[Nocturnal sleep-related eating disorder that responds to topiramate]. / Sindrome de ingesta nocturna relacionada con el sueno con respuesta al topiramato.

INTRODUCTION: Nocturnal sleep-related eating disorder is a non-REM sleep parasomnia that is associated to other sleep disorders, especially sleepwalking. It becomes chronic, is not remitting and consists in episodes of compulsive eating during the night, which are then partially or completely forgotten by the patient. This condition must be differentiated from night-eating syndrome, which is far more common and is linked to endocrinological and psychiatric disorders, as well as to other disorders involving eating behaviour during sleeping hours. CASE REPORT: A 28-year-old male who had suffered from the clinical picture every day for 10 years; this condition consisted in nocturnal episodes of binge eating in a state of semi-sleepiness, with no remembrance of what had happened the next morning. The patient had no history of psychiatric pathologies or any other eating disorder, but he did not rest adequately at night, was overweight and had a family and personal history of other sleep disorders. Since he did not respond to other treatments, we decided to try therapy with topiramate; as a result, the episodes disappeared, tolerance was excellent and effectiveness was maintained throughout the two years' follow-up. CONCLUSIONS: In this paper we review eating disorders that occur during sleep, nocturnal sleep-related eating disorder and its therapeutic possibilities, while highlighting the usefulness of topiramate to treat this condition.

Síndrome de ingesta nocturna relacionada con el sueño con respuesta al topiramato / Nocturnal sleep-related eating disorder that responds to topiramite

El síndrome de ingesta nocturna relacionada con el sueño es una parasomnia de sueño no REM, asociadaa otros trastornos del sueño, en especial al sonambulismo, crónica, no remitente y que consiste en episodios de ingesta compulsiva de alimento durante la noche con amnesia parcial o completa del episodio. Este cuadro debe ser diferenciado del síndrome de la cena durante el sueño, que es mucho más frecuente y se asocia a trastornos endocrinos y psiquiátricos, y deotros trastornos de la conducta alimentaria durante el sueño. Caso clínico. Varón de 28 años, con un cuadro diario de, al menos, 10 años de duración, consistente en episodios nocturnos de ingesta compulsiva en un estado de semisomnolencia, con amnesia del suceso a la mañana siguiente. El paciente no tenía historia de patología psiquiátrica o de otro trastorno de la alimentación,pero sí un descanso nocturno pobre, sobrepeso y antecedentes familiares y personales de otros trastornos del sueño.No respondió a otros tratamientos, por lo que se probó el topiramato con casi total desaparición de los episodios, excelente tolerancia y mantenimiento de la eficacia durante dos años de seguimiento. Conclusiones. Revisamos en este artículo lostrastornos de la conducta alimentaria durante el sueño, el síndrome de ingesta nocturna relacionada con el sueño y sus posibilidades terapéuticas, señalando la utilidad del topiramato en este cuadro

Nocturnal sleep-related eating disorder is a non-REM sleep parasomnia that is associated to othersleep disorders, especially sleepwalking. It becomes chronic, is not remitting and consists in episodes of compulsive eating during the night, which are then partially or completely forgotten by the patient. This condition must be differentiated fromnight-eating syndrome, which is far more common and is linked to endocrinological and psychiatric disorders, as well as to other disorders involving eating behaviour during sleeping hours. Case report. A 28-year-old male who had suffered from the clinical picture every day for 10 years; this condition consisted in nocturnal episodes of binge eating in a state of semisleepiness,with no remembrance of what had happened the next morning. The patient had no history of psychiatric pathologies or any other eating disorder, but he did not rest adequately at night, was overweight and had a family and personal history of other sleep disorders. Since he did not respond to other treatments, we decided to try therapy with topiramate; as a result, the episodes disappeared, tolerance was excellent and effectiveness was maintained throughout the two years’ follow-up.Conclusions. In this paper we review eating disorders that occur during sleep, nocturnal sleep-related eating disorder and its therapeutic possibilities, while highlighting the usefulness of topiramate to treat this condition

[Antipyretic effectiveness of ibuprofen and paracetamol]. / Eficacia de ibuprofeno y paracetamol como antitérmicos.

OBJECTIVE: To compare the antipyretic effectiveness of ibuprofen and paracetamol and to evaluate the possible influence of patients' sex, weight, height and underlying disease on effectiveness. PATIENTS AND METHODS: A total of 166 children with fever, defined as a temperature equal to or above 38 degrees C, were enrolled. Of these, 80 were given paracetamol at a dose of 15 mg per kg and 86 were given 7 mg of ibuprofen per kg. Temperature was recorded at 60, 120,180 and 240 minutes after drug administration. Data were statistically analyzed, including analysis of paired data. RESULTS: Ninety percent of the children became afebrile at some time during the study with both paracetamol and ibuprofen. Seventy-four percent of the patients remained afebrile 4 hours after drug administration. The mean temperatures obtained with ibuprofen versus paracetamol were 37.66 +/- 0.73 vs 37.8 +/- 0.65, p = 0.22 one hour after drug administration; 37.09 +/- 0.83 vs 37.29 +/- 0.71, p = 0.14 two hours after drug administration; 37.12 +/- 1.05 vs 37.28 +/- 0.87, p = 0.64 three hours after drug administration; and 37.40 +/- 1.12 vs 37.46 +/- 1.00, p = 0.72 four hours after drug administration. The maximum rate of temperature decrease was achieved during the first 60 minutes after drug administration (-1.32 +- 0.83 with ibuprofen vs -1.09 +/- 0.77 with paracetamol, p = 0.10). In children aged between 5 and 12 years, ibuprofen achieved significantly lower temperatures than paracetamol (38.00 +/- 0.65 vs 37.45 +/- 0.43, p = 0.02 at 1 hour; 36.71 +/- 0.66 vs 37.60 +/- 0.93, p = 0.01 at 2 hours; 36.80 +/- 0.79 vs 37.67 +/- 1.12, p = 0.03 at 3 hours). Analysis by weight, height or underlying disease revealed no significant differences. CONCLUSIONS: Both ibuprofen and paracetamol proved to be successful in reducing temperature. The effectiveness of ibuprofen and paracetamol was similar, except in children aged more than 5 years old, in whom ibuprofen was more effective. Weight, sex and underlying disease had no influence on effectiveness.

