Sara Beltrán, Elena Aranda, Carlos Martín, Mercedes Odriozola, Mercedes Cemeli
Bronchiolitis obliterans is a rare chronic obstructive respiratory disease secondary to damage of the lower respiratory tract causing inflammation and partial or total obliteration of it. There are different causes, being infectious the most frequent in pediatrics, mainly due to adenovirus. We present the case of an 18-month-old male infant with a history of admission to the Pediatric Intensive Care Unit at 8 months of age due to bronchitis secondary to respiratory syncytial virus and adenovirus. After this episode, he presented persistent respiratory distress and pathological pulmonary auscultation. High resolution pulmonary computed tomography showed a mosaic pattern with areas of air trapping and decreased vascular caliber in the affected areas, findings suggestive of bronchiolitis obliterans.
{"title":"Post-infectious bronchiolitis obliterans secondary to adenovirus","authors":"Sara Beltrán, Elena Aranda, Carlos Martín, Mercedes Odriozola, Mercedes Cemeli","doi":"10.60147/8ef93f7f","DOIUrl":"https://doi.org/10.60147/8ef93f7f","url":null,"abstract":"Bronchiolitis obliterans is a rare chronic obstructive respiratory disease secondary to damage of the lower respiratory tract causing inflammation and partial or total obliteration of it. There are different causes, being infectious the most frequent in pediatrics, mainly due to adenovirus. We present the case of an 18-month-old male infant with a history of admission to the Pediatric Intensive Care Unit at 8 months of age due to bronchitis secondary to respiratory syncytial virus and adenovirus. After this episode, he presented persistent respiratory distress and pathological pulmonary auscultation. High resolution pulmonary computed tomography showed a mosaic pattern with areas of air trapping and decreased vascular caliber in the affected areas, findings suggestive of bronchiolitis obliterans.","PeriodicalId":515071,"journal":{"name":"Revista Pediatría Atención Primaria","volume":"245 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140443404","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}
Victoria Domínguez, Beatriz Flores, Cristóbal Coronel
Introduction: sleep disorders in paediatrics are a growing problem. Melatonin is the drug of choice and it is common to receive advertising for multiple products containing melatonin in primary care. In this paper, a comparative analysis of these products is carried out, examining the most recent scientific evidence, in order to determine whether their use is justified or not. Methods: a descriptive study was conducted on melatonin-containing products sold in pharmacies in Spain and aimed at the paediatric population. Subsequently, a systematic review of documents on the use of melatonin in children and on each extra component present in the products collected was carried out. Results: fifty-three products were analysed. The most common form of administration was drops or millilitres. The usual recommended dose of melatonin was 1 mg per day. The most frequently reported added component was vitamin B6, and lemon balm and passionflower were the most frequently used herbs. None of the products were specifically listed in the Spanish Agency for Medicines and Health Products, and no bibliographical references were found in the advertising of any of the products. Conclusions: although the efficacy of melatonin in sleep disorders is well known, there is currently no consensus on its effective dose in children. The substances most frequently associated with melatonin have little literature to support their results in sleep, and there are no standardised doses for them either, or doses lower than these are used due to a lack of studies in the paediatric population.
{"title":"Melatonin in sleep disorders. comparison of different products and literature review","authors":"Victoria Domínguez, Beatriz Flores, Cristóbal Coronel","doi":"10.60147/45efa623","DOIUrl":"https://doi.org/10.60147/45efa623","url":null,"abstract":"Introduction: sleep disorders in paediatrics are a growing problem. Melatonin is the drug of choice and it is common to receive advertising for multiple products containing melatonin in primary care. In this paper, a comparative analysis of these products is carried out, examining the most recent scientific evidence, in order to determine whether their use is justified or not. Methods: a descriptive study was conducted on melatonin-containing products sold in pharmacies in Spain and aimed at the paediatric population. Subsequently, a systematic review of documents on the use of melatonin in children and on each extra component present in the products collected was carried out. Results: fifty-three products were analysed. The most common form of administration was drops or millilitres. The usual recommended dose of melatonin was 1 mg per day. The most frequently reported added component was vitamin B6, and lemon balm and passionflower were the most frequently used herbs. None of the products were specifically listed in the Spanish Agency for Medicines and Health Products, and no bibliographical references were found in the advertising of any of the products. Conclusions: although the efficacy of melatonin in sleep disorders is well known, there is currently no consensus on its effective dose in children. The substances most frequently associated with melatonin have little literature to support their results in sleep, and there are no standardised doses for them either, or doses lower than these are used due to a lack of studies in the paediatric population.","PeriodicalId":515071,"journal":{"name":"Revista Pediatría Atención Primaria","volume":"12 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140460792","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}
Marcelo Vivas, Beatriz Barbarin, Silvia García de Garayo, José Tomás Ramos
Background and objective: to analyze the degree of adequacy to consensus therapeutic guidelines in acute pharyngotonsillitis and acute otitis media of primary care pediatricians. Material and Methods: retrospective observational study with data collection from electronic medical records of patients with suppurative AOM and streptococcal AAF in patients from 0 to 14 years of age residing in Araba, in an 18-month period study. Results: in the group of patients with suppurative AOM, 238 episodes have been evaluated, with a degree of therapeutic adequacy of 56.7%, being underdosing the main cause of inadequacy. In the group of patients with streptococcal AAF, 1721 episodes have been evaluated, with a degree of therapeutic adequacy of 57%, being the main causes of inadequacy overdose and short-duration regimens. Conclusion: in both suppurative AOM and streptococcal AAF, the degree of therapeutic adequacy is somewhat lower than in other analysed studies. To achieve a correct treatment in these processes in primary care settings is of vital importance due to its high frequency of diagnosis. It is also important to improve the quality of registered data in medical records of all patients.
