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2.
Arch. argent. pediatr ; 123(1): e202410430, feb. 2025. tab, graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1586504

ABSTRACT

El presente documento es la actualización de las recomendaciones de la Sociedad Argentina de Pediatría basadas en la revisión bibliográfica de los últimos años sobre el empleo del anticuerpo monoclonal contra el virus sincicial respiratorio (VSR), palivizumab, en grupos de pacientes con alto riesgo de desarrollar infección respiratoria grave. Se destaca la continua relevancia del VSR como agente causante de infecciones respiratorias agudas bajas e internaciones. Se revisó la epidemiología del VSR en el país tras la pandemia por COVID-19. Se discutieron los grupos de riesgo en los que se indica el uso de palivizumab según la condición de base, así como aspectos sobre su dosificación y futuras opciones terapéuticas.


The current document is an update of the recommendations of the Sociedad Argentina de Pediatría based on a bibliographic review of publication from recent years on the use of the monoclonal antibody against respiratory syncytial virus (RSV), palivizumab, in groups of patients at high risk of developing severe respiratory infection. The continuing relevance of RSV as a causative agent of acute lower respiratory infections and hospitalizations are highlighted. The epidemiology of RSV in the country after the COVID-19 pandemic was reviewed. The risk groups in which the use of palivizumab is indicated according to the underlying condition were discussed, as well as aspects of its dosing and future therapeutic options.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Antiviral Agents/administration & dosage , Antiviral Agents/therapeutic use , Respiratory Syncytial Virus Infections/prevention & control , Respiratory Syncytial Virus Infections/epidemiology , Palivizumab/administration & dosage , Palivizumab/therapeutic use , Argentina
3.
Arch. argent. pediatr ; 123(1): e202410370, feb. 2025.
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1585802

ABSTRACT

El lupus eritematoso sistémico pediátrico (LESp) es una enfermedad multisistémica, cuya gravedad depende de los órganos afectados. Se han descrito enfermedades monogénicas que predisponen a la aparición de LESp. Para la confirmación diagnóstica, se realizan pruebas analíticas e inmunológicas. El objetivo principal del tratamiento es la remisión de la enfermedad y la prevención de brotes. Se presenta un caso clínico de una paciente con síndrome febril prolongado, artralgias y anemia, con pruebas analíticas positivas para ANA, anti-ADN y valores bajos de complemento C3, C4 y C1q, por lo que se realizó diagnóstico de LESp asociado a deficiencia de C1q. Los pacientes con deficiencia de C1q presentan inicio temprano y daño importante a órganos blanco con nefritis. Realizar un diagnóstico oportuno de LESp es importante para garantizar un tratamiento temprano y adecuado. El tratamiento se podría individualizar dependiendo del defecto subyacente que genere el subtipo de lupus.


Childhood-onset systemic lupus erythematosus (cSLE) is a multisystem disease; its severity depends on the organs involved. Monogenic diseases have been described as predisposing to the onset of cSLE. Analytical and immunological tests are used for diagnostic confirmation. The main goal of treatment is remission and flare prevention. Here we describe the clinical case of a patient with prolonged febrile syndrome, arthralgias, and anemia, positive analytical tests for antinuclear antibodies and anti-DNA antibodies and low values of complement C3, C4, and C1q; so the patient was diagnosed with cSLE associated with C1q deficiency. Patients with C1q deficiency present with early onset of disease and significant target organ damage with nephritis. An early diagnosis of cSLE is important to ensure an early and appropriate treatment. Treatment may be personalized depending on the underlying defect that generates the subtype of lupus.


Subject(s)
Humans , Female , Child, Preschool , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/immunology , Complement C1q/deficiency , Complement C1q/immunology , Age of Onset
4.
Arch. argent. pediatr ; 123(1): e202310222, feb. 2025. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1585637

ABSTRACT

Los tumores hepáticos primarios son indicación creciente de trasplante hepático pediátrico. Reportamos los 10 pacientes con trasplantes hepáticos por tumores hepáticos primarios en nuestro centro desde 2001 hasta la actualidad. Hasta el año 2011, se realizó un trasplante por hepatoblastoma de 117 trasplantes hepáticos (0,8 %). Desde 2012, fueron 9 pacientes de 141 (6,4 %) (5 hepatoblastomas, 2 hepatocarcinomas, 1 hemangioendotelioma epitelioide hepático y 1 hamartoma mesenquimático hepático). Seguimiento 13,2 meses (media), edad al trasplante 4,7 años (media), peso 17,6 kg (mediana). El 80 % recibió injertos desde donantes relacionados. No hubo recurrencia tumoral y la sobrevida fue del 100 % en el período de seguimiento. En nuestra serie, los pacientes con tumores hepáticos primarios que requirieron trasplante presentaron buena evolución, aun en hepatocarcinoma. El trasplante hepático con donante relacionado acortó los tiempos entre la indicación y la realización.


