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BackgroundFeeding practices in the first two years of life have a direct impact on nutritional status and adiposity. The purpose of this study was to identify the differences in feeding practices during the first two years of life by sex and type of feeding in the first semester of postnatal life and their relationships with adiposity in toddlers.MethodsAn analytical cross-sectional study that included 150 toddlers aged 12 to 24 months who were healthy, full-term, and had adequate weight for their gestational ages, was conducted at the New Civil Hospital and at a private practice in Guadalajara. Body compositions were obtained by bioelectrical impedance (BIA) measurements, and a modified questionnaire was used. Then, the parents completed two 24-h dietary recalls. In addition to the descriptive statistics, ANOVA, Kruskal–Wallis and Mann–Whitney U tests were used in the contrast analysis of the quantitative variables. To analyze the qualitative variables, we used X2tests. Afterward, linear regression tests were conducted to identify the relationships between adiposity and feeding practices during the first two years.ResultsThere were direct relationships between adiposity and duration of full breastfeeding (r = 0.610,p = 0.021), age of introduction of ultra-processed products (r = 0.311,p = 0.011), sugar (r = 0.186;p = 0.024) and age at which eggs were introduced (r = -0.202;p = 0.016).ConclusionsAdiposity was related to feeding practices in the first two years of life in toddlers.

To determine the association between serum ferritin levels, lipid profile and adiposity in school-age children. Methods: A cross-sectional study was conducted on obese and non-obese children. Weight, height, waist circumference and blood pressure were measured for all participants. Lipid profile, serum ferritin and glucose were determined and analysed through absorbance. The Spearman correlation was performed for the quantitative variables and a regression analysis was used to determine the interaction between variables. Eighty-nine children were included, with a median age of 9.0 years. Results: When comparing serum ferritin levels in normal weight group, vs. the overweight and obesity group, values were significantly higher in the latter. Serum ferritin correlated positively with BMI (Rho .282, p

Introduction: childhood obesity is associated with an increased risk of chronic diseases. We aimed to examine the relation between serum levels of 25-hydroxyvitamin D (25[OH]D) and blood pressure in obese schoolchildren. Material and methods: a cross-sectional study in school-age children with obesity. The serum levels of 25(OH)D were measured and classified as sufficient or insufficient/deficient. Blood pressure was measured. Normal values were considered90th percentile, elevated blood pressure ≥ 90th to95th percentiles, and hypertension ≥ 95th percentile, according to blood pressure reference tables specific for age, sex, and height. A Pearson correlation was performed. Results: a total of 256 obese schoolchildren (123 [48.0 %] females and 133 [51.9 %] males) were evaluated. The prevalence rates of vitamin D deficiency, insufficiency, and sufficiency were 23.4 %, 52.3 %, and 24.2 %, respectively. Normal blood pressure was observed in 101 (39.4 %) children; the frequencies of elevated blood pressure and hypertension were 10.9 % and 49.6 %, respectively. A moderate inverse correlation of 25(OH)D levels with systolic blood pressure levels (r = -0.54, p = 0.03) was observed. When analyzed by sex, a significantly high inverse correlation between 25(OH)D levels and systolic blood pressure was observed in males (r = -0.85 and p ≤ 0.001). No significant correlation was found in females (systolic r = -0.16 and p = 0.67; diastolic r = -0.15 and p = 0.812). When performing the multiple regression analysis, the 25(OH)D levels and BMI were the significant predictors for systolic blood pressure. Conclusions: we identified an inverse correlation between 25[OH]D levels and systolic blood pressure in male schoolchildren with obesity.Introducción: la obesidad infantil se asocia con un mayor riesgo de desarrollar enfermedades crónicas. El objetivo fue analizar la relación entre los niveles séricos de 25-hidroxivitamina D (25[OH]D) y la presión arterial (PA) en escolares obesos. Material y métodos: estudio transversal en niños en edad escolar con obesidad. Los niveles séricos de 25(OH)D se clasificaron como suficientes e insuficientes/deficientes. Los valores de PA se clasificaron como normales sipercentil 90, presión elevada entre los percentiles ≥ 90 y95, e hipertensión si ≥ percentil 95, de acuerdo con las tablas de referencia de la PA, específicas para cada edad, sexo y altura. Se realizaron una correlación de Pearson y una regresión múltiple. Resultados: se evaluaron 256 escolares obesos (123 [48,0 %] mujeres y 133 [51,9 %] hombres). La frecuencia de la deficiencia, insuficiencia y suficiencia de vitamina D fue del 23,4 %, 52,3 % y 24,2 %, respectivamente. Se observó una PA normal en 101 (39,4 %) niños; las frecuencias de la PA elevada y la hipertensión fueron del 10,9 % y 49,6 %, respectivamente. Se observó una correlación inversa moderada de los niveles de 25(OH)D con los niveles de presión arterial sistólica (PAS) (r = -0,54; p = 0,03). Cuando se analizó por sexos, se observó una correlación inversa entre los niveles de 25(OH)D y la PAS en los niños (r = -0,85; p ≤ 0,001). No se encontró ninguna correlación significativa en las niñas (sistólica, r = -0,16; p = 0,67; diastólica, r = -0,15; p = 0,812). Al realizar el análisis de regresión múltiple, los niveles de 25(OH)D y el IMC fueron predictores significativos de la PAS. Conclusiones: identificamos una correlación inversa entre los niveles de 25[OH]D y la PAS en niños escolares con obesidad.

