Dietary and sociodemographic factors associated with nonalcoholic fatty liver in obese pediatric patients.

INTRODUCTION: Obesity is associated with nonalcoholic fatty liver disease (NAFLD) in children. Our aim was to analyze the association of dietary and sociodemographic factors with NAFLD in obese children and adolescents. MATERIALS AND METHODS: Thirty-three obese patients from 6-16 years of age were included in the present analytic cross-sectional study. Obesity was diagnosed with a body mass index z-score > 2 SD. NAFLD was estimated by liver ultrasound, serum amino transferases, and elastography. The sociodemographic variables were evaluated using validated questionnaires. Diet was estimated through two 24-h recall dietary surveys focused on the quantity of food energy, simple sugars, polyunsaturated fatty acids (PUFAs), and antioxidants. RESULTS: Hepatic steatosis was identified by abdominal ultrasound in 13 patients (39.4%) and the serum alanine aminotransferase level was above the upper reference value in 54.2%. A higher educational level in both parents, greater monthly food expenditure, and a higher socioeconomic level were associated with NAFLD. Overall, simple sugar and saturated fat consumption was above the recommended daily intake, whereas vitamin E and PUFA consumption was below those parameters. CONCLUSIONS: NAFLD was identified in one-third of the cases. There was an association between NAFLD and sociodemographic variables. Both groups had an increased intake of simple sugars and a reduced intake of PUFAs. The selective occurrence of NAFLD could be related to a genetic predisposition that has been demonstrated in a Mexican population.

Prolonged breastfeeding and delayed introduction of whole cow's milk into the diet are factors associated with egg sensitization: a matched case-control study

BACKGROUND: Both breastfeeding and the moment at which introduction to solid food occurs have been associated with food allergy. OBJECTIVE: To evaluate whether prolonged breastfeeding and the delayed introduction of whole cow's milk into an infant's diet are factors that can be associated with egg sensitization. METHODS: This was a hospital-based case-control study, matched by age and sex: each study group comprised 97 atopic children. Additionally, logistic regression was used to identify the factors associated with egg protein sensitization. RESULTS: The most common type of allergic disease among both groups was allergic rhinitis. After adjusting for possible confounding variables, a delayed introduction to whole cow's milk decreased the odds of egg protein sensitization; OR = 0.16 (95% CI: 0.07-0.36, p < 0.0001). Notably, breastfeeding during the first six months of life, regardless of whether it was the only milk an infant drank, increased the risk for sensitization to chicken eggs; OR = 5.54 (95% CI: 2.41-12.7, p < 0.0001). CONCLUSION: Prolonged breastfeeding, regardless of whether it was the only milk an infant drank, greatly increased the risk of egg sensitization. Interestingly, a delayed introduction to whole cow's milk was associated with a reduced possibility of becoming sensitized to eggs. Further studies are required to elucidate these findings

No disponible

Prolonged breastfeeding and delayed introduction of whole cow's milk into the diet are factors associated with egg sensitization: A matched case-control study.

BACKGROUND: Both breastfeeding and the moment at which introduction to solid food occurs have been associated with food allergy. OBJECTIVE: To evaluate whether prolonged breastfeeding and the delayed introduction of whole cow's milk into an infant's diet are factors that can be associated with egg sensitization. METHODS: This was a hospital-based case-control study, matched by age and sex: each study group comprised 97 atopic children. Additionally, logistic regression was used to identify the factors associated with egg protein sensitization. RESULTS: The most common type of allergic disease among both groups was allergic rhinitis. After adjusting for possible confounding variables, a delayed introduction to whole cow's milk decreased the odds of egg protein sensitization; OR=0.16 (95% CI: 0.07-0.36, p<0.0001). Notably, breastfeeding during the first six months of life, regardless of whether it was the only milk an infant drank, increased the risk for sensitization to chicken eggs; OR=5.54 (95% CI: 2.41-12.7, p<0.0001). CONCLUSION: Prolonged breastfeeding, regardless of whether it was the only milk an infant drank, greatly increased the risk of egg sensitization. Interestingly, a delayed introduction to whole cow's milk was associated with a reduced possibility of becoming sensitized to eggs. Further studies are required to elucidate these findings.

[Blood pressure variability in 24 hours in obese and non-obese adolescents with breast development 4 and 5 of Tanner's criteria]. / Variabilidad de la presión arterial en 24 horas en adolescentes obesas y no-obesas con desarrollo mamario 4 y 5 de los criterios de Tanner.

