Anales de pediatria最新文献

{"title":"¿Qué funciona en primeros auxilios para escolares? El impacto de metodologías y recursos docentes innovadores en escolares de 3 a 12 años: una revisión sistemática y metaanálisis","authors":"Santiago Martínez-Isasi,&nbsp;Carlos Berlanga-Macías,&nbsp;José Alberto Martínez-Hortelano,&nbsp;Lidia Lucas-de la Cruz,&nbsp;Montserrat Solera-Martínez,&nbsp;Cristina Jorge-Soto","doi":"10.1016/j.anpedi.2026.504342","DOIUrl":"10.1016/j.anpedi.2026.504342","url":null,"abstract":"<div><h3>Introduction</h3><div>The lack of evidence, which would serve as a structure for a legal framework for the implementation of first aid (FA) training in the school setting, justifies this systematic review. The aim was to analyze the effectiveness of learning methods in improving FA knowledge and skills in children aged 3 to 12<!--> <!-->years.</div></div><div><h3>Patients and methods</h3><div>Systematic review and meta-analysis. A literature search was conducted in MEDLINE, EMBASE and Web of Science. The risk of bias was assessed through the Cochrane and Joanna Briggs Institute tools. The probability of acquiring knowledge in each of the outcomes was analyzed through relative risks, which were calculated for each different type of training methodology as an estimate of effect size (ES). We used the DerSimonian and Laird random-effects method to calculate pooled ES estimates with the corresponding 95% confidence intervals (CI).</div></div><div><h3>Results</h3><div>Six studies, with 1038 schoolchildren from 5 to 12<!--> <!-->years, were included. The targeted knowledge areas included emergency recognition and call, quality of cardiopulmonary resuscitation, foreign body airway obstruction, injury, or bleeding. The ES for innovative training on emergency call (correct information), compared to control group, was 1.28 (95%<!--> <!-->CI: 1.10-1.47). On emergency call, compared to traditional training, it was 1.18 (95%<!--> <!-->CI: 1.08-1.28).</div></div><div><h3>Conclusions</h3><div>Innovative methodologies appeared to be equally or more effective than traditional training in teaching FA to schoolchildren aged 3 to 12<!--> <!-->years, especially with age-appropriate resources. Still, the heterogeneity of the applied methodologies and the lack of robust evidence call for further studies which could elucidate the identified gaps in knowledge.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"105 4","pages":"Article 504342"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eficacia de las estrategias terapéuticas de segunda línea en los pacientes con osteomielitis crónica no bacteriana: revisión sistemática","authors":"Ana Isabel Turrión Nieves,&nbsp;Cristina Sobrino Garijo,&nbsp;Belén Miguel Ibañez,&nbsp;Rafael Martín Holguera","doi":"10.1016/j.anpedi.2026.504350","DOIUrl":"10.1016/j.anpedi.2026.504350","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and safety of second-line therapies in pediatric patients with chronic nonbacterial osteomyelitis (CNO) that responded poorly to nonsteroidal anti-inflammatory drugs (NSAIDs)</div></div><div><h3>Methods</h3><div>A systematic review of observational studies, cohort studies, and case series (n<!--> <!-->=<!--> <!-->13) involving patients aged less than 15 years with a diagnosis of CNO. We analyzed clinical and radiological remission rates, safety profiles, and the incidence of adverse events for the different therapeutic regimens.</div></div><div><h3>Results</h3><div>The efficacy of NSAIDs in monotherapy was limited (18-57%). Among second-line therapies, bisphosphonates (particularly pamidronate) and tumor necrosis factor-α inhibitors (TNF inhibitors) achieved the highest response rates, with remission levels between 70% and 91%. Pamidronate proved highly effective for spinal lesions, achieving rapid pain resolution. TNF inhibitors were particularly effective in refractory cases and for the prevention of long-term relapses. The efficacy of disease-modifying antirheumatic drugs (DMARDs) was lower and inconsistent (12-50%). No seriou adverse effects were reported; the most frequent event was flu-like syndrome following the first pamidronate infusion.