Role of troponin in COVID-19 pandemic: a review of literature.

Acute SARS-CoV-2 respiratory disease is an infectious respiratory disease caused by the virus SARS-CoV-2 belonging to the coronaviridae family. A pandemic is still present as of May 2020. In addition to causing pneumonia, SARS-CoV-2 may induce a direct damage to the heart, causing myocarditis, with significant impairment of cardiac contractility, and/or pericarditis. Elderly patients and those with cardiovascular risk factors, such as hypertension and diabetes mellitus, are at increased risk of heart complications from COVID-19. In this review, we focused on the correlation between COVID-19 infection and the high sensitivity troponin T and I, and their significance in the development of myocarditis. Data emerging from the studies so far conducted indicate that a high value of high-sensitivity troponin represents a negative prognostic indicator when associated with heart damage on an infectious-inflammatory basis (i.e. myopericarditis). We should identify a safe and clear diagnostic algorithm, possibly combining patient clinical history, troponin levels and cardiac ultrasound findings that could help us in the prediction of myopericarditis.

Markers of acute coronary syndrome in emergency room.

Acute coronary syndromes (ACS) encompasses a spectrum of coronary heart diseases, ranging in severity from unstable angina to ST-elevation myocardial infarction (STEMI). Early diagnosis and risk stratification are needed in order to address correctly hospitalization and treatment. Although the diagnosis of STEMI in the presence of typical electrocardiogram (ECG) changes and symptoms is easy and does not require the use of biomarkers, cardiac biomarkers are particularly important in the Emergency Department (ED), where about 25% of patients admitted are affected by ACS but clinical presentation is often atypical and ECG alterations may be absent. The ideal marker in the ED should have rapid release, high sensitivity and specificity and risk stratifying properties. Classic cardiac biomarkers, like myoglobin, cardiac troponin T or I and creatine kinase-MB, have a poor sensitivity, dependent on the time past from the onset of symptoms to presentation, the duration of ischemia and the amount of myocardial tissue involved. Although the serial testing of these cardiac biomarkers can improve the detection of myocardial necrosis, there is still a need for the development of early markers that can reliably rule out ACS from the ED at presentation and also detect myocardial ischemia in the absence of irreversible myocyte injury. There are several markers which represent the different features of ACS pathogenesis and that can be divided into three major groups: markers of cardiac ischemia and necrosis, markers of inflammation and coronary plaque instability and marker of cardiac function.

[Nutritional status of adopted Chinese girls in Spain]. / El estado nutricional de niñas chinas adoptadas en España.

INTRODUCTION: Given the increasing number of adoptions from China in countries such as Spain, a study was designed to know and assess the nutritional profile at arrival and its likely implication in global health status, growth, and development of adopted Chinese girls. PATIENTS AND METHODS: Eighty-five Chinese girls adopted in Spain during the 2002-2003 period and ages ranging 7-33 months of life were studied at the Social Pediatrics Unit of the "Niño Jesús" Hospital, Madrid. Datas regarding institution of origin, nutritional parameters (anthropometrical and biochemical), presence of associated diseases, and developmental retardations (psychomotor/bone age) were gathered. RESULTS: Waterlow's nutritional index showed a malnourishment rate of 11% based on Chinese reference tables, as compared to 58% based on Spanish tables, of which 82% was acute malnourishment. When comparing the efficacy of both nutritional assessment methods proposed by Waterlow and Gomez, there were no differences in detection of malnourishment in spite of the fact that the latter author gives priority to the weight/age index as a nutritional indicator at ages lower than 2 years. Eighteen percent of the girls were considered at (height/age < p10) of suffering chronic malnourishment, but this was only confirmed in 67% of the group according to Waterlow's criteria. Among assessed plasma parameters, decreased prealbumin, lymphocytes, iron, and transferrin stand out. The predominant pathological findings were thalassemia, dermatitis, psychomotor retardation, and ferropenic anemia. CONCLUSIONS: These results make us believe in a possible improvement in the conditions at Chinese orphanages. The low age at the time of adoption may justify the low incidence of chronic nutritional deficiencies. As a whole, anthropometrical / nutritional impairments found may be related with the consequences of carelessness and vulnerability of the adoption process. In any case, early diagnosis and implementation of appropriate therapy as soon as possible, as it is being done, is essential to provide appropriate growth and development of these girls.

Evaluation of a lifestyle modification program for treatment of overweight and nonmorbid obesity in primary healthcare and its influence on health-related quality of life.

