Archivos argentinos de pediatria最新文献

{"title":"Enhancing the microbiome in the maternal-infant dyad: Perspectives from maternal and infant nutrition.","authors":"Diana C Londoño-Sierra, Sandra L Restrepo-Mesa, Adriane E Costa Antunes, Katia Sivieri, Julián P Martínez-Galán","doi":"10.5546/aap.2025-10860.eng","DOIUrl":"10.5546/aap.2025-10860.eng","url":null,"abstract":"<p><p>Establishing the microbiome is an important milestone for infant health. The type of delivery, gestational age, antibiotic use, and infant feeding practices significantly impact this process. However, interest in the effects of maternal diet and nutrition has grown. The objective of this review is to present an update on the microbiota in the mother-child dyad and the role of maternal nutritional status and diet in its modulation. Scientific articles in electronic databases were reviewed. Adherence to established dietary guidelines during pregnancy and lactation, as well as otherrecommendations based on the study of foods that are sources of fiber, unsaturated fatty acids, and fermented foods, is a good starting point for promoting a healthy microbiome from the early years of life.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202510860"},"PeriodicalIF":0.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502545","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":"Congenital dengue with detection of viral RNA in cerebrospinal fluid: A case report.","authors":"Felipe Cabezón Jarvis, Valentina Medrano Paz, Mariana Rodríguez Braumüller","doi":"10.5546/aap.2026-11082.eng","DOIUrl":"10.5546/aap.2026-11082.eng","url":null,"abstract":"<p><p>Dengue virus infection is the most common arbovirus disease worldwide, and its spread has increased the relevance of less common forms, such as vertical transmission. Congenital dengue poses a diagnostic challenge due to its nonspecific presentation and overlap with late-onset sepsis. Transmission occurs during maternal viremia, especially when the infection occurs in the days leading up to delivery, and may present with fever and hematological abnormalities. We present the case of a 35-week preterm newborn, the daughter of a mother with confirmed dengue before delivery, who developed a fever and hyporesponsiveness on the seventh day. Detection of viral RNA via polymerase chain reaction in serum and cerebrospinal fluid confirmed the infection. She developed thrombocytopenia and coagulation abnormalities, with normal neurological findings and a favorable clinical course. This case highlights the importance of considering congenital dengue in neonatal sepsis when appropriate clinical settings are present.</p><p><p>La infección por el virus dengue es la arbovirosis más frecuente a nivel mundial y su expansión ha incrementado la relevancia de formas menos habituales, como la transmisión vertical. El dengue congénito representa un desafío diagnóstico por su presentación inespecífica y superposición con sepsis tardía. La transmisión ocurre durante la viremia materna, especialmente cuando la infección se presenta en los días previos al parto, y puede manifestarse con fiebre y alteraciones hematológicas. Se presenta una recién nacida pretérmino de 35 semanas, hija de madre con dengue confirmado antes del nacimiento, que al séptimo día desarrolló fiebre e hiporreactividad. La detección de ARN viral mediante reacción en cadena de la polimerasa en suero y líquido cefalorraquídeo confirmó la infección. Evolucionó con trombocitopenia y alteración del coagulograma, con estudios neurológicos normales y evolución favorable. Este caso resalta la importancia de considerar dengue congénito ante sepsis neonatal en contextos compatibles.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611082"},"PeriodicalIF":0.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148300739","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":"Large-caliber congenital portocaval shunt and hepatopulmonary syndrome: Limitations of closure and the role of liver transplantation.","authors":"Emilie Balent Aguirre, José G Cervantes, Lucía Navarro, Rosana Pérez Carusi, Patricia D'Alia, Anahí Reartes, Carlos Luque, Miguel Palmeiro, Fabián Salgueiro, Fernando R García Maida, Marcelo E Lenz Virreira, Fernando Cairo, Francisco J Mattera, Emilio G Quiñonez","doi":"10.5546/aap.2026-11066.eng","DOIUrl":"https://doi.org/10.5546/aap.2026-11066.eng","url":null,"abstract":"<p><p>Congenital portosystemic shunts (CPS) are rare vascular malformations associated with hepatic and extrahepatic complications, including hepatopulmonary syndrome (HPS). We present a 16-year-old