Do children with overweight respond faster to food-related words?

Overweight in childhood is a risk factor in developing obesity as an adult, thus having severe consequences on the individuals' physical health and psychological well-being. Therefore, studying the cognitive and emotional processes that sustain overweight is essential not only at a theoretical level but also to develop effective interventions. In the present experiment, we examined whether children with overweight respond faster to food-related than non-food-related words in a word recognition task: lexical decision. The participants were 24 children diagnosed with exogenous overweight and 24 children with a healthy weight. The stimulus list included positively valenced food-related words and positively valenced non-food-related words matched in a number of psycholinguistic variables-we also included negatively valenced non-food words. While children with a healthy weight showed similar response times to positively valenced food-related and non-food-related words, children with overweight showed much faster response times to food-related words than to non-food-related words. Furthermore, both children with overweight and children with a healthy weight responded faster to positive than to negative words. These findings suggest a complex interplay of cognitive and emotional factors during word processing that can be used to implement more effective treatments for childhood overweight.

Marchiafava-Bignami disease in a patient with schizophrenia and alcohol use disorder.

Substance-related disorders are the most frequent comorbidity in schizophrenia. Concretely, alcohol is the most commonly consumed substance after tobacco. Patients with schizophrenia with this comorbidity have a worse clinical course and can develop serious neuropsychiatric complications. One of them, Marchiafava-Bignami disease (MBD) can be incorrectly diagnosed as a decompensation of their mental disorder.

[C1q nephropathy. Report of one case]. / Nefropatía por C1q: una rara variedad de síndrome nefrótico. Caso clínico.

C1q nephropathy is a rare glomerulopathy characterized by mesangial deposition of the complement component C1q. These deposits can be isolated or associated with immunoglobulins or complement fractions, which are observed by immunofluorescence or immunohistochemical microscopy. In ultramicroscopy, dense mesangial deposits and alterations of the podocyte are observed. Clinically it presents as a nephrotic syndrome (NS) or by alterations of the urinalysis such as proteinuria and/or hematuria in children and young adults. In light microscopy, it is expressed with a morphological pattern of minimal change disease (MCD), mesangial proliferative glomerulonephritis or focal segmental glomerulosclerosis (FSGS). The NS during its evolution usually evolve in steroid resistance or steroid dependency, often requiring the association of immunosuppressants to obtain remission. We report a 14 years old male with a history of NS and its evolution under various treatments during a 12-year follow-up.

The role of attentional biases to appetitive stimuli in childhood overweight.

Overweight during childhood constitutes a high-risk factor for adult obesity. An abnormal attention to food stimuli (i.e., a bias) has been suggested as an underlying mechanism to the onset and/or maintenance of obesity. Previous literature supports the existence of a biased attention toward food stimuli in adults with obesity. However, it is unknown whether this attentional bias occurs in high-risk children for adult obesity. We aimed to examine attentional biases to food at different stages of attention processing in overweight children. A dot-probe task was applied to 25 children with overweight and 25 healthy-weight children (8-12 years old). Attentional preference to or avoidance of pleasant food stimuli, which were displayed simultaneously with pleasant non-food stimuli (matched in valence and arousal), was examined at 100-ms (initial visual orienting), 500-ms (attention engagement), and 1500-ms (maintained attention) presentation rates. Both children with overweight and healthy-weight children showed an attentional bias toward food images at a 100-ms presentation rate. However, unlike healthy-weight children, those with overweight showed an attentional preference toward food images at 500- and 1500-ms presentation rates. A biased initial orienting to food cues can be found regardless of weight. However, a biased attention engagement and a biased maintained attention toward food cues are characteristics of children with overweight. Therefore, as in adults, children at risk of adult obesity have an abnormal attentional processing of food stimuli.

