PediatríaPub Date : 2021-09-01DOI: 10.14295/RP.V54I1.143
Maritza Afanador Cataño, Johana Andrea Betancourt Ramírez, Diego Fernando Suero Pérez, O. Villanueva, Kimberly Prieto
{"title":"¿La lactancia exclusiva es un factor protector en las infecciones respiratorias? Revisión sistemática de la literatura","authors":"Maritza Afanador Cataño, Johana Andrea Betancourt Ramírez, Diego Fernando Suero Pérez, O. Villanueva, Kimberly Prieto","doi":"10.14295/RP.V54I1.143","DOIUrl":"https://doi.org/10.14295/RP.V54I1.143","url":null,"abstract":"Introducción: La lactancia materna (LM) es una práctica milenaria en la mayoría de las culturas y en la mayoría de los animales mamíferos. En este estudio la reconocemos hipotéticamente como un factor protector contra las infecciones respiratorias. Por esa razón, se emprendió una búsqueda científica acerca de la literatura relacionada con sus efectos en la salud respiratoria en menores de 5 años. Se tuvieron en cuenta estudios de todo el mundo, sin restricciones de raza o cultura. Se incluyeron estudios que trataran todo el tracto respiratorio, incluidos la nariz, la garganta y los oídos. Objetivos: Se buscó determinar evidencias de los beneficios de la lactancia materna (LM) y de la lactancia materna exclusiva (LME) en la prevención de enfermedades del tracto respiratorio en niños menores de 5 años. Métodos: Se consultaron las bases de datos Pubmed, Medline, Ovid, BVS, además de los buscadores Scielo y Science Direct. Se identificaron ensayos clínicos aleatorizados que estudiaban el efecto de la lactancia materna y las infecciones respiratorias, los resultados obtenidos fueron 275 estudios, de los cuales cuatro estudios, presentaron bajo riesgo de sesgo y alta calidad metodológica. Conclusiones: La lactancia materna evidentemente previene la aparición de infecciones respiratorias, pero se necesitan más estudios al respecto. Existe controversia entre los estudios respecto a los beneficios, lo cual puede estar relacionado con sesgos de selección y de información.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72724887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PediatríaPub Date : 2021-09-01DOI: 10.14295/RP.V54I1.233
M. Olave, S. Gómez‐Ochoa, Kihara Alejandra Jerez-Torra, Paula Liseth Martínez-González, Diego Felipe Sarmiento-Villamizar, L. Díaz-Martínez, Martha Lucía Africano-León, Mario Augusto Rojas-Devia, L. A. Pérez-Vera
{"title":"Early INSURE Therapy Reduces CPAP Failure in Late Preterm Newborns with Respiratory Distress Syndrome","authors":"M. Olave, S. Gómez‐Ochoa, Kihara Alejandra Jerez-Torra, Paula Liseth Martínez-González, Diego Felipe Sarmiento-Villamizar, L. Díaz-Martínez, Martha Lucía Africano-León, Mario Augusto Rojas-Devia, L. A. Pérez-Vera","doi":"10.14295/RP.V54I1.233","DOIUrl":"https://doi.org/10.14295/RP.V54I1.233","url":null,"abstract":"Background: INSURE (Intubation, Surfactant administration, and Extubation) therapy is controversial in managing respiratory distress syndrome (RDS) in late preterm newborns. This study aims to determine whether the use of the INSURE in late preterm infants with RDS is associated with improved outcomes compared to similar infants managed with CPAP alone. Methods: A retrospective cohort study compared two different neonatal care units with two different treatments of RDS in late preterm infants in Bucaramanga, Colombia. One cohort used selective bubble CPAP and rescue surfactant, the second cohort used selective bubble CPAP and INSURE within the first hour of life. We included all the newborns with gestational age between 33 - 366/7 weeks, born between 2012 to 2017, that developed early RDS and were treated with CPAP. Results: We recruited 208 patients (57 CPAP and rescue surfactant and 151 CPAP + INSURE). Early INSURE was reported in 117 patients (56.3 %). INSURE therapy was associated with a reduced risk of CPAP failure (RR = 0.50; 95 % CI 0.26 - 0.98); this effect was evident only when surfactant was administered within the first two hours of life (RR = 0.29; 95 % CI 0.12 - 0.69). Early INSURE was associated with a decreased risk of pneumothorax (RR = 0.07; 95 % CI 0.01 - 0.77) and pulmonary hypertension (RR = 0.34; 95 % CI 0.14 - 0.78). Conclusions: Early INSURE therapy was associated with a reduced incidence of CPAP failure, pneumothorax, and pulmonary hypertension in late preterm infants with moderate to severe RDS. Large, well-powered randomized controlled trials are needed to confirm these observations, but its use is supported by studies with similar results in more premature infants.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72956837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PediatríaPub Date : 2021-09-01DOI: 10.14295/RP.V54I1.258
María Eugenia Cuastumal Cuastumal, Liliana María Jiménez Zapata
