Translation and psychometric evaluation of the Spanish version of the problem areas in diabetes-pediatric version (PAID-Peds) survey.

BACKGROUND: Metabolic control and psychological management of paediatric type 1 diabetes mellitus (T1DM) can be challenging over time. Development of an instrument to assess the youth-reported burden could aid in preventing T1DM-associated diseases. METHODS: The aim of this study was to translate and validate the Spanish version of the Problem Area in Diabetes Survey-Pediatric version (PAID-Peds). A multicentre, cross-sectional translation and linguistic validation study was performed on a sample of 30 participants aged 8-17 years with a minimum 1-year history of T1DM diagnosed at the Miguel Servet University Hospital in Zaragoza (Aragon, Spain), Ramón y Cajal University Clinical Hospital in Madrid (Spain), and Sant Joan de Déu Hospital in Barcelona (Catalonia, Spain). The qualitative validation consisted of translation into Spanish and back-translation into English of the Paid-Peds survey and subsequent administration to the sample population. Data were gathered on parameters related to sociodemographic characteristics and metabolic control. Validity, feasibility, and test-retest reliability were evaluated. Internal consistency was determined using Cronbach's alpha coefficient, test-retest reliability by means of interclass correlation, and paired samples using the Wilcoxon W-test. The study was approved by the ethics and research committees at each participating centre. RESULTS: The study assessed 30 children (46.7% female) with an average age of 13.33 ± 2.98 years; mean age at onset was 5.70 ± 3.62 years, and the mean disease duration was 7.63 ± 4.36 years. The mean score on the PAID-Peds survey was 42.88 ± 17.85. Cronbach's alpha coefficient was 0.90. Test-retest reliability measured by interclass correlation coefficient was 0.8 (95% CI: 0.63-0.90). No significant differences in total scores were found between test and retest (Wilcoxon W-test: 289; p = 0.051). CONCLUSIONS: The Spanish version of the PAID-Peds survey is a feasible, valid, and reliable instrument to assess the youth-perceived burden of T1DM.

Response to growth hormone treatment in patients with sufficient secretion.

BACKGROUND: There are situations of short stature, with a normal stimulus test for GH, but decreased nocturnal secretion in which there could be a benefit with GH treatment. OBJETIVES: To assess adult height and height gain in patients with neurosecretory dysfunction diagnosis treated with growth hormone. MATERIAL Y METHODS: Longitudinal, retrospective and observational study including 61 patients treated with growth hormone after diagnosis of neurosecretory dysfunction who have already reached adult height. Variables such as adult height gain, growth rate, growth prognosis variation and IGF-I and IGFBP-3 were evaluated. Variables related to a good response in the first year have also been calculated, using the Index of responsiveness (IoR). RESULTS: GH treatment produces an improvement in growth rate and height, observing an increase in adult height with respect to initial height of 1.15±0.60 SD, height with respect to genetic height of -0.015±0.62 SD and adult height with respect to the initial growth prognosis 0,74±1,13 DE. The IoR in the first year is associated with a greater increase in height in the first year (p=0.000), with a greater adult height (p=0.000) and with a greater gain in adult height compared to its initial height (p=0.039). CONCLUSIONS: Patients with growth delay due to neurosecretory dysfunction of GH show a good response to treatment with rhGH, observing a significant height gain in their genetic size and improving their initial growth prognosis.

Microduplicación 17q12: comunicación de un caso y revisión de la bibliografía / 17q12 microduplication: a case report and review of the literature

No disponible

Interrupción de la cadena de frío vacunal en un centro de atención primaria y su valoración económica / Vaccine cold chain interruption in a primary care center and economic evaluation

OBJETIVOS: El control de la cadena de frío constituye uno de los eslabones más importantes para garantizar la efectividad de las vacunas, por lo que es necesario disponer de recursos materiales y humanos específicos para su gestión. El objetivo principal es valorar las interrupciones de la cadena de frío de los últimos 6 años y el posible ahorro económico que supondrían nuevas mejoras. MÉTODO: Estudio retrospectivo, descriptivo, basado en la revisión de todas las interrupciones de la cadena de frío en los últimos 6 años, en el Centro de Salud Valdefierro. RESULTADOS: Cinco interrupciones, con temperatura máxima de 23,1±3,4°C y 25,2±20,7 h de interrupción; 1.611 vacunas fueron afectadas y 165 desechadas. La pérdida económica total fue 2.098,10 € y el ahorro 33.611,64 €. El fallo de suministro eléctrico fue la causa de interrupción en los 5 casos. CONCLUSIONES: El equipamiento y el personal son esenciales. Se tomaron medidas como minimizar los periodos entre controles sobre la nevera, control de stocks mínimos y, valorar cambios en la población, y se ha solicitado un sistema de suministro eléctrico