Changes in genetic and environmental influences on disordered eating between pre-menarche and postmenarche girls. A twin study.

significantly increase during puberty. The goal of this research is to evaluate changes during puberty which could have genetic and environmental influences on a broad spectrum of disordered eating attitudes and behaviors. Methods. Participants were 158 pairs of adolescent female twins, categorized in two groups according to menarche stage (pre or post). ED measures: Disordered eating attitudes and behaviors were assessed by means of the Children’s Eating Attitudes Test and four sub-scales of the Eating Disorders Inventory: Drive for thinness, Body dissatisfaction, Ineffectiveness, and Perfectionism. Intra-class correlations in monozygotic (MZ) and dizygotic (DZ) twins were calculated separately in premenarche and premenarche group for each ED subscale Results. 48 premenarche twins (30 MZ twins and 18 DZ twins) and 110 premenarche twins (66 MZ and 44 DZ twins) were included. The intra-class correlations suggested no genetic influence on the total ChEAT score of participants at the premenarche stage. For the premenarche participants, however, sources of variance suggested a very high heritability. Regarding the EDI sub-scales, only the trait “Ineffectiveness” exhibited a moderate heritability among premenarche subjects, while all the four eating sub-scales showed moderate heritability estimates in the premenarche stage group. Conclusions. Our findings reveal that there are significant differences in genetic and environmental effects on eating attitudes and behaviors depending on being in a premenarche or premenarche stage. Therefore, clinicians should pay attention to female adolescents at high risk of developing ED, especially during the critical period of menarche.

Involvement of leucocyte/endothelial cell interactions in anorexia nervosa.

BACKGROUND: Anorexia nervosa is a common psychiatric disorder in adolescence and is related to cardiovascular complications. Our aim was to study the effect of anorexia nervosa on metabolic parameters, leucocyte-endothelium interactions, adhesion molecules and proinflammatory cytokines. MATERIALS AND METHODS: This multicentre, cross-sectional, case-control study employed a population of 24 anorexic female patients and 36 controls. We evaluated anthropometric and metabolic parameters, interactions between leucocytes polymorphonuclear neutrophils (PMN) and human umbilical vein endothelial cells (HUVEC), proinflammatory cytokines such as tumour necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) and soluble cellular adhesion molecules (CAMs) including E-selectin, vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1). RESULTS: Anorexia nervosa was related to a decrease in weight, body mass index, waist circumference, systolic blood pressure, glucose, insulin and HOMA-IR, and an increase in HDL cholesterol. These effects disappeared after adjusting for BMI. Anorexia nervosa induced a decrease in PMN rolling velocity and an increase in PMN rolling flux and PMN adhesion. Increases in IL-6 and TNF-α and adhesion molecule VCAM-1 were also observed. CONCLUSIONS: This study supports the hypothesis of an association between anorexia nervosa, inflammation and the induction of leucocyte-endothelium interactions. These findings may explain, in part at least, the increased risk of vascular disease among patients with anorexia nervosa.

Further evidence of the role of microRNA in schizophrenia: a case report.

According to the neurodevelopmental hypothesis of schizophrenia, genetic predisposing factors cause abnormalities in neural functions, leading to the disease. A 2-year follow-up of a young woman with schizophrenia is presented. Karyotype, Affymetrix CytoScanTM 750K SNP array, and optical genome mapping ultra-high molecular weight were carried out. The case presented a severe and resistant to treatment schizophrenia. A 404 kbp microduplication in 2q13 (chr2 : 112088944-112492811; Hg19) was revealed, which includes an only gene (MIR4435-2HG, OMIM 617144). The Positive and Negative Syndrome Scale of Schizophrenia questionnaire showed a moderate improvement after 2 years, but functioning was still poor. The presented case had a microduplication of copy number variants at 2q13, previously linked to schizophrenia, but it only involved one gene, encoding a microRNA, which regulates the expression of candidate genes associated to neurodevelopment. This case provides further evidence of the importance of microRNA in the pathogenesis of schizophrenia.

Teasing and disordered eating behaviors in Spanish adolescents.

