The prevalence of overweight and obesity in children at a Health Maintenance Organization in Hawai'i.

In the past 20-30 years, the number of overweight children in the United States has doubled.1 Overweight children are acquiring conditions such as hypertension, type II diabetes, hypercholesterolemia, sleep apnea, and orthopedic problems. The purpose of this study was to explore the prevalence of and factors associated with at risk and overweight in children 2-10 years of age in a Health Maintenance Organization (HMO) in Hawai'i. This quantitative, retrospective cross-sectional study included a stratified random sample of 554 children ages 2-10 years who received a well child health care exam at a HMO in 2003. The prevalence of at risk and overweight were examined including the relationship between ethnicity, socioeconomic status, place of residence, and a child being overweight. Thirteen percent were at risk for overweight (BMI 85-95%) and 19% (BMI >95%) were overweight. In the 6-10 year age group, 42 % were overweight or at risk for being overweight. Boys had a higher incidence of being overweight (54%) than the girls (46%). Pacific Islanders had the highest incidence of overweight (40%), followed by the Hawaiian/Part Hawaiians (19%) and Filipinos (19%). Ethnicity and place of residence were significantly associated with being at risk or overweight. Pacific Islanders were 4 times more likely to be overweight/at risk for overweight and those residing in the West O'ahu, Honolulu, and Central O'ahu/North Shore areas were 2-3 times more likely to be at risk for overweight when compared to children living in the Windward side. With increased age, the prevalence of overweight increased. Findings suggest that targeted obesity prevention strategies need to be initiated early in life and geared for ethnically and geographically diverse children and their families.

Staged hybrid left pulmonary artery rehabilitation in post-fontan left pulmonary artery hypoplasia.

Left pulmonary artery hypoplasia in the setting of Fontan circulation predisposes to pulmonary artery discontinuity. We describe a novel approach to correct post-Fontan left pulmonary artery discontinuity by a strategy to produce isolated left pulmonary artery growth, followed by a catheter-based reincorporation of the left pulmonary artery into the Fontan circuit.