Omar E Naveda Romero, Andrea Fabiola Naveda Meléndez, Rafael José Meléndez Freitez
Introduction: severe burns may involve all organs and tissues of the human body, leading to a series of pathophysiological processes and even death. Objective: To determine risk factors for mortality in major burns children. Methods: a retrospective cross-sectional study was conducted in the Hospital Universitario de Pediatria "Dr. Agustin Zubillaga (Barquisimeto, Lara State, Venezuela) between 2010 to 2019. Results: a total of 116 children with major burns were included in the analysis. The mortality rate was 27.6 %. The factors associated with mortality were total burned surface area more than 35 %, burn full-thickness, mechanisms: flame, inhalation injury, weight loss during hospitalization greater than 15 %, and five or more red blood cell transfusions (RBCT). Through binary logistic regression was identified as predictors for mortality in major burn children: burn full-thickness (OR=11.736; CI-95%: 1.138 – 121.074; p = 0.039) and weight loss during hospitalization greater than 15 % (OR=22,257; CI-95 %: 2.783 - 178.024; p = 0.003). A significant increase in the risk of mortality among burn children according to five or more RBCT (p = 0.049) was observed as per the Kaplan-Meier method. Conclusions: Burn full thickness and weight loss during hospitalization greater than 15 % were identified as independent variables related to mortality in major burn children.
{"title":"Factores de riesgo para mortalidad en el niño gran quemado","authors":"Omar E Naveda Romero, Andrea Fabiola Naveda Meléndez, Rafael José Meléndez Freitez","doi":"10.14295/RP.V53I3.225","DOIUrl":"https://doi.org/10.14295/RP.V53I3.225","url":null,"abstract":"Introduction: severe burns may involve all organs and tissues of the human body, leading to a series of pathophysiological processes and even death. Objective: To determine risk factors for mortality in major burns children. Methods: a retrospective cross-sectional study was conducted in the Hospital Universitario de Pediatria \"Dr. Agustin Zubillaga (Barquisimeto, Lara State, Venezuela) between 2010 to 2019. Results: a total of 116 children with major burns were included in the analysis. The mortality rate was 27.6 %. The factors associated with mortality were total burned surface area more than 35 %, burn full-thickness, mechanisms: flame, inhalation injury, weight loss during hospitalization greater than 15 %, and five or more red blood cell transfusions (RBCT). Through binary logistic regression was identified as predictors for mortality in major burn children: burn full-thickness (OR=11.736; CI-95%: 1.138 – 121.074; p = 0.039) and weight loss during hospitalization greater than 15 % (OR=22,257; CI-95 %: 2.783 - 178.024; p = 0.003). A significant increase in the risk of mortality among burn children according to five or more RBCT (p = 0.049) was observed as per the Kaplan-Meier method. Conclusions: Burn full thickness and weight loss during hospitalization greater than 15 % were identified as independent variables related to mortality in major burn children.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73479474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Janneth Consuelo Parra García, Paola Andrea Roldán Tique, María Paula Torres Nossa
Introduction: The COVID-19 pandemic impacts the economy, health systems, education, domestic violence, and mental health, among others. Consequently, the most vulnerable populations will be affected, including the pediatric population and those under five years of age. Objective: to know some social determinants of health that were altered before the pandemic and how they have been affected by the current public health situation. Methods: a narrative bibliographic review. A review of the literature was carried out through PubMed and directly in search engines such as Google and Safari, where information was obtained from international organizations in the period 2016-2020. Results: We selected 31 articles from international organizations that evaluate the impact that the COVID-19 pandemic in the pediatric population. Conclusions: the COVID-19 pandemic affects the pediatric population with direct consequences on the social determinants of health and poses new challenges in pediatrics beyond the disease's morbidity and mortality. Globalized interdisciplinary care is needed to positively impact physical and mental health, education, and violence prevention, contributing to this population's integral development.
