The relevance of music therapy in paediatric and adolescent cancer patients: a scoping review.

BACKGROUND: Music therapy is an emerging and useful methodology to improve the quality of life of children and adolescents with cancer. OBJECTIVES: The objective of this scoping review was to examine the available literature and offer an analysis of the relevance of music therapy in paediatric oncology. We considered the effects of music therapy on children and adolescents with cancer as well as the perception of this population, their families, music therapists, and health professionals regarding the music therapy sessions conducted. Finally, we analysed the characteristics of the distinct types of music therapy interventions reported in the literature. METHODS: In this review, we applied the methodology proposed by Arksey and O'Malley. After performing a comprehensive academic literature database search, 522 articles were identified of which, 27 met the inclusion criteria. RESULTS: The results shed light on the use of music therapy as a means to facilitate self-esteem, to improve the physical, emotional, and cognitive aspects related to disease and, to a lesser extent, alleviate their physiological symptoms. Both children and adolescents with cancer were represented in the academic literature. The most prevalent findings described in these studies were the benefits of music therapy in terms of improved psychological well-being and social relationships in this population. CONCLUSIONS: Music therapy interventions are generally well received, not only by children and adolescents with cancer, but also by their families, music therapists, and health professionals. Nevertheless, several gaps were identified in some of the studies we considered, including a lack of specificity regarding the results obtained or music therapy intervention methods used.

[Main changes in the «COVID-19 in paediatrics¼ clinical practice guideline]. / Principales modificaciones en la guía de práctica clínica «COVID-19 en pediatría¼.

We present a summary of the main modifications to the «COVID-19 in Paediatrics¼ clinical practice guideline made from its initial version, published in 2021, and the version published in 2022. The document was developed following the structured steps of evidence-based medicine and applying the GRADE system to synthesize the evidence, assess its quality and, when appropriate, issue graded recommendations (based on the quality of the evidence, values and preferences, the balance between benefits, risks and costs, equity and feasibility). This update also includes the modifications proposed by external reviewers.We summarised the main modifications in the following sections: epidemiology, clinical features, diagnosis, prevention, treatment and vaccines. In relation to the body of knowledge achieved in the first year of the pandemic, the literature published in the second year contributed additional data, but without substantial modifications in many of the areas. The main changes took place in the field of vaccine research. This update was completed in December 2021, coinciding with the emergence of infections by the omicron variant, so the document will need to be updated in the future.

Main changes in the "COVID-19 in paediatrics" clinical practice guideline.

We present a summary of the main modifications to the "COVID-19 in Paediatrics" clinical practice guideline made from its initial version, published in 2021, and the version published in 2022. The document was developed following the structured steps of evidence-based medicine and applying the GRADE system to synthesize the evidence, assess its quality and, when appropriate, issue graded recommendations (based on the quality of the evidence, values and preferences, the balance between benefits, risks and costs, equity and feasibility). This update also includes the modifications proposed by external reviewers. We summarised the main modifications in the following sections: epidemiology, clinical features, diagnosis, prevention, treatment and vaccines. In relation to the body of knowledge achieved in the first year of the pandemic, the literature published in the second year contributed additional data, but without substantial modifications in many the areas. The main changes took place in the field of vaccine research. This update was completed in December 2021, coinciding with the emergence of infections by the omicron variant, so the document will need to be updated in the future.

A systematic review on pediatric medication errors by parents or caregivers at home.

INTRODUCTION: Medication errors (MEs) are frequent and, in some cases, can lead to hospitalization, disability, increased healthcare costs or, even, death. Most of pediatric medications are administered by parents or caregivers at home. It is necessary to explore the MEs at home to improve pediatric patient safety. AREAS COVERED: This study aimed to review the current literature on the frequency of pediatric MEs by parents or caregivers at home, their associated factors, and pediatric ME reporting systems. Citable original articles of any type of study design or reviews published from 2013 to 2021 were searched in Medline, Scopus, Embase, and ScienceDirect databases. EXPERT OPINION: The available data about the frequency of pediatric MEs at home varied from 30% to 80%. Current research suggests the risk of making a ME in pediatric patients at home may depend on the characteristics of the caregiver and may increase if a prescription contains ≥3 drugs. Findings conclude that providing dosing tools more closely matched to prescribed dose volumes, recommending the use of syringes as a measurement tool, and educational intervention for caregivers could be useful to reduce MEs. Concerning the reporting systems for pediatric MEs in the outpatient setting, no information was found.

