Progresión de la obesidad infantil en Tenerife / Children obesity progression in Tenerife Island

Introducción: En nuestra práctica asistencial hemos observado recientemente un aumento de la obesidad en la población infantil y un adelanto en su edad de aparición. Nuestro objetivo es comprobar estos fenómenos, identificando la edad de mayor riesgo de inicio de obesidad infantil y estudiar su asociación a otros factores, como el sexo y el peso al nacimiento. Material, pacientes y métodos: Se analizan las historias clínicas de todos los niños (n= 660), pertenecientes a tres cohortes, según el año de nacimiento (1989, 1997 y 2000), en tres centros de salud del área de Tenerife. El peso al nacimiento se expresó como z-score, se calculó el índice de masa corporal(IMC) anualmente a partir del año de edad y hasta los 8 años. La progresión del IMC se representa gráficamente con su valor medio anual, por sexos y cohortes. Las diferencias de evolución del IMC por sexos, intra/intercohortes, se obtienen mediante un modelo lineal general multivariante para medidas repetidas, usándose modelos ANOVA para diferenciar la edad a laque se separan las diferentes cohortes en relación con el IMC. El poder predictivo independiente del año de nacimiento, elz-score del peso al nacer y el sexo del recién nacido sobre el IMC a los 8 años de edad se valora con modelos de regresión lineal múltiple. El riesgo de estos tres factores en relación con la aparición de la obesidad a los 8 años de edad se evalúa mediante modelos de regresión logística binaria multivariable. Resultados: El año de nacimiento, el z-score del peso al nacer y el sexo muestran un poder predictivo sobre el IMC a los 8 años de edad, y el primero es el factor de mayor significación y el que supone un riesgo significativo para presentar obesidad a esta edad. La edad más probable de inicio de obesidad infantiles a los 4 años. Conclusiones: a) la edad de inicio de la obesidad se ha adelantado en nuestra población infantil; b) la obesidad se inicia, como promedio, a la edad de 4 años, aunque es mayor en los varones, y c) al menos hasta los 8 años de edad, un mayor peso al nacer se asocia a un aumento del IMC (AU)

Introduction and aim: We have perceived an increased frequency and earlier onset of child overweight and obesity. Our objetive is to prove this hypothesis by identifying the age of higher risk of child obesity onset and by studying its association to gender and birth weight. Material and methods: Birth weight was expressed as zscore and yearly Body Mass Index (BMI) from the first year to the age of eight were collected from all clinical records of 660children of three Primary Health Centers of Tenerife. Data were classified into three cohorts by their birth year (1989, 1997 and 2000). BMI progression plots were done by gender and cohort.BMI evolution by gender, so intra as among cohorts, has been tested using a multivariate generalized linear model for iterated measurements. ANOVA test was used to estimate at which age the cohorts show a different BMI. The independent predictive power of birth year, birth weight z-score and gender on BMI at the age of eight was evaluated using multiple linear regression models, whereas the influence of these variables on the risk of obesity at eight years old was evaluated using binary multivariable logistic regression models. Results: Birth year, birth weight z-score and gender show predictive power on BMI at eight years of age, being the former which implies as significant risk of obesity at that age. Obesity onset is more frequent at the age of four years. Conclusions: a) obesity onset occur at earlier age in our children; b) obesity begins at four years of age in average and is more frequent in boys, and c) a higher birth weight is associated with an increased BMI, at least until the age of eight(AU)

[Postoperative cortical blindness after resection of a retroperitoneal teratoma]. / Ceguera cortical postoperatoria tras resección de teratocarcinoma retroperitoneal.

We present a rare case of cerebrovascular accident involving non-cardiac, non-neurological, non-carotid surgery in a 44-year-old man with no cardiovascular risk factors who underwent retroperitoneal resection of a teratocarcinoma, immediately after which he showed signs of confusion accompanied by cortical blindness. Neurological signs and symptoms remitted completely 5 days after surgery. Complementary tests and the patient's evolution confirmed a diagnosis of reversible ischemic neurological deficit.

[Visceral leishmaniasis and AIDS. Report of 2 cases with cutaneous dissemination]. / Leishmaniasis visceral y SIDA. A propósito de dos casos con diseminación cutánea.

The cutaneous affection in visceral leishmaniasis (VL) or Kala-azar, is well known although poorly documented. The coinfection by the human immunodeficiency virus (HIV) has resulted in the development of frequent atypical forms of VL, increasing the descriptions of cutaneous affection in its evolution. We present two cases of VL-HIV, stressing the location of Leishmania in cutaneous lesions and in apparently normal skin. We suggest the cutaneous biopsy as diagnostic procedure and criteria for the definition of VL-HIV as indicative of AIDS.

[Reticular and confluent papillomatosis of Gougerot and Carteaud. A clinical case]. / Papilomatosis reticular y confluent de Gougerot y Carteaud. Caso clínico.

We present a seventeen-year-old patient with reticular and confluent papillomatosis. Yeast forms were identified in wet mount preparation of scales with KOH. Although yeast forms disappeared with antifungal therapy, we couldn't obtain clinical improvement. With this presentation we case sustain the theory that P. ovale is not the causal agent of this illness.

[Yellow nail syndrome associated with sinusitis, rheumatoid arthritis, and chronic bronchitis]. / Síndrome de las uñas amarillas asociado a sinusitis, artritis reumatoide y bronquitis crónica.

A case of a 70 year old patient with the "yellow nail syndrome", that was associated to sinusitis, rheumatoid arthritis and chronic bronchitis. We comment the several studies realized (radiologic, mycologic, bacteriologic and laboratory studies) and the low effectivity of the treatment assayed.