Archivos argentinos de pediatria最新文献

Introduction. Middle-ear ventilation tubes are commonly placed in pediatric patients because of the high frequency of otitis media. Although avoidance of water activity has been recommended to prevent otorrhea, studies indicate that exposure to water does not increase these episodes. However, a survey in the northwestern United States showed low adherence to these guidelines. This study evaluates the current recommendations of otolaryngologists and pediatricians on water exposure in patients with ventilation tubes. Population and methods. We surveyed 235 health professionals from Argentina, Brazil, Chile, and other countries, including general otolaryngologists, pediatric otolaryngologists, otologists, residents, and pediatricians. The questionnaire addressed tubing preferences, swimming recommendations, and depth limits. Results. A total of 87.62% of respondents preferred diabolos as ventilation tubes. Regarding swimming, 54% recommended protection, such as earplugs or caps, while 28.5% prohibited aquatic activity. Permissiveness varied according to age and specialty; residents and pediatricians were the most permissive. One-third allowed only shallow swimming, and 20% imposed no limits. Conclusion. Young professionals and pediatricians were the most permissive concerning water exposure. Within the subspecialties, pediatric otolaryngologists and pediatricians were the respondents who indicated the least restrictions on their patients.

Exclusive breastfeeding during the first six months of life, and prolonged with complementary feeding until 2 years of age or more, is the best nutritional approach in the first stage of life. Mastitis is a pathology that can jeopardize the continuity of breastfeeding. Different methods have been proposed for the prevention and treatment of mastitis, including probiotics. This narrative review aims to describe the problem of mastitis during lactation and the role of probiotics in its prevention. Mastitis should not be confused with the physiological phenomenon known as milk coming in. In persistent pain, timely medical consultation is key to avoiding complications. The administration of specific probiotics in the perinatal period has shown efficacy in reducing the incidence of mastitis.

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. The highest levels of childhood overweight and obesity in Latin America correspond to Argentina; this condition increases the risk of obesity, type 2 diabetes, cardiovascular and cerebrovascular diseases, and other conditions in adulthood. More than 25% of childhood and adolescent obesity are attributable to the consumption of sugar-sweetened beverages (SSBs). Our objective was to assess the disease and financial burden of SSB consumption among children and adolescents in Río Negro, the morbidity and mortality in adulthood, and the impact of reducing sugar consumption via the implementation of Law no. 27642 on the Promotion of Healthy Eating. Population and methods. We used a mathematical simulation model with a comparative risk assessment approach in the Río Negro population aged 0 to 17 years. The burden of obesity attributable to SSB consumption in the short and long term and direct medical costs were assessed. Results. The average consumption of SSBs was 348 mL/day; the prevalence of overweight and obesity was 16.6% and 11.6%, respectively. There were over 6600 cases of overweight in children and adolescents; while in adulthood, there were over 17 500 cases of overweight, 34 deaths attributable to SSBs, 3200 cases of diabetes, and over 4230 other health events. Direct medical costs were estimated at ARS 250 000 000 attributable to SSB consumption. Conclusion. The implementation of a comprehensive policy as established by Law no. 27642 on the Promotion of Healthy Eating in Río Negro would decrease 24% of overweight cases, morbidity, mortality, and associated medical costs.

