Vitamin d deficiency with high parathyroid hormone levels is related to late onset SEPSIS among preterm infants.

Preterm infants (PTs) are at greater risk for vitamin D deficiency, which relates to the possibility of a higher incidence of comorbidities. Our goal was twofold, 1) to monitor vitamin D, calcium, phosphorus, parathyroid hormone (PTH), matrix metalloproteinase-8 (MMP-8) serum levels at three-time points during hospitalization, and 2) to assess the association between 25-hydroxyvitamin D (25OHD) levels and outcomes in PTs. METHODS: We carried out a follow-up on 50 Caucasian PTs ≤ 32 weeks of gestational age (GA) and/or ≤ 1500 g birth weight at 28 days and at 4 months. PTs were divided into two subgroups for tests of association with clinical outcomes based on vitamin D deficient infants 25(OH) D cord blood levels: ≤ 20 ng/ml). At an initial stage, 25(OH) D levels were determined in maternal/preterm blood samples and were compared to full term delivery infants. RESULTS: There were no differences in 25(OH) D serum levels at birth when comparing PTs to term infants, or regarding maternal levels. A strong positive correlation was detected between maternal and neonatal 25(OH) D serum levels among PTs and term infants (r: 0.466; p < 0.001). Neonates with vitamin D deficiency did not present a higher incidence of comorbidities. PTs were classified in two subgroups based on vitamin D and PTH (group 1: vitamin D < 20 ng/mL and PTH > 60 pg/mL; group 2: vitamin D > 20 and PTH < 60 pg/mL). The PTs in group 1 showed a higher incidence of LOS (RR: 2; 95% CI: 1.31-3.55). No relationship was observed between MMP-8 serum levels and the incidence of sepsis. CONCLUSIONS: This study did not find any evidence of an increase in preterm birth risk related to vitamin D level at birth. Vitamin D deficiency by itself is not associated with a higher incidence of comorbidities. However, the binomial vitamin D-PTH must be taken into consideration.

Metabolic profiling in children with autism spectrum disorder with and without mental regression: preliminary results from a cross-sectional case-control study.

INTRODUCTION: It is challenging to establish the mechanisms involved in the variety of well-defined clinical phenotypes in autism spectrum disorder (ASD) and the pathways involved in their pathogeneses. OBJECTIVES: The aim of the present study was to evaluate the metabolomic profiles of children with ASD subclassified by mental regression (AR) phenotype and with no regression (ANR). METHODS: The present study was a cross-sectional case-control study. Thirty children aged 2-6 years with ASD were included: 15 with ANR and 15 with AR. In addition, a control group of 30 normally developing children was selected and matched to the ASD group by sex and age. Plasma samples were analyzed with a metabolomics single platform methodology based on liquid chromatography-mass spectrometry. Univariate and multivariate analysis, including orthogonal partial least squares-discriminant analysis modeling and Shared-and-Unique-Structures plots, were performed using MetaboAnalyst 4.0 and SIMCA-P 15. The primary endpoint was the metabolic signature profiling among healthy children and autistic children and their subgroups. RESULTS: Metabolomic profiles of 30 healthy children, 15 ANR and 15 AR were compared. Several differences between healthy children and children with ASD were detected, involving mainly amino acid, lipid and nicotinamide metabolism. Furthermore, we report subtle differences between the ANR and AR groups. CONCLUSIONS: In this study, we report, for the first time, the plasmatic metabolomic profiles of children with ASD, including two different phenotypes based on mental regression status. The use of a liquid chromatography-mass spectrometry platform approach for metabolomics in ASD children using plasma appears to be very efficient and adds further support to previous findings in urine. Furthermore, the present study documents several changes related to amino acid, NAD+ and lipid metabolism that, in some cases, such as arginine and glutamate pathway alterations, seem to be associated with the AR phenotype. Further targeted analyses are needed in a larger cohort to validate the results presented herein.

Analysis of the local and systemic inflammatory response in hospitalized infants with respiratory syncitial virus bronchiolitis.

