Archivos argentinos de pediatria最新文献

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.

Rhabdomyolysis is the clinical picture characterized by the destruction of skeletal muscle. It is associated with the consequent elevation of serum creatine kinase above five times its standard value or greater than 1,000 U/L. Its most frequent causes are acquired. However, less frequent causes, such as congenital metabolic diseases, should be considered when the rhabdomyolysis event recurs. We describe the case of a pediatric patient with recurrent rhabdomyolysis, which triggered by a type IX glycogenosis with a PHKA1 gene mutation. This pathogenic variant generates muscle phosphorylase kinase enzyme deficiency, hindering the use of glycogen as an energy source during prolonged fasting or metabolic demands. We consider it essential to increase knowledge about these entities in the face of recurrent rhabdomyolysis in the pediatric age for early detection and timely referral to a specialist.

Introduction. Endotracheal intubation is one of the most important technical skills in neonatal resuscitation. However, it can be challenging in various situations. The use of the laryngeal mask (LM) may be an alternative. However, its use is not yet standardized in current neonatal resuscitation algorithms. The study aimed to evaluate whether the standardized use of an LM in difficult airway (DAW) situations reduces the time to achieve effective ventilation (EVT) in a clinical simulation setting. Population and methods. This was a blinded, randomized, simulation-based study. A modified algorithm was developed that emphasized the early use of LM in cases of DAW. Two groups of neonatologists were randomly assigned to receive training in two different resuscitation algorithms (standard and modified). After training, the physicians participated in two simulation scenarios, one with a normal airway and one with a difficult airway. Results. Sixty-nine neonatologists participated in the study, 36 in the intervention group. No significant differences in EVT were observed between the two groups. However, when we analyzed those participants who used the LM on the first attempt, regardless of the training received, a shorter time was observed: 9.5 seconds (IQR 7-11) versus 63 seconds (IQR 42-89); p <0.01. Conclusions. Standardized use of LM in DAW situations could reduce the time to achieve effective ventilation.

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. Child development is a complex process influenced by genetic and environmental factors. An enriching linguistic environment is fundamental for cognitive development and language learning in the first years of life. Objective. To describe caregivers' knowledge of cognitive and language development of children under 5 years of age. Population and methods. Cross-sectional, analytical study. Caregivers of children under the age of 5 years who attended the offices of a pediatric hospital during January-March. A self-administered survey, the Survey of Parent/Provider Expectations and Knowledge (SPEAK), probes caregivers' knowledge of cognitive and language development. Demographic characteristics were explored. A univariate descriptiveanalysis was performed for each variable, and a bivariate analysis was conducted using demographic data as predictor variables and the total survey score as the outcome variable. Results. The median global score obtained in the SPEAK survey was 31 (interquartile range 26-34), out of a maximum possible 54 points. The analysis revealed a significant association between the caregiver's educational level and their knowledge of child development (r = 0.211; p = 0.012). Conclusion. The population studied presented an intermediate level of knowledge about language and cognitive development in early childhood. An association was found between a higher level of education and greater knowledge of development.

Introduction. In Pediatrics, communication involves children and their families. Students with the highest interaction with children can approach this subject with greater confidence. Objective. To assess the interaction with children of medical students in their daily lives and its correlation with confidence at the start of the Pediatrics course. Methods. A self-administered survey study of pediatric students of the School of Medicine of the Universidad de Buenos Aires inquired about the frequency of interaction with children under 12 years of age and confidence in this interaction. Results. A total of 286/450 responses were obtained. Only 27 students lived with children, and 14 were parents. Most had little interaction (1-2 times a year or less) with children (64% infants, 64.3% preschoolers, 54.6% schoolchildren). A positive correlation was found between interaction level and confidence (p < 0.01). Conclusion. Medical students have limited interaction with minors in their daily lives, which affects their confidence in taking a Pediatrics course.

In recent years, access to high-performance genetic techniques has allowed new diagnoses to become evident, allowing us to say today that genetic causes represent more than one-third of the etiologies of cholestasis in newborns and infants. When faced with a pediatric patient with cholestasis, with similar clinical and biochemical findings, an early genetic diagnosis will facilitate specific treatment, delay or exclude invasive diagnostic procedures (for example, liver biopsy), and offer genetic counseling to the family. We recently published a classification of genetic cholestasis, considering how the molecular defect affects biliary secretion. In this opportunity, we briefly summarize each of them to facilitate their identification by the pediatrician, who is the first professional to detect them and promptly refer them to a high-complexity center.