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Sanchez Bayle M.,Hospital Infantil Universitario Nino Jesus
Revista Espanola de Pediatria | Year: 2011

There are essentially four health determinants of the persons: health care system (11%), the setting, that is the environment, equipments, work conditions, etc. (19%), genetic inheritance (27%) and individual habits or style of life (43%). Risk factor is considered to be an aspect of behavior or style of life, environmental exposure or innate or hereditary characteristic which, on the basis of the epidemiological evidence, is known to be associated with a related health condition whose prevention is considered important. The cardiovascular risk factors (CVR) totally fall within this category of determinants, either because they have a genetic origin or because of bad the result of the styles and habits of life. There is much evidence regarding the positive effects of preventive activities in relationship with cardiovascular risk, especially regarding primordial prevention which is of most interest in the pediatric age. The actions having the most evidence are along the lines of avoiding smoking and obesity, promoting regular physical exercise and a healthy diet (rich in fruits, vegetables and fiber, and low in salt and saturated fats) and controlling blood pressure, hyperlipidemia and hyperglycemia.


Trindade F.,Hospital de Cascais Dr. Jose de Almeida | Kutzner H.,Dermatohistopathologische Gemeinschaftslabor | Tellechea O.,Hospital Universitario Of Coimbra | Requena L.,Fundacion Jimenez Diaz | Colmenero I.,Hospital Infantil Universitario Nino Jesus
Journal of the American Academy of Dermatology | Year: 2012

Background: Hobnail hemangioma (HH) is currently classified as a benign vascular tumor, although it is not well understood whether this lesion differentiates toward blood or lymphatic endothelial cells. Immunostaining with the endothelial marker Wilms tumor 1 (WT1) helps distinguish between vascular neoplasms and malformations, being positive in the former and negative in the latter. Objective: We sought to investigate WT1, human herpesvirus 8 latent nuclear antigen, D2-40, and Ki-67 immunoprofile in HH, to gain further insight into its histogenesis. Methods: We evaluated 52 HHs collected in Dermatohistopathologische Gemeinschaftslabor, Friedrichshafen, Germany. Immunohistochemical expression of WT1 was performed in all cases. Ten of 52 lesions were also studied for D2-40 and Ki-67 staining and 12 lesions were stained for human herpesvirus 8 latent nuclear antigen. Results: All 52 HHs were completely negative for WT1 immunostaining. Immunohistochemistry performed in 10 HHs showed diffuse and strong positive staining for D2-40 in 8 lesions and focal positivity in two. All cases tested showed negative staining for Ki-67 and human herpesvirus 8 latent nuclear antigen. Limitations: There are no limitations. Conclusions: Although the exact histogenesis of HH is unknown, most of the performed immunohistochemical studies support a lymphatic line of differentiation. However, on the basis of the WT1 negativity, we believe that HH is better considered as a lymphatic malformation rather than a lymphatic neoplasm. © 2010 by the American Academy of Dermatology, Inc.


Robledillo J.C.L.,Hospital Infantil Universitario Nino Jesus
Pediatria Integral | Year: 2013

Musculoskeletal symptoms are common in children and adolescents. Most of the cases are benign but a number of children develop a chronic pain syndrome and become quite disable. The focus of the review is on chronic or recurrent musculoskeletal complaints. Chronic pain in childhood can be caused by a wide variety of conditions, several of which are discussed here: growing pains, hypermobility syndrome, fibromyalgia, chronic fatigue syndrome and reflex sympathetic dystrophy. The aetiology of the majority of cases is unknown. Differential diagnosis is broad, then when evaluating a child meticulous history taking and a careful examination is required in order to avoid misdiagnosis. Only a small proportion has an inflammatory or systemic origin. Various treatments have been propose but effective managing is based on interdisciplinary approach to reverse pain associated disability with education, simple analgesics and psycologic intervention.


Garcia-Penas J.J.,Hospital Infantil Universitario Nino Jesus
Revista de Neurologia | Year: 2015

Introduction. School failure, learning and behavioral problems are more common in children with epilepsy than the general population. The aim of this study is to examine the different factors which can affect the school performance of children with epilepsy. Development. Various psychosocial, medication-related, and epilepsy-related factors may be associated with learning disorders in epilepsy. The age of onset of epilepsy, the type of syndrome, its aetiology, and the response to treatment are some of the most important epilepsy-related factors. All of the established antiepileptic drugs can produce cognitive side effects, which are increased with polypharmacy and with increasing dosage and anticonvulsant blood levels. Conclusions. Judicious management of all related factors is essential for an optimal outcome. Recent onset of educational problems in a child with epilepsy deserves immediate and exhaustive evaluation and management. © 2015 Revista de Neurología.


Tuberous sclerosis complex is an autosomal dominant disease, with variable expressivity and multisystemic involvement, which is characterised by the growth of benign tumours called hamartomas. The organs that are most commonly affected are the brain, skin, kidneys, eyes, heart and lungs. Of all the children with this disease, 85% present neurological manifestations that, due to their severity, are the main cause of morbidity and mortality. The most significant neurological manifestations are epilepsy, autism spectrum disorders and mental retardation. It has been shown that in tuberous sclerosis complex the genes TSC1 and TSC2 alter the mTOR enzyme cascade, which sets off inhibition of this pathway. The possibility of resorting to treatments applied at the origin, thus inhibiting this pathway, is currently being evaluated.

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