Evaluación de la composición corporal mediante antropometría y bioimpedanciometría en supervivientes de leucemia aguda infantil

Introduccio´n: los supervivientes de leucemia aguda infantil (LAI) tienen riesgo de desarrollar obesidad. El objetivo del estudio fue evaluar la composición corporal en estos pacientes mediante las diferentes técnicas de empleadas en la práctica clínica y compararlas con el empleo del índice de masa corporal (IMC). Me´todos: estudio transversal de 39 supervivientes de LAI con más de diez an~os desde el diagno´stico. Se evaluó el grado de acuerdo entre diferentes técnicas antropométricas y composición corporal y se analizaron factores de riesgo asociados al desarrollo de obesidad. Resultados: prevalencia de obesidad según porcentaje masa grasa por IMC 38,5%, perímetro cintura 46,1%, sumatorio cuatro pliegues 51,3% y bioimpedanciometría (BIA) 56,4%. Existe adecuada correlación entre los métodos, pero el IMC infraestima la adiposidad respecto al perímetro de cintura (-1,03 ± 2,01), pliegues (-2,95 ± 5,78 y BIA (-3,78 ± 7,4), con mayor infraestimación en % masa magra > 28%. Tres pacientes mostraron sarcopenia y solo uno, obesidad sarcopénica. La adiposidad estimada por el perímetro de cintura fue el parámetro con mejor asociación con los factores de riesgo cardiovascular (colesterol-LDL: r = 0,703; colesterol-HDL: r = -0,612; p < 0,05 e hipertensión: OR 4,17; IC 95%: 1,012-19,3). Los factores de riesgo asociados a obesidad fueron: sexo femenino, alto riesgo tumoral, tratamiento con radioterapia y trasplante de progenitores hematopoyéticos. Conclusiones: el IMC infraestima el porcentaje de supervivientes obesos respecto al empleo del perímetro de cintura, pliegues cutáneos y bioimpedanciometría, existiendo riesgo de clasificar erróneamente a sujetos obesos como no obesos. El sexo femenino, el alto riesgo tumoral, la radioterapia y el trasplante son factores de riesgo para presentar obesidad

Spanish cardiac catheterization in congenital heart diseases registry. First official report from the ACI-SEC and the GTH-SECPCC (2020)

Introduction and objectives: The Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC) and the Spanish Society of Pediatric Cardiology Working Group on Interventional Cardiology (GTH-SECPCC) introduce their annual activity report for 2020, the starting year of the pandemic of coronavirus disease (COVID-19). Methods: All Spanish centers with cath labs and interventional activity in congenital heart diseases were invited to participate. Data were collected online, and analyzed by an external company together with members from the ACI-SEC and the GTH-SECPCC. Results: A total of 16 centers participated (all of them public) including 30 cath labs experienced in the management of congenital heart diseases, 7 of them (23.3%) dedicated exclusively to pediatric patients. A total of 1046 diagnostic studies, and 1468 interventional cardiac catheterizations were registered. The interventional procedures were considered successful in 93.4% of the cases with rates of major procedural complications and mortality of 2%, and 0.1%, respectively. The most frequent procedures were atrial septal defect closure (377 cases), pulmonary angioplasty (244 cases), and the percutaneous closure of the patent ductus arteriosus (199 cases). Conclusions: This report is the first publication from the Spanish Cardiac Catheterization in Congenital Heart Diseases Registry. The data recorded are conditioned by the COVID-19 pandemic. Diagnostic cardiac catheterization still plays a key role in this field. Most interventional techniques have reported excellent security and efficacy rates

Evolución cardiológica postnatal y factores asociados a la agenesia de ductus venoso de diagnóstico prenatal

