Birth weight, slowness in eating and feeding practices as independent determinants of rapid weight gain.

AIM: Our aim was to identify independent determinants of rapid weight gain in infants at 3-4, 6, and 12 months of age. METHODS: A cohort study was conducted on Mexican term infants in public and private settings between March 2021 and May 2023. Rapid weight gain was defined as a ≥0.67 SD change in weight-for-age-Z-score from birth to 3-4, 6, and 12 months of age. Maternal and infant characteristics were described, and infant feeding practices, appetitive traits, weight, and length were analysed at 3-4, 6, and 12 months of age. Rapid weight gain predictors were determined using generalised linear regression models. RESULTS: In total, 168 infants were recruited (55% boys). Small-for-gestational-age status increased rapid weight gain risk 1.5 times, whereas large-for-gestational-age status represented a 20%-30% decrease. Slowness in eating decreased the risk by 10%. Protective factors were older maternal age and higher educational level, whereas formula feeding, early complementary feeding, greater food enjoyment, and satiety responsiveness increased the risk. CONCLUSIONS: Small for gestational age, slowness in eating, and feeding practices can be rapid weight gain predictors across the first year of life.

Cerebellar Cognitive Affective Syndrome in Mexican Pediatric Patients with Ataxia-Telangiectasia.

Ataxia-telangiectasia (A-T) is a disease caused by mutations in the ATM gene (11q22.3-23.1) that induce neurodegeneration Sasihuseyinoglu AS et al.  Pediatr Allergy Immunol Pulmonol 31(1):9-14, 2018, Teive HAG et al. Parkinsonism Relat Disord 46:3-8, 2018. Clinically, A-T is characterized by ataxia, mucocutaneous telangiectasia, immunodeficiency, and malignancy. Movement disorders have been the most described and well-studied symptoms of A-T. Other studies have reported visuospatial processing disorders, executive function disorders and emotional regulation disorders, which are clinical manifestations that characterize cerebellar cognitive affective syndrome (CCAS) Choy KR et al. Dev Dyn 247(1):33-46, 2018. To describe the neurocognitive and emotional state of pediatric patients with ataxia-telangiectasia and to discuss whether they have cerebellar cognitive affective syndrome. This observational, cross-sectional, and descriptive study included 9 patients with A-T from May 2019 to May 2021. A complete medical history was retrieved, and tests were applied to assess executive functions, visual-motor integration and abilities, language, psychological disorders, and ataxia. Six girls and 3 boys agreed to participate. The age range was 6 to 14 years. The participants included five schoolchildren and four teenagers. Eight patients presented impaired executive functioning. All patients showed some type of error in copying and tracing (distortion) in the performance of visual perceptual abilities. Emotional disorders such as anxiety and depression were observed in six patients. Eight patients presented with dyslalia and impairments in word articulation, all patients presented with ataxia, and seven patients used a wheelchair. All patients presented symptoms consistent with CCAS and had variable cognitive performance.

Anthropometric Indicators and Dietary Intake in Toddlers Aged from 12 to 24 Months Who Attended Private Clinics in the Metropolitan Area of Guadalajara.

The objective was to evaluate the anthropometric indicators and dietary intake of toddlers attending private clinics in Guadalajara. In a cross-sectional study, 101 toddlers aged 12 to 24 months were included. They were born full term, had an adequate weight for gestational age, and attended private clinics in Guadalajara. Two 24 h dietary recalls were administered. Anthropometric measurements were taken, and anthropometric indices were estimated. Student's t test or the Mann-Whitney U test, chi-square test, and odds ratio were used for quantitative or qualitative variables. Males had lower Z scores for the weight/age index than females. During the week, energy intake was excessive in males [OR = 5.5 (95% CI 1.4, 20.8)], and cholesterol intake was insufficient in females [OR = 3.03 (95% CI 1.2, 7.1)]. On weekends, energy [OR = 2.5 (95% CI 1.1, 5.7)] and fiber intake [OR = 3.1 (95% CI 1.2, 7.8)] were insufficient in females. Most of the toddlers who attend the private clinics in the upper-middle socioeconomic stratum of the Guadalajara Metropolitan Area had excessive protein intake, excessive consumption of added sugars was frequent, and there was insufficient intake of vitamin D and calcium. Sex was shown to be a factor influencing nutrient intake in these toddlers aged 12-24 months. Males had a Z-score of weight/age lower than females, suggesting nutritional risk.

Índice neutrófilo/linfocito en anestesia general con ventilación controlada por volumen versus ventilación controlada por presión: ensayo clínico aleatorizado / Neutrophil/lymphocyte ratio in general anesthesia with volume-controlled ventilation versus pressure-controlled ventilation: a randomized clinical trial

Resumen: Introducción: se ha demostrado que la ventilación mecánica induce la producción de citocinas proinflamatorias. El IN/L es un parámetro sencillo que se utiliza para evaluar el estado inflamatorio. Objetivo: comparar los promedios y porcentajes del índice neutrófilo/linfocito (IN/L) elevado, entre pacientes con anestesia general con ventilación mecánica controlada por volumen (VMCV) y ventilación mecánica controlada por presión (VMCP). Material y métodos: se seleccionaron adultos ≥ 18 años, ASA I-III con cirugía electiva y anestesia general. Ensayo clínico aleatorizado: 25 pacientes con VMCV y 25 con VMCP. A todos los pacientes se les determinó dos biometrías hemáticas: antes y 2 horas después de la cirugía. El IN/L fue medido en forma de razón y dicotómica (< 3 o ≥ 3). Análisis estadístico: se utilizaron las pruebas t de Student, χ2 y McNemar. Resultados: se estudiaron 50 pacientes (27 mujeres y 23 hombres) con un promedio de edad de 47 ± 16 años. El grupo de VMCV tuvo tendencia a presentar valores más bajos de promedios y porcentajes IN/L; sin embargo, no fue estadísticamente significativa (p = 0.06). En la comparación pareada ambos grupos presentaron incremento estadísticamente significativo de los promedios y porcentajes de IN/L. No obstante, el porcentaje de IN/L > 3 en el grupo de VMCP fue de 64%, mientras que en el grupo de VMCV fue de 40%. Conclusiones: la VMCV presenta promedios y porcentajes más bajos del IN/L comparados con VMCP; sin embargo, no fueron estadísticamente significativos.

