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1.
Allergol. immunopatol ; 46(1): 9-14, ene.-feb. 2018. tab
Article in English | IBECS | ID: ibc-170782

ABSTRACT

Background: This study examined the relationship between different food groups and the adherence to a Mediterranean diet during pregnancy and the risk of wheezing and eczema in children aged 12-15 months. Methods: The study involves 1087 Spanish infants from the International Study of Wheezing in Infants (Estudio Internacional de Sibilancias en Lactantes, EISL). The study of the association of the different food consumption and Mediterranean diet with wheezing, recurrent wheezing and eczema was performed using different models of unconditional logistic regression to obtain adjusted prevalence odds ratios (OR) and 95% confidence intervals (95% CI). Results: No association was found between a good adherence to the Mediterranean diet during pregnancy and the development of wheezing (p = 0.372), recurrent wheezing (p = 0.118) and eczema (p = 0.315). The consumption once or twice a week of white fish (OR: 1.95[1.01-3.75]), cooked potatoes (OR: 1.75[1.22-2.51]) and industrial pastry (OR: 1.59[1.13-2.24]), and the consumption more than three times a week of industrial pastry (OR: 1.47 [1.01-2.13]) during pregnancy increases the risk of "wheezing" at 12 months. Instead, high fruit consumption during the pregnancy has a protective effect against "wheezing" in 12-month-old infants (OR: 0.44 [0.20-0.99]). No statistically significant differences were observed between food intake during pregnancy and "recurrent wheezing". No statistically significant differences were observed between the consumption of any food during pregnancy and the presence of eczema at 12 months. Conclusions: The present study showed that the consumption of Mediterranean diet during pregnancy did not have a protective effect for wheezing, recurrent wheezing or eczema (AU)


No disponible


Subject(s)
Humans , Child , Diet, Mediterranean/statistics & numerical data , Prenatal Nutrition , Eczema/epidemiology , Respiratory Sounds , Protective Agents/analysis , Hypersensitivity, Immediate/epidemiology , Nutrition Surveys/statistics & numerical data
2.
Allergol Immunopathol (Madr) ; 46(1): 9-14, 2018.
Article in English | MEDLINE | ID: mdl-28629669

ABSTRACT

BACKGROUND: This study examined the relationship between different food groups and the adherence to a Mediterranean diet during pregnancy and the risk of wheezing and eczema in children aged 12-15 months. METHODS: The study involves 1087 Spanish infants from the International Study of Wheezing in Infants (Estudio Internacional de Sibilancias en Lactantes, EISL). The study of the association of the different food consumption and Mediterranean diet with wheezing, recurrent wheezing and eczema was performed using different models of unconditional logistic regression to obtain adjusted prevalence odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS: No association was found between a good adherence to the Mediterranean diet during pregnancy and the development of wheezing (p=0.372), recurrent wheezing (p=0.118) and eczema (p=0.315). The consumption once or twice a week of white fish (OR: 1.95[1.01-3.75]), cooked potatoes (OR: 1.75[1.22-2.51]) and industrial pastry (OR: 1.59[1.13-2.24]), and the consumption more than three times a week of industrial pastry (OR: 1.47 [1.01-2.13]) during pregnancy increases the risk of "wheezing" at 12 months. Instead, high fruit consumption during the pregnancy has a protective effect against "wheezing" in 12-month-old infants (OR: 0.44 [0.20-0.99]). No statistically significant differences were observed between food intake during pregnancy and "recurrent wheezing". No statistically significant differences were observed between the consumption of any food during pregnancy and the presence of eczema at 12 months. CONCLUSIONS: The present study showed that the consumption of Mediterranean diet during pregnancy did not have a protective effect for wheezing, recurrent wheezing or eczema.