The purpose of this study is to investigate the associations between peer teasing and body dissatisfaction (BD), emotional symptoms, drive for thinness (DT), and abnormal eating behaviors, as well as to analyze the mediating role of gender and body mass index (BMI) in such disorders. We screened 57,997 school children between 13 and 16 years of age. Scores in weight-related teasing and competency-related teasing were higher among girls, as well as overweight or obese individuals. Weight-teasing correlated more strongly with abnormal eating attitudes and behaviors, whereas competency-teasing correlated with emotional symptoms. Multiple linear regression analysis showed that weight-teasing is significantly and independently associated with BD, especially in boys. Multivariate analysis revealed a significant association between weight-teasing and abnormal eating in girls, although its predictive value was very low (Exp(B) = 1.009). Mediation analysis and Path analysis showed the mediating role of DT in this association. Interventions on teasing do not seem to be a priority in eating disorder prevention programs.

Auditory hallucinations in anorexia nervosa.

The paper describes two case studies of patients with anorexia nervosa who suffer from auditory hallucinations as the only psychotic symptom. A review of the literature regarding clinical cases of anorexic patients with hallucinations is discussed. Hallucinations in anorexic patients are conceptualized according to different theoretical models which point to a dimensional view of eating disorders.

Teasing as a risk factor for abnormal eating behaviours: A prospective study in an adolescent population. / Burlas como factor de riesgo para conductas alimentarias anómalas: estudio prospectivo en una población adolescente.

INTRODUCTION: There are discrepancies in the literature about the role of teasing in the onset of eating pathology. This article aims to establish the influence of teasing in abnormal eating behaviors and attitudes in the adolescent population. MATERIAL AND METHODS: This is a two-year prospective study conducted in 7,167 adolescents between 13 and 15 years of age. In a first assessment, teasing about weight and teasing about abilities were measured by means of the POTS.questionnaire. Its association with eating psychopathology after two years was analyzed controlling nutritional status (BMI), body dissatisfaction, drive to thinness, perfectionism (EDI), emotional symptoms and hyperactivity (SDQ) which had also been measured in the first assessment. The analysis was carried out independently for both genders. RESULTS: The multivariant analysis found no significant or independent effect of teasing about weight or teasing about abilities in the onset of later eating psychopathology. The obtained models were similar for both genders although in girls, but not in boys, controlling BMI was enough to make any effect of teasing disappear. CONCLUSIONS: Teasing about weight or abilities has no direct effect, neither in boys nor in girls of 13 to 15 years old, in the development of eating psychopathology.

Genetic and environmental influences on psychological traits and eating attitudes in a sample of Spanish schoolchildren. / Influencias genéticas y ambientales en rasgos psicológicos y actitudes alimentarias en una población escolar española.

INTRODUCTION: The heritability of eating disorders has been estimated to range from 22% to over 62%.The aim of this study is to determine the relative influence of genetics and environment that contribute to the drive for thinness, body dissatisfaction, perfectionism, and ineffectiveness, by evaluating sex differences in a sample of adolescent twins from Valencia, Spain. MATERIAL AND METHODS: Five hundred eighty-four pairs of adolescent twins between 13 and 18 years of age completed the study. To determine zygosity, teachers responded to a questionnaire on physical similarity. Psychological traits of eating disorders were assessed with four sub-scales of the Eating Disorder Inventory (EDI); drive for thinness, body dissatisfaction, perfectionism, and ineffectiveness. Twin models were used to assess genetic and environmental (common and unique) factors affecting these four psychological traits. RESULTS: All four traits showed significant genetic contributions among girls, with heritability estimates of 37.7% for ineffectiveness, 42.8% for perfectionism, 56.9% for drive for thinness, and 65.5% for body dissatisfaction. Among boys, body dissatisfaction showed no additive genetic contributions, indicating significant shared and individual specific environment effects. The three other traits in boys showed significant additive genetic contributions, but were lower than in girls. CONCLUSIONS: With the exception of body dissatisfaction in boys, psychological traits of eating disorders show heritability patterns that differ according to sex.

