J.L. Olivares López

Intoxicación por monóxido de carbono

OBJECTIVE: To describe epidemiological and clinical data from a series of children hospitalized for acute carbon monoxide (CO) poisoning. PATIENTS AND METHODS: We reviewed the medical records of children admitted to the Pediatrics Department of the Hospital Clinico Universitario de Zaragoza with acute CO poisoning from 1993 to 2003. All the children were clinically monitored and venous blood levels of carboxyhemoglobin (COHb) were determined. RESULTS: There were 14 patients (seven boys and seven girls) aged 1.3 to 13.8 years (mean age: 8.2 years; SD: 3.9). The peak incidence was in the winter months (seven cases in December). All poisonings took place in poorly ventilated rooms and were produced by gas inhalation due to incomplete combustion of organic fuels (charcoal, propane and butane). Clinical symptoms were gastrointestinal (nausea, vomiting, abdominal pain) and neurologic (dizziness, headache and alterations in level of consciousness). COHb levels in blood were elevated (from 4.8% to 27.6% in the first determination). Outcome was favorable in all patients. CONCLUSIONS: Despite environmental improvements introduced in the last few years, CO poisoning is highly frequent in our environment and children are at higher risk. The best preventive measure is proper adjustment of gas appliances.

Características nutricionales de los recién nacidos de madres con sobrepeso y obesidad

INTRODUCTION Maternal nutritional status is an important factor of adequate intrauterine growth and neonatal weight. The aim of this study is to evaluate the relationship between pre-gestational BMI (Body Mass Index) and breastfeeding duration, as well as infant anthropometric measurements during their first six months of life. MATERIALS AND METHODS Anthropometric measurements and the type of feeding were evaluated in a representative sample of 1,547 newborns from our population during 2009, according to their maternal BMI, and also in a sub-cohort of 759 infants followed up to 6 months of life. RESULTS A total of 72.9% of women had a normal weight, 18.7% were overweight and 8.4% obese. Women with a BMI ≥ 25 kg/m(2) had lower weight gain during pregnancy (P < .001), lower socioeconomic and cultural level (P < .001), and their infants had higher weight at delivery (P=.003) and at 6 months of life, with no differences in body length. Newborn weight increased in relation to maternal BMI, but over 35 kg/m(2) it decreased progressively (P < .001). Breastfeeding prevalence in obese women was 58.5% at hospital postpartum discharge, and 8.6% at six months of life; as opposed to 70.8% and 13.9%, respectively in women with normal BMI. CONCLUSIONS In our sample, maternal obesity is associated with a low socioeconomic and cultural level, higher infant weight at delivery and at 6 months of life, and less prevalence of exclusive breastfeeding; all of them nutritional risk factors in the short and long term.

Características socioculturales, obstétricas y antropométricas de los recién nacidos hijos de madre fumadora

INTRODUCTION One in every four women smoke at the beginning of the pregnancy in Spain; of these, 25-50% give up smoking during gestation and most of them smoke again after childbirth. Maternal smoking has harmful effects on babies, such as low birth-weight with its resulting morbidity. The objective of this study is to compare the anthropometric and socio-cultural characteristics between newborns from smoking motheŕs and those from non- smoking ones. MATERIALS AND METHODS Smoking habits and the socio-cultural characteristics were assessed from a sample of 1499 pregnant women, as well as their newborn anthropometric variables of their newborn babies during 2009 in the Aragon region of Spain. RESULTS In the sample of 1499 pregnant women the prevalence of smoking during pregnancy was 19.6%; among the Spanish women, 23% of them smoked during the gestation compared with only 11% in women from other countries. The smoker mothers were younger and they had a lower educational level than the non smoker ones; however, there were no statistical differences between their anthropometric characteristics. Newborns from smoker women in Aragon had a lower weigh at delivery (3155 vs. 3295 grams: p<.001) and a relative risk of low weight at birth for their gestational age of 2.1 (95% CI: 1.35 - 2.97). The length and the rest of newborn anthropometric variables were also affected. CONCLUSION The prevalence of smoking during gestation is high in Aragon. The mothers who smoke are younger and have different socio-cultural characteristics compared with non-smoker mothers. Maternal smoking habits have a harmful effect on newborn nutritional status, representing an avoidable risk of low weight at birth.

Síndrome del babuino

Se describen los casos de tres ninos diagnosticados de sindrome del babuino, definido por la aparicion de lesiones dermatologicas de morfologia y distribucion caracteristicas como consecuencia del contacto con mercurio. Se han descrito otras sustancias asociadas a la aparicion de este sindrome, cuya patogenia no esta del todo clara, aunque se cree que es otra forma de dermatitis de contacto. El diagnostico se basa en la historia clinica y la exploracion fisica y no existe un tratamiento especifico.

