Association between personality traits, eating behaviors, and the genetic polymorphisms FTO-rs9939609 and MAO-A 30 bp u-VNTR with obesity in Mexican Mayan children.

Introduction: Genetic variants that control dopamine have been associated with obesity in children through loss of control of satiety and impulses, the manifestation of addictive eating behaviors, and specific personality traits. The variants include FTO-rs9939609 and the MAO-A 30 pb u-VNTR low-transcription alleles (LTA). Objective: To evaluate the genetic association of FTO-rs9939609 and the MAO-A LTA, along with personality traits and eating behavior with obesity in Mayan children from Mexico. Methods: We cross-sectionally evaluated 186 children (70 with obesity and 116 with normal weight) 6-12 years old from Yucatan, Mexico. Nutritional status was defined with body mass index (BMI) percentiles. Personality traits were evaluated with the Conners and TMCQ tests; eating behavior was evaluated with the CEBQ test. Genotyping with real-time PCR and TaqMan probes was used for FTO-rs9939609, whereas PCR amplification was used for MAO-A u-VNTR. Results: High-intensity pleasure (p = 0.013) and moderate appetite (p = 0.032) differed according to nutritional status. Heterozygous FTO-rs9939609 T/A children showed higher mean scores of low-intensity pleasure (p = 0.002) and moderate appetite (p = 0.027) than homozygous T/T. Hemizygous boys having MAO-A LTA showed significantly higher mean scores of anxiety (p = 0.001) and impulsivity (p = 0.008). In multivariate models, only LTA alleles of MAO-A explained obesity in boys (OR = 4.44; 95% CI = 1.18-16.63). Conclusion: In the present study, MAO-A u-VNTR alleles were associated with obesity in multivariate models only in boys. These alleles might also have a role in personality traits such as anxiety and impulsivity, which secondly contribute to developing obesity in Mayan boys.

Nutrimetry: BMI assessment as a function of development. / Nutrimetría: evaluando el IMC en función del desarrollo.

BACKGROUND AND OBJECTIVE: Adequate nutritional assessment is required to fight malnutrition (undernutrition and overfeeding) in children and adolescents. For this, joint interpretation of certain indicators (body mass index [BMI], height, weight, etc.) is recommended. This is done clinically, but not epidemiologically. The aim of this paper is to present "nutrimetry", a simple method that crosses anthropometric information allowing for bivariate interpretation at both levels (clinical and epidemiological). MATERIALS AND METHODS: Data from 41,001 children and adolescents aged 0-19 years, taken from Mexico's National Health and Nutrition Survey 2012, were analyzed. Data crossed were BMI-for-age z-scores (BAZ) with height-for-age z-scores (HAZ) according to the World Health Organization (WHO) standards. Conditional prevalences were calculated in a 3×3 grid and were compared with expected values. RESULTS: This method identified subgroups in each BAZ category showing heterogeneity of the sample with regard to WHO standards for HAZ and nutritional status. According to the method, nutritional status patterns differed among Mexican states and age and sex groups. CONCLUSION: Nutrimetry is a helpful and accessible tool to be used in epidemiology. It allows for detecting unexpected distributions of conditional prevalences, its graphical representation facilitates communication of results by geographic areas, and enriched interpretation of BAZ helps guide intervention actions according to their codes.

Dosis y eficacia de la toxina botulínica en pacientes pediátricos con espasticidad / Dose and efficacy of botulinum toxin in pediatric patients with spasticity

Objetivo. Evaluar la efectividad de la toxina botulínica en el tratamiento de la espasticidad de los miembros superiores e inferiores en pacientes pediátricos en un entorno clínico real. Pacientes y métodos. Se realizó un estudio retrospectivo basado en el historial clínico de 79 pacientes pediátricos con espasticidad en diferentes formas clínicas y grados de afectación tratados con toxina botulínica tipo A. La mejoría de la rigidez y movilidad fue estimada por el médico tratante mediante exploración física, evaluando la marcha, la calificación en la escala de Ashworth y la medición de los ángulos de movilidad articular mediante un goniómetro. Se registró el número de inyecciones, el intervalo entre ellas, el sitio de aplicación y la dosis, y se consideró una respuesta positiva al tratamiento la disminución del al menos un punto en la escala de Ashworth o un incremento en los grados de movilidad articular. Resultados. Los pacientes recibieron inyecciones en 10 ± 7 músculos diferentes en intervalos de 4 a 50 semanas (media: 13 ± 9 semanas). Un 90% de los pacientes recibió rehabilitación. Las articulaciones de la rodilla, el tobillo y la muñeca presentaron un mayor porcentaje de mejoría. En el 24% de los pacientes se encontró mejoría en los grados de movimiento articular. Conclusión. La aplicación de toxina botulínica tipo A fue efectiva para el tratamiento de la espasticidad en la población pediátrica