Adenovirus 5 (Ad-5) infection is a common cause of acute respiratory infections and the main vector used in gene therapy. There are few studies on the relationship of Ad-5 to obesity. In the present study, we evaluated the chronic effects of Ad-5 infection on golden (Syrian) hamsters fed either a balanced diet (BD) or a high-fat diet (HFD). After a single inoculation with Ad-5 (1 × 107 pfu), the body weight of the animals was measured weekly. Medium-term (22 weeks) serum biochemical analyses and long-term (44 weeks) liver morphology, adiposity, and locomotive functionality (movement velocity) assessments were carried out. In the animals fed the BD, adenovirus infection produced hyperglycemia and hyperlipidemia. In the long term, it produced a 57% increase in epididymal pad fat and a 30% body weight gain compared with uninoculated animals. In addition, morphological changes related to non-alcoholic fatty liver disease (NAFLD) were observed. The animals fed the HFD had similar but more severe changes. In addition, the hamsters presented an obesity paradox: at the end of the study, the animals that had the most morphological and functional changes (significantly reduced movement velocity) had the lowest body weight. Despite the fact that an HFD appears to be a more harmful factor in the long term than adenovirus infection alone, infection could increase the severity of harmful effects in individuals with an HFD. Epidemiological studies are needed to evaluate the effect of adenovirus as a precursor of chronic liver and cardiovascular diseases, including the chronic effects of gene therapy.

Background: an association between low 25(OH)D levels and blood lipids has been identified in children, adolescents, and adults but not in the early stages of life, and a relation to carotid and aortic intima-media thickness has not been well studied and is controversial. Objective: to identify whether 25(OH)D levels are correlated with blood lipids and aortic and carotid intima-media thickness in infants aged 3 to 9 months. Methods: a cross-sectional study was conducted in 109 healthy term infants between the ages of 3 and 9 months. Serum vitamin D [25(OH)D], total cholesterol, HDL-cholesterol, non-HDL-cholesterol, and aortic and carotid intima-media thickness were measured. Feeding method, vitamin D supplementation, and sun exposure habits were recorded. Results: only 2.8 % (n = 3) and 10.1 % (n = 14) had vitamin D deficiency and insufficiency, respectively. Infants with inadequate levels of vitamin D were younger (6 months) (p = 0.004), and a lower percentage of their body surface area was exposed to the sun (p = 0.006). A significant positive correlation was found between 25(OH)D levels and non-HDL-cholesterol in the infants that consumed breastmilk substitutes (rho = 0.600, p0.001) or were partially breastfed (rho = 0.371, p = 0.026), whereas a positive correlation was found with total cholesterol in the infants receiving breastmilk substitutes (rho = 0.618, p0.001). No significant correlation was found between vitamin D and aortic or carotid intima-media thickness. Conclusions: there was a positive correlation between 25(OH)D levels and both total and non-HDL-cholesterol only in infants receiving breastmilk substitutes. The frequency of vitamin D deficiency and insufficiency was low.Introducción: se ha identificado una asociación entre los niveles de 25(OH)D y de lípidos en sangre en los niños, adolescentes y adultos, pero no en las primeras etapas de la vida, mientras que la asociación con el grosor de la íntima-media aórtica (a-IMT) o carotídea (c-IMT) no se ha estudiado totalmente y es objeto de controversia. Objetivo: identificar si existe correlación entre los niveles de 25(OH)D y de lípidos en sangre y el a-IMT y c-IMT en lactantes de 3 a 9 meses. Métodos: se realizó un estudio transversal en 109 lactantes sanos de entre 3 y 9 meses de edad; se midieron la vitamina D sérica [25(OH)D], el colesterol total, el colesterol HDL, el colesterol no HDL, el a-IMT y el c-IMT. Se registraron el tipo de alimentación, la suplementación con vitamina D y la exposición solar. Resultados: aquellos con niveles inadecuados de vitamina D fueron los menores de 6 meses (p = 0,004) y los expuestos en un menor porcentaje de su cuerpo al sol (p = 0,006). Se encontró una correlación positiva significativa entre la 25(OH)D, el colesterol total (rho = 0,618, p0,001) y el colesterol no HDL (rho = 0,600, p0.001) en aquellos que consumían sustitutos de la leche materna. No se encontró correlación entre la vitamina D y el grosor de la íntima-media aórtica o carotídea. Solo el 2,8 % y el 10,1 % presentaron deficiencia e insuficiencia de vitamina D, respectivamente. Conclusiones: se encontró una correlación positiva entre los niveles de 25(OH)D, colesterol total y colesterol no HDL en los lactantes que recibían sustitutos de la leche materna.