{"title":"Adequacy of medical prescriptions in streptococcal pharyngitis and acute otitis media to therapeutic guidelines","authors":"Marcelo Vivas, Beatriz Barbarin, Silvia García de Garayo, José Tomás Ramos","doi":"10.60147/c4a39d2d","DOIUrl":"https://doi.org/10.60147/c4a39d2d","url":null,"abstract":"Background and objective: to analyze the degree of adequacy to consensus therapeutic guidelines in acute pharyngotonsillitis and acute otitis media of primary care pediatricians. Material and Methods: retrospective observational study with data collection from electronic medical records of patients with suppurative AOM and streptococcal AAF in patients from 0 to 14 years of age residing in Araba, in an 18-month period study. Results: in the group of patients with suppurative AOM, 238 episodes have been evaluated, with a degree of therapeutic adequacy of 56.7%, being underdosing the main cause of inadequacy. In the group of patients with streptococcal AAF, 1721 episodes have been evaluated, with a degree of therapeutic adequacy of 57%, being the main causes of inadequacy overdose and short-duration regimens. Conclusion: in both suppurative AOM and streptococcal AAF, the degree of therapeutic adequacy is somewhat lower than in other analysed studies. To achieve a correct treatment in these processes in primary care settings is of vital importance due to its high frequency of diagnosis. It is also important to improve the quality of registered data in medical records of all patients.","PeriodicalId":515071,"journal":{"name":"Revista Pediatría Atención Primaria","volume":"86 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140461574","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}
Sara Beltrán, Eva M.ª Jiménez, Paula Vidal, M.ª Pilar Vicente, Mercedes Cemeli
The Alice in Wonderland syndrome is defined by the presence of visual perception disorders with several etiologies, being the most frequent the infections in pediatrics. It is a rare clinical condition, but it is important to recognize it because of the generally self-limited nature. We present a 11 years old child who presented visual body distortions, micropsia and macropsia 48 after SARS-CoV-2 infection. Other organic causes were discarded, maintaining an expectant treatment because of its benign evolution. To point this syndrome associated with SARS-CoV-2 infection, has not yet published right now.
{"title":"Alice in Wonderland syndrome in SARS-CoV-2 infection","authors":"Sara Beltrán, Eva M.ª Jiménez, Paula Vidal, M.ª Pilar Vicente, Mercedes Cemeli","doi":"10.60147/1dec69fd","DOIUrl":"https://doi.org/10.60147/1dec69fd","url":null,"abstract":"The Alice in Wonderland syndrome is defined by the presence of visual perception disorders with several etiologies, being the most frequent the infections in pediatrics. It is a rare clinical condition, but it is important to recognize it because of the generally self-limited nature. We present a 11 years old child who presented visual body distortions, micropsia and macropsia 48 after SARS-CoV-2 infection. Other organic causes were discarded, maintaining an expectant treatment because of its benign evolution. To point this syndrome associated with SARS-CoV-2 infection, has not yet published right now.","PeriodicalId":515071,"journal":{"name":"Revista Pediatría Atención Primaria","volume":"68 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140497879","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}
Introduction: the objectives were to provide longitudinal data on growth and determine the age of thelarche and menarche in girls adopted from Russia. Material and methods: prospective cohort study in 24 girls from Russia adopted in Spain in the 2002-2010 period, who were followed up for 12 years. The history of adverse childhood experiences was collected by reviewing pre-adoption medical records. We recorded standardised measurements of weight, height and head circumference and the age at thelarche and menarche. The mean values were compared with reference standards. Results: Salient history: preterm birth (33.3%), low birth weight (41.7%), prenatal alcohol exposure (45.8%), abuse and neglect (54.2%). Initial evaluation: mean age, 3 years (standard deviation [SD] 1.6) years; weight z-score (z), −1.35; height z, −2.42; head circumference z −1.77. One year after adoption, there was significant catch-up growth in weight (z +0.68), height (z +0.98), and head circumference (z +0.76). Temporal trends in growth: no weight delay from age 7 years; height continued to recover until age 10 (z −0.40) and remained stable until age 15 (z −0.46); the delay was greater compared to weight at every timepoint. The mean age at onset of thelarche was 9.9 years (SD 0.8) with a height of 135.4 cm (z −0.43). The mean age at menarche was 11.9 years (SD 0.7) years, with a height of 147.6 cm (z −0.44). Conclusions: the pattern of growth and development was characterized by severe delay in linear growth and a moderate delay in weight and head circumference at the time of adoption, rapid, significant and prolonged catch-up growth, acceleration of pubertal development with early thelarche and menarche and an incomplete recovery of linear growth.