{"title":"Impacto oculto de la pandemia por SARS-CoV-2, un reto en pediatría","authors":"Janneth Consuelo Parra García, Paola Andrea Roldán Tique, María Paula Torres Nossa","doi":"10.14295/RP.V53I3.247","DOIUrl":"https://doi.org/10.14295/RP.V53I3.247","url":null,"abstract":"Introduction: The COVID-19 pandemic impacts the economy, health systems, education, domestic violence, and mental health, among others. Consequently, the most vulnerable populations will be affected, including the pediatric population and those under five years of age. Objective: to know some social determinants of health that were altered before the pandemic and how they have been affected by the current public health situation. Methods: a narrative bibliographic review. A review of the literature was carried out through PubMed and directly in search engines such as Google and Safari, where information was obtained from international organizations in the period 2016-2020. Results: We selected 31 articles from international organizations that evaluate the impact that the COVID-19 pandemic in the pediatric population. Conclusions: the COVID-19 pandemic affects the pediatric population with direct consequences on the social determinants of health and poses new challenges in pediatrics beyond the disease's morbidity and mortality. Globalized interdisciplinary care is needed to positively impact physical and mental health, education, and violence prevention, contributing to this population's integral development.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89445019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carlos Ernesto Bolaños-Almeida, L. Saldaña, Laura Victoria Guio Mahecha
In Colombia, with the current COVID-19 pandemic, some sleep units suspended the performance of sleep studies in the pediatric population due to the potential contagion and spread. According to the competent authorities, since June 2020, Colombia is in the mitigation phase of COVID-19, and the mandatory prevention measures implemented by the Colombian government such as frequent hand washing, the use of masks in public places, the physical and social distancing, and the confinement of most of the population in their homes, have helped to reduce the speed of spread of the virus. However, due to the severe economic crisis caused by the pandemic, local health authorities have issued several biosecurity measures to gradually return to relative normality, including the provision of health services to non-COVID-19 patients. This article aims to make recommendations for local sleep units to implement the minimum biosecurity measures that allow the restart and adequate development of sleep studies in the pediatric population. These recommendations are based on local health authorities' mitigation strategies, on a review of the relevant available literature, and the recommendations of some sleep medicine associations.
{"title":"Recomendaciones para la realización de estudios de sueño pediátricos durante la pandemia covid-19","authors":"Carlos Ernesto Bolaños-Almeida, L. Saldaña, Laura Victoria Guio Mahecha","doi":"10.14295/RP.V53I3.241","DOIUrl":"https://doi.org/10.14295/RP.V53I3.241","url":null,"abstract":"In Colombia, with the current COVID-19 pandemic, some sleep units suspended the performance of sleep studies in the pediatric population due to the potential contagion and spread. According to the competent authorities, since June 2020, Colombia is in the mitigation phase of COVID-19, and the mandatory prevention measures implemented by the Colombian government such as frequent hand washing, the use of masks in public places, the physical and social distancing, and the confinement of most of the population in their homes, have helped to reduce the speed of spread of the virus. However, due to the severe economic crisis caused by the pandemic, local health authorities have issued several biosecurity measures to gradually return to relative normality, including the provision of health services to non-COVID-19 patients. This article aims to make recommendations for local sleep units to implement the minimum biosecurity measures that allow the restart and adequate development of sleep studies in the pediatric population. These recommendations are based on local health authorities' mitigation strategies, on a review of the relevant available literature, and the recommendations of some sleep medicine associations.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79561038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antecedentes: El hidrocolpos neonatal es una patología infrecuente caracterizada por dilatación y acumulación de líquido en el canal vaginal como resultado de obstrucciones vaginales congénitas. La utilización de ecografía es un medio de diagnóstico importante para brindar un tratamiento oportuno y disminuir las complicaciones que conlleva. Reporte de caso: Recién nacida de 39 semanas presentó ano imperforado y abdomen distendido. Se realizó ecografía abdominal evidenciándose hidrocolpos e hidroureteronefrosis bilateral moderada. Dentro de los hallazgos de laboratorio se evidenciaron: falla renal, hiponatremia, y trastorno de coagulación que fue corregido oportunamente. Fue intervenida quirúrgicamente realizándose colpotomía y drenaje de hidrocolpos, evidenciando posteriormente en ecografía control desaparición de este. Se dio el alta a la paciente con 28 días de vida por presentar una evolución satisfactoria. Conclusión: Se debe tener alta sospecha de hidrocolpos ante una masa a nivel de pelvis en una recién nacida. El diagnóstico precoz mediante la ecografía es importante para la prevención de complicaciones obstructivas y renales que aumentan la morbimortalidad de las pacientes.
