Perfil de presión arterial e historia familiar de hipertensión en niños escolares sanos de Santiago de Chile / Blood pressure and family history of hypertension in children from Santiago, Chile

Background: The prevalence of pediatric arterial hypertension (AHT) is approximately 1% to 2%. In the last ten years, mean blood pressure levels (BP) have raised due to obesity and changes in lifestyles. Family history (FH) of AHT is a risk factor to develop AHT inchildren. Aim: To assess blood pressure, cardiovascular risk factors and family history in healthy children of Santiago. Material and methods: Blood pressure, family history of AHT, birth weight(BW), gestational age, puberal stage, blood glucose, serum lipids and ultrasensitive Reactive C Protein (usCRP) were analyzed, using data from a study of early markers of atherosclerosis in children. Results: Data of 112 children aged between 6-12 years was analyzed. Hypertension (BP >percentile 95) was detected in 2.7% and pre hypertension (BP in percentiles 90-95) in 3.6% of thesample. Children with abnormal BP had higher levels of usCRP (p <0.05) and a non significant tendency towards a higher body mass index. All hypertensive and one pre hypertensive children had FH of AHT. Eleven percent of parents, had high blood pressure. In no children, both parents werehypertensive. Children with a family history of hypertension had higher concentrations of total serum cholesterol (p <0.05). Conclusions: The abnormal prevalence of AHT found in this study is comparable to other studies. FH associated to higher levels of BP in children. Children withabnormal BP had a higher subclinical level of inflammation.

Arterioesclerosis subclinica, factores de riesgo cardiovascular clásicos y emergentes en niños obesos chilenos / Subclinical atherosclerosis, traditional cardiovascular risk factors in obese children and emerging Chilean

La arteriosclerosis puede comenzar en la niñez y desarrollarse crónicamente dependiendo de la carga de factores de riesgo (FR) cardiovascular. Comparar niños obesos con eutrófilos en cuanto a FR clásicos, emergentes (proteina C Reactiva ultrasensible: PCRus) y arteriosclerosis subclínica, mediante dos nuevas técnicas no invasivas.

Arterioesclerosis subclínica, factores de riesgo cardiovascular clásicos y emergentes en niños obesos chilenos / Subclinical atherosclerosis: classic and emerging cardiovascular risk factors in Chilean obese children

La arteriosclerosis puede comenzar en la niñez y desarrollarse crónicamente dependiendo de la carga de factores de riesgo (FR) cardiovascular. Objetivo: Comparar niños obesos con eutróficos en cuanto a FR clásicos, emergentes (Proteína C Reactiva ultrasensible: PCRus) y arteriosclerosis subclínica, mediante dos nuevas técnicas no invasivas: dilatación mediada por flujo de la arteria braquial (DMF) y grosor de la íntima-media carotídea (IMT). Método: Se estudiaron 26 niños obesos (IMC ³ Pc95) y 57 eutróficos (IMC: Pc10 - Pc85). Se evaluó antropometría, presión arterial (PA), DMF, IMT, y se determinó de PCRus, perfil lipídico y glicemia de ayunas. Resultados: El 50 por ciento fueron mujeres y 41 por ciento prepúberes. Con edad de 9,9 + - 1,6 y 9,8 + - 1,8 años (ns), zIMC: 2,0 + - 0 2 y 1,7 + - 0,6, perímetro de cintura (por ciento Media): 133,5 + - 16 y 100,5 + -1 0 por ciento en obesos y eutróficos respectivamente. Los obesos tuvieron mayor Colesterol Total, CLDL, Triglicéridos, PCRus y menor CHDL (p < 0,005). No hubo diferencia significativa en DMF: 9,03 + - 5,2 por ciento vs 9,3 + - 4,2 por ciento, IMT: 0,49 + - 0,03 vs 0,50 + - 0,03 mm, glicemia ni PA. Conclusión: Este grupo de niños obesos chilenos presenta mayor carga de FR clásicos y nivel de PCRus que los eutróficos, pero no se encontró diferencia significativa en marcadores sustitutos de arteriosclerosis subclínica.

Costo-efectividad de la promoción de la salud en Chile: experiencia del programa íMirame! / Cost-effectiveness of health promotion in Chile: experience with íMirame! Program

Background : íMirame! program was launched in Chile in 1993, to promote a healthy life style at school age. Aim: To evaluate cost-effectiveness of this program. Material and methods: Fifth and sixth grade school children, from 5 selected municipalities of the Metropolitan Region were studied. The design was a quasi-experiment with an intervention (IP, 1,435 children) and reference population (RP, 1,246 children). Tobacco (T-C) and alcohol (OH-C) consumption were the indicators. A baseline survey was done in 1993 and repeated in 1996 in both groups. The criterion of Net Change was applied to assess effectiveness. For cost evaluation, an institutional perspective was considered. Direct municipal administration and "íMirame!" program costs were analyzed and incremental costs were calculated, using reference municipalities as controls. A univariate sensitivity analysis was done based on the beneficial discount rate and cost discount rate. Cost effectiveness coefficient was calculated. Results: The incremental cost per each boy and girl prevented from OH-C was US$ 112 (103.6-114.3) and US$ 132 (129.9-133.3) respectively. The figures for each boy and girl prevented from T-C was US$ 154 (142.7-157.4) and US$ 130 (122.5-135.2) respectively. The program caused an additional cost per child, for the city hall of US$ 11.7 in two years. Conclusions: It is possible to apply health promotion interventions in schools with a good cost effectiveness in the short run (Rev MÚd Chile 2004; 132: 361-70).

Estudio de contactos familiares de casos de glomerulonefritis aguda postestreptocócica / Family contacts of post streptococcal acute glomerulonephritis

Este trabajo complementa la caracterización epidemiológica de la glomerulonefritis postestreptocócica (GNPE), considerando el estudio de contactos familiares. Se evaluó situación socioeconómica (SS), actividad estreptocócica (AE) serológica-bacteriológica y actividad nefrítica (AN). Se estudió 143 familias (868 personas), con grupo familiar promedio de 20,8 (51,8% mujeres y 48,2% hombres). Indice personas-pieza mayor que 4 (23,4%) e índice personas-cama mayor que 2 (21,4%). Vivienda y barrio, calificaron en el nivel más bajo (55,2% y 62,5%) de una clasificación convencional. El 13,5% de frotis faríngeos y el 47,7% de frotis cutáneos dio estreptococo grupo A. Títulos significativos de A.S.O. (333 UT) en el 20%, hematuria presente en 10,6%, C3 bajo en 17,7%. Ambos en 2,6%, y en 1,3% considerando AE en casos índices, contactos y población general: la SS familiar en pacientes con GNPE es de peor nivel que en la población general; la AE es mayor y existe AN subclínica, fundamentando así la prevención primaria en los contactos