Abstract: Introduction: it has been shown that mechanical ventilation induces production of proinflammatory cytokines. The Neutrophil-to-lymphocyte ratio (N/L r) is a simple parameter that is used to assess the inflammatory state. Objective: to compare the means and percentages of elevated neutrophil/lymphocyte ratio (N/L r) in patients under general anesthesia with volume-controlled mechanical ventilation (VCMV) and pressure-controlled mechanical ventilation (PCMV). Material and methods: adults ≥ 18 years old, ASA I-III, with elective surgery and general anesthesia. Randomized clinical trial: 25 patients with VCMV and 25 with PCMV. All patients had two blood counts determined: before and 2 hours after surgery. N/L r was measured as a ratio and dichotomous (< 3 or ≥ 3). Statistical analysis: the t-Student, χ2 and McNemar tests were used. Results: 50 patients (27 women and 23 men) with a mean age of 47 ± 16 years (range 18-84 years) were studied. The VCMV group tended to present lower values of means and percentages N/L r, however, it was not statistically significant (p = 0.06). In the paired comparison, both groups presented a statistically significant increase in the means and percentages of N/L r. However, the percentage of N/L r > 3 in the PCMV group was 64%, while in the VCMV group it was 40%. Conclusions: the VCMV presents lower means and percentages of N/L r compared to PCMV, however, they were not statistically significant.

Adiposity and feeding practices in the first two years of life among toddlers in Guadalajara, Mexico.

BACKGROUND: Feeding practices in the first two years of life have a direct impact on nutritional status and adiposity. The purpose of this study was to identify the differences in feeding practices during the first two years of life by sex and type of feeding in the first semester of postnatal life and their relationships with adiposity in toddlers. METHODS: An analytical cross-sectional study that included 150 toddlers aged 12 to 24 months who were healthy, full-term, and had adequate weight for their gestational ages, was conducted at the New Civil Hospital and at a private practice in Guadalajara. Body compositions were obtained by bioelectrical impedance (BIA) measurements, and a modified questionnaire was used. Then, the parents completed two 24-h dietary recalls. In addition to the descriptive statistics, ANOVA, Kruskal-Wallis and Mann-Whitney U tests were used in the contrast analysis of the quantitative variables. To analyze the qualitative variables, we used X2 tests. Afterward, linear regression tests were conducted to identify the relationships between adiposity and feeding practices during the first two years. RESULTS: There were direct relationships between adiposity and duration of full breastfeeding (r = 0.610, p = 0.021), age of introduction of ultra-processed products (r = 0.311, p = 0.011), sugar (r = 0.186; p = 0.024) and age at which eggs were introduced (r = -0.202; p = 0.016). CONCLUSIONS: Adiposity was related to feeding practices in the first two years of life in toddlers.

Serum 25-Hydroxyvitamin D correlates with systolic blood pressure in obese male schoolchildren.

Introduction: Introduction: childhood obesity is associated with an increased risk of chronic diseases. We aimed to examine the relation between serum levels of 25-hydroxyvitamin D (25[OH]D) and blood pressure in obese schoolchildren. Material and methods: a cross-sectional study in school-age children with obesity. The serum levels of 25(OH)D were measured and classified as sufficient or insufficient/deficient. Blood pressure was measured. Normal values were considered < 90th percentile, elevated blood pressure ≥ 90th to < 95th percentiles, and hypertension ≥ 95th percentile, according to blood pressure reference tables specific for age, sex, and height. A Pearson correlation was performed. Results: a total of 256 obese schoolchildren (123 [48.0 %] females and 133 [51.9 %] males) were evaluated. The prevalence rates of vitamin D deficiency, insufficiency, and sufficiency were 23.4 %, 52.3 %, and 24.2 %, respectively. Normal blood pressure was observed in 101 (39.4 %) children; the frequencies of elevated blood pressure and hypertension were 10.9 % and 49.6 %, respectively. A moderate inverse correlation of 25(OH)D levels with systolic blood pressure levels (r = -0.54, p = 0.03) was observed. When analyzed by sex, a significantly high inverse correlation between 25(OH)D levels and systolic blood pressure was observed in males (r = -0.85 and p ≤ 0.001). No significant correlation was found in females (systolic r = -0.16 and p = 0.67; diastolic r = -0.15 and p = 0.812). When performing the multiple regression analysis, the 25(OH)D levels and BMI were the significant predictors for systolic blood pressure. Conclusions: we identified an inverse correlation between 25[OH]D levels and systolic blood pressure in male schoolchildren with obesity.

