Hipovitaminosis D y malnutrición por exceso en niños asmáticos hospitalizados / Hypovitaminosis D and malnutrition by excess in hospitalized asthmatic children

La tasa de hospitalización por crisis de asma en niños chilenos se ha duplicado en los últimos años. Diversos estudios muestran una asociación entre hipovitaminosis D y crisis de asma. El objetivo principal del presente estudio fue describir la prevalencia de déficit e insuficiencia de vitamina D (vitD) en escolares asmáticos hospitalizados por crisis de asma y evaluar su estado nutricional. METODOLOGÍA: Estudio analítico, transversal, que incluyó a todos los pacientes de 5 años o más que se hospitalizaron por crisis de asma durante un año calendario en el Servicio de Pediatría del Hospital Clínico de la Universidad de Chile. Se aplicó una encuesta que incluyó datos sociodemográficos y clínicos, se evaluó el nivel de control del asma mediante el cuestionario Asthma Control Test (ACT), se determinó el estado nutricional y se midió la concentración de vitD. RESULTADOS: Se observó que 6 de cada 10 pacientes presentaba déficit o insuficiencia de vitD (22,8 ng/ml ± 10,5), encontrándose una asociación positiva entre concentración de vitD y ACT. La malnutrición por exceso estaba presente en casi la mitad de los pacientes. Aquellos pacientes que se hospitalizaron por más de 3 días tenían una concentración sérica de vitD significativamente menor. CONCLUSIONES: La hipovitaminosis D afectó a la mayoría de los niños hospitalizados por crisis de asma. Se encontró una asociación significativa entre concentración de vitD con días de hospitalización y control de la enfermedad medido por ACT.

Asthma hospitalization rates in Chilean children has doubled in recent years. Multiple studies show an association between hypovitaminosis D and asthma attacks. OBJECTIVES: To determine the prevalence of vitamin D (vitD) deficiency and insufficiency in asthmatic school age children hospitalized for asthma crisis and to evaluate their nutritional status. METHODS: Cross-sectional, analytical study that included patients 5 years of age or older hospitalized for asthma attacks during one calendar year, in the Pediatric Service of the University of Chile Clinical Hospital. A survey was conducted that included sociodemographic and clinical data, the level of asthma control was evaluated using the Asthma Control Test questionnaire (ACT), the nutritional status was determined and the concentration of vitD was measured. RESULTS: 6 out of 10 patients had either Vit D deficiency or insufficiency (22,8 ng/ml ± 10,5), showing a positive association between vitD concentration and ACT. Malnutrition due to excess was present in almost half of the patients. Children hospitalized for more than 3 days had a significantly lower vitD serum concentration. CONCLUSIONS: Most of the patients had hypovitaminosis D. An association was found between vitD concentration and hospital stay and between vitD concentration and asthma control, measured by ACT .

Caracterización clínica y epidemiológica de pacientes con Covid-19 atendidos en Servicio de Emergencia del Hospital Clínico Universidad de Chile entre marzo y mayo 2020 / Clinical and epidemiological characterization of patients with Covid-19 treated in the Emergency Service of the Hospital Clínico Universidad de Chile between March and May 2020

In December 2019, a novel coronavirus (SARS-CoV-2) emerged in China and has spread globally, creating a pandemic. The objective of this is study is to determinate clinical and epidemiological characteristics of patients with coronavirus en emergency department. The HCUCH Emergency Service treated a total of 6959 patients between March 13th and May 31th, of whom 1.278 were positive and had confirmed with coronavirus. The male sex was the most prevalent (59.7%). The most frequent symptoms in both groups were cough, myalgia and fever. In the group of ambulatory patients, headache stood out in 50% and in hospitalized patients, dyspnea with 67%. The mortality rate in hospitalized patients was 15.6%. Of these, 66.6% were older than 65 years. Regarding diagnosis of hospital discharge, 87.5% correspond to pneumonia. There is a higher prevalence of coronavirus disease in male patients. The most frequent comorbidities in hospitalized patients were HT and DM2. The highest rate of hospitalization and case fatality in people over 65 years of age. This information helps to characterize the profile of patients at risk in which prevention efforts should be focused. (AU)

