Asunto(s)
Dermatosis de la Mano/diagnóstico , Infecciones por Serratia/diagnóstico , Serratia marcescens/aislamiento & purificación , Infección de Heridas/diagnóstico , Absceso/etiología , Adulto , Antibacterianos/uso terapéutico , Celulitis (Flemón)/etiología , Ciprofloxacina/administración & dosificación , Ciprofloxacina/uso terapéutico , Quimioterapia Combinada , Exudados y Transudados/microbiología , Dermatosis de la Mano/tratamiento farmacológico , Dermatosis de la Mano/etiología , Dermatosis de la Mano/microbiología , Traumatismos de la Mano/complicaciones , Traumatismos de la Mano/microbiología , Humanos , Inmunocompetencia , Masculino , Recurrencia , Infecciones por Serratia/tratamiento farmacológico , Infecciones por Serratia/etiología , Infecciones por Serratia/microbiología , Combinación Trimetoprim y Sulfametoxazol/administración & dosificación , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico , Infección de Heridas/tratamiento farmacológico , Infección de Heridas/microbiología , Heridas Penetrantes/complicaciones , Heridas Penetrantes/microbiologíaRESUMEN
Despite the well-known pro-coagulant effect of hyperhomocysteinemia, data is limited regarding the result on recurrent coronary event (RCE) in young people. One hundred and forty patients <55 years old with a first acute coronary syndrome (ACS) were prospectively followed for a mean (+/-S.D.) follow-up of 49+/-14 months in order to investigate the relationship between homocysteine levels (tHcy) at admission and the incidence of RCE. The tHcy values were divided into quartiles to examine their relationship with end points. Furthermore, we determined the effect of C677T methylene tetrahydrofolate reductase (MTHFR) polymorphism, as well as other risk factors for developing a RCE. The median plasma homocysteine concentration was 9.6 mumol/L (interquartile range, 3.7). In the screening of MTHFR C677T polymorphism in patients with ACS, the T allele frequency was 0.4 and the genotype frequency distributions were in Hardy-Weinberg equilibrium. At time of final evaluation, 49 (35%) of the 140 valuable patients had developed a RCE. Increasing numbers of RCE were observed for increasing quartiles of tHcy according to Kaplan-Meier survival (Log-rank test=0.0092). The MTHFR C677T polymorphism was not associated with an increased incidence of RCE. In multivariate analysis, the variables independently associated with a higher risk of RCE were age older than 45 years [HR=2.7; (95% CI, 1.3-6.1); p=0.030], body mass index more than 25 [HR=2.6; (95% CI, 1.1-5.9); p=0.034] and tHcy levels into quartile 4 (tHcy>12.37 mumol/L) [HR=2.5; (95% CI, 1.1-4.7); p=0.04]. Elevated plasma homocysteine level at admission is an independent risk factor for RCE after the first episode of ACS in young patients irrespective of the status of MTHFR C677T.
