The usefulness of the leuprolide stimulation test as a diagnostic method of idiopathic central precocious puberty in girls.

Central precocious puberty (CPP) diagnosis is based on clinical evaluation, but hormonal evaluation is crucial. The aim of the study was to evaluate the usefulness of the leuprolide stimulation test for diagnosis of idiopathic CPP. Sixty-one girls, aged 5-8 years, were evaluated retrospectively for premature breast development. According to clinical evolution, 28 had progressive puberty and 33 nonprogressive puberty. All underwent a leuprolide stimulation test. Cutoff points, sensitivity, and specificity for gonadotropins and estradiol were determined by receiver operating characteristic (ROC) curves. Cutoff points for CPP were: baseline LH: > 0.1 mUI/l, FSH: > 2.3 mUI/l, LH/FSH ratio: > 0.23, estradiol: > 12 pg/ml; and stimulated LH: > 5.5 mUI/l, LH/FSH ratio: > 0.24, estradiol: > 79.67 pg/ml. The best diagnostic efficiency for progressive puberty were stimulated LH/FSH ratio (sensitivity: 100%, specificity 94%) followed by stimulated LH (sensitivity: 93%, specificity: 100%). Stimulated LH/FSH ratio and LH resulted in the most useful parameters for the diagnosis of CPP. Stimulated estradiol did not add more information.

[Relationship among the eruption of the first temporal teeths, the breast feeding duration and the anthropometric development in the first two years of life]. / Duración de la lactancia materna, erupción de los primeros dientes temporales y desarrollo antropométrico alcanzado a los dos años de vida.

BACKGROUND: The anthropometric development in the first two years of life can be influenced by diverse factors, being analyzed in this study the implication of the primary tooth eruption and the breast feeding duration in this development. METHODS: Longitudinal study. 141 healthy children participated (67 boys and 74 girls), being analyzed the association among the duration of breast feeding, the number of teeth present at the 6, 7, 9 and 12 months, the anthropometrics parameters weight, height and body mass index (BMI) to the birth, 1-7, 9, 12, 15, 18 and 24 months and the growth rate. RESULTS: The weight and height at the birth or the duration of breast feeding didn't associate significantly with the weight and height at the 2 years or the number of teeth at 6,7,9 or 12 months, but the women with more weight (r = 0,366) and height (r = 0,377) at month of life have a bigger number of teeth at 9 months (p = 0,001). In both sexes, the number of teeth at the 9 months are associated significantly with the weight (boys r = 0,328, p = 0,01; girls r = 0,307, p = 0,011) and height (r = 0,352 boys and girls p = 0,005) at two years. CONCLUSIONS: In healthy children the duration of maternal nursing doesn't influence in the degree of anthropometric development reached at 2 years, but yes makes it the number of teeth present at 9 months, result that suggests that the eruption dental early could suppose an evolutive advantage.

Duración de la lactancia materna, erupción de los primeros dientes temporales y desarrollo antropométrico alcanzado a los dos años de vida / Relationship among the eruption of the first temporal teeths, the breast feeding duration and the anthropometric development in the first two years of life

Fundamento: El desarrollo antropométrico en los dos primeros años de vida puede verse influido por diversos factores, analizándose en este estudio la implicación de la dentición temporal y la duración de la lactancia materna en dicho desarrollo. Métodos: Estudio longitudinal. Participaron 141 niños (67 varones y 74 mujeres) sanos, analizándose la asociación entre la duración de la lactancia materna, el número de dientes temporales presentes a los 6, 7, 9 y 12 meses, los parámetros antropométricos peso, talla e índice de masa corporal (IMC) al nacimiento, 1-7, 9, 12, 15, 18 y 24 meses y la velocidad de crecimiento. Resultados: El peso y la talla al nacimiento o la duración de la lactancia materna no se asociaron significativamente con el peso y talla a los 2 años o el número de dientes a los 6, 7, 9 ó 12 meses, pero las mujeres con mayor peso (r = 0,366) y talla (r = 0,377) al mes de vida tienen mayor número de dientes a los 9 meses (p = 0,001). En ambos sexos, el número de dientes a los 9 meses se asoció significativamente con el peso (varones r= 0,328, p= 0,01; mujeres r = 0,307, p = 0,011) y la talla (r= 0,352 varones y mujeres, p= 0,005) a los dos años. Conclusiones: En niños sanos la duración de la lactancia materna no influye en el grado de desarrollo antropométrico alcanzado a los 2 años, pero sí lo hace el número de dientes presentes a los 9 meses, resultado que sugiere que la erupción dentaria temprana podría suponer una ventaja evolutiva (AU)

