Perfil de prescripción de levetiracetam en niños menores de cuatro años atendidos en un hospital de alta complejidad de Chile / Levetiracetam prescription profile in children younger than 4 years treated at a tertiary care hospital in Chile

Introducción. El levetiracetam (LEV) es un antiepiléptico aprobado por el Instituto de Salud Pública de Chile como terapia concomitante en crisis epilépticas en niños mayores de cuatro años. Sin embargo, es ampliamente indicado desde el periodo neonatal, lo que hace necesario evaluar su utilización fuera de ficha técnica. Objetivo. Determinar el perfil de prescripción-indicación de LEV en el tratamiento de las crisis epilépticas en menores de cuatro años en un hospital de alta complejidad del sur de Chile. Población y método. Estudio observacional, descriptivo y retrospectivo. Se revisaron las historias clínicas de quienes iniciaron tratamiento con LEV entre 2014 y 2019, y se recopilaron datos sobre variables sociodemográficas, farmacológicas y clínicas. El análisis se basó en la descripción del perfil de los pacientes, prescripción, seguimiento y seguridad. Resultados. Se incluyeron 68 pacientes: 40 (58,8 %) de sexo masculino, 49 (72,1 %) con edad gestacional ≥ 37 semanas. La etiología principal de la epilepsia fue de tipo estructural (35,3 %); el LEV se utilizó principalmente en niños diagnosticados con malformación del sistema nervioso central (17,6 %) y predominó la monoterapia (55,9 %). En el 50 % se usó LEV para crisis focales. Cinco niños (7,3 %) presentaron trastornos de tipo psiquiátrico clasificados como probables reacciones adversas al medicamento. Conclusión. El LEV se utilizó en niños con diferentes diagnósticos con baja frecuencia de eventos adversos. El perfil de utilización varió en los diferentes grupos etarios. Es necesario identificar en futuros estudios la efectividad especialmente en el recién nacido y en epilepsias refractarias.

Introduction. Levetiracetam (LEV) is an antiepileptic drug approved by the Chilean Institute of Public Health as concomitant therapy for epileptic seizures in children older than 4 years of age. However, it is widely prescribed from the neonatal period, which makes it necessary to evaluate its off-label use. Objective. To determine the prescription-indication profile of LEV in the treatment of epileptic seizures in children younger than 4 years in a tertiary care hospital in southern Chile. Population and method. Observational, descriptive, and retrospective study. The medical records of patients who started treatment with LEV between 2014 and 2019 were reviewed, and data on sociodemographic, pharmacological, and clinical variables were collected. The analysis was based on the description of the profile of patients, prescriptions, follow-up, and safety. Results. A total of 68 patients were included: 40 (58.8%) were males, 49 (72.1%) were born at a gestational age ≥ 37 weeks. The main etiology of epilepsy was structural (35.3%); LEV was mostly used in children diagnosed with central nervous system malformation (17.6%), and monotherapy was the prevailing dosage (55.9%). LEV was used for focal seizures in 50% of cases. Five children (7.3%) had psychiatric disorders, classified as probable adverse drug reactions. Conclusion. LEV was used in children with various diagnoses, with a low rate of adverse events. The profile of drug use varied in the different age groups. Future studies are needed to identify effectiveness, especially in newborn infants and patients with refractory epilepsy.

New reference nomograms for the study of ventricular size in preterm infants.

INTRODUCTION: Transfontanellar brain ultrasound is an essential tool for monitoring the size of the ventricles in preterm neonates and has many advantages over other alternative diagnostic techniques, including its accessibility and non-use of ionizing radiation. When considering the normal ventricular size, it is essential to have reference measurements based on age-matched populations. The objective of this article is to present our reference measures, based on a sample of preterm infants that we have studied. METHODS: A retrospective observational study was conducted. Measurements of the Levene index, frontal horn thickness, and Evans index were obtained in preterm neonates from 25 to 45 weeks, over a period of 5 years, between January 2016 and December 2020. After applying the exclusion criteria, a sample of 199 patients and 350 ultrasound scans were obtained. The independent samples t-test and the Mann-Whitney test were used for the comparison of samples. RESULTS: The distribution of the right and left Levene indices was normal (Shapiro-Wilk test with p = 0.16 and 0.05, respectively), unlike the thickness distribution of the frontal horns (p < 0.05 on both sides). No significant differences were detected between the sexes (p = 0.08). A linear correlation was found between the biparietal diameter and the Levene index. CONCLUSION: From the results obtained in our study, we present reference tables for ventricular size, with the 3rd, 25th, 50th, 75th, and 97th, being the first ones made in our country.

Utilidad y confiabilidad del cuestionario PreViAs para la evaluación de la visión en neonatos y lactantes turcos / The utility and reliability of the PreViAs questionnaire for the assessment of vision in Turkish neonates and infants

Introducción. La evaluación de la visión en los niños durante el periodo preverbal, con un método fácil de usar y basado en la evidencia, permitiría el diagnóstico temprano y la intervención en los trastornos visuales. El objetivo del estudio fue determinar la utilidad y confiabilidad de la versión en idioma turco del cuestionario Preverbal Visual Assessment (PreViAs), desarrollado para evaluar la visión en niños preverbales. Población y métodos. El cuestionario PreViAs se administró a los cuidadores primarios de niños nacidos de término, antes de los 24 meses de edad. Se registraron sus respuestas. Resultados. Se analizaron los datos de 278 participantes para evaluar la consistencia interna del cuestionario PreViAs. Se encontró un alto nivel de consistencia con un alfa de Cronbach de 0,958 para el puntaje total, lo que sugiere una fuerte coherencia interna. Los valores del alfa de Cronbach para cada dominio fueron: 0,890 ­ 0,913 ­ 0,951 y 0,922 para la atención visual, la comunicación visual, el procesamiento visual y la coordinación visomotora respectivamente; esto indica una buena consistencia interna para cada subdominio. Conclusión. La versión en idioma turco del cuestionario PreViAs es útil y confiable para evaluar la visión durante el periodo preverbal.

Introduction: Evaluating the visual functions of children with an easy-to-use and evidence-based method during the preverbal period will enable early diagnosis and intervention of visual impairments. The aim of this study is to determine the utility and reliability of the Turkish version of the Preverbal Visual Assessment (PreViAs) questionnaire, which was developed to evaluate the visual functioning of preverbal infants. Population and Methods: The PreViAs questionnaire was administered to primary caregivers of term infants under 24 months of age, and their responses were recorded. Results: Data from the 278 participating infants were analyzed to assess the internal consistency of the PreViAs questionnaire. Results showed a high level of consistency with Cronbach's alpha value of 0.958 for the total score, suggesting strong internal coherence. In addition, the Cronbach's alpha values for each domain were 0.890, 0.913, 0.951, and 0.922 for visual attention, visual communication, visual processing, and visual-motor coordination, respectively, indicating good internal consistency for each subdomain. Conclusion: The Turkish version of the PreViAs questionnaire is useful and reliable for assessing functional vision during the preverbal period.