NOTA CLÍNICA: Enfermedad deMarchiafava-Bignami en un paciente con esquizofrenia y trastorno por uso de alcohol / CLINICAL NOTE: Marchiafava-Bignami disease in a patient with schizophrenia and alcohol use disorder

Introducción: Los trastornos por abuso de sustancias sonla comorbilidad más frecuente en la esquizofrenia, siendo elalcohol, concretamente, la sustancia más frecuentementeconsumida tras el tabaco. Los pacientes con esquizofreniaque presentan esta comorbilidad presentan una peor evolución clínica y pueden desarrollar graves complicaciones neuropsiquiátricas. Una de ellas, la enfermedad de Marchiafava-Bignami (EMB), puede ser erróneamente diagnosticadacomo una descompensación del trastorno mental, conllevando graves consecuencias.Método. Se presenta el caso de un varón de 51 años,diagnosticado de esquizofrenia y trastorno por consumode alcohol. Experimentó síntomas neuropsiquiátricos agudos por los que se sospechó una descompensación de suesquizofrenia. Dada la presentación clínica atípica y susantecedentes médicos, se sospechó una patología orgánicay se realizó una prueba de imagen cerebral en la que sediagnosticó una EMB.Conclusiones. La EMB es una entidad clínica infrecuenteque debe formar parte del diagnóstico diferencial en pacientes con trastorno por consumo de alcohol que experimenten síntomas neuropsiquiátricos atípicos. (AU)

Introduction: Substance-related disorders are the mostfrequent comorbidity in schizophrenia. Concretely, alcohol isthe most commonly consumed substance after tobacco. Patients with schizophrenia with this comorbidity have a worseclinical course and can develop serious neuropsychiatriccomplications. One of them, Marchiafava-Bignami disease(MBD) can be incorrectly diagnosed as a decompensation oftheir mental disorder.Methods. A case of a 51-year-old man, diagnosed withschizophrenia and alcohol use disorder is presented. He experienced acute neuropsychiatric symptoms for which schizophrenia decompensation was suspected. Based on his atypical symptoms and medical history, a brain imaging test wasperformed and MBD was diagnosed.Conclusions. MBD is an infrequent clinical entity thatshould be part of differential diagnosis in patients with alcohol abuse disorder experiencing atypical neuropsychiatricsymptoms. (AU)

Nefropatía por C1q: una rara variedad de síndrome nefrótico: caso clínico / C1q nephropathy: report of one case

C1q nephropathy is a rare glomerulopathy characterized by mesangial deposition of the complement component C1q. These deposits can be isolated or associated with immunoglobulins or complement fractions, which are observed by immunofluorescence or immunohistochemical microscopy. In ultramicroscopy, dense mesangial deposits and alterations of the podocyte are observed. Clinically it presents as a nephrotic syndrome (NS) or by alterations of the urinalysis such as proteinuria and/or hematuria in children and young adults. In light microscopy, it is expressed with a morphological pattern of minimal change disease (MCD), mesangial proliferative glomerulonephritis or focal segmental glomerulosclerosis (FSGS). The NS during its evolution usually evolve in steroid resistance or steroid dependency, often requiring the association of immunosuppressants to obtain remission. We report a 14 years old male with a history of NS and its evolution under various treatments during a 12-year follow-up.

Genetic and environmental contributions to perfectionism and its common factors.

