Neuropediatria

Piedra de Amolar, Mexico

Neuropediatria

Piedra de Amolar, Mexico

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Soto Insuga V.,Neuropediatria | Merino M.,Hospital la Paz | Losada Del Pozo R.,Neuropediatria | Castano De La Mota C.,Hospital Infanta Leonor | And 2 more authors.
Acta Pediatrica Espanola | Year: 2013

Obesity and metabolic syndrome are two of the major child health problems in Western society. During the last years, it has been also noticed a decline in sleeping hours among children. Since 1992, many epidemiological studies, both cross-sectional and longitudinal, have shown that chronic sleep deprivation in children relates to an increasing risk of developing overweight-obesity and/or metabolic syndrome (hypertension, increasing resistance to insulin and dyslipidemia). Although precise proccess that make obesity leads to a reduction of sleeping hours are currently unknown, a number of proccess that seem to be somehow involved have been identified. Among others, we may mention the alterations in the hypothalamic-pituitary (several neuropeptides such as leptin and ghrelin), an increasing appetite with special foods high avidity energy, a greater sense of fatigue with consequent reduction in physical activity, and changes in sleep-wake cycle (melatonin rhythm disturbances). This work contains a review of current evidence on the relationship between sleep and obesity within the pediatric population. It is now accepted that children who sleep less hours are more likely to develop overweight and metabolic syndrome, but it has not been possible to demonstrate a clear causality yet. It is necessary to promote adequate sleep among children, not only due to the many beneficial effects already known (cognitive, immunological, behavioral, metabolic and even decrease mortality), but also given its potential ability to prevent obesity and metabolic syndrome. ©2013 Ediciones Mayo, S.A. All rights reserved.


Pascual Sanchez M.T.,Hospital General Of Catalonia | Velasco L.H.,Hospital General Of Catalonia | Guijarro P.A.,Neuropediatria
Acta Otorrinolaringologica Espanola | Year: 2010

Sleep is a biological mechanism essential to maintaining good health. A series of physiological changes takes place during sleep. From a ventilation point of view, during deep sleep, tidal volume increases, the inhalation and expiration phases become longer, and respiratory frequency slows, while the same volume/time ratio as in wakefulness is maintained. The concept of " sleep-related respiratory disorders" refers to a group of respiratory diseases that are aggravated during sleep. Some of these disorders are almost exclusively manifested during sleep, such as sleep apnea-hypopnea syndrome -undoubtedly the most frequent respiratory disease despite being underdiagnosed- and congenital central hypoventilation syndrome (also called Ondine's curse). However, this concept also encompasses other disorders that occur during the daytime since they worsen while patients are asleep, as seen in many obstructive or restrictive pulmonary diseases. Sleep disorders can be a manifestation of underlying diseases, some of which are highly prevalent such as obesity and gastroesophageal reflux. Likewise, abnormal sleep cycles may be a cause or a result of cognitive disorders and disturbances in children's learning processes. © 2010 Elsevier España S.L.


INTRODUCTION: Hearing loss is a condition that must be diagnosed early considering alarm factors, in order to achieve a proper development of language. OBJECTIVE: To establish the relationship between hearing loss and alarm factors in high-risk infants evaluated by means of auditory evoked potentials. METHODS: This is an observational, longitudinal study in which 8,000 auditory evoked potentials were performed in high-risk infants to diagnose hearing loss. The population comprised 4,000 patients who presented between January 2000 and January 2012 for evaluation of probable hearing loss. A questionnaire on pregnancy and neonatal risk factors was applied. Auditory evoked potentials at 6 and 12 months of age were performed. RESULTS: The semester evaluation reported mild hearing loss in 325 (8.1%) patients, moderate in 85 (2.1%), and severe in 62 (1.5%), with a total of 472 (11.8%). The annual evaluation showed mild hearing loss in 0 (0%), moderate in 28 (0.7%), and severe in 40 (1%), with a total of 68 (1.7%) (p < 0.001). The identified risk factors for severe hearing loss at one year were ototoxic drugs intake, occupational acoustic trauma of the mother, alcohol, cocaine use, TORCH group infection, 5 minutes Apgar < 3, birth weight < 1,500 g, gestational age < 33 weeks, mechanical ventilation > 10 days, NICU stay > 1 month, cranial malformations, family history and subependymal hemorrhage. CONCLUSION: The monitoring of auditory evoked potentials in the first year of life helps in the early diagnosis of hearing loss, which could result in a better prognosis for language development.

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