[Consequences of COVID-19 pandemic over acute bronchiolitis hospitalizations in the center and east of Spain]. / Pandemia por COVID-19 y su repercusión sobre las hospitalizaciones por bronquiolitis en el Centro y Este de España.

INTRODUCTION: Non-pharmaceutical interventions that have been implemented in southern hemisphere countries because of COVID-19 pandemic declaration in March 2020, have evidenced some unexpected changes in the way of spreading of many other viruses. This study as a part of ECEALHBA's Project, reports the consequences of COVID-19 pandemic over 2020-2021 bronchiolitis epidemic period in the Central and Eastern regions of Spain. METHOD: Multicenter, observational, descriptive and ambispective study of admitted infants with the diagnosis of bronchiolitis in 16 Spanish hospitals involved in the investigation project. Five epidemic periods previous to COVID-19 pandemic, from 2015 to 2020, were compared with the current one, 2020-2021, in both a qualitative and quantitative manner. RESULTS: Total of 4643 infants were admitted to the participating hospitals along the study period. Pandemic season hospital admissions for bronchiolitis were 94.1% lower than in pre-pandemic period. December and January were peak months for bronchiolitis admissions during pre-pandemic period, but September was the peak month during pandemic year. There was a progressive decrease of admissions from this moment until the end of the follow up, in April 2021. Rhinovirus has been the commonest etiology for bronchiolitis in 2020-2021 epidemic period of bronchiolitis. CONCLUSIONS: Some of the non-pharmaceutical interventions initiated because of COVID-19 pandemic are probably related to the dramatic decrease of bronchiolitis cases in 2020-2021 season. It would be rewarding to purpose novel research to clarify how these simple interventions can be useful, close to vaccines and antiviral drugs, to achieve the goal of avoiding the spread of respiratory viruses in pediatric population.

Gender inequalities on editorial boards of indexed pediatrics journals.

BACKGROUND: The presence of women in decision-making positions, such as on editorial committees of biomedical journals, is not the same as that of men. This paper analyzes the gender composition of editorial committees (EBMs) and editors-in-chief (ECs) positions of pediatric journals. METHODS: The gender of EBMs and ECs of 125 journals classified in the pediatrics area of the Journal Citation Report (JCR) was analyzed. The following indicators were calculated: gender distribution of ECs and EBMs by journal, publisher, subject speciality, country, quartile of the journal in JCR and country of affiliation of the members. RESULTS: The total number of EBMs was 4242. The distribution by sex of the ECs was 19.44% women and 80.56% men, while that of the EBMs were 33.05% women and 66.95% men. Twenty journals exhibited a greater representation of women than of men, and in four there was parity. Journals with greater participation of women specialized in nursing and physical therapy and were related to nutrition (lactation and breastfeeding). CONCLUSIONS: Only one-fifth of ECs and one-third of EBMs are females. Women's participation is higher in journals related to nursing, physical and occupational therapy, and nutrition. The United States has the highest number of EBMs, followed by the European Union. IMPACT: Only one-fifth of Editors-in-chief in pediatrics journals are female. Only one-third of Editorial Board Members in pediatrics journals are female. Women's participation is higher in editorials committees in pediatrics journals related to nursing, physical and occupational therapy, and nutrition. Medical and pediatric associations and societies must work together to eliminate the disparities that exist between women and men. Achieving gender equity and empowering all women is one of the World Health Organization's Sustainable Development Goals.

[Scientific impact and bibliometric contextualisation of Paediatrics compared to other specialities]. / Impacto científico y contextualización bibliométrica de la Pediatría respecto a otras áreas temáticas.