Background: It has been observed that breastfeeding mobilizes the deposits of fat that accumulate during pregnancy and promotes weight loss through energy expenditure. The purpose of this study was...

The main objective was to assess the efficacy of a probiotic (Lactobacillus reuteri DSM 17938), a prebiotic (agave inulin), and a synbiotic on the stool characteristics in children with cerebral palsy and chronic constipation. Thirty-seven children with cerebral palsy and chronic constipation were included. The probiotic group received 1 &times, 108 colony forming unit (cfu) of L. reuteri DSM 17938 plus placebo, the prebiotic group received 4 g of agave inulin plus placebo, the synbiotic group received L. reuteri DSM 17938 plus agave inulin, and the placebo group received two placebos for 28 days. The probiotic group showed a significant decrease in stool pH (p = 0.014). Stool consistency improved in the prebiotic group (p = 0.008). The probiotic, prebiotic, and synbiotic groups showed a significant improvement in the history of excessive stool retention, the presence of fecal mass in the rectum, and the history of painful defecation. L. reuteri concentration in feces was higher in the probiotic group than in the placebo group (p = 0.001) and showed an inverse correlation with stool pH in the probiotic group (r = &minus, 0.762, p = 0.028). This study showed that the use of L. reuteri DSM 17938 and/or agave inulin improved the stool characteristics such as the history of painful defecation and the presence of fecal mass in the rectum against placebo in children with cerebral palsy and chronic constipation.

Objetivo: presentar los resultados de una encuesta aplicada a pediatras gastroenterologos de Latinoamerica para conocer como realizan el abordaje diagnostico y terapeutico de pancreatitis. Material y metodos: estudio transversal, encuesta exploratoria, multicentrica. Resultados: el 73,6 % definio los tres tipos de pancreatitis de acuerdo con el grupo INSPPIRE. La enfermedad biliar, trauma abdominal e ingesta de medicamentos fueron la etiologia mas frecuente. El 80 % fueron pancreatitis leve. El 73 % utilizo soporte nutricional; la nutricion enteral fue la mas empleada. Conclusion: es el primer estudio exploratorio que permite tener una estimacion del abordaje diagnostico y terapeutico de la pancreatitis por PG en Latinoamerica.

To identify the concordance between the nutritional status of preschoolers and the maternal perception of the children’s nutritional status and physical appearance, a cross-sectional study was cond...

BackgroundObesity in children and adolescents has increased alarmingly, placing them at a higher risk for impaired glucose tolerance and type 2 diabetes. The prevalence of vitamin D deficiency has increased as well. Vitamin D is critical for glucose homeostasis and insulin secretion. Studies on adults have reported an inverse association between vitamin D levels and insulin resistance (IR), but the results in children are inconsistent. The aim of our study was to determine the association between IR and serum vitamin D levels in obese Mexican children and adolescents.MethodsA cross-sectional study was performed on 227 children and adolescents between 6 and 19 years of age. Obesity was diagnosed through body mass index (BMI) for age, according to the World Health Organization (WHO) criteria (2007). 25-Hydroxyvitamin D (25[OH]D) was measured using an immunoassay technique and the homeostatic model assessment of insulin resistance (HOMA-IR) was calculated using the Matthews equation. Student’s t-test was carried out.ResultsThe mean serum 25(OH)D level was 35.80 ng/mL, and 55.1% of the subjects had levels classified as sufficient, 33.5% as insufficient, and 11.5% as deficient. The mean level of HOMA-IR was 3.16, and 70% of the subjects were diagnosed with IR. Fasting insulin levels and HOMA-IR were significantly different in adolescents with hypovitaminosis, compared with adolescents in the vitamin D sufficiency group (p = 0.01 and p = 0.03, respectively).ConclusionsThe insulin levels and HOMA-IR were higher in adolescents with hypovitaminosis. The girls presented higher levels of insulin and HOMA-IR than the boys.

