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Gonzalez Jimenez D.,Hospital Universitario Central Of Asturias | Bousono Garcia C.,Hospital Universitario Central Of Asturias | Rivas Crespo M.F.,Hospital Universitario Central Of Asturias | Diaz Martin J.J.,Hospital Universitario Central Of Asturias | And 4 more authors.
Anales de Pediatria | Year: 2012

Aim: To determine the prevalence of overweight in paediatric patients with cystic fibrosis (CF) and to analyse its role as diabetogenic insulin resistance factor and risk of hypertriglyceridaemia. Patients and methods: A total of 109 CF patients (47% males) between 5 and 18 years were divided into 3 groups according to body mass index (BMI): underweight, normal and overweight. Total cholesterol, triglycerides, C- reactive protein (CRP), glycosylated haemoglobin, HOMA-IR and QUICKI index were determined. Insulinogenic index, ISI composite and areas under the curve (AUC) for glucose and insulin were obtained by oral glucose tolerance test (OGTT). Results: Six patients (5.5%) were overweight. All groups had similar distribution by age, sex and CFTR mutation, although the proportion of pancreatic sufficient (3/6, 50%) was higher in overweight patients (P=.003). The prevalence of glycaemic disorders was similar between groups. Baseline insulin, HOMA-IR, and insulin during the OGTT (peak and AUC) were higher in overweight patients. All patients had a delayed insulin response in OGTT. Conclusions: Overweight CF patients do not have a higher incidence of glycaemic disorders, but their hyperinsulinism and insulin resistance may be additional diabetogenic risk factors. © 2011 Asociación Española de Pediatría. Published by Elsevier España, S.L. All rights reserved.


Alonso Hernandez J.,Hospital Infantil Universitario del Nino Jesus
Pediatria Integral | Year: 2014

Limping is a common reason for consultation in Pediatrics, which should always be considered a pathological finding. The etiological diagnosis should be the goal of our assessment, even though not being always easy for the wide range of conditions in different locations that may manifest as a limp. A detailed knowledge of the most common causes of limp in terms of age and a systematic study of these children, will avoid a delay or misdiagnosis that can have serious consequences on child health. This diagnostic study consists of a complete medical history and a delicate and sometimes difficult examination, including a detailed gait analysis. In some cases, the study will be completed with laboratory tests (usually a blood test and sometimes joint fluid test) and imaging tests (usually radiographs and joint ultrasound). © 2014, Ediciones Ergon SA. All rights reserved.


Guillen-Navarro E.,Hospital Clinico Universitario Virgen Of La Arrixaca | Blasco A.J.,Tecnicas Avanzadas de Investigacion en Servicios de Salud TAISS | Gutierrez-Solana L.G.,Hospital Infantil Universitario del Nino Jesus | Couce M.L.,Hospital Clinico Universitario Of Santiago | And 2 more authors.
Medicina Clinica | Year: 2013

The Hunter syndrome (HS), or mucopolysaccharidosis type II, is a disease caused by a deficiency or absence of the enzyme iduronate-2-sulfatase (I2S) due to mutations in the IDS gene. I2S deficiency causes a block in the degradation of glycosaminoglycans (GAG) in cytoplasmic lysosomes which leads to their accumulation in cells. This causes a generalized cellular disorder and increased elimination of these GAG in urine. The HS is an inherited X-linked recessive disease, which affects one in 49,000 to 526,000 male live births. The HS progressive and multisystem involvement usually causes the need of various medical specialties for managing the disease. Recently a new enzyme replacement therapy with recombinant I2S is available, which improves and slows the disease progression. Thus, early diagnosis and treatment are key factors for managing HS. For these reasons, this clinical practice guideline (CPG) has been developed. This CPG aims to help the different specialists who manage patients with SH in the early detection, follow-up and treatment. This guide has been developed by a working group set up by the Spanish Hunter Group (multidisciplinary team of physician specialists in the diagnosis and management of HS) and researchers with methodological experience in developing GPC. The recommendations are based on the synthesis of the best available scientific evidence and the experience of experts. © 2013 Elsevier Españ a, S.L. All rights reserved.


Alonso Hernandez J.,Hospital Infantil Universitario del Nino Jesus
Pediatria Integral | Year: 2010

The child with a limp is a common reason for consultation, which should always be considered a pathological finding. The etiological diagnosis should be the goal of our assessment, even though not being always easy for the wide range of conditions and locations that may manifest as a limp. A detailed knowledge of the most common causes of limp in terms of age and a systematic study of these children, will avoid a delay or misdiagnosis that can have serious consequences on child health. This diagnostic study consists of a complete medical history and a delicate and sometimes difficult examination, including a detailed gait analysis. In some cases, the study will be completed with laboratory tests (usually a blood test and sometimes joint fluid test) and imaging tests (usually radiographs and joint ultrasound).


Barranco P.,Hospital la Paz Institute for Health Research IdiPaz | Perez-Frances C.,Hospital Universitario Dr Peset | Quirce S.,Hospital la Paz Institute for Health Research IdiPaz | Gomez-Torrijos E.,Hospital General de Ciudad Real | And 4 more authors.
Journal of Investigational Allergology and Clinical Immunology | Year: 2012

Background: The concepts of asthma severity, control, and exacerbation are important in the evaluation of patients and their response to treatment. However, terminology is not standardized, and terms are often used interchangeably. Patients with uncontrolled severe asthma pose a major health care problem. Over the last decade, it has become increasingly clear that, in order to facilitate the development of novel targeted therapies, patients must be further characterized and classified. Objective: To draft a consensus statement on the diagnosis, management, and treatment of severe uncontrolled asthma. The statement is meant to serve as a guideline for health professionals and clinical researchers. Methods: The consensus was led by the Severe Asthma Working Group of the Spanish Society of Allergology and Clinical Immunology Asthma Committee. A review was conducted of the best available scientific evidence (until December 2011) on severe asthma in adults and children. Results: Definitions for severe asthma, level of control, and exacerbation are developed. Different phenotypes and endophenotypes of severe uncontrolled asthma and new specific therapeutic interventions are presented. A systematic algorithm for the evaluation of patients presenting with severe persistent asthma symptoms is proposed. Conclusions: A consensus statement on the diagnosis, management, and treatment of severe uncontrolled asthma is presented. © 2012 Esmon Publicidad.

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