Dietary patterns of mothers and nutritional status of nursing children of a peri-urban zone of Peru / Dietary patterns of mothers and nutritional status of nursing children of a peri-urban zone of Peru / Padrões alimentares de mães e estado nutricional de bebês em uma área periurbana do Peru

Objetivo: identificar los patrones alimentarios de las madres y el estado nutricional de los lactantes de una zona periurbana de la sierra central del Perú. Métodos: el estudio fue observacional, transversal y prospectivo. La población censal fueron 93 madres y sus lactantes, se aplicó un cuestionario de patrones alimentarios; para medir el peso y la talla de los lactantes se aplicaron instrumentos mecánicos. Se aplicó la prueba de Fisher y Rho de Spearman, considerándose p < 0,05. Resultados: los patrones alimentarios de las madres, fueron adecuados 95,7 % (89). Al valorar el estado nutricional de los lactantes, en el peso para la edad, la mayoría tuvo la condición de normal con 79,6 % (74); 15,1 % (14) tuvieron sobrepeso, un 5,4 % (5) tuvieron desnutrición global; en el peso para la talla, 64,5 % (60) tuvieron el diagnóstico de normal, seguido de los desnutridos agudos 24,7 % (23), sobrepeso 7,5 % (7) fueron el 3,2 % (3). Y, en la talla para la edad, 77,4 % (72) fueron normales. A mayor cantidad de miembros en la familia el estado nutricional del lactante era peor (Rho = -0,294; p-valor = 0,004) y la talla para la edad del lactante tuvo relación con la visita de la madre al nutricionista (p-valor = 0,018). Conclusión: a mayor cantidad de miembros en la familia, el estado nutricional del lactante era peor, en el peso para la edad y la talla para la edad del lactante se halló relación con la visita al nutricionista.

Objective: identify the dietary patterns of mothers and the nutritional status of nursing children of a peri-urban zone of the central highlands of Perú. Methodology: the study was observational, cross-sectional and prospective. Census population were 93 mothers and their nursing children, It was applied a dietary patterns questionnaire; to measure the weight and height of the nursing children was applied machanics instruments. It was applied Fisher y Rho de Spearman test, considering p<0,05. Results: the dietary patterns of mothers were proper 95,7 % (89). To value the nutritional status of nursing children; in the weight for age, the most of them had the normal condition with 79,6 % (74); 15.1 % (14) al lof them had overweight, 5,4 % (5) underweight; in weight-for-height, 64,5 % (60) had the normal diagnosis, followed by acuate malnutrition 24,7 % (23), overweight 7,5 % (7) were 3,2 % (3). And, in height for age, 77,4 % (72) were normals. The higher the amount of family members the nutritional status of nursing children was worse (Rho = -0,294; p-value = 0,004) and the height for age of nursing children had relation with the mother visit had to the nutricionist (p-value = 0,018). Conclusion: the higher amount of members family, the nutritional status of nursing children was worse, in weight for age and height for age of nursing children was found relation with the visit to the nutritionist.

Objetivo: identificar os padrões alimentares das mães e o estado nutricional dos bebês em uma área periurbana do planalto central do Peru. Métodos: o estudo foi observacional, transversal e prospectivo. A população censitária foi de 93 mães e seus bebês, foi aplicado um questionário sobre padrões alimentares; Instrumentos mecânicos foram aplicados para medir o peso e a altura dos bebês. Foi aplicado o teste Rho de Fisher e Spearman, considerando p < 0,05. Resultados: o padrão alimentar das mães estava adequado em 95,7% (89). Ao avaliar o estado nutricional dos lactentes, em peso para idade, a maioria apresentou estado normal com 79,6% (74); 15,1% (14) apresentavam excesso de peso, 5,4% (5) apresentavam desnutrição global; no peso para estatura, 64,5% (60) tiveram o diagnóstico de normalidade, seguido de desnutrição aguda 24,7% (23), excesso de peso 7,5% (7) foram 3,2% (3). E, na altura para idade, 77,4% (72) eram normais. Quanto maior o número de familiares, pior o estado nutricional do lactente (Rho = -0,294; p-valor = 0,004) e a altura do lactente para a idade esteve relacionada com a visita da mãe ao nutricionista (p-valor = 0,018). Conclusão: quanto maior o número de membros na família pior o estado nutricional do lactente. No peso para idade e altura para idade do lactente foi encontrada relação com a visita ao nutricionista.

The consensus of the Asociación Mexicana de Gastroenterología on the diagnosis and treatment of gastroesophageal reflux and gastroesophageal reflux disease in infants.

Gastroesophageal reflux (GER) is a frequent normal phenomenon in children of any age. It is more common in infants, in whom the majority of episodes are short-lived and cause no other symptoms or complications, differentiating it from gastroesophageal reflux disease (GERD). The diagnosis and management of GER and GERD continue to be a challenge for the physician. Therefore, the aim of the Asociación Mexicana de Gastroenterología was to adapt international documents to facilitate their adoption by primary care physicians, with the goal of standardizing quality of care and reducing the number of diagnostic tests performed and inappropriate medication use. The ADAPTE methodology was followed, and the recommendations were approved utilizing the Delphi strategy. The executive committee carried out the review of the guidelines, position papers, and international reviews that met the a priori quality criteria and possible applicability in a local context. The recommendations were taken from those sources and adapted, after which they were approved by the working group. The consensus consists of 25 statements and their supporting information on the diagnosis and treatment of GER and GERD in infants. The adapted document is the first systematic effort to provide an adequate consensus for use in Mexico, proposing a practical approach to and management of GER and GERD for healthcare providers.

Nasolabial anthropometry using 3D computed tomography scan reconstruction: baseline study for nasolabial correction in Indonesian children with cleft lip and palate / Antropometría nasolabial mediante reconstrucción con tomografía computarizada 3D: estudio de referencia para la corrección nasolabial en niños Indonesios con fisura labiopalatina

Background: The normal nasolabial structure of infants and chil-dren from East Asian, specifically Indonesian, descent groups has been less explored in the literature. This anthropometric study is used as a guide in lip repair in patients with clefts. This retrospective study used archived CT images from the Indonesian population. Materials and Methods: Computed tomography records of children under 5 years of age were extracted from a provincial hospital. The images were then filtered based on the inclusion and exclusion criteria and then the 2D slices were reconstructed using the open source software Invesalius. Twenty-five variable nasolabial parameters of the nasolabial structure were then measured in the 3D rendering mode. Images with craniofacial dysmorphism or cannulas that passed over the nasolabial structure were excluded. Results were summarized using descriptive statistics. Results: Fourteen of 128 CT images were included in this study. The samples were divided into two age groups: 0-12 months and 25-54 months. There were moderate to strong, positive correlations between age and all nasolabial variables, which were statistically significant (p<0.05) except for nasal length, nares circumference, columella width, superior philtrum width, philtrum column height, and cutaneous upper lip height. Conclusions: This study described anthropometric measurements of normal nasolabial structures as a reference point for lip correction surgery. However, to obtain more accurate anthropometric guidelines, further studies with larger sample sizes are desirable. Although surgical repair of the lip is usually performed within the first year of life, some cases of surgery are performed after infancy.

