Abordaje diagnóstico y terapéutico de pancreatitis en niños y adolescentes en Latinoamérica / No disponible

OBJETIVO: presentar los resultados de una encuesta aplicada a pediatras gastroenterólogos de Latinoamérica para conocer como realizan el abordaje diagnóstico y terapéutico de pancreatitis. MATERIAL Y MÉTODOS: estudio transversal, encuesta exploratoria, multicéntrica. RESULTADOS: el 73,6 % definió los tres tipos de pancreatitis de acuerdo con el grupo INSPPIRE. La enfermedad biliar, trauma abdominal e ingesta de medicamentos fueron la etiología más frecuente. El 80 % fueron pancreatitis leve. El 73 % utilizo soporte nutricional; la nutrición enteral fue la más empleada. CONCLUSIÓN: es el primer estudio exploratorio que permite tener una estimación del abordaje diagnóstico y terapéutico de la pancreatitis por PG en Latinoamérica

No disponible

Diagnostic and therapeutic approach to pancreatitis in children and adolescents in Latin America.

OBJECTIVE: to present the results of a survey applied to Latin American pediatric gastroenterologists (PGs) to learn how they perform the diagnostic and therapeutic approach to pancreatitis. MATERIAL AND METHODS: a descriptive, exploratory, multicenter study and survey was conducted. RESULTS: 73.6 % defined the three types of pancreatitis according to the INSPPIRE group. Biliary disease, abdominal trauma, and medication intake were the most frequent causes. 80 % of cases were considered mild pancreatitis. 73 % of the PGs utilized nutritional support, with enteral nutrition predominating. CONCLUSION: this is the first exploratory study to describe the diagnostic and therapeutic approach of PGs to pancreatitis in Latin America.

Índice cintura-estatura como indicador de riesgo metabólico en niños / Waist-to-height ratio is an indicator of metabolic risk in children

Introducción La grasa abdominal, especialmente la visceral, está asociada con un riesgo alto de complicaciones metabólicas. El índice cintura-estatura es usado para evaluar grasa abdominal en individuos de todas las edades. Objetivo Identificar la capacidad del índice cintura-estatura (ICE) para detectar riesgo metabólico en niños mexicanos de edad escolar. Pacientes y método Se estudiaron niños entre 6 y 12 años. Se diagnosticó obesidad con un índice de masa corporal (IMC) ≥ percentil 85, y obesidad abdominal con ICE ≥0,5. Se midieron niveles sanguíneos de glucosa, colesterol y triglicéridos. Se determinó sensibilidad, especificidad, valor predictivo positivo y negativo, área bajo la curva, coeficiente de verosimilitud positivo y negativo de la RCE e IMC para identificar alteraciones metabólicas. Se compararon ICE e IMC para determinar cuál tiene mejor eficiencia diagnóstica. Resultados Se estudiaron 223 niños, 51 presentaron hipertrigliceridemia, 27 hipercolesterolemia y 9 hiperglucemia. Comparando la eficiencia diagnóstica del ICE contra el IMC se encontró sensibilidad del 100 vs.56% para hiperglucemia, del 93% contra 70% para hipercolesterolemia y del 76% contra 59% para hipertrigliceridemia, especificidad, valor predictivo negativo, valor predictivo positivo, coeficiente de verosimilitud positivo, coeficiente de verosimilitud negativo y área bajo la curva fueron superiores para ICE. Conclusiones El ICE es un indicador más eficiente que el IMC para identificar riesgo metabólico en niños mexicanos de edad escolar.

Introduction Abdominal fat, particularly visceral, is associated with a high risk of metabolic complications. The waist-height ratio (WHtR) is used to assess abdominal fat in individuals of all ages. Objective To determine the ability of the waist-to-height ratio to detect metabolic risk in mexican schoolchildren. Patients and Method A study was conducted on children between 6 and 12 years. Obesity was diagnosed as a body mass index (BMI) ≥ 85th percentile, and an ICE ≥0.5 was considered abdominal obesity. Blood levels of glucose, cholesterol and triglycerides were measured. The sensitivity, specificity, positive predictive and negative value, area under curve, the positive likelihood ratio and negative likelihood ratio of the WHtR and BMI were calculated in order to identify metabolic alterations. WHtR and BMI were compared to determine which had the best diagnostic efficiency. Results Of the 223 children included in the study, 51 had hypertriglyceridaemia, 27 with hypercholesterolaemia, and 9 with hyperglycaemia. On comparing the diagnostic efficiency of WHtR with that of BMI, there was a sensitivity of 100% vs. 56% for hyperglycaemia, 93 vs. 70% for cholesterol, and 76 vs. 59% for hypertriglyceridaemia. The specificity, negative predictive value, positive predictive value, positive likelihood ratio, negative likelihood ratio, and area under curve were also higher for WHtR. Conclusions The WHtR is a more efficient indicator than BMI in identifying metabolic risk in mexican school-age.

