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.

Cervicovaginal agenesis treated with modified Yang-Monti technique in two steps: Case report and literature review.

INTRODUCTION: Müllerian duct anomalies are rare with less than 200 cases published in the literature. Recently, the implementation of the Yang-Monti principle for the creation of the neovagina has been used in 10 previous published cases. Here, we report the first case of cervicovaginal agenesis treated with the modified Yang-Monti technique in two steps in México. PRESENTATION OF CASE: A 14-year-old female presented to the pediatric consult with a history of primary amenorrhea and a chronic-cyclic pelvic pain. She had normal external genitalia and secondary sexual characteristics, with a small vaginal pouch. Pelvic ultrasonography and magnetic resonance showed the absence of cervix and proximal vagina. The surgical approach was carried out in two steps. In the first, a neovagina was created with the modified Yang-Monti technique. On a second step one year after, the neovaginal dome was anastomosed with the uterus in a diamond shape, using Gore-tex® in the cervicovaginal anastomosis, and a Foley catheter to prevent stenosis. After an 18-month follow-up, no complications have been observed. She has been taking Drospirenone and Ethinyl Estradiol with regular menstrual cycles. DISCUSSION: The surgical treatment of cervicovaginal agenesis has evolved. The advantages of the modified Yang-Monti technique lie in the possible diminution of the tension on the vascular pedicle, and the gained length of the neovagina. To perform this procedure in two steps, likely diminishes the risk of neovaginal ischemia and leakage of the anastomosis. CONCLUSION: The two-steps modified Yang-Monti technique represents a safe alternative for the management of cervicovaginal agenesis.

[Measurement of adenoid tissue in the lateral plate of the nasopharynx. Clinico-radiologic correlation]. / Medición de tejido adenoideo en placa lateral de nasofaringe. Correlación clínico radiológica.

172 children were studied, being 113 hypertrophy symptomatic adenoid (AH) and 59 of control group. Clinical findings were compiled of such entity in a direct way; without knowing the results, measurings of the diameter of the adenoid tissue were taken, at the trachea and preadenoid aerial column (PAAC). It was shown that their involvement is a forecaster of undoubtful value in the prognosis of AH, specially if it is considered that other procedures are hard to carry out such as in the case of the child affected by posterior rhinoscopy.

Pseudoacondroplasia tipo II, presentacion de una familia. / Pseudoachondroplastic dysplasia, type II. Report of a family

La pseudoacondroplasia es una displasia osea que representa un grupo heterogeneo de padecimientos que puede distinguirse de otras osteocondrodisplasias tanto clinica como radiologicamente; sus principales caracteristicas son baja talla desproporcionada con miembros cortos y morfologia craneofacial normal. Se presenta una familia con dos casos de pseudoacondroplasia tipo II, se revisa la clasificacion y se discuten el cuadro clinico y el diagnostico diferencial