Comprehensive analysis of right fascicular and right bundle branch blocks: A multi-center study.

Electrocardiographic patterns of right bundle branch and fascicular blocks were comprehensively analyzed in a two-phase study. The research aimed to address the scarcity of literature and the absence of standardized diagnostic criteria for these conditions. It revealed a weak correlation between the cardiac axis and age and highlighted the high misdiagnosis rate of these blocks. Furthermore, it discussed the challenges in fulfilling existing diagnostic criteria. The study emphasizes the need for a more precise understanding of right ventricular conduction disorders and the importance of developing robust diagnostic criteria.

Estudio de la vía aérea superior frente a apneas obstructivas del sueño persistentes en pediatría / An approach to the upper airway evaluation in pediatric persistent obstructive sleep apnea

El síndrome de apneas obstructivas del sueño (SAOS) en pediatría constituye un trastorno asociado a múltiples consecuencias en el espectro cognitivo y comportamental. El principal factor de riesgo asociado es la hipertrofia amigdalina y las vegetaciones adenoideas. La adenoamigdalectomía es el tratamiento de primera línea. La incidencia del SAOS persistente varía entre un 15 % y un 75 % según las comorbilidades. Este se presenta como un desafío a la hora de tratarlo; requiere un abordaje integral para su diagnóstico y tratamiento adecuado. El objetivo de esta revisión bibliográfica es proponer un abordaje diagnóstico y terapéutico para el SAOS persistente.

In pediatrics, obstructive sleep apnea syndrome (OSAS) is a disorder associated with multiple consequences at the cognitive and behavioral level. The main associated risk factor is the presence of tonsillar hypertrophy and adenoids. An adenotonsillectomy is the first-line treatment. The incidence of persistent OSAS varies from 15% to 75%, depending on comorbidities. This is a challenge in terms of management; it requires a comprehensive approach for an adequate diagnosis and treatment. The objective of this bibliographic review is to propose a diagnostic and therapeutic approach for persistent OSAS.

An approach to the upper airway evaluation in pediatric persistent obstructive sleep apnea. / Estudio de la vía aérea superior frente a apneas obstructivas del sueño persistentes en pediatría.

In pediatrics, obstructive sleep apnea syndrome (OSAS) is a disorder associated with multiple consequences at the cognitive and behavioral level. The main associated risk factor is the presence of tonsillar hypertrophy and adenoids. An adenotonsillectomy is the first-line treatment. The incidence of persistent OSAS varies from 15% to 75%, depending on comorbidities. This is a challenge in terms of management; it requires a comprehensive approach for an adequate diagnosis and treatment. The objective of this bibliographic review is to propose a diagnostic and therapeutic approach for persistent OSAS.

El síndrome de apneas obstructivas del sueño (SAOS) en pediatría constituye un trastorno asociado a múltiples consecuencias en el espectro cognitivo y comportamental. El principal factor de riesgo asociado es la hipertrofia amigdalina y las vegetaciones adenoideas. La adenoamigdalectomía es el tratamiento de primera línea. La incidencia del SAOS persistente varía entre un 15 % y un 75 % según las comorbilidades. Este se presenta como un desafío a la hora de tratarlo; requiere un abordaje integral para su diagnóstico y tratamiento adecuado. El objetivo de esta revisión bibliográfica es proponer un abordaje diagnóstico y terapéutico para el SAOS persistente.

Congenital pyriform aperture stenosis: Ten years experience.

INTRODUCTION: Congenital nasal pyriform aperture stenosis (CNPAS) is an uncommon malformation and a rare cause of respiratory distress in neonates that may require early surgical intervention. The aim of this study is to report our experience in patients operated for CNPAS and present characteristics of this population. MATERIAL AND METHODS: A retrospective, analytical cohort study was conducted of patients who underwent surgical treatment for CNPAS in the Hospital de Pediatría Garrahan from May 2008 to May 2018. RESULTS: Nineteen patients underwent surgical treatment; 47.36% had some associated genetic syndrome. The surgical approach was sublabial. Follow-up was more than 45 days in 14 patients, 9 did not require additional treatment, and the remaining 5 required further surgical and/or medical treatment. Short-term post-surgical outcome was good in 85.7%. CONCLUSIONS: Better post-surgical results were obtained in patients in whom endonasal stenting was not used and who did not present associated craniofacial malformations.