Antecedentes: La estructura nasolabial normal de bebés y niños de grupos de ascendencia de Asia oriental, específicamente de Indonesia, ha sido menos explorada en la literatura. Este estudio antropométrico se utiliza como guía en la reparación del labio en pacientes con fisuras. Este estudio retrospectivo utilizó imágenes de tomografía computarizada archivadas de la población indonesia. Materiales y Métodos: Se extrajeron los registros de tomografía computarizada de niños menores de 5 años de un hospital provincial. Luego, las imágenes se filtraron según los criterios de inclusión y exclusión y luego se reconstruyeron los cortes 2D utilizando el software de código abierto Invesalius. Luego se midieron veinticinco parámetros nasolabiales variables de la estructura nasolabial en el modo renderizado 3D. Se excluyeron imágenes con dismórfica craneofacial y cánula que pasa sobre la estructura nasolabial. Los resultados se resumen mediante estadística descriptiva. Resultado: En este estudio se incluyeron catorce de 128 imágenes de TC. Las muestras se dividieron en dos grupos de edad: 0-12 meses y 25-54 meses. Hubo una correlación positiva de moderada a fuerte entre la edad y todas las variables nasolabiales, que fueron estadísticamente significativas (p<0,05) excepto la longitud nasal, la circunferencia de las narinas, el ancho de la columela, el ancho del filtrum superior, la altura de la columna del filtrum y la altura cutánea del labio superior. Conclusión: Este estudio describió las medidas antropométricas de estructuras nasolabiales normales como base para la cirugía de corrección de labios. Sin embargo, para obtener directrices antropométricas más precisas, son deseables más estudios con tamaños de muestra más grandes. Aunque la reparación quirúrgica del labio normalmente se realiza dentro del primer año de vida, en algunos casos la cirugía se realiza después de la infancia.

Consumo de alimentos ultraprocesados en niños entre 6 y 23 meses según la Segunda Encuesta Nacional de Nutrición y Salud de Argentina / Consumption of ultra-processed foods among children aged 6 to 23 months as per the Second National Survey on Nutrition and Health of Argentina

Introducción. Contar con los datos del consumo de alimentos ultraprocesados en los niños resulta importante para planificar políticas públicas. Objetivos. Describir la prevalencia de consumo de alimentos ultraprocesados en menores de 2 años e identificar factores asociados. Describir la proporción que los alimentos ultraprocesados representan del número total de los alimentos consumidos en el día. Métodos. Análisis secundario de los datos de niños entre 6 y 23 meses de edad con al menos un recordatorio de 24 horas de consumo de alimentos de la Segunda Encuesta Nacional de Nutrición y Salud de Argentina del año 2018. Se estudiaron como variables principales: "consumo de alimentos ultraprocesados" (según el sistema NOVA) categorizada en sí/no y la "proporción de ultraprocesados del total de alimentos consumidos". Los factores asociados explorados fueron lactancia materna, sexo, edad y el número de alimentos no ultraprocesados consumidos. Se realizó un modelo de regresión logística multivariable y se aplicó un factor de expansión para ponderar los datos. Resultados. Se incluyeron 4224 niños (ponderado 908 104). La prevalencia de consumo de ultraprocesados fue del 90,8 % (IC95%: 89,5-92) y fue asociado con mayor edad (OR 3,21; IC95% 2,28-4,52) y con el número de alimentos no ultraprocesados consumidos (OR 1,17; IC95% 1,13-1,23). Los ultraprocesados representaron una mediana del 20 % (RIC: 12,5-28,6 %) del total de alimentos consumidos en el día. Conclusiones. Este estudio señala la alta penetración de los alimentos ultraprocesados en la alimentación complementaria.

Introduction. The availability of data on the consumption of ultra-processed foods among children is important for planning public policies. Objectives. To describe the prevalence of consumption of ultra-processed foods in children under 2 years of age and identify associated factors. To describe the proportion that ultra-processed foods represent out of the total number of foods consumed in a day. Methods. Secondary analysis of data from children aged 6­23 months with at least a 24-hour recall of food consumption based on the Second National Survey on Nutrition and Health of Argentina (2018). The following primary variables were studied: "consumption of ultra-processed foods" (according to the NOVA system) categorized into yes/no and "proportion of ultra-processed out of total foods consumed." The following associated factors were studied: breastfeeding, sex, age, and number of non-ultra-processed foods consumed. A multivariate logistic regression model was developed and an expansion factor was applied to weight the data. Results. A total of 4224 children were included (weighed: 908 104). The prevalence of ultra-processed food consumption was 90.8% (95% CI: 89.5­92) and was associated with an older age (OR: 3.21, 95% CI: 2.28­4.52) and the number of non-ultra-processed foods consumed (OR: 1.17, 95% CI: 1.13­1.23). Ultra-processed foods accounted for a median 20% (IQR: 12.5­28.6%) of all foods consumed in a day. Conclusions. This study highlights the high penetration of ultra-processed foods in complementary feeding.

Consumo de antibióticos en los primeros meses de vida: un estudio transversal / Antibiotic consumption in the first months of life: A cross-sectional study

Introducción: Los factores y patrones asociados al consumo de antibióticos en los lactantes no están claros. Nuestro objetivo fue evaluar la incidencia acumulada de consumo de antibióticos desde el nacimiento hasta los 16meses e identificar los factores asociados al consumo de antibióticos entre lactantes de 4 a 16meses. Material y métodos: Se realizó un estudio transversal en 2016 que incluyó una muestra de la población de 18.882 mujeres españolas de Galicia que habían dado a luz a un niño vivo entre el 1 de septiembre de 2015 y el 31 de agosto de 2016. Se calculó la incidencia acumulada de consumo de antibióticos a partir de los resultados de la entrevista a la madre sobre el consumo del lactante desde el nacimiento hasta los 14meses; no se estimó a los 15 y 16meses debido al reducido tamaño muestral. Para valorar las características asociadas al consumo de antibióticos se anidó en el estudio transversal un estudio de casos y controles emparejando por mes de nacimiento, un control por caso. Resultados: La incidencia acumulada de consumo de antibióticos entre los lactantes de 0 a 14meses de edad aumentó del 7,5% al 66,0%. Para el estudio de casos y controles, se obtuvo información de 1.852 casos y de 1.852 controles. La asistencia a la guardería (OR: 3,8 [IC95%: 3,2-4,6]), tener hermanos/as mayores (OR: 1,8 [IC95%: 1,6-2,1]), las consultas sanitarias en la clínica privada (OR: 1,6 [IC95%:1,4-2,0]) o haber estado expuesto al humo ambiental de tabaco (OR: 1,3 [IC95%: 1,1-1,6]) se asociaron con un mayor riesgo de consumo de antibióticos. Tener madres de entre 30 y 39años o de 40años y más en el momento del parto se asoció con un menor riesgo de consumo de antibióticos (OR: 0,8 [IC95%: 0,7-1,0] y OR: 0,6 [IC95%: 0,5-0,8], respectivamente).(UA)

Introduction: The factors and patterns associated with antibiotic consumption in infants are unclear. Our aim was to assess the cumulative incidence of antibiotic consumption from birth to 16 months and identify factors associated with antibiotic consumption among infants aged 4 to 16 months. Material and methods: We conducted a cross-sectional study in 2016 in a sample of 18,882 women from Galicia, Spain, who had given birth to a live child between September 1, 2015 and August 31, 2016. We calculated the cumulative incidence of antibiotic consumption based on maternal reports regarding the infant's consumption from birth to 14 months obtained through interviews; we did not estimate consumption at ages 15 and 16 months due to the small sample size. To assess which factors were associated with antibiotic consumption, we carried out a nested case-control study matching cases and controls for birth month on a 1:1 ratio. Results: The cumulative incidence of antibiotic consumption among infants aged 0 to 14 months increased from 7.5% to 66.0%. The case-control study included data for 1,852 cases and 1,852 controls. Daycare attendance (OR: 3.8 [95%CI: 3.2-4.6]), having older siblings (OR: 1.8 [95%CI: 1.6-2.1]), health care visits to private clinics (OR: 1.6 [95%CI: 1.4-2.0]), and passive smoking (OR: 1.3 [95%CI: 1.1-1.6]) were associated with an increased probability of antibiotic consumption. Maternal age between 30-39 years or 40 years and over at the time of birth was associated with a decreased probability of antibiotic consumption (OR: 0.8 [95%CI, 0.7-1.0] and OR: 0.6 [95%CI: 0.5-0.8], respectively). Conclusions: Some of the factors associated with antibiotic consumption in infants are modifiable and should be considered in the development of public health measures aimed at reducing antibiotic consumption.(AU)

