Anales de pediatria最新文献

英文中文

Paediatric endoscopy in Spain: current situation and recent developments.

Anales de pediatria

Pub Date : 2024-12-01 Epub Date: 2024-12-05 DOI: 10.1016/j.anpede.2024.11.004

María Navalón Rubio, Carmen Jovani Casano, Marta Soria López, Alfonso Rodríguez Herrera, Miguel Ángel López Casado, Víctor Manuel Navas-López, Víctor Vila Miravet

Introduction: Paediatric gastrointestinal endoscopy (pGIE) has advanced significantly over the last decade, with increased diagnostic and therapeutic applications.

Objectives: This study examines the current state of pGIE in Spain, changes in the field over 5 years, and the involvement of paediatric gastroenterologists (pGEs).

Materials and methods: A structured self-administered questionnaire was distributed by the Endoscopy Working Group of the Spanish Society of Paediatric Gastroenterology, Hepatology, and Nutrition (SEGHNP) through the REDCap platform. The questionnaire included questions concerning techniques, sedation, indications, and organizational barriers. We compared the results with data from 2015.

Results: Eighty-one of the 103 invited hospitals participated (66.4%). Paediatric gastroenterologists performed 71% of scheduled pGIEs and 24% of emergency pGIEs. Therapeutic endoscopies accounted for 72% of procedures, including foreign body removal (50%) and polypectomy (36%), and were performed by pGEs in 61% and 63% of cases, respectively. When it came to other procedures, pGEs performed 24% in the case of hydrostatic dilation, 20% in the case of variceal sclerotherapy and of haemoclip placement, and 18% in the case of endoscopic coagulation. None of the endoscopic ultrasound, endoscopic retrograde cholangiopancreatography or enteroscopy procedures were performed by pGEs. Sedation was administered by anaesthesiologists in 70% of cases. Compared to 2015, there was an increase in the scheduled endoscopies performed by pGEs (71% vs 54%), the performance of gastroscopies (>180 per year in 61% vs 24%) and colonoscopies (60-120 per year in 31% vs 12%) and the use of picosulfate for colonoscopy preparation (44% vs 10%).

Conclusions: There has been a significant increase in the involvement of pGEs in pGIE in Spain, although of lesser magnitude in emergency and therapeutic endoscopy procedures.

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引用次数: 0

Metabolopathy with characteristic clinical triad: Sengers syndrome.

Anales de pediatria

Pub Date : 2024-12-01 Epub Date: 2024-11-28 DOI: 10.1016/j.anpede.2024.11.001

Laura Naqui Xicota, Elisenda Cortès-Saladelafont, Elena Berrocal Acevedo, Andrea Ros Peña, Berta Brussosa Ventura, Roser Porta Ribera

引用次数: 0

Childhood desmoplastic ganglioglioma in an infant, radiological aspects to know.

Anales de pediatria

Pub Date : 2024-12-01 Epub Date: 2024-12-05 DOI: 10.1016/j.anpede.2024.11.003

Juan Ramón Y Cajal Calvo, Laura Pérez Abad, Patricia Morte Coscolin

引用次数: 0

Management of respiratory distress syndrome in moderate/late preterm neonates: A Delphi consensus 中度/晚期早产新生儿呼吸窘迫综合征的管理：德尔菲共识。

Anales de pediatria

Pub Date : 2024-11-01 DOI: 10.1016/j.anpede.2024.10.003

Segundo Rite Gracia , Juan José Agüera Arenas , Gemma Ginovart Galiana , María Jesús Rodríguez Revuelta

Introduction

Respiratory distress syndrome (RDS) is the most frequent cause of respiratory distress in preterm neonates. In the management of RDS, surfactant plays a pivotal role, but there are no evidence-based recommendations for moderate/late preterm neonates (32–36 weeks).

Methods

A scientific committee developed a questionnaire with 53 questions addressing diagnosis, treatment, potential complications and future trends in RDS specifically focused on moderate and late preterm neonates. This was followed by the performance of a Delphi survey of expert neonatologists.

Results

Consensus was reached on 98 of the 109 items. The recommendations for the diagnosis of RDS included performing a lung ultrasound and including mild respiratory distress, transient tachypnoea of the newborn, congenital pneumonia and primary pulmonary hypertension in the differential diagnosis. Most panellists agreed on the need for studies that determine the benefit/harm balance, clinical profile and methods of surfactant administration in moderate/late preterm neonates. All respondents would use the MIST approach with devices specifically designed for surfactant administration. Regarding sedation measures during MIST, most participants agreed on the use of nonpharmacological interventions and, if these proved ineffective, an opioid. All respondents agreed that moderate/late preterm neonates are at increased risk of neonatal morbidity and mortality, particularly respiratory problems, and considered the need for more specialised monitoring in hospital follow-up visits in neonates with associated risk factors or a history of complications in the neonatal period. Finally, all respondents agreed that there is a lack of studies identifying risk factors and medium-term adverse outcomes in moderate/late preterm neonates.

