Boletín médico del Hospital Infantil de México最新文献

{"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}

{"title":"Innovative monitoring of therapeutic adherence in children with persistent asthma through text messaging.","authors":"Roxana Aznaran-Torres, Natalia Nombera-Aznaran, Milagros Nombera-Aznaran, Omar Aznaran-Torres","doi":"10.24875/BMHIM.24000154","DOIUrl":"https://doi.org/10.24875/BMHIM.24000154","url":null,"abstract":"<p><strong>Background: </strong>Approximately 25% of children with asthma experience uncontrolled symptoms, leading to frequent exacerbations, emergency visits, systemic corticosteroid use, unnecessary antibiotic prescription, and increased mortality risk. Poor treatment adherence is a critical factor hindering asthma control. This study aimed to implement and evaluate therapeutic adherence in children with persistent asthma through a technological solution based on short message service (SMS) reminders sent to patients' mobile phones and receiving their responses to optimize disease management and follow-up.</p><p><strong>Method: </strong>We conducted a quasi-experimental pilot study with 28 children to develop the software RoxySMS for remotely monitoring therapeutic adherence in a tertiary hospital. Participants included caregivers of children aged 5-14 years with persistent asthma requiring daily inhaled corticosteroids alone or with long-acting beta-agonists. Caregivers needed a postpaid mobile phone for SMS communication. Outcome evaluators and data analysts were blinded to the intervention.</p><p><strong>Results: </strong>The software achieved an average response percentage of 80.8%, with individual responses ranging from 37.9% to 98.9%. On average, 50% of messages were answered immediately (5-87%), 24% within 15-60 min (2-55%), and 26% within 1-24 h (2-84%).</p><p><strong>Conclusions: </strong>RoxySMS successfully automated message delivery, validating it as a viable and cost-effective tool for monitoring adherence in chronic conditions, such as asthma, particularly in resource-limited settings.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 3","pages":"172-179"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706277","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":"Cough-related spontaneous retropharyngeal emphysema in a pediatric patient with Influenza A infection: a case report.","authors":"Javier Arredondo-Montero","doi":"10.24875/BMHIM.24000108","DOIUrl":"10.24875/BMHIM.24000108","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous retropharyngeal emphysema (SRE) is a scarce condition in the pediatric population.</p><p><strong>Clinical case: </strong>An 11-year-old boy presented with respiratory distress and cervical pain after a severe cough attack. A cervical examination revealed a marked subcutaneous emphysema. A polymerase chain reaction (PCR) for respiratory viruses was positive for influenza A/H3. A blood culture was obtained and was negative. A chest and a cervical X-ray showed pneumomediastinum and SRE. A computed tomography scan showed a pulmonary condensation on the left lower lobe and ectopic air at the level of the cardioesophageal junction. An upper gastrointestinal series demonstrated the absence of contrast leakage. The patient was managed conservatively with good clinical evolution and resolution of symptoms. Two weeks after the episode, a chest and a cervical X-ray showed almost complete resolution of the SRE and the pneumomediastinum.</p><p><strong>Conclusions: </strong>The exceptional presentation of spontaneous pneumomediastinum in a pediatric patient without asthma underscores the importance of considering SRE in the differential diagnosis of cervical and thoracic ectopic air in the pediatric population.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 4","pages":"263-266"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882108","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":"Immunotherapies and their potential to preserve beta cells in type 1 diabetes: a review of current immunotherapy.","authors":"Juan D Bonilla-Bonilla, Luis Chávez-Sánchez, María V Legorreta-Haquet","doi":"10.24875/BMHIM.24000174","DOIUrl":"10.24875/BMHIM.24000174","url":null,"abstract":"<p><p>Type 1 diabetes is a chronic immune-mediated disease that leads to the loss of beta cells in the pancreas, clinically characterized by polydipsia, polyphagia, and weight loss. The disease is most prevalent in the first and second decades of life, with a consistent annual increase. The dependence on insulin therapy indefinitely is well known. Although advances in this area, such as new continuous glucose monitoring devices with continuous subcutaneous insulin infusion, have improved patient quality of life, they do not affect disease pathogenesis and do not consistently reduce long-term complications. In addition to requiring lifestyle sacrifices and, in many cases, failing to meet therapeutic target points, it increases the risk of hypoglycemia, an acute and potentially fatal complication. Following decades of research and advances in therapeutic technologies, approaches have been developed based on diverse mechanisms in the disease's pathogenesis. This review focuses on new immunotherapy approaches for type 1 diabetes, including cell-targeted therapies, cytokines, and cell transplants to preserve beta-cell function.