Higher values of triglycerides: HDL-cholesterol ratio hallmark disease severity in children and adolescents with sickle cell anemia

Dyslipidemia has been described in sickle cell anemia (SCA) but its association with increased disease severity is unknown. Here, we examined 55 children and adolescents with SCA as well as 41 healthy controls to test the association between the lipid profiles in peripheral blood and markers of hemolysis, inflammation, endothelial function, and SCA-related clinical outcomes. SCA patients exhibited lower levels of total cholesterol (P<0.001), low-density lipoprotein cholesterol (LDL-c) (P<0.001), and high-density lipoprotein cholesterol (HDL-c) (P<0.001), while displaying higher triglyceride (TG) levels and TG/HDL-c ratio values (P<0.001). TG/HDL-c values were positively correlated with lactate dehydrogenase (P=0.047), leukocyte count (P=0.006), and blood flow velocity in the right (P=0.02) and left (P=0.05) cerebral artery, while being negatively correlated with hemoglobin levels (P<0.04). Acute chest syndrome (ACS) and vaso-occlusive events (VOE) were more frequent in SCA patients exhibiting higher TG/HDL-c values (odds ratio: 3.77, P=0.027). Multivariate logistic regression analysis confirmed independent associations between elevated TG/HDL-c values and SCA. Thus, children and adolescents with SCA exhibited a lipid profile associated with hemolysis and inflammatory parameters, with increased risk of ACS and VOE. TG/HDL-c is a potential biomarker of severity of disease.

Estado convulsivo: consideraciones acerca de su clasificación y terapéutica / Convulsive state: considerations about their classification and therapeutic

Se presentan algunas consideraciones sobre el estadoconvulsivo mas conocido por estaco epileptico, su clasificación y tratamiento. Se muestran resultados deuna investigación de los ultimos 6 años (hasta abrilde 1992) en la unidad de cuidados intensivos de nuestro hospital que incluyó a 42 pacientes los cuales presentaron 52 episodios, la epilepsia fue la etiología principal y el factor fundamental lo constituyó el abandono del tratamiento el tipo de convulsión masfrecuente fue la tonico-clonica generalizada y el tratamiento. El tipo de convulsión mas frecuente fue la tónico-clónica generalizada y el tratamiento se basó en el uso de diazepan, fenitoina y fenobarbital