Anales de pediatria最新文献

英文中文

Sleep disorders in children managed in the pediatric palliative care unit of a tertiary hospital 在一家三级医院的儿科姑息治疗部门管理儿童睡眠障碍。

Anales de pediatria

Pub Date : 2026-01-01 DOI: 10.1016/j.anpede.2025.504084

Lucía Monfort Belenguer , Andrés Piolatti Luna , María Isabel Lázaro Carreño , Teresa Cantavella Pons , Cristina Villar Vera

Introduction

In pediatric palliative care, 30% of patients suffer from cancer and the remaining 70% suffer mainly from neurologic, metabolic and genetic disorders. Sleep disorders affect 30% of healthy preschool children and up to 80% of neurologic patients, so these problems are likely to be common in PPC units. Addressing sleep quality is essential, as adequate rest improves the emotional and physical health of both children and their caregivers, thereby increasing their quality of life.

Objective

To determine the prevalence and specific characteristics of sleep problems in patients managed by the PPC unit of a tertiary care hospital between March and August 2024.

Material and methods

Quantitative, observational, and prospective study of patients receiving PPC at a tertiary care hospital. Sleep was assessed with instruments validated in the Spanish pediatric population (BISQ, SDSC and sleep diary).

Results

The study included 23 patients, of who 86.95% had neurologic disease. The most common sleep disorders were chronic insomnia and circadian rhythm disorders, with an overall prevalence of 78.26%. Low ferritin levels and the need for respiratory support during sleep were associated with worse scores on the sleep scale (SDSC).

Conclusions

Sleep disorders are highly prevalent in PPC, but validated scales and studies in large PPC samples are needed to improve their diagnosis and treatment and, consequently, the quality of life of patients and their families.

在儿童姑息治疗中，30%的患者患有癌症，其余70%的患者主要患有神经、代谢和遗传疾病。睡眠障碍影响30%的健康学龄前儿童和高达80%的神经系统患者，因此这些问题可能在PPC单位很常见。解决睡眠质量问题至关重要，因为充足的休息可以改善儿童及其照顾者的情绪和身体健康，从而提高他们的生活质量。目的：了解某三级医院PPC科室2024年3月至8月住院患者睡眠问题的患病率及特点。材料和方法：对三级医院接受PPC的患者进行定量、观察性和前瞻性研究。使用西班牙儿科人群（BISQ， SDSC和睡眠日记）验证的工具评估睡眠。结果：本研究纳入23例患者，其中86.95%患有神经系统疾病。最常见的睡眠障碍是慢性失眠和昼夜节律障碍，总患病率为78.26%。低铁蛋白水平和睡眠时需要呼吸支持与睡眠量表（SDSC）得分较差有关。结论：睡眠障碍在PPC中非常普遍，但需要在大PPC样本中进行有效的量表和研究，以改善其诊断和治疗，从而改善患者及其家属的生活质量。

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引用次数: 0

Vaccination and immunization schedule of the Pediatric Spanish Association: 2026 recommendations 西班牙儿科协会的疫苗接种和免疫计划：2026条建议

Anales de pediatria

Pub Date : 2026-01-01 DOI: 10.1016/j.anpede.2025.504051

Francisco José Álvarez García , Antonio Iofrío de Arce , Javier Álvarez Aldeán , Elisa Garrote Llanos , Lucía López Granados , María Luisa Navarro Gómez , Valentín Pineda Solas , Irene Rivero Calle , Jesús Ruiz-Contreras , Ignacio Salamanca de la Cueva , Pepe Serrano Marchuet

The 2026 Vaccination and Immunization Schedule recommended by the Spanish Association of Pediatrics (AEP) for children, adolescents and pregnant women residing in Spain includes the following new features: introduction of routine vaccination against hepatitis A with a single-dose schedule at 12–15 months; universal vaccination against influenza in children from 6 months and adolescents up to 17 years of age; catch-up vaccination and reengagement campaigns added to the routine immunization schedule and a new table featuring the vaccinations recommended for specific chronic diseases or risk conditions.

