Trastornos de la conducta alimentaria: alteraciones cardiovasculares al ingreso y evolución a 3 meses / Female adolescents with eating disordes: cardiac abnormalities

Background: Cardiovascular complications can occur in up to 80% of adolescent patients with eating disorders (ED) and account for 30% of their mortality. Aim: To evaluate cardiovascular complications in adolescents with ED and their evolution after refeeding. Patients and Methods: In adolescents with ED admitted to treatment, we assessed the nutritional status, weight loss prior to consultation, presence of bradycardia (BC, defined as heart rate < 60 bpm), we performed an electrocardiogram (ECG) and an echocardiography and measured thyroid hormones. Results: We studied 53 women aged 16.4 ± 2.3 years. Fifteen had a diagnosis of Anorexia Nervosa (AN), seven of Bulimia (BN), eight a not otherwise specified ED (ED-NOS), four a Binge Eating Disorder (BED), sixteen an Atypical Anorexia (AAN) and three an Atypical Bulimia (ABN). Thirty four percent were malnourished and 3.8% overweight. The most common cardiac problem was BC in 51%. In eight of 26 patients in whom an echocardiogram was done, it was abnormal. Six had a decreased ventricular mass, three a pericardial effusion and three valvular involvement. There was a significant association between bradycardia and malnutrition, weight loss and low free triiodothyronine levels. BC was significantly more common in patients with AN, but it also occurred in half of the patients with AAN and in one of three patients with other types of ED. At follow up, bradycardia significantly improved with refeeding. Conclusions: There is an association between all types of ED and bradycardia, as well as anatomical and functional cardiac anomalies.

Resultados maternos y perinatales en mujeres con diabetes gestacional según criterios de pesquisa / Maternal and perinatal health in women with gestational diabetes research results according to criteria

OBJETIVO: Conocer los resultados maternos y perinatales de mujeres con diabetes gestacional diagnosticada según los Criterios de la Asociación Internacional de Grupos de Estudio de Diabetes y Embarazo y la Asociación Latinoamericana de Diabetes. MÉTODOS: Se estudiaron ciento veintidós embarazadas con diagnóstico de diabetes gestacional, aplicando los criterios Asociación Internacional de Grupos de Estudio de Diabetes y Embarazo y Asociación Latinoamericana de Diabetes. Se compararon datos socio-demográficos, factores de riesgo para diabetes gestacional, parámetros clínicos y metabólicos durante el embarazo y la pesquisa posparto de diabetes en ambos grupos. Las determinaciones de glucemias de las pruebas de tolerancia oral a la glucosa se realizaron mediante el método enzimático. Se utilizó Chi cuadrado y t de Student para la asociación de variables. Se consideró significativo un valor de P < 0,05. RESULTADOS: Al usar los criterios de la Asociación Internacional de Grupos de Estudio de Diabetes y Embarazo, el número de pacientes con diabetes gestacional aumentó 22,95 %. No hubo diferencias en cuanto a factores de riesgo para diabetes gestacional, resultados maternos y perinatales entre los dos grupos. En el grupo según los criterios Asociación Latinoamericana de Diabetes, las glucemias 2 horas poscarga en el posparto eran más altas (P< 0,02) y resultaron casos de prediabetes. CONCLUSIONES: Se incrementó la proporción de casos con diabetes gestacional, al emplear los criterios de la Asociación Internacional de Grupos de Estudio de Diabetes y Embarazo y se detectaron más alteraciones glucémicas maternas en el posparto con los criterios Asociación Latinoamericana de Diabetes. Se requieren investigaciones ulteriores, cuyos resultados puedan contribuir a las decisiones institucionales sobre los criterios para la pesquisa de diabetes gestacional.

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