Body composition analysis by dual-energy X-ray absorptiometry in young preschool children.

BACKGROUND/OBJECTIVES: Dual-energy X-ray absorptiometry (DXA) is considered a specific method for measuring body composition to assess obesity and osteoporosis, although few studies have been conducted in preschool children. The aim of this study was to provide sex - and age-specific references for bone mineral density (BMD), bone mineral content (BMC), fat mass (FM) and fat-free mass (FFM) normative data for children aged 2 to <6 years. SUBJECTS/METHODS: One hundred and eighty seven healthy white children from Buenos Aires City suburbs, Argentina, were studied by the Lunar DPX-L DXA, pediatric software: BMC less head (g), BMD (g/cm2), FM (%) and FFM (g). RESULTS: BMD and BMC increased significantly with age (P<0.0001), but only BMD was significantly different between boys and girls of similar age, being greater for boys (P=0.013). FM was not significantly different among the various age groups of boys and girls. However, the FFM/height was higher in boys and the BMC/FFM was higher in girls. The Z-scores and centile curves were derived separately for each sex and age. Q-Q detrended plots and LMS curves produced robust, unbiased fits that generated references for the 3rd, 50th and 97th percentiles for BMD, BMC, FM and FFM data, respectively. CONCLUSIONS: These DXA scans add to the scarcity of accurate measurements of body composition of white young children. The data analyses provided greater accuracy, particularly at the upper and lower ends of the distribution, which is important in clinical settings for identification of children with impaired body composition.

[Treatment of Torode and Zieg type IV unstable pelvic fractures in children]. / Tratamiento de las fracturas de pelvis inestable tipo IV de la clasificación de Torode y Zieg en niños.

INTRODUCTION: Pelvic fractures are infrequent in pediatric patients; they account for 1% of hospital admissions. Acetabular fractures are still more infrequent, but when they are associated, they are life threatening. To distinguish pelvic fractures in children from those in adults, one first needs to know their anatomical differences. The magnitude of the trauma can usually cause injuries in other organs and systems, including the abdominal organs, the genitourinary system, vascular and nerve injuries, etc., as well as long bone, spinal and chest fractures. These injuries may be life threatening and must be treated before the pelvic fracture is addressed. OBJECTIVE: To show the results obtained from the surgical treatment of Torode and Zieg type IV pelvic fractures. METHODS: This is a retrospective, observational, longitudinal, descriptive study of 26 patients with Torode and Zieg type IV unstable pelvic fractures during a two-year period. RESULTS: The age group 14-16 years was the most affected one, with 83.3% of the fractures, followed by the 12-14 years group with 8.33% and the group under this age with 8.33%. The most frequent mechanism of injury was trauma resulting from being run over, with 41.66%, car crash with 37.5%, and falls from a height with 20.83%; 37.5% of patients were polytraumatized and required intensive care; the mortality rate in the study was 7.69%. CONCLUSIONS: According to the results and the patient assessment, we propose that unstable pelvic fractures be managed surgically. The mechanism of injury observed in these patients was not lateral compression, as the literature states, but rather a combined mechanism.

Solución de morfina mas lidocaína peridural en el dolor crónico neoplásico, manejo médico y de enfermería: informe preliminar / Morphine solution and peridural lidocaine in chronic neoplasic pain, medical and nursery management: preliminary report

Generalmente al paciente portador de dolor crónico neoplásico (DCN) se deja morir en paz, la realidad es que lo hace con gran sufrimiento. Este informe preliminar evaluó el rendimiento como analgésico de una solución de morfina más lidocaína a través de un catéter peridural en forma permanente en 36 pacientes portadores de DCN. En 94,5 per cent se logró analgesia, todos presentaron a lo menos una reacción adversa a medicamento (RAM) que fué de fácil manejo domiciliario, las mínimas complicaciones del catéter y el bajo costo, hacen de esta técnica una excelente indicación para el tratamiento del DCN