Anales de pediatria最新文献

{"title":"La salud de los niños y la Ley Trans","authors":"Ángel Hernández Merino","doi":"10.1016/j.anpedi.2025.503901","DOIUrl":"10.1016/j.anpedi.2025.503901","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503901"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valoración del dolor en pacientes menores con disfunción cognitiva: adaptación y validación de la escala r-FLACC","authors":"Débora Sierra-Núñez ,&nbsp;Alejandro Bosch-Alcaraz ,&nbsp;María Auxiliadora Flores Ordóñez ,&nbsp;M. Mercedes Nebra Muñoz ,&nbsp;Anna García Merino ,&nbsp;Erika González Lucena ,&nbsp;Esperanza Zuriguel-Pérez","doi":"10.1016/j.anpedi.2025.503898","DOIUrl":"10.1016/j.anpedi.2025.503898","url":null,"abstract":"<div><h3>Introduction</h3><div>Minors with cognitive dysfunction are at increased risk for pain and inadequate pain management. Pain assessment in children with cognitive and verbal dysfunction should be performed using specific behavioral scales. The main objective of this study was the translation and adaptation to Spanish of the revised Face, Legs, Activity, Cry and Consolability (r-FLACC) scale, one of the best-rated scales for assessing pain in children with cognitive dysfunction, followed by its validation.</div></div><div><h3>Patients and methods</h3><div>We carried out a prospective, observational and psychometric study in three phases: translation and adaptation, content validity analysis using mixed methods, and analysis of the psychometric properties of the Spanish version of the r-FLACC scale.</div></div><div><h3>Results</h3><div>We obtained an overall content validity index of 0.99, supported by qualitative data obtained in a focus group of patients’ relatives. The internal consistency of the Spanish version was demonstrated by a Cronbach α of 0.876 and a McDonald omega of 0.880; and the interobserver agreement by a concordance correlation coefficient of 0.933. The r-FLACC scale exhibited the capacity to detect changes in pain severity after pharmacological intervention, with <em>P</em> <!-->&lt;<!--> <!-->0.001 in the Wilcoxon test.</div></div><div><h3>Conclusions</h3><div>The Spanish version of the r-FLACC scale proved to be a valid and reliable instrument for assessing pain intensity in children with cognitive dysfunction, thus providing professionals a tool that had not been available in our area and contributing to improving the scientific evidence available on the subject.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503898"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¿Por qué los pediatras debemos ser también científicos?","authors":"Alejandro Avila-Alvarez","doi":"10.1016/j.anpedi.2025.503882","DOIUrl":"10.1016/j.anpedi.2025.503882","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503882"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hiperplasia de células neuroendocrinas de la infancia: descripción de 6 casos","authors":"Laura Gil Blanco ,&nbsp;Alicia Hernando Larroy ,&nbsp;Javier Sainz García ,&nbsp;Carlos Martín de Vicente","doi":"10.1016/j.anpedi.2025.503904","DOIUrl":"10.1016/j.anpedi.2025.503904","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503904"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¿Existe un componente biológico en la identidad de género?","authors":"Natalia S. Fernández ,&nbsp;Rosa Fernández ,&nbsp;Marcelino Gómez-Balaguer ,&nbsp;Mireia Mora ,&nbsp;Julio Guerrero-Fernández ,&nbsp;Amadora Moral-Martos","doi":"10.1016/j.anpedi.2025.503883","DOIUrl":"10.1016/j.anpedi.2025.503883","url":null,"abstract":"<div><h3>Introduction</h3><div>Gender identity is each person's internal sense of being a woman, a man, both, neither, or anywhere along the gender spectrum, which may (cisgender) or may not (transgender) coincide with the sex assigned at birth. The multiple difficulties experienced by transgender individuals constitutes a risk factor for mood disorders and self-harming behaviors. However, knowledge about biological influences on gender identity development has the potential to reduce the stigmatization of gender minorities.</div></div><div><h3>Materials and methods</h3><div>We conducted a literature review of the available literature on the biological basis of gender identity, summarizing the main scientific evidence in the field in addition to its limitations.</div></div><div><h3>Results</h3><div>A growing body of research supports that the broad spectrum that characterizes gender identity constitutes a multifactorial trait with a heritable component. At the neuroanatomical level, this model translates to the high variability observed in the degree of masculinization/feminization of different features within a single brain, with considerable overlap between different gender identities at the individual level. Hence, neither genetic variants nor neuroanatomic measures can be used to identify or predict an individual's gender identity.