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Serious games are more than just games. 严肃游戏不仅仅是游戏。
IF 0.8 4区 医学 Q3 Medicine Pub Date : 2024-04-11 DOI: 10.5546/aap.2023-10218.eng
Santiago de Matos Lima, Paula Otero
Serious games (SG) or educational games are complete games designed for a specific purpose that fulfill both their classic function of entertainment and promote the learning of specific concepts or skills and optimize health care in general. In the pediatric setting, these games combine strategies to educate about health issues, promote healthy behaviors, provide therapy or medical treatment. SG have been shown to promote adherence to treatment in children with chronic diseases, reduce anxiety in those undergoing invasive medical procedures, and stimulate the development of cognitive, emotional, or psychomotor skills. However, it is important to emphasize that the success of SG in pediatrics depends to a large extent on game quality, their design based on clear objectives, and their accurate adaptation to the individual needs and preferences of patients.
严肃游戏(SG)或教育游戏是为特定目的而设计的完整游戏,既能实现其传统的娱乐功能,又能促进特定概念或技能的学习,还能优化总体医疗保健。在儿科环境中,这些游戏结合了健康教育、促进健康行为、提供治疗或医疗的策略。事实证明,SG 可促进慢性病患儿坚持治疗,减少接受侵入性医疗程序的患儿的焦虑,以及刺激认知、情感或心理运动技能的发展。不过,必须强调的是,在儿科领域,SG 的成功在很大程度上取决于游戏的质量、基于明确目标的设计以及对患者个人需求和偏好的准确调整。
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引用次数: 0
Effectiveness of assisted standing on bone mineral density in children with cerebral palsy. A systematic review. 辅助站立对脑瘫儿童骨矿物质密度的影响。系统综述。
IF 0.8 4区 医学 Q3 Medicine Pub Date : 2024-04-04 DOI: 10.5546/aap.2023-10251.eng
Fernando Valenzuela-Aedo, Camila Reyes-Moreno, Teresa Balboa-Castillo

Cerebral palsy is associated with complications such as low bone mineral density, which is more severe in patients with greater motor involvement. Assisted standing helps to prevent or delay this complication; however, its effect is controversial because the type of stander, the type of standing (dynamic or static), and its dosage are not clear. The objective of this study was to determine the effectiveness of assisted standing on bone mineral density in children with cerebral palsy. A systematic review was carried out in compliance with the PRISMA guidelines, using 5 databases. The results were presented using tables, a risk of bias analysis, and a narrative synthesis. Four studies met the inclusion criteria. Assisted standing generates positive changes in bone mineral density, but further research is required, with studies that have greater methodological rigor, longer follow-up periods, and a larger number of patients.

脑性瘫痪与骨质密度低等并发症有关,运动受累程度越大的患者骨质密度越低。辅助站立有助于预防或延缓这种并发症的发生;然而,由于站立器的类型、站立的类型(动态或静态)及其剂量尚不明确,因此其效果还存在争议。本研究旨在确定辅助站立对脑瘫儿童骨矿物质密度的影响。根据 PRISMA 指南,我们使用 5 个数据库进行了系统性回顾。研究结果采用表格、偏倚风险分析和叙述性综述的形式呈现。四项研究符合纳入标准。辅助站立可使骨矿物质密度发生积极变化,但仍需进一步研究,研究方法应更加严谨、随访时间更长、患者人数更多。
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引用次数: 0
Tuberculosis in childhood and adolescence: The situation after the COVID-19 pandemic. 儿童和青少年结核病:COVID-19大流行后的情况。
IF 0.8 4区 医学 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2023-10-12 DOI: 10.5546/aap.2023-10193.eng
Norma E González
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引用次数: 0
Impact of the SARS-CoV-2 pandemic on the body mass index of children seen in the City of Buenos Aires. 严重急性呼吸系统综合征冠状病毒2型疫情对布宜诺斯艾利斯市儿童体重指数的影响。
IF 0.8 4区 医学 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2023-10-12 DOI: 10.5546/aap.2023-10064.eng
Gabriela Sanluis Fenelli, Manuel Rodríguez Tablado, Fernando Ferrero, María F Ossorio, Mabel Ferraro, Fernando Torres

