Boletín médico del Hospital Infantil de México最新文献_第3页

Waiting time for pediatric patients to be admitted for elective surgery at a National Pediatric Health Institute in Mexico City. 在墨西哥城的国家儿科健康研究所，儿科患者接受选择性手术的等待时间。

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Boletín médico del Hospital Infantil de México Pub Date : 2025-01-01 DOI: 10.24875/BMHIM.24000046

Edmundo Vázquez-Cornejo, Elizabeth Cruz-Cruz, Heriberto Gómez-Gaytán, Daniela de la Rosa-Zamboni, Miriam G Herrera-Segura, Araceli Saldívar-Flores, Olga Morales-Ríos, Juan Garduño-Espinosa

{"title":"Waiting time for pediatric patients to be admitted for elective surgery at a National Pediatric Health Institute in Mexico City.","authors":"Edmundo Vázquez-Cornejo, Elizabeth Cruz-Cruz, Heriberto Gómez-Gaytán, Daniela de la Rosa-Zamboni, Miriam G Herrera-Segura, Araceli Saldívar-Flores, Olga Morales-Ríos, Juan Garduño-Espinosa","doi":"10.24875/BMHIM.24000046","DOIUrl":"https://doi.org/10.24875/BMHIM.24000046","url":null,"abstract":"Background: Waiting times for elective surgery can be a physically and psychologically distressing experience for patients, affecting their satisfaction and perceptions of service quality. This study aimed to estimate the waiting time for pediatric patients admitted for elective surgery, identify events causing delays, and compare variations in the admission process.Method: Three cohorts of pediatric patients scheduled for elective surgery were prospectively followed: (A) weekday general surgery admissions, (B) weekday admissions to other surgical specialties, and (C) weekend surgical admissions. The admission process was mapped, timescales of each stage were recorded, and delay incidents were identified through direct non-participant observation after obtaining informed consent or assent.Results: The mean waiting time was 6.9 h (95% confidence interval [CI]: 6.6-7.2 h) for all scheduled surgical admissions. Patients in cohort B experienced the longest waiting time at 8.1 h (95% CI: 7.7-8.5 h, p < 0.0001). Primary causes of delay included lengthy transfers to the admission area, bed management issues, and limited staff availability during shift changes. Avoidable delays resulted in a mean additional waiting time of 1.4 h.Conclusions: The findings suggest that hospital waiting times could be reduced through organizational interventions targeting the main causes of delay and simplifying administrative processes.","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 1","pages":"35-43"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596253","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}

引用次数: 0

[Homenaje al Dr. Luis Velásquez Jones]. [向Luis Velasquez Jones博士致敬]。

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Boletín médico del Hospital Infantil de México Pub Date : 2025-01-01 DOI: 10.24875/BMHIM.M24000040

Mara Medeiros

引用次数: 0

Early developmental screening tools constructed in Latin American countries: umbrella review. 拉丁美洲国家构建的早期发育筛查工具：总括性审查。

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Boletín médico del Hospital Infantil de México Pub Date : 2025-01-01 DOI: 10.24875/BMHIM.24000161

Luisa Schonhaut, Antonia Valdés, Ilan Oppenheimer, Antonio Rizzoli-Córdoba, Rolando Rivera

{"title":"Early developmental screening tools constructed in Latin American countries: umbrella review.","authors":"Luisa Schonhaut, Antonia Valdés, Ilan Oppenheimer, Antonio Rizzoli-Córdoba, Rolando Rivera","doi":"10.24875/BMHIM.24000161","DOIUrl":"https://doi.org/10.24875/BMHIM.24000161","url":null,"abstract":"Background: Multiple early childhood development (ECD) screening instruments have been developed in Latin America.Objective: The objective of this study was to describe ECD screening tests for children under 4 years of age constructed in Latin American countries in the context of healthcare, currently in use.Methods: A systematic review of literature published until April 2024 was conducted to identify screening tests constructed in Latin America. The search for each test was expanded, and individual records were completed. Authors of the instruments and/or their validations were identified and contacted to corroborate the information. An ECD screening test was defined as one that assesses at least three different domains. Only tests used in the healthcare system were included in the study. Those without publications and/or accessible information were excluded from the study.Results: Twenty-one tests constructed in nine countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, Mexico, Peru, and Uruguay) were included, many used in different countries of the region. Seven were constructed and/or validated in the past 5 years. They predominantly consist of direct assessment or questions to primary caregivers. Four were validated for online use, and one for virtual use. In the validation, most combined different psychometric analyses, with heterogeneity in methodology and reference patterns. Median summary sensitivity was 0.67 (95% confidence interval [CI] 0.34-1.0), and specificity was 0.71 (95% CI 0.42-1.0).Conclusions: The ECD screening tests developed in Latin America show thorough validation and ongoing updates, though they exhibit some variability. Direct assessment using paper predominates. The consistency of the instruments, when used in different countries and populations, stands out.","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 1","pages":"5-24"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633527","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}