Riesgos y beneficios de la profilaxis con sulfato ferroso en lactantes nacidos a término con niveles de hemoglobina y ferremia desconocidos / Risks and benefits of iron supplementation in full-term infants with unknown hemoglobin and ferritin levels

La seguridad y eficacia de los programas de suplementación con hierro a lactantes, está actualmente en discusión. El objetivo de esta revisión fue identificar estudios sobre riesgos y beneficios de la suplementación con hierro profiláctico en lactantes menores de un año, nacidos a término, con niveles de hemoglobina (Hb) y ferremia desconocidos. Se realizó una búsqueda en Pubmed y Cochrane, identificando 3 revisiones sistemáticas y metaanálisis. Estos estudios arrojaron resultados que indican mejoras en los niveles séricos de hierro y hemoglobina como resultado de la suplementación con hierro. Sin embargo, no se observó un beneficio significativo en el desarrollo cognitivo de los lactantes. Los efectos adversos más reportados son los gastrointestinales, efectos en el crecimiento (menor ganancia de talla y peso) y menor absorción de zinc. En resumen, la evidencia en cuanto a la profilaxis con hierro en lactantes es limitada, lo que nos lleva a recomendar un seguimiento cercano de los lactantes que reciben suplementos de hierro, con el objetivo de detectar posibles eventos adversos. Es fundamental evaluar cuidadosamente los riesgos y beneficios de esta intervención antes de su implementación (AU)

The safety and efficacy of iron supplementation programs for infants are currently under discussion. The objective of this review was to identify studies on the risks and benefits of prophylactic iron supplementation in infants under one year of age, born at term, with unknown hemoglobin (Hb) and serum iron levels. The search was conducted on Pubmed and Cochrane, identifying three systematic reviews and meta-analyses. The results indicate improvements in serum iron and hemoglobin levels as a result of iron supplementation. However, a significant benefit in infant cognitive development was not observed. The most reported adverse effects were gastrointestinal, effects on growth (reduced height and weight gain), and reduced zinc absorption. In summary, the evidence regarding iron prophylaxis in infants is limited, leading us to recommend close monitoring of infants receiving iron supplements to detect potential adverse events. It is crucial to carefully assess the risks and benefits of this intervention before implementation (AU)

Antibiotic consumption in the first months of life: A cross-sectional study.

INTRODUCTION: The factors and patterns associated with antibiotic consumption in infants are unclear. Our aim was to assess the cumulative incidence of antibiotic consumption from birth to 16 months and identify factors associated with antibiotic consumption among infants aged 4-16 months. MATERIAL AND METHODS: We conducted a cross-sectional study in 2016 in a sample of 18 882 women from Galicia, Spain, who had given birth to a live child between September 1, 2015 and August 31, 2016. We calculated the cumulative incidence of antibiotic consumption based on maternal reports regarding the infant's consumption from birth to 14 months obtained through interviews; we did not estimate consumption at ages 15 and 16 months due to the small sample size. To assess which factors were associated with antibiotic consumption, we carried out a nested case-control study matching cases and controls for birth month on a 1:1 ratio. RESULTS: The cumulative incidence of antibiotic consumption among infants aged 0-14 months increased from 7.5% to 66.0%. The case-control study included data for 1852 cases and 1852 controls. Daycare attendance (OR: 3.8 [95% CI: 3.2-4.6]), having older siblings (OR: 1.8 [95% CI: 1.6-2.1]), health care visits to private clinics (OR: 1.6 [95% CI: 1.4-2.0]), and passive smoking (OR: 1.3 [95% CI: 1.1-1.6]) were associated with an increased probability of antibiotic consumption. Maternal age between 30-39 years or 40 years and over at the time of birth was associated with a decreased probability of antibiotic consumption (OR: 0.8 [95% CI, 0.7-1.0] and OR: 0.6 [95% CI: 0.5-0.8], respectively). CONCLUSIONS: Some of the factors associated with antibiotic consumption in infants are modifiable and should be considered in the development of public health measures aimed at reducing antibiotic consumption.

Calendario de inmunizaciones de la Asociación Española de Pediatría: recomendaciones 2024 / Immunisation schedule of the Spanish Association of Pediatrics: 2024 recommendations

El Calendario de Inmunizaciones de la AEP para 2024, con sus recomendaciones de inmunización para embarazadas, niños y adolescentes residentes en España, hace el número 25 desde el primero presentado en 1995, siendo anual desde 2003, como calendario de vacunaciones, y desde 2023 como calendario de inmunizaciones por la inclusión de un anticuerpo monoclonal para la prevención de la enfermedad por VRS. Como novedades de este año, se encuentran las siguientes: • Tabla de inmunizaciones sistemáticas para personas sanas y otra para pertenecientes a grupos de riesgo. • Aunque ya anteriormente se hacían recomendaciones de vacunación en embarazadas, se han añadido a la tabla y se ha creado un apartado específico. • Se recomienda la vacunación frente al neumococo con una de las nuevas vacunas conjugadas de valencia ampliada, en sustitución de VNC13. • Se recomienda la sustitución de la vacuna frente al meningococo C a los 4 meses de edad por la vacuna MenACWY, quedando la pauta recomendada como 1+1+1 (4 meses, 12 meses y 12 años, manteniendo el rescate en adolescentes hasta los 18 años). • Se recomienda la vacuna intranasal frente a gripe como la preferente en mayores de 2 años. • Siguiendo las propuestas de OMS, ECDC y CISNS, la vacunación frente al SARS-CoV-2 pasa a ser recomendada solo para personas mayores de 6 meses con factores de riesgo, con preparados que contengan el linaje XBB.1. Las recomendaciones de vacunación contra la covid en pediatría se actualizarán periódicamente en la web del CAV-AEP.Se mantienen el resto de las recomendaciones del calendario anterior.(AU)

The AEP Immunization Calendar for 2024, with its immunization recommendations for pregnant women, children and adolescents residing in Spain, marks the 25th edition since the first one was introduced in 1995, being annual since 2003, as a vaccination calendar, and since 2023 as immunization schedule due to the inclusion of a monoclonal antibody for the prevention of RSV disease. Novelties for this year include the following: • Tables of systematic immunizations for healthy people and those belonging to risk groups. • Although vaccination recommendations were previously made for pregnant women, they have been now included in the table and a specific section has been created. • Vaccination against pneumococcus is recommended with one of the new expanded valence conjugate vaccines, replacing PCV13. • It is recommended to replace the meningococcus C vaccine at 4 months of age with the MenACWY vaccine, thus leaving the recommended schedule as 1+1+1 (4 months, 12 months and 12 years, with a catch-up for adolescents up to 18 years). • The intranasal flu vaccine is recommended as the preferred vaccine for people over 2 years of age. • Following the proposals of the WHO, ECDC and CISNS, vaccination against SARS-CoV-2 is now recommended only for people over 6 months of age with risk factors, using vaccines containing the XBB.1 lineage. Vaccination recommendations against covid in pediatrics will be updated periodically on the CAV-AEP website.The rest of the recommendations from the previous calendar remain unchanged.(AU)

Immunisation schedule of the Spanish Association of Pediatrics: 2024 recommendations.

