scholarly journals Diagnostic Accuracy of Body Mass Index (BMI) When Diagnosing Obesity in a Saudi Adult Population in a Primary Care Setting, Cross Sectional, Retrospective Study

2020 ◽  
Vol Volume 13 ◽  
pp. 2515-2520
Author(s):  
Muath Alammar ◽  
Suad Alsoghayer ◽  
Kossay El-Abd ◽  
Abdullah Alkhenizan
2014 ◽  
Vol 27 (5) ◽  
pp. 609 ◽  
Author(s):  
Inês Campos-Matos ◽  
André Peralta-Santos ◽  
Bernardo Gomes ◽  
Gustavo Borges ◽  
Pedro Aguiar

<p><strong>Introduction:</strong> Obesity is an important public health problem because it is a risk factor for numerous diseases and is associated with a higher death risk. Evidence concerning the prevalence of excess weight in health professionals is scarce and this group is often overlooked in weight interventions programs. This paper aims to estimate the prevalence of obesity and overweight among Portuguese primary health care professionals and to describe differences between occupational groups.<br /><strong>Material and Methods:</strong> This was a cross sectional study based on a primary care setting in Portugal in 2011. We collected data on occupation, age, sex and height of professionals from four primary care centers. We did a descriptive analysis of the main variables and an analysis of covariance to compare mean Body Mass Index.<br /><strong>Results:</strong> Our sample represented 52.8% of the total population of the four primary care centers, and 38.6% were overweight and 16.9% were obese. When adjusted for age and gender, health service personnel had the highest average Body Mass Index, followed by nurses, physicians, and superior technicians, in that order.<br /><strong>Discussion:</strong> Although we can’t ensure the generalisation of the results and cannot exclude the possibility of sampling bias, these results suggest high prevalence obesity and overweight in workers of primary health care in Portugal.<br /><strong>Conclusion:</strong> In this primary care setting more than half of the health care professionals were overweight or obese. Tailored interventions might be needed to tackle this issue.</p><p><br /><strong>Keywords:</strong> Body Mass Index; Health Personnel; Obesity; Portugal; Primary Health Care; Prevalence.</p>


2019 ◽  
Vol 12 (1) ◽  
pp. 56-60 ◽  
Author(s):  
Phenchamat Khamthana ◽  
Yaowaluck Meebunmak ◽  
Issara Siramaneerat

Purpose:We aimed to describe the outcomes of primary care setting of type 2 diabetes patient at Sub-District Health Promoting Hospital (SDHPH).Methods:This study was a cross-sectional study on 1,890 patients with type 2 diabetes who were participating in the primary care research networks in the Ratchaburi Province of Thailand. Data was obtained through a self-administered questionnaire about the state of health and care. Patient medical records were used to examine the condition of complications, treatment and several indicators of DM care. The data was processed by using logistic regression to analyse the effect of independent variables on the dependent variable. The hypothesis-null was rejected at p-values <0.05.Results:The participants in this study were of age 57.56 years (SD=12.10), and most (55.58%) were female. Most respondents (36.20%) completed a Bachelor’s degree and were working as employees (28.35%). Regarding duration of diabetes, the majority (28.35%) had 11-20 years. In terms of body mass index, 29.67% had body mass index between 25.0-29.9 (overweight). Regarding complications and comorbidities, the common complication and comorbidity was nephropathy (33.63%) while Ischemic heart disease was the major of other comorbid health problems (48.3%). Furthermore, patients were mostly taking Antihypertensive (67.80%) and ACE Inhibitor or ARB (59.00%). The majority of HbA1c level (42.74%) was lower than 7.0%. Regarding the logistic analysis, it showed that education and treatment significantly influenced Hemoglobin A1c level at significant levels of 0.05.Conclusion:Only modest numbers of patients achieved established targets of diabetes control. Reengineering primary care practice may be necessary to substantially improve health care.


2020 ◽  
Author(s):  
Molly Jacobs ◽  
Jordan Harris ◽  
Kay Craven ◽  
Lauren Sastre

Abstract Background Clinical provision of intensive behavioral therapy for obesity (IBTO) has been a reimbursable treatment for obesity since 2012. However, gaps remain in the literature regarding its impact on patient outcomes. Objectives The primary objective of this study was to examine the integration of registered dietitian nutritionist provided IBTO into a primary care setting and evaluate clinic outcomes for Medicare Part B beneficiaries. A secondary objective was to examine intensity of IBTO (quantity of IBTO visits) versus clinical outcomes and influence of socioeconomic factors. Methods A case–control retrospective chart review was conducted at a rural, Academic Family Medicine Clinic in Eastern North Carolina for patients seen between 1 January 2016 and 1 January 2019. In order to be included in the treatment group, patients had to be female, white or black race, have Medicare insurance and a body mass index ≥ 30 kg/m2. Results Mixed model analysis showed statistically significant improvements in clinical outcomes from IBTO treatment. Weight decreased by nearly 3 pounds, while body mass index was half a point lower. A1C was 0.1 units lower for IBTO patients, and they took prescription medication and average of 6 days less than the control group. Minorities and older respondents experienced smaller, all else constant, and annual fixed effects suggest that differentials widen over time. Conclusions Registered dietitian nutritionist (RDN) provision of IBTO has demonstrated benefit in improving clinical outcomes including weight, A1C, and reduced medication duration (use) as demonstrated by the IBTO treatment group versus control. IBTO intensity was not predictive of success, and its impact was reduced with older and African American patients. IBTO is beneficial and can be delivered within the primary care setting by a RDN.


