Boletín médico del Hospital Infantil de México最新文献

{"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":"Effectiveness and safety of topical sirolimus in children with angiofibromas and tuberous sclerosis complex.","authors":"Andrea Fernández de Lara-Arrieta, Silvestre García-de La Puente, Janett Flores-Pérez, Carmen Flores-Pérez, Rodrigo Lomelí-Valdez, Andrea Venegas-Andrade, Carolina Palacios-López","doi":"10.24875/BMHIM.24000091","DOIUrl":"10.24875/BMHIM.24000091","url":null,"abstract":"<p><strong>Background: </strong>Tuberous sclerosis complex (TSC) is an autosomal dominant disease that can affect any organ with hamartomas. It is characterized by early-onset seizures and is associated with intellectual disability. The main dermatological findings include hypopigmented macules, shagreen patches, and angiofibromas, which appear in 81-96% of patients.</p><p><strong>Method: </strong>We conducted a quasi-experimental, before-and-after, open-label study in 10 patients with TSC and facial angiofibromas, aged 8-17 years, who were treated at the dermatology service of the Instituto Nacional de Pediatría in 2019 and 2020. All patients agreed to participate in the study and signed both consent and assent forms. All patients received treatment with 1% topical sirolimus for 6 months on the right side of the face, followed by 6 months on the left side of the face to assess recurrence. Each patient served as their own control. Measurements of baseline lesions were taken and followed monthly for 6 months. The changes in lesion size, measured in millimeters at each time point, were compared using repeated measures analysis of variance.</p><p><strong>Results: </strong>All children showed a decrease in the size and number of angiofibromas, as well as reduced erythema, from the 3^rd month of treatment. Few recurrences were observed beginning at 4 months after discontinuation of the medication.</p><p><strong>Conclusion: </strong>Topical sirolimus is effective and safe for treating patients with angiofibromas and TSC.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 2","pages":"115-120"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109677","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":"Cross-cultural adaptation, validation, and reliability of the child development evaluation test (EDI) in Colombia.","authors":"Luisa M Salamanca-Duque, Ma Mercedes Del C Naranjo-Aristizábal, Luz A Botero-Montoya, Luz Ma Velásquez-Palacio, Sandra Garnica-López, Ma Angélica Enciso-Rodríguez, Yadira Henao-Valencia, Antonio Rizzoli-Córdoba","doi":"10.24875/BMHIM.24000155","DOIUrl":"10.24875/BMHIM.24000155","url":null,"abstract":"<p><strong>Background: </strong>Monitoring child development requires not only the determination of developmental milestones but also surveillance and continuous monitoring, hence the importance of having valid and reliable evaluation instruments. This research aimed to cross-culturally adapt the Child Development Evaluation (CDE) test for Colombia and determine its validity and reliability.</p><p><strong>Methods: </strong>The cross-cultural adaptation process was conducted in four phases: I. Adaptation to Colombian Spanish: adjustments of the test to Colombian Spanish and analysis of equivalences; II. Content and face validity: evaluation by five expert judges who performed quantitative and qualitative assessments of the test; III. Review by the original author; IV. Pilot test. Reliability analyses for internal consistency and intra-rater reliability were performed.</p><p><strong>Results: </strong>For the adaptation to Colombian Spanish, most test items were equivalent to Mexican Spanish, with some requiring minimal conceptual and contextual changes to maintain their meaning; culturally relevant formulations and expressions were adjusted. In the content and face validity assessment, adequate results were found regarding the importance, influence, and observability of the items. Internal consistency reliability was moderate, with Cronbach's α values between 0.41 and 0.57, and intra-rater reliability was very good, with Kappa index values > 0.76.</p><p><strong>Conclusion: </strong>The CDE test demonstrates cross-cultural adaptation, content and face validity, and reliability for its application and use in Colombia.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 1","pages":"36-44"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633525","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 analysis of child development evaluation test (CDE test or Prueba EDI) in children under 5 years old in Mexico: a simulation model study.","authors":"José R García-Lira, Rita E Zapata-Vázquez, Alfonso Reyes-López, Antonio Rizzoli-Córdoba","doi":"10.24875/BMHIM.24000171","DOIUrl":"10.24875/BMHIM.24000171","url":null,"abstract":"<p><strong>Background: </strong>The Health Ministry has incorporated the Child Development Evaluation test (CDE test) as the national screening tool for children < 5 years old. The aim of this study is to analyze the cost-effectiveness of the CDE test compared to standard medical consultation in Mexico.