Gerard Martínez-Segura , Silvia Rodríguez Ferradas , Cristina Macias Borras , Victoria Trenchs Sainz de la Maza , Ana Isabel Curcoy Barcenilla
{"title":"Suspected abuse in the emergency room: Appropriateness of consultations","authors":"Gerard Martínez-Segura , Silvia Rodríguez Ferradas , Cristina Macias Borras , Victoria Trenchs Sainz de la Maza , Ana Isabel Curcoy Barcenilla","doi":"10.1016/j.anpede.2025.503808","DOIUrl":"10.1016/j.anpede.2025.503808","url":null,"abstract":"","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"102 6","pages":"Article 503808"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287446","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}
David Gonzalez Jiménez , Juan Rodríguez Delgado , Cristina Campoy , Rafael Galera Martínez , Mercedes Gil-Campos , Susana Redecillas Ferreiro , Miguel Sáenz de Pipaón , Rosaura Leis , en representación del Comité de Nutrición y Lactancia Materna de la AEP
{"title":"Vitamin D supplementation in the healthy pediatric population","authors":"David Gonzalez Jiménez , Juan Rodríguez Delgado , Cristina Campoy , Rafael Galera Martínez , Mercedes Gil-Campos , Susana Redecillas Ferreiro , Miguel Sáenz de Pipaón , Rosaura Leis , en representación del Comité de Nutrición y Lactancia Materna de la AEP","doi":"10.1016/j.anpede.2025.503874","DOIUrl":"10.1016/j.anpede.2025.503874","url":null,"abstract":"<div><h3>Objective</h3><div>To review the current scientific evidence on the efficacy of universal vitamin D supplementation in healthy children with no risk factors and to propose updated modifications to the recommendations provided in the main clinical practice guidelines.</div></div><div><h3>Methods</h3><div>Scoping review through a literature search conducted in PubMed for articles published in English or Spanish in the past 15 years using the following MeSH search terms: <em>(vitamin D) AND (supplementation)</em>. The search yielded 2133 articles, of which 22 were selected.</div></div><div><h3>Results</h3><div>In infants aged less than 1 year without risk factors, administration of 400 IU/day improves serum levels of calcifediol, but most studies have not found an association with improved bone health assessed by dual-energy X-ray absorptiometry. In children aged more than 1 year with calcifediol levels of less than 35 ng/mL, supplementation with 400 to 800 IU/day of vitamin D decreases the risk of respiratory infection. There is still no evidence in the pediatric population that vitamin D supplementation either decreases the risk or severity of other infections or offers any other clinically significant extraskeletal benefits.</div></div><div><h3>Conclusion</h3><div>Based on the main clinical practice guidelines, supplementation with vitamin D at a dose of 400 IU/day is recommended for breastfed infants aged less than 1 year or infants who do not achieve the recommended daily intake through infant formula. In children aged more than 1 year, supplementation should be individualized.</div></div>","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"102 6","pages":"Article 503874"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303872","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}
Johanna Ramírez-Romero, Claudia Cifuentes, Beatriz Azkunaga, Santiago Mintegi, Grupo de Trabajo de Intoxicaciones de la Sociedad Española de Urgencias Pediátricas
{"title":"Poisoning due to medication dosing errors in Spain","authors":"Johanna Ramírez-Romero, Claudia Cifuentes, Beatriz Azkunaga, Santiago Mintegi, Grupo de Trabajo de Intoxicaciones de la Sociedad Española de Urgencias Pediátricas","doi":"10.1016/j.anpede.2025.503888","DOIUrl":"10.1016/j.anpede.2025.503888","url":null,"abstract":"<div><h3>Introduction</h3><div>Dosage errors are a common mechanism of poisoning in childhood. The aim of this study was to analyze the characteristics and management of poisoning secondary to dosage errors in pediatric emergency departments (EDs) in Spain.</div></div><div><h3>Methodology</h3><div>Study based on a prospective register of poisonings documented in 58 Spanish EDs participating in the Toxicology Surveillance Observatory of the Spanish Society of Paediatric Emergency Medicine (SEUP) between 2008 and 2023.