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ABSTRACT Objective: The literature indicates a single universal cut-off point for weight loss after birth for the risk of hypernatremia, without considering other factors. The aim of this study was to construct and internally validate cut-off points for the percentage weight loss associated with the risk of hypernatremia, taking into account risk factors. Methods: A prospective study with a three-day follow-up was conducted in 165 neonates with a gestational age ≥35 weeks. The main outcome variable was mild or moderate hypernatremia (serum sodium ≥ 145 mmol/L). Secondary variables (risk factors) were maternal and infant variables. A multivariate logistic regression model was constructed to predict hypernatremia, obtaining its probability and the optimal discriminant cut-off point for hypernatremia (receiver operating characteristic analysis). Based on this point, threshold weight loss values were obtained according to the other variables. These values were internally validated by bootstrapping. Results: There were 51 cases (30.9%) of hypernatremia. The mean percentage weight loss for hypernatremic infants was 8.6% and 6.0% for the rest. Associated variables in the multivariate model included greater weight loss, male gender, higher education level, multiparity, and cesarean delivery. The model had an area under the receiver operating characteristic curve of 0.84 (sensitivity = 77.6%; specificity = 73.2%). Similar values were obtained in the bootstrapping validation. The lowest percentage weight loss was 4.77%, for cesarean delivery in male infants of mothers with a higher education level. Conclusions: The weight loss percentage values depended on the type of delivery, parity, newborn gender, and level of maternal education. External studies are required to validate these values.

RESUMO Objetivo: A literatura indica um único ponto de corte universal na perda de peso após o nascimento para risco de hipernatremia, sem considerar outros fatores. Nosso objetivo foi criar e validar internamente pontos de corte para o percentual de perda de peso associado ao risco de hipernatremia considerando fatores de risco. Métodos: Foi feito um estudo prospectivo que incluiu 165 neonatos com idade gestacional ≥ 35 semanas, acompanhados por três dias. A principal variável de resultado foi hipernatremia leve ou moderada (sódio sérico ≥ 145 mmol/L). As variáveis secundárias (fatores de risco) foram variáveis maternas e dos neonatos. Um modelo multivariado de regressão logística foi criado para diagnosticar hipernatremia, obteve sua probabilidade e o ponto de corte discriminativo ideal para hipernatremia (análise da Característica de Operação do Receptor). Com base nesse ponto, obtivemos então os valores limites de perda de peso de acordo com as outras variáveis. Esses valores foram internamente validados por. Resultados: Há 51 casos (30,9%) de hipernatremia. O percentual de perda de peso para neonatos hipernatrêmicos foi 8,6% e 6,0% para o restante. As variáveis associadas no modelo multivariado incluíram maior perda de peso, sexo masculino, maior nível de escolaridade, multiparidade e cesárea. O modelo apresentou uma área sob a curva da Característica de Operação do Receptor de 0,84 (sensibilidade = 77,6%; especificidade = 73,2%). Valores semelhantes foram obtidos na validação da bootstrapping. O menor percentual de perda de peso foi 4,77% para cesárea em neonatos do sexo masculino de mães com maior nível de escolaridade. Conclusões: Os valores percentuais de perda de peso dependem do tipo de parto, paridade, sexo do recém-nascido e nível de escolaridade materna. São necessários estudos externos para validar esses valores.

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OBJECTIVE: The literature indicates a single universal cut-off point for weight loss after birth for the risk of hypernatremia, without considering other factors. The aim of this study was to construct and internally validate cut-off points for the percentage weight loss associated with the risk of hypernatremia, taking into account risk factors. METHODS: A prospective study with a three-day follow-up was conducted in 165 neonates with a gestational age ≥35 weeks. The main outcome variable was mild or moderate hypernatremia (serum sodium≥145mmol/L). Secondary variables (risk factors) were maternal and infant variables. A multivariate logistic regression model was constructed to predict hypernatremia, obtaining its probability and the optimal discriminant cut-off point for hypernatremia (receiver operating characteristic analysis). Based on this point, threshold weight loss values were obtained according to the other variables. These values were internally validated by bootstrapping. RESULTS: There were 51 cases (30.9%) of hypernatremia. The mean percentage weight loss for hypernatremic infants was 8.6% and 6.0% for the rest. Associated variables in the multivariate model included greater weight loss, male gender, higher education level, multiparity, and cesarean delivery. The model had an area under the receiver operating characteristic curve of 0.84 (sensitivity=77.6%; specificity=73.2%). Similar values were obtained in the bootstrapping validation. The lowest percentage weight loss was 4.77%, for cesarean delivery in male infants of mothers with a higher education level. CONCLUSIONS: The weight loss percentage values depended on the type of delivery, parity, newborn gender, and level of maternal education. External studies are required to validate these values.

