Health-related quality of life among siblings of kidney transplant recipients.

Studies are increasingly recognizing health-related quality of life (HRQOL) as a key pediatric outcome in both clinical and research settings and an essential health outcome measure to assess the effectiveness of medical treatment. However, it has not yet been studied among the healthy siblings of kidney transplant recipients. The aim of this study, therefore, is to examine HRQOL among this population. We asked the following three groups to complete a validated measure of HRQOL among children (KIDSCREEN-52): siblings of children who had received kidney transplants (n = 50), kidney transplant recipients (n = 43), and a healthy control group (n = 84). We found that siblings of kidney transplant patients exhibited lower scores for financial resources and autonomy than kidney transplant recipients. They also served lower on physical well-being, financial resources, autonomy, and parent relations/home life than the control group. However, they scored higher on social acceptance than kidney transplant recipients. Our study underscores the importance of assessing HRQOL in families including a child diagnosed with a chronic illness. Siblings require social and psychological support to promote coping and adaptation.

Raynaud's phenomenon of the nipple during breastfeeding: A case series. / Fenómeno de Raynaud en el pezón durante la lactancia: serie de casos.

Raynaud's phenomenon consists of excessive contraction of the blood vessels in response to various stimuli; although it usually affects the extremities, other locations are less frequently involved. This study focused on describing the characteristics of a series of women with Raynaud's phenomenon of the nipple. Through medical record review and direct communication with patients, data from 12 women diagnosed with Raynaud's phenomenon of the nipple between 2016 and 2023 were collected and analyzed. The following variables were assessed: age, symptoms, triggering factors, treatment, and duration of symptoms. In this case series, Raynaud's phenomenon of the nipple in breastfeeding women was more common among primiparous women around 10 days after delivery; pain was severe and, in most cases, improved with local and/or drug treatment, and did not limit the duration of breastfeeding.

El fenómeno de Raynaud consiste en la contracción excesiva de los vasos sanguíneos en respuesta a diversos estímulos y, si bien suele comprometer las extremidades, existen otras localizaciones menos frecuentemente afectadas. Este trabajo se enfoca en describir las características de una serie de mujeres con fenómeno de Raynaud en el pezón. Mediante revisión de historias clínicas y comunicación directa con las pacientes, se recopilaron y analizaron los datos de 12 mujeres con Raynaud del pezón entre 2016 y 2023. Se evaluaron variables como edad, síntomas, desencadenantes, tratamientos y duración de los síntomas. En esta serie de casos, el fenómeno de Raynaud del pezón en mujeres lactantes se manifestó con mayor frecuencia en primigestas alrededor del décimo día posparto; el dolor fue intenso, en la mayoría mejoró con tratamientos locales y/o farmacológicos, y no limitó la duración de la lactancia materna.

Adolescents with eating disorders during the COVID-19 pandemic: Changes in social ties and healthcare modalities. / Adolescentes con trastornos de la conducta alimentaria durante la pandemia por COVID-19: cambios en vínculos sociales y modalidades de atención.

Introduction. The COVID-19 pandemic has had a profound impact on the health of young people worldwide, especially on people with eating disorders (EDs) due to the stress, anxiety, and changes experienced in access to health care. Objective. To explore adolescents' perceptions on changes in their social ties and the modalities of health care for patients with EDs. Population and methods. Qualitative study using in-depth interviews with adolescents with EDs seen at a teaching hospital during the COVID-19 pandemic. Results. Fifteen adolescents were interviewed; their mean age was 18 years; 93% were girls. Anorexia nervosa was observed in 86.6%. The most relevant negative aspects perceived were discomfort with family life (80%) and dissatisfaction with social media content regarding body image and dieting (73%). The aspects perceived as positive were peer support (66%) and improvements in eating habits (66%). The main change identified regarding the management before the COVID-19 pandemic was online followup by the mental healthcare team (73%). Conclusion. The adolescent population with EDs during the mandatory social isolation period reported discomfort with family life and dissatisfaction with social media content regarding body image and dieting. Notwithstanding this, adolescents highlighted peer support and improvements in their eating habits as positive aspects.

Introducción. La pandemia por COVID-19 ha tenido un impacto profundo en la salud de la población joven de todo el mundo y especialmente en personas con trastornos de la conducta alimentaria (TCA) por situaciones de estrés, ansiedad y cambios en el acceso a la atención médica. Objetivo. Explorar las percepciones de adolescentes sobre los cambios en sus vínculos sociales y modalidades de atención en pacientes con TCA. Población y métodos. Se realizó un estudio cualitativo a través de entrevistas en profundidad a adolescentes con TCA en un hospital universitario durante la pandemia por COVID-19. Resultados. Se entrevistó a 15 adolescentes; el 93 % fueron mujeres y la mediana de edad fue 18 años. El 86,6 % tuvo anorexia nerviosa. Los aspectos negativos percibidos más importantes fueron los malestares en la convivencia familiar (80 %) y la disconformidad con los contenidos de las redes sociales sobre la imagen corporal y dietas (73 %). Los aspectos percibidos positivos fueron la ayuda de los pares (66 %) y mejoras en relación con la alimentación (66 %). El principal cambio identificado en comparación con el tratamiento recibido previo a la pandemia por COVID-19 fue el seguimiento virtual por salud mental (73 %). Conclusión. La población adolescente con TCA durante el ASPO manifestó malestar en la convivencia familiar y disconformidad en los contenidos en redes sociales sobre imagen corporal y dietas. Aunque resaltaron como aspectos positivos la ayuda de los pares y mejoras en su alimentación.