</div></div><div><h3>Results</h3><div>The register documented 3429 episodes of exposure to toxic substances, of which 289 (8.4%) were medication dosing errors, with a vast majority occurring in the home setting. Seventy-eight (27.0%) occurred in children aged less than 1 year (amounting to 37.9% of poisonings in this age group and 85.0% of poisonings in infants aged less than 3 mo). Overall, the most commonly involved medications were antipyretics/analgesics (35.6%, mainly paracetamol), with significant differences depending on patient age. Forty-nine of the patients (17.0%) were symptomatic, 118 (41.8%) underwent additional testing, 83 (28.7%) received treatment, and 115 (39.8%) were admitted to the ED observation unit or to hospital. All had favorable outcomes.</div></div><div><h3>Conclusions</h3><div>Medication dosing errors constitute an important mechanism of poisoning, especially in children aged less than 1 year, leading to a significant number of interventions in EDs. Preventive measures aimed at educating families to avoid these poisonings should be considered.</div></div>","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"102 6","pages":"Article 503888"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328086","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}
Patricia Corniero , Mònica Girona-Alarcón , Carme Alejandre , Roi Campos , Nuria Millán García del Real , Elisabeth Esteban
{"title":"Assessment of patient safety during interfacility transport","authors":"Patricia Corniero , Mònica Girona-Alarcón , Carme Alejandre , Roi Campos , Nuria Millán García del Real , Elisabeth Esteban","doi":"10.1016/j.anpede.2025.503884","DOIUrl":"10.1016/j.anpede.2025.503884","url":null,"abstract":"<div><h3>Objective</h3><div>The transport of critically ill pediatric patients is associated with the occurrence of adverse events (AE) and incidents that worsen patient outcomes. The primary objective was to determine the AEs and incidents that occurred during interhospital transport and to analyze changes after the implementation of safety measures. The secondary objective was to analyze the association between the presence of family accompanying the patient in the ambulance and the number of incidents.</div></div><div><h3>Material and methods</h3><div>Prospective and observational study, including patients transferred by a specialized pediatric transport team during two periods: period 1 (2017-2018) and period 2 (2022-2023). We compared incidents in the two periods after the implementation of safety measures. We also compared the presence of parents during the transport and its association with the occurrence of incidents.</div></div><div><h3>Results</h3><div>We analyzed 1369 transports. A total of 273 (20.7%) patients experienced some incident during transport, with a lower percentage in period 2 (29.2% vs 12.0%; <em>P</em> < .001), especially in patients with clinical incidents (20.3% vs 5.1%; <em>P</em> < .001). Incidents involving a lack of devices or supplies were least frequent, with no differences between the two periods.</div><div>Family accompanied the patient in the ambulance more frequently in the second period (76.0% vs 82.6%; <em>P</em> = .001), a finding that was not associated with an increase in incidents, with a higher percentage of transports with parents in the care cabin.</div></div><div><h3>Conclusions</h3><div>Interhospital pediatric transport performed by teams trained in clinical safety leads to few incidents. Implementing measures to improve patient safety can reduce the frequency of these incidents and optimize care quality.</div></div>","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"102 6","pages":"Article 503884"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318931","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}
Reyes Fernández Montes , María Agustina Alonso Álvarez , María Fernández Miaja , Luis Vega López , María Álvarez Merino , Estíbaliz Garrido García
