Anales de pediatria最新文献

{"title":"Impacto en la morbilidad neonatal del retraso de crecimiento intrauterino precoz moderado-grave definido por criterios doppler: estudio multicéntrico","authors":"Jesús Alberto Fuentes Carballal ,&nbsp;Marcelino Pumarada Prieto ,&nbsp;Pilar Adelaida Crespo Suárez ,&nbsp;José Luaces González ,&nbsp;Isabel López Conde ,&nbsp;Rosaura Picans Leis ,&nbsp;Alicia Sardina Ríos ,&nbsp;Cristina Durán Fernández-Feijoo ,&nbsp;Alejandro Avila-Alvarez","doi":"10.1016/j.anpedi.2024.05.010","DOIUrl":"10.1016/j.anpedi.2024.05.010","url":null,"abstract":"<div><h3>Introduction</h3><p>In recent years, there has been a change in the conceptualization of fetal growth restriction (FGR), which has gone from being defined solely based on weight criteria to being defined and staged based on Doppler criteria. The aim of our study was to evaluate neonatal risk in a cohort of neonates with moderate to severe early-onset FGR defined by Doppler criteria.</p></div><div><h3>Population and methods</h3><p>We conducted a multicentre prospective cohort study in a cohort of neonates with early-onset fetal growth restriction and abnormal Doppler findings, and a control cohort without Doppler abnormalities matched for sex and gestational age.</p></div><div><h3>Results</h3><p>A total of 105 patients (50 cases, 55 controls) were included. We found a higher frequency of respiratory morbidity in the FGR group, with an increased need of surfactant (30 vs. 27.3%; OR 5.3 [95% CI 1.1-26.7]), an increased need for supplemental oxygen (66 vs. 49.1%; OR 5.6 [95% CI 1.5-20.5]), and a decreased survival without bronchopulmonary dysplasia (70 vs. 87.3%; OR 0.16 [95% CI 0.03-0.99]). Patients with FGR required a longer length of stay and more days of parenteral nutrition and had a higher incidence of haematological abnormalities such as neutropenia and thrombopenia. The lactate level at birth was higher in the severe FGR subgroup (6.12 vs. 2.4<!--> <!-->mg/dL; <em>P</em> <!-->=<!--> <!-->.02).</p></div><div><h3>Conclusions</h3><p>The diagnosis of early-onset moderate to severe FGR defined by Doppler criteria carries a greater risk of respiratory, nutritional and haematological morbidity, independently of weight and gestational age. These patients, therefore, should be considered at increased risk compared to constitutionally small for gestational age preterm infants or preterm infants without FGR.</p></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"101 2","pages":"Pages 104-114"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1695403324001097/pdfft?md5=4ed9b2b65e52234f6aa2833a0c354ad0&pid=1-s2.0-S1695403324001097-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141962116","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":"Escasa adecuación a las guías de práctica clínica en el manejo del asma en atención primaria de la Comunidad de Madrid","authors":"","doi":"10.1016/j.anpedi.2024.05.008","DOIUrl":"10.1016/j.anpedi.2024.05.008","url":null,"abstract":"<div><h3>Introduction</h3><p>Asthma is a common chronic disease in the paediatric age group that requires close followup. Clinical practice guidelines offer evidence-based recommendations to achieve adequate control of the disease.</p></div><div><h3>Objective</h3><p>To assess the management of childhood asthma in the primary care setting in the Community of Madrid, and the adherence of health care professionals to guideline recommendations. To analyse the association of asthma management with age, the socioeconomic level of the catchment population and the workload of primary care centres.</p></div><div><h3>Methods</h3><p>retrospective longitudinal study in patients aged 6 to 14 years newly diagnosed with asthma in primary care centres of the Community of Madrid in 2021. We analysed sociodemographic and clinical variables and the compliance with recommendations at the time of diagnosis and over 1 year of followup. The source of data was the electronic health record database of the primary care system.</p></div><div><h3>Results</h3><p>We found a proportion of compliance with the recommendations upon diagnosis of the disease of 5.84%, with differences associated to the socioeconomic level of the catchment population (<em>P=.