Frontal penetrating arrow injury: A case report.

BACKGROUND: Penetrating arrow injuries of the head and neck are exceedingly rare in pediatric patients. This pathology has high morbidity and mortality because of the presence of vital organs, the airway, and large vessels. Therefore, the treatment and removal of an arrow is a challenge that requires multidisciplinary management. CASE SUMMARY: A 13-year-old boy was brought to the emergency room after an arrow injury to the frontal region. The arrowhead was lodged in the oropharynx. Imaging studies showed a lesion of the paranasal sinuses without compromising vital structures. The arrow was successfully removed by retrograde nasoendoscopy without complications, and the patient was discharged. CONCLUSION: Although rare, maxillofacial arrow injuries have high morbidity and mortality and require multidisciplinary management to preserve function and aesthetics.

Differences in omentin-1 levels in term newborns according to birth weight.

BACKGROUND: Adipokines are produced by adipose tissue and are involved in metabolic processes. Omentin-1 is an adipokine that has been shown in vitro to possibly be involved in insulin sensitivity modulation. The prenatal stage is a crucial period for development of metabolic diseases in the long term, therefore, small (SGA) and large (LGA) for gestational age newborns have an increased risk of type 2 diabetes and metabolic syndrome later in life. AIMS: To evaluate the differences in omentin-1 concentrations in umbilical cord blood from healthy term newborns according to birth weight and explore the association between omentin-1 and anthropometry, glucose, insulin and insulin sensitivity. STUDY DESIGN: This was a secondary analysis of stored umbilical cord blood of term newborns. SUBJECTS: Newborns classified according to birth weight as SGA (n = 30), adequate for gestational age (AGA) (n = 12) and LGA (n = 34). OUTCOME MEASURES: An analysis of omentin-1, glucose and insulin were performed. RESULTS: Differences were found in serum omentin-1 levels (ng/mL) between SGA 328.17 ±â€¯108.04, AGA 253.05 ±â€¯98.25 and LGA 250.91 ±â€¯100.48 (p = 0.009). In the linear regression analysis, the independent variables HOMA-IR, QUICK-I and FGIR were predictors of serum omentin-1 levels (r = 0.175, p = 0.003). CONCLUSIONS: Omentin-1 cord blood levels have a differentiated behavior according to weight for gestational age with LGA newborns having lower levels and SGA newborns higher levels. HOMA-IR, QUICK-I and FGIR weakly predicted omentin-1 in cord blood, suggesting that omentin-1 possibly has an implication in insulin sensitivity since birth.

Comparación del incremento del perímetro abdominal con la prueba de hidrógeno espirado como predictor clínico de intolerancia a la lactosa / Comparison of an increased waist circumference with a positive hydrogen breath test as a clinical predictor of lactose intolerance

Introducción. La intolerancia a la lactosa es una afección frecuente en pediatría, cuyo diagnóstico erróneo conlleva morbilidad. El objetivo primario del estudio fue evaluar la utilidad del incremento del perímetro abdominal durante la prueba de hidrógeno espirado como predictor de intolerancia a la lactosa. El objetivo secundario fue analizar la influencia del índice de masa corporal, de la medida de la cintura y de la edad en la distensión abdominal de pacientes intolerantes a la lactosa. Población y métodos. Se incluyó a 138 sujetos de entre 3 y 15 años de edad a los cuales se les realizaron mediciones seriadas del perímetro abdominal y determinaciones de hidrógeno espirado cada 30 minutos por 3 horas, durante la prueba de hidrógeno espirado. Resultados. Del total de la muestra, 35 (25,4%) resultaron intolerantes a la lactosa. El incremento de 0,85 cm en el perímetro abdominal comparado con el perímetro abdominal basal tiene sensibilidad del 88% y especificidad del 85% para predecir intolerancia a la lactosa (OR 42,14; IC 95%: 13,08-135,75; p <0,001). El índice de masa corporal y la medida de la cintura no afectaron la distensibilidad del abdomen (p= NS); sin embargo, la edad modificó el momento de la distensión. Conclusiones. El incremento del perímetro abdominal de 0,85 cm en relación con el perímetro abdominal basal durante la prueba de hidrógeno espirado es un parámetro útil para diagnosticar la intolerancia a la lactosa en pediatría. Las variaciones en relación con el índice de masa corporal y la cintura no modificaron la utilidad del incremento del perímetro abdominal a diferencia de la edad.