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INTRODUCTION: despite the fact that childhood obesity is a serious health problem, little is known about its related factors in early childhood. OBJECTIVE: to evaluate which maternal, cognitive and infant factors influence the infant's energy intake and if these influence their nutritional status before the year. METHODS: descriptive study of correlation. Two hundred and sixty-seven dyads (mother/child) participated. The questionnaires consisted of four instruments for the cognitive variables of the mother (maternal self-efficacy, attitude in the diet, perception of signs of hunger, satiety and weight of the child), energy intake through a 24-hour reminder and sociodemographic and anthropometric data of the mother and child, through which maternal body mass index (BMI) and Z-score of infant weight/height have been calculated. RESULTS: the model was significant for the intake of kcal/kg weight (F = 8.624, p < 0.001, R2 = 0.104), negatively correlating with the maternal perception of the weight of the child (B = -9.73, p = 0.002), hours of sleep (B = -2.19, p = 0.044) and age of the child (B = -2.26, p = 0.001). Also for the Z-score (weight/length) (F = 68.979, p < 0.001, R2 = 0.564) and explained positively with perception of the weight of the child (B = 1.133, p < 0.001) and age of the child (B = 0.054, p = 0.006) and negatively with hours of sleep of the mother (B = -0.07, p = 0.040) and caloric intake (B = -0.004, p = 0.027). CONCLUSION: mothers of nursing infants who underestimate their child's weight and sleep fewer hours provide more caloric intake and their children have a higher Z-score weight/length.

INTRODUCCIÓN: a pesar de que la obesidad infantil es un problema de salud serio, poco se sabe de los factores relacionados con esta en la primera infancia.Objetivo: evaluar qué factores maternos, cognitivos y del lactante influyen en la ingesta energética del lactante y si estos a la vez influyen en su estado nutricional antes del año. MÉTODOS: estudio descriptivo de correlación. Participaron 267 diadas (madre/hijo). Los cuestionarios consistieron en cuatro instrumentos para las variables cognitivas de la madre (autoeficacia materna, actitud en la alimentación, percepción sobre señales de hambre, saciedad y peso delhijo), aporte energético mediante recordatorio de 24 horas y datos sociodemográficos y antropométricos de la madre y del niño, mediante losque se han calculado el índice de masa corporal (IMC) materno y Z-score de peso/talla del lactante. RESULTADOS: el modelo fue significativo para la ingesta de kcal/kg peso (F = 8,624; p < 0,001; R2 = 0,104), correlacionando negativamente con la percepción materna del peso del hijo (B = -9,73; p = 0,002), las horas de sueño (B = -2,19; p = 0,044) y la edad del hijo (B = -2,26; p = 0,001). También para el Z-score (peso/longitud) (F = 68,979; p < 0,001; R2 = 0,564), y se explicó de manera positiva con percepción del peso del hijo (B = 1,133; p < 0,001) y edad del hijo (B = 0,054; p = 0,006) y negativamente con horas de sueño de la madre (B = -0,07; p = 0,040) e ingesta calórica (B = -0,004; p = 0,027). CONCLUSIÓN: las madres de hijos lactantes que subestiman el peso de su hijo y duermen menos horas proporcionan más ingesta calórica y sus niños presentan mayor Z-score del peso/longitud.

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La tiroiditis de Hashimoto es la causa más común de bocio e hipotiroidismo en niños y adolescentes. Las manifestaciones clínicas y la evolución son variables. El objetivo de este trabajo es revisar las particularidades clínicas y evolutivas de la enfermedad de Hashimoto en población pediátrica. Se analizaron datos clínicos, analíticos, ecográficos, epidemiológicos y evolutivos de los pacientes con tiroiditis autoinmune del Hospital Universitario San Juan de Alicante desde enero de 2010 hasta enero de 2016. En el estudio, se incluyeron un total de 29 pacientes. Se observó una mayor prevalencia en niñas con una relación 2:1. El principal motivo de consulta fue la detección casual de una hormona estimulante de la tiroides elevada o de positividad de anticuerpos antitiroideos en una analítica por otro motivo. En la analítica inicial, el 53,3% de los pacientes presentaba hipotiroidismo subclínico y tan solo el 10% de ellos, hipotiroidismo franco. Dos de los pacientes desarrollaron cáncer de tiroides.

