[Metabolic control and the prevalence of dyslipidemia in children and adolescents with insulin-dependent diabetes mellitus]. / El control metabólico y la prevalencia de dislipidemia en niños y adolescentes con diabetes mellitus insulino-dependiente.

Cholesterol, triglycerides and lipoprotein levels were assayed in serum of 152 children and teenagers with IDDM and in 228 non-diabetic siblings. A poor control of diabetes, reflected by high levels of glycosylated hemoglobin and/or high fasting blood glucose, was associated with statistically significant increases in total cholesterol, LDL-cholesterol and triglycerides, and a reduction in HDL-cholesterol. Mean total cholesterol levels in diabetic patients (171 +/- 33 mg/dL for males and 199 +/- 53 mg/dL for females) were statistically higher than those in their siblings (158 +/- 30 mg/dL and 164 +/- 33 mg/dL respectively). The prevalence of hypercholesterolemia (HC) and hypertriglyceridemia (HTG) were higher in the diabetic patients but statistically significant exclusively in females (prevalences of 40% vs 12% for HC and 30% vs 9% for HTG with a p value < 0.005). The diabetic patients in good metabolic control had similar lipid levels to those of their non-diabetic siblings. These data support the hypothesis that poor control of blood glucose is associated with atherogenic lipid profiles. The prevalence of hypercholesterolemia is impressively high in our diabetic population and indicates that all IDDM patients should have a serum lipid and lipoprotein analysis done annually; blood glucose control and dietary guidelines should be improved in these cases.

[The quantitative analysis of thyroid hormones and thyrotropin in children critically ill with septicemia]. / Cuantificación de hormonas tiroideas y tirotropina en niños críticamente enfermos con septicemia.

The function of the hypothalamus, hypophysis, and thyroid glands was studied in 23 critically-ill septicemic children and 15 other healthy children used as controls. A comparison in the quantification of 3,3'5-triiodothyronine (T3), 3,3',5'triiodothyronine (T3r), thyroxine (T4) and thyrotropin (TSH) from those in the control group with the initial values from the patients showed a notable decrease of T3 and T4 and a rise in T3r and TSH in the septicemic children, with a statistical significant difference (P less than 0.001). These biochemical changes which translate into a homeostatic command to avoid catabolism through the conservation of energy, spontaneously returned to normal in 18 of the surviving septicemic children once they recuperated.

Bloqueo de la respuesta hipofisaria de TSH en ninos mediante dosis elevadas de TRH oral. / Large single doses of oral TRH blockade the TSH response in children

Se administraton dosis unicas de 5,10 y 20 mg de TRH oral a 15 ninos sanos con baja talla primordial. La respuesta mas importante en la secrecion de TSH hipofisaria se obtuvo con la dosis de 10 mg, mientras que se obtuvo una respuesta significativamente mas baja con 20 mg (limites de p de 0.02 a 0.001). La respuesta mas pobre se observo con 5 mg. Las concentraciones sericas de T3 y T4 se incrementaron de manera paralela a los incrementos de TSH; asi se descarto que el mecanismo de retroalimentacion fuera el encargado de la inhibicion paradojica de TSH producida por la dosis mayor de TRH. Este efecto inhibitorio sobre la secrecion de TSH puede atribuirse a cambios en el numero, la afinidad o ambas cosas de los receptores hipofisarios para TSH, en lugar de un efecto inhibitorio de la T3

[Hyperglycemia of the dehydrated infant]. / Hiperglicemia del lactante deshidratado.

Hyperglycemia and glucosuria are frequently seen during the acute phase of dehydration secondary to gastroenteritis. In this paper, 33 patients in hypovolemic shock due to diarrhea were studied. Serum glucose resulted above 140 mg/100 ml. in 14 patients (41%); it was below 27 mg/100 ml. in 2 more patients (5.8%). Despite high glucose concentration, only 4 out of the 14 hyperglycemic patients had serum insulin concentration above that observed in normal fasting children. Plasma cortisol was significantly higher in the group with hyperglycemia (54 +/- 24 micrograms/100 ml.) in comparison with the group with normal glucose levels (15 +/- 6.4 micrograms/100). No correlation was found between serum glucose and the concentrations of sodium, potassium, bicarbonate, growth hormone nor with plasma osmolarity. All disturbances observed turned normal after rehydration. Hyperglicemia is explained as a response to stress and is probably due to the gluconeogenic action of cortisol and the inhibitory effect of catecholamines upon insulin secretion.