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BACKGROUND: Patients with obesity have an increased risk for adverse COVID-19 outcomes. Body mass index (BMI) does not acknowledge the health burden associated this disease. The performance of the Edmonton Obesity Staging System (EOSS), a clinical classification tool that assesses obesity-related comorbidity, is compared with BMI, with respect to adverse COVID-19 outcomes. METHODS: 1071 patients were evaluated in 11 COVID-19 hospitals in Mexico. Patients were classified into EOSS stages. Adjusted risk factors for COVID-19 outcomes were calculated and survival analysis for mechanical ventilation and death was carried out according to EOSS stage and BMI category. RESULTS: The risk for intubation was higher in patients with EOSS stages 2 and 4 (HR 1.42, 95% CI 1.02-1.97 and 2.78, 95% CI 1.83-4.24), and in patients with BMI classes II and III (HR 1.71, 95% CI 1.06-2.74, and 2.62, 95% CI 1.65-4.17). Mortality rates were significantly lower in patients with EOSS stages 0 and 1 (HR 0.62, 95% CI 0.42-0.92) and higher in patients with BMI class III (HR 1.58, 95% CI 1.03-2.42). In patients with a BMI ≥ 25 kg/m2, the risk for intubation increased with progressive EOSS stages. Only individuals in BMI class III showed an increased risk for intubation (HR 2.24, 95% CI 1.50-3.34). Mortality risk was increased in EOSS stages 2 and 4 compared to EOSS 0 and 1, and in patients with BMI class II and III, compared to patients with overweight. CONCLUSIONS: EOSS was associated with adverse COVID-19 outcomes, and it distinguished risks beyond BMI. Patients with overweight and obesity in EOSS stages 0 and 1 had a lower risk than patients with normal weight. BMI does not adequately reflect adipose tissue-associated disease, it is not ideal for guiding chronic-disease management.
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COVID-19 , Obesidade , Adulto , Idoso , COVID-19/complicações , COVID-19/epidemiologia , COVID-19/mortalidade , Comorbidade , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/fisiopatologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
INTRODUCTION: Cloacogenic Polyps are characterized by the presence of inflammatory lesions in the lower rectum, and the anal transition zone. The polyps can prolaps; this is due to the malfunction of the internal anal sphincter; and the smooth muscle that covers the rectum. This is the result of the chronic inflammatory process. The lesions are more common in women during the third and fourth decade of life, however lesion have been described in 10 and 83 year olds. 85% lesions are located above the anal border and predominantly in the anterior lateral wall. The polyps vary in size from 3-4 cm in diameter, and have a sessile appearance. CASE REPORT: 10-year-old female presents with a 3-month history of irregular abdominal pain, with occasional vomiting, constipation, and occasional diarrhea. CONCLUSIONS: This entity of colon polyps is somewhat rare, and is seen in young adults; however its presence in infancy requires that we think of this entity when we formulate our differential diagnosis. Due to the character of the lesions, this entity could be confused with colorectal malignant tumors. All children and infants with a rectal mass, and blood in their stools should get a biopsy sent for histopathology. This technique can aid in analyzing the origin of the lesion.