BACKGROUND: Respiratory syncytial virus acute bronchiolitis (RSV-AB) is a major cause of hospital admission among our infants. The immune and inflammatory mechanisms involved in the RSV-AB and factors influencing severity have not been clearly established, although an imbalanced Th1 and Th2 response seems to be crucial. OBJECTIVES: To assess the local and systemic inflammatory response in RSV-AB. To find a possible marker of clinical severity and/or oxygen requirements. PATIENTS AND METHODS: Levels of nine cytokines were measured in nasopharyngeal aspirate (NPA) and peripheral blood (PB) of 45 infants with RSV-AB and 27 peer controls, including IFNγ, TNFα, VEGF, interleukins 4, 6 and 10, and chemokines (IL-8 and macrophage inflammatory proteins 1-α and 1-ß). RESULTS: The levels of the analyzed cytokines and chemokines were significantly higher in the NPA of RSV-AB group, with a decrease in IL-4/IFNγ ratio. IL-6 and MIP-1ß levels in NPA were directly correlated to oxygen therapy. PB showed an increase in IL-8 and a decrease in MIP-1α and MIP-1ß in the RSV-AB group (only MIP-1ß associated to the need for oxygen therapy). No correlation was found between cytokines and chemokines levels in NPA and PB. CONCLUSIONS: This study shows that RSV triggers an inflammatory response fundamentally at the respiratory level, with scant systemic repercussion. This local response is characterized by an increase in Th1 and Th2 cytokines, although with a relative predominance of Th1. The determination upon patient admission of IL-6 and MIP-1ß levels in NPA, and of MIP-1ß in PB could help predict severe forms and the need for oxygenotherapy.

Effects of parenteral nutrition formulas on plasma lipid profile in children with bone marrow transplantation.

BACKGROUND/AIMS: Children undergoing bone marrow transplantation (BMT) often require parenteral nutrition (PN). This is a comparative study of plasma lipid profiles in BMT children after fish oil or soybean PN. METHODS: A total of 14 children with BMT requiring PN for at least 10 days were recruited during 24 months. They were randomized to receive a lipid emulsion enriched with ω3 polyunsaturated fatty acid, or soybean oil. Clinical monitoring was performed. Blood samples were collected before and after administration of PN to analyze the lipid profile. RESULTS: There were no complications associated with PN. The increase in TG levels was more pronounced after administration of an enriched ω3 emulsion and the decrease in cHDL and apo A was greater after administration of soybean. The ω3 group showed an increase in eicosapentaenoic and a decrease in arachidonic acids compared to the soybean group. Both groups showed similar levels of linolenic acid. CONCLUSION: PN with soybean or ω3 emulsions for 10 days is safe in children. However, research in children are necessary in order to examine the impact of the duration of PN and the type of lipid formula used, and determine their health benefits in relation to the fatty acid profile.

Experience in neuromuscular diseases in children and adolescents and their comorbidities in a tertiary hospital.

INTRODUCTION: Neuromuscular diseases include a large group of heterogeneous and rare pathologies that affect different components of the motor unit. It is essential to optimize resources to know the prevalence of comorbidities in the most frequent groups to establish an early multidisciplinary approach in a specialized setting. PATIENTS AND METHODS: Retrospective descriptive study of pediatric and adolescent patients with neuromuscular diseases (NMDs). The Inclusion criteria were NMDs patients with motor neuron involvement divided into three groups, depending on the affected component of the motor unit. Group I: involvement of the motor neuron; Group II: peripheral neuropathies; Group III: myopathies. Demographic variables, association with comorbidities, need for respiratory support, and rehabilitative treatment were collected in each group. RESULTS: Ninety-six patients who met the inclusion criteria were studied. In group I, when compared to the other two groups, a higher incidence of scoliosis (68.3%, p = 0.011), deformity of the rib cage (31.3%, p = 0.0001), chronic respiratory insufficiency (62.5%, p = 0.001) and bronchial aspiration (12.5%, p = 0.03) was detected. In this group, 50%of the patients required non-invasive mechanical ventilation (p = 0.0001). The in-hospital requirement for respiratory physiotherapy was higher in group I (75%, p = 0.001). We observed a higher incidence of scoliosis in Group III compared to Group II. CONCLUSIONS: Neuromuscular diseases with motor neuron involvement present more comorbidities and require an early approach after diagnosis to improve prognosis.