Health-related quality of life in children with Down syndrome. / Calidad de vida relacionada con la salud en niños y niñas con síndrome de Down.

Introduction. The characteristics of patients with Down syndrome (DS) may affect their quality of life. The objective of this study was to assess the health-related quality of life (HRQoL) in patients with DS. Population and methods. This was a cross-sectional study to assess the HRQoL with the PedsQL 4.0 questionnaire administered to patients with DS and healthy patients aged 2 to 4 years in 2020-2021 at a teaching hospital. Results. Each study group included 51 patients. The HRQoL score in children with DS was 82.1 compared to 88 (p = 0.003) in the population without DS. Psychosocial health was impacted the most (p = 0.007), especially in terms of social and school functioning (p = 0.0001). Conclusion. Children with DS aged 2 to 4 years were observed to have a lower HRQoL. The psychosocial health scale was affected the most, especially in terms of social and school functioning.

Introducción. Los pacientes con síndrome de Down (SD) presentan características que pueden afectar su calidad de vida. El objetivo de este trabajo fue evaluar la calidad de vida relacionada con la salud (CVRS) en pacientes con síndrome de Down. Población y métodos. Se realizó un estudio de corte transversal para evaluar CVRS con el cuestionario PedsQL 4.0 a pacientes de 2 a 4 años con síndrome de Down y a pacientes sanos en 2020-2021 en un hospital universitario. Resultados. Se incluyeron 51 pacientes en cada grupo. El puntaje de CVRS en infantes con SD fue 82,1 vs. 88 (p = 0,003) comparado con población sin SD. La salud psicosocial fue la más afectada (p = 0,007), especialmente, en el funcionamiento social y el escolar (p = 0,0001). Conclusión. Se observó que los niños y niñas con SD de 2 a 4 años tuvieron menor CVRS. La escala de la salud psicosocial fue más afectada, especialmente, el funcionamiento social y el escolar.

Clinical characteristics and course of patients with Kawasaki disease at a general hospital. / Características clínicas y evolución de los pacientes con enfermedad de Kawasaki en un hospital general.

Kawasaki disease (KD) is considered the leading cause of acquired heart disease in children younger than 5 years. Our objective was to know the clinical characteristics, coronary involvement, and course of patients seen at our facility. A case series from 2001 to 2018 was reviewed. Sixty-three patients were included; their median age was 2.6 years; 58% were males. The median duration of fever at the time of diagnosis was 5.5 days. The incomplete form was observed in 33% and coronary involvement, in 20%. Among patients with coronary involvement, 60% had incomplete KD versus 28% among those without coronary involvement (p:0.06). No differences were observed between groups in laboratory data based on coronary involvement. To conclude, 33% had incomplete KD and 20%, coronary involvement. There was a trend to a higher risk for coronary artery damage in the incomplete form of KD.

La enfermedad de Kawasaki (EK) es la principal causa de cardiopatía adquirida en menores de cinco años. Nuestro objetivo fue conocer las características clínicas, el compromiso coronario y la evolución de pacientes atendidos en nuestra institución. Se revisó una serie de casos desde 2001 hasta 2018. Se incluyeron 63 pacientes, 58 % varones; la mediana de edad fue 2,6 años. La mediana de días de fiebre al diagnóstico fue 5,5 días. El 33 % presentó la forma incompleta y se detectó compromiso coronario en el 20 %. El 60 % de los pacientes con afectación coronaria presentaron EK incompleta versus el 28 % de presentación incompleta en los pacientes sin compromiso coronario (p 0,06). No se observaron diferencias en datos de laboratorio entre los grupos según el compromiso coronario. En conclusión, 33 % presentó EK incompleta y el 20 %, afectación coronaria. Hubo una tendencia de mayor riesgo para daño coronario en la forma incompleta.

Analysis of the incidence of central precocious puberty treated with gonadotropin-releasing hormone analogs. Impact of the COVID-19 pandemic. / Análisis de la incidencia de pubertad precoz central tratada con análogos de hormona liberadora de gonadotrofina. Impacto de la pandemia por COVID-19.

Introduction. Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, consultations of girls with idiopathic central precocious puberty (ICPP) increased in several countries, but there were no data from Argentina. This increase may be related to changes in lifestyle and stress levels resulting from the lockdown, which particularly affected the child population. Objectives. 1) To describe the progression of the incidence of ICPP requiring inhibition of the hypothalamic-pituitary-gonadal (HPG) axis in girls between 2010 and 2021 in a cohort from the Metropolitan Area of Buenos Aires. 2) To compare the characteristics of girls diagnosed with ICPP during the pandemic with those of a control group. Methods. Interrupted time-series and case-control study. Results. The annual incidence remained stable between 2010 and 2017. Since 2017, it increased to an average of 59.9% (95% CI: 18.6-115.5) and appears to have accelerated during the pandemic. We found an association between ICPP and requiring inhibitory treatment between June 1st, 2020 and May 31st, 2021 and 2 variables: maternal age at menarche (OR: 0.46, 95% CI: 0.28-0.77) and family history of ICPP (OR: 4.42, 95% CI: 1.16-16.86). Conclusion. We evidenced a significant increase in the incidence of ICPP with requirement of HPG axis inhibition since 2017. Increased exposure to various environmental triggers during the COVID-19 pandemic may have had a greater influence in girls with some genetic predisposition.