Resumen: Introducción: la agenesia del ductus venoso es una anomalía infrecuente con pronóstico variable. Puede ir de hallazgo aislado a producir muerte fetal. Así mismo, puede asociarse a otras anomalías y síndromes genéticos. Material y métodos: estudio descriptivo de 12 niños con diagnóstico prenatal de agenesia del ductus venoso. Se evaluó lugar de drenaje de vena umbilical, variables perinatales, obstétricas, otras anomalías asociadas y evolución. Resultados: el 75% (9/12) presentaba drenaje extrahepático de vena umbilical; de ellos, el 44,4% (4/9) presentó insuficiencia cardiaca fetal. Al nacimiento, un 50% (6/12) asociaba anomalías cardiacas estructurales y un 41,6% (5/12) precisaron tratamiento médico. El 25% (3/12) asociaba síndromes genéticos. 25% (3/12) de niños fallecieron (100% con cardiopatía), y un tercio de los supervivientes (3/9) presentó anomalías estructurales cardiacas. El 50% (6/12) de madres tenían antecedente de aborto o muerte fetal intraútero previa, 25% (3/12) de embarazos fueron producto de reproducción asistida y 25% (3/12) de gestaciones múltiples. Conclusiones: se halló una incidencia elevada de defectos estructurales cardiacos en niños con agenesia del ductus venoso. Son más usuales si el drenaje es extrahepático y en ellos hay mayor frecuencia de anomalías genéticas y mortalidad. Un porcentaje importante de pacientes precisan tratamiento perinatal; la evolución es satisfactoria en los supervivientes. Abstract: Introduction: The absence of ductus venosus is an uncommon condition with a variable prognosis, which can vary from an isolated finding to causing foetal death. Furthermore, it can also be associated with other genetic anomalies and syndromes. Material and method: A descriptive study was conducted on 12 children with a prenatal diagnosis of absence of ductus venosus. An evaluation was made of the umbilical vein drainage site, perinatal and obstetric variables, other associated anomalies, and the outcomes. Results: Extra-hepatic drainage of the umbilical vein was observed in 75% (9/12) of cases, of which 44.4% (4/9) had foetal heart failure. At birth, 50% (6/12) were associated with cardiac structure anomalies, and 41.6% (5/12) required medical treatment. Genetic syndromes were detected in 25% (3/12) of cases. There were 25% (3/12) deaths (100% with heart disease), and one-third (3/9) of the survivors had cardiac structure anomalies. A history of abortion or previous intrauterine death was recorded in 50% (6/12) of the mothers, and in 25% (3/12) the pregnancies were the result of assisted reproduction, and 25% (3/12) multiple gestations. Conclusions: An elevated incidence of cardiac structure defects is found in children with absence of ductus venosus. They are more common if the drainage is extrahepatic, and within those, there is a higher frequency of genetic anomalies and death. A significant percentage of patients require perinatal treatment: The outcome is satisfactory in the survivors. Palabras clave: Pediatría, Cardiopatía congénita, Cortocircuito, Keywords: Paediatrics, Congenital heart disease, Short circui

Consenso español sobre el hemangioma infantil.

Infantile haemangiomas are benign tumours produced by the proliferation of endothelial cells of blood vessels, with a high incidence in children under the age of one year (4-10%). It is estimated that 12% of them require treatment. This treatment must be administered according to clinical practice guidelines, expert experience, patient characteristics and parent preferences. The consensus process was performed by using scientific evidence on the diagnosis and treatment of infantile haemangiomas, culled from a systematic review of the literature, together with specialist expert opinions. The recommendations issued were validated by the specialists, who also provided their level of agreement. This document contains recommendations on the classification, associations, complications, diagnosis, treatment, and follow-up of patients with infantile haemangioma. It also includes action algorithms, and addresses multidisciplinary management and referral criteria between the different specialities involved in the clinical management of this type of patient. The recommendations and the diagnostic and therapeutic algorithms of infantile haemangiomas contained in this document are a useful tool for the proper management of these patients

Spanish cardiac catheterization in congenital heart diseases registry. First official report from the ACI-SEC and the GTH-SECPCC (2020)