[Waist-to-height ratio is an indicator of metabolic risk in children]. / Índice cintura-estatura como indicador de riesgo metabólico en niños.

INTRODUCTION: Abdominal fat, particularly visceral, is associated with a high risk of metabolic complications. The waist-height ratio (WHtR) is used to assess abdominal fat in individuals of all ages. OBJECTIVE: To determine the ability of the waist-to-height ratio to detect metabolic risk in mexican schoolchildren. PATIENTS AND METHOD: A study was conducted on children between 6 and 12 years. Obesity was diagnosed as a body mass index (BMI) ≥ 85th percentile, and an ICE ≥0.5 was considered abdominal obesity. Blood levels of glucose, cholesterol and triglycerides were measured. The sensitivity, specificity, positive predictive and negative value, area under curve, the positive likelihood ratio and negative likelihood ratio of the WHtR and BMI were calculated in order to identify metabolic alterations. WHtR and BMI were compared to determine which had the best diagnostic efficiency. RESULTS: Of the 223 children included in the study, 51 had hypertriglyceridaemia, 27 with hypercholesterolaemia, and 9 with hyperglycaemia. On comparing the diagnostic efficiency of WHtR with that of BMI, there was a sensitivity of 100% vs. 56% for hyperglycaemia, 93 vs. 70% for cholesterol, and 76 vs. 59% for hypertriglyceridaemia. The specificity, negative predictive value, positive predictive value, positive likelihood ratio, negative likelihood ratio, and area under curve were also higher for WHtR. CONCLUSIONS: The WHtR is a more efficient indicator than BMI in identifying metabolic risk in mexican school-age.

[Helicobacter pylori detection in children with initially negative Gram, Giemsa and Wharting-Starry methods, using other histologic techniques]. / Detección de Helicobacter pylori en niños con los métodos de gram, giemsa y Warthing-Starry, inicialmente negativos con otras técnicas histológicas.

OBJECTIVE: To identify Helicobacter pylori by Gram, Giemsa and Warthing-Starry histological staining methods in biopsies of the digestive tract in children, when Helicobacter pylori identification was negative with hematoxilin and eosin. MATERIAL AND METHODS: We carried out a retrospective, cross-sectional and comparative study of 36 gastric biopsies received in the department of Anatomic-Pathology, in a period often months. All the biopsies were initially stained with routine Hematoxilin and Eosin. Of the 36 biopsies, 24 were negative to Helicobacter pylori. From paraffin blocks of these last biopsies three new histological sections were obtained to dye them with Gram, Giemsa and Warthing-Starry, and two medical pathologists performed the microscopic interpretation of these samples. RESULTS: The search for Helicobacter pylori was carried out in 24 initially negative biopsies, one was positive for Gram (4.16%) and negative for Giemsa and Warthing-Starry and four were both positive for Giemsa and Warthing-Starry (16.66%) and both were also negative for Gram. Only one biopsy was positive for the three methods. The remaining samples were negative for the three stains. CONCLUSION: The Giemsa and/or Warthing-Starry histologic techniques can be a more specific alternative for the determination of Helicobacter pylori in patients with negative digestive tract biopsies with the traditional method of hematoxilin and eosin.

Dolor Abdominal crónico recurrente / Recurring chronic abdominal pain

Introducción. Objetivo: analizar datos clínicos, métodos de diagnóstico, tratamiento y evolución de niños con dolor abdominal crónico recurrente (DACR). Material y métodos. Se estudiaron prospectivamente a 35 niños de 2 a 15 años de edad con DACR, realizando estudios de filtro y específicos de acuerdo a cada caso. Se efectuó análisis de varianza y prueba de X² para las características del dolor. Resultados. La evolución del DACR varió de 3 a 120 meses, fue muy intenso en 12 y moderado en 23; hubo significancia estadística únicamente en la intensidad del dolor cuando era de origen orgánico. Resultaron más útiles en el diagnóstico el ultrasonido abdominal, la serie gastrointestinal y la panendoscopia de vías digestivas altas. Los diagnósticos finales establecidos fueron: causa orgánica: 17, psicógenos: 7, disfuncional: 6 y 5 no se logró establecer el origen. El tratamiento resultó exitoso en los casos de origen orgánico y disfuncional, en los de causa psicógena hubo 3 éxitos, 2 fracasos y 2 abandonos. Conclusiones. El elevado porcentaje de casos de DACR de origen orgánico probablemete esté en relación a que el estudio se llevó a cabo en un centro de tercer nivel de atención, aunque los informes de casos de origen orgánico y disfuncional están aumentando con el advenimiento de nuevas técnicas de diagnóstico