Boletín médico del Hospital Infantil de México最新文献

{"title":"[MIA 2.0, Comprehensive asthma management, guidelines for Mexico].","authors":"Désirée E S Larenas-Linnemann, Jorge A Jorge A, Arturo Cortés-Telles, Elsy M Navarrete-Rodríguez, Blanca E Del Río-Navarro, Ricardo Lemus-Rangel, Rodrigo F Del Río-Hidalgo, Ulises N García-Ramírez, Mario Soto-Ramos, Federico I Hernández-Rocha, Eulogio Muñoz-Miranda, Iván Zamarrón-Reyes, Catalina Casillas-Suárez, Irlanda Alvarado-Amador, Marcos A Jiménez-Chobillón, Abril D Alemán-Ortega, Roberto Camargo-Ángeles, Armando Campos-Rivera, José L Carrillo-Alduenda, Víctor M Carrillo-Rodríguez, Francisco J Cuevas-Schacht, Roberto Dávalos-Valenzuela, Karina Díaz-Jiménez, Ma de Lourdes Rodríguez-Aguilera, Elizabeth Estrada-Reyes, Yair H González-Tuyub, Emilia M Hidalgo-Castro, Carlos Juárez-Ortíz, Ma de la Luz López-Vázquez, Adriana Del C Luna-Castañeda, Nora E Martínez-Aguilar, Anabell D Méndez-García, Carol V Moncayo-Coello, Ernesto Onuma-Takane, Jorge Vazquez-García, Ma Mayela Villarreal-de la Rosa, Benjamín Zepeda-Ortega, Andrés Sánchez-González, Luis C Hinojos-Gallardo, Adela Reyes-Herrera","doi":"10.24875/BMHIM.M25000042","DOIUrl":"https://doi.org/10.24875/BMHIM.M25000042","url":null,"abstract":"<p><strong>Background: </strong>In 2020, a multidisciplinary group developed Integrated Asthma Management (MIA), guidelines for asthma in Mexico, based on international asthma guidelines. Since then, several concepts and treatments have been updated.</p><p><strong>Objective: </strong>To create a current version of MIA, strongly based on evidence, and to add the management of severe asthma exacerbations.</p><p><strong>Methodology: </strong>MIA 2.0 uses the ADAPTE method. The MIA 2.0 guideline development group consists of a core group (experts in pulmonology-allergology-methodology) and representatives of 16 institutions/societies of specialties that manage asthma. The international reference guidelines (selected with AGREE-II) were: GINA 2024, GEMA 5.4, BTS/SIGN 2024 and Australian Asthma Handbook 2021. MIA 2.0 covers diagnosis, treatment, severe asthma, exacerbations and special groups. Key clinical questions were formulated for I) diagnosis, II) treatment steps 1-4, III) severe asthma and IV) exacerbations.</p><p><strong>Results: </strong>Based on evidence in reference guidelines, safety, cost and local reality, the core group developed responses to the clinical questions. Through a Delphi process, the MIA 2.0 development group suggested adjustments until consensus was reached.</p><p><strong>Conclusion: </strong>A document was generated with multiple figures and algorithms, about asthma management including exacerbations treatment, adjusted for Mexico broadly based among different societies that participated in its development.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 2","pages":"1-50"},"PeriodicalIF":0.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tribute to Dr. Luis Velásquez Jones.","authors":"Mara Medeiros","doi":"10.24875/BMHIME.M24000072","DOIUrl":"https://doi.org/10.24875/BMHIME.M24000072","url":null,"abstract":"","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 1","pages":"5-6"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial steps in the selection of a child development screening instrument in the peruvian context.","authors":"Carla P Cortez-Vergara, Gisely Hijar-Guerra, Blanca Távara-Campos, María E Ugaz-Villacorta","doi":"10.24875/BMHIM.24000156","DOIUrl":"10.24875/BMHIM.24000156","url":null,"abstract":"<p><strong>Background: </strong>The foundational elements for optimal well-being and health are established during the early stages of life. When progress does not meet expectations, it is necessary to explore possible disorders, health conditions, or other probable factors affecting it. Health professionals in our country must have access to developmental screening instruments that facilitate early detection of these potential risks and delays, thus enabling timely intervention.</p><p><strong>Methods: </strong>After a pre-selection of the evidence and adequate training of a multi-sectoral panel, a virtual deliberative dialog was held with key stakeholders and decision-makers to determine the most appropriate development screening instrument for the Peruvian context. The evidence was analyzed and discussed in light of the established criteria. In addition, factors pertaining to implementation on a national level were discussed.