Biomedical subjects
Publications and source records attributed to A Nogales Espert.
Aspects of interest with regard to childhood maltreatment are studied. Data (not published) of the "Instituto del Menor y la Familia de la Comunidad de Madrid" are reported from January 1999 to June 2.000: 200 cases of child neglect, 187 cases of physical abuse, 143 cases of sexual abuse and 123 of psychological abuse. Risk factors, prediction, therapy and prevention of child maltreatment are also studied.
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Since about ten years ago there has been a great interest in the treatment of pediatric pain, previously neglected in medical practice. A review of procedures of pain assessment is made: self-assessment, behavioural analysis and biological measurements. The main therapeutic procedures are also reviewed (drugs, physical agents and psychological treatment), emphasizing the interest of prophylaxis and parental participation in children's pain treatment.
The main aspects of infant feeding are studied specially LC-PUFAs and free nucleotides. LC-PUFAs are studied from the ontogenic and phylogenic points of view, specially its relations to nervous system and as origin of prostaglandins, leukotriens and thrombohexanes. Regarding free nucleotides its function as well as its capacity to activate enzymes of metabolism of LC-PUFAs are studied. Finally the need of giving intermediate elements of LC-PUFAs (DHA, AA) in prematures and normal newborns is discussed.
OBJECTIVES: The objective of this study was to evaluate the body composition of the pre-school children in the city of Madrid as a part of their nutritional evaluation. MATERIAL AND METHODS: Seven hundred and three healthy children of both sexes were studied by means of a cross-sectional sample. The children, between 2 and 6 years of age, attended nursery schools in the city of Madrid. The study evaluated the arm muscle and fat areas through an anthropometric assessment. After measuring the triceps skinfold and the arm circumference, we obtained the arm muscle circumference, the arm area, and the arm muscle and fat areas. Once all data were gathered, they were statistically evaluated. RESULTS: The parameters studied reveal a normal distribution in the population in question. The mean values of muscle and fat areas were normal in relationship to age.
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PATIENTS AND METHODS: Serum eosinophil cationic protein (ECP) was measured in 99 chronic asthmatic patients (51 males and 48 females) with a mean age of 10.59 years and correlated with the number of eosinophils, lung function, symptoms in the last 6 months and clinical scoring (that reflecting the clinical situation during the last 15 days). RESULTS: Serum ECP showed a significant correlation with the total number of eosinophils (p < 0.001, R = 0.44), clinical scoring (p < 0.05, R = 0.26), number of inhaled beta 2-agonist doses needed in the last 15 days (p < 0.05, R = 0.26), forced expiratory volume during 1 second (FEV1; p < 0.01, R = -0.27), forced vital capacity (FVC; p < 0.05, R = -0.23), maximal mid-expiratory flow (FEF25-27; p < 0.001, R = -0.37). However, there was no significant correlation between the total number of eosinophils and the clinical situation of the children or the FEV1, but we found a significant correlation with the FEF25-27. Patients with ECP < 20 had better results on lung function tests than patients with ECP > 20 (FEV1: 108.89 +/- 17.7 vs 100.5 +/- 22 (p < 0.05), FEF25-27: 93.81 +/- 24.4 vs 75.21 +/- 24.5 (p < 0.001). CONCLUSIONS: The findings of this study suggest that the ECP level is a good marker of the situation of asthma in childhood. The levels of ECP will probably be able to help us to evaluate the degree of bronchial inflammation that neither the clinical state nor the lung function define completely.
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OBJECTIVE: Neopterin is released mainly by macrophages during immune system activation. Therefore, the production of neopterin should be increased by infections and its levels in blood and urine are perhaps in relation to the type of infection. PATIENTS AND METHODS: Neopterin levels in urine were determined in 194 healthy children to obtain normal values. Levels of neopterin were also studied in 91 children with viral and 41 with bacterial infections by using high performance liquid chromatography (HPLC). The results are expressed by means of the neopterin/creatinine quotient (neopterin factor = NF). RESULTS: NF significantly increased in 95.6% of the viral infections (sensitivity of 95.6% and specificity of 92.7%) and in 40.4% of the bacterial infections (sensitivity of 40.4% and specificity of 92.7%). CONCLUSIONS: NF rises more frequently in viral than in bacterial infections, reaching higher levels earlier in the former.
We have studied the clinical profile, cause and outcome of 105 infants with the diagnosis of gastroesophageal reflux. In most cases, pharmacological treatment managed to control the symptoms in 9 out of 10 infants followed in our series. Complications were described in 26.2%, of which esophagitis and chronic respiratory disease were the most common. Corrective surgery of the reflux was indicated in those cases in which pharmacological treatment was not successful. This managed to control the reflux in 90% of all cases. Morbidity was scarce. In all, 75% of the infants were considered to be medically cured within 15.5 months from the time that they were diagnosed and within 18.5 months after the appearance of the first symptoms.
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During the period between 1981 to 1985, 40,243 children have been born. Among these children, 1,747 suffered from dysplasia, subluxation or dislocation of the hip. In this paper the following parameters are examined: frequency, sex, the hip affected and the order of birth. Dislocation of the hip is more frequent in females with a ratio of 5.3 to 1. The hip more frequently affected is the left. Fifty percent of the children affected are first-born. In this study we want to emphasize the importance of a thorough explanation of the newborn, due to the frequency of the affection and especially its greater frequency in female and its predominance in the left hip.
We study 1,747 children who presented luxating hip disease evaluating the following parameters: a) Frequency of breach presentation. b) Weight at birth. c) Inheritance. It was observed that out of 1,747 children affected, 159 were by breach presentation, representing 9.10%. With regard to weight, it seems that under-weight babies are more affected than those of average weight. Lastly, we observed greater incidence in patients with a family history of hip dysplasia.
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We report the occurrence of familial erythrophagocytic lymphohistiocytosis disease in a child who had greater involvement of the brain than of visceral organs. The diagnosis was made during life, allowing us to carry out biological, histological and immunological studies. The natural Killer activity was abolished in this patient. The combination chemotherapy--including systemic administration of VP 16-213, steroids and intrathecal methotrexate--, failed to stem the rapid course of the disease.
Secretory component of IgA is the major class of immunoglobulin in secretions and mucous membranes. Many causes have been involved in etiopathogenesis of respiratory tract disease in children, one of them the possible deficit of secretory component of IgA. Authors have studied 191 children with respiratory tract disease secondary to infections and/or allergy and a control group of 35 healthy children. In all of them the secretory IgA non stimulated sputum was measured. In the group with respiratory disease serum IgA, IgG, IgM and IgE were also measured. Levels of secretory IgA were greater in group with respiratory disease than in control; also serum level of IgA was above normal for their ages. Level of secretory IgA was greater in children with "wheezing respiratory disease". These findings do not agree with theory of existence of an IgA secretory deficit as a cause or respiratory tract disease in children.