Aim. To evaluate the effectiveness of botulinum toxin in the treatment of upper and lower limb spasticity in pediatric patients in a real clinical setting. Patients and methods. A retrospective study was conducted based on information from clinical records of 79 pediatric patients with spasticity in different clinical forms and severity treated with botulinum toxin type A. The improvement of rigidity and mobility was estimated by the attending physician through physical examination, evaluating the gait, rating on the Ashworth scale and measurement of joint mobility angles using a goniometer. The number of injections, the interval between them, the site of application and the dose were recorded, considering the reduction of at least one point on the Ashworth scale or an increase in the degrees of joint mobility as treatment response. Results. Patients received injections in a mean of 10 ± 7 muscles at intervals of 4 to 50 weeks (average: 13 ± 9 weeks). A 90% also received rehabilitation. The knee, ankle and wrist showed presented a higher percentage of improvement. An improvement in the degrees of movement was found in 24% of patients. Conclusion. The application of botulinum toxin type A was effective for the treatment of spasticity in the pediatric population

Nutrimetría de z-IMC vs z-peso en función al desarrollo lineal en edades de 0 a 30 meses / Nutrimetry of z-BMI vs z-weight in relation to lineal development from 0 to 30 agemonths

Fundamentos: Para favorecer la salud del individuo es necesario contar con indicadores que permitan valorar su estado nutricional a lo largo de todo su desarrollo. El IMC/edad podría permitir esto pero en menores de 2 años su uso no es habitual. Este trabajo compara IMC/edad vs peso/edad en función de longitud/edad por medio de la Nutrimetría, proponiendo ambas como herramientas de vigilancia nutricional para su uso clínico y epidemiológico.Métodos:5,186 niños divididos por edades (0-6, 7-12, 13-18, 19-24 y 25-30 meses) derivados de ENSANUT-2012, con Nutrimetría considerando puntuaciones Z según OMS, ponderando para longitud/edad: z≤-2=1, z≥2=5, o 3 al resto, y para IMC/edad o peso/edad: z≤-1=0, z≥1=6, o 3 al resto resultando dos nutricódigos (longitud-IMC y longitud-peso). Resultados: Diferencias en prevalencias de longitud-IMC menos longitud-peso en las 9 clasificaciones (1,3,5,4,6,8,7,9,11) por grupo de edad: (1)-5,19;0,37;1,94;1,91;-11,13;-0,47;3,29;10,76;-1,46; (2)-5,04;-1,10;1,70;-1,68;-10,00;-1,03;6,73;11,11;-0,67; (3)-8,82;-2,73;1,29;1,84;-18,64;-0,74;6,99;21,37;-0,55; (4)-8,69;-4,31;0,59;3,12;-11,91;-0,12;5,56;16,22;-0,46; (5)-7,04;-2,41;0,43;2,03;-12,95;0,13;5,01;15,35;-0,56. Correlación IMC/edad con longitud/edad (r=-0,19, p≤0,01) y peso/longitud (r=0,97, p≤0,01). Conclusiones: El Nutricódigo longitud-peso en niños altos, sobreestima la proporción de riesgo de sobrepeso/obesidad (R-Sp/Ob) y subestima la de desnutrición, y en longitud/edad baja sobreestima la desnutrición crónica y subestima el R-Sp/Ob, esto y las correlaciones muestran más adecuado usar en Nutrimetría el cruce longitud/edad con IMC/edad

Background: People's health should be enhanced since childhood, so indicators that allow assessing their nutrition status throughout their development are necessary. Body mass index for age (BMI/age) could allow this, but in children under 2 years of age its use is not usual. The present study compares BMI-for-age vs weight-for-age according to length-for-age through Nutrimetry, proposing both as nutritional surveillance tools for clinical and epidemiological use. Methods: We analyzed 5,186 children divided by age (0-6, 7-12, 13-18, 19-24 and 25-30 months) derived from ENSANUT-2012, with Nutrimetry according to WHO's Z scores, assigning for length-for-age: z≤-2=1, z≥2=5, or 3 for the rest, and for BMI-for-age or weight-for-age: z≤-1=0, z≥1=6, or 3 to the rest resulting in two nutricodes (length-BMI and length-weight). Results: Differences of prevalences of length-BMI minus length-weight in their 9 classifications (1,3,5,4,6,8,7,9,11) per age group: (1)-5.19;0.37;1.94;1.91;-11.13;-0.47;3.29;10.76;-1.46; (2)-5.04;-1.10;1.70;-1.68;-10.00;-1.03;6.73;11.11;-0.67; (3)-8.82;-2.73;1.29;1.84;-18.64;-0.74;6.99;21.37;-0.55; (4)-8.69;-4.31;0.59;3.12;-11.91;-0.12;5.56;16.22;-0.46; (5)-7.04;-2.41;0.43;2.03;-12.95;0.13;5.01;15.35;-0.56. Correlation BMI-for-age with length-for-age (r=-.19, p≤0.01) and weight-for-length (r=.97, p≤0.01). Conclusions: With length-weight nutriticode in tall children, proportion of overweight/obesity risk was overestimated and malnutrition underestimated, and in low length-for-age children, chronic malnutrition was overestimated and risk of overweight /obesity underestimated, thus and correlations shows more suitable the use of Nutrimetry crossing length with BMI-for-age