Evaluation of the vasoactive-inotropic score, mid-regional pro-adrenomedullin and cardiac troponin I as predictors of low cardiac output syndrome in children after congenital heart disease surgery.

OBJECTIVE: To determine the predictive value of the inotropic score (IS) and vasoactive-inotropic score (VIS) in low cardiac output syndrome (LCOS) in children after congenital heart disease surgery involving cardiopulmonary bypass (CPB), and to establish whether mid-regional pro-adrenomedullin (MR-proADM) and cardiac troponin I (cTn-I), associated to the IS and VIS scores, increases the predictive capacity in LCOS. DESIGN: A prospective observational study was carried out. SETTING: A Paediatric Intensive Care Unit. PATIENTS: A total of 117children with congenital heart disease underwent CPB. Patients were divided into two groups: LCOS and non-LCOS. INTERVENTIONS: The clinical and analytical data were recorded at 2, 12, 24 and 48h post-CPB. Logistic regression was used to develop a risk prediction model using LCOS as dependent variable. MAIN OUTCOME MEASURES: LCOS, IS, VIS, MR-proADM, cTn-I, age, sex, CPB time, PIM-2, Aristotle score. RESULTS: While statistical significance was not recorded for IS in the multivariate analysis, VIS was seen to be independently associated to LCOS. On the other hand, VIS>15.5 at 2h post-CPB, adjusted for age and CPB timepoints, showed high specificity (92.87%; 95%CI: 86.75-98.96) and increased negative predictive value (75.59%, 95%CI: 71.1-88.08) for the diagnosis of LCOS at 48h post-CPB. The predictive power for LCOS did not increase when VIS was combined with cTn-I >14ng/ml at 2h and MR-proADM >1.5nmol/l at 24h post-CPB. CONCLUSIONS: The VIS score at 2h post-CPB was identified as an independent early predictor of LCOS. This predictive value was not increased when associated with LCOS cardiac biomarkers. The VIS score was more useful than IS post-CPB in making early therapeutic decisions in clinical practice post-CPB.

Tubular particles in a case of recurrent lymphocytic meningitis followed by amyotrophic lateral sclerosis.

A patient suffered recurrent episodes of aseptic lymphocytic meningitis for many years and then developed amyotrophic lateral sclerosis (ALS). Immune-complexes were deposited in the renal glomerular basement membrane and mesangia. The necropsy study revealed both lymphocytic meningitis and ALS. Study of the motor neurons with the electron microscope revealed proliferation of endoplasmic reticulum, small cytoplasmolytic areas and focal neurofibrillar accumulations in axons. Interwoven, serpentine 10-15 nm. tubules first appeared with ER proliferation and, presumably at a later stage, were sometimes present in large masses. These tubules might be virus material but virus cultures, including tissue culture, and animal inoculations have thus far been negative.

Lipofuscin in amyotrophic lateral sclerosis.

Lipofuscin has been reported to accumulate in abnormal amounts in motor neurons of patients with amyotrophic lateral sclerosis (ALS). Microdensitometry was used to quantitate such lipid masses in spinal motor neurons in normal subjects compared with spinal motor neurons in ALS cases. No overall difference in lipofuscin level was found between the normal and the ALS material. Some neurons of intermediate size did show increased amounts of lipofuscin, which is attributed to shrinkage during degeneration by larger cells having proportionately more lipofuscin originally.

Passive transfer experiments in amyotrophic lateral sclerosis.

To test the hypothesis that a serum factor might play a role in the pathogenesis of amyotrophic lateral sclerosis, whole plasma obtained by plasmapheresis from patients with the disease was injected daily intraperitoneally into mice for periods of up to three months. Similar experiments were carried out with an isolated immunoglobulin fraction. Control experiments were carried out simultaneously. The animals were tested electrophysiologically, and histologic examinations of the brain, spinal cord, and peripheral nerves were performed. No ill effects were noted in the animals, and no neurophysiologic or microscopic abnormalities were detected.

