ABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Infant , Glycogen Storage Disease/classification , Glycogen Storage Disease/epidemiology , Glycogen Storage Disease/genetics , Sprains and Strains/complications , Sprains and Strains/diagnosis , Sprains and Strains/prevention & control , Hypoglycemia/diagnosis , Hypoglycemia/prevention & control , Hypoglycemia/therapy , Infant , Diagnosis, Differential , Enteral Nutrition/instrumentation , Enteral Nutrition/methods , Enteral Nutrition , Carbohydrates/administration & dosage , Carbohydrates/therapeutic useABSTRACT
INTRODUCCIÓN: El déficit de vitamina D ha sido relacionado con manifestaciones extraesqueléticas, como insulinorresistencia, diabetes mellitus tipo 2 y enfermedad cardiovascular. El objetivo de este estudio es determinar la prevalencia del déficit de vitamina D en niños obesos españoles y analizar la relación entre niveles de vitamina D y alteraciones del metabolismo hidrocarbonado. PACIENTES Y MÉTODOS: Estudio descriptivo, transversal, donde se recogieron datos clínicos y analíticos de 120 niños obesos y 50 niños con normopeso atendidos en las consultas externas de Pediatría entre enero del 2011 y enero del 2013. RESULTADOS: Los niveles medios de vitamina D fueron de 19,5 ng/ml en obesos y de 31,6 ng/ml en controles. El 58,3% de los obesos presentaron déficit de vitamina D frente al 10% de los controles. Los niveles de vitamina D eran significativamente menores en invierno. Se encontraron cifras más elevadas de HOMA-SDS (3,8 versus 2,4) y triglicéridos (97 versus 81 mg/dl) en los obesos con déficit de vitamina D respecto a los obesos que no tenían déficit. Se halló una correlación negativa entre los niveles de vitamina D y el valor absoluto de HOMA (r = −0,2; p = 0,04), que no se mantiene al analizar HOMA-SDS. CONCLUSIONES: Existe una elevada prevalencia de déficit de vitamina D entre la población obesa infantil de etiología multifactorial. Los niveles deficitarios de vitamina D podrían influir en el desarrollo de insulinorresistencia y diabetes mellitus tipo 2 en la población obesa
INTRODUCTION: Vitamin D deficiency has been associated with extra-skeletal outcomes such as, insulin resistance, type 2 diabetes, and cardiovascular disease. The aim of this study is to determine the prevalence of vitamin D deficiency among obese children and adolescents in Spain and to analyze the relationship between 25-OH-vitamin D (25-OH-D) levels and markers of abnormal glucose metabolism. PATIENTS AND METHODS: A cross-sectional study was conducted in which the clinical and biochemical data were recorded for 120 obese and 50 non-overweight children in Pediatric Clinics from January 2011 to January 2013. RESULTS: The mean 25-OH-D levels among obese children was 19.5 ng/ml and among non-overweight children was 31.6 ng/ml. 58,3% of obese subjects, and 10% of non-overweight subjects had vitamin D deficiency. Serum 25-OH-D levels were lower in winter. Higher HOMASDS (3.8 versus 2.4), and triglycerides (97 versus 81 mg/dl) were found in vitamin D deficient obese children compared to obese children without vitamin D deficiency. A negative correlation was found between 25-OH-D levels and HOMA in absolute values (r=-0.2; P=0.04) that was not maintained when HOMA-SDS was analyzed. CONCLUSIONS: There is a high prevalence of vitamin D deficiency among obese children with a multifactorial etiology. A lower 25-OH-D level could be a risk factor for developing insulin resistance and type 2 diabetes in obese population
Subject(s)
Humans , Vitamin D Deficiency/epidemiology , Obesity/epidemiology , Metabolic Syndrome/epidemiology , Insulin Resistance , Carbohydrate Metabolism, Inborn Errors/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Body Mass Index , Case-Control Studies , Age and Sex Distribution , Ethnic DistributionABSTRACT
INTRODUCTION: Vitamin D deficiency has been associated with extra-skeletal outcomes such as, insulin resistance, type 2 diabetes, and cardiovascular disease. The aim of this study is to determine the prevalence of vitamin D deficiency among obese children and adolescents in Spain and to analyze the relationship between 25-OH-vitamin D (25-OH-D) levels and markers of abnormal glucose metabolism. PATIENTS AND METHODS: A cross-sectional study was conducted in which the clinical and biochemical data were recorded for 120 obese and 50 non-overweight children in Pediatric Clinics from January 2011 to January 2013. RESULTS: The mean 25-OH-D levels among obese children was 19.5 ng/ml and among non-overweight children was 31.6 ng/ml. 58,3% of obese subjects, and 10% of non-overweight subjects had vitamin D deficiency. Serum 25-OH-D levels were lower in winter. Higher HOMA-SDS (3.8 versus 2.4), and triglycerides (97 versus 81 mg/dl) were found in vitamin D deficient obese children compared to obese children without vitamin D deficiency. A negative correlation was found between 25-OH-D levels and HOMA in absolute values (r=-0.2; P=.04) that was not maintained when HOMA-SDS was analyzed. CONCLUSIONS: There is a high prevalence of vitamin D deficiency among obese children with a multifactorial etiology. A lower 25-OH-D level could be a risk factor for developing insulin resistance and type 2 diabetes in obese population.