Introduction. Lactose intolerance is a common disease in pediatrics, and its wrong diagnosis will lead to morbidity. The primary objective of this study was to assess the usefulness of an increased waist circumference during the hydrogen breath test as a predictor of lactose intolerance. The secondary objective was to analyze the impact of body mass index, waist circumference measurement, and age on the abdominal distension of patients with lactose intolerance. Population and methods. A total of 138 subjects aged 3 to 15 years were included. They underwent serial measurements of the waist circumference and hydrogen levels in the breath every 30 minutes over 3 hours during the hydrogen breath test. Results. Out of the entire sample, 35 (25.4%) patients had lactose intolerance. An increase of 0.85 cm in waist circumference compared to the baseline waist circumference results in a sensitivity of 88% and a specificity of 85% to predict lactose intolerance (odds ratio: 42.14, 95% confidence interval: 13.08-135.75, p < 0.001). The body mass index and waist circumference measurement did not affect abdominal distension (p= not significant); however, age modified the time of distension. Conclusions. A 0.85 cm increase in waist circumference compared to the baseline waist circumference during the hydrogen breath test is a useful parameter for the diagnosis of lactose intolerance in pediatrics. Variations in relation to body mass index and waist circumference did not affect the usefulness of an increased waist circumference, unlike age.

Comparison of an increased waist circumference with a positive hydrogen breath test as a clinical predictor of lactose intolerance. / Comparación del incremento del perímetro abdominal con la prueba de hidrógeno espirado como predictor clínico de intolerancia a la lactosa.

INTRODUCTION: Lactose intolerance is a common disease in pediatrics, and its wrong diagnosis will lead to morbidity. The primary objective of this study was to assess the usefulness of an increased waist circumference during the hydrogen breath test as a predictor of lactose intolerance. The secondary objective was to analyze the impact of body mass index, waist circumference measurement, and age on the abdominal distension of patients with lactose intolerance. POPULATION AND METHODS: A total of 138 subjects aged 3 to 15 years were included. They underwent serial measurements of the waist circumference and hydrogen levels in the breath every 30 minutes over 3 hours during the hydrogen breath test. RESULTS: Out of the entire sample, 35 (25.4%) patients had lactose intolerance. An increase of 0.85 cm in waist circumference compared to the baseline waist circumference results in a sensitivity of 88% and a specificity of 85% to predict lactose intolerance (odds ratio: 42.14, 95% confidence interval: 13.08-135.75, p ≤ 0.001). The body mass index and waist circumference measurement did not affect abdominal distension (p= not significant); however, age modified the time of distension. CONCLUSIONS: A 0.85 cm increase in waist circumference compared to the baseline waist circumference during the hydrogen breath test is a useful parameter for the diagnosis of lactose intolerance in pediatrics. Variations in relation to body mass index and waist circumference did not affect the usefulness of an increased waist circumference, unlike age.

La intolerancia a la lactosa es una afección frecuente en pediatría, cuyo diagnóstico erróneo conlleva morbilidad. El objetivo primario del estudio fue evaluar la utilidad del incremento del perímetro abdominal durante la prueba de hidrógeno espirado como predictor de intolerancia a la lactosa. El objetivo secundario fue analizar la influencia del índice de masa corporal, de la medida de la cintura y de la edad en la distensión abdominal de pacientes intolerantes a la lactosa.