{"title":"Plasmalyte versus saline solution for rapid rehydration in gastroenteritis: prospective observational study","authors":"Reyes Fernández Montes , María Agustina Alonso Álvarez , María Fernández Miaja , Luis Vega López , María Álvarez Merino , Estíbaliz Garrido García","doi":"10.1016/j.anpede.2025.503855","DOIUrl":"10.1016/j.anpede.2025.503855","url":null,"abstract":"<div><h3>Introduction</h3><div>General recommendations suggest using physiological saline solution (PSS) in the guidelines for rapid intravenous rehydration (RIR) in children with dehydration secondary to acute gastroenteritis, although the use of a balanced crystalloid solution, such as Plasmalyte (PLA), could be more beneficial since its composition is more similar to plasma.</div></div><div><h3>Materials and methods</h3><div>Single-center prospective and observational study with two treatment groups. The sample consisted of patients aged 3 months to 13 years with mild to moderate dehydration in whom RIR was indicated based on the SEUP guideline, who visited the pediatric emergency department (PED) of a tertiary care hospital. A total of 40<!--> <!-->mL/kg of solution (PLA or PSS, at the discretion of the physician in charge) supplemented with 2.5% glucose was administered over 2<!--> <!-->h. We collected data on clinical and laboratory variables before and after RIR, length of stay, need for readmission and adverse events.</div></div><div><h3>Results</h3><div>A total of 169 patients (50.9% male; median age, 40 months) completed the study. Of these, 49.1% received PLA. The group that received PLA showed greater improvement in bicarbonate levels (3.7<!--> <!-->mmol/L vs 1.4<!--> <!-->mmol/L; <em>P</em> < .001) and a lower increase in chloride levels (0.9<!--> <!-->mmol/L vs 4.1<!--> <!-->mmol/L; <em>P</em> < .001). There were no differences in clinical dehydration scales, length of stay in PED or need for readmission. No serious adverse events were observed.</div></div><div><h3>Conclusions</h3><div>The use of PLA in the RIR protocol was effective and safe, showing greater recovery of bicarbonate with lesser elevation of chloride levels compared to the use of PSS. However, we did not find differences in clinical outcomes.</div></div>","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"102 6","pages":"Article 503855"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276948","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}
María Angustias Salmerón-Ruiz , Cristina García de Ribera , Valero Sebastián Barberán , Lefa Eddy Ives , Julio Álvarez-Pitti
{"title":"Impact of digital media on development and physical health","authors":"María Angustias Salmerón-Ruiz , Cristina García de Ribera , Valero Sebastián Barberán , Lefa Eddy Ives , Julio Álvarez-Pitti","doi":"10.1016/j.anpede.2025.503876","DOIUrl":"10.1016/j.anpede.2025.503876","url":null,"abstract":"<div><div>The goal of screen health is to reduce the deleterious impact of the use of screens, digital content and connected devices (collectively known as the ‘Internet of Things’) and harmful design. That is, of any information, application, software or hardware that affects physical, mental, social, sexual or brain health. With this objective in mind, the screen health working group of the Health Promotion Committee of the Asociación Española de Pediatría (AEP, Spanish Association of Pediatrics) published the Family Digital Plan (FDP) online in 2022 based on the evidence available through 2021. The purpose of this article is to offer a review of the evidence published from 2021 and to determine whether changes need to be made to the recommendations of the FDP. It is reasonable to state that there is sufficient evidence supporting the association between screen time and the displacement of healthy lifestyle habits such as sleep, diet, physical activity and face-to-face social interactions. Furthermore, screen use also has an impact on cardiovascular risk, visual health, brain volume and quality of life. Its effects are greater in children, especially those aged less than six years, and in adolescents, as it interferes with neurodevelopment and affect integration and reduces the ability to regulate emotion. The Health Promotion Committee of the AEP considers several actions necessary: the revision of the recommendations of the FDP, declaring screen use a public health problem, improving the training of pediatricians to prevent and detect it, improving research on the use of screens in education and health care systems, the establishment of legislation by governments to protect health and development, and advocating for the requirement of rigorous research to demonstrate, from the early stages of design and development, that technological products or services are safe for the health and brain of the population.</div></div>","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"102 6","pages":"Article 503876"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217833","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}
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