Anales de pediatria最新文献

{"title":"¿Es necesario un score predictivo de reingreso para el paciente crónico complejo?","authors":"Jimena Pérez-Moreno,&nbsp;Emiliana Armas Castillo,&nbsp;Juan José Escalonilla García,&nbsp;Blanca Toledo del Castillo,&nbsp;Felipe González Martínez,&nbsp;María Isabel González Sánchez,&nbsp;Rosa Rodríguez-Fernández","doi":"10.1016/j.anpedi.2026.504247","DOIUrl":"10.1016/j.anpedi.2026.504247","url":null,"abstract":"<div><h3>Introduction</h3><div>the HOSPITAL score is a tool that assesses the risk of readmission, but it considers oncological disease as the sole chronic condition category linked to readmission risk. In pediatrics, there is no score that includes children with medical complexity (CMC).</div></div><div><h3>Objective</h3><div>The objective of this study was to analyze the clinical characteristics of all non-oncological pediatric readmissions and to describe risk factors for readmission of CMC.</div></div><div><h3>Methods</h3><div>We conducted a retrospective and analytical study of readmissions to the pediatric wards of a tertiary hospital (January 2021-June 2023). Readmission was defined as occurring within 30 days of discharge. We compared variables from the HOSPITAL score and the PedCom score in patients with chronic and acute conditions.</div></div><div><h3>Results</h3><div>the analysis included 241 readmissions; 41.5% were CMC readmissions. Readmitted CMCs were older, predominantly male (76%), and were readmitted more frequently due to worsening of their underlying disease and for the same reason as the first admission (26% vs 7.1%; <em>P</em> &lt;<!--> <!-->.01) compared to acute patients. Both the HOSPITAL (5 [3-7] vs 2 [1-4]; <em>P</em> &lt;<!--> <!-->.01) and PedCom (9 [5-14] vs 1 [0-2]; <em>P</em> &lt;<!--> <!-->.01) scores were higher in the readmitted CMC group. Children with complex chronic disease that have higher PedCom scores are at increased risk of potentially preventable readmission.</div></div><div><h3>Conclusions</h3><div>Hospital readmissions of CMC patients have different characteristics that must be taken into account for the implementation of preventive measures to avoid readmission.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"104 6","pages":"Article 504247"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148192079","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":"Mioclonía palatina esencial: escucha los clicks","authors":"Esther Mesa Lombardero,&nbsp;Raquel Blanco Lago,&nbsp;Nelly Álvarez Álvarez,&nbsp;Ignacio Málaga","doi":"10.1016/j.anpedi.2026.504154","DOIUrl":"10.1016/j.anpedi.2026.504154","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"104 6","pages":"Article 504154"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148191560","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":"Estratificación de la complejidad en niños con enfermedad crónica y complejidad: estudio retrospectivo","authors":"Dorleta López de Suso Martínez de Aguirre ,&nbsp;Carlos Martín Gómez ,&nbsp;Iñigo de Noriega Echevarría ,&nbsp;Ricardo Martino Alba ,&nbsp;Raquel Jiménez García","doi":"10.1016/j.anpedi.2026.504239","DOIUrl":"10.1016/j.anpedi.2026.504239","url":null,"abstract":"<div><h3>Introduction</h3><div>Advances in medical care have increased the survival of children with chronic diseases, resulting in a growing population of patients with paediatric chronic complex conditions (PCCCs). The heterogeneity in the used terminology and identification tools hampers consistent stratification and appropriate planning of health care resources.</div></div><div><h3>Objective</h3><div>To determine the level of complexity in pediatric patients with chronic conditions using validated tools.</div></div><div><h3>Material and methods</h3><div>We conducted a retrospective cross-sectional study in a representative sample of paediatric patients with chronic conditions documented in the administrative records from the Community of Madrid in 2023. We collected data on sociodemographic variables and the main diagnosis according to the ICD-10. A sequential stratification process was applied using the Pediatric Medical Complexity Algorithm (PMCA), followed by the PedCom scale in patients classified as having PCCCs with the PMCA. We analyzed differences in patient categorization between the two tools and the variation in complexity according to the primary diagnosis.</div></div><div><h3>Results</h3><div>The analysis included a total of 355 patients with a median age of 8.1 years, of who 41.4% were female. According to the PMCA, 66.2% of patients were classified as having PCCCs. In this group, only 49.3% met the criteria for PCCCs using the PedCom scale. There was substantial varition in PedCom scores among patients sharing the same primary diagnosis.