Introduction. Hypercalcemia is infrequent in pediatrics, of diverse etiology, and with multiorgan morbidity. Objective. Describe the etiology, biochemistry, clinical, and treatment in pediatric patients with hypercalcemia. Population and methods. Retrospective and descriptive study of a cohort of patients with hypercalcemia between 2008 and 2022. They were classified into three groups (G): hypercalcemia of iatrogenic cause (G1), parathyroid hormone (PTH) independent (G2), or PTH-dependent (G3). Results. One hundred forty-seven patients were included; 57% were male, with a median age of 3.7 years, median calcemia of 11.8 mg/dl, and mean phosphatemia of 4.9 mg/dl. Symptoms were present in 29% of patients, and 28.6% required additional treatments to those of the first line. In G1, 76 patients (51.7%) were included; in G2, 58 (39.4%), and in G3, 13 (8.8%). Median calcemia was lower in G1 vs. G2 and G3 (11.6 mg/dl, 12.6 mg/dl, and 12.3 mg/dl), and mean phosphatemia was lower in G3 vs. G1 and G2 (3.7 mg/dl, 5.3 mg/dl, and 4.9 mg/dl). Most of the patients with hypercalcemia were asymptomatic and did not require additional treatments. The percentage of symptomatic patients and the percentage requiring additional treatment were lower in G1 than in the other two groups. Conclusions. Iatrogenesis was the most frequent cause, presenting lower calcemia, while PTH-dependent causes presented the lowest phosphatemia. PTH-independent causes represented a diagnostic and therapeutic challenge due to lacking a characteristic biochemical profile.

The design and implementation of simulation-based learning is a major institutional challenge. It involves planning the activity and preparing information and resources, as well as accompanying and guiding participants towards the achievement of learning outcomes. There are currently different global recommendations that contribute to a high-quality implementation of simulations. The objective of this article is to present a simulation model that both integrates these guidelines and serves as a guide for those who are in the early stages of this educational strategy.

Introduction. The onset of the SARS-CoV-2 pandemic raised questions about its behavior in different scenarios. Objective. To describe the clinical and epidemiological behavior of COVID-19 in pediatric patients living in an agricultural-industrial city across 3 periods (2020 to 2022). Population and methods. Observational, analytical study of children under 18 years diagnosed with COVID-19 in General Cabrera. Sex, age, symptoms, comorbidities, hospitalization, and death were analyzed. The χ² test was used to analyze the association between symptoms and period and the KruskalWallis test, to analyze differences in symptom duration per period. Confidence level: 95%. Results. In the study period, 194 cases in children under 18 years were confirmed. Only 1% required hospitalization; no deaths were recorded. Children's median age was 14 years; 51% were boys; 68% were asymptomatic; 2% had associated comorbidities. Conclusion. SARS-CoV-2 infection was low in pediatrics and showed a distinct behavior by period.

Pityriasis rubra pilaris (PRP) is a rare skin condition. The etiology of PRP is unknown; however, it has been associated with infections, autoimmune diseases, and neoplasms. Here we describe the cases of 2 pediatric patients with PRP triggered by a respiratory syncytial virus infection concurrently with obstructive bronchial syndrome. PRP resolved after treatment with topical emollients, topical corticosteroids, and calcineurin inhibitors.

Introduction. Overweight adolescents are confronted daily with stereotypes that condition their body image, self-esteem, and mood. Objectives. To describe, in adolescents with overweight, the subjective experiences related to the body in daily life and their perceptions regarding the interventions and empathy of the health team. Population and methods. Descriptive study with qualitative approach. Semi-structured interviews were conducted with adolescents aged 11 to 18 years with selfreported mass index (BMI) ≥ 26 and referring to medical or nutritional follow-up for overweight, attended at the Adolescence Service of a hospital in the Autonomous City of Buenos Aires, between October 1, 2021, and May 31, 2022. Results. Twenty adolescents were evaluated, with a median age of 13.5 years, most of them from female sex (16/20). All reported body dissatisfaction from an early age (median age: 10 years old). They mention difficulty dressing due to the lack of different sizes; they even limit sports practice. They suffered weight- related body humiliation at school, in the family, or public (15/20). They perceived weight control in a dual way: weight loss was the primary stimulus for treatment, but its centrality in the consultations generated discomfort. The leading causes of therapeutic abandonment were the impossibility of temporarily sustaining the recommendations and the lack of weight loss. The treating team was willing to listen to the patients but needed to understand their daily experiences, physical, material, esthetic, social conditioning, beliefs, and perceptions. Conclusion. The adolescents included in this study perceived specific interventions of the healthcare team as beneficial, with empathic deficiencies.