Frequency of malnutrition in children and adolescents with child maltreatment / Frecuencias de mala nutrición en niños y adolescentes con maltrato infantil

Introduction: child maltreatment (CM) can have a negative impact on physical and mental health in childhood and throughout life. Objective: to determine the frequency of malnutrition in cases of CM from the Clínica de Atención Integral al Niño Maltratado (CAINM) of the Instituto Nacional de Pediatría (INP), Mexico. Material and methods: this was a cross-sectional, retrospective, descriptive study of children with CM. Height/age, weight/height, and body mass index/age were used to determine malnutrition status (undernutrition and overweight or obesity). The frequency of malnutrition by age group and sex were compared using χ2 tests. The prevalence of malnutrition at CAINM was compared to that expected in Mexico (ENSANUT-2012), serving as a reference for children without CM, using one-sample Poisson tests. Results: of the 117 cases, 41 % presented wasting or overweight/obesity, and 25 % were growth-stunted. Neither wasting nor stunting displayed any difference between age groups (p > 0.05). Overweight/obesity was observed more frequently in adolescents than in schoolchildren (p < 0.05). Being overweight or obese was most frequently associated with sexual abuse, and wasting and stunting were most often associated with neglect. Compared to the population without CM, the group under 5 years of age had a higher prevalence of wasting (p < 0.01), and those aged 5 to 11 years had a higher prevalence of both wasting and stunting (p < 0.001). Conclusions: CM cases were characterized by acute undernutrition and stunting as well as by adolescents who were overweight or obese. Malnutrition in the pediatric population should be analyzed from a wider perspective, including possible CM (AU)

Introducción: el maltrato infantil (MI) puede afectar la salud física y mental en la niñez y a largo plazo. Objetivo: determinar las frecuencias de mala nutrición en casos de MI de la Clínica de Atención Integral al Niño Maltratado (CAINM), perteneciente al Instituto Nacional de Pediatría de México. Métodos: estudio transversal, retrospectivo y descriptivo. Se utilizaron los cocientes de peso/talla, talla/edad e IMC/edad. Las frecuencias de mala nutrición (desnutrición y sobrepeso/obesidad) se compararon entre los grupos de edad y sexo a través de la prueba del χ2. Utilizando pruebas de Poisson para una sola muestra se compararon las prevalencias de la mala nutrición con las esperadas en México (ENSANUT-2012). Resultados: de los 117 casos de MI, el 41 % presentaban emaciación o sobrepeso/obesidad, y el 25 % talla baja. Ni por emaciación ni por talla baja hubo diferencias entre los grupos de edad (p > 0,05). La frecuencia del sobrepeso/obesidad fue mayor en los adolescentes que en los escolares (p < 0,05). En el grupo de abuso sexual destacó el sobrepeso/obesidad; en el de negligencia, la emaciación y la talla baja. En comparación con las prevalencias de los niños sin MI, los niños < 5 años tuvieron prevalencias más altas de emaciación (p < 0,01); los de 5 a 11 años, de emaciación y talla baja (para ambas, p < 0,001). Conclusiones: los niños con MI se caracterizaron por desnutrición y talla baja, así como también por sobrepeso/obesidad en los adolescentes. La mala nutrición en las poblaciones pediátricas debe analizarse desde una perspectiva amplia, incluido el posible maltrato infantil (AU)

Clinical and biological acceptance of a fibrocollagen-coated mersylene patch for tracheal repair in growing dogs.

BACKGROUND: Collagen-covered prostheses can be used as a non-circumferential segmental tracheal replacement. However, the applicability of these implants in young subjects has not yet been reported. METHODS: In this experimental, longitudinal study, dogs aged 29-32 days underwent limited segmental tracheal replacement with a polyester prosthesis or were allocated to a control, untreated group. The dogs were evaluated clinically, endoscopically and tomographically for up to one year. RESULTS: Although there was evidence of tracheal growth in the experimental group, tomographic measurements were significantly smaller in this group than in the control group throughout the observation period. At the end of the study, there was no evidence of implant rejection, stenosis or collapse. Normal respiratory epithelium had grown across the implanted membrane in the experimental group. CONCLUSION: The homologous collagen mersylene membrane allowed for limited structural tracheal growth and was functionally integrated into the segmented tracheal wall in growing dogs.

Pharmacokinetics of lidocaine and its metabolite as a hepatic function marker in dogs.

Measuring hepatic metabolic function is critical for detection and treatment of liver failure. Several tests have been widely used to characterize the integrity of liver; however, they do not evaluate the metabolic function of the organ, most requiring multiple blood draws. The purpose of this study was to establish if the ratio of the lidocaine metabolite monoethylglycinexylidide (MEGX) divided by lidocaine concentration at 30 min post intravenous lidocaine administration is a good marker of metabolic activity of the liver. Nine healthy and two partially hepatectomized and auto-transplanted dogs were included in the study. A single 1.5 mg/kg intravenous dose of lidocaine and serum samples were obtained at selected times for 150 minutes. Serum concentrations of lidocaine and MEGX were determined by a validated high-performance liquid chromatographic method. Pharmacokinetic parameters were obtained by non-compartmental methods and ratio of AUC of MEGX divided by AUC of lidocaine was determined for each dog. This ratio was correlated with the ratio of the concentration of the compounds obtained 30 minutes after drug administration. A good concordance was obtained, suggesting that ratio obtained with a single sample may be useful to predict the hepatic metabolism function. To validate the test, dogs hepatectomized and auto-transplanted were plotted and the results obtained were within the values obtained in healthy dogs. These results suggest that ratio of MEGX/lidocaine obtained 30 min after administration could be a good marker of hepatic metabolic function.