Mediastinal meningioma.

A case of meningioma appearing to arise from the stellate ganglion and associated with a unilateral Horner syndrome of long standing is presented. Clinical absence of central nervous system involvement and a normal computerized tomographic scan of the brain favor the neoplasm as being a primary extracranial meningioma. Light and electron microscopy showed characteristic structural features. A brief review of the literature is made, and theories concerning the origin of extracranial primary meningioma are presented.

Pharmacological investigation into the effects of histamine and histamine analogues on guinea-pig and rat colon in vitro.

The effects of histamine and specific histamine agonists has been examined on isolated longitudinal colon strips of guinea-pig and rat. Histamine and 2-pyridyl-ethylamine but not 4 methylhistamine produced a concentration-related contractile response in the guinea-pig colon. The H1-antagonist clemizole antagonized competitively the effect of histamine but the H2-antagonist ranitidine did not modify the dose-response curve to histamine in the guinea-pig colon. Atropine, hexamethonium, prazosin and propranolol failed to modify the contractile response to histamine. Tone induced with KCl in guinea-pig isolated colon was not modified by histamine agonists even in tissues pretreated with clemizole or ranitidine. Histamine and histamine analogues were without effect on the isolated longitudinal strip of the rat colon. It is concluded that histamine produced dose-dependent contractions of the guinea-pig colon due to direct activation of H1-histamine receptors. There is no evidence in favour of the existence of H2-histamine receptors in this preparation. The lack of effect of histamine agonists in rat colon strip argues against the existence of histamine receptors in this preparation.

Cerebral amyloid angiopathy.

Cerebral amyloid angiopathy is nonspecific disease entity that has been associated with a number of neuropathologic conditions, the most prominent being dementia and cerebral hemorrhage. It occurs more commonly than is generally appreciated, with implications that may be overlooked. Amyloid deposits are found in the vessels of the leptomeninges and cerebral cortex. There is often a close topographic relation to senile plaques, the histologic abnormality characteristic of Alzheimer's disease and senile dementia. Because of this relation and the well documented presence of amyloid in senile plaques, a similar natural history has been postulated for each. Histochemical studies indicate, however, that there are distinct differences between the amyloid deposits in cerebral vessels and senile plaques. An association between cerebral amyloid angiopathy and other forms of amyloidosis has similarly failed to be established, and a successful form of therapy has yet to be devised.

Protection from lung damage by blood filtration during deep hypothermia in puppies.

Ten puppies underwent deep hypothermia with surface cooling and bypass cooling. They were subjected to circulatory arrest for 30 minutes and then were rewarmed by means of bypass. There were 5 control puppies and 5 for which a Swank filter was placed in the arterial perfusion line. All puppies had some degree of lung damage, but it was more severe in those in which perfused blood was not filtered. The damage involved the lung vessels, interstitial tissue, and alveoli. Platelet-fibrin aggregates and margination and sequestration of leukocytes appeared to be important pathological findings. Apparently, the Swank blood filter protects the lung by removing leukocytes and damaged platelets from the circulation.

Corticosteroids and prevention of pulmonary damage following cardiopulmonary bypass in puppies.

A technique of inducing hypothermia using surface cooling and rewarming with a pump oxygenator has been applied clinically in infants with satisfactory results. Respiratory problems postoperatively, however, are reported to be among the complications contributing most to mortality and morbidity. Prednisolone sodium succinate (Solumedrol) has helped to obviate pulmonary damage in hemorrhagic and endotoxic shock and therefore may be effective in preventing pulmonary damage following hypothermia. This hypothesis was investigated in 12 mongrel puppies, 6 that had hypothermic cardiopulmonary bypass and circulatory arrest but were not given Solumedrol, and 6 that were treated preoperatively with Solumedrol. In lung biopsies taken immediately after bypass the pathological changes in both the group treated with steroids and the control group were similar. At six hours, however, lung biopsies from the control group showed further signs of progressive damage, while in the steroid-treated group there was a striking improvement with some lung biopsies showing a normal appearance. Thus, Solumedrol did not prevent initial lung damage, but the progressive and probably permanent changes were reduced.