</div></div><div><h3>Conclusion</h3><div>The evolutionary advantage of sexual reproduction lies in the huge increase in variation produced among individuals. The continuous distribution of gender identities in the population appears to be just one more aspect of sexual reproduction as a source of variability.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503883"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigación pediátrica en España: desafíos y oportunidades","authors":"Laura Moreno-Galarraga ,&nbsp;César García Vera ,&nbsp;Irene Rivero-Calle ,&nbsp;Federico Martinón-Torres ,&nbsp;Ignacio Díez López ,&nbsp;Fernando Cabañas ,&nbsp;Cristina Calvo ,&nbsp;en nombre de la Plataforma INVEST-AEP","doi":"10.1016/j.anpedi.2025.503854","DOIUrl":"10.1016/j.anpedi.2025.503854","url":null,"abstract":"<div><h3>Introduction</h3><div>Pediatric research is key for improving the diagnosis, treatment and prevention of childhood diseases. In Spain, however, this vital area of research remains underfunded and underrepresented compared to both domestic research in the adult population and pediatric research in other countries.</div></div><div><h3>Objective</h3><div>To identify the main barriers to pediatric research in Spain and propose strategies to strengthen its development and integration into the public healthcare system.</div></div><div><h3>Methods</h3><div>The INVEST-AEP working group conducted an analysis of the current state of pediatric research in Spain. The analysis identified barriers related to funding, training, clinical workloads and bureaucracy, based on which the group proposed several potential improvement strategies.</div></div><div><h3>Results</h3><div>The main barriers include limited funding (5% of national grants), insufficient training in research (both in undergraduate and residency programs), substantial clinical workloads with no protected research time and insufficient collaborative networks. The situation is even more critical in primary care, and, in addition, research efforts do not receive the recognition they deserve for professional career advancement or the competitive application process for public positions. Potential solutions were identified, such as improvements in medical and residency training, consolidation of structured research networks, dedicated sources of funding for pediatric research, protected research time, centralization of ethics committees and recognition of research in merit-based evaluations.</div></div><div><h3>Conclusions</h3><div>Urgent strategies are needed to strengthen pediatric research in Spain, including increased investment, specific training programs and collaborative networks. A skilled pediatrician should seamlessly integrate clinical practice, teaching and research. Pediatricians, institutions, universities, and the central and autonomous community governments in Spain need to actively promote pediatric research to improve child health and to position Spain as a leader in the field.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503854"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efectividad de la liraglutida en el tratamiento de la obesidad del adolescente","authors":"Mónica Ruiz Pons ,&nbsp;Marina Gutiérrez Vilar ,&nbsp;Celia García Zurita ,&nbsp;Manuel Enrique Fuentes Ferrer ,&nbsp;Alejandra Pérez Rodríguez ,&nbsp;Cristina Rosado Alonso","doi":"10.1016/j.anpedi.2025.503856","DOIUrl":"10.1016/j.anpedi.2025.503856","url":null,"abstract":"<div><h3>Introduction</h3><div>In the management of adolescent obesity, therapeutic options are limited and the outcomes of lifestyle modification (LM) alone are poor. Liraglutide, a GLP-1 receptor agonist, was the first drug approved in Spain for the management of obesity in adolescents aged 12 years or older.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of liraglutide combined with LM in adolescents with obesity compared to LM alone.</div></div><div><h3>Methods</h3><div>Retrospective observational study of 62 adolescents (12-18 years) with a body mass index (BMI) at or above the 95th percentile. The intervention group (n<!--> <!-->=<!--> <!-->31) received liraglutide plus LM, while controls (n<!--> <!-->=<!--> <!-->31) matched for age, sex and treatment duration were managed with LM alone. We analyzed anthropometric, cardiovascular and body composition variables at three time points: baseline (T1), end of treatment (T2: mean, 6.9 months; SD, 4.7), and followup (T3: mean, 12.5 months; SD, 4.9 months). Comparisons between groups were performed using adjusted analysis of covariance model for changes in quantitative variables and logistic regression for BMI reductions of 5% or greater and 10% or greater.</div></div><div><h3>Results</h3><div>In the intervention group, the BMI <em>z</em> score decreased significantly (mean,<!