Anales de pediatria最新文献

{"title":"Pain assessment in patients with cognitive dysfunction: Adaptation and validation of the r-FLACC scale","authors":"Débora Sierra-Núñez ,&nbsp;Alejandro Bosch-Alcaraz ,&nbsp;María Auxiliadora Flores Ordóñez ,&nbsp;M. Mercedes Nebra Muñoz ,&nbsp;Anna García Merino ,&nbsp;Erika González Lucena ,&nbsp;Esperanza Zuriguel-Pérez","doi":"10.1016/j.anpede.2025.503898","DOIUrl":"10.1016/j.anpede.2025.503898","url":null,"abstract":"<div><h3>Introduction</h3><div>Minors with cognitive dysfunction are at increased risk for pain and inadequate pain management. Pain assessment in children with cognitive and verbal dysfunction should be performed using specific behavioral scales. The main objective of this study was the translation and adaptation to Spanish of the revised Face, Legs, Activity, Cry and Consolability (r-FLACC) scale, one of the best-rated scales for assessing pain in children with cognitive dysfunction, followed by its validation.</div></div><div><h3>Patients and methods</h3><div>We carried out a prospective, observational and psychometric study in three phases: translation and adaptation, content validity analysis using mixed methods, and analysis of the psychometric properties of the Spanish version of the r-FLACC scale.</div></div><div><h3>Results</h3><div>We obtained an overall content validity index of 0.99, supported by qualitative data obtained in a focus group of patients’ relatives. The internal consistency of the Spanish version was demonstrated by a Cronbach α of 0.876 and a McDonald omega of 0.880; and the interobserver agreement by a concordance correlation coefficient of 0.933. The r-FLACC scale exhibited the capacity to detect changes in pain severity after pharmacological intervention, with <em>P</em> &lt; 0.000 in the Wilcoxon test.</div></div><div><h3>Conclusions</h3><div>The Spanish version of the r-FLACC scale proved to be a valid and reliable instrument for assessing pain intensity in children with cognitive dysfunction, thus providing professionals a tool that had not been available in our area and contributing to improving the scientific evidence available on the subject.</div></div>","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503898"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610545","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":"Different clinical presentations of idiopathic pulmonary hemosiderosis","authors":"Javier Sainz García ,&nbsp;Sabina Bona Gazol ,&nbsp;Irene Sancho Marquina ,&nbsp;Javier Martínez Castillón ,&nbsp;Carlos Martín de Vicente","doi":"10.1016/j.anpede.2025.503813","DOIUrl":"10.1016/j.anpede.2025.503813","url":null,"abstract":"","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503813"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621531","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":"Lice: Be careful, not just on the head!","authors":"Aniza Giacaman,&nbsp;Francisca Mestre-Bauzá","doi":"10.1016/j.anpede.2025.503810","DOIUrl":"10.1016/j.anpede.2025.503810","url":null,"abstract":"","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503810"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556139","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":"How to develop and evaluate consensus documents: Methods and checklists","authors":"María Aparicio Rodrigo ,&nbsp;Paz González Rodríguez ,&nbsp;Nieves Balado Insunza ,&nbsp;Garazi Fraile Astorga ,&nbsp;Pilar Aizpurua Galdeano ,&nbsp;Carlos Ochoa Sangrador","doi":"10.1016/j.anpede.2025.503890","DOIUrl":"10.1016/j.anpede.2025.503890","url":null,"abstract":"<div><div>Evidence-based medicine seeks the rigorous application of the best available scientific evidence to clinical decision-making. However, when the evidence is insufficient or inconsistent, consensus documents can guide clinical practice and reduce variability of care. These documents, developed by experts, require a structured approach to ensure their validity and applicability. A consensus document is a report produced by experts following a formalized process to answer a specific clinical question. The methodology used must be rigorous to minimize biases, such as dominance of certain experts or the panel not being representative. The most widely used formal consensus methods are the Delphi technique, the nominal group technique, the RAND/UCLA method, consensus conferences and other, less structured methods such as consensus meetings and focus groups. To ensure the quality of a consensus document, the use of standards such as the ACCORD guideline is essential. This guideline provides drafting criteria, ensuring the inclusion of detailed information regarding the materials, resources (both human and financial) and procedures used during the consensus process. The critical reading of these documents should take into account factors such as the representativeness of the panel, the clarity of the consensus criteria and potential conflicts of interest. In this sense, critical appraisal tools, such as those proposed by the Joanna Briggs Institute, facilitate the identification of biases and the evaluation of the validity of recommendations.</div></div>","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503890"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602525","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":"Recurrent ranulas: What is the diagnosis?","authors":"Joana Baptista de Lima ,&nbsp;José Banquart Leitão ,&nbsp;Carla Zilhão ,&nbsp;Sérgio Alves","doi":"10.1016/j.anpede.2025.503806","DOIUrl":"10.1016/j.anpede.2025.503806","url":null,"abstract":"","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503806"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369705","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":"Divergences in recommendations between the toxicological information service and two reference resources in pediatric poisoning management","authors":"Carlos M. Angelats ,&nbsp;Inmaculada Vilaplana-Mora ,&nbsp;Paula Forner-García ,&nbsp;A. Lora-Martin ,&nbsp;Beatriz Azkunaga-Santibañez","doi":"10.1016/j.anpede.2025.503841","DOIUrl":"10.1016/j.anpede.2025.503841","url":null,"abstract":"","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503841"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621532","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":"Pediatric research in Spain: Challenges and opportunities","authors":"Laura Moreno-Galarraga ,&nbsp;Cesar Gracía Vera ,&nbsp;Irene Rivero-Calle ,&nbsp;Federico Martinón-Torres ,&nbsp;Ignacio Diez López ,&nbsp;Fernando Cabañas ,&nbsp;Cristina Calvo ,&nbsp;en nombre de la Plataforma INVEST-AEP","doi":"10.1016/j.anpede.2025.503854","DOIUrl":"10.1016/j.anpede.2025.503854","url":null,"abstract":"<div><h3>Introduction</h3><div>Pediatric research is key for improving the diagnosis, treatment and prevention of childhood diseases. In Spain, however, this vital area of research remains underfunded and underrepresented compared to both domestic research in the adult population and pediatric research in other countries.