Juan Brines

Carotid Artery Stiffness as an Early Marker of Vascular Lesions in Children and Adolescents With Cardiovascular Risk Factors

INTRODUCTION AND OBJECTIVES The availability of a noninvasive marker of vascular lesions that enables their detection in the preclinical phase would be of great benefit for cardiovascular disease prevention. The aim of this study was to investigate the usefulness of a range of indices of arterial wall stiffness in the common carotid artery, as derived using high-resolution Doppler ultrasonography, for identifying vascular damage in children with risk factors. METHODS The study involved 99 children (age, 8-16 years) divided into two groups: 65 had cardiovascular risk factors (45 obesity, 20 dyslipidemia) and 34 were controls. Family histories of cardiovascular risk factors and anthropometric and biochemical measurements were recorded. Functional parameters of arterial stiffness (i.e., arterial compliance, elastic modulus, beta stiffness index, pulse wave velocity, and augmentation index) and the intima-media thickness were also measured. RESULTS Some functional vascular parameters were higher in obese children than controls: there were significant differences in beta stiffness index (P< .02), elastic modulus (P< .001) and pulse wave velocity (P< .01). There was a significant difference in arterial compliance between dyslipidemics and controls (P< .05). No significant difference in intima-media thickness was found between the groups. In obese children, there were positive correlations between body mass index, systolic pressure and triglyceride levels and vascular parameters (i.e., elastic modulus and pulse wave velocity); in dyslipidemic children, triglyceride levels and the same parameters were correlated. CONCLUSIONS Ultrasonographic measurement of arterial stiffness is a sensitive technique that can detect vascular damage in children with cardiovascular risk factors earlier than intima-media thickness measurement.

Copper, iron and zinc determinations in human milk using FAAS with microwave digestion.

Abstract A method for determining copper, iron and zinc in human milk was optimized and validated. It includes microwave mineralization of the sample and measuring the elements by flame atomic absorption spectroscopy (FAAS). Only 2 ml of milk is needed, and the method is free of matrix interferences. The values obtained for the detection limits (0.07; 0.07; 0.11 μg/ml milk, for copper, iron and zinc) precision of the method, intra-assay (2.9; 5.2; 6.1%RSD for copper, iron and zinc) and accuracy, evaluated using recovery assays (98.8; 100.4; 95.9% for copper, iron and zinc) show that the method is useful for the purpose mentioned. Moreover, the method is rapid and simple, and the determinations are carried out by FAAS.

Association between WHO cut-offs for childhood overweight and obesity and cardiometabolic risk.

OBJECTIVE To examine the association between cardiovascular risk and childhood overweight and obesity using the BMI cut-offs recommended by the WHO. DESIGN Children were classified as normal weight, overweight and obese according to the WHO BMI-for-age reference. Blood pressure, lipids, glucose, insulin, homeostasis model assessment-insulin resistance (HOMA-IR) and uric acid levels were compared across BMI groups. ANOVA and tests of linearity were used to assess overall mean differences across groups. Crude and adjusted odds ratios were calculated for adverse plasma levels of biochemical variables. SETTING Paediatric care centres. SUBJECTS Children (n 149) aged 8-18 years. RESULTS About 37 %, 22 % and 41 % of children were classified respectively as normal weight, overweight and obese. There were significant linear mean differences between BMI groups in systolic blood pressure, HDL-cholesterol, TAG, insulin, HOMA-IR and uric acid. Obese children were 10·6 times more likely than normal-weight children to have hypertension; OR for other associations were 60·2 (high insulin), 39·5 (HOMA-IR), 27·9 (TAG), 16·0 (HDL-cholesterol), 4·3 (LDL-cholesterol) and 3·6 (uric acid). Overweight children were more likely than normal-weight children to have hypertension (OR = 3·5), high insulin (OR = 28·2), high HOMA-IR (OR = 23·3) and high TAG (OR = 16·1). Nearly 92 % and 57 % of the obese and overweight children, respectively, had one or more risk factor. CONCLUSIONS Obesity and overweight defined using the WHO BMI-for-age cut-offs identified children with higher metabolic and vascular risk. These results emphasize the importance of prevention of overweight and obesity in childhood to reduce cardiovascular risk.