[Recommendations for the perinatal management and follow up of late preterm newborns]. / Recomendaciones para el manejo perinatal y seguimiento del recién nacido prematuro tardío.

Prematurity is the main reason for neonatal morbidity and mortality, and has become one of the greatest problems in public health, especially in developed countries. Prematurity rate has increased during the last 2 decades. This increase may be attributed to late preterm babies, that is, those with a gestational age between 34(+0) and 36(+6) weeks. Perinatal morbidities, as well as long term complications, are more frequent in this population than in term babies. The incidence is more similar to the one observed in earlier premature babies. The SEN34-36 group of the Spanish Society of Neonatology suggests these recommendations for the management of late preterm babies. Strategies are offered not only for the early detection of possible complications, but also for the correction of these morbidities, and from the point of view of a family and development centered care. Follow up is strongly recommended due to the high rate of late morbidities.

[Trans fatty acids in the nutrition of children with neurological disorders]. / Ácidos grasos trans en la nutrición de niños con trastornos neurológicos.

INTRODUCTION: Trans-fatty acids are present in various foods, being the only source of the same in humans. Its presence in high concentrations is a risk factor for health, being involved in a series of events, cardiovascular, inflammatory, etc. Therefore, steps have been taken for its decrease in the diet. The aim is to determine serum and phospholipids of membranes in healthy children and neurological alterations. MATERIAL AND METHODS: It has analyzed the fatty acids trans in 34 healthy children and 374 with various neurological pathologies. Serum and blood cells, making the lipid extraction, samples have been separation of the phospholipids of cells membranes, methylation of fatty acids, separation by gas chromatography and quantification using mass detector. The data have been processed statistically. RESULTS: The distribution of trans fatty acids and their sum is not normally distributed, so its nonparemetric tests were used. The values are higher than in serum phospholipids and membrane with a weak but significant correlation. The tC18: 1 is in a double proportion in children with neurological disorders in healthy children, both in serum and membrane phospholipids, with significant differences. DISCUSSION: The highest proportion of trans-fatty acids in the group of children with neurological disorders is caused no doubt by an increase in intake, due to less adequate food.

Introducción: Los ácidos grasos trans (AGT) están presentes en diversos alimentos, y son la única fuente de los mismos en humanos. Su presencia en concentraciones elevadas supone un factor de riesgo para la salud, por lo que se ven implicados en toda una serie de eventos cardiovasculares, inflamatorios, etc. Por ello, se han adoptado medidas para su disminución en la dieta. Como objetivo, se pretende determinarlos en el suero y en los fosfolípidos de las membranas, tanto en los niños sanos, como en los que padecen alteraciones neurológicas. Material y métodos: Se han analizado los AGT de 34 niños sanos y de 374 con diversas patologías neurológicas. Se han utilizado muestras de suero y de células sanguíneas, para lo que se lleva a cabo una extracción lipídica, con separación de los fosfolípidos de las membranas de las células, metilación de los ácidos grasos, separación mediante cromatografía de gases y, finalmente, cuantificación mediante detector de masas. Los datos han sido procesados estadísticamente. Resultados: La distribución de los AGT y su suma no tienen una distribución normal, por lo que se han efectuado pruebas no paramétricas. Los valores son mayores en suero que en los fosfolípidos de membrana y con una correlación débil, aunque significativa. El tC18:1 tiene una proporción doble en los niños con trastornos neurológicos, frente a los niños sanos, tanto en el suero como en los fosfolípidos de membrana, con diferencias significativas. Discusión: La mayor proporción de AGT en el grupo de niños con trastornos neurológicos está causada, sin duda, por un incremento en su ingesta, lo que se debe a una alimentación menos adecuada.

[High ratio of omega 6/omega 3 ratio children with neuropathies; cause or effect]. / Índice elevado de ácidos grasos omega 6/omega3 en niños con neuropatía; causa o efecto.