The following recommendations from the 2025 schedule, among others, are maintained: immunization with nirsevimab in infants younger than 6 months, or up to 12 months in the case of preterm infants born before 35 weeks of gestation and up to 24 months in children with risk factors; routine vaccination against meningococcal disease (MenB in infancy [starting at 2 months] and at 12 years, plus booster doses for those vaccinated in childhood with 4CMenB; MenACWY at 4 months, 12 months and 12 years); advancing the second doses of MMR and varicella vaccines to 24 months and the Tdap at 10–12 years; and vaccination against SARS-CoV-2 for children older than 6 months with risk factors. During pregnancy, vaccination with Tdap and against influenza and COVID-19 is indicated. Vaccination against RSV in pregnant women is available, although not funded, as it is not currently approved as a public health strategy.

西班牙儿科协会（AEP）为居住在西班牙的儿童、青少年和孕妇推荐的2026年疫苗接种和免疫计划包括以下新特点：在12-15个月时采用单剂量常规接种甲型肝炎疫苗；在6个月大的儿童和17岁以下的青少年中普遍接种流感疫苗；在常规免疫计划中增加了补充疫苗接种和重新参与运动，并新增了针对特定慢性疾病或危险状况推荐的疫苗接种表。除其他外，2025年时间表中的以下建议得到维持：在6个月以下的婴儿中接种尼塞维单抗，在妊娠35周前出生的早产儿中接种最多12个月，在有危险因素的儿童中接种最多24个月；常规接种脑膜炎球菌病疫苗（婴儿期（2个月开始）和12岁时接种b型脑膜炎球菌病疫苗，儿童期接种b型脑膜炎球菌病疫苗者接种加强剂；4个月、12个月和12岁接种b型脑膜炎球菌病疫苗）；将第二剂MMR和水痘疫苗的接种时间提前至24个月，将百白破疫苗的接种时间提前至10至12岁；为有危险因素的6个月以上儿童接种SARS-CoV-2疫苗。在怀孕期间，建议接种百白破疫苗，预防流感和COVID-19。针对孕妇的呼吸道合胞病毒疫苗接种是可用的，尽管没有资助，因为它目前没有被批准为一项公共卫生战略。

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引用次数: 0

Terminology and respect in addressing vaccine hesitancy 解决疫苗犹豫的术语和尊重。

Anales de pediatria

Pub Date : 2026-01-01 DOI: 10.1016/j.anpede.2025.504055

Rafael Jiménez Alés , Raquel Páez González , María José González Arranz , Cristina Rodríguez Arranz

引用次数: 0

Neonatal resuscitation with the 15 chest compressions to 2 ventilations pediatric ratio. Would it be comparable to the 3:1 standard? 新生儿复苏采用15次胸外按压对2次呼吸的儿科比例。它能与3:1的标准相媲美吗？

Anales de pediatria

Pub Date : 2026-01-01 DOI: 10.1016/j.anpede.2025.504083

Myriam Santos-Folgar , Alejandra Alonso-Calvete , Martín Otero-Agra , Felipe Fernández-Méndez , Antonio Rodríguez-Nuñez

Introduction

Neonatal asphyxia is a major cause of neonatal mortality and morbidity worldwide. Most births in resource-limited settings are not attended by a specialist, so the implementation of a universal (for all children) cardiopulmonary resuscitation technique could be efficient. The aim of this study was to compare the quality of neonatal CPR using compression-to-ventilation ratios of 15:2 versus 3:1.

Methods

A randomized crossover study was conducted with 36 trained nursing students. Neonatal CPR simulations were performed using manikins. Each participant completed four 2-minute CPR simulations, alternating between ventilation and chest compressions using the 15:2 and 3:1 ratios. Rest periods were included to avoid fatigue. Compression and ventilation variables were measured using the Resusci Baby QCPR manikin and SimPad PLUS. We also documented participant preferences.