Introducción. Desde inicios de la pandemia por coronavirus 2019 (COVID-19), fue comunicado en varios países un incremento de las consultas de niñas con pubertad precoz central idiopática (PPCI), sin que contáramos con datos argentinos. Este aumento estaría vinculado con los cambios en el estilo de vida y los niveles de estrés resultantes del aislamiento que afectó particularmente a la población infantil. Objetivos. 1) Describir la evolución de la incidencia de PPCI con requerimiento de inhibición del eje hipotálamo-hipófiso-gonadal (EHHG) en niñas entre 2010 y 2021 en una cohorte del Área Metropolitana de Buenos Aires. 2) Comparar las características de las niñas, con dicho diagnóstico realizado durante la pandemia, con las de un grupo control. Métodos. Serie de tiempo interrumpida y estudio de casos y controles. Resultados. La incidencia anual fue estable entre 2010 y 2017. Desde 2017 hubo un ascenso anual que promedió el 59,9 % (IC95 % 18,6-115,5) y pareciera haberse acelerado durante la pandemia. Constatamos asociación entre haber desarrollado PPCI y haber requerido tratamiento inhibitorio entre el 01 de junio de 2020 y el 31 de mayo de 2021, y dos variables: edad de menarca materna (OR 0,46; IC95 % 0,28-0,77) y antecedente familiar de PPCI (OR 4,42; IC95 % 1,16-16,86). Conclusión. Evidenciamos desde 2017 un aumento significativo en la incidencia de PPCI con requerimiento de inhibición del EHHG. El incremento en la exposición a diversos desencadenantes ambientales durante la pandemia por COVID-19 podría haber ejercido mayor influencia en las niñas con alguna predisposición genética.

Juvenile scoliosis as the first manifestation of syringomyelia associated with Chiari malformation type I.

BACKGROUND: Scoliosis is a spinal deformity that usually manifests as a structural curve determining a variable deformity of the trunk. According to some published series, 4 to 26% of scoliosis initially classified as idiopathic show neurological alterations when studied with nuclear magnetic resonance, such as syringomyelia and Chiari malformation, among the most frequent. Chiari malformations are characterized by descending herniation of the cerebellar tonsils, brainstem, and IV ventricle into the spinal canal. CASE REPORT: We present the case of a patient whose first symptomatic manifestation was early-onset scoliosis. The overlapping of some physical examination signs, such as postural lateralization and scoliosis, reinforced the active suspicion of neuroaxis alterations. CONCLUSIONS: Early childhood-onset scoliosis should raise a high degree of suspicion for association with neuro-spinal diseases. Although the frequency of Chiari malformation is low, its early approach could reduce the progression of associated comorbidities. An early detection could change the prognosis of the disease.

INTRODUCCIÓN: La escoliosis es una deformidad de la columna que usualmente se manifiesta como una curva estructural que determina una deformidad variable del tronco. Las malformaciones de Chiari se caracterizan por la herniación descendente de las amígdalas cerebelosas, tronco encefálico y IV ventrículo hacia el canal espinal. Según algunas series publicadas, del 4 al 26% de las escoliosis inicialmente catalogadas como idiopáticas muestran alteraciones neurológicas al ser estudiadas con resonancia magnética nuclear, como la siringomielia y malformación de Chiari, dentro de las más frecuentes. CASO CLÍNICO: Se presenta el caso de un paciente cuya primera manifestación sintomática fue escoliosis de comienzo temprano. El solapamiento de algunos signos del examen físico, como la lateralización de la postura y la escoliosis, reforzaron la sospecha activa de alteraciones del neuroeje. CONCLUSIONES: La escoliosis de inicio temprano en la infancia debe despertar un alto grado de sospecha de asociación con enfermedades neuro-espinales. Dentro de este contexto, aunque malformación Chiari es de baja frecuencia, su abordaje precoz permitiría disminuir la progresión de comorbilidades asociadas. La detección temprana podría cambiar el pronóstico de la enfermedad.

Autonomy in entrustable professional activities after the COVID-19 pandemic: the perspectives of residents and teachers. / Autonomía en actividades profesionales confiables luego de la pandemia por COVID-19: perspectivas de residentes y docentes.

Introduction. The entrustable professional activities (EPAs) are 13 activities that new medical graduates should be able to perform without direct supervision. Our objective was to assess the perceptions of residents and teachers regarding their autonomy to perform the EPAs 2 years after the onset of the COVID-19 pandemic. Materials and methods. Cross-sectional study of first-year residents of clinical and surgical specialties and their teachers. Electronic, anonymous questionnaires were used. Results. Subjects were 31 residents and 20 teachers. Most residents believed that they were able to perform 8 of the 13 EPAs independently. According to most teachers, residents required direct supervision to perform 11 of the 13 EPAs. Significant differences were observed between residents' and teachers' perceptions in 8 of the 13 EPAs. Conclusion. The perception of autonomy to perform the EPAs in the beginning of the residency program was considerably better among residents than their teachers.