ABSTRACT Introduction and objectives: The Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC) and the Spanish Society of Pediatric Cardiology Working Group on Interventional Cardiology (GTH-SECPCC) introduce their annual activity report for 2020, the starting year of the pandemic of coronavirus disease (COVID-19). Methods: All Spanish centers with cath labs and interventional activity in congenital heart diseases were invited to participate. Data were collected online, and analyzed by an external company together with members from the ACI-SEC and the GTH-SECPCC. Results: A total of 16 centers participated (all of them public) including 30 cath labs experienced in the management of congenital heart diseases, 7 of them (23.3&#x0025;) dedicated exclusively to pediatric patients. A total of 1046 diagnostic studies, and 1468 interventional cardiac catheterizations were registered. The interventional procedures were considered successful in 93.4&#x0025; of the cases with rates of major procedural complications and mortality of 2&#x0025;, and 0.1&#x0025;, respectively. The most frequent procedures were atrial septal defect closure (377 cases), pulmonary angioplasty (244 cases), and the percutaneous closure of the patent ductus arteriosus (199 cases). Conclusions: This report is the first publication from the Spanish Cardiac Catheterization in Congenital Heart Diseases Registry. The data recorded are conditioned by the COVID-19 pandemic. Diagnostic cardiac catheterization still plays a key role in this field. Most interventional techniques have reported excellent security and efficacy rates

Registro español de intervencionismo en cardiopatías congénitas. Primer informe oficial de la ACI-SEC y el GTH-SECPCC (2020)

RESUMEN Introducci&#x00F3;n y objetivos: La Asociaci&#x00F3;n de Cardiolog&#x00ED;a Intervencionista de la Sociedad Espa&#x00F1;ola de Cardiolog&#x00ED;a (ACI-SEC) y el Grupo de Trabajo de Hemodin&#x00E1;mica de la Sociedad Espa&#x00F1;ola de Cardiolog&#x00ED;a Pedi&#x00E1;trica y Cardiopat&#x00ED;as Cong&#x00E9;nitas (GTH-SECPCC) presentan el informe de actividad hemodin&#x00E1;mica en cardiopat&#x00ED;as cong&#x00E9;nitas de 2020, a&#x00F1;o de inicio de la pandemia de la enfermedad coronav&#x00ED;rica de 2019 (COVID-19). M&#x00E9;todos: Se invit&#x00F3; a participar a los centros espa&#x00F1;oles con laboratorio de hemodin&#x00E1;mica y actividad intervencionista en cardiopat&#x00ED;as cong&#x00E9;nitas. La recogida de datos se realiz&#x00F3; telem&#x00E1;ticamente; una empresa externa, junto con miembros de la ACI-SEC y el GTH-SECPCC, los analiz&#x00F3;. Resultados: Participaron 16 centros (todos p&#x00FA;blicos), que acumulan 30 salas de hemodin&#x00E1;mica con actividad en cardiopat&#x00ED;as cong&#x00E9;nitas, 7 (23,3&#x0025;) de ellas con dedicaci&#x00F3;n exclusiva a pacientes pedi&#x00E1;tricos. Se registraron 1.046 estudios diagn&#x00F3;sticos y 1.468 cateterismos intervencionistas. Los procedimientos terap&#x00E9;uticos fueron exitosos en el 94,9&#x0025;, con una tasa de complicaciones mayores del 2&#x0025; y una mortalidad del 0,1&#x0025;. Las t&#x00E9;cnicas m&#x00E1;s frecuentes fueron el cierre de comunicaci&#x00F3;n interauricular (377 casos), la angioplastia pulmonar (244 casos) y el cierre de ductus arterioso (199 casos). Conclusiones: El presente trabajo representa la primera publicaci&#x00F3;n del Registro Espa&#x00F1;ol de Intervencionismo en Cardiopat&#x00ED;as Cong&#x00E9;nitas. La casu&#x00ED;stica registrada est&#x00E1; condicionada por la pandemia de la COVID-19. Los cateterismos diagn&#x00F3;sticos siguen teniendo un papel relevante en esta actividad. Para la mayor&#x00ED;a de las t&#x00E9;cnicas intervencionistas se han reportado excelentes datos de seguridad y eficacia