UNLABELLED: The aims of this study: (1) To evaluate the relative contributions of genetics and environment to perfectionism and it's two constructs: self-oriented, and socially prescribed perfectionism. (2) To clarify genetic and environmental common origins of both personal and social components. METHODS: Participants were 258 pairs of adolescent Spanish twins. Socially prescribed and self-oriented perfectionism were assessed using the perfectionism subscale of the Eating Disorder Inventory. STATISTICS: univariate and bivariate twin models, according to sex. Results; Heritability of self-oriented perfectionism was 23% in boys and 30% in girls, and of socially prescribed perfectionism 39% in boys and 42% in girls. Bivariate analysis suggested a common genetic and environmental pathway model. The genetic correlation between both perfectionisms was 0.981 in boys and 0.704 in girls. The non-shared environmental correlation was 0.254 in boys and 0.259 in girls. Conclusions; genetic influences on perfectionism are moderate during adolescence. Our results point toward a shared genetic component underlying both kind of perfectionism. These findings generate doubts about the hypothesis of a leading role of genetics in the pathogenesis of Self-oriented perfectionism and of environment in socially prescribed. The high genetic correlation seems to indicate that self-oriented and socially prescribed are the same dimension of perfectionism.

Burlas como factor de riesgo para conductas alimentarias anómalas: estudio prospectivo en una población adolescente / Teasing as a risk factor for abnormal eating behaviours: a prospective study in an adolescent population

Introducción: Existen discrepancias en la literatura sobre el papel de las burlas en la aparición de clínica alimentaria. El objetivo de este artículo es establecer la influencia de las burlas sobre la aparición de conductas alimentarias anómalas en una población adolescente. Material y métodos: Se trata de un estudio prospectivo a 2 años en el que participaron 7.167 adolescentes de entre 13 y 15 años. En una evaluación basal se estudió su exposición a burlas sobre el peso y sobre las capacidades, mediante el cuestionario POTS. Posteriormente, se analizó su asociación con psicopatología alimentaria (EAT) ulterior controlando el efecto del estado nutricional (IMC), la insatisfacción corporal, el impulso a la delgadez, el perfeccionismo (EDI), los síntomas emocionales y la hiperactividad (SDQ), también evaluados en la línea base. El análisis se hizo de manera independiente para ambos géneros. Resultados: El análisis multivariante descartó la existencia de un efecto significativo e independiente de las burlas sobre el peso y de las burlas sobre las capacidades sobre la aparición de psicopatología alimentaria posterior. Los modelos obtenidos fueron similares en ambos sexos, aunque en las chicas, a diferencia de los chicos, el control del IMC bastó para anular cualquier repercusión de las burlas. Conclusiones: Las burlas sobre el peso o sobre las capacidades carecen de efecto directo, en chicos y chicas de 13 a 15 años, sobre el desarrollo de psicopatología alimentaria posterior

Introduction: There are discrepancies in the literature about the role of teasing in the onset of eating pathology. This article aims to establish the influence of teasing in abnormal eating behaviors and attitudes in the adolescent population. Material and methods: This is a two-year prospective study conducted in 7,167 adolescents between 13 and 15 years of age. In a first assessment, teasing about weight and teasing about abilities were measured by means of the POTS.questionnaire. Its association with eating psychopathology after two years was analyzed controlling nutritional status (BMI), body dissatisfaction, drive to thinness, perfectionism (EDI), emotional symptoms and hyperactivity (SDQ) which had also been measured in the first assessment. The analysis was carried out independently for both genders. Results: The multivariant analysis found no significant or independent effect of teasing about weight or teasing about abilities in the onset of later eating psychopathology. The obtained models were similar for both genders although in girls, but not in boys, controlling BMI was enough to make any effect of teasing disappear. Conclusions: Teasing about weight or abilities has no direct effect, neither in boys nor in girls of 13 to 15 years old, in the development of eating psychopathology

Altered mitochondrial function and oxidative stress in leukocytes of anorexia nervosa patients.