Asunto(s)
Enfermedad Coronaria/complicaciones , Enfermedad Coronaria/genética , Hiperhomocisteinemia/etiología , Metilenotetrahidrofolato Reductasa (NADPH2)/genética , Isquemia Miocárdica/etiología , Polimorfismo Genético , Enfermedad Aguda , Adulto , Factores de Edad , Índice de Masa Corporal , Estudios de Cohortes , Enfermedad Coronaria/fisiopatología , Citosina , Femenino , Frecuencia de los Genes , Heterocigoto , Homocigoto , Humanos , Estimación de Kaplan-Meier , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Estudios Prospectivos , Recurrencia , Factores de Riesgo , Síndrome , TiminaRESUMEN
La alimentación durante la infancia tiene una influenciaimportante en la salud del adulto.La obesidad, la enfermedad coronaria, la hipertensiónarterial y la osteoporosis están en relaciónde una u otra forma con la dieta.Los nuevos hábitos y estilos de vida de la poblaciónhan marcado un cambio en la alimentación delos escolares que se sienten influidos por sus padresy por la televisión que incitan al consumo frecuentede alimentos con calorías vacías.La ausencia de casa de los padres durante untiempo prolongado debido a su jornada laboral propiciaque los niños se vean obligados a realizar lacomida principal fuera del hogar, en un restauranteo en el comedor escolar.El comedor escolar debe ser el vehículo para iniciara los niños en la adquisición de buenos hábitosdietéticos, higiénicos y sociales.La educación nutricional en la escuela es clavepara enseñar a los niños un estilo de vida saludable
The feeding during the infancy have an importantinfluence on the health of the future adult.The obesity, the coronary disease, the arterial hypertensionand the osteoporosis are in a close relationshipin one way or another with the diet.The new habits and life styles of the populationhave labeled a substancial change in the alimentationof the young students that are influenced bytheir parents and by the television incitating to haveas usual food that one with empty calories.Parents absence during a extended time due totheir occupational sessions makes children able tohave their basic meals away from their home, in arestaurant or in the school dining room.The school dining room must be the appropriatevehicle to begin children in the acquisition of properdietetic habits, as well as, hygienic and social ones.The Nutritional education in the School is a veryimportant issue in order to teach a healthy life styleto children
Asunto(s)
Masculino , Femenino , Niño , Humanos , Necesidades Nutricionales , Trastornos de la Nutrición del Niño/epidemiología , Fenómenos Fisiológicos Nutricionales Infantiles , Servicios de Salud Escolar , Conducta Alimentaria , Alimentos Integrales , Trastornos de la Nutrición del Niño/prevención & control , Educación Alimentaria y NutricionalRESUMEN
El dolor abdominal recurrente (DAR) es un tipo de patología: que encontramos frecuentemente como motivo de consulta en la edad infantil. Se estima que lo presentan entre el 10 y el 15 por ciento de los escolares (el 5 por ciento de las consultas pediátricas). En la génesis del DAR influyen un conjunto de estímulos somáticos y/o psicosociales capaces de producir alteraciones en la motilidad gastrointestinal causando dolor abdominal en individuos predispuestos.La etiología es multifactorial y conceptualmente distinguidos tres tipos de DAR: de causa funcional (síndrome del intestino irritable, dispepsia no ulcerosa, etc.), de origen orgánico debido a anomalías estructurales, inflamatorias, alteraciones bioquímicas, del tracto gastrointestinal, urinario...), y de origen emocional o psIcógeno donde el estrés, la depresión, la fobia a la escuela pueden manifestarse como DAR.Se propone un protocolo de estudio clínico con el fin de realizar una aproximación diagnóstica y diferencial de los 3 tipos de DAR y se dan pautas de tratamiento para cada situación.Se hace hincapié en los signos de alarma que permitan-sospechar la existencia de patología orgánica (AU)
Asunto(s)
