[Iodine nutritional status in the school-aged population in Alicante (Spain)]. / Situación nutricional de yodo en la población escolar de Alicante.

BACKGROUND: According to the World Health Organization (WHO), goiter is endemic in Spain. The main cause of endemic goiter is iodine deficiency, which is also the principal cause of mental retardation and avoidable cerebral palsy throughout the world. MATERIAL AND METHODS: We conducted an observational study to determine the prevalence of endemic goiter and nutritional iodine status in the province of Alicante. Urinary iodine excretion was measured in a morning urine sample, and thyroid volume was measured by means of a thyroid ultrasound scan. A case of goiter was diagnosed if thyroid volume was above the 97th percentile adjusted by age, as published by the WHO. RESULTS: No cases of goiter were found. In addition, the median urinary iodine excretion levels adjusted by age were within the normal range, as defined by the WHO's criteria. CONCLUSIONS: Endemic goiter was not found in the province of Alicante and urinary iodine excretion values demonstrated adequate iodine intake. Further ultrasound studies are needed to establish reference thyroid volumes for our population.

Situación nutricional de yodo en la población escolar de Alicante / Iodine nutritional status in the school-aged population in Alicante (Spain)

Antecedentes Según la Organización Mundial de la salud (OMS), España se consideró un país afectado de endemia bociosa. El déficit de yodo es el responsable de dicha endemia además de ser la principal causa de retraso mental y parálisis cerebral evitable en el mundo. Material y métodos Estudio observacional para determinar la prevalencia de bocio endémico y el estado nutricional de yodo en la provincia de Alicante. Para ello se midió la yoduria en una muestra aislada y el volumen tiroideo mediante ecografía. Se consideró bocio todo volumen tiroideo superior al percentil 97 por edad publicado por la OMS. Resultados No se ha encontrado ningún caso de bocio. Así mismo las cifras de yoduria obtenidas también pueden ser consideradas dentro de la normalidad bajo los criterios de la OMS. Conclusiones Se puede decir que la provincia de Alicante no padece endemia bociosa y que además las cifras de yoduria demuestran una adecuada ingesta de yodo. Se evidencia la necesidad de realizar más estudios ecográficos de tiroides en otras zonas para establecer volúmenes tiroideos de referencia para nuestra población

Background According to the World Health Organization (WHO), goiter is endemic in Spain. The main cause of endemic goiter is iodine deficiency, which is also the principal cause of mental retardation and avoidable cerebral palsy throughout the world. Material and methods We conducted an observational study to determine the prevalence of endemic goiter and nutritional iodine status in the province of Alicante. Urinary iodine excretion was measured in a morning urine sample, and thyroid volume was measured by means of a thyroid ultrasound scan. A case of goiter was diagnosed if thyroid volume was above the 97th percentile adjusted by age, as published by the WHO. Results No cases of goiter were found. In addition, the median urinary iodine excretion levels adjusted by age were within the normal range, as defined by the WHO's criteria. Conclusions Endemic goiter was not found in the province of Alicante and urinary iodine excretion values demonstrated adequate iodine intake. Further ultrasound studies are needed to establish reference thyroid volumes for our population

Fibrosis endomiocárdica o enfermedad de Davies / Endomyocardial fibrosis or Davies’ disease

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[Ethnic difference in attendance at emergency departments. An approximation to the gypsy reality]. / Diferencia étnica en la actividad asistencial de urgencias. Aproximación a la realidad gitana.

BACKGROUND: Demand for emergency services is increasing, especially among children from non-Caucasian ethnic groups. OBJECTIVES: To objectify this observation and to determine the healthcare and social differences between the gypsy and Caucasian populations. METHODS: We performed a descriptive, observational study in the Pediatric Emergency Unit of a tertiary care hospital. Systematic sampling was performed and 420 children were selected. Data on age, sex, compliance with primary healthcare preventive programs, reason for attendance, type of healthcare center, diagnosis and familial characteristics were collected through a questionnaire. RESULTS: The median age of the patients was 24 months. The percentage of patients of gypsy race was 16.4 %. Most of the gypsy population (68.1 %) attended small, local healthcare centers compared with 34.8 % of the Caucasian population (p 0.0001). Only 58 % of the gypsy children were taken to healthcare centers for regular check-ups compared with 96.7 % of the non-gypsy population (p 0.0001). The percentage of gypsy children who had never being vaccinated was 18.8 %. There were no such cases among the non-gypsy population (p 0.0001). The percentage of gypsy children visiting the emergency unit who were hospitalized was 11.6 % compared with 1.9 % of non-gypsy children. Illiteracy rates were 30.4 % and 15.9 % in gypsy mothers and fathers, respectively, compared with 0.6 % and 0.3 % in non-gypsy mothers and fathers, respectively (p 0.0001). CONCLUSIONS: This study reveals significant differences between the gypsy and Caucasian pediatric populations in terms of healthcare and identifies a group at high health risk.