{"title":"Hidrocolpos neonatal","authors":"Rubén Coca Pasapera, Liz Arlet Elera Romero, J. Ramírez, Víctor Peralta Chávez, Luz Cisneros Infantas","doi":"10.14295/rp.v53i3.145","DOIUrl":"https://doi.org/10.14295/rp.v53i3.145","url":null,"abstract":"Antecedentes: El hidrocolpos neonatal es una patología infrecuente caracterizada por dilatación y acumulación de líquido en el canal vaginal como resultado de obstrucciones vaginales congénitas. La utilización de ecografía es un medio de diagnóstico importante para brindar un tratamiento oportuno y disminuir las complicaciones que conlleva. Reporte de caso: Recién nacida de 39 semanas presentó ano imperforado y abdomen distendido. Se realizó ecografía abdominal evidenciándose hidrocolpos e hidroureteronefrosis bilateral moderada. Dentro de los hallazgos de laboratorio se evidenciaron: falla renal, hiponatremia, y trastorno de coagulación que fue corregido oportunamente. Fue intervenida quirúrgicamente realizándose colpotomía y drenaje de hidrocolpos, evidenciando posteriormente en ecografía control desaparición de este. Se dio el alta a la paciente con 28 días de vida por presentar una evolución satisfactoria. Conclusión: Se debe tener alta sospecha de hidrocolpos ante una masa a nivel de pelvis en una recién nacida. El diagnóstico precoz mediante la ecografía es importante para la prevención de complicaciones obstructivas y renales que aumentan la morbimortalidad de las pacientes.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87443557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sergio A. Arbeláez Eslait, Koretta K. Esmeral Atehortúa, Sebastián Peluffo Vergara
Antecedentes: La comunicación interauricular (CIA) es una entidad frecuente en pediatría, representando un 10-15 % de las cardiopatías congénitas. En términos de fisiopatología y cuadro clínico es muy variable, ya que existen cuatro tipos de presentación clínica: CIA tipo ostium secundum (70 %), CIA tipo ostium primum (20 %), CIA tipo seno venoso (10 %) y CIA del seno coronario (<1 %). Reporte de caso: En este artículo de revisión se discute el caso de un paciente de 1 día de vida, quien ingresó al servicio de Cuidados Intensivos Neonatales (UCIN), por presentar dificultad respiratoria y taquipnea. Se realizó un enfoque diagnóstico inicial mediante un ecocardiograma transtorácico que identificó un defecto septal auricular con lo que se confirmó el diagnóstico de comunicación interauricular. El paciente recibió tratamiento farmacológico logrando una evolución satisfactoria. Conclusiones: Siendo la CIA una entidad frecuente en pediatría, es de suma importancia diagnosticarla oportunamente, ya que implica tratarse de forma temprana para evitar posibles complicaciones que podrían poner en riesgo la vida del paciente. El ecocardiograma es el estudio de elección para el diagnóstico de CIA. El tratamiento integral dependerá de la severidad de la CIA y de la edad del paciente, variando desde seguimiento expectante hasta cirugías correctivas.
