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      Curvas de crecimiento infantil para detectar precozmente la talla baja en el menor de 2 años

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          Abstract

          Pregunta de investigación: ¿Permitirán las curvas de crecimiento infantil (T/E) identificar el retardo en el crecimiento lineal en forma previa a la talla baja (<-2 DE) y la edad promedio de alteración del crecimiento en niños de 6 a 24 meses de edad que demandan atención en establecimientos de salud? Objetivo: Optimizar el uso de los datos del Carnet de Salud Infantil para identificar alteraciones en el crecimiento lineal previa a la talla baja (< -2DE) y los tiempos promedio de inicio de la declinación de curva de crecimiento normal hasta llegar por debajo de -2DE, relacionando esta tendencia con la curva de crecimiento ponderal. Material y métodos: Estudio descriptivo, longitudinal y retrospectivo, que incluyo a 71 niños menores de 2 años. Se analizaron datos del Carnet de Salud Infantil e indicadores antropométricos a partir de ellos. El punto de corte de Talla/Edad fue menor a la -2DE para clasificar talla baja. Resultados: La talla baja en uno o varios de los controles fue de 38.08%, y desde el primer control 48.1 %. Los que presentaron talla baja como inicio en controles posteriores al primero (51.8%) mostraban una T/E por debajo a la -1 DE al primer control en el 64.2%; en este último grupo, el tiempo de descenso desde la T/E <-1 DE hasta <-2DE fue en promedio de 3.9 meses. En el 74% que iniciaban con talla baja no se observo la presencia concomitante de P/E <-2DE. Existe una asociación estadísticamente significativa entre T/E <-1 DE al primer control y talla baja (chi²14.07; p=0.0001). Conclusiones: El uso adecuado de las curvas de crecimiento lineal infantil permite identificar de forma previa retardo en el crecimiento, con una T/E <-1 DE en el primer control. La talla baja en nuestro medio se caracteriza por presentarse en edad temprana y acompañarse de retardo en el crecimiento ponderal (P/E) solamente en los casos con inicio de esta en el primer control.

          Translated abstract

          Abstract Research question: Do curves of children growth (height/age) let us to identify growth delayed in advance to short stature (<-2DS) and average age of abnormal growth on 6 to 24 years old children who are attended in health centers? Background: Chronic malnutrition is one of the nutritional problems with high magnitude in Latin-America and high prevalence in Bolivia. Objetive: To improve the use ofchildren's health cards data to let it identify abnormal growth in advance to short stature (<-2DS) and overage time of declination beginning from a normal growth lineal curve to across the -2DS relating this tendency whit the weight growth curve. Material and method: A descriptive and prospective longitudinal study, including 71 children less than 2 year's old age. The children's health card data were analyzed generating anthropometric indicators of them. Sort stature was classified as a height/age under -2DS. Results: The frequency of short stature in one or several controls was 38,08% taking place since the first control in 48,15%. Children who has short stature as beginning after the first control (51,85%) showed a height/age under -1DS in the first control in 64,29%. The Children who have begun short stature without weight/age <-2DE were 74,04%. There is a hard association between height/age under -1DS at the first control and short stature (chi2 14,07; p=0,0001). Conclusions: The children's growth curves used rightly let us identify growth delayed previously with a height/age under-1DS in the first control or 3,92 previous mouths to the diagnostic of short stature. In our environment, the short stature is characterized because of to take place in early age and is accompanied with weight growth delayed (weight/age) just in cases with beginning in the first control

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          Most cited references25

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          Worldwide Timing of Growth Faltering: Implications for Nutritional Interventions

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            Consensus Guidelines for the Diagnosis and Treatment of Growth Hormone (GH) Deficiency in Childhood and Adolescence: Summary Statement of the GH Research Society

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              Developing evidence-based guidelines for referral for short stature.

              To establish evidence-based guidelines for growth monitoring on a population basis. Several auxological referral criteria were formulated and applied to longitudinal growth data from four different patient groups, as well as three samples from the general population. Almost 30% of pathology can be detected by height standard deviation score (HSDS) below -3 or at least two observations of HSDS below -2.5 at a low false-positive rate ( 2 SD in combination with HSDS <-2.0 has the best predictive value. In combination with a rule on severe short stature (<-2.5 SDS) and a minor contribution from a rule on "height deflection", 85.7% of children with Turner syndrome and 76.5% of children who are short because of various disorders are detected at a false-positive rate of 1.5-2%. The proposed guidelines for growth monitoring show high sensitivity at an acceptably low false-positive rate in 3-10-year-old children. Distance to target height is the most important criterion. Below the age of 3 years, the sensitivity is considerably lower. The resulting algorithm appears to be suitable for industrialised countries, but requires further testing in other populations.
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                Author and article information

                Journal
                chc
                Cuadernos Hospital de Clínicas
                Cuad. - Hosp. Clín.
                Universidad Mayor de San Andrés, Facultad de Medicina (La Paz, , Bolivia )
                1562-6776
                2014
                : 55
                : 1
                : 13-23
                Affiliations
                [03] orgnameUMSA orgdiv1Facultad de Medicina
                [02] orgnameUMSA orgdiv1Facultad de Medicina
                [04] orgnameUMSA orgdiv1Facultad de Medicina
                [05] orgnameUMSA orgdiv1IINSAD
                [01] orgnameMédico Cirujano
                Article
                S1652-67762014000100003 S1652-6776(14)05500100003
                28ef8280-0441-47ba-bf41-7d175db7dfd3

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 27, Pages: 11
                Product

                SciELO Bolivia

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                Artículos Originales

                crecimiento lineal,crecimiento ponderal,atención primaria en salud,altitud,short stature,growth delayed,growth curves,linear growth,weight growth,primary health care,altitude,talla baja,retardo en el crecimiento,curvas de crecimiento

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