Santiago Muzzo B

CRECIMIENTO NORMAL Y PATOLÓGICO DEL NIÑO Y DEL ADOLESCENTE

Se presentan las caracteristicas del crecimiento normal del nino y del adolescente, precisando los factores que influyen en el, las caracteristicas del fenomeno de sobre aceleracion del crecimiento con especial referencia al que se produce despues que actua una noxa que frena el crecimiento y a la tendencia secular del crecimiento tanto en Chile como en otras partes del mundo. Se explica la importancia de las mediciones antropometricas para la evaluacion del crecimiento y desarrollo. Se define el retraso de crecimiento, las tecnicas para diagnosticarlo y las multiples etiologias que lo pueden producir

EVOLUCION DE LOS PROBLEMAS NUTRICIONALES EN EL MUNDO. EL CASO DE CHILE

El mundo ha progresado notoriamente en la solucion de los problemas nutricionales, de mortalidad infantil e infecciosos. En Latinoamerica, Chile ha sido el que mas ha mejorado estos indicadores, lo que explicaria la rapida transicion epidemiologica que ha experimentado. Sin embargo han aumentado los problemas nutricionales por exceso, con un considerable aumento de las enfermedades cronicas no transmisibles del adulto, las que constituyen actualmente la principal causa de muerte en el pais. El desafio actual es disminuir la obesidad sin aumentar la desnutricion, la que actualmente es una enfermedad latente. En los ultimos anos la disminucion del retraso estatural ha sido menos notoria que el aumento de la obesidad y la disminucion de la desnutricion, lo que podria deberse a algun deficit de micronutriente o bien visualizarse mejor al no existir deficits de macronutrientes

Nutrición de yodo en escolares de cuatro zonas de Chile en el año 2001

: A 6.4% goiter prevalence was found (5,9%in boys and 6,8% in girls). Grade Ia goiter was more common (5.0%), without detecting differ-ences between areas (7.3% in Calama, 5.9% in Santiago, 5.9 in Temuco and 6.7 in PuntaArenas). Iodine concentration in salt for human consumption of the areas was adequate ac-cording to the recent modification of Chilean legislation (25.4 mgI/g salt in Calama, 36.2 inSantiago, 27.7 in Temuco and 33.4 in Punta Arenas). Urinary iodine excretion was very highaccording to recommendation in boys and girls (2838 and 2852 mgI/g salt in Calama, 700and 837 in Santiago, 1318 and 1438 in Temuco, 407 and 312 in Punta Arenas).

Tendencia del desarrollo puberal en escolares de la Región Metropolitana de Chile: Menor edad de presentación, mayor duración y dimorfismo sexual en la estatura

Background: There is a worldwide tendency towards an earlier appearance of puberal development among children, associated with an increase in weight and height. Aim: To study the trends in puberal development in Chilean school age children, between the years 1986 and 2001 and correlate it with weight and height changes. Subjects and Methods: In two representative samples of school age children, collected between years 1985 and 1987 (m-1986) and another between years 2000 and 2002 (m-2001), girls between 7 and 15years (958 and 935, respectively) and boys between 9 and 15 years (842 and 870 respectively), were selected. Breast development (B) in females and genital development (G) in males were classified according to Tanner stages. Weight, height, body mass index (BMI) and nutritional status (according to Centers for Disease Control/ National Center for Health Statistics (CDC/NCHS) standards) were assessed. Results: The prevalence of obesity increased four fold between 1986 and 2001. The 2001 generation had a significantly higher degree of puberal development than their counterparts studied in 1986. Compared to m-1986, m-2001 subjects had a lower mean age at puberal development stage two and three, but no differences at puberal stages 4 and 5. BMI of m-2001 subjects was significantly higher than that of m-1986 subjects at all puberal stages. The m-2001 males showed highest stature than m-1986 in all puberal stage, however, in females there is no difference in height between m-2001 and m-1986. Conclusions: The highest BMI observed in the cohort of 2001, could be facilitating an earlier puberal development and ethnic factors could explain the sexual dimorphism in stature.

