0000000000141338
AUTHOR
Juan Brines
Usefulness of telemedicine for home ventilator-dependent children.
Introduction Medical care for ventilator-dependent children must avoid hospital confinement, which is detrimental to the patient, their family and Paediatric Intensive Care Unit. Our objective was to assess the role of telemedicine in facilitating early and permanent discharge of such patients to home care. Methods This was a prospective clinical study (2007–2017) in tracheotomised ventilator-dependent children. We used a Big Data Telemedicine home system (Medlinecare 2.1) from the Paediatric Intensive Care Unit. Specialised home-nursing services were available. Clinical events were analysed using the Chi-square test (significance p < 0.05). Families subsequently completed a satisfaction…
Prenatal and neonatal risk factors for the development of enamel defects in low birth weight children
Oral Diseases (2010) 16, 257–262 Objective: To analyse the influence of several prenatal and neonatal risk factors in the development of enamel defects in low birth weight children. Subjects and methods: Children between 4 and 5 years of age (n = 102) were classified into: Group 1) 52 low birth weight (<2500 g); Group 2) 50 normal birth weight (≥2500 g). Medical history, prenatal and neonatal variables were collected. Enamel defects were evaluated with the modified Developmental Defects of Enamel Index. Results: The prevalence of hypoplasia and average number of affected teeth were significantly higher in group 1 than in group 2 (59.6%vs 16% and 1.6 vs 0.3 respectively). Low gestational …
Medical complications in a telemedicine home care programme for paediatric ventilated patients.
Introduction Advances in paediatric medicine have increased survival rates for patients with severe chronic illnesses, of which the most complex are ventilator-dependent children (VDCs). Although home care improves their quality of life, morbidity and mortality rates are high. Our aim was to study the medical complications (events) that occur at home and assess the usefulness of telemedicine in their detection and treatment. Methods A prospective clinical study (2007–2017) was performed for tracheotomised VDCs. We used a high-density data telemedicine monitoring system from our Paediatric Intensive Care Unit and analysed events during the first two years of home care to study how different …
Association between WHO cut-offs for childhood overweight and obesity and cardiometabolic risk
AbstractObjectiveTo examine the association between cardiovascular risk and childhood overweight and obesity using the BMI cut-offs recommended by the WHO.DesignChildren were classified as normal weight, overweight and obese according to the WHO BMI-for-age reference. Blood pressure, lipids, glucose, insulin, homeostasis model assessment–insulin resistance (HOMA-IR) and uric acid levels were compared across BMI groups. ANOVA and tests of linearity were used to assess overall mean differences across groups. Crude and adjusted odds ratios were calculated for adverse plasma levels of biochemical variables.SettingPaediatric care centres.SubjectsChildren (n149) aged 8–18 years.ResultsAbout 37 %,…
Carotid artery stiffness as an early marker of vascular lesions in children and adolescents with cardiovascular risk factors.
INTRODUCTION AND OBJECTIVES The availability of a noninvasive marker of vascular lesions that enables their detection in the preclinical phase would be of great benefit for cardiovascular disease prevention. The aim of this study was to investigate the usefulness of a range of indices of arterial wall stiffness in the common carotid artery, as derived using high-resolution Doppler ultrasonography, for identifying vascular damage in children with risk factors. METHODS The study involved 99 children (age, 8-16 years) divided into two groups: 65 had cardiovascular risk factors (45 obesity, 20 dyslipidemia) and 34 were controls. Family histories of cardiovascular risk factors and anthropometric…
Arteriovenous fistula of the vertebral artery in a female infant with hypotonia and cephalocorporal disproportion
Background: Congenital arteriovenous fistulas are exceptional in childhood and imply a therapeutic challenge. Case report: A 9-month-old female infant was studied for cephalocorporal disproportion, hypotonia, progressive muscular atrophy and hyperreflexia. Computed tomography of the brain and electroencephalography were normal. Electromyographic patterns suggested proximal myopathic involvement. A continuous murmur with systolic reinforcement was audible in the neck. Angioresonance detected intracranial aneurysmal dilatations behind the bulbo-medullary junction and cerebral panangiography evidenced a direct vertebrovertebral fistula with extra- and intra-cranial varices and extreme medulla…
Medida de la rigidez de la arteria carótida como marcador precoz de lesión vascular en niños y adolescentes con factores de riesgo cardiovascular
Introduccion y objetivos Para la prevencion de la enfermedad cardiovascular resulta de gran interes disponer de un marcador incruento de lesion vascular que permita su deteccion en fase preclinica. Nuestro objetivo fue analizar diversos indices de rigidez arterial de la carotida comun mediante ultrasonografia Doppler de alta resolucion para definir su utilidad como detector de dano vascular en ninos con factores de riesgo. Metodos Se estudio a 99 ninos (edades, 8-16 anos) divididos en dos grupos: 65 ninos con factores de riesgo cardiovascular (45 obesos, 20 dislipemicos) y 34 controles. Se recogieron antecedentes familiares de riesgo cardiovascular y variables antropometricas y bioquimicas.…
Breast-Feeding from an Evolutionary Perspective.
Lactation is the most critical period of mammal feeding given the compulsory dependence on milk of the offspring during a more or less extensive period following birth. This has also been the case for the human species until relatively recent times when heterologous milk processing has allowed the alternative of artificial lactation. The advantages and disadvantages of natural and artificial lactation (formula) have been widely discussed from the biological, psychological and cultural perspectives, without reaching a general agreement among the breastfeeding women themselves or among the health professionals concerned. On the subject of breastfeeding, the information available is enormous b…
Adult Lactose Tolerance Is Not an Advantageous Evolutionary Trait
To the Editor. I read with great interest the recent article from Fomon1 in which he refers to the well-known hypothesis that views the variable frequencies of lactase persistence in different human populations and, consequently, the possibility for some adults to feed on milk (lactose tolerance) as an advantageous evolutionary trait that has been genetically determined and brought about through centuries of natural selection. This notion stands as a common statement in current medical literature, and most authors have accepted its validity since the 1970s.2,3 Because adult mammals are lactose-intolerant, this hypothesis is, moreover, based on the low percentage of lactose malabsorption and…
Relationship between childhood obesity cut-offs and metabolic and vascular comorbidities: comparative analysis of three growth standards
Background: To compare the association between metabolic and vascular comorbidities and the body mass (BMI)-for-age cut-off criteria from three growth standards [Centers for Disease Control and Prevention (CDC), 2000; World Health Organization (WHO), 2007; Spanish Reference Criteria (Carrascosa Lezcano et al., 2008)] that are used to define being overweight and obese in childhood. Methods: A prospective study was conducted in 137 children (aged 8–16 years). Based on BMI-for-age Z-scores according to WHO cut-offs, 59 participants were obese, 35 were overweight and 43 were normal-weight. All participating children were subsequently reclassified applying the CDC and Spanish Reference Criteria.…
Foetal erythrocytes exhibit an increased ability to scavenge for nitric oxide
The presence of adult human whole blood inhibited in vitro relaxations of rat aortic rings by the nitric oxide (NO) donor S-nitroso-N-acetyl-DL-penicillamine (SNAP). Incubation with foetal blood containing the same concentration of haemoglobin produced a shift to the right of the relaxation curve. SNAP-induced vasorelaxations were more inhibited by dialysed solutions of haemoglobin than by the presence of erythrocytes in the organ bath, but there were no differences between the effect of adult or foetal haemoglobins. The presence of plasma from adult or foetal blood did not modify the effects of SNAP. Relaxations induced by endogenous, endothelium-derived, NO were more inhibited by foetal t…