Índices numéricos Ebrí-metacarpofalángico y carpiano para el cálculo de la edad ósea y predicción de talla adulta / Metacarpophalangeal and carpal numeric indices to calculate bone age and predict adult size

Introducción: En este trabajo se presenta unos nuevos métodos numéricos a partir de los índices metacarpofalángico y carpiano para el cálculo de la edad ósea, así como poder predecir la talla adulta por medio de ecuaciones multiregresión. Material y métodos: La casuística longitudinal comprende a 160 niños zaragozanos sanos de ambos sexos, con edades comprendidas desde los 6meses hasta los 20años, estudiados anualmente, incluido el estudio radiológico. Para la labor estadística se ha utilizado el paquete estadístico «Statistix», así como el programa Excel. Resultados: Los nuevos índices se encuentran íntimamente correlacionados con la edad cronológica, dando por ello lugar a ecuaciones predictivas para el cálculo de la edad ósea de niños hasta 20 años, presentándose además ecuaciones propias hasta los cuatro, a efectos de poder afinar más el diagnóstico a estas cortas edades. Las edades óseas calculadas pueden ser llevadas tanto a tablas numéricas de desviación típica, como a una figura de equivalencias que nos dan el diagnóstico osificativo directamente. Las ecuaciones predictivas de talla adulta permiten una estimación fiable de la talla futura del niño a estudio. Estas estimaciones analizadas por el test de Student no han dado diferencias significativas respecto a la talla adulta que los niños de la casuística al final alcanzaron. Los resultados pueden obtenerse con una calculadora o a través de un programa informático a disposición gratuita del lector. Conclusiones: Son presentadas por vez primera, por métodos propios no foráneos, estándares de edad ósea, así como ecuaciones de predicción de talla adulta para el estudio de niños. Se invita al clínico a utilizar estos métodos metacarpofalángico y carpiano a fin de conseguir la experiencia necesaria para su idónea aplicación en población sana y con diversa patología(AU)

Introduction: This work presents new numerical methods from the meta-carpal-phalangeal and carpal indexes, for calculating bone age. In addition, these new methods enable the adult height to be predicted using multiple regression equations. Materials and Methods: The longitudinal case series studied included 160 healthy children from Zaragoza, of both genders, aged between 6months and 20 years, and studied annually, including the radiological study. For the statistical analysis the statistical package "Statistix", as well as the Excel program, was used. Results: The new indexes are closely co-related to the chronological age, thus leading to predictive equations for the calculation of the bone age of children up to 20 years of age. In addition, it presents particular equations for up to 4years of age, in order to optimise the diagnosis at these early ages. The resulting bones ages can be applied to numerical standard deviation tables, as well as to an equivalences chart, which directly gives us the ossification diagnosis. The predictive equations of adult height allow a reliable forecast of the future height of the studied child. These forecasts, analysed by the Student test did not show significant differences as regards the adult height that children of the case series finally achieved. The results can be obtained with a pocket calculator or through free software available for the reader. Conclusions: For the first time, and using a centre-developed and non-foreign methods, bones age standards and adult height predictive equations for the study of children, are presented. We invite the practitioner to use these meta-carpal-phalangeal and carpal methods in order to achieve the necessary experience to apply it to a healthy population and those with different disorders(AU)

[Metacarpophalangeal and carpal numeric indices to calculate bone age and predict adult size]. / Índices numéricos Ebrí-metacarpofalángico y carpiano para el cálculo de la edad ósea y predicción de talla adulta.