Subject(s)
Diet, Mediterranean/statistics & numerical data , Eczema/epidemiology , Maternal Exposure/statistics & numerical data , Cross-Sectional Studies , Female , Fruit , Humans , Infant , Male , Odds Ratio , Pregnancy , Prevalence , Respiratory Sounds , Risk Factors , Spain/epidemiology
3.
Allergol. immunopatol ; 45(3): 227-233, mayo-jun. 2017. tab
Article in English | IBECS | ID: ibc-162383

ABSTRACT

BACKGROUND: The objective of the study was to examine the relationship between asthma and overweight-obesity in Spanish children and adolescents and to determine whether this relationship was affected by gender and atopy. METHODS: The study involves 8607 Spanish children and adolescents from the International Study of Asthma and Allergies in Childhood phase III. Unconditional logistic regression was used to obtain adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for the association between asthma symptoms and overweight-obesity in the two groups. Afterwards, it was stratified by sex and rhinoconjunctivitis. RESULTS: The prevalence of overweight and obesity in 6-7-year-old children was 18.6% and 5.2% respectively and in 13-14 year-old teenagers was 11.4% and 1.1% respectively. Only the obese children, not the overweight children, of the 6-7 year old group had a higher risk of any asthma symptoms (wheezing ever: OR 1.68 [1.15-2.47], asthma ever: OR 2.29 [1.43-3.68], current asthma 2.56 [1.54-4.28], severe asthma 3.18 [1.50-6.73], exercise-induced asthma 2.71 [1.45-5.05]). The obese girls had an increased risk of suffering any asthma symptoms (wheezing ever: OR 1.73 [1.05-2.91], asthma ever: OR 3.12 [1.67-5.82], current asthma 3.20 [1.65-6.19], severe asthma 4.83[1.94-12.04], exercise-induced asthma 3.68 [1.67-8.08]). The obese children without rhinoconjunctivitis had a higher risk of asthma symptoms. CONCLUSIONS: Obesity and asthma symptoms were associated in 6-7 year-old children but not in 13-14 year-old teenagers. The association was stronger in non-atopic children and obese girls


No disponible


Subject(s)
Humans , Male , Female , Child , Adolescent , Obesity/complications , Asthma/complications , Asthma/epidemiology , Asthma, Exercise-Induced/epidemiology , Conjunctivitis/epidemiology , Overweight/complications , Clinical Protocols , Surveys and Questionnaires , Spain/epidemiology , Conjunctivitis/complications
4.
Allergol Immunopathol (Madr) ; 45(3): 227-233, 2017.
Article in English | MEDLINE | ID: mdl-28126313

ABSTRACT

BACKGROUND: The objective of the study was to examine the relationship between asthma and overweight-obesity in Spanish children and adolescents and to determine whether this relationship was affected by gender and atopy. METHODS: The study involves 8607 Spanish children and adolescents from the International Study of Asthma and Allergies in Childhood phase III. Unconditional logistic regression was used to obtain adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for the association between asthma symptoms and overweight-obesity in the two groups. Afterwards, it was stratified by sex and rhinoconjunctivitis. RESULTS: The prevalence of overweight and obesity in 6-7-year-old children was 18.6% and 5.2% respectively and in 13-14 year-old teenagers was 11.4% and 1.1% respectively. Only the obese children, not the overweight children, of the 6-7 year old group had a higher risk of any asthma symptoms (wheezing ever: OR 1.68 [1.15-2.47], asthma ever: OR 2.29 [1.43-3.68], current asthma 2.56 [1.54-4.28], severe asthma 3.18 [1.50-6.73], exercise-induced asthma 2.71 [1.45-5.05]). The obese girls had an increased risk of suffering any asthma symptoms (wheezing ever: OR 1.73 [1.05-2.91], asthma ever: OR 3.12 [1.67-5.82], current asthma 3.20 [1.65-6.19], severe asthma 4.83[1.94-12.04], exercise-induced asthma 3.68 [1.67-8.08]). The obese children without rhinoconjunctivitis had a higher risk of asthma symptoms. CONCLUSIONS: Obesity and asthma symptoms were associated in 6-7 year-old children but not in 13-14 year-old teenagers. The association was stronger in non-atopic children and obese girls.


