Archivos argentinos de pediatria最新文献

Introduction. The medical residency system is a professional training program. In Argentina, the Unified Exam (UE) centralizes admission to most residencies. In 2025, a five-point bonus was added for graduates of Argentine universities to compensate for differences observed in graduation averages compared to those of foreign graduates. Objective. To analyze the average grade point average, UE score, and differences according to foreign status. Population and methods. Cross-sectional study. It included 470 applicants for pediatric residency; 32.8% were foreign nationals, and 28.3% were graduates of foreign universities. Results. Foreign university graduates had higher academic averages (7.8 vs. 7.4; p <0.001) but lower UE performance (58.8 vs. 72.6; p <0.001). The correlation between career average and UE score was significant (R2 = 0.25).Conclusion. These results provide evidence for evaluating the impact and relevance of the applied bonus to ensure equity in access to residencies.

Introduction. This study highlights the importance of early speech therapist intervention in assessing infants' swallowing and feeding. However, it is difficult to identify standardized tests, and therefore, unvalidated instruments are used. Methods. An exploratory systematic review with a qualitative approach and retrospective design, under the PRISMA statement. Results. Fifteen studies were obtained for analysis, with a medium-to-high methodological assessment, including three specific instruments for parental reporting and one clinical instrument. Fiberoptic endoscopy (FE) and video swallow study (VSS) are the gold-standard objective tests for evaluating swallowing. Conclusion. The findings show the need to continue generating evidence on swallowing assessment to improve the detection and management of swallowing disorders in young children during critical periods, also considering the characteristics of each period of psychomotor development.

Establishing the microbiome is an important milestone for infant health. The type of delivery, gestational age, antibiotic use, and infant feeding practices significantly impact this process. However, interest in the effects of maternal diet and nutrition has grown. The objective of this review is to present an update on the microbiota in the mother-child dyad and the role of maternal nutritional status and diet in its modulation. Scientific articles in electronic databases were reviewed. Adherence to established dietary guidelines during pregnancy and lactation, as well as otherrecommendations based on the study of foods that are sources of fiber, unsaturated fatty acids, and fermented foods, is a good starting point for promoting a healthy microbiome from the early years of life.

Patients with Klinefelter syndrome have an increased risk of certain neoplasms, particularly germ cell tumors, especially those located outside the gonads. We report a case of a mediastinal germ cell tumor in an adolescent patient. The diagnosis was reached based on unusual gonadotropin values.

Dehydrated hereditary stomatocytosis (DHSt) is a heterogeneous group of rare hemolytic disorders with autosomal dominant inheritance. A series of 20 cases demonstrates that early identification of DHSt can prevent unnecessary interventions and improve the management of anemia, iron overload, and other complications in pediatric and adult patients. The presence of elevated mean corpuscular hemoglobin concentration (MCHC) with resistant erythrocytes suggested a possible association with variants in PIEZO1. Patients with KCNN4 variants showed no clear signs of erythrocyte dehydration, but, as with PIEZO1, macrocytosis, hemolytic anemia, and iron overload were common manifestations.

This report highlights the importance of differential diagnosis of laryngeal obstructive airway pathologies, as well as the growing value of endoscopic techniques, such as cryobiopsy, in achieving a definitive, accurate diagnosis. This is an 8-month-old infant who presented with signs of airway obstruction and a history consistent with foreign body aspiration. During endoscopy under general anesthesia, a supraglottic tumor was observed, which was resected using a cryobiopsy probe, a method that is not widely used in pediatrics and in our setting. Postoperative pathological anatomy confirmed the diagnosis of juvenile xanthogranuloma, a form of non-Langerhans cell histiocytosis with an uncommon location in the larynx.

Introduction. Peripheral facial paralysis (PFP) is an acute neuropathy of the VII cranial nerve, a frequent reason for pediatric consultation due to its functional, aesthetic, and emotional impact. Children generally have a good prognosis; however, a lack of recovery may require specialized follow-up. Objective. To describe clinical and epidemiological characteristics and evaluate complete clinical recovery at one month in pediatric patients with peripheral facial paralysis. Population and methods. Observational, prospective, cohort study conducted in the Moderate Risk Clinic of a general hospital in the Buenos Aires metropolitan area from April 2019 to March 2021. Patients aged 1 month to 14 years with a first episode of PFP were included. Severity was assessed using the House-Brackmann (HB) scale. Primary variable: complete recovery at one month. Secondary variables: clinical and epidemiological characteristics (age, sex, seasonality, laterality, previous symptoms), initial severity, and pharmacological treatment. Results. Seventy-four patients were included. Median age: 8.5 years (IQR 3-13), 48 females. At one month, 57 patients were evaluated, of whom 40 (70%) had complete recovery. Those with mild initial involvement (HB = 2) recovered completely. No difference in recovery was observed with corticosteroid treatment.Conclusion. The outcome was favorable for most patients. Less severe initial symptoms were associated with recovery within one month, regardless of the treatment received.

At the beginning of the 20th century, childbirth was attended to naturally without the aid of a hospital or a midwife and the responsibility of delivering the child fell to the eldest in the family. Key figures like Sir James Young Simpson (1811-1870) and John William Ballantyne (1861-1923) in Edinburgh during the first quarter of the 20 th century played crucial roles in advancing maternal and perinatal care. Ballantyne took a particular interest in both the physiology and pathology of pregnancy. His interest extended from prematernity care to beyond intrauterine life to matters related to the newborn and diseases of the child.

Introduction. Clinical deterioration in hospitalized pediatric patients is often preceded by early signs that healthcare personnel may not recognize. Implementing validated early warning systems, such as the EWAS (Early Warning Assessment Scale), aims to improve early detection of clinical deterioration. We describe the process of implementing EWAS in a general pediatric ward and analyze its impact on the incidence of clinical deterioration events and their morbidity and mortality. Methods. Before-and-after study. Patients with clinical deterioration events before and after EWAS implementation were included. Event rates, mortality, and critical interventions in the general ward were compared. Results. There were 7.64 events per 1000 patient days pre-implementation and 6.42 per 1000 patient days post-implementation (p = 0.34). Associated mortality decreased from 9.43% to 3.03% (p = 0.14). There were no significant differences in mechanical ventilation, inotropics, or length of stay. A significant reduction in critical interventions performed in the general ward was observed: 15.4% pre-implementation vs. 3.0% post-implementation (p = 0.01). The error rate in EWAS use remained <15% throughout the implementation. Conclusion. The implementation of EWAS was feasible and had good adherence. Although no significant differences in mortality were observed, the reduction in critical interventions outside the PICU suggests improved identification and response to clinical deterioration, which is why we consider EWAS a useful tool in the context of care safety strategies.