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 4","pages":"203-218"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882113","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":"Microorganisms identified in neonatal sepsis and their antimicrobial resistance in a hospital in Western Mexico.","authors":"Juan C Lona-Reyes, Braulio Guillén-Chávez, Lucia Miramontes-Buiza, Larissa M Gómez-Ruiz, Moisés Quiles-Corona, René O Pérez-Ramírez, Brandon J de la Cruz-Bravo","doi":"10.24875/BMHIM.25000002","DOIUrl":"10.24875/BMHIM.25000002","url":null,"abstract":"<p><strong>Background: </strong>Neonatal sepsis is a serious condition that increases neonatal mortality. The objective of this study was to describe the microorganisms causing neonatal sepsis and their resistance patterns in a neonatal intensive care unit (NICU).</p><p><strong>Methods: </strong>A cross-sectional cohort study was conducted. Microorganisms identified in blood or cerebrospinal fluid cultures from newborns (NBs) admitted to the Nuevo Hospital Civil de Guadalajara Dr. Juan I. Menchaca were studied. Microorganism identification and susceptibility testing were performed using VITEK^® 2. The cutoff points for classifying resistance were according to the Clinical and Laboratory Standards Institute. Infections were classified as early-onset sepsis (EOS) or late-onset sepsis (LOS).</p><p><strong>Results: </strong>A total of 73 NBs with EOS and 261 with LOS were identified; the incidence rate of EOS was 7.1 events/1000 live births and of LOS was 25.5 events/1000 live births. In both infections, the risk was significantly higher in premature NBs and/or NBs with birth weight < 2500 g. The predominant etiology in all infections was Enterobacterales (63.3%). In EOS, resistance to first-line antibiotics for Enterobacterales was ampicillin 46.6% (27/58) and gentamicin 24.1% (14/58), while in LOS, it was ampicillin 63.7% (186/292) and gentamicin 28.1% (82/292). The second most frequently identified bacteria were Staphylococcus spp. 13.6% (n = 75) with oxacillin resistance of 78.7% (59/75). No ampicillin-resistant Streptococcus spp. or Enterococcus spp. was identified.</p><p><strong>Conclusions: </strong>The incidence of EOS and LOS in a Mexican NICU was 7.1 and 25.5 events/1000 live births, and the main etiologies were Enterobacterales and Staphylococcus spp.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 4","pages":"219-227"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882114","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":"Effects of 6 months of permanence in an early intervention program on the developmental level of children 18-42 months of age in poverty: cohort study.","authors":"Miguel Á Villasis-Keever, Jesús H Trujillo-Flores, Angélica Ocaña-Zavaleta, Perla Ma Ortega-Lomelín, Christian A Delaflor-Wagner, Alejandro I Soto-Briseño, Laura A Hernández-Trejo, José A García-Aranda, Daniel Aceves-Villagrán, Hortensia Reyes-Morales, Antonio Rizzoli-Córdoba","doi":"10.24875/BMHIM.24000167","DOIUrl":"10.24875/BMHIM.24000167","url":null,"abstract":"<p><strong>Background: </strong>The Child Care Facilities Program (PEI, for its Spanish acronym) in Mexico targets parents of children aged 1-3 years living in poverty, providing education and care strategies 5 days a week. This study aimed to evaluate the impact of a 6-month stay in childcare centers on the developmental levels of children under 4 years old.</p><p><strong>Methods: </strong>A longitudinal, before-and-after study was conducted. Children aged 12-42 months enrolled in the PEI were included in the study. All participants remained in the program for 6 months from the first measurement. The overall and area-specific developmental levels were assessed using the Early Childhood Development Assessment (EDI, for its Spanish acronym) test. The percentages of developmental levels (normal, delayed, and at risk of delay) were compared between the baseline and 6-month assessments using the McNemar test.