A neuroanatomical study of the feline brain using MRI and mulligan staining: functional and pathological considerations.

BACKGROUND: Despite multiple studies describing accurate diagnoses using advanced neuroimaging techniques, low and mid-field magnetic resonance imaging (MRI) are still the most frequent scanners in veterinary clinics. To date, these studies in cats do not show a clear distinction of nerve centres in MRI data. AIMS: The objective of this study is to determine the efficacy of Mulligan histological staining as a tool in facilitating the location and identification of the main structures of the feline brain in MRI. This study aims to facilitate the interpretation of MRI obtained with these types of scanners. METHODS: A total of 10 feline brains were used. One specimen was used for MRI (T2 sequence using a 1.5T scanner). The other 9 brains were sectioned and stained with the three Mulligan staining techniques (Mulligan, Le Masurier and Robert). RESULTS: The uptake of stain by the grey matter in these sections allowed the determination of the location and the limits of these nervous structures within the brain. The histological location of these structures was correlated with the MRI scans, leading to the successful identification of many small, indistinct nuclei. CONCLUSION: Mulligan staining is proposed as a tool that facilitates the location of nerve structures in comparison with data from the most frequently-used MRI scanners in veterinary clinics.

Valoración de la tendencia secular de la pubertad en niños y niñas / Assessment of the secular trend in puberty in boys and girls

Objetivo: El objetivo de este estudio es analizar la secuencia de la pubertad en los niños y las niñas de nuestra área sanitaria. Métodología: Trescientos diez niños y niñas sanos de raza caucásica participaron en este estudio prospectivo. Se recogieron las siguientes variables: peso de recién nacido (PRN), peso (kg), talla (cm) e índice de masa corporal (IMC) (%) en los diferentes estadios puberales, edad ósea al inicio y final de la pubertad el tiempo de duración de la pubertad y el crecimiento durante el mismo. Resultados: Media (DE): la pubertad se inicia en los niños a los 12,4 años (1,5) con edad ósea de 11,9 años (1,3) y se alcanza el Tanner V a los 15,6 años (1,5) con edad ósea de 14,5 años. En las niñas la pubertad empieza a los 10,1 años (1,4) con edad ósea de 10,3 años (1,1), y la menarquia a los 12,0 años (1,3) con edad ósea: de 13,2 años (0,9). El tiempo de crecimiento hasta el Tanner V en los niños es de 3 años (1,2) con un crecimiento total de 19,5cm (7,6) En las niñas el tiempo de pubertad hasta la menarquia es de 2,5 años (1,1) con un crecimiento total de 15,7cm (5,0). Los niños que comenzaron la pubertad antes de los 11 años mostraron un crecimiento mayor durante la misma 27,3cm (7,9) que los que lo iniciaron después 17,4cm (5,9) (p<0,0001) y crecieron durante más tiempo 3,9 años (1,2) versus 2,7 (1,1) (p<0,001). De igual forma las niñas que comenzaron la pubertad antes de los 9 años crecieron más 19,7cm (4,3) que las que lo hicieron después 14,4cm (4,5) (p<0,0001) y más tiempo 3,1 años (0,8) versus 2,3(0,9) (p<0,0001). Conclusión: Los niños inician la pubertad a edades similares que otras poblaciones españolas, sin embargo en las niñas se adelanta, así como la menarquia. La edad ósea es acorde a la edad cronológica en ambos sexos al inicio de la pubertad pero no al final, adelantándose en las niñas. La duración de la pubertad y el crecimiento durante la misma es mayor en aquellos que inician la pubertad antes, para ambos sexos. No se encontró ninguna relación entre el IMC y el PRN con el inicio de la pubertad (AU)

