Archivos argentinos de pediatria最新文献

The current document is an update of the recommendations of the Sociedad Argentina de Pediatría based on a bibliographic review of publication from recent years on the use of the monoclonal antibody against respiratory syncytial virus (RSV), palivizumab, in groups of patients at high risk of developing severe respiratory infection. The continuing relevance of RSV as a causative agent of acute lower respiratory infections and hospitalizations are highlighted. The epidemiology of RSV in the country after the COVID-19 pandemic was reviewed. The risk groups in which the use of palivizumab is indicated according to the underlying condition were discussed, as well as aspects of its dosing and future therapeutic options.

Western equine encephalitis (WEE) is vector-borne infection caused by an RNA virus of the genus Alphavirus, disseminated by mosquitoes that can cause WEE in humans. There are two cycles of transmission, a maintenance cycle and an occasional amplification with vector augmentation, where equines and humans are terminal hosts. In Argentina, no human cases had been reported since 1983. Here we describe 2 pediatric patients with brain symptoms and serological diagnosis of WEE. Both samples of cerebrospinal fluid (CSF) showed pleocytosis, while the neuroimaging test showed alterations in the basal ganglia. The serological diagnosis was based on the detection of specific IgM in serum and CSF and neutralizing antibodies 14 days after symptom onset. The patients were managed with supportive treatment. One patient recovered his normal neurological status without seizures before discharge, while the other was discharged with right hemiparesis, which resolved after 2 months, and continued with anticonvulsants due to a pathological EEG.

Introduction. The Internet and social media have revolutionized access to information on health and parenting issues. Virtual consultations are spreading worldwide, are increasing, and represent a challenge for professional practice. Objective. To characterize the use of the Internet and social media by mothers and fathers as a source of information on the health and parenting of their children. Population and methods. A descriptive, cross-sectional study in an outpatient pediatric center in the City of Buenos Aires to determine the online consultation habits of caregivers of healthy children or children with health problems. Results. Two hundred-one surveys were analyzed, and the answers were predominantly from mothers of healthy children; 70.6% search online for health and parenting topics; 80% consult more than once a month. Although 36% of the families use the information to complement the medical consultation, 95% would not replace the pediatric consultation with the online search. The participants are not in the habit of following official pages, nor do they tend to verify the veracity of the contents. The search topics are related to the child's age, and satisfaction with the information results are modified according to whether the child is healthy or has a health problem. Only 4.7% responded that the search always answers their questions. Conclusions. Caregivers frequently seek online parenting and health information, but the sources are not always reliable. Although consultation with pediatricians is not displaced, we need to know the impact of online information on health decision-making. Pediatricians can intervene and guide caregivers to safe sources.

Introduction. The trans population in Argentina represents 0.43%. Our objective was to describe the characteristics of trans and non-binary children and adolescents. Population and methods. A cross-sectional study was designed. The population was all trans or nonbinary persons under 24 years of age seen by an interdisciplinary team in a tertiary university hospital from January 2019 to May 2023. The sample was obtained from the database of patients seen by reviewing electronic medical records (EMR). Results. The EMRs of 107 individuals were analyzed; the average age at first consultation was 15.3 years, and the age of self-perceived transgender identity was 11.1 years. Seventy-two percent perceived themselves as having a trans male identity; in 89.7%, their gender expression was by their self-perception, and 46.3% had a bisexual sexual orientation. Seventy-six percent acknowledged having family support; 87.3%, school support; and 92.5%, peer support. 44.8% had a hormonal strategy, 14.1% had surgery, 57.1% had mental health intervention, and 29.1% received psychiatric medication. Only three patients (2.8%) detransitioned their gender identity. Conclusion. Most individuals were trans men and perceived good support from their environments. Almost half received a hormonal strategy; less than a quarter received a surgical intervention; more than half received a mental health intervention. The detransition was infrequent.

Childhood-onset systemic lupus erythematosus (cSLE) is a multisystem disease; its severity depends on the organs involved. Monogenic diseases have been described as predisposing to the onset of cSLE. Analytical and immunological tests are used for diagnostic confirmation. The main goal of treatment is remission and flare prevention. Here we describe the clinical case of a patient with prolonged febrile syndrome, arthralgias, and anemia, positive analytical tests for antinuclear antibodies and anti-DNA antibodies and low values of complement C3, C4, and C1q; so the patient was diagnosed with cSLE associated with C1q deficiency. Patients with C1q deficiency present with early onset of disease and significant target organ damage with nephritis. An early diagnosis of cSLE is important to ensure an early and appropriate treatment. Treatment may be personalized depending on the underlying defect that generates the subtype of lupus.

Hyperparathyroidism is a rare entity in pediatrics. It is defined as the increased production of parathyroid hormone. It may be due to a primary defect of the parathyroid glands (primary hyperparathyroidism) or to a compensatory parathyroid hormone production to correct hypocalcemia states of various origins (secondary hyperparathyroidism). We describe the case of a 15-year-old adolescent girl with a history of several months of deteriorating school performance, anxiety crises, weight loss, and tachycardia. Laboratory results showed hypercalcemia, hypophosphatemia, increased parathyroid hormones, and hypovitaminosis D; imaging studies showed generalized bone involvement and parathyroid nodular formation. A parathyroidectomy and right hemithyroidectomy were performed, after which she presented persistent hungry bone syndrome. The anatomopathological diagnosis was an atypical parathyroid tumor. We describe the form of presentation, the results of the different complementary tests performed, and the short- and long-term evolution.

Introduction. Sleep-disordered breathing (RBD), from habitual snoring to obstructive sleep apnea syndrome (OSAS), can influence brain functioning by affecting executive functions such as attention and inhibitory control. Objective. To analyze the association between snoring and executive functions, specifically attention, impulsivity/inhibitory control in Argentine adolescents. Population and methods. In 2018, a cross-sectional study was conducted on 831 adolescents attending public and private schools in La Pampa. Sleep duration, snoring, and the risk of OSAS were assessed using the pediatric sleep questionnaire (PSQ) and executive functions (attention and inhibitory control) using the Go/No-Go test. The association between SRT and executive functions was performed using a robust regression model adjusted for body mass index, hours of sleep, and physical activity. Results. About 10% of the participants were habitual snorers, and about 7% were at risk of OSA (positive PSQ), with no significant differences between sexes. Errors of commission (No-Go errors) (β= 2.06; -3.20, -0.92) and errors of omission (Go errors) (β= -0.66; -1.31, -0.01) were significantly higher in snorers vs.non-snorers. In addition, individuals at risk for OSAS showed significantly more commission errors (NoGo errors) than those without OSAS risk (β= -1.98; -3.31, -0.66). Conclusions. The associations between snoring and inattention and impulsivity, and between the risk of sleep apnea and lower inhibitory control found in the present study suggest alterations in executive functions due to sleep disorders.