Medida de la rigidez de la arteria carótida como marcador precoz de lesión vascular en niños y adolescentes con factores de riesgo cardiovascular

Introduccion y objetivos Para la prevencion de la enfermedad cardiovascular resulta de gran interes disponer de un marcador incruento de lesion vascular que permita su deteccion en fase preclinica. Nuestro objetivo fue analizar diversos indices de rigidez arterial de la carotida comun mediante ultrasonografia Doppler de alta resolucion para definir su utilidad como detector de dano vascular en ninos con factores de riesgo. Metodos Se estudio a 99 ninos (edades, 8-16 anos) divididos en dos grupos: 65 ninos con factores de riesgo cardiovascular (45 obesos, 20 dislipemicos) y 34 controles. Se recogieron antecedentes familiares de riesgo cardiovascular y variables antropometricas y bioquimicas. Se midieron parametros funcionales de rigidez arterial (compliance arterial, modulo elastico, indice beta de rigidez, velocidad de la onda de pulso e indice de aumento) y el grosor intima-media. Resultados Los ninos obesos presentaron parametros vasculares funcionales elevados respecto a los controles, que fueron significativos para el indice beta (p Conclusiones La medida ultrasonografica de la rigidez arterial es un procedimiento sensible que puede resultar mas precoz que el grosor intima-media para detectar dano vascular en ninos con factores de riesgo cardiovascular.

Copper, iron, and zinc contents in human milk during the first three months of lactation: a longitudinal study.

The aim of the study has been to analyze the evolution of copper, iron, and zinc contents in human milk, from colostrum to the third postpartum month, following a longitudinal design, under specific conditions of sample collection and to apply an analytical procedure previously optimized to reduce any variation outside physiological lactation.The copper, iron, and zinc concentrations in 144 milk samples from 39 healthy puerpera women, were analyzed in five stages by flame atomic absorption spectrometry, following a standardized protocol.Copper presented a gradual decrease from 0.38 mg/L to 0.19 mg/L by the 90th day; the particular analysis from colostrum to transitional milk manifested the following two tendencies. Whereas an increase from 0.19 to 0.42 mg/L was observed in some women, a decrease from 0.53 to 0.45 mg/L was detected in others; therefore, copper presented two significant behaviors in the evolution from colostrum to transitional milk. In both cases, the evaluated changes were significant. The iron content varied from 0.56 to 0.40 mg/L by the 30th day, remaining constant until the first trimester concluded. The average zinc concentration decreased sharply from 7.99 to 3.3 mg/L on d 15; the rate of decrease slowed down gradually until 1.05 mg/L.

A study of factors that may influence the determination of copper, iron, and zinc in human milk during sampling and in sample individuals.

The aim of this study was to establish the possible effects of the sampling protocol (between-breast, within-feed, and diurnal differences) and the mother’s personal factors (age, parity, iron supple-mentation, smoking habits, and lactation period) on the copper, iron, and zinc contents in human milk.One hundred thirty-six human milk samples identified by their origin and sampling conditions were analyzed. The samples were obtained from the 2nd to 15th d postpartum from 62 women. The data on the individuals required for the study were available. Mineral determinations were analyzed by flame atomic absorption spectrometry following a standarized protocol.The results showed that iron contents were higher in hind-milk samples and at the nighttime feeding and depended on the breast from which the sample was taken. The copper and zinc concentrations showed no significant variations. There was no significant relationship among the mothers’ age, parity, smoking habits, iron supplementation, and copper content. Milk from older women had lower zinc contents than that of younger women. Increased amounts of iron were found in multiparous women. Between colostrum and transitional milk, a sharp decrease in zinc content was observed, whereas copper and iron contents remained constant.All of these results make it clear that standardized sampling protocols are needed in order to obtain comparable values.

Foetal erythrocytes exhibit an increased ability to scavenge for nitric oxide.

The presence of adult human whole blood inhibited in vitro relaxations of rat aortic rings by the nitric oxide (NO) donor S-nitroso-N-acetyl-DL-penicillamine (SNAP). Incubation with foetal blood containing the same concentration of haemoglobin produced a shift to the right of the relaxation curve. SNAP-induced vasorelaxations were more inhibited by dialysed solutions of haemoglobin than by the presence of erythrocytes in the organ bath, but there were no differences between the effect of adult or foetal haemoglobins. The presence of plasma from adult or foetal blood did not modify the effects of SNAP. Relaxations induced by endogenous, endothelium-derived, NO were more inhibited by foetal than by adult erythrocytes. These results suggest that foetal erythrocytes have a higher NO scavenging effect than those present in adult blood.

Arteriovenous fistula of the vertebral artery in a female infant with hypotonia and cephalocorporal disproportion

Background:  Congenital arteriovenous fistulas are exceptional in childhood and imply a therapeutic challenge.

Promoting the Health of Children and Adults by Primary School Teacher

Submit Manuscript | http://medcraveonline.com Promote health and education of children is the best way to guarantee the future of any society. In order to reduce child mortality, combating diseases and promoting children’s health, pediatrics emerged in the nineteenth century as a branch broken off from the green tree of medicine. As important for mankind is health and education of children that the United Nations General Assembly adopted, in 1959, the Declaration of the Rights of the Child, where health and education are the main components.