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Calderon C.,University of Barcelona | Forns M.,University of Barcelona | Varea V.,Seccion de Gastroenterologia Pediatrica
Nutricion Hospitalaria | Year: 2010

Objectives: the goals of the present study were: 1) to compare the levels of anxiety, depression, and eating disorders in young patients assisted at a children's hospital for obesity; 2) to determine whether anxiety and depression explain the symptoms of the eating disorders; and 3) to know which of these symptoms better discriminate the young people with different degrees of obesity. Materials and method: Descriptive, cross-sectional study with a sample comprised by 281 youngsters (56% girls) aged 11-17 years. The BMI percentiles were calculated by using the WHO growth tables. Two study groups were created: severe obesity and overweight/light-moderate obesity. The following questionnaires were used: Eating Disorders Inventory-2 (EDI-2), depression questionnaire (DQ), and Status-Trait Anxiety Questionnaire (STAI). Results: The youngsters with obesity showed more psychological problems than youngsters with overweight/light-moderate obesity, 12% had anxiety, and 11% depression. In both groups, the behaviours related with eating disorders were partially explained by the presence of symptoms of anxiety and depression. Dissatisfaction with the body and high anxiety trait increased the risk for perpetuating the obesity and were the two symptoms that better discriminated the patients with or without severe obesity. Conclusion: Obesity prevention programmes should include body dissatisfaction and the anxiety trait into the assessment and management protocols, and prevent anxiety getting fixed as a personality trait. Source

Objectives. To analyze growth patterns, tolerance, adherence and incidence of minor digestive disorders and their resolution in infants with modified commercial adapted formula. Patients and methods. A longitudinal, prospective, open-label and controlled study in Primary Health Care. Healthy infants with indication of artificial feeding, group A (Almiron 1, adapted formula) and group B with minor digestive disorders (Almiron Digest, modified formula) were included. Epidemiological and anthropometric variables (weight, length, head circumference, weight/length ratio), digestive disorders, tolerance, adherence and satisfaction survey for parents/professionals in the controls (baseline, at one month, 3 and 6 months) were recorded. Results. From November 2007 to May 2008, 172 pediatricians included 777 infants, 537 in group A (69%) and 240 in group B (31%). Inclusion age of 3.35 weeks ± 3.4 days (42% younger than 1 month); 54% were males. No statistically significant differences were found between groups for epidemiological variables, personal backgrounds or anthropometric parameters in any visit. The growth pattern was adequate according to the reference curves. In the baseline visit, statistically significant differences were observed between groups A and B for regurgitations (236 infants, 22% versus 49.5%), dyschezia (111 infants, 5% versus 35%), cholics in infants (301 infants, 20% versus 81%), constipation (162 infants, 11% versus 43%). Decrease of digestive disorders was significantly greater in group B (p< 0.001) in months 1 and 3. No statistically significant differences were observed for tolerance, adherence or in satisfaction surveys, these being adequate in both groups Conclusions. The growth patterns were adequate in both groups, reaching reference curves at the end of the study. The minor digestive disorders improved in the modified formula group at month 1 and 3 of initiation of its administration. Acceptability and adherence in the modified formula group were very satisfactory. Source

Millan-Bueno M.P.,UGC de Anestesiologia y Reanimacion | Arevalo-Garrido A.,Seccion de Gastroenterologia Pediatrica | Perez-Parras A.,Seccion de Gastroenterologia Pediatrica
Revista Espanola de Anestesiologia y Reanimacion | Year: 2015

Objective: The bispectral index (BIS) values that predict appropriate anesthetic level to perform an upper gastrointestinal endoscopy in spontaneous breathing are not well established in Pediatrics. The objective of this study is to determine whether it is possible to find an appropriate, less profound, BIS level in the pediatric patient that would enable an upper gastrointestinal endoscopy (UGE) to be performed in spontaneous breathing without causing gag reflex or motor response. Material and method: A prospective study was designed and included 61 patients from 12-167. months old, and an ASA. I-II who needed a diagnostic UGE. The study was conducted from October 2011 to March 2013. Intervention: UGE performed with an anesthetic protocol using propofol. The vital signs measured were heart and respiratory rate, pulse oximetry, non-invasive blood pressure. The sedation level score (Ramsay scale) and BIS values were also measured. The first attempt was performed at BIS level 60-69, and this was not feasible, then the anesthetic was deepened and a second attempt made at BIS level 50-59. If this was still not possible a deeper anesthetic level was then achieved and a third attempt made at BIS level 45-49. Variables of interest were: effective BIS level (eBIS), BIS level at which UGE was performed without gag reflex or motor response; propofol total dose (mgkg-1), induction time (time from onset of sedation to effective start of UGE). A logistic regression analysis was performed to obtain an equation to estimate the possibility of UGE success. Results: The distribution of the patient was: male 40%, female 60%, with 11 (18%) patients under 36 months. The statistical values are expressed as mean and standard deviation, with following results; age (months): 95.9 ± 45.86; weight (kg): 30.5 ± 14.68; effective BIS: 56.41 ± 4.63; induction time (minutes): 11.07 ± 2.69; total propofol dose (per kg): 4.86 ± 1.21. An additional intra-procedure propofol bolus was given in 38 patients (62%), with 7/38 of them (18%) due to movement, and 31/38 (82%) due to BIS level increase. No statistical differences were found in effective BIS level between older and younger patients. Conclusions: According to the results, BIS levels below 59 predict UGE success, with 72.13% sensitivity and 88.06% specificity in the pediatric population studied. © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Source

Introduction: The objective of this investigation is to determine whether bispectral index (BIS®) monitoring during intravenous anaesthesia with spontaneous breathing for upper gastrointestinal endoscopy (UGE) in a pediatric population is useful for: a) decreasing the amount of drug, b) decreasing the time for awakening, and c) improving patient safety. Patients and method: A quasi-experimental case-control prospective study was conducted in the setting of a second level hospital pediatric intensive care unit. Patients: Children aged 1-13 years. Case: ASA I patient who needed a diagnostic UGE; eligible, 36, participants, 30. Control: historical cohort of patients who needed UGE (years 2008-2010): 50 patients. Intervention: UGE performed with anaesthetic protocol, vital signs monitoring, sedation level (Ramsay scale) and BIS monitoring. Variables of interest: propofol total dose (mg/kg), induction time, time in performing the UGE, awakening time (min); initial BIS (iBIS), and BIS during the UGE; adverse effects. Results: There were no significant differences in sex, age or weight between case (B) and control (C) population. No significant differences in total propofol doses: (B 4.9 ± 1.4 mg/kg; C 5.2 ± 1.6 mg/kg, P=.492), awakening time (B 12.2 ± 4.6 min; C 12.8 ± 4.4 min, P=.402), time for execution of UGE (B 9.5 ± 4.8 min; C 11.3 ± 6.5 min, P=.335) and induction time (B 11.1 ± 2.6 min; C 10.1 ± 4.2 min, P=.059), iBIS 55.4 ± 6.9. There were no significant differences in adverse effects: 2 patients suffered from mild desaturation in the control group. Conclusions: BIS monitoring for diagnostic UGE in spontaneous breathing in a pediatric population is feasible, but does not appear to decrease awakening time or the amount of propofol needed. Furthermore, there was no statistically significant decrease in the number of adverse effects. © 2012 Asociación Española de Pediatría. Published by Elsevier España, S.L. All rights reserved. Source

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