Introducción. Las actividades profesionales confiables (APROC) son 13 actividades que los médicos recién graduados deberían poder realizar sin supervisión directa. Nuestro objetivo fue evaluar la percepción de residentes y docentes acerca de la autonomía para realizar las APROC, luego de 2 años del inicio de la pandemia. Materiales y métodos. Estudio de corte transversal, que incluyó residentes de primer año de especialidades clínicas y quirúrgicas, y sus docentes. Se enviaron cuestionarios electrónicos y anónimos. Resultados. Se incluyeron 31 residentes y 20 docentes. La mayoría de los residentes creía que podía realizar en forma autónoma 8 de las 13 APROC. Para la mayoría de los docentes, los residentes requerían supervisión directa para 11 de las 13 actividades. Se observaron diferencias significativas entre la percepción de residentes y docentes en 8 de las 13 APROC. Conclusión. La percepción de autonomía para realizar las APROC al inicio de la residencia fue considerablemente mayor en residentes que en sus docentes.

Canalization of growth between 2 and 5 years of age in apparently healthy children with short stature at age 2 years. / Canalización del crecimiento entre los 2 y los 5 años en niños aparentemente sanos con talla baja a los 2 años.

Introduction. Newborn size is associated with intrauterine conditions. Genetic potential is expressed later; the canalization of growth is typically described up to 24 months of age. Objective. To describe the canalization of growth between 2 and 5 years of age in apparently healthy children with short stature at age 2 years. Population and methods. Retrospective, cohort study. Children seen at a community teaching hospital between 2003 and 2019, who had a Z-score for height below -2 SDs for age and sex at age 2 years were included. Infants born preterm, with a low birth weight, and chronic conditions were excluded. Growth patterns were assessed. Canalization was defined as reaching a normal stature for the general population. Results. Sixty-four children were included; 37 (58%) showed canalization of growth at 5 years old (20 at 3 years, 8 at 4 years, and 9 at 5 years). The growth rate at 3 and 5 years of age was significantly higher among those who showed canalization compared to those who did not; a similar trend was observed at 4 years of age. Among 27 children with short stature at 5 years of age, 25 had at least 1 annual growth velocity below the 25th centile. Conclusions. Most apparently healthy children with short stature at 2 years old reached a normal stature at 5 years old. The annual growth velocity allows to detect children at risk of not showing canalization.

Introducción. El tamaño del recién nacido se asocia a condiciones intrauterinas. El potencial genético se expresa más tarde; la canalización del crecimiento se describe clásicamente hasta los 24 meses. Objetivo. Describir la canalización del crecimiento entre los 2 y los 5 años en niños aparentemente sanos con talla baja a los 2 años. Población y métodos. Estudio de cohorte retrospectiva. Se incluyeron niños seguidos en un hospital universitario de comunidad entre 2003 y 2019, con puntaje Z de talla menor a -2 DE para edad y sexo a los 2 años. Se excluyeron los nacidos prematuros, con bajo peso y con enfermedades crónicas. Se evaluó la trayectoria de crecimiento. Se definió canalización como la adquisición de talla normal para la población general. Resultados. Se incluyeron 64 niños, de los cuales 37 (58 %) presentaron canalización del crecimiento a los 5 años (20 a los 3 años, 8 a los 4 años, y 9 a los 5 años). La velocidad de crecimiento a los 3 y a los 5 años fue significativamente mayor en los que canalizaron en comparación con los que no lo hicieron; hubo una tendencia similar a los 4 años. De los 27 niños con talla baja a los 5 años, 25 tuvieron al menos un registro de velocidad de crecimiento anual menor al percentil 25. Conclusiones. La mayoría de los niños aparentemente sanos con baja talla a los 2 años alcanzan una talla normal a los 5 años. La velocidad de crecimiento anual permite detectar a los niños con riesgo de no canalizar.

To improve postgraduate training: medical residents' input in residency quality improvement.

INTRODUCTION: The "Open Space Technology" (OST) is an innovative group process introduced by Harrison Owen in 1997. There is some evidence for its effectiveness in education quality improvement. However, its application in higher education has not been reported. Our objective was to apply a modified OST as a quality improvement tool in a postgraduate training quality improvement program at a university hospital in Argentina. METHODS: OST is a method in which a program's participants propose and discuss topics of their interest with an aim that had been defined for them by coordinators. After proposing and writing down themes important to improving the quality of their postgraduate training, residents were divided into small groups to discuss the suggested topics for 90 minutes. They then reconvened in the large group and presented the conclusions of their small group discussions. RESULTS: Thirty-six percent of residents (75/208) participated in one of the two OST sessions. Topics suggested by participants were similar in both sessions: (1) work hours, (2) work conditions, (3) residency curriculum, (4) residents' duties, (5) salaries, (6) professional burnout, (7) patient care load, and (8) interdisciplinary activities. DISCUSSION: In only four hours, residents were able to share their concerns and proposals for improving the quality of their residencies with their faculty. Most of the topics they suggested were subsequently included in the program's quality improvement agenda.

[Learning conditions in health team residences during the COVID-19 pandemic, Argentina 2020]. / Condiciones del aprendizaje en las residencias del equipo de salud durante la pandemia COVID-19, Argentina 2020.