The AEP Immunization Calendar for 2024, with its immunization recommendations for pregnant women, children and adolescents residing in Spain, marks the 25th edition since the first one was introduced in 1995, being annual since 2003, as a vaccination calendar, and since 2023 as immunization schedule due to the inclusion of a monoclonal antibody for the prevention of RSV disease. Novelties for this year include the following: The rest of the recommendations from the previous calendar remain unchanged.

Exclusive breastfeeding duration within a cohort of indigenous Terena living in the urban area of Campo Grande, Central-West Region, Brazil / Duração do aleitamento materno exclusivo em uma coorte de indígenas Terena residentes na zona urbana de Campo Grande, Região Centro-oeste do Brasil / Duración de la lactancia materna exclusiva en una cohorte de indígenas Terena que viven en el área urbana de Campo Grande, región Centro-oeste de Brasil

Abstract In Brazil, current information about breastfeeding indicators among indigenous living in the urban areas is lacking. This article describes the duration of exclusive breastfeeding and its associations with mother and child characteristics in a cohort of Terena infants. The study enrolled infants born between June 2017 to July 2018 (n = 42) and living in villages of the urban area of Campo Grande, Mato Grosso do Sul State, Brazil. Information was collected in four time-points. Variables on maternal sociodemographics and on maternal and child health characteristics were collected, respectively, during the antenatal and the first-month interviews. Variables on breastfeeding practices and bottle use were collected during the first-, six- and 12-month interviews. Associations were examined using Wilcoxon, Kruskal-Wallis, Pearson's chi-square, and Fisher's exact tests. The prevalence of exclusive breastfeeding duration to the ages of three and six months were, respectively, 50% and 11.9%. Compared to infants never introduced to bottles during the first three months of life, those bottle-fed had lower median duration of exclusive breastfeeding (15 versus 150 days) and lower prevalence of exclusive breastfeeding duration to the age of three months (22.7% versus 80%). Most Terena infants fell short of meeting the international recommended duration of exclusive breastfeeding until six months of age and suggested the negative impact of bottle use in the duration of exclusive breastfeeding.

Resumo No Brasil, não há informações atuais sobre indicadores de aleitamento materno entre indígenas residentes em áreas urbanas. O objetivo deste estudo foi descrever a duração do aleitamento materno exclusivo e suas associações com características maternas e infantis em uma coorte de lactentes Terena. O estudo incluiu crianças nascidas de junho de 2017 a julho de 2018 (n = 42) e residentes em povoados da zona urbana de Campo Grande, Mato Grosso do Sul, Brasil. As informações foram coletadas em quatro momentos. Variáveis sociodemográficas maternas e características de saúde materno-infantil foram coletadas durante o pré-natal e o primeiro mês de entrevistas, respectivamente. As variáveis sobre práticas de amamentação e uso de mamadeira foram coletadas durante as entrevistas realizadas no primeiro mês, seis meses e 12 meses. As associações foram examinadas pelos testes de Wilcoxon, Kruskal-Wallis, qui-quadrado de Pearson e exato de Fisher. As prevalências de duração do aleitamento materno exclusivo até os três e seis meses de idade foram, respectivamente, de 50% e 11,9%. Em relação aos bebês que nunca foram introduzidos à mamadeira durante os três primeiros meses de vida, aqueles que usaram mamadeira tiveram menor duração média de amamentação exclusiva (15 versus 150 dias) e menor prevalência de duração de amamentação exclusiva até os três meses de idade (22,7% versus 80%). A maioria dos lactentes Terena não atingiu a duração recomendada internacionalmente para o aleitamento materno exclusivo até os seis meses, sugerindo um impacto negativo do uso da mamadeira na duração do aleitamento materno exclusivo.

Resumen En Brasil no existe información actual sobre los indicadores de lactancia materna entre los indígenas que viven en áreas urbanas. El objetivo de este estudio fue describir la duración de la lactancia materna exclusiva y sus asociaciones con las características maternas e infantiles en una cohorte de lactantes Terena. Este estudio incluyó a niños nacidos entre junio de 2017 y julio de 2018 (n = 42) y que vivían en aldeas del área urbana de Campo Grande, Mato Grosso do Sul, Brasil. La información se recopiló en cuatro momentos. Las variables sociodemográficas maternas y las características de salud materno-infantil durante la atención prenatal y el primer mes de entrevistas, respectivamente, se recogieron para este estudio. Las variables sobre prácticas de lactancia materna y alimentación con biberón fueron recolectadas de las entrevistas realizadas en el primer mes, seis meses y 12 meses. Las asociaciones pasaron por las pruebas de Wilcoxon, de Kruskal-Wallis, el chi-cuadrado de Pearson y la prueba exacta de Fisher. La prevalencia de duración de la lactancia materna exclusiva fue del 50% hasta los tres meses de edad y del 11,9% hasta los seis meses. En comparación con los bebés que no utilizaron biberón durante los primeros tres meses de vida, los que usaron biberón tuvieron una duración promedio más corta de lactancia materna exclusiva (15 versus 150 días) y una menor prevalencia de lactancia materna exclusiva hasta los tres meses de edad (22,7% versus 80%). La mayoría de los bebés Terena no alcanzaron la duración recomendada internacionalmente para la lactancia materna exclusiva hasta los seis meses, lo que sugiere un impacto negativo de la alimentación con biberón en la duración de la lactancia materna exclusiva.

Complementary feeding indicators from the World Health Organization and the Ministry of Health: agreement analysis and comparison of estimated prevalence in a cohort of children in southwestern Bahia, Brazil, 2018 / Indicadores de alimentación complementaria de la Organización Mundial de la Salud y del Ministerio de Salud: análisis de concordancia y comparación de prevalencias estimadas en una cohorte de niños del suroeste de Bahía, Brasil, 2018 / Indicadores de alimentação complementar da Organização Mundial da Saúde e do Ministério da Saúde: análise de concordância e comparação das prevalências estimadas em uma coorte de crianças no sudoeste da Bahia, 2018

ABSTRACT Objective To assess the agreement between complementary feeding indicators established by the World Health Organization (WHO) and the Ministry of Health (MOH) and to compare the prevalence of these indicators in the first year of a child's life. Methods : This was a cross-sectional study in a cohort of 286 children from Vitória da Conquista, state of Bahia, Brazil; agreement between indicators and comparison between prevalences were analyzed using the Kappa coefficient and McNemar's test; the prevalence of the indicators "introduction of complementary feeding" (ICF), "minimum dietary diversity" (MDD), "minimum meal frequency" (MMF) and "minimum acceptable diet" (MAD) were calculated. Results : Three indicators showed poor agreement, with only one demonstrating moderate agreement; prevalence of WHO indicators was higher than that of the MOH (ICF, 94.3% vs. 20.7%; MDD, 75.2% vs. 50.7%; MMF, 97.2% vs. 44.8%; MAD, 96.8% vs. 26.9%). Conclusion The majority of indicators showed poor agreement and the prevalence of WHO indicators exceeded that of the Ministry of Health.