Introducción: Introducción: la obesidad infantil se asocia con un mayor riesgo de desarrollar enfermedades crónicas. El objetivo fue analizar la relación entre los niveles séricos de 25-hidroxivitamina D (25[OH]D) y la presión arterial (PA) en escolares obesos. Material y métodos: estudio transversal en niños en edad escolar con obesidad. Los niveles séricos de 25(OH)D se clasificaron como suficientes e insuficientes/deficientes. Los valores de PA se clasificaron como normales si < percentil 90, presión elevada entre los percentiles ≥ 90 y < 95, e hipertensión si ≥ percentil 95, de acuerdo con las tablas de referencia de la PA, específicas para cada edad, sexo y altura. Se realizaron una correlación de Pearson y una regresión múltiple. Resultados: se evaluaron 256 escolares obesos (123 [48,0 %] mujeres y 133 [51,9 %] hombres). La frecuencia de la deficiencia, insuficiencia y suficiencia de vitamina D fue del 23,4 %, 52,3 % y 24,2 %, respectivamente. Se observó una PA normal en 101 (39,4 %) niños; las frecuencias de la PA elevada y la hipertensión fueron del 10,9 % y 49,6 %, respectivamente. Se observó una correlación inversa moderada de los niveles de 25(OH)D con los niveles de presión arterial sistólica (PAS) (r = -0,54; p = 0,03). Cuando se analizó por sexos, se observó una correlación inversa entre los niveles de 25(OH)D y la PAS en los niños (r = -0,85; p ≤ 0,001). No se encontró ninguna correlación significativa en las niñas (sistólica, r = -0,16; p = 0,67; diastólica, r = -0,15; p = 0,812). Al realizar el análisis de regresión múltiple, los niveles de 25(OH)D y el IMC fueron predictores significativos de la PAS. Conclusiones: identificamos una correlación inversa entre los niveles de 25[OH]D y la PAS en niños escolares con obesidad.

Vitamin D and its correlation with blood lipids and intima-media thickness in term infants / Vitamina D y su correlación con los lípidos en sangre y el grosor de la íntima-media en lactantes

Background: an association between low 25(OH)D levels and blood lipids has been identified in children, adolescents, and adults but not in the early stages of life, and a relation to carotid and aortic intima-media thickness has not been well studied and is controversial. Objective: to identify whether 25(OH)D levels are correlated with blood lipids and aortic and carotid intima-media thickness in infants aged 3 to 9 months. Methods: a cross-sectional study was conducted in 109 healthy term infants between the ages of 3 and 9 months. Serum vitamin D [25(OH)D], total cholesterol, HDL-cholesterol, non-HDL-cholesterol, and aortic and carotid intima-media thickness were measured. Feeding method, vitamin D supplementation, and sun exposure habits were recorded. Results: only 2.8 % (n = 3) and 10.1 % (n = 14) had vitamin D deficiency and insufficiency, respectively. Infants with inadequate levels of vitamin D were younger (< 6 months) (p = 0.004), and a lower percentage of their body surface area was exposed to the sun (p = 0.006). A significant positive correlation was found between 25(OH)D levels and non-HDL-cholesterol in the infants that consumed breastmilk substitutes (rho = 0.600, p < 0.001) or were partially breastfed (rho = 0.371, p = 0.026), whereas a positive correlation was found with total cholesterol in the infants receiving breastmilk substitutes (rho = 0.618, p < 0.001). No significant correlation was found between vitamin D and aortic or carotid intima-media thickness. Conclusions: there was a positive correlation between 25(OH)D levels and both total and non-HDL-cholesterol only in infants receiving breastmilk substitutes. The frequency of vitamin D deficiency and insufficiency was low. (AU)

Introducción: se ha identificado una asociación entre los niveles de 25(OH)D y de lípidos en sangre en los niños, adolescentes y adultos, pero no en las primeras etapas de la vida, mientras que la asociación con el grosor de la íntima-media aórtica (a-IMT) o carotídea (c-IMT) no se ha estudiado totalmente y es objeto de controversia. Objetivo: identificar si existe correlación entre los niveles de 25(OH)D y de lípidos en sangre y el a-IMT y c-IMT en lactantes de 3 a 9 meses. Métodos: se realizó un estudio transversal en 109 lactantes sanos de entre 3 y 9 meses de edad; se midieron la vitamina D sérica [25(OH)D], el colesterol total, el colesterol HDL, el colesterol no HDL, el a-IMT y el c-IMT. Se registraron el tipo de alimentación, la suplementación con vitamina D y la exposición solar. Resultados: aquellos con niveles inadecuados de vitamina D fueron los menores de 6 meses (p = 0,004) y los expuestos en un menor porcentaje de su cuerpo al sol (p = 0,006). Se encontró una correlación positiva significativa entre la 25(OH)D, el colesterol total (rho = 0,618, p < 0,001) y el colesterol no HDL (rho = 0,600, p < 0.001) en aquellos que consumían sustitutos de la leche materna. No se encontró correlación entre la vitamina D y el grosor de la íntima-media aórtica o carotídea. Solo el 2,8 % y el 10,1 % presentaron deficiencia e insuficiencia de vitamina D, respectivamente. Conclusiones: se encontró una correlación positiva entre los niveles de 25(OH)D, colesterol total y colesterol no HDL en los lactantes que recibían sustitutos de la leche materna. (AU)

Vitamin D and its correlation with blood lipids and intima-media thickness in term infants.