Primary liver tumors are an increasing indication for pediatric liver transplantation. Here we report the cases of 10 patients who underwent liver transplantation for primary liver tumors in our hospital, from 2001 to date. Up to 2011, 1 transplant due to hepatoblastoma was done out of 117 liver transplants (0.8%). Since 2012, there were 9 patients out of 141 (6.4%) (5 due to hepatoblastoma, 2 due to hepatocellular carcinoma, 1 due to hepatic epithelioid hemangioendothelioma, and 1 due to hepatic mesenchymal hamartoma). Follow-up: 13.2 months (median); age at transplantation: living 4.7 years (median); weight: 17.6 kg (median). Eighty percent of patients received grafts from living donors. No tumor recurrence was observed. Survival was 100% in the follow-up period. In our series, patients with primary liver tumors requiring transplantation showed an adequate course, even in the case of hepatocellular carcinoma, Related living donors liver transplantation shortened the time between the indication and the surgery.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Liver Transplantation/methods , Carcinoma, Hepatocellular/surgery , Liver Neoplasms/surgery , Retrospective Studies , Hepatoblastoma/surgery
5.
Arch. argent. pediatr ; 123(1): e202410390, feb. 2025. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1585226

ABSTRACT

Introducción. La intoxicación por cianuro, sea accidental o intencional, es un peligro importante para adultos y niños, en especial en las comunidades donde la agricultura es la fuente principal de ingresos. Se describe la evolución clínica, complicaciones y resultados de casos de intoxicación por cianuro ocurridos luego de ingerir carozos y semillas de plantas que contienen glicósidos de cianuro, como los carozos de damasco y las almendras amargas. Población y métodos. Se incluyeron todos los niños de 1-18 años de edad que ingresaron a la Unidad de Cuidados Intensivos Pediátricos (UCIP), con el diagnóstico presuntivo de intoxicación por cianuro, entre el 1 de enero de 2017 y el 8 de enero de 2022. Sus datos se analizaron retrospectivamente. Resultados. Se analizaron 14 pacientes de los cuales 8 eran mujeres. El mes con más ingresos fue julio (42,8 %) en coincidencia con la estación de mayor actividad agrícola. Los síntomas más frecuentes fueron debilidad y fatiga (n = 7). Durante la internación, 4 pacientes presentaron cianosis y 3 tuvieron alteración del nivel de conciencia. Fue menos frecuente la presencia de vómitos, convulsiones, cefaleas, mareos y palpitaciones. En 4 pacientes se indicó hidroxocobalamina como antídoto por presentar acidosis en el estudio de gases en sangre. Todos los pacientes fueron dados de alta. Conclusiones. La intoxicación por cianuro debería considerarse en pacientes pediátricos con hallazgos sospechosos, pérdida brusca de conocimiento, acidosis con brecha aniónica aumentada y acidosis láctica. Se debería investigar el antecedente de ingestión de damascos y almendras amargas.


Introduction: Cyanide poisoning, whether it be accidental or intentional, remains a significant danger to adults and children, especially in societies where agriculture is a primary source of income. We examined the clinical follow-up, complications, and results of cyanide poisoning cases that occurred after eating the pits and seeds of plants containing cyanide glycosides, such as apricot kernels and almonds. Methods: Between 01/01/2017 and 01/08/2022, 14 children aged 1-18 years who were followed up with a prediagnosis of cyanide poisoning in our Paediatric Intensive Care Unit (PICU) were retrospectively analysed. Results: Eight of the patients followed with a preliminary diagnosis of cyanide poisoning were female and six were male. The most common admission month was July (42.8%) coinciding with the agricultural season. The most common symptoms at presentation were weakness and fatigue (n = 7). In the PICU, 4 patients presented lip cyanosis; 3, altered level of consciousness. Vomiting, seizure, headache, dizziness and palpitatons were less frequent. Four patients were treated with hydroxocobalamin (Cyanokit®) as an antidote due to acidosis in their blood gases. All patients treated for cyanide poisoning were discharged. Conclusions: Cyanide poisoning should be considered in paediatric patients with suspicious findings, sudden loss of consciousness, increased anion gap acidosis and lactic acidosis. The history of eating the seeds of plants such as apricot and almonds should be investigated.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Cyanides/poisoning , Prunus armeniaca , Seeds/adverse effects , Seeds/poisoning , Intensive Care Units, Pediatric , Acute Disease
6.
Arch. argent. pediatr ; 123(1): e202410399, feb. 2025. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1585132

ABSTRACT

Introducción. La prueba de ventilación espontánea (PVE) en el proceso de liberación de la asistencia ventilatoria mecánica invasiva (AVMi) pediátrica es una práctica avalada; su positividad se sustenta en parámetros clínicos. Sin embargo, sus resultados están escasamente documentados. Objetivo. Describir los resultados de la PVE en el proceso de liberación de la AVMi. Población y métodos. Análisis retrospectivo. Pacientes con ≥ 48 h en AVMi del 1 de marzo de 2022 al 31 de enero de 2024. Resultados. Se analizaron 493 PVE en 304 pacientes; el 71 % (348) fueron positivas y el 87 % (302) redundó en extubaciones exitosas. Las causas de las PVE negativas fueron mayor trabajo respiratorio (70 %), frecuencia respiratoria (57 %) y frecuencia cardíaca (27 %). En el análisis univariado, la dificultad respiratoria como motivo de ingreso, la presión inspiratoria máxima previo a la PVE y el uso de tubo en T fueron predictores de PVE negativa. En el análisis multivariado, esta asociación persistió para el ingreso por causa respiratoria, la mayor frecuencia respiratoria programada en la AVM y la modalidad tubo en T. Quienes presentaron PVE negativas permanecieron más días en AVMi [9 (7-12) vs. 7 (4-10)] y en UCIP [11 (9-15) vs. 9 (7-12)]. Conclusión. La PVE positiva predijo la extubación exitosa en un alto porcentaje. La dificultad respiratoria al ingreso, la mayor frecuencia respiratoria programada y la mayor proporción de la modalidad tubo en T fueron predictores negativos para la prueba. La PVE negativa se asoció a mayor estadía en AVMi y UCIP.