Subject(s)
Asthma/epidemiology , Adolescent , Child , Cross-Sectional Studies , Female , Humans , Male , Obesity/epidemiology , Overweight/epidemiology , Prevalence , Spain , Surveys and Questionnaires
5.
An Pediatr (Barc) ; 82(3): 131-8, 2015 Mar.
Article in Spanish | MEDLINE | ID: mdl-25086487

ABSTRACT

INTRODUCTION: Changes in lifestyle and diet have led to a progressive increase in the prevalence of overweight and obesity. This disorder can lead to significant physical and psychosocial effects that affect the health related quality of life (HRQOL). Adolescence is a time of great vulnerability and very decisive in personality development. The objective of this study was to assess the influence of weight status on HRQoL in adolescents. POPULATION AND METHODS: A cross-sectional study conducted on adolescents of 12-16 years old and an assessment of HRQOL using the CHIP-Adolescents Edition questionnaires. RESULTS: Out of a total of 89 adolescents included, 60.7% had a normal weight and 39.3% were overweight-obese. The normal weight participants had a higher mean age than overweight-obesity participants, 14.2 vs. 13.6 years old, respectively. There were no other differences in sociodemographic characteristics between groups. Overweight-obese adolescents had a worse HRQoL, specifically as regards less resilience, lower capacity for physical activity, less family involvement, and greater peer influence. Moreover, the girls showed a lower self-esteem, satisfaction, resilience and physical activity than boys. Furthermore, less home safety and health, higher individual risk and greater peer influence was reported with increasing age of participants. CONCLUSION: Overweight-obesity negatively affects the HRQoL of adolescents. It is important to evaluate the psychosocial aspects from the perspective of the adolescents, in order to offer them a complete, personalized and multidisciplinary care.


Subject(s)
Overweight , Quality of Life , Adolescent , Child , Cross-Sectional Studies , Female , Health Status , Humans , Male , Socioeconomic Factors , Surveys and Questionnaires
6.
Nutr Hosp ; 27(1): 165-76, 2012.
Article in English | MEDLINE | ID: mdl-22566317

ABSTRACT

BACKGROUND: Dietary treatment for obese adolescents should aim to ensure adequate growth and development, by reducing excessive fat mass accumulation, avoiding loss of lean body mass, improving well-being and self-esteem and preventing cyclical weight regain. The aim of this article is to describe the dietary intervention design and the methods used to evaluate nutritional knowledge and behavior in the EVASYON study (Development, implementation and evaluation of the efficacy of a therapeutic programme for overweight/obese adolescents). METHODS/DESIGN: EVASYON is a multi-centre study conducted in 5 Spanish hospital settings (Granada, Madrid, Pamplona, Santander and Zaragoza), where 204 overweight/obese Spanish adolescents were treated in groups of 9 to 11 subjects over 20 visits. The study was implemented in two stages: an intensive, calorie-restricted period for the first 9 weeks, and an extensive body-weight follow-up period for the last 11 months. A moderate energy intake restriction was applied in the intensive period according to the degree of obesity, on the basis of a balanced diet supplying 50-55% of daily energy as carbohydrates; 30-35% as fats and 10-15% as proteins. In the intensive period, adolescents were prescribed both a fixed full-day meal plan for the first three weeks and a full day meal plan with different food-choices for 6 weeks. Later, adolescents received a flexible meal plan based on food exchanges for the follow-up period until the end of the trial. Data on food intake, dietary and meal-related habits and behavior were collected by means of dietary questionnaires. To analyse nutritional knowledge, adolescents were examined regarding nutrient concepts and food adoitems for a healthy diet with the appropriate tools. Participants were given nutritional information with complementary teaching material, which was available on the EVASYON website (www.estudioevasyon.com). DISCUSSION: The dietary intervention of the EVASYON programme with a moderate calorie restriction for a limited period of time could be a good strategy in treating overweight and obese adolescents and that will be tested further. Moreover, combining fixed plan with free-choice menus may help adolescents and their families to make right decisions for every day meals.


