Archivos argentinos de pediatria最新文献

Objective: In this paper, we analyzed the outcomes of foreign bodies in the digestive tract of 42 children who were hospitalized in the pediatric department of a tertiary hospital in a medium-sized city in China. The focus is on discussing the indications for removal of foreign bodies via digestive endoscopy. Methods: Forty-two children with foreign bodies in the digestive tract, hospitalized from June 2020 to October 2022 were selected. Results: (1) The majority of the children (52.4%) who had coins in their digestive tracts were between the ages of 3 to 6 years. (2) Symptoms were most commonly observed in the esophagus (62.5%), and gastroscopy was used to remove all foreign bodies. (3) There were 13 cases with foreign bodies in the stomach, and only 4 required removal of the foreign bodies. (4) Among 4 cases where imaging was unable to detect the foreign bodies, gastroscopy revealed the foreign bodies in the esophagi of 2 symptomatic cases, and were removed; the other 2 asymptomatic cases excreted the foreign bodies in the stools. Conclusion: The timing for foreign body removal via digestive endoscopy depends on factors such as location, nature, and symptoms. Single foreign bodies that migrate within the stomach and intestine may be observed without intervention if asymptomatic. Sharp foreign bodies usually pass spontaneously if beyond the esophagus. Emergency gastroscopy is recommended for symptomatic cases; otherwise, clinical observation is suggested.

The National Committee for Palliative Care expressed their commitment to approach the decision of foregoing life sustaining treatment from a palliative care perspective, allowing the implementation of a care program to prevent therapeutic obstinacy, respect the dignity of the patient and their parents, and evaluate a rational, reasonable and adequate use of health and technological resources by focusing on the quality of life of the child, in order to realize their best interest, providing a guide that facilitates the decision-making process in dilemmatic situations in pediatrics.

Glycerol kinase deficiency is a rare X-linked genetic disorder, which may be associated with adrenal hypoplasia congenita and Duchenne muscular dystrophy. Here we describe a complex pediatric case of adrenal insufficiency with persistent hyponatremia and hyperkalemia despite an adequate management with corticosteroids, hypertriglyceridemia since birth, and chronic malnutrition in nutritional recovery. No cases have been reported in the Argentine literature, which increases the relevance of this case in pediatric clinical practice due to its unusual presentation.

Neurofibromatosis type 1 (NF1) is the most common neurocutaneous disease. It is characterized by café-au-lait spots, melanocytic hamartomas of the iris, pseudo-freckles, neurofibromas, and tumor predisposition. The presence of neurofibromas in the thyroid gland is extremely rare. Here we present the case of a 6-year-old male patient with NF1 who consulted at the Department of Endocrinology due to a thyroid tumor and whose ultrasound confirmed a heterogeneous mass at the posterior level of the right lobe. A cervical surgery found the tumor was adhered to the larynx and trachea, with the recurrent laryngeal nerve entering the tumor. Due to the impossibility of dissection, a right hemithyroidectomy was performed and the pathological examination confirmed the presence of plexiform neurofibroma and intrathyroidal neurofibroma. This is the second case reported in childhood and the youngest case to date. Neurofibroma with thyroid involvement should be suspected in patients with cervical mass and NF1, since diagnostic guidance allows avoiding unnecessary studies and guide treatment.

Introduction. Active humidification treatment in incubators effectively reduces risks related to loss of barrier function in preterm infants. However, no conclusive evidence exists on the criteria for active humidification care. This study aimed to describe active humidification in incubators in newborn infants under 32 weeks in high-complexity public maternity hospitals in Argentina. Methods. An observational and cross-sectional study in supervisors of 68 neonatal intensive care units (NICU) in 2023, using a digital survey, designed ad hoc, anonymous, and voluntary, with four dimensions (sociodemographic variables, humidification criteria, nursing care, and humidity decrease, and withdrawal criteria) and 35 questions. Results. Sixty-four responses were obtained (94%); 84.3% of the NICUs use humidity in the incubators, ranging between 80-90% relative humidity; 57.8% use it, considering the gestational age. The average active humidification time was 11 days. During this period, 84.4% did not perform skin-to-skin contact. The patient's clinical condition was used in 35.9% as a criterion for withdrawal; 30% did not perceive any risk associated with the treatment, and although 48.4% identified a risk of infection, no measures were implemented to reduce it. Conclusions. The findings of this study show great variability in the criteria for initiation, duration, and withdrawal of active humidification in incubators in newborns younger than 32 weeks.

The inappropriate use of electronic devices can affect the psychological and physical health of children and adolescents. Therefore, it is essential to accompany them and promote media literacy to ensure a healthy and responsible use of technology. On occasions that depend on a multifactorial complex, the inappropriate use of networks can trigger problematic consumption and seriously affect the lives of young people. In 2022, the World Health Organization recognized, through ICD-11, the addiction to video games and used the term "problematic use" for the Internet and social networks. This article attempts to update professionals on new trends in the consumption of social networks, video games, and online gambling platforms and their consequences on the psychophysical well-being of children and adolescents.

Introduction. Echocardiographic measurement of inferior vena cava diameters and collapsibility index (IVCCI) can estimate right heart chamber function and intravascular volume status. Few reports of reference values for diameters and IVCCI in the pediatric population exist. This exploratory study aimed to understand the behavior of diameters and IVCCI as a function of body surface area (BSA) in healthy children to establish possible reference values in the future. Population and methods. Ninety-nine Mexican children aged 12 to 204 months were included. Anthropometry and transthoracic M-mode echocardiography were performed to assess the maximum expiratory diameter (MAXDE) and the minimum inspiratory diameter (MINDI). IVCCI was calculated with the formula (MAXDE - MINDI) / MAXDE × 100. Results. A linear regression model was performed to calculate the predicted values (mean ± 2 standard deviations of MAXDE and MINDI expressed per BSA). The predicted value of the IVCCI for each representative BSA value was calculated from the MAXDE and MINDI values predicted by the model. Conclusions. Variations were found in the values of diameters and IVCCI concerning studies performed in other pediatric groups. This indicates the importance of having specific reference values for each population and opens the door to generating more research in healthy children and even those with cardiac disorders.

Introduction. Dengue is a viral infection that may be asymptomatic or include severe manifestations. This study aims to describe the characteristics of a pediatric population during the epidemic outbreak in 2023. Population and methods. This cross-sectional study included patients with probable or confirmed dengue fever who were seen from March 13, 2023, to May 19, 2023, in a pediatric hospital in the Autonomous City of Buenos Aires. Results. A total of 112 patients were included. The median age was 12 years; 58% were male. Seventy-six percent of them came from the City of Buenos Aires. Twenty-five percent had cohabitants with symptoms compatible with a suspected case. The most frequent clinical manifestations were fever, headache, retro-ocular pain, myalgia, and arthralgia. The most frequent laboratory alterations were leukopenia (65%) and elevated transaminases (60%). Twenty-one percent (24/112) presented alarm signs and required hospitalization. Leukopenia, plateletopenia, and elevated transaminases were associated with the presence of alarm signs. RT-PCR was detected in fifty-three patients; serotype 2 was the most frequent. Twenty-one patients had positive NS1 tests, 18 patients had positive IgM, and 20 patients with clinical and epidemiological links were assumed to be probable dengue cases. There were no cases of severe dengue. Conclusion. Early clinical suspicion and recognition of laboratory parameters associated with alarm signs are essential for an adequate approach to the disease and early supportive treatment during dengue infection.