INTRODUCTION: Background: an association between low 25(OH)D levels and blood lipids has been identified in children, adolescents, and adults but not in the early stages of life, and a relation to carotid and aortic intima-media thickness has not been well studied and is controversial. Objective: to identify whether 25(OH)D levels are correlated with blood lipids and aortic and carotid intima-media thickness in infants aged 3 to 9 months. Methods: a cross-sectional study was conducted in 109 healthy term infants between the ages of 3 and 9 months. Serum vitamin D [25(OH)D], total cholesterol, HDL-cholesterol, non-HDL-cholesterol, and aortic and carotid intima-media thickness were measured. Feeding method, vitamin D supplementation, and sun exposure habits were recorded. Results: only 2.8 % (n = 3) and 10.1 % (n = 14) had vitamin D deficiency and insufficiency, respectively. Infants with inadequate levels of vitamin D were younger (< 6 months) (p = 0.004), and a lower percentage of their body surface area was exposed to the sun (p = 0.006). A significant positive correlation was found between 25(OH)D levels and non-HDL-cholesterol in the infants that consumed breastmilk substitutes (rho = 0.600, p < 0.001) or were partially breastfed (rho = 0.371, p = 0.026), whereas a positive correlation was found with total cholesterol in the infants receiving breastmilk substitutes (rho = 0.618, p < 0.001). No significant correlation was found between vitamin D and aortic or carotid intima-media thickness. Conclusions: there was a positive correlation between 25(OH)D levels and both total and non-HDL-cholesterol only in infants receiving breastmilk substitutes. The frequency of vitamin D deficiency and insufficiency was low.

INTRODUCCIÓN: Introducción: se ha identificado una asociación entre los niveles de 25(OH)D y de lípidos en sangre en los niños, adolescentes y adultos, pero no en las primeras etapas de la vida, mientras que la asociación con el grosor de la íntima-media aórtica (a-IMT) o carotídea (c-IMT) no se ha estudiado totalmente y es objeto de controversia. Objetivo: identificar si existe correlación entre los niveles de 25(OH)D y de lípidos en sangre y el a-IMT y c-IMT en lactantes de 3 a 9 meses. Métodos: se realizó un estudio transversal en 109 lactantes sanos de entre 3 y 9 meses de edad; se midieron la vitamina D sérica [25(OH)D], el colesterol total, el colesterol HDL, el colesterol no HDL, el a-IMT y el c-IMT. Se registraron el tipo de alimentación, la suplementación con vitamina D y la exposición solar. Resultados: aquellos con niveles inadecuados de vitamina D fueron los menores de 6 meses (p = 0,004) y los expuestos en un menor porcentaje de su cuerpo al sol (p = 0,006). Se encontró una correlación positiva significativa entre la 25(OH)D, el colesterol total (rho = 0,618, p < 0,001) y el colesterol no HDL (rho = 0,600, p < 0.001) en aquellos que consumían sustitutos de la leche materna. No se encontró correlación entre la vitamina D y el grosor de la íntima-media aórtica o carotídea. Solo el 2,8 % y el 10,1 % presentaron deficiencia e insuficiencia de vitamina D, respectivamente. Conclusiones: se encontró una correlación positiva entre los niveles de 25(OH)D, colesterol total y colesterol no HDL en los lactantes que recibían sustitutos de la leche materna.

Full Breastfeeding Modifies Anthropometric and Body Composition Indicators in Nursing Mothers.

Background: It has been observed that breastfeeding mobilizes the deposits of fat that accumulate during pregnancy and promotes weight loss through energy expenditure. The purpose of this study was to demonstrate that full breastfeeding (FBF) reduces anthropometric and body composition indicators in women between the 8th and the 16th week postpartum. Methods: In a nonrandom cohort study, 170 mothers at the Hospital Civil de Guadalajara, Guadalajara, México, were enrolled: FBF 74, partial breastfeeding (PBF) 57, and human milk substitutes (HMS) 39. Anthropometric indicators and body composition were measured at the 8th and 16th week postpartum. We performed analysis of variance to compare body composition according to the type of feeding and paired Student's t-test to compare the changes from the 8th to 16th week postpartum. Results: We found that FBF mothers had a trend to lower arm fat area and triceps skinfold than PBF and HMS mothers at 8 and 16 weeks postpartum. We observed a decrease in weight (p = 0.004), weight/age index (p = 0.003), body mass index (p = 0.003), hip circumference (p = 0.037), and lean mass (p = 0.003) from 8 to 16 weeks postpartum in mothers who offered FBF. The mid-upper arm circumference, the arm total area, and their z-score increased in the three feeding groups. Conclusions: Our results show that FBF mothers had some lower adiposity from 8 to 16 weeks postpartum compared with the result observed among PBF mothers and those who utilized HMS.

Serum ferritin levels among schoolchildren and its correlation with lipid profile and adiposity

To determine the association between serum ferritin levels, lipid profile and adiposity in school-age children. Methods: A cross-sectional study was conducted on obese and non-obese children. Weight, height, waist circumference and blood pressure were measured for all participants. Lipid profile, serum ferritin and glucose were determined and analysed through absorbance. The Spearman correlation was performed for the quantitative variables and a regression analysis was used to determine the interaction between variables. Eighty-nine children were included, with a median age of 9.0 years. Results: When comparing serum ferritin levels in normal weight group, vs. the overweight and obesity group, values were significantly higher in the latter. Serum ferritin correlated positively with BMI (Rho .282, p <0.01), waist circumference (Rho .372, p < 0.01), diastolic blood pressure (Rho .244, p < 0.05), body fat percentage (Rho .375, p < 0.001), insulin (Rho .254, p <.05) and sex (Rho .224, p <.05); and negatively with high-density lipoprotein cholesterol (Rho. -221, p< 0.05). When analysing the significant variables in a multivariate regression model, sex, body mass index, waist circumference, and body fat percentage remained statistically significant (p <0.01). Conclusion: We observed associations between serum ferritin and obesity in Mexican school aged children(AU)