Síndrome de Miller-Fisher en edad pediátrica: un debut inusual / Miller-Fisher syndrome in pediatric age:an unusual debut

Miller-Fisher syndrome is a peripheral neuropathy characterized by ophthalmoplegia, areflexia and ataxia. The incidence of this syndrome is estimated at 1 in a million, and just 14% of these occur on a pediatric age, making it an infrequent diagnosis in pediatrics. In this article we report a case of Miller-Fisher syndrome with an unusual onset on a pediatric patient along with infrequent radiological findings. (AU)

Lenguaje e inteligencia de preescolares: análisis de su relación y factores asociados / Preschoolers language and intelligence: associated factors and relationship analysis

Background: Language and intelligence are brain superior functions and their development is vital for school and future work performance. Objective: To establish the correlation between language and intelligence, in order to identify possible factors involved in preschoolers of low socioeconomical status. Methods: Prospective and blind study that performs specific language tests, audiometry, WPSSI and pediatric-neurological examination to all children between 3-5 year-old attending a day care, belonging to families of low socioeconomical conditions at the Metropolitan Region of Chile, during 2007. Children with major diseases, explaining language difficulties (LD) were excluded. Results: 61 preschoolers, in which 22 (36 percent) LD were identified. Cognitive performance presented a normal distribution (mean 92,69 +15). There was a significant correlation between intelligence and language (p 0.002). Children with LD had lower cognitive performance, both in verbal (p 0.004) and in manual tests (p 0.0007). The family history of LD or learning difficulties and history of developmental delay were associated with a lower language performance (p 0,05 and p < 0.0000, respectively). Children of mothers with superior studies showed better scores in their cognitive potential (p 0.0079). Conclusion: Language and intelligence are significantly associated. Biological and hereditary factors were correlated with LD, whereas social factors (ex: maternal education) were associated with cognitive performance. These findings should be considered in the planification of health politics related with children development, implementing multidisciplinary strategies.

Introducción: El lenguaje y la inteligencia son funciones cerebrales superiores cuyo desarrollo es determinante para el desempeño escolar y futuro laboral. Objetivo: Establecer la correlación entre lenguaje e inteligencia, e identificar posibles factores asociados, en preescolares de nivel socio económico bajo. Metodología: Durante el año 2007 en forma prospectiva, simultánea y ciega, se aplicaron pruebas específicas de lenguaje, audiometría, WPSSI y evaluación pediátrica y neurológica completa, a todos los niños de 3 a 5 años, asistentes a un establecimiento de educación preescolar, de nivel socioeconómico bajo, de la Región Metropolitana de Chile. Se excluyeron los niños portadores de patología de base que pudiera dar cuenta de las dificultades de lenguaje (DL). Resultados: La muestra fue conformada por 61 preescolares. En 22 (36 por ciento) se identificó DL. El rendimiento cognitivo siguió una distribución normal (promedio 92,69+15). Hubo correlación significativa entre inteligencia y lenguaje (p 0,002). Los niños con DL presentaron menor rendimiento cognitivo, tanto verbal (p 0,004) como de ejecución (p 0,0007). El antecedente familiar de DL o trastornos de aprendizaje e historia de déficit del DSM se asociaron a menor rendimiento de lenguaje (p 0,05 y p < 0,0000). Los hijos de madres con educación superior mostraron mejor rendimiento en su potencial cognitivo (p 0,0079). Conclusión: El lenguaje y la inteligencia se asociaron significativamente; factores hereditarios y biológicos se correlacionaron con DL, mientras que factores sociales con el rendimiento cognitivo. Estos hallazgos debieran considerarse en las políticas de desarrollo infantil, implementando estrategias multisectoriales y multidisciplinarias.