Femenino , Masculino , Niño , Humanos , Recurrencia , Enfermedades Funcionales del Colon/diagnóstico , Enfermedades Funcionales del Colon/etiología , Dispepsia/diagnóstico , Dispepsia/etiología , Dolor Abdominal/diagnóstico , Dolor Abdominal/etiología , Dolor Abdominal/patología , Motilidad Gastrointestinal , Enfermedades Ambientales/diagnóstico , Enfermedades Ambientales/etiología , Intolerancia a la Lactosa/diagnóstico , Intolerancia a la Lactosa/etiología , Parasitosis Intestinales/diagnóstico , Parasitosis Intestinales/etiología , Protocolos Clínicos , Disacáridos/efectos adversos , Disacáridos/inmunología , Conducta Alimentaria , Pielonefritis/diagnóstico , Pielonefritis/etiología , Hidronefrosis/diagnóstico , Hidronefrosis/etiología , Cálculos Urinarios/diagnóstico , Cálculos Urinarios/etiología , Dismenorrea/diagnóstico , Dismenorrea/etiología , Enfermedad Celíaca/diagnóstico , Enfermedad Celíaca/etiología , Enfermedades Gastrointestinales/diagnóstico , Enfermedades Gastrointestinales/etiología , Pancreatitis/diagnóstico , Pancreatitis/etiología , Epilepsia del Lóbulo Temporal/diagnóstico , Epilepsia del Lóbulo Temporal/etiología , Estreñimiento/diagnóstico , Estreñimiento/etiología , Enfermedad Inflamatoria Pélvica/diagnóstico , Enfermedad Inflamatoria Pélvica/etiología , Divertículo Ileal/diagnóstico , Divertículo Ileal/etiologíaRESUMEN
Using a simplified questionnaire from the NADYA group, data referring to age, sex, diagnosis, access route, duration, form of administration, complications, and quality of life have been gathered from 1,400 patients (57% male, 43% female) who receive home enteral nutrition, and from 38 patients (20% male and 18% female) who receive home parenteral nutrition. All of these patients come from the 1996 national registry. The most common indication for home enteral nutrition are neoplasias (39%) followed by neurological alterations (33%). The most common access route is oral (48%), followed by a nasogastric tube in 34%, PEG in 10% and surgical ostomies in 7%. The average treatment duration is 6 months. There is an index of 0.74 complications/patient-year (gastrointestinal 0.28 and mechanical alterations 0.19). At the end of the year 58% of the patients continued to use at home enteral nutrition, with a death rate of 17%. The majority of the treated patients presented a severe social disability (28%) or was bed-ridden (22%). The most common indications for home parenteral nutrition are: neoplasia (42%), Crohn_s disease (10%), and mesenteric ischemia (10%). AIDS (8%), radical enteritis (5%), and motility disorders (5%) are less common. In 42% of the cases tunneled catheters are used, and port-a-cath are used in 53%. The average treatment duration is 6.9 months. 1.06 hospitalizations/patient-year have been registered in relation to the nutritional treatment (mainly catheter sepsis). A mortality of 29% is registered, and there is recovery of the oral route in 7.9% of the cases. 50% of the patients present a severe social disability.
Asunto(s)
Encuestas Nutricionales , Nutrición Parenteral Total en el Domicilio , Sistema de Registros , Femenino , Humanos , Masculino , EspañaRESUMEN
We studied serum levels of total cholesterol, lipoproteins and triglycerides in venous blood samples and the intake of nutrients using the subject's daily record of food eaten during a period of 7 d. The material comprised 7367 children and adolescents. The overall average lipid levels (4.55 +/- 0.91 mmol/L for TC, 1.42 +/- 0.47 mmol/L for HDL-C, 2.74 +/- 0.96 mmol/L for LDL-C) are high and similar to those found in other regions of Spain in the 1990s. The proportion of children with TC > or = 5.17 mmol/L (200 mg/dl) was 19%; that of children with HDL-C < or = 0.91 mmol/L (35 mg/dL) 6.5%. There is a striking and statistically significant difference between the proportions of boys and girls aged 15-20 y who have HDL-C levels in this range (15.8% for boys and only 4.2% for girls). We also demonstrate a high total fat (44% of TCV), saturated fat (16% TCV) and cholesterol (387 mg) intake. Because of the elevated fat and saturated fat intake and the increment of a more atherogenic lipid profile in our children, preventive nutritional measures are necessary, and life habits such as physical exercise and actively reducing fat and saturated fat intake have to be applied and inculcated in children from an early age.