Objective: Changes in the onset of puberty have been reported in the last few years. The aim of this study is to determine pubertal trends in boys and girls. Method: Longitudinal study was conducted on 310 caucasian children. We analysed birth weight (BW), weight (kg), height (cm) and body mass index (BMI) (%), bone age, duration of puberty growth and pubertal height spurt. Results: For boys the mean age at stage 2 was 12.4 (1.5) years with a bone age of 11.9 (1.3) years, and stage 5: 15.6 (1.5) with a bone age of 14.5. Mean age (years) (SD) for girls stage 2 was 10.1 (1.4), with a bone age of 10.3 (1.1). Age at menarche was 12.0 (1.3), with a bone age of 13.2 (0.9). Duration of puberty growth for boys was 3 years (1.2), and for girls 2.5 years (1.1). Pubertal height spurt in boys was 19.5cm (7.6) and for girls was 15.7cm (5.0). Girls with puberty onset<9 years of age show a greater pubertal height gain (19.7cm (4.3)) than girls >9 years of age [14.4 (4.5) (P<0.0001)] and a longer period of pubertal growth 3.1 years (0.8) versus 2.3 (0.9) (P<0.0001). Boys with puberty onset <11 years of age had a greater pubertal height gain [27.3cm (7.9)] than boys > 11 years of age [17.4 (5.9) (P<0.0001)] and a longer period of puberty growth of 3.9 years (1.2) versus 2.7 (1.1) (P<0.001). Conclusions: Boys presented secondary sex characteristics at the same age as other studies, but the girls reached puberty and menarche at a younger age than previous studies in the Mediterranean area. Bone age correlates with chronological age for both sexes at the beginning of puberty but not at the end. Early onset of puberty was associated with a greater pubertal height gain and a longer period of pubertal growth. There was no correlation between BW or BMI with onset of puberty (AU)

[Assessment of the secular trend in puberty in boys and girls]. / Valoración de la tendencia secular de la pubertad en niños y niñas.

OBJECTIVE: Changes in the onset of puberty have been reported in the last few years. The aim of this study is to determine pubertal trends in boys and girls. METHOD: Longitudinal study was conducted on 310 caucasian children. We analysed birth weight (BW), weight (kg), height (cm) and body mass index (BMI) (%), bone age, duration of puberty growth and pubertal height spurt. RESULTS: For boys the mean age at stage 2 was 12.4 (1.5) years with a bone age of 11.9 (1.3) years, and stage 5: 15.6 (1.5) with a bone age of 14.5. Mean age (years) (SD) for girls stage 2 was 10.1 (1.4), with a bone age of 10.3 (1.1). Age at menarche was 12.0 (1.3), with a bone age of 13.2 (0.9). Duration of puberty growth for boys was 3 years (1.2), and for girls 2.5 years (1.1). Pubertal height spurt in boys was 19.5cm (7.6) and for girls was 15.7cm (5.0). Girls with puberty onset<9 years of age show a greater pubertal height gain (19.7cm (4.3)) than girls >9 years of age [14.4 (4.5) (P<0.0001)] and a longer period of pubertal growth 3.1 years (0.8) versus 2.3 (0.9) (P<0.0001). Boys with puberty onset <11 years of age had a greater pubertal height gain [27.3cm (7.9)] than boys > 11 years of age [17.4 (5.9) (P<0.0001)] and a longer period of puberty growth of 3.9 years (1.2) versus 2.7 (1.1) (P<0.001). CONCLUSIONS: Boys presented secondary sex characteristics at the same age as other studies, but the girls reached puberty and menarche at a younger age than previous studies in the Mediterranean area. Bone age correlates with chronological age for both sexes at the beginning of puberty but not at the end. Early onset of puberty was associated with a greater pubertal height gain and a longer period of pubertal growth. There was no correlation between BW or BMI with onset of puberty.

Caracterización ayurvedica de estudiantes de primer año De la ELAM / First years students ELAM characterization

Se realiza un estudio analítico en 260 estudiantes de primer año de la Escuela Latinoamericana de Medicina del curso 2005-2006 en el período de enero a marzo de 2006, con la finalidad de caracterizarlos desde el punto de vista ayurvédico. Los estudiantes fueron seleccionados a través de un muestreo aleatorio simple utilizando una lista de aleatorización. A cada estudiante se le realiza examen físico y se le aplica un formulario-encuesta para identificar las variables objeto de estudio: edad, sexo, peso corporal, talla, antecedentes patológicos personales, número de comidas al día, número de horas diarias dedicadas al sueño y tipo constitucional metabólico. Con la información obtenida se conforma una base de datos. Se utiliza el porcentaje como medida de resumen de las variables cualitativas. Predominaron los estudiantes del sexo femenino (52.7 por ciento), con menos de 20 años de edad (43.8 por ciento) y del tipo constitucional metabólico Vatta (68.8 por ciento). Las afecciones alérgicas fueron el antecedente patológico personal más referido y la mayoría de los estudiantes refirieron tener entre 3 y 6 comidas al día y dedicar menos de 6 horas diarias al sueño (AU)

[The HOMA and QUICKI indexes, and insulin and C-peptide levels in healthy children. Cut off points to identify metabolic syndrome in healthy children]. / Indice HOMA y QUICKI, insulina y péptido C en niños sanos. Puntos de corte de riesgo cardiovascular.