INTRODUCTION: The purpose of this paper is twofold. On the one hand, to identify and characterise the production, citation, impact and collaboration indicators of the Pediatrics area of the Journal Citation Reports, and on the other hand, to place the journal Anales de Pediatría in the context of the Spanish journals of another twenty areas and medical specialties. MATERIAL AND METHOD: The sources of information used to obtain the indicators were Science Citation Index-Expanded, Journal Citation Reports, and Scimago Journal & Country Rank. A regression analysis was performed to determine the correlation between the citation and other variables. RESULTS: Pediatrics ranked 8th in scientific production during the period 2009-2018. In citations per journal it ranks 17th, and the average citations per article approaches 27, occupying, in this case, the 18th position. Below Pediatrics are Emergency Medicine, Rehabilitation, and Primary Health Care. There are no citations for 12.47% of the articles. The average impact factor places the area in 18th place and its h index was 197, reaching 14th position, and standing above seven other areas. The percentage of works carried out with international collaboration was 17.71%, above Primary Health Care (12.88%), Oncology (16.37%), and Emergency Medicine (17.03%). Among the Spanish journals, Anales de Pediatría was the fourth most productive journal, and occupied an intermediate position in terms of the number of citations. CONCLUSIONS: The indicators of citation and impact of the Pediatrics area tend to be above areas such as Emergency Medicine, Primary Health Care, Dentistry, Oral Surgery & Medicine, and Rehabilitation. Professional practice outside large hospitals, together with poor funding, as well as the low number of clinical trials due to the ethical requirements imposed on studies with children, may be the causes that result in moderate citation and impact indicators.

[«I Prepare My Rotation By¼, a virtual complement of paediatric specialist training]. / «Preparo Mi Rotación Por¼, complemento virtual de la formación MIR en Pediatría.

The Spanish Paediatric Association (AEP) has, among its objectives, to develop activities aimed at the training of its members. Thus, in 2013, it began its most ambitious training project, the virtual platform, «Continuum¼. Now it presents a new section aimed at Internal Medicine Residents (MIR) in Paediatrics and their tutors: «I Prepare My Rotation By¼ (PMRP), which has as objectives to reduce the variation in MIR training, to help the tutors in their teaching function, to facilitate collaborative and skill-based learning, reflective training, and the resolving of the particular problems of the professional profile of each paediatric speciality. PMRP is split into three main sections: «From where do we start¼ (with the sub-sections: self-assessment questionnaire and learning agreement), «Situations to resolve¼ (where the clinical scenarios that have been selected in the learning agreement are broken down), and «To where have we got¼ (which includes again the sub-sections at the beginning of the rotation in order to check if the expected objectives have been reached, and the assessment report). It also has other resources: prior knowledge, portfolio, and discussion forum. Five features of the proposed training model should be highlighted: the clinical scenario as a starting point; skill-based learning (based on the Global Paediatric Educational Consortium); the assessment as a training stimulus; the power of collaborative learning, and the participation of the different specialist societies of the AEP in the development of its contents.

[Half a century of ANALES DE PEDIATRÍA. Evolution of its main bibliometric indicators in the Web of Science and Scopus international databases]. / Medio siglo de ANALES DE PEDIATRÍA. Evolución de sus principales indicadores bibliométricos en las bases de datos internacionales Web of Science y Scopus.

PURPOSE: To analyse the coverage and main bibliometric indicators of ANALES DE PEDIATRÍA in Scopus and Science Citation Index Expanded of the Web of Science (SCIE) databases. MATERIAL AND METHOD: The evolution of the journal production was identified according to the document types, collaboration indexes between authors and institutions, and citations, and impact indicators (number of citations, impact factor, 5-years impact factor and without self-citations, Scimago Journal Rank, quartile, h index and most cited works). RESULTS: A total of 10,128 papers were included in Scopus (a mean of around 225 per year) and 1,861 in SCIE (a mean of around 207 per year). The index of collaboration was 4.4 for authors and 2 for institutions. There was international collaboration in 4.2% of the papers. The number of citations received in Scopus (619) exceeded the number of citations received in SCIE (385) by 234. The mean number of citations per paper was lower in SCIE (2.27 in Scopus compared to 1.5 in SCIE). The h index was 18 in Scopus and 14 in SCIE. CONCLUSIONS: Discrepancies were observed in the indicators obtained in both databases due to the different indexation policies, coverage, and classification methods of the papers. The number of citations, the mean number of citations per work, and the h index were higher in Scopus due to the longer life of the journal in that database. There is a positive evolution of the impact factor in SCIE, of the impact factor excluding self-citations, and of the 5-year impact factor.

