COVID-19 pandemic. What have we learned?

Since the COVID-19 pandemic was declared in March 2020, we have learned a lot about the SARS-CoV-2 coronavirus, and its role in pediatric pathology. Children are infected in a rate quite similar to adults, although in most cases they suffer mild or asymptomatic symptoms. Around 1% of those infected require hospitalization, less than 0.02% require intensive care, and mortality is very low and generally in children with comorbidities. The most common clinical diagnoses are upper or lower respiratory infections, gastrointestinal infection and, more seriously, multisystemic inflammatory syndrome (MIS-C). Most episodes do not require treatment, except for MIS-C. Remdesivir has been widely used as a compassionate treatment and its role has yet to be defined. The newborn can become infected, although vertical transmission is very low (<1%) and it has been shown that the baby can safely cohabit with its mother and be breastfed. In general, neonatal infections have been mild. Primary care has supported a very important part of the management of the pandemic in pediatrics. There has been numerous collateral damage derived from the difficulty of access to care and the isolation suffered by children. The mental health of the pediatric population has been seriously affected. Although it has been shown that schooling has not led to an increase in infections, but rather the opposite. It is essential to continue maintaining the security measures that make schools a safe place, so necessary not only for children's education, but for their health in general.

Pediatría y COVID-19 / Pediatrics and COVID-19

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Seroma de Morel-Lavallée / Morel-Lavallée seroma

El seroma de Morel-Lavallée consiste en una separación de la piel y el tejido celular subcutáneo con respecto a la fascia muscular, lo que origina un espacio que se rellena por líquido. Se presenta el caso de un niño de ocho años que acudió a nuestra consulta por tumefacción fluctuante tras antecedente traumático

Morel-Lavallée seroma consists of a separation of the skin and the subcutaneous cellular tissue from the muscular fascia, which originates a space that is filled by liquid. We present the case of an eight-year-old boy who went to our medical office for fluctuating swelling after traumatic antecedent

Auscultación patológica persistente: no todo son broncoespasmos / Persistent pathological auscultation, not all is brochospasms

Los síntomas respiratorios constituyen un motivo de consulta frecuente en Atención Primaria y de derivación al especialista si se manifiestan crónicamente. Describimos dos casos tratados por asma y neumonía recurrente en los que se planteó el diagnóstico diferencial por una auscultación patológica persistente. El diagnóstico final fue: secuestro pulmonar y bronquiolitis obliterante. Se revisan los aspectos más relevantes de estas patologías graves y poco frecuentes

Respiratory symptoms are the most common reason for primary care visits and, when chronic, a frecuent indication for hospital specialist referrals. We describe two patients treated for asthma and recurrent pneumonia. A differential diagnosis was needed to find out the cause of persistent pathological auscultation. Final diagnosis was: Pulmonary sequestration and Bronchiolitis obliterans. We review the most relevant aspects of this uncommon and severe chronic lung diseases

Prevalencia de resistencia a insulina en una población de jóvenes adultos. Relación con el estado ponderal / Prevalence of insulin resistance in a young adult population. relationship with weight status

Calcular la prevalencia de la resistencia a la insulina mediante índice HOMA (homeostatic model assessment) e insulinemia basal, y estudiar su asociación con estados de sobrepeso según índice de masa corporal (IMC) y perímetro de cintura (PC) en población adulta joven de un centro de salud. Pacientes y métodos Se estudió una serie de 118 jóvenes de 18 y 19 años, no diabéticos, pertenecientes a un centro de salud de atención primaria, con los que se contactó telefónicamente y en los que se determinaron el IMC, PC, HOMA e insulinemia entre otros parámetros. Resultados Un 9,3% de la muestra presentaba cifras de HOMA ≥ al P90 (HOMA≥ 3,15), 50% en el grupo de obesidad. Un 11% presentaron cifras de insulinemia ≥ al P90 (16,9). Según IMC, presentan sobrepeso un 17,8% (26,5% hombres y 11,6% mujeres) y obesidad un 6,8% (6,1% hombres y 7,2% de mujeres). Las cifras de obesidad según PC fueron de 5,71% si se consideraba cintura a nivel de punto medio y 15,38% si se consideraba a nivel de cresta ilíaca. Existía una correlación significativa del HOMA con aumento de peso, IMC, PC, tensión arterial sistólica, triglicéridos y glucemia, mientras que sólo la había entre insulinemia y aumento de PC y disminución de cifras de fracción de colesterol unido a proteínas de alta densidad (HDL).Conclusión En estaserie de jóvenes adultos, el aumento de IMC y de PC se asocia con aumento de la resistencia a insulina. La frecuencia de HOMA elevado en personas obesas fue del 50% (AU)

Aim To estimate the prevalence of insulin resistance using both the Homeostatic Model Assessment (HOMA) index and basal insulinemia, and to analyze its relationship to overweight, as measured by body mass index (BMI) and waist circumference (WC).Patients and methods A series of 118 non-diabetic young adults aged 18 and 19 years attending a primary care health center were studied. They were contacted by telephone, and their BMI, WC, HOMA and basal insulinemia were measured, among other parameters. Results HOMA values ≥ P90 (HOMA ≥3.15) were found in 9.3% of the sample (50% in the obesity group). Insulinemia ≥ P90 (16,9) was found in 11%. Based on BMI, 17.8% were overweight (26.5% of men, 11.6% of women), and 6.8% were obese (6.1% of men, 7.2% of women). Based on WC, 5.71% were obese when waist was measured at the midpoint and 15.38%, when measured at the iliac crest. HOMA was found to be significantly correlated to weight increase, BMI, WC, systolic blood pressure, triglycerides, and blood glucose, while correlation was only found between insulinemia and increased WC and decreased high lipoprotein cholesterol (HDL) levels. Conclusion In this young adult sample, increased BMI and WC were associated to increased insulin resistance. High HOMA values were found in 9.3% of subjects (AU)

Prevalence of insulin resistance in a young adult population. Relationship with weight status.

AIM: To estimate the prevalence of insulin resistance using both the Homeostatic Model Assessment (HOMA) index and basal insulinemia, and to analyze its relationship to overweight, as measured by body mass index (BMI) and waist circumference (WC). PATIENTS AND METHODS: A series of 118 non-diabetic young adults aged 18 and 19 years attending a primary care health center were studied. They were contacted by telephone, and their BMI, WC, HOMA and basal insulinemia were measured, among other parameters. RESULTS: HOMA values ≥ P90 (HOMA ≥3.15) were found in 9.3% of the sample (50% in the obesity group). Insulinemia ≥ P90 (16,9) was found in 11%. Based on BMI, 17.8% were overweight (26.5% of men, 11.6% of women), and 6.8% were obese (6.1% of men, 7.2% of women). Based on WC, 5.71% were obese when waist was measured at the midpoint and 15.38%, when measured at the iliac crest. HOMA was found to be significantly correlated to weight increase, BMI, WC, systolic blood pressure, triglycerides, and blood glucose, while correlation was only found between insulinemia and increased WC and decreased high lipoprotein cholesterol (HDL) levels. CONCLUSION: In this young adult sample, increased BMI and WC were associated to increased insulin resistance. High HOMA values were found in 9.3% of subjects.