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Biomedical subjects

S Málaga Guerrero

Publications and source records attributed to S Málaga Guerrero.

At least 19 recordsLinked to original sources
PubMed2005

[Clustering of cardiovascular risk factors in obese offspring of parents with essential hypertension].

INTRODUCTION: The prevalence of obesity in industrialized countries is increasing and is closely related to essential hypertension (EHT) in adolescents. OBJECTIVE: To analyze the prevalence of obesity and its association with other known cardiovascular risk factors in a sample of children and young adults with at least one parent with EHT. METHODS: The EHT group consisted 51 children and young adults (28 males [aged 5.4-25.6 years]) with at least one parent with EHT. The control group comprised 73 healthy normotensive children and young adults (43 males [aged 7.2-25.2 years]) who completed the follow-up visits of the RICARDIN study. Blood pressure (BP) was measured with a standardized technique using a mercury sphygmomanometer. A 12-hour fasting blood sample was taken for lipid profile and high sensitivity C-reactive protein (CRP) determinations. Financial support: FIS 03/0350, ESV Foundation Grant, 2003. RESULTS: The prevalence of obesity was five times higher in the EHT group than in controls (19.6% vs. 4.1%, p = 0.007). In this group, obese subjects showed higher systolic BP (122.0 vs. 110.4 mmHg p = 0.004) and lower high-density lipoprotein cholesterol (HDL-C) levels (47.6 vs. 58.0 mg/dl, p < 0.05). After adjustment for age and systolic BP, obese subjects in the EHT group showed significantly higher CRP values than non-obese subjects in this group (p = 0.024). CONCLUSIONS: The prevalence of obesity is higher in the offspring of parents with EHT than in non HT-prone subjects. Clustering of other additional risk factors indicates the need for high-risk preventive interventions in this group of children and young adults.

Adolescent↗
PubMed2003

[Ambulatory blood pressure monitoring in multicystic dysplastic kidney disease].

OBJECTIVE: To evaluate blood pressure in a group of patients with multicystic dysplastic kidney (MDK) disease through ambulatory blood pressure (ABP) monitoring. PATIENTS AND METHODS: ABP monitoring was performed in 16 patients with MDK disease using a Spacelabs 90207 monitor and an appropriately sized armband. The patients performed their normal daily activities except physical exercise. The activity period was 8:00 am to 8:00 pm and the resting period was midnight to 6:00 am. Patients with a percentage of correct readings of less than 70 % were excluded. The mean systolic and diastolic blood pressures for each period were calculated. Circadian variability was determined by the ratio between mean systolic and diastolic values in the active and resting periods, respectively. The results were compared with ABP values in healthy children. RESULTS: Fourteen patients (mean age 16 3.1 years, range: 6-27.6) were included. No patients with hypertension were found through casual measurement. One patient had daytime systolic hypertension. Five patients presented an abnormal drop in blood pressure during sleep. CONCLUSION: Blood pressure should be monitored in patients with MDK disease. ABP monitoring may detect alterations that can go unnoticed in casual determinations. Further studies with large samples are needed to establish the real prevalence of hypertension in these patients.

Adolescent↗
PubMed2003

[Drug abuse in pregnancy and neonatal morbidity: epidemiologic changes in the last ten years].

BACKGROUND: In the last few years, patterns of drug abuse have varied. This may have changed the problems presented by the infants of drug-abusing mothers. OBJECTIVES: To determine the incidence of prenatal drug-exposure in neonates in our health area in the last decade, to analyze possible changes in the drugs consumed, routes of administration and the infectious diseases affecting drug-abusing mothers, and to study possible changes in the clinical features presented by their offspring. PATIENTS AND METHODS: An observational, descriptive, retrospective study of all the infants born to drug-abusing mothers from January 1, 1992 to December 31, 2001 was performed. The series was analyzed and the periods 1992-1996 and 1997-2001 were compared. RESULTS: The mean incidence was 7.5 cases per 1000 live-born infants (8.7 in 1992-1996 and 6.3 in 1997-2001). Mothers in the second half of the study were less likely to use heroin and the intravenous route and were more likely to use methadone and cocaine than mothers in the 1997-2001 period. Hepatitis C virus infection and instrumental delivery were more frequent in the 1997-2001 period. No differences were found in neonates born in either period. Birthweight was less than 2500 g in 40 % and was low for gestational age in 20 %. Preterm deliveries were performed in 24 %. Congenital malformations were found in 6 %, neonatal withdrawal syndrome in 79 %, human immunodeficiency virus infection in 2 %, and hepatitic C virus infection in 3 %. Four percent were given in adoption. CONCLUSIONS: Maternal drug abuse patterns changed in the ten years under study, but outcome in their offspring showed no differences. Drug abuse by pregnant women is linked to a high rate of low birthweight, prematurity, neonatal withdrawal syndrome, vertical infection by human immunodeficiency virus and hepatitis C virus, as well as to social and family problems.