INTRODUCTION: This work presents new numerical methods from the meta-carpal-phalangeal and carpal indexes, for calculating bone age. In addition, these new methods enable the adult height to be predicted using multiple regression equations. MATERIALS AND METHODS: The longitudinal case series studied included 160 healthy children from Zaragoza, of both genders, aged between 6 months and 20 years, and studied annually, including the radiological study. For the statistical analysis the statistical package "Statistix", as well as the Excel program, was used. RESULTS: The new indexes are closely co-related to the chronological age, thus leading to predictive equations for the calculation of the bone age of children up to 20 years of age. In addition, it presents particular equations for up to 4 years of age, in order to optimise the diagnosis at these early ages. The resulting bones ages can be applied to numerical standard deviation tables, as well as to an equivalences chart, which directly gives us the ossification diagnosis. The predictive equations of adult height allow a reliable forecast of the future height of the studied child. These forecasts, analysed by the Student test did not show significant differences as regards the adult height that children of the case series finally achieved. The results can be obtained with a pocket calculator or through free software available for the reader. CONCLUSIONS: For the first time, and using a centre-developed and non-foreign methods, bones age standards and adult height predictive equations for the study of children, are presented. We invite the practitioner to use these meta-carpal-phalangeal and carpal methods in order to achieve the necessary experience to apply it to a healthy population and those with different disorders.

[Association patterns of risk factors or cardiovascular disease, in a high risk Spanish population of 2,264 patients]. / Perfiles de asociación de factores de riesgo o enfermedad cardiovascular en población española de alto riesgo de 2.264 pacientes.

UNLABELLED: INTRODUCTION, BASES AND AIMS: The aim of this study is to present the different association patterns between cardiovascular disease risk factors and target organs lesion due to arterial hypertension (AH), and to establish the possible differences by gender and age, and compare our findings with the existing references in the medical literature. MATERIAL AND METHODS: Nationwide croo-sectional study with 2264 consecutive patients in the Outpatient Clinic of Internal Medicine 18 years of age or older and with high cardiovascular risk taken from the CIFARC (Integral Control of High Risk Cardiovascular Factors) study run by the SEMI (Spanish Internal Medicine Association) cardiovascular Risk Group. RESULTS AND DISCUSSION: We have obtained statistically significant correlations between: Raised levels of total cholesterol and LDL cholesterol, low HDL cholesterol and smoking habit. LDL cholesterol with Family History of early cardiovascular events (hereinafter FH) and ischemic cardiopathy. Low HDL cholesterol with FH. Smoking habit with FH. Left ventricular hypertrophy (LVH) with raised levels of proteinuria and creatinine, atheromatosis, retinopathy I-II, ischemic cardiopathy, and diabetic nephropathy. Ischemic cardiopathy with LVH, diabetic nephropathy, peripheral vascular disease (PVD) and age. Proteinuria with raised levels of creatinine, atheromatosis, retinopathy I-II, nephropathy and severe retinopathy. Retinopathy I-II with raised levels of creatinine, atheromatosis, nephropathy, PVD and severe retinopathy. Raised levels of creatinine with reduced levels of HDL cholesterol, proteinuria, atheromatosis, retinopathy I-II, nephropathy and PVD. FH inversely with age: patients with FH consult a doctor an average of three years earlier than patients who do not experience FH. Atheromatosis with LVH, raised levels of proteinuria and creatinine, retinopathy I-II, cerebrovascular disease, nephropathy, PVD and age. PVD with raised levels of creatinine, atheromatosis, retinopathy I-II, and ischemic cardiopathy. Cerebrovascular disease with atheromatosis, age and weight. Severe retinopathy with proteinuria, nephropathy, and retinopathy I-II. Diabetic nephropathy with raised levels of proteinuria and creatinine, atheromatosis, retinopathy I-II, ischemic cardiopathy, and severe retinopathy. Age with raised creatinine, atheromatosis, ischemic cardiopathy, and cerebrovascular disease. With respect to gender, we found differences in most of the studied variables. CONCLUSIONS: There exist different association patterns between the studied variables.

