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Publisher: Elsevier   (Total: 3030 journals)

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Showing 1 - 200 of 3030 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 20, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 16, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 79, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 22, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 27, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 303, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription  
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 196, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 9, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 21, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 5, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 4)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 120, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 24, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 21, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 26, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 24, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 8, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 4)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 39, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 38, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 41, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 14)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 18, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 22)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 33, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 4)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 7, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 8)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 5, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 6, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 20, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 14)
Advances in Pharmacology     Full-text available via subscription   (Followers: 13, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 7, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 17, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 56)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 1, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 332, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 7)
Advances in Surgery     Full-text available via subscription   (Followers: 6, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 28, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 14)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 12)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 42, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 304, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 4, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 7, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 390, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 29, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 36, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 48, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 3, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 9, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 5)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 7, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 5, SJR: 0.776, h-index: 35)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 6, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 45, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 3)
American Heart J.     Hybrid Journal   (Followers: 45, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 34, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 6, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 32, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 25, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 31, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 48, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 174, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 51, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 2)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 22, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 23, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 32, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 13, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 52, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 3)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 38, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 154, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 7, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 10)
Anesthésie & Réanimation     Full-text available via subscription  
Anesthesiology Clinics     Full-text available via subscription   (Followers: 21, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 143, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

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Journal Cover Anales de Pediatría (English Edition)
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   Full-text available via subscription Subscription journal  (Not entitled to full-text)
   ISSN (Print) 2341-2879
   Published by Elsevier Homepage  [3030 journals]
  • A real-world study focused on the effectiveness and safety of adalimumab
           as first-line anti-TNF treatment for paediatric Crohn's disease
    • Authors: Víctor Manuel Navas-López; Gemma Pujol-Muncunill; Enrique Llerena; María Navalón Rubio; David Gil-Ortega; Vicente Varea-Calderón; Carlos Sierra Salinas; Javier Martin-de-Carpi
      Abstract: Publication date: Available online 22 April 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Víctor Manuel Navas-López, Gemma Pujol-Muncunill, Enrique Llerena, María Navalón Rubio, David Gil-Ortega, Vicente Varea-Calderón, Carlos Sierra Salinas, Javier Martin-de-Carpi
      Background and objectives Adalimumab (ADA), a monoclonal humanised anti-TNF antibody, is usually prescribed as a second-line treatment in paediatric Crohn's disease (CD) patients who have become unresponsive or developed intolerance to infliximab (IFX). In the case series reported, more than 70% of patients had initially been treated with IFX. Data on short- and long-term efficacy of ADA in anti-TNF naïve patients is limited. The aim of this study is to describe our experience with ADA as a first-line anti-TNF in paediatric CD patients. Material and methods This is a multicentre retrospective study including anti-TNF naïve paediatric CD patients treated with ADA as first-line anti-TNF. Results Sixty-two patients (34 males), with a mean age of 13.0±2.4 years and a disease duration of 7.3 (IQR 2.7–21) months were included. Median wPCDAI was 35 (IQR 24.3–47.5). Fifty-eight out of 62 (93.5%) were on combo therapy at baseline. Clinical remission at week 12 was achieved in 50 out of 62 (80.6%) and in 57 out of 60 (95.0%) at week 52. Eight patients (13%) reported adverse events. Mean height, growth rate and BMI z-scores improved significantly between baseline and week 52, especially in patients with growth failure. Conclusions ADA treatment leads to lasting clinical remission in anti-TNF naïve paediatric patients with CD. ADA significantly improved growth rate in children with CD who had growth delay at baseline. Some patients remain in remission for prolonged time periods under monotherapy; however, some patients would require dose escalation.

      PubDate: 2017-04-23T06:43:29Z
      DOI: 10.1016/j.anpede.2017.03.001
       
  • Risks associated with the uncontrolled use of donated breast milk
    • Authors: Nadia Raquel García Lara; Manuela Peña Caballero
      Abstract: Publication date: Available online 12 April 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Nadia Raquel García Lara, Manuela Peña Caballero