{"title":"Comunicación Interauricular","authors":"Sergio A. Arbeláez Eslait, Koretta K. Esmeral Atehortúa, Sebastián Peluffo Vergara","doi":"10.14295/rp.v53i3.157","DOIUrl":"https://doi.org/10.14295/rp.v53i3.157","url":null,"abstract":"Antecedentes: La comunicación interauricular (CIA) es una entidad frecuente en pediatría, representando un 10-15 % de las cardiopatías congénitas. En términos de fisiopatología y cuadro clínico es muy variable, ya que existen cuatro tipos de presentación clínica: CIA tipo ostium secundum (70 %), CIA tipo ostium primum (20 %), CIA tipo seno venoso (10 %) y CIA del seno coronario (<1 %). Reporte de caso: En este artículo de revisión se discute el caso de un paciente de 1 día de vida, quien ingresó al servicio de Cuidados Intensivos Neonatales (UCIN), por presentar dificultad respiratoria y taquipnea. Se realizó un enfoque diagnóstico inicial mediante un ecocardiograma transtorácico que identificó un defecto septal auricular con lo que se confirmó el diagnóstico de comunicación interauricular. El paciente recibió tratamiento farmacológico logrando una evolución satisfactoria. Conclusiones: Siendo la CIA una entidad frecuente en pediatría, es de suma importancia diagnosticarla oportunamente, ya que implica tratarse de forma temprana para evitar posibles complicaciones que podrían poner en riesgo la vida del paciente. El ecocardiograma es el estudio de elección para el diagnóstico de CIA. El tratamiento integral dependerá de la severidad de la CIA y de la edad del paciente, variando desde seguimiento expectante hasta cirugías correctivas.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90111044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. M. B. Ferrández, M. I. Hernández, J. J. L. Velillas, Andrés Ruiz Pardo
Objectives: To evaluate the clinical characteristics, the degree of disease control, and quality of life of patients and patients’ caregivers assigned to the "Asthmatic Child Care Program" in a primary healthcare center. Methods: a descriptive observational study, with prospective collection of data from three standardized questionnaires, delivered to the patient or caregivers: Asthma Control Questionnaire (ACQ)TM, Pediatric Asthma Quality of Life Questionnaire (PAQLQ)TM and Pediatric Asthma Caregivers Quality of Life Questionnaire (PACQLQ)TM, and retrospective collection of data from the patient's medical history. The sample comes from the population included in the "Asthmatic Child Care Program" of a primary healthcare center. Results: 40% of the patients had a maternal or paternal history of asthma, and 80% had a personal history of atopic dermatitis, allergic rhinitis, or food allergy. Average ACQTM result in 0.87 +/- 1.06 points (range 0 – 3.6). Average PAQLQTM results in: 6.08 +/- 0.77 (range 5 – 7). PACQLQTM mean of 5.48 +/- 1.06 (range 3 – 7). In patients with ACQTM 1 it was: 4.66 +/- 0.72. Conclusions: The presence of personal atopy and a family history of asthma is the risk factor most related to asthma development in our study. The degree of asthma control in the sample can be improved, with poorer disease control being related to a lower score on the quality-of-life scale, making it necessary to implement improvement measures in the educational, clinical, and healthcare settings.
{"title":"Características, control de la enfermedad y calidad de vida de los pacientes asignados al ‹‹Programa de Atención al Niño Asmático›› de un centro de atención primaria.","authors":"S. M. B. Ferrández, M. I. Hernández, J. J. L. Velillas, Andrés Ruiz Pardo","doi":"10.14295/RP.V53I2.202","DOIUrl":"https://doi.org/10.14295/RP.V53I2.202","url":null,"abstract":"Objectives: To evaluate the clinical characteristics, the degree of disease control, and quality of life of patients and patients’ caregivers assigned to the \"Asthmatic Child Care Program\" in a primary healthcare center. Methods: a descriptive observational study, with prospective collection of data from three standardized questionnaires, delivered to the patient or caregivers: Asthma Control Questionnaire (ACQ)TM, Pediatric Asthma Quality of Life Questionnaire (PAQLQ)TM and Pediatric Asthma Caregivers Quality of Life Questionnaire (PACQLQ)TM, and retrospective collection of data from the patient's medical history. The sample comes from the population included in the \"Asthmatic Child Care Program\" of a primary healthcare center. Results: 40% of the patients had a maternal or paternal history of asthma, and 80% had a personal history of atopic dermatitis, allergic rhinitis, or food allergy. Average ACQTM result in 0.87 +/- 1.06 points (range 0 – 3.6). Average PAQLQTM results in: 6.08 +/- 0.77 (range 5 – 7). PACQLQTM mean of 5.48 +/- 1.06 (range 3 – 7). In patients with ACQTM 1 it was: 4.66 +/- 0.72. Conclusions: The presence of personal atopy and a family history of asthma is the risk factor most related to asthma development in our study. The degree of asthma control in the sample can be improved, with poorer disease control being related to a lower score on the quality-of-life scale, making it necessary to implement improvement measures in the educational, clinical, and healthcare settings.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90216948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sonia Esperanza Guevara Suta, Martha O. Ospina-Rubiano, Héctor F. Restrepo-Guerrero
Preterm birth is considered a public health problem and responsible for a high neonatal morbidity and mortality. A large percentage of premature infants require oxygen and mechanical ventilation to meet their physiological needs, and about 40% of them are discharged from neonatal units to kangaroo mother programs. Objective: To describe the experiences of mothers of babies with oxygen admitted to a kangaroo mother program, from their cultural context. Materials and methods: Qualitative, ethnographic study, a semi-structured interview was applied to nineteen mothers of babies with oxygen, aged between 16-38 years. Results: four categories: identification of respiratory alarm signs and care of equipment at home; adaptation to handling with oxygen; relationship with cultural setting and attendance at oximetry controls, which arose from the interview analysis process. Conclusions: the mothers stated that they received training on identifying respiratory warning signs and oxygen equipment care before discharge, expressed feelings such as fear, worry, fatigue and nerves to face new challenges, indicated that babies need “extreme care”, They reported difficulties the first night at home to manage oxygen and how important it is to be confident and do “things right”, but they also felt joy in having their babies at home.
