44 results on '"Varea Calderón V"'
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2. Problemas nutricionales percibidos por los pediatras en niños españoles menores de 3 años
- Author
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Moráis López, A., Martínez Suárez, V., Dalmau Serra, J., Martínez Gómez, M.ª J., Peña-Quintana, L., and Varea Calderón, V.
- Subjects
Desnutrición ,Child nutrition disorders ,Nutritional status ,Infant nutrition disorders ,Estado nutricional ,Malnutrition ,Obesidad ,Obesity ,Trastornos de la nutrición del lactante ,Trastornos de la nutrición del niño - Abstract
Introducción: Los padres son los principales responsables de la educación nutricional de sus hijos y es labor del pediatra orientar y resolver problemas al respecto. En este estudio se pretende conocer la relevancia de las cuestiones nutricionales en la consulta del pediatra y los principales problemas nutricionales percibidos en los menores de 3 años. Métodos: Estudio descriptivo, transversal en dos fases. La primera consistió en entrevistas y grupos de discusión con 30 pediatras seleccionados aleatoriamente en Madrid y Barcelona. Los resultados se utilizaron para diseñar el cuestionario online (76 preguntas relacionadas con la nutrición en niños de 0-3 años) de la siguiente fase, en la que participaron pediatras seleccionados de forma aleatoria y representativa del territorio nacional. Resultados: De 258 pediatras seleccionados, completaron el cuestionario 151, que atendían a una media de 588 pacientes/mes. Los principales problemas nutricionales percibidos hasta los 12 meses fueron las deficiencias de hierro y vitaminas y la escasa ganancia de peso, y posteriormente la ingesta excesiva de carbohidratos y lípidos y el sobrepeso. Los padres fueron considerados los actores principales en la salud nutricional de sus hijos, pero su preocupación por esta cuestión se reduce significativamente (p < 0,0001) con la edad del niño. Los aspectos considerados más importantes para obtener unos buenos hábitos alimentarios fueron la alimentación adaptada a las necesidades del niño y respetar el tiempo de sueño. El porcentaje de pacientes que recibe recomendaciones de hábitos nutricionales varió del 88% (0-6 meses) al 61% (24-36 meses). Conclusiones: A pesar de considerar la salud nutricional importante, la intervención educativa del pediatra al respecto no es óptima. Los problemas nutricionales percibidos fueron distintos según la edad. Introduction: Parents are most responsible for nutritional education of children, and pediatritians must advise and help them with their doubts. The purpose of this study was to know the relevance of nutritional topics in daily practice and the main nutritional problems perceived by pediatritians in children under 3 years of age. Methods: Descriptive, cross-sectional study performed in 2 stages. First stage consisted on discussion meetings with 30 random-selected pediatritians from Madrid and Barcelona. Results were used to design the on-line questionnaire of the second stage (76 questions related to nutrition in children under 3 years). A random and representative sample of Spanish pediatritians was selected for this stage. Results: One hundred and fifty one pediatritians, among 258 sampled, completed the questionnaire. They referred to see a mean of 588 patients/month. The main perceived nutritional problems in the first year of life were iron and vitamin deficiencies and poor weight gain. In the next months, excess in carbohydrates and lipid intake and overweight were the main problems perceived. Parents were considered the main actors regarding their children's nutritional health, but their concern in these questions significantly reduced with children's age (p < 0,0001). Factors considered to have the greatest relevance in the acquisition of good nutritional habits were to provide a diet adjusted for children's requirements and to observe the appropriate sleeping hours. The proportion of children who receive nutritional counseling varied from 88% (0-6 months) to 61% (24-36 months). Conclusions: Despite of the relevance given by pediatritians, educational intervention regarding nutritional health is not ideal. Nutritional problems perceived by pediatritians varied with children's age.
- Published
- 2012
3. Hepatitis autoinmune en la edad pediátrica
- Author
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García Romero, R., Martín de Carpi, J., Bernal Cuartas, C., Pinillos Pisón, S., and Varea Calderón, V.