      PubDate: 2017-04-16T03:52:42Z
      DOI: 10.1016/j.anpedi.2017.02.002
       
  • Self-medication, self-prescription and medicating “by proxy”
           in paediatrics
    • Authors: Valenzuela Ortiz; Francisco Javier Ruiz-Cabello Uberos Ana Checa Ros Cristina
      Abstract: Publication date: Available online 12 April 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): María Valenzuela Ortiz, Francisco Javier Sánchez Ruiz-Cabello, José Uberos, Ana Fátima Checa Ros, Cristina Valenzuela Ortiz, María Carmen Augustín Morales, Antonio Muñoz Hoyos
      Introduction Self-prescribing or medicating ‘by proxy’ is not an autonomous, free and voluntary decision in the case of children. On the contrary, in this case it is based on the subjective interpretation of symptoms made by the mother or by a third person who is legally responsible for the minor. Analysing this situation is of great importance in order to know the determining factors, perceptions, and realities related to this problem. Methods Our proposal is to perform a prospective observational study for analysing maternal and familiar determinant factors related to self-prescribing and self-medicating ‘by proxy’ in paediatrics. A validated survey was developed to be applied to mothers of children aged 0–14 who are users of the Paediatric Emergency Department in a hospital. Results A total of 1.714 mothers were recruited in a random period of time. This sample included 345 mothers who exclusively self-medicated their children (case group), and 1.369 mothers (control group) who did not meet this requirement. The overall percentage of medicating ‘by proxy’ was 32.8%. There is a significant association between self-medicating and educational level of the mother, the number of children, and the birth order among siblings. Neither maternal age nor social-occupational level are related to this problem. Most frequently used drugs include antipyretics and ‘anticatharrals’, usually administered as a monotherapy. Conclusions Our results seem to indicate that the educational level and the parental experience acquired with previous children could generate the required confidence in parents to choose the medication by themselves. Almost 85% of these drugs come from the ‘home first-aid kit’.

      PubDate: 2017-04-16T03:52:42Z
       
  • Effects of growth hormone treatment on anthropometrics, metabolic risk,
           and body composition variables in small for gestational age patients
    • Authors: Esther Aurensanz Clemente; Pilar Samper Villagrasa; Ariadna Ayerza Casas; Pablo Ruiz Frontera; Olga Bueno Lozano; Luis Alberto Moreno Aznar; Gloria Bueno Lozano
      Abstract: Publication date: Available online 10 April 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Esther Aurensanz Clemente, Pilar Samper Villagrasa, Ariadna Ayerza Casas, Pablo Ruiz Frontera, Olga Bueno Lozano, Luis Alberto Moreno Aznar, Gloria Bueno Lozano
      Introduction and objectives Small for gestational age (SGA) children without catch-up growth can benefit from treatment with growth hormone (rhGH). However, they should be monitored very closely because they are at increased risk of metabolic syndrome. Material and method A group of 28 SGA children with a mean age of 8.79 years and undergoing treatment with rhGH were selected for evaluation. Over the course of 4 years, an annual evaluation was performed on the anthropometric variables (weight, height, body mass index [BMI], growth rate, blood pressure and waist perimeter), metabolic risk variables (glycaemia, glycosylated haemoglobin, cholesterol ratio, insulinaemia, insulin-like growth factor 1[IGF1], IGF binding protein-3 [IGFBP-3], IGF1/IGFBP3 ratio, and HOMA index), and body composition variables. Results Treatment with rhGH was associated with a significant increase in height (−2.76±.11 SD to −1.53±.17 SD, P =.000), weight (−1.50±.09 SD to −1.21±.13 SD; P =.016), and growth rate (−1.43±.35 SD to .41±.41 SD; P =.009), without a corresponding change in the BMI. Insulinaemia (9.33±1.93mU/ml to 16.55±1.72mU/ml; P =.044) and the HOMA index (3.63±.76 to 6.43±.67; P =.042) increased, approaching insulin resistance levels. No changes were observed in the lipid profile. Body composition changes were observed, with a significant increase in lean mass (73.19±1.26 to 78.74±1.31; P =.037), and a reduction of fat mass (26.81±1.26 to 21.26±1.31; P =.021). Conclusion Treatment with rhGH is effective for improving anthropometric variables in SGA patients who have not experienced a catch-up growth. It also produces changes in body composition, which may lead to a reduction in risk of metabolic syndrome. However, some insulin resistance was observed. It is important to follow up this patient group in order to find out whether these changes persist into adulthood.