Low-value clinical practices and harm caused by non-adherence to 'do not do' recommendations in primary care in Spain: a Delphi study.

OBJECTIVE: To determine the non-adherence to the primary care 'do not do' recommendations (DNDs) and their likelihood to cause harm. DESIGN: Delphi study. SETTING: Spanish National Health System. PARTICIPANTS: A total of 128 professionals were recruited (50 general practitioners [GPs], 28 pediatricians [PEDs], 31 nurses who care for adult patients [RNs] and 19 pediatric nurses [PNs]). INTERVENTIONS: A selection of 27 DNDs directed at GPs, 8 at PEDs, 9 at RNs and 4 at PNs were included in the Delphi technique. A 10-point scale was used to assess whether a given practice was still present and the likelihood of it causing of an adverse event. MAIN OUTCOME MEASURE: Impact calculated by multiplying an event's frequency and likelihood to cause harm. RESULTS: A total of 100 professionals responded to wave 1 (78% response rate) and 97 of them to wave 2 (97% response rate). In all, 22% (6/27) of the practices for GPs, 12% (1/8) for PEDs, 33% (3/9) for RNs and none for PNs were cataloged as frequent. A total of 37% (10/27) of these practices for GPs, 25% (2/8) for PEDs, 33% (3/9) for RNs and 25% (1/4) for PNs were considered as potential causes of harm. Only 26% (7/27) of the DNDs for GPs showed scores equal to or higher than 36 points. The impact measure was higher for ordering benzodiazepines to treat insomnia, agitation or delirium in elderly patients (mean = 57.8, SD = 25.3). CONCLUSIONS: Low-value and potentially dangerous practices were identified; avoiding these could improve care quality.

Drivers and strategies for avoiding overuse. A cross-sectional study to explore the experience of Spanish primary care providers handling uncertainty and patients' requests.

OBJECTIVES: Identify the sources of overuse from the point of view of the Spanish primary care professionals, and analyse the frequency of overuse due to pressure from patients in addition to the responses when professionals face these demands. DESIGN: A cross-sectional study. SETTING: Primary care in Spain. PARTICIPANTS: A non-randomised sample of 2201 providers (general practitioners, paediatricians and nurses) was recruited during the survey. PRIMARY AND SECONDARY OUTCOME MEASURES: The frequency, causes and responsibility for overuse, the frequency that patients demand unnecessary tests or procedures, the profile of the most demanding patients, and arguments for dissuading the patient. RESULTS: In all, 936 general practitioners, 682 paediatricians and 286 nurses replied (response rate 18.6%). Patient requests (67%) and defensive medicine (40%) were the most cited causes of overuse. Five hundred and twenty-two (27%) received requests from their patients almost every day for unnecessary tests or procedures, and 132 (7%) recognised granting the requests. The lack of time in consultation, and information about new medical advances and treatments that patients could find on printed and digital media, contributed to the professional's inability to adequately counter this pressure by patients. Clinical safety (49.9%) and evidence (39.4%) were the arguments that dissuaded patients from their requests the most. Cost savings was not a convincing argument (6.8%), above all for paediatricians (4.3%). General practitioners resisted more pressure from their patients (x2=88.8, P<0.001, percentage difference (PD)=17.0), while nurses admitted to carrying out more unnecessary procedures (x2=175.7, P<0.001, PD=12.3). CONCLUSION: Satisfying the patient and patient uncertainty about what should be done and defensive medicine practices explains some of the frequent causes of overuse. Safety arguments are useful to dissuade patients from their requests.

Epidemiological and clinical features of visceral leishmaniasis in children in Alicante Province, Spain.