</p><p><strong>Results: </strong>A set of instruments were obtained and prioritized in the following order: Evaluation of Child Development (EDI, Spanish acronym) ranked first, followed by the Abbreviated Developmental Scale Third Edition (EAD-3, Spanish acronym) and the Ages and Stages Questionnaire (ASQ-3, Spanish acronym), based on the established criteria. The primary components implicated in the execution of this evaluation on a national scale were subsequently identified.</p><p><strong>Conclusions: </strong>This deliberative dialog has enabled a first approach to the selection of a development screening instrument on the national level, providing valuable information to guide the implementation process.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 1","pages":"25-35"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between development level and nutritional status in children under 5 years of age in primary care.","authors":"Miguel Á Villasis-Keever, Antonio Rizzoli-Córdoba, Blanca B Mares-Serratos, Karla E Falcón-Millán, Edwin O Vargas-Ávila, Christian A Delaflor-Wagner, Daniel Aceves-Villagrán, Hortensia Reyes-Morales, José A García-Aranda","doi":"10.24875/BMHIM.25000004","DOIUrl":"10.24875/BMHIM.25000004","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition is a risk factor for childhood development disorders. Although undernutrition is recognized as a public health problem, the impact of overweight/obesity on childhood development remains unknown. The objective is to determine the effects of undernutrition, overweight, and obesity on development in children aged between 1 and 59 months in rural/urban areas of Mexico.</p><p><strong>Methods: </strong>The Childhood Development Evaluation (EDI, for its acronym in Spanish) test was administered to children 1-59 months of age who visited primary care units in Guanajuato State, Mexico, between 2013 and 2015. The World Health Organization classification (weight/height ratio) was used for nutritional status. Logistic regression adjusted by sex, age, rural/urban, and level of marginalization, used to calculate odds ratios (OR) to stablish the association between nutritional status and developmental outcomes.</p><p><strong>Results: </strong>34,972 participants were included. 50.3% were male, 39.5% had a very low level of marginalization, 58.6% lived in urban areas, and 55.0% were beneficiaries of a conditional cash transfer program. Age distribution: 31.9% between 1 and 12 months old; 17.5% between 13 and 24 months old; 16.3% between 25 and 36 months old; and 34.3% between 37 and 59 months old. Overall 85.8% of participants had normal nutritional status, whereas 9.1% were identified as malnourished, and 5.0% were classified as overweight or obese. 79.1% had typical development. The OR for atypical development was 1.820 (95% confidence interval [95% CI], 1.671-1.981) for mild undernutrition; 2.796 (95% CI: 2.195-3.562) for moderate undernutrition; 14.903 (95% CI: 8.149-27.257) for severe undernutrition; and 1.160 (95% CI: 1.030-1.307) for overweight/obesity.</p><p><strong>Conclusion: </strong>Undernutrition and overweight/obesity are factors that increase the risk of developmental problems in children < 5 years of age.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 1","pages":"66-72"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of silver diamine fluoride for the prevention and control of early childhood caries: a scoping review.","authors":"Carmen D Macedo-Jaramillo, Estefany García-Cruz, Paulina De La Portilla-Robles, Daniela I Guadarrama-García","doi":"10.24875/BMHIM.24000090","DOIUrl":"10.24875/BMHIM.24000090","url":null,"abstract":"<p><p>Early childhood caries (ECC) is the presence of one or more decayed, missing, or filled teeth in children up to 71 months of age. Among the recommendations proposed by the World Health Organization to counteract this condition is the application of silver diamine fluoride (SDF). The aim of this research was to analyze the available information on the cost-effectiveness of SDF as a public health intervention in the prevention and control of ECC. This scoping review included articles published in English between 2008 and 2023 about the cost-effectiveness of SDF for pre-schoolers. Scientific journal databases (PubMed, Free Medical Journal, Science Direct, Springer Link, and Google Scholar) were searched using the following keywords: ECCs, effectiveness, cost, SDF, economic evaluation, caries, pre-school, infant, and minimal invasive treatment. The information extracted included author, year, objective, population, design, perspective of the analysis, options to be compared, time horizon, discount rate, costs, and effectiveness. We identified a total of 526 articles. Of these, 514 were excluded due to lack of relevance to the study objective, and 5 were duplicates. The final sample comprised 7 articles. The reported costs of SDF treatments from the perspective of healthcare practitioners ranged from $0.7 to $1,456, with an incremental cost-effectiveness ratio ranging from -$7.73 to -$518.50. SDF is a cost-effective treatment for public health interventions to prevent and control ECC in pre-schoolers.