Subject(s)
Nutrition Therapy/methods , Obesity/diet therapy , Overweight/diet therapy , Adolescent , Adolescent Nutritional Physiological Phenomena , Caloric Restriction , Dietetics , Eating , Feeding Behavior , Female , Health Education , Humans , Male , Motor Activity , Nutritional Requirements , Spain
7.
Pediatr. aten. prim ; 14(53): 61-67, ene.-mar. 2012. tab, ilus
Article in Spanish | IBECS | ID: ibc-99948

ABSTRACT

La síntesis de andrógenos en la mujer se produce en las glándulas suprarrenales, en el ovario y en los tejidos diana periféricos para la acción androgénica (piel, músculo y tejido adiposo). El exceso de producción androgénica (o hiperandrogenismo) en la infancia y adolescencia puede determinar alteraciones en estos tejidos diana, condicionando la aparición de hirsutismo, acné, trastornos menstruales o virilización, cuya intensidad y momento de aparición dependerán del origen del exceso de producción de andrógenos. La etiología del hiperandrogenismo variará según la edad. Así, en el periodo prepuberal, en ausencia de maduración gonadal la hiperproducción androgénica tendrá origen en la glándula suprarrenal en la mayoría de los casos, mientras que en el periodo peripuberal y postpuberal el ovario será el responsable (AU)


The synthesis of androgens in women is produced in the adrenal gland, ovary, and peripheral target tissues for androgen action (skin, muscle and adipose tissue). Excessive androgen production (or hyperandrogenism) in childhood and adolescence may determine alterations in these target tissues, determining the onset of hirsutism, acne, menstrual disorders or virilization, whose intensity and time of onset depend on the origin of the excess production of androgens. The etiology of hyperandrogenism will vary according to age. Therefore, in the prepubertal period in the absence of androgen overproduction gonadal maturation have originated in the adrenal gland in most cases, while in the peripubertal post-pubertal period the ovary is the main cause (AU)


Subject(s)
Humans , Male , Female , Child , Adolescent , Hyperandrogenism/complications , Hyperandrogenism/diagnosis , Hyperandrogenism/therapy , Polycystic Ovary Syndrome/complications , Polycystic Ovary Syndrome/diagnosis , Hyperprolactinemia/complications , Diagnosis, Differential , Hyperandrogenism/physiopathology , Polycystic Ovary Syndrome/etiology , Polycystic Ovary Syndrome/physiopathology , Metformin/therapeutic use , Androgen Antagonists/therapeutic use , Flutamide/therapeutic use
8.
Nutr. hosp ; 27(1): 165-176, ene.-feb. 2012. ilus, tab
Article in English | IBECS | ID: ibc-104867

ABSTRACT

Background: Dietary treatment for obese adolescents should aim to ensure adequate growth and development, by reducing excessive fat mass accumulation, avoiding loss of lean body mass, improving well-being and self-esteem and preventing cyclical weight regain. The aim of this article is to describe the dietary intervention design and the methods used to evaluate nutritional knowledge and behavior in the EVASYON study (Development, implementation and evaluation of the efficacy of a therapeutic programme for overweight/obese adolescents). Methods/design: EVASYON is a multi-centre study conducted in 5 Spanish hospital settings (Granada, Madrid, Pamplona, Santander and Zaragoza), where 204 overweight/obese Spanish adolescents were treated in groups of 9 to 11 subjects over 20 visits. The study was implemented in two stages: an intensive, calorie-restricted period for the first 9 weeks, and an extensive body-weight follow-up period for the last 11 months. A moderate energy intake restriction was applied in the intensive period according to the degree of obesity, on the basis of a balanced diet supplying 50-55% of daily energy as carbohydrates; 30-35% as fats and 10-15% as proteins. In the intensive period, adolescents were prescribed both a fixed full-day meal plan for the first three weeks and a full day meal plan with different food-choices for 6 weeks. Later, adolescents received a flexible meal plan based on food exchanges for the follow-up period until the end of the trial. Data on food intake, dietary and meal-related habits and behavior were collected by means of dietary questionnaires. To analyse nutritional knowledge, adolescents were examined regarding nutrient concepts and food adoitems for a healthy diet with the appropriate tools. Participants were given nutritional information with complementary teaching material, which was available on the EVASYON website (www.estudioevasyon.com). Discussion: The dietary intervention of the EVASYON programme with a moderate calorie restriction for a limited period of time could be a good strategy in treating overweight and obese adolescents and that will be tested further. Moreover, combining fixed plan with free-choice menus may help adolescents and their families to make right decisions for every day meals (AU)


