Anales de pediatria最新文献

{"title":"Evidence-based medicine: 5 steps to navigate uncertainty","authors":"Rafael Martín-Masot ,&nbsp;Carlos Ochoa Sangrador ,&nbsp;Jaime Javier Cuervo Valdés ,&nbsp;Carolina Blanco Rodríguez ,&nbsp;Paz González Rodríguez ,&nbsp;Javier González de Dios","doi":"10.1016/j.anpede.2025.503930","DOIUrl":"10.1016/j.anpede.2025.503930","url":null,"abstract":"<div><div>Evidence-based medicine provides a structured and practical approach for addressing the challenges of modern medicine, which is characterized by an overload of information and the need for well-founded clinical decision-making. This method consists of five steps: formulating clear structured clinical questions, conducting efficient literature searches, critically appraising the evidence, evaluating its applicability and, finally, integrating the resulting knowledge into clinical practice. The first step involves creating structured questions that address specific clinical needs, often using the widely known PICO framework developed by the Centre for Evidence-Based Medicine in Oxford. Subsequently, to avoid information overload, it is essential to manage the abundance of data by prioritizing high-quality sources and adopting strategies that can yield quick and reliable answers. The core of evidence-based medicine lies in critical appraisal, whereby the validity, importance, and applicability of studies are assessed. This process helps avoid the mistake of accepting conclusions without questioning them. The final steps emphasize integrating evidence with clinical expertise and patient preferences, highlighting that, without proper implementation, evidence-based medicine can remain a theoretical framework without practical impact. In demanding clinical settings, evidence-based medicine aims to balance care quality, efficiency, and resource management, supporting professionals in making optimal, evidence-based decisions to improve health care.</div></div>","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 2","pages":"Article 503930"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818625","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":"Impact of a specialized pediatric dysphagia rehabilitation program on caregiver quality of life and coping strategies","authors":"Pilar Ortiz Pérez ,&nbsp;Inés Valero Arredondo ,&nbsp;Encarnación Torcuato Rubio ,&nbsp;Marta Herrador López ,&nbsp;Andrés Rosa López ,&nbsp;Pascual García-Herrera Taillefer ,&nbsp;Víctor Manuel Navas-López","doi":"10.1016/j.anpede.2025.503958","DOIUrl":"10.1016/j.anpede.2025.503958","url":null,"abstract":"<div><h3>Introduction</h3><div>We conducted a prospective quasi-experimental study with the aim of assessing the perceived quality of life (QoL) and burden of caregivers of pediatric patients with dysphagia undergoing a specific assessment and treatment program.</div></div><div><h3>Methods</h3><div>The study included pediatric patients aged less than 14 years with a diagnosis of dysphagia managed in a specialized unit. Patients underwent clinical assessments, including an oral motor assessment and diagnostic tests such as videofluoroscopy. Individualized rehabilitative treatment was initiated, including dietary modifications and rehabilitation approaches. Quality of life was evaluated by means of validated tools, including the Pediatric Quality of Life Inventory-Family Impact Module (PedsQL-FIM) and an adapted version of the Swallowing Quality of Life Questionnaire (SwalQOL).</div></div><div><h3>Results</h3><div>A total of 117 patients were recruited initially, and the final analysis included 99 patients. We observed significant improvements in dysphagia severity, oral diet expansion and safety outcomes after treatment. Caregivers of patients with greater neurological impairment, particularly those with GMFCS IV-V and using feeding tubes, were more likely to have higher post-intervention PedsQL-FIM scores.</div></div><div><h3>Conclusion</h3><div>Our findings underscore the significant impact of dysphagia on caregiver QoL and the effectiveness of individualized rehabilitation programs in improving patient outcomes and mitigating caregiver burden. Future research should focus on refining assessment tools and enhancing comprehensive care approaches to further support caregivers and patients in managing dysphagia.</div></div>","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 2","pages":"Article 503958"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651504","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":"Congenital aplasia cutis with unusual presentation","authors":"Laura Jiménez Blanco,&nbsp;Ana María Gil Fenoy,&nbsp;Esther Aguilera Rodríguez,&nbsp;Francisco Javier Díez-Delgado Rubio","doi":"10.1016/j.anpede.2025.503807","DOIUrl":"10.1016/j.anpede.2025.503807","url":null,"abstract":"","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503807"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556138","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":"Is there a biological component in gender identity?","authors":"Natalia S. Fernández ,&nbsp;Rosa Fernández ,&nbsp;Marcelino Gómez-Balaguer ,&nbsp;Mireia Mora ,&nbsp;Julio Guerrero-Fernández ,&nbsp;Amadora Moral-Martos","doi":"10.1016/j.anpede.2025.503883","DOIUrl":"10.1016/j.anpede.2025.503883","url":null,"abstract":"<div><h3>Introduction</h3><div>Gender identity is each person’s internal sense of being a woman, a man, both, neither, or anywhere along the gender spectrum, which may (cisgender) or may not (transgender) coincide with the sex assigned at birth. The multiple difficulties experienced by transgender individuals constitutes a risk factor for mood disorders and self-harming behaviors. However, knowledge about biological influences on gender identity development has the potential to reduce the stigmatization of gender minorities.</div></div><div><h3>Materials and methods</h3><div>We conducted a literature review of the available literature on the biological basis of gender identity, summarizing the main scientific evidence in the field in addition to its limitations.