Asunto(s)
Dieta Aterogénica , Lípidos/sangre , Triglicéridos/sangre , Adolescente , Adulto , Niño , Preescolar , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Femenino , Humanos , Masculino , Encuestas Nutricionales , EspañaRESUMEN
By means of a simplified questionnaire, the NADYA group has gathered and analyzed data with regard to the age, sex, diagnosis, access route, duration, form of administration, complications, and quality of life, in 812 patients (62% male; 37% female) with At Home Enteral Nutrition (AHEN), and 19 patients (42% male; 57% female) with At Home Parenteral Nutrition (AHPN) corresponding the National Registry of 1995. The most frequent indication of AHEN was a neoplasm (41%), followed by neurological alterations (33%). The most common access route is the NGT (37%) followed by oral administration in 37%, PEG in 13% and surgical ostomics in 8%. The mean treatment time is 8 months. The index of complications/patient-year is 0.50 (gasterointestinal 0.17, and mechanical alterations 0.9). At the end of the study, 63% of the patients continued to receive AHEN, showing a mortality rate of 70%. The majority of the patients undergoing treatment presented a sever social disability (20%) or were bed ridden (18%). The most common indications for the AHPN are: radical enteritis (26%), Crohn's disease (21%), and mesenteric ischemia (16%). AIDS, motility alterations, and neoplasic diseases are scantly represented (10%). Tunneled catheters are used in 58% of the cases, and Port-a-Cath in 31%). The mean duration for the treatment was 7.9 months. An index of 0.47 hospitalization/patient-year was seen in relation to the nutritional treatment (mainly due to catheter septicemia). A mortality of 16% is noted, and 21% show a recovery of the oral route. 42% of the patients did not present an assessable social disability.
Asunto(s)
Nutrición Parenteral en el Domicilio , Nutrición Enteral , Femenino , Humanos , MasculinoRESUMEN
BACKGROUND: The aim of the current study was to evaluate the prevalence of lactose malabsorption (LM) in Galicia (NW Spain) in order to design nutritional intervention and/or public education strategies for high risk groups. METHODS: We conducted a study of LM by breath-hydrogen carbohydrate absorption test (BH2 test) in 850 healthy subjects. All subjects underwent BH2 tests following ingestion of a aqueous solution of 2 g lactose/kg body weight up to a maximum of 50 g. Subjects with LM were retested after ingesting 250 ml of milk and/or 250 ml of yogurt. RESULTS: The frequency of LM in the subjects who ingested 2 g lactose/kg body weight was 32.5%. This percentage decreased significantly with a decrease in the quantity of administered lactose and the vehicle was milk or yogurt-only 13.7% was LM after 250 ml of milk and 3.8% after 250 ml of yogurt. Gastrointestinal symptoms also depend on dosage of lactose and vehicle, decreasing from 54.3% after 2 g lactose/kg to 18.5% after milk and to 0% after yogurt. The frequency and number of gastrointestinal symptoms were significantly higher (p < 0.001) in LM than in lactose absorption (LA). CONCLUSIONS: Lactose malabsorption is prevalent in the population of Galicia. An important number of subjects identified as LM with usual clinical testing become LA when the ingestion of dairy products is limited so that the amount of lactose consumed is similar to that contained in a usual serving. Our results suggest the importance of BH2 testing following ingestion of usual consumed amounts of lactose per serving.
Asunto(s)
Intolerancia a la Lactosa/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Niño , Preescolar , Femenino , Humanos , Intolerancia a la Lactosa/fisiopatología , Masculino , Persona de Mediana Edad , Leche , España , YogurRESUMEN
OBJECTIVE: The results of in situ dissolution of a cystine calculus is described. This approach was attempted in a female patient for whom surgery was not considered to be the best therapeutic option. METHODS: An obstructive cystine calculus was treated by in situ litholysis using N-acetylcysteine applied locally via two percutaneous nephrostomies and adjuvant oral metaphylaxis. The patient had a long clinical history of lithiasis that had also required surgery and a family history of cystinuria. RESULTS: In situ litholysis completely dissolved the cystine calculus and avoided the need for a complex surgery. The procedure and a pharmacological analysis are presented. CONCLUSIONS: In our view, this procedure is practical, carries minimal morbidity and should be considered in the management of cystine calculus.
