BODYFAT: a new calculator to determine the risk of being overweight validated in Spanish children between 11 and 17 years of age.

The assessment of body fat of children in primary care requires consideration of the dynamic changes in height, weight, lean mass, and fat mass during childhood growth. To achieve this, we aim to develop a predictive equation based on anthropometric values, with optimal diagnostic utility. This is a cross-sectional observational study, involving schoolgoers aged 11-17 years in the Vigo metropolitan area. Out of 10,747 individuals, 577 were randomly recruited. VARIABLES: age, sex, ethnicity/country of origin, weight, height, 8 skinfolds, 3 diameters, 7 perimeters, and 85% percentile of body fat mass as the gold standard. Generalized additive regression was selected by cross-validation and compared using receiver operating characteristic curves (ROC curves). Sensitivity, specificity, positive and negative predictive values, true positive and true negative values, false positive and false negative values, accuracy, and positive and negative likelihood ratios were calculated. Two models were identified. The optimal model includes sex, weight, height, leg perimeter, and arm perimeter, with sensitivity of 0.93 (0.83-1.00), specificity of 0.91 (0.83-0.96), accuracy of 0.91 (0.84-0.96), and area under the curve (AUC) of 0.957 (0.928-0.986). The second model includes sex, age, and body mass index, with sensitivity of 0.93 (0.81-1.00), specificity of 0.90 (0.80-0.97), accuracy of 0.90 (0.82-0.96), and an AUC of 0.944 (0.903-0.984). CONCLUSION: Two predictive models, with the 85th percentile of fat mass as the gold standard, built with basic anthropometric measures, show very high diagnostic utility parameters. Their calculation is facilitated by a complementary online calculator. WHAT IS KNOWN: • In routine clinical practice, mainly in primary care, BMI is used to determine overweight and obesity. This index has its weaknesses in the assessment of children. WHAT IS NEW: • We provide a calculator whose validated algorithm, through the determination of fat mass by impedanciometry, makes it possible to determine the risk of overweight and obesity in the community setting, through anthropometric measurements, providing a new practical, accessible and reliable model that improves the classification of overweight and obesity in children with respect to that obtained by determining BMI.

Interrupted Time Series Analysis of Pediatric Infectious Diseases and the Consumption of Antibiotics in an Atlantic European Region during the SARS-CoV-2 Pandemic.

The increasing concern about bacterial resistance has made the rational prescription of antibiotics even more urgent. The non-pharmacological measures established to reduce the impact of the SARS-CoV-2 pandemic have modified the epidemiology of pediatric infections and, consequently, the use of antibiotics. Interrupted time series (ITS) analyses are quasi-experimental studies that allow for the estimation of causal effects with observational data in "natural experiments", such as changes in health policies or pandemics. The effect of the SARS-CoV-2 pandemic on the incidence of infectious diseases and the use of antibiotics between 2018 and 2020 in the Health Area of Vigo (Galicia, Spain) was quantified and analyzed. This paper outlines a real-world data study with administrative records from primary care services provided for the pediatric population. The records were related to episodes classified as infectious by the International Classification of Primary Care (ICPC-2) and oral medication in the therapeutic subgroup J01, corresponding to antibiotics for systemic use, according to the World Health Organization's Anatomical Therapeutic Chemical (ATC) classification system. The records were classified according to incident episodes, age, dose per inhabitant, and year. Segmented regression models were applied using an algorithm that automatically identifies the number and position of the change points. During the SARS-CoV-2 pandemic, the number of infectious diseases being transmitted between individuals, through the air and through the fecal-oral route, significantly decreased, and a slight decrease in infections transmitted via other mechanisms (urinary tract infections) was also found. In parallel, during the months of the pandemic, there has been a marked and significant reduction in antibacterial agent utilization, mainly of penicillins, cephalosporins, and macrolides.

[Early detection of the problematic Internet use in adolescents, in pediatrics of primary care.] / Detección precoz del uso problemático de Internet en adolescentes, en pediatría de atención primaria.