INTRODUCTION: The n-3 and n-6 fatty acids compete for the same elongases and desaturases, still highly deficient synthesis of polyunsaturated fatty acids from n-3 linolenic acid. The n-3 polyunsaturated prevent disease and are important in the development and maintenance of neuronal activities, necessitating a proper relationship with their antagonists n-6. This paper studies the proportion of these fatty acids. MATERIAL AND METHODS: We analyzed the fatty acids of n- 3 and n-6 in sera and membrane phospholipid with 374 children neuropathies and 34 healthy children, using gas chromatography with mass detector. It has made the relevant statistical study. RESULTS: The n-3 (EPA and DHA) in serum and their corresponding membrane phospholipids correlate better than the n-6 family. The major n-6 (LA and ARA) are equally in serum, being significantly higher in phospholipids of healthy children. The n-3 (EPA and DHA) have higher values in healthy children, both in serum and phospholipids, their sum is equal to the membrane phospholipids. The n-6/n-3 ratio is higher in children with neurological disorder in both samples. CONCLUSION: Not being the cause of the high rate n-6/n- 3 neuropathy, however it is advisable to increase the intake of n-3, DHA particularly across the population, especially in children with neurological disorders.

Introducción: Los ácidos grasos n-3 y n-6 compiten por las mismas elongasas y desaturasas, siendo muy deficiente la síntesis de ácidos grasos poliinsaturados n-3 a partir de ácido linolénico. Los poliinsaturados n-3 previenen enfermedades y son importantes en el desarrollo y mantenimiento de las actividades neuronales, siendo necesaria una relación adecuada con sus antagonistas n- 6. En este trabajo se estudia la proporción de estos ácidos grasos. Material y métodos: Se han analizado los ácidos grasos n-3 y n-6 en sueros y fosfolípidos de membrana de 374 niños con neuropatías y de 34 niños sanos, mediante cromatografía de gases con detector de masas. Se ha realizado el estudio estadístico pertinente. Resultados: Los ácidos grasos n-3 (EPA y DHA) en suero y su correspondientes fosfolípidos de membrana correlacionan mejor que los de la familia n-6. Los mayoritarios n-6 (LA y ARA) están en igual proporción en sueros, siendo más elevados significativamente en los fosfolípidos de los niños sanos. Los n-3 (EPA y DHA) tienen valores más altos en los niños sanos, tanto en suero como en fosfolípidos, su suma se iguala en los fosfolípidos de membrana. El índice n-6/n-3 es mayor en los niños con trastorno neurológico en ambas muestras. Conclusión: No siendo la causa de la neuropatía el alto índice n-6/n-3, sin embargo es aconsejable incrementar la ingesta de n-3, sobre todo DHA en toda la población y en especial en los niños con trastornos neurológicos.

[Correspondence between the fatty acids in healthy children serum and in membrane phospholipids]. / Relación entre los ácidos grasos en suero y en los fosfolípidos de membrana en niños sanos.

INTRODUCTION: The diet is important in the supply of fatty acids in humans, especially those of the n-3 and n-6 families by its essentiality and related physiological function. It is important to have reference values in accessible biological samples: serum and erythrocyte membranes, in order to alleviate potential shortfalls. The objective is quantifying fatty acids present in these samples from C6 to C26. MATERIAL AND METHODS: the determinations of the fatty acids of 30 healthy children in serum and its corresponding membrane phospholipids from blood cells by lipid extraction, methylation, separation and quantification in gas chromatography with detection of masses have been. It is comparing the values obtained in each serum and its partner of cell membranes. RESULTS AND DISCUSSION: It is have obtained normal values in healthy children. The C16, which represent a quarter of all fatty acids, it is in the same proportion in both samples, in the rest of fatty acids, there is no clear correspondence between both values. In the n-6 family, the C18:2n6 is higher in serum against the C20:4n6 which is in the phospholipids. In the same way between the n-3 family, the C20:5n3 is higher in serum and the C22:6n3 is in membrane phospholipids. These values are cause of different processes, recent nutritional contribution to serum and with long-term implications and metabolic values in the phospholipids of membranes.