Introduction. Childhood overweight and obesity are a public health problem. The onset of the COVID-19 pandemic may have contributed to this condition. The body mass index (BMI) Z-score has been accepted as an indicator for overweight and obesity diagnosis and follow-up. Objective. To assess whether the prevalence of overweight and obesity and the BMI Z-score in children aged 2 to 5 years increased during the pandemic. Population and methods. Retrospective, cohort study. Patients included were those seen at public health care facilities in the City of Buenos Aires (CABA), who were aged 2 to 5 years, had weight and height values recorded at 2 different visits, before and after the establishment of the preventive and mandatory social isolation policy. Patients' nutritional status (BMI Z-score) and the variation in this indicator between both visits were recorded. Results. A total of 3866 subjects were assessed; their average age was 3.4 ± 0.8 years; 48.1% were girls. The average interval between both visits was 14.3 ± 2.5 months. The prevalence of overweight/ obesity increased from 12.6% (95% CI: 11.6-13.6) to 20.9% (95% CI: 19.6-22.2), p < 0.001, and so did the BMI Z-score (0.4 ± 1.1 versus 0.8 ± 1.3, p < 0.001). Conclusion. The prevalence of overweight and obesity and the BMI Z-score in children aged 2 to 5 years increased significantly during the pandemic.

介绍儿童超重和肥胖是一个公共健康问题。新冠肺炎大流行的爆发可能导致了这种情况。体重指数(BMI)Z评分已被公认为超重和肥胖诊断和随访的指标。客观的评估疫情期间2至5岁儿童超重和肥胖的患病率以及BMI Z评分是否增加。人口和方法。回顾性队列研究。包括在布宜诺斯艾利斯市公共卫生保健机构就诊的患者,年龄在2至5岁之间,在制定预防性和强制性社会隔离政策之前和之后,在两次不同的就诊中记录了体重和身高值。记录患者的营养状况(BMI Z评分)以及两次就诊之间该指标的变化。后果共对3866名受试者进行了评估;平均年龄3.4±0.8岁;48.1%是女孩。两次就诊的平均间隔时间为14.3±2.5个月。超重/肥胖的患病率从12.6%(95%CI:11.6-13.6)增加到20.9%(95%CI:19.6-22.2),p<0.001,BMI Z评分也增加了(0.4±1.1对0.8±1.3,p<0.001)。在疫情期间,2至5岁儿童超重和肥胖的患病率以及BMI Z评分显著增加。
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引用次数: 0
Dengue fever in a 32-day-old patient. A rare case report. 一名32天大的患者出现登革热。罕见病例报告。
IF 0.8 4区 医学 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2023-10-26 DOI: 10.5546/aap.2023-10144.eng
Carolina G Goldberg, Alejandra F López Alarcón, María L Salocha, María F Otero, Mairena Jiménez, Andrea Medina, Rubén de Sousa Serro

Dengue fever is a viral disease transmitted by the Aedes aegypti mosquitoes. In Argentina, dengue fever is an epidemic disease; most cases are reported during the hot months. Until epidemiological week (EW) 20/2023, 106 672 cases were reported across 18 of the 24 provinces of Argentina. Children younger than 2 years are among the main groups at risk. Recognizing signs and symptoms and identifying risk factors is fundamental for the management of cases at a higher risk of severity. Here we describe the case of a 32-day-old female patient who was hospitalized due to febrile syndrome without a source, who had a differential diagnosis of viral meningitis and sepsis and progressed to leukocytosis, thrombocytopenia, hypoalbuminemia in association with rash and edema. The diagnosis of dengue fever was established based on clinical, epidemiological, and positive IgM data.

登革热是一种由埃及伊蚊传播的病毒性疾病。在阿根廷,登革热是一种流行病;大多数病例是在炎热的月份报告的。截至2023年20日流行病学周(EW),阿根廷24个省中的18个省报告了106672例病例。2岁以下的儿童是面临风险的主要群体。识别体征和症状并识别风险因素对于管理严重程度较高的病例至关重要。在这里,我们描述了一例32天大的女性患者,她因无来源的发热综合征住院,对病毒性脑膜炎和败血症进行了鉴别诊断,并发展为白细胞增多症、血小板减少症、低蛋白血症并伴有皮疹和水肿。登革热的诊断是根据临床、流行病学和阳性IgM数据确定的。
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引用次数: 0
Methemoglobinemia and acute ıntravascular hemolysis after naphthalene poisoning in a pediatric patient. 一名儿童患者萘中毒后的甲血红蛋白血症和急性血管内溶血。
IF 0.8 4区 医学 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2023-10-12 DOI: 10.5546/aap.2023-10095.eng
Özhan Orhan, Mehmet N Talay

Poisoning by naphthalene is uncommon in children. It is a type of poisoning brought on by ingesting, inhaling, or coming into touch with naphthalene-containing substances on the skin. Patients typically present with an initial onset of dark brown urine, watery diarrhea, and bile vomit. The signs include fever, tachycardia, hypotension, and low pulse oximetry readings even with oxygen support. Hemolytic anemia, methemoglobinemia, renal failure, and hyperbilirubinemia are all detected in blood tests. Erythrocyte transfusion, ascorbic acid, methylene blue, and N-acetylcysteine (NAC) therapies are provided to inpatients in addition to symptomatic treatment. We present a 23-month-old male patient who developed methemoglobinemia and acute ıntravascular hemolysis, who was followed up in the intensive care unit for five days due to naphthalene intoxication. Although naphthalene poisoning is very rare, it should be known that it has fatal consequences, and more care should be taken in its use and sale.