RESUMEN Introducción La prevalencia de desnutrición en México se ha mantenido superior en la población rural nacional con respecto a las zonas urbanas. El patrón de crecimiento publicado por la OMS en 2006 confirma que los niños ≤5 años tienen el mismo potencial de crecimiento si las condiciones de vida son óptimas, existiendo diversos factores que pueden afectar el estado nutricional. El objetivo del estudio fue determinar si existe asociación entre los factores demográficos-socioeconómicos con el estado nutricional en poblaciones rurales de Colima. Material y Métodos Diseño: transversal analítico. Se incluyeron 72 niños ≤5 años (34 género masculino; 38 femenino) de las poblaciones de Suchitlán, Cofradía de Suchitlán y Zacualpan, (2015 abril-junio). Se realizaron mediciones de peso y talla y se calcularon los indicadores de peso/edad, talla/edad, peso/talla e índice de masa corporal/edad. Se aplicó un cuestionario de factores demográficos y socioeconómicos y se realizó el análisis estadístico usando χ2 o exacta de Fisher para buscar asociaciones entre el estado nutricional y los factores socioeconómicos o demográficos. Resultados La prevalencia de desnutrición crónica fue 25%, desnutrición aguda 2,8% y sobrepeso/obesidad 11,2%. Se asoció el ser hijo único con el sobrepeso/obesidad (p=0,016) y el recibir lactancia materna con la desnutrición crónica (p=0,014). Conclusiones Se identificó el ser hijo único como factor de riesgo para el desarrollo de sobrepeso/obesidad y la lactancia materna con la presencia de desnutrición crónica.

Recent studies suggest that vitamin D plays an important role in the control of blood pressure. Unfortunately, because older adults are more likely to have low 25-hydroxyvitamin-D [25(OH)D] levels, this study investigated whether calcitriol supplementation reduces blood pressure in older adults with hypertension. The design was a double-blind placebo-controlled randomized clinical trial with 36 randomly assigned subjects (71.7 ± 10 years). Blood pressure and serum levels of 25(OH)D before and after calcitriol intervention (1,000 IU daily for 6 weeks; n = 22) or placebo (n = 23) for 6 weeks were analyzed. At the end of the study, the calcitriol group presented a significant decrease of systolic blood pressure [20.25 mmHg (p = 0.001)] and diastolic blood pressure [7 mmHg (p = 0.01)], compared with the placebo group. In conclusion, 1,000 IU/day of calcitriol for 6 weeks efficiently reduced systolic and diastolic blood pressure levels in this population of older adults presenting with high blood pressure (Clinical Trial Approbation NCT02047799).

Introduction: Patients on dialysis have important changes in body composition. Objectives: To determine the correlation between skinfold thickness (SKF) and bioimpedance analysis (BIA) for estimating fat mass (FM) and lean body mass (LBM) in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD). Methods: Cross-sectional study. We included 50 patients under dialysis treatment. To measure SKF, we used the Lange® skinfold caliper (Beta Technology, California, USA) and we carried out the impedance analysis with the Bodystat Quadscan 4000® (Quadscan, Isle of Man, UK). The measurements were performed post-hemodialysis. The PD patients were measured with and without peritoneal dialysate and body weight was corrected for peritoneal fluid. We determined the Pearson’s correlation coefficient between SKF and BIA for estimating FM and LBM. We also evaluated the influence of age, sex, diuretic use, dialysis vintage, extracellular water (ECW), and intracellular water (ICW) through a multivariate regression analysis. Results: Of the 50-patient total, 29 were men (58%) and patient mean age was 46.3 ± 16.5 years. The correlation between SKF and BIA was r = 0.784 (p < 0.001) for FM and r = 0.925 (p < 0.001) for LBM. Age and sex influenced the variability of FM, whereas sex, age, and ECW influenced the variability of LBM, both evaluated through the SKF and BIA methods. Conclusion: SKF and BIA are useful methods in clinical practice. The strong and statistically significant correlations between the two methods show they are interchangeable. Age, sex, ECW, and ICW influence the variability of FM and LBM.

