Boletín médico del Hospital Infantil de México最新文献

{"title":"Complications and blood transfusions in newborns are associated with a higher milliliters per kilogram ratio of blood extracted for laboratory studies.","authors":"Lorena Salazar-Cavazos, Jesus J Solis-Flores, Carmen L de Hoyos-Ramón, Marco A Flores-Heredia, Luis G Martínez-Valades, Lucas A Garza-Garza","doi":"10.24875/BMHIM.24000148","DOIUrl":"10.24875/BMHIM.24000148","url":null,"abstract":"<p><strong>Background: </strong>Phlebotomy-associated blood loss is a clinical concern in term and pre-term newborns. Previous reports have associated a higher volume of phlebotomy associated blood loss to a more pre-term status and to the need for blood transfusions. The present study was undertaken to evaluate the amount of phlebotomy-associated blood loss and its associations.</p><p><strong>Methods: </strong>Retrospective, observational, and analytical study conducted through a retrospective chart review. The primary objective was to determine the association between the presence of the endpoint \"any complications\" and the mean phlebotomy-associated blood loss in milliliters/kilograms (mL/kg). Blood loss was quantified using the corresponding documentation sheet in the clinical record, as reported by the nursery service.</p><p><strong>Results: </strong>176 patients were included in the present study. Male: female ratio was 1.67:1.00. Mean gestational weeks was 34.2 with a standard deviation of 3.7. Patients meeting the composite endpoint \"any complications\" had a higher mean mL/kg of phlebotomy-associated blood loss than those who did meet it (10.93 vs. 2.91, p < 0.001). In addition, patients requiring blood transfusions had higher mL/kg of phlebotomy-associated blood loss than those who did not (21.16 vs. 4.21, p < 0.001). Finally, more pre-term status was significantly associated with a higher phlebotomy-associated blood loss (p < 0.001).</p><p><strong>Conclusions: </strong>The presence of any complications, more pre-term status and need for blood transfusions was significantly associated with a higher mL/kg phlebotomy-associated blood loss. Bigger, prospective studies controlling other variables and temporality are needed to fully grasp the clinical consequences of a high mL/kg phlebotomy-associated blood loss.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 5","pages":"289-294"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147759","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":"Clinical and dermoscopic findings of classic-type nevus lipomatosus cutaneous superficialis in an adolescent. Case report.","authors":"Juan A Godínez-Chaparro, Marissa de J Quintal-Ramírez, Baldomero García-Gálvez","doi":"10.24875/BMHIM.24000112","DOIUrl":"https://doi.org/10.24875/BMHIM.24000112","url":null,"abstract":"<p><strong>Background: </strong>Nevus Lipomatosus Cutaneous Superficialis (NLCS) is a rare benign tumor characterized by the presence of ectopic adipocytes distributed among the collagen bundles in the dermis. Dermoscopy of this lesion has been poorly documented, but it aids in diagnosis.</p><p><strong>Clinical case: </strong>A female patient, 11 years and 5 months old, presented with lesions in the lumbar region that had gradually increased in size and number since birth. In September 2023, she was evaluated at CMN La Raza, where a lesion in the lumbar region was observed, consisting of a linear plaque measuring 30 × 15 mm in diameter, composed of multiple skin-colored papules and nodules that coalesced. Dermoscopy revealed a cerebriform surface, a web-like pigment network, and the presence of yellowish structureless areas. Histopathology showed a proliferation of mature adipocytes in the reticular and papillary dermis. The adipocytes were located perianexally, perivascularly, and dispersed among the collagen bundles. An increase in the density of collagen bundles was observed. The diagnosis was NLCS. The lesion was completely excised without recurrence.</p><p><strong>Conclusions: </strong>The condition may be underdiagnosed due to a lack of medical familiarity. Dermoscopy facilitates a more accurate diagnosis. An increased number of reports will contribute to the creation of a database for future studies and potential associations.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 5","pages":"319-322"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147779","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":"Relación entre genotipo y carga viral de virus del papiloma humano y la gravedad de presentación de la papilomatosis respiratoria recurrente en niños.","authors":"Enrique G Ortiz-Hernández, Ariadna Vallejo, Diego Guzmán, Melissa León, Natalia Calderón","doi":"10.24875/BMHIM.24000145","DOIUrl":"https://doi.org/10.24875/BMHIM.24000145","url":null,"abstract":"<p><strong>Background: </strong>Recurrent respiratory papillomatosis is a condition that occurs mainly in the pediatric population with a rate of 3.62 to 4.3 per 100,000 children. The most common clinical manifestation is dysphonia; however, the disease can progress to more severe forms, generating serious obstruction of the airway.