Introduction. spontaneous breathing trial (SBT) in weaning from pediatric invasive mechanical ventilation (IMV) is an endorsed practice, its positivity is based on clinical parameters; however, its results could be better documented. Objective. To describe the results of the SBT in the IMV weaning process. Population and methods. Retrospective analysis. Patients with ≥48 h in IMV from March 1, 2022 to January 31, 2024. Results. A total of 493 SBT were analyzed in 304 patients; 71% (348) were positive, and 87% (302) resulted in successful extubations. The causes of negative SBT were increased work of breathing (70%), respiratory rate (57%), and heart rate (27%). In univariate analysis, respiratory distress as the reason for admission, peak inspiratory pressure before SBT and T-tube use, were predictors of negative SBT. In multivariate analysis, this association persisted for admission for respiratory cause, the higher programmed respiratory rate in IMV, as the T-tube modality. Those with negative SBT stayed more days in IMV (9 [712] vs. 7 [4-10]) and in PICU (11 [9-15] vs. 9 [7-12]). Conclusion. Positive SBT predicted successful extubation in a high percentage of cases. Respiratory distress on admission, higher programmed respiratory rate, and a higher proportion of T-tube mode were negative predictors of the test. Negative SBT was associated with more extended stays in IMV and PICU.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Respiration, Artificial/methods , Ventilator Weaning/methods , Respiration , Intensive Care Units, Pediatric , Work of Breathing/physiology , Retrospective Studies , Treatment Outcome , Respiratory Rate , Airway Extubation/methods , Length of Stay
7.
Arch. argent. pediatr ; 123(1): e202410451, feb. 2025. tab, graf
Article in English, Spanish | BINACIS, LILACS | ID: biblio-1585056

ABSTRACT

Introducción. La llegada de internet y las redes sociales ha revolucionado el acceso a la información sobre temas de salud y crianza. Las consultas virtuales se extienden en el mundo, van en aumento y representan un desafío para el ejercicio profesional. Objetivo. Caracterizar el uso, por parte de madres y padres, de internet y redes sociales como fuente de información sobre la salud y/o crianza de sus hijos. Población y métodos. Estudio descriptivo, transversal en un centro pediátrico ambulatorio de la Ciudad Autónoma de Buenos Aires para conocer hábitos de consulta en línea de cuidadores de niños sanos o con problemas de salud. Resultados. Se analizaron 201 encuestas, respondidas predominantemente por madres de niños sanos. El 70,6 % realiza búsquedas en línea sobre temas de salud y/o crianza; de ellos, el 80 % consulta más de una vez al mes. Si bien el 36 % de las familias usa la información en forma complementaria a la consulta médica, el 95 % no reemplazaría la consulta pediátrica por la búsqueda en línea. Los participantes no tienen el hábito de seguir páginas oficiales ni suelen verificar la veracidad de los contenidos. Los temas de búsqueda se relacionan con la edad del niño y la satisfacción con los resultados de la información se modifican según el niño sea sano o tenga un problema de salud. Solo el 4,7 % respondió que la búsqueda siempre responde sus dudas. Conclusiones. Los cuidadores buscan información en línea sobre crianza y salud con alta frecuencia, pero las fuentes no siempre son confiables. Aunque la consulta con pediatras no se ve desplazada, desconocemos el impacto de la información en línea en la toma de decisiones sobre la salud. Los pediatras podemos intervenir y orientar hacia fuentes seguras.


Introduction. The Internet and social media have revolutionized access to information on health and parenting issues. Virtual consultations are spreading worldwide, are increasing, and represent a challenge for professional practice. Objective. To characterize the use of the Internet and social media by mothers and fathers as a source of information on the health and parenting of their children. Population and methods. A descriptive, cross-sectional study in an outpatient pediatric center in the City of Buenos Aires to determine the online consultation habits of caregivers of healthy children or children with health problems. Results. Two hundred-one surveys were analyzed, and the answers were predominantly from mothers of healthy children; 70.6% search online for health and parenting topics; 80% consult more than once a month. Although 36% of the families use the information to complement the medical consultation, 95% would not replace the pediatric consultation with the online search. The participants are not in the habit of following official pages, nor do they tend to verify the veracity of the contents. The search topics are related to the child's age, and satisfaction with the information results are modified according to whether the child is healthy or has a health problem. Only 4.7% responded that the search always answers their questions. Conclusions. Caregivers frequently seek online parenting and health information, but the sources are not always reliable. Although consultation with pediatricians is not displaced, we need to know the impact of online information on health decision-making. Pediatricians can intervene and guide caregivers to safe sources.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Parenting , Internet/statistics & numerical data , Social Media/statistics & numerical data , Parents/psychology , Cross-Sectional Studies , Consumer Health Information , Information Seeking Behavior , Information Sources
8.
Braz. j. oral sci. (Online) ; 24: e252692, 2025. tab
Article in English | LILACS, BBO | ID: biblio-1587286