Diferencia étnica en la actividad asistencial de urgencias. Aproximación a la realidad gitana / Ethnic differences in attendance at emergency departments. An approximation of gypsy reality

Existe un incremento de la presión asistencial en los servicios de urgencias y se percibe una importante afluencia de niños de otras etnias. Objetivos Comprobar esta percepción y conocer las características sanitarias, sociales y asistenciales de la etnia gitana frente a la población caucásica. Métodos Estudio observacional descriptivo realizado en un servicio de urgencias pediátricas de un hospital terciario. Se seleccionó una muestra poblacional significativa (n = 420) por muestreo sistemático. Se recogieron mediante cuestionario las variables edad, sexo, adhesión a los programas preventivos de atención primaria, justificación de la consulta, diagnóstico y características familiares. Resultados La mediana de edad fue 24 meses. Pertenecían a la etnia gitana el 16,4% y eran mayoritariamente atendidos en ambulatorios (68,1% frente al 34,8% de los caucásicos) (p < 0,0001). Acudían a las revisiones del programa de niño sano el 58% de los niños gitanos frente al 96,7% del resto (p < 0,0001). El 18,8% de los niños gitanos no habían recibido ninguna vacuna, no encontrando ningún niño caucásico en esta situación (p < 0,0001). Ingresaron el 11,6% de los niños gitanos que consultaron frente al 1,9% de los caucásicos. En cuanto a los padres, el 30,4% de las madres y el 15,9% de los padres gitanos eran analfabetos, frente al 0,6% de las madres y el 0,3% de los padres caucásicos (p < 0,0001). Conclusiones El estudio pone en evidencia las diferencias sanitarias entre la población infantil gitana y la caucásica, identificando un grupo de alto riesgo sanitario (AU)

[Familial hypomagnesemia with hypercalciuria and nephrocalcinosis]. / Hipomagnesemia familiar con hipercalciuria y nefrocalcinosis.

Familiar hypomagnesemia with hypercalciuria and nephrocalcinosis is a rare syndrome belonging to the group of heterogeneous tubular diseases whose common characteristic is renal magnesium wasting. We present a 9 year old boy with polyuria, polydipsia and enuresis. Radiologic and ultrasonographic examinations showed nephrocalcinosis. Hypomagnesemia, normokaliemia, hypermagnesiuria, hypercalciuria, incomplete distal tubular acidosis, hypocitraturia and mild renal failure were found. Treatment with magnesium salts, hydrochlorothiazide, potassium citrate and sodium bicarbonate did not restore magnesium or calcium levels to normal. Renal function and nephrocalcinosis remain stable after 3 year's treatment. In conclusion, we report a new case of this rare syndrome caused by a congenital defect in magnesium reabsorption and discuss the evolution of the illness during 3 years' treatment.

Hipomagnesemia familiar con hipercalciuria y nefrocalcinosis / Familial hypermagnesemia with hypercalciuria and nephrocalcinosis

La hipomagnesemia familiar con hipercalciuria y nefrocalcinosis es un síndrome poco frecuente que pertenece a un grupo de tubulopatías de naturaleza heterogénea, cuya característica común es la pérdida urinaria de magnesio. Se presenta el caso de un niño de 9 años de edad con sintomatología de poliuria, polidipsia y enuresis. Existía nefrocalcinosis ecográfica y radiológica. Se encontró hipomagnesemia, normopotasemia, hipermagnesiuria, hipercalciuria, acidosis tubular distal incompleta, hipocitraturia e insuficiencia renal leve. El tratamiento con sales de magnesio, hidroclorotiacida, citrato potásico y bicarbonato sódico no ha conseguido normalizar ni la magnesiuria ni la calciuria. La función renal y la nefrocalcinosis permanecen estables tras 3 años de control. Se trata de un nuevo caso de este raro síndrome producido por un defecto congénito de la resorción tubular de magnesio, y su evolución clínica y analítica tras 3 años de seguimiento (AU)