[Cholestasis as an atypical presentation of Epstein-Barr virus infection].
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Cholestasis↗
Biomedical subjects
M L Cilleruelo Pascual
Publications and source records attributed to M L Cilleruelo Pascual.
[Once-daily gentamicin dosing versus thrice-daily dosing in infants with acute pyelonephritis].
BACKGROUND: Once-daily dosing (ODD) of gentamicin is advocated as an effective and safe treatment of Gram-negative bacterial infections in adults. There are insufficient data in the literature to justify its use in infants. OBJECTIVES: To compare the efficacy of ODD of gentamicin with that of classical thrice-daily (t.i.d.) administration in infants with acute pyelonephritis. METHODS: We performed a quasi-experimental study comparing 33 infants who received ODD of gentamicin with a historical control group of 25 infants treated with gentamicin t.i.d. Leukocytosis, C-reactive protein, creatinine, gentamicin dose, peak and trough values, time required for disappearance of fever, and outcome were analyzed. RESULTS: The mean doses of gentamicin (mg/kg/day) were higher in the t.i.d. group (6.4 1.14) than in the ODD group (5.06 0.22; p < 0.001). Peak serum gentamicin concentrations (micro g/ml) were significantly higher in the ODD group (9.32 1.4) than in the t.i.d. group (5.09 1.15; p < 0.001). Mean trough gentamicin concentrations (micro g/ml) were lower in the ODD group than in the t.i.d. group (0.23 0.26 vs 0.78 0.45; p 0.001). There were no significant differences in the duration of fever between the groups (30.64 32 hours in the t.i.d. group vs. 28.57 32 hours in the ODD group). Serum creatinine levels were normal during treatment in both groups. In all patients outcome was good and no adverse effects were noted. CONCLUSIONS: Treatment with ODD of gentamicin in our population of infants with acute pyelonephritis was as effective as traditional administration t.i.d. and possibly was equally safe or safer.
Acute Disease↗
[Silent celiac disease: exploring the iceberg in the school-aged population].
BACKGROUND: Epidemiological studies have shown a high prevalence of silent celiac disease (CD) among unselected pediatric populations and a low ratio of diagnosed to undiagnosed CD. OBJECTIVES: To quantify the prevalence of silent CD, to assess the clinical features of subclinical CD and to determine the total prevalence of CD (silent plus symptomatic cases). METHODS: We determined total serum IgA, IgA antiendomysial antibodies (EMA) and IgG antigliadin antibodies (IgG AGA), if IgA deficiency was found, in schoolchildren aged 10-12 years from health district IX in Madrid. RESULTS: A total of 3,378 schoolchildren (47.8 % of the eligible population) were studied. Fifteen were EMA-positive and one child with IgA deficiency was IgG AGA-positive. CD was confirmed by intestinal biopsy in 12 children, representing a prevalence of undiagnosed CD of 1/281. Of these 12 children, 7 showed clinical features of CD. The most frequent symptom was iron-deficiency, followed by recurrent aphthous stomatitis and mild malnutrition. Before the start of this study, CD had been diagnosed in seven children from the same population, which would increase the total prevalence of the disease to 1/220 with an estimated ratio of diagnosed to undiagnosed CD of 1 to 3.5. CONCLUSIONS: We confirm the high prevalence of silent celiac disease among the school-aged population. This ratio is one of the highest published and could be due to a high diagnostic suspicion for CD among pediatricians in our health district. Greater awareness of the minor symptoms of CD would reduce the number of patients with undiagnosed CD.
Celiac Disease↗
[Triple-therapy treatment during 1 month versus 2 weeks in gastroduodenal disease due to Helicobacter pylori in children].
The aim of this study was to assess the clinical outcome of two different durations of triple therapy in children with Helicobacter pylori infection. We established two treatment groups: 1) Short treatment, including 2 week of bismuth subcitrate, amoxycillin and metronidazole treatment (n = 21) and 2) Long treatment, which included the same therapy for two weeks plus bismuth subcitrate alone for two weeks more (n = 26). We found no difference between the short and long treatments. The infection remained in 14% and 19%, respectively. In both groups, we observed children (19%) with persistent abdominal pain in spite of Helicobacter pylori eradication and gastritis healing. We conclude that it is not necessary to prolong triple therapy more than 2 weeks in order to have therapeutic success.
Adolescent↗
[The consumption of dairy products and their contribution to the nutrients in the diet of schoolchildren in the community of Madrid. The Food Consumption and Nutritional Status of the School-Age Population of the Autonomous Community of Madrid Group].
The aim of this report, included in the CAENPE study, was to assess the actual intake of milk products by children from Madrid and their nutrient contribution to the diet. In a sample of 2,608 children, 1,343 boys and 1,265 girls, between 6 and 14 years of age, representative of the school child population from Madrid, a dietary assessment of 4 non-consecutive days was carried out by applying a combination of the methods of 24-hour recall (2 days) and an estimated food intake record (2 days). We found that the average total milk product intake was 410 +/- 173 g/person/day, with this being significantly higher in boys (p < 0.0001) and increasing with age (p < 0.001). Milk products are the primary source of calcium, 1,076 +/- 374 mg/person/day, which represents 61% of the total calcium intake and is below the RDA for children over 10 years of age. In addition, following meat and meat products, dairy products are the second largest source of saturated fat (28% of total intake). They also supply 31% of the dietary phosphorus, 17% of protein, 16% of total fat, 15% of the cholesterol, 10% of the carbohydrates and 14% of the the energy intake. We conclude that milk products are the major source of calcium in the diet of schoolchildren. Their low consumption explains the insufficient calcium intake in certain age groups, which might be associated to a higher risk of osteoporosis in later life. We encourage an increase in the intake of milk products, especially milk, and a reduction in the consumption of sweets and meat in order to decrease the dietary saturated fats.
Adolescent↗