OBJECTIVE: The aim of this study was to establish the reference values of the Homeostasis Model Assessment (HOMA) and Quantitative Insulin Sensitivity Check (QUICKI) indexes, as well as those of insulin and C-peptide levels in healthy children and adolescents with a view to determining reference percentiles to detect those at cardiovascular risk. MATERIAL AND METHODS: A total of 372 children boys and girls of different ages and at distinct pubertal stages with normal body mass index participated in the study. Fasting glucose, insulin and C-peptide values were measured by chemiluminescence and the HOMA and QUICKI indexes were calculated. RESULTS: Fasting glucose levels were normal in all children. The mean values obtained for each variable were (mean (SD)): fasting glucose 87(7.75) mg/dL, insulin 7.74 (5.35) microU/mL, C-peptide: 1.76 (0.79) ng/mL, HOMA index 1.72 (1.27) and QUICKI index 0.72 (0.29). All the variables progressively increased with age, with statistically significant differences between prepubertal and pubertal children. The QUICKI index showed an inverse relationship. In addition, significant differences were found between sexes. The 90th percentile for all the variables was as follows: insulin 15.05 microU/mL, C-peptide: 2.85 ng/mL, HOMA index 3.43 and QUICKI index 1.10. CONCLUSIONS: Values of fasting glucose, insulin, C-peptide and the HOMA index significantly increased with age and pubertal stage, while the QUICKI index decreased. We defined the 90th percentile for all the parameters studied as the cut-off point to identify children at cardiovascular risk in our population.

Índice HOMA y QUICKI, insulina y péptido C en niños sanos. Puntos de corte de riesgo cardiovascular / The HOMA and QUICKI indexes, and insulin and C-peptide levels in healthy children. Cut off points to identify metabolic syndrome in healthy children

Objetivo: El objetivo de este trabajo ha sido establecer los valores de referencia de los índices Homeostasis Model Assessment (HOMA) y Quantitative Insulin Sensitivity Check Index (QUICKI), insulina y péptido C en ayunas en niños sanos, y con ello obtener percentiles de referencia a partir de los cuales establecer un punto de corte para valorar el riesgo cardiovascular en nuestra población infantil. Material y métodos: En este estudio participan 372 niños de ambos sexos y diferente estadio puberal con un índice de masa corporal (IMC) normal. Se determinan los valores de glucemia, insulina y péptido C (mediante quimioluminiscencia), y se calculan los índice HOMA y QUICKI. Resultados: Todos los niños presentan niveles de glucemia normales (media [DE]): 87 (7,75) mg/dl. Los valores medios obtenidos para cada variable son: insulina 7,74 (5,35) μU/ml, péptido C: 1,76 (0,79) ng/ml, índice HOMA: 1,72 (1,27), e índice QUICKI 0,72 (0,29). De forma global se objetiva un aumento progresivo de los valores de glucosa, insulina, péptido C y el índice HOMA en relación con la edad, existiendo diferencias estadísticamente significativas entre estadios prepuberales y puberales para ambos sexos, siguiendo el índice QUICKI un patrón inverso. Así mismo existen diferencias significativas entre sexos para todas las variables e índices estudiados. Los valores obtenidos para el percentil P90 para cada variable e índice de forma global son: insulina 15,05 μU/ml, péptido C: 2,85 ng/ml, índice HOMA 3,43 e índice QUICKI: 1,10. Conclusiones: Los valores de glucemia, insulina, péptido C y el índice HOMA aumentan con la edad y el estadio puberal de forma significativa. El índice QUICKI por el contrario disminuye. Establecemos el percentil P90 de estas variables que nos servirá como punto de referencia para valorar el riesgo cardiovascular en nuestra población