- Subjects
Cirrhosis ,Hepatitis autoinmune ,Hypergammaglobulinemia ,Hipergammaglobulinemia ,Azathioprine ,Azatioprina ,Cirrosis ,Autoimmune hepatitis - Abstract
Introducción: la hepatitis autoinmune es una enfermedad inflamatoria de origen desconocido responsable de una destrucción progresiva del hígado y evolución hacia la cirrosis. Objetivo: el objetivo es evaluar las características de las hepatitis autoinmunes en la población infantil. Material y métodos: estudio retrospectivo de pacientes diagnosticados en nuestro servicio en los últimos 10 años. Las variables analizadas son: edad, sexo, forma de presentación, función hepática, inmunoglobulinas, autoinmunidad, histología, tratamiento, necesidad de trasplante y evolución clínica. Según la positividad de los auto-anticuerpos se clasifican en tipo I (ANA y/o ASMA) y tipo II (LKM-1). Resultados: se diagnostica a siete pacientes, 5 mujeres (71,5%) y 2 varones (28,5%); tipo I 5 y tipo II dos pacientes. La edad al diagnóstico es 21 meses a 12 años. En el tipo I la presentación clínica es como hepatitis aguda en 3 casos y 2 pacientes con insuficiencia hepática progresiva. Las tipo II se diagnostican tras un hallazgo analítico siendo asintomáticas. La elevación de transaminasas (x10 su valor) se observa en el 71,5% e hipergammaglobulinemia en el 85%. El tratamiento instaurado es azatioprina y corticosteroides con un tiempo medio de remisión de 14 meses. Dos pacientes recaen al retirar corticosteroides. Conclusión: las formas de presentación son variadas y puede ser indistinguible a una hepatitis viral. Se debe sospechar ante una elevación de las aminotransferasas y la presencia de hipergammaglobulinemia. Con buenos resultados el tratamiento recomendado sería azatioprina y corticosteroides. Existen altos porcentajes de recaídas al retirar la corticoterapia por lo que algunos pacientes precisarían de dosis mínimas para mantener la remisión. Background: autoimmune hepatitis (AIH) is an inflammatory disease of unknown origin that is responsible for progressive liver necrosis and ultimately cirrhosis. Objective: our aim was to evaluate the characteristics of autoimmune hepatitis presenting in the pediatric age. Material and methods: we conducted a retrospective study of all patients diagnosed with AIH in our hospital department during the last 10 years. Variables analyzed included age, sex, clinical presentation, hepatic function, immunoglobulins, autoimmunity markers, histology, treatment, need for transplant, and clinical evolution. According to the positive level of auto-antibodies, AIH patients were classified as type I AIH (ANA and/or smooth-muscle antibodis) and type II (anti-LKM-1). Results: seven patients were diagnosed in this period -5 girls (71.5%) and 2 boys (28.5%). Five patients presented with type-I serological markers, and two with type-II markers. Age range at diagnosis was from 21 months to 12 years. In the type-I group, 3 patients presented with acute hepatitis while 2 other patients were diagnosed from laboratory findings while asymptomatic. Elevated aminotransferase (10 times the normal level) was observed in 71.5%, and 85% had elevated immunoglobulins. Treatment with azathioprine and prednisone was started after diagnosis with an average time to remission of 14 months. Two patients relapsed following steroid withdrawal. Conclusion: AIH can have different forms of clinical presentation, and is sometimes indistinguishable from viral hepatitis. AIH must be ruled out in patients presenting with concomitant elevation of aminotransferases and immunoglobulins. The commonly accepted treatment is a combination of azathioprine and corticosteroids. A high percentage of patients experience a relapse of disease after steroids are withdrawn. Therefore, some patients will need to stay on combined therapy with minimal doses of steroids.
- Published
- 2007
4. Enfermedad de Crohn y eritema nudoso: ¿es útil la nutrición enteral exclusiva?
- Author
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Pujol Muncunill, G., primary, Martín de Carpi, J., additional, and Varea Calderón, V., additional
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- 2014
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5. P578 Adalimumab as first-line anti-TNF treatment in pediatric Crohn's disease
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Martín-de-Carpi, J., primary, Navas-Lopez, V.M., additional, Navalón-Rubio, M., additional, Llerena-Santa-Cruz, E., additional, Gil-Ortega, D., additional, Varea-Calderón, V., additional, and Sierra-Salinas, C., additional
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- 2014
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6. Recomendaciones para el tratamiento del estreñimiento funcional
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Bautista Casasnovas, A., primary, Argüelles Martín, F., additional, Peña Quintana, L., additional, Polanco Allué, I., additional, Sánchez Ruiz, F., additional, and Varea Calderón, V., additional
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- 2011
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7. Quiste de vía biliar tras portoenterostomía de Kasai en atresia de vías biliares extrahepáticas y su relación con colangitis de repetición
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Venturini, F., primary, Varea Calderón, V., additional, and Martín de Carpi, J., additional
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- 2009
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8. Manifestaciones cutáneas de la enfermedad inflamatoria intestinal
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Martín de Carpi, J., primary, Chávez Caraza, K., additional, Vicente Villa, M.A., additional, González Enseñat, M.A., additional, Vilar Escrigas, P., additional, Vila Miravet, V., additional, Guallarte Alias, P., additional, and Varea Calderón, V., additional
- Published
- 2009
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9. Coexistencia de enfermedad celíaca y enfermedad inflamatoria intestinal
- Author
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Martín de Carpi, J., primary, Vilar Escrigas, P., additional, and Varea Calderón, V., additional
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- 2009
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10. Infliximab como terapia de rescate en colitis ulcerosa grave resistente al tratamiento corticoideo
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Martín de Carpi, J., primary, Vilar Escrigas, P., additional, and Varea Calderón, V., additional
- Published
- 2008
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11. Vasculitis cerebral asociada a colitis ulcerosa
- Author
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Martín de Carpi, J., primary, Ribó Cruz, J.M.a, additional, Antón López, J., additional, and Varea Calderón, V., additional
- Published
- 2007
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12. Hepatitis autoinmune en la edad pediátrica
- Author
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García Romero, R., primary, Martín de Carpi, J., additional, Bernal Cuartas, C., additional, Pinillos Pisón, S., additional, and Varea Calderón, V., additional
- Published
- 2007
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13. Colitis seudomembranosa secundaria a infección por Salmonella
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Bernal Cuartas, C., primary, Martín de Carpi, J., additional, García-Romero, R., additional, and Varea Calderón, V., additional
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- 2006
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14. Aumento del diagnóstico de esofagitis eosinofílica en nuestro medio
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Martín de Carpi, J., primary, Gómez Chiari, M., additional, Castejón Ponce, E., additional, Masiques Mas, M.ªL., additional, Vilar Escrigas, P., additional, and Varea Calderón, V., additional
- Published
- 2005
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15. Papel de los cereales en la alimentación infantil.
- Author
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Varea Calderón, V., Dalmau Serra, J., Lama More, R., and Leis Trabazo, R.