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 2","pages":"98-106"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric arrhythmias: a comprehensive integrative review, symptom-based conceptual framework, and practical care guide.","authors":"Ana C Cepeda-Nieto, Corazón de J Roblero-Aguilar, Janetzy Martínez-López, Norma A Balderrábano-Saucedo","doi":"10.24875/BMHIM.24000059","DOIUrl":"10.24875/BMHIM.24000059","url":null,"abstract":"<p><p>Pediatric arrhythmia encompass a diverse array of conditions, ranging from asymptomatic cases to severe life-threatening episodes. Effective management of these conditions, especially for non-specialist physicians, is crucial to improving patient outcomes and reducing the risk of sudden cardiac death (SCD). This integrative review aims to synthesize the present evidence on the strategies for diagnosing and treating pediatric arrhythmias, providing a practical, symptom-based guide for non-specialist physicians. Following Cooper's methodological framework, we conducted a comprehensive literature search using electronic databases (PubMed/MEDLINE and Cochrane Library) up to August 7, 2024. Inclusion criteria focused on studies published between 2019 and 2024, involving pediatric patients aged 2-18 years with several types of arrhythmias, excluding those with congenital heart disease or other systemic conditions. Quality appraisal was performed using the GRADE and CONSORT methodologies. From 176 initially selected studies, 69 met the inclusion criteria. The evidence was synthesized into a symptom-based conceptual framework, categorizing arrhythmias into asymptomatic, paroxysmal tachycardia, and those associated with low cardiac output or syncope. Common arrhythmias, such as sinus arrhythmia, sinus bradycardia, and wandering atrial pacemaker typically do not require treatment. In contrast, conditions, such as supraventricular tachycardia, ventricular tachycardia, and inherited arrhythmias (e.g., long QT syndrome, Brugada syndrome) necessitate specific diagnostic and therapeutic strategies. This review provides a practical guide for non-specialist physicians to diagnose and manage pediatric arrhythmias, aiming to improve patient outcomes and reduce SCD incidence in children. Future research should focus on pediatric-specific studies and the development of novel therapeutic interventions.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 2","pages":"67-97"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental knowledge and caregiving practices related to early childhood development.","authors":"Antonio Rizzoli-Córdoba, Alicia Lebrija-Hirschfield, Laura A Hernández-Trejo, Christian A Delaflor-Wagner, Miguel Á Villasis-Keever","doi":"10.24875/BMHIM.25000005","DOIUrl":"10.24875/BMHIM.25000005","url":null,"abstract":"<p><strong>Background: </strong>Early childhood development (ECD) is a critical period for achieving milestones in cognitive, motor, and socioemotional development. Parental knowledge of ECD influences the manner in which children are stimulated, as evidenced in previous studies, particularly in developing countries. This study examined parents' understanding of ECD, their stimulation and caregiving practices, and the sources of information that they utilize in the Mexican context.</p><p><strong>Methods: </strong>A descriptive cross-sectional field study was conducted using a questionnaire validated by a panel of experts and a pilot test. A total of 536 mothers and fathers from socioeconomic levels C-, D+, and D/E residing in three Mexican cities were surveyed using non-probability convenience sampling. The questionnaire inquired about respondents' knowledge, stimulation practices, and sources of information related to ECD.</p><p><strong>Results: </strong>In all, 60% of the surveyed parents did not consider the first 3 years of life as a relevant learning stage. Although 44.3% of mothers and 37.6% of fathers identified early learning (at 0-3 months), few socioemotional activities were considered relevant. Only 33% were familiar with the term \"early stimulation,\" and television was the most consulted medium (30%).</p><p><strong>Conclusions: </strong>It is necessary to raise awareness among parents about the importance of play, as well as socioemotional and communicative activities in ECD. The quality of information disseminated through mass media should be improved and public policies to strengthen parental education should be promoted.