Results

We found a higher percentage of compressions with adequate depth with the 15:2 CPR ratio (26% vs 11%, P = .005). In terms of ventilations, the 3:1 CPR ratio achieved a higher mean tidal volume (27 vs 24 mL, P = .002) a higher mean ventilation rate per minute (32 vs 15, P < .001) and a higher mean minute volume (809 mL/min vs 351 mL/min, P < .001). The proportion of ventilations with an adequate tidal volume was higher for the 15:2 CPR ratio (74% vs 64%, P = .14), although this difference was not statistically significant.

Conclusions

In a neonatal CPR simulation model, the 15:2 compression-to-ventilation ratio achieved quality parameters comparable to the 3:1 ratio in terms of performance. The implementation of a unified compression:ventilation ratio (15:2) for CPR from birth through childhood could simplify training and improve the effectiveness of neonatal resuscitation, particularly in settings with limited resources for birth care training. Our results, obtained in a simulated environment, support the performance of studies in real patients.

新生儿窒息是全世界新生儿死亡和发病的主要原因。在资源有限的环境中，大多数分娩都没有专科医生，因此实施一种普遍的（对所有儿童）心肺复苏技术可能是有效的。本研究的目的是比较新生儿心肺复苏术在按压通气比为15:2和3:1时的质量。方法：对36名护理专业学生进行随机交叉研究。使用人体模型进行新生儿心肺复苏模拟。每位参与者完成四次2分钟的心肺复苏模拟，以15:2和3:1的比例交替进行通气和胸外按压。休息时间包括在内，以避免疲劳。使用Resusci Baby QCPR人体模型和SimPad PLUS测量压缩和通气变量。我们还记录了参与者的偏好。结果：我们发现，在心肺复苏术比例为15:2的情况下，适当深度的按压比例更高（26% vs 11%, P = 0.005）。在通气量方面，3:1 CPR比获得更高的平均潮气量（27 vs 24 mL, P = .002），更高的平均每分钟通气量（32 vs 15, P < .001）和更高的平均分钟容积（809 mL/min vs 351 mL/min, P < .001）。在15:2 CPR比例下，潮气量足够的通气比例更高（74% vs 64%, P = 0.14），尽管这一差异无统计学意义。结论：在新生儿心肺复苏模拟模型中，15:2的按压通气比与3:1的按压通气比在性能方面达到了相当的质量参数。从出生到儿童期实施统一的按压通气比（15:2）可以简化培训，提高新生儿复苏的有效性，特别是在分娩护理培训资源有限的环境中。我们在模拟环境中获得的结果支持在真实患者中进行的研究。

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引用次数: 0

Hemolacria in acute hemorrhagic edema of infancy. 婴儿急性出血性水肿的溶血。

Anales de pediatria

Pub Date : 2025-12-30 DOI: 10.1016/j.anpede.2025.504108

Beatriz de Sousa, Joana Baptista, Andreia Lopes, Liliana Macedo

引用次数: 0

Hip pain and claudication… An unexpected diagnosis! 髋关节疼痛和跛行…一个意想不到的诊断！

Anales de pediatria

Pub Date : 2025-12-30 DOI: 10.1016/j.anpede.2025.504107

Sara Silva Rodrigues, Alexandra M Lopes Santos, Patrícia Terroso, Sónia Carvalho

引用次数: 0

One artery, two circulations: diagnostic challenges of anomalous origin of unilateral pulmonary artery from the ascending aorta in neonates. 一条动脉，两条循环：新生儿升主动脉单侧肺动脉异常起源的诊断挑战。

Anales de pediatria

Pub Date : 2025-12-30 DOI: 10.1016/j.anpede.2025.504109

Laia Brunet-Garcia, Flavio Zuccarino, Juan Manuel Carretero Bellon

引用次数: 0

Assessment and Management of Cholestasis: Consensus Document of the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP), the Spanish Association of Primary Care Pediatrics (AEPap) and the Spanish Society of Primary Care Pediatrics (SEPEAP) 胆汁淤积的评估和管理：西班牙儿科胃肠病学、肝病学和营养学学会（SEGHNP）、西班牙初级保健儿科协会（AEPap）和西班牙初级保健儿科学会（SEPEAP）的共识文件。