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GRAIN ,CHILDREN ,BREASTFEEDING ,DIET ,FOOD - Abstract
Copyright of Acta Pediátrica Española is the property of Ediciones Mayo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2013
16. Problemas nutricionales percibidos por los pediatras en niños Españoles menores de 3 años.
- Author
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Moráis López, A, Martínez Suárez, V, Dalmau Serra, J, Martínez Gómez, M J, Peña-Quintana, L, Varea Calderón, V, and Martínez Gómez, Ma J
- Abstract
Introduction: Parents are most responsible for nutritional education of children, and pediatricians must advise and help them with their doubts. The purpose of this study was to know the relevance of nutritional topics in daily practice and the main nutritional problems perceived by pediatricians in children under 3 years of age.Methods: Descriptive, cross-sectional study performed in 2 stages. First stage consisted on discussion meetings with 30 random-selected pediatricians from Madrid and Barcelona. Results were used to design the on-line questionnaire of the second stage (76 questions related to nutrition in children under 3 years). A random and representative sample of Spanish pediatricians was selected for this stage.Results: One hundred and fifty one pediatricians, among 258 sampled, completed the questionnaire. They referred to see a mean of 588 patients/month. The main perceived nutritional problems in the first year of life were iron and vitamin deficiencies and poor weight gain. In the next months, excess in carbohydrates and lipid intake and overweight were the main problems perceived. Parents were considered the main actors regarding their children's nutritional health, but their concern in these questions significantly reduced with children's age (p < 0,0001). Factors considered to have the greatest relevance in the acquisition of good nutritional habits were to provide a diet adjusted for children's requirements and to observe the appropriate sleeping hours. The proportion of children who receive nutritional counseling varied from 88% (0-6 months) to 61% (24-36 months).Conclusions: Despite of the relevance given by pediatricians, educational intervention regarding nutritional health is not ideal. Nutritional problems perceived by pediatricians varied with children's age. [ABSTRACT FROM AUTHOR]- Published
- 2012
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17. [A real-world study focused on the effectiveness and safety of adalimumab as first-line anti-TNF treatment for pediatric Crohn's disease].
- Author
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Navas-López VM, Pujol Muncunill G, Llerena E, Navalón Rubio M, Gil-Ortega D, Varea-Calderón V, Sierra Salinas C, and Martin-de-Carpi J
- Subjects
- Adalimumab adverse effects, Adolescent, Anti-Inflammatory Agents adverse effects, Child, Female, Humans, Male, Remission Induction, Retrospective Studies, Treatment Outcome, Adalimumab therapeutic use, Anti-Inflammatory Agents therapeutic use, Crohn Disease drug therapy, Tumor Necrosis Factor-alpha antagonists & inhibitors
- Abstract
Background and Objectives: Adalimumab (ADA), a monoclonal humanised anti-TNF antibody, is usually prescribed as a second-line treatment in paediatric Crohn's disease (CD) patients who have become unresponsive or developed intolerance to infliximab (IFX). In the case series reported, more than 70% of patients had initially been treated with IFX. Data on short- and long-term effectiveness of ADA in anti-TNF naïve patients is limited. The aim of this study is to describe our experience with ADA as a first-line anti-TNF in paediatric CD patients., Material and Methods: This is a multicentre retrospective study including anti-TNF naïve paediatric CD patients treated with ADA as first-line anti-TNF., Results: Sixty-two patients (34males), with a mean age of 13.0±2.4years and a disease duration of 7.3 (IQR 2.7-21) months were included. Median wPCDAI was 35 (IQR 24.3-47.5). Fifty-eight out of 62 (93.5%) were on combo therapy at baseline. Clinical remission at week12 was achieved in 50 out of 62 (80.6%) and in 57 out of 60 (95.0%) at week52. Eight patients (13%) reported adverse events. Mean height, growth rate and BMI z-scores improved significantly between baseline and week 52, especially in patients with growth failure., Conclusions: ADA treatment leads to lasting clinical remission in anti-TNF naïve paediatric patients with CD. ADA significantly improved growth rate in children with CD who had growth delay at baseline., (Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2018
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18. [Malnutrition in children admitted to hospital. Results of a national survey].
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Moreno Villares JM, Varea Calderón V, and Bousoño García C
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- Child, Child, Preschool, Cross-Sectional Studies, Female, Health Surveys, Humans, Male, Prevalence, Child Nutrition Disorders diagnosis, Child Nutrition Disorders epidemiology, Patient Admission
- Abstract
Introduction: Malnutrition on admission is closely related to a longer hospital stay and a higher morbidity. The prevalence of hospital malnutrition has been reported as almost as high as 50%, with 6% being the lowest. DHOSPE study investigates nutrition status in Spanish hospitals and its outcome during the hospital stay., Patients and Methods: A longitudinal, multicentre, descriptive, cross-sectional study, with a short follow-up period was conducted in 32 hospitals during 2011. A total of 991 patients were included, with ages from 0 to 17 years. Each patient was measured at admission (weight, length, weight for length -W/L-, length for age -L/A-), and at 7 and 14 days. The STAMP nutritional screening tool was completed on admission. Anthropometric measurements were reported as z-score, and nutrition status classified according to W/L and L/A for acute and chronic malnutrition, respectively., Results: The prevalence of malnutrition was 7.1% for moderate, and 0.7% for severe acute malnutrition. For chronic malnutrition, it was 2.7% moderate, and 1.4% severe. There were significant differences according to the underlying condition but not according to age. Results of STAMP show that around 75% of patients had a moderate to high risk of malnutrition. Nutritional status changed during admission for weight, as well as W/L and L/A. A worst nutritional status at admission and a higher STAMP score were positively correlated with the need for nutrition support., Conclusions: The prevalence of undernutrition was slightly lower (<8%) than previously reported, probably in relation to the variety of hospitals in the survey. Nevertheless, nutritional risk when evaluated with STAMP showed a high risk of malnutrition., (Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2017
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19. [Comparison of the effectiveness and safety of polyethylene glycol with and without electrolytes in the treatment of chronic constipation].
