Faringoamigdalitis no estreptocócicas ¿hay "algo" más allá de las guías clínicas? / No disponible

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Test de detección rápida en infecciones ORL y respiratorias: utilidad en la consulta / Rapid tests in otolaryngologic and respiratory tract infections: usefulness in the medical office

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[Metabolic alterations related to syndrome X and low vitamin E levels in obese children with acanthosis nigricans]. / Alteraciones relacionadas con el síndrome X y bajos niveles de vitamina E en niños con obesidad y acantosis nigricans.

BACKGROUND: In adults, both metabolic alterations related to syndrome X and lower plasma vitamin E levels have been associated with an increased risk of developing cardiovascular disease. OBJECTIVES: To study the presence of metabolic alterations related to syndrome X and to determine the plasma levels of vitamin E in obese children with acanthosis nigricans. METHODS: We performed a prospective study in 42 obese children [15 with acanthosis nigricans (AN) and 27 without]. Thirteen healthy non-obese children were also studied. After a 12-hour fast, plasma levels of glucose, insulin, triglycerides, cholesterol, high-density lipoprotein (HDL)-cholesterol, and vitamin E were determined. The insulin resistance index was also calculated. Differences between groups were determined using ANOVA. RESULTS: Obese children with AN showed higher plasma levels of insulin and triglycerides and lower plasma levels of HDL-cholesterol and vitamin E, as well as a higher insulin resistance index than non-obese children and obese children without AN. CONCLUSIONS: In obese children, the presence of acanthosis nigricans is linked to a group of metabolic alterations associated with a higher risk of developing cardiovascular disease and type 2 diabetes.

Alteraciones relacionadas con el síndrome X y bajos niveles de vitamina E en niños con obesidad y acantosis nigricans / Metabolic alterations related to syndrome X and low vitamin E levels in obese children with acanthosis nigricans

Antecedentes: En adultos, tanto las alteraciones metabólicas asociadas al síndrome X, como la disminución en las concentraciones plasmáticas de vitamina E, se han asociado a un mayor riesgo de desarrollar enfermedades cardiovasculares. Objetivos: Estudiar en niños obesos con acantosis nigricans la presencia de alteraciones metabólicas relacionadas con el síndrome X y determinar las concentraciones plasmáticas de vitamina E. Métodos: Se llevó a cabo un estudio prospectivo en 42 niños obesos, 15 con acantosis nigricans (OB+AN) y 27 sin ella (OB-AN), y 13 niños sanos sin obesidad. En todos ellos, y tras 12 h de ayuno, se determinaron las concentraciones plasmáticas de glucosa, insulina, vitamina E, triglicéridos, colesterol y colesterol HDL. Se calculó el índice de resistencia a la insulina. Las diferencias entre grupos se determinaron mediante el análisis de la varianza. Resultados: Los niños obesos con acantosis nigricans presentaron mayores concentraciones de insulina plasmática y de triglicéridos, menores niveles de colesterol HDL (lipoproteínas de alta densidad) y de vitamina E en plasma, así como un índice de resistencia a la insulina más elevado que los niños obesos sin acantosis nigricans o que los valores observados en un grupo de niños sin obesidad. Conclusiones: La presencia de acantosis nigricans en niños obesos define a un grupo de niños con alteraciones metabólicas asociadas a un mayor riesgo de desarrollar enfermedades cardiovasculares y diabetes de tipo 2 (AU)

[Primary hyperlipidemia in children and adolescents: effects of dietary and pharmacological intervention]. / Dislipemias primarias en la infancia y la adolescencia: efectos del tratamiento dietético y farmacológico.

A retrospective study was performed on children with hypercholesterolemia or hypertriglyceridemia referred to the Endocrine Clinic of the Niño Jesús University Hospital over a period of 5 years. One hundred twenty-seven children, from 2 to 16 years of age, were followed. The subjects were classified into the following groups: 90 with primary hyperlipidemia [55 polygenic hypercholesterolemia (PH), 23 familial hypercholesterolemia (FH) and 12 with familial combined hyperlipidemia (FCH)]; 2 with secondary hypercholesterolemia and 35 were found to have normal cholesterol and triglyceride values. All patients with primary hyperlipoproteinemia were instructed to carry out dietary intervention during a 6 month period, following the step I recommendations of the National Cholesterol Education Program (NCEP). The following results were obtained: In the group of children with PH and FH a decrease in total and LDL cholesterol was observed (p < 0.0001 for both groups). In the group of FH, a decrease in the LDL/HDL ratio was also observed (p < 0.01). In contrast, the group of children with FCH did not show any changes in the lipoprotein pattern after dietary intervention. In the three groups studied, no statistically significant differences were observed in the remaining parameters (HDL-C, VLDL, and apo A1) after dietary intervention. Lp(a) levels above 30 mg/dl were observed in 25%, 37% and 46% of the children with PH, FH and FCH, respectively. Nine patients with FH were treated with resins for 3 months. In these children a decrease in total and LDL cholesterol, apo B and in the LDL/HDL ratio was observed (p < 0.05). No changes in Lp(a) and HDL-C were observed in this group of children. In our experience, dietary intervention to reduce fat and cholesterol intake in children with primary hyperlipoproteinemia, a population at high risk of developing atherosclerosis, is safe and useful. The treatment with resins in children with FH improves their lipoprotein profile.