Female↗
PubMed2003

[Estimation of creatinine clearance by the height/plasma creatinine formula in critically-ill children].

INTRODUCTION: Critically-ill children frequently show impaired renal function, necessitating adjustment of drug dosages. Our objectives were to study estimated creatinine clearance through the correlation between the height/plasma creatinine formula (CrClest) and measured creatinine clearance (CrClms) and to examine whether CrClest over- or underestimates CrClms by analyzing the influence of diagnosis, severity, and the practical consequences. PATIENTS AND METHODS: Seventy-seven patients admitted to the pediatric intensive care unit were included. CrClms was calculated using serum creatinine and creatinine in urine collected over 24 hours. CrClest was estimated using serum creatinine, height, and a constant. The difference between CrClms and CrClest was expressed as a percentage: (CrClms CrClest) x 100/CrClms. Differences of greater than 15 % were considered poor estimates. ResultsThe mean percentage difference was 29.2 (standard error: 39.9). There were no differences among diagnoses in the distribution of significant bias, although the frequency of metabolic diagnoses was high. Incorrect evaluation of CrClest would result in a therapeutic error in 11.69 % of the cases, with overdosage in 10.39 %. The Pediatric Risk of Mortality (PRISM) score was higher (p < 0.05) in patients at risk for overdosage. CONCLUSIONS: CrClest estimation using the height/plasma creatinine formula was not an accurate method in critically ill children. In 10.39 % of patients with more severe illness, the dosage of renally excreted drugs would be too high. The highest risk was found in patients with metabolic and neurological diagnoses.

Adolescent↗
PubMed2000

[Pattern of the distribution of total cholesterol and cHDL cholesterol Spanish children and adolescents: RICARDIN Study].

BACKGROUND: The RICARDIN Study multicenter study of cardiovascular risk factors in children and adolescents has described the standards of normality of blood cholesterol levels in the Spanish school population. The objective of the present study was to compare mean values of cholesterol between different regions of Spain, and to compare the global mean with a pool international study. Also, the pattern of total cholesterol and cHDL by age and sex using mathematical model is described, and comparison with two international studies carried out in USA and Japan is performed. SUBJECTS AND METHODS: 10,683 children aged 6 to 18 were selected from 7 different Spanish provinces (Madrid, Vizcaya, Lugo, Badajoz, Murcia, Asturias and Barcelona). Blood samples were obtained by capilar puncture (Reflotron). RESULTS: Mean values of total cholesterol was different among provinces, and globally, were lower than the international pooled population, although the pattern observed in each population was very similar. Total cholesterol curve for Spanish boys showed a curvilinear trend that can be estimated through a cubic function that explains 89% of observed data, while for girls the best estimate was obtained through an inverse function (R2 = 0.40). cHDL for boys showed a cubic function as the best estimate (R2 = 0.90), while for girls the best estimate was obtained through a quadratic function (R2 = 0.59). CONCLUSIONS: There are important physiological variations of total cholesterol level by age and sex in children and adolescents. The pattern of cholesterol does not follow a linear model but a curvilinear one, that need to be considered in clinically assessing individual determinations of cholesterol, since highest percentiles can vary by age and sex.

Adolescent↗
PubMed2000

[Blood pressure in childhood and adolescence. Its relationship with growth and maturation variables].

AIM: To analyze the relationship between blood pressure in childhood and adolescence and different variables including gender, age, weight, height, body mass index and sexual maturation. METHODS: Cross-sectional study conducted in 1278 boys and girls aged 6 to 18 years old. Two blood pressure measurements were obtained. Mean value in the two measurements was obtained for each of the pressures: systolic (SBP), diastolic IV (DBPIV) and diastolic V (DBPV). Simple and multiple regression analysis were done to evaluate association between variables. RESULTS: 14 years 0.33; SBP boys > 14 years 0.34; DBPIV 0.25; DBPV 0.24) and height (SBP 6-13 years 0.33; SBP girls > 14 years 0.23; SBP boys > 14 years 0.29; DBPIV 0.25; DBPV 0.24) than for age (SBP 6-13 years 0.27; SBP girls > 14 years 0.17; SBP boys > 14 years 0.15; DBPIV 0.23; DBPV 0.22) for each of the blood pressures. Multiple regression analysis demonstrated a significant association between body mass index, height and SBP in the group of boys and girls aged 6-13 years old. No other significant associations were obtained. CONCLUSIONS: Blood pressure values in childhood and adolescence show a positive association with growth and maturation variables. It's of capital importance to considerate not only age, but also height, weight and body mass index when evaluating the blood pressure value of a child.