萘中毒在儿童中并不常见。这是一种由摄入、吸入或接触皮肤上含萘物质引起的中毒。患者通常最初出现深棕色尿液、水样腹泻和胆汁呕吐。症状包括发烧、心动过速、低血压和脉搏血氧计读数低,即使有氧气支持。溶血性贫血、高铁血红蛋白血症、肾衰竭和高胆红素血症都在血液测试中检测到。除了症状治疗外,还为住院患者提供红细胞输注、抗坏血酸、亚甲基蓝和N-乙酰半胱氨酸(NAC)治疗。我们报告了一名23个月大的男性患者,他出现了高铁血红蛋白血症和急性血管内溶血,由于萘中毒在重症监护室随访了五天。虽然萘中毒非常罕见,但应该知道它有致命的后果,在使用和销售时应该更加小心。
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引用次数: 0
Unconditional cash transfers: Is it possible to reverse the cost of poverty during childhood? 无条件现金转移:有可能扭转童年时期的贫困代价吗?
IF 0.8 4区 医学 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2023-12-28 DOI: 10.5546/aap.2023-10248.eng
María E Serra
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引用次数: 0
Guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis in pediatrics. 儿科糖皮质激素诱发骨质疏松症的预防和治疗指南。
IF 0.7 4区 医学 Q4 PEDIATRICS Pub Date : 2024-04-01 Epub Date: 2023-07-06 DOI: 10.5546/aap.2022-02948.eng
Oscar Brunetto, Hamilton R Cassinelli, Graciela Espada, Gisela L Viterbo, Silvia M Meiorin, María F Ahumada, Luciana Brenzoni, María C Maher, Ignacio Chavero, Luis A Ramírez Stieben, María L Brance

Objective. To provide a framework for healthcare professionals managing pediatric patients who are on active glucocorticoid (GC) therapy and to develop recommendations for the prevention and treatment of GC-induced osteoporosis in the pediatric population. Methods. A panel of experts on bone and pediatric diseases developed a series of PICO questions that address issues related to the prevention and treatment of osteoporosis in patients on GC therapy. In accordance with the GRADE approach, we conducted a systematic review of the literature, summarized effect estimations, and classified the quality of the evidence. Then, voting and the formulation of recommendations followed. Results. Seven recommendations and six general principles were developed for GC-induced osteoporosis in the pediatric population. Conclusion. These recommendations provide guidance for clinicians who must make decisions concerning pediatric patients undergoing treatment with GC.

目的为医护人员管理正在接受糖皮质激素(GC)治疗的儿科患者提供一个框架,并为预防和治疗 GC 引起的儿科骨质疏松症提出建议。方法。一个由骨骼和儿科疾病专家组成的小组提出了一系列 PICO 问题,以解决与预防和治疗接受糖皮质激素治疗的患者骨质疏松症相关的问题。根据 GRADE 方法,我们对文献进行了系统性回顾,总结了效果评估,并对证据质量进行了分类。然后进行投票并提出建议。结果。针对 GC 引起的儿童骨质疏松症提出了七项建议和六项一般原则。结论。这些建议为必须对接受 GC 治疗的儿科患者做出决定的临床医生提供了指导。
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引用次数: 0
Evaluation of breastfeeding behaviors and complementary feeding practices of Turkish and Syrian refugee mothers. 评估土耳其和叙利亚难民母亲的母乳喂养行为和辅食喂养方法。
IF 0.8 4区 医学 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2023-09-07 DOI: 10.5546/aap.2023-10083.eng
Özhan Orhan, Hüseyin Elçi