adolescent with no relevant medical history who presented with episodes of abdominal pain, jaundice, and dark urine. Ultrasound revealed a heterogeneous liver with multiple hyperechoic nodules and no visualization of the intrahepatic portal vein. Angiography demonstrated an extrahepatic portocaval shunt at the level of the portal trunk, with no opacification of the intrahepatic portal tree and low portal pressures; liver biopsy revealed regenerative nodular hyperplasia. Subsequently, he developed hypoxemia with orthodeoxygenation and required home oxygen therapy. He was placed on the waiting list and received an orthotopic liver transplant from a deceased donor. This case highlights the need for timely diagnosis, proper anatomical characterization, and individualized treatment planning in CPS associated with HPS.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611066"},"PeriodicalIF":0.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015230","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":"Acute viral myositis and rhabdomyolysis: A descriptive study.","authors":"Lucía Mateos Camino, Irene Martínez Negro, Ana Muñoz Lozón, María Cabrerizo Ortiz, Begoña Pérez-Moneo, Sara Suárez-Cabezas","doi":"10.5546/aap.2026-11028.eng","DOIUrl":"https://doi.org/10.5546/aap.2026-11028.eng","url":null,"abstract":"<p><p>Introduction. Acute viral myositis is an inflammatory condition caused by respiratory viruses, characterized by lower-extremity pain and difficulty walking. It is a benign, self-limiting condition; complications such as rhabdomyolysis or acute kidney injury are rare. The objective of this study is to analyze the clinical course and treatment of patients seen in a pediatric emergency department (PED). Population and methods. Retrospective observational study with exploratory analysis of associations. Patients diagnosed with acute viral myositis between January 2018 and March 2023 at the PED were analyzed. Demographic, clinical, and laboratory data were collected and analyzed using means, standard deviations, and bivariate analysis (Student's t-test or chi-square test), as well as correlations (Pearson or Spearman). Results. Forty patients were included, with a mean age of 6.75 years (SD 2.59). Blood tests were performed in 30 of 40 patients (75.0%; 95% CI: 59.8-85.8). Eleven of 40 patients (27.5%; 95% CI: 16.1-42.8) met the criteria for rhabdomyolysis. No cases of renal failure or other complications were observed. Exploratory analysis revealed that creatine phosphokinase (CPK) levels were higher in males than in females and were associated with age, the AST/ALT ratio, lactate dehydrogenase (LDH), and the need for hospitalization and intravenous fluid therapy. Conclusion. Acute viral myositis in this pediatric series had a favorable clinical course. A proportion of patients presented with markedly elevated CPK levels and criteria for rhabdomyolysis, with no cases of acute renal failure.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611028"},"PeriodicalIF":0.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015327","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":"Erythromelalgia secondary to type 1 diabetes mellitus in a pediatric patient: An uncommon presentation.","authors":"Matías N Franciulli, Malena Silberkasten, Claudia F Rojas Montaño, Erika San Martín, María E Andrés","doi":"10.5546/aap.2026-11090.eng","DOIUrl":"https://doi.org/10.5546/aap.2026-11090.eng","url":null,"abstract":"<p><p>Erythromelalgia is a rare acral clinical syndrome characterized by episodes of burning pain, erythema, and increased skin temperature in the extremities. Its occurrence in children is exceptional. It may occur as a primary form or secondary to an underlying organic disorder; type 1 diabetes mellitus is an uncommon cause. Diagnosis is clinical and is established after other etiologies have been excluded. Treatment is aimed at alleviating symptoms and managing the underlying condition. We present a pediatric case of erythromelalgia secondary to type 1 diabetes mellitus.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611090"},"PeriodicalIF":0.