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ABSTRACT Objective To assess the prevalence and clustering patterns of cardiometabolic risk factors among low-income, female adolescents. Materials and methods Cross-sectional study involving 196 students of public schools (11-19 years old). The following risk factors were considered in the analysis: excess weight, central obesity, dyslipidemia, high blood pressure, and high fasting glucose. The ratio between observed and expected prevalence and its confidence interval were used to identify clustering of risk factors that exceeded expected prevalence in the population. Results The most prevalent risk factors were dyslipidemia (70.9%), and central obesity (39.8%), followed by excess weight (29.6%), and high blood pressure (12.8%). A total of 42.9% of adolescents had two or more risk factors, and 24% had three or more. Excess weight, central obesity, and dyslipidemia were common risk factors in the clustering patterns that showed higher-than-expected prevalence. Conclusions Clustering of risk factors (≥ two factors) among the adolescents showed considerable prevalence, and there was a non-casual coexistence of excess weight, central obesity, and dyslipidemia (mainly low HDL-cholesterol).

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Objetivo Analisar a prevalência da síndrome metabólica (SM) nos estágios pubertários de escolares do sexo feminino. Métodos Estudo transversal com 449 escolares, entre oito e 18 anos, estratificadas nos estágios pubertário, índice de massa corporal (IMC) e percentual de gordura (%G). A SM foi classificada pela International Diabetes Federation. A análise feita pela distribuição de frequências, intervalos de confiança (95 %), Qui-quadrado e razão de chance para associações. Resultados A prevalência de SM foi 3,3 % (IC:2 %-5 %), sendo 2,5 % (IC:0,1 %-5%) no púbere e 7,9 % (IC:3,2 %-12,6 %) no pós-púberes, com associação significante destes com a SM (X²=5,2 [p<0,02]). A razão de chance aponta meninas pós-púberes (3,3 [IC:1,2-5]) e obesas (2,1 [CI:2-2,2]) mais propensas à SM, indicando associação linear significante do IMC com o desfecho (X²=29,4 [p<0,001]). Púberes menos de 10 anos com SM apresentaram maiores %G. Os componentes prevalentes foram: circunferência da cintura alterada (27,2 % [IC23 %-31 %]) e colesterol HDL baixo (39,6 % [IC35 %-44 %]) e prevalência da hipertensão sistêmica nas pós-púberes. Conclusões A SM inicia-se no estágio púbere, com prevalência no pós-púbere, sendo o excesso de gordura o desencadeador nas menores de 10 anos. Estratégias de prevenção são necessárias à população de crianças e adolescentes.(AU)

Objective To analyze the prevalence of metabolic syndrome (MS) in pubertal stages of female students. Methods Cross-sectional study of 449 school children between eight and 18 years, stratified by pubertal stage, body mass index (BMI) and body fat percentage (BF %). The MS was classified according to the International Diabetes Federation. The analysis by frequency distribution, confidence intervals (95 %), Chi-square and odds ratio for associations was performed. Results The prevalence of MS was 3.3 % (CI:2 %-5 %) and 2.5 % (CI: 0.1 - 5 %) in pubertal and 7.9% (CI:3.2 % - 12.6 %) in the post-pubescent, with a significant association of this group with MS (X² = 5.2 [p <0.02]). The odds ratio shows that post-pubescent girls (3.3 [CI: 1.2 to 5]) and obese girls (2.1 [CI: 2 - 2.2]) are more likely to have MS, indicating significant linear association between BMI and the outcome (X²=29.4 [p<0.001]). Pubescent children under 10 years of age with MS had higher %G. The prevalent components were altered waist circumference (27.2 % [CI23 %-31 %]) and low HDL cholesterol (39.6 % [CI 35 % - 44 %]), as well as prevalence of systemic hypertension in post-pubertal girls. Conclusions MS begins in the pubertal stage, with prevalence in the post-pubertal stage. Excess fat is a trigger in children under 10 years of age. Prevention strategies are needed for the population of children and adolescents.(AU)

Objetivo Analizar la prevalencia del síndrome metabólico (SM) en el estadio puberal de estudiantes de sexo femenino. Métodos Estudio transversal con 449 niños en edad escolar entre ocho y 18 años, estratificado en la etapa de la pubertad, el índice de masa corporal (IMC) y el porcentaje de grasa corporal (% GC). El SM fue clasificado por la Federación Internacional de Diabetes. El análisis se adelantó por medio de la distri study bución de frecuencias, intervalos de confianza (95 %), Chi-cuadrado y Odds ratio para las asociaciones. Resultados La prevalencia de SM fue del 3,3 % (IC:2 %-5 %) y 2,5 % (IC:0,1 %-5 %) en la pubertad y el 7,9 % (IC:3,2 %-12,6 %) en el post-pubescente, con estas asociación significativa con SM (X²=5,2 [p <0,02]). El Odds ratio señala niñas post-púberes (3,3 [IC: 1.2 a 5]) y obesidad (2,1 [IC: 2-2,2]) más probabilidades de SM, lo que indica la asociación lineal significativa entre el IMC y la resultado (X²=29,4 [p<0,001]). Pubescentes menos de 10 años con EM tenía mayor %G. Los componentes predominantes fueron alterados circunferencia de la cintura (27,2 % [IC del 23 %-31 %]) y colesterol HDL bajo (39,6 % [IC del 35 %-44 %]) y la prevalencia de la hipertensión arterial sistémica en la post-puberal. Conclusiones SM comienza en la etapa puberal, con una prevalencia en el post-puberal, y el exceso de grasa es el desencadenante en niños menores de 10 años. Se necesitan estrategias de prevención para la población de niños y adolescentes.(AU)