Consenso en el diagnóstico y tratamiento de la diabetes tipo 1 del niño y del adolescente

1. Medico Endocrinologo Pediatrico.2. Servicio de Pediatria, Departamento de Pediatria, Facultad de Medicina Universidad de Concepcion.3. Instituto de Nutricion y Tecnologia de los Alimentos (INTA), Universidad de Chile.4. Servicio de Pediatria, Hospital San Juan de Dios.5. Servicio de Pediatria, Hospital Exequiel Gonzalez Cortes.6. Servicio de Pediatria, Hospital Militar.Correspondencia a:Dr. Santiago Muzzo B.E-mail: smuzzo@inta.cl

Cambio secular del retraso de talla en escolares chilenos de tres regiones del país

Se analizo el cambio secular del retraso estatural (RE) entre los anos 1986 y 1994 en escolares de 6 a 16 anos de edad, de tres regiones del pais (II, IX y XIII). Las muestras de cada region se obtuvo por sorteo aleatorio dando representatividad por sexo, ciclo educativo (basico o medio) y tipo de establecimiento (municipal, subvencionado o particular); quedando constituidas los anos 1986 por 4 331 mujeres y 3 354 varones, en 1991 por 1 620 mujeres y 1 675 varones y en 1994 por 1 437 mujeres y 1 822 varones de las ciudades de Santiago, Calama, Antofagasta y Temuco. Se evaluo la estatura y se califico como talla baja la adecuacion estatural bajo 95% de los es-tandares OMS. En ambos sexos, se observo una disminucion progresiva del porcentaje del RE al comparar los anos 1986, 1991 y 1994 (de 27,8%, a 24,9% y a 13,0% en las mujeres y de 31,2%, a 29,6% y a 18,2% en los varones, respectivamente). Al separar por edad en mujeres < de 10 anos (me-10), varones < de 12 anos(me-12), mujeres 10 anos (ma-10) y varones 12 anos (ma-12); se encontro que en me-10 y me-12 el RE fue menor (27,8%, 24,9% y 13,0% en las mujeres y 31,2%, 29,6% y 18,2% en los varones) que en los ma-10 y ma-12 (41,1%, 39,8 % y 25,5% en las mujeres y 44,2%, 41,7% y 26,2% en los varones), aunque la tendencia fue la misma. El cambio secular hacia una mayor estatura, observado en escolares de estas regiones, sugiere una mejoria en la calidad del ambiente. Sin embargo, el crecimiento no se ha estabilizado y los ninos en edades mayores (ma-10 y ma-12) son el grupo con mayor retraso. Es necesario investigar otros deficit para implementar programas dirigidos a continuar mejorando la calidad ambiental y de esta forma la expresion del potencial genetico de crecimiento del nino chileno

EXCRECIÓN URINARIA DE SODIO EN NIÑOS Y ADULTOS DE UNA COMUNA DE LA REGIÓN METROPOLITANA DE SANTIAGO DE CHILE

Arterial hypertension has increased sharply in Chile, during the last 3 decades. The National Health Survey (2003) registered a 33.7% prevalence in Chilean population over 17 years of age. It is known that an excessive sodium intake is a risk factor for arterial hypertension (AH). Objective: To measure urinary sodium excretion in an exploratory study in school age children and adults of a borough of the Metropolitan Region, and later on increase to a representative population sample. Subjects and method: 158 school age children of both sexes aged 10.6 ± 2.5 years and 48 adults older than 20 years were evaluated. Weight was measured in a 0.1 kg precision scale (SECA model 286). Body Mass index (BMI) was calculated according to the formula weight (kg)/stature (m)2. Arterial pressure was measured with a mercury manual sphygmomanometer. Urinary sodium in 24 hours was calculated with the formula of Tanaka et al. This information was used to predict theoretical NaCl intake using the equation Na mg/day = Na mEq/d x 23; NaCl = Na g/d x 100/ 39.3. Results: BMI in children was 19.2 ± 4,9 and 29.0 ± 5.9 in adults. In 28.6% and 40.5% of adults diastolic and systolic pressure were higher than 90 mm Hg and over 130 mm Hg, respectively. In 1.7% and 0.9% of children systolic and diastolic pressure were high, according to age and sex. Salt intake per day was calculated assuming that all sodium ingested was consumed as NaCl. Children NaCl intake was 3 ± 2.2 g per day and in adults was 10.4 ± 2.5 g per day. Conclusions: BMI was elevated in children and adults in accordance with the high obesity prevalence in the country. The high percentages of elevated blood pressure present in adults were in accordance with high prevalence of hypertension in Chilean adults. Salt intake was high in children and adults constituting a risk factor of hypertension in our population.