{"title":"Growth and pubertal development in girls adopted from Russia: 12-year follow-up","authors":"Gonzalo Oliván","doi":"10.60147/43e0f65f","DOIUrl":"https://doi.org/10.60147/43e0f65f","url":null,"abstract":"Introduction: the objectives were to provide longitudinal data on growth and determine the age of thelarche and menarche in girls adopted from Russia. Material and methods: prospective cohort study in 24 girls from Russia adopted in Spain in the 2002-2010 period, who were followed up for 12 years. The history of adverse childhood experiences was collected by reviewing pre-adoption medical records. We recorded standardised measurements of weight, height and head circumference and the age at thelarche and menarche. The mean values were compared with reference standards. Results: Salient history: preterm birth (33.3%), low birth weight (41.7%), prenatal alcohol exposure (45.8%), abuse and neglect (54.2%). Initial evaluation: mean age, 3 years (standard deviation [SD] 1.6) years; weight z-score (z), −1.35; height z, −2.42; head circumference z −1.77. One year after adoption, there was significant catch-up growth in weight (z +0.68), height (z +0.98), and head circumference (z +0.76). Temporal trends in growth: no weight delay from age 7 years; height continued to recover until age 10 (z −0.40) and remained stable until age 15 (z −0.46); the delay was greater compared to weight at every timepoint. The mean age at onset of thelarche was 9.9 years (SD 0.8) with a height of 135.4 cm (z −0.43). The mean age at menarche was 11.9 years (SD 0.7) years, with a height of 147.6 cm (z −0.44). Conclusions: the pattern of growth and development was characterized by severe delay in linear growth and a moderate delay in weight and head circumference at the time of adoption, rapid, significant and prolonged catch-up growth, acceleration of pubertal development with early thelarche and menarche and an incomplete recovery of linear growth.","PeriodicalId":515071,"journal":{"name":"Revista Pediatría Atención Primaria","volume":"22 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140500548","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}
Introduction: cardiovascular diseases constitute a public health problem worldwide and among them cardiorespiratory arrest (CPA) stands out. School canteens are spaces with potential risk of witnessing a PCR. Materials and methods: quasi-experimental analytical study of intervention. The participants received training through an interactive virtual platform and a face-to-face clinical simulation session on the Heimlich maneuver, basic cardiopulmonary resuscitation (CPR) and the use of the semiautomatic external defibrillator (SAED). A descriptive analysis of the study population and a comparative statistical analysis between the results obtained in a test before and after the virtual training were carried out. A variable was created by subtracting the score obtained before training from that obtained after it. Clinical simulation was analyzed by direct observation. Statistical significance was defined as p < 0.05. Statistical analysis with SPSS version 19.0. The principles of the Declaration of Helsinki and the guidelines on good clinical practice were followed. Results: the entire sample was women with a median age of 48.50 years. The median mark of the pre-test was 6.7/10 and the post-test had a constant result of 10/10. The difference between the post-test and the pre-test had a median of 3.3 (p 0.01) and was found in the simulation that the learning was optimal. Conclusions: training in CPR is a strategy with a social impact, related to an improvement in the response to a case of CPA, reducing the morbidity and mortality that this implies.
{"title":"Effectiveness of theoretical-practical training in basic life support for school canteen monitors from Primary Care","authors":"Gustavo Andrés Salom, Natalia Campos","doi":"10.60147/a767b139","DOIUrl":"https://doi.org/10.60147/a767b139","url":null,"abstract":"Introduction: cardiovascular diseases constitute a public health problem worldwide and among them cardiorespiratory arrest (CPA) stands out. School canteens are spaces with potential risk of witnessing a PCR. Materials and methods: quasi-experimental analytical study of intervention. The participants received training through an interactive virtual platform and a face-to-face clinical simulation session on the Heimlich maneuver, basic cardiopulmonary resuscitation (CPR) and the use of the semiautomatic external defibrillator (SAED). A descriptive analysis of the study population and a comparative statistical analysis between the results obtained in a test before and after the virtual training were carried out. A variable was created by subtracting the score obtained before training from that obtained after it. Clinical simulation was analyzed by direct observation. Statistical significance was defined as p < 0.05. Statistical analysis with SPSS version 19.0. The principles of the Declaration of Helsinki and the guidelines on good clinical practice were followed. Results: the entire sample was women with a median age of 48.50 years. The median mark of the pre-test was 6.7/10 and the post-test had a constant result of 10/10. The difference between the post-test and the pre-test had a median of 3.3 (p 0.01) and was found in the simulation that the learning was optimal. Conclusions: training in CPR is a strategy with a social impact, related to an improvement in the response to a case of CPA, reducing the morbidity and mortality that this implies.","PeriodicalId":515071,"journal":{"name":"Revista Pediatría Atención Primaria","volume":"97 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140504986","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}
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