BACKGROUND: Visceral leishmaniasis (VL) is endemic to the Mediterranean basin. In children, VL often presents with non-specific symptoms and can be life-threatening without proper treatment. AIM: To describe the epidemiological and clinical features of pediatric VL in children in Alicante, Spain. METHODS: The study included all paediatric (<15 years) cases admitted to three hospitals in the province of Alicante from May 1992 to May 2015 with diagnosis of VL (detection was either by anti-Leishmania antibodies in serology or Leishmania in blood and/or bone marrow aspirates). RESULTS: There were 38 cases of pediatric VL (18 aged <24 months, 15 aged 24-59 months and 5 aged ≥5 years). The main symptoms were fever (97.4%), followed by pallor (75.0%) and loss of appetite (46.4%). Eighty-seven per cent of patients were anaemic (haemoglobin < 9 g/dL), 73.7% had neutropenia and 68.4% had thrombocytopenia. Before 2004, 92.3% of patients were treated with meglumine antimoniate (MA) and 7.7% with liposomal amphotericin B (LAmB); after 2004, 84% were treated with LAmB and just one (16%) with MA (p < 0.001). LAmB performed better than MA in terms of mean treatment length (7.4 days vs 25.9 days, p < 0.001), time to becoming afebrile (1.7 vs 13.7 days, p < 0.001), and length of hospital stay (10.9 vs 19.4 days, p = 0.001). CONCLUSION: Paediatric VL in Alicante mainly affects children under five. Children aged ≤24 months present with a lower haemoglobin and white blood cell count. Treatment with LAmB reduces treatment length, time to becoming afebrile and length of hospital stay.

[Bioethics in end-of-life decisions in neonatology: Unresolved issues]. / La bioética en el final de la vida en neonatología: cuestiones no resueltas.

This document is the result of previous work carried out by different expert groups and submitted to multidisciplinary debate at a Conference about controversial, deficient, or new aspects in the field of neonatal palliative care, such as: 1) the deliberative decision-making process, 2) hospital and domiciliary palliative care, 3) donation after controlled cardiac death, and 4) moral stress in professionals. The most relevant conclusions were: the need to instruct professionals in bioethics and in the deliberative method to facilitate thorough and reasonable decision-making; the lack of development in the field of perinatal palliative care and domiciliary palliative care in hospitals that attend newborns; the need to provide neonatal units with resources that help train professionals in communication skills and in the management of moral distress, as well as delineate operational procedure and guidelines for neonatal organ donation.

Decálogo de recomendaciones para una mejor comunicación con los padres en las UCIN

Decálogo de recomendaciones (basadas en la ética y la etiqueta) para una mejor comunicación con los padres (y familias) en las UCIN. Se trata de una adaptación del artículo “Ethics and Etiquette in Neonatal Intensive Care”, publicado en la revista JAMA.

Home versus hospital intravenous antibiotic therapy for cystic fibrosis.

BACKGROUND: Recurrent endobronchial infection in cystic fibrosis requires treatment with intravenous antibiotics for several weeks usually in hospital, affecting health costs and quality of life for patients and their families. This is an update of a previously published review. OBJECTIVES: To determine whether home intravenous antibiotic therapy in cystic fibrosis is as effective as inpatient intravenous antibiotic therapy and if it is preferred by individuals or families or both. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Most recent search of the Group's Trials Register: 23 November 2015. SELECTION CRITERIA: Randomized and quasi-randomized controlled studies of intravenous antibiotic treatment for adults and children with cystic fibrosis at home compared to in hospital. DATA COLLECTION AND ANALYSIS: The authors independently selected studies for inclusion in the review, assessed methodological quality of each study and extracted data using a standardised form. MAIN RESULTS: Eighteen studies were identified by the searches. Only one study could be included which reported results from 17 participants aged 10 to 41 years with an infective exacerbation of Pseudomonas aeruginosa. All their 31 admissions (18 hospital and 13 at home after two to four days of hospital treatment) were analysed as independent events. Outcomes were measured at 0, 10 and 21 days after initiation of treatment. Home participants underwent fewer investigations than hospital participants (P < 0.002) and general activity was higher in the home group. No significant differences were found for clinical outcomes, adverse events, complications or change of intravenous lines,or time to next admission. Home participants received less low-dose home maintenance antibiotic.Quality of life measures showed no significant differences for dyspnoea and emotional state, but fatigue and mastery were worse for home participants, possibly due to a higher general activity and need of support. Personal, family, sleeping and eating disruptions were less important for home than hospital admissions.Home therapy was cheaper for families and the hospital. Indirect costs were not determined. AUTHORS' CONCLUSIONS: Current evidence is restricted to a single randomized clinical trial. It suggests that, in the short term, home therapy does not harm individuals, entails fewer investigations, reduces social disruptions and can be cost-effective. There were both advantages and disadvantages in terms of quality of life. The decision to attempt home treatment should be based on the individual situation and appropriate local resources. More research is urgently required.