Determinar la asociación entre los niveles de ferritina sérica, el perfil de lípidos y la adiposidad en niños en edad escolar. Metodología: Se realizó un estudio transversal en niños obesos y no obesos. Se midieron el peso, la altura, la circunferencia de cintura y la presión arterial en todos los participantes. El perfil lipídico, la ferritina sérica y la glucosa se determinaron y analizaron mediante absorbancia. Se realizó correlación de Spearman para las variables cuantitativas y se utilizó un análisis de regresión para determinar la interacción entre las variables. Se incluyeron ochenta y nueve niños, con una edad media de 9,0 años. Resultados: Al comparar los niveles de ferritina sérica en el grupo de peso normal, frente al grupo de sobrepeso y obesidad, los valores fueron significativamente más altos en este último. La ferritina sérica se correlacionó positivamente con el IMC (Rho 0,282, p <0,01), la circunferencia de cintura (Rho 0,372, p <0,01), la presión arterial diastólica (Rho 0,244, p <0,05), el porcentaje de grasa corporal (Rho 0,375, p < 0,001), insulina (Rho 0,254, p <0,05) y sexo (Rho 0,224, p < 0,05); y negativamente con colesterol de lipoproteínas de alta densidad (Rho -0,221, p <0,05). Al analizar las variables significativas en un modelo de regresión multivariante, el sexo, el índice de masa corporal, la circunferencia de cintura y el porcentaje de grasa corporal se mantuvieron estadísticamente significativos (p <0,01). Conclusión: Observamos asociaciones entre la ferritina sérica y la obesidad en niños mexicanos en edad escolar(AU)

Abordaje diagnóstico y terapéutico de pancreatitis en niños y adolescentes en Latinoamérica / No disponible

OBJETIVO: presentar los resultados de una encuesta aplicada a pediatras gastroenterólogos de Latinoamérica para conocer como realizan el abordaje diagnóstico y terapéutico de pancreatitis. MATERIAL Y MÉTODOS: estudio transversal, encuesta exploratoria, multicéntrica. RESULTADOS: el 73,6 % definió los tres tipos de pancreatitis de acuerdo con el grupo INSPPIRE. La enfermedad biliar, trauma abdominal e ingesta de medicamentos fueron la etiología más frecuente. El 80 % fueron pancreatitis leve. El 73 % utilizo soporte nutricional; la nutrición enteral fue la más empleada. CONCLUSIÓN: es el primer estudio exploratorio que permite tener una estimación del abordaje diagnóstico y terapéutico de la pancreatitis por PG en Latinoamérica

No disponible

Vitamin D status and its relation to insulin resistance in a Mexican pediatric population.

Background Obesity in children and adolescents has increased alarmingly, placing them at a higher risk for impaired glucose tolerance and type 2 diabetes. The prevalence of vitamin D deficiency has increased as well. Vitamin D is critical for glucose homeostasis and insulin secretion. Studies on adults have reported an inverse association between vitamin D levels and insulin resistance (IR), but the results in children are inconsistent. The aim of our study was to determine the association between IR and serum vitamin D levels in obese Mexican children and adolescents. Methods A cross-sectional study was performed on 227 children and adolescents between 6 and 19 years of age. Obesity was diagnosed through body mass index (BMI) for age, according to the World Health Organization (WHO) criteria (2007). 25-Hydroxyvitamin D (25[OH]D) was measured using an immunoassay technique and the homeostatic model assessment of insulin resistance (HOMA-IR) was calculated using the Matthews equation. Student's t-test was carried out. Results The mean serum 25(OH)D level was 35.80 ng/mL, and 55.1% of the subjects had levels classified as sufficient, 33.5% as insufficient, and 11.5% as deficient. The mean level of HOMA-IR was 3.16, and 70% of the subjects were diagnosed with IR. Fasting insulin levels and HOMA-IR were significantly different in adolescents with hypovitaminosis, compared with adolescents in the vitamin D sufficiency group (p = 0.01 and p = 0.03, respectively). Conclusions The insulin levels and HOMA-IR were higher in adolescents with hypovitaminosis. The girls presented higher levels of insulin and HOMA-IR than the boys.

Factores asociados a las características de las evacuaciones en niños con parálisis cerebral infantil y estreñimiento crónico / No disponible

INTRODUCCIÓN: el estreñimiento crónico es un problema gastrointestinal común en los niños con parálisis cerebral infantil. Varios factores pueden influir en la frecuencia, la consistencia y el pH de las evacuaciones. OBJETIVO: identificar la asociación entre factores dietéticos, uso de anticonvulsivantes y antecedentes familiares con las características de las evacuaciones en niños con parálisis cerebral infantil y estreñimiento crónico. MATERIAL Y MÉTODOS: estudio transversal analítico en 45 niños con parálisis cerebral y estreñimiento crónico (19 niñas y 26 niños) con edad de 37 ± 13 meses. Se analizaron factores dietéticos, uso de anticonvulsivantes y antecedentes familiares. Se determinaron la frecuencia de las evacuaciones, la consistencia (escala Bristol) y el pH de las heces (con un potenciómetro). RESULTADOS: hubo correlación positiva entre la frecuencia de las evacuaciones y el consumo de oleaginosas (r = 0,339, p = 0,023). Existió correlación negativa entre las heces duras y la ingestión de líquidos (r = -0,336, p = 0,042); y entre el pH de las heces y el consumo de cereales ricos en fibra insoluble, las verduras ricas en fibra soluble, la zanahoria y la papa (r = -0,339, p = 0,030; r = -0,308, p = 0,044; r = -0,336, p = 0,027; y r = -0,307, p = 0,045, respectivamente). Se identificó asociación entre el uso de la politerapia anticonvulsivante y la consistencia dura de las evacuaciones (OR = 14,2 [IC 95% 1,16-174], p = 0,038). No se observó asociación entre los antecedentes familiares y el estreñimiento. CONCLUSIONES: el consumo de alimentos ricos en fibra, la ingestión de líquidos y la politerapia anticonvulsivante se asocian con las características de las evacuaciones en niños con parálisis cerebral infantil y estreñimiento crónico

No disponible

Factors associated with the stool characteristics of children with cerebral palsy and chronic constipation.