Objectives: The purpose of this study was to compare breastfeeding and related factors (age, level of education, age at first pregnancy, etc.), and complementary feeding practices between Syrian refugee and native Turkish mothers. Material and methods: This descriptive-comparative study examined the nutritional characteristics of infants aged 9 to 60 months whose mothers were Turkish or Syrian refugees who attended Kızıltepe State Hospital between January 2022 and July 2022. Results: 204 mothers (126 Turkish and 78 Syrian) who had a child aged 9-60 months were included. The average age of the mothers was 27.60 ± 5.17 years for Turkish citizens and 28.91 ± 5.62 for Syrian refugees, without significant difference between the two groups (p: 0.091). Postpartum breastfeeding was 91.3% and breastfeeding duration was 12 (0-24) months in Turkish citizens; in Syrian refugees, breastfeeding was 84.6% and average breastfeeding time was 9 (0- 24) months (respectively, breast milk intake p: 0.144, uptake time p: 0.161; no statistical difference). Breastfeeding training was received by 23.8% of Turkish citizens and 5.1% of Syrian refugees; there was a significant difference between the two groups (p: 0.001). Conclusion: In refugee groups, infant and maternal nutrition practices are disrupted. Working in conjunction with local and international organizations and state agencies that give help to refugee groups, the appropriate interventions, initiatives, supports, and awareness-raising activities would strive to improve practices in mother and baby nutrition and narrow gaps.

研究目的本研究的目的是比较叙利亚难民母亲和土耳其本地母亲的母乳喂养和相关因素(年龄、教育水平、首次怀孕年龄等)以及辅食喂养方法。材料和方法:这项描述性比较研究调查了2022年1月至2022年7月期间在Kızıltepe州立医院就诊的9至60个月婴儿的营养特征,这些婴儿的母亲分别是土耳其人或叙利亚难民。结果:204 位母亲(126 位土耳其人和 78 位叙利亚人)的孩子年龄在 9 到 60 个月之间。土耳其公民母亲的平均年龄为(27.60 ± 5.17)岁,叙利亚难民母亲的平均年龄为(28.91 ± 5.62)岁,两组之间无显著差异(P:0.091)。土耳其公民的产后母乳喂养率为 91.3%,母乳喂养时间为 12(0-24)个月;叙利亚难民的母乳喂养率为 84.6%,平均母乳喂养时间为 9(0-24)个月(分别为母乳摄入量 p:0.144,摄入时间 p:0.161;无统计学差异)。23.8%的土耳其公民和5.1%的叙利亚难民接受了母乳喂养培训;两组之间存在显著差异(P:0.001)。结论在难民群体中,婴儿和产妇的营养习惯被打乱了。与当地和国际组织以及向难民群体提供帮助的国家机构合作,采取适当的干预措施、倡议、支持和提高认识活动,将努力改善母婴营养的做法,缩小差距。
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引用次数: 0
Airway management during a respiratory arrest in a clinical simulation scenario. Experience at a pediatric residency program. 临床模拟场景中呼吸骤停时的气道管理。儿科住院医师培训项目的经验。
IF 0.8 4区 医学 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2024-01-04 DOI: 10.5546/aap.2023-10172.eng
Julia Lomez, M Belén Rodríguez, Sofía Rigou, Sonia Rojas, Pilar Torterola, Nicolás Fortini Cabarcos, Christian Elias Costa, Diego Enriquez

Introduction. Respiratory failure is the most common cause of cardiac arrest in pediatrics. Recognizing and managing it adequately is critical. Simulation is used to improve medical skills. The objective of this study was to establish the proportion of pediatric residents who recognized a respiratory arrest in a child at a simulation center. Methods. This was an observational study in 77 residents. A simulation of a patient with respiratory distress that progressed to respiratory arrest was used. Results. Among the 77 participants, 48 recognized respiratory arrest (62.3%). The mean time to recognize respiratory arrest was 38.16 seconds. Conclusion. Respiratory arrest was recognized by 62.3% of participants. Among those who did so, the average time was 38.16 seconds. Severe failures were noted in some of the expected interventions.

简介:呼吸衰竭是小儿心脏骤停最常见的原因。呼吸衰竭是导致儿科心脏骤停的最常见原因。充分认识和处理呼吸衰竭至关重要。模拟训练可用于提高医疗技能。本研究旨在确定儿科住院医师在模拟中心识别儿童呼吸骤停的比例。研究方法这是一项针对 77 名住院医师的观察性研究。模拟了一名呼吸窘迫并发展到呼吸骤停的患者。结果。在 77 名参与者中,48 人(62.3%)识别出呼吸骤停。识别呼吸骤停的平均时间为 38.16 秒。结论。62.3%的参与者识别出呼吸骤停。其中,平均识别时间为 38.16 秒。一些预期干预措施严重失效。
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引用次数: 0
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Archivos argentinos de pediatria
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