</div></div><div><h3>Conclusions</h3><div>Complexity in pediatric chronic conditions does not depend solely on the main diagnosis but on multiple clinical and psychosocial factors. The combined use of tools such as the PMCA and the PedCom may improve identification of children with greater complexity and support more tailored health care planning.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"104 6","pages":"Article 504239"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148192077","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":"Gastroptosis en adolescente con hiperlaxitud ligamentosa","authors":"María Dagraza Pérez ,&nbsp;Nazareth Martinón Torres ,&nbsp;Nathalie Carreira Sande ,&nbsp;Vanesa Crujeiras Martínez","doi":"10.1016/j.anpedi.2026.504158","DOIUrl":"10.1016/j.anpedi.2026.504158","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"104 6","pages":"Article 504158"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148191559","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":"Actualización y revisión del tratamiento en acondroplasia","authors":"Silvia Gallego-Gutiérrez ,&nbsp;Ana-Coral Barreda-Bonis ,&nbsp;Isolina Riaño-Galán ,&nbsp;Antonio Leiva-Gea ,&nbsp;Josep Maria de Bergua-Domingo ,&nbsp;Enrique Galán-Gómez ,&nbsp;Isabel Leiva Gea","doi":"10.1016/j.anpedi.2026.504241","DOIUrl":"10.1016/j.anpedi.2026.504241","url":null,"abstract":"<div><h3>Introduction</h3><div>Achondroplasia is the most common skeletal dysplasia associated with disproportionate short stature, with an estimated prevalence of 4.6 per 100,000 births. It is caused by a pathogenic variant in the gene encoding fibroblast growth factor receptor<!--> <!-->3 <em>(FGFR3)</em>, which disrupts endochondral ossification of the growing skeleton.</div></div><div><h3>Objective</h3><div>To provide an updated overview of the therapeutic approach to achondroplasia, including currently approved treatments and those under investigation.</div></div><div><h3>Content</h3><div>The approval of vosoritide in 2021 has brought a major shift in the management of these patients. Updated follow-up guidelines have been published, along with initial outcomes in treated patients, with the aim of determining not only the impact on growth and final height but also on associated comorbidities, such as foramen magnum stenosis, and body proportions. We also review other emerging therapeutic strategies currently under development.</div></div><div><h3>Conclusions</h3><div>The availability of targeted therapies has modified the traditional approach to the management of achondroplasia, which makes ongoing updates on approved and investigational treatments essential.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"104 6","pages":"Article 504241"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148192074","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":"Cribado gestacional de la infección por toxoplasma y repercusión neonatal. Análisis y posicionamiento de la Sociedad Española de Neonatología","authors":"Alejandro Pérez-Muñuzuri ,&nbsp;María Cernada ,&nbsp;María-Dolores Sánchez-Redondo ,&nbsp;Hector Boix ,&nbsp;Ana Martín ,&nbsp;María-Gracia Espinosa-Fernández ,&nbsp;Noelia González-Pacheco ,&nbsp;Belén Fernández-Colomer ,&nbsp;María-Luz Couce ,&nbsp;en representación del Comité de Estándares de la Sociedad Española de Neonatología","doi":"10.1016/j.anpedi.2026.504221","DOIUrl":"10.1016/j.anpedi.2026.504221","url":null,"abstract":"<div><div>Gestational infection with <em>Toxoplasma gondii</em> remains a significant concern for the adequate progression of pregnancy, fetal health, and neonatal well-being. The current status of toxoplasmosis screening in Spain is heterogeneous, with a growing trend toward abandoning universal screening for this infection during pregnancy. However, its incidence has only declined marginally, and based on the current scientific evidence, we consider it beneficial to support gestational screening for toxoplasmosis.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"104 6","pages":"Article 504221"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148192060","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":"Acondroplasia temprana: ¿seguimiento en vez de tratamiento? La normalidad de lo diferente. Necesidad de una revisión","authors":"Angel Bejarano Palma ,&nbsp;Mónica Carretié Warleta ,&nbsp;Rosalía Campuzano Fernández-Colina","doi":"10.1016/j.anpedi.2026.504233","DOIUrl":"10.1016/j.anpedi.2026.504233","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"104 6","pages":"Article 504233"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148191561","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":"Proyectar lo construido: una nueva etapa para la Asociación Española de Pediatría","authors":"Luis Carlos Blesa Baviera","doi":"10.1016/j.anpedi.2026.504260","DOIUrl":"10.1016/j.anpedi.2026.504260","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"104 6","pages":"Article 