OBJECTIVE: Use of the Internet has grown exponentially and adolescents are considered one of the most vulnerable groups in this new environment. Hence the problematic use of the Internet (PIU) at this stage has become a concern for a growing number of researchers. Taking into account the interest that this issue has generated at many levels, the aim of this paper is to find the prevalence of PIU among adolescents in the health area of Vigo (Spain). METHODS: Cross-sectional descriptive study. The PIU validated scale was applied to children between 10 and 16 years old, captured by systematic sampling with replacement in the primary care consultations of four health centers. A descriptive and bivariate analysis was performed. RESULTS: The questionnaire was applaid to 165 children, 51.2% men. Problematic Internet use was observed in 38.8% (95% CI: 31.7-46.4), higher in women (46.3%) than in men (31.8%), with no significant differences (p 0.07). By age groups, the positive rate on the scale reached 36.8% in the 13-14 year range and 48.6% in the 15-16 range. The item that reached the highest score was "When I am online, I feel that time flies and hours pass without me realizing it" (60.6%). CONCLUSIONS: The prevalence of UPI in children / adolescents is similar to that observed in Asian adolescents. This study is the first to apply a scale validated and adapted to the Spanish cultural context in the daily practice of Primary Care consultations. Its use would allow to identify the PIU in this context and intervene if necessary.

OBJETIVO: El uso de Internet ha crecido exponencialmente y los adolescentes son considerados uno de los grupos más vulnerables en este nuevo contexto. De ahí que el uso problemático de Internet (UPI) en esta etapa se haya convertido en una preocupación para un número creciente de investigadores. Teniendo en cuenta el interés que este tema ha generado en muchos niveles, el objetivo de este trabajo fue conocer la prevalencia del uso problemático de Internet entre los niños/adolescentes del área sanitaria de Vigo (España). METODOS: Se realizó un estudio descriptivo transversal. Se aplicó la escala validada EUPI-a a niños entre 10 y 16 años, captados por muestreo sistemático con reposición en las consultas de atención primaria de cuatro centros de salud. Se elaboró posteriormente un análisis descriptivo y bivariante. RESULTADOS: Se entregó el cuestionario a 165 niños, de los que el 51,2% eran varones. Se objetivó un uso problemático de Internet en el 38,8% (IC 95%: 31,7-46,4), mayor en mujeres (46,3%) que en varones (31,8%), aunque no se constataron diferencias estadísticamente significativas (p=0,07). Por grupos de edad, la tasa de positivos en la escala alcanzó un 36,8% en la franja de 13-14 años y un 48,6% en la de 15-16 años. El ítem que alcanzó mayor puntuación fue "Cuando me conecto siento que el tiempo vuela y pasan las horas sin darme cuenta" (60,6%). CONCLUSIONES: La prevalencia de UPI en niños/adolescentes es similar a la observada en adolescentes asiáticos. Este estudio es el primero en aplicar una escala validada y adaptada al contexto cultural español en la práctica diaria de una consulta de atención primaria. Su utilización en este entorno permitiría identificar el UPI e intervenir si fuera preciso.

Detección precoz del uso problemático de internet en adolescentes, en pediatría de atención primaria / Early detection of the problematic internet use in adolescents, in pediatrics of primary care

OBJETIVO: El uso de Internet ha crecido exponencialmente y los adolescentes son considerados uno de los grupos más vulnerables en este nuevo contexto. De ahí que el uso problemático de Internet (UPI) en esta etapa se haya convertido en una preocupación para un número creciente de investigadores. Teniendo en cuenta el interés que este tema ha generado en muchos niveles, el objetivo de este trabajo fue conocer la prevalencia del uso problemático de Internet entre los niños/adolescentes del área sanitaria de Vigo (España). MÉTODOS: Se realizó un estudio descriptivo transversal. Se aplicó la escala validada EUPI-a a niños entre 10 y 16 años, captados por muestreo sistemático con reposición en las consultas de atención primaria de cuatro centros de salud. Se elaboró posteriormente un análisis descriptivo y bivariante. RESULTADOS: Se entregó el cuestionario a 165 niños, de los que el 51,2% eran varones. Se objetivó un uso problemático de Internet en el 38,8% (IC 95%: 31,7-46,4), mayor en mujeres (46,3%) que en varones (31,8%), aunque no se constataron diferencias estadísticamente significativas (p = 0,07). Por grupos de edad, la tasa de positivos en la escala alcanzó un 36,8% en la franja de 13-14 años y un 48,6% en la de 15-16 años. El ítem que alcanzó mayor puntuación fue "Cuando me conecto siento que el tiempo vuela y pasan las horas sin darme cuenta" (60,6%). CONCLUSIONES: La prevalencia de UPI en niños/adolescentes es similar a la observada en adolescentes asiáticos. Este estudio es el primero en aplicar una escala validada y adaptada al contexto cultural español en la práctica diaria de una consulta de atención primaria. Su utilización en este entorno permitiría identificar el UPI e intervenir si fuera preciso