COVID-19 pandemic modified learning conditions in health professions' residences. The objective of the research was to explore Argentinian residents' perceptions regarding training conditions during the first year of pandemic. A descriptive, quali-quantitative study was developed through an online, anonymous questionnaire, with 42 items: 17 closed options and 25 Likert scale from 1 to 5; and 2 open questions. Sampling was intentional and non-probabilistic. The questionnaire was answered by 1595 residents, 74% were physicians, 47.1% belonged to clinical specialties and 21.8% worked on the front line of care. A 77.2% worked in the public sector and 89.4% in hospital practice, 42.1% assumed tasks not typical of their specialty. They agreed on the availability of personal protection and supplies (mean 3.8 ± 1.3), reduction of lectures (mean 3.5 ± 1.6), procedures (mean 3.8 ± 1.4) and rotations (mean 3.7 ± 1.2). They concurred on the need to extend training to recover learning (mean 3 ± 1.6). The decrease in practices was associated with surgical specialties (p = 0.0001) and not practicing in the front line of care (p = 0.007). They perceived as positive aspects the chance to strengthen bonds between residents and closeness with relatives, and negative aspects the effects on health due to stress and social distancing. In conclusion, the general conditions of training were affected. This leads to rethink the teaching and assessment curricular alternatives, as well as interventions related to the well-being of the residents.

La pandemia COVID-19 afectó las condiciones de aprendizaje en las residencias del equipo de salud. El objetivo fue explorar las percepciones de residentes de Argentina sobre las condiciones generales de su formación en este contexto. Se realizó un estudio descriptivo, cuali-cuantitativo, a través de un cuestionario en línea, anónimo, con 17 ítems de opciones cerradas y 25 con escala de Likert de 1 a 5, con un muestreo no probabilístico e intencional. Respondieron 1595 residentes, 74% médicos, 47.1% pertenecía a una especialidad clínica y 21.8% a la primera línea de atención. El 77.2% se desempeñó en residencias públicas y el 89.4% en el ámbito hospitalario. El 42.1% asumió tareas no propias de su especialidad. Hubo acuerdo sobre la disponibilidad de insumos y protección personal (media 3.8 ± 1.3), la afectación de clases y conferencias (media 3.5 ± 1.6), procedimientos (media 3.8 ± 1.4) y rotaciones (media 3.7 ± 1.2). Asimismo, sobre prorrogar la formación para recuperar aprendizajes (media 3 ± 1.6). La disminución de prácticas se asoció a especialidades quirúrgicas (p = 0.0001) y no estar en la primera línea de atención (p = 0.007). Percibieron positivamente el fortalecimiento de vínculos entre residentes y con familiares, y negativos los efectos en la salud por estrés y distanciamiento social. En conclusión, las condiciones generales de la formación se vieron afectadas. Esto conduce a pensar tanto en la necesidad de alternativas curriculares de enseñanza y evaluación, como en intervenciones vinculadas al bienestar de los residentes.

Exploration of gender perceptions among adolescents. / Exploración de las percepciones de género en adolescentes.

INTRODUCTION: Gender expression and sexual identity are not always the same as the sex assigned at birth. Our objective was to explore gender perceptions among adolescents who attended a teaching hospital in the Autonomous City of Buenos Aires. MATERIAL AND METHODS: This was a cross-sectional study. An anonymous survey was administered to patients aged 13-20 years at the waiting room of the outpatient adolescent clinic between April and December 2019. RESULTS: A total of 834adolescents completed the survey; their average age was 16.3 ± 2.3 years. Among them, 3.3% (2.9% females and 4.3% males) perceived their gender identity as different from their sex assigned at birth; 26% perceived their sexual orientation was not heteronormative; almost 10% experienced discrimination due to their sexual orientation; and this was associated with a non-heteronormative sexual orientation (p < 0.0001). Female adolescents kissed same sex persons on the mouth more often than male adolescents: 44.8% versus 19% (p < 0.0001). CONCLUSIONS: In this population of adolescents, 3.3% perceived their gender identity was different from their sex assigned at birth and 26% had a non-heteronormative sexual orientation.

Introducción. La expresión del género y la identidad sexual no siempre coinciden con el sexo asignado al nacer. Nos propusimos como objetivo explorar las percepciones de género en adolescentes que consultaron en un hospital universitario de la comunidad. Población y métodos. Se diseñó un estudio de corte transversal. Se realizó una encuesta anónima en la sala de espera a los pacientes de 13 a 20 años que se atendieron en los consultorios externos de adolescencia entre abril y diciembre del 2019. Resultados. Respondieron la encuesta 834 adolescentes y el promedio de edad de los encuestados fue de 16,3 ± 2,3 años. El 3,3 % de los adolescentes (2,9 % mujeres y 4,3 % varones) se percibieron con una identidad de género diferente a su sexo de nacimiento. El 26 % no percibió su orientación sexual en términos heteronormativos, casi el 10 % se sintió discriminado por su orientación sexual, y esto estuvo asociado a la orientación sexual no heteronormativa (p< 0,0001). Las adolescentes mujeres besaron en la boca a personas del mismo sexo en mayor medida que los varones, 44,8 % versus 19 % (p<0,0001). Conclusiones. El 3,3 % de la población adolescente se percibió con una identidad de género diferente al sexo de nacimiento y el 26 % tuvo una orientación sexual no heteronormativa.

Virtual interviews for admission to health care residency programs during the COVID-19 pandemic. / Entrevistas virtuales para el ingreso a residencias de profesionales de la salud durante la pandemia por COVID-19.