Antecedentes: El tratamiento dietético para los adolescentes obesos debería asegurar el crecimiento y desarrollo adecuados al reducir la acumulación excesiva de masa grasa, evitar la pérdida de masa magra corporal, mejorar el bienestar y la autoestima y prevenir la ganancia cíclica de peso. El objetivo de este artículo es el de describir el diseño de la intervención dietética y los métodos empleados para evaluar el conocimiento y la conducta nutricionales del estudio EVASYON (Desarrollo, implantación y evaluación de la eficacia de un programa terapéutico para adolescentes con sobrepeso/obesidad). Métodos/diseño: EVASYON es un estudio multicéntrico realizado en 5 hospitales españoles (Granada, Madrid, Pamplona, Santander y Zaragoza), en el que se trató a 204 adolescentes españoles con sobrepeso/obesidad en grupos de 9 a 11 individuos a lo largo de 20 visitas. El estudio se implantó en dos etapas: un período intensivo de restricción calórica durante las 9 primeras visitas y un período extensivo de seguimiento del peso corporal durante los últimos 11 meses. Se aplicó una restricción moderada de consumo de energía durante el período intensivo en función del grado de obesidad, sobre la base de una dieta equilibrada que aporta el 50-55% de la energía diaria en forma de carbohidratos; 30-35% como grasas y 10-15% como proteínas. En el período intensivo, se prescribió a los adolescentes un régimen de comidas fijo para todo el día durante las 3 primeras semanas y un plan de comidas para todo el día con diferentes opciones durante 6 semanas. Posteriormente, los adolescentes recibieron un régimen de comidas flexible sobre la base de los intercambios de alimentos durante el período de seguimiento hasta el final del ensayo. Se recogieron los datos de consumo de alimentos, dietéticos y hábitos relacionados con las comidas mediante cuestionarios de dieta. Para analizar el conocimiento nutricional, se examinó a los adolescentes con respecto a conceptos de nutrición y alimentos concretos para una dieta sana con las herramientas adecuadas. Se proporcionó a los participantes información nutricional con material educativo complementario que estaba disponible en la página web del estudio (www.estudioevasyon.com). 
Discusión: La intervención dietética del programa EVASYON con una restricción calórica moderada durante un período de tiempo limitado podría ser una buena estrategia para el tratamiento de los adolescentes con sobrepeso y obesidad y se probará más adelante. Además, el combinar el plan fijo con menús de elección libre podría ayudar a los adolescentes y sus familias a tomar las decisiones correctas para las comidas de todos los días (AU)


Subject(s)
Humans , Male , Female , Adolescent , Overweight/therapy , Obesity/therapy , Diet, Reducing , Evaluation of Results of Therapeutic Interventions , Self Concept , Food and Nutrition Education
9.
An. pediatr. (2003, Ed. impr.) ; 69(5): 420-425, nov. 2008. ilus, tab
Article in Es | IBECS | ID: ibc-69174