OBJECTIVE: The aim of the study was to investigate the blood pressure variability during 24 h by using ambulatory blood pressure monitoring (ABPM) in a group of obese and non-obese female adolescents with breast development status 4 and 5 of Tanner´s criteria. METHODS: A cross-sectional study was conducted at the Cardiovascular Research Institute, Mexico. All subjects underwent 24 h non-invasive ABPM recording device. Pubertal status was determined by breast development. MEASUREMENTS: office systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR). Height, weight, body mass index (BMI), waist and hip circumferences, arm circumference, waist to hip ratio (W/H), and skinfold thickness measurements: triceps, subscapular, abdominal and supraspinal. RESULTS: Fifty-nine adolescents 13-16 years old; 29 obese (BMI 31.2±4.0), and 30 non- obese (BMI 21.2±2.2). Obese vs. non-obese: Office SBP 116.9 vs. 105.9±9.3 mmHg (p<0.001); ABPM in 24 h: SBP 113.8±6.3 vs. 107.6±5.7 mmHg (p<0.001); diurnal SBP 117.3 mmHg vs. 111.2 mmHg (p<0.001); nocturnal SBP 105.5±8 vs. 99.4 mmHg; absolute variability in 24 h DBP 10.0±1.8 vs. 8.7±1.5 (p<0.003); coefficient of variation 24 h DBP 17.3±3 vs. 15.4±2.6% (p<0.05); systolic non-dipper 16 (55.2%) vs. 9 (30%) (p<0.05); pulse pressure 24 h 49.3±8 vs. 43.5±9 mmHg (p<0.01). CONCLUSION: Obese adolescents are presenting changes in BP variability during 24-h in comparison with nonobese adolescents; it also includes higher pulse pressure. Thus, these can be early indicators for the development of hypertension or other cardiovascular diseases in the adult life.

Variabilidad de la presión arterial en 24 horas en adolescentes obesas y no-obesas con desarrollo mamario 4 y 5 de los criterios de Tanner / Blood pressure variability in 24 hours in obese and non-obese adolescents with breast development 4 and 5 of Tanner's criteria

Objetivo: Investigar el comportamiento de la presión arterial (PA) mediante monitoreo ambulatorio de la presión arterial (MAPA) en 24 h en un grupo de adolescentes obesas y no-obesas con estadios mamarios de Tanner 4 y 5. Métodos: Estudio transversal realizado en el Instituto de Investigación Cardiovascular en México, incluyendo 64 adolescentes entre 13 a 16 años de edad con estadios mamarios 4 o 5 de la clasificación de Tanner. Se midió PA en la oficina, frecuencia cardiaca (FC), índice de masa corporal (IMC), índice cintura-cadera, circunferencia de brazo, pliegues cutáneos tricipital, subescapular, abdominal y supraespinal. Se analizaron PA con MAPA en 24 h en obesas y no-obesas. Resultados: Cincuenta y nueve adolescentes, 29 obesas (IMC 31,2 ± 4,0) y 30 no-obesas (IMC 21,2 ± 2,2). Obesas vs no-obesas PAs en la oficina 116,9 vs 105,9 ± 9,3 mmHg (p < 0,001); MAPA en 24 h: PAS 113,8 ± 6,3 vs 107,6 ± 5,7 mmHg (p < 0,001); PAS diurno 117,3 mmHg vs 111,2 mmHg (p < 0,001); PAS nocturna 105,5 ± 8 vs 99,4 mmHg; variabilidad absoluta en 24 h PAD 10,0 ± 1,8 vs 8,7 ± 1,5 (p < 0,003); coeficiente de variación en 24 h PAD 17,3 ± 3 vs 15,4 ± 2,6% (p < 0,05); No-descendedores sistólicos 16 (55,2%) vs 9 (30%) (p < 0,05); presión de pulso en 24 h 49,3 ± 8 vs 43,5 ± 9 mmHg (p < 0,01). Conclusión: Cambios tempranos en la variabilidad de la PA en 24 h en adolescentes obesas, incluyendo presión de pulso, pudieran ser indicadores importantes para hipertensión arterial y riesgo cardiovascular en la edad adulta (AU)