RESUMEN Objetivo evaluar la concordancia entre indicadores de alimentación complementaria definidos por la Organización Mundial de la Salud (OMS) y el Ministerio de Salud (MS), y comparar la prevalencia entre estos indicadores en niños de un año. Métodos estudio transversal en una cohorte de 286 niños de Vitória da Conquista, Bahía, Brasil; se calculó la prevalencia de "introducción de alimentos complementarios" (IAC), "diversidad dietética mínima" (DMD), "frecuencia mínima de comidas" (FMR) y "dieta mínima aceptable" (DMA); para evaluar la concordancia y comparar prevalencias se utilizó el índice Kappa y la prueba de McNemar. Resultados cuatro indicadores mostraron un acuerdo pobre y sólo uno moderado; las prevalencias fueron mayores según la definición de la OMS (IAC, 94,3% vs 20,7%; DMD, 75,2% vs 50,7%; FMR, 97,2% vs 44,8%; DMA, 96,8% vs 26,9%). Conclusión la mayoría de las concordancias entre los indicadores fueron deficientes, con prevalencias más altas según las definiciones de la OMS.

RESUMO Objetivo Analisar a concordância entre indicadores de alimentação complementar da Organização Mundial da Saúde (OMS) e do Ministério da Saúde (MS) e comparar as prevalências entre esses indicadores em crianças no primeiro ano de vida. Métodos Estudo transversal em uma coorte de 286 crianças de Vitória da Conquista, Bahia, Brasil; a concordância entre indicadores e a comparação entre prevalências foram analisadas pelo índice Kappa e teste de McNemar; foram calculadas as prevalências dos indicadores "introdução de alimentos complementares" (IAC), "diversidade mínima da dieta" (DMD), "frequência mínima de refeição" (FMR) e "dieta minimamente aceitável" (DMA). Resultados Três indicadores apresentaram concordância ruim, e apenas um moderada; as prevalências dos indicadores da OMS foram superiores às do MS (IAC, 94,3% versus 20,7%; DMD, 75,2% versus 50,7%; FMR, 97,2% versus 44,8%; DMA, 96,8% versus 26,9%). Conclusão A maioria dos indicadores tiveram concordância ruim e as prevalências de indicadores da OMS superaram as do MS.

Determinants of continued breastfeeding in children aged 12-23 months in three regions of Haiti / Determinantes de la continuación de la lactancia materna en la población infantil de entre 12 y 23 meses en tres regiones de Haití / Determinantes do aleitamento materno continuado em crianças de 12 a 23 meses de idade em três regiões do Haiti

ABSTRACT Objectives To identify the prevalence and determinants of continued breastfeeding in Haitian children aged 12-23 months. Methods Three cross-sectional surveys were conducted yearly during the summers of 2017 to 2019 as part of a 4-year (2016-2020) multisectoral maternal and infant health initiative in the regions of Les Cayes, Jérémie, and Anse d'Hainault in Haiti. A total of 455 children 12-23 months of age and their mothers participated in the study. A child was considered to be continuing breastfeeding if the mother reported giving breast milk in the 24-hour dietary recall. Unadjusted and adjusted prevalence ratios were estimated, and associations were assessed between continued breastfeeding and explanatory factors related to sociodemographic characteristics, household food security, maternal nutrition, and breastfeeding knowledge and practices. Results The prevalence of continued breastfeeding was 45.8%. Continued breastfeeding was significantly more prevalent among younger children, children who did not have a younger sibling, children whose mother was not pregnant, those living in the Jérémie region, children who had been exclusively breastfed for less than 1 month, and children whose mother knew the World Health Organization's recommendation for continued breastfeeding up to 2 years or beyond. Conclusions The study results highlight the need for geographically equitable access to tailored and adequate health services and education that support breastfeeding in a way that is compatible with the local context.

RESUMEN Objetivos. Determinar la prevalencia y los determinantes asociados a la continuación de la lactancia materna en la población infantil haitiana de entre 12 y 23 meses. Métodos. Durante los veranos del 2017 al 2019 se llevaron a cabo tres encuestas transversales anuales como parte de una iniciativa multisectorial de salud materna e infantil de 4 años (2016 a 2020) en las regiones de Les Cayes, Jérémie y Anse d'Hainault de Haití. En el estudio participaron 455 menores de edades comprendidas entre 12 y 23 meses y sus madres. Se consideró que un menor continuaba con la lactancia materna si, en la evaluación de la alimentación basada en el recuerdo de 24 horas, la madre declaraba la toma de leche materna. Se calcularon los cocientes de prevalencia ajustados y sin ajustar y se evaluó la asociación entre la continuación de la lactancia materna y posibles factores explicativos relacionados con las características sociodemográficas, la seguridad alimentaria de la familia, la nutrición materna y los conocimientos y prácticas en materia lactancia materna. Resultados. La prevalencia de la continuación de la lactancia materna fue del 45,8%. Esta prevalencia fue significativamente mayor cuando se trataba de lactantes de menor edad, cuando no había hermanos menores, cuando la madre no estaba embarazada, en los residentes en la región de Jérémie, cuando había habido una alimentación exclusiva con leche materna durante menos de un mes y cuando la madre conocía la recomendación de la Organización Mundial de la Salud de continuar con la lactancia materna hasta los dos años o más. Conclusiones. Los resultados del estudio ponen de relieve la necesidad de disponer de un acceso geográfico equitativo a unos servicios de salud y una educación que respalden la lactancia materna de una manera compatible con el contexto local.

RESUMO Objetivos Identificar a prevalência e os determinantes do aleitamento materno continuado em crianças haitianas de 12 a 23 meses de idade. Métodos Três pesquisas transversais foram realizadas anualmente nos verões de 2017 a 2019 como parte de uma iniciativa multissetorial de saúde materno-infantil de quatro anos (2016-2020) nas regiões de Les Cayes, Jérémie e Anse d'Hainault no Haiti. Um total de 455 crianças de 12 a 23 meses de idade e suas mães participaram do estudo. Considerou-se que a criança continuava sendo amamentada se a mãe relatasse ter dado leite materno no recordatório alimentar de 24 horas. Foram estimadas as taxas de prevalência não ajustadas e ajustadas e foram avaliadas as associações entre o aleitamento materno continuado e os fatores explicativos relacionados às características sociodemográficas, à segurança alimentar da família, à nutrição materna e aos conhecimentos e práticas de aleitamento materno. Resultados A prevalência de aleitamento materno continuado foi de 45,8%. O aleitamento materno continuado foi significativamente mais prevalente entre crianças mais novas, crianças que não tinham irmão mais novo, crianças cuja mãe não estava grávida, residentes da região de Jérémie, crianças que haviam sido exclusivamente amamentadas por menos de um mês e crianças cuja mãe conhecia a recomendação da Organização Mundial da Saúde de manter o aleitamento materno por 2 anos ou mais. Conclusões Os resultados do estudo destacam a necessidade de acesso geograficamente equitativo a educação e serviços de saúde adaptados e adequados para apoiar o aleitamento materno de forma compatível com o contexto local.

