Hipercrecimiento y adenoma hipofisario / Excessive growth and pituitary adenoma

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Prevalencia de sobrepeso y obesidad en escolares de zonas rurales / Prevalence of overweight and obesity in schoolchildren in rural areas

Objetivos Estimar la prevalencia de sobrepeso y obesidad en escolares del entorno rural. Método Estudio descriptivo transversal. Muestra de 1513 escolares de 6, 11 y 14 años de edad. Se recogieron datos de peso y talla con una báscula digital de columna con tallímetro. Se utilizaron tres criterios para definir sobrepeso y obesidad: puntos de Cole, criterios de los Centers for Disease Control and Prevention (CDC) y tablas de Hernández. Resultados Usando los puntos de Cole la prevalencia del sobrepeso fue del 24,6% (intervalo de confianza del 95% [IC95%]: 22,5-26,8) y la de la obesidad fue del 11,6% (IC95%: 10-13,3), mayor en los niños de 11 y 6 años de edad, respectivamente. Según los criterios CDC, el 19,8% (IC95%: 17,9-21,9) tenía sobrepeso y el 16,5% (IC95%: 14,7-18,4) obesidad, correspondiendo los porcentajes mayores a los 14 y 6 años de edad. Empleando las tablas de Hernández se encontró un 11,5% (IC95%: 10-13,2) de sobrepeso y un 18,6% (IC95%: 16,7-20,6) de obesidad, ambos más altos a los 11 años de edad. El riesgo de presentar obesidad y sobrepeso es mayor en los municipios pequeños (<5000 habitantes), con unas odds ratio de 1,49 (IC95%: 1,13-1,95) y 1,33 (IC95%: 1,06-1,67), respectivamente. Conclusiones La prevalencia de sobrepeso y obesidad en el entorno rural es muy alta, y es mayor en los municipios de menos de 5000 habitantes (AU)

Objectives To estimate the prevalence of overweight and obesity in schoolchildren in rural areas. Methods A cross-sectional study was carried out in a sample of 1,513 schoolchildren aged 6, 11 and 14 years. Data were collected on height and weight with digital scales equipped with a measuring rod. We used three criteria to define overweight and obesity: Cole's points, the Centers for Disease Control and Prevention (CDC) criteria and Hernandez's tables. Results When Cole's points were used, 24.6% (95%CI: 22.5 - 26.8) were overweight and 11.6% (95%CI: 10-13.3) were obese; these percentages were higher in children aged 11 and 6 years, respectively. According CDC growth charts, 19.8% of children (95%CI: 17.9-21.9) were overweight and 16.5% (95%CI: 14.7-18.4) were obese, corresponding to higher percentages at 14 and 6 years. When Hernandez's tables were used, 11.5% (95%CI: 10-13.2) were overweight and 18.6% (95%CI: 16.7-20.6) were obese, and both disorders were higher in children aged 11 years. The risk of obesity and overweight was higher in small rural areas (<5,000 people), with OR = 1.49 (95%CI: 1.13-1.95) and OR = 1.33 (95%CI: 1.06-1.67), respectively. Conclusions The prevalence of overweight and obesity in schoolchildren in rural areas is very high and is even higher in towns with less than 5,000 inhabitants (AU)

[Prevalence of overweight and obesity in schoolchildren in rural areas]. / Prevalencia de sobrepeso y obesidad en escolares de zonas rurales.

OBJECTIVES: To estimate the prevalence of overweight and obesity in schoolchildren in rural areas. METHODS: A cross-sectional study was carried out in a sample of 1,513 schoolchildren aged 6, 11 and 14 years. Data were collected on height and weight with digital scales equipped with a measuring rod. We used three criteria to define overweight and obesity: Cole's points, the Centers for Disease Control and Prevention (CDC) criteria and Hernandez's tables. RESULTS: When Cole's points were used, 24.6% (95%CI: 22.5 - 26.8) were overweight and 11.6% (95%CI: 10-13.3) were obese; these percentages were higher in children aged 11 and 6 years, respectively. According CDC growth charts, 19.8% of children (95%CI: 17.9-21.9) were overweight and 16.5% (95%CI: 14.7-18.4) were obese, corresponding to higher percentages at 14 and 6 years. When Hernandez's tables were used, 11.5% (95%CI: 10-13.2) were overweight and 18.6% (95%CI: 16.7-20.6) were obese, and both disorders were higher in children aged 11 years. The risk of obesity and overweight was higher in small rural areas (<5,000 people), with OR = 1.49 (95%CI: 1.13-1.95) and OR = 1.33 (95%CI: 1.06-1.67), respectively. CONCLUSIONS: The prevalence of overweight and obesity in schoolchildren in rural areas is very high and is even higher in towns with less than 5,000 inhabitants.

[Experience with the Norwood operation for hypoplastic left heart syndrome]. / Resultados de la intervención de Norwood para el síndrome del corazón izquierdo hipoplásico.

