Cambios en la masa ósea en una población infantil con diabetes mellitus tipo 1. Estudio longitudinal / Changes in bone mass in a paediatric population with type 1 diabetes mellitus. Longitudinal study

Objetivo: Evaluar, a lo largo de un seguimiento de 79,2 meses, el comportamiento de la densidad mineral ósea (DMO) determinada mediante Densitometría Axial Computarizada (DXA), la densidad mineral ósea volumétrica (DMOvol) y su relación con los datos antropométricos, junto con los parámetros relativos al metabolismo óseo (calcio, fósforo, fosfatasa alcalina, parathormona (PTH) y vitamina D (25-OH-D3)) en una población infantil con Diabetes Mellitus Tipo 1 (DM1) sin complicaciones microvasculares y un grupo control de referencia de similares características.Material y métodos: Inicialmente, se realizó un estudio transversal en 40 niños diabéticos (edad media 9,4±2,8 años) y 108 controles (9,3±1,5 años) para valorar las posibles diferencias entre ambas poblaciones. 26 pacientes del grupo diabético inicial, fueron reevaluados tras 79,2 meses de seguimiento.Resultados: Se observó que, al inicio, la masa ósea fue similar en los diabéticos y controles. Después del seguimiento, la DMO de los niños diabéticos era muy inferior a la esperada en población infantil no diabética.El peso, la altura y el Índice de Masa Corporal (IMC) siguieron el mismo patrón que la DMO. Los valores de calcio, fósforo, fosfatasa alcalina, PTH y vitamina D, aunque en rango de normalidad, fueron más bajos que en los controles. La fosfatasa alcalina no se incrementó en el periodo puberal.Conclusiones: El presente estudio demuestra que los niños y adolescentes con un diagnóstico reciente de DM1 tienen una DMO normal. Sin embargo, con el paso del tiempo, y sobre todo durante la adolescencia, muestran una menor ganancia de masa ósea y alteraciones en los parámetros de recambio óseo. (AU)

[Eosinophilic esophagitis, a pathology on the rise]. / Esofagitis eosinofílica, una enfermedad en auge.

The eosinophilic esofagitis is a pathology that consists of an inflammatory condition of the esophagus, which is characterized for having a high percentage of eosinophils. It is a problem of allergic origin and his diagnosis is increasing in the population, especially in children and adult young persons, throughout last decade. The fisiopathology is not completely established nowadays. The diagnosis is confirmed with endoscopia and capture of biopsies. The differential diagnosis is necessary to be done with the disease for reflux gastroesofágico, gastroenteritis eosinofílica, by Crohn's disease, pathology of connective fabric, syndrome hipereosinofílico, infections and response of hypersensitivity to medicaments. Nowadays there is no a treatment that is definitive. We present a clinical case, which was valued initially for the consultation of Primary care.

Esofagitis eosinofílica, una enfermedad en auge / Eosinophilic esophagitis, a pathology on the rise

La esofagitis eosinofílica es una enfermedad que consiste en una condición inflamatoria del esófago, que se caracteriza por tener un elevado porcentaje de eosinófilos. Es un problema de origen alérgico y su diagnóstico está aumentando en la población, sobre todo en niños y adultos jóvenes, a lo largo de la última década. La fisiopatología no está completamente establecida actualmente. El diagnóstico se confirma con endoscopia y toma de biopsias. El diagnóstico diferencial hay que hacerlo con la enfermedad por reflujo gastroesofágico, gastroenteritis eosinofílica, enfermedad de Crohn, enfermedad del tejido conjuntivo, síndrome hipereosinofílico, infecciones y respuesta de hipersensibilidad a fármacos. Actualmente no hay un tratamiento que sea definitivo. A continuación se presenta un caso clínico, que fue valorado inicialmente en la consulta de atención primaria (AU)

The eosinophilic esofagitis is a pathology that consists of an inflammatory condition of the esophagus, which is characterized for having a high percentage of eosinophils. It is a problem of allergic origin and his diagnosis is increasing in the population, especially in children and adult young persons, throughout last decade. The fisiopathology is not completely established nowadays. The diagnosis is confirmed with endoscopia and capture of biopsies. The differential diagnosis is necessary to be done with the disease for reflux gastroesofágico, gastroenteritis eosinofílica, by Crohn’s disease, pathology of connective fabric, syndrome hipereosinofílico, infections and response of hypersensitivity to medicaments. Nowadays there is no a treatment that is definitive. We present a clinical case, which was valued initially for the consultation of Primary care (AU)

Risk factors associated with hepatitis C virus infection in an urban population of the State of Mexico.