[Influence of the month of birth on the demand for healthcare to treat attention deficit hyperactivity disorder. Results of a retrospective study conducted in a neuropaediatric clinic]. / Influencia del mes de nacimiento en la demanda asistencial por trastorno por deficit de atencion/hiperactividad. Resultados de un estudio retrospectivo realizado en una consulta de neuropediatria.

INTRODUCTION: There is an increase in the child neurology attention and, specially in attention deficit hyperactivity disorder (ADHD). It's been proposed that the birth date affects the diagnosis of ADHD, so the youngest children more susceptible of being diagnosed. AIMS: To analyse if there is a relationship between the birth date and the suspicion of ADHD, and to investigate the health demand of child neurology and its evolution regarding diagnostic categories. PATIENTS AND METHODS: Retrospective study of patients been attended in a child neurology clinic between 1992 and 2012. Different diagnostic groups were compared considering epidemiologic variables and trimester and semester of birth to determine whether exists a seasonal pattern. RESULTS: 3469 patients were included, 58.5% were male with a median age of 6 years old. The first reason of consultation was the headache, and the ADHD has experienced an increase of 350% in the last 10 years of the study. 61.6% of patients with ADHD suspicion were born in the second semester of the year. The difference was higher for girls. This pattern was not observed in other neurologic diseases when a comparative analysis was done. CONCLUSIONS: There is an increase of child neurologic demand within the last years, mainly of ADHD patients. Children born in the last semester of the year have a higher risk of being sent to a neurology clinic for evaluation.

TITLE: Influencia del mes de nacimiento en la demanda asistencial por trastorno por deficit de atencion/hiperactividad. Resultados de un estudio retrospectivo realizado en una consulta de neuropediatria.Introduccion. Las consultas de neuropediatria se han incrementado en los ultimos años, especialmente por trastorno por deficit de atencion/hiperactividad (TDAH). Se postula que los niños mas jovenes del curso tienen mas riesgo de ser diagnosticados de TDAH. Objetivos. Analizar la demanda asistencial de neuropediatria, comparar su evolucion por grupos diagnosticos y determinar si existe una relacion entre la fecha de nacimiento de los pacientes y la sospecha de TDAH. Pacientes y metodos. Estudio retrospectivo de los pacientes remitidos a neuropediatria entre 1992 y 2012. Se compararon las distintas categorias diagnosticas segun variables epidemiologicas y se exploro si existia un factor relativo a la edad. Resultados. Se incluyeron 3.469 pacientes, un 58,5% varones, con una mediana de edad de 6 años. El principal motivo de consulta fue la cefalea, y todos los grupos diagnosticos sufrieron un incremento de las consultas. El TDAH experimento un aumento del 350% en los ultimos 10 años. El 61,6% de los niños con sospecha de TDAH nacio en el segundo semestre del año, y la diferencia es mas notable en las niñas. Se objetiva un incremento de sospecha de TDAH en los niños nacidos antes de la fecha de corte del curso escolar que no aparece en ninguna de las otras patologias en el analisis comparativo. Conclusiones. Existe un incremento de la demanda asistencial de neuropediatria en los ultimos años, principalmente por TDAH. Los niños nacidos el ultimo semestre del año tienen un riesgo mayor de ser remitidos por sospecha de esta enfermedad.

Bibliometric profile of the global scientific research on multiple sclerosis (2003-2012).