引用次数: 0

Validity of administering the child development evaluation test through telemedicine to children aged 18-72 months. 远程医疗对18-72月龄儿童发展评价测验的有效性。

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Boletín médico del Hospital Infantil de México Pub Date : 2025-01-01 DOI: 10.24875/BMHIM.24000163

Ilma R Torres-Escobar, Miguel Á Villasis-Keever, Martha M Zapata-Tarrés, Laura A Hernández-Trejo, Christian A Delaflor-Wagner, Antonio Rizzoli-Córdoba

{"title":"Validity of administering the child development evaluation test through telemedicine to children aged 18-72 months.","authors":"Ilma R Torres-Escobar, Miguel Á Villasis-Keever, Martha M Zapata-Tarrés, Laura A Hernández-Trejo, Christian A Delaflor-Wagner, Antonio Rizzoli-Córdoba","doi":"10.24875/BMHIM.24000163","DOIUrl":"https://doi.org/10.24875/BMHIM.24000163","url":null,"abstract":"Background: Early childhood development is a complex process that requires reliable tools for the timely detection of alterations that may affect a child's progress. The Child Development Evaluation test (EDI, in its Spanish acronym) is a screening test developed and validated in Mexico to be administered in person by a professional. The objective is to evaluate the validity of administering the EDI test through telemedicine in terms of its diagnostic concordance with the face-to-face modality.Methods: This analytical, prospective, and cross-sectional study included patients aged 18-72 months and was conducted at a tertiary care hospital in Mexico City. The test was administered through telemedicine and subsequently in person. In addition, sensitivity and specificity data were reported with confidence interval of 95% (95% CI). The face-to-face evaluator was blinded to the telemedicine results.Results: Fifty children with a median age of 47 months participated in the study. A sensitivity of 100% (95% CI, 91-100) and specificity of 100% (95% CI, 70-100) overall were obtained. Language was the higher area with a sensitivity of 100 (95% CI: 91-100) and specificity of 90 (59-98); the results for the other areas are shown. The lowest sensitivity was neurological examination (67; CI 95%: 30-90) but has the highest specificity (98; CI 95%: 88-99).Conclusion: The EDI test implemented through telemedicine shows high correlation with the face-to-face modality, maintaining high sensitivity and specificity. These results make it an appropriate method for screening children of this age, although further larger studies are needed to corroborate it.","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 1","pages":"52-58"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633457","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}

引用次数: 0

Teenager with persistent facial edema and induration. 面部持续水肿和凹陷的青少年。

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Boletín médico del Hospital Infantil de México Pub Date : 2024-01-01 DOI: 10.24875/BMHIM.24000052

Mónica Dávalos-Tanaka, Ma Teresa García-Romero

{"title":"Teenager with persistent facial edema and induration.","authors":"Mónica Dávalos-Tanaka, Ma Teresa García-Romero","doi":"10.24875/BMHIM.24000052","DOIUrl":"10.24875/BMHIM.24000052","url":null,"abstract":"Introduction: Acute lymphoblastic leukemia (ALL) is the most common oncological disease in the pediatric population; however, skin infiltration occurs only in 1-3% of the patients and almost always manifests after the diagnosis is made.Clinical case: A male teenage patient who presented with facial edema and infiltration, associated with systemic symptoms such as asthenia and adynamia. On physical examination, the patient presented facial edema and indurated plaques, as well as cervical, inguinal, and axillary adenopathy. Complete blood count showed pancytopenia and a chest X-ray revealed a mediastinal mass. Due to a high suspicion of malignancy a bone marrow and skin biopsy was taken, both with pre-B ALL. Chemotherapy was started and the patient is now in maintenance phase.Conclusions: Leukemia cutis manifestations are heterogenous, from a small papule to a big nodule. It is more common in patients with acute myeloid leukemia and it is rare in patients with pre-B ALL, specially in the pediatric population. The diagnosis should be done with a biopsy and the treatment is with systemic chemotherapy. The diagnosis should always be considered in patients with unexplained edematous or indurated lesions, especially in the context of systemic symptoms.","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"81 5","pages":"301-304"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387827","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}

引用次数: 0

Intramuscular vascular malformations in pediatric patients: a retrospective study in a vascular anomalies clinic. 小儿肌内血管畸形：血管畸形诊所的回顾性研究。