{"title":"Caracterización de quiste tirogloso en pacientes pediátricos","authors":"María Eugenia Cuastumal Cuastumal, Liliana María Jiménez Zapata","doi":"10.14295/RP.V54I1.258","DOIUrl":"https://doi.org/10.14295/RP.V54I1.258","url":null,"abstract":"Introducción: el quiste del conducto tirogloso es una anomalía congénita frecuente en la línea media del cuello, generalmente se manifiesta durante la primera década de la vida, pero puede manifestarse a cualquier edad. Clásicamente se presenta como una masa en la línea media anterior que se mueve con la deglución y la protrusión de la lengua; en ocasiones se presenta de manera atípica lo que puede dificultar el diagnostico. Tiene una tasa de recurrencia del 4% al 50 % aun después de la cirugía electiva de Sistrunk. Objetivo: caracterizar la forma de presentación clínica y el tratamiento de los pacientes pediátricos con diagnostico de quiste tirogloso en una institución pediátrica. Métodos: estudio descriptivo retrospectivo durante el periodo del 2010 - 2020 Resultados: se identificaron 59 pacientes con quiste tirogloso, de los cuales el promedio de edad fue de 5.8 años, el 50.9 % eran del sexo masculino, la localización más frecuente hallada fue en la región medial del cuello 86.4 %, los pacientes principalmente presentaron sensación de masa indolora en esta región en el 74.5 %, secreción 18.6 %, sensibilidad y enrojecimiento 5.1 %, disfagia 1.7 %. La expresión clínica más frecuente de la masa en cuello fue la presencia de quiste tirogloso en el 74.8 % de los casos y el debut con fistula en el 11.6 %. Conclusión: la ecografía de cuello evidencio en un 100 % de los casos el quiste tirogloso y logro ubicar la presencia de glándula tiroides en su sitio habitual en el 88 %, al 20.3 % de los pacientes se les tomo pruebas tiroideas y gammagrafía al 12 % de ellos; se detectó recurrencia en 9 pacientes.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90978060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PediatríaPub Date : 2021-09-01DOI: 10.14295/RP.V54I1.190
Andreina Zannin, L. G. Celis, I. Fernandez, H. Ossa, María Camila López Garzón, S. Mayorga, Luz Ángela Murillo, Paola Zuleta
{"title":"Holoprosencefalia de tipo recesivo en una familia endogámica Colombiana.","authors":"Andreina Zannin, L. G. Celis, I. Fernandez, H. Ossa, María Camila López Garzón, S. Mayorga, Luz Ángela Murillo, Paola Zuleta","doi":"10.14295/RP.V54I1.190","DOIUrl":"https://doi.org/10.14295/RP.V54I1.190","url":null,"abstract":"La holoprosencefalia es una anomalía congénita cerebral compleja resultante de una división incompleta del prosencéfalo, generando una ausencia total o parcial de la separación de los hemisferios cerebrales, manifestándose clínicamente en diferentes malformaciones craneofaciales. \u0000En el presente artículo se presenta el caso de una recién nacida femenina, en quien se realizó una historia clínica y examen físico completo, observándose características fenotípicas principales de esta anomalía congénita al igual que muestras sanguíneas y estudios complementarios. \u0000Esta patología tiene una etiología heterogénea, variada y son pocos los casos relacionados con un herencia autosómica recesiva por lo que es importante apostar por un diagnóstico temprano prenatal y brindar un asesoramiento multidisciplinario y genético dando una adecuada información a los padres.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84819099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PediatríaPub Date : 2021-09-01DOI: 10.14295/rp.v54i1.151
Ricardo Hernandez Sarmiento, Sarah Bastidas Legarda, Sara Aguilera Martínez, Maria Isabel Lozano Jaramillo
{"title":"Pancreatitis necrosante como presentación atípica de fibrosis quística en paciente preescolar","authors":"Ricardo Hernandez Sarmiento, Sarah Bastidas Legarda, Sara Aguilera Martínez, Maria Isabel Lozano Jaramillo","doi":"10.14295/rp.v54i1.151","DOIUrl":"https://doi.org/10.14295/rp.v54i1.151","url":null,"abstract":"Antecedentes: La fibrosis quística es una enfermedad de herencia autosómica recesiva, consistente en mutaciones en el gen regulador de la conductibilidad transmembrana, provocando una alteración en la viscosidad de las secreciones. Reporte de caso: Presentamos el caso de una paciente preescolar que ingresa por un cuadro de dolor abdominal crónico en quien se le diagnosticó pancreatitis necrosante como debut de fibrosis quística, quien requirió cuatro meses de hospitalización. Conclusión: La fibrosis quística es una enfermedad con alta tasa de morbimortalidad en la población pediátrica, por lo que se deben conocer sus posibles formas de debut y su clínica, para un manejo oportuno y seguimiento interdisciplinario.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":"149 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76350691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PediatríaPub Date : 2021-04-16DOI: 10.14295/RP.V53I4.206
Irma Caro Castelar, Sindy Margareth Bermejo Padilla, Osmar Pérez, Victor Barbosa Sarabia, Lady Triviño Barrios