INTRODUCTION AND OBJECTIVES: To describe our experience and to identify risk factors for in-hospital mortality. METHODS: Between October 1991 and June 2005, 42 children underwent the Norwood procedure. In the first 30 patients, pulmonary circulation was established using a modified Blalock-Taussig shunt (Group 1), while a right ventricle to pulmonary artery conduit was used in the remaining 12 (Group 2). Preoperative anatomic features and procedural factors were analyzed with respect to their impact on mortality. Postoperatively, data were collected on arterial blood pressure, arterial and venous oxygen saturation, arterial pH, venous pCO2, the PaO2/FiO2 ratio, tissue oxygen extraction, and dead space fraction. The association between each individual variable and mortality was investigated. RESULTS: Thirty patients (71.4%) had both aortic and mitral atresia, eight (19%) had either aortic or mitral atresia, and four (9.5%) had no valvular atresia. There was no statistically significant difference in postoperative mortality between the groups 1 and 2 (12/22 [54.5%] vs 7/12 [58.3%]; P=.56). The only significant risk factor for in-hospital mortality was a longer cardiopulmonary bypass time (P=.01) and, for intraoperative mortality, primary rather than delayed sternal closure (P=.004). Venous pCO2, the mean dead space fraction, and tissue oxygen extraction all tended to be higher among infants who died, but the difference was not statistically significant. CONCLUSIONS: Use of a right ventricle to pulmonary artery conduit did not improve postoperative survival. Both a long cardiopulmonary bypass time and primary sternal closure were associated with increased mortality.

Resultados de la intervención de Norwood para el síndrome del corazón izquierdo hipoplásico / Experience with the norwood operation for hypoplastic left heart syndrome

Introducción y objetivos. Describir nuestra experiencia e identificar factores de riesgo de mortalidad hospitalaria. Métodos. Entre octubre de 1991 y junio de 2005 intervinimos a 42 niños con la técnica de Norwood. Los 30 primeros recibieron una fístula de Blalock-Taussig (grupo 1) y los 12 restantes, un conducto entre el ventrículo derecho y la arteria pulmonar (grupo 2). Se analizaron los factores anatómicos y de la técnica con respecto a la mortalidad. Se recogieron variables del postoperatorio, incluidas la presión arterial, la saturación arterial y venosa de oxígeno, el pH arterial, la pCO2 venosa, la relación PaO2/FiO2, la extracción tisular de oxígeno y el espacio muerto, para estudiar su asociación con la mortalidad. Resultados. En total, 30 (71,4%) pacientes tenían atresia aórtica y mitral; 8 (19%) tenían atresia aórtica o mitral y 4 (9,5%) no tenían atresia. No hubo diferencias significativas en la mortalidad postoperatoria entre los grupos 1 y 2 (12/22 [54,5%] frente a 7/12 [58,3%]; p = 0,56). El único factor de riesgo de mortalidad hospitalaria fue un tiempo de circulación extracorpórea prolongado (p = 0,01), y el de mortalidad intraoperatoria, el cierre primario del esternón (p = 0,004). La pCO2 venosa, el espacio muerto pulmonar y la extracción tisular de oxígeno fueron superiores en los niños fallecidos, pero las diferencias no fueron significativas. Conclusiones. El uso de un conducto entre el ventrículo derecho y la arteria pulmonar no mejoró la supervivencia postoperatoria. Un tiempo de circulación extracorpórea prolongado y el cierre primario del esternón se asociaron con un aumento de la mortalidad (AU)

Introduction and objectives. To describe our experience and to identify risk factors for in-hospital mortality. Methods. Between October 1991 and June 2005, 42 children underwent the Norwood procedure. In the first 30 patients, pulmonary circulation was established using a modified Blalock-Taussig shunt (Group 1), while a right ventricle to pulmonary artery conduit was used in the remaining 12 (Group 2). Preoperative anatomic features and procedural factors were analyzed with respect to their impact on mortality. Postoperatively, data were collected on arterial blood pressure, arterial and venous oxygen saturation, arterial pH, venous pCO2, the PaO2/FiO2 ratio, tissue oxygen extraction, and dead space fraction. The association between each individual variable and mortality was investigated. Results. Thirty patients (71.4%) had both aortic and mitral atresia, eight (19%) had either aortic or mitral atresia, and four (9.5%) had no valvular atresia. There was no statistically significant difference in postoperative mortality between the groups 1 and 2 (12/22 [54.5%] vs 7/12 [58.3%]; P=.56). The only significant risk factor for in-hospital mortality was a longer cardiopulmonary bypass time (P=.01) and, for intraoperative mortality, primary rather than delayed sternal closure (P=.004). Venous pCO2, the mean dead space fraction, and tissue oxygen extraction all tended to be higher among infants who died, but the difference was not statistically significant. Conclusions. Use of a right ventricle to pulmonary artery conduit did not improve postoperative survival. Both a long cardiopulmonary bypass time and primary sternal closure were associated with increased mortality (AU)