Proteína C reactiva y escala SOFA: una simple escala como factor predictivo temprano de la necesidad de cuidados críticos en los pacientes con neumonía causada por COVID-19 en España

ObjectiveTo identify potential markers at admission predicting the need for critical care in patients with COVID-19 pneumonia.Material and methodsAn approved, observational, retrospective study was conducted between March 15 to April 15, 2020. 150 adult patients aged less than 75 with Charlson comorbidity index ≤ 6 diagnosed with COVID-19 pneumonia were included. Seventy-five patients were randomly selected from those admitted to the critical care units (critical care group [CG]) and seventy-five hospitalized patients who did not require critical care (non-critical care group [nCG]) represent the control group. One additional cohort of hospitalized patients with COVID-19 were used to validate the score.Measurements and main resultsMultivariable regression showed increasing odds of in-hospital critical care associated with increased C-reactive protein (CRP) (odds ratio 1.052 [1.009-1.101]; P = .0043) and higher Sequential Organ Failure Assessment (SOFA) score (1.968 [1.389-2.590]; P < .0001), both at the time of hospital admission. The AUC-ROC for the combined model was 0.83 (0.76-0.90) (vs AUC-ROC SOFA P < .05). The AUC-ROC for the validation cohort was 0.89 (0.82-0.95) (P > 0.05 vs AUC-ROC development).ConclusionPatients COVID-19 presenting at admission SOFA score ≥ 2 combined with CRP ≥ 9,1 mg/mL could be at high risk to require critical care.     

Una combinación de alto riesgo: obesidad,marcas de alimentación,menores y retos en YouTube

ObjectiveTo identify high-risk content in food advertising that combines obesogenic features with a highly emotionally engaging format.MethodComparison of 304 videos (47 hours and 41 minutes) from 13 food brand channels (traditional advertising) and from 15 child YouTuber channels (endorsement and influence) posted in 2019. Exploratory content analysis of variables describing the communication style of the “challenges” format.ResultsChallenges are the most common type of content (53.3%; n = 162), with a greater prevalence on child YouTuber channels (59%; n = 131) than on brand channels (41%; n = 31).ConclusionsContent created by consumers is not covered by current audiovisual communication legislation. Increased control of these practices is urgently needed, in terms of legislation, self-regulation and codes of ethics. Creativity, enjoyment or mere entertainment is not a sufficient argument for the persuasive promotion of behaviors that endanger the physical health of children.     

藜草花粉过敏与支气管哮喘的研究

为了确定藜草花粉过敏原对哮喘患者的致敏作用。对外源性哮喘患者用藜草花粉过敏原进行了皮肤挑刺试验（SPT）和支气管激发试验（BPT）。结果藜草花粉SPT阳性者为28.2％,18例BPT阳性者中,14例出现哮鸣音。藜草花粉BPT与SPT的符合率为85％。提示藜草花粉过敏原是我国哮喘患者的一个重要吸入性过敏原。     

新生儿窒息史对儿童神经心理发育五项功能的影响

目的：分析有新生儿窒息史儿童五项神经心理发育测查结果，了解新生儿窒息对小儿神经心理发育的影响。方法：对有新生儿窒息史儿童98例分别于6月、12月、24月进行“小儿五项神经心理发育测查”，同时选择50例无新生儿窒息史、无其它重大疾病史儿童于相同月龄进行相同测量作对照，计算测得月龄与实际月龄的相差百分比平均值作标准化对比分析。结果：轻度窒息组57例与对照组无显著性差异，重度窒息组与对照组有显著性差异。结论：新生儿重度窒息对小儿五项神经心理发育有显著性影响。     

Poisoning in children

Drug-induced poisoning of children represents a serious medical as well as a social problem linked both to the fields of prevention and therapy. This paper analyses the occurrence and the causative agents of poisoning cases of children under the age of 15, hospitalized in a children's hospital over a two-year period (1985–1986). 33 Poisoning cases represented 1.7% of all hospitalizations, and 49% thereof were induced by drugs.     