</div></div><div><h3>Conclusions</h3><div>Bisphosphonates and TNF inhibitors constitute the most effective and safe second-line strategies for the treatment of refractory CNO. Early diagnosis and appropriate therapeutic scaling are essential to achieve complete remission and prevent permanent bone sequelae, such as spinal fractures or deformities.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"105 4","pages":"Article 504350"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pinzamiento diferido del cordón umbilical y fracción inspiratoria de oxígeno en el paciente prematuro: implicaciones en la estabilización posnatal","authors":"Nerea Valles-Murcia,&nbsp;Laura Torrejón-Rodriguez,&nbsp;Alba Cayuela-Hernández,&nbsp;Raquel Escrig,&nbsp;Alba González-Timoneda,&nbsp;Máximo Vento,&nbsp;Álvaro Solaz-García","doi":"10.1016/j.anpedi.2026.504343","DOIUrl":"10.1016/j.anpedi.2026.504343","url":null,"abstract":"<div><div>The transition to extrauterine life involves profound respiratory and hemodynamic changes that enable the shift from transplacental to pulmonary gas exchange and the conversion of fetal circulation to neonatal circulation. In recent years, important modifications have been introduced in delivery room stabilization strategies, particularly regarding umbilical cord management and the initial fraction of inspired oxygen (FiO₂) in preterm infants. The aim of this review is to analyze the available evidence on delayed umbilical cord clamping, ventilation with an intact umbilical cord, and initial oxygen strategies during postnatal stabilization. We performed a narrative review of the recent scientific literature, including experimental studies, clinical trials, and meta-analyses evaluating the impact of these interventions in term and preterm newborns during early neonatal transition. Delayed cord clamping allows additional placental transfusion, increasing the circulating blood volume, improving ventricular preload, and promoting a more stable cardiovascular transition. These effects are associated with earlier stabilization of heart rate and oxygen saturation, as well as reduced supplemental oxygen requirements. Ventilation with an intact umbilical cord allows initiation of respiration while maintaining placental hemodynamic support, facilitating a more gradual cardiorespiratory transition. In addition, recent evidence suggests that initial FiO₂ levels above 0.30 may facilitate achieving the target oxygen saturation in the first minutes of life, particularly in extremely preterm infants.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"105 4","pages":"Article 504343"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiología pediátrica: innovar también significa evitar irradiar","authors":"Santiago González Martínez,&nbsp;Jordi Delás","doi":"10.1016/j.anpedi.2026.504311","DOIUrl":"10.1016/j.anpedi.2026.504311","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"105 4","pages":"Article 504311"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intoxicaciones no intencionadas por productos del hogar en los servicios de urgencias pediátricas en España","authors":"Johanna Ramírez-Romero,&nbsp;Beatriz Azkunaga,&nbsp;Santiago Mintegi,&nbsp;Grupo de Trabajo de Intoxicaciones de la Sociedad Española de Urgencias Pediátricas","doi":"10.1016/j.anpedi.2026.504337","DOIUrl":"10.1016/j.anpedi.2026.504337","url":null,"abstract":"<div><h3>Introduction</h3><div>Household products are a frequent cause of unintentional poisoning in children under 7 years of age. However, very few studies analyze their characteristics. The objective of our study was to analyze the typology, epidemiology, interventions, and outcomes of cases of unintentional poisoning by household products managed in pediatric emergency departments (PEDs) in Spain.</div></div><div><h3>Methods</h3><div>Observational study based on the prospective registry of the Toxicology Observatory of the Poisoning Working Group of the Spanish Society of Pediatric Emergency Medicine (SEUP), including 58 PEDs. We analyzed cases registered between 2008 and 2025.