{"title":"Calidad de vida en población pediátrica entre los 7 a 11 años con discapacidad intelectual. Barranquilla 2017–2018.","authors":"Irma Caro Castelar, Sindy Margareth Bermejo Padilla, Osmar Pérez, Victor Barbosa Sarabia, Lady Triviño Barrios","doi":"10.14295/RP.V53I4.206","DOIUrl":"https://doi.org/10.14295/RP.V53I4.206","url":null,"abstract":"Background: Intellectual disability occurs in approximately 3% of the world population, increase in the child population by up to 10%. Intellectual disability requires interdisciplinary intervention in different professional areas, medical, psychological, and educational services. Knowledge about the quality of life in these patients is the cornerstone in reviewing protocols, recommendations, and decision-making to focus on improving their quality of life. Objective: Evaluate the quality of life in children between 7 and 11 years old with intellectual disabilities. Barranquilla, period 2017 - 2018. Materials and Methods: Descriptive, prospective study with survey application; patients between 7 and 11 years of age diagnosed with some degree of intellectual disability, being followed up by neuro pediatric. The KidsLife Scale was applied, designed, and validated to assess children and adolescent's quality of life with intellectual disabilities. Results: The male sex reached the highest frequency of population with 61%, mean age 9.2 ± 1.4 years, 50% had a mild intellectual disability, the distribution by dimensions showed that for social inclusion, 69% had a <50 percentile, in self-determination 51% percentile ≥ 50, in emotional well-being 54% percentile ≥ 50. Conclusions: The quality-of-life index in children between 7 to 11 years of age with an intellectual disability presents lower 50th percentiles in 37%, which that demonstrates a perception of quality of life with some degree of deficiency, denoting itself primarily in the dimensions of self-determination, interpersonal relationships, physical well-being, and personal development.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":"18 1","pages":"138-144"},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80477311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PediatríaPub Date : 2021-04-16DOI: 10.14295/RP.V53I4.205
Daniel Ozaeta, A. Casallas, Leila Martínez, A. Castillo, O. Baquero, O. Cobos
{"title":"Supervivencia de los niños con Leucemia Linfoide Aguda manejados con protocolo Basado en ALL-IC-BFM 2009 en Bogotá D.C. Colombia.","authors":"Daniel Ozaeta, A. Casallas, Leila Martínez, A. Castillo, O. Baquero, O. Cobos","doi":"10.14295/RP.V53I4.205","DOIUrl":"https://doi.org/10.14295/RP.V53I4.205","url":null,"abstract":"Introduction: Acute Lymphoid Leukemia is the most frequent neoplasm in childhood, and therefore, the treatment strategy and access to each of the interventions are defining aspects in the patient's cure. Objectives: To determine the overall and event-free survival of patients with Acute Lymphoid Leukemia treated with a strategy based on the Intercontinental Berlin Frankfurt and Munster Acute Lymphoid Leukemia protocol (ALL-IC-BFM 2009) with a permanent administrative follow-up program to which they are admitted. The patient once the oncological diagnosis is made. To establish the patients' survival according to the assigned risk group and describe the relapse rate in the evaluated group. Methods: 51 patients under 18 years of age diagnosed with Acute Lymphoid Leukemia, treated with the ALL-IC-BFM 2009 strategy, entered the comprehensive care program for cancer patients at the Colsubsidio Children's Clinic, were followed for four years. Observational prospective cohort study with survival analysis. Results: Overall survival for the 4-year cohort was 71.1%, while event-free survival was 69.4%. According to the risk groups, the overall survival was 89%; for the standard risk, it was 85.2% for the intermediate-risk group and 39.8% for the high-risk group. Conclusions: Overall survival behaved as reported in the region; however, the results obtained in standard and intermediate-risk patients exceeded overall survival.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":"8 1","pages":"145-152"},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78690297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PediatríaPub Date : 2021-04-16DOI: 10.14295/RP.V53I4.226
Ana Yibby Forero Torres, Luis Carlos Forero Ballesteros