CONTEXT: Anorexia nervosa is a common illness among adolescents and is characterised by oxidative stress. OBJECTIVE: The effects of anorexia on mitochondrial function and redox state in leukocytes from anorexic subjects were evaluated. DESIGN AND SETTING: A multi-centre, cross-sectional case-control study was performed. PATIENTS: Our study population consisted of 20 anorexic patients and 20 age-matched controls, all of which were Caucasian women. MAIN OUTCOME MEASURES: Anthropometric and metabolic parameters were evaluated in the study population. To assess whether anorexia nervosa affects mitochondrial function and redox state in leukocytes of anorexic patients, we measured mitochondrial oxygen consumption, membrane potential, reactive oxygen species production, glutathione levels, mitochondrial mass, and complex I and III activity in polymorphonuclear cells. RESULTS: Mitochondrial function was impaired in the leukocytes of the anorexic patients. This was evident in a decrease in mitochondrial O2 consumption (P<0.05), mitochondrial membrane potential (P<0.01) and GSH levels (P<0.05), and an increase in ROS production (P<0.05) with respect to control subjects. Furthermore, a reduction of mitochondrial mass was detected in leukocytes of the anorexic patients (P<0.05), while the activity of mitochondrial complex I (P<0.001), but not that of complex III, was found to be inhibited in the same population. CONCLUSIONS: Oxidative stress is produced in the leukocytes of anorexic patients and is closely related to mitochondrial dysfunction. Our results lead us to propose that the oxidative stress that occurs in anorexia takes place at mitochondrial complex I. Future research concerning mitochondrial dysfunction and oxidative stress should aim to determine the physiological mechanism involved in this effect and the physiological impact of anorexia.

[Eating disorders: Considerations on nosology, etiology and treatment in the XXI century]. / Los trastornos de la conducta alimentaria: consideraciones sobre nosología, etiopatogenia y tratamiento en el siglo XXI.

Amazing advances have been made in medical sciences since the first international conference on eating disorders (ED) was held in the 1970s, and there have been remarkable changes in the field of ED itself. Back then, virtually all that was talked about was anorexia nervosa; clinicians and researchers were mainly concerned about the possible hypothalamic and endocrine factors that seemed to be involved and there had been no epidemiological studies or controlled trials with psychiatric drugs or psychotherapy. Although the picture today is quite different, there are still significant gaps which even affect the classification of these disorders, as well as their neurobiological bases and both the pharmacological and psychological treatments which should be used. This paper gives a brief summary of these gaps and discusses the need to find endophenotypes which may help in categorising and directing research into these disorders. Mention is made of possible contributions from other fields for the benefit of greater progress in understanding eating disorders. Specific reference is made to the addictive model, out of which neuropsychology and animal models may provide data transferable to our area of expertise. Lastly, the current state of ED treatment is discussed with pointers as to from what perspective it would be most useful to seek improvements.

Influencias genéticas y ambientales en rasgos psicológicos y actitudes alimentarias en una población escolar española / Genetic and environmental influences on psychological traits and eating attitudes in a sample of Spanish schoolchildren

Introducción. La heredabilidad de los trastornos de la conducta alimentaria, como la anorexia nerviosa y la bulimia nerviosa, se ha estimado alrededor del 22% al 62%. El objetivo del presente trabajo es determinar la influencia de los factores genéticos y ambientales que contribuyen en la expresión de los factores psicológicos medidos a través del Eating Disorders Inventory, en función del sexo, en adolescentes de la Comunidad Valenciana (España). Material y métodos. Quinientas ochenta y cuatro parejas de gemelos de 13 a 18 años de edad. Para determinar la cigosidad los profesores rellenaron un cuestionario de similitud física. Se aplicaron las subescalas del Eating Disorders Inventory, impulso a la delgadez, insatisfacción corporal, perfeccionismo e ineficacia. Se ha realizado una modelización de las mismas para establecer los componentes genéticos y ambientales (comunes y específicos) de su varianza. Resultados. En las niñas las 4 variables mostraron un componente de heredabilidad, del 37,7% para la ineficacia, del 42,8% para el perfeccionismo, del 56,9% para el impulso a la delgadez y del 65,5% para la insatisfacción corporal. En los niños se descarta una influencia genética para la insatisfacción corporal, que aparece influenciada exclusivamente por factores ambientales. El resto de variables mostraron un componente heredable, pero en menor medida que en las niñas. Conclusiones. A excepción de la IC en niños, las actitudes y comportamientos alimentarios muestran un patrón parcialmente heredable, que varía en función del sexo (AU)