BACKGROUND AND OBJECTIVES: The aim of this paper is to analyse the scientific research on multiple sclerosis using a bibliographic analysis of articles published during the period 2003-2012. METHODS: The items under study were obtained from the Science Citation Index-Expanded (SCI-E) database, which was accessed through the Web of Science (WOS) platform. All records with the term 'multiple sclerosis' in the title, plus all articles published in the journals Multiple Sclerosis and Multiple Sclerosis Journal, were analysed. RESULTS: A total of 9778 articles, with 160,966 citations, were retrieved on multiple sclerosis, and the majority of the articles were published in Multiple Sclerosis Journal (n = 1511). The articles were published in journals belonging to 135 different subject areas, with the greatest number of papers falling under the category of clinical neurology. The countries that published the largest numbers of articles were the United States (US) (n = 2786), Italy (n = 1263), the United Kingdom (n = 1147) and Germany (n = 1018). International collaborations produced 20.4% of the papers. CONCLUSIONS: We emphasise the progressive growth of publications worldwide, the publication of articles in a wide variety of journals covering numerous subject areas, and the research leadership of Western countries, most notably European countries, the US and Canada.

[Systematic review about dental caries in children and adolescents with obesity and/or overweight]. / Revisión sistemática sobre la caries en niños y adolescentes con obesidad y/o sobrepeso.

INTRODUCTION: Obesity and overweight (O/OW) in children have reached epidemic character and both are a risk factor for chronic serious health problems. This study was perfomed in order to research the relationship between O/OW and dental caries. MATERIAL AND METHODS: [corrected] A SR was conducted between 2007-2011 in tertiary information sources (Trip, Cochrane and NGC), secondary (PubMed, IME, MEDES IBECS) and primary (reference checks). INCLUSION CRITERIA: Patients (children 0-18 years), risk factor (O/OW) and outcomes (primary: caries, secondary: other oral pathology). DATA COLLECTED: Author, year, country, type of study, patient age, cases (with O/OW) and controls (body mass index-BMI-normal or low), comorbidities, socioeconomic status, prevalence of caries and other results in oral health. RESULTS: Forty-seven documents were located, 37 of them met the criteria of the RS, temporarily distributed in 2007 (6 articles), 2008 (6), 2009 (5), 2010 (11) and 2011 (9). They presented a very wide degree of heterogeneity (in patients, intervention, primary outcome and type of design), which does not allow to apply quantitative synthesis of data (meta-analysis). Studies are conflicting regarding the relationship between BMI and frequency of dental caries (DMFT, dmft). CONCLUSIONS: Systematic review allows dentists and pediatricians to know the relationship between O/OW and dental caries.

Introducción: Obesidad y el sobrepeso (O/SP) infantil han alcanzado caracteres de epidemia y son un factor de riesgo de enfermedades crónicas graves para la salud. El objetivo es realizar una revisión sistemática (RS) sobre la relación de O/SP con caries en pediatría. Material y métodos: RS de la literatura 2007-2011 en fuentes de información terciaria (Trip, Cochrane y NGC), secundaria (PubMed, IME, IBECS y MEDES) y primarias (revisión de referencias). Criterios de inclusión: Pacientes (niños de 0-18 años), factor de riesgo (O/SP) y variable de interés (primaria: caries; secundarias: resto patología bucodental). Datos recogidos: Autor, año, país, tipo de estudio, edad pacientes, casos (con O/SP) y controles (con índice de masa corporal -IMC- normal o bajo), estado socioeconómico, prevalencia de caries y otros resultados en salud bucodental. Resultados: Se localizaron un total de 48 documentos, de los que 37 cumplieron los criterios de búsqueda de la RS, distribuidos temporalmente: 6 artículos del año 2007, 6 del 2008, 5 del 2009, 11 del 2010 y 9 del 2011. Presentaron un grado de heterogeneidad muy amplio (en pacientes, intervención, variable principal de interés y tipo de diseño), lo que no permite aplicar síntesis cuantitativa (metanálisis) de los datos, pero si cualitativa. Los estudios son discordantes respecto a la relación entre IMC y frecuencia de caries (CAOD, caod). Conclusiones: La RS permite al odontólogo y pediatra conocer la potencial relación entre O/SP y caries dental.