</p><p><strong>Results: </strong>The study included 1835 children, of whom 52% were male. The age distribution was as follows: 28.1% were 12-24 months old, 48.4% were 25-36 months old, and 23.5% were 37-42 months old. At baseline, 80.5% (n = 1,476) of the children were classified as having normal overall development, 16% had developmental delay, and 3.5% were at risk for delay. After 6 months, the percentage of children with normal development increased to 90.1%, while those with developmental delay and those at risk for delay decreased to 8.7% and 1.2%, respectively. Similar improvements were observed across various developmental areas, except in the knowledge area.</p><p><strong>Conclusions: </strong>A 6-month stay in childcare centers is beneficial for improving the developmental levels of children under 4 years old, both overall and in motor, language, social, and cognitive areas.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 1","pages":"86-93"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633530","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":"Persistent facial edema due to spider bite: a case of edematous cutaneous loxoscelism.","authors":"Carla Gonzales-Flores, Natalia I Vigo, Noé Atamari-Anahui, Jorge Cuadros-Castro","doi":"10.24875/BMHIM.24000125","DOIUrl":"10.24875/BMHIM.24000125","url":null,"abstract":"<p><strong>Background: </strong>The bite of spiders of the Loxosceles genus causes loxoscelism. It can occur in cutaneous-necrotic, cutaneous-visceral, or predominantly edematous cutaneous loxoscelism forms. This last form is a rare variant characterized by edema without necrosis with a frequency of 5% of all cases of loxoscelism.</p><p><strong>Clinical case: </strong>A 6-year-old girl presented edema in the eyelid that progressively increased and spread to the entire face. The relative reported that this event occurred after a spider bite. Physical examination revealed a bite-type lesion on the lower left eyelid, generalized edema throughout the face, and dysphonia. The tests showed elevated creatinine and bilirubin; the rest were normal. Initially, she received corticosteroids, antihistamines, and adrenaline. Due to the persistence of edema, we administrated anti-loxosceles serum and continued with corticosteroids and antibiotics. After 48 hours, edema decreased, and on the seventh day, it was almost entirely resolved, so the patient was discharged without complications.</p><p><strong>Conclusions: </strong>Predominantly edematous cutaneous loxoscelism is a rare variant. It can mimic other diseases like cellulitis or anaphylaxis in the emergency room. Supportive treatment is essential to avoid complications in children.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 4","pages":"267-271"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882115","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":"Airway ultrasound in pediatric patients with stridor and extubation failure.","authors":"Omar A Burgos-Flores, Gerardo Félix-Ramos, Isaac A Gómez-Jiménez, Luis R Cadena-Mejía, Imuvira D Cruz-Loustaunau","doi":"10.24875/BMHIM.24000104","DOIUrl":"https://doi.org/10.24875/BMHIM.24000104","url":null,"abstract":"<p><strong>Background: </strong>Orotracheal intubation can cause complications such as stridor and airway obstruction, which favors weaning failure. The objective of this study was to assess the usefulness of airway ultrasound prior to extubation to predict stridor and extubation failure.</p><p><strong>Method: </strong>Cross-sectional descriptive study, from March 2023 to June 2024. A total of 50 patients were studied, admitted to the pediatric emergency service of the Children's Hospital of the State of Sonora, under mechanical ventilation ≥ 24 hours and in whom the first extubation attempt. An ultrasound of the airway was performed, calculating the peritube free space and the width of the air column before extubation, and the total number of patients who presented post-extubation stridor and extubation failure were identified.</p><p><strong>Results: </strong>The mean peritube free space in patients who presented stridor was 3.2 mm (0.3-6.2), with a statistically significant difference (p = 0.012) compared to patients who did not present stridor. The mean width of the air column in patients who presented stridor was 1.21 mm (0.16-4.78 mm), but it did not show a statistically significant difference (p = 0.153) compared to patients who did not present stridor. There were no statistically significant differences in both measurements for the outcome of extubation failure.</p><p><strong>Conclusions: </strong>Airway ultrasound seems to have a good correlation with the risk of post-extubation stridor.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 3","pages":"145-151"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706240","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}