The purpose of the study was to identify the current status of backpack weight in primary schoolchildren in Colima, Mexico, in relation to gender, school grade level, and body mass index. A cross-sectional study was conducted on 240 randomly selected children from 20 primary schools. The participating children’s parents signed statements of informed consent. Descriptive statistics, the χ2 test, Student’s t-test, and Kruskal–Wallis test were used. The mean age was 8.55 ± 2 years (range: 5–12 years). Seventy-eight percent of the schoolchildren presented with a backpack overload that was greater than 10% of their body weight. No significant differences were found in relation to gender. Four out of every five schoolchildren presented with backpack overload, exposing them to a potential health problem. Education and public policy prevention strategies for this situation should be implemented in Mexico and other regions of the world with the same problem.

Introduction: Caustic ingestion (CI) in children and adolescents may lead to esophageal burns, esophageal stenosis and secondary dysphagia. These complications may limit the normal feeding process leading to malnutrition and growth impairment. Aims: Our aim was to evaluate the nutritional status and its association with dysphagia and esophageal stenosis in children with CI. Methods: Sixty-two patients with caustic ingestion treated at a pediatric referral hospital were included in this cross-sectional study. Independent variables were dysphagia/normal swallowing and esophageal stenosis/normal barium-swallow. The dependent variables were growth and nutritional status evaluated by anthropometry. Analysis: c2 test, OR, 95% CI, kappa test and Student’s t-test. Results: The average age at the time of CI was 39.7 months; 38.7% of the patients were girls. Endoscopy performed upon admission revealed erosive esophagitis (II-b, III-a, and III-b) in 46 (77.8%) of the patients, dysphagia in twenty-four (38.7%) and esophageal stenosis in forty (64.5%). Both complications occurred simultaneously in 20 children (32.3%, kappa = 0.3, p = 0.014).The z-score of height-for-age was below -2 SD in five children (8.1%). The z score of body mass index (BMI) was-2 SD in three children (4.8%) and it was above +1 SD in 24.2%. The z-score means of the arm anthropometric indicators of fat stores and muscle mass in both the dysphagia and esophageal stenosis groups were located in the negative area of the z-score curve and their values differed significantly from the z-scores of the non-dysphagia and non-stenosis groups. Conclusions: The proportion of erosive esophagitis, esophageal stenosis and dysphagia was high. Children with dysphagia and/or esophageal stenosis associated with CI had lower fat stores and muscle mass than the cases without esophageal complications.la ingestión de cáusticos (IC) en niños y adolescentes puede ocasionar esofagitis erosiva, estenosis esofágica y disfagia, entidades que pueden alterar el proceso de alimentación y originar desnutrición y retraso en el crecimiento.evaluar el estado nutricio de niños con IC y su asociación con disfagia y estenosis esofágica.estudio transversal analítico en el que se incluyó a 62 niños atendidos en un hospital pediátrico de referencia que sufrieron IC. Lasvariables independientes fueron la presencia/ausencia de disfagia y/o estenosis esofágica; las dependientes fueron el crecimiento y el estado nutricio evaluados mediante antropometría. Análisis estadístico: c2, OR, IC 95%, kappa y t de Student.la edad promedio fue 39,7 meses, el 39,7% eran niñas. Cuarenta y dos (77,8%) presentaron esofagitis erosiva (II-b, III-a, and III-b) en la endoscopia. En 24 (38,7%) ocurrió disfagia y en 40 (64,5%) estenosis esofágica. El puntaje z de la talla para la edad fue-2 DE en cinco niños (8,1%) y el puntaje z del IMC-2 DE en tres (4,8%). En 24.2% la z-IMC fue+1 DE. El puntaje z de los indicadores del brazo relacionados a reservas grasa y masa muscular tanto en el grupo de estenosis como de disfagia se localizó en el lado negativo de la curva y ambos fueron significativamente menores a los del grupo sin disfagia o estenosis.la proporción de esofagitis erosiva, estenosis o disfagia fue elevada. En los niños con disfagia o estenosis esofágica se identificaron reservas de grasa y masa muscular menores a las de los niños sin estas complicaciones.