</div></div><div><h3>Objective</h3><div>To identify the main barriers to pediatric research in Spain and propose strategies to strengthen its development and integration into the public healthcare system.</div></div><div><h3>Methods</h3><div>The INVEST-AEP working group conducted an analysis of the current state of pediatric research in Spain. The analysis identified barriers related to funding, training, clinical workloads and bureaucracy, based on which the group proposed several potential improvement strategies.</div></div><div><h3>Results</h3><div>The main barriers include limited funding (5% of national grants), insufficient training in research (both in undergraduate and residency programs), substantial clinical workloads with no protected research time and insufficient collaborative networks. The situation is even more critical in primary care, and, in addition, research efforts do not receive the recognition they deserve for professional career advancement or the competitive application process for public positions. Potential solutions were identified, such as improvements in medical and residency training, consolidation of structured research networks, dedicated sources of funding for pediatric research, protected research time, centralization of ethics committees and recognition of research in merit-based evaluations.</div></div><div><h3>Conclusions</h3><div>Urgent strategies are needed to strengthen pediatric research in Spain, including increased investment, specific training programs and collaborative networks. A skilled pediatrician should seamlessly integrate clinical practice, teaching and research. Pediatricians, institutions, universities, and the central and autonomous community governments in Spain need to actively promote pediatric research to improve child health and to position Spain as a leader in the field.</div></div>","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503854"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621535","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":"Why must pediatricians also be scientists?","authors":"Alejandro Avila-Alvarez","doi":"10.1016/j.anpede.2025.503882","DOIUrl":"10.1016/j.anpede.2025.503882","url":null,"abstract":"","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503882"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531607","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 of liraglutide in the treatment of adolescent obesity","authors":"Mónica Ruiz Pons ,&nbsp;Marina Gutiérrez Vilar ,&nbsp;Celia García Zurita ,&nbsp;Manuel Enrique Fuentes Ferrer ,&nbsp;Alejandra Pérez Rodríguez ,&nbsp;Cristina Rosado Alonso","doi":"10.1016/j.anpede.2025.503856","DOIUrl":"10.1016/j.anpede.2025.503856","url":null,"abstract":"<div><h3>Introduction</h3><div>In the management of adolescent obesity, therapeutic options are limited and the outcomes of lifestyle modification (LM) alone are poor. Liraglutide, a GLP-1 receptor agonist, was the first drug approved in Spain for the management of obesity in adolescents aged 12 years or older.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of liraglutide combined with LM in adolescents with obesity compared to LM alone.</div></div><div><h3>Methods</h3><div>Retrospective observational study of 62 adolescents (12-18 years) with a body mass index (BMI) at or above the 95th percentile. The intervention group (n<!--> <!-->=<!--> <!-->31) received liraglutide plus LM, while controls (n<!--> <!-->=<!--> <!-->31) matched for age, sex and treatment duration were managed with LM alone. We analyzed anthropometric, cardiovascular and body composition variables at three time points: baseline (T1), end of treatment (T2: mean, 6.9 months; SD, 4.7), and follow-up (T3: mean, 12.5 months; SD, 4.9 months). Comparisons between groups were performed using adjusted analysis of covariance model for changes in quantitative variables and logistic regression for BMI reductions of 5% or greater and 10% or greater.</div></div><div><h3>Results</h3><div>In the intervention group, the BMI z score decreased significantly (mean, −1.09 [SD, 0.24] vs −0.10 [SD, 0.25] in controls; P<!--> <!-->=<!--> <!-->.001). This corresponded to a BMI reduction of 5% or greater in 48.4% of patients and 10% or greater in 29%, compared to 3% and 1%, respectively, in the control group (P<!--> <!-->&lt;<!--> <!-->.05). The weight loss was maintained at six months of follow-up (T3). There was a significant reduction in insulin levels, the HOMA-IR, triglyceride levels, systolic hypertension (HTN), and the number of prediabetic patients.</div></div><div><h3>Conclusions</h3><div>Liraglutide combined with LM achieved a greater reduction in the BMI z score, waist/height ratio and cardiometabolic parameters compared to the LM alone. Further research is needed to assess its long-term effects and difficulties in its implementation.</div></div>","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503856"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621533","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":"Use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in three adolescents with heart failure due to non-obstructive hypertrophic cardiomyopathy","authors":"Carlos Baena-Palomino,&nbsp;Ana Castellano-Martínez,&nbsp;Moisés Rodríguez-González","doi":"10.1016/j.anpede.2025.503802","DOIUrl":"10.1016/j.anpede.2025.503802","url":null,"abstract":"","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"102 6","pages":"Article 503802"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287447","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}