OBJECTIVE: Use of the Internet has grown exponentially and adolescents are considered one of the most vulnerable groups in this new environment. Hence the problematic use of the Internet (PIU) at this stage has become a concern for a growing number of researchers. Taking into account the interest that this issue has generated at many levels, the aim of this paper is to find the prevalence of PIU among adolescents in the health area of Vigo (Spain). METHODS: Cross-sectional descriptive study. The PIU validated scale was applied to children between 10 and 16 years old, captured by systematic sampling with replacement in the primary care consultations of four health centers. A descriptive and bivariate analysis was performed. RESULTS: The questionnaire was applaid to 165 children, 51.2% men. Problematic Internet use was observed in 38.8% (95% CI: 31.7-46.4), higher in women (46.3%) than in men (31.8%), with no significant differences (p 0.07). By age groups, the positive rate on the scale reached 36.8% in the 13-14 year range and 48.6% in the 15-16 range. The item that reached the highest score was "When I am online, I feel that time flies and hours pass without me realizing it" (60.6%). CONCLUSIONS: The prevalence of UPI in children / adolescents is similar to that observed in Asian adolescents. This study is the first to apply a scale validated and adapted to the Spanish cultural context in the daily practice of Primary Care consultations. Its use would allow to identify the PIU in this context and intervene if necessary

Prevalencia de trastornos del neurodesarrollo, comportamiento y aprendizaje en Atención Primaria / Prevalence of neurodevelopmental, behavioural and learning disorders in Pediatric Primary Care

OBJETIVOS: Conocer la prevalencia de patología psiquiátrica en atención primaria en la Galicia atlántica. MÉTODOS: Se realizó un estudio observacional, descriptivo, transversal de prevalencia, en 9 consultas de A Coruña y Pontevedra, con una población de 8.293 niños, entre septiembre y noviembre del 2015. Se incluyó a 1.286 pacientes entre 0 y 14 años que acudieron a las consultas en unos días aleatoriamente seleccionados. Se registraron los siguientes datos de la historia clínica: edad, sexo, diagnóstico psiquiátrico establecido por criterios DSM-IV-TR en sus 5 ejes. Se determinó qué profesionales intervinieron en el diagnóstico y tratamiento del proceso y qué tipo de tratamiento recibían. Se obtuvo la autorización del Comité de Ética de Investigación de Galicia número 2015/427. RESULTADOS: Ciento cuarenta y ocho de los 1.286 pacientes presentaban patología psiquiátrica (11,5%, IC del 95%, 9,73-13,29), 68% varones. Entre los 0 y 5 años la prevalencia fue del 4,5%; entre los 6 y 10 del 18,5% y entre los 11 y 14, del 22%. El tiempo de duración de los síntomas tenía una mediana de 25 meses. Las patologías más frecuentes en los 1.286 pacientes fueron TDAH (5,36%), trastornos del lenguaje (3,42%), trastornos del aprendizaje (3,26%) trastornos ansioso-depresivos (2,4%) y trastornos de la conducta (1,87%). De los 148 casos, el 47% presentaba comorbilidad con otro trastorno mental; la mayoría precisó atención por múltiples profesionales del ámbito social, sanitario y educativo; un 33% recibía tratamiento psicofarmacológico. CONCLUSIONES: La prevalencia de patología psiquiátrica en pediatría de atención primaria es frecuente, crónica y compleja, aumenta con la edad y precisa muchos recursos sanitarios, educativos y sociales

