ABSTRACT
Objetivo: Evaluar la eficacia de un preparado lácteo suplementado con fibra en niños con estreñimiento funcional. Material y métodos: Ensayo clínico, aleatorizado, doble ciego, controlado con placebo. Se incluyeron 19 niños de entre 4 y 12 años con criterios de Roma III para estreñimiento funcional. El grupo de intervención recibió durante 4 semanas 200 ml al día de leche con fibra, mientras los controles recibieron una ración similar de leche sin suplementar. Resultados: Tras 4 semanas no se encontraron diferencias estadísticamente significativas entre grupos respecto a la realización de al menos 3 deposiciones a la semana (88,9% en tratados frente a 100% en controles, p = 0,474), número de deposiciones semanales, consistencia de deposiciones o presencia de conductas de retención, dolor con la defecación e incontinencia fecal, o la salud autopercibida. En ambos se observó tendencia al aumento en el número de deposiciones; en el grupo de tratamiento de 3,6 ± 1,9 a 5,8 ± 2,0 deposiciones/semana (p = 0,059) y en el grupo placebo de 3,3 ± 1,3 a 5,8 ± 1,3 deposiciones/semana (p = 0,001). También disminuyó la presencia de dolor con la defecación en el grupo de tratamiento del 77,8% al 11,1% (p = 0,031) y en placebo del 80,0% al 20,0% (p = 0,031). Conclusiones: No se ha podido confirmar la eficacia de un preparado lácteo con fibra para el estreñimiento funcional infantil. Son necesarios estudios bien diseñados y de mayor tamaño muestral para determinar el papel de los suplementos de fibra en los niños con estreñimiento
Objective: To assess the effectiveness of a fibre-fortified milk in children with chronic functional constipation. Patients and methods: Randomised, double-blind, placebo-controlled clinical trial involving 19 children, 4 to 12-year-old, who were diagnosis with functional constipation according to Rome III Criteria. Intervention group received 200 ml of fibre-fortified milk daily for 4 weeks, while the other group received a similar portion of nonfortified milk. Results: At the end of the intervention there were no statistically significant differences between groups with respect to having at least three bowel movements a week (88.9% in intervention group vs. 100% in control group, p = 0.474), frequency of bowel movements, stool consistency, presence of painful defecation, retentive posturing, or fecal incontinence, or self-reported perceived health. Both groups tended to increase bowel movements. Fibre group increased from 3.6 ± 1.9 to 5.8 ± 2.0 bowel movements/week (p = 0.059), while control group increased from 3.3 ± 1.3 to 5.8 ± 1.3 bowel movements/week (p = 0.001). Presence of painful defecation decreased both in fibre group, 77.8% to 11.1% (p = 0.031), and in control group, 80.0% to 20,0% (p = 0.031). Conclusions: Effectiveness of a fibre-fortified milk was not confirmed in children with chronic functional constipation. High quality clinical trials are required to know the efficacy of fibre supplements in children with functional constipation
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Dairy Products , Constipation/diet therapy , Dietary Fiber , Inulin/therapeutic use , Double-Blind Method , Placebos/therapeutic use , Clinical Protocols , Feeding Behavior/physiologyABSTRACT
Introducción: las guarderías surgen para atender una necesidad social, pero no están exentas de influir sobre la salud infantil. Pacientes y métodos: estudio longitudinal prospectivo de dos cohortes de niños entre 0 y 24 meses (se diferencian en asistencia o no a guardería) que acuden a las consultas de 33 pediatras del Servicio Público de Salud del Principado de Asturias. Los datos se obtuvieron de la historia clínica informatizada y entrevistas programadas (6, 12, 18 y 24 meses). Se compararon: número medio de visitas a Servicios de Urgencias y Pediatría e influencia de diferentes variables recogidas. Se analizaron: la morbilidad registrada (infecciones agudas y sibilancias recurrentes) entre hiperfrecuentadores (HF) y no HF. Resultados: el número medio de visitas a las consultas pediátricas es significativamente mayor para los niños que acuden a guardería en todos los tramos de edad estudiados. Hay mayor porcentaje de HF entre los que acuden a guardería: los niños de entre 0 y 6 meses que acuden tienen un riesgo relativo de ser HF a Servicios de Urgencias de hasta seis veces mayor que los que no acuden y cuatro veces mayor de ser HF en las consultas de Pediatría. Conclusiones: 1) la asistencia a guardería se asocia con mayor probabilidad de ser HF en Urgencias y en la consulta de Pediatría de Atención Primaria (AP); 2) los niños HF padecen más enfermedades respiratorias e infecciosas, que no son explicadas por su asistencia a guardería, y 3) lo anterior conlleva un mayor consumo de fármacos (AU)
Introduction: nurseries arise to attend a social need, but are not without influence on childrens health. Patients and methods: prospective longitudinal study of two cohorts of children aged 0-24 months (they differ in nursery assistance or not) who come to the consultations of 33 pediatricians at the Public Health Service of Asturias. The data were obtained from the clinical history and interviews scheduled (6, 12, 18 and 24 months). They were compared: average number of visits to Emergency and Paediatrics Services, and influence of different variables collected. We analyzed: the registered morbidity (acute infections and recurrent wheezing) between frequent attenders (HF) and not HF. Results: the average number of visits to pediatric visits is significantly higher for children attending kindergarten in all age groups studied. There is a higher percentage of HF among those attending nursery: children between 0 and 6 months that have a relative risk of HF to Emergency Services up to 6 times higher than those not attending and four times higher of being HF in consultations of a Primary Care center. Conclusions: 1) attendance at kindergarten is associated with increased probability of being HF in Emergency departments and Paediatrics Primary Care services; 2) the HF children suffer more respiratory and infectious diseases, which are not explained by their attendance at a nursery, y 3) the above carries a higher drug consumption (AU)
Subject(s)
Humans , Male , Female , Child , Child Day Care Centers/methods , Child Day Care Centers/standards , Child Day Care Centers , Child Health/standards , Bacteremia/complications , Bacteremia/drug therapy , Emergency Medicine/methods , Child Care/methods , Child Care/standards , Child Care , Primary Health Care/methods , Primary Health Care/trends , Longitudinal Studies , Prospective StudiesABSTRACT
Non pyogenic discitis is a benign disease of the pediatric age grup. 1st diagnosis is difficult, as the initial symtons may divert the physician to different organs or systems other than the spine. Establishing the diagnosis in the early stage of the disease is important in order to avoid unnecessary and expensive diagnostic procedures. Non pyogenic discitis is diagnosed on radiograms by the demonstration of the narrow disc-space with involvement of the adjacent vertebral bodies. Four phases are recognised in the development of the imaging changes.