Asunto(s)
Acetilcisteína/administración & dosificación , Cistina/análisis , Cálculos Renales/terapia , Adulto , Enfermedad Crónica , Terapia Combinada , Cistinuria/genética , Cistinuria/terapia , Femenino , Humanos , Cálculos Renales/química , Inducción de Remisión , Soluciones , Factores de TiempoRESUMEN
We determined serum levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), and triglycerides (TGs) in 125 healthy children and in 119 children with epilepsy who had been receiving carbamazepine (58 children), phenobarbital (22 children), or valproic acid (39 children) for 7 months to 10.5 years (mean, 5.8 years). None of the variables considered was significantly correlated with time elapsed since start of treatment or with drug concentration in serum. In the groups receiving carbamazepine or phenobarbital, mean TC, HDL-C, and LDL-C levels were higher than in the control group, the differences being statistically significant for all except LDL-C in the phenobarbital group. In neither group did mean TC/HDL-C ratio or mean LDL-C/HDL-C ratio differ significantly from the corresponding control-group mean. In the group receiving valproic acid, mean TC level, mean LDL-C level, mean TC/HDL-C ratio, and mean LDL-C/HDL-C ratio were significantly lower than in the control group. In none of the treated groups did mean VLDL-C or TG level differ significantly from the corresponding control-group mean. Our results suggest, in contrast to previous reports, that the effects on the serum lipid profile of long-term treatment with hepatic-enzyme-inducing antiepileptic drugs (such as carbamazepine and phenobarbital) are probably not beneficial as regards risk of atherosclerosis-related disease. Our results additionally suggest a need for careful monitoring of serum cholesterol levels in children with epilepsy receiving carbamazepine or phenobarbital.
Asunto(s)
Anticonvulsivantes/uso terapéutico , Colesterol/sangre , Epilepsia/sangre , Epilepsia/tratamiento farmacológico , Carbamazepina/uso terapéutico , Niño , Preescolar , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Femenino , Humanos , Lactante , Masculino , Fenobarbital/uso terapéutico , Ácido Valproico/uso terapéuticoRESUMEN
Adenosine monophosphate, inosine monophosphate, inosine, adenosine, guanosine, adenine, guanine, hypoxanthine, xanthine, uric acid, and pyrimidines bases were determined in cerebrospinal fluid (CSF) of 52 children after simple febrile seizures and in a control group of 63 children. There was no statistically significant difference between the two groups for any of these metabolites, suggesting that simple febrile seizures (SFS) neither significantly disturb the metabolism of nucleotides, nucleosides, or bases nor significantly deplete neuron adenosine ATP levels. Therefore, they do not appear to constitute a threat of neuronal damage.
Asunto(s)
Purinas/líquido cefalorraquídeo , Purinas/metabolismo , Pirimidinas/líquido cefalorraquídeo , Convulsiones Febriles/líquido cefalorraquídeo , Preescolar , Femenino , Humanos , Lactante , Masculino , Nucleósidos/metabolismo , Nucleótidos/metabolismo , Nucleótidos de Purina/metabolismo , Pirimidinas/metabolismoAsunto(s)
Necesidades Nutricionales , Adolescente , Consumo de Bebidas Alcohólicas , Bebidas , Composición Corporal , Imagen Corporal , Peso Corporal , Caries Dental/etiología , Dieta , Dieta Vegetariana , Quimioterapia , Conducta Alimentaria , Crecimiento , Humanos , Hipercolesterolemia/etiología , Estilo de Vida , Obesidad/etiología , Factores de Riesgo , FumarRESUMEN
Two cases of Alagille syndrome are reported, father and son. This, a 6-year-old boy, presented with neonatal cholestasis but thereafter evolved with progressively decreasing jaundice and persisting pruritus. A liver biopsy confirmed the absence of intrahepatic bile ducts with preservation of hepatic architecture and no fibrosis. The patient had a characteristic phenotype: short stature, triangular face, deep eyes with hypertelorism, partial embryotoxon and data of peripheral pulmonary artery stenosis. His father died 43-year-old by a hepatocarcinoma. His liver biopsy showed also absence of intrahepatic bile ducts. In addition to the association Alagille's syndrome hepatocarcinoma (previously reported in six cases, three into the same family), it should be stressed in this case the long survival and the fact he had many children: the case with Alagille's syndrome, five children in good health, and one who died shortly after birth.