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015280","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":"Educational workshop for caregivers of children with spinal muscular atrophy: A mixed-methods study.","authors":"Magalí Squitín Tasende, Javiera Ortega, Carla Pereyra, Maximiliano Sánchez, Florencia Ibarra, Natalia Ponomareff, Matías Cestari, Gonzalo Magno, Javier Muntadas","doi":"10.5546/aap.2026-11114.eng","DOIUrl":"https://doi.org/10.5546/aap.2026-11114.eng","url":null,"abstract":"<p><p>Introduction. Spinal muscular atrophy (SMA) is a genetic neuromuscular disorder that places a heavy physical, emotional, and social burden on caregivers. Structured therapeutic education is a key strategy for strengthening their role in daily support and care, although there is little local evidence regarding its impact. Population and methods. Descriptive observational study with a mixed-methods approach. Four sessions of interdisciplinary educational workshops were held between 2024 and 2025 at a high-complexity university hospital in the Autonomous City of Buenos Aires. Sociodemographic variables were collected via a registration form, and satisfaction was assessed using a Likert scale (1-5) and open-ended questions, which were analyzed using inductive thematic coding. Results. A total of 49 caregivers participated; 75.5% were women, and 79.6% were engaged in paid work. The majority were not affiliated with the institution (79.6%). The satisfaction survey was completed by 14 participants (28.6%), who gave high scores across all dimensions (averages ranging from 4.71 to 5.00). The qualitative analysis identified three key themes: peer exchange, technical empowerment, and appreciation of the professional team. Participants highlighted the need for a longer workshop and content on emerging therapies. Conclusion. Interdisciplinary educational workshops proved to be a feasible, well-received intervention that had a positive impact on the acquisition of practical skills, emotional support, and peer interaction. Their implementation could be useful in the comprehensive care of patients with neuromuscular diseases and other complex chronic conditions in pediatrics.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611114"},"PeriodicalIF":0.5,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966579","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":"Molecular diagnosis of spinal muscular atrophy: Experience in a pediatric hospital in Argentina.","authors":"Michelle Bursztyn, Hilda V Aráoz, Josefina Chinton, María E Foncuberta, Julieta Mozzoni, Victoria Huckstadt, María G Obregón, Soledad Monges, Luis P Gravina","doi":"10.5546/aap.2026-11044.eng","DOIUrl":"https://doi.org/10.5546/aap.2026-11044.eng","url":null,"abstract":"<p><p>Introduction. Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disease caused by the loss of the SMN1 gene, with a variable clinical spectrum determined primarily by the number of copies of the SMN2 gene. The development of new therapies underscores the importance of early molecular diagnosis and genotype-phenotype characterization. Objective. To describe 27 years of experience in the molecular diagnosis of SMA at a pediatric referral hospital in Argentina and to evaluate the correlation between SMN2 copy number and the SMA types.Population and methods. A retrospective descriptive study was conducted on 1060 pediatric patients with clinically suspected SMA who were evaluated between 1997 and 2024. Molecular diagnosis was performed using PCR-RFLP and, since 2012, MLPA to determine SMN1 and SMN2 copy number. Genotype-phenotype correlation was evaluated in 260 patients with complete clinical characterization. Results. The diagnosis was confirmed in 513 patients. A homozygous deletion of the SMN1 gene was detected in 99.6% of unrelated cases. The positivity rate increased over time. A significant correlation was observed between the number of SMN2 copies and the type of SMA, with milder phenotypes associated with a higher number of copies. Conclusion. Molecular diagnosis of SMA enabled accurate and timely characterization of patients, avoiding invasive procedures and optimizing therapeutic decision-making. Genotype-phenotype correlation is a fundamental tool for prognosis and clinical management, highlighting the importance of an interdisciplinary approach.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611044"},"PeriodicalIF":0.5,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966562","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":"Respiratory viral infections in patients with inherited metabolic disorders: Pathogen distribution and clinical outcomes.","authors":"Kubra Aykac, Ozkan Uzunoglu, Aylin I Kuruc, Osman O Demir, Yilmaz Yildiz, Serap Sivri, Ali Dursun, Ali B Cengiz, Yasemin Ozsurekci","doi":"10.5546/aap.2026-11121.eng","DOIUrl":"https://doi.org/10.5546/aap.2026-11121.eng","url":null,"abstract":"<p><p>Introduction: Children with inborn errors of metabolism (IEMs) are at increased risk for severe viral infections, which may precipitate acute metabolic decompensation, PICU