OBJECTIVES: To determine the prevalence of psychiatric disorders in primary care pediatrics in Atlantic Galicia. METHODS: An observational, descriptive, cross-sectional prevalence study was carried out in 9 outpatient clinics in A Coruña and Pontevedra with a population of 8293 children between September and November 2015. A total of 1286 randomly selected patients from 0 to 14 years of age were included. From the medical history was registered: age, sex, psychiatric diagnosis established by DSM-IV-TR criteria in its five axes, professionals who participated in the diagnosis and treatment of the process and what type of treatment was received. Authorization was obtained from the Research Ethics Committee of Galicia number 2015/427. RESULTS: 148 of 1286 patients presented psychiatric pathology (11,5% IC 95% 9.73-13,29), 68% male. Between 0 and 5 years, the prevalence was 4.5%; between 6 y and 10 y, 18.5% and between 11y and 14 y 22%. Symptoms lasted a median of 25 months. The most frequent pathologies in 1286 patients were ADHD (5.36%), language disorders (3.42%), learning disorders (3.26%), anxiety-depressive disorders (2.4%) and behavior disorders (1.87%). Of the 148 cases, 47% had comorbidity with another mental disorder. Most of them required attention by multiple social, health and educational professionals; 33% received psychopharmacological treatment. CONCLUSIONS: The prevalence of psychiatric disorders in pediatric primary care is frequent, chronic and complex, increases with age and requires many health, educational and social resources

[Prevalence of neurodevelopmental, behavioural and learning disorders in Pediatric Primary Care]. / Prevalencia de trastornos del neurodesarrollo, comportamiento y aprendizaje en Atención Primaria.

OBJECTIVES: To determine the prevalence of psychiatric disorders in primary care pediatrics in Atlantic Galicia. METHODS: An observational, descriptive, cross-sectional prevalence study was carried out in 9 outpatient clinics in A Coruña and Pontevedra with a population of 8293 children between September and November 2015. A total of 1286 randomly selected patients from 0 to 14 years of age were included. From the medical history was registered: age, sex, psychiatric diagnosis established by DSM-IV-TR criteria in its five axes, professionals who participated in the diagnosis and treatment of the process and what type of treatment was received. Authorization was obtained from the Research Ethics Committee of Galicia number 2015/427. RESULTS: 148 of 1286 patients presented psychiatric pathology (11,5% IC 95% 9.73-13,29), 68% male. Between 0 and 5years, the prevalence was 4.5%; between 6y and 10y, 18.5% and between 11y and 14y 22%. Symptoms lasted a median of 25 months. The most frequent pathologies in 1286 patients were ADHD (5.36%), language disorders (3.42%), learning disorders (3.26%), anxiety-depressive disorders (2.4%) and behavior disorders (1.87%). Of the 148 cases, 47% had comorbidity with another mental disorder. Most of them required attention by multiple social, health and educational professionals; 33% received psychopharmacological treatment. CONCLUSIONS: The prevalence of psychiatric disorders in pediatric primary care is frequent, chronic and complex, increases with age and requires many health, educational and social resources.

Asociación de valores elevados de péptido natriurético auricular y copeptina con riesgo de mortalidad / High levels of atrial natriuretic peptide and copeptin and mortality risk

OBJETIVO: Determinar si los niveles plasmáticos de región media del péptido natriurético proauricular (RM-proPNA), copeptina y procalcitonina (PCT) se asocian con aumento del riesgo de mortalidad. MÉTODOS: Estudio prospectivo observacional que incluyó a 254 niños críticamente enfermos. Se compararon los niveles de RM-proPNA, copeptina y PCT entre niños con alto (grupo A; n=33) y bajo (grupo B; n=221) riesgo de mortalidad y entre pacientes con un número de órganos en fallo mayor de 1 (grupo 1; n=71) y menor de 2 (grupo 2; n=183). RESULTADOS: Las medianas (rangos) de RM-proPNA, copeptina y PCT en grupo A vs. grupo B fueron, respectivamente: 209,4 (30,5-1.415,8) vs. 75,0 (14,6-867,2) pmol/l (p < 0,001); 104,4 (7,4-460,9) vs. 26,6 (0,00-613,1) pmol/l (p < 0,001) y 7,8 (0,3-552,0) vs. 0,3 (0,02-107,0) ng/ml (p < 0,001). El área bajo la curva (AUC) para diferenciar grupo A y B fue (intervalo de confianza del 95%): 0,764 (0,674-0,854) para RM-proPNA; 0,735 (0,642-0,827) para copeptina y 0,842 (0,744-0,941) para PCT, sin diferencias significativas. Las AUC para diferenciar los grupos 1 y 2 fueron: 0,837 (0,784-0,891) para RM-proPNA, 0,735 (0,666-0,804) para copeptina y 0,804 (0,715-0,892) para PCT, con diferencias significativas entre RM-proPNA y copeptina, p = 0,01. CONCLUSIONES: Los niveles elevados de RM-proPNA, copeptina y PCT se asocian con aumento de las puntuaciones de riesgo de mortalidad. RM-proPNA mostró mayor asociación que la copeptina con el número de órganos en fallo