Perfiles de asociación de factores de riesgo o enfermedad cardiovascular en población española de alto riesgo de 2.264 pacientes / Asociation patterns of risk factors or cardiovascular disease, in a high risk Spanish population of 2,264 patients

Introducción, fundamentos y objetivos: El objetivo de este estudio es presentar los diversos perfiles asociativos entre factores de riesgo cardiovascular y lesión de órganos diana de la HTA, así como establecer las posibles diferencias entre sexos y por edades y comparar nuestros hallazgos con los reseñados en la bibliografía. Material y métodos: Estudio transversal de ámbito nacional con 2.264 pacientes consecutivos de las Consultas Externas de Medicina Interna, mayores de 18 años y con riesgo cardiovascular alto o muy alto, procedentes del Estudio CIFARC del Grupo de Riesgo Vascular de la SEMI. El tratamiento estadístico (Chi cuadrado, ANOVA y regresión líneal de Pearson) se ha realizado mediante el programa STATISTIX. Resultados y discusión: Hemos obtenido correlaciones estadísticamente significativas, entre: Colesterol total elevado y colesterol LDL, colesterol HDL bajo y tabaquismo. Colesterol LDL con Antecedentes Familiares Precoces de eventos cardiovasculares (AFP) y cardiopatía isquémica. Colesterol HDL bajo con AFP. Tabaquismo con AFP. HVI con elevaciones de proteinuria y creatinina, ateromatosis, retinopatía I-II, cardiopatía isquémica y nefropatía diabética. Cardiopatía isquémica con HVI, nefropatía diabética, enfermedad vascular periférica (EVP) y edad. Proteinuria con elevaciones de creatinina, ateromatosis, retinopatía I-II, nefropatía y retinopatía grave. Retinopatía I-II con elevaciones de creatinina, ateromatosis, nefropatía, EVP, y retinopatía grave. Elevaciones de creatinina con colesterol HDL descendido, proteinuria, ateromatosis, retinopatía I-II, nefropatía y EVP. AFP con la edad inversamente: Los pacientes con AFP acuden una media de tres años antes a consultas que los pacientes que no los presentan. Ateromatosis con HVI, elevaciones de proteinuria y creatinina, retinopatía I-II, enfermedad cerebrovascular, nefropatía, EVP y edad. EVP con creatinina elevada, ateromatosis, retinopatía I-II y cardiopatía isquémica. Enfermedad cerebrovascular con ateromatosis, edad y peso. Retinopatía grave con proteinuria, nefropatía y retinopatía I-II nefropatía diabética con elevaciones de proteinuria y creatinina, ateromatosis, retinopatía I-II, cardiopatía isquémica y retinopatía grave. Edad con creatinina elevada, ateromatosis, cardiopatía isquémica y enfermedad cerebrovascular. Respecto al sexo encontramos diferencias en casi todas las variables. Conclusiones: Existen diferentes perfiles asociativos entre las variables estudiadas

Introduction, bases and aims: The aim of this study is to present the different association patterns between cardiovascular disease risk factors and target organs lesion due to arterial hypertension (AH), and to establish the possible differences by gender and age, and compare our findings with the existing references in the medical literature. Material and methods: Nationwide croo-sectional study with 2264 consecutive patients in the Outpatient Clinic of Internal Medicine 18 years of age or older and with high cardiovascular risk taken from the CIFARC (Integral Control of High Risk Cardiovascular Factors) study run by the SEMI (Spanish Internal Medicine Association) cardiovascular Risk Group. Results and discussion: We have obtained statistically significant correlations between: Raised levels of total cholesterol and LDL cholesterol, low HDL cholesterol and smoking habit. LDL cholesterol with Family History of early cardiovascular events (hereinafter FH) and ischemic cardiopathy. Low HDL cholesterol with FH. Smoking habit with FH. Left ventricular hypertrophy (LVH) with raised levels of proteinuria and creatinine, atheromatosis, retinopathy I-II, ischemic cardiopathy, and diabetic nephropathy. Ischemic cardiopathy with LVH, diabetic nephropathy, peripheral vascular disease (PVD) and age. Proteinuria with raised levels of creatinine, atheromatosis, retinopathy I-II, nephropathy and severe retinopathy. Retinopathy I-II with raised levels of creatinine, atheromatosis, nephropathy, PVD and severe retinopathy. Raised levels of creatinine with reduced levels of HDL cholesterol, proteinuria, atheromatosis, retinopathy I-II, nephropathy and PVD. FH inversely with age: patients with FH consult a doctor an average of three years earlier than patients who do not experience FH. Atheromatosis with LVH, raised levels of proteinuria and creatinine, retinopathy I-II, cerebrovascular disease, nephropathy, PVD and age. PVD with raised levels of creatinine, atheromatosis, retinopathy I-II, and ischemic cardiopathy. Cerebrovascular disease with atheromatosis, age and weight. Severe retinopathy with proteinuria, nephropathy, and retinopathy I-II. Diabetic nephropathy with raised levels of proteinuria and creatinine, atheromatosis, retinopathy I-II, ischemic cardiopathy, and severe retinopathy. Age with raised creatinine, atheromatosis, ischemic cardiopathy, and cerebrovascular disease. With respect to gender, we found differences in most of the studied variables. Conclusions: There exist different association patterns between the studied variables

