Diabetes Gestacional: asociación con grupo ABO / Association of abo blood groups with gestational diabetes mellitus

Background: ABO and Rhesus blood systems are associated with type 2 Diabetes Mellitus (DM2). Gestational Diabetes (GDM) is a model to study DM. Aim: To study the association between GDM and ABO and Rhesus groups. Material and Methods: A retrospective cohort study was performed in 1,078 women who gave birth to a singleton in Talca Regional Hospital, Chile, during 2008. We analyzed personal, obstetric, medical data and ABO and Rh blood groups. Results: GDM was diagnosed in 6.6% of women. Age and body mass index were significantly associated with GDM. There were no differences in Rh blood groups (p = 0.604), while ABO groups were different between GDM and controls. B antigen was present in 3% of GDM women and in 10.8% of controls (p = 0.037), with an odds ratio of 0.25 after adjusting for other associated risk factors (p = 0.06). Conclusions: ABO group is suggested as a possible protector marker for GDM.

Frecuencia de administración de psicoestimulantes en escolares de primero a sexto básico en Talca / Stimulant drugs intake among first to sixth grade schoolchildren in Talca

Introducción: Los psicoestimulantes son medicamentos de primera línea en el tratamiento del síndrome por déficit atencional (TDA). Su indicación en menores varía según edad y sexo. Existen pocos datos a nivel nacional de frecuencia de uso de psicoestimulantes en niños y no hay datos en nuestra región. Objetivo: Estudiar la frecuencia de uso de psicoestimulantes en escolares de primero a sexto básico en Talca y los factores asociados a su uso. Material y Método: Estudio de corte de alumnos entre primero y sexto básico provenientes de establecimientos educacionales del radio urbano de Talca, estratificados según nivel socioeconómico. Se obtuvo lista con sexo y edad de los alumnos desde la dirección de cada establecimiento. La información acerca de la prescripción de psicoestimulantes fue proporcionada por el profesor jefe o encargado de educación diferencial. Resultados: De una muestra de 2.905 niños, el 1,76 por ciento utilizaba psicoestimulantes, 0,96 por ciento, metilfenidato y 0,76 por ciento, anfetaminas. La probabilidad de consumo de psicoestimulantes fue mayor en varones (OR = 5,8; 95 por ciento, IC: 2,6-13,2), alumnos de cuarto básico (OR = 2,3; 95 por ciento, IC: 1,26-4,15) y de 11 años de edad (OR = 2,4; 95 por ciento, IC: 1,35-4,43). En el nivel socioeconómico alto se registró el mayor consumo de metilfenidato (p = 0,0495) y en el medio bajo la mayor utilización de anfetaminas (p = 0,0014). Discusión: La frecuencia de uso de psicoestimulantes en Talca es baja en relación a la encontrada en otras regiones del país. La frecuencia y tipo de fármaco utilizado en el tratamiento del TDA, se asocia con la edad, el sexo y el nivel socioeconómico de los alumnos.

Background: Stimulant drugs are frequently prescribed in the treatment of Attention-Deficit/ Hyperactivity Disorder (ADHD) in children. Drug prescription is associated with children's age and gender. Chile has few reports of Stimulant drugs prescription and there are no records in our region. Objective: To evaluate the prevalence of Stimulant drugs intake in schoolchildren from first to sixth grade in Talca. Material and Methods: A cross-sectional study in schoolchildren attending first to sixth grade at urban schools in Talca was performed. The schools were stratified according to socioeconomic status. A list with sex and age of the children was obtained from the headmaster of each school. The information about stimulant drugs prescription was provided by the class teacher or the person in charge of special education. Results: We studied 2,905 children, 1.76 percent of them were under stimulant drugs, 0.96 percent took methylphenidate and 0.76 percent took dexamphetamine. Administration of ADHD drugs was higher in boys than in girls (OR = 5.8; 95 percent IC: 1.35-4.43), in fourth grade students (OR = 2.3; 95 percent, IC: 1.26-4.15) and in 11-year-old children (OR = 2,4; 95 percent, IC: 1,35-4,43). Intake of methylphenidate was higher in the highest socioeconomic status (p = 0.0496), while the highest intake of dexamphetamine was found in the lowest socioeconomic status (p = 0.0014). Discussion: The use of stimulant drugs medication is low in Talca compared to national records. The prescription of these drugs is related to the age, sex of the students while the kind of drug prescribed was related to the socioeconomic status of the child.

Antropometría como predictor de diabetes gestacional: Estudio de cohorte / Anthropometry as predictor of gestational diabetes mellitus

Background: Gestational diabetes mellitus (GDM) is a high incidence disease. Easily measured predictor factors could help to implement preventive policies and early detection tests. Aim: To measure recognizable risk factors for GDM such as skinfolds and analyze the association between these factors and the development of GDM in a cohort of pregnant women. Material and Methods: Evaluation of 76 mothers that developed gestational diabetes, aged 32.2 ± 0.6 years and 324 control mothers that did not develop the disease, aged 30.1 ± 0.3 years. Weight, height, arm circumference, tricipital, bicipital, subscapular, suprailiac, knee, costal and mid-thigh skinfolds were measured in the pre-diseased stage. History of diabetes, fasting glucose and insulin levels were also evaluated. Results: Age, body mass index (BMI), fasting blood glucose, the homeostasis model assessment of insulin resistance (HOMA), bi-cipital, tricipital, costal, subscapular, suprailiac, and knee skinfolds were associated with GDM development. Age, fasting blood glucose and subscapular skinfolds were independent predictors in the logistic regression model. The odds ratio for a subs-capular skinfold over percentile 90 was 1.7 (95 percent confdence intervals: 1.07-3.04). Conclusions: Age and fasting blood glucose are independent risk factors for GDM. Subscapular skinfold is also an independent risk factor and could be used to detect high risk pregnant women and implement preventive policies.