ABSTRACT

Introducción: La función tiroidea materna durante los primeros meses de embarazo desempeña un papel determinante en el desarrollo del cerebro fetal, porque no existe producción de hormona tiroidea fetal hasta la semana 20. Material y métodos: Durante el año 2002 se seleccionó una muestra de 147 mujeres embarazadas en la semana 37 de gestación. Para valorar la función tiroidea de estas gestantes se determinaron las concentraciones séricas de T4 libre y de hormona tiroestimulante (TSH). Posteriormente, se evaluó el desarrollo psicomotor de los hijos de dichas mujeres mediante las escalas McCarthy. Resultados: Se obtuvo una mediana de T4 libre de 9,37 pmol/l, y más de la mitad de las gestantes de la muestra presentaron valores por debajo del umbral de hipotiroxinemia. Los hijos de madres con concentraciones de T4 por debajo del percentil 10 presentaban una puntuación en el índice general cognitivo significativamente más baja que la de los hijos cuyas madres tenían concentraciones séricas de T4 libre normales. Existe una correlación positiva entre el valor de T4 libre materna y el índice general cognitivo (r=0,43; p < 0,01). Conclusiones: Las concentraciones de T4 libre materna no sólo son importantes durante los primeros meses de gestación para asegurar un desarrollo adecuado del cerebro fetal, sino durante todo el embarazo (AU)


Introduction: The maternal thyroid function during early pregnancy plays a fundamental role in foetal brain development as synthesis of thyroid hormone does not begin until the 20th week of gestation. Material and methods: Throughout the year 2002, 147 women in their 37th week of pregnancy were enrolled for the study. To evaluate their thyroid function, the serum concentrations of free T4 and of TSH were determined. After birth, the psychomotor development of their children was evaluated with the Mc-Carthy scales. Results: The median value of free T4 was 9.37 pmol/l, being the data obtained from more than half of the sampled women below the hypothyroxinaemia threshold. Children born from mothers with T4 levels below percentile 10 showed a significantly lower score on the general cognitive index than those whose mothers had normal free T4 serum concentrations. A positive correlation was found between the values of maternal free T4 and the general cognitive index (r=0.43; p < 0.01). Conclusions: The concentrations of maternal free T4 are important, not only during the first months of pregnancy, but all along the process to ensure adequate development of the foetal brain (AU)


Subject(s)
Humans , Pregnancy , Male , Female , Adult , Infant, Newborn , Psychomotor Performance/physiology , Pregnancy Complications/diagnosis , Pregnancy Complications/physiopathology , Thyroid Diseases/complications , Thyroid Function Tests , Thyroxine/analysis , Thyroxine , Thyroid Hormones/deficiency , Iodine/administration & dosage , Iodine/therapeutic use , Pregnancy Trimester, Third/genetics , Pregnancy Trimester, Third/metabolism , Thyroid Hormones/metabolism , Informed Consent
10.
An Pediatr (Barc) ; 68(5): 481-5, 2008 May.
Article in Spanish | MEDLINE | ID: mdl-18447993

ABSTRACT

BACKGROUND: Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycaemia in infancy. The differential diagnosis between focal and diffuse forms of CHI is of great importance when planning surgery. The aim of this article is to show the first case of focal CHI diagnosed in Spain using PET-CT imaging combined with genetic analysis. METHODS: A 13 month child with CHI and normal conventional radiological investigations treated with diazoxide, diet control and feeding by gastrostomy is presented. Genetic analysis of ABCC8 and KCNJ11 genes and PET-TAC using 18F-fluoro-L-DOPA were performed. RESULTS: A pathological mutation (G111R) in the paternal allele of ABCC8 was detected. PET-CT scanning using 18F-fluoro-L-DOPA showed a focus of high uptake in the body of the pancreas compatible with adenoma that was hystopathologically confirmed. After surgical resection the patient is asymptomatic without needing either pharmacological treatment or dietetic control. CONCLUSIONS: The combination of genetic analysis and 18F-fluoro-L-DOPA PET-TAC shows a great potential for the identification, location and guideline for surgery in CHI.


Subject(s)
Congenital Hyperinsulinism , Dihydroxyphenylalanine , Fluorodeoxyglucose F18 , Pancreas/diagnostic imaging , Positron-Emission Tomography , Radiopharmaceuticals , Tomography, X-Ray Computed , ATP-Binding Cassette Transporters/genetics , Congenital Hyperinsulinism/classification , Congenital Hyperinsulinism/diagnosis , Congenital Hyperinsulinism/genetics , DNA Mutational Analysis , Growth Hormone/analogs & derivatives , Growth Hormone/genetics , Humans , Infant , Male , Point Mutation , Potassium Channels, Inwardly Rectifying/genetics , Receptors, Drug/genetics , Severity of Illness Index , Sulfonylurea Receptors
11.
An. pediatr. (2003, Ed. impr.) ; 68(5): 481-485, mayo 2008. ilus
Article in Es | IBECS | ID: ibc-64576

