Iloprost inhalado: una alternativa terapéutica para la hipertensión pulmonar persistente del recién nacido / Inhaled iloprost: a therapeutic alternative for persistent pulmonary hypertension of the newborn

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Análisis de los factores pronósticos de la respuesta antipirética del ibuprofeno / Analysis of prognostic factors for the antipyretic response to ibuprofen

OBJETIVO: Analizar los factores que influyen en la respuesta antitérmica del ibuprofeno. PACIENTES Y MÉTODOS: Niños de entre 1y 10años que acudieron al servicio de urgencias con temperatura superior a 38ºC. Se les administró una dosis de 7mg/kg de ibuprofeno, anotándose después la temperatura a los 30, 60, 90, 120, 180y 240min. Se analizó la influencia de la edad, sexo, peso, superficie corporal, entidad nosológica, administración previa de antitérmicos y asociación de medidas físicas sobre la evolución de la temperatura. RESULTADOS: Se estudiaron 384 niños, con temperatura corporal comprendida entre 38y 42ºC (39,1 ñ 60,6ºC), en el 77,8 por ciento la fiebre duraba más de 6h y el 59,5 por ciento habían recibido al menos un antitérmico. El 93,5 por ciento de los niños redujeron su temperatura hasta 37,5ºC o menos, alcanzándose dicha temperatura en el 80,2 por ciento de los niños entre 1y 2horas después del tratamiento. El 95 por ciento de los pacientes alcanzó un descenso de la temperatura corporal de al menos 1ºC. La temperatura inicial más alta (odds ratio[OR] 0,008; intervalo de confianza [IC] 95 por ciento, 00,14) y la mayor superficie corporal (OR, 0,004; IC 95 por ciento, 00,89) facilitan la consecución de dicho objetivo, mientras que la mayor edad la dificulta (OR, 1,67; IC 95 por ciento, 1,032,7). CONCLUSIÓN: El ibuprofeno es un fármaco muy eficaz en el tratamiento de la fiebre infantil y la magnitud de su efecto antitérmico guarda cierta relación con la edad, el grado de temperatura inicial y la superficie corporal (AU)

Evaluación de la eficacia antipirética y seguridad de dos formulaciones pediátricas de ibuprofeno / Evaluation of the antipyretic safety and accuracy of two pediatric ibuprofen formulations

OBJETIVO: Comparar la eficacia y evaluar la bioequivalencia clínica de dos presentaciones de ibuprofeno para niños, suspensión y gránulos efervescentes, en el tratamiento de la fiebre. MÉTODOS: Ensayo clínico abierto, de distribución aleatoria y multicéntrico. Se administró a niños con pesos superiores a 25kg, que acudieron con temperatura axilar superior a38º C a servicios de urgencias hospitalarios, una dosis de ibuprofeno en suspensión de 7 mg/kg, o una dosis de gránulos efervescentes con la siguiente posología: 200 mg en niños con pesos entre 25 y 40 kg, o 400 mg si pesaban entre 35 y 40 kg y tenían una temperatura axilar superior a 39 ºC, así como en los niños de más de 40 kg. Se tomó la temperatura axilar antes del tratamiento y a los 30, 60, 90, 120, 180 y 240 min, y se registraron posibles efectos adversos. RESULTADOS: Se incluyeron 103 pacientes, 51 recibieron gránulos y 52 suspensión. La temperatura media se redujo en los dos grupos a lo largo del estudio (p < 0,005), sin diferencias entre ellos. Las diferencias medias de temperatura en cada momento del estudio se situó dentro del intervalo de bioequivalencia (60,5ºC). En un caso se alcanzó una temperatura axilar de 35,9 ºC, siendo el único acontecimiento adverso ocurrido. CONCLUSIÓN: Ambas formulaciones se mostraron eficaces en la reducción de la temperatura y pueden considerarse bioequivalentes clínicamente (AU)

[Analysis of prognostic factors for the antipyretic response to ibuprofen]. / Análisis de los factores pronósticos delarespuesta antipirética del ibuprofeno.

