Are the Growth Standards of the World Health Organization Valid for Spanish Children? The SONEV Study

Background: The use of different growth tables to assess the population’s nutritional status has given rise to a series of limitations arising from the lack of consensus and uniform methodological criteria. This leads to a disparity of results that prevent an accurate and reliable diagnosis of whether a child is overweight or obese. Objective: The purpose of this study was to develop growth references for weight, height, and body mass index for Eastern-Spanish children from 6 to 16 years of age. Methods: The final sample used to fit the growth curves was made up of 1,102 observations. The 2007 WHO curves are currently used for Child Health Service Cards. Therefore, tomake the comparison of the internal values obtained as realistic as possible, the same construction method has been used for the internal curves, modeling age as a continuous variable and simultaneously adjusting the curves, smoothing them using cubic splines and further smoothing the edge effects by means of data extending above or below the upper and lower age limits. Results: Growth curves for percentiles were constructed for both sexes and higher values were noticeably found to set as growth-standard compared to WHO-standards. Conclusion: Our analysis shows that the WHO 2007 standard references are not suitable for Eastern-Spanish children. The standards shown in this study are much more realistic and current, and we believe that their use will help healthcare professionals more effectively combat the current epidemic of overweight and obesity.Nutrición humana y dietétic

Atezolizumab and Bevacizumab Combination Therapy in the Treatment of Advanced Hepatocellular Cancer

Liver cancer, particularly hepatocellular carcinoma, is a global concern. This study focuses on the evaluation of Atezolizumab and Bevacizumab combination therapy as a promising alternative in the treatment of advanced hepatocellular carcinoma. The objectives of this systematic review include evaluating the efficacy of Atezolizumab and Bevacizumab combination therapy compared to conventional therapies with Sorafenib and other conventional therapies, analyzing the associated adverse effects, and exploring prognostic factors in the setting of advanced hepatocellular carcinoma. A systematic literature review was carried out using the PubMed and Web of Science databases. Fifteen related articles were included and evaluated according to their level of evidence and recommendation. Results: The combination therapy of Atezolizumab and Bevacizumab, along with Sorafenib, showed positive results in the treatment of patients with advanced hepatocellular carcinoma. Significant adverse effects were identified, such as gastrointestinal bleeding, arterial hypertension, and proteinuria, which require careful attention. In addition, prognostic factors, such as transforming growth factor beta (TGF-β), alpha-fetoprotein (AFP), and vascular invasion, were highlighted as key indicators of hepatocellular carcinoma progression. Conclusions: The combination of Atezolizumab and Bevacizumab is shown to be effective in the treatment of advanced hepatocellular carcinoma, although it is essential to take into consideration the associated adverse effects. The prognostic factors identified may provide valuable information for the clinical management of this disease. This study provides a comprehensive overview of a promising emerging therapy for liver cancer.Medicin

Differences in Classification Standards For the Prevalence of Overweight and Obesity in Children. A Systematic Review and Meta-Analysis

The prevalence of childhood obesity has increased dramatically all over the world in recent years. While obesity in adults can be easily measured using the BMI calculation, determining overweight and obesity in children is more controversial. The aim was to compare the three most used international classification systems (WHO 2007, CDC 2000 and Cole-IOTF) to determine overweight and obesity in infant and adolescent populations. We performed a systematic review in accordance with the PRISMA 2020 guidelines of articles comparing any of the three classification systems. The main findings were that the WHO 2007 criteria show the highest prevalence of overweight and obesity in the child and youth population. The prevalence of childhood overweight and obesity was determined to be higher in boys than in girls in most studies, when analysing the classifications of the WHO 2007, CDC 2000 and Cole-IOTF together. However, there was a higher prevalence of overweight and obesity in girls than in boys when only the CDC 2000 and Cole-IOTF criteria were considered. Both the results of the review and the great heterogeneity found in the meta-analysis show that it is necessary to unify the criteria for the classification of childhood overweight and obesity. International standards are insufficient for working with the current population. A working group should be created to address this issue and agree on the unification of a gold standard, taking into account the geographical region, the ethnic groups and the age groups of the child and youth population and above all, the secular growth.Catholic University of Valencia for their contribution and help in the payment of the Open Access publication under grant number 2022-275-002. Likewise,Medicin

Estudio neuroético del uso del Metilfenidato (MFD) en pacientes menores de 18 años con diagnóstico de Trastorno de déficit de atención (TDAH)

Presentamos este trabajo con la finalidad de poner de relevancia la relación entre el riesgo/beneficio del uso de Metilfenidato (MFD) en pacientes pediátricos con Trastorno de déficit de atención e hiperactividad (TDAH) y sus consecuencias neuroéticas. Estudios recientes muestran que el efecto farmacológico en cerebros adultos del MFD no es el mismo que en el córtex prefrontal de cerebros en desarrollo. Este hecho, sumado a la posibilidad de un mal uso farmacológico es lo que se conoce como enhancement neuronal en cerebros adultos. Todo ello, puede llevar a entender que también ocurre en niños con TDAH o incluso en ausencia de patología. Así pues, cabe diferenciar claramente el tratamiento con MFD del paciente pediátrico con TDAH donde se pretende estabilizar la proporción dopamina (DA) y noradrenalina (NA) en la sinapsis nerviosa o el uso del MFD en pacientes con neurodegeneración para aumentar su memoria mejorando la neuroplasticidad y diferenciarlo del “neuro-utilitarismo” del MFD para un aumento de las capacidades cognitivas en cerebros jóvenes sin percibir el riesgo de daños en partes del córtex que rigen la conducta moral-social. Por tanto, se sugiere la evaluación ética del uso del MFD en pacientes menores de 18 años.We present this work in order to highlight the relationship between the risk / benefit of the use of methylphenidate (MFD) in pediatric patients with attention deficit hyperactivity disorder (ADHD) and its neuroethical consequences. Recent studies show that the pharmacological effect in adult brains of MFD is not the same as in the prefrontal cortex of developing brains. This fact, added to the possibility of pharmacological misuse, is what is known as neuronal enhancement in adult brains. All of this may lead to the understanding that it also occurs in children with ADHD or even in the absence of pathology. Thus, it is possible to clearly differentiate the treatment with MFD of the pediatric patient with ADHD where it is intended to stabilize the DA and NA ratio in the nerve synapse or the use of MFD in patients with neurodegeneration to increase their memory by improving neuroplasticity and differentiate it from the “neuro -utilitarianism” of the MFD for an increase in cognitive capacities in young brains without perceiving the risk of damage to parts of the cortex that govern moral-social behavior. Therefore, the ethical evaluation of the use of the MFD in patients under 18 years is suggested.MedicinaInstituto de Ciencias de la Vid