2018 ◽  
Vol 50 (07) ◽  
pp. 556-561 ◽  
Author(s):  
Xiaojing Ma ◽  
Chengyin Zhang ◽  
Hong Su ◽  
Xiaojie Gong ◽  
Xianglei Kong

AbstractWhile obesity is a recognized risk factor for chronic kidney disease, it remains unclear whether change in body mass index (ΔBMI ) is independently associated with decline in renal function (evaluated by the change in estimated glomerular filtration rate, ΔeGFR) over time. Accordingly, to help clarify this we conducted a retrospective study to measure the association of ΔBMI with decline in renal function in Chinese adult population. A total of 4007 adults (aged 45.3±13.7 years, 68.6% male) without chronic kidney disease at baseline were enrolled between 2008 and 2013. Logistic regression models were applied to explore the relationships between baseline BMI and ΔBMI, and rapid decline in renal function (defined as the lowest quartile of ΔeGFR ). During 5 years of follow-up, the ΔBMI and ΔeGFR were 0.47±1.6 (kg/m2) and –3.0±8.8 (ml/min/1.73 m2), respectively. After adjusted for potential confounders, ΔBMI (per 1 kg/m2 increase) was independently associated with the rapid decline in renal function [with a fully adjusted OR of 1.12 (95% CI, 1.05 to 1.20). By contrast, the baseline BMI was not associated with rapid decline in renal function [OR=1.05 (95% CI, 0.98 to 1.13)]. The results were robust among 2948 hypertension-free and diabetes-free participants, the adjusted ORs of ΔBMI and baseline BMI were 1.14 (95% CI, 1.05 to 1.23) and 1.0 (95% CI, 0.96 to 1.04) for rapid decline in renal function, respectively. The study revealed that increasing ΔBMI predicts rapid decline in renal function.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Johannes Just ◽  
Marie-Therese Puth ◽  
Felix Regenold ◽  
Klaus Weckbecker ◽  
Markus Bleckwenn

Abstract Background Combating the COVID-19 pandemic is a major challenge for health systems, citizens and policy makers worldwide. Early detection of affected patients within the large and heterogeneous group of patients with common cold symptoms is an important element of this effort, but often hindered by limited testing resources, false-negative test results and the lack of pathognomonic symptoms in COVID-19. Therefore, we aimed to identify anamnestic items with an increased/decreased odds ratio for a positive SARS-CoV-2 PCR (CovPCR) result in a primary care setting. Methods We performed a multi-center cross-sectional cohort study on predictive clinical characteristics for a positive CovPCR over a period of 4 weeks in primary care patients in Germany. Results In total, 374 patients in 14 primary care centers received CovPCR and were included in this analysis. The median age was 44.0 (IQR: 31.0–59.0) and a fraction of 10.7% (n = 40) tested positive for COVID-19. Patients who reported anosmia had a higher odds ratio (OR: 4.54; 95%-CI: 1.51–13.67) for a positive test result while patients with a sore throat had a lower OR (OR: 0.33; 95%-CI: 0.11–0.97). Furthermore, patients who had a first grade contact with an infected persons and showed symptoms themselves also had an increased OR for positive testing (OR: 5.16; 95% CI: 1.72–15.51). This correlation was also present when they themselves were still asymptomatic (OR: 12.55; 95% CI: 3.97–39.67). Conclusions Several anamnestic criteria may be helpful to assess pre-test probability of COVID-19 in patients with common cold symptoms.


2014 ◽  
Vol 8 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Maira Sayuri Sakay Bortoletto ◽  
Selma Maffei de Andrade ◽  
Tiemi Matsuo ◽  
Maria do Carmo Lourenço Haddad ◽  
Alberto Durán González ◽  
...  

2011 ◽  
Vol 64 (10) ◽  
pp. 916-920 ◽  
Author(s):  
C Rinaldi A Lesmana ◽  
Simon Salim ◽  
Irsan Hasan ◽  
Andri S Sulaiman ◽  
Rino A Gani ◽  
...  

BackgroundA non-invasive method to assess liver fibrosis by measuring liver stiffness with transient elastography (TE) has been recently introduced. The role of TE among chronic hepatitis B (CHB) patients in starting antiviral therapy in the primary care setting is still controversial because of its high cost. The AST to platelet ratio index (APRI) could be a much cheaper alternative.ObjectivesThis study compares the diagnostic accuracy of TE and APRI in assessing liver fibrosis in CHB patients.Patients and MethodsA cross-sectional study in CHB patients intending to start antiviral treatment. Liver fibrosis was staged according to the METAVIR scoring system. Liver stiffness was measured by TE performed on the same day with liver biopsy, while APRI was calculated as follows: APRI=(AST/upper limit of normal)×100/platelet count (109/l). Cutoff levels of liver stiffness and APRI were calculated by using the receiver operating characteristic curve to detect significant liver fibrosis, defined as fibrosis stage F2 or more.Results117 patients were enrolled in the study; their mean age was 40.6±10.97 years. The median liver stiffness was 5.9 kPa (2.5–48 kPa) and the median APRI was 0.239 (0.09–2.73). The cutoff level of liver stiffness was 5.85 kPa for ≥F2 with an AUC of 0.614, 60.3% sensitivity, 63.6% specificity, 73.3% PPV, 49.1% NPV and a LR+ of 1.66. The APRI cutoff level was 0.235 for F≥2 with an AUC of 0.693, 64.4% sensitivity, 70.5% specificity, 78.3% PPV, 54.4% NPV and a LR+ of 2.18. Both methods gave comparable diagnostic accuracy.ConclusionAPRI is a useful marker to screen liver fibrosis in the primary care setting when TE is not available.


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