Spanish national registry of celiac disease: incidence and clinical presentation.

OBJECTIVES: The aim of this study was to assess the incidence and clinical pattern of celiac disease (CD) presently diagnosed in Spanish children. METHODS: A prospective, multicenter, nationwide registry of new cases of CD in children <15 years was conducted from June 1, 2006 to May 31, 2007. The parameters studied were age at diagnosis, sex, clinical symptoms, associated diseases, nutritional status, CD serology, histological lesions, and HLA-DQ2/-DQ8. The crude incidence rate of CD was calculated as new cases per 1000 live births and as new cases per 100,000 person-years <15 years of age. RESULTS: A total of 974 new cases of CD were included. The median age at diagnosis was 2.3 years; 39.5% of CD diagnoses occurred in the first 2 years, 42% between 2 and 6, and 18.4% from 6 to 15. Total number of cases in each age group was 385, 409, and 180, respectively. Regarding clinical presentation 70.9% showed classical symptoms, 21.9% were nonclassical, and 7% were asymptomatic. A total of 95.7% of 931, 94.7% of 611, and 86.7% of 651 children tested positive, respectively, for immunoglobulin A (IgA) anti-transglutaminase type 2 antibodies, IgA endomysial antibodies, and IgA anti-gliadin antibodies. Villous atrophy was observed in 92.4% and increased intraepithelial lymphocytes with crypt hyperplasia in 3.3%. Of the children, 55% had normal growth, and 3.4% were overweight. The HLA phenotype was DQ2: 88.3%, DQ2/DQ8: 8.4%, and DQ8: 2.3%. The incidence rate was 7.9 cases of CD per 1000 live births and 54 cases per 100,000 person-years. CONCLUSIONS: In Spain, the most frequent clinical presentation of CD is the classical form, mainly diagnosed during the first 2 years of life. The observed incidence of CD in Spanish children is much higher than the present CD incidence rates observed in other European countries.

Psychological inflexibility and mental health symptoms during the COVID-19 lockdown in Spain: A longitudinal study.

Spain, one of the European countries most affected by the COVID-19 pandemic, underwent a strict lockdown between March and May 2020. This study examines longitudinally the evolution of both psychological inflexibility and mental health symptoms in a sample of college students from the beginning and throughout the end of the mandated lockdown period. We present the results from 197 participants who responded to an online survey at least at two of three data-collection waves scheduled at the beginning (N = 226), halfway (N = 172), and end (N = 188) of the lockdown. The analyses revealed that psychological inflexibility and symptomatology increased over time, and that inflexibility at the beginning of the lockdown indirectly predicted self-reported symptoms at the end of the lockdown via autoregressive parallel paths that also connected cross-sectionally to reveal that changes in inflexibility were predictive of changes in mental health. These results present a dynamic and robust relationship between psychological inflexibility and mental health symptoms throughout a relatively long and presumably stressful period of time.

Papel del pediatra en la prevención de la obesidad / No disponible

La obesidad es considerada por la OMS desde 1998 comouna epidemia global. Constituye un problema serio desalud en las sociedades occidentales donde el nivel devida y los medios de comunicación incitan al consumode alimentos con alto poder energético. Los factoresambientales juegan un papel importante en el aumentode la prevalencia de la obesidad. Actividad física regularescasa unida al incremento en el consumo de comidasaltamente calóricas entre los niños explican de formaclara este aumento. Aparte de los riesgos asociados a laobesidad, ser un niño obeso conlleva una carga psicológicay emocional importante.El mejor tratamiento de la obesidad infantil es la prevención.Esta debe comenzar por el pediatra desde la infancia, basándoseen la promoción de hábitos de alimentación saludables,aumento de la actividad física y modificación de hábitosobesogénicos. El objetivo prioritario es favorecer una dietaequilibrada y variada, adaptada al ritmo de crecimiento ydesarrollo del niño, al mantenimiento del peso ideal y deuna salud óptima en todas las edades.En el manejo y prevención de la obesidad infantil se implicaneducación, investigación e intervención. La educación debeir dirigida hacia los ámbitos familiar y comunitario, escolar,empresarial, sanitario y político(AU)

WHO considers obesity a global epidemy since 1998. Itis a major public health issue in western societies wherethe standard of living, lifestyles and mass media invite toconsume high energy density foods. Environmental factorsplay an important role in the increasing prevalence rates ofobesity. Limited practice of regular physical activity alongincreased consumption levels of foods of high caloric contentamong children explain to a great extent this growing rates.Apart from obesity associated comorbidites, being and obesechild das high emotional and psychological distress.Prevention is the best treatment for childhood obesity andshould start from early stages of life, following pediatricadvice from infancy, focused in supporting healthier eatingpractices and physical activity as well as helping changeof obesogenic habits. The main objective is to encouragevariety and balance in the diet, adequate for growth anddevelopment of the child, maintain body weight in theadequate range and optimal health at all ages.Education, research and intervention should be involved inthe management and prevention of children obesity. Educationshould be targeted to family, community, school, healthand political environment as well as the industry(AU)