Knowledge about sudden infant death syndrome prevention among postpartum women in Southern Brazil, 2019: a cross-sectional survey / Conocimiento sobre la prevención del síndrome de muerte súbita del lactante en puérperas del Sur de Brasil, 2019: un estudio transversal / Conhecimento sobre prevenção da síndrome da morte súbita do lactente entre puérperas no Sul do Brasil, 2019: um estudo transversal

ABSTRACT Objective To assess knowledge on sudden infant death syndrome (SIDS) prevention among postpartum women who received prenatal care in public and private services in Rio Grande, Rio Grande do Sul, Brazil, in 2019. Methods A cross-sectional study was conducted with postpartum women who gave birth in that municipality in 2019; the outcome was the indication of incorrect sleeping position (side/supine position) to prevent SIDS; the chi-square test was used to compare proportions between those who underwent prenatal care in public and private services. Results Among all 2,195 postpartum women, 67.7% (95%CI 65.7;69.6) were unaware of the position that prevents SIDS, 71.6% were public care service users; 77.8% of them feared choking/suffocation; 1.9% were informed about SIDS during prenatal care; doctors/nurses (70.5%) and grandmothers (65.1%) were influential regarding the baby's sleeping position. Conclusion Most postpartum women were unaware of the sleeping position that prevents SIDS, especially those receiving care in the public sector; in general, this subject is not discussed in prenatal care.

RESUMEN Objetivo Evaluar el conocimiento sobre la prevención del síndrome de muerte súbita del lactante (SMSL) entre puérperas que realizaron prenatal en servicios públicos y privados en Rio Grande, Rio Grande do Sul, Brasil, en 2019. Métodos Estudio transversal, con puérperas que dieron a luz en Rio Grande, en 2019; el resultado consistió en la indicación de posición incorrecta para dormir (lado/supino) para prevenir el SMSL; utilizando chi-cuadrado, se compararon las proporciones entre mujeres que recibieron atención prenatal en servicios públicos y privados. Resultados Entre las 2.195 puérperas, 67,7% (IC95% 65,7;69,6) desconocían como se previene el SMSL, estando el 71,6%, en la red pública; 77,8% temía asfixiarse/ahogarse; el 1,9% fue informado sobre el SMSL durante el prenatal; los médicos(as)/enfermeros(as) (70,5%) y los abuelos (65,1%) influyeron en la posición para dormir del bebé. Conclusión La mayoría de las puérperas desconocían la posición que previene el SMSL, especialmente en la red pública; en general, este tema no está cubierto en la atención prenatal.

RESUMO Objetivo Avaliar o conhecimento sobre prevenção da síndrome da morte súbita do lactente (SMSL) entre puérperas com pré-natal realizado nos serviços público e privado de Rio Grande, Rio Grande do Sul, Brasil, 2019. Métodos Estudo transversal, com puérperas do município; seu desfecho constituiuse da indicação de posição incorreta para dormir (decúbito lateral ou dorsal), visando prevenir a SMSL; utilizou-se o teste qui-quadrado para comparar proporções do desfecho e de exposição entre puérperas que realizaram pré-natal nos serviços público e privado. Resultados De 2.195 puérperas, 67,7% (IC95% 65,7;69,6), majoritariamente atendidas na rede pública (71,6%), desconheciam a posição preventiva da SMSL; 77,8% temiam engasgo/afogamento; 1,9% foram informadas sobre SMSL no pré-natal; médicos(as)/enfermeiros(as) (70,5%) e avós (65,1%) mostraram-se influentes na decisão sobre como posicionar o bebê adormecido. Conclusão A maioria das puérperas, especialmente as atendidas na rede pública, desconhecia a posição que previne SMSL; geralmente, o tema não é abordado no pré-natal.

Website for families of non-breastfed children: development and validation of content and interface / Sitio de Internet para familias de niños no amamantados: desarrollo y validación de contenido y de interfaz / Website para família de crianças não amamentadas: desenvolvimento e validação de conteúdo e de interface

ABSTRACT Objectives: to develop and validate the content and interface of a guidance website to support families in promoting Food and Nutrition Security for children under six months who are not breastfed. Methods: methodological study, Knowledge Translation, in two stages of creation: 1) content and validation on the criterion of accuracy in a panel of experts; 2) interface and validation on the criteria of content, language, illustrations, layout, motivation, culture and applicability. Results: the "Milky Way" website is freely available: https://www.ufsm.br/pet/ciencia-da-computacao/alimentacao-lactea. The content was structured in a decision tree made up of types of milk: milk formula, whole cow's milk and powdered milk; and utensils: bottle, cup and measuring spoon. There were 46 illustrations to elucidate the content, facilitate understanding and engage the target population. The Content Validity Index was 0.91. Conclusions: the website is a validated technology with evidence-based written and pictorial content translated for use with families.

RESUMEN Objetivos: desarrollar y validar el contenido y la interfaz de sitio web orientador para apoyar a familias en la promoción de Seguridad Alimentaria y Nutricional de niños menores de seis meses no amamantadas. Métodos: estudio metodológico, de Traducción del Conocimiento, en dos etapas de creación: 1) contenido y validación según el criterio de precisión por panel de expertos; 2) interfaz y validación según los criterios contenido, lenguaje, ilustraciones, maquetación, motivación, cultura y aplicabilidad. Resultados: el sitio "Vía Láctea" es de libre acceso: https://www.ufsm.br/pet/ciencia-da-computacao/alimentacao-lactea. El contenido se estructuró en un árbol de decisión compuesto por tipos de leche: fórmula láctea, leche entera de vaca y leche en polvo; y utensilios: biberón, taza y cuchara dosificadora. Hay 46 ilustraciones para elucidar el contenido, facilitar la comprensión y atraer a la población objeto. El índice de validez del contenido fue de 0,91. Conclusiones: el sitio web es una tecnología validada con contenidos escritos y visuales basados en pruebas y traducidos para su uso con las familias.

RESUMO Objetivos: desenvolver e validar o conteúdo e a interface de website orientativo para apoiar a família na promoção de Segurança Alimentar e Nutricional de crianças menores de seis meses não amamentadas. Métodos: estudo metodológico, de Tradução do Conhecimento, em duas etapas de criação: 1) conteúdo e validação no critério precisão em painel de especialistas; 2) interface e validação nos critérios conteúdo, linguagem, ilustrações, layout, motivação, cultura e aplicabilidade. Resultados: o website "Via láctea" está disponível em livre acesso: https://www.ufsm.br/pet/ciencia-da-computacao/alimentacao-lactea. O conteúdo foi estruturado em árvore de decisão composta por tipo de leite: fórmula láctea, leite de vaca integral e em pó; e utensílios: mamadeira, copinho e colher dosadora. Constam 46 ilustrações para elucidar conteúdo, facilitar compreensão e engajar população-alvo. O Índice de Validade do Conteúdo foi de 0,91. Conclusões: o website é uma tecnologia validada com conteúdo escrito e imagético baseado em evidências e traduzido para uso com famílias.

