[Lipid profile and hormonal study in the schoolchildren of the province of Alicante]. / Perfil lipídico y estudio hormonal en población escolar de la provincia de Alicante.

INTRODUCTION: Childhood obesity has increased alarmingly in Europe and the USA, with a rise in the consequences of this epidemic, such as type 2 diabetes, hyperlipidemia and cardiovascular disease. OBJECTIVE: To study the lipid and hormonal profile of schoolchildren in the province of Alicante and to analyze the relationship between body mass index (BMI) and the variables of interest in this study. MATERIALS AND METHODS: We performed a cross-sectional epidemiological study of a cohort of schoolchildren (6-11 years) from the province of Alicante (n = 394, 204 boys and 190 girls). Height and weight were measured. We measured the following analytic variables: total cholesterol, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), triglycerides, leptin, thyrotropin (TSH), free thyroxin (T4), insulin-like growth factor-1 (IGF-1), cortisol, androstenedione, dehydroepiandrosterone sulfate (DHEAS), testosterone and estradiol. Obesity was defined as a BMI > or = 2 SD, using the population curves in the longitudinal study of Zaragoza (Spain) as the reference. RESULTS: When studying lipid risk, we observed that 13.5% had cholesterol levels of > 200 mg/dl, 9.4% had triglyceride levels of > 100 mg/dl and 30.5% had LDL-c/HDL-c values of > 2.2. We found a correlation between BMI and plasmatic concentrations of triglycerides (r = 0.23), IGF-1 (r = 0.211), leptin (r = 0.583), androstenedione, DHEAS, testosterone and estradiol (r = 0.35, r = 0.27, r = 0.23 and r = 0.15, respectively). There was a negative correlation between BMI and HDL-c (r = -0.21) and cortisol (r = -0.09). There was no statistically significant correlation between the degree of obesity and concentrations of cholesterol (p = 0.434) and LDL-c (p = 0.452). CONCLUSIONS: We observed a high prevalence of lipid disturbances in children under 11 years old in our population in relation to obesity.

Perfil lipídico y estudio hormonal en población escolar de la provincia de Alicante / Lipid profile and hormonal study in schoolchildren in the province of Alicante (Spain)

Introducción: La obesidad infantil ha alcanzado unas cifras alarmantes en Europa y Estados Unidos y se ha producido un aumento de las consecuencias de dicha epidemia como diabetes mellitus tipo 2, hiperlipemia y enfermedad cardiovascular. Objetivos: Analizar el perfil lipídico y estudio hormonal en población escolar de la provincia de Alicante. Relacionar el índice de masa corporal (IMC) con las variables estudiadas. Material y métodos: Estudio observacional sobre una muestra representativa de la población de la provincia de Alicante de 6 a 11 años de edad (n = 394; 204 niños y 190 niñas). Se determinaron las siguientes variables antropométricas (peso, talla) y analíticas (perfil lipídico, leptina, tirotropina, tiroxina (T4) libre, factor de crecimiento insulínico tipo I (IGFI), cortisol, androstendiona, dehidroepiandrosterona sulfato (DHEA-S), testosterona y estradiol). La obesidad se definió como valores de IMC ≥ 2 desviaciones estándar, tomando como referencia las curvas del estudio longitudinal de Zaragoza. Resultados: Al estudiar el riesgo lipídico hemos observado que el 13,5% de los sujetos presentaron colesterol total > 200 mg/dl; el 9,4%, concentraciones plasmáticas de triglicéridos > 100 mg/dl, y el 30,5%, cociente cLDL/cHDL > 2,2. También hemos encontrado una correlación positiva estadísticamente significativa entre IMC y concentraciones plasmáticas de triglicéridos (r = 0,23), IGF-I (r = 0,211), leptina (r = 0,583), androstendiona, DHEA-S, testosterona y estradiol (r = 0,35, r = 0,27, r = 0,23 y r = 0,15, respectivamente). Hay correlación negativa entre el IMC y los valores plasmáticos de cHDL (r = ¿0,21) y cortisol total (r = ¿0,09). No hay correlación estadísticamente significativa entre grado de obesidad y concentraciones plasmáticas de colesterol (p = 0,434) y cLDL (p = 0,452). Conclusiones: Hemos observado una prevalencia elevada de alteraciones lipídicas en niños menores de 11 años en relación con el aumento de la adiposidad en esta población (AU)