Anales de pediatria

Pub Date : 2025-12-01 DOI: 10.1016/j.anpede.2025.504034

Maria Mercadal-Hally , Inés Loverdos , Joaquín Reyes-Andrade , Samuel Héctor Campuzano Martín , Ana Moreno Álvare , Ana María Vegasa-Álvarez , Ana Pilar Galera Peinado

Cholestasis is indicative of hepatobiliary dysfunction and is always pathological. Early detection helps improve the prognosis of some of the underlying diseases that cause it. The most common liver disease that causes cholestasis in the first months of life is biliary atresia, followed by monogenic diseases. The objective of this document is to provide consensus-based recommendations for the adequate management of cholestasis based on the review of the current evidence. A working group was created for the purpose, with participation of members of the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition, the Spanish Association of Primary Care Pediatrics and the Spanish Society of Primary Care Pediatrics. The group established 26 recommendations to guide management in everyday clinical practice in both primary care and hospital settings.

胆汁淤积是肝胆功能障碍的表现，通常是病理性的。早期发现有助于改善一些潜在疾病的预后。在出生头几个月引起胆汁淤积的最常见的肝脏疾病是胆道闭锁，其次是单基因疾病。本文件的目的是在回顾现有证据的基础上，为充分管理胆汁淤积症提供基于共识的建议。为此目的设立了一个工作组，由西班牙儿科胃肠病学、肝病学和营养学学会、西班牙初级保健儿科协会和西班牙初级保健儿科学会的成员参加。该小组提出了26项建议，以指导初级保健和医院环境中日常临床实践中的管理。

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引用次数: 0

The importance of endocrine disruptors: an environmental prevention approach 内分泌干扰物的重要性：一种环境预防方法。

Anales de pediatria

Pub Date : 2025-12-01 DOI: 10.1016/j.anpede.2025.504027

Paula Sol Ventura Wichner , Ana María Prado Carro , en representación del Grupo de Trabajo de Disruptores Endocrinos de la Sociedad Española de Endocrinología Pediátrica (SEEP)

引用次数: 0

Taking a closer look at the early onset of childhood obesity risk 让我们仔细看看儿童肥胖的早期发病风险。

Anales de pediatria

Pub Date : 2025-12-01 DOI: 10.1016/j.anpede.2025.504037

Empar Lurbe , Julio Álvarez-Pitti , José Manuel Sastre , Francisco Aguilar

Epidemiological studies and studies in animal models have demonstrated the importance of the early stages of life and their relationship with health and disease in adulthood. Intervening in the risk of adult diseases by acting early in life is possible due to the great plasticity of this period, when timely actions can have a great impact. These would be aimed at reducing risk factors which would help to break the intergenerational vicious circles of maternal and childhood obesity, diabetes and related cardiometabolic health consequences, with a potential impact on the next generation.

Obesity in children and adolescents is a global health problem whose prevalence is increasing. When it comes to the risk of developing childhood obesity, the periods from conception and pregnancy through the end of the first 2 years of life are particularly relevant. Despite the special relevance of this stage, it has not always received the attention it deserves, and the approach at this time not free of difficulties.

Due to their importance, each of these stages requires specific approaches. Education on the concept of the relevance of healthy lifestyles during this period should be delivered not only to health care personnel but also to the general population.

流行病学研究和动物模型研究表明，生命早期阶段及其与成年期健康和疾病的关系十分重要。通过在生命早期采取行动来干预成人疾病的风险是可能的，因为这一时期具有很大的可塑性，及时的行动可以产生很大的影响。这些措施的目的是减少危险因素，从而有助于打破产妇和儿童肥胖、糖尿病和相关的心脏代谢健康后果的代际恶性循环，并可能对下一代产生影响。儿童和青少年肥胖是一个全球性的健康问题，其患病率正在上升。当谈到患儿童肥胖的风险时，从受孕和怀孕到生命结束前两年的这段时间尤为相关。尽管这一阶段具有特殊的意义，但它并不总是得到应有的重视，目前的做法并非没有困难。由于它们的重要性，每个阶段都需要特定的方法。在此期间，不仅应向保健人员，而且应向一般民众进行健康生活方式相关概念的教育。

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