Subject(s)
Obesity/complications , Vitamin D Deficiency/complications , Vitamin D Deficiency/epidemiology , Adolescent , Biomarkers/blood , Child , Cross-Sectional Studies , Female , Humans , Male , Obesity/blood , Prevalence , Spain , Vitamin D Deficiency/bloodABSTRACT
La úlcera rectal solitaria es un trastorno crónico, benigno, excepcional en pediatría, caracterizado por un conjunto de síntomas, como tenesmo, dolor perianal y prolapso rectal ocasional, con unos hallazgos anatomopatológicos típicos. La histología pone de manifiesto un engrosamiento de la mucosa y la muscularis mucosae, la elongación y distorsión de las glándulas, un edema de la lámina propia y, a veces, una ulceración de la lesión. Las lesiones se localizan con frecuencia en la pared anterior del recto, y la ulceración no siempre está presente. El diagnóstico suele ser tardío, dada la inespecificidad y la variabilidad clínica, y se basa en los estudios endoscópicos e histológicos. Aunque se trata de una entidad bien conocida en la edad adulta, resulta inusual en pediatría. Presentamos el caso de un adolescente de 16 años diagnosticado 4 años después del inicio de los síntomas(AU)
Solitary rectal ulcer syndrome is a rare condition in children, with benign chronic curse that is characterised by a complex of clinical and histological features. It usually appears with rectal bleeding, tenesmus and perinial pain, occasional rectal prolapsed and typical anatomopathological findings. Histologically, the presence of thickening of the mucous portion and muscularis mucosae, elongation and distortion of the glands and edema of the lamina propria and occasionally, ulceration of the lesion. The lesions are most often located on the anterior wall of the rectum, and ulceration is not always present. The diagnosis is usually delayed due to the nonspecific and clinical variability and is based on samples obtained by colonoscopy and biopsy. Although this entity is well recognized in adults, there are few pediatric cases reported in literature. We reporta 16 year-old boy case who was diagnosed 4 years after the onset of the symptoms(AU)
Subject(s)
Humans , Male , Adolescent , Rectal Fistula/diagnosis , Fissure in Ano/diagnosis , Gastrointestinal Hemorrhage/etiology , Intestinal Mucosa/pathologyABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Carcinoma, Hepatocellular/diagnosis , Focal Nodular Hyperplasia/diagnosis , Liver Neoplasms/diagnosis , Diagnosis, DifferentialABSTRACT
No disponible
Subject(s)
Female , Child, Preschool , Humans , Puberty, Precocious/etiology , Pinealoma/complications , Pineal Gland/physiopathology , Age Determination by SkeletonABSTRACT
Familial hypobetalipoproteinemia (FHB) is a rare genetically heterogeneous disorder provoking abnormally low serum levels of apoprotein (apo) B, total cholesterol, and low-density lipoprotein (LDL-C). Patients carrying heterozygous mutations in the APOB (2p24) gene are usually asymptomatic, but homozygous mutations cause clinical disturbances as a result of intestinal fat malabsorption and fat-soluble vitamin deficiency. We present an asymptomatic boy, aged 8 years and 7 months, with low serum levels of apo-B, total cholesterol, triglyceride, LDL-C and very low-density lipoprotein (VLDL-C), as well as vitamin E deficiency. Three asymptomatic relatives also exhibited low apo-B, total cholesterol and LDL-C levels. The APOB (2p24) gene was fully sequenced, demonstrating a heterozygous mutation in exon 26 (G --> T) in all four members of this family. Familial genetic studies in FHB could be useful in the early detection and treatment of homozygous carriers.