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Llerena E, Varea Calderón V, Pujol Muncunill G, Hernandez Hernandez K, Sosa Giraldo FJ, Suarez Fuentes T, and Martín de Carpi J
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- Child, Preschool, Chronic Disease, Electrolytes adverse effects, Female, Humans, Infant, Longitudinal Studies, Male, Polyethylene Glycols adverse effects, Prospective Studies, Treatment Outcome, Constipation therapy, Electrolytes therapeutic use, Polyethylene Glycols therapeutic use
- Abstract
Introduction: To compare the effectiveness and safety of polyethylene glycol with and without electrolytes (EL) over a 12 week period in treatment of chronic constipation in paediatrics., Material and Methods: This was an observational, prospective, longitudinal, parallel group study, including 62 children with chronic constipation according to ROME III criteria and a history of faecal impaction. The children were divided into groups, one group of 30 received polyethylene glycol without EL (PEG) and 32 PEG with EL (PEG+EL) for at least 12 weeks. The main outcomes were the number of bowel movements at 6 and 12 weeks, and the presence of electrolyte disturbances at 6 weeks., Results: The mean weekly stool frequencies were similar in both groups at 6 and 12 weeks, with 5.4 and 4.6 stools per week in the PEG+EL and PEG groups, respectively at 12 weeks. After 6 weeks of treatment, 83% (25 of 30) of the PEG group had at least one electrolyte disturbance compared with 56% (18 of 32) in the PEG+EL group (P=.02). Hyponatraemia was found in 15% (5 of 32) vs. 36% (11 of 30) of PEG+EL and PEG groups, respectively (P=.05). None of the laboratory abnormalities were clinically relevant., Conclusions: PEG formulations with or without EL have a quite similar effectiveness, safety and acceptability. PEG without EL produced more electrolyte abnormalities, but none of them were symptomatic., (Copyright © 2015 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2016
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20. [Ulcerative colitis associated with autoimmune hepatitis: a differential form of inflammatory bowel disease?].
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Giraldo Escobar LM, Crespo Madrid N, Vila Miravet V, Pujol Muncunill G, Varea Calderón V, and Martín de Carpi J
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- Child, Preschool, Diagnosis, Differential, Female, Humans, Colitis, Ulcerative complications, Colitis, Ulcerative diagnosis, Hepatitis, Autoimmune complications, Hepatitis, Autoimmune diagnosis, Inflammatory Bowel Diseases diagnosis
- Abstract
Inflammatory bowel Disease (IBD) is a group of chronic inflammatory diseases that can be associated with different autoimmune diseases, including autoimmune hepatitis (AIH). Some specific and differential characteristics in children with IBD associated to AIH have been described. Our aim is to describe the clinical pattern of this association observed in our patients, confirming its differential characteristics as compared to classical IBD in children., (Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.)
- Published
- 2015
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21. [Crohn's disease and erythema nodusum: is exclusive enteral nutrition useful?].
- Author
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Pujol Muncunill G, Martín de Carpi J, and Varea Calderón V
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- Child, Crohn Disease complications, Erythema etiology, Humans, Male, Crohn Disease therapy, Enteral Nutrition, Erythema therapy
- Published
- 2014
- Full Text
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22. [Nutrition status on pediatric admissions in Spanish hospitals; DHOSPE study].
- Author
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Moreno Villares JM, Varea Calderón V, Bousoño García C, Lama Moré R, Redecillas Ferreiro S, and Peña Quintana L
- Subjects
- Child, Child, Preschool, Cross-Sectional Studies, Female, Hospitals, Humans, Infant, Male, Prevalence, Spain, Malnutrition epidemiology, Nutritional Status, Patient Admission
- Abstract
Unlabelled: Malnutrition among hospitalized patients has clinical implications and is associated with adverse outcomes: depression of the immune system, impaired wound healing, muscle wasting, longer length of stay, higher costs and increased mortality. Although the rate of malnutrition in hospitalized children varies in different studies, it seems to be lower than in adult population. Nevertheless, this is a population that has a higher risk of developing malnutrition during hospital stay. There is a need to find the most suitable nutrition screening tool for pediatric patients., Aim: As a first step, we have performed a nationwide study on the prevalence of malnutrition on admission, in order to further evaluate the results of employing a screening tool (STAMP)., Material and Methods: The study is a multicenter, transversal study performed in 32 Spanish hospital between June and September 2011 in patients under 17 admitted to a the hospital longer than 48 hours. Weight, height and STAMP questionnaire were done on admission and repeated at day 7, 14 or at discharge. Nutritional status was classified according to Waterlow index for height and for weight. The study was approved by the Ethics Research Committee in each hospital and informed consent obtained prior to be included in the study., Results: 991 patients were finally included. Mean age was 5.0 years (SD: 4.6), distributed uniformly among ages. Moderate to severe malnutrition was present in 7.8%, and overweight-obesity in 37.9%. We found a significant correlation between nutritional status and type of disease. There were no correlationship with age, or with plasmatic albumin levels. comments: This is the first nationwide study on the prevalence of malnutrition on admission in pediatric patients. Malnutrition in pediatric patients was present in around 8% of admissions, slightly inferior to other series. The most likely explanation is that the study included patients from different types of hospitals, mimicking real life conditions., (Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)
- Published
- 2013
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23. [Nutritional problems perceived by pediatricians in Spanish children younger than 3 years].