Introduction: Caustic ingestion (CI) in children and adolescents may lead to esophageal burns, esophageal stenosis and secondary dysphagia. These complications may limit the normal feeding process leading to malnutrition and growth impairment. Aims: Our aim was to evaluate the nutritional status and its association with dysphagia and esophageal stenosis in children with CI. Methods: Sixty-two patients with caustic ingestion treated at a pediatric referral hospital were included in this cross-sectional study. Independent variables were dysphagia/normal swallowing and esophageal stenosis/normal barium-swallow. The dependent variables were growth and nutritional status evaluated by anthropometry. Analysis: χ² test, OR, 95% CI, kappa test and Student's t-test. Results: The average age at the time of CI was 39.7 months; 38.7% of the patients were girls. Endoscopy performed upon admission revealed erosive esophagitis (II-b, III-a, and III-b) in 46 (77.8%) of the patients, dysphagia in twenty-four (38.7%) and esophageal stenosis in forty (64.5%). Both complications occurred simultaneously in 20 children (32.3%, kappa = 0.3, p = 0.014). The z-score of height-for-age was below -2 SD in five children (8.1%). The z score of body mass index (BMI) was < -2 SD in three children (4.8%) and it was above +1 SD in 24.2%. The z-score means of the arm anthropometric indicators of fat stores and muscle mass in both the dysphagia and esophageal stenosis groups were located in the negative area of the z-score curve and their values differed significantly from the z-scores of the non-dysphagia and non-stenosis groups. Conclusions: The proportion of erosive esophagitis, esophageal stenosis and dysphagia was high. Children with dysphagia and/or esophageal stenosis associated with CI had lower fat stores and muscle mass than the cases without esophageal complications.

Introducción: la ingestión de cáusticos (IC) en niños y adolescentes puede ocasionar esofagitis erosiva, estenosis esofágica y disfagia, entidades que pueden alterar el proceso de alimentación y originar desnutrición y retraso en el crecimiento.Objetivos: evaluar el estado nutricio de niños con IC y su asociación con disfagia y estenosis esofágica.Métodos: estudio transversal analítico en el que se incluyó a 62 niños atendidos en un hospital pediátrico de referencia que sufrieron IC. Lasvariables independientes fueron la presencia/ausencia de disfagia y/o estenosis esofágica; las dependientes fueron el crecimiento y el estado nutricio evaluados mediante antropometría. Análisis estadístico: c2, OR, IC 95%, kappa y t de Student.Resultados: la edad promedio fue 39,7 meses, el 39,7% eran niñas. Cuarenta y dos (77,8%) presentaron esofagitis erosiva (II-b, III-a, and III-b) en la endoscopia. En 24 (38,7%) ocurrió disfagia y en 40 (64,5%) estenosis esofágica. El puntaje z de la talla para la edad fue +1 DE. El puntaje z de los indicadores del brazo relacionados a reservas grasa y masa muscular tanto en el grupo de estenosis como de disfagia se localizó en el lado negativo de la curva y ambos fueron significativamente menores a los del grupo sin disfagia o estenosis.Conclusiones: la proporción de esofagitis erosiva, estenosis o disfagia fue elevada. En los niños con disfagia o estenosis esofágica se identificaron reservas de grasa y masa muscular menores a las de los niños sin estas complicaciones.

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.

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 relative's 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, mother's age 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.

Objectives To describe the clinical picture and outcome, and to assess the etiological factors of acute and recurrent pancreatitis in children. Methods Thirty-six (65.5%) patients with acute and 19 (34.5%) with recurrent pancreatitis were studied. Mean age was 126 (41.3 SD) months; 27 (49.1%) were females. Setting A pediatric referral hospital. Period 2000-2005. Design Cross-sectional. Variables Clinical and laboratory data and etiological factors. Statistics Chi2-test, Fisher test, OR, confidence interval, Student t-test and Mann-Whitney U-test. Results The most frequent symptom in acute and recurrent pancreatitis was abdominal pain, followed by vomiting and ileus. The severity of pancreatitis and complications were similar in both groups. Biliary stones, family history of pancreatitis, drug ingestion and hypercalcemia occurred in both groups. Abdominal trauma and acute hepatitis A occurred in patients with acute pancreatitis; triglyceride>5.65 mmol/L, pancreas divisum and DeltaF508 mutation occurred in patients with recurrent pancreatitis. No difference was observed when frequency factors between study groups were compared. Conclusions The clinical picture and etiological factors were similar in both groups. Since one out of every three children with acute pancreatitis in this series presented recurrences, it was not considered to be a 'benign disease'. Fifteen different etiological factors were identified in two-thirds of the cases.