{"title":"Vivencia de madres de prematuros con oxígeno en un programa madre canguro de Bogotá, Colombia","authors":"Sonia Esperanza Guevara Suta, Martha O. Ospina-Rubiano, Héctor F. Restrepo-Guerrero","doi":"10.14295/RP.V53I2.224","DOIUrl":"https://doi.org/10.14295/RP.V53I2.224","url":null,"abstract":"Preterm birth is considered a public health problem and responsible for a high neonatal morbidity and mortality. A large percentage of premature infants require oxygen and mechanical ventilation to meet their physiological needs, and about 40% of them are discharged from neonatal units to kangaroo mother programs. Objective: To describe the experiences of mothers of babies with oxygen admitted to a kangaroo mother program, from their cultural context. Materials and methods: Qualitative, ethnographic study, a semi-structured interview was applied to nineteen mothers of babies with oxygen, aged between 16-38 years. Results: four categories: identification of respiratory alarm signs and care of equipment at home; adaptation to handling with oxygen; relationship with cultural setting and attendance at oximetry controls, which arose from the interview analysis process. Conclusions: the mothers stated that they received training on identifying respiratory warning signs and oxygen equipment care before discharge, expressed feelings such as fear, worry, fatigue and nerves to face new challenges, indicated that babies need “extreme care”, They reported difficulties the first night at home to manage oxygen and how important it is to be confident and do “things right”, but they also felt joy in having their babies at home.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85981931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francy Cantor Cruz, Hannie Jhuliana Niño Vargas, María Ligia Cifuentes Álvarez, Sandra Patricia Zorro Ceron, Nancy Yomayusa González
Introduction: Hospitalization is a situation that children can experience as negative, intimidating, or adverse, contributing to the appearance of needs that may go unnoticed during medical care and are more evident in extended hospital stays. Objective: To describe the experience in identifying and addressing hospitalized children's perceived needs, using a play-based strategy during 2018, in three clinics in Bogota. Methods: A mixed-methods study was carried out, with retrospective data analysis on the care medical records carried out in 2018. The selection of patients was consecutive and convenient. For identifying the children's necessities, structured interviews were carried out, and a psycho-pedagogical strategy based on the play was implemented. Results: Pediatric hospitalized patients, regardless of their age or admission pathology, present during the first three weeks of hospitalization needs related to mood and interaction with the caregiver. Caregivers also present needs related to the management of uncertainty due to the child's diagnosis and prognosis, the interruption in family dynamics and functioning, and concerns about medical care, psychosocial and educational aspects of the children during their stay in the hospital Conclusions: Educational strategies based on play are a valuable resource with which service-providing institutions could improve the experience of children requiring hospitalization and their caregivers.