Conclusion

This expert consensus will help with the diagnosis and management of RDS and guide decision-making about surfactant administration in moderate/late preterm neonates.

简介呼吸窘迫综合征（RDS）是早产新生儿呼吸窘迫的最常见原因。在 RDS 的治疗中，表面活性物质起着关键作用，但目前还没有针对中度/晚期早产新生儿（32-36 周）的循证建议：方法：一个科学委员会编制了一份调查问卷，其中包含 53 个问题，涉及 RDS 的诊断、治疗、潜在并发症和未来趋势，特别关注中度和晚期早产新生儿。随后对新生儿专家进行了德尔菲调查：结果：在 109 个项目中，有 98 个项目达成了共识。诊断 RDS 的建议包括进行肺部超声波检查，并将轻度呼吸困难、新生儿一过性呼吸困难、先天性肺炎和原发性肺动脉高压纳入鉴别诊断。大多数小组成员一致认为有必要开展研究，以确定中度/晚期早产新生儿表面活性物质给药的利弊平衡、临床概况和方法。所有受访者都表示将使用 MIST 方法和专门为表面活性物质给药设计的设备。关于 MIST 期间的镇静措施，大多数参与者都同意使用非药物干预措施，如果无效，则使用阿片类药物。所有答复者都认为，中度/晚期早产新生儿的新生儿发病率和死亡率，尤其是呼吸系统问题的风险会增加，并认为有必要在医院随访时对有相关风险因素或新生儿期并发症病史的新生儿进行更专业的监测。最后，所有受访者一致认为，目前缺乏对中度/晚期早产新生儿风险因素和中期不良后果的研究：该专家共识将有助于 RDS 的诊断和管理，并为中晚期早产新生儿使用表面活性物质的决策提供指导。

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引用次数: 0

Nutritional status in patients with protein metabolism disorders. Case-control study 蛋白质代谢紊乱患者的营养状况。病例对照研究。

Anales de pediatria

Pub Date : 2024-11-01 DOI: 10.1016/j.anpede.2024.10.012

Isidro Robredo García , Paula Grattarola , Patricia Correcher Medina , Fátima Abu-Sharif Bohigas , Verónica Vélez García , Isidro Vitoria Miñana , Cecilia Martínez Costa

Introduction

Patients with protein metabolism disorders (PMDs) require a diet with strict protein control that can affect their growth and development. The aim of the study was to assess nutritional status and growth in patients with PMDs undergoing dietary treatment.

Patients and methods

Prospective observational case-control study in 63 patients with PMDs and 63 healthy controls matched for age and sex. We collected data for anthropometric variables (weight, height, BMI, tricipital and subscapular skinfolds, arm and waist circumference) and calculated the corresponding z scores. We also estimated the body fat mass and classified patients into nutritional status categories.

Results

The overall analysis found a lower height z score in patients with PMDs and an equal proportion of overweight and obesity with respect to controls (30.2%). When we divided patients with PMDs into 2 groups (phenylketonuria and other aminoacidopathies), we found that patients with phenylketonuria had a height that was similar to the height of controls and significantly higher compared to patients with other aminoacidopathies. When it came to nutritional status, the prevalence of overweight and obesity was greater in the phenylketonuria group (45.5%), while underweight and short stature were more frequent in the group with other aminoacidopathies.

Conclusion

Not all patients with PMDs follow the same growth pattern, and their body composition is variable. In our sample, the group of patients with phenylketonuria had an adequate height but also a higher prevalence of overweight and obesity. On the other hand, patients with other aminoacidopathies had a higher prevalence of underweight and lower z scores for height and arm circumference.

导言：蛋白质代谢紊乱症（PMDs）患者的饮食需要严格控制蛋白质，这可能会影响他们的生长发育。本研究旨在评估接受饮食治疗的蛋白质代谢障碍患者的营养状况和生长情况：前瞻性观察病例对照研究：63 名 PMD 患者和 63 名年龄和性别匹配的健康对照者。我们收集了人体测量变量（体重、身高、体重指数、三趾和肩胛下皮褶、臂围和腰围）的数据，并计算了相应的z得分。我们还估算了体脂质量，并将患者划分为营养状况类别：总体分析发现，与对照组（30.2%）相比， PMD 患者的身高 z 评分较低，超重和肥胖的比例相当。当我们将 PMD 患者分为两组（苯丙酮尿症和其他氨基酸疾病）时，我们发现苯丙酮尿症患者的身高与对照组相似，而其他氨基酸疾病患者的身高则明显高于对照组。在营养状况方面，苯丙酮尿症组超重和肥胖的发生率更高（45.5%），而体重不足和身材矮小在其他氨基酸疾病组中更为常见：结论：并非所有 PMD 患者都遵循相同的生长模式，他们的身体组成也各不相同。在我们的样本中，苯丙酮尿症患者的身高适中，但超重和肥胖的发生率较高。另一方面，其他氨基酸缺乏症患者体重不足的发生率较高，身高和臂围的 Z 值较低。