BACKGROUND: chronic constipation is a common gastrointestinal problem in children with cerebral palsy and several factors can influence the stool frequency, consistency and pH in these cases. AIM: to identify the association of dietary factors, use of anticonvulsants and family history of constipation with the stool characteristics of children with cerebral palsy and chronic constipation. METHODS: an analytical cross-sectional study was performed of 45 children with cerebral palsy and chronic constipation that included 19 females and 26 males, aged 37 ± 13 months. Dietary factors, the use of anticonvulsants and family history were analyzed. Stool frequency, consistency (Bristol Stool Form Scale) and pH (using a pH-meter) were also determined. RESULTS: there was a positive correlation between stool frequency and the consumption of oilseeds (r = 0.339, p = 0.023). There was a negative correlation between hard stools and fluid intake (r = -0.336, p = 0.042) and between stool pH and the consumption of cereals rich in insoluble fiber, high soluble fiber vegetables, carrots and potatoes (r = -0.339, p = 0.030; r = -0.308, p = 0.044; r = -0.336, p = 0.027; r = -0.307, p = 0.045, respectively). An association was also identified between the use of anticonvulsant polytherapy and hard stools (OR = 14.2 [95% CI 1.16-174], p = 0.038). There was no association between family history and constipation. CONCLUSIONS: rich-fiber food consumption, fluids intake and anticonvulsant polytherapy were associated with the stool characteristics of children with cerebral palsy and chronic constipation.

La formación del talento humano en el área de la salud en las zonas económicas especiales de Venezuela. Retos y logros I / The formation of human talent in the area of health in the special economic zones of Venezuela. Challenges and achievements I

A partir del gobierno de Hugo Chávez, la salud y la educación se convirtieron en derechos consagrados en la Constitución de 1999, por lo cual, las políticas públicas se aplicaron desde el principio para que no fuera letra muerta y saldar la deuda social que dejaron los gobiernos neoliberales de la IV República. Es por ello que una de las acciones, entre otras, que se ejecutaron para impulsar la inclusión a la educación universitaria (EU) fue el de crear el Sistema Nacional de Ingreso (SNI), hecho que ocurrió en el 2008 en el CNU, y posteriormente se ratificó y modificó en el 2014. Con el fin de estudiar los efectos de tales políticas, en esta primera parte del trabajo, se enfocó como ha sido la inclusión a las instituciones de educación universitaria (IEU) a nivel nacional, especialmente en el área de las Ciencias de la Salud, mediante un análisis descriptivo y comparativo de los parámetros académicos: Demanda, oferta académica y asignación de cupos por las IEU; la matrícula universitaria y el número de egresados durante los últimos 20 años; así como la inversión financiera por Estado a la EU. Los resultados obtenidos reflejan el incremento de la inclusión a la EU por las mayorías del país, logrando la formación del talento humano para el sector salud, en el cual hay muchas necesidades. A pesar de estos esfuerzos, aún existen problemas serios sobre el proceso de inclusión y la cobertura de la oferta académica.

From the Hugo Chávez government, health and education became rights enshrined in the 1999 Constitution, therefore, public policies were applied from the beginning so that it was not a dead letter and to pay the social debt left by the neoliberal governments of the IV Republic. That is why one of the actions, among others, that were carried out to promote inclusion in university education (EU) was to create the National Income System (SNI), a fact that occurred in 2008 at the CNU, and later it was ratified and modified in 2014. In order to study the effects of such policies, in this first part of the work the focus was on the inclusion of university education institutions (IEU) at the national level, especially in the area of the Health Sciences, by means of a descriptive and comparative analysis of the academic parameters: Demand, academic supply and allocation of quotas by the SNI; university enrollment and the number of graduates during the last 20 years; as well as the financial investment by State to the EU. The results obtained reflect the increase in inclusion in the EU by the majority of the country, achieving the training of human talent for the health sector, in which there are many needs. Despite these efforts, there are still serious problems regarding the inclusion process and the coverage of the academic offer

La formación del talento humano en el área de la salud en las zonas económicas especiales de Venezuela. Retos y logros II / The formation of human talent in the area of health in the special economic zones of Venezuela. Challenges and achievements II

En esta segunda parte del estudio sobre las políticas del gobierno para el incremento de la inclusión a la educación universitaria (EU), especialmente para el sector salud, quisimos hacer el análisis descriptivo y comparativo en las cuatro Zonas Económicas Especiales (ZEE) que ha creado el presidente Nicolás Maduro en su primera gestión, recordando que la primera parte las estudiamos a escala nacional. En esta oportunidad, realizamos el estudio con similares parámetros académicos, enfocados al área de las Ciencias de la Salud. Es decir, la demanda de cupos universitarios por parte del estudiantado, la oferta de plazas por las Instituciones de Educación Universitaria (IEU) y la asignación de cupos por el Sistema Nacional de Ingreso (SNI). Sin embargo, la matrícula y los valores de egresados de las IEU se estudiaron en tres periodos diferentes: Los tres últimos años de la presidencia de Rafael Caldera (1996-1998); los tres últimos años del presidente Hugo Chávez (2010-2012) y los cuatro primeros años de la primera gestión del presidente Nicolás Maduro (2013-2016). Finalmente, se investigó sobre los proyectos académicos aprobados por el CNU que han introducido las IEU de gestión pública de las ZEE desde 2006 hasta el 2013. Los resultados obtenidos evidencian que los primeros años de la revolución se ha logrado incrementar notablemente los valores de todos estos parámetros, indicando el aumento de la inclusión a la EU en las regiones, pero existen deficiencias notables sobre la oferta académica, algunas veces divorciadas de la realidad circundante de la ZEE, la demanda no satisfecha aún y los pocos proyectos académicos aprobados por el CNU