</div></div><div><h3>Results</h3><div>Of the 3900 registered poisonings, 726 (18.6%) corresponded to unintentional ingestion of household products in children under 7 years of age. The median age was 24 months (interquartile range, 16-35), 57% were male, and 94% of the episodes occurred at home, primarily in the kitchen (318 cases; 74.6%). Household products were the main group of toxic substances involved in children aged 12 to 20 months. Caustics were the most frequently involved type of product (214 cases [29.5%]; bleach was the most frequent individual agent, involved in 159 cases [21.9%]), and poisoning by caustic substances was significantly associated with storage in nonoriginal containers and within reach of children, as well as with a higher proportion of symptoms, additional tests, and endoscopies. No patients died. Esophageal caustic burns were documented in 6 patients (0.82%), all of them after ingestion of caustics (2.8% of this group).</div></div><div><h3>Conclusions</h3><div>Unintentional ingestion of household products is the leading cause of poisoning in children aged 12 to 20 months managed in Spanish emergency departments. The implementation of effective prevention strategies, especially regarding caustic substances, is urgently needed.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"105 4","pages":"Article 504337"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vacunación antigripal en la infancia y adolescencia: evaluación de la campaña 2025-2026 en España y estrategias de mejora. Informe AEV, CAV-AEP y SEIP","authors":"Javier Alvarez Aldeán,&nbsp;Francisco José Alvarez García,&nbsp;Fernando Baquero Artigao,&nbsp;Marta Cruz Cañete,&nbsp;María Fernández Prada,&nbsp;Laura Francisco González,&nbsp;Ana María Grande Tejada,&nbsp;Antonio Iofrío de Arce,&nbsp;Alejandra Méndez Sánchez,&nbsp;Fernando Moraga Llop,&nbsp;Ignacio Salamanca de la Cueva,&nbsp;en representación del Comité Asesor de Vacunas e Inmunizaciones de la Asociación Española de Pediatría (CAV-AEP), la Sociedad Española de Infectología Pediátrica (SEIP) y la Asociación Española de Vacunología (AEV)","doi":"10.1016/j.anpedi.2026.504373","DOIUrl":"10.1016/j.anpedi.2026.504373","url":null,"abstract":"<div><div>Seasonal influenza represents a significant burden in childhood. This article analyzes pediatric influenza vaccination during the 2025-2026 campaign, as well as epidemiological, effectiveness, and preliminary vaccination coverage data. Routine vaccination against influenza between ages 6 and 59<!--> <!-->months, as well as the extension of the recommendation up to 17<!--> <!-->years, as outlined in the 2025 AEV, CAV-AEP, and SEIP consensus document, is key to individual and collective protection. We propose advancing further in developing effective strategies to continue increasing vaccination coverage, as well as expanding the age range for vaccination, as has already been implemented in some autonomous communities in 2025-2026.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"105 4","pages":"Article 504373"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¿Es momento de reconsiderar la intubación sistemática en la hernia diafragmática congénita leve?","authors":"Jorge L. Alvarado Socarras,&nbsp;Delia Theurel Martin","doi":"10.1016/j.anpedi.2026.504334","DOIUrl":"10.1016/j.anpedi.2026.504334","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"105 4","pages":"Article 504334"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diferencias analíticas en pacientes con PFAPA durante un brote frente a estado asintomático, más allá de los reactantes de fase aguda. Un estudio multicéntrico de muestras emparejadas","authors":"Mara Rodríguez Ortiz,&nbsp;Sara Murias Loza,&nbsp;María Garrido Martín,&nbsp;Clara Udaondo Gascón,&nbsp;Julián Rodríguez Suárez","doi":"10.1016/j.anpedi.2026.504349","DOIUrl":"10.1016/j.anpedi.2026.504349","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"105 4","pages":"Article 504349"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventilación mecánica neonatal","authors":"Marta Aguar Carrascosa,&nbsp;Jordi Clotet Caba,&nbsp;Ana Concheiro Guisan,&nbsp;José María Garrido Pedraz,&nbsp;Noelia González Pacheco,&nbsp;Sonia Lareu Vidal,&nbsp;Marta Costa Romero","doi":"10.1016/j.anpedi.2026.504319","DOIUrl":"10.1016/j.anpedi.2026.504319","url":null,"abstract":"<div><div>Neonatal mechanical ventilation is a cornerstone in the management of respiratory failure in newborns (NBs), particularly in preterm infants, in whom pulmonary and neurologic increases their vulnerability to ventilation-induced lung injury. At present, the primary objective of respiratory support is to ensure adequate ventilation while minimizing lung and brain injury through lung-protective strategies and careful oxygen titration.