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in which patients diagnosed with laryngeal papillomatosis confirmed by histopathological analysis and polymerase chain reaction were included. The genotype of the virus and its viral load were determined through a search in the clinical records, and the clinical and genetic variables of each case were captured through a structured form.</p><p><strong>Results: </strong>A total of 32 patients were enrolled, of which the prevalence of genotype 6 was found in 41% and the same prevalence in the case of genotype 11, with a percentage of coinfection with both subtypes of 18%. Genotype 11 was found to be associated with a greater number of resections (p = 0.004), a higher score on the Derkay scale (p = 0.02) and greater severity when presenting ≥ 4 surgeries per year and/or ≥ 10 total surgeries (p = 0.04).</p><p><strong>Conclusions: </strong>Human papillomavirus genotype 11 showed a greater association with the presentation of greater severity of recurrent respiratory papillomatosis in pediatric patients; therefore, this population is more susceptible to a poor outcome (which increases the demand for medical services), as well as impact on the quality of life of minors.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 5","pages":"282-288"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147831","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":"Decannulation outcomes in pediatric patients with acquired brain injury: a retrospective study.","authors":"Juan I Indo, Zelmira Ríos, Carla de Nicola, Mauro F Andreu","doi":"10.24875/BMHIM.25000014","DOIUrl":"10.24875/BMHIM.25000014","url":null,"abstract":"<p><strong>Background: </strong>Decanulation in paediatric patients with tracheostomy due to acquired brain injury is a key objective in rehabilitation, and there is a lack of consensus about the optimal protocol and success factors in decannulation. Therefore, the aim of this study is to describe the experience of decannulation in a paediatric neurorehabilitation centre in Buenos Aires.</p><p><strong>Methods: </strong>An observational, retrospective, and descriptive study was conducted on patients under 18 years old with acquired brain injury and tracheostomy, admitted between January 2016 and August 2023. Demographic, clinical data, and fibroendoscopy results were collected. Decannulation was performed according to institutional criteria, and a 48-hour monitoring period was implemented to evaluate post-decannulation complications.</p><p><strong>Results: </strong>Of the 41 patients included in the study, 12 (29.3%) were successfully decannulated, while 29 (70.7%) were discharged with a speaking valve, an occluded cannula, or with the initial tracheostomy configuration. Fibroendoscopy was performed on 13 patients, detecting lesions in 11 cases.</p><p><strong>Conclusions: </strong>The decannulation rate observed falls within the range documented in the literature, although it is closer to the lower end, which may be due to the complexity of the cases and the conservative approach adopted. The presence of disorders of consciousness and comorbidities were important factors in the decannulation process.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 4","pages":"245-251"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882110","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":"Hospitalizations due to acute respiratory tract infections caused by human metapneumovirus in Costa Rican children.","authors":"Luisana Guier-Bonilla, Adriana Yock-Corrales, Marco T Vargas-Acuña, Rolando Ulloa-Gutierrez","doi":"10.24875/BMHIM.24000184","DOIUrl":"10.24875/BMHIM.24000184","url":null,"abstract":"<p><strong>Background: </strong>Human metapneumovirus (hMPV) is a leading cause of acute respiratory infection in children, particularly early in life. Despite this, there are few prospective hMPV studies in Latin American children and this is the only of that kind in Costa Rica.</p><p><strong>Methods: </strong>We conducted an observational descriptive prospective study at the only national tertiary referral pediatric hospital of the country. We included children < 13 years of age with a laboratory-confirmed hMPV episode of acute respiratory tract infection requiring hospitalization from September 1, 2015, to September 30, 2017. Diagnosis was confirmed by direct immunofluorescence assay and/or polymerase-chain reaction.