Background: The anthropometric development in the first two years of life can be influenced by diverse factors, being analyzed in this study the implication of the primary tooth eruption and the breast feeding duration in this development. Methods: Longitudinal study. 141 healthy children participated (67 boys and 74 girls), being analyzed the association among the duration of breast feeding, the number of teeth present at the 6, 7, 9 and 12 months, the anthropometrics parameters weight, height and body mass index (BMI) to the birth, 1-7, 9, 12, 15, 18 and 24 months and the growth rate. Results: The weight and height at the birth or the duration of breast feeding didn't associate significantly with the weight and height at the 2 years or the number of teeth at 6, 7, 9 or 12 months, but the women with more weight (r= 0,366) and height (r = 0,377) at month of life have a bigger number of teeth at 9 months (p = 0,001). In both sexes,the number of teeth at the 9 months are associated significantly with the weight (boys r = 0,328, p = 0,01; girls r =0,307, p = 0,011) and height (r = 0,352 boys and girls p =0,005) at two years. Conclusions: In healthy children the duration of maternal nursing doesn't influence in the degree of anthropometric development reached at 2 years, but yes makes it the number of teeth present at 9 months, result that suggests that the eruption dental early could suppose an evolutive advantage (AU)

[The effect on the use of hospital resources in a geriatric domiciliary care program among the elderly patients with advanced cardiorespiratory diseases]. / Efecto sobre el consumo de recursos hospitalarios de un programa de atención geriátrica domiciliaria en personas ancianas con patología cardiorrespiratoria muy evolucionada.

BACKGROUND: One of the objectives of the geriatric home care teams is that of the follow-up of elderly patients having a high risk of hospital readmission. Although they have been operating in our country for years, no data shows the impact on the use of hospital resources in accordance with this follow-up. The objective of this study is that of analyzing the effect which the monitoring, by geriatric home care unit, involves on patients having very advanced chronic cardiorespiratory disease. METHODS: The patients with chronic cardiorespiratory disease followed up by the unit during the January 1995-January 1999 period were included, excluding those on follow-up for less than 3 months. A comparison is drawn among the number of hospital emergency room visits, hospital admissions and days of hospitalization for the year prior to the care provided by the unit and throughout the follow-up time thereof are compared. RESULTS: Eighty-one (81) patients, mean age 80.57 years (DE 7.39) and a median length of care per unit of nine (9) months (5-13.5), were included in the study. The uses per patient and month of follow-up decreased by 0.07 Emergency Room visits (0.02-0.11) (p = 0.04), 0.10 hospital admissions (0.07-0.14) (p < 0.001) and 2.01 days of hospitalization (1.87-2.15) (p < 0.001). CONCLUSIONS: A specialized geriatric home care unit reduces the use of hospital resources on elderly people diagnosed as severe chronic cardiorespiratory disease.

[Adverse effects associated with influenza vaccine in pediatrics]. / Efectos adversos asociados a la vacunación antigripal en pediatría.

BACKGROUND: The difficulties which exist in order to value correctly the morbimortality caused by influenza during the childhood and the limitations of the proper vaccine make that the use of this vaccination is still limited in this phase. The objective of the present study is to value the adverse reactions associated to the influenza immunization in children. METHODS: Prospective study, carried out in the campaigns 92/93, 93/94 97/98 on 105 children of Navalcarnero with split-virion influenza vaccine with vaccinal strains recommended by the OMS. All the doses are administered by a nurse who also carries out the postimmunization-controls after 72 hours. The adverse reactions are valued, like the zone of injection, sex, age, the previous vaccination and the collection of data by telephone or in consultation. RESULTS: Of global form (318 doses), on a local level appears a reaction of 10.7%, in form of erythema (8.5%), induration (7.9%) and pain (only 97/98, 13.9%) and on a systemic level appears a reaction of 11.9%, in form of rhinorrhea (3.1%), general discomfort (2.5%), fever (2.5%), muscular pains (1.6%) and cough (1.6%). In a 89.5% the systemic effects disappear during the first 48 hours. In no case medical consultation was precised. CONCLUSIONS: The vaccine is safe. The adverse reactions that may appear are scarce, slight and well tolerated. There do not exist significant differences in terms of age, sex, the previous vaccination or the collection of the results by telephone or in consultation. The gluteus presents greater local reactogenicity that the deltoidal zone.