AIM: To assess the factors influencing the antipyretic activity of ibuprofen in children. PATIENTS AND METHODS: Children aged between 1 and 10 years attending the emergency department with a temperature of> 38 degrees C were given one dose of ibuprofen (7 mg/kg). Temperature was recorded before and 30, 60, 90, 120, 180 and 240 min after ibuprofen administration. The influence of age, sex, weight, body surface, nosologic entity, previous antipyretic administration, and the association between physical measurements and temperature evolution were assessed. RESULTS: A total of 384 children were studied. Baseline temperatures were between 38 degrees C and 42 degrees C (mean: 39.1 +/- 60.6). Most of the patients (77.8%) had been feverish for more than 6 hours and 59.5% had received antipyretic treatment. In 93.5% of the children temperature was lowered to 37.5 degrees C or less. In 80.2% of the children this temperature was reached 12 hours after treatment. In 95% of ther children a decrease of at least 1 degree C was achieved. Older age (OR 1.67; 95% CI: 1.032.7), smaller body surface (OR 0.004; 95% CI 00.89) and lower baseline temperature (OR 0.008; 95%CI 00.14) were associated with a smaller antipyretic response (decrease in body temperature lower than 1 degree C). CONCLUSIONS: Ibuprofen is effective in the treatment of fever in children. Its effectiveness is related to age, the degree of fever and body surface.

Serum insulin-like growth factor (IGF) binding protein-3 and IGF-I levels during childhood and adolescence. A cross-sectional study.

To investigate the effect of pubertal development on serum levels of IGF binding protein-3 (IGFBP-3) and IGF-I, and the relationship between IGFBP-3 levels and height, weight, weight for height and age (WFHA), and IGF-I levels, a cross-sectional study was performed in a Spanish basic education school in Vigo (NW Spain). The study was made up of 181 girls with a mean chronologic age of 11.03 +/- 0.22 y and 173 boys with a mean chronologic age of 10.9 +/- 0.23 y. The pubertal development was graded into three groups according to estradiol and testosterone concentrations for girls and boys, respectively. All subjects were in good health and among the 5th and 95th percentile for height. Serum IGFBP-3 and plasma IGF-I concentration was determined by RIA. Pubertal development was significantly associated with IGFBP-3 and IGF-I concentrations in girls and boys, respectively (p < 0.0001, analysis of variance). Multivariate regression analyses between IGF-I or IGFBP-3 with age, sex, and estradiol or testosterone show significative correlation in prepubertal children for IGF-I (r = 0.545, p = 0.0001 and r = 0.574, p = 0.0001 for girls and boys, respectively) and only in prepubertal boys for IGFBP-3 (r = 0.336, p = 0.0012). The linear correlation between IGF-I and IGFBP-3 was significant in both prepubertal (r = 0.25, p < 0.0001) and pubertal (r = 0.40, p < 0.0001) girls, but only in prepubertal boys (r = 0.30, p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

[The TPN of newborn infants: the rationalization of the calculations and of the prescription]. / NPT de neonatos: racionalización de los cálculos y de la presecripción.

We try to simplify the calculus of TPN necessities in newborns adjusting the most common bibliography tabulated values to mathematical equations. Values are transformed into factors: Fn (g of N/Kg of weight), Fk (no protein Kcal/g of N), Fg (glucose Kcal/total Kcal) and Fv (volume/total Kcal) that can be correlated with the analytical state of patient, weight and nutrition day. Once the functions were established we automated calculations using a spreadsheet program that simplifies and make easier the TPN elaboration.

[Ventriculoperitoneal shunt in the treatment of hydrocephalus in children. Results and complications]. / Derivación ventrículo peritoneal en el tratamiento de la hidrocefalia infantil. Resultados y complicaciones.

Shunting the ventricular fluid to a body cavity out side the cranium is the preferred method of treatment of progressive hydrocephalus of whatever cause. The distal end of the shunt should be in the peritoneal cavity or in the right atrium by way of the jugular vein and superior vena cava. The advantages of peritoneal over atrial placement of the distal catheter are: avoidance of cardiopulmonary complications: faster and simpler placement of the distal catheter; space to place a longer distal catheter, prolonging the interval before revision. A series of 173 extracranial cerebrospinal fluid shunts (CSF) performed between 1978 and 1986 for hydrocephalus in children is reviewed. Ventriculoperitoneal shunt was used essentially. The most common complications we catheter obstruction peritoneal and ventricular.