ABSTRACT

Aim: To evaluate parents' knowledge about obstructive sleep apnea syndrome in preschoolers in the primary dentition in the city of Parnaíba-PI. Methods: The questionnaire on obstructive sleep apnea syndrome (OSAS) in children was applied to parents of children between 2 and 6 years of age, in the deciduous dentition who were attending preschool in public and private kindergarten. It contained objective questions distributed in two parts: the first that determined the epidemiological profile of parents and children; the second part with 22 questions that checked the parents' knowledge about the child's sleep and behavior during the day. As an interpretation, the questionnaires that presented 36.3% of the answers YES to the 22 specific questions, the child was considered at high probability for developing OSAS. Results: The average age of the children was approximately 4 years old. Regarding weight, an average of 22 kilos and an average height of 107.45 cm and an average BMI of 18.75, confirmed by notes on the vaccination card. Loud snoring, loud or heavy breathing, and overweight were significantly associated with OSAS (p < 0.001). From a total of 250 children, it was observed that the prevalence rate of high possibility for the development of OSAS was 6% (n=15). Conclusion: Parents were not aware of OSAS, but after applying the questionnaire, they were able to understand the suggestive signs of the syndrome and the importance of early diagnosis.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Parents , Sleep Apnea Syndromes , Sleep Wake Disorders , Child, Preschool , Knowledge
9.
Med. infant ; 31(4): 394-399, Diciembre 2024. Ilus, Tab
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1586750

ABSTRACT

En el área de terapia intensiva del Hospital Garrahan se desarrolló un programa de capacitación de enfermería con el propósito de optimizar el manejo del dolor, sedación, abstinencia y delirium en nuestros pacientes. El programa incluyó la descripción del uso de fármacos más frecuentes en el tratamiento de sedación y dolor. Conocer escalas de valoración del dolor, sedación, abstinencia y delirium y entrenar al personal en su uso. Incorporar de manera sistemática la evaluación de la sedoanalgesia al conjunto de los signos vitales que se registran (AU)


In the intensive care unit of Garrahan Hospital, a nursing training program was implemented to optimize the management of pain, sedation, withdrawal, and delirium in our patients. The program included a detailed overview of the most commonly used drugs for sedation and pain management. It also included education on assessment scales for pain, sedation, withdrawal, and delirium, as well as staff training in their application. In addition, the program aimed to systematically integrate sedoanalgesia assessment into the routine recording of vital signs (AU)


Subject(s)
Humans , Infant , Child, Preschool , Intensive Care Units, Pediatric , Nursing Records , Critical Care , Deep Sedation/nursing , Pain Management/nursing , Critical Care Nursing , Analgesia/nursing , Prospective Studies , Health Services Programming , Observational Study
10.
Semina cienc. biol. saude ; 45(2): 211-222, jul./dez. 2024. tab
Article in Portuguese | LILACS | ID: biblio-1554836

ABSTRACT

As queimaduras provocam efeitos físicos e psicológicos devastadores nos indivíduos, sobretudo em crianças e adolescentes, e podem modificar a qualidade de vida da pessoa. O objetivo foi analisar o impacto das cicatrizes por queimaduras em crianças menores de oito anos na interação com amigos, família e escola, na perspectiva dos pais. Estudo quantitativo de corte transversal realizado com os pais de crianças <8 anos de idade, vítimas de queimaduras e internadas em um Centro de Tratamento de Queimados no norte do Paraná e acompanhadas ambulatorialmente, de 2017 a 2020. A coleta de dados ocorreu por meio de dois instrumentos: caracterização sociodemográfica e clínica; e Brisbane Burn Scar Impact Profile. Realizou-se análise descritiva e teste Qui-quadrado utilizando-se o SPSS®. Participaram 34 pais cujas crianças sofreram queimaduras, sendo 52,9% de 1 a 3 anos de idade, 58,8% sexo masculino, 82,2% por agente etiológico térmico e a internação foi de 73,5% devido à Superfície Corpórea Queimada ≤20%. Após a alta os pais identificaram que as cicatrizes de queimaduras tinham "um pouco" e "pouco" impacto nas cicatrizes nas relações de amizade e na interação social. Para os pais, prevaleceu a resposta "nada" de impacto, seguido por "um pouco" e "muito" na escola, nas brincadeiras, nos jogos e nas atividades diárias. Quanto às reações emocionais e ao humor, a maior parte dos pais considerou "nada". Nesse sentido, os pais responderam às questões quanto à própria percepção sobre as atividades diárias do seu filho e, em geral, a cicatriz de queimadura não impactou na qualidade de vida da criança.


Burns cause devastating physical and psychological effects on individuals, especially children and adolescents, and can change a person's quality of life. The objective was to analyze the impact of burn scars in children under eight years of age in the interaction with friends, family and school, from the parents' perspective. Quantitative cross-sectional study carried out with the parents of children <8 years old who were victims of burns and admitted to a Burn Treatment Center in northern Paraná and monitored on an outpatient basis, from 2017 to 2020. Data collection occurred using two instruments: sociodemographic and clinical characterization; Brisbane Burn Scar Impact Profile. Descriptive analysis and Chi-square test were performed using SPSS®. 34 parents participated whose children suffered burns, 52.9% aged 1 to 3 years old, 58.8% male, 82.2% due to thermal etiological agent and 73.5% hospitalization was due to Burned Body Surface ≤ 20%. After discharge, the parents identified that the burn scars had "a little" and "little" impact on the scars in friendship relationships and social interaction. For parents, the answer "nothing" of impact prevailed, followed by "a little" and "a lot" in school, play, games and daily activities. As for emotional reactions and mood, most parents considered "nothing" that impacted the child with burn scars. In this sense, parents answered questions regarding their own perception of their child's daily activities and, in general, the burn scar did not impact the child's quality of life.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool
11.
Semina cienc. biol. saude ; 45(2): 81-90, jul./dez. 2024. ilus; tab.
Article in Portuguese | LILACS | ID: biblio-1562672