</p><p><strong>Results: </strong>One hundred and eighty-eight patients were analyzed. One hundred and sixteen (62%) were male. About 65% were < 15 months of age; median age was 12 months (interquartile range [IQR] = 6-23). Median hospital stay was 5 days (IQR = 3-8). The most common underlying conditions were prematurity (21.8%;41), recurrent wheeze-asthma (22,8%;43), and low birth weight (17%;32). About 52.6% patients received intravenous antibiotics. Complications occurred in 37.5%, among which, ventilatory failure occurred in 17% (32), shock 4.2% (8), and pleural effusion 1.6% (3). Forty-five (23.9%) patients needed high-flow nasal cannula (average of 3.4 days [standard deviation (SD) = 2.08]). Fifty-four (28.7%) children required pediatric intensive care unit admission. Twenty-eight (14.8%) of them were on assisted mechanical ventilation for a mean duration of 6.3 days (SD = 6.03). Ten patients went home with requiring supplementary oxygen; no deaths occurred.</p><p><strong>Conclusions: </strong>hMPV-associated hospitalizations in Costa Rican children are associated with significant morbidity. A concerning finding in our study was the high proportion of patients requiring antibiotic therapy, either on admission or during hospitalization. This should prompt us to antimicrobial stewardship interventions.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 4","pages":"238-244"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882112","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":"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}

{"title":"Validation of a screening tool for developmental problems in children 60-71 months in Mexico.","authors":"María S Rodríguez-Trejo, Antonio Rizzoli-Córdoba, Laura A Hernández-Trejo, Ilma R Torres-Escobar, Miguel Á Villasis-Keever","doi":"10.24875/BMHIM.24000160","DOIUrl":"10.24875/BMHIM.24000160","url":null,"abstract":"<p><strong>Background: </strong>Early childhood is a critical period for child development. The Child Development Evaluation Test (EDI in Spanish), developed and validated in Mexico, is a screening tool for developmental problems in children from 1 month to 4 years and 11 months.</p><p><strong>Objective: </strong>To validate group 15 of the EDI test for children aged 60-71 months, comparing sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) using the Battelle Developmental Inventory 2^nd edition (BDI-2) in Spanish as the gold standard.</p><p><strong>Methods: </strong>A cross-sectional analytic study with 46 children aged 60-71 months was conducted at the Hospital Infantil de México Federico Gómez. Children were evaluated using group 15 of the EDI test and BDI-2. The sample was non-probabilistic by convenience. Diagnostic metrics and comparisons were performed globally and in the developmental domain.</p><p><strong>Results: </strong>The sensitivity and specificity of group 15 for the EDI test were 93.8% (95% confidence interval [CI]: 81.8%-100%) and 73.3% (95%CI: 57.5%-89.1%), respectively. The PPV was 65.2%, and the NPV 95.5%. The highest percentage of false negatives was in the cognitive domain, followed by the adaptive domain.</p><p><strong>Conclusion: </strong>In this first study, group 15 of the EDI test shows high sensitivity and NPV, allowing early detection in an age group previously not covered, thus facilitating interventions in this group.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 1","pages":"45-51"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633536","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":"Antibiotic therapy in dysentery of infectious etiology in early childhood: a systematic scoping review.","authors":"Juan F Guevara-Ramírez, Andrés F Rodríguez-Gutiérrez, Ingrid S Sánchez-Escobar, Samuel D Bolaños-Rodríguez, Valentina Adames-Restrepo, Simón A Ruiz-Galvis, Valentina Sánchez-Sánchez, Néstor A De La Cruz-Torres, Erwin H Hernández-Rincón, Samuel D Barbosa","doi":"10.24875/BMHIM.24000085","DOIUrl":"10.24875/BMHIM.24000085","url":null,"abstract":"<p><p>Acute diarrhea (AD) is one of the leading causes of child mortality, particularly in children under 5 years old. Dysentery, a severe form of AD characterized by blood and mucus in the stool, raises controversies regarding the appropriate use of antibiotics. The objective of this manuscript is to synthesize the available information on the indications, risks, and benefits of antibiotics used in infectious dysentery during early childhood. A scoping systematic review was conducted using international reference documents and the databases PubMed, Scopus, and Google Scholar, following the PRISMA-ScR guidelines. Studies from 2014 onwards that addressed antibiotic management in children under 5 years old with bacterial or parasitic dysentery were included. Among the 39 selected studies, the evidence shows limited benefits and significant risks associated with antibiotic use, with recommendations varying based on specific etiology and the patient's clinical conditions, where it is evident that the rational use of antibiotics in pediatric dysentery is crucial to avoid bacterial resistance and adverse effects. There is a need for future research to establish guidelines based on robust clinical trials, to optimize targeted treatment and improve clinical outcomes in this population.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 1","pages":"15-27"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596234","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}