In this second part of the study on government policies for increasing inclusion in university education (EU), especially for the health sector, we wanted to do a descriptive and comparative analysis in the four Special Economic Zones (EEZ) that it has created President Nicolás Maduro in his first term, remembering that we studied the first part on a national scale. In this opportunity, we carried out the study with similar academic parameters, focused on the area of Health Sciences. That is, the demand for university quotas by the student body, the offer of places by the University Education Institutions (IEU) and the allocation of quotas by the National Income System (SNI). However, the enrollment and values of IEU graduates were studied in three different periods: The last three years of Rafael Caldera's presidency (1996-1998); the last three years of President Hugo Chávez (2010-2012) and the first four years of President Nicolás Maduro's first term (2013-2016). Finally, research was carried out on the academic projects approved by the CNU that have been introduced by the UIS of public management of the EEZs from 2006 to 2013. The results obtained show that the first years of the revolution have managed to significantly increase the values of all these parameters, indicating the increase of the inclusion to the EU in the regions, but there are notable deficiencies in the academic offer, sometimes divorced from the surrounding reality of the ZEE, the demand not yet satisfied and the few academic projects approved by the CNU

Correlation between skinfold thickness and bioelectrical impedance analysis for the evaluation of body composition in patients on dialysis.

INTRODUCTION: Patients on dialysis have important changes in body composition. OBJECTIVES: To determine the correlation between skinfold thickness (SKF) and bioimpedance analysis (BIA) for estimating fat mass (FM) and lean body mass (LBM) in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD). METHODS: Cross-sectional study. We included 50 patients under dialysis treatment. To measure SKF, we used the Lange® skinfold caliper (Beta Technology, California, USA) and we carried out the impedance analysis with the Bodystat Quadscan 4000® (Quadscan, Isle of Man, UK). The measurements were performed post-hemodialysis. The PD patients were measured with and without peritoneal dialysate and body weight was corrected for peritoneal fluid. We determined the Pearson's correlation coefficient between SKF and BIA for estimating FM and LBM. We also evaluated the influence of age, sex, diuretic use, dialysis vintage, extracellular water (ECW), and intracellular water (ICW) through a multivariate regression analysis. RESULTS: Of the 50-patient total, 29 were men (58%) and patient mean age was 46.3 ± 16.5 years. The correlation between SKF and BIA was r = 0.784 (p < 0.001) for FM and r = 0.925 (p < 0.001) for LBM. Age and sex influenced the variability of FM, whereas sex, age, and ECW influenced the variability of LBM, both evaluated through the SKF and BIA methods. CONCLUSION: SKF and BIA are useful methods in clinical practice. The strong and statistically significant correlations between the two methods show they are interchangeable. Age, sex, ECW, and ICW influence the variability of FM and LBM.

The serum arachidonic acid/eicosapentaenoic acid ratio in children with healthy weight and obesity

The western diet is characterized by a high consumption of n-6 polyunsaturated fatty acids (PUFAs) and reduced n-3PUFAs, this phenomenon has been parallel to the increase in the prevalence of obesity. The studies that have analyzed the association between serum PUFAs and the influence on the development of adiposity in children is limited and the findings are controversial. The present study compared the ARA/EPA (arachidonic/eicosapentaenoic) PUFA ratio in children with healthy weight vs. obesity in a cross-sectional study. Thirty children were diagnosed with obesity and 32 children with healthy weight determined through the age-specific body mass index (BMI) Z score, according to the WHO. The variables included were weight, BMI, waist circumference (WC), and the serum ARA/EPA ratio. The Student's t test and Pearson correlation were performed and statistical significance was set at a p <0.05. The project was approved by the local ethics committee of the hospital Instituto Mexicano del Seguro Social. The serum ARA/EPA ratio was significantly higher in children with obesity compared with healthy weight (9.0 vs 5.4; p = 0.012). A statistically significant difference was observed between healthy weight boys and obese boys (p=0.003). Furthermore, the ARA/EPA ratio correlated positively with weight (r=0.336; p=0.008), BMI (r=0.373; p=0.003), WC (r=0.319; p=0.012) and cardio-metabolic risk (r=0.302; p=0.017). When performing a multivariate regression analysis, we identified that BMI was the only variable that remained significant and predicted the ARA/EPA ratio. In conclusion, the serum ARA/EPA ratio differed significantly in relation to weight and was higher in the obese children(AU)