</em>033), and the pressure of care (<em>P=.</em>006). The proportion of compliance with recommendations during followup was 12.73%, with differences based on age (<em>P=.</em>01), socioeconomic level (<em>P</em>=.006) and centre workloads (<em>P=.</em>002).</p></div><div><h3>Conclusions</h3><p>Compliance with the recommendations of the main childhood asthma management guidelines in the primary care setting was low in the Community of Madrid. Strategies need to be implemented to improve the management of this disease and the adherence of professionals to the protocols developed for this purpose.</p></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"101 2","pages":"Pages 84-94"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1695403324001073/pdfft?md5=9248f5489c2e604156710bf571cb069e&pid=1-s2.0-S1695403324001073-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141403382","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":"Tendencia creciente de pacientes con condiciones limitantes para la vida y crónicos complejos","authors":"","doi":"10.1016/j.anpedi.2024.05.009","DOIUrl":"10.1016/j.anpedi.2024.05.009","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>To estimate the frequency of patients with diagnoses associated with life-limiting conditions (LLCs) or complex chronic conditions (CCCs).</p></div><div><h3>Methods</h3><p>Retrospective mixed population-based and hospital-based cohort study. Study universe consisted of the population aged less than 18 years of an autonomous community in Spain in the 2001-2021 period; the cases were patients admitted to hospital with a diagnosis associated with LLC or CCC during this period. We estimated age-adjusted annual prevalences and analysed changes in trends using Joinpoint regression.</p></div><div><h3>Results</h3><p>The prevalence of LLCs increased significantly from 20.7 per 10,000 inhabitants under 18 years in 2001 to 51.3 per 10,000 in 2019. There was also a significant increase in CCCs from 39.9 per 10,000 in 2001 to 54.4 per 10,000 in 2019. The prevalence of patients with any of these conditions rose from 45 per 10,000 in 2001 to 86.8 per 10,000 in 2019; 30.3% of these patients had conditions of both types. There was a turning point in this increasing trend between 2019 and 2020, coinciding with the COVID-19 pandemic.</p></div><div><h3>Conclusions</h3><p>The prevalence of patients requiring specialized care has increased progressively in the last 20 years, similar to what has happened in other countries. The magnitude of the affected population must be taken into account when planning specialized paediatric palliative care and complex chronic care services.</p></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"101 2","pages":"Pages 95-103"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1695403324001085/pdfft?md5=217d9ef121c24af89465a0454fec5399&pid=1-s2.0-S1695403324001085-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141406755","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":"Análisis de factores asociados a la mortalidad por sepsis derivada de infecciones relacionadas con dispositivos","authors":"Ana Cristina Alba Amarante ,&nbsp;Arnildo Linck Junior ,&nbsp;Rosângela Aparecida Pimenta Ferrari ,&nbsp;Gilselena Kerbauy Lopes ,&nbsp;Jaqueline Dario Capobiango","doi":"10.1016/j.anpedi.2024.05.015","DOIUrl":"10.1016/j.anpedi.2024.05.015","url":null,"abstract":"<div><h3>Introduction</h3><p>Health care-associated infections (HAIs) contribute to morbidity and mortality and to the dissemination of multidrug-resistant organisms. Children admitted to the intensive care unit undergo invasive procedures that increase their risk of developing HAIs and sepsis. The aim of the study was to analyse factors associated with mortality due to sepsis arising from HAIs.</p></div><div><h3>Patients and methods</h3><p>We conducted a case-control study in a 7-bed multipurpose paediatric intensive care unit in a tertiary care teaching hospital. The sample consisted of 90 children admitted between January 2014 and December 2018. The case group consisted of patients who died from sepsis associated with the main health care-associated infections; the control group consisted of patients who survived sepsis associated with the same infections.