INTRODUCTION: The COVID-19 pandemic forced residency programs to adapt their selection processes. Our objective was to describe the experience of virtual interviews conducted to select residents through applicants' perception. POPULATION AND METHODS: An electronic questionnaire was sent to health care residency applicants after their interviews conducted in 2020. RESULTS: Two-hundred and twenty-one questionnaires were collected and the average distance to the facility was 163 km. Also, 67.9% of the applicants used a personal computer, 98.2% felt that they were treated appropriately, 77.8% were able to state their ideas, and 12.2% reported technical difficulties. In addition, 32.6% said that they would prefer virtual interviews for future selection processes and 17.6%, that it would be irrelevant. CONCLUSIONS: Virtual interviews allowed the resident selection process to be completed; one third of applicants would prefer virtual interviews in the future and there were no apparent technological limitations.

Introducción. La pandemia por COVID-19 obligó a los sistemas de residencias a adaptar sus procesos de selección. Nuestro objetivo fue describir la experiencia de virtualización de las entrevistas de selección de residentes a través de la percepción de las personas aspirantes. Población y métodos. Se envió un cuestionario electrónico a las personas aspirantes de residencias para profesionales de la salud luego de las entrevistas en 2020. Resultados. Se obtuvieron 221 respuestas y la distancia promedio a la institución fue 163 km. El 67,9 % de los aspirantes utilizaron computadora personal; el 98,2 % percibió un trato apropiado; el 77,8 % pudo expresar sus ideas, y el 12,2 % manifestó dificultades técnicas. El 32,6 % refirió que, para próximos procesos de selección, preferiría entrevistas virtuales y al 17,6 % le sería indistinto. Conclusiones. Las entrevistas virtuales permitieron completar el proceso de selección de residentes; un tercio preferiría entrevistas virtuales en el futuro y no hubo limitaciones tecnológicas evidentes.

Adolescent behaviors during the preventive and mandatory social isolation in Argentina in 2020. / Conductas adolescentes durante el aislamiento social, preventivo y obligatorio en Argentina en el año 2020.

INTRODUCTION: In March 2020, Argentina established a preventive and mandatory social isolation policy (ASPO, for its acronym in Spanish) due to the COVID-19 pandemic. OBJECTIVE: To explore the behaviors and habits of the adolescent population during the ASPO and the extent of compliance. POPULATION AND METHODS: Qualitative and quantitative, cross sectional study in Argentine adolescents aged 12-20 years. An anonymous, semi-structured questionnaire was administered during epidemiological weeks 34 to 36. RESULTS: A total of 1535 questionnaires were analyzed. Participants' average age was 16 years; 72% were females. Non-compliance with the ASPO during the first 3 months was 27% versus 59% during the past month. A good to excellent family environment was described by 73%, and 87% performed educational activities. The average non-educational screen time was 6.8 hours per day. Results. A total of 1535 questionnaires were analyzed. Participants' average age was 16 years; 72% were females. Non-compliance with the ASPO during the first 3 months was 27% versus 59% during the past month. A good to excellent family environment was described by 73%, and 87% performed educational activities. The average non-educational screen time was 6.8 hours per day. CONCLUSIONS: Most adolescents maintained their educational activities, spent a lot of noneducational screen time, and referred a low drug use. Adherence to the ASPO decreased progressively over time. The main positive aspects were strengthening family bonds and discovering or returning to activities; whereas negative aspects were emotional distress and not being able to see family members or friends.

Introducción. En marzo de 2020 comenzó en Argentina el aislamiento social, preventivo y obligatorio (ASPO) debido a la pandemia por COVID-19. Objetivo. Explorar las conductas y hábitos de la población adolescente durante el ASPO y su grado de acatamiento. Población y métodos. Estudio cualicuantitativo de corte transversal en adolescentes de Argentina entre 12 y 20 años. Se envió un cuestionario semiestructurado anónimo durante las semanas epidemiológicas 34 a 36. Resultados. Se analizaron 1535 cuestionarios. La edad promedio fue 16 años, el 72 % de sexo femenino. El incumplimiento del ASPO durante los primeros 3 meses fue del 27 % frente el 59 % durante el último mes. El 73 % refirió un clima familiar bueno a excelente y el 87 % realizó actividades educativas. El tiempo promedio de pantallas sin fines educativos fue de 6,8 horas por día. INTRODUCCIÓN El adolescente, como sujeto social, participa de un mundo de relaciones primarias y secundarias que lo contienen, afectan y transforman. Durante la adolescencia, los seres humanos experimentamos una serie de cambios físicos, psicológicos y sociales, conocidos como crisis de la adolescencia, una crisis vital y normativa. Cualquier otra crisis que aparezca en ese momento afectará la búsqueda de independencia y de interacción social característica de esta etapa.1 El 70 % manifestó que no consumió drogas durante el último mes. Describieron como aspectos positivos: afianzar vínculos familiares (34 %) y descubrir o retomar actividades (20 %); y como negativos: malestares emocionales (23 %) y no ver a la familia o a los amigos (21 %). a. Sección de Adolescencia, Servicio de Clínica Pediátrica, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina. Correspondencia: Alfredo Eymann: alfredo.eymann@ hospitalitaliano.org.ar Financiamiento: Ninguno. Conflicto de intereses: Ninguno que declarar. Recibido: 31-5-2021 Aceptado: 26-8-2021 Conclusiones. La mayoría de los adolescentes mantuvo actividades educativas, estuvo un elevado tiempo en pantallas sin fines educativos y refirió un bajo consumo de drogas. El cumplimiento del ASPO fue decreciendo a lo largo del tiempo. Los principales aspectos positivos fueron afianzar vínculos familiares y descubrir o retomar actividades, y los negativos, malestares emocionales y no poder ver a la familia o a los amigos.