ABSTRACT

Fundamento: La distinción entre el hiperinsulinismo congénito (CHI) focal y difuso es esencial de cara al tratamiento y pronóstico de la enfermedad. El objetivo es presentar el primer caso de CHI focal diagnosticado en España combinando los estudios genético y PET-TC. Métodos: Paciente de 13 meses con CHI y pruebas de imagen convencionales normales, tratado con diazóxido, control dietético y alimentación por gastrostomía. Se analizó la secuencia de los genes ABCC8 y KCNJ11, y realizó una PET-TC con 18F-fluoro-L-DOPA. Resultados: Se detectó una mutación patogénica (G111R) en el alelo paterno de ABCC8. La PET-TC demostró un foco hipercaptante en el cuerpo del páncreas compatible con un adenoma confirmado histopatológicamente. Tras la cirugía el paciente continúa asintomático sin tratamiento farmacológico ni medidas dietéticas. Conclusiones: La combinación del análisis genético y la PET-TC con 18F-fluoro-L-DOPA muestra un gran potencial para la identificación, localización y guía de la cirugía del CHI (AU)


Background: Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycaemia in infancy. The differential diagnosis between focal and diffuse forms of CHI is of great importance when planning surgery. The aim of this article is to show the first case of focal CHI diagnosed in Spain using PET-CT imaging combined with genetic analysis. Methods: A 13 month child with CHI and normal conventional radiological investigations treated with diazoxide, diet control and feeding by gastrostomy is presented. Genetic analysis of ABCC8 and KCNJ11 genes and PET-TAC using 18F-fluoro-L-DOPA were performed. Results: A pathological mutation (G111R) in the paternal allele of ABCC8 was detected. PET-CT scanning using 18F-fluoro-L-DOPA showed a focus of high uptake in the body of the pancreas compatible with adenoma that was hystopathologically confirmed. After surgical resection the patient is asymptomatic without needing either pharmacological treatment or dietetic control. Conclusions: The combination of genetic analysis and 18F-fluoro-L-DOPA PET-TAC shows a great potential for the identification, location and guideline for surgery in CHI (AU)


Subject(s)
Humans , Male , Infant , Hyperinsulinism/diagnosis , Hyperinsulinism/genetics , Homeopathic Clinical-Dynamic Prognosis , Hypoglycemia/complications , Hydrocortisone/therapeutic use , Glucagon/therapeutic use , Octreotide/therapeutic use , Genes, Dominant , Genes, Dominant/genetics , Mutation/genetics , Gastrostomy , Diazoxide/therapeutic use , Informed Consent , Pancreas/abnormalities , Pancreas , Chromosome Aberrations/embryology , Chromosome Disorders/complications , Genes, Dominant/physiology , Gene Expression/physiology
12.
An Pediatr (Barc) ; 69(5): 420-5, 2008 Nov.
Article in Spanish | MEDLINE | ID: mdl-19128742

ABSTRACT

INTRODUCTION: The maternal thyroid function during early pregnancy plays a fundamental role in foetal brain development as synthesis of thyroid hormone does not begin until the 20th week of gestation. MATERIAL AND METHODS: Throughout the year 2002, 147 women in their 37th week of pregnancy were enrolled for the study. To evaluate their thyroid function, the serum concentrations of free T4 and of TSH were determined. After birth, the psychomotor development of their children was evaluated with the Mc-Carthy scales. RESULTS: The median value of free T4 was 9.37 pmol/l, being the data obtained from more than half of the sampled women below the hypothyroxinaemia threshold. Children born from mothers with T4 levels below percentile 10 showed a significantly lower score on the general cognitive index than those whose mothers had normal free T4 serum concentrations. A positive correlation was found between the values of maternal free T4 and the general cognitive index (r=0.43; p<0.01). CONCLUSIONS: The concentrations of maternal free T4 are important, not only during the first months of pregnancy, but all along the process to ensure adequate development of the foetal brain.