偏头痛患儿的大脑血流动力学变化

目的　研究偏头痛患儿的脑动脉血流动力学改变 ,探讨其在小儿偏头痛发生中的作用。方法　应用经颅多普勒 (TCD)技术 ,检测 90例 7～ 14岁头痛间歇期的偏头痛患儿和 80例健康同龄儿童脑动脉血管血流动力学指标。结果　 90例偏头痛患儿中脑动脉血流动力学异常者 77例 (86 % ) ,其中 6 0例 (6 7% )流速增快 ,9例 (10 % )减慢 ,与对照组相比 ,差异具有显著性 (P <0 0 1) ;90例中 2 3例 (2 6 % )存在双侧同名动脉血流速度不对称 ,其中伴有血流速度异常者15例 ,血流速度正常者 8例 ,差异具有显著性 (P <0 0 1)。结论　脑动脉血流动力学因素异常改变 ,在小儿偏头痛的发生中具有重要作用。尤其值得注意的是 ,双侧同名动脉流速不对称的改变 ,在小儿偏头痛的发生中同样可能起着重要的作用。     

雷公藤多苷治疗儿童肾病综合征的机制探讨

目的 :探讨雷公藤多苷在治疗儿童肾病综合征中的作用及其机制。　方法 :对 16年来在我科住院明确病理类型的 5 5 0例中 10 5例肾病综合征患儿 ,在激素逐渐减量的同时用雷公藤多苷 ( 1m g/ kg· d- 1 )治疗。　结果 :81例肾病综合征获得缓解 ,总缓解率达 77.1% ,其中 MCNS( 2 4例 )、Ms PGN ( 46例 )、MPGN ( 17例 )、MN ( 13例 )和FSGS( 5例 )的缓解率分别为 91.7%、89.1%、76 .5 %、38.5 %和 0 % ,FSGS效果最差 ;14例改善 ,10例无效。　结论 :由于病理类型不同疗效相差较大 ,临床上对激素治疗无效或耐药的肾病综合征患儿 ,应及时行肾活检以明确病理诊断 ,对病理类型为 MCNS和 Ms PGN者可单用雷公藤多苷治疗 ,以避免长期应用激素的不良反应 ,这是治疗儿童肾病综合征的有效方法之一     

不同剂量糖皮质激素对重症支气管哮喘的疗效观察

目的 观察不同剂量的糖皮质扩素对重症支气管哮喘的疗效。方法 观察组１６例采用小剂量激素（地塞米松２０ｍｇ／ｄ）治疗,对照组１６例使用较大量激素（地塞米松４０ｍｇ／ｄ）治疗。基他治疗措施及方法基本桢。结果 两组病人症状均在１～２ｄ缓解,动脉血ＰａＯ２恢复正常所需时间两组无差异（Ｐ〉０．０５）。结论 对重症哮喘者早期应用小剂量激素、氩茶碱持续静脉点滴,可避免大剂量应用产生的副作用,可收到较好效果。     

Effect of regular training on the anthropometric parameters and urine steroids in childhood

The changes in the anthropometric data and urine steroid metabolites caused by regular training in children in two age groups (11 and 14 years old) were investigated. The skinfolds of older girls participating in regular athletic, swimming or soccer training were thinner compared with age-matched control groups (P < 0.01) and their body mass and constitution were lower (P < 0.05). In the other groups no significant differences were observable in the anthropometric parameters. The trained children in all groups had significantly higher exercise times on the cycle ergometer (P < 0.01, in young boysP < 0.05). The strength of their hands was lower in three trained groups: in younger boys (P < 0.05), in younger girls (P < 0.01) and in older girls (right handP < 0.01, left handP < 0.05). The urinary excretion of androsterone (P < 0.02), 11-ketopregnanetriol (P < 0.01) and pregnenetriol (P < 0.02) was decreased in the older trained girls; pregnenetriol was increased in younger boys (P < 0.05). Urinary excretion of cortisol metabolites was increased in trained boys [in younger boys: tetrahydrocorticosterone (P < 0.05) and 20-hydroxycortisol (P < 0.05); in older boys allotetrahydrocortisol (P < 0.02), cortisol (P < 0.05) and 20-hydroxycortisol (P < 0.05)]. There were no significant differences in the younger girls. In the trained older girls urinary excretion of cortisol metabolites was decreased: tetrahydrocortisone (P < 0.02), allotetrahydrocorticosterone (P < 0.01), tetrahydrocortisol (P < 0.05), -cortolone (P < 0.01), cortisol (P < 0.02), 6-hydroxycortisol (P < 0.01) and 20-hydroxycortisol (P < 0.05). A multivariate analysis of the data from the trained groups and sedentary, age-matched control groups showed that regular training has a significant effect on steroid excretion.