--> <!-->−1.09 [SD, 0.24] vs<!--> <!-->−0.10 [SD, 0.25] in controls; <em>P</em> <!-->=<!--> <!-->.001). This corresponded to a BMI reduction of 5% or greater in 48.4% of patients and 10% or greater in 29%, compared to 3% and 1%, respectively, in the control group (<em>P</em> <!-->&lt;<!--> <!-->.05). The weight loss was maintained at six months of followup (T3). There was a significant reduction in insulin levels, the HOMA-IR, triglyceride levels, systolic hypertension, and the number of prediabetic patients.</div></div><div><h3>Conclusions</h3><div>Liraglutide combined with LM achieved a greater reduction in the BMI <em>z</em> score, waist/height ratio and cardiometabolic parameters compared to the LM alone. Further research is needed to assess its long-term effects and difficulties in its implementation.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503856"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recomendaciones para el uso seguro de los medicamentos de alto riesgo en pediatría","authors":"María José Otero ,&nbsp;Belén Rodríguez Marrodan ,&nbsp;Nuria Prieto Santos ,&nbsp;Enrique Villalobos Pinto ,&nbsp;Silvia Manrique Rodríguez ,&nbsp;Rebeca Padilla Peinado ,&nbsp;Cecilia M. Fernández-Llamazares ,&nbsp;Aurora Madrid Rodríguez ,&nbsp;en representación de la Asociación Española de Pediatría, Sociedad Española de Farmacia Hospitalaria y representantes de las comunidades autónomas","doi":"10.1016/j.anpedi.2025.503815","DOIUrl":"10.1016/j.anpedi.2025.503815","url":null,"abstract":"<div><h3>Objective</h3><div>The objectives of this consensus document were to establish a standardized list of high-risk medications for the pediatric population and to compile the recommended practices for their safe use with the aim of promoting the implementation of medication error prevention programs in health care centers.</div></div><div><h3>Method</h3><div>The Ministry of Health, the Spanish Institute for Safe Medication Practices, the Spanish Association of Pediatrics and the Spanish Society of Hospital Pharmacy and regional administration representatives participated in the project. The <em>Recommendations for the Safe Use of High-Risk Medications</em> was used as reference, and its contents adapted and expanded to address specific issues in the pediatric population based on the current evidence.</div></div><div><h3>Results</h3><div>The document provides a reference list of high-risk medicines in pediatric care. It recommends that health care centers, in addition to prioritizing interventions in relation to anticoagulants, insulins, opioids, neuromuscular blockers, IV potassium, oral methotrexate and cytostatic agents, also consider interventions for IV adrenergic agonists, aminoglycosides and vancomycin, drugs for moderate and minimal sedation, parenteral nutrition and IV paracetamol in pediatric patients. The document emphasizes the need to implement multiple safe practices at every stage of the medication use process, prioritizing those with the greatest effectiveness, and involving pediatricians, pharmacists and other healthcare professionals. It also highlights the importance of active involvement by patients and caregivers. Finally, it provides general guidelines common to all these medications, as well as specific practices for each prioritized pharmacological group or medication, which should be combined to enhance pediatric patient safety.</div></div><div><h3>Conclusion</h3><div>Developing programs to increase the safety of high-risk medications in pediatric patients is essential in order to reduce medication errors in this vulnerable population. The implementation of safe practices should be accompanied by continuous monitoring and periodic updates to guarantee effectiveness and strengthen the safety culture in health care centers.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503815"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Divergencias en las recomendaciones del Servicio de Información Toxicológica y 2 recursos de referencia para el manejo de intoxicaciones pediátricas","authors":"Carlos Miguel Angelats ,&nbsp;Inmaculada Vilaplana-Mora ,&nbsp;Paula Forner-García ,&nbsp;Alberto Lora-Martín ,&nbsp;Beatriz Azkunaga-Santibañez","doi":"10.1016/j.anpedi.2025.503841","DOIUrl":"10.1016/j.anpedi.2025.503841","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503841"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diferentes presentaciones clínicas de la hemosiderosis pulmonar idiopática","authors":"Javier Sainz García ,&nbsp;Sabina Bona Gazol ,&nbsp;Irene Sancho Marquina ,&nbsp;Javier Martínez Castillón ,&nbsp;Carlos Martín de Vicente","doi":"10.1016/j.anpedi.2025.503813","DOIUrl":"10.1016/j.anpedi.2025.503813","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503813"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}