Objective: The aim of this study was to establish the reference values of the Homeostasis Model Assessment (HOMA) and Quantitative Insulin Sensitivity Check (QUICKI) indexes, as well as those of insulin and C-peptide levels in healthy children and adolescents with a view to determining reference percentiles to detect those at cardiovascular risk. Material and methods: A total of 372 children boys and girls of different ages and at distinct pubertal stages with normal body mass index participated in the study. Fasting glucose, insulin and C-peptide values were measured by chemiluminescence and the HOMA and QUICKI indexes were calculated. Results: Fasting glucose levels were normal in all children. The mean values obtained for each variable were (mean (SD)): fasting glucose 87(7.75) mg/dL, insulin 7.74 (5.35) mcU/mL, C-peptide: 1.76 (0.79) ng/mL, HOMA index 1.72 (1.27) and QUICKI index 0.72 (0.29). All the variables progressively increased with age, with statistically significant differences between prepubertal and pubertal children. The QUICKI index showed an inverse relationship. In addition, significant differences were found between sexes. The 90th percentile for all the variables was as follows: insulin 15.05 mcU/mL, C-peptide: 2.85 ng/mL, HOMA index 3.43 and QUICKI index 1.10. Conclusions: Values of fasting glucose, insulin, C-peptide and the HOMA index significantly increased with age and pubertal stage, while the QUICKI index decreased. We defined the 90th percentile for all the parameters studied as the cut-off point to identify children at cardiovascular risk in our population

Hernia de spiegel. A propósito de 16 casos / Spigelian hernia. A report of 16 cases

Presentamos una serie de 16 casos de hernia de Spiegel operados en nuestro Servicio, uno de los cuales precisó intervención de urgencia y resección intestinal. Se revisa la anatomía de estas hernias y sus formas clínicas de presentación. Exponemos los procedimientos diagnósticos usados en esta enfermedad, destacando el gran valor de la ecografía y la TC para localizar el defecto parietal y el contenido herniario. En todos los casos, la hernia se localizó infraumbilicalmente y por debajo de la aponeurosis del oblicuo mayor. A todos los pacientes se les realizó herniorrafia con o sin prótesis. La morbilidad, mortalidad y recidiva herniaria fueron nulas (AU)

[Comparative study of medical advice and cognitive-behavioral group therapy in the treatment of child-adolescent obesity]. / Estudio comparativo entre el consejo médico y la terapia grupal cognitivo conductual en el tratamiento de la obesidad infantojuvenil.

OBJECTIVE: The aim of this study was to compare the efficacy of medical advice and cognitive-behavioral group therapy in the treatment of primary obesity in children and adolescents 7 to 15 years old. PATIENTS AND METHODS: From five primary care centers 353 subjects (176 boys and 177 girls) were recruited and assigned to three groups. These groups were: medical advice (Group 1), cognitive-behavioral group therapy (Group 2) and those that rejected all treatments (Group 3). Forty variables were controlled and studied for association with prognosis. RESULTS: A significant, but modest decrease in relative body mass index was noted in groups 1 and 2 in the first 6 months, but at two years no differences between the three groups were detected. CONCLUSIONS: It is concluded that cognitive-behavioral group therapy is not more effective than medical advice in our population and neither had a significant effect at two years when compared to no treatment.

[Usefulness of sectorization of pediatric hospital emergency units in the community of Madrid]. / Utilidad de la sectorización de las urgencias hospitalarias pediátricas en la comunidad de Madrid.

We have studied the procedence of the children that came to the Emergency Department of the Niño Jesús Hospital, analyzing if they belonged to the pediatric emergency area corresponding to this hospital, the procedence from the different postal districts of Madrid, from other localities of the Madrid Community, or from the Health Areas of this Community. We found that only 12.42% of the children came from the corresponding area of the emergency care sectorization, and that they came from very disperse zones, having no clear relation with any of the Health Care Areas. We conclude that current sectorization of the pediatric emergencies in hospitals is not being usefull, and we suggest alternative solutions.

[Demand for care in the emergency service department of a pediatric hospital]. / Estudio de la demanda asistencial de un servicio de urgencias hospitalario de pediatría.

We have done a prospective study of the emergencies that arrived to a Children's Hospital from 8 to 15 hours in labour day 987 enquires were filled, which represents 53.53% of those who came. Males were predominant and also the younger ones with 24.58% less than 1 year of age, and progressively diminishing with age. Frequency was higher on Mondays, Thursdays and Fridays, with a significant reduction on Tuesdays. The hourly distribution demonstrated an accumulation in the intermediate hours in the morning, with a reduction before 10 and after 14 hours. 83.58% arrived due to personal initiative, and 22.28% of them had been with their pediatrician in the previous 48 hours. 3.64% of patients were admitted to hospital; considering a justified reason for hospital emergency care in 14.69% of the cases, and dubious reasons in 16.61%. The socioeconomic status was slightly higher than that of the Madrid Community in which the hospital is situated. Our data show that the majority of children that come to the emergency department present problems that could have been solved in another level of care. We also found indirect signs, may evidentiate that the family members are conscious in many cases that they are making an unjustified use of this level of care.