaciones en cuanto a persistencia en etapas posteriores de la vida y relación con diversas entidades patológicas, como la enfermedad cardiovascular y la diabetes, se ha convertido en uno de los problemas de salud infantil más importantes. El objetivo de este estudio ha sido conocer la prevalencia de obesidad y sobrepeso en 2003 en la población de 14 años atendida en las consultas de pediatría de un centro de atención primaria, así como la evolución ponderal de esta cohorte desde los 2 años de edad. Pacientes y métodos. Se realiza un estudio longitudinal de los 277 niños nacidos en 1989, determinando su índice de masa corporal (IMC) a los 2, 3, 4, 6, 8, 11 y 14 años. Se considera obesidad un IMC > P95, y sobrepeso IMC > P85, según las tablas de los Centers for Diseases Control and Prevention (CDC) de 2000. Resultados. La prevalencia de obesidad a los 14 años es del 13,2 % (15,2 % en niños y 11,5 % en niñas). La prevalencia de sobrepeso es de 17,4 % (18,7 % en niños y 16,2 % en niñas). Las diferencias entre sexos no son significativas en ninguna de las edades en que se realizan determinaciones. Conclusiones. La prevalencia de obesidad y sobrepeso a los 14 años en los niños de nuestras consultas es importante y comparable a la registrada en otras zonas de España. Las consultas de pediatría de atención primaria deben tener un papel relevante en la prevención y control de la misma

Introduction. Childhood obesity is an increasingly common diagnosis in western society and is related to certain changes in lifestyle. Because of its persistence in adulthood and its relationship with several pathological entities such as cardiovascular disease and diabetes, it has become one of the most important problems in children's health. The objective of this study was to determine the prevalence of obesity and overweight in 14-year-old adolescents attending the pediatric outpatient clinics of a primary care center in 2003, and their weight changes from the age of two years old. Subjects and methods. A long-term study of 277 children born in 1989 was performed. Their body mass index (BMI) was calculated at the age of 2,3,4,6,8,11 and 14 years. Obesity was defined as a BMI > P95 and overweight as a BMI > P85 according to the Centers for Disease Control and Prevention (CDC) growth charts 2000. Results. The prevalence of obesity in 14 year-olds was 13.2 % (15.2 % in boys and 11.5 % in girls). The prevalence of overweight was 17.4 % (18.7 % in boys and 16.2 % in girls). Gender differences were not significant in any of the age groups studied. Conclusions. The prevalence of obesity and overweight in 14 year-old adolescents in our centers is considerable and is similar to that reported in other Spanish regions. The pediatric outpatient clinics of primary care centers should play an active role in the control and prevention of obesity

[Antibiotic prescribing patterns in primary health care. Do pediatricians use antibiotics rationally?]. / Patrones de prescripción de antibióticos en atención primaria. Usamos racionalmente los antibióticos en pediatría?

OBJECTIVES: To determine antibiotic prescribing patterns in the pediatric (infants and children) population attended to at a primary health care centre in the community of Madrid. We also wanted to determine the necessity or otherwise of antibiotic therapy and whether the selected antibiotic drug was appropriate for the pathology diagnosed. METHODS: Retrospective study of all infectious or respiratory processes diagnosed during 1 year and of the respective antibiotic cycles prescribed in all patients under the age of 4 years. The prescribing physician and the appropriateness of all therapeutic decisions, including those where the decision was not to treat with antibiotic drugs, were analyzed. RESULTS: We evaluated 910 children under the age of 4 years with a total of 3, 847 processes (mean of 4.55 +/-3.6 processes per child per year). Sixty-three percent of the children received at least one cycle of antibiotic drugs per year (mean 1.63+/-1.69 cycles of treatment per child per year). Of all therapeutic decisions, 85.2% were considered appropriate. In 36% of the processes antibiotics were prescribed (1,386 cycles), 46% of which were considered inappropriate either because no antibiotic therapy should have been given (71.6%) or because the chosen drug was not appropriate for the pathology (28.4%). There were significant differences among the evaluated physicians. The most correct decisions were taken by the pediatrician in the outpatient clinic, especially when compared with physicians in the emergency ward (p<0.0001). The most frequently prescribed antibiotic drugs were amoxicillin (41.2%) and amoxicillin combined with clavulanic acid (33%). Cephalosporin accounted only for 6.9% of the prescriptions. CONCLUSIONS: Antibiotic therapy is overprescribed in children, a situation that should be corrected.