504260"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148192081","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":"Proceso asistencial «Crisis epilépticas graves en la Comunidad de Madrid: Código Crisis»","authors":"Adrián García-Ron ,&nbsp;Victor Soto-Insuga ,&nbsp;Noemí Núñez Enamorado ,&nbsp;Eva Arias Vivas ,&nbsp;Elena González Alguacil ,&nbsp;María Concepción Miranda-Herrero ,&nbsp;Cristina Barcia Aguilar ,&nbsp;Alfonso Martín Martínez ,&nbsp;Irene García-Morales","doi":"10.1016/j.anpedi.2026.504242","DOIUrl":"10.1016/j.anpedi.2026.504242","url":null,"abstract":"<div><h3>Introduction</h3><div>The Urgent Epileptic Seizures Care Process (UESP), also known as the Seizure Code, is a care process implemented in the Community of Madrid with the objective of standardizing and optimizing the urgent management of epileptic seizures (ESs) in pediatric and adult patients.</div></div><div><h3>Material and methods</h3><div>The aim of this care process, which is based on the recommendations of the national consensus guideline in Spain and international guidelines, is to standardize the diagnosis, treatment, and follow-up of severe ESs across all levels of care. It was developed through a multidisciplinary collaborative effort involving professionals in emergency medicine, intensive care, neurophysiology, pediatric neurology, and primary care, and was structured into twelve sub-processes reviewed and endorsed by Spanish scientific societies.</div></div><div><h3>Results</h3><div>The Seizures Code establishes operational criteria for activation and defines specific algorithms for management in different clinical settings. It includes intervention times, therapeutic sequences with early and systematic use of benzodiazepines and early combination therapy with antiseizure medications, as well as strategies for coordination between care levels. It also promotes early use of electroencephalography (EEG), ongoing training for health care professionals and families, and a standardized registry of care activity.</div></div><div><h3>Conclusions</h3><div>The Seizure Code is the first comprehensive model for urgent management of severe ESs implemented in a Spanish autonomous community. Its design promotes an early, homogeneous, and evidence-based response, with particular impact on the pediatric population. It enhances interhospital coordination and therapeutic adherence and is a dynamic tool that supports continuous evaluation and improvement of care quality in pediatric neurology.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"104 6","pages":"Article 504242"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148192075","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":"Perímetro de cuello en el cribado de presión arterial elevada","authors":"Carlos Recio Añón ,&nbsp;Manuel Alejandro Sastre Domínguez ,&nbsp;Julia Carracedo Añón ,&nbsp;Antonio González Martín ,&nbsp;María Dolores Marrodán Serrano","doi":"10.1016/j.anpedi.2026.504226","DOIUrl":"10.1016/j.anpedi.2026.504226","url":null,"abstract":"<div><h3>Introduction</h3><div>High blood pressure (BP) in childhood is associated with excess adiposity. The aim of our study was to compare anthropometric and body composition indicators for screening of high BP (≥ 90th percentile) in school-aged children.</div></div><div><h3>Materials and methods</h3><div>Cross-sectional study in 497 school-aged children (aged 6-15 years) in rural Andalusia. We recorded weight, height, waist and neck circumference, and biceps, triceps, subscapular, and suprailiac skinfold values to calculate the body mass index, waist-to-height ratio, the sum of the four skinfolds and the body fat percentage. Blood pressure was measured by oscillometry (3 readings, the mean of the last two was used) and classified using Spanish age- and sex-specific references (≥90th percentile for systolic and/or diastolic BP). We fitted age- and sex-adjusted logistic models and performed sex-stratified analyses of discrimination and calibration, and derived optimal cutoffs with the Youden index.</div></div><div><h3>Results</h3><div>The prevalence of high BP was 5.8% and increased with excess weight, particularly in girls. After multivariable adjustment, neck circumference (NC) was the indicator most consistently associated with high BP. The discriminatory power was moderate in boys and high in girls, with optimal cutoffs of 29.15 and 30.65<!--> <!-->cm, respectively.</div></div><div><h3>Conclusions</h3><div>The NC is a simple, low-cost measure that may complement traditional indicators for high BP screening in school and primary care settings; the proposed cutoffs require external validation.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"104 6","pages":"Article 504226"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148192076","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}