</div></div><div><h3>Results</h3><div>A growing body of research supports that the broad spectrum that characterizes gender identity constitutes a multifactorial trait with a heritable component. At the neuroanatomical level, this model translates to the high variability observed in the degree of masculinization/feminization of different features within a single brain, with considerable overlap between different gender identities at the individual level. Hence, neither genetic variants nor neuroanatomic measures can be used to identify or predict an individual’s gender identity.</div></div><div><h3>Conclusion</h3><div>The evolutionary advantage of sexual reproduction lies in the huge increase in variation produced among individuals. The continuous distribution of gender identities in the population appears to be just one more aspect of sexual reproduction as a source of variability.</div></div>","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503883"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562327","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":"Recommendations for the safe use of high-risk medications in pediatrics","authors":"María José Otero ,&nbsp;Belén Rodríguez Marrodan ,&nbsp;Nuria Prieto Santos ,&nbsp;Enrique Villalobos Pinto ,&nbsp;Silvia Manrique Rodríguez ,&nbsp;Rebeca Padilla Peinado ,&nbsp;Cecilia M. Fernández-Llamazares ,&nbsp;Aurora Madrid Rodríguez ,&nbsp;representing the Spanish Association of Pediatrics, the Spanish Society of Hospital Pharmacy and Autonomous Communities","doi":"10.1016/j.anpede.2025.503815","DOIUrl":"10.1016/j.anpede.2025.503815","url":null,"abstract":"<div><h3>Objective</h3><div>The objectives of this consensus document were to establish a standardized list of high-risk medications for the pediatric population and to compile the recommended practices for their safe use with the aim of promoting the implementation of medication error prevention programs in health care centers.</div></div><div><h3>Method</h3><div>The Ministry of Health, the Spanish Institute for Safe Medication Practices, the Spanish Association of Pediatrics and the Spanish Society of Hospital Pharmacy and regional administration representatives participated in the project. The <em>Recommendations for the Safe Use of High-Risk Medications</em> was used as reference, and its contents adapted and expanded to address specific issues in the pediatric population based on the current evidence.</div></div><div><h3>Results</h3><div>The document provides a reference list of high-risk medicines in pediatric care. It recommends that health care centers, in addition to prioritizing interventions in relation to anticoagulants, insulins, opioids, neuromuscular blockers, IV potassium, oral methotrexate and cytostatic agents, also consider interventions for IV adrenergic agonists, aminoglycosides and vancomycin, drugs for moderate and minimal sedation, parenteral nutrition and IV paracetamol in pediatric patients. The document emphasizes the need to implement multiple safe practices at every stage of the medication use process, prioritizing those with the greatest effectiveness, and involving pediatricians, pharmacists and other healthcare professionals. It also highlights the importance of active involvement by patients and caregivers. Finally, it provides general guidelines common to all these medications, as well as specific practices for each prioritized pharmacological group or medication, which should be combined to enhance pediatric patient safety.</div></div><div><h3>Conclusion</h3><div>Developing programs to increase the safety of high-risk medications in pediatric patients is essential in order to reduce medication errors in this vulnerable population. The implementation of safe practices should be accompanied by continuous monitoring and periodic updates to guarantee effectiveness and strengthen the safety culture in health care centers.</div></div>","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503815"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653667","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":"Tofacitinib in alopecia areata and nephrotic syndrome","authors":"Irene Comino-Hidalgo ,&nbsp;Ana Belén Martínez-López ,&nbsp;Minia Campos Domínguez ,&nbsp;Olalla Álvarez-Blanco","doi":"10.1016/j.anpede.2025.503834","DOIUrl":"10.1016/j.anpede.2025.503834","url":null,"abstract":"","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503834"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610546","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":"Neuroendocrine cell hyperplasia of infancy: Description of 6 cases","authors":"Laura Gil Blanco ,&nbsp;Alicia Hernando Larroy ,&nbsp;Javier Sainz García ,&nbsp;Carlos Martín de Vicente","doi":"10.1016/j.anpede.2025.503904","DOIUrl":"10.1016/j.anpede.2025.503904","url":null,"abstract":"","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503904"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621534","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":"Study of an outbreak of impetigo due to methicillin-sensitive Staphylococcus aureus resistant to topical antibiotics","authors":"Irene López-Ramos ,&nbsp;Natalia Martín Iranzo ,&nbsp;María José Carrasco Villanueva ,&nbsp;Silvia García-Cobos ,&nbsp;Verónica Casquero-García","doi":"10.1016/j.anpede.2025.503812","DOIUrl":"10.1016/j.anpede.2025.503812","url":null,"abstract":"","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503812"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531606","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":"Children's Health and the Trans Law","authors":"Ángel Hernández Merino","doi":"10.1016/j.anpede.2025.503901","DOIUrl":"10.1016/j.anpede.2025.503901","url":null,"abstract":"","PeriodicalId":93868,"journal":{"name":"Anales de pediatria","volume":"103 1","pages":"Article 503901"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593157","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":"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}