      PubDate: 2017-04-16T03:52:42Z
      DOI: 10.1016/j.anpede.2016.05.005
       
  • Spanish patients with central hypoventilation syndrome included in the
           European Registry. The 2015 data
    • Authors: María Angeles García Teresa; Raquel Porto Abal; Silvia Rodríguez Torres; Diego García Urabayen; Silvia García Martínez; Ha Trang; Angel Campos Barros
      Abstract: Publication date: Available online 10 April 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): María Angeles García Teresa, Raquel Porto Abal, Silvia Rodríguez Torres, Diego García Urabayen, Silvia García Martínez, Ha Trang, Angel Campos Barros
      Introduction Congenital central hypoventilation syndrome (CCHS) is a very rare genetic disease. In 2012 the European Central Hypoventilation Syndrome (EuCHS) Consortium created an online patient registry in order to improve care. Aim To determine the characteristics and outcomes of Spanish patients with CCHS, and detect clinical areas for improvement. Materials and method An assessment was made on the data from Spanish patients in the European Registry, updated on December 2015. Results The Registry contained 38 patients, born between 1987 and 2013, in 18 hospitals. Thirteen (34.2%) were older than 18 years. Three patients had died. Genetic analysis identified PHOX2B mutations in 32 (86.5%) out of 37 patients assessed. The 20/25, 20/26 and 20/27 polyalanine repeat mutations (PARMs) represented 84.3% of all mutations. Longer PARMs had more, as well as more severe, autonomic dysfunctions. Eye diseases were present in 47%, with 16% having Hirschsprung disease, 13% with hypoglycaemia, and 5% with tumours. Thirty patients (79%) required ventilation from the neonatal period onwards, and 8 (21%) later on in life (late onset/presentation). Eight children (21%) were using mask ventilation at the first home discharge. Five of them were infants with neonatal onset, two of them, both having a severe mutation, were switched to tracheostomy after cardiorespiratory arrest at home. Approximately one-third (34.3%) of patients were de-cannulated and switched to mask ventilation at a mean age of 13.7 years. Educational reinforcement was required in 29.4% of children attending school. Conclusion The implementation of the EuCHS Registry in Spain has identified some relevant issues for optimising healthcare, such as the importance of genetic study for diagnosis and assessment of severity, the high frequency of eye disease and educational reinforcement, as well as some limitations in ventilatory techniques.

      PubDate: 2017-04-16T03:52:42Z
      DOI: 10.1016/j.anpede.2016.05.006
       
  • Malnutrition in children admitted to hospital. Results of a national
           survey
    • Authors: José Manuel Moreno Villares; Vicente Varea Calderón; Carlos Bousoño García
      Abstract: Publication date: Available online 8 April 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): José Manuel Moreno Villares, Vicente Varea Calderón, Carlos Bousoño García
      Introduction Malnutrition on admission is closely related to a longer hospital stay and a higher morbidity. The prevalence of hospital malnutrition has been reported as almost as high as 50%, with 6% being the lowest. DHOSPE study investigates nutrition status in Spanish hospitals and its outcome during the hospital stay. Patients and methods A longitudinal, multicentre, descriptive, cross-sectional study, with a short follow-up period was conducted in 32 hospitals during 2011. A total of 991 patients were included, with ages from 0 to 17 years. Each patient was measured at admission (weight, length, weight for length -W/L-, length for age -L/A-), and at 7 and 14 days. The STAMP nutritional screening tool was completed on admission. Anthropometric measurements were reported as z-score, and nutrition status classified according to W/L and L/A for acute and chronic malnutrition, respectively. Results The prevalence of malnutrition was 7.1% for moderate, and 0.7% for severe acute malnutrition. For chronic malnutrition, 2.7% was moderate, and 1.4% severe. There were significant differences according to the underlying condition but not according to age. Results of STAMP show that around 75% of patients had a moderate to high risk of malnutrition. Nutritional status changed during admission for weight, as well as W/L and L/A. A worse nutritional status at admission and a higher STAMP score were positively correlated with the need for nutrition support. Conclusions The prevalence of undernutrition was slightly lower (<8%) than previously reported, probably in relation to the variety of hospitals in the survey. Nevertheless, nutritional risk when evaluated with STAMP showed a high risk of malnutrition.

      PubDate: 2017-04-09T01:13:21Z
      DOI: 10.1016/j.anpede.2015.12.006
       
  • Growth hormone treatment in small for gestational age children in Spain
    • Authors: José Manuel Rial Rodríguez; Antonio de Arriba Muñoz; Jordi Bosch Muñoz; Paloma Cabanas Rodríguez; Ramón Cañete Estrada; Ignacio Díez López; María Magdalena Hawkins Solís; María José Martínez-Aedo Ollero; Ana Cristina Rodríguez Dehli; Lourdes Ibáñez Toda
      Abstract: Publication date: Available online 8 April 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): José Manuel Rial Rodríguez, Antonio de Arriba Muñoz, Jordi Bosch Muñoz, Paloma Cabanas Rodríguez, Ramón Cañete Estrada, Ignacio Díez López, María Magdalena Hawkins Solís, María José Martínez-