ABSTRACT

Introdução: os primeiros anos de vida são essenciais para o crescimento e o desenvolvimento. A criança já nasce com a preferência pelo sabor doce, e ao consumir preparações açucaradas, propicia--se uma alimentação de baixa qualidade nutricional. O objetivo do estudo é descrever a ingestão de alimentos que contenham açúcar por crianças com dificuldades alimentares menores de 2 anos atendidas em um centro especializado. Material e métodos: trata-se de um estudo observacional retrospectivo, com dados obtidos do prontuário de crianças de ambos os sexos, atendidas no Centro de Excelência em Nutrição e Dificuldades Alimentares (CENDA), localizado no município de São Paulo. Dentre os alimentos consumidos foram selecionados aqueles que continham açúcar de adição em sua composição. Para categorizar os alimentos foi usada a classificação da What We Eat in America (WWEIA). Resultados: participaram do estudo 31 crianças com dificuldades alimentares, 77,4% apresentaram consumo de pelo menos um alimento contendo açúcar. Os alimentos mais consumidos foram biscoitos e brownies, bolos e tortas, milk-shakes e outras bebidas lácteas. Discussões e Conclusão: a fase de alimentação complementar pode se tornar um grande desafio para os pais e cuidadores, a mesma foi o ponto de partida para a maioria das crianças com dificuldade alimentares. O aprendizado do comer é um processo complexo que exige aquisição de habilidades na oferta de alimentos adequados e variados, contudo, o contexto se torna favorável com as práticas inadequadas, sendo uma delas a permissão do consumo de alimentos e produtos adoçados pelas mesmas.


Introduction: the first years of life are essential for growth and development. Children are born with a preference for sweet tastes, and through sugary consumption, they are provided with a diet of low nutritional quality. The objective of the study is to describe the intake of foods containing sugar by children with eating difficulties under 2 years of age treated in a specialized center. Material and methods: this is a retrospective observational study, with data obtained from the medical records of children of both sexes, attended at the Center for Excellence in Nutrition and Eating Difficulties (CENDA), located in the city of São Paulo. Among the foods consumed, those that contained added sugar in their composition were selected. To categorize foods, the What We Eat in America (WWEIA) classification was used. Results: 31 children with eating difficulties participated in the study, 77.4% consumed at least one food containing sugar. The most consumed foods were cookies and brownies, cakes and pies, milkshakes and other dairy drinks. Discussions and Conclusion: the complementary feeding phase can become a great challenge for parents and caregivers, as it was the starting point for the majority of children with eating difficulties. Learning to eat is a complex process that requires the acquisition of skills in offering adequate and varied foods. However, the context becomes favorable to inappropriate practices, one of which is allowing the consumption of sweetened foods and products, for the same reasons.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool
12.
Arch. argent. pediatr ; 122(6): e202410317, dic. 2024. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1580529

ABSTRACT

La lepra infantil, aquella que afecta a niños de hasta 14 años, se caracteriza por la demora en su diagnóstico, ya que habitualmente es confundida con otras dermatosis. Su presencia en un niño es un indicador epidemiológico relevante, dado que señala la transmisión activa de la enfermedad. Presentamos 4 pacientes de entre 5 y 14 años asistidos en un hospital público de la Ciudad de Buenos Aires. Dos pacientes presentaron lepra borderline tuberculoide; uno, lepra lepromatosa; y otra, lepra indeterminada. La Organización Mundial de la Salud facilita la terapéutica para la población entre 10 y 14 años, pero no contempla a los menores de 10 años. Esta dificultad implica adecuar la dosis y la forma farmacéutica a cada paciente menor de la edad referida. Finalmente, es de destacar que el diagnóstico de los pacientes llevó al diagnóstico y tratamiento de la enfermedad en convivientes adultos.


Childhood leprosy, which affects children up to 14 years old, is characterized by a delay in diagnosis since it is usually confused with other dermatoses. Its presence in a child is a relevant epidemiological indicator since it signals active disease transmission. We present 4 patients between 5 and 14 years old who attended a public hospital in Buenos Aires ­two patients with borderline tuberculoid leprosy, one with lepromatous leprosy, and one with indeterminate leprosy.The World Health Organization provides therapy for people between 10 and 14 but does not consider children under 10. This difficulty implies adapting the dosage and pharmaceutical form to each patient under this age. Finally, it should be noted that the diagnosis of the patients led to the diagnosis and treatment of the disease in adult cohabitants.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Leprosy/diagnosis , Argentina , Urban Health
13.
Arch. argent. pediatr ; 122(6): e202310306, dic. 2024. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1580514

ABSTRACT

El síndrome ABCD (por sus siglas en inglés, ABnormal Calcium, Calcinosis and Creatinine in Down syndrome) se caracteriza por la asociación de hipercalcemia, hipercalciuria, nefrocalcinosis y alteración de la función renal en pacientes con síndrome de Down. Existen solo 7 casos previamente publicados en el mundo, aunque se cree que está subdiagnosticado. En este reporte, presentamos 2 nuevos pacientes con este síndrome y realizamos una comparación con los casos informados hasta el momento. Si bien es una causa rara de hipercalcemia pediátrica, debe considerarse en niños con síndrome de Down una vez descartadas otras etiologías más frecuentes. Al confirmarse este diagnóstico, el tratamiento recomendado es la reducción de calcio en la dieta, trabajando de manera interdisciplinaria para mantener un aporte calórico proteico adecuado.


