Juvenile obesity and its association with utilisation and costs of pharmaceuticals - results from the KiGGS study

<p>Abstract</p> <p>Background</p> <p>According to a national reference, 15% of German children and adolescents are overweight (including obese) and 6.3% are obese. An earlier study analysed the impact of childhood overweight and obesity on different components of direct medical costs (physician, hospital and therapists). To complement the existing literature for Germany, this study aims to explore the association of body mass index (BMI) with utilisation of pharmaceuticals and related costs in German children and adolescents.</p> <p>Methods</p> <p>Based on data from 14, 836 respondents aged 3-17 years in the German Interview and Examination Survey for Children and Adolescents (KiGGS), drug intake and associated costs were estimated using a bottom-up approach. To investigate the association of BMI with utilisation and costs, univariate analyses and multivariate generalised mixed models were conducted.</p> <p>Results</p> <p>There was no significant difference between BMI groups regarding the probability of drug utilisation. However, the number of pharmaceuticals used was significantly higher (14%) for obese children than for normal weight children. Furthermore, there was a trend for more physician-prescribed medication in obese children and adolescents. Among children with pharmaceutical intake, estimated costs were 24% higher for obese children compared with the normal weight group.</p> <p>Conclusions</p> <p>This is the first study to estimate excess drug costs for obesity based on a representative cross-sectional sample of the child and adolescent population in Germany. The results suggest that obese children should be classified as a priority group for prevention. This study complements the existing literature and provides important information concerning the relevance of childhood obesity as a health problem.</p

S1 Leitlinie zur Diagnostik und Therapie der kutanen Larva migrans (Creeping Disease) = S1 guideline diagnosis and therapy of cutaneous larva migrans (creeping disease)

Die kutane Larva migrans ist eine in ihrem klinischen Bild typische Hautinfektion, die durch aktives Eindringen und anschließende epidermale Wanderung von Nematodenlarven hervorgerufen wird. Dieses typische klinische Bild wird durch Larven von Hakenwürmern, meist Ancylostoma braziliense, selten andere bei Kaniden und Feliden vorkommende Hakenwurmarten, verursacht. Ziele der Leitlinie sind die Verbesserung der Versorgung der Patienten durch Optimierung von Diagnostik und Therapie bei Infektionen mit Larva migrans cutanea sowie die Verbesserung der Kenntnisse von Ärztinnen und Ärzte über aktuelle Therapieoptionen.Cutaneous larva migrans is a skin infection with a typical clinical appearance caused by active penetration of nematode larvae and their subsequent epidermal migration. The typical clinical appearance is caused by hookworm larvae, usually Ancylostoma braziliense but sometimes other canine or feline types of hookworm. This guideline aims to enhance patient care by optimizing the diagnosis and treatment of infections due to creeping disease (cutaneous larva migrans) and to raise awareness among doctors of current treatment options