{"title":"Mediciones de obesidad abdominal como predictores de riesgo metabólico en escolares y adolescentes, Colombia 2018.","authors":"Ana Yibby Forero Torres, Luis Carlos Forero Ballesteros","doi":"10.14295/RP.V53I4.226","DOIUrl":"https://doi.org/10.14295/RP.V53I4.226","url":null,"abstract":"Background: obesity is related to chronic non-communicable diseases in children and adolescents. Obesity is a public health problem that leads to greater morbidity and mortality in adulthood. The risk of suffering complications associated with excess body fat and related factors to lipid and carbohydrate metabolism is known as metabolic risk. Objective: To determine the capacity of the waist-to-height index and the waist circumference to detect the presence of metabolic risk factors compared with the body mass index in a school population from Cundinamarca, Colombia. Methods: a descriptive cross-sectional study in a population aged 6 to 17 years. Anthropometric and biochemical measurements were performed, and total and abdominal obesity were defined. The variables were compared with the Mann-Whitney U test and the statistics. Sensitivity, specificity, and area under the curve analyzes were performed. Results: 35% presented hypercholesterolemia, 32% hypertriglyceridemia and 1.6% hyperglycemia. 12% had a waist-height index equal to or greater than 0.5, while 24% had abdominal obesity due to waist circumference. According to the area under the curve, the body mass index, the waist circumference, and the waist-height index had a low discriminative capacity. For hypercholesterolemia, the highest value was for the waist-height index (0.55). For hypertriglyceridemia, the waist circumference (0.61). Conclusions: The results showed that the waist height index and waist circumference are better predictors of metabolic risk than the body mass index. Also, they constituted simple measures that do not need to be adjusted for sex, age and compared with reference tables.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":"1 2 1","pages":"131-137"},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83637375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PediatríaPub Date : 2021-04-16DOI: 10.14295/RP.V53I4.210
Monica Paola Gutierrez Gaitan, A. Montoya, Javier-Yesid Pinzón-Salamanca, Monica Cediel Echeverri, José Miguel Suescún-Vargas
{"title":"Quiste aracnoideo gigante ¿Debe el pediatra alarmarse? a propósito de un caso asociado hemorragia intraquística espontánea.","authors":"Monica Paola Gutierrez Gaitan, A. Montoya, Javier-Yesid Pinzón-Salamanca, Monica Cediel Echeverri, José Miguel Suescún-Vargas","doi":"10.14295/RP.V53I4.210","DOIUrl":"https://doi.org/10.14295/RP.V53I4.210","url":null,"abstract":"Background: Arachnoid cysts are benign unilocular masses composed of a collagenous membrane, lined by arachnoid cells, with cerebrospinal fluid. Case report: We present the case of a 9-year-old boy with headache, nausea, and vomiting, with a subsequent diagnosis of a giant arachnoid cyst parietal-temporal-left frontal, with a deviation of the midline to the right, with spontaneous intracystic hemorrhage documented by neuroimaging (brain magnetic resonance imaging without contrast), without behavioral changes, seizures, or deficits in neurological status. A surgical approach was performed with craniotomy and drainage of a subdural blood collection that compressed the adjacent parenchyma with suspected cerebrospinal fluid fistula without signs of intracranial hypertension. Conclusions: Currently, the incidence of arachnoid cysts has increased in pediatric patients, being evident from the third trimester of gestation, with a high prevalence in men and the left hemisphere. A pediatric clinical approach is performed for a convenient approach.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":"7 1","pages":"158-161"},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72657903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PediatríaPub Date : 2020-09-30DOI: 10.14295/RP.V53I3.212
Lizeth Marín Gómez, Juan Salazar
{"title":"Enfisema lobar congénito","authors":"Lizeth Marín Gómez, Juan Salazar","doi":"10.14295/RP.V53I3.212","DOIUrl":"https://doi.org/10.14295/RP.V53I3.212","url":null,"abstract":"Congenital lobar emphysema is a rare lung malformation characterized by hyperinflation ofthe lung lobe affected; 50% of patients present symptoms at birth, which can be confused with other entities such as respiratory infections, atelectasis, pneumothorax, among others. Chest radiography is useful for diagnosis; however, a chest tomography is necessary to differentiate it from other malformations. In most cases, the treatment of choice is a lobectomy, and pneumothorax the most frequent complication. We present an 18-day old patient with symptoms of acute respiratory infection and ventilatory failure, diagnosed with congenital lobar emphysema, who underwent lobectomy.Respiratory symptoms may be the first manifestation of congenital lobar emphysema. Its clinical and radiological suspicion can carry out an early diagnosis, avoiding confusion with other entities such as atelectasis and cystic adenomatous malformation.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":"228 1","pages":"107-110"},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80195417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}