</p><p><strong>Methods: </strong>The study was conducted with information available until 2020. A cost-effectiveness analysis was conducted from perspective of the public/social sectors in Mexico with a decision tree model to evaluate the strategies. The time horizon was set at 1 year, no discounting applied. Costs were calculated in Mexican pesos (MXN) at 2019 prices and included both direct/indirect costs. Direct costs encompassed CDE test administration, specialist consultations, and rehabilitation sessions. Indirect costs considered transportation expenses and lost wages related to caregiving. To account for variability and uncertainty, a Monte Carlo simulation with 10,000 iterations was performed. Probabilistic sensitivity analysis was conducted to test robustness of the results.</p><p><strong>Results: </strong>The results confirm that the CDE test consistently outperforms the standard approach, delivering improved outcomes at reduced costs in the majority of scenarios. The incremental net monetary benefit of implementing CDE screening was $44,608 MXN (2019 value), providing additional evidence of its cost-effectiveness.</p><p><strong>Conclusion: </strong>This study suggests that the CDE test is cost-saving from the public and social sector perspective, generating a net increase in both monetary benefits and health outcomes. Furthermore, its implementation is feasible within the Mexican healthcare system, particularly considering its potential to enhance long-term efficiency.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 1","pages":"59-65"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633524","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":"Acknowledgments to reviewers 2024.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 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":"143596231","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":"Hemodynamic phenotypes in congenital diaphragmatic hernia and their association with morbidity and mortality.","authors":"Daniel Ibarra-Ríos, José G Mantilla-Uresti, Diana M Barrios-Bautista, Alejandro Peñarrieta-Daher, Cristian R Zalles-Vidal, Deneb A Morales-Barquet, Horacio Márquez-González","doi":"10.24875/BMHIM.24000093","DOIUrl":"10.24875/BMHIM.24000093","url":null,"abstract":"<p><strong>Background: </strong>Congenital diaphragmatic hernia (CDH) is a severe condition associated with high morbidity and mortality. Its severity correlates with the degree of pulmonary hypoplasia. Recent literature has emphasized the importance of identifying distinct hemodynamic phenotypes (HP) to guide physiology-based management.</p><p><strong>Method: </strong>We included all CDH patients evaluated by targeted neonatal echocardiography from January 2017 to April 2022. HPs were classified into three groups: HP1 (mild pulmonary hypertension [PH] without ventricular dysfunction), HP2 (pre-capillary PH), and HP3 (post-capillary PH). We compared differences between survivors and non-survivors using the Mann-Whitney U-test, analyzed baseline and pre/post-surgical echocardiographic parameters using the Wilcoxon test, estimated survival curves using Kaplan-Meier analysis, and compared length of stay using the Kruskal-Wallis test.</p><p><strong>Results: </strong>Among 28 included neonates, 24 survived (86%). HP distribution was: HP1 9 patients (32%), HP2 8 patients (29%), and HP3 11 patients (39%). Four patients died, two post-surgery and two without surgical intervention. Mortality-associated factors included higher pCO₂, lower left ventricular (LV) output, decreased LV compliance, and elevated pulmonary vascular resistance (PVR). Survival analysis revealed a non-significant trend toward higher mortality in HP2 (one death) and HP3 (three deaths). Follow-up demonstrated progressive increases in biventricular output, PVR reduction, and compensatory cerebral vasodilation.</p><p><strong>Conclusion: </strong>HP correlated with patient mortality, particularly in cases with greater pulmonary hypoplasia (higher CO₂) and compromised ventricular performance. Echocardiographic monitoring revealed improvements in biventricular performance, decreased PVR facilitating surgical intervention, and cerebral perfusion adaptation.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 1","pages":"54-62"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596165","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":"Mitochondria-based medicine.","authors":"Salvador Vázquez-Vega, José D Martínez-Ezquerro, Sergio Sánchez-García, Edwin R Marka-Castro, Fernando Minauro-Sanmiguel","doi":"10.24875/BMHIM.24000058","DOIUrl":"10.24875/BMHIM.24000058","url":null,"abstract":"<p><p>At the balance between human health and disease (from the very first moments to the end of life), the mitochondrion is central players because of its metabolic role in adenosine triphosphate synthesis, cell signaling, immune response, and other processes of clinical interest. On the other hand, impairments at the optimal mitochondria function have important consequences in complex diseases, such as heart disease, diabetes, and cancer, among others. These mitochondrial impairments can occur at any age damaging multiple body systems, which have prompted the mitochondrial medicine development. Since mitochondrial diseases have great variability in their clinical manifestations, early studies were centered on mitochondriopathies, however nowadays, this focus has broadened to understand and encompass the mitochondrial role of in diseases development of both pediatric and adult age. The mitochondria potential to improve diagnostic, prognostic, and treatment response strategies has been revealed by experimental approaches using proteomics, genomics, and metabolomics to identify clinical biomarkers showing disease development. Thus, the perspective of mitochondria-based medicine recognizes the importance of generating scientific evidence related to mitochondria and their role in pathological conditions from a comprehensive approach.