Análisis descriptivo de una población de niños mexicanos con atresia de esófago y alteraciones cromosómicas / Esophageal atresia and chromosomal abnormalities in a mexican children population: descriptive analysis

Introducción. La asociación de alteraciones cromosómicas y atresia de esófago parece tener una morbiletalidad diferente al resto de la población con atresia de esófago (AE). Con el objetivo de conocer las características de esta asociación en una población de niños mexicanos se realizó este estudio. Material y métodos. Ensayo observacional, descriptivo, retrospectivo, transversal que incluyó pacientes con AE y alteraciones cromosómicas, que ingresaron en un hospital de tercer nivel de atención, durante un período de 31 años consecutivos. Se analizó la edad gestacional y de ingreso, sexo, tipo de atresia, alteración cromosómica, malformaciones adicionales, tratamiento, evolución y causa de muerte. Resultados. Se incluyeron 17 pacientes de 368 con AE (4,61%); 12 con trisomía 21 y 5 con trisomía 18; 16 de ellos presentaron de una a tres malformaciones adicionales. Se realizaron 15 diversos procedimientos quirúrgicos por la AE y 6 por malformaciones asociadas. Fallecieron catorce niños en un período de 140 días. Conclusiones. La coexistencia AE, trisomías y otras malformaciones mayores estuvo caracterizada por complicaciones multifactoriales que determinaron una evolución desfavorable a corto plazo (AU)

Introduction. Chromosome alterations are associated with esophageal atresia (EA) in up to 11% of the cases. The morbidity and mortality index of this population is different from other EA patients. The present study was aimed to determine the characteristics of this association in a Mexican infant patient population. Material and methods. Observational, descriptive, retrospective, transversal assay including patients with AE and chromosome alterations over a 31-year period. Gestational age, admittance age, sex, type of atresia, chromosome alteration, additional malformations, treatment, evolution and death cause, were registered. Results. Seventeen patients (4.61%) out of 368 with EA were included. Chromosome 21 trisomy was detected in 12 children and 5 with 18 trisomy. One to 3 additional malformations were found in 16 patients. Fifteen children were subjected to surgical procedures for EA, and 6 for associated malformations. Fourteen children died in a 140-day followup period. Conclusions. Coexistence between AE, trisomys and major malformations was characterized by multifactorial complications which determined adverse evolution in the short term (AU)

[Esophageal atresia and chromosomal abnormalities in a Mexican children population: descriptive analysis]. / Análisis descriptivo de una población de niños mexicanos con atresia de esófago y alteraciones cromosómicas.

INTRODUCTION: Chromosome alterations are associated with esophageal atresia (EA) in up to 11% of the cases. The morbidity and mortality index of this population is different from other EA patients. The present study was aimed to determine the characteristics of this association in a Mexican infant patient population. MATERIAL AND METHODS: Observational, descriptive, retrospective, transversal assay including patients with AE and chromosome alterations over a 31-year period. Gestational age, admittance age, sex, type of atresia, chromosome alteration, additional malformations, treatment, evolution and death cause, were registered. RESULTS: Seventeen patients (4.61%) out of 368 with EA were included. Chromosome 21 trisomy was detected in 12 children and 5 with 18 trisomy. One to 3 additional malformations were found in 16 patients. Fifteen children were subjected to surgical procedures for EA, and 6 for associated malformations. Fourteen children died in a 140-day follow-up period. CONCLUSIONS: Coexistence between AE, trisomys and major malformations was characterized by multifactorial complications which determined adverse evolution in the short term.

Pharmacokinetics of a cephalone (CQ-M-EPCA) in rats after oral, intraduodenal and intravenous administration.

As part of the development of a new series of antibacterial agents derived from coupling a beta-lactamic precursor with a fluoroquinolone and named cephalones, the pharmacokinetics of one derivate: CQ-M-EPCA in rats after intravenous, intragastric and intraduodenal routes, was carried out. After the IV injection of 20 mg/kg or 40 mg/kg of this cephalone, plasma concentrations at the time zero (Cp0) were 3.1 and 11.26 microg/ml, respectively. Plasma concentrations decreased rapidly to almost disappear in both instances. Forty-five minutes later, a surge in concentrations, in the 40 mg/kg group, with a maximal plasma concentration (Cpmax) of 2.97 microg/ml was observed. An elimination half-life (T1/2el) of 2.36 +/- 0.33 h. was calculated. The drug was undetected by the ninth hour. Intragastric administration of the drug resulted in Cpmax of 3.78 +/- 0.26 microg/ml with a time to reach Cpmax (Tmax) of 25 min and T1/2el = 3.22 h. Same variables after intraduodenal administration were Cpmax 4.71 microg/ml; Tmax 1h, and T1/2el 3.41 h. Outstandingly high bioavailabilities after intragastric and intraduodenal administration (169 and 246%, respectively), together with the shape of the concentration versus time profiles after IV administration suggest that the drug undergoes a complex redistribution phenomenon, while showing high tissue diffusion with an apparent volume of distribution of 3.33 l/kg.