[Differences in variables representative of cardiovascular disease or repercussion between subjects with high cardiovascular risk with and without any family history of early cardiovascular events]. / Diferencias en variables representativas de enfermedad o repercusión cardiovascular entre sujetos de alto riesgo cardiovascular con y sin antecedentes familiares de eventos cardiovasculares precoces.

UNLABELLED: INTRODUCTION, BASES AND AIMS: Study the possible associations between any family history of early heart disease and variables expressive of heart disease, lesion or repercussion in subjects of high cardiovascular risk. MATERIAL AND METHODS: Nationwide cross-sectional study with 2264 consecutive patients in the Outpatient Clinic of Internal Medicine 18 years of age or older and with high or extremely high cardiovascular risk taken from the CIFARC (Integral Control of High Risk Cardiovascular Factors) study run by the SEMI (Spanish Internal Medicine Association) cardiovascular Risk Group. We have studied the relationship between the presence or lack of same in family histories of early heart disease (AFP-Family History of early heart disease, hereafter FH) and different variables in the factors concerning cardiovascular risk and target organ lesion. The statistical treatment (Chi-2, ANOVA and Pearson s linear regression) was performed using the STATISTIX programme. RESULTS AND DISCUSSION: We observed a significative increase (p<0.05) in the group with FH with a percentage of the following variables: Total cholesterol>250 mg/dl, HDL<40 mg/dl, LDL>130 mg/dl, LVH (left ventricular hypertrophy), creatinine 1.2-2mg/dl, retinopathy I-II, serious retinopathy, smoking, proteinuria>300 mg/dl, kidney insufficiency and peripheral vascular disease. This significative increase in the variables under study appeared in males of over 55 years of age and in females of over 65 years of age; nevertheless, this increase in the incidence rate is becoming more common as of age 50 in males, with a maximum in both sexes after the age of 70. No significative differences were noted with regard to sex, BMI (Body Mass Index), atheromatosis, ischemic cardiopathy and cerebrovascular disease. On the whole, subjects of both sexes of the FH group have come to the clinic 3 years earlier than those of the group without FH. CONCLUSIONS: Patients with FH show a greater incidence of certain factors concerning heart risk and target organ lesion.

Diferencias en variables representativas de enfermedad o repercusión cardiovascular entre sujetos de alto riesgo cardiovascular con y sin antecedentes familiares de eventos cardiovasculares precoces / Differences in variables representatives of cardiovascular disease or repercussion between subjects with high cardiovascular risk with and without any family history of early cardiovascular events