Introduction. The heritability of eating disorders has been estimated to range from 22% to over 62%.The aim of this study is to determine the relative influence of genetics and environment that contribute to the drive for thinness, body dissatisfaction, perfectionism, and ineffectiveness, by evaluating sex differences in a sample of adolescent twins from Valencia, Spain. Material and methods. Five hundred eighty-four pairs of adolescent twins between 13 and 18 years of age completed the study. To determine zygosity, teachers responded to a questionnaire on physical similarity. Psychological traits of eating disorders were assessed with four sub-scales of the Eating Disorder Inventory (EDI); drive for thinness, body dissatisfaction, perfectionism, and ineffectiveness. Twin models were used to assess genetic and environmental (common and unique) factors affecting these four psychological traits. Results. All four traits showed significant genetic contributions among girls, with heritability estimates of 37.7% for ineffectiveness, 42.8% for perfectionism, 56.9% for drive for thinness, and 65.5% for body dissatisfaction. Among boys, body dissatisfaction showed no additive genetic contributions, indicating significant shared and individual specific environment effects. The three other traits in boys showed significant additive genetic contributions, but were lower than in girls. Conclusions. With the exception of body dissatisfaction in boys, psychological traits of eating disorders show heritability patterns that differ according to sex (AU)

Uso oportuno de inmunoglobulinas intravenosas y riesgo de alteraciones coronarias en pacientes con enfermedad de Kawasaki / Early use of immunoglobulin and risk of coronary abnormalities in patients with Kawasaki's disease

La enfermedad de Kawasaki es una vasculitis sistémica de vasos de mediano calibre, que afecta principalmente a las arterias coronarias, provocando dilatación y aneurismas coronarios en un 15 - 25% de los casos no tratados. El tratamiento recomendado actualmente es el uso de inmunoglobulina intravenosa antes del décimo día de enfermedad, lo cual reduce el riesgo de aneurismas coronarios de un 20% a un 4%. Objetivos: Determinar la relación entre el tratamiento oportuno con inmunoglobulina y el riesgo de presentar alteración coronaria en la ecocardi ografía en pacientes con Enfermedad de Kawasaki. Métodos: Se revisó la base de datos de Cardiología Infantil del hospital, identificando 66 pacientes que presentaron la enfermedad entre los años 1994 y 2014. Se determinó el momento en que se inició el tratamiento con inmunoglobulina y se analizó el hallazgo ecocardiográfico de alteraciones coronarias durante el período de hospitalización. Resultados: 52 niños (79%) recibieron tratamiento precoz, antes de 10 días del comienzo de la enfermedad; en el resto el tratamiento fue tardío. El tratamiento precoz se asoció a un menor riesgo de presentar aneurismas coronarios (5.8% vs 50% de los casos, p<0.01). Conclusión: En la enfermedad de Kawasaki es de suma importancia el diagnóstico y tratamiento oportuno con inmunoglobulina intravenosa para reducir el riesgo de formación de aneurismas coronarios.

Kawasaki’s disease is a systemic vasculitis of the mediumsized blood vessels, primarily affecting the coronary arteries, causing coronary dilation and aneurysms in 15 - 25% of untreated children. Use of Intravenous immunoglobulin within the first 10 days of illness is the recommended treatment, redugin the risk of coronary artery aneurysm develo-pment from 20% to 4%. Objective: To determine the association of early treatment to risk of echocardiographic coronary changes on patients with the disease. Methods and Results: A review of the institutional Pediatric Cardiology Database, allowed the identification of 66 patients who had Kawasaki’s disease between 1994 and 2014. The echocardiographic findings at follow up were related to the time of treatment initiation in relation to the beginning of the disease. Treatment with im-munoglobulin within 10 days was associated to coronary artery aneurysms in 5.8% of patients, as opposed to 50% in those with a delayed initiation of therapy. Conclusión: Early treatment with immunoglobulins (within 10 days of illness) significantly reduces the short term risk of developing coronary aneurysms in patients with Kawasaki’s disease.