Eficacia de ibuprofeno y paracetamol como antitérmicos / Antipyretic effectiveness of ibuprofen and paracetamol

Objetivo: El objetivo del estudio es analizar comparativamente la eficacia de ibuprofeno y paracetamol, y evaluar la posible repercusión sobre la misma de sexo, peso, talla y enfermedad subyacente. Pacientes y métodos: Se recogieron los datos de filiación de 166 niños con temperatura axilar igual o superior a 38 °C. Se administraron 15 mg/kg de paracetamol a 80 de ellos y 7 mg/kg de ibuprofeno a 86. Se recogió después la temperatura que presentaban a los 60, 120, 180 y 240 min de su administración. Con estos datos se realizó un análisis estadístico, incluyendo un análisis de datos apareados. Resultados: Ibuprofeno y paracetamol consiguieron dejar afebriles en algún momento del estudio al 90 % de los niños. El 74% de los pacientes permanecieron afebriles 4 h después de administrarlos. En la muestra global, las temperaturas obtenidas con ibuprofeno frente a paracetamol fueron: 37,66 +/- 0,73 frente a 37,80 +/- 0,65 (p = 0,22) a la hora de su administración; 37,09 +/- 0,83 frente a 37,29 +/- 0,71 a las 2 h; 37,12 +/- 1,05 frente a 37,28 +/- 0,87 (p = 0,64) a las 3 h; 37,40 +/- 1,12 frente a 37,46 +/- 1,00 (p = 0,72) a las 4 h. La máxima velocidad de descenso se alcanzó durante los primeros 60 min (–1,32 +/- 0,83 para ibuprofeno frente a –1,09 +/- 0,77 con paracetamol; p = 0,10). En cuanto al factor edad, en los niños de edad comprendida entre 5 y 12 años se lograron temperaturas significativamente menores con ibuprofeno que con paracetamol (38,00 +/- 0,65 frente a 37,45 +/- 0,43 [p = 0,02] en la primera hora; 36,71 +/- 0,66 frente a 37,60 +/- 0,93 [p = 0,01] en la segunda hora; 36,80 +/- 0,79 frente a 37,67 +/- 1,12 [p = 0,03] en la tercera hora). El análisis de datos en función del peso, sexo y enfermedad no mostró diferencias significativas. Conclusiones: Ibuprofeno y paracetamol demostraron ser efectivos a la hora de descender la temperatura. Ambos fármacos mostraron una eficacia antitérmica similar, salvo en los niños mayores de 5 años, donde se demostró mayor eficacia con ibuprofeno. Peso, sexo y enfermedad de base no determinaron diferencias de eficacia

Objective: To compare the antipyretic effectiveness of ibuprofen and paracetamol and to evaluate the possible influence of patients’ sex, weight, height and underlying disease on effectiveness. Patients and methods: A total of 166 children with fever, defined as a temperature equal to or above 38 °C, were enrolled. Of these, 80 were given paracetamol at a dose of 15 mg per kg and 86 were given 7 mg of ibuprofen per kg. Temperature was recorded at 60, 120,180 and 240 minutes after drug administration. Data were statistically analyzed, including analysis of paired data. Results: Ninety percent of the children became afebrile at some time during the study with both paracetamol and ibuprofen. Seventy-four percent of the patients remained afebrile 4 hours after drug administration. The mean temperatures obtained with ibuprofen versus paracetamol were 37.66 +/- 0.73 vs 37.8 +/- 0.65, p = 0.22 one hour after drug administration; 37.09 +/- 0.83 vs 37.29 +/- 0.71, p = 0.14 two hours after drug administration; 37.12 +/- 1.05 vs 37.28 +/- 0.87, p = 0.64 three hours after drug administration; and 37.40 = 1.12 vs 37.46 +/- 1.00, p = 0.72 four hours after drug administration. The maximum rate of temperature decrease was achieved during the first 60 minutes after drug administration (–1.32 +/- 0.83 with ibuprofen vs –1.09 +/- 0.77 with paracetamol, p = 0.10). In children aged between 5 and 12 years, ibuprofen achieved significantly lower temperatures than paracetamol (38.00 +/- 0.65 vs 37.45 +/- 0.43, p = 0.02 at 1 hour; 36.71 +/- 0.66 vs 37.60 +/- 0.93, p = 0.01 at 2 hours; 36.80 +/- 0.79 vs 37.67 +/- 1.12, p = 0.03 at 3 hours). Analysis by weight, height or underlying disease revealed no significant differences. Conclusions: Both ibuprofen and paracetamol proved to be successful in reducing temperature. The effectiveness of ibuprofen and paracetamol was similar, except in children aged more than 5 years old, in whom ibuprofen was more effective. Weight, sex and underlying disease had no influence on effectiveness