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Pólipos Intestinais/diagnóstico , Doenças Retais/diagnóstico , Adolescente , Feminino , Humanos , Pólipos Intestinais/complicações , Pólipos Intestinais/patologia , Proctite/complicações , Doenças Retais/complicações , Doenças Retais/patologiaRESUMO
INTRODUCTION: The infection by Helicobacter pylori affects approximately 50% of the world population, in average, nevertheless the geographical area and the socioeconomic conditions are determining for the infection in earlier ages, not even that, only 20% of these patients will develop gastroduodenal disease. The infection is distributed universally, concerning more to the countries in routes of development, where he appears with major frequency in the infantile and young population. In Mexico the seroprevalence studies founded that 20% of the children of one year old already had developed antibodies Ig G against Helicobacter pylori and 50% of them are positive 10 years after The major prevalence is reached between 25 and 30 years of age. In our community we do not know the prevalence of active infection. MATERIAL AND METHODS: The study group became from three different communities: Group A. Formed with children from half-low socioeconomic level, which they come habitually to a school placed in the conurban zone of the city of Puebla, Mexico and that inhabit a marginal area of asistential services of sanitary attention. Group B. Formed with children from the rural zone, of socioeconomic rural way, which habitually they come to a school placed in the surroundings of the City of Puebla, Mexico and that live in a rural zone, with regular services of sanitary attention. Group C. Formed with children from high socioeconomic level, which they come habitually to a private school placed in the city of It Populates, Mexico and that inhabit in zones with all the sanitary services. RESULTS: The group A was formed by 94 children, 23 of them was positive to Hp antigen (24.46%) and negatives 71 (75.54%). The group B was formed by 94 children, 17 of them was positive to Hp antigen (18.08%) and negatives 77 (81.92%). The group C was formed by 94 children, two of them was positive to Hp antigen (2.12%) and 92 negatives (97.88%). Statistically significant differences was found in: The days that eat meat, the drainage in the domicile, in the prevalence of antigen, if they have breakfast every day, the number of persons who live in the room, if there is drinkable water in the domicile, if they have drainage in the domicile, if they present diarrheic stools, if they possess wild animals. And no relation with the age, the kind (genre), the existence of domestic animals and the presence of abdominal pain. CONCLUSIONS: It is a question of three different populations in the same territory, the first one located in a conurban zone of regular services of health demonstrates a prevalence of almost 25%. The second from a rural zone, who live and study out of the circle of the city and in this one found 18% of positive results and the third group living in the city but with all the sanitary services that reported 2%. Only the drainage presence intra domiciliary and the fact that they were eating meat a week demonstrated to have statistic importance in three groups. To have drinkable water and the number of persons who coexist in the house demonstrated the sanitary conditions that also prevailed statistically in the group A and B in relation to the control group; The presence of diarrheic stools in the group A statistically significant make us suspect that one hand the sanitary environmental conditions to that these children are submitted are not the bestones.
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Infecções por Helicobacter/epidemiologia , Helicobacter pylori , Adulto , Criança , Feminino , Infecções por Helicobacter/imunologia , Humanos , Imunoglobulina G/análise , Imunoglobulina G/imunologia , Masculino , México/epidemiologia , Fatores de Risco , População Rural , Saneamento , Fatores Socioeconômicos , População UrbanaRESUMO
Introducción: La infección por rota virus se ha reconocido como un patógeno en el humano y causante de enfermedad diarreica grave; la infección se ha asociado con meningitis aséptica, enterocolitis necrotizante, miositis aguda , abscesos hepáticos, neumonía, enfermedad de Kawasaki , síndrome de muerte súbita y enfermedad de Crohn. En este caso se informa la asociación con hepatitis infecciosa. Caso Clínico: Masculino, con colitis alérgica a las proteínas de la leche de vaca y de la soya, desde el nacimiento. Al mes y medio presenta enfermedad diarreica por rota virus asociada a hepatitis. Conclusiones: Tradicionalmente se ha considerado que es una infección del intestino delgado y que todos los eventos fisiopatologicos son el resultado de este tipo de lesión y de la intolerancia alimentaria que provoca a nivel local, sin embargo se han informado enfermedades que se presentan en otros órganos, como respuesta a la infección viral del sistema digestivo. En esta ocasión la invasión por el virus provoca daño hepático.
We describe a 3- month-old infant that was diagnosed with hepatitis secondary to infection by the rotavirus. The rotavirus has been recognized as a human pathogen that has been associated with severe diarrhea, aseptic meningitis, necrotizing enterocolitis, acute miositis, hepatic abscesses, pneumonia, Kawasaki disease, sudden infant death syndrome, and inflammatory bowel disease such as Crohns. To our knowledge, only three reports have associated the rotavirus with acute hepatitis, however, one of the three reports was in an immunodeficient patient. In this report we present another case of acute hepatitis secondary to the rotavirus, in an immunocompetent patient.