OBJECTIVES: Cold chain control is one of the most important facts to ensure the effectiveness of vaccines links, which requires specific material and human resources for management. The principal objective is to evaluate the interruptions in cold chain of the last 6 years and the possible cost savings that would result in further improvements. Method: A retrospective and descriptive study based on a review of all cold chain interruptions during the last 6 years, at Valdefierro Primary Health Center. RESULTS: We had 5 interruptions, the maximum temperature reached was 23.1±3.4°C and the longest interruption lasted 25.2±20.7 hours.1611 vaccines were affected and 165 discarded. Total economic loss was 2.098,10 € and 33.611,64 € were savings. The electrical failure was the disruption cause in 5 cases. CONCLUSIONS: Equipment and staff are essential. The center did some corrective actions, such as minimizing refrigerator time control, minimum stock control, considering population changes, and the center has requested a electrical supply system

[Vaccine cold chain interruption in a primary care center and economic evaluation]. / Interrupción de la cadena de frío vacunal en un centro de atención primaria y su valoración económica.

OBJECTIVES: Cold chain control is one of the most important facts to ensure the effectiveness of vaccines links, which requires specific material and human resources for management. The principal objective is to evaluate the interruptions in cold chain of the last 6 years and the possible cost savings that would result in further improvements. METHOD: A retrospective and descriptive study based on a review of all cold chain interruptions during the last 6 years, at Valdefierro Primary Health Center. RESULTS: We had 5 interruptions, the maximum temperature reached was 23.1±3.4°C and the longest interruption lasted 25.2±20.7hours. 1611 vaccines were affected and 165 discarded. Total economic loss was 2.098,10 € and 33.611,64 € were savings. The electrical failure was the disruption cause in 5 cases. CONCLUSIONS: Equipment and staff are essential. The center did some corrective actions, such as minimizing refrigerator time control, minimum stock control, considering population changes, and the center has requested a electrical supply system.

Estudio de los efectos de la implantación de un banco de leche donada en los recién nacidos pretérmino en Aragón / Study of the effects of the implementation of a human milk donor bank in preterm newborns in Aragon

INTRODUCCIÓN: Numerosos obstáculos pueden impedir que un prematuro o un neonato enfermo reciba leche de su madre. En estos casos las sociedades científicas pediátricas recomiendan la alimentación con leche materna donada. Explicamos qué es un banco de leche, cómo funciona, el método de selección de donantes y sus beneficios. Finalmente, describimos la situación actual en Aragón. MATERIAL Y MÉTODOS: Estudio retrospectivo de tipo descriptivo de las características perinatales de la muestra y analítico observacional, comparando 2 grupos de la muestra: prebanco y posbanco de leche. Finalmente se buscan diferencias dentro de la etapa posbanco entre los alimentados con leche materna propia y donada. RESULTADOS: Un total de 234 pacientes (104 hombres y 130 mujeres). Dos grupos: prebanco (152 pacientes) y posbanco (82 pacientes), comparables al nacimiento; longitud y perímetro cefálico significativamente mayor en grupo posbanco y menor tasa de enterocolitis necrosante. Sin diferencias estadísticamente significativas en el resto de variables, y tampoco entre los subgrupos de leche materna propia y donada. Discusión La implantación del banco supone un efecto beneficioso, con reducción de la morbilidad neonatal en el caso de la enterocolitis necrosante, y la alimentación con leche materna podría ser un factor protector frente a sepsis neonatal tardía al mejorar la inmunidad. CONCLUSIONES: La incidencia de enterocolitis necrosante es menor tras la implantación del banco de leche. Estudios con mayor número de pacientes quizás demostrasen diferencias en otras variables