{"title":"Necesidades percibidas en el paciente pediátrico hospitalizado","authors":"Francy Cantor Cruz, Hannie Jhuliana Niño Vargas, María Ligia Cifuentes Álvarez, Sandra Patricia Zorro Ceron, Nancy Yomayusa González","doi":"10.14295/RP.V53I2.183","DOIUrl":"https://doi.org/10.14295/RP.V53I2.183","url":null,"abstract":"Introduction: Hospitalization is a situation that children can experience as negative, intimidating, or adverse, contributing to the appearance of needs that may go unnoticed during medical care and are more evident in extended hospital stays. Objective: To describe the experience in identifying and addressing hospitalized children's perceived needs, using a play-based strategy during 2018, in three clinics in Bogota. Methods: A mixed-methods study was carried out, with retrospective data analysis on the care medical records carried out in 2018. The selection of patients was consecutive and convenient. For identifying the children's necessities, structured interviews were carried out, and a psycho-pedagogical strategy based on the play was implemented. Results: Pediatric hospitalized patients, regardless of their age or admission pathology, present during the first three weeks of hospitalization needs related to mood and interaction with the caregiver. Caregivers also present needs related to the management of uncertainty due to the child's diagnosis and prognosis, the interruption in family dynamics and functioning, and concerns about medical care, psychosocial and educational aspects of the children during their stay in the hospital Conclusions: Educational strategies based on play are a valuable resource with which service-providing institutions could improve the experience of children requiring hospitalization and their caregivers.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75318007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Scrotal hematoma is a rare manifestation of neonatal adrenal hemorrhage (0.2% of newborns). It is commonly associated with perinatal hypoxia, but it can be spontaneous. Blood from the adrenal bed can reach the scrotum through the inguinal canal, explaining this clinical sign. Clinical case: a 24-hour-old male born at term, with adequate weight for his gestational age, presented with bruising and swelling of the right hemiscrotum. Torsion was ruled out in a doppler sonography, identifying a structure compatible with a hematocele. An abdominal ultrasound showed signs of an evolving right adrenal hemorrhage. A conservative management and follow-up with imaging tests were decided. The evolution was favorable and remission was achieved. Conclusions: We highlight the importance of including this entity in the differential diagnosis of acute scrotum, since an ultrasound can prevent an unnecessary surgery in newborns.
{"title":"Hematoma escrotal como signo infrecuente de hemorragia suprarrenal en recién nacidos","authors":"Verónica Alonso Arroyo, Harsha Nallurib","doi":"10.14295/RP.V53I2.140","DOIUrl":"https://doi.org/10.14295/RP.V53I2.140","url":null,"abstract":"Background: Scrotal hematoma is a rare manifestation of neonatal adrenal hemorrhage (0.2% of newborns). It is commonly associated with perinatal hypoxia, but it can be spontaneous. Blood from the adrenal bed can reach the scrotum through the inguinal canal, explaining this clinical sign. Clinical case: a 24-hour-old male born at term, with adequate weight for his gestational age, presented with bruising and swelling of the right hemiscrotum. Torsion was ruled out in a doppler sonography, identifying a structure compatible with a hematocele. An abdominal ultrasound showed signs of an evolving right adrenal hemorrhage. A conservative management and follow-up with imaging tests were decided. The evolution was favorable and remission was achieved. Conclusions: We highlight the importance of including this entity in the differential diagnosis of acute scrotum, since an ultrasound can prevent an unnecessary surgery in newborns.","PeriodicalId":101003,"journal":{"name":"Pediatría","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76447768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. C. Ramírez, Laura Jimena Hernández-Corredor, Jorge Luis Córdoba-Gravini, José Luis Junco-González
Introduction: Modified Wood's clinical asthma severity scale (M-WCAS), a validated scale in Colombia, is a useful tool to measure severity in acute bronchiolitis. The scale could prevent interobserver variability, and support better patients' management location (ambulatory, hospitalization, intensive care unit). Objective: to estimate the concordance between the severity of acute bronchiolitis measured by M-WCAS, management location, and hospital stay days of patients with acute bronchiolitis in a pediatric referral center. Methods: In a retrospective concordance study, 364 medical records of patients with acute bronchiolitis were reviewed. Researchers calculated the M-WCAS score. Concordance was estimated between the scale score at admission, management location, and hospital stay days of patients who required in-hospital treatment. Results: We found a kappa index of -0.51 between clinical severity by M-WCAS scale and management location. A Lin concordance coefficient of 0.03 between M-WCAS score and hospital stay days. Conclusions: We found no correlation between the clinical severity of bronchiolitis measured by the M-WCAS scale with the patient´s management location. We identified a slight concordance between the M-WCAS score, and hospital stay days.
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