- Author
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Moráis López A, Martínez Suárez V, Dalmau Serra J, Martínez Gómez MJ, Peña-Quintana L, and Varea Calderón V
- Subjects
- Child Nutrition Disorders diagnosis, Child, Preschool, Feeding Behavior, Health Education, Health Promotion, Humans, Infant, Nutritional Status, Physicians, Spain epidemiology, Surveys and Questionnaires, Child Nutrition Disorders epidemiology, Child Nutritional Physiological Phenomena
- Abstract
Introduction: Parents are most responsible for nutritional education of children, and pediatricians must advise and help them with their doubts. The purpose of this study was to know the relevance of nutritional topics in daily practice and the main nutritional problems perceived by pediatricians in children under 3 years of age., Methods: Descriptive, cross-sectional study performed in 2 stages. First stage consisted on discussion meetings with 30 random-selected pediatricians from Madrid and Barcelona. Results were used to design the on-line questionnaire of the second stage (76 questions related to nutrition in children under 3 years). A random and representative sample of Spanish pediatricians was selected for this stage., Results: One hundred and fifty one pediatricians, among 258 sampled, completed the questionnaire. They referred to see a mean of 588 patients/month. The main perceived nutritional problems in the first year of life were iron and vitamin deficiencies and poor weight gain. In the next months, excess in carbohydrates and lipid intake and overweight were the main problems perceived. Parents were considered the main actors regarding their children's nutritional health, but their concern in these questions significantly reduced with children's age (p < 0,0001). Factors considered to have the greatest relevance in the acquisition of good nutritional habits were to provide a diet adjusted for children's requirements and to observe the appropriate sleeping hours. The proportion of children who receive nutritional counseling varied from 88% (0-6 months) to 61% (24-36 months)., Conclusions: Despite of the relevance given by pediatricians, educational intervention regarding nutritional health is not ideal. Nutritional problems perceived by pediatricians varied with children's age.
- Published
- 2012
- Full Text
- View/download PDF
24. [Guidelines for the treatment of functional constipation].
- Author
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Bautista Casasnovas A, Argüelles Martín F, Peña Quintana L, Polanco Allué I, Sánchez Ruiz F, and Varea Calderón V
- Subjects
- Child, Humans, Practice Guidelines as Topic, Constipation therapy
- Abstract
Constipation is common in childhood. It can affect around 5-30% of the child population, depending on the criteria used for diagnosis. The currently recommended treatment is based on three main points: a) explanation, b) disimpaction and c) maintenance therapy consisting of diet changes, behavioural modification, and the use of laxatives. In the last decades treatment on disimpaction have changed radically from the rectal route to the oral route with polyethylene glycol 3350 (PEG), the most used and accepted regimen nowadays. Treatment and care should take into account the individual needs and preferences of the patient. Good communication is essential, to allow patients to reach informed decisions about their care. Maintenance therapy consists of dietary interventions, toilet training, and laxatives to obtain daily painless defaecation in order to prevent re-accumulation of stools. Maintenance therapy should be start as soon as the child's bowel is disimpacted. Early intervention with oral laxatives may improve complete resolution of functional constipation. Enemas using phosphate, mineral oil, or normal saline are effective in relieving rectal impaction, but carry the risk of mechanical trauma and are not recommended for maintenance therapy in the paediatric population. Among osmotic agents, polyethylene glycol 3350 plus electrolyte solutions appear to be the first-line drug treatment to use in children of any age, as it is safe, effective, and well-tolerated. Recommended doses ranges from 0.25 to 1.5g/kg. Advances in the understanding of the gastrointestinal enteric nervous system and epithelial function have led to the development of new substances that bind to serotonin receptors or are chloride channel activators., (Copyright © 2010 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.)
- Published
- 2011
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25. [Biliary tract cyst after Kasai portoenterostomy in extrahepatic biliary tract atresia and its relationship with repeated cholangitis].
- Author
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Venturini F, Varea Calderón V, and Martín de Carpi J
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- Humans, Infant, Male, Recurrence, Bile Duct Diseases etiology, Bile Ducts, Intrahepatic, Cholangitis etiology, Cysts etiology, Portoenterostomy, Hepatic adverse effects
- Published
- 2009
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26. [Skin manifestations of pediatric inflammatory bowel disease].
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Martín de Carpi J, Chávez Caraza K, Vicente Villa MA, González Enseñat MA, Vilar Escrigas P, Vila Miravet V, Guallarte Alias P, and Varea Calderón V
- Subjects
- Adolescent, Child, Female, Humans, Male, Skin Diseases pathology, Inflammatory Bowel Diseases complications, Skin Diseases etiology
- Abstract
Skin manifestations have been described in 10-15% of patients with inflammatory bowel disease (Crohn's disease, ulcerative colitis, indeterminate colitis/inflammatory bowel disease type unclassified). There are limited data on the prevalence of these manifestations in paediatric patients, but recent studies have reported its presence in 8% of them at diagnosis. Our aim is to report the different skin manifestations observed in our paediatric patients with inflammatory bowel disease. Case 1: Erythema nodosum at Crohn's disease diagnosis. Typical presentation with painful erythematous nodules in the pretibial region and with good response to infliximab. Case 2: Coexistence of pyoderma gangrenosum and mucocutaneous Sweet's syndrome in a Crohn's disease patient. A rapidly progressive disease that was controlled with systemic steroids but with significant residual lesions. Case 3 and 4: Metastatic Crohn's disease with good response to infliximab.
- Published
- 2009
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27. [Co-existing coeliac and inflammatory bowel disease].