Subject(s)
Apolipoproteins B/genetics , Hypobetalipoproteinemia, Familial, Apolipoprotein B/genetics , Mutation , Child , Humans , MaleABSTRACT
La hipobetalipoproteinemia familiar (HBF) es un trastorno infrecuente, con un patrón de herencia heterogéneo, que da origen a valores anormalmente disminuidos de apoproteína (apo) B, colesterol total o lipoproteínas de baja densidad (c-LDL). Los pacientes portadores de mutaciones en el gen APOB (2p24) en heterozigosis suelen ser asintomáticos, pero aquellos que las portan en homozigosis pueden presentar diferentes alteraciones clínicas, debidas a la malabsorción de grasas y deficiencia de vitaminas liposolubles. Se presenta un varón asintomático de 8 años y 7 meses de edad con disminución de los niveles de colesterol total, triglicéridos, c-LDL, lipoproteínas de muy baja densidad (c-VLDL) y apo-B, así como deficiencia de vitamina E. Un total de 3 familiares también asintomáticos presentaron niveles disminuidos de colesterol total, c-LDL y apo-B. La secuenciación del gen APOB demostró, tanto en el paciente como en los 3 familiares afectados, una mutación en heterozigosis en el exón número 26 (G → T). El estudio genético familiar en la HBF puede ser útil para la detección de los portadores homozigotos y la instauración de tratamiento precoz
Familial hypobetalipoproteinemia (FHB) is a rare genetically heterogeneous disorder provoking abnormally low serum levels of apoprotein (apo) B, total cholesterol, and low-density lipoprotein (LDL-C). Patients carrying heterozygous mutations in the APOB (2p24) gene are usually asymptomatic, but homozygous mutations cause clinical disturbances as a result of intestinal fat malabsorption and fat-soluble vitamin deficiency. We present an asymptomatic boy, aged 8 years and 7 months, with low serum levels of apo-B, total cholesterol, triglyceride, LDL-C and very low-density lipoprotein (VLDL-C), as well as vitamin E deficiency. Three asymptomatic relatives also exhibited low apo-B, total cholesterol and LDL-C levels. The APOB (2p24) gene was fully sequenced, demonstrating a heterozygous mutation in exon 26 (G → T) in all four members of this family. Familial genetic studies in FHB could be useful in the early detection and treatment of homozygous carriers
Subject(s)
Male , Child , Humans , Cholesterol/analysis , Cholesterol/deficiency , Vitamin E Deficiency/complications , Vitamin E Deficiency/diagnosis , Lipids/analysis , Vitamin E/therapeutic use , Vitamin A/therapeutic use , Hyperlipidemias/complications , Hyperlipidemias/diagnosis , Fat Soluble Vitamins , Fats, Unsaturated/therapeutic use , Dietary Fats, Unsaturated/therapeutic use , Dietary Fats/therapeutic useABSTRACT
No disponible
Subject(s)
Male , Female , Child , Humans , Referral and Consultation/classification , Referral and Consultation/trends , Primary Health Care/methods , Primary Health Care/trends , Referral and Consultation/ethics , Referral and Consultation/organization & administration , Referral and Consultation/standards , Referral and Consultation , Pediatrics/education , Pediatrics/organization & administrationABSTRACT
Introducción: Se presenta el cuadro de mandos de sociosanitario utilizado en el grupo Capio Sanidad como instrumento de gestión del sistema de calidad. Objetivos: Impulsar la mejora cualitativa, de forma continuada y sostenida, en todos los centros sociosanitarios del grupo. Ello implica el desarrollo de una sistemática de gestión por procesos. Establecer una sistemática de medición que permita evaluar la consecución de los objetivos de calidad y la comparabilidad interna y externa. Material y métodos: En el Núcleo Central de Calidad (NCC) se ha definido un cuadro de mandos integral para centros sociosanitarios, formado por indicadores básicos relacionados con los procesos identificados en cada ámbito, a partir de su propio mapa de procesos. Todos los indicadores disponen de fichas descriptivas de su contenido, que se hallan a disposición de las personas con acceso al portal de calidad en la intranet corporativa. Los grupos promotores de calidad (NPC) constituidos en cada centro se encargan de integrar la información de los indicadores y la envían trimestralmente al NCC, que aporta los resultados globales a la dirección corporativa. Con independencia de los indicadores básicos, cada propietario de proceso determina y define los indicadores específicos que considere adecuados para el control completo de su proceso. Cuando se superan los límites de alarma preestablecidos, automáticamente se ponen en contacto los grupos de calidad implicados (corporativo y de centro) para gestionar medidas de mejora inmediatas. Resultados: El NCC evalúa trimestralmente la implantación de los indicadores básicos en los centros del grupo, siendo el objetivo para el año 2006 que se supere el 80%. Se describen los indicadores de los procesos estratégicos, de atención sociosanitaria, de soporte asistencial y de soporte no asistencial. Conclusiones: El sistema de monitorización de indicadores utilizado se ha mostrado como un instrumento eficaz y válido, que permite la evaluación de procesos, la comparación entre centros, la fijación de objetivos de mejora y objetivar su logro