Objective: The aim of the study was to investigate the blood pressure variability during 24 h by using ambulatory blood pressure monitoring (ABPM) in a group of obese and non-obese female adolescents with breast development status 4 and 5 of Tanner´s criteria. Methods: A cross-sectional study was conducted at the Cardiovascular Research Institute, Mexico. All subjects underwent 24 h non-invasive ABPM recording device. Pubertal status was determined by breast development. Measurements: office systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR). Height, weight, body mass index (BMI), waist and hip circumferences, arm circumference, waist to hip ratio (W/H), and skinfold thickness measurements: triceps, subscapular, abdominal and supraspinal. Results: Fifty-nine adolescents 13-16 years old; 29 obese (BMI 31.2 ± 4.0), and 30 non- obese (BMI 21.2 ± 2.2). Obese vs. non-obese: Office SBP 116.9 vs. 105.9 ± 9.3 mmHg (p < 0.001); ABPM in 24 h: SBP 113.8 ± 6.3 vs. 107.6 ± 5.7 mmHg (p < 0.001); diurnal SBP 117.3 mmHg vs. 111.2 mmHg (p < 0.001); nocturnal SBP 105.5 ± 8 vs. 99.4 mmHg; absolute variability in 24 h DBP 10.0 ± 1.8 vs. 8.7 ± 1.5 (p < 0.003); coefficient of variation 24 h DBP 17.3 ± 3 vs. 15.4 ± 2.6% (p < 0.05); systolic non-dipper 16 (55.2%) vs. 9 (30%) (p < 0.05); pulse pressure 24 h 49.3 ± 8 vs. 43.5 ± 9 mmHg (p < 0.01). Conclusion: Obese adolescents are presenting changes in BP variability during 24-h in comparison with nonobese adolescents; it also includes higher pulse pressure. Thus, these can be early indicators for the development of hypertension or other cardiovascular diseases in the adult life (AU)

Report and review of the fetal brain disruption sequence.

UNLABELLED: The fetal brain disruption sequence (FBDS), a rare cause of extreme microcephaly, is described in a patient and compared with 19 previously reported cases. Clinical findings present in almost all patients included: severe microcephaly (average occipitofrontal circumference -5.8 SD), overlapping sutures, prominent occipital bone, scalp rugae with normal hair patterning and marked neurological impairment. Early death occurred in 7/20 cases. The FBDS was sporadic in 17 out of 19 reported cases supporting a low recurrence risk for genetic counselling purposes. A group of related observations in cases were thromboembolic phenomenon following death of the co-twin, vascular and/or haematological involvement by prenatal cytomegalovirus infection, prenatal cocaine exposure, direct vascular fetal trauma (cordocentesis) and fetal vascular changes after a maternal car accident causing intracranial bleeding and brain damage. Normal scalp hair pattern in all cases and the second or third trimester location of the disruptive event in two cases suggest that in the FBDS, brain growth is normal throughout the first 18 weeks of gestation at least. CONCLUSION: Pathogenic factors suggest that different forms of vascular injury to the fetal brain (emboli, haemorrhage, vasoconstriction, disseminated intravascular coagulation) can produce partial brain destruction, diminished intracranial pression and skull collapse in the fetal brain disruption sequence.

[The nutritional status of the child entering the Nuevo Hospital Civil de Guadalajara]. / Estado de nutrición del niño que ingresa al Nuevo Hospital Civil de Guadalajara.

With the purpose to evaluate the nutritional status of children hospitalized in the Nuevo Hospital Civil de Guadalajara, they were included 278 subjects that entered in the infant, preschool, schoolchildren and infectious disease clinical ward of the Division of Pediatrics. There were chosen two subjects every day during one year. It was obtained information about family and sociodemographic background. In addition, there were undertaken anthropometric measurements; weight/age, weight/height and height/age indices were also calculated. It was obtained the parameters of median, percentiles and Z-score. Undernutrition was determined by the Gómez and Waterlow classifications. Is was also compared the reference pattern of Ramos-Galván and National Center for Health Statistics (NCHS). Blood was drawn for total protein and hemoglobin. Mean of height/age was 95.74% (NCHS), weight/age 84.04% and weight/height 89.7%. It was not difference on weight/age between Ramos-Galván and NCHS. Weight/height and height/age had little difference. The median system identified more cases with deficit than Z-score, which seems to be more specific and conservative. There is a high prevalence of acute and chronic malnutrition identified with the median system, and maybe reflects the poor quality of life and major morbidity in this population.

[Mortality in children under 5 years of age in families of marginal settlements in Guadalajara]. / Mortalidad en niños menores de cinco años en familias de colonias marginadas de Guadalajara.

The purpose was, to determine the frequency of infant mortality in the marginal areas of Guadalajara and, find its association with sociodemographic and economical factors, which are known as determinant of the nutritional status of children. There were included 898 families in a cross sectional design among children who applied to the food supplementation program of ONI of Guadalajara. Through an interview and home visit, it was obtained information about sociodemographic and economical characteristics and food habits. The data was recorded and analyzed by the Dbase III Plus and Epi-Info program. It was also used Chi square test and Odds Ratio for the statistical analysis. Education of the mother and income per capita for feeding (as a percentage of the minimum salary) had a significantly and inverse association with infant mortality (P less than 0.0001 and P less than 0.001 respectively). There was also major mortality among children with no social security (P less than 0.05). The Odds Ratio for infant mortality was of 3.02 for education of the father, 8.42 for education of the mother and 6.8 for income per capita for feeding. Meanwhile the level of education and the economical situation of the studied population remain so low, it seems improbable to decrease the rate of infant mortality.