Cambios en la influencia genética y ambiental en los trastornos de la alimentación entre niñas en estadio pre y post menarquia. Un estudio gemelar / Changes in genetic and environmental influences on disordered eating between pre-menarche and post-menarche girls. A twin study

Introducción. La incidencia y heredabilidad de los trastornos de la conducta alimentaria (TCA) se incrementa durante la pubertad. El objetivo de la presente investigación fue evaluar los cambios en las influencias genéticas ambientales sobre un amplio espectro de actitudes y conductas alimentarias anómalas durante la pubertad. Metodología. participaron 160 parejas de gemelas adolescentes, que se categorizaron en dos grupos en función del estado de menarquia (pre y pos). Medidas de TCA: Las actitudes y conductas alimentarias anómalas fueron evaluadas mediante el ChEAT (Children's Eating Attitudes Test) y cuatro subescalas del EDI (Eating Disorders Inventory); Impulso a la delgadez, Insatisfacción corporal, Ineficacia y Perfeccionismo. Las correlaciones intrapareja en gemelas MZ (monozigotas) y DZ (dizigotas) se calcularon por separado en los grupos de premenarquia y posmenarquia para cada medida de TCA. Resultados. Cuarenta y ocho gemelas premenarquia (30 MZ y 18 DZ) y 110 gemelas posmenarquia (66 MZ y 44 DZ). Las correlaciones sugirieron que no hay una influencia genética en la puntuación total del ChEAT en las niñas en estado premenarquia, mientras que en las niñas posmenarquia el porcentaje de la varianza para las influencias genéticas es elevado. En relación a las subescalas del EDI, únicamente la variable "Ineficacia" mostró una moderada heredabilidad en las niñas en estadio premenarquia, mientras que las cuatro actitudes alimentarias mostraron una moderada heredabilidad en el grupo de niñas posmenarquia. Conclusiones. Nuestro abordaje revela cambios significativos relacionados con la menarquia en las contribuciones de las influencias genéticas y ambientales sobre las conductas y actitudes alimentarias anómalas. Los clínicos deberían centrar su atención en las niñas adolescentes con alto riesgo de desarrollar TCA especialmente durante el periodo crítico de la menarquia

Background. Eating disorders' incidence and heritability significantly increase during puberty. The goal of this research is to evaluate changes during puberty which could have genetic and environmental influences on a broad spectrum of disordered eating attitudes and behaviors. Methods. Participants were 158 pairs of adolescent female twins, categorized in two groups according to menarche stage (pre or post). ED measures: Disordered eating attitudes and behaviors were assessed by means of the Children's Eating Attitudes Test and four sub-scales of the Eating Disorders Inventory: Drive for thinness, Body dissatisfaction, Ineffectiveness, and Perfectionism. Intra-class correlations in monozygotic (MZ) and dizygotic (DZ) twins were calculated separately in premenarche and premenarche group for each ED subscale Results. 48 premenarche twins (30 MZ twins and 18 DZ twins) and 110 premenarche twins (66 MZ and 44 DZ twins) were included. The intra-class correlations suggested no genetic influence on the total ChEAT score of participants at the premenarche stage. For the premenarche participants, however, sources of variance suggested a very high heritability. Regarding the EDI sub-scales, only the trait "Ineffectiveness" exhibited a moderate heritability among premenarche subjects, while all the four eating sub-scales showed moderate heritability estimates in the premenarche stage group. Conclusions. Our findings reveal that there are significant differences in genetic and environmental effects on eating attitudes and behaviors depending on being in a premenarche or premenarche stage. Therefore, clinicians should pay attention to female adolescents at high risk of developing ED, especially during the critical period of menarche