ABCD syndrome (ABnormal Calcium, Calcinosis, and Creatinine in Down syndrome) is characterized by an association of hypercalcemia, hypercalciuria, nephrocalcinosis, and impaired kidney function in patients with Down syndrome. Only 7 cases have been published worldwide, although it is believed to be underdiagnosed. This report describes 2 new patients with ABCD syndrome and compares them with the cases reported to date. Although it is a rare cause of pediatric hypercalcemia, it should be considered in children with Down syndrome once other more common etiologies have been ruled out. Once this diagnosis is confirmed, the recommended treatment is to reduce dietary calcium intake and work with an interdisciplinary team to maintain an adequate calorie and protein intake.


Subject(s)
Humans , Male , Infant , Child, Preschool , Down Syndrome/complications , Hypercalcemia/diagnosis , Hypercalcemia/etiology , Hypercalcemia/therapy , Calcinosis/complications , Calcinosis/diagnosis , Calcinosis/etiology , Creatinine/blood , Nephrocalcinosis/complications , Nephrocalcinosis/diagnosis , Nephrocalcinosis/etiology
14.
Arch. argent. pediatr ; 122(6): e202410339, dic. 2024. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1580508

ABSTRACT

La pitiriasis rubra pilaris (PRP) es una enfermedad dermatológica poco frecuente. Se desconoce su etiología, sin embargo, se ha asociado a infecciones, enfermedades autoinmunes y neoplasias. Se describen los casos de dos pacientes pediátricos que presentaron PRP gatillada por una infección por virus sincicial respiratorio mientras cursaban un síndrome bronquial obstructivo. Los cuadros de PRP remitieron luego del tratamiento tópico con emolientes, corticoesteroides tópicos e inhibidores de la calcineurina.


Pityriasis rubra pilaris (PRP) is a rare skin condition. The etiology of PRP is unknown; however, it has been associated with infections, autoimmune diseases, and neoplasms. Here we describe the cases of 2 pediatric patients with PRP triggered by a respiratory syncytial virus infection concurrently with obstructive bronchial syndrome. PRP resolved after treatment with topical emollients, topical corticosteroids, and calcineurin inhibitors


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Pityriasis Rubra Pilaris/complications , Pityriasis Rubra Pilaris/diagnosis , Pityriasis Rubra Pilaris/etiology , Respiratory Syncytial Virus Infections/complications
15.
Arch. argent. pediatr ; 122(6): e202310254, dic. 2024. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1580312

ABSTRACT

La tinea capitis es una dermatofitosis, más frecuente en niños. Está causada por hongos dermatofitos que varían según la región; el más frecuentemente aislado en nuestro medio es el Microsporum canis. Dado su carácter antropofílico, la transmisión por vía interpersonal y mediante el uso de instrumentos de cuidado capilar es muy habitual. En el transcurso del último año, se ha reportado un incremento en la incidencia de un patógeno que era muy poco habitual en nuestro medio: el Trichophyton tonsurans. Presentamos un estudio retrospectivo de los casos de tinea capitis por Trichophyton tonsurans identificados en el período comprendido entre septiembre de 2021 y marzo de 2023 en la Sección de Dermatología Infantil de un hospital general de la Ciudad Autónoma de Buenos Aires.


Tinea capitis is a dermatophytosis, which is more common in children. It is caused by dermatophytes that vary according to the region; the most frequently isolated dermatophyte in our setting is Microsporum canis. Given its anthropophilic nature, its dissemination via interpersonal transmission and through the use of hair care tools is very common. In the course of the past year, an increase has been reported in the incidence of a pathogen that was very rare in our setting: Trichophyton tonsurans. Here we describe a retrospective study of cases of tinea capitis caused by Trichophyton tonsurans identified between September 2021 and March 2023 in the Department of Pediatric Dermatology at a general hospital of the City of Buenos Aires.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Tinea Capitis/diagnosis , Tinea Capitis/microbiology , Tinea Capitis/epidemiology , Argentina/epidemiology , Retrospective Studies , Communicable Diseases, Emerging/microbiology , Communicable Diseases, Emerging/epidemiology , Arthrodermataceae/isolation & purification
16.
Arch. argent. pediatr ; 122(6): e202310251, dic. 2024. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1580249

ABSTRACT

La parálisis cerebral tiene complicaciones asociadas como una baja densidad mineral ósea; esta es más acentuada a mayor compromiso motor. La bipedestación asistida ayuda a prevenir y/o a retrasar esta complicación, aunque su efecto es controversial, porque no está claro el tipo de bipedestador, el tipo de bipedestación (dinámica o estática) ni su dosificación. El objetivo de este estudio es determinar la efectividad de la bipedestación asistida en la densidad mineral ósea, en niños con parálisis cerebral. Se realizó una revisión sistemática bajo los lineamientos PRISMA, se utilizaron cinco bases de datos. Los resultados se presentaron a través de tablas, análisis de riesgo de sesgo y síntesis narrativa. Cuatro estudios cumplieron los criterios de inclusión. La bipedestación asistida genera cambios positivos en la densidad mineral ósea, pero se necesita más investigación, con estudios que tengan un mayor rigor metodológico, períodos de seguimiento más largos y que incluyan una mayor cantidad de pacientes.


Cerebral palsy is associated with complications such as low bone mineral density, which is more severe in patients with greater motor involvement. Assisted standing helps to prevent or delay this complication; however, its effect is controversial because the type of stander, the type of standing (dynamic or static), and its dosage are not clear. The objective of this study was to determine the effectiveness of assisted standing on bone mineral density in children with cerebral palsy. A systematic review was carried out in compliance with the PRISMA guidelines, using 5 databases. The results were presented using tables, a risk of bias analysis, and a narrative synthesis. Four studies met the inclusion criteria. Assisted standing generates positive changes in bone mineral density, but further research is required, with studies that have greater methodological rigor, longer follow-up periods, and a larger number of patients.