Paediatric bilateral vocal cord paralysis: our experience. / Parálisis bilateral de cuerdas vocales en pediatría: nuestra experiencia.

Bilateral vocal cord paralysis (BVCP) is the second most common cause of neonatal stridor. The aim of this study was to describe the demographic features, aetiology, comorbidities, and management of our patients with BVCP. MATERIAL AND METHODS: We conducted a retrospective review of the clinical charts of all patients diagnosed with BVCP seen at the Department of Respiratory Endoscopy between 2011 and 2015. RESULTS: 47 patients were included. Mean age at diagnosis was 1 month and male sex predominated (63%). The aetiology was congenital in 59% and acquired in 41% of the infants. The cause was most frequently idiopathic in the former group and secondary to postoperative injury in the latter. Overall, 42 patients (89%) required tracheostomy, without statistically significant differences between the causes. Of all the patients, 39% regained vocal-cord mobility; 44% of those with congenital BVCP, 31% of those with acquired BVCP and 62.5% with idiopathic BVCP. In five patients a laryngotracheoplasty was performed with a posterior costal cartilage graft and one underwent posterior cordectomy. All were decannulated. In one patient vocal-cord lateralization was performed, avoiding tracheostomy. CONCLUSION: BVCP was most commonly of congenital cause and was mainly idiopathic within this group of patients, with a slight male preponderance. A high percentage of patients required tracheostomy. A higher recovery rate of vocal-cord mobility was observed in idiopathic BVCP, which allowed for successful decannulation. In this series, decannulation was possible in all patients that underwent surgery; however, further studies with comparison of techniques and objective assessment of swallowing and phonation are necessary.

Peligro de asfixia: conocimiento de los padres sobre la aspiración de cuerpos extraños en niños / Choking hazard: parental knowledge on foreign body aspiration in children / Perigo de asfixia: o conhecimento dos pais sobre aspiração de corpos estranhos em crianças

La aspiración de un cuerpo extraño es una causa importante y prevenible de morbimortalidad en la infancia. Uno de los factores de riesgo principales de la asfixia es la falta de conocimiento de los padres y cuidadores acerca de los objetos peligrosos, las situaciones de riesgo y los signos clínicos de un cuerpo extraño en la vía aérea. Para evitar eventos de asfixia y realizar diagnósticos oportunos para el manejo adecuado, el conocimiento en la comunidad acerca de esta problemática debe aumentar. Evaluamos el conocimiento de los padres sobre la aspiración de cuerpos extraños en niños a fin de proponer estrategias de prevención y evitar nuevos accidentes.

The aspiration of a foreign body is an important and preventable cause of morbidity and mortality in childhood. One of the major risk factors of asphyxia is that parents or caregivers may lack knowledge of the dangerous nature of many objects, risk situations, and clinical signs of a foreign body in the airway. To avoid choking events and make an early and adequate diagnosis for the proper management of this unfortunate event, community awareness should be increased. We evaluate how much parents know about the aspiration of foreign bodies in children in order to propose prevention strategies as well as to avoid further accidents.

A aspiração de corpo estranho é uma causa importante e evitável de morbidade e mortalidade na infância. Um dos principais fatores de risco de asfixia é a falta de conhecimento dos pais e cuidadores sobre objetos perigosos, situações de risco e sinais clínicos de um corpo estranho na via aérea. Para evitar a asfixia eventos e fazer diagnósticos atempados para a correcta gestão, o conhecimento da comunidade sobre este problema deve aumentar. Nós avaliar o conhecimento dos pais sobre aspiração de corpo estranho em crianças, a fim de propor estratégias para a prevenção e evitar novos acidentes.

Fístula broncobiliar congénita: Caso dínico / Congenital broncho-biliary fistula: A case report

La fístula traqueo- o broncobiliar congénita o fístula hepatopulmonar congénita es una rara malformación con alta morbimortalidad si su diagnóstico no se realiza a tiempo. Existe una comunicación entre el sistema respiratorio (tráquea o bronquio) y el tracto biliar. Hasta la fecha, se han reportado solo 35 casos. Presentamos el caso de un neonato con neumopatía derecha y débito bilioso por el tubo endotraqueal. El diagnóstico se realizó mediante broncoscopía con radioscopía y la resección de la fístula broncobiliar fue por videotorascopía. Posteriormente, se requirió de una hepatectomía izquierda con anastomosis biliodigestiva en Y de Roux por presentar hipoplasia de colédoco.