Men's perception of paternal parenthood and the promotion of child development / La percepción de los hombres sobre la paternidad y la promoción del desarrollo infantil / A percepção dos homens sobre a parentalidade paterna e a promoção do desenvolvimento infantil

ABSTRACT Objectives: to comprehend men's perception of paternal parenthood while caring for infants to promote child development. Methods: this qualitative study adopts an exploratory approach and was conducted with undergraduate and graduate students, faculty, and staff who are fathers of infants up to 6 months old from a higher education institution, excluding fathers from mononuclear families. Data collection occurred through semi-structured interviews and was analyzed using thematic categorical analysis. Results: fifteen men participated in the study. From the analysis, two empirical categories emerged: "Perception of being a father: challenges and novelties" and "Promotion of child development: actions carried out by fathers". Fathers revealed feeling unprepared, the need for emotional support, and recognized activities aimed at their children's development. Final Considerations: the relevance of the paternal figure for child development is highlighted, as well as the need for public policies to encourage paternal parenthood.

RESUMEN Objetivos: comprender la percepción de los hombres en relación con la paternidad ejercida en el cuidado de los lactantes para promover el desarrollo infantil. Métodos: estudio cualitativo, de enfoque exploratorio, realizado con estudiantes, profesores y personal administrativo que son padres de lactantes de hasta 6 meses de edad de una institución de educación superior, excluyendo a padres de familias mononucleares. La recolección de datos se realizó a través de entrevistas semiestructuradas y se analizó bajo el enfoque del análisis temático categorial. Resultados: participaron en la investigación 15 hombres. A partir del análisis, surgieron dos categorías empíricas: "Percepción sobre ser padre: desafíos y novedades" y "Promoción del desarrollo infantil: acciones realizadas por los padres". Los padres revelaron sentirse poco preparados, la necesidad de apoyo emocional y reconocen las actividades promovidas para el desarrollo de sus hijos. Conclusiones: se destaca la importancia de la figura paterna para el desarrollo infantil y la necesidad de políticas públicas que fomenten la paternidad activa.

RESUMO Objetivos: compreender a percepção dos homens em relação à parentalidade paterna exercida no cuidado aos lactentes para a promoção do desenvolvimento infantil. Métodos: estudo qualitativo, de abordagem exploratória, realizado com discentes, docentes e técnicos administrativos que são pais de lactentes com até 6 meses de vida de uma instituição de ensino superior, sendo excluídos pais de famílias mononucleares. A coleta de dados ocorreu por meio de entrevista semiestruturada e foi analisada à luz da análise categorial temática. Resultados: participaram da pesquisa 15 homens. A partir da análise, emergiram duas categorias empíricas: "Percepção sobre ser pai: desafios e novidades" e "Promoção do desenvolvimento infantil: ações realizadas pelos pais". Os pais revelaram sentir-se despreparados, a necessidade de apoio emocional e reconhecem as atividades promovidas para o desenvolvimento de seus filhos. Considerações Finais: destaca-se a relevância da figura paterna para o desenvolvimento infantil e a necessidade de políticas públicas de incentivo à parentalidade paterna.

Fatores associados a agravos agudos de saúde em prematuros / Factores asociados a problemas de salud agudos en prematuros / Factors Associated With Acute Health Problems In Premature Infants

Objetivo: analisar fatores neonatais e socioeconômicos associados ao desenvolvimento de agravos agudos de saúde de prematuros tardios e moderados no primeiro ano de vida. Método: estudo epidemiológico, longitudinal, em que foram acompanhados 151 prematuros (nascidos com idade gestacional de 32 a 37 semanas incompletas) durante o primeiro ano de vida. A coleta de dados ocorreu, trimensalmente, por meio de instrumento de caracterização com variáveis neonatais e socioeconômicas. O acompanhamento se deu por meio da utilização de formulários, aplicados via telefonema aos pais dos prematuros, para identificação dos agravos agudos de saúde. Os dados foram submetidos à estatística analítica com a aplicação da correlação de Pearson. Resultados: os agravos agudos apresentaram tendência linear ao longo do primeiro ano de vida. As afecções gastrointestinais foram mais frequentes nos primeiros meses, e a alergia de pele e as afecções respiratórias ocorreram mais frequentemente ao final do primeiro ano de vida. A vitalidade neonatal foi fator associado a maior intensidade de agravos agudos. Conclusão: a intensidade dos agravos agudos tem correlação significativa com fatores neonatais no primeiro trimestre de vida.(AU)

Objetivo:analizar los factores neonatales y socioeconómicos asociados al desarrollo de problemas de salud agudos en prematuros tardíos y moderados durante el primer año de vida. Método:estudio epidemiológico, longitudinal, en el que se siguieron 151 prematuros (nacidos con una edad gestacional de 32 a 37 semanas incompletas) durante el primer año de vida. La recolección de datos se realizó trimestralmente mediante un instrumento de caracterización con variables neonatales y socioeconómicas. El seguimiento se llevó a cabo mediante la utilización de formularios aplicados por teléfono a los padres de los prematuros, para la identificación de problemas de salud agudos. Los datos se sometieron a un análisis estadístico utilizando la correlación de Pearson. Resultados:los problemas de salud agudos mostraron una tendencia lineal a lo largo del primer año de vida. Las afecciones gastrointestinales fueron más frecuentes en los primeros meses, y las alergias cutáneas y las afecciones respiratorias ocurrieron más a menudo al final del primer año de vida. La vitalidad neonatal fue un factor asociado a una mayor intensidad de problemas de salud agudos. Conclusión:la intensidad de los problemas de salud agudos tiene una correlación significativa con factores neonatales en el primer trimestre de vida.(AU)

Objective: to analyze neonatal and socioeconomic factors associated with the development of acute health problems in late and moderate preterm infants in the first year of life. Method: longitudinal epidemiological study, in which 151 premature babies (born with a gestational age of 32 to 37 incomplete weeks) were followed during the first year of life. Data collection occurred, quarterly, using a characterization instrument with neonatal and socioeconomic variables. Monitoring took place using forms, applied via telephone call to parents of premature babies, to identify acute health problems. The data were subjected to analytical statistics using Pearson's correlation. Results: acute illnesses showed a linear trend throughout the first year of life. Gastrointestinal disorders were more frequent in the first months, and skin allergies and respiratory disorders occurred more frequently at the end of the first year of life. Neonatal vitality was a factor associated with greater intensity of acute illnesses. Conclusion: the intensity of acute illnesses has a significant correlation with neonatal factors in the first trimester of life.

Los colirios antibióticos acortan la duración de las conjuntivitis infecciosas en niños / Antibiotic eye drops shorten the duration of infectious conjunctivitis in children

Conclusiones de los autores del estudio: el tratamiento de la conjuntivitis infecciosa aguda en niños con antibióticos tópicos se asoció con una duración significativamente menor de la sintomatología conjuntival. Comentario de los revisores: el uso de antibiótico tópico, aunque de forma modesta, beneficia al paciente, acortando la curación clínica en las conjuntivitis agudas. No obstante, dado el curso autolimitado de esta patología y la falta de estudios de coste-efectividad en este ámbito, no parece justificada su indicación generalizada desde Atención Primaria. Se necesitarían realizar dichos estudios para evaluar el impacto global en la sociedad del tratamiento en estos pacientes. (AU)

Authors´ conclusions: topical antibiotics were associated with significantly shorter durations of conjunctival symptoms in children with acute infective conjunctivitis. Reviewers´ commentary: the use of topical antibiotics modestly benefits the patient, shortening the clinical cure in acute conjunctivitis. However, given the self-limited course of this pathology and the lack of cost-effectiveness studies in this area, its generalized prescription in primary care does not seem justified. Such studies should be carried out to assess the overall impact on society of the treatment of these patients. (AU)