NUTRICION DE YODO EN ESCOLARES DE UNA ZONA CON ALTA INGESTA DE YODO (CALAMA) COMPARADA CON ZONA DE INGESTA NORMAL (PUNTA ARENAS)

Resumen es: Se evaluo la prevalencia de bocio por palpacion de la glandula tiroidea en 1296 escolares de educacion basica de una zona con alta ingesta de yodo (Calam...

APORTE DEL PAN A LA NUTRICION DE YODO DEL ESCOLAR CHILENO

Se describe la evolucion de la nutricion de yodo en el escolar chileno perteneciente a 4 zonas censorias del pais, destacando la excesiva excrecion urinaria de yodo a pesar que el Reglamento Sanitario de los Alimentos disminuyo el ano 2000 la concentracion de yodo en la sal de 100 ppm a un rango de 20 a 60 ppm. Nos intereso estudiar porque no disminuyeron las yodurias en los escolares. Para ello se midio el contenido de yodo en el pan, por tener un alto consumo en Chile (en promedio 250 g por dia). En diferentes tipos de pan se determino la concentracion de yodo que fue alrededor de 0.5 ug /g, valor 10 veces mas alta que en mediciones efectuadas en Inglaterra y Espana. Sin embargo se estimo que el consumo de pan en Chile aportaria alrededor de 130 ug I/dia, lo que no explicaria totalmente las altas cifras de excrecion de yodo actuales. De importancia es continuar indagando las causas de este alto consumo para evitar sus posibles complicaciones

Información sexual de los adolescentes según sexo

1782 adolescents representing all socioeconomic levels and enrolled in schools in Greater Santiago were surveyed concerning topics related to sex and reproduction. The 991 girls were aged 11-13 and the 781 boys were 14-16 years old. Sources of sexual information reported by girls and boys respectively included mothers for 84.4 and 53.1% teachers for 60.5 and 72.3% books for 46.2 and 57.5% fathers for 34.8 and 50.8% friends for 42.0 and 50.3% companions for 33.8 and 44.5% newspapers and magazines for 34.7 and 39.8% television and movies for 27.2% and 36.8% and physicians for 40.8 and 37.8%. 26.1% of girls and 31.8% of boys reported discussing sexual topics with both parents. 23.7% of girls and 44.4% of boys did not discuss sex with either parent. 49/6% of girls and 14.8% of boys discussed sexual topics only with the mother and 9.0% of boys did so only with the father. 37.4% of girls and 70.6% of boys estimated that girls become fecund at 11-16 years. 26.8% of girls estimated the onset of fecundity at 16-20 and 29.8% at 20-25 years. 26.9% of girls and 66.0% of boys estimated the age at onset of fecundity for males at 16-20 years. 8.4% of girls and 19% of boys believed that women under 19 are responsible enough to be parents. 3.8% of girls and 10/7% of boys thought that boys under 19 would be responsible enough for parenthood. 46.5% of the girls and 17.5% of the boys reported practicing enough for parenthood. 46.5% of the girls and 27.5% of the boys reported practicing religion at least once per week. 30.7% of girls and 35.1% of boys reported doing so between once per week and once per month. The lack of knowledge of the girls especially about the age at which males and females become able to procreate may be related to the problem of early pregnancy in Chile.