Mismatch between the prevalence of overweight and obese children and adolescents and recording in electronic health records: a cross-sectional study.

BACKGROUND: The prevalence of obesity has increased dramatically in recent years. An electronic health record (EHR) can be used to identify and manage overweight and obesity by providing timely information. OBJECTIVE: To estimate the prevalence of overweight and obesity using anthropometric data from an EHR and to compare it with the frequency of diagnoses of 'overweight' and 'obesity' registered by pediatricians. METHODS: Cross-sectional, descriptive analytical study from a sample of records from children aged between 2 and 19 years who had at least one well-child visit registered in the EHR over the 24-month period between 2007 and 2008. The record of a diagnosis of overweight or obesity by physicians was compared with estimations based on body mass index (BMI; World Health Organization Growth Reference Data). RESULTS: Of 14 743 patients aged 2-19 years, 22.1% were overweight and 9.8% were obese. By contrast, a diagnosis of overweight was registered in the EHR for 3.3% of patients, with a figure of 1.1% for obesity. The prevalence of overweight/obesity was lower in adolescents than in children and preschoolers. Based on BMI cut-off points, we found that only 11.5% of the overweight or obese patients had these diagnoses registered in the EHR. Referral to a nutritionist or endocrinolist, and the frequency of selected laboratory tests based on BMI categories vary between 11.8 and 52.5%. CONCLUSION: An EHR can contribute to the identification of a population at risk when there is a sub-registry of these diagnoses by primary care physicians.

Current impact and future consequences of the pandemic on children's and adolescents' health. / Impacto presente y consecuencias futuras de la pandemia en la salud de niños, niñas y adolescentes.

There is plenty bibliography about the impact of the coronavirus disease 2019 (COVID-19) pandemic on the mental and social health of children, adolescents, and youth. A very high percentage of this population developed emotional symptoms and their levels of anxiety, depression, and suicidal ideation increased considerably. The adults who were responsible for generating a support network were impacted and suffered emotional symptoms and job and economic uncertainty. In many children, without a supportive context, exposure to adverse experiences increased, so the pandemic may be considered an adverse experience itself. The future effect of such unfavorable experience on childhood and how family and social support may help to reduce stress through the development of resilience were reviewed. As citizens and health care providers, our responsibility is to reflect, discuss, and develop strategies to mitigate such damage that may have severe consequences on the mental and physical health of children and adults.

Existe abundante bibliografía relacionada con el impacto de la pandemia de la enfermedad por el coronavirus 2019 (COVID-19) en la salud mental y social de niños, niñas, adolescentes y jóvenes. Un altísimo porcentaje de esta población tuvo síntomas emocionales y el nivel de ansiedad, depresión y pensamientos suicidas aumentaron considerablemente. Los adultos responsables de generar una red de soporte sufrieron el impacto con síntomas emocionales, inseguridad laboral y económica. En muchos niños, sin un entorno contenedor, aumentó la exposición a experiencias adversas, por lo que la pandemia puede considerarse como una experiencia adversa en sí misma. Se revisó el efecto a futuro de estas experiencias desfavorables en la infancia y cómo, con adecuado soporte familiar y social, podría disminuirse la sensibilidad al estrés generando mecanismos de resiliencia. La responsabilidad como ciudadanos y profesionales de la salud es reflexionar, discutir y desarrollar estrategias para mitigar estos daños que pueden tener graves consecuencias en la salud mental y física durante la niñez y la adultez.

[Remote presentation of thesis and final postgraduate works during the COVID-19 pandemic. Are there advantages in the non-face-to-face presentations?] / Presentación a distancia de tesis y trabajos finales de Posgrado durante la pandemia COVID-19.

Introduction: The COVID-19 pandemic limited in person presentation of final works and theses for the completion of specializations, masters and doctorates. Objective: To describe the experience in remote presentations of summative essays and thesis. Materials and methods: A qualitative-quantitative cross-sectional study was carried out. Perceptions of graduates and examiner board members were explored through a questionnaire. Results: 54 presentations were included: 53.7% specializations, 40.7% masters and 5.6% doctorates. The average audience number was 34 and distance to the university was 273.6 km. 116 professionals answered: graduates 28.4% and examiner board members 71.6%. They were female gender in 51.5% and 36.1%, respectively. 100% of graduates and 96.3% of examiner board members believed that they were able to present the results of the investigation, and only 3% and 7.3%, respectively, reported technical difficulties. Positive aspects identified by graduates were higher comfort (45.5%), and greater audience number (36.4%); while the examiner board members identified preventing transportation (37,8%) and taking advantage of technologies (35,4%). Graduates identified as negative aspects audience invisibility (33.3%), and potential threat of technical difficulties (27.3%); whilst the examiner board members identified none (31,7%), and potential threat of technical difficulties (20,7%). Conclusion: Remote presentations were successful for graduates and examiner board members, and allowed to continue and finish academic postgraduate training.

