Hemorragia digestiva alta: Helicobacter pylori e ingesta de ácido acetil salicílico / Upper gastrointetinal bleeding. Helicobacter pylori and intake of acetylsalicylic acid

Introducción. La hemorragia digestiva en niños requiere un adecuado diagnóstico etiológico, que variará en función de la localización, edad del paciente. Ante la presencia de hemorragia digestiva alta, se debe considerar la infección por Helicobacter pylori, ya que se asocia a gastritis crónica y desarrollo de úlcera garoduodenal. Además se deberán tener encuentra otros factores como realización de pruebas invasivas, ingesta de cuerpo extraño o tratamiento con antinflamatorios no esteroideos. Caso clínico. Describimos el caso de un niño de 11 años, que presenta una hemorragia digestiva alta asociada a enfermedad ulceropéptica por helicobacter pylori exacerbada por la ingesta de ácido acetil salicílico. Conclusiones. La infección por Helicobacter pylori puede permanecer asintomática hasta la edad adulta y aunque la primera manifestación suele ser el dolor abdominal, no deberemos olvidarla ante la presencia de hemorragia digestiva, patología poco habitual en la edad pediátrica, peor que se correlaciona con este microrganismo de manera similar a la población adulta. Se deberá descartar la presencia de otros factores de riesgo como la ingesta de ácido acetil salicílico u otros antinflamatorios no esteroideos, que pueden provocar exacerbaciones en una mucosa dañada previamente (AU)

Introduction. Gastrointestinal hemorrhage in children requires an adequate etiologic diagnosis, which depends on the location and the age of the patient. In upper gastrointestinal bleeding, Helicobacter pylori infection should be considered, because it is associated with chronic gastritis an peptic ulcer. In addition other factors such invasive techniques, foreign body ingestion or AINES therapy should be investigated. Clinical case. We report the case of a child under 11 years, who presents an upper gastrointestinal bleeding, associated with Helicobacter pylori peptic ulcer disease which was exacerbated by aspirin ingestion. Conclusions. Helicobacter pylori infection can remain asymptomatic until adulthood, and although the first manifestation is usually abdominal pain, we shouldn´t forget it in the presence of gastro intestinal bleeding, unusual disease in children, but with similar correlation that in the adult people. We should investigate other risk factors such as the ingestion of aspirin or other AINES, which cause exacerbation in a previously damaged mucosa (AU)

Características nutricionales de los recién nacidos de madres con sobrepeso y obesidad / Nutritional characteristics of newborns of overweight and obese mothers

Introducción: El estado nutricional materno es determinante para el crecimiento fetal y el peso del recién nacido (RN). El objetivo de este estudio es evaluar en nuestro medio la relación existente entre el IMC pregestacional materno y la antropometría de los niños desde el nacimiento hasta los 6 meses de vida, así como la prevalencia de lactancia materna. Material y métodos: Se han evaluado las variables antropométricas y el tipo de alimentación en una muestra de 1.547 RN durante 2009, representativa de nuestra población, en dependencia del IMC materno y en una cohorte de 759 lactantes de dicha muestra seguida hasta los 6 meses de vida. Resultados: El 72,9% de las gestantes presentaban normopeso, el 18,7% sobrepeso y el 8,4% obesidad. Las gestantes con IMC ≥ 25 kg/m2 ganaron menos peso durante el embarazo (p < 0,001), tenían menor nivel sociocultural (p < 0,001) y sus hijos pesaban más al nacer (p = 0,003) y a los6 meses de vida, sin encontrar diferencia en su longitud. El peso medio de los RN aumentó en relación con el IMC materno pero a partir de 35 kg/m2 disminuyó progresivamente (p < 0,001).Las mujeres obesas tuvieron una prevalencia de lactancia materna exclusiva del 58,5% al alta hospitalaria tras el parto y del 8,6% a los 6 meses frente al 70,8 y el 13,9%, respectivamente, en mujeres con normopeso (p < 0,05). Conclusiones: En nuestra muestra, la obesidad materna se asocia a un bajo nivel sociocultural, mayor peso del recién nacido que se mantiene hasta los 6 meses de vida y menor prevalencia de lactancia materna exclusiva. En conjunto, todos ellos son factores de riesgo nutricional acorto y largo plazo (AU)

Introduction: Maternal nutritional status is an important factor of adequate intrauterine growth and neonatal weight. The aim of this study is to evaluate the relationship between pregestational BMI (Body Mass Index) and breastfeeding duration, as well as infant anthropometric measurements during their first six months of life. Materials and methods: Anthropometric measurements and the type of feeding were evaluated in a representative sample of 1,547 newborns from our population during 2009, according to their maternal BMI, and also in a sub-cohort of 759 infants followed up to 6 months of life. Results: A total of 72.9% of women had a normal weight, 18.7% were overweight and 8.4% obese. Women with a BMI ≥ 25 kg/m2 had lower weight gain during pregnancy (P < 0.001), lower socioeconomic and cultural level (P < 0.001), and their infants had higher weight at delivery (P = 0.003) and at 6 months of life, with no differences in body length. Newborn weight increased in relation to maternal BMI, but over 35 kg/m2 it decreased progressively (P <0.001). Breastfeeding prevalence in obese women was 58.5% at hospital postpartum discharge, and 8.6% at six months of life; as opposed to 70.8% and 13.9%, respectively in women with normal BMI. Conclusions: In our sample, maternal obesity is associated with a low socioeconomic and cultural level, higher infant weight at delivery and at 6 months of life, and less prevalence of exclusive breastfeeding; all of them nutritional risk factors in the short and long term (AU)

[Nutritional characteristics of newborns of overweight and obese mothers]. / Características nutricionales de los recién nacidos de madres con sobrepeso y obesidad.

INTRODUCTION: Maternal nutritional status is an important factor of adequate intrauterine growth and neonatal weight. The aim of this study is to evaluate the relationship between pre-gestational BMI (Body Mass Index) and breastfeeding duration, as well as infant anthropometric measurements during their first six months of life. MATERIALS AND METHODS: Anthropometric measurements and the type of feeding were evaluated in a representative sample of 1,547 newborns from our population during 2009, according to their maternal BMI, and also in a sub-cohort of 759 infants followed up to 6 months of life. RESULTS: A total of 72.9% of women had a normal weight, 18.7% were overweight and 8.4% obese. Women with a BMI ≥ 25 kg/m(2) had lower weight gain during pregnancy (P < .001), lower socioeconomic and cultural level (P < .001), and their infants had higher weight at delivery (P=.003) and at 6 months of life, with no differences in body length. Newborn weight increased in relation to maternal BMI, but over 35 kg/m(2) it decreased progressively (P < .001). Breastfeeding prevalence in obese women was 58.5% at hospital postpartum discharge, and 8.6% at six months of life; as opposed to 70.8% and 13.9%, respectively in women with normal BMI. CONCLUSIONS: In our sample, maternal obesity is associated with a low socioeconomic and cultural level, higher infant weight at delivery and at 6 months of life, and less prevalence of exclusive breastfeeding; all of them nutritional risk factors in the short and long term.