Subject(s)
Humans , Child, Preschool , Child , Bone Density , Cerebral Palsy/physiopathology , Standing Position , Treatment Outcome
17.
Arch. argent. pediatr ; 122(6): e202410319, dic. 2024. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1580231

ABSTRACT

Introducción. La aparición de la pandemia por SARS-CoV-2 generó grandes interrogantes sobre su comportamiento en diferentes escenarios. Objetivo. Describir el comportamiento clínico y epidemiológico de la COVID-19 en pacientes pediátricos residentes en una ciudad agroindustrial en tres períodos (2020 a 2022). Población y métodos. Estudio observacional, analítico de menores de 18 años con diagnóstico de COVID-19 en General Cabrera. Se evaluó sexo, edad, sintomatología, comorbilidades, internación y muerte. Se aplicó la prueba de chi-cuadrado para analizar la asociación entre sintomatología y período, y la prueba de Kruskal-Wallis para analizar diferencias en la duración de los síntomas por período. Nivel de confianza del 95 %. Resultados. En el período estudiado, se confirmaron 194 casos en menores de 18 años. Solo el 1 % requirió internación y no se registraron fallecimientos. El 51 % eran varones, con una mediana de edad 14 años para ambos sexos. El 68 % fue asintomático. Se detectaron comorbilidades asociadas en el 2 %. Conclusión. La infección por el SARS-CoV-2 tuvo baja presentación en pediatría, con comportamiento diferenciado según período.


Introduction. The onset of the SARS-CoV-2 pandemic raised questions about its behavior in different scenarios. Objective. To describe the clinical and epidemiological behavior of COVID-19 in pediatric patients living in an agricultural-industrial city across 3 periods (2020 to 2022). Population and methods. Observational, analytical study of children under 18 years diagnosed with COVID-19 in General Cabrera. Sex, age, symptoms, comorbidities, hospitalization, and death were analyzed. The χ² test was used to analyze the association between symptoms and period and the KruskalWallis test, to analyze differences in symptom duration per period. Confidence level: 95%. Results. In the study period, 194 cases in children under 18 years were confirmed. Only 1% required hospitalization; no deaths were recorded. Children's median age was 14 years; 51% were boys; 68% were asymptomatic; 2% had associated comorbidities. Conclusion. SARS-CoV-2 infection was low in pediatrics and showed a distinct behavior by period


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , COVID-19/epidemiology , Argentina/epidemiology , Time Factors , Comorbidity , Pandemics , Hospitalization/statistics & numerical data
18.
Arch. argent. pediatr ; 122(6): e202310257, dic. 2024. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1580223

ABSTRACT

La parálisis cerebral (PC) afecta la postura y la coordinación del movimiento, y es la causa más común de discapacidad grave en la población pediátrica. El diagnóstico de PC no describe el funcionamiento ni la interacción de la persona con el contexto en el cual se desarrolla. Por lo tanto, el diagnóstico se debe complementar con una descripción del funcionamiento, utilizando herramientas basadas en el modelo biopsicosocial de la Clasificación del Funcionamiento (CIF) de la Organización Mundial de la Salud (OMS). En esta comunicación, describimos los datos preliminares de un estudio multicéntrico en Argentina destinado a estandarizar la descripción del perfil de funcionamiento en niños y adolescentes con PC. Estos datos mostraron que los participantes tienen algunas habilidades en las funciones del sueño, las funciones mentales del lenguaje y las visuales, así como en algunas relacionadas con el contexto. Presentan dificultades importantes en categorías tales como mantener la posición del cuerpo, el andar y la higiene.


Cerebral palsy (CP) affects body posture and movement coordination and is the most common cause of severe disability in the pediatric population. The diagnosis of CP is not a description of a person's functioning or interaction with their environment. Therefore, the diagnosis should be complemented with a description of functioning, using tools based on the biopsychosocial model proposed by the World Health Organization's International Classification of Functioning, Disability and Health (ICF). This report describes the preliminary data from a multicenter study conducted in Argentina with the aim of standardizing the description of the profiles of functioning of children and adolescents with CP. These data showed that the participants had some skills in sleep functions, mental functions of language, seeing functions, and in some environmental factors. They showed significant difficulties in categories such as maintaining body position, walking, and toileting.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Cerebral Palsy/diagnosis , Cerebral Palsy/physiopathology , Argentina , Disability Evaluation
19.
Arch. argent. pediatr ; 122(6): e202410388, dic. 2024. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1580218

ABSTRACT

Introducción. La hipercalcemia es infrecuente en pediatría, de etiología diversa y con morbilidad multiorgánica. Objetivo. Describir etiología, bioquímica, clínica y tratamiento en pacientes pediátricos con hipercalcemia. Población y métodos. Estudio retrospectivo y descriptivo de una cohorte de pacientes con hipercalcemia entre 2008 y 2022. Se clasificaron en tres grupos (G): hipercalcemia de causa iatrogénica (G1), paratohormona (PTH) independiente (G2) o PTH dependiente (G3). Resultados. Se incluyeron 147 pacientes; el 57 % eran varones, edad mediana de 3,7 años, calcemia mediana 11,8 mg/dl y fosfatemia media 4,9 mg/dl. El 29,9 % de los pacientes fueron sintomáticos y el 28,6 % requirió tratamientos adicionales a los de la primera línea. En G1 se incluyeron 76 pacientes (51,7 %); en G2, 58 (39,4 %), y en G3, 13 (8,8 %). La calcemia mediana fue menor en G1 vs. G2 y G3 (11,6 mg/dl, 12,6 mg/dl y 12,3 mg/dl). La fosfatemia media fue menor en G3 vs. G1 y G2 (3,7 mg/dl, 5,3 mg/dl y 4,9 mg/dl). La mayoría de los pacientes con hipercalcemia fueron asintomáticos sin requerimientos de tratamientos adicionales. El porcentaje de pacientes sintomáticos y el de requerimiento de tratamientos adicionales fue menor en G1 que en los otros dos grupos. Conclusiones. La iatrogenia fue la causa más frecuente, y se presentó con calcemias más bajas; mientras que las causas PTH dependientes presentaron las fosfatemias más bajas. Las causas PTH independientes representaron un desafío diagnóstico y terapéutico por la falta de un perfil bioquímico característico.