admission, and death. Pathogen specific outcomes in this population remain poorly defined. The objective was to evaluate the epidemiology, viral etiology, and clinical severity of respiratory viral infections in hospitalized children with IEMs. Method: This single-center retrospective study included children with IMDs hospitalized with acute infectious illness and laboratory-confirmed respiratory viral detection during 2018-2024. Demographic features, underlying metabolic diagnoses, viral pathogens, and outcomes were evaluated. Result: A total of 45 infection episodes among 41 children were included; median age was 4 years (IQR:0.5-9.5), and 31 patients (75.6%) were male. The most common IEMs categories were amino acid metabolism disorders (36.6%) and complex molecule degradation and processing defects (26.8%). Respiratory disease was the predominant presentation (77.8%), followed by gastroenteritis (8.9%), sepsis (6.7%), and meningoencephalitis (6.7%). Acute metabolic decompensation occurred in 11/23 infection episodes in metabolically vulnerable patients (47.8%). Influenza was the most frequently identified virus (35.6%), followed by rhinovirus (22.2%), seasonal coronavirus (sCoV) (13.3%), and respiratory syncytial virus (11.1%). PICU admission was required in 13.3% (6/45) of cases. Infection-related mortality was 6.7% (n = 3), and all fatal cases had sCoV infection. Conclusion: Influenza was the most frequently identified pathogen, while sCoV was detected in all three infection-related deaths. Our results suggest that respiratory viral infections may be associated with clinical burden in children with IMDs, highlighting the importance of close clinical monitoring and supportive management in this vulnerable population.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611121"},"PeriodicalIF":0.5,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966241","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":"Plain language in pediatric communication: Concepts and strategies.","authors":"Rodrigo Matamoros","doi":"10.5546/aap.2026-11191.eng","DOIUrl":"https://doi.org/10.5546/aap.2026-11191.eng","url":null,"abstract":"","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611191"},"PeriodicalIF":0.5,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148965998","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":"Parents' initial concerns about children and adolescents with developmental disorders.","authors":"Viviana M Enseñat, María G Morell, Daiana Tribouley, María P Graziani, María L Fernie, Glenda Ernst, Sebastián Chapela","doi":"10.5546/aap.2026-11042.eng","DOIUrl":"https://doi.org/10.5546/aap.2026-11042.eng","url":null,"abstract":"<p><p>Introduction. Developmental disorders (DD) are a group of chronic conditions that begin during brain development and typically manifest during childhood. Assessing parents' concerns about their child's development is a central part of developmental monitoring. Objective. To analyze the relationship between the initial concerns expressed by families and the developmental diagnoses obtained at a specialized unit. Population and methods. This was a cross-sectional, retrospective, observational, and analytical study. We reviewed transdisciplinary diagnostic evaluations conducted between April 1, 2017, and February 29, 2024, at a Developmental Pediatrics Unit. Patients aged 4 months to 19 years referred for suspected developmental disorders were included. Associations between parental concern profiles and diagnoses were analyzed using bivariate analysis and multivariate logistic regression. Results. A total of 570 patients were analyzed. Family concerns showed statistically significant and diagnosis-specific associations. In autism spectrum disorders, concerns related to language and social skills were consistently associated with the diagnosis. In intellectual disability and learning disorders, academic concerns showed the most significant association, with distinct patterns compared to other areas. Additionally, associations were observed between male gender and attention-deficit/hyperactivity disorder, and between genetic syndromes and intellectual disability. Conclusion. Parental concerns are a clinically relevant descriptive tool with specific patterns linked to developmental diagnoses. Systematic identification of these concerns can guide the initial evaluation and help prioritize referrals.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611042"},"PeriodicalIF":0.5,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966558","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}