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Martín de Carpi J, Vilar Escrigas P, and Varea Calderón V
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- Child, Female, Humans, Infant, Male, Celiac Disease complications, Colitis, Ulcerative complications
- Published
- 2009
- Full Text
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28. [Infliximab as rescue therapy in severe steroid-resistant ulcerative colitis].
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Martín de Carpi J, Vilar Escrigas P, and Varea Calderón V
- Subjects
- Child, Female, Humans, Infliximab, Severity of Illness Index, Anti-Inflammatory Agents therapeutic use, Antibodies, Monoclonal therapeutic use, Colitis, Ulcerative drug therapy
- Abstract
Paediatric ulcerative colitis tends to be more severe and more extensive than in adults. Steroid-resistance is also more frequent, producing a high colectomy rate in these patients. Cyclosporine A has showed to be an effective rescue therapy in acute attacks, avoiding colectomy. However, the long-term benefits are less promising and there is also very serious toxicity associated with its use. Therefore, novel effective therapies in paediatric ulcerative colitis are mandatory. We present a patient with a severe attack of steroid-resistant ulcerative-colitis in whom infliximab has proved effective in inducing a maintained remission and in avoiding the need for colectomy.
- Published
- 2008
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29. [Cerebral vasculitis associated with ulcerative colitis].
- Author
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Martín de Carpi J, Ribó Cruz JM, Antón López J, and Varea Calderón V
- Subjects
- Adolescent, Cerebral Angiography, Colectomy, Colitis, Ulcerative diagnosis, Colitis, Ulcerative surgery, Female, Follow-Up Studies, Humans, Ileostomy, Time Factors, Treatment Outcome, Vasculitis, Central Nervous System diagnosis, Vasculitis, Central Nervous System diagnostic imaging, Colitis, Ulcerative complications, Vasculitis, Central Nervous System etiology
- Published
- 2007
- Full Text
- View/download PDF
30. [Autoimmune hepatitis in pediatric patients].
- Author
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García Romero R, Martín de Carpi J, Bernal Cuartas C, Pinillos Pisón S, and Varea Calderón V
- Subjects
- Azathioprine therapeutic use, Child, Child, Preschool, Female, Humans, Immunosuppressive Agents therapeutic use, Infant, Male, Hepatitis, Autoimmune diagnosis, Hepatitis, Autoimmune drug therapy
- Abstract
Background: Autoimmune hepatitis (AIH) is an inflammatory disease of unknown origin that is responsible for progressive liver necrosis and ultimately cirrhosis., Objective: Our aim was to evaluate the characteristics of autoimmune hepatitis presenting in the pediatric age., Material and Methods: We conducted a retrospective study of all patients diagnosed with AIH in our hospital department during the last 10 years. Variables analyzed included age, sex, clinical presentation, hepatic function, immunoglobulins, autoimmunity markers, histology, treatment, need for transplant, and clinical evolution. According to the positive level of auto-antibodies, AIH patients were classified as type I AIH (ANA and/or smooth-muscle antibodies) and type II (anti-LKM-1)., Results: Seven patients were diagnosed in this period -5 girls (71.5%) and 2 boys (28.5%). Five patients presented with type-I serological markers, and two with type-II markers. Age range at diagnosis was from 21 months to 12 years. In the type-I group, 3 patients presented with acute hepatitis while 2 other patients were diagnosed from laboratory findings while asymptomatic. Elevated aminotransferase (10 times the normal level) was observed in 71.5%, and 85% had elevated immunoglobulins. Treatment with azathioprine and prednisone was started after diagnosis with an average time to remission of 14 months. Two patients relapsed following steroid withdrawal., Conclusion: AIH can have different forms of clinical presentation, and is sometimes indistinguishable from viral hepatitis. AIH must be ruled out in patients presenting with concomitant elevation of aminotransferases and immunoglobulins. The commonly accepted treatment is a combination of azathioprine and corticosteroids. A high percentage of patients experience a relapse of disease after steroids are withdrawn. Therefore, some patients will need to stay on combined therapy with minimal doses of steroids.
- Published
- 2007
- Full Text
- View/download PDF
31. [Pseudomembranous colitis due to Salmonella infection].
- Author
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Bernal Cuartas C, Martín de Carpi J, García-Romero R, and Varea Calderón V
- Subjects
- Child, Humans, Male, Enterocolitis, Pseudomembranous microbiology, Salmonella Infections, Salmonella enteritidis
- Published
- 2006
- Full Text
- View/download PDF
32. [Increasing diagnosis of eosinophilic esophagitis in Spain].