Introduction: Childhood obesity has increased alarmingly in Europe and the USA, with a rise in the consequences of this epidemic, such as type 2 diabetes, hyperlipidemia and cardiovascular disease. Objective: To study the lipid and hormonal profile of schoolchildren in the province of Alicante and to analyze the relationship between body mass index (BMI) and the variables of interest in this study. Materials and methods: We performed a cross-sectional epidemiological study of a cohort of schoolchildren (6-11 years) from the province of Alicante (n = 394, 204 boys and 190 girls). Height and weight were measured. We measured the following analytic variables: total cholesterol, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), triglycerides, leptin, thyrotropin (TSH), free thyroxin (T4), insulin-like growth factor-1 (IGF-1), cortisol, androstenedione, dehydroepiandrosterone sulfate (DHEAS), testosterone and estradiol. Obesity was defined as a BMI ≥ 2 SD, using the population curves in the longitudinal study of Zaragoza (Spain) as the reference. Results: When studying lipid risk, we observed that 13.5% had cholesterol levels of > 200 mg/dl, 9.4% had triglyceride levels of > 100 mg/dl and 30.5% had LDL-c/HDL-c values of > 2.2. We found a correlation between BMI and plasmatic concentrations of triglycerides (r = 0.23), IGF-1 (r = 0.211), leptin (r = 0.583), androstenedione, DHEAS, testosterone and estradiol (r = 0.35, r = 0.27, r = 0.23 and r = 0.15, respectively). There was a negative correlation between BMI and HDL-c (r = ¿0.21) and cortisol (r = ¿ 0.09). There was no statistically significant correlation between the degree of obesity and concentrations of cholesterol (p = 0.434) and LDL-c (p = 0.452). Conclusions: We observed a high prevalence of lipid disturbances in children under 11 years old in our population in relation to obesity (AU)

Aumento de la prevalencia de sobrepeso y obesidad en la población infantil de la provincia de Alicante en los últimos 10 años / Increase in the prevalence of overweight and obesity in the pediatric population of the province of Alicante (Spain) in the last 10 years

Introducción: La obesidad en la infancia y la adolescencia ha alcanzado unas cifras alarmantes en Europa y Estados Unidos. La incidencia de obesidad ha aumentado y, por lo tanto, las complicaciones producidas como diabetes mellitus tipo 2, hiperlipidemia y enfermedad cardiovascular. Material y método: Estudio observacional sobre una muestra representativa de la población infantil de la provincia de Alicante de 6 a11 años (n = 394; 204 niños y 190 niñas). Se determinaron peso, talla perímetros corporales y pliegues cutáneos. La obesidad se definió como los valores del índice de masa corporal (IMC), pliegues cutáneos o perímetros corporales 2 desviaciones estándar o p97, tomando como referencia las curvas del estudio longitudinal de Zaragoza y del estudio nacional en Kid. Se compararon nuestros resultados con un estudio realizado en 1993 en la provincia de Alicante. También se realizó una encuesta dietética y de ejercicio físico. Resultados: La prevalencia de obesidad en la población infantil de la provincia de Alicante, según el IMC, varía entre el 13,5 y el 18,8%,dependiendo de las curvas de crecimiento utilizadas como referencia. La prevalencia de sobrepeso y obesidad ha aumentado en los últimos10 años desde el 9,71 hasta el 22,3% y desde el 8,93 al 18,8% en niños y niñas respectivamente, en función de las curvas de crecimiento y peso, en la población escolar de la provincia de Alicante. Según la encuesta nutricional, nuestra población consume poca fruta y verdura. Por el contrario, existe una relación entre obesidad y ejercicio físico. Se considera que éste es un aspecto de gran importancia en la patogenia de la obesidad infantil. Conclusiones: La prevalencia de sobrepeso y obesidad infantiles ha aumentado en la provincia de Alicante desde 1993 (AU)