Hashimoto's thyroiditis is the most common cause of goiter and hypothyroidism among children and adolescents. Its clinical manifestations and course vary. The objective of this study was to review the clinical and evolutionary characteristics of Hashimoto's disease in the pediatric population. Clinical, analytical, ultrasound, epidemiological, and evolutionary data of patients with autoimmune thyroiditis seen at Hospital Universitario San Juan de Alicante between January 2010 and January 2016 were analyzed. A total of 29 patients were included in the study. A higher prevalence of girls was observed, at a 2:1 ratio. The main reason for consultation was the accidental detection of high thyroid stimulating hormone levels or positive anti-thyroid antibodies in a lab test done for other reason. In the initial analysis, 53.3% of patients had subclinical hypothyroidism and only 10% of them had frank hypothyroidism. Two patients developed thyroid cancer.

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Hashimoto's thyroiditis is the most common cause of goiter and hypothyroidism among children and adolescents. Its clinical manifestations and course vary. The objective of this study was to review the clinical and evolutionary characteristics of Hashimoto's disease in the pediatric population. Clinical, analytical, ultrasound, epidemiological, and evolutionary data of patients with autoimmune thyroiditis seen at Hospital Universitario San Juan de Alicante between January 2010 and January 2016 were analyzed. A total of 29 patients were included in the study. A higher prevalence of girls was observed, at a 2:1 ratio. The main reason for consultation was the accidental detection of high thyroid stimulating hormone levels or positive anti-thyroid antibodies in a lab test done for other reason. In the initial analysis, 53.3% of patients had subclinical hypothyroidism and only 10% of them had frank hypothyroidism. Two patients developed thyroid cancer.

La tiroiditis de Hashimoto es la causa más común de bocio e hipotiroidismo en niños y adolescentes. Las manifestaciones clínicas y la evolución son variables. El objetivo de este trabajo es revisar las particularidades clínicas y evolutivas de la enfermedad de Hashimoto en población pediátrica. Se analizaron datos clínicos, analíticos, ecográficos, epidemiológicos y evolutivos de los pacientes con tiroiditis autoinmune del Hospital Universitario San Juan de Alicante desde enero de 2010 hasta enero de 2016. En el estudio, se incluyeron un total de 29 pacientes. Se observó una mayor prevalencia en niñas con una relación 2:1. El principal motivo de consulta fue la detección casual de una hormona estimulante de la tiroides elevada o de positividad de anticuerpos antitiroideos en una analítica por otro motivo. En la analítica inicial, el 53,3% de los pacientes presentaba hipotiroidismo subclínico y tan solo el 10% de ellos, hipotiroidismo franco. Dos de los pacientes desarrollaron cáncer de tiroides.

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UNLABELLED: Background. Little research exists on the impact of paid work on academic performance of students of health sciences. No research exists on this subject for students in Colombia. Objectives. This paper seeks to analyze the impact of paid work on academic performance among nursing students. DESIGN, SETTINGS AND PARTICIPANTS: cross-sectional research, involving 430 of nursing students from the National University of Colombia (N = 566). Methods. Variables analyzed: sex, age, work activity, attendance, current semester, degree subjects studied and unavailable, lost credits, grades during the second semester of 2013, and delayed semesters. Subgroups analyzed: (i) according to labor activity: do not work, work up to 20 h and work more than 20 h per week; (ii) Grade point average: failing is considered as less than 3.0 and passing 3.0 or above out of 5.0. Percentage of delayed semesters were calculated. Qualitative and quantitative variables were analyzed for groups by work activity. The percentage and probability of students getting a grade point average less than 3.0 and delaying semesters were calculated by multivariate logistic regression. Results. A total of 219 of the students work (50.9%), the main reason is socioeconomic, of which 99 (45.2%) work more than 20 h per week and have an increased risk of failing, which is higher in the first semester. They also get lower grades, lose more credits and take longer to finish the degree. The logistic bivariate regressions of success (grade point average, credits gained, courses gained and not having delayed semesters) reduce with work, above all in those who work more than 20 h per week and increase as the number of semesters completed increases, independent of sex. Conclusion. A high percentage of nursing students work more than 20 h per week. The compatibility of paid work with studies in university nursing students has a negative impact on academic performance, more so when they work more than 20 h per week. This negative impact diminishes as the student completes semesters, irrespective of the sex of the students.