</p></div><div><h3>Results</h3><p>Death was associated with age less than or equal to 12<!--> <!-->months, presence of comorbidity, congenital disease, recurrent ventilator-associated pneumonia and septic shock. In the multiple regression analysis, heart disease (OR: 12.48; 95%<!--> <!-->CI: 2.55-60.93; <em>P</em> <!-->=<!--> <!-->.002), infection by carbapenem-resistant bacteria (OR: 31.51; 95%<!--> <!-->CI: 4.01-247.25; <em>P</em> <!-->=<!--> <!-->.001), cancer (OR: 58.23; 95%<!--> <!-->CI: 4.54-746.27; <em>P</em> <!-->=<!--> <!-->.002), and treatment with adrenaline (OR: 13.14; 95%<!--> <!-->CI: 1.35-128.02; <em>P</em> <!-->=<!--> <!-->.003) continued to be significantly associated with death.</p></div><div><h3>Conclusions</h3><p>Hospital sepsis secondary to carbapenem-resistant bacteria contributed to a high mortality rate in this cohort. Children with heart disease or neoplasia or who needed vasopressor drugs had poorer outcomes.</p></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"101 2","pages":"Pages 115-123"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1695403324001243/pdfft?md5=43b46208a4169693d2e8549662196afe&pid=1-s2.0-S1695403324001243-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141716762","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":"Efectividad de la litotricia extracorpórea por ondas de choque en la nefro-uretero-cistolitiasis","authors":"Julio César Moreno-Alfonso ,&nbsp;Borja Moraleda de Heredia ,&nbsp;Ada Molina Caballero ,&nbsp;Zaloa Amelibia Álvaro ,&nbsp;Alberto Pérez Martínez","doi":"10.1016/j.anpedi.2024.04.017","DOIUrl":"10.1016/j.anpedi.2024.04.017","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"101 2","pages":"Pages 145-147"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S169540332400119X/pdfft?md5=bd4a89718c64000f39829b5ddba759f9&pid=1-s2.0-S169540332400119X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141962123","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":"Un inusual tumor intravesical: adenoma nefrogénico","authors":"Sara Fuentes ,&nbsp;Jaume Margarit-Mallol ,&nbsp;Carme Ferrer-Cassadó ,&nbsp;Carme Grande-Moreillo","doi":"10.1016/j.anpedi.2024.05.012","DOIUrl":"10.1016/j.anpedi.2024.05.012","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"101 2","pages":"Pages 149-150"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1695403324001206/pdfft?md5=ba1f659e52f7249c81ea63eca0c87994&pid=1-s2.0-S1695403324001206-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141962125","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":"Llamada a la prudencia en el uso de las pantallas: ausencia de evidencia no es evidencia de ausencia","authors":"María Angustias Salmerón-Ruiz ,&nbsp;Irene Montiel ,&nbsp;Catherine L’Ecuyer","doi":"10.1016/j.anpedi.2024.03.009","DOIUrl":"10.1016/j.anpedi.2024.03.009","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"101 2","pages":"Pages 73-74"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1695403324000742/pdfft?md5=c6222b30cbc62ed2098862b11daba2f4&pid=1-s2.0-S1695403324000742-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141962126","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":"Aproximación diagnóstica y terapéutica de las espondilodiscitis en niños españoles a través de la Red RIOPed: evaluación antes y después de la publicación de un documento de consenso nacional","authors":"","doi":"10.1016/j.anpedi.2024.03.010","DOIUrl":"10.1016/j.anpedi.2024.03.010","url":null,"abstract":"<div><h3>Objective</h3><p>Pediatric spondylodiscitis (PSD) is an uncommon condition, for which there are no specific international clinical guidelines. Factors related to complications have not been stablished. Our aim was to describe clinical and epidemiological characteristics of PSD, to analyze factors associated with complications and to evaluate adherence to the recommendations of the Spanish National Consensus Document (NCD) for the diagnostic and therapeutic approach to acute osteoarticular infections.</p></div><div><h3>Material and methods</h3><p>Ambispective, multicenter, national study of two PSD cohorts: historical (2008-2012) and prospective (2015-2020, after publication of NCD).