Congenital tracheo-or-bronchobiliary fistula or congenital he-patopulmonary fistula is a rare malformation with high morbidity and mortality if the diagnosis is not made early. The tracheo-or-bronchobiliary fistula is a communication between the respiratory (trachea or bronchus) and biliary tract. To date, only 35 cases have been published worldwide. We report a case of a neonate with right pneumonia and bilious fluid in the endotracheal tube. Diagnosis was made using bronchoscopy with fluoroscopy. Videothoracoscopy was used to remove the bronchobiliary fistula. Subsequently, a left he-patectomy with Roux-en-Y biliary-digestive anastomosis was performed as bile ductus hypoplasia was present.

[Congenital broncho-biliary fistula: a case report]. / Fístula broncobiliar congénita: caso dínico.

Congenital tracheo-or-bronchobiliary fistula or congenital he-patopulmonary fistula is a rare malformation with high morbidity and mortality if the diagnosis is not made early. The tracheo-or-bronchobiliary fistula is a communication between the respiratory (trachea or bronchus) and biliary tract. To date, only 35 cases have been published worldwide. We report a case of a neonate with right pneumonia and bilious fluid in the endotracheal tube. Diagnosis was made using bronchoscopy with fluoroscopy. Videothoracoscopy was used to remove the bronchobiliary fistula. Subsequently, a left he-patectomy with Roux-en-Y biliary-digestive anastomosis was performed as bile ductus hypoplasia was present.

La fístula traqueo- o broncobiliar congénita o fístula hepatopulmonar congénita es una rara malformación con alta morbimortalidad si su diagnóstico no se realiza a tiempo. Existe una comunicación entre el sistema respiratorio (tráquea o bronquio) y el tracto biliar. Hasta la fecha, se han reportado solo 35 casos. Presentamos el caso de un neonato con neumopatía derecha y débito bilioso por el tubo endotraqueal. El diagnóstico se realizó mediante broncoscopía con radioscopía y la resección de la fístula broncobiliar fue por videotorascopía. Posteriormente, se requirió de una hepatectomía izquierda con anastomosis biliodigestiva en Y de Roux por presentar hipoplasia de colédoco.

Diagnóstico y tratamiento de las estenosis subglóticas en pediatría: experiencia en un hospital de alta complejidad / Diagnosis and treatment of pediatric subglottic stenosis: experience in a tertiary care center

La estenosis subglótica es una de las causas más frecuentes de obstrucción de la vía aérea en pediatría. El 90% son secundarias a la intubación endotraqueal. El diagnóstico se sustenta en la clínica del paciente, la evaluación radiológica, la laringoscopía flexible y la endoscopía rígida de la vía aérea bajo anestesia general. Debe sospecharse en niños con dificultad respiratoria posextubación. La conducta terapéutica dependerá de la gravedad de la estenosis subglótica y de la sintomatología del paciente. Describimos nuestra experiencia en cuanto a las etiologías de las estenosis subglóticas, el diagnóstico, el tratamiento y la evolución de pacientes con esta patología.

Subglottic stenosis is among the most common causes of airway obstruction in children, 90% of which resulting from endotracheal intubation. The diagnosis is based on the patient's clinical, radiologic evaluation, flexible laryngoscopy and rigid airway endoscopy under general anesthesia. It must be suspected in children with respiratory distress after extubation. The therapeutic approach depends on the severity of the subglottic stenosis and the patient's symptoms. We describe our experience with the subglottic stenosis etiologies, diagnosis, treatment and outcome of patients with this condition.

[Diagnosis and treatment of pediatric subglottic stenosis: experience in a tertiary care center]. / Diagnóstico y tratamiento de las estenosis subglóticas en pediatría: experiencia en un hospital de alta complejidad.

Subglottic stenosis is among the most common causes of airway obstruction in children, 90% of which resulting from endotracheal intubation. The diagnosis is based on the patient's clinical, radiologic evaluation, flexible laryngoscopy and rigid airway endoscopy under general anesthesia. It must be suspected in children with respiratory distress after extubation. The therapeutic approach depends on the severity of the subglottic stenosis and the patient's symptoms. We describe our experience with the subglottic stenosis etiologies, diagnosis, treatment and outcome of patients with this condition.