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Síndrome de Prader-Willi. Abordaje multidisciplinar de la obesidad

que ser conscientes de que no será sólo la formación que la enfermera aporte la que asegurará la salud de los escolares.

El verdadero tratamiento transversal tiene lugar cuando todas o gran parte de las áreas de conocimiento contribuyen al desarrollo de los contenidos de salud. Para ello se exige la colaboración del equipo docente, pero no basta con profesores preparados, se requiere la colaboración de otros profesionales sanitarios, psicólogos o enfermeros (entre otros), que colaboren con los docentes en todo lo que se refiere a conductas saludables, puesto que una sociedad sana, no está basada en la curación, sino en la prevención. Todos ellos tienen el fin de alcanzar un amplio objetivo: que los alumnos sean considerados agentes activos de salud, que exporten las actividades del aula fuera del Centro, fomentando la coordinación con otras instituciones.

Referencias bibliográficas

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2. Holm, V.A.; Cassidy, S.B.; Butler, M.G.; Hanchett, J.M.; Greenswag, L.R.; Whitman, B.Y., et al.. Prader-Willi syndrome: Consensus diagnostic criteria. Pediatrics. 1993; 91:398–402.

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4. Butler, M.G.; Bittel, D.C.; Kibiryeva, N.; Talebizadeh, Z. y Thompson, T. Behavioral differences among subjects with Prader-Willi syndrome and type i or type ii deletion and maternal disomy. Pediatrics 2004; 113:565–73.

5. Christian, S.L.; Fantes, J.A.; Mewborn S.K.; Huang, B.; Ledbetter D.H. Large genomic duplicons map to sites of instability in the Prader-Willi/Angelman syndrome chromosome region (15q11-q13). Hum Mol Genet. 1999; 8:1025–37.

6. Purvis-Smith, S.G.; Saville, T.; Manass, S.; Yip, M.Y.; Lam-Po-Tang, P.R.; Duffy, B., et al.. Uniparental disomy 15 resulting from )correction* of an initial trisomy 15. Am J Hum Genet. 1992; 50:1348–50.

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9. Zipf, W.B.; Berntson, G.G.. Characteristics of abnormal food-intake patterns in children with Prader-Willi syndrome and study of effects of naloxone. Am J Clin Nutr 1987; 46:277-81.

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14. Swaab, D.F.; Purba, J.S.; Hofman, M.A. Alterations in the hypo¬thalamic paraventricular nucleus and its oxitocin neurones (putative satiety cells) in Prader-Willi syndrome. A study of five cases. J Clin Endocrinol Metab 1995; 80: 573-79.

15. Swaab, D.F. Prader-Willi syndrome and the hypothalamus. Acta Pediatr Suppl 1997; 423: 50-4.

16. Goldstone, A.P.; Unmehopa, U.A.; Thomas, E.L.; Brynes, A.E.; Bell, J.D.; Frost, G.; Ghatei, M.A.; Holland, A.; Bloom, S.R.; Saab, D.F. Hypothalamic neuropeptides and regulation of fat mass in Prader-Willi syndrome. En: Eiholzer U, L’Allemand D, Zipf WB (eds.). Prader-Willi syndrome as a model for obesity. Zú-rich: Karger; 2002. p. 31-43.

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18. Wagstaff, J.; Knoll, J.H.; Fleming, J.; Kirkness, E.F.; Martin-Gallar¬do, A.; Greenberg, F.; Graham, J.M.; Menninger, J.; Ward, D.; Venter, J.C.; Lalande, M. Localization of gene encoding the GABA-A receptor beta-3 subunit to the Angelman/Prader-Willi region of human chromosome 15. Am J Hum Genet 1991; 49: 330-7.

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21. Feigerlová, E.; Diene, G.; Conte-Auriol, F.; Molinas, C.; Gennero, I.; Salles, J.P.; Arnaud, C.; Tauber, M. Hyperghrelinemia precedes obesity in Prader-Willi syndrome. J Clin Endocrinol Metab 2008; 93: 2800-05.

22. Goldstone, A.P.; Brynes, A.E.; Thomas, E.L.; Bell, J.D.; Frost, G.; Ho¬lland, A.; Ghatei, M.A.; Blom, S.R. Resting metabolic rate, plasma leptin concentrations, leptin receptor expression, and adipose tissue measured by whole-body magnetic resonance imaging in women with Prader-Willi syndrome. Am J Clin Nutr 2002; 75: 468-75.

23. Zipf, W.B.; Odorisio, T.M..; Cataland, S.; Dixon, K. Pancreatic po¬lypeptide responses to protein meal challenges in obese but otherwise normal children and obese children with Prader-Willi syndrome. J Clin Endocrinol Metab 1983; 57: 1074-80.

24. Tomita, T.; Greeley, G.; Watt, L.; Doull, V.; Chance, R. Protein meal-stimulated pancreatic polypeptide secretion in Prader-Willi syndrome of adults. Pancreas 1989; 4: 395-400.

25. Zipf, W.B.; O’Dorisio, T.M.; Cataland, S.; Sotos, J. Blunted pan¬creatic polypeptide responses in children with obesity of Prader-Willi syndrome. J Clin Endocrinol Metab 1981; 52: 1264-6.

26. Guerra, C. E.; Cabrera, A. C.; Santana, I.; González, A.E.; Almaguer, P.; Urra, T. Manejo práctico del sobrepeso y la obesidad en