Archivos argentinos de pediatria最新文献

Mucormycosis is an opportunistic fungal infection with high mortality, especially in immunocompromised patients. This article emphasizes the importance of early diagnosis and aggressive treatment. We describe the case of a child with leukemia treated with corticosteroids, vincristine, and daunorubicin, who developed rhino-orbital mucormycosis. Treatment included extensive surgical debridement until the right orbital contents emptied and prolonged antifungal therapy with liposomal amphotericin and anidulafungin. The article highlights the need for an early multidisciplinary approach to improve prognosis.

Recurrent acute pancreatitis (RAP) affects 15-36% of children with acute pancreatitis (AP) and may progress to chronicity. To determine the etiology and evolution of RAP, a descriptive retrospective cohort study was conducted in patients aged 1-18 years. Twelve patients with RAP were included out of 79 with AP, and demographic, etiological, clinical, analytical, and imaging data were collected. The results showed that the median age was 11 years for RAP and 13 years for AP. There were no significant differences between sexes or initial severity. Significant associations were found in the weight percentile, ultrasound findings, and genetic studies. These factors may influence the progression of RAP. Biliary lithiasis was the most common etiology in both groups. The multidisciplinary approach allows for avoiding its progression to chronicity.

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. 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.