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引用次数: 0

Frequency of passive smoking exposure in Pediatric Primary Care Consultations: BACCO study 儿科初级保健咨询中被动吸烟暴露的频率：BACCO 研究。

Anales de pediatria

Pub Date : 2024-11-01 DOI: 10.1016/j.anpede.2024.10.007

María Almudena Santos Sánchez-Rey , Irene Zamanillo Herreros , Aida Frías González , María Rosa Albañil Ballesteros

引用次数: 0

Primary ciliary dyskinesia: additional diagnosis in a patient with cardiospondylocarpofacial syndrome 原发性睫状肌运动障碍：心软骨面容综合征患者的附加诊断。

Anales de pediatria

Pub Date : 2024-11-01 DOI: 10.1016/j.anpede.2024.10.010

Patricia Morte-Coscolín , Sandra Rovira-Amigo , Carlos Martín-de Vicente

引用次数: 0

The minor in Spanish legislation: an ethics perspective 西班牙立法中的未成年人：伦理视角。

Anales de pediatria

Pub Date : 2024-11-01 DOI: 10.1016/j.anpede.2024.08.007

María Alija , Isolina Riaño , Montserrat Esquerda

Introduction

Legislation embodies and regulates the common values by which a society is governed. Today’s society is multicultural and dynamic, a consensus must be reached and values consolidated on which different ideological groups can agree, an approach known as the ethics of minima. The concept of the minor has also been changing over the years; from being perceived as passive to being considered an autonomous individual engaged in the development of his or her life project and the bearer of duties and rights to be progressively exercised according to his or her capacity. This approach entails emerging problems. Both aspects need to be regulated in our legislation.

Objective

The objective of this work was to consider the different laws that concern minors from an ethical perspective and from the point of view of the practicing paediatrician.

Material and methods

We reviewed legislation concerning minors from the 1990s to the present day. For the purpose of discussion, we grouped it into 4 sections: the minor as a patient, protection of the minor, education and new social realities.

Conclusions

Current laws reflect a plural society and focus on protecting minority groups. They recognize the minor as the bearer of rights and duties, and consider the acquisition of autonomy to be progressive, guaranteeing equal opportunity and respecting the child’s own pace in achieving his or her potential. Current legislation also stresses the need for a stable environment and states that all forms of violence are preventable. Furthermore, it respects different moral, social and cultural perspectives.

导言：立法体现并规范着一个社会所遵循的共同价值观。当今社会是一个多元文化和充满活力的社会，必须达成共识，巩固不同意识形态群体能够达成一致的价值观，这种方法被称为未成年人伦理。多年来，未成年人的概念也在发生变化：从被视为被动者到被视为参与其生活项目发展的自主个人，以及根据其能力逐步行使的义务和权利的承担者。这种方法会带来新的问题。这两个方面都需要在我们的立法中加以规范：这项工作的目的是从伦理角度和儿科执业医师的角度来考虑与未成年人有关的不同法律：我们回顾了 20 世纪 90 年代至今有关未成年人的法律。为了便于讨论，我们将其分为四个部分：未成年人作为病人、保护未成年人、教育和新的社会现实：现行法律反映了一个多元化的社会，重点保护少数群体。这些法律承认未成年人是权利和义务的承担者，认为获得自主权是渐进的，保障机会均等，尊重儿童在实现自身潜能方面的发展速度。现行法律还强调需要一个稳定的环境，并指出一切形式的暴力都是可以预防的。此外，它还尊重不同的道德、社会和文化观点。

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引用次数: 0

Utility of the Amplatzer Piccolo™ occluder in the endovascular treatment of pulmonary sequestration in infants Amplatzer Piccolo™ 闭塞器在血管内治疗婴儿肺动脉栓塞中的应用。

Anales de pediatria

Pub Date : 2024-11-01 DOI: 10.1016/j.anpede.2024.10.011

Justo Santiago , Jorge Alvarado , Michell Guarin , María I. Diaz , Alexandra Hurtado

引用次数: 0

Are adverse childhood experiences the hidden iceberg of emotional distress in children and adolescents? 童年的不良经历是儿童和青少年情绪困扰的隐秘冰山吗？

Anales de pediatria

Pub Date : 2024-11-01 DOI: 10.1016/j.anpede.2024.10.013

Ana Rosa Sánchez Vázquez

引用次数: 0

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