Archivos argentinos de pediatria最新文献

Introduction. Insufficient physical activity (IPA) affects a significant number of children and adolescents. Understanding its associated factors is key to improving their health. This study aimed to determine the prevalence and characteristics associated with IPA in adolescents. Population and methods. Adolescents aged 13 to 18 years who attended health checkups at two primary care centers during August and September 2023. A survey was applied to determine the physical activity level and its associated factors. Results. A total of 111 adolescents were included in the study. Of the total, 61.26% (68) considered themselves to have not done enough physical activity; 88% (98) had an IPA. The only factor significantly associated with greater physical activity was having to work or help around the house. Conclusion. The prevalence of IPA was 88%, and the need to work or help at home was associated with higher levels of physical activity.

Introduction. Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant vascular dysplasia characterized by bleeding telangiectasias and arteriovenous malformations (AVMs) in the brain, lungs, liver, and gastrointestinal tract. In childhood, its manifestations are often subtle or absent, making it difficult to recognize. The lack of evidence in pediatrics, especially in Latin America, favors underdiagnosis and limits the timely management of its complications. This study describes the epidemiological, clinical, genetic, and therapeutic characteristics of pediatric patients with HHT at a referral center. Population and methods. Retrospective, descriptive study of pediatric patients evaluated between 2010 and 2022 in the HHT Unit of a referral center. Epidemiological, clinical, genetic, and therapeutic data were collected from the institutional registry. Results. A total of 158 patients were included, mainly from Buenos Aires and surrounding areas; nearly 70% consulted due to a family history of the disease. The average age at the first consultation was 9 years, with 52% of participants being female. HHT was confirmed in 80 patients using Curaçao criteria and/or genetic testing, with a positivity rate of 50%. Mutations were identified in ACVRL1 (56%), ENG (40%), and MADH4 (2.7%). Epistaxis was the most common symptom (92%), with an average onset at age 7. Pulmonary (13%), central nervous system (11%), hepatic (8%), and digestive (2%) AVMs were detected. Conclusion. The importance of early diagnosis of HHT in pediatrics, as well as the need to recognize signs such as recurrent epistaxis or unexplained hypoxemia, is highlighted to facilitate detection and specialized treatment.

In the last two years, the Nephrology Unit of our hospital recorded an increasing percentage of consultations corresponding to renal damage related to chemotherapy treatments. This increase could be attributed to more precise diagnoses, the development of targeted therapies, and improved survival rates. Chemotherapy prolongs and improves the lives of people with cancer, but it can also negatively affect renal function. Therefore, it is essential to detect predisposing nephrotoxic factors early, such as pre-existing renal damage, neoplastic renal infiltration, the presence of toxic metabolites, and the tubular transport system used by these drugs, with their consequent accumulation in the renal interstitium. It is essential to implement the renal prevention measures recommended in the context of chemotherapy treatment, to administer these drugs at the recommended doses, and to conduct strict clinical monitoring.

Scurvy is a rare disease caused by exogenous ascorbic acid deficiency. It should be considered in atrisk groups, such as patients with neurodevelopmental disorders who present restrictive diets due to food selectivity. Although pulmonary hypertension associated with vitamin C deficiency is extremely rare, its occurrence is possible. Signs and symptoms such as edema, tachycardia, palpitations, and dyspnea should raise suspicion about the diagnosis. In most cases, this condition is transient and can be reversed with early diagnosis and adequate supplementation with ascorbic acid. We present a case of a patient with autism spectrum disorder and vitamin C deficiency who developed pulmonary hypertension.

The advent of the 20-valent pneumococcal conjugate vaccine (PCV20) in Argentina is a tool to optimize the prevention of invasive pneumococcal disease. Nonetheless, this new vaccine has complicated the diagnosis of selective antibody deficiency (SAD), an inborn error of immunity characterized by an inadequate response to the polysaccharide antigens present in the 23-valent pneumococcal polysaccharide vaccine (PPSV23). The withdrawal of PPSV23 and the introduction of PCV20 hinder the evaluation of polysaccharide responses, given that PCV20 induces a T-dependent immune response. This review examines the current diagnostic criteria for SAD and the limitations of available diagnostic tests in the context of these vaccine changes. Alternative strategies for measuring polysaccharide antibodies are discussed, and the need to maintain PPSV23 availability for a specific patient cohort is emphasized.

The Epstein-Barr virus, was discovered in 1964, and was the first identified human oncogenic virus that can persist asymptomatically for life. It is associated with a broad spectrum of diseases in the pediatric population, including benign pathologies such as infectious mononucleosis or severe ones such as hemophagocytic lymphohistiocytosis, among others.Professor Sir Anthony Epstein (1921-2024), an English pathologist and virologist, was its co-discoverer with the Irish virologist Yvonne Barr (1932-2016). We will review the history, and the particularities of the serendipitous character that ended with the virus identification, together with the biography of both scientists who gave rise to this famous eponym, which endures to this day.

Introduction. Dengue fever presents a broad clinical spectrum in pediatrics, and there is limited information on its course in children. During 2023-2024, Argentina experienced its largest dengue epidemic. Objective. To describe the clinical manifestations and hematological and biochemical alterations in pediatric patients with confirmed dengue and compare the results by age subgroup. Population and methods. Retrospective, observational, analytical study in children under 17 years of age with dengue confirmed by RT-PCR or IgM, treated between July 1, 2023, and June 30, 2024, at a privately managed tertiary general hospital. Clinical, biochemical, and hematological variables were analyzed, comparing subgroups by age (<13 vs. ≥13 years). Results. A total of 383 patients were included; 86.4% presented dengue without warning signs and 13.6% with warning signs. The most frequent symptoms were fever, headache, and myalgia. The most common laboratory abnormalities were leukopenia, thrombocytopenia, and elevated transaminases. Patients ≥13 years of age had a higher frequency of warning signs and hematological abnormalities. Most were treated on an outpatient basis; only 1.8% required hospitalization. No patients with severe dengue or deaths were recorded. Conclusions. Early leukopenia and thrombocytopenia were the most frequent findings. The group aged ≥13 years had a higher proportion of dengue with warning signs.