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Diarrhea is a serious public health problem in Mexico and other countries. A widely used alternative in the treatment of diarrhea is the use of herbal medicines. Infusions of chamomile and star anise possess anti-inflammatory and antimotility properties that could help alleviate gastrointestinal disorders. The aim of this study was to determine the effect of the mixture of chamomile and star anise infusions on gastrointestinal activity in mice. A gastrointestinal assessment of the mixture of chamomile and star anise was carried out in mice, and the percentage of advance of administered activated carbon through the intestinal tract of the animals was measured. Furthermore, the diarrhea model was induced with castor oil. The infusions were prepared using a mix with a 50:50 ratio of the herbs, and were administered at Mix-10, 20, 40 and 80 (mg/kg) orally. The results indicate that Mix-40 and Mix-80 decreased the completion percentage of the activated carbon, delayed the appearance of diarrhea and decreased the number of evacuations in comparison with the control group. This suggests that the combination of chamomile and star anise can be used as an alternative antidiarrheal treatment.
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Introducción: Helicobacter pylori produce inflamación crónica de la mucosa gástrica y provoca varios tipos de gastritis, que van desde la crónica superficial hasta la atrófica y al adenocarcinoma gástrico. Existen estudios que demuestran el porcentaje tan variable de infección que ocurre en los niños dependiendo de la edad y las condiciones socioeconómicas. El objetivo de este estudio fue conocer, en una muestra de niños aparentemente sanos de una comunidad de medio socioeconómico medio-bajo, la prevalencia de infección activa y su correlación con la sintomatología y los diversos factores de riesgo implicados.Material y métodos: Se estudiaron dos grupos de niños de dos escuelas con edades entre 6 y 13 años, con una media de 9 años, 46 del género masculino (49 por ciento) y 48 del femenino (51 por ciento); previo consentimiento de padres y directivos se les realizó una encuesta para valorar factores de riesgo y sintomatología a 94 sujetos elegidos al azar; se les solicitó una muestra de materia fecal para la determinación de antígeno de Helicobacter pylori. Las pruebas estadísticas utilizadas fueron Chi cuadrada y Exacta de Fisher.Resultados: Los resultados positivos para antígeno de Helicobacter pylori fueron 23 (24.5 por ciento) y negativos 71 (75 por ciento); las muestras de niños con resultados positivos fueron 13 (14 por ciento) y 10 (10.5 por ciento) de niñas, sin mostrar significancia estadística para el género, de acuerdo con la prueba exacta de Fisher. Respecto a los factores de riesgo estudiados: número de veces a la semana de ingestión de carne, hábito de desayuno, hacinamiento, agua potable, drenaje, convivencia con animales domésticos o silvestres, y antecedentes de síntomas como dolor abdominal y periodos de diarrea frecuentes no hubo significancia, con valores de p< 0.734 usando Chi cuadrada.