Adolescent↗
PubMed1999

[Renal function and functional renal reserve in adolescents who acquired minimal change nephrotic syndrome in childhood].

OBJECTIVE: The aim of this study was to evaluate glomerular filtration rate (GFR) and renal functional reserve (RR) in young patients after diagnosis of minimal change nephrotic syndrome (MCNS) during childhood. PATIENTS AND METHODS: GFR and RR were evaluated in 15 young patients (10 female) diagnosis of childhood MCNS 18.5 +/- 4 years before. Creatinine clearance (CC) was measured before and after an acute protein load to determine GFR and RR. Based on the tendency towards relapses, the study subjects were divided into two groups: Group A had less than five relapses and group B five or more relapses. Study subjects (groups A and B) and control subjects (group C) were matched for sex and age. RESULTS: Group B showed a higher GFR than groups A and C (group B = 133.9 +/- 16.26 ml/min/1.73 m2, group A = 107.91 +/- 18.19 ml/min/1.73m2; p = 0.014, group C = 113.89 +/- 13.17 ml/min/1.73m2, p = 0.015). RR was significantly lower (absolute and relative) in group B than in group C (group B = 10.9 +/- 15.46 ml/min/1.73m2, group C = 38.58 +/- 21.47 ml/min/1.73m2, p = 0.016 and group B = 8.56 +/- 11.75%, group C = 34.35 +/- 21.43%, p = 0.016, respectively). CONCLUSIONS: After childhood MCNS, young patients who presented more than five relapses showed an increase in GFR and a decrease in RR.

Adult↗
PubMed1999

[Pediatricians' opinion on sedation in children].

OBJECTIVE: Our objective was t evaluate the current knowledge and attitudes of pediatricians regarding the issue of pediatric sedation. PATIENTS AND METHODS: In October 1996 we conducted a mail survey of all 686 members of the Asturias, Cantabria and Castilla y Leon Pediatric Society. Physicians were asked to complete and return a confidential 18-item questionnaire. RESULTS: One hundred fifty-seven (23%) of the eligible physicians responded. Of the responding physicians, 90% agreed that they had insufficient training in pain and sedation management. Seventeen percent thought childhood sedation to be very effective, 76% effective and 7% little effective. Fifty-nine percent thought infant sedation was easy and 36% considered it to be difficult. Thirty-six percent of the pediatricians who work in hospitals considered the cooperation of children under 8 to be good versus only 17% of the primary attention pediatricians (p < 0.05). Thirty-nine percent thought that it was only necessary on some occasions that the parents are present when the child is sedated before surgery. Forty-eight percent of the male pediatricians considered that sedation was always or almost always indicated versus 67% of the female pediatricians (p < 0.05). The most used sedative drugs are midazolam (24%), diazepam (23%) and chloral hydrate (14%). Eleven percent indicated that it was necessary to monitor cardiorespiratory function and oxygen saturation during sedation. CONCLUSIONS: Pediatricians in this Society seem to have a lack of knowledge concerning sedation of their patients. Training in childhood sedation is needed.

Adult↗
PubMed1998

[A survey on the inclusion criteria in pediatric dialysis and transplantation programs in terminal renal failure].

OBJECTIVE: The purpose of this study was to know the current practices of Spanish pediatric nephrologists concerning the inclusion or not of children with end-stage renal disease (ESRD) in programs of dialysis and transplantation in order to open a discussion on the topic that would allow a consensus to be reached. PATIENTS AND METHODS: A descriptive and prospective study using an anonymously mailed survey to 90 members of the Spanish Pediatric Nephrology Association was carried out. RESULTS: The index of response was 43%. In 90% of the physicians polled they believe that some situations exist where it is advisable not to include a child with ERF in dialysis and, although all assure that there are no written procedures, a large majority (85%) think that they should exist, at least in the most representative cases. Serious physical and/or intellectual handicap and poor prognosis constitute the most important factors for making a decision. The expressed desire of the parents is considered the third most important factor by 56%. Of the answers, 82% placed economic cost of the substituting treatments as least important. Ninety-two percent think that not always and not in all cases is it necessary to turn to all possible technical means to extend the life. More than half (54%) think that the last decision must be taken by the physician and the family, although 44% confer this power to the Ethical Committee. CONCLUSIONS: It would be useful to develop guidelines to help pediatric nephrologists and/or ethical committees to decide, with the family of the patient, about the inclusion of the child in ESRD in programs of dialysis and transplantation.

Adolescent↗
PubMed1998

[Association between lipid profile and Apo E genotype in Spanish children (8-15 years old)].

