The ethnic distribution of the 208 study subjects was 76% Hispanic, 20% African American, and 4% other. In 159 (76%) of 208 subjects between two and 18 years of age, the BMI was < 90th percentile in 101 (64%) and > 90th percentile for age and gender in 58 (36%). The mean ages (X+SD) were 6.8 years + 4.3 for subjects in < 90th percentile group, and 7.2 years ±4.1 for those in >90th percentile group (t= -0.6, p=0.55). By gender, overweight was identified in 37 (35%) of 94 males, and 21 of 65 (32%) females (X² =0.82, p=0.4). According to ethnicity, overweight was found in 36.4% of the Hispanics, and 34.4% African American, (X²=0.043, p=0.83). In the remaining 49 (24%) of 208 subjects who were < two years of age, 10 had BMI or weight/height ratios at or above the 90th percentile. These 10 patients had no documentation indicating provider awareness, planned evaluation, or intervention for suspected increase in body weight.

PROVIDER DOCUMENTATION

In 58 subjects with BMI >90th percentile, 17 (29%) satisfied the criteria for medical record documentation. When the subjects were stratified by resident level (1,2, and 3), first level residents examined seven of the 58 overweight subjects without documenting overweight or obesity in any subject, where as second level examined 36 and documented 11 (31%); and third level examined 15 and documented 6 (40%). The differences in frequency among the different training levels of residents did not reach the level of significance (p=0.08). The mean (X±SD) percentiles of the BMI were 99.5±1.5 in the 17 overweight subjects with documentation, and 93.9+4.0 in the remaining 41 subjects who were identified as overweight but not documented (t=7.6, p<0.001). buy antibiotics amoxicillin

PROVIDER INTERVENTION

In those fulfilling the criteria for overweight, 15(26%) of 58 subjects had some type of intervention documented by the provider, with nutrition counseling or assessment only being the most frequent in seven subjects (12%). Eight (14%) subjects received a combination of nutrition, exercise, and/or behavioral counseling. Two (12%) of the 17 documented overweight subjects had no record of an intervention prescribed by the provider. Table 1 illustrates the distribution and combination of the interventions among the documented overweight subjects. There were no subjects with a weight loss goal recorded except one who was in the normal weight group.

Blood Pressure and Cholesterol Determinations

In the overweight group, 48 (83%) of 58 subjects had blood pressure values recorded as compared to 12 (12%) of 101 subjects in the normal weight group (X²=75.7, p<0.001). The mean blood pressure values (X+SD) in the 48 overweight and 12 normal weight subjects were 109mmHg±19 and 95mmHg±14 for systolic (p=0.002), and 64mmHg±15 and 55mmHg+ll for diastolic respectively (p=0.013). Likewise, cholesterol values were measured in 34 (59%) of 58 overweight subjects as compared to 7 (7%) of 101 normal weight subjects. (X²=5L1, p<0.001). The compared mean values (X+SD) for cholesterol were higher in the 34 overweight subjects (170±39mg/dl) than in the 7 normal weight subjects (144+28), but the difference was not statistically significant, (p=0.14).

In the 58 overweight subjects, first year residents recorded blood pressure in three (43%) of seven examined, second year residents in 31 (86%) of 36 examined, and third year in 14 (93%) of 15 examined reflecting a significant upward trend, p=0.01. The differences in cholesterol determinations by the first (28%), second (64%), and third (60%) year residents in the 58 overweight subjects were not significant, p=0.31.

Table 1. PATIENTS DOCUMENTED AS OBESE OR OVERWEIGHT: CHOICE OF INTERVENTIONS PRESCRIBED BY THE PHYSICIAN

Overweight Subjects: Documented vs. Not Documented

The frequencies of blood pressure measurements in the 17 documented overweight subjects were 100% (17/17) as compared to 76% (31/41) of the subjects not documented by the provider, p=0.02. (Table 2) The mean blood pressure (X±SD) levels for both documented and not documented groups were 109±19 and 95±14 for systolic (p=0.004), and 64±15 and 55±10 for diastolic (p=0.02), respectively. The frequencies of blood cholesterol determinations were 76% (13/17) in the documented subjects, and 51% (21/41) not documented, p=0.07. The mean (X+SD) cholesterol levels were 170±50 mg/dl in the documented overweight subjects (17), and 165+31 mg/dl in the overweight (41), but not documented, p=0.70.
generic viagra online

Table 2. PERCENT OF BLOOD PRESSURE AND CHOLESTEROL DETERMINATIONS AND MEAN (+ SD) VALUES IN NORMAL AND OVERWEIGHT SUBJECTS

Overweight Not Documented vs. Normal Weight Subjects

The frequencies of blood pressure measurements were 76% (31/41) in the overweight subjects not documented, and 12% (12/101) in the normal weight subjects, (X²=56.1, p< 0.001) (Table 2). The mean blood pressure (X±SD) levels for both normal weight and overweight not documented subjects were 94+13/54+13 mmHg and 95±14/54+10 mmHg (p>0.1), respectively. The frequencies of blood cholesterol determinations were 51% (21/41) in the overweight subjects not documented, and 7% (7/101) in the normal weight subjects, (X²=36.2, p<0.001). The mean (±SD) cholesterol levels were 144± 28 mg/dl in the normal weight subjects, and 165+31 mg/dl in the overweight not documented, p=0.12. canadian antibiotics

­