Introduction. Hypercalcemia is infrequent in pediatrics, of diverse etiology, and with multiorgan morbidity. Objective. Describe the etiology, biochemistry, clinical, and treatment in pediatric patients with hypercalcemia. Population and methods. Retrospective and descriptive study of a cohort of patients with hypercalcemia between 2008 and 2022. They were classified into three groups (G): hypercalcemia of iatrogenic cause (G1), parathyroid hormone (PTH) independent (G2), or PTH-dependent (G3). Results. One hundred forty-seven patients were included; 57% were male, with a median age of 3.7 years, median calcemia of 11.8 mg/dl, and mean phosphatemia of 4.9 mg/dl. Symptoms were present in 29% of patients, and 28.6% required additional treatments to those of the first line. In G1, 76 patients (51.7%) were included; in G2, 58 (39.4%), and in G3, 13 (8.8%). Median calcemia was lower in G1 vs. G2 and G3 (11.6 mg/dl, 12.6 mg/dl, and 12.3 mg/dl), and mean phosphatemia was lower in G3 vs. G1 and G2 (3.7 mg/dl, 5.3 mg/dl, and 4.9 mg/dl). Most of the patients with hypercalcemia were asymptomatic and did not require additional treatments. The percentage of symptomatic patients and the percentage requiring additional treatment were lower in G1 than in the other two groups. Conclusions. Iatrogenesis was the most frequent cause, presenting lower calcemia, while PTH-dependent causes presented the lowest phosphatemia. PTH-independent causes represented a diagnostic and therapeutic challenge due to lacking a characteristic biochemical profile.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Parathyroid Hormone/blood , Tertiary Care Centers , Hospitals, Pediatric , Hypercalcemia/diagnosis , Hypercalcemia/etiology , Hypercalcemia/therapy , Retrospective Studies , Cohort Studies , Iatrogenic Disease/epidemiology
20.
Arch. argent. pediatr ; 122(6): e202310270, dic. 2024. tab, graf
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1579528

ABSTRACT

Introducción. Diversos estudios han evidenciado diferencias poblacionales en el tamaño cefálico que cuestionan la validez universal del estándar de la Organización Mundial de la Salud (OMS) para evaluar el crecimiento cefálico. Objetivos. Comparar las referencias argentinas de perímetro cefálico (PC) de 0 a 5 años con los estándares de la OMS. Población y métodos. Se compararon los percentiles 3 y 97 de PC de las referencias argentinas con los correspondientes del estándar de la OMS y se calcularon los porcentajes de niños clasificados como microcefálicos (PC < percentil 3 de la OMS) y macrocefálicos (PC > percentil 97 de la OMS) a edades específicas entre el nacimiento y los 5 años de edad. Resultados. La comparación de las referencias argentinas con los estándares de la OMS, muestra que ­en ambos sexos­ en el percentil 3, desde el primer mes y hasta los 6 meses, las referencias argentinas se encuentran por debajo de los estándares de la OMS, son similares entre los 9 y 18 meses, y luego se ubican por encima hasta los 60 meses. En relación con el percentil 97, las referencias argentinas se ubican por encima de los estándares de la OMS desde el nacimiento hasta los 60 meses en ambos sexos. Conclusiones. El tamaño cefálico de los niños y niñas argentinos difiere del de los estándares de la OMS. La adopción de los estándares de la OMS en nuestra población incrementa el porcentaje de diagnóstico de macrocefalia a todas las edades.


Introduction. Several studies have shown population differences in head circumference (HC) that question the universal validity of the World Health Organization (WHO) standard to assess head growth. Objectives. To compare the Argentine reference charts for HC from 0 to 5 years of age with the WHO standards. Population and methods. The 3rd and 97th percentiles for HC based on the Argentine reference charts were compared with the corresponding WHO standard and the percentage of children classified as having microcephaly (HC < 3rd percentile of the WHO) and macrocephaly (HC > 97th percentile of the WHO) at specific ages between 0 and 5 years were estimated. Results. The comparison of the Argentine reference charts with the WHO standards shows that, in both males and females, at the 3rd percentile, the Argentine reference charts are below the WHO standards from 1 to 6 months of age, similar from 9 to 18 months of age, and then above until 60 months old. In relation to the 97th percentile, the Argentine reference charts are above the WHO standards from birth to 60 months in both boys and girls. Conclusions. The head size of Argentine children is different from that established by the WHO standards. The adoption of the WHO standards for our population increases the percentage of macrocephaly diagnosis at all ages.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , World Health Organization , Head/anatomy & histology , Argentina , Reference Values , Cephalometry/standards , Growth Charts , Megalencephaly/diagnosis , Microcephaly/diagnosis
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