- Author
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Martín de Carpi J, Gómez Chiari M, Castejón Ponce E, Masiques Mas ML, Vilar Escrigas P, and Varea Calderón V
- Subjects
- Child, Eosinophilia diagnosis, Esophagitis diagnosis, Female, Humans, Male, Spain epidemiology, Eosinophilia epidemiology, Esophagitis epidemiology
- Abstract
Introduction: Eosinophilic esophagitis is a chronic inflammation of the esophagus characterized by marked eosinophilic infiltration. It is frequently associated with other allergic diseases. In the last few years, the incidence of eosinophilic infiltration has shown a striking increase in Spain, partly due to better knowledge of the disease and to the correct diagnosis of patients previously thought to be suffering from gastroesophageal reflux., Material and Methods: To report our experience in the diagnosis of eosinophilic esophagitis in the last few years and compare our data with previously published findings and current knowledge of the subject., Results: From January 1997 to November 2003, 11 patients (nine boys and two girls) were diagnosed with eosinophilic esophagitis. The mean age at diagnosis was 9 years and 7 months. The most frequent symptoms were dysphagia with solids and food impaction. Seven patients had a familial history of allergy. Allergic tests were positive in eight patients; five had food allergy, five were positive for aeroallergens and two patients had mixed allergy. Endoscopy showed esophageal trachealization in two patients and papular whitish exudate in a further two; both these findings are characteristic of eosinophilic esophagitis. Endoscopic appearance was normal in seven patients. Esophageal biopsies showed > 20 eosinophils/hpf. Five patients had eosinophilic infiltration in other parts of the digestive tract. All the patients with food allergy were put on exclusion diets. Three patients received systemic steroids and cromolyn sodium and three received montelukast, with good response in all patients., Conclusions: The incidence of eosinophilic esophagitis is increasing. This disease should be considered in patients with longstanding symptoms presumed to be caused by gastroesophageal reflux or motility disorders with poor response to standard therapy. Eosinophilic esophagitis is frequently associated with allergy. A normal appearance of esophageal mucosa on endoscopy should not prevent the clinician from taking multiple biopsies. Patients with eosinophilic esophagitis show good response to anti-allergic treatment.
- Published
- 2005
- Full Text
- View/download PDF
33. Role of manometry, defecography and anal endosonography in the evaluation of colorectal disorders.
- Author
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Varea Calderón V, Delgado Carbajal L, Camacho Díaz E, Estringana Pérez M, and Alert Casas E
- Subjects
- Adolescent, Anus Diseases diagnosis, Child, Child, Preschool, Constipation diagnosis, Encopresis diagnosis, Fecal Incontinence diagnosis, Female, Humans, Male, Rectal Diseases diagnostic imaging, Anal Canal diagnostic imaging, Defecography, Endosonography, Manometry, Rectal Diseases diagnosis
- Abstract
Objective: altered motility or anatomy of the rectum, anus and perineal floor may lead to symptoms which are unresponsive to routine therapeutic approaches. These disturbances usually lead to constipation, fecal incontinence, or both. Different tests and techniques for evaluating anorectal and perineal disorders, developed in the last two decades, make a better understanding of these disorders possible. This study was designed to evaluate the diagnostic benefits of combining manometry, defecography and anal endosonography in the assessment of patients with anorectal disorders., Methods: twenty-five children with constipation (with or without soiling), incontinence and/or prolapse underwent anal manometry, defecography and anal endosonography. Group A consisted of 9 children with fecal incontinence, group B consisted of 10 children with constipation with soiling, and group C comprised 6 children with constipation without soiling., Results: in group A resting incontinence was associated with a hypotonic external sphincter in 4 out of 9 patients, 2 of whom had internal anal sphincter thinning. In group B resting incontinence was associated with a hypotonic external sphincter in 8 out of 10 patients, 6 of whom had internal anal sphincter thinning. In group C these associations were not seen in any of the patients., Conclusions: barium enema is not sufficient for an accurate diagnosis of anorectal disorders. No single test is capable of revealing the type of disease. Anal manometry, defecography and endosonography are complementary procedures in the assessment of this group of disorders. This new approach will improve our knowledge of the pathogenesis of these disorders in children. However, further studies are needed to obtain conclusive evidence.
- Published
- 2000
34. Concordance between breath test and histologic damage in Helicobacter pylori associated infections in infancy.
- Author
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Jané Santamaría M, Varea Calderón V, and Camacho E
- Subjects
- Adolescent, Breath Tests, Child, Child, Preschool, Female, Helicobacter Infections microbiology, Humans, Male, Stomach pathology, Urease metabolism, Helicobacter Infections diagnosis, Helicobacter Infections pathology, Helicobacter pylori
- Abstract
Objective: the purpose of this study was to investigate the concordance between urea breath test values and the histological severity of gastric mucosa lesions in children., Method: forty children ranging in age from 3 to 17 years were examined endoscopically because of abdominal pain and positive breath test results. Histological status was determined by the intensity of the inflammatory infiltrate and by the depth of the damage. Histologically, four groups were considered: normal-appearing gastric mucosa (group 0), mild antrum gastritis (group 1), moderate antrum gastritis (group 2), and severe antrum gastritis (group 3)., Results: normal-appearing gastric mucosa was observed in 8 children with a mean breath test value of 44.07; mild chronic gastritis was observed in 17 children with a mean breath test value of 36.15; moderate gastritis was demonstrated in 10 children with a mean breath test value of 48.50, and severe gastritis was observed in 5 children with a mean breath test value of 52.31., Conclusion: we conclude that there is no concordance between urea breath test values and histological severity of gastric mucosa lesions in children.
- Published
- 1999
35. [Dental plaque in Helicobacter pylori infection].
- Author
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Santamaría MJ, Varea Calderón V, and Muñoz Almagro MC
- Subjects
- Adolescent, Child, Child, Preschool, DNA, Bacterial isolation & purification, Female, Humans, Male, Polymerase Chain Reaction, Stomach microbiology, Dental Plaque microbiology, Helicobacter pylori isolation & purification
- Abstract
Objective: The aim of this study was to determine the role of Helicobacter pylori infection in dental plaque from 53 children, between 3 and 17 years of age, with recurrent abdominal pain and/or upper gastrointestinal bleeding., Patients and Methods: Dental plaque was analyzed by using polymerase chain reaction (PCR) for a specific internal urease gene (as described by Clayton). Esophago-gastro-duodenoscopy was performed after the dental plaque was obtained and biopsies were taken from the gastric antrium and fundus and analyzed by PCR. An individual interview was performed to know the customs and attitudes about bucodental hygiene., Results: None of the children were positive with the PCR test in dental plaque, while 35 children (66%) had a positive gastric PCR result., Conclusions: This study does not confirm the hypothesis that dental plaque might act as a reservoir for this microorganism.