Hemiparálisis velopalatina idiopática

Idiopathic soft palate paralysis is an infrequent clinical entity, both in children and adults. We describe the clinical manifestations in two new cases, manifested by fluid dysphagia, rhinolalia, absent gag reflex, and nasal escape of fluids. The remission period is the shortest observed in published cases. Thirty-three reports have been published in the literature to data, 32 in children and adolescents and one in an adult. This paralysis suggests a viral etiology, affects mainly children, and resolves spontaneously.

Aspectos perinatales, crecimiento y tipo de lactancia de los nacidos pequeños para su edad gestacional

INTRODUCTION Being born small for gestational age (SGA) has short and long term risks. The aim of this study was to describe perinatal and socio-cultural characteristics, and the pattern of growth and diet of SGA infants during their first 6 months of life. MATERIALS AND METHODS Anthropometry and diet were evaluated during six months in a representative sample of 1596 newborns the population of Aragon (Spain). RESULTS Mothers of SGA (N=94) infants gained less weight during pregnancy (10.5±5.8 vs 12.0±5.07 kg, P=.012), gestational age at birth was lower (37.84±1.7 vs 39.06±1.6 weeks, P<.001), and the probability of cesarean delivery was higher (37.2% vs 20.5%, P=.001). The height of the mother was lower in the SGA group (1.61±0.58 vs 1.63±0.06 metres, P=.004), but their body mass index was similar. No differences were found between groups in social or cultural aspects. Mothers of SGA infants smoked more during pregnancy (32.3% vs 18.5%, P=.003) (RR = 1.92; 95% CI; 1.31 to 3.02). Infants born SGA remained smaller during the first 6 months of life, and the monthly weight gain was similar to the rest. In the SGA group, the prevalence of breastfeeding was lower at 4 months of age (54.9% vs 68.2%, RR = 0.58, 95% CI; 0.38 to 0.89). CONCLUSIONS Infants born SGA are more likely to converge a number of characteristics that must be considered together because they may lead to health risks. SGA do not show a rapid recovery pattern of postnatal growth, and their smaller size persists at six months.

Síndrome de Asperger asociado a macrosomía y trastorno de identidad sexual

Asperger Syndrome is a pervasive developmental disorder of unknown origin, characterized by pedantic language, lack of reciprocity in social interactions, unusual interests, motor clumsiness and normal or above average intelligence quotient, among other symptoms. Since 1994 it has been defined as a specific entity. We describe the case of a boy with this syndrome, with elevated body weight and height and sexual identity disorder. These alterations have not previously been described in the scientific literature on Asperger syndrome.

Teratoma bilateral de ovario

Sr. Editor: Los tumores de células germinales son un conjunto de neoplasias de localización gonadal o extragonadal que comparten las características de derivar de las células germinales primordiales. Bajo este término se agrupan tanto tumores benignos (teratoma) como tumores malignos (germinoma, carcinoma embrionario, etc.) y tumores con histología mixta. Constituyen el 2-4% de todas las neoplasias de la infancia y adolescencia1.

Concentraciones séricas de selenio en recién nacidos

Antecedentes A pesar de su creciente importancia en nutricion infantil, los estudios en Espana sobre los niveles de selenio en recien nacidos son escasos y, a menudo, contradictorios. Objetivos Establecer unos niveles de normalidad de selenio serico en neonatos a termino sanos de nuestro medio y contribuir al mejor conocimiento de aquellos factores perinatales que influyen sobre estos. Metodos Determinamos la seleniemia serica por espectrofotometria de absorcion atomica de 247 recien nacidos, distribuidos en 70 a termino sanos, 60 a termino patologicos, 18 con retraso de crecimiento intrauterino (> 37 semanas y peso al nacimiento Resultados Los a termino sanos presentaron concentraciones de selenio sericas superiores a los pretermino sanos (35,11 6 6,94 μg/l, rango 18,4-48 μg/l frente a 28,65 6 5,95 μg/l, rango 15-44,4 μg/l; p Conclusiones Prematuridad y bajo peso al nacimiento son los mejores predictores de riesgo de hiposeleniemia neonatal.

Valoracion del estado nutricional en los pacientes afectos de atresia de esofago

OBJECTIVE The aim of the study was to find out whether patients who underwent esophageal atresia (EA) surgery suffered from nutritional problems, to compare the nutritional status of these patients with a control group, and to determine if there is a relationship between the type of atresia and the nutritional condition. MATERIAL AND METHODS We selected 25 patients out of a total of 32 who underwent EA surgery in our hospital from 2000 to 2006. A retrospective was conducted study based on the information obtained from the medical histories. A case-control study was also carried out by selecting a control group from a randomized population. RESULTS The analyses performed showed that the mean weight and height Z-score was always negative, but not below -2 SD. There was a significant decrease in the weight Z-score between 3 and 9 months and in the weight/size Z-score between 3 and 24 months. Significant differences in weight and size Z-score were found between cases and controls, but not in skin-fold thickness. Independently of the type of atresia and the presence or not of congenital heart defects, no significant differences were found. CONCLUSIONS There are significant differences in the weight and height Z-score between cases and controls. We stress the need to be aware of the nutritional status in order to prevent changes that could lead to a further deterioration of the patient.