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Boletín médico del Hospital Infantil de México Pub Date : 2024-01-01 DOI: 10.24875/BMHIM.23000154

Andrea Gallardo-Villamil, Anahí Pérez-Quispe, Adolfo E Lizardo-Rodríguez, María T García Romero, Carola Durán-McKinster

{"title":"Intramuscular vascular malformations in pediatric patients: a retrospective study in a vascular anomalies clinic.","authors":"Andrea Gallardo-Villamil, Anahí Pérez-Quispe, Adolfo E Lizardo-Rodríguez, María T García Romero, Carola Durán-McKinster","doi":"10.24875/BMHIM.23000154","DOIUrl":"10.24875/BMHIM.23000154","url":null,"abstract":"Background: Intramuscular vascular malformations (IVMs) are rare developmental congenital structural abnormalities. Their clinical diagnosis is difficult, and imaging studies are essential to determine the type and extent of vessels involved. Treatment can be challenging and must be managed by a multidisciplinary team.Methods: A descriptive, observational, retrospective, longitudinal study of clinical records of patients diagnosed with IVMs who were evaluated at the vascular anomalies clinic from January 2011 to December 2021 was performed. Demographic, clinical, imaging, diagnosis, treatment, and response data were collected.Results: Seven patients (five females and two males) with a mean age of 13.66 years (standard deviation 5.82 years) were included in the study. In all cases, the clinical diagnosis was venous and lymphatic malformation. The radiological findings were dilated and tortuous vascular structures or multilobulated lesions with septa inside, with or without vascular flow; these findings allowed diagnosis in all cases. Treatment modalities included sclerotherapy in five patients, surgical resection in two, medical treatment with sirolimus in three, and surveillance in one. Subsequent clinical evolution was favorable in all patients, with decreased pain in six (partial in four and total in two) and size reduction in one patient.Conclusion: IVMs in our pediatric population most frequently affect the lower extremities. The main symptoms and signs were pain on exertion and volume increase. Treatment can be challenging given the extension and depth of the malformations, so a combination of therapeutic modalities may be necessary to obtain the best outcome.","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"81 5","pages":"280-286"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387825","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}

引用次数: 0

Linear IgA bullous dermatosis in a latin adolescent treated with cyclosporine and prednisone. 用环孢素和泼尼松治疗一名拉丁裔青少年的线性 IgA 大疱性皮肤病。

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Boletín médico del Hospital Infantil de México Pub Date : 2024-01-01 DOI: 10.24875/BMHIM.24000043

Andrea Ríos-Sánchez, Juan A Godínez-Chaparro, Marissa de J Quintal-Ramírez, Ixchel R Ramírez-Ricarte

{"title":"Linear IgA bullous dermatosis in a latin adolescent treated with cyclosporine and prednisone.","authors":"Andrea Ríos-Sánchez, Juan A Godínez-Chaparro, Marissa de J Quintal-Ramírez, Ixchel R Ramírez-Ricarte","doi":"10.24875/BMHIM.24000043","DOIUrl":"https://doi.org/10.24875/BMHIM.24000043","url":null,"abstract":"Introduction: Linear IgA bullous dermatosis (LABD) is a rare autoimmune disease. Although dapsone is the initial treatment, other immunomodulators are used in resistant cases or when dapsone is unavailable.Case report: A 12-year-old Mexican child, with no relevant medical history, developed in May 2023 a disseminated dermatosis affecting all body segments, including mucous membranes, characterized by erythematous patches and plaques evolving into the formation of serous and serosanguinous blisters and vesicles, distributed in a \"string of pearls\" pattern. LABD was suspected and confirmed by skin biopsy, which showed a subepidermal blister with neutrophilic infiltration and linear Immunoglobulin A deposits at the dermo-epidermal junction by direct immunofluorescence. Treatment with prednisone (2 mg/kg/day) and cyclosporine (5 mg/kg/day) resulted in improvement and lesion remission within 2 weeks. Both drugs needed to be discontinued for 3 months due to intermittent blistering. Cyclosporine was continued as maintenance therapy at a dose of 4 mg/kg/day for 8 months.Conclusions: The report highlights the use of cyclosporine as an alternative immunomodulator for DAAL, an immunosuppressive agent used in autoimmune disorders. Few cases, including this one, have described complete remission and control of the dermatosis with cyclosporine, accompanied by prednisone at the start of treatment.","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"81 5","pages":"305-310"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387826","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}

引用次数: 0

Acknowledgments to reviewers 2023. 鸣谢审稿人 2023.