Subject(s)
Child Development , Pregnancy Complications/blood , Psychomotor Performance , Thyroid Diseases/blood , Thyroxine/blood , Adult , Child, Preschool , Female , Humans , Male , Pregnancy , Young Adult
13.
An Esp Pediatr ; 54(6): 540-6, 2001 Jun.
Article in Spanish | MEDLINE | ID: mdl-11412400

ABSTRACT

BACKGROUND: Osteoporosis is a frequent health problem in adults. Optimization of bone mass acquisition during childhood and adolescence may play a major role in the prevention of this disease. Osteosonography is a recent technique for measuring bone mineralization without exposing the patient to radiation. OBJECTIVES: To measure bone mineral density using osteosonography in healthy Spanish Caucasian children and adolescents in order to determine normal values. METHODS: We performed a cross sectional study of 829 healthy child and adolescent volunteers (360 girls and 469 boys) randomly selected from the urban area of Pamplona in Navarre (Spain). Ages ranged from 6 to 18 years. ADBM Sonic 1200 ultrasound densitometer from IGEA was used. Daily calcium dietary intake and amount of physical activity were recorded. RESULTS: Cross sectional standards for Ad-SOS are presented. Ad-SOS did not significantly change between the ages of 6 and 9 years in girls or until the age of 10 years in boys. From the ages of 10 to 14 years, Ad-SOS values were higher in girls than in boys. After the age of 14 years, no significant differences were found. No correlation was found between calcium dietary intake, amount of physical exercise or bone mineralization values. CONCLUSIONS: Measurement of Ad-SOS by osteosonography is an easy, fast and inexpensive method for measuring bone mineral density in children and adolescents without exposing them to radiation. It can be used in the pediatric population to detect early alterations in bone mineralization.


Subject(s)
Bone Density , Bone and Bones/diagnostic imaging , Adolescent , Child , Cross-Sectional Studies , Female , Humans , Male , Reference Values , Ultrasonography
14.
An. esp. pediatr. (Ed. impr) ; 54(6): 540-546, jun. 2001.
Article in Es | IBECS | ID: ibc-1942

ABSTRACT

Antecedentes: La osteoporosis es una enfermedad frecuente en adultos. La adquisición de una masa ósea óptima durante la infancia y adolescencia es importante en la prevención de la enfermedad. La osteosonografía permite valorar la mineralización ósea sin radiación. Objetivos: Determinar la mineralización ósea mediante osteosonografía en niños y adolescentes caucásicos españoles para proporcionar valores normales. Métodos: Estudio transversal en 829 niños y adolescentes voluntarios sanos de edades comprendidas entre los 6 y los 18 años (360 mujeres y 469 varones) seleccionados al azar del área urbana de Pamplona (Navarra). Se utilizó un densitómetro DBM Sonic 1200 de IGEA(r). Se registraron la ingesta diaria de calcio y el grado de ejercicio físico. Resultados: Se presentan los valores de normalidad para la velocidad del sonido (a través del hueso) dependiente de la amplitud (Ad-SOS). La Ad-SOS no cambia de manera significativa desde los 6 a los 9 años en las niñas y hasta los 10 años en los niños. Los valores de la Ad-SOS son más altos en las niñas que en los niños desde los 10 a los 14 años. A partir de esa edad no se encontraron diferencias significativas. No se encontró ninguna correlación entre la ingesta diaria de calcio, el grado de ejercicio físico y la mineralización ósea. Conclusiones: La medida de la Ad-SOS mediante osteosonografía es un método carente de radiación, fácil, rápido y económico para medir la mineralización ósea en niños y adolescentes. Es un método que puede utilizarse en la población pediátrica para la detección precoz de alteraciones en la mineralización ósea (AU)


Subject(s)
Child , Adolescent , Male , Female , Humans , Bone Density , Reference Values , Bone and Bones , Cross-Sectional Studies
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