</p><p>Patients with diagnosis of PSD were included. Demographic, clinical, microbiological and radiological data were recorded. Factors related to the development of complications were analized by logistic regression. Comparisons between both cohorts were performed.</p></div><div><h3>Results</h3><p>Ninety-eight PSD were included. In 84.7%, diagnosis was confirmed by magnetic resonance imaging. Microbiological isolation was obtained in 6.1%, with methicillin-sensitive <em>S. aureus</em> as the main etiologic agent. Complications occurred in 18.9%, the most frequent being soft tissue abscess. Of the 8.6% of patients with sequelae, persistent pain was the most common. Comparing cohorts, there was better adherence to NCD treatment recommendations in the prospective one (57.6% vs. 12.9%, p<!--> <!-->&lt;<!--> <!-->0.01), including a reduction in the lenght of intravenous antibiotic therapy (10 vs. 14 days, p<!--> <!-->&lt;<!--> <!-->0.01).</p></div><div><h3>Conclusions</h3><p>The evolution of PSD in our series was favorable, with low frequency of complications and sequelae. The adherence to the recommendations of the NCD was high. Studies with larger sample size are needed to establish new recommendations to optimize the approach to these infections.</p></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"101 2","pages":"Pages 75-83"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1695403324000894/pdfft?md5=5007cd40746d2e0d6326f13344c47226&pid=1-s2.0-S1695403324000894-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141054829","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":"¿Fundoscopia o ecografía ocular a pie de cama?","authors":"","doi":"10.1016/j.anpedi.2024.05.007","DOIUrl":"10.1016/j.anpedi.2024.05.007","url":null,"abstract":"","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"101 2","pages":"Pages 151-153"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1695403324001061/pdfft?md5=6b417d0a0efea34da59239410d5d417c&pid=1-s2.0-S1695403324001061-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141401188","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":"Recién nacido pequeño para la edad gestacional: concepto, diagnóstico y caracterización neonatal, seguimiento y recomendaciones","authors":"Ignacio Díez López ,&nbsp;María Cernada ,&nbsp;Laura Galán ,&nbsp;Hector Boix ,&nbsp;Lourdes Ibañez ,&nbsp;Maria L. Couce","doi":"10.1016/j.anpedi.2024.06.004","DOIUrl":"10.1016/j.anpedi.2024.06.004","url":null,"abstract":"<div><p>Newborns who do not reach a weight appropriate for their gestational age and sex can be classified in different ways. This article defines the concepts of small for gestational age (SGA) and intrauterine growth restriction, as well as the underlying causes of these conditions, with the goal of establishing consensus definitions for these patients, in whom treatment with growth hormone throughout childhood may be indicated and who may be at risk of developing endocrine or metabolic disorders in puberty and adulthood. Most SGA children experience spontaneous catch-up growth that is usually completed by age 2 years. In SGA children who remain short, treatment with recombinant human growth hormone is effective, increasing the adult height. Small for gestational age infants with rapid catch-up growth and marked weight gain are at increased risk of premature adrenarche, early puberty, polycystic ovary syndrome (girls), insulin resistance and obesity, all of which are risk factors for type 2 diabetes and metabolic syndrome in adulthood. Small for gestational age status can affect different areas of neurodevelopment and manifest at different stages in life; neurodevelopmental outcomes are better in SGA infants with spontaneous catch-up growth. Due to the potential risks associated with SGA, adequate characterization of these patients at birth is imperative, as it allows initiation of appropriate follow-up and early detection of abnormalities.</p></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"101 2","pages":"Pages 124-131"},"PeriodicalIF":1.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1695403324001346/pdfft?md5=21e4bd98e084a367cb880396f0103f07&pid=1-s2.0-S1695403324001346-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700297","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}