INTRODUCTION: Numerous obstacles may prevent a premature or sick neonate receiving their mother's milk. In these cases, pediatric scientific societies recommend feeding with donor human milk. In this article, it is explained what a milk bank is, how it works, the donors' selection method, and the benefits. We also describe the current situation in Aragon (Spain) is also described. MATERIAL AND METHODS: A retrospective and descriptive study was conducted on the perinatal sample characteristics, as well as an analytical observational study, comparing two sample groups: pre- and post-human milk bank. Finally, differences in the post-bank stage between those patients fed with own-mother's or donor human milk were determined. RESULTS: The study included a total of 234 PATIENTS: 104 females and 130 males. Two groups: pre and post-bank, with 152 and 82 patients, respectively, which had similar characteristics at birth; length and head circumference were significantly higher in the post-bank group and a lower rate of necrotizing enterocolitis was also found. No statistically significant differences were found in other variables between subgroups fed with own-mother's milk and donor human milk. Discussion The establishment of the human milk donor bank has a beneficial effect, as it reduces neonatal morbidity in cases of necrotizing enterocolitis. Human milk feeding could be a protective factor against neonatal sepsis due to improve immunity. CONCLUSIONS: The incidence of necrotizing enterocolitis is lower after the establishment of the milk bank. Studies with more patients may demonstrate differences in other variables

[Study of the effects of the implementation of a human milk donor bank in preterm newborns in Aragon]. / Estudio de los efectos de la implantación de un banco de leche donada en los recién nacidos pretérmino en Aragón.

INTRODUCTION: Numerous obstacles may prevent a premature or sick neonate receiving their mother's milk. In these cases, pediatric scientific societies recommend feeding with donor human milk. In this article, it is explained what a milk bank is, how it works, the donors' selection method, and the benefits. We also describe the current situation in Aragon (Spain) is also described. MATERIAL AND METHODS: A retrospective and descriptive study was conducted on the perinatal sample characteristics, as well as an analytical observational study, comparing two sample groups: pre- and post-human milk bank. Finally, differences in the post-bank stage between those patients fed with own-mother's or donor human milk were determined. RESULTS: The study included a total of 234 patients: 104 females and 130 males. Two groups: pre and post-bank, with 152 and 82 patients, respectively, which had similar characteristics at birth; length and head circumference were significantly higher in the post-bank group and a lower rate of necrotizing enterocolitis was also found. No statistically significant differences were found in other variables between subgroups fed with own-mother's milk and donor human milk. DISCUSSION: The establishment of the human milk donor bank has a beneficial effect, as it reduces neonatal morbidity in cases of necrotizing enterocolitis. Human milk feeding could be a protective factor against neonatal sepsis due to improve immunity. CONCLUSIONS: The incidence of necrotizing enterocolitis is lower after the establishment of the milk bank. Studies with more patients may demonstrate differences in other variables.

Diagnóstico retrospectivo de la infección congénita por citomegalovirus / Retrospective diagnosis of citomegalovirus congenital infection

La infección por citomegalovirus (CMV) es la infección viral congénita más frecuente. Es causa de múltiples anomalías que involucran al sistema nervioso central. Debido a que es principalmente asintomática, dos tercios de las secuelas se producen en niños asintomáticos al nacimiento. Pasadas las primeras 2 a 3 semanas de vida, se ha propuesto como método ideal y único de certeza para el diagnóstico retrospectivo la detección del ADN viral en la muestra de sangre seca procedente de la pesquisa neonatal. La técnica se lleva a cabo mediante dilución, amplificación y extracción, con resultado en menos de 48 horas. Se han publicado en la bibliografía numerosos protocolos, que refieren variadas sensibilidades in vitro que dependen fundamentalmente del método de extracción, desde la prueba del talón y de la amplificación, que son muy heterogéneas (entre 35% y 98%). La sensibilidad es mayor si es secundaria a primoinfección, en pacientes seleccionados, si se utiliza un buen método de extracción y amplificación, y una amplificación duplicada o, incluso, triplicada. La especificidad en todos ellos es concordante y alcanzaca si el 100%. La carga viral de la prueba del talón está subestimada, pero altamente relacionada con la de sangre fresca y, aunque puede no haber viremia al nacimiento, los neonatos virémicos son los que tienen mayor riesgo de presentar secuelas neurosensoriales, por lo que los índices de detección clínica en pacientes seleccionados son altos. Se ha descrito la viabilidad de otras alternativas, como el cordón umbilical en Japón y, en los últimos años, el uso de orina seca en papel de filtro, y se comunicaron buenos resultados...