OBJECTIVE: Different studies conclude that apoprotein E (Apo E) is a genetic determinant of lipid levels and cardiovascular risk, although these studies have been carried out principally in adults, with scarce and variable results available in children. The aim of our study was to analyze the association between lipid profile and the different Apo E isoforms (E2, E3 and E4) in a group of Spanish children. PATIENTS AND METHODS: In a transversal study, apo E genotypes and the lipid profile [total cholesterol (TC), LDL-c, HDL-c, triglycerides (TG), Apo A1, apo B and Lp(a)] were determined in 191 children (110 boys and 81 girls) between 8 and 15 years of age. Apo E genotyping was performed by means of polymerase chain reaction and subsequent digestion with the restriction enzyme HhaI. RESULTS: The relative frequency for the E3, E4 and E2 alleles were 0.87, 0.09 and 0.04, respectively. Total cholesterol, LDL-c and Apo B serum levels were highest in the group of individual with the genotypes E3/E4 and lowest in the group E2/E3, while E3/E3 individuals had intermediate levels. When analyzed according to gender, we only found statistical significance in the group of girls (p < 0.004). CONCLUSIONS: The apo E genotype was significantly associated with lipid differences observed in the childhood population and this is modulated by gender.

Adolescent↗
PubMed1998

[The opinion of pediatricians on childhood pain].

OBJECTIVE: The objective of this study was to evaluate the current sensibility and knowledge of pediatricians regarding the issue of pediatric pain assessment and management. PATIENTS AND METHODS: In October 1996 we conducted a mail survey of all 686 members of the Asturias, Cantabria and Castilla y León Pediatric Society. Physicians were asked to complete and return a confidential 95-item questionnaire. RESULTS: One hundred fifty-seven (23%) of eligible physicians responded. Ninety percent of the respondents agreed they had insufficient training in pain management. Sixty-nine percent though their knowledge to deal with acute pain was adequate. Only 12% admitted to having enough background to treat chronic pain. Sixty-five percent of the respondents admitted to know no method at all for pain evaluation, while 82% had never applied any in their clinical practice. About half the respondents (42%) did not know any guidelines for the management of pediatric pain, although 75% considered they would be very useful. A high percentage of pediatricians answered that analgesia was required before performing certain diagnostic or therapeutic procedures (lumbar puncture, venous canalization, arterial puncture and others), but differences in relation to age, sex and clinical setting of the physicians were detected in these responses. The most used drug for the treatment of moderate acute pain is acetaminophen (88%), for severe acute pain metamizol (58%) and for severe chronic pain acetaminophen-codeine (37%). Only 48% admitted to having used opioids. CONCLUSIONS: Pediatricians in this society seem to be too confident about the topic of acute pain management in their patients, even though they report a lack of training which could influence the quality of the care they are offering to their patients. Opioid use is very low. Training in childhood pain management is needed.

Adult↗
PubMed1997

[Influence of diet in idiopathic hypercalciuria].

OBJECTIVES: To find out if differences in diet may justify the presence of idiopathic hypercalciuria (IH) and to verify if the calcium-restricted diet, often recommended for treatment of IH, is nutritionally appropriate. PATIENTS AND METHODS: Dietary intake and mineral and electrolyte urinary excretion were studied twice in 10 children diagnosed of IH and in 9 controls. First, while being on a free diet. Second, after a week of suppression of milk and dairy products. RESULTS: Intakes of calories, proteins, carbohydrates, fats, and minerals were similar in IH patients and controls. Withdrawal of dairy products of diet resulted in an important reduction in the intakes of calcium (71.1%), phosphorus (63.5%) and fats (30.1%), although only calcium intake was remarkably below international recommendations (33.6 +/- 10.4%). CONCLUSIONS: Spontaneous diet of this group of hypercalciuric children was no different from that of control children. Suppression of milk and dairy products causes a nutritionally inappropriate diet.

Adolescent↗
PubMed1993

[Urinary concentration capacity in neonatal hydronephrosis].

In order to determine the renal concentration capacity in neonatal hydronephrosis, 10 micrograms of DDAVP were administered intranasally to 18 infants with hydronephrosis. Fluid intake was restricted to 50% of normal for 3 hours before and 6 hours after the administration of DDAVP. Maximal urine osmolality (mean +/- SD) was 348 +/- 180 mOsm/kg in 7 newborns younger than 21 days and 420 +/- mOsm/kg in 11 neonates between 22-50 days of age. Both osmolarities were inferior to the standard response to DDAVP reported in normal neonates. After 24 hours of clinical observation, we did not notice any secondary effects caused by this test.

Deamino Arginine Vasopressin↗