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"documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2020;154:323" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "On the protection of patient data" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "323" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Acerca de la protección de los datos de los pacientes" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Javier Velasco Montes, Silvia González Díez" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Javier" "apellidos" => "Velasco Montes" ] 1 => array:2 [ "nombre" => "Silvia" "apellidos" => "González Díez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775319302106" "doi" => "10.1016/j.medcli.2019.03.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775319302106?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020620301030?idApp=UINPBA00004N" "url" => "/23870206/0000015400000008/v1_202004190641/S2387020620301030/v1_202004190641/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2387020620300899" "issn" => "23870206" "doi" => "10.1016/j.medcle.2018.11.039" "estado" => "S300" "fechaPublicacion" => "2020-04-24" "aid" => "4722" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Clin. 2020;154:320-1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Influenza A virus infections. Prevalence and associated clinical factors in a tertiary hospital" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "320" "paginaFinal" => "321" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Gripe A nosocomial. Prevalencia y factores clínicos asociados en un hospital de tercer nivel" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María José Pérez-Pedrero Sánchez-Belmonte, Marcelino Sánchez Casado, Cesar Gómez Hernando" "autores" => array:3 [ 0 => array:2 [ "nombre" => "María José" "apellidos" => "Pérez-Pedrero Sánchez-Belmonte" ] 1 => array:2 [ "nombre" => "Marcelino" "apellidos" => "Sánchez Casado" ] 2 => array:2 [ "nombre" => "Cesar" "apellidos" => "Gómez Hernando" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775318307498" "doi" => "10.1016/j.medcli.2018.11.020" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775318307498?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020620300899?idApp=UINPBA00004N" "url" => "/23870206/0000015400000008/v1_202004190641/S2387020620300899/v1_202004190641/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Down syndrome: Current incidence and comorbidities" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "321" "paginaFinal" => "322" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Aída María Gutiérrez Sánchez, Marta Marín Andrés, Antonio de Arriba Muñoz" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Aída María" "apellidos" => "Gutiérrez Sánchez" "email" => array:1 [ 0 => "aidagutierrez@outlook.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Marta" "apellidos" => "Marín Andrés" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Antonio" "apellidos" => "de Arriba Muñoz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Pediatría, Hospital Universitario Miguel Servet, Zaragoza, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Endocrinología Pediátrica, Hospital Universitario Miguel Servet, Zaragoza, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome de Down: incidencia actual y comorbilidades" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1205 "Ancho" => 2143 "Tamanyo" => 155698 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Weight, height/size and BMI mean <span class="elsevierStyleItalic">Z-Score</span> development, from new-born to 8 years of age in children with Down syndrome compared to the reference population.</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">BMI: body mass index; NB: new-born.</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Source</span>: Carrascosa et al.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Children with Down syndrome (DS) have different growth patterns and have an increased risk of certain diseases. The incidence of this syndrome has decreased due to prenatal diagnosis and voluntary termination of pregnancy.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> The objectives of this work are: to describe the incidence of births of children with DS in a tertiary hospital between January 2007 and December 2017, describe the associated comorbidities during childhood and study the growth patterns.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A retrospective, observational and descriptive study of 52 cases was carried out. The auxological data were compared with current normal values.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> This research project was presented and approved by the Clinical Research Ethics Committee.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The sample consists of 52 cases (50% male and 50% female). The average gestational age was 37.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2 weeks. The delivery was premature (<37 weeks of gestational age) in 29.9% of cases. The maternal age was ≥35 years in 57.1% of cases. Fifty cases (96.2%) had simple trisomy 21 (47,XY, +21 or 47,<span class="elsevierStyleSmallCaps">XX</span>, +21) and 2 (3.8%) a Robertsonian translocation t(21;21). There were 6 deaths (11.5%), of which 3 had a history of congenital heart disease. The incidence of births with DS was 7.6/10,000 live births (8.4 in 2007–2011 vs. 6.9 in 2012–2017).