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 1","pages":"101-112"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Septic shock upon admission to pediatric intensive care units: prognostic analysis of mortality in a retrospective cohort.","authors":"Ricardo Rodriguez-Portilla, Isabel Pinedo-Torres, Claudia C Guerra-Ríos, Angela Parra Del Riego-Freundt-Thurne, Nilton Yhuri-Carreazo","doi":"10.24875/BMHIM.24000056","DOIUrl":"10.24875/BMHIM.24000056","url":null,"abstract":"<p><strong>Background: </strong>Septic shock is a common cause of admission to pediatric intensive care units (PICU) and is associated with significant mortality. Our objective was to analyze the association between septic shock diagnosis at PICU admission and mortality during hospitalization.</p><p><strong>Method: </strong>This retrospective cohort study was conducted in the PICU of Hospital Nacional Edgardo Rebagliati Martins (HNERM) in Lima, Peru, from January 2018 to December 2021. The sample size was determined based on annual mortality rates, and randomization was used to create two groups: patients with and without septic shock. To evaluate mortality risk, we performed a Poisson regression with robust variances and 95% confidence intervals (CI) using both crude and adjusted models.</p><p><strong>Results: </strong>Of 1,341 patients admitted to the PICU during the study period, 358 were included in the analysis. The study population was 51.9% female, with a median age of 3.7 years. The largest age group was children under 1 year, comprising 29.6% of participants. The septic shock group showed higher rates of mechanical ventilation requirement, longer hospital stays, and increased mortality. The risk of mortality was 2.73 times higher in patients admitted with septic shock compared to those admitted with other diagnoses (relative risks: 2.73; 95% CI: 1.36-5.46).</p><p><strong>Conclusion: </strong>Patients admitted to the PICU with septic shock demonstrated a 2.73 times higher risk of death compared to those admitted for other reasons.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 1","pages":"28-34"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first 1000 days: the great opportunity.","authors":"Marta M Zapata-Tarrés","doi":"10.24875/BMHIM.24000173","DOIUrl":"https://doi.org/10.24875/BMHIM.24000173","url":null,"abstract":"","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 1","pages":"1-2"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a federal early education program in Mexico on the developmental level of children aged 13-48 months: national survey.","authors":"Antonio Rizzoli-Córdoba, Hortensia Reyes-Morales, Jesús H Trujillo-Flores, Mario R Paredes-Saldaña, Angélica Ocaña-Zavaleta, Laura A Hernández-Trejo, José A García-Aranda, Daniel Aceves-Villagrán, Miguel Á Villasis-Keever","doi":"10.24875/BMHIM.24000159","DOIUrl":"10.24875/BMHIM.24000159","url":null,"abstract":"<p><strong>Background: </strong>Early childhood development is crucial. The objective of this study was to evaluate, on a national scale, the level of development of children enrolled in the federal childcare program, according to the length of stay in the childcare centers and by geographic area.</p><p><strong>Methods: </strong>A national cross-sectional study was conducted. The study population comprised 231,058 children aged between 13 and 48 months, enrolled in 9200-day care centers across the 32 states of Mexico. The developmental level was measured using the Child Development Evaluation test. The effect of length of stay was analyzed by logistic regression, using odds ratio of prevalence and 95% confidence intervals.</p><p><strong>Results: </strong>Of the total number of participants, 53% were male, and the 37-48 month-old group was the largest (45%, n = 103,976). The length of stay ranged from 1 to > 24 months. The proportion of children with normal developmental outcomes increased alongside the length of stay, from 72.3% for children with < 6 months of stay to 88.7% for those who attended centers for > 24 months. By geographical region, Guerrero and Oaxaca, two low-income states, showed the best results, along with the highest-income states. The distribution for each area of development and geographic area are shown.</p><p><strong>Conclusion: </strong>At the national level, long-term enrollment in daycare centers favors normal development. Particularly important is the high result in low-income regions, and it could be an equalizing strategy as a public policy. The different results among areas could help to improve the curricula.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 1","pages":"73-85"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}