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OBJECTIVE: To determine the prevalence of the metabolic syndrome (SM) and its components in teenagers from the metropolitan area of Monterrey Nuevo Leon, Mexico (AMM). METHOD: A transversal research involving 254 teenage students from 10 to 19 years old. To research investigated their personal characteristics, anthropometrics measures, glucose, triglycerides and cholesterol HDL. The SM definition was adapted from the one suggested by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII). RESULTS: The SM prevalence was 9.4 % (IC95%: 5.8 to 13.0), there was not a difference between the sexes. The prevalence among each SM component was: 24.4% for high triglycerides, 20.1% for abdominal obesity, 19.0% for cholesterol of lipoproteins of a high density (HDL-c) low, 11.4 % for high glucose and for high blood pressure (9.1% diastolic and 5.9% systolic). The prevalent SM phenotypes were corporal mass (IMC) (OR = 4.93, IC95%: 2.26, 10.73) and the IMC interaction of the teenager with a family history of obesity (OR = 1.37, IC95%: 1.0, 1.87). It was observed that those with a family history of diabetes type 2 only experienced a marginal effect. CONCLUSION: The SM prevalence in teenagers from AMM is high it was an alarming situation if it continues into adulthood. The existence of obesity in relatives of the first and second grade, altogether with teenager IMC are important prediction factors of SM.

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Objetivo: Determinar la prevalencia del síndrome metabólico (SM) y de sus componentes en adolescentes del área metropolitana de Monterrey, Nuevo León, México (AMM). Método: Se realizó un estudio transversal de población, que incluyó a 254 escolares con edades entre 10 a 19 años. Se investigó: características personales, mediciones antropométricas, glucosa, triglicéridos y colesterol-HDL. Para determinar si un sujeto padecía SM, se adaptó la definición recomendada por el Nacional Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII). Resultados: La prevalencia de SM fue de 9.4% (IC95%: 5.8 a 13.0), sin que se observaran diferencias significativas entre sexos. Los distintos componentes de SM tuvieron la siguiente prevalencia: hipertigliceridemia, 24.4%; obesidad abdominal, 20.1%; colesterol de alta densidad (HDL-c) bajo, 19.0%; niveles de glucosa elevados, 11.4 %, e hipertensión arterial: 9.1% diastólica y 5.9% sistólica. Los fenotipos de predicción de SM fueron índice de masa corporal (IMC) (OR = 4.93, IC95%: 2.26, 10.73), e interacción entre el IMC del adolescente y sus antecedentes familiares de obesidad (OR = 1.37, IC95%: 1.0, 1.87). Se observó que la diabetes tipo 2 familiar sólo tuvo un efecto marginal. Conclusiones: La prevalencia de SM en escolares del AMM es alta, situación que resulta alarmante si este riesgo se mantiene durante el desarrollo y hasta la vida adulta. La obesidad en familiares de primero y segundo grados, junto con IMC del adolescente, son factores de predicción importantes de SM.

Objective: To determine the prevalence of the metabolic syndrome (SM) and its components in teenagers from the metropolitan area of Monterrey Nuevo Leon, Mexico (AMM). Method: A transversal research involving 254 teenage students from 10 to 19 years old. To research investigated their personal characteristics, anthropometrics measures, glucose, triglycerides and cholesterol HDL. The SM definition was adapted from the one suggested by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII). Results: The SM prevalence was 9.4 % (IC95%: 5.8 to 13.0), there was not a difference between the sexes. The prevalence among each SM component was: 24.4% for high triglycerides, 20.1% for abdominal obesity, 19.0% for cholesterol of lipoproteins of a high density (HDL-c) low, 11.4 % for high glucose and for high blood pressure (9.1% diastolic and 5.9% systolic). The prevalent SM phenotypes were corporal mass (IMC) (OR = 4.93, IC95%: 2.26, 10.73) and the IMC interaction of the teenager with a family history of obesity (OR = 1.37, IC95%: 1.0, 1.87). It was observed that those with a family history of diabetes type 2 only experienced a marginal effect. Conclusion: The SM prevalence in teenagers from AMM is high it was an alarming situation if it continues into adulthood. The existence of obesity in relatives of the first and second grade, altogether with teenager IMC are important prediction factors of SM.

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