Seguimiento médico de los niños con síndrome de Down

Arizmendi, Karla Adney Flores; Robledo, Tania Tonantzin Vargas; Díaz, Gabriela Eguiarte; Puente, Lidia del Carmen Gómez

doi:10.18233/apm42no3pp142-1482176

Cited by 4 publications

(5 citation statements)

References 19 publications

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“…There is a lack of conclusive evidence regarding the influence of cardiovascular risk factors on the incidence of cardiovascular events in DS individuals. Current health guidelines for DS mainly emphasise BMI monitoring and obesity prevention through educational efforts; however, the recommendation for periodic monitoring of the lipid profile is not indicated (Lizama et al 2013;Flores et al 2021;Michael & Marder 2021;Bull et al 2022;Dalrymple et al 2022). Furthermore, despite the recently development of guidelines aimed to the adult DS population (Tsou et al, 2020), which had been previously focused to a greater extent on paediatric population, strong recommendations for the assessment and monitoring of serum lipid levels remain unclear given the scarcity of robust evidence needed to support them.…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta‐analysis of serum lipid concentrations in people with Down syndrome

Gastelum Guerrero,

Cháidez Fernández,

Magaña Ordorica

et al. 2024

J intellect Disabil Res

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BackgroundDown syndrome (DS) is the most prevalent chromosomal disorder, being the leading cause of intellectual disability. The increased life expectancy of individuals with DS has led to a shift in the incidence of non‐communicable chronic diseases, resulting in new concerns, particularly cardiovascular disease (CVD) and Alzheimer's disease. This study aimed to analyse the blood lipid profile of a large DS cohort to establish a baseline for evaluating health risk parameters.MethodsA comprehensive literature search was conducted on PubMed and Virtual Health Library databases to identify original articles published before July 2022. Selected studies were included in the meta‐analysis.ResultsFifteen studies reporting serum lipid levels in individuals with DS were incorporated into the analysis. The meta‐analysis used the means and standard deviations extracted from the selected studies. The analysis encompassed 671 participants in the DS group and 898 euploid controls. The results indicated significant differences in total cholesterol [C] (mean difference [MD]: −3.34; CI: 95%: −4.94 to −1.73; P < 0.0001), HDL‐C (MD: −3.39; CI: 95%: −6.72 to −0.06; P = 0.05) and triglycerides (MD: 21.48; CI: 95%: 9.32 to 33.65; P = 0.0005) levels between individuals with DS and their control counterparts.ConclusionsIndividuals with DS have less favourable blood lipid concentrations than their controls, particularly HDL‐C, triglycerides, and total‐C, even when grouped by age. These findings underscore the importance of closer monitoring of lipid profiles in people with DS and the necessity for specific cut‐offs for this population, considering the risk for ischemic heart and Alzheimer's diseases.

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Section: Discussionmentioning

confidence: 99%

A systematic review and meta‐analysis of serum lipid concentrations in people with Down syndrome

Gastelum Guerrero,

Cháidez Fernández,

Magaña Ordorica

et al. 2024

J intellect Disabil Res

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“…11,27,46 Future directions include creating a standard workflow to screen, diagnose, and treat oSDB in patients with TS, similar to well-established clinical care guidelines for other syndromes, such as Trisomy 21 and PWS. 15,47…”

Section: Discussionmentioning

confidence: 99%

“…Clinicians should have a low threshold to refer to pediatric otolaryngology and obtain a PSG for girls with TS who have oSDB symptoms and pre‐existing conditions that have been previously linked to worsen and/or contribute to oSDB 11,27,46 . Future directions include creating a standard workflow to screen, diagnose, and treat oSDB in patients with TS, similar to well‐established clinical care guidelines for other syndromes, such as Trisomy 21 and PWS 15,47 …”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Obstructive Sleep‐Disordered Breathing in Pediatric Patients With Turner Syndrome