- Published
- 1999
36. [Helicobacter pylori infection diagnosis].
- Author
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Varea Calderón V
- Subjects
- Child, Child, Preschool, Humans, Helicobacter Infections diagnosis, Helicobacter pylori
- Published
- 1997
37. [Lacto-bezoar in a full-term neonate].
- Author
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Iriondo Sanz M, Varea Calderón V, Jane Santamaría M, Riverola de Veciana A, Llorens Jove E, and Manzanares Bahi R
- Subjects
- Animals, Bezoars therapy, Female, Fluid Therapy, Gastrointestinal Transit, Humans, Infant, Low Birth Weight, Infant, Newborn, Milk, Pregnancy, Radionuclide Imaging, Risk Factors, Ultrasonography, Prenatal, Bezoars diagnostic imaging
- Published
- 1993
38. [Ingestion of alkaline batteries: a better alternative for their extraction].
- Author
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Gutiérrez Bethancourt D, Varea Calderón V, Aguilar Téllez R, Llorens Jove E, Vilar Escrigás P, and Amat Ballarín L
- Subjects
- Anesthesia, General, Child, Child, Preschool, Deglutition, Esophagoscopy, Female, Fiber Optic Technology, Gastroscopy, Humans, Infant, Male, Pentobarbital administration & dosage, Foreign Bodies therapy
- Published
- 1992
39. [Chronic gastritis in childhood].
- Author
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Varea Calderón V
- Subjects
- Child, Child, Preschool, Chronic Disease, Female, Gastritis classification, Gastritis microbiology, Humans, Infant, Male, Gastritis diagnosis
- Published
- 1991
40. [Lipoprotein lipase deficiency. A familial study].
- Author
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Vidal Serra J, Ferrer Codina I, Amat Ballarín L, Reina del Pozo M, Varea Calderón V, Llovera Pons M, Llorén Jove E, Aguilar Tellés E, and Farré Masip C
- Subjects
- Adolescent, Female, Humans, Hyperlipoproteinemia Type I genetics, Hyperlipoproteinemia Type I diagnosis
- Published
- 1990
41. [Complex lymphatic malformation as a cause of ascites in the infant].
- Author
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Agulló Martí J, Varea Calderón V, Vila Escrigas PJ, Amat Ballarín L, Cot Martínez X, and Sotoca J
- Subjects
- Humans, Infant, Lymphangiectasis, Intestinal diagnostic imaging, Lymphangiectasis, Intestinal surgery, Lymphography, Male, Ascites etiology, Lymphangiectasis, Intestinal complications, Protein-Losing Enteropathies complications
- Published
- 1984
42. [Solitary ulcer of the rectum. Apropos of a case in childhood and review of bibliography].
- Author
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Gallastegui Dañobeitia C, Trías i Folch E, Vilar i Escrigas P, Varea Calderón V, Amat Ballarín L, and Medina Zurinaga M
- Subjects
- Child, Constipation etiology, Female, Gastrointestinal Hemorrhage etiology, Humans, Rectal Diseases complications, Rectal Diseases therapy, Ulcer complications, Ulcer pathology, Ulcer therapy, Rectal Diseases pathology
- Abstract
A case of a chronically constipated 10 year-old-girl, who had severe rectal bleeding associated with her monthly bowel movement is presented. Barium enema revealed an irregular and rigid area in rectal and sigmoid wall. Endoscopy showed an irregular erosion of 4 by 2 cm, from which biopsies were taken. These were reported as compatible with solitary ulcer of rectum. Patient was treated with dietetic management and clinically and psychiatrically controlled. Two years after initial admission she had no clinical or endoscopic evidence of disease.
- Published
- 1987
43. [Angiodysplasia of the colon in a child: preoperative diagnosis].
- Author
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Amat Ballarín L, Villar Escrigas P, Varea Calderón V, Trías Folch E, Vidal Serra J, and Bonet Rodes J
- Subjects
- Adolescent, Arteriovenous Malformations complications, Dilatation, Pathologic diagnosis, Female, Gastrointestinal Hemorrhage etiology, Humans, Rectum, Arteriovenous Malformations diagnosis, Colon blood supply
- Published
- 1989
44. [The role of IgA and IgA antigliadin antibodies in the diagnosis and management of celiac disease].
- Author
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Torregrosa Sánchez R, Polo Martín P, Calabuig Sánchez M, Tomás Rates C, Vilar Escrigas P, Farre Massip C, Varea Calderón V, Alvarez Angel V, and Sanchís-Bayarri Vaillant V
- Subjects
- Celiac Disease diagnosis, Celiac Disease diet therapy, Child, Enzyme-Linked Immunosorbent Assay, Humans, Celiac Disease immunology, Gliadin immunology, Glutens adverse effects, Immunoglobulin A immunology, Immunoglobulin G immunology, Plant Proteins immunology
- Abstract
The authors reports the results of ELISA IgG and IgA antigliadin antibodies measurements in a study of 271 serum samples proceeding from celiac patients (with and without gluten containing diet) and control subjects. IgA antigliadin antibody measurement had the most specificity and positive predictive value, IgG antigliadin antibody measurement had the most sensitivity and negative predictive value. Our results point out that antigliadin antibodies are helpful in the diagnosis and management of celiac disease. Un the same manner, antigliadin antibodies are helpful to evaluate the adherence of patients to gluten-free diet.
- Published
- 1989
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