Introducción: La dieta es importante para el suministro de ácidos grasos del hombre, en especial los de las familias n-3 y n-6, por su esencialidad y las amplias funciones fisiológicas relacionadas. Es importante tener valores de referencia en las muestras biológicas accesibles, tales como suero y membranas eritrocitarias, con el fin de paliar posibles déficit. El objetivo del presente trabajo consiste en cuantificar los ácidos grasos esenciales (AGE) presentes en dichas muestras, desde la C6 hasta la C26. Material y métodos: Se han efectuado las determinaciones de los ácidos grasos de 30 niños sanos en suero y en sus correspondientes fosfolípidos de membrana de células sanguíneas, mediante su extracción lipídica, metilación, separación y cuantificación en cromatografía de gases con detección de masas. Se han comparado los valores obtenidos en cada suero y su pareja de membranas celulares. Resultados y discusión: Se han obtenido los valores normales en niños sanos. El C16, que supone la cuarta parte de todos los ácidos grasos, está en la misma proporción en ambas muestras; entre el resto, no se encuentra una correspondencia clara entre ambos valores. Entre los n-6, el C18:2n6 está en mayor proporción en suero, frente al C20:4n6 que lo está en los fosfolípidos. De igual forma, entre los n-3, el C20:5n3 está en mayor proporción en suero y el C22:6n3 lo está en fosfolípidos de membrana. Dichos valores son la causa de procesos distintos, aporte nutricional reciente para el suero y con implicaciones a largo plazo y metabólicas los valores en los fosfolípidos de las membranas.

[Plasma fatty acids profile in paediatric cancer patients]. / Perfil de ácidos grasos en pacientes oncológicos pediátricos.

UNLABELLED: The small number of cases of cancer in children and the difficulties of research, have contributed to there being few studies on the metabolic and nutritional status of these patients. The main objective of this study was to investigate the nutritional and metabolic alterations in children with cancer, and specifically the plasma fatty acid profile after receiving chemotherapy, compared with a group of healthy children. METHODS: We selected 12 children with cancer aged between 0 and 16, who had received at least one cycle of chemotherapy, one month before the study and were not end-stage disease. Nutritional survey was conducted, anthropometric measurements, general biochemical analysis and profile of fatty acids in plasma were evaluated. RESULTS: No changes in anthropometric and nutritional biochemical parameters were detected. In the omega-6 fatty acids, lower values of linoleic and docosapentaenoic acid, and higher levels of gamma-linolenic acid, and normal levels of arachidonic acid were observed. In the omega-3, we found normal values of alpha-linolenic acid and docohexanoic acid, and lower values of eicosapentaenoic acid. CONCLUSION: It seems glimpsed a partial deficiency in the metabolism of polyunsaturated fatty acids in children with cancer, good nutrition and having received at least one cycle of chemotherapy. Further research is needed to allow specific supplementations.

Factor structure and psychometric properties of the center for epidemiologic studies depression scale (CES-D) in older populations with and without cognitive impairment.

The CES-D is widely used for the assessment of depressive symptoms in the adult population. However, few studies have been performed to assess the utility of this scale in an older population with cognitive impairment. The factor structure of the Spanish version of the CES-D was examined in an observational, cross sectional study in 623 older adults (M = 72.74 years; SD = 7.7). The validity of the scale was determined in two samples of older adults, one comprising 162 participants with cognitive impairment (M = 76.73 years; SD = 8.1) and one with 58 participants without cognitive impairment (M = 74.64 years; SD = 9.0). The results confirm previous results of a four factor structure. With regard to the validity of the scale, in the group with cognitive impairment the area under the ROC curve is 0.84 (95% CI: 0.77-0.89) and the cut-off point for possible depression is 13, while in the group without cognitive impairment the area is 0.90 (95% CI: 0.79-0.96) and the optimal cut-off point is 28. These results show that the Spanish version of the CES-D is a valid instrument for the identification of depression in older adults with and without cognitive impairment.