Pham,

Davis,

Tong

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveGirls with Turner syndrome (TS) often have features that have been associated with obstructive sleep‐disordered breathing (oSDB). However, little is known about oSDB in TS. Herein, we aimed to characterize oSDB in young patients with TS and identify associated risk factors.Study DesignRetrospective cross‐sectional study.SettingTertiary care pediatric hospital.MethodsWe reviewed medical records for patients diagnosed with TS seen at our institution between October 1, 2007 and December 31, 2019 with the first outpatient visit before age 6 years. The prevalence of oSDB was compared to the general pediatric population with 1‐sample binomial proportion tests. Clinical characteristics were compared between those diagnosed with oSDB and those without oSDB, and risk factors for oSDB were identified.ResultsOf 151 patients with TS, 73 (48%) were diagnosed with oSDB which is 4‐fold higher than the general pediatric population (12%, P < 0.0001). In the multivariable model, adenoid, tonsillar, and inferior turbinate hypertrophy, birthweight, failure to thrive, and older age at the last clinic visit were all associated with increased odds for oSDB.ConclusionYoung children with TS have a high prevalence of oSDB and thus should be screened for oSDB. Polysomnography should be performed in those with associated risk factors and symptoms oSDB. Treatment of oSDB is imperative as individuals with TS are already at increased risk of behavioral problems, neurocognitive deficits, and growth impairment that may be worsened with oSDB.

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“…Children with T21 are at a higher risk of developing OSA compared to the general population, with a prevalence of 40%-80%, compared to the 1%-4% prevalence rate in healthy children. 3,16,26 In fact, all children with T21 are recommended to undergo polysomnography screening for OSA as per the American Academy of Pediatrics, 27 as even asymptomatic children have evidence of sleep apnea when tested with polysomnography. 3,5 With such high prevalence of OSA, many children with T21 undergo adenotonsillectomy as the first-line treatment for their OSA.…”

Section: Discussionmentioning

confidence: 99%

Intracapsular Versus Total Tonsillectomy in Patients with Trisomy 21

Timashpolsky,

Aggarwal,

Ruiz

et al. 2023

The Laryngoscope

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ObjectivesIntracapsular tonsillectomy and adenoidectomy (iTA) has become a popular alternative to extracapsular tonsillectomy and adenoidectomy (TT) for the treatment of pediatric obstructive sleep apnea (OSA) due to improved recovery and fewer complications. The objective of this study was to compare surgical recovery and impact on OSA of iTA versus TT in patients with Trisomy 21 (T21).MethodsThis is a case series with chart review of all T21 patients who underwent iTA or TT at our institution between July 1, 2015 and August 15, 2022. Data collected included demographics, comorbidities, preoperative sleep studies, intraoperative data, complications and recovery, postoperative sleep studies, and follow‐up data.ResultsThere were 62 (21.7%) patients who underwent iTA and 224 (78.3%) patients who underwent TT. The iTA group had significantly lower pain scores (p < 0.001), decreased use of narcotics (p < 0.001), shorter length of stay (p = 0.003), and faster return to oral intake (p = 0.01) during their postoperative hospital admission, and fewer 30‐day complications (p = 0.009) compared to the TA group. Both groups showed significant improvements in their sleep studies. For 41 (66.1%) of iTA patients who had follow‐up, median follow‐up was 1.8 years and for 169 (75.4%) TT patients, median follow‐up was 2.6 years. At follow‐up, 21 of 41 (51.2%) iTA patients and 83 of 169 (49.1%) TT patients exhibited OSA symptoms (p = 0.084) and tonsillar regrowth was not significantly different between the two groups (p = 0.12).ConclusionPatients with T21 experience less pain and fewer postoperative respiratory complications from iTA than from TT. The short‐term impact of iTA versus TT on OSA, as measured by poysomnography, does not differ between the two techniques.Level of EvidenceIII Laryngoscope, 2023

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Seguimiento médico de los niños con síndrome de Down

Cited by 4 publications

References 19 publications

A systematic review and meta‐analysis of serum lipid concentrations in people with Down syndrome

A systematic review and meta‐analysis of serum lipid concentrations in people with Down syndrome

High Prevalence of Obstructive Sleep‐Disordered Breathing in Pediatric Patients With Turner Syndrome

Intracapsular Versus Total Tonsillectomy in Patients with Trisomy 21

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