Greater Calcium Intake is Associated with Better Bone Health Measured by Quantitative Ultrasound of the Phalanges in Pediatric Patients Treated with Anticonvulsant Drugs

We aimed to investigate and compare the effects of chronic antiepileptic therapy on bone health in pediatric patients using quantitative ultrasound of the phalanges (QUS) and controlling for potential confounding factors, particularly nutrient intake. The amplitude-dependent speed of sound (Ad-SoS) was measured in 33 epileptic children and 32 healthy children aged 6.5 ˘ 3.1 and 6.3 ˘ 1.1 (mean ˘ SD) years, respectively. There were no significant differences in the demographics such as age, weight and height between epileptic children and the control group children. None of the children in the epileptic or the treatment group were found to have a vitamin D deficiency. There were no significant differences in laboratory tests between groups. Lower QUS figures were found in the epileptic children (p = 0.001). After further adjustment for potential confounders such age, height, weight, calcium intake, vitamin D intake, physical activity and sex, the differences remained significant (p < 0.001). After further classification of the participants based on the tertile of calcium intake, no significant differences were found between patients and healthy controls in the greatest tertile of calcium intake (p = 0.217). We conclude that anticonvulsant therapy using valproate may lead to low bone mass in children and that an adequate intake of calcium might counteract such deleterious effects

Analysis of professional identity through nurses' educational competence

El presente artículo se centra en la percepción que tienen las propias enfermeras sobre sus competencias profesionales, la visión que tienen otros profesionales sanitarios y la visión social que tienen los usuarios sobre este colectivo. Para ello se configuraron dos grupos de discusión formados por enfermeras/os que trabajan en dos hospitales de Madrid, en cuyos ámbitos de trabajo se desarrolla gran parte de nuestro estudio general. Se seleccionaron dos grupos con perfiles diferentes, de manera que sus discursos en muchos aspectos, también son diferentes, como se podrá observar en el análisis y las conclusiones del trabajo. Lo que se pretende es conocer los discursos que elaboraban las enfermeras/os, en interacción con otros compañeros de trabajo del mismo hospital, respecto de su competencia en educación con pacientes crónicos hospitalizados. Analizando los discursos que fluían entorno al rol educativo, se pudo identificar las características que estos grupos de enfermeras/os asignaban a la educación que llevan a cabo en el hospital, así como la problemática derivada de su realización, y los factores que la condicionan. La propia dinámica de los grupos de discusión, facilitó la emergencia de otros discursos que estas enfermeras/os ligaban de manera directa con el desempeño de su rol educativo, como son, el reconocimiento social de la profesión.The present article deals with nurses’ perception of their own professional competence, other health professionals’ view and patients’ social perspective. Two discussion groups integrated by nurses working in two Madrid hospitals were constituted; most of our general study was carried out in these two hospitals. Both groups had different profiles, thus their discourses varied in many aspects, as can be seen in the analysis and conclusions. The aim was to identify discourses elaborated by nurses interacting with other colleagues from the same hospital regarding educational competence towards hospitalised chronic patients. From the analysis of discourses on the educational role, characteristics assigned to education by these two groups of nurses were identified, along with difficulties and conditioning factors. The discussion groups own dynamics facilitated other discourses emerging in connection to the development of their educational role, such as social acknowledgement of the profession

Greater calcium intake is associated with better bone health measured by quantitative ultrasound of the phalanges in pediatric patients treated with anticonvulsant drugs

Decidimos investigar y comparar los efectos del tratamiento antiepiléptico crónico sobre la salud ósea en pacientes pediátricos con ultrasonido cuantitativo de las falanges (QUS) y el control de posibles factores de confusión, especialmente el consumo de nutrientes. La amplitud depende de la velocidad del sonido Ad-So(S) fue medido en 33 niños epilépticos y 32 niños sanos entre 6.5 años ± 3.1 y 6.3 años ± 1.1 (Media ± SD), respectivamente. No hubo diferencias significativas en los datos demográficos como edad, peso y altura entre los niños epilépticos y los niños del grupo de control. Ninguno de los niños en la epilepsia o el grupo de tratamiento se encontró una deficiencia de vitamina D. No hubo diferencias significativas entre los grupos en las pruebas de laboratorio. QUS se encontraron cifras inferiores en los niños epilépticos (p = 0,001). Tras el ajuste para posibles confundidores de dicha edad, la altura, el peso, la ingesta de calcio, vitamina D, la actividad física y el sexo, seguían existiendo diferencias significativas (p < 0,001). Tras una nueva clasificación de los participantes sobre la base de la ingesta de un tercil de calcio, no se encontraron diferencias significativas entre pacientes y controles sanos en la mayor ingesta de un tercil de calcio (p = 0.217). Concluimos que la terapia anticonvulsiva utilizando el valproato sódico puede conducir a una disminución de la masa ósea en los niños y que una ingesta adecuada de calcio podrían contrarrestar tales efectos deletéreos.We aimed to investigate and compare the effects of chronic antiepileptic therapy on bone health in pediatric patients using quantitative ultrasound of the phalanges (QUS) and controlling for potential confounding factors, particularly nutrient intake. The amplitude-dependent speed of sound (Ad-SoS) was measured in 33 epileptic children and 32 healthy children aged 6.5 ± 3.1 and 6.3 ± 1.1 (mean ± SD) years, respectively. There were no significant differences in the demographics such as age, weight and height between epileptic children and the control group children. None of the children in the epileptic or the treatment group were found to have a vitamin D deficiency. There were no significant differences in laboratory tests between groups. Lower QUS figures were found in the epileptic children (p = 0.001). After further adjustment for potential confounders such age, height, weight, calcium intake, vitamin D intake, physical activity and sex, the differences remained significant (p < 0.001). After further classification of the participants based on the tertile of calcium intake, no significant differences were found between patients and healthy controls in the greatest tertile of calcium intake (p = 0.217). We conclude that anticonvulsant therapy using valproate may lead to low bone mass in children and that an adequate intake of calcium might counteract such deleterious effects.peerReviewe