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 1","pages":"7-14"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596248","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":"Results of a concurrent training protocol in muscle function and quality of life in the pediatric population with type 1 diabetes: a pilot study in public health.","authors":"Phillip Foster, Erna Gálvez, Patricio Pinto, Eduardo Cifuentes-Silva, Sandra Mahecha-Matsudo, Mauricio Inostroza-Mondaca","doi":"10.24875/BMHIM.24000117","DOIUrl":"10.24875/BMHIM.24000117","url":null,"abstract":"<p><strong>Background: </strong>Type 1 diabetes mellitus (T1DM) prevalence has increased in prevalence worldwide. T1DM is characterized by negative changes in glycemic control (e.g., increased risk of hypoglycemia) and moreover negatively impacts the quality of life and muscle function of the pediatric population with the disease.</p><p><strong>Method: </strong>seven participants of the Hospital Dr. Exequiel González Cortés (age 11 [10-13] years, 4 male and 3 female) participated in a 12-week, twice-weekly concurrent training program plus continuous glucose monitoring (CGM). The participants underwent the following assessments: anthropometric measurements (weight, height, and BMI), glycemic control (Glycated hemoglobin [HbA1c], hypoglycemic events diaries, time in range, and glycemic diaries), muscle function (standing broad jump, prone plank, 10 maximum repetitions [10RM] squat, and chest press), quality of life (Kidscreen-27 questionnaire), and aerobic capacity (20 m shuttle run test). Statistical analysis used the Shapiro-Wilk test (normality), one-way Analysis of variance (differences between months), and paired t-test (pre-post differences).</p><p><strong>Results: </strong>The HbA1c increased (p = 0.047). Muscle function improved in standing broad jump (p = 0.03), prone plank (p = 0.01), 10RM squat (p = 0.03), and 10RM chest press (p = 0.01). Quality of life increased in physical function (p = 0.03) and total score (p = 0.01). The running distance in the 20 m shuttle run test increased (p = 0.01).</p><p><strong>Conclusion: </strong>The concurrent training program plus CGM is effective in improving quality of life, muscle function, and running capacity in the pediatric population with T1DM.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 2","pages":"129-137"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109688","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":"Hodgkin and non-Hodgkin lymphomas in pediatric-age patients of Northeast Mexico: 18-year outcomes and survival rates at an academic center.","authors":"José C Jaime-Pérez, Ana L Beltrán-López, Valentina Jiménez-Antolínez, Renata Barragán-Longoria, Julia E Colunga-Pedraza, Óscar González-Llano, David Gómez-Almaguer","doi":"10.24875/BMHIM.24000080","DOIUrl":"10.24875/BMHIM.24000080","url":null,"abstract":"<p><strong>Background: </strong>Hodgkin lymphoma (HL) and non-HL (NHL) are the third and fourth most common malignancies during childhood, with limited information available from Latin America.</p><p><strong>Method: </strong>We retrospectively studied patients with HL and NHL from a single academic center in Northeast Mexico between 2002 and 2020. Data included treatment regimens, staging, and survival outcomes. Survival was determined by Kaplan-Meier analysis, and features of lymphomas were compared using the X² test.</p><p><strong>Results: </strong>The study included 75 patients, 36 (48%) with HL and 39 (52%) with NHL. Males predominated (70%); the median age was 9 years. Stages III and IV were detected in 59% and median follow-up reached 50 months. Relapse occurred in 16 (21%) patients, 9 (12%) in the HL group and 7 (9%) in the NHL group. Thirteen (17.3%) patients underwent transplantation, 12 (85%) in the HL group; 11 are alive. Most deaths, 10/11 (91%), occurred in NHL patients. Five-year overall survival rates were 96% (95% confidence interval [CI] 95.6-97) for HL and 75% (95% CI 74.9-76.3) for NHL (p = 0.004). Five-year disease-free survival was 70% for HL (95% CI 69-72.5) and 69% (95% CI 67.7-71) for NHL (p = 0.672).</p><p><strong>Conclusion: </strong>Pediatric-age HL and NHL had similar frequency in the study population; most patients presented with advanced disease at diagnosis. A high success rate was documented for HL, while NHL outcomes were suboptimal.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 2","pages":"107-114"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109680","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}