The aim of this study was to determine the seroprevalence anti-hepatitis C virus (HCV) antibodies and risk factors associated with patients attending primary-care clinics in the State of Mexico. A cross-sectional, prospective study was conducted on 10,524 consenting patients with history of at least one risk factor for HCV. Antibodies were detected by immunoassay, third-generation ELISA; RT-PCR was carried out to confirm HCV infection. The seroprevalence of HCV antibodies was 1.2% (128). The most common risk factor was blood transfusion prior to 1993 (56.3%), followed by family history of cirrhosis 29 (22.7%); tattoos and/or piercings, 28 (21.9%); high-risk sexual practices, 4 (3.1%); healthcare work, 8 (6.3%); and intravenous drug use, 1 (8%). RT-PCR was performed on samples from 83 patients. Forty-five were considered positive. Genotype 1a was the most prevalent (37.7%).

La contribución enfermera en operaciones de paz, catástrofes naturales y ayuda humanitaria / No disponible

Paralelamente a los cambios sociales que se desarrollanen cada etapa de la vida en el transcurso de la historia, laEnfermería, como profesión dinámica, se ha ido adaptandoa nuevos escenarios y nuevas realidades que traspasan elámbito cotidiano del desempeño de su trabajo.La profesión enfermera, ha ido evolucionando creándoseun espacio, ahora imprescindible, en áreas tan importantescomo la cooperación internacional y ayuda humanitaria.Esta ayuda humanitaria está regulada por las leyesdel Derecho Internacional y humanitario, y su contribuciónse basa en la prevención, asistencia y posteriorreconstrucción de la zona afectada, pudiéndose tratar deuna misión de paz o armada. Esta contribución ha puestomuchas veces en peligro la propia integridad del cooperanteenfermero. Esta evolución además ha evolucionadohacia estándares de alta cualificación basados en el rigorcientífico, tiene cada vez mayor protagonismo e implicaciónen temas de mantenimiento y promoción de la salud,no sólo en sociedades estructuradas, sino también enentornos de riesgo, socialmente vulnerables e inseguros(AU)

Parallel to the social changes taking place in everystage of life in the course of history nursing, and dynamicprofession, has adapted to new scenarios an new realitiesthan transcend the everyday level of job performance. Thenursing profession has evolved, creating a space, nowindispensable in such an important areas as internationalcooperation and humanitarian aid. This humanitarian aidis governed by the laws of international law and humanitarianlaw, and its contribution is based on prevention,assistance and the reconstruction of the affected area,being able to try a mission of peace or armed. The contributionhas often threatened the very integrity of the cooperatingnurse. This development has also evolvedtowards a higher qualification standards based on soundscience, is increasingly greater role and involvement inissues of maintenance and health promotion, not only instructured societies, even in environments of risk, sociallyvulnerable and insecure(AU)

[Double blind comparative randomized study of the efficacy of celiprolol versus amiloride-hydrochlorothiazide in mild to moderate AHT]. / Estudio comparativo randomizado a doble ciego de la eficacia del celiprolol "versus" amiloride-hidroclorotiazida en la HTA ligera-moderada.

We tried to assess the antihypertensive effectivity of a betablocker, celiprolol, in the control of mild to moderate essential arterial hypertension. A double-blind randomized comparative study was conducted between celiprolol and amiloride-hydrochlorothiazide in 40 patients with mild to moderate essential hypertension. Both drugs were effective in the therapeutical control of hypertension, although reductions in systolic blood pressure were more significant among the celiprolol group, being the percentage of patients with reduction of diastolic blood pressure below 90 mmHg., 89.5% in the celiprolol group and 82.4% in the amiloride group. The average dose of celiprolol used was 200 mg/day, with few mide effects.

[Effect of an oral calcium supplement in the treatment of slight-to- moderate essential arterial hypertension]. / Influencia de un suplemento oral de calcio en el tratamiento de la hipertensión arterial esencial ligera-moderada.

51 patients with mild essential hypertension (EH) were randomly divided into two groups; the first group (31 patients) was treated with 1 g. of oral calcium during a period of 8 weeks; the second group received a placebo. The treated with calcium showed a significant decrease in blood pressure (BP), the maximal reduction being of 6 mm Hg in the systolic pressure (SBP) and 3 mm in the diastolic (DBP) at the end of the 8th week. We found a substantial positive relationship between the decrease in SBP and seric renin activity (p less than 0.05), as well as a significant negative relationship (p less than 0.05) between DBP and the seric level of parathyroid hormone (PTH). During the administration of the oral calcium supplement, the BP decreased in an inverse proportion to the plasmatic renin and seric level of PTH.