Carmen A. Sánchez-Ramírez

Acute and recurrent pancreatitis in children: etiological factors

Objectives: To describe the clinical picture and outcome, and to assess the etiological factors of acute and recurrent pancreatitis in children.

Socio-demographic factors associated with caustic substance ingestion in children and adolescents.

OBJECTIVE Caustic substance ingestion is a public health issue in some underdeveloped countries. Published information on socio-demographic factors related to this problem is scarce. The aim of this study was to evaluate the association of socio-demographic factors with caustic ingestion in children. METHODS DESIGN case-control study. Cases were children with caustic substance ingestion who were attended to during 2006 (n=94) at a pediatric referral hospital in Guadalajara, Mexico; the controls were a random sample of children who were hospitalized or seen as outpatients in the same pediatric referral hospital (n=641). The socio-demographic variables were studied using a validated questionnaire (Children Nutrition Organization Survey). STATISTICS OR, 95% CI and logistic regression. RESULTS Mean age of the cases was 3.2 years (SD 2.4) and 37.2% of cases were girls. Caustic ingestion occurred at home in 63.8% of cases and at a relatives home in 23.4% of cases. Alkaline products were ingested by 85.1%; containers had no warning labels in 72.3% of cases and no childproof safety caps in 92.6% of cases. The socio-demographic variables associated with caustic ingestion included higher family income, lower educational level of the mother, higher proportion of fathers working as independent professionals, extended family, mothers age <30 years, and mother working outside the home. CONCLUSIONS The observed family risk profile for caustic ingestion was higher family income, young working mother with low educational level, father working as independent professional, and extended family.

Screening of R122H and N29I mutations in the PRSS1 gene and N34S mutation in the SPINK1 gene in Mexican pediatric patients with acute and recurrent pancreatitis.

Objectives The study’s objective was to assess the association between the PRSS1 R122H and N29I and the SPINK1 N34S mutations and acute pancreatitis (AP) and recurrent pancreatitis in Mexican pediatric patients. Methods The N34S and R122H mutations were detected using polymerase chain reaction–restriction fragment length polymorphism, and the N29I mutation was detected using allele-specific polymerase chain reaction in 92 pancreatitis patients (58 AP and 34 recurrent pancreatitis patients) and 144 controls. Results We found 1 mutated allele in 4 (4.3%) of 92 pancreatitis patients and none in the controls. All 4 patients bearing mutations had AP, with a frequency of 6.8% (4/58). Three (5.2%) of 58 patients were heterozygous for the N34S mutation, and 1 (1.7%) of 58 patients was heterozygous for the N29I mutation. The comparison between the AP and control groups revealed both a significant number of patients carrying any mutations in the screened genes (P = 0.008) and bearing the N34S mutation (P = 0.023). Moreover, we found that the N34S G allele increased the risk of developing AP (odds ratio, 10.3; confidence interval, 1.1–248.8). Conclusions Patients bearing the N34S G allele exhibited a 10-fold increased risk of developing AP compared with controls, suggesting that the SPINK1 N34S mutation represents an etiologic risk factor for AP in our Mexican pediatric patients.

Seasonal variation of enteropathogens in infants and preschoolers with acute diarrhea in western Mexico.

The present study estimates the prevalence of some enteropathogens in infants and preschoolers with acute diarrhea. From 2006 to 2007, 5459 consecutive stool samples were evaluated. Cryptosporidium parvum was the parasite identified with the higher frequency (5.1%), followed by Giardia lamblia (1.2%). Campylobacter jejuni was isolated in 858 cases (15.7%) and was the most frequent enteropathogen overall. The rates of C parvum, Shigella, and Salmonella were higher in the summer. Rotavirus had the expected winter peak and it was the third enteropathogen because of its frequency. Overall frequency of stool-reducing substances was 15.6% and was associated with a rotavirus-positive test.

Pancreatitis in Children

Alfredo Larrosa-Haro1, Carmen A. Sanchez-Ramirez2 and Mariana Gomez-Najera3 1Instituto de Nutricion Humana, Centro Universitario de Ciencias de la Salud, Departamento de Clinicas de la Reproduccion Humana, Crecimiento y Desarrollo Infantil, Universidad de Guadalajara. Guadalajara Jalisco, 2Universidad de Colima, Facultad de Medicina, Colonia Las Viboras, Colima, Col 3Division de Pediatria, Hospital de Gineco-Pediatria # 48, Centro Medico del Bajio, Avenida Mexico e Insurgentes, Colonia Los Paraisos, Leon Guanajuato Mexico