Incidencia de diabetes gestacional y su relación con obesidad en embarazadas chilenas / Incidence of gestational diabetes and relationship to obesity in Chilean pregnant women

Background: Gestational diabetes (GDM) is associated to a worse outcome of pregnancy. This justifies efforts for finding possible causes of GDM that would allow implementing preventive interventions. Aim: To study incidence of GDM and its relation with obesity and other traditional risk factors. Material and methods: A retrospective study was performed in 234 women who had delivered a singleton during the last 12 months, attended in an outpatient clinic in Santiago, Chile. Familiar and personal history, body mass index (BMI), obstetrical-related pathology and data about the labor and the newborn were analyzed. Results: GDM was diagnosed in 11.2 percent of the women. BMI before pregnancy was 26.6 ± 4.4 kg/m2 (mean ± SD) and it was 25 or over in 37.8 percent of women. Women who developed GDM had significantly higher BMI in the pre-pregnancy stage and in the second and third trimester of pregnancy (p <0.001). The average age was greater in the GDM group (31±0.2 yr versus 26±0.41 yr). Incidence of GDM was 14.4 percent among women 25 years old or older and increased to 21.4 percent when they had, in addition, a BMI of 25 or over. Age, BMI, and family history of diabetes were all independently correlated with the development of GDM. Elective caesarean sections were more common in GDM than in non-GDM women (p = <0.01) and complications were present in 3/23 of newborns of women with GDM and 2/199 among women without GDM (p <0.01) Conclusions: GDM and obesity are highly prevalent in Chilean pregnant women. BMI, first degree relative with DM and age are independent risk factors for the development of GDM (Rev Méd Chile 2004; 132: 931-8).

Estado nutricional en pacientes hospitalizados en el Hospital Regional de Talca / Nutritional status in hospitalized patients in the Talca Regional Hospital

La prevalencia de desnutrición intrahospitalaria varía entre 40 y 50 porciento según distintos estudios. sin embargo, datos internacionales muestran que la obesidad ha desplazado a la desnutrición. no existen datos nacionales actuales al respecto. metodologia: se evaluó el estado nutricional de 385 pacientes ingresados al hospital y se comparó la realidad entre los servicios de medicina y cirugía. resultados: se encontró desnutrición en 23 porciento de los pacientes; 13,7 porciento presentó desnutrición calórica y 16,5 porciento, proteica. la desnutrición fue mas frecuente en el servicio de medicina. no se encontró diferencia significativa al relacionar la prevalencia de desnutrición con el diagnóstico de ingreso. el 51,3 porciento de los pacientes eran obesos, siendo más obesas las mujeres y los pacientes en el servicio de cirugía. conclusiones: el estado nutricional de nuestros pacientes se relaciona al servicio de ingreso y al sexo del paciente. la desnutrición intrahospitalaria es muy frecuente, sin embargo, la obesidad es más prevalente, siguiendo el mismo patrón de distribución por sexo que en la población general. estos datos apoyan la necesidad de crear programas nacionales, incluyendo un enfoque intrahospitalario, dirigidos a la prevención y tratamiento de la obesidad, con el objetivo de prevenir las enfermedades crónicas relacionadas.

Prevalencia de desnutrición calórico proteica en pacientes hemodializados crónicos / Prevalence of caloric protein malnutrition among patients in chronic hemodialysis

Background: Malnutrition has been strongly associated with morbidity and mortality in hemodialysis patients. In the other hand, dialysis allows a nutritional improvement in patients with more than 12 months in dialysis. Aim: To study the prevalence of malnutrition among patients in hemodialysis. Patients and methods: We measured clinical, anthropometric and biochemical parameters of nutritional status in chronic hemodialysed patients. Results were related to individual time in dialysis. Patients with more and less than 12 months in dialysis were compared. Results: Twenty nine patients (18 male) aged 14 to 65 years old, were studied. Mean caloric intake was 23,8 Cal/Kg and protein intake was 0,7 g/Kg. Mean body mass index was 21.7ñ3.7 kg/m2 Thirty eight percent of patients had a body mass index of less than 20 kg/m2. Mean serum albumin was 4.1ñ0.7 g/L; mean prealbumin was 33.5ñ7.9 mg percent and creatinine was 9.6ñ2.8 mg percent. Serum cholesterol was 182 mg percent and triacylglycerol 129 mg percent. PCR was 42.2ñ18.8 and Kt/V was 1.45ñ0.3. We did not find a correlation between nutritional markers and time in dialysis or a difference in nutritional parameters between patients with less or more than 12 months in dialysis. Conclusions: These patients in chronic dialysis have a high prevalence of caloric malnutrition, which may be due to a poor caloric intake. Protein malnutrition parameters were normal in most patients. The absence of abnormal lipid levels, common in chronic renal failure, is noticeable