Asunto(s)
Anomalías Múltiples/diagnóstico , Atresia Biliar/diagnóstico , Carcinoma Hepatocelular/diagnóstico , Neoplasias Hepáticas/diagnóstico , Anomalías Múltiples/genética , Anomalías Múltiples/patología , Adulto , Atresia Biliar/genética , Atresia Biliar/patología , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/patología , Niño , Humanos , Hígado/patología , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/patología , Masculino , SíndromeAsunto(s)
Enfermedad Crónica , Trastornos del Crecimiento , Trastornos Nutricionales , Niño , Fenómenos Fisiológicos Nutricionales Infantiles , Trastornos del Crecimiento/dietoterapia , Trastornos del Crecimiento/etiología , Humanos , Factor I del Crecimiento Similar a la Insulina/sangre , Trastornos Nutricionales/sangre , Trastornos Nutricionales/dietoterapia , Trastornos Nutricionales/etiologíaRESUMEN
Diagnostic and therapeutical uses of vitamin D3 and its metabolites are reviewed. Special emphasis is dedicated to the fetomaternal relationships of 1,25 (OH)2 D3 and 25-OH-D3 at term. The serum levels of 1,25 (OH)2 D3 have been found to be higher in the maternal serum then in the corresponding fetus (85.3 pg/ml and 50.9 pg/ml, respectively). The highest serum levels of 1,25 (OH)2 D3 were found in October and the lowest ones in January showing that there is a dependence on the ultraviolet light. It has been found that there is a correlation between the fetomaternal serum levels of 1,25 (OH)2 D3 and 25-OHD. However, there is no correlation between the serum levels of 1,25 (OH)2 D3 and 25-OHD3, neither in the fetus nor in the mother.
Asunto(s)
Colecalciferol/uso terapéutico , Raquitismo/terapia , Deficiencia de Vitamina D/terapia , Adulto , Calcifediol/sangre , Calcifediol/uso terapéutico , Calcitriol/sangre , Calcitriol/uso terapéutico , Niño , Colecalciferol/metabolismo , Femenino , Sangre Fetal/metabolismo , Feto/metabolismo , Humanos , Hipofosfatemia Familiar/tratamiento farmacológico , Lactante , Recién Nacido , Necesidades Nutricionales , Embarazo , Raquitismo/diagnóstico , Raquitismo/tratamiento farmacológico , Estaciones del Año , Rayos UltravioletaRESUMEN
In a patient with congenital chloride diarrhea, the hyperreninemia, hyperaldosteronism, hypokaliemia and hypokaliuria diminished during treatment with prostaglandin synthetase inhibitor. These findings suggest that probably prostaglandins stimulate renin-aldosterone system in congenital chloride diarrhea.
Asunto(s)
Cloruros/metabolismo , Diarrea Infantil/tratamiento farmacológico , Cetoprofeno/uso terapéutico , Fenilpropionatos/uso terapéutico , Alcalosis/etiología , Inhibidores de la Ciclooxigenasa , Diarrea Infantil/complicaciones , Diarrea Infantil/metabolismo , Femenino , Humanos , Hiperaldosteronismo/etiología , Hipopotasemia/etiología , Lactante , Cetoprofeno/farmacología , Masculino , Renina/sangreRESUMEN
Authors report a four month old patient, admitted to hospital because of blood in stools. Diagnosis of congenital deficiency of factor VII was established because such factor was practically absent; on the contrary, other coagulation factors were normal. His parents and sister presented a mild deficit of factor VII without clinical manifestations. An up-to date review of the problem is presented.