</p><p id="par0020" class="elsevierStylePara elsevierViewall">100% of the sample had one or more comorbidities; 50% 4 or more associated diseases. 65.4% had congenital heart disease (CHD) (38.2% secondary pulmonary hypertension) and 64.7% required corrective surgery. The most common CHD was the atrioventricular septal defect (CAV) (44.1%), followed by ventricular septal defect (35.3%), <span class="elsevierStyleItalic">ostium secundum</span> atrial septal defect (32.4%), patent ductus arteriosus with need for surgical or percutaneous closure (11.8%), pulmonary artery stenosis (5.9%) and tetralogy of Fallot (2.9%).</p><p id="par0025" class="elsevierStylePara elsevierViewall">15.4% had congenital gastrointestinal abnormalities. The most common malformation was duodenal atresia, present in 50% and associated in 3 of them with annular pancreas. Other defects were: Two cases of oesophageal atresia (type <span class="elsevierStyleSmallCaps">I</span> and type <span class="elsevierStyleSmallCaps">III</span>), one of jejunal atresia and one of imperforate anus.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Thyroid function abnormalities were found in 34.6% of cases, 2 due to congenital hypothyroidism and 16 due to hyperthyrotropinemia; 18.75% had positive antithyroid antibodies.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Clonal diseases were recorded in 3.8%: a case of transient myeloproliferative syndrome at birth and a case of acute megakaryoblastic myeloid leukaemia at 17 months of age, both with good progression.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Celiac disease was observed in 5.8%, gastroesophageal reflux in 7.7%, obstructive sleep apnoea syndrome in 7.7%, iron deficiency anaemia or isolated iron deficiency in 11.5%, neuropsychiatric disorders in 19.2% (50% epilepsy, 3 due to West syndrome during the breastfeeding period and 2 due to epileptic encephalopathy), eye disease in 55.8% (86.2% refractive errors, 41.4% nystagmus, 24.1% tear duct abnormalities, 20.7% strabismus and 3.4% partial cataract), hearing impairments in 17.3% (66.7% serous recurrent otitis and 55.6% sensorineural and/or transmission hearing loss) and orthopaedic disorders in 28.8% (86.7% lower limbs and feet deformities, 13.3% congenital hip dislocation and 6.7% mild incomplete atlanto-axial dislocation).</p><p id="par0045" class="elsevierStylePara elsevierViewall">Regarding weight progression, they showed a diminished weight gain from 2 to 12 months compared to the reference population, with subsequent improvement from the age of 4. As for the height/size, a progressive distancing was observed with respect to the reference values from birth to 2 years, with the <span class="elsevierStyleItalic">Z-Score</span> height/size average between 24 months and 8 years being between −2 and −2.5<span class="elsevierStyleHsp" style=""></span>SD. The average BMI <span class="elsevierStyleItalic">Z-Score</span> during the first year of life tends to remain between −1 and −1.5<span class="elsevierStyleHsp" style=""></span>SD. However, the trend increases between 12 and 36 months, averaging between 0 and 1<span class="elsevierStyleHsp" style=""></span>SD between 4 and 8 years of age (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">As can be seen, people with DS have numerous health problems associated with this syndrome and different growth patterns when compared to the reference population. Therefore, this population needs the implementation of specific preventive activity programs<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">3,4</span></a> as well as to correlate height-weight measures to specific standards for children with DS.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">In conclusion, the incidence of births with DS decreased slightly during the period studied, associated comorbidities were observed in all patients, as well as a slower growth and a tendency to overweight from the first year of life.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Gutiérrez Sánchez AM, Marín Andrés M, de Arriba Muñoz A. Síndrome de Down: incidencia actual y comorbilidades. Med Clin (Barc). 2020;154:321–322.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1205 "Ancho" => 2143 "Tamanyo" => 155698 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Weight, height/size and BMI mean <span class="elsevierStyleItalic">Z-Score</span> development, from new-born to 8 years of age in children with Down syndrome compared to the reference population.</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">BMI: body mass index; NB: new-born.</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Source</span>: Carrascosa et al.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Demografía e inclusión social de las personas con síndrome de Down" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. 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Serés" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Med Int Sindr Down" "fecha" => "2004" "volumen" => "8" "paginaInicial" => "34" "paginaFinal" => "46" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015400000008/v1_202004190641/S2387020620300905/v1_202004190641/en/main.assets" "Apartado" => array:4 [ "identificador" => "43311" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015400000008/v1_202004190641/S2387020620300905/v1_202004190641/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020620300905?idApp=UINPBA00004N" ]