Introduction: Obesity in childhood and adolescence has reached alarming proportions in Europe and the United States. As the incidence of childhood obesity has increased during last few years, the consequences of obesity in children, including type 2 diabetes, hyperlipidemia and cardiovascular disease, have also increased. Material and method: We performed across-sectional epidemiological study of a cohort of schoolchildren in the province of Alicante, aged 6-11 years old (n = 394; 204boys and 190 girls). Height, weight, body perimeters and skin folds were measured. Obesity was defined according to body mass index (BMI), body perimeters and skin folds 2 standard deviations or 97thpercentile, using the longitudinal study of Zaragoza and Spanish growth data provided by the en Kid study as the reference populations. We compared our results with the study performed in 1993 in the same province. A survey on nutritional and exercise habits was also carried out. Results: The prevalence of obesity in schoolchildren in the province of Alicante, according to their BMI, ranged from 13.5%to 18.8%, depending on the growth curves used as a reference. The prevalence of overweight and obesity, based on growth and weight growth curves, increased from9.71% to 22.3% and from 8.93% to 18.8% in boys and girls, respectively, in the last 10years in the schoolchildren in the province of Alicante. According to our nutritional survey, intake of fruit and vegetables was low in this population. Moreover, a clear association was found between obesity and lack of physical exercise, this factor being highly important in the pathogenesis of childhood obesity. Conclusions: The prevalence of overweight and obesity has increased in Alicante since 1993 (AU)

Increase in the prevalence of overweight and obesity in the pediatric population of the province of Alicante (Spain) in the last 10 years.

INTRODUCTION: Obesity in childhood and adolescence has reached alarming proportions in Europe and the United States. As the incidence of childhood obesity has increased during last few years, the consequences of obesity in children, including type 2 diabetes, hyperlipidemia and cardiovascular disease, have also increased. MATERIAL AND METHOD: We performed a cross-sectional epidemiological study of a cohort of schoolchildren in the province of Alicante, aged 6-11 years old (n=394; 204 boys and 190 girls). Height, weight, body perimeters and skinfolds were measured. Obesity was defined according to body mass index (BMI), body perimeters and skinfolds≥2 standard deviations or≥97th percentile, using the longitudinal study of Zaragoza and Spanish growth data provided by the enKid study as the reference populations. We compared our results with the study performed in 1993 in the same province. A survey on nutritional and exercise habits was also carried out. RESULTS: The prevalence of obesity in schoolchildren in the province of Alicante, according to their BMI, ranged from 13.5% to 18.8%, depending on the growth curves used as a reference. The prevalence of overweight and obesity, based on growth and weight growth curves, increased from 9.71% to 22.3% and from 8.93% to 18.8% in boys and girls, respectively, in the last 10 years in the schoolchildren in the province of Alicante. According to our nutritional survey, intake of fruit and vegetables was low in this population. Moreover, a clear association was found between obesity and lack of physical exercise, this factor being highly important in the pathogenesis of childhood obesity. CONCLUSIONS: The prevalence of overweight and obesity has increased in Alicante since 1993.

Auditoría clínica sobre la utilización de la radiografía en el abordaje del traumatismo craneal pediátrico / Clinical audit of skull radiography in pediatric head injury

Objetivos: La aplicación de un protocolo diagnóstico, consensuado de manera interdisciplinaria y adaptado localmente, puede disminuir la frecuencia de uso de la radiografía en el manejo del traumatismo craneal infantil y mejorar la calidad asistencial y el consumo de recursos. Pacientes y método: Auditoría clínica con dos fases, de 12 meses cada una, antes y después de la aplicación de un protocolo diagnóstico basado en las recomendaciones disponibles en la bibliografía y adaptado al medio asistencial. Resultados: Tras la aplicación del protocolo, la frecuencia de uso de la radiografía pasó del 45,8 al 38,9% y la proporción de inadecuación de la prueba se redujo del 25,1 al 14,7%. No hubo diferencias estadísticamente significativas en la utilización de la tomografía computarizada y se observó una reducción del número de ingresos. Conclusiones: La aplicación del protocolo no sólo redujo el número total de radiografías solicitadas, sino que su utilización se adecuó mejor a la situación clínica del paciente. Se deben realizar de forma sistemática auditorías clínicas de la actividad desarrollada en las unidades de urgencias y favorecer la puesta en marcha de cambios que permitan una mejora continua de la calidad asistencial

Objectives: Implementation of a diagnostic protocol, developed after consensus and adapted to the local setting, could reduce the frequency of radiography in the management of pediatric head injury and could improve healthcare quality and resource utilization. Patients and method: A clinical audit, with two 12-month phases, before and after the implementation of a diagnostic protocol, was performed. The audit was based on a literature review and was adapted to local conditions. Results: After the implementation of the protocol, the use of skull radiography decreased from 45.8% to 38.9% and inappropriate use fell from 25.1% to 14.7%. No statistically significant differences were found in the use of computerized tomography, but hospital admissions were reduced. Conclusions: Implementation of the protocol reduced the number of radiographies and increased appropriate use of this resource. Clinical audits of pediatric emergency units should be carried out systematically to produce changes that improve the appropriateness of healthcare