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Boletín médico del Hospital Infantil de México Pub Date : 2024-01-01

引用次数: 0

Vestibular evaluation with video head impulse test in pediatric cochlear implant patients. 通过视频头脉冲测试对小儿人工耳蜗植入患者的前庭进行评估。

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Boletín médico del Hospital Infantil de México Pub Date : 2024-01-01 DOI: 10.24875/BMHIM.24000022

Teresa Pérez-Castillo, Silvia Ortiz-Rodríguez, Sandra K Vélez-Pelcastre, Jessica Ma González-Corona

{"title":"Vestibular evaluation with video head impulse test in pediatric cochlear implant patients.","authors":"Teresa Pérez-Castillo, Silvia Ortiz-Rodríguez, Sandra K Vélez-Pelcastre, Jessica Ma González-Corona","doi":"10.24875/BMHIM.24000022","DOIUrl":"https://doi.org/10.24875/BMHIM.24000022","url":null,"abstract":"Background: The cochlear implant (CI) is effective for rehabilitating patients with severe to profound sensorineural hearing loss. However, its placement and use have been associated with various complications, such as those affecting the vestibular system. The objective of this study was to compare vestibular function using the video head impulse test (vHIT) in pediatric patients before and after CI placement.Methods: A descriptive and retrospective study was conducted. The outcomes of 11 pediatric patients of both sexes with a history of profound hearing loss were evaluated. The results of vestibular-ocular reflex (VOR) gain, saccades, asymmetry, Pérez Rey (PR) index, and VOR/saccade ratio for both ears obtained by the vHIT test before and after CI placement were compared.Results: Of the 11 patients evaluated, the VOR gain showed that 81.8% had normal function, 18.2% had hypofunction, and no patients had hyperfunction before implantation. No statistically significant differences were found when compared with post-implant off and post-implant on conditions (p > 0.05). The extracted variables, asymmetry, PR index, and the VOR/saccades ratio also showed no statistically significant differences between the pre- and post-implant conditions, whether off or on.Conclusions: The vestibular function of pediatric patients did not show significant changes before and after CI placement. The vHIT test is a valuable tool for assessing vestibular function and could be considered a criterion for surgical and rehabilitation decisions in patients undergoing CI placement.","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"81 3","pages":"162-169"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466175","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}

引用次数: 0

Clinical and epidemiological factors related to mortality due to septic shock in a pediatric intensive care unit. 与儿科重症监护室脓毒性休克死亡率相关的临床和流行病学因素。

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Boletín médico del Hospital Infantil de México Pub Date : 2024-01-01 DOI: 10.24875/BMHIM.24000023

Ricardo Rodriguez-Portilla, Herminio R Hernández-Díaz

{"title":"Clinical and epidemiological factors related to mortality due to septic shock in a pediatric intensive care unit.","authors":"Ricardo Rodriguez-Portilla, Herminio R Hernández-Díaz","doi":"10.24875/BMHIM.24000023","DOIUrl":"https://doi.org/10.24875/BMHIM.24000023","url":null,"abstract":"Introduction: Septic shock is a potentially life-threatening condition. The aim of this study was to identify clinical and epidemiological factors associated with mortality in pediatric patients admitted to a pediatric intensive care unit (PICU) with septic shock.Materials and methods: A retrospective comparative case series study was conducted with children aged 1 month to 14 years with septic shock from 2018 to 2020 in a PICU in Lima, Peru. Patients were divided into deceased and survivor groups based on their condition at discharge from the PICU. The influence of each variable on mortality was assessed using a logistic regression model.Results: A total of 174 patients were included in the study, with 51 (29.3%) fatalities. Deceased patients, compared to survivors, were older, had a higher incidence of oncological disease (31.4% vs. 14.6%; p = 0.011), more frequently presented with hemoglobin ≤ 9 g/dL (44% vs. 28%; p = 0.043), lactate > 2 mmol/L (70% vs. 44%; p = 0.002), platelets ≤ 150 (×103)/μL (77% vs. 42%; p < 0.001), and pH ≤ 7.1 (31% vs. 6%; p < 0.001). In the logistic regression model, factors related to mortality were having a pH ≤ 7.1 (odds ratio [OR] = 8.95; 95% confidence interval [CI]: 2.52-31.75) and platelets ≤ 150 (×103)/μL (OR = 3.89; 95% CI: 1.40-10.84).Conclusions: Factors associated with mortality in pediatric patients with septic shock were a pH ≤ 7.1 and platelets ≤ 150 (×103)/μL in the assessments conducted upon admission to the PICU.","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"81 4","pages":"210-216"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139285","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}

引用次数: 0