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OBJECTIVE: To assess the prevalence and clustering patterns of cardiometabolic risk factors among low-income, female adolescents. MATERIALS AND METHODS: Cross-sectional study involving 196 students of public schools (11-19 years old). The following risk factors were considered in the analysis: excess weight, central obesity, dyslipidemia, high blood pressure, and high fasting glucose. The ratio between observed and expected prevalence and its confidence interval were used to identify clustering of risk factors that exceeded expected prevalence in the population. RESULTS: The most prevalent risk factors were dyslipidemia (70.9%), and central obesity (39.8%), followed by excess weight (29.6%), and high blood pressure (12.8%). A total of 42.9% of adolescents had two or more risk factors, and 24% had three or more. Excess weight, central obesity, and dyslipidemia were common risk factors in the clustering patterns that showed higher-than-expected prevalence. CONCLUSIONS: Clustering of risk factors (≥ two factors) among the adolescents showed considerable prevalence, and there was a non-casual coexistence of excess weight, central obesity, and dyslipidemia (mainly low HDL-cholesterol).

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Objective To analyze the prevalence of metabolic syndrome (MS) in pubertal stages of female students. Methods Cross-sectional study of 449 school children between eight and 18 years, stratified by pubertal stage, body mass index (BMI) and body fat percentage (BF %). The MS was classified according to the International Diabetes Federation. The analysis by frequency distribution, confidence intervals (95 %), Chi-square and odds ratio for associations was performed. Results The prevalence of MS was 3.3 % (CI:2 %-5 %) and 2.5 % (CI: 0.1 - 5 %) in pubertal and 7.9% (CI:3.2 % - 12.6 %) in the post-pubescent, with a significant association of this group with MS (X² = 5.2 [p <0.02]). The odds ratio shows that post-pubescent girls (3.3 [CI: 1.2 to 5]) and obese girls (2.1 [CI: 2 - 2.2]) are more likely to have MS, indicating significant linear association between BMI and the outcome (X²=29.4 [p<0.001]). Pubescent children under 10 years of age with MS had higher %G. The prevalent components were altered waist circumference (27.2 % [CI23 %-31 %]) and low HDL cholesterol (39.6 % [CI 35 % - 44 %]), as well as prevalence of systemic hypertension in post-pubertal girls. Conclusions MS begins in the pubertal stage, with prevalence in the post-pubertal stage. Excess fat is a trigger in children under 10 years of age. Prevention strategies are needed for the population of children and adolescents.

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INTRODUCTION: This research project examined influence of the doctors' speciality on primary health care (PHC) problem solving in Belo Horizonte (BH) Brazil, comparing homeopathic with family health doctors (FH), from the management's and the patients' viewpoint. In BH, both FH and homeopathic doctors work in PHC. The index of resolvability (IR) is used to compare resolution of problems by doctors. METHODS: The present research compared IR, using official data from the Secretariat of Health and test requests made by the doctors and 482 structured interviews with patients. A total of 217,963 consultations by 14 homeopaths and 67 FH doctors between 1 July 2006 and 30 June 2007 were analysed. RESULTS: The results show significant differences greater problem resolution by homeopaths compared to FH doctors. CONCLUSION: In BH, the medical speciality, homeopathy or FH, has an impact on problem solving, both from the managers' and the patients' point of view. Homeopaths request fewer tests and have better IR compared with FH doctors. Specialisation in homeopathy is an independent positive factor in problem solving at PHC level in BH, Brazil.

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Objetivo: Alérgenos domiciliares representam um importante fator causal na asma, principalmente poeira domiciliar, mofo, pêlos e penas de animais, irritantes e produtos químicos. O objetivo deste estudo é fazer uma revisão dos artigos sobre a adesão às medidas de controle ambiental na asma. Métodos: A revisão foi feita por levantamento bibliográfico de banco de dados obtidos através de pesquisa direta, LILACS, MEDLINE e capítulos de livros Resultados: A adesão variou de 17 a 42 per cent em trabalhos nacionais e internacionais. Não obstante os resultados controversos sobre a eficácia do controle ambiental, há uma dissociação entre o que os estudos e a literatura preconizam e a realidade encontrada. Apesar disso, medidas de controle ambiental devem ser adotadas sempre que possível, até mesmo diante dos resultados ainda conflitantes quanto à sua eficácia, porque, de modo geral podem melhorar as manifestações clínicas e reduzir a necessidade de tratamento farmacológico. Conclusão: O controle ambiental nem sempre é realizado e pode ser influenciado por fatores socioeconômicos e culturais.

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