Archivos argentinos de pediatria最新文献

Feeding difficulty is common in the infant; the causes are varied and often multifactorial, resulting from a confluence of comorbid conditions. Heterotopic brain tissue is an unexpected reason for feeding difficulty, with approximately only 49 cases reported in the pharyngeal region. In this case report, we present a 2-month-old male infant with feeding difficulty, who was finally diagnosed as oropharyngeal heterotopic brain tissue. The patient underwent surgical excision; no functional disturbance of the oropharynx was found postoperatively. This study aims to enhance the comprehension, accurate diagnosis, and appropriate treatment of of feeding difficulty and pharyngeal heterotopic brain tissue by presenting an unusual case.

ntroduction. The recently approved vaccine against respiratory syncytial virus (RSV) is administered to pregnant women and confers immunity to their babies; however, the evaluation of its effectiveness is limited. Objective. To evaluate the effectiveness of the vaccine against hospitalization due to RSV in children under 6 months of age during the vaccination campaign for pregnant women. Population and methods. Case-control study nested in a cohort of newborns whose mothers were indicated for RSV vaccination in Córdoba, Argentina. We included 180 cases with positive laboratory results for RSV and 1,069 asymptomatic controls who attended routine check-ups. Multiple logistic regression models were performed considering the presence of RSV as the primary response variable, adjusted for maternal age, gestational age, birth weight, maternal influenza vaccination, maternal education level, and multiple births. Vaccine effectiveness was calculated using the formula EV = (1 - OR) × 100. Results. The RSV vaccine reduces the likelihood of becoming ill with RSV by 74.0% (OR: 0.26; CI: 0.170.39); the influenza vaccine reduces it by 70% (OR: 0.30; CI: 0.21-0.43). For each completed week of gestational age, protection against the disease increases by 10% (OR: 0.90; CI: 0.81-0.99). Conclusion. The vaccine is effective against hospitalization due to RSV in children under 6 months of age, who are the most vulnerable population, and could be an essential tool for reducing morbidity and mortality due to RSV.

Bartonella henselae is a gram-negative pleomorphic fastidious bacillus that predominantly affects the pediatric population. Its best-known clinical manifestation is cat scratch disease (CSD), which is initiated by inoculation of the bacterium through feline saliva, its main reservoir. The clinical spectrum of Bartonella henselae infections is broad; fever with lymphadenopathy is the most frequent presentation, usually self-limited. Despite the availability of specific serological tests, a delay in diagnosis is common, especially in cases with unusual manifestations. This paper aims to describe an atypical form of systemic bartonellosis with lymph node, pleural and extradural spinal involvement in a pediatric patient.

Mucormycosis is an aggressive fungal infection caused by fungi of the order Mucorales. Diagnosis is based on histopathological identification of microorganisms and culture confirmation. In case of suspicion, early surgical debridement and early antifungal therapy are recommended. The diagnosis and treatment of these infections pose a significant challenge, especially in pediatrics. Initial nonspecific clinical variability leads to late diagnosis. Their suspicion requires urgent intervention due to their rapid progression; late initiation of therapy is associated with higher mortality. We describe the case of a girl with acute lymphoblastic leukemia and steroid-induced diabetes who presented with a Rhizopus spp. infection in the deltoid muscle during the induction phase of oncologic treatment, with bone involvement.

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.

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.

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.