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Humanos , Masculino , Feminino , Adolescente , Helicobacter pylori , Gastrite , Criança , PrevalênciaRESUMO
Se revisan los signos y síntomas que se observan en los niños que cursan con elevación de la presión del sistema venoso porta. Se propone una forma de estudio sistematizado, para el análisis de los mismos, mediante los cuales se pueda llegar al diagnóstico del sitio de la obstrucción y de la causa que originó el problema
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Humanos , Hipertensão Portal/diagnósticoRESUMO
Se informa del caso de un niño de siete años de edad, quien presentó, desde el nacimiento, ictericia. A los dos años de edad se agregaron prurito y xantomas en la piel. Sus estudios demonstraron la presencia de hipoplasias de vías biliares intrahepáticas asociada a anormalidades en la cara, vértebras, arteria pulmonar, ojos y retraso en el desarrollo físico. Estas anormalidades establecen el síndrome de Alagille (displasia arteriohepática). Se discuten los hallazgos clínicos del paciene en función de lo observado por otros autores. El presente caso ejemplifica claramente y en forma amplia al síndrome de Alagille, entidad, hasta ahora, poco estudiada en nuestro país
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Criança , Humanos , Masculino , Ductos Biliares Intra-Hepáticos/anormalidades , Anormalidades Múltiplas , Cardiopatias Congênitas , SíndromeRESUMO
Se analizan los sintomas predominantes en 80 niños con hipertensión porta, 37 femininos y 43 masculinos, con edades comprendidas de 8 meses a 17 años; se mencionan las causas más frecuentes que incluyeron la trombosis de la vena porta, la cirrosis, la degeneración cavernomatosa de la vena porta y la fibrosis hepática congenética, entre otras. Se hace un análisis estadístico con respecto a la sintomatologia de estos niños, según el tipo de obstrucción que presentaron
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Lactente , Pré-Escolar , Criança , Adolescente , Humanos , Masculino , Feminino , Hipertensão Portal/etiologia , Biópsia , Fígado/patologia , Hipertensão Portal/diagnósticoRESUMO
La hipoplasia de conductos biliares intrahepáticos forma parte del diagnóstico diferencial de los síndromes colestásicos de los niños. El propósito del presente trabajo es el de informar la experiencia que en el Hospital Infantil de México Federico Gómez se tiene en los últimos años sobre esta entidad. Analizamos los expedientes de 31 niños con hipoplasia de conductos biliares intrahépaticos y encontramos un leve predominio del sexo masculino, la mayoría fueron pacientes menores de tres meses de edad, la colestasis fue el hallazgo más frecuente y hubo una buena correlación entre la clínica y la imagen histológica que fue estadísticamente significativa; el resto de los hallazgos fue semejante a lo previamente informado por otros autores a excepción de una peculiar distorsión de la arquitectura hepática observada en la presente revisiòn que puede ser secundaria a la disminución de los conductos interlobulillares; finalmente es probable que estos pacientes cursen con retardo en crecimiento desde la vida intrauterina
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Humanos , Criança , Masculino , Feminino , Colestase Intra-Hepática/diagnóstico , Diagnóstico DiferencialRESUMO
Se informa de la experiencia obtenida con el empleo de la dieta elemental, en el estudio inicial de la recuperación de 12 niños afectados por desnutrición grave, acompañada de diarrea de evolución prolongada. Los resultados sugieren que entre la segunda y tercera semana del tratamiento, esta dieta promueve el incremento de peso de los niños a razón de 27.1 g/día. Por otro lado, los niños aumentan diariamente 4.3 g de peso por cada 100 Kcal o bien, 1.9 g para gramo de proteína. Lo más trascendente viene a ser el hecho de que los incrementos ocurren con aportes de aproximadamente 100 Kcal/Kg/ día y 2 g/Kg?día de proteínas. En niños marasmáticos la respuesta a esta dieta es pobre
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Humanos , Masculino , Feminino , Alimentos Formulados , Desnutrição Proteico-Calórica/dietoterapiaRESUMO
Se realizo un estudio comparativo de la prueba de D-xilosa oral para investigar si existe asociacion entre el resultado de la prueba y la biopsia intestinal por succion en 85 ninos con diarrea cronica, en edades comprendidas desde el mes de edad hasta los 12 anos. En 68 de los pacientes, la biopsia intestinal mostro mucosa normal; 12 presentaron atrofia parcial y cinco atrofia total de las vellosidades intestinales (yeyuno). Al relacionar los niveles de la D-xilosa a la hora y dos horas con la presencia de atrofia parcial o total, no se encontraron diferencias estadisticamente significativas. La prueba de la D-xilosa se realizo tomando muestras de sangue a la hora y dos horas. El sexo, la edad, el peso y la superficie corporal no modificaron los resultados