Nutrimetría: evaluando el IMC en función del desarrollo / Nutrimetry: BMI assessment as a function of development

Antecedentes y objetivo: Para combatir la malnutrición (desnutrición y sobrealimentación) en los niños y adolescentes se necesita una evaluación nutricional adecuada, y para ello se recomienda interpretar conjuntamente ciertos indicadores (índice de masa corporal [IMC], talla, peso, etc.). Clínicamente esto se realiza, pero epidemiológicamente no. El objetivo de este trabajo es presentar la «Nutrimetría», un método simple que cruza información antropométrica permitiendo una interpretación bivariada en ambos niveles (clínico y epidemiológico). Materiales y métodos: Se analizaron datos de 41.001 niños y adolescentes de 0-19años derivados de la Encuesta Nacional de Salud y Nutrición 2012 de México. Se cruzó la información de la puntuación Z del IMC para la edad (Z-IMC) con Z de talla para edad (Z-talla) según estándares de la Organización Mundial de la Salud (OMS). Se calcularon prevalencias condicionales del cruce en una rejilla de 3×3 celdas y se comparó con lo esperable. Resultados: Se identificaron subgrupos en cada categoría del Z-IMC que permitieron apreciar heterogeneidad de la muestra respecto a los estándares de la OMS en estatura y estado nutricional. Según este método, los patrones nutricionales diferían entre estados mexicanos, edades y sexos. Conclusión: Nutrimetría es una herramienta útil y accesible para ser usada en epidemiología. Permite detectar distribuciones inesperadas de las prevalencias condicionales, su representación gráfica facilita la comunicación de resultados por áreas geográficas y la interpretación enriquecida del Z-IMC ayuda a orientar sobre acciones de intervención de acuerdo a sus códigos (AU)

Background and objective: Adequate nutritional assessment is required to fight malnutrition (undernutrition and overfeeding) in children and adolescents. For this, joint interpretation of certain indicators (body mass index [BMI], height, weight, etc.) is recommended. This is done clinically, but not epidemiologically. The aim of this paper is to present "nutrimetry", a simple method that crosses anthropometric information allowing for bivariate interpretation at both levels (clinical and epidemiological). Materials and methods: Data from 41,001 children and adolescents aged 0-19 years, taken from Mexico's National Health and Nutrition Survey 2012, were analyzed. Data crossed were BMI-for-age z-scores (BAZ) with height-for-age z-scores (HAZ) according to the World Health Organization (WHO) standards. Conditional prevalences were calculated in a 3×3 grid and were compared with expected values. Results: This method identified subgroups in each BAZ category showing heterogeneity of the sample with regard to WHO standards for HAZ and nutritional status. According to the method, nutritional status patterns differed among Mexican states and age and sex groups. Conclusion: Nutrimetry is a helpful and accessible tool to be used in epidemiology. It allows for detecting unexpected distributions of conditional prevalences, its graphical representation facilitates communication of results by geographic areas, and enriched interpretation of BAZ helps guide intervention actions according to their codes (AU)

Mechner's notatoon used as a comparative tool o diabetes self-management enhanncement interventions / Notación de echnner como herramienta comparativa de interveniones para optiimizar auto-manejo dibéético

Elder population is becoming proportionally a larger segment of the total population and among their health problems, diabetes mellitus (DM) is one of their main causes of death and disability. In DM, self-management is the basis for a better control, which is why public policy makers and healthcare providers should have available analytic tools that allow them to discriminate among the best self-care interventions in diabetes for older patients. Even though there are several meta-analyses already that offer this kind of review, this article proposes the use of Mechner's behavioral contingencies language to compare different approaches. Three interventions were described with this notation and even though there were some limitations for this analysis due to the fact that some results were not comparable or not available in the original papers, this formal symbolic language demonstrated to be useful for making analytical comparisons visually accessible, providing a better understanding of the contingencies that are at play in the situation and giving the advantage of cutting across all natural languages.

Actualmente existe un incremento en la proporción de adultos mayores (AM) en la población en general. Dentro de los problemas de salud de este grupo, la diabetes mellitus (DM) es uno de los padecimientos que causa mayor muerte e incapacidad. En la DM el auto-manejo es la base para un mejor control, por lo cual los tomadores de decisiones en política pública y los proveedores de servicios de salud, deben contar con herramientas de análisis que les permitan discriminar entre las mejores intervenciones que mejoren el auto-cuidado del paciente diabético mayor. A pesar de que ya existen a la fecha varios meta-análisis que hacen este tipo de revisiones, este artículo propone el uso del lenguaje de análisis contingencial de la conducta desarrollado por Mechner para comparar diferentes aproximaciones. Tres intervenciones fueron descritas usando esta notación y a pesar de existir ciertas limitaciones para el análisis debido a que algunos componentes de los estudios no eran comparables o no estaban disponibles para su consulta en los documentos originales, éste lenguaje gráfico fue útil para hacer visualmente accesible el análisis comparativo entre estudios, proveyendo un mejor entendimiento de las contingencias en juego dentro de la situación, con la ventaja de traspasar la barrera del idioma.