La dieta occidental se caracteriza por un alto consumo de ácidos grasos poliinsaturados n-6(AGPI) y AGPIn-3 reducidos, fenómeno que ha sido paralelo al aumento en la prevalencia de la obesidad. Los estudios que han analizado la asociación entre AGPN en suero y adiposidad en niños son limitados y con hallazgos inconsistentes. El presente estudio comparó la relación ARA/EPA (ácido araquidónico/eicosapentaenoico) AGPI en niños con peso normal vs. obesidad. Es un estudio transversal donde treinta niños fueron diagnosticados con obesidad y 32 niños con peso normal determinado mediante el puntaje z del IMC para la edad, de acuerdo a la OMS. Las variables incluidas fueron peso, IMC, circunferencia de cintura (CC) y la relación ARA/EPA en suero. Se realizó prueba de t de Student y correlación de Pearson, la significación estadística se estableció en p <0,05. El proyecto fue aprobado por el comité de ética local del Hospital del Instituto Mexicano del Seguro Social. La relación ARA/EPA en suero fue significativamente mayor en niños con obesidad en comparación con el peso normal (9,0 frente a 5,4; p = 0,012). Además, la relación ARA/EPA se correlacionó positivamente con el peso (r = 0.336; p = 0.008), IMC (r = 0.373; p = 0.003), CC (r = 0.319; p = 0.012). Al realizar un análisis de regresión multivariable, identificamos que el IMC fue la variable predictora que permaneció significativa. En conclusión, la relación de suero ARA/EPA fue significativamente mayor en los niños con obesidad(AU)

Correlation between skinfold thickness and bioelectrical impedance analysis for the evaluation of body composition in patients on dialysis / Correlación entre la plicometría y el análisis de bioimpedancia eléctrica para la evaluación de la composición corporal en pacientes en diálisis

Introduction: Patients on dialysis have important changes in body composition. Objectives: To determine the correlation between skinfold thickness (SKF) and bioimpedance analysis (BIA) for estimating fat mass (FM) and lean body mass (LBM) in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD). Methods: Cross-sectional study. We included 50 patients under dialysis treatment. To measure SKF, we used the Lange® skinfold caliper (Beta Technology, California, USA) and we carried out the impedance analysis with the Bodystat Quadscan 4000® (Quadscan, Isle of Man, UK). The measurements were performed post-hemodialysis. The PD patients were measured with and without peritoneal dialysate and body weight was corrected for peritoneal fluid. We determined the Pearson’s correlation coefficient between SKF and BIA for estimating FM and LBM. We also evaluated the influence of age, sex, diuretic use, dialysis vintage, extracellular water (ECW), and intracellular water (ICW) through a multivariate regression analysis. Results: Of the 50-patient total, 29 were men (58%) and patient mean age was 46.3 ± 16.5 years. The correlation between SKF and BIA was r = 0.784 (p < 0.001) for FM and r = 0.925 (p < 0.001) for LBM. Age and sex influenced the variability of FM, whereas sex, age, and ECW influenced the variability of LBM, both evaluated through the SKF and BIA methods. Conclusion: SKF and BIA are useful methods in clinical practice. The strong and statistically significant correlations between the two methods show they are interchangeable. Age, sex, ECW, and ICW influence the variability of FM and LBM (AU)

Introducción: los pacientes en tratamiento con diálisis presentan cambios importantes en la composición corporal. Objetivos: determinar la correlación entre la plicometría y el análisis de bioimpedancia eléctrica (BIE) para la estimación de la masa grasa (MG) y la masa magra (MM) en pacientes sometidos a hemodiálisis (HD) y diálisis peritoneal (DP). Métodos: diseño transversal-analítico. Se incluyeron 50 pacientes en tratamiento con diálisis. Se utilizó el plicómetro Lange® (Beta Technology, California, USA) para la medición de pliegues cutáneos y la BIE fue realizada con el Bodystat Quadscan 4000 ® (Quadscan, Isle of Man, UK). Las mediciones fueron realizadas poshemodiálisis. Los pacientes en DP fueron medidos con y sin líquido peritoneal y el peso corporal fue corregido. Determinamos el coeficiente de correlación de Pearson entre la plicometría y la BIE en la estimación de la MG y la MM. Se evaluaron otras variables como edad, sexo, uso de diuréticos, tiempo en tratamiento de diálisis, agua extracelular (AEC) e intracelular (AIC) a través de un análisis de regresión multivariada. Resultados: veintinueve pacientes (58%) son del sexo masculino; la edad promedio de 46,3 ± 16,5 años. Se obtuvo una correlación significativa y positiva entre la plicometría y la BIE [r = 0,784 (p < 0,001) para MG y r = 0,925 (p < 0,001)] para MM. La edad y el sexo influyeron en la variabilidad de la MG, mientras que el sexo, la edad y el AEC influyeron en la variabilidad de la MM, evaluados con ambos métodos. Conclusiones: la plicometría y la BIE son métodos útiles en la práctica clínica. La correlación que se obtuvo entre los dos métodos muestra que son intercambiables. Por otro lado, variables como la edad, el sexo, el agua AEC y AIC se identificó que influyen en la variabilidad de la MG y MM (AU)

Effect of Calcitriol Supplementation on Blood Pressure in Older Adults.

Recent studies suggest that vitamin D plays an important role in the control of blood pressure. Unfortunately, because older adults are more likely to have low 25-hydroxyvitamin-D [25(OH)D] levels, this study investigated whether calcitriol supplementation reduces blood pressure in older adults with hypertension. The design was a double-blind placebo-controlled randomized clinical trial with 36 randomly assigned subjects (71.7 ± 10 years). Blood pressure and serum levels of 25(OH)D before and after calcitriol intervention (1,000 IU daily for 6 weeks; n = 22) or placebo (n = 23) for 6 weeks were analyzed. At the end of the study, the calcitriol group presented a significant decrease of systolic blood pressure [20.25 mmHg (p = 0.001)] and diastolic blood pressure [7 mmHg (p = 0.01)], compared with the placebo group. In conclusion, 1,000 IU/day of calcitriol for 6 weeks efficiently reduced systolic and diastolic blood pressure levels in this population of older adults presenting with high blood pressure (Clinical Trial Approbation NCT02047799).