[Importance of breastfeeding in the prevalence of metabolic syndrome and degree of childhood obesity]. / Importancia de la lactancia materna en la prevalencia de síndrome metabólico y en el grado de obesidad infantil.

OBJECTIVES: To evaluate the relationship between breastfeeding and the prevalence of obesity and metabolic syndrome in a group of obese children and adolescents. MATERIAL AND METHODS: We performed a retrospective study in obese children and adolescents treated at the Endocrinology and Nutrition Service of the Hospital de Getafe (Madrid). The variables studied were age, sex, height, weight, body mass index (BMI), waist circumference, waist-height ratio, blood pressure, triglycerides, high-density lipoprotein and fasting glucose. Information was also collected on food received in the first months of life. Breastfeeding was defined as feeding with maternal milk for at least 3 months. The SPSS v.15 statistical package was used. RESULTS: A total of 126 patients with obesity were recruited (71 boys and 55 girls) with a mean age of 11.94 +/- 3.12 years. Of these, 117 (92.86%) were morbidly obese (BMI > 97th percentile for age and sex). All patients had a waist circumference > 90th percentile for age and sex. Of the 126 patients evaluated, 36.8% were breastfed for more than 3 months and 63.2% were fed with artificial milk only. Compared with patients fed with artificial milk, those who were breast fed had a lower BMI (31.53 +/- 5.77 vs 32.08 +/- 6.78) and lower waist circumference (95.02 +/- 3.4 vs. 95.69 +/- 3.2 cm), although this difference was not statistically significant. The prevalence of metabolic syndrome in the study population was 19.8%. Within this group, 64% had not been breast fed compared with 36% who had been fed with artificial milk. CONCLUSIONS: Breast feeding for at least 3 months was associated with lower levels of obesity, smaller waist circumference and fewer complications related to metabolic syndrome in childhood and adolescence. Sixty-four percent of children with complete metabolic syndrome had received artificial feeding. Further studies are needed to ascertain the impact of breastfeeding on the development of obesity and cardiometabolic risk.

[A serious adverse effect: sepsis due to carbimazole]. / Un efecto secundario grave: sepsis por carbimazol.

Thyonamides are widely used drugs to treat hyperthyroidism, because of their efficacy and security. However, although with less frequency, they can cause hepatic and haemathologic toxicity. Neutropenia produced for this kind of drugs, can be very serious, to such an extent it may jeopardize patient's life. If it appears, it is necessary to stop the antithyroid treatment and, if the patient have fever or agranulocytosis, start wide spectrum antibiotics and definitive treatment with radioiodine or surgery. A file case report of a 26-years-old woman with a thyrotoxicosis secondary to Graves' disease in treatment with carbimazole. She suffered a serious sepsis, as a consequence of the drug induced neutropenia.

[Primary trimethylaminuria: the fish odor syndrome]. / Trimetilaminuria: el síndrome de olor a pescado.

Primary trimethylaminuria, or fish odor syndrome, is a congenital metabolic disorder characterized by a failure in the hepatic trimethylamine (TMA) oxidation route to trimethylamine N-oxide (TMANO). TMA is mostly derived from dietary precursors such as choline, carnitine and TMANO. The presence of abnormal amounts of TMA in the urine, sweat, exhaled air and other body secretions confers a very unpleasant body odor resembling that of decaying fish. As a consequence, patients can suffer from serious psychosocial sequelae. We present a case of primary trimethylaminuria with the aim of raising awareness about this condition.