OBJECTIVE: To determine whether high levels of mid-regional pro-atrial natriuretic peptide (MR-proANP), copeptin, and procalcitonin (PCT) plasma concentrations are associated with increased mortality risk. METHODS: Prospective observational study including 254 critically ill children. MR-proANP, copeptin and PCT were compared between children with high (Group A; n=33) and low (Group B; n=221) mortality risk, and between patients with failure of more than 1 organ (Group 1; n=71) and less than 2 (Group 2; n=183). RESULTS: Median (range) of MR-proANP, copeptin, and PCT levels in group A vs B were, respectively: 209.4 (30.5-1415.8) vs. 75.0 (14.6-867.2) pmol/L (P<.001); 104.4 (7.4-460.9) vs. 26.6 (0.00-613.1) pmol/L (P<.001), and 7.8 (0.3-552.0) vs. 0.3 (0.02-107.0) ng/mL (P<.001). The area under the curve (AUC) for the differentiation of group A and B was 0.764 (95% CI: 0.674-0.854) for MR-proANP; 0.735 (0.642-0.827) for copeptin, and 0.842 (0.744-0.941) for PCT, with no statistical differences. The AUCs for the differentiation of group 1 and 2 were: 0.837 (0.784-0.891) for MR-proANP, 0.735 (0.666-0.804) for copeptin, and 0.804 (0.715-0.892) for PCT, with statistical differences between MR-proANP and copeptin, P=.01. CONCLUSIONS: High levels of MR-proANP, copeptin and PCT were associated with increased mortality risk scores. MR-proANP showed a higher association than copeptin with number of organs in failure

[High levels of atrial natriuretic peptide and copeptin and mortality risk]. / Asociación de valores elevados de péptido natriurético auricular y copeptina con riesgo de mortalidad.

OBJECTIVE: To determine whether high levels of mid-regional pro-atrial natriuretic peptide (MR-proANP), copeptin, and procalcitonin (PCT) plasma concentrations are associated with increased mortality risk. METHODS: Prospective observational study including 254 critically ill children. MR-proANP, copeptin and PCT were compared between children with high (Group A; n=33) and low (Group B; n=221) mortality risk, and between patients with failure of more than 1 organ (Group 1; n=71) and less than 2 (Group 2; n=183). RESULTS: Median (range) of MR-proANP, copeptin, and PCT levels in group A vs B were, respectively: 209.4 (30.5-1415.8) vs. 75.0 (14.6-867.2) pmol/L (P<.001); 104.4 (7.4-460.9) vs. 26.6 (0.00-613.1) pmol/L (P<.001), and 7.8 (0.3-552.0) vs. 0.3 (0.02-107.0) ng/mL (P<.001). The area under the curve (AUC) for the differentiation of group A and B was 0.764 (95% CI: 0.674-0.854) for MR-proANP; 0.735 (0.642-0.827) for copeptin, and 0.842 (0.744-0.941) for PCT, with no statistical differences. The AUCs for the differentiation of group 1 and 2 were: 0.837 (0.784-0.891) for MR-proANP, 0.735 (0.666-0.804) for copeptin, and 0.804 (0.715-0.892) for PCT, with statistical differences between MR-proANP and copeptin, P=.01. CONCLUSIONS: High levels of MR-proANP, copeptin and PCT were associated with increased mortality risk scores. MR-proANP showed a higher association than copeptin with number of organs in failure.