Obesity in children is now an increasing health risk worldwide in which the insulin-resistance can be present. Studies have linked a diet rich in n-3 fatty acids with a lower prevalence of insulin-resistance.To compare the levels of eicosapentaenoic acid among obese children with and without insulin-resistance.In 56 randomly school-age children with obesity, insulin-resistance was determined by the homeostasis model assessment for insulin-resistance index and the serum levels of eicosapentaenoic acid were determined by gas chromatography. Insulin-resistance was established when the index was6.0, non- insulin- resistance when that index was within the range of 1.4-5.9. The serum levels of eicosapentaenoic acid were compared with the Kruskal-Wallis and Mann-Whitney U tests, as needed.No differences in age or sex were identified among the groups studied. The anthropometric parameters were significantly higher in the group of children with insulin-resistance than in the other two groups. The children with insulin- resistance had significantly lower levels of eicosapentaenoic acid than the non- insulin-resistance group [12.4% area under the curve vs. 37.4%, p = 0.031], respectively.Obese primary school-aged children with insulin-resistance had lower plasma levels of eicosapentaenoic acid.Introducción: La obesidad en los niños es un problema de salud pública en todo el mundo y la resistencia a la insulina puede estar presente. Existen estudios publicados que han relacionado una dieta rica en n-3 ácidos grasos con una menor prevalencia de resistencia a la insulina en sujetos obesos. Objetivo: Comparar los niveles de ácido eicosapentaenoico en niños escolares obesos con y sin resistencia a la insulina. Métodos: Se eligieron al azar 56 niños en edad escolar con obesidad, a los cuales se les determinó resistencia a la insulina mediante la evaluación del modelo de homeostasis para el índice de resistencia a la insulina y se determinaron los niveles séricos de ácido eicosapentaenoico por cromatografía de gases. La resistencia a la insulina se estableció cuando el índice fue6,0, no resistencia a la insulina cuando ese índice fue.

Aim: The study aims to evaluate the association of esophageal damage with clinical data and feeding practices in children who suffered a caustic substance ingestion (CSI). Methods: Cross-sectional design was used in this study. The setting was at a pediatric referral hospital in 2006. Ninety-four children with CSI were used as study samples, with mean age of 38.4 months, and 37.2% were females. The independent variable was esophageal damage; the dependent variables were clinical data and feeding practices. Results: Main symptoms included salivation, oropharyngeal burns and vomiting. On endoscopy, 84.6% had second- or third-degree burns. Esophageal stricture occurred in 48.9%. Severe burns were associated with esophageal stricture and ingestion of alkaline products; dysphagia was associated with esophageal stricture. In about one fourth of the cases, a nutritional intervention with complete and balanced liquid diets was required to maintain the adequate daily recommended intake (DRI). Conclusions: Alkali ingestion was associated with severe burns and esophageal stricture. The presence of esophageal strictures and dysphagia required changes in the feeding practices in order to maintain an adequate nutritional status and/or to complete their DRI. Language: en

The development of chronic-degenerative diseases secondary to obesity in early infancy has alerted health providers to the importance of identifying the risk factors for obesity and assessing preventive treatment to reduce risks. Studies performed on a pediatric population have examined the role of inflammatory biomarkers (specifically CRP and TNF-α) and adiposity with inconsistent results.To assess the relationship between the serum levels of C-reactive protein and tumor necrosis factor-alfa with adiposity measured by bioimpedance analysis in schoolchildren.Cross sectional design. Data were collected from 74 schoolchildren randomly selected in a local primary school in the city of Colima, Mexico. The mean age was 9.4 years (1.5, SD); 33 (44.6%) were girls. The adiposity (percentage of fat mass) was measured using bioimpedance analysis and anthropometric measurements. Serum C-reactive protein and tumor necrosis factor alpha were determined with enzyme-linked immunosorbent assay. The association between adiposity and serum inflammatory biomarkers was assessed with non parametric tests (Mann Whitney and Kruskall Wallis tests), and parametric tests (Pearson's correlation).Children with obesity had a significantly higher level of C-reactive protein [2.90 mg/L (0.07-9.37)] compared with children with a normal percentage of fat mass [0.71 mg/L (0.07-5.75)] (p0.001). No differences between groups were identified regarding serum levels of tumor necrosis factor-alfa. Modest correlations were identified between serum levels of C-reactive protein, adiposity determined by bioimpedance analysis (r = 0.453, p0.001); body mass index (r = 0.398, p = 0.001); triceps skinfold (r = 0.369, p = 0.002); and subescapular skinfold (r = 0.405, p0.001). No correlation was found between adiposity and serum tumor necrosis factor-alfa.Subclinical inflammation manifested by higher serum levels of C-reactive protein was identified in schoolchildren with higher percentage of fat mass as determined by bioimpedance analysis and other anthropometric measurements.Introducción: Las enfermedades crónico-degenerativas, secundarias a la obesidad en niños, ha alertado a los profesionales de la salud sobre la importancia de identificar los factores de riesgo asociados a obesidad y establecer un enfoque preventivo para reducir el riesgo de complicaciones. Algunos estudios realizados en población pediátrica han estudiado el papel de los biomarcadores inflamatorios [específicamente proteína C-reactiva (PCR) y factor de necrosis tumoral alfa (TNF-)] asociado a adiposidad con resultados inconsistentes. Objetivo: Evaluar la relación entre los niveles séricos de PCR y TNF-con adiposidad determinada mediante impedancia bioeléctrica en niños en edad escolar. Métodos: Diseño transversal analítico. Se recopilaron los datos de 74 alumnos seleccionados al azar en una escuela primaria local en la ciudad de Colima, México. La edad media fue de 9,4 años (1.5 DE), treinta y tres (44.6%) fueron niñas. La adiposidad (porcentaje de grasa) se midió mediante impedancia bioeléctrica y antropometría. La PCR y TNF-séricos se determinaron con el ensayo por inmunoabsorción ligado a enzimas (ELISA). Las comparaciones de las variables entre los grupos se analizaron con pruebas no paramétricas (U de Mann Whitney y Kruskall Wallis) y la correlación de Pearson. Resultados: Los niños con obesidad presentaron un nivel sérico [2,90 mg/L (0,07-9,37)] significativamente más alto de PCR en comparación con los niños con un porcentaje normal de grasa [0,71 mg/L (0,07-5,75)] (p0,001). Con respecto a los niveles séricos de TNF-no se identificaron diferencias entre los grupos estudiados. Se obtuvieron correlaciones modestas entre los niveles séricos de PCR con la adiposidad determinado por impedancia bioeléctrica (r = 0,453, p0,001); índice de masa corporal (r = 0,398, p = 0,001); pliegue cutáneo tricipital (r = 0,369, p = 0,002), y pliegue cutáneo subescapular (r = 0,405, p0,001). No se encontró correlación entre la adiposidad y el nivel sérico de TNF-. Conclusión: La inflamación subclínica determinada por elevación de los niveles séricos de proteína C-reactiva fue identificada en niños en edad escolar con mayor porcentaje de grasa determinado por impedancia bioeléctrica y antropometría.