Introduction: We present the geriatric center control panel used by Capio Spain as an instrument for managing the quality system. Objectives: Stimulate qualitative improvements in a continuous and sustained manner in all Capio Spain geriatric centers. This necessitates the development of a system of management-by-process. Establish a barometer system which permits the assessment of quality-objective attainment along with internal and external comparability. Material and methods: The Central Quality Core (CQC) has laid out a global control panel for geriatric centers consisting of basic indicators related to the processes identified in each area, all in accordance with their own Process Map. All indicators have corresponding description files detailing their content; these are made available to those with access to the quality portal located in the corporate intranet. Each center quality promotion group (QPC) is responsible for compiling the information regarding the indicators and forwarding it to the CQC on a quarterly basis; the CQC will then inform corporate management of its overall findings. Independently of the basic indicators, each process owner determines and defines the specific indicators that he/she finds suitable for the complete control of the process in question. When the preestablished alert levels are surpassed, the responsible quality groups (at both corporate and center levels) automatically contact each other. Results: Each quarter, the CQC assesses the introduction of the basic indicators, with the goal that all Capio centers achieve 80% fulfilment by 2006. A description as to the indicators is provided regarding strategic processes, geriatric care, health care- and non-health care support. Conclusions: The system used for monitoring indicators has proven to be valid and effective: it allows for the assessment of processes, inter-center comparison, the designing of improvement objectives and an unbiased analysis of their fulfilment
Subject(s)
Humans , Quality Indicators, Health Care/statistics & numerical data , 34002 , Health Services for the Aged/statistics & numerical data , Quality Assurance, Health Care/methods , Management Information Systems/trends , Benchmarking/organization & administrationABSTRACT
No disponible
Subject(s)
Humans , Female , Child , Arthritis, Infectious , Meningococcal Infections , BacteremiaABSTRACT
The transfer factors (TF) for natural uranium isotopes (238U and 234U), thorium isotopes (232Th, 230Th and 228Th), and 226Ra were obtained in plant samples (grass-pasture) growing in granitic and alluvial soils around a disused uranium mine located in the Extremadura region in the south-west of Spain. Affected and non-affected areas of the mine presented large differences in the activity concentrations of radionuclides of the uranium series. We also determined transfer factors for several stable elements (essential and non-essential). A set of statistical tests were applied to validate the data. The results showed that the transfer factors for both the natural radionuclides and the stable elements are independent of the two substrate types involved and also of the two areas considered in the study.
Subject(s)
Radon/pharmacokinetics , Soil Pollutants, Radioactive/pharmacokinetics , Thorium/pharmacokinetics , Uranium/pharmacokinetics , Environmental Monitoring , Mediterranean Region , Mining , Poaceae/chemistry , Radon/analysis , Soil Pollutants, Radioactive/analysis , Thorium/analysis , Uranium/analysisABSTRACT
The activity concentrations of soil and sediment samples are determined by alpha spectrometry with a sample size usually < 1 g. Hence, a systematic and careful procedure must be followed in the sampling and pre-treatment of the sample in order to ensure that the aliquot analysed represents the activity concentration of the entire sample. Statistical analyses of the activity concentrations of uranium and thorium isotopes in soil and sediment samples were performed to study the activity variation due to the lack of the representativity of the sample. These studies showed that, although some uncertainty in the determination of the sample activity concentration may be due to the lack of representativity (about 10%), the procedure followed for the pre-treatment of the sample can be considered adequate, providing an acceptable level of representativity.