BACKGROUND: The impact of overweight and nonmorbid obesity on health-related quality of life (HRQL) has not been widely researched. The aim of this study was to evaluate the effects of a lifestyle modification program (LMP) focused on diet, exercise, and psychological support on HRQL in overweight and nonmorbidly obese patients treated in a primary healthcare setting. METHODS: Sixty patients with grade II overweight and nonmorbid grade I-II obesity were included in this open pilot clinical trial; subjects' ages ranged from 18 to 50 years. They were provided with an LMP combining nutrition education, physical activity, and psychological support. Subjects attended group sessions every 2 weeks. The main outcome measures at baseline and 6 months were body composition parameters (body mass index, body fat percentage, and waist circumference) and HRQL using the 1.4 Spanish version of the SF-36 questionnaire. The questionnaire yields an 8-scale profile of physical functioning (PF), role--physical (RP), bodily pain (BP), vitality (VT), social functioning (SF), role--emotional (RE), mental health (MH), and general health (GH) factors. RESULTS: The LMP achieved improvements in SF-36 subscales at the end of the intervention: PF (80.37 ± 18.90 vs 89.40 ± 13.95, P < .001), RP (20.37 ± 9.10 vs 23.14 ± 6.67, P < .05), VT (58.71 ± 21.98 vs 70.91 ± 26.56, P < .01), SF (79.62 ± 27.76 vs 86.57 ± 25.45, P < .03), and GH (61.03 ± 19.13 vs 69.42 ± 18.80, P < .001). CONCLUSION: An LMP focused on balanced and moderate energy-restricted diets, increased physical activity, and psychological support may improve the anthropometric parameters and the quality of life in moderately obese patients treated in a primary healthcare center.

El estado nutricional de niñas chinas adoptadas en España / Nutritional status in chinese adopted girls in Spain

Introducción: Frente al creciente número de adopciones chinas en algunos países como España, se planteó un estudio para conocer y evaluar el perfil nutricional a la llegada y su probable implicación en el estado general de salud, crecimiento y desarrollo de niñas chinas adoptadas. Pacientes y métodos: Se estudiaron 85 niñas chinas adoptadas en España en el periodo de 2002 a 2003, con edades comprendidas entre 7 y 33 meses de vida, remitidas a la Unidad de Pediatría Social del Hospital Niño Jesús, Madrid. Se recogieron datos referentes a la institución de procedencia, parámetros nutricionales (antropométricos y bioquímicos), presencia de enfermedades asociadas y retrasos de desarrollo (psicomotor/ edad-ósea). Resultados: El índice nutricional de Waterlow reflejó un 11% de malnutrición basándose en las tablas de referencia china, frente a un 58% obtenido por las tablas españolas, del cual el 82% era malnutrición aguda. Comparando la eficacia de dos métodos de valoración nutricional, propuestos por Waterlow y Gómez, no hubo diferencias en la detección de malnutrición, a pesar de que este último autor prioriza el índice peso/edad como indicador nutricional en edades por debajo de los 2 años. El 18% de las niñas fueron consideradas en grupo de riesgo (talla/edad < p10) para padecer desnutrición crónica, pero esto sólo se confirmó en el 67% del grupo, según criterios de Waterlow. Entre los parámetros plasmáticos valorados, destaca la disminución de la prealbúmina, linfocitos, hierro y transferrina. Los hallazgos patológicos predominantes fueron la talasemia, dermatitis, retraso psicomotor y anemia ferropénica. Conclusiones: Estos resultados nos llevan a creer en una posible mejoría en las condiciones ofrecidas en los orfanatos chinos. La baja edad en el momento de la adopción, podría justificar la pequeña incidencia de deficiencias nutricionales de carácter crónico. En general, las alteraciones antropométricas/nutricionales encontradas pueden relacionarse con las consecuencias del abandono y la vulnerabilidad del proceso de adopción. De cualquier manera, el diagnóstico precoz y la instauración de un tratamiento adecuado lo antes posible, como se viene haciendo, es fundamental para proporcionar un adecuado crecimiento y desarrollo de estas niñas

Introduction: Given the increasing number of adoptions from China in countries such as Spain, a study was designed to know and assess the nutritional profile at arrival and its likely implication in global health status, growth, and development of adopted Chinese girls. Patients and methods: Eighty-five Chinese girls adopted in Spain during the 2002-2003 period and ages ranging 7-33 months of life were studied at the Social Pediatrics Unit of the “Niño Jesús” Hospital, Madrid. Datas regarding institution of origin, nutritional parameters (anthropometrical and biochemical), presence of associated diseases, and developmental retardations (psychomotor/ bone age) were gathered. Results: Waterlow’s nutritional index showed a malnourishment rate of 11% based on Chinese reference tables, as compared to 58% based on Spanish tables, of which 82% was acute malnourishment. When comparing the efficacy of both nutritional assessment methods proposed by Waterlow and Gomez, there were no differences in detection of malnourishment in spite of the fact that the latter author gives priority to the weight/age index as a nutritional indicator at ages lower than 2 years. Eighteen percent of the girls were considered at (height/age < p10) of suffering chronic malnourishment, but this was only confirmed in 67% of the group according to Waterlow’s criteria. Among assessed plasma parameters, decreased prealbumin, lymphocytes, iron, and transferrin stand out. The predominant pathological findings were thalassemia, dermatitis, psychomotor retardation, and ferropenic anemia. Conclusions: These results make us believe in a possible in the conditions at Chinese orphanages. The low age at the time of adoption may justify the low incidence of chronic nutritional deficiencies. As a whole, anthropometrical / nutritional impairments found may be related with the consequences of carelessness and vulnerability of the adoption process. In any case, early diagnosis and implementation of appropriate therapy as soon as possible, as it is being done, is essential to provide appropriate growth and development of these girls

Actividad física, factor clave en la prevención de la obesidad / No disponible

No disponible