Introduction: Obesity is considered one of the most serious public health problems of the 21st century in children and adolescents. The percentile or Z-score of the body mass index is widely used in children and adolescents to define and assess overweight and obesity, but it does not determine the percentage of total body fat. Other anthropometric measurements that determine total body fat are skinfold thickness and methods of body composition assessment such as bio impedance analysis, both of which are rapid and inexpensive. Objetive: The aim of the study was to correlate the percentage of body fat determined by the Slaughter equation with the percentage of body fat determined by the bio impedance analysis technique, and the body mass index in schoolchildren. Methods: The design of the study is cross-sectional and it was performed on a random selection of 74 children (9.47 ± 1.55 years old) attending a primary school in Colima, Mexico during 2011. The percentage of body fat was measured by the Slaughter equation and bio impedance analysis technique. Body mass index was calculated. Inferential statistics were performed with the non-paired Student's t test, Pearson's correlation for quantitative variables (percentage of body fat by the Slaughter equation and bio impedance analysis) and the Fisher exact test for qualitative variables. Results: A significant correlation (r = 0.74; p < 0.001) was identified between the percentage of fat measured by the Slaughter equation and bio impedance analysis. We also identified a significant correlation between the percentage of fat measured by the Slaughter equation and body mass index (r = 0. 85; p < 0.001) and the percentage of fat measured by bio impedance analysis and body mass index (r = 0.78; p < 0.001). Conclusion: Given that we identified a significant positive correlation between BIA and STE, we conclude that both are adequate alternatives for measuring the percentage of body fat among schoolchildren in our population.

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.

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

Alagille syndrome, a dominant inherited disorder, is characterized by cholestatic liver disease, associated to interlobular bile duct paucity combined with; cardiac, skeletal, ocular and facial abnormalities. Increased levels of serum lipids are present in more than 80% of probands. Parents and siblings of children with Alagille syndrome are often found to have a mild expression of this probable disease gene; it is not known if dyslipidemia occurs in parents and siblings of children with Alagille syndrome. The aim of the study was to investigate the lipid profile in sibs and parents of children with Alagille syndrome.Four children with Alagille syndrome and 21 first-degree relatives were studied.A pediatric referral hospital.July-October 2005.cross-sectional.Total, low-density, high-density cholesterol and triglyceride.chi2, Mann-Whitney U and Kruskal-Wallis.Probands had higher levels of total cholesterol, low-density cholesterol and triglycerides than their siblings (p0.05); however, no differences with their parents were observed (p0.05).Dyslipidemia does not seem to be a phenotypic expression in first degree relatives of children with Alagille syndrome. The increased level of serum lipids observed in some of the parents is similar to the expected prevalence of hypercholesterolemia in the adult Mexican population.