Introducción: La pandemia por COVID-19 limitó la presentación de trabajos finales y tesis para la finalización de especializaciones, maestrías y doctorado en forma presencial. Objetivo: Describir la experiencia en presentaciones a distancia de trabajos finales integradores y tesis. Materiales y métodos: Estudio cuali-cuantitativo de corte transversal. Se exploraron las percepciones de los graduados y jurados mediante un cuestionario. Resultados: Se incluyeron 54 presentaciones: 53,7% especializaciones, 40,7% maestrías y 5,6% doctorados. El promedio de audiencia fue de 34 personas y la distancia a la universidad fue 273,6 km. Respondieron 116 profesionales: graduados 28,4% y jurados 71,6%. Entre ellos 51,5% y 36,1% eran de género femenino, respectivamente. El 100% de los graduados y el 96,3% de los jurados opinaron que pudieron exponer los resultados de la investigación y solo el 3% y 7,3% respectivamente expresó que existieron dificultades técnicas. Los aspectos positivos identificados por los graduados fueron mayor comodidad (45,5%) y mayor número de audiencia (36,4%); mientras que los jurados identificaron evitar traslados (37,8%) y aprovechamiento de tecnologías (35,4%). Los graduados identificaron como aspectos negativos la invisibilidad de la audiencia (33,3%) y potenciales dificultades técnicas (27,3%); mientras que los jurados no identificaron ninguno (31,7%) y potenciales de dificultades técnicas (20,7%). Conclusión: La modalidad de presentaciones a distancia fue satisfactoria tanto para los graduados como para los jurados y permitió dar continuidad y completar el proceso educativo de las carreras de posgrado.

[Treatment of eating disorders in adolescents: case series]. / Evolución y tratamiento de los trastornos de la conducta alimentaria en adolescentes: serie de casos.

Eating disorders are highly prevalent diseases in adolescence and have an impact on overall health. The objective was to describe the evolution and treatment of eating disorders in adolescents. Adolescents under 18 years of age with at least 6 months of follow-up and treated by an interdisciplinary team were studied. Forty one adolescents were included, 23 presented anorexia nervosa, 9 unspecified eating disorders, 7 bulimia nervosa and 2 binge eating disorders. Thirty five percent of patients with anorexia nervosa required hospitalization for complications of malnutrition. Sixty nine percent of the patients with anorexia nervosa, 57 % with bulimia nervosa, and 78 % with unspecified eating disorders had total or partial remission and there were no deceased patients. The majority presented a favorable evolution with the treatment.

Los trastornos de la conducta alimentaria son enfermedades de elevada prevalencia en la adolescencia y tienen repercusión en la salud integral. El objetivo fue describir su evolución y tratamiento en un grupo de adolescentes. Se estudiaron adolescentes menores de 18 años con al menos 6 meses de seguimiento y tratados por un equipo interdisciplinario. Se incluyeron 41 adolescentes: 23 presentaron anorexia nerviosa; 9, trastornos alimentarios no especificados; 7, bulimia nerviosa y 2, trastorno por atracones. El 35 % de pacientes con anorexia nerviosa requirió internación por complicaciones de la desnutrición. El 69 % de las pacientes con anorexia nerviosa, el 57 % de quienes tenían bulimia nerviosa y el 78 % de quienes tenían un trastorno alimentario no especificado presentaron remisión total o parcial, y no hubo pacientes fallecidos. La mayoría presentó una evolución favorable con el tratamiento.

Quality of life in pediatric liver transplantation in a single-center in South America.

HRQOL in children after LT has not been systematically measured in transplant recipients from South American countries. The aim of this study was to determine the HRQOL using a validated measure for children. The CHQOL-PF50 was completed by the parents of 54 patients after the clinical assessment. Subscale mean scores were compared with both a normal population (n = 274) and a group of chronic illness patients with Juvenile Idiopathic Arthritis (n = 23). Compared with the normal population, LT recipients had lower subscales scores for general health perceptions, role/social emotional, mental health, and parental impact on time. Bodily pain was significantly lower in our study group. Both mean physical and psychosocial summary scores were lower compared to the normal population but similar to the JIA group. Within the LT population, gender, original diagnosis, type of immunosuppression, type of transplant and time elapsed since LT did not significantly influence any of the summary scores. Our study showed LT children's physical and psycho-social areas were lower compared with those of the general population. LT children had less limitations due to pain. Family functioning appeared normal.

Benign transient hyperphosphatasemia of infancy. A common benign scenario, a big concern for a pediatrician.

Benign transient hyperphosphatasemia of infancy (BTH) is a condition characterized by disproportionately high levels of serum alkaline phosphatase (SAP). We report 4 cases of healthy patients with an elevated SAP. The mean age of the patients was 33 (14-52) months, with three females and one male. All children had a normal physical exam and anthropometric measures. The maximum values of serum alkaline phosphatase recorded in the 4 patients were: 11900, 6500, 9700 and 7600 UI/L respectively, with the rest of the laboratory exams and diagnostic images being normal. The clinical course of all the patients was favourable and no patient presented signs of symptoms of illness. Blood was drawn on 6 occasions in patients 1 and 5 occasions in the rest. Benign transient hyperphosphatasemia of infancy was diagnosed. It is important to know the characteristics of this condition to order the necessary amount of complementary studies.