Introducción, fundamentos y objetivos: Estudiar las posibles asociaciones entre antecedentes familiares precoces (AFP) de enfermedad cardiovascular y variables expresivas de enfermedad, lesión o repercusión cardiovascular en los sujetos de alto riesgo cardiovascular. Material y métodos: Estudio transversal de ámbito nacional con 2.264 pacientes consecutivos de las Consultas Externas de Medicina Interna, mayores de 18 años y con riesgo cardiovascular alto o muy alto, procedentes del Estudio CIFARC del Grupo de Riesgo Vascular de la SEMI. Se estudia la relación entre la presencia o no de antecedentes familiares de enfermedad cardiovascular precoz (AFP) y distintas variables de factores de riesgo cardiovascular y lesión de órgano diana. El tratamiento estadístico (Chi cuadrado, ANOVA y regresión líneal de Pearson) se ha realizado mediante el programa STATISTIX. Resultados y discusión: Observamos un incremento significativo (p 250 mg/dl, HDL 130 mg/dl, HVI (hipertrofia ventricular izquierda), creatinina 1,2-2 mg/dl, retinopatía I-II, retinopatía grave, tabaquismo, proteinuria > 300 mg/dl, Insuficiencia renal y enfermedad vascular periférica. Este incremento significativo de las variables estudiadas se produce en varones de más de 55 años y en mujeres de más de 65 años; no obstante comienza a observarse este aumento del porcentaje de incidencia a partir de los 50 años en varones, con un máximo en ambos sexos tras los setenta. No se observan diferencias significativas respecto a sexo, IMC (índice de masa corporal) ateromatosis, cardiopatía isquémica y enfermedad cerebrovascular. Existe en general en ambos sexos un adelanto de tres años en el grupo de AFP en acudir a la consulta médica respecto al grupo que no posee AFP. Conclusiones: Los pacientes con AFP presentan mayor incidencia de ciertos factores de riesgo cardiovascular y de lesión de órgano diana

Introduction, bases and aims: Study the possible associations between any family history of early heart disease and variables expressive of heart disease, lesion or repercussion in subjects of high cardiovascular risk. Material and methods: Nationwide cross-sectional study with 2264 consecutive patients in the Outpatient Clinic of Internal Medicine 18 years of age or older and with high or extremely high cardiovascular risk taken from the CIFARC (Integral Control of High Risk Cardiovascular Factors) study run by the SEMI (Spanish Internal Medicine Association) cardiovascular Risk Group. We have studied the relationship between the presence or lack of same in family histories of early heart disease (AFP – Family History of early heart disease, hereinafter FH) and different variables in the factors concerning cardiovascular risk and target organ lesion. The statistical treatment (Chi-2, ANOVA and Pearson’s linear regression) was performed using the STATISTIX programme. Results and discussion: We observed a significative increase (p 250 mg/dl, HDL 130 mg/dl, LVH (left ventricular hypertrophy), creatinine 1.2-2mg/dl, retinopathy I-II, serious retinopathy, smoking, proteinuria > 300 mg/dl, kidney insufficiency and peripheral vascular disease. This significative increase in the variables under study appeared in males of over 55 years of age and in females of over 65 years of age; nevertheless, this increase in the incidence rate is becoming more common as of age 50 in males, with a maximum in both sexes after the age of 70. No significative differences were noted with regard to sex, BMI (Body Mass Index), atheromatosis, ischemic cardiopathy and cerebrovascular disease. On the whole, subjects of both sexes of the FH group have come to the clinic 3 years earlier than those of the group without FH. Conclusions: Patients with FH show a greater incidence of certain factors concerning heart risk and target organ lesion

[New method for evaluating ossification of the carpal bone. From a study with 5225 Spanish children]. / Nouvelle méthode d'évaluation de l'ossification du carpe. A partir d'une étude de 5225 enfants espagnols.

The author present a new method of assessment of bone age derived from the analysis of carpal osseous development of 5,225 Spanish children and adolescents. The method is based upon the determination of a carpal index from the measurement of the largest diameter of the eight carpal bones, the proximal epiphysis of the first metacarpal and the distal cubital and radial epiphyses. There is a highly significant correlation of this carpal index with chronological age (P < 0.0001). From this index the author has set up an equation defining an index of evaluation of carpal ossification which helps to estimate bone age according to six different ranges of significance: significant retardation, moderate non significant retardation, borderline normality, complete normality, moderate non significant advance, significant advance. The method is simple to realize. It reduces the risk of errors in the evaluation of bone age due to asynchronisms of maturation of the ossification centres and to the individual subjective factor occurring with a morphologic assessment. Furthermore it takes into account the physiological variations of bone age on both sides of the mean normal value.