</div><div>Noninvasive ventilation (NIV) is currently the first-line approach for both initial respiratory support and post-extubation care, as it reduces the need for invasive ventilation and the incidence of ventilator-induced lung injury. Multiple modalities and devices are available, and their selection should be individualized according to the underlying disease, gestational age, and clinical response. The selection of the appropriate interface and ventilatory settings and patient-ventilator synchronization are of utmost importance. Noninvasive ventilation failure should be preceded by systematic optimization and requires well-defined criteria for timely therapeutic escalation.</div><div>Conventional mechanical ventilation continues to be necessary in more severe cases. Its use should be synchronized and volume-targeted whenever possible, as this strategy has been shown to reduce major complications such as pneumothorax, intraventricular hemorrhage, and the composite outcome of death or bronchopulmonary dysplasia. High-frequency oscillatory ventilation serves as a rescue strategy in refractory cases and selected clinical condition, relying on the maintenance of lung recruitment with extremely low tidal volumes.</div><div>Finally, ventilatory management of the most common neonatal respiratory conditions—such as respiratory distress syndrome, meconium aspiration syndrome, air leak syndrome, and bronchopulmonary dysplasia—requires a dynamic, individualized approach focused on lung protection from the earliest hours of life.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"105 4","pages":"Article 504319"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estado nutricional y habilidades de alimentación en niños españoles con parálisis cerebral: estudio observacional","authors":"Víctor Manuel Navas-López,&nbsp;Marta Herrador-López,&nbsp;Ramón Cancho Candela,&nbsp;José Luis Peña Segura,&nbsp;Ruth García Romero,&nbsp;Juan José Díaz Martín,&nbsp;miembros del Grupo de Trabajo Multidisciplinar de Parálisis Cerebral Pediátrica","doi":"10.1016/j.anpedi.2026.504368","DOIUrl":"10.1016/j.anpedi.2026.504368","url":null,"abstract":"<div><h3>Objectives</h3><div>Cerebral palsy (CP) often causes motor impairment and comorbidities, including gastrointestinal problems that contribute to undernutrition. This study characterizes feeding capabilities and nutritional needs in Spanish children with CP.</div></div><div><h3>Methods</h3><div>We conducted a multicenter observational study in 10 Spanish hospitals in pediatric patients (4-14 years) with CP classified according to Gross Motor Function Classification System (GMFCS) level. We collected data on sociodemographic, anthropometric, and nutritional variables. We used the Eating and Drinking Ability Classification System (EDACS) to assess feeding and drinking dysfunction, and the Structured Satisfaction with Gastrostomy Feeding (SAGA-8) questionnaire to assess caregiver satisfaction.</div></div><div><h3>Results</h3><div>A total of 112 patients (median age, 9 years; IQR, 7-11 years) were included; 70.5% had GMFCS levels IV-V. Most patients (77.7%) received oral feeding, and oral nutritional supplementation increased with GMFCS severity. The EDACS distribution differed significantly in relation to the GMFCS level, as did the total energy intake, energy expenditure, and daily protein and fat intakes. The dietary intake of vitamin D and selenium and the serum vitamin B12 concentration also differed significantly by GMFCS level. Approximately 80% of caregivers reported high satisfaction with gastrostomy feeding (SAGA-8).</div></div><div><h3>Conclusion</h3><div>Children with CP differ in feeding ability, energy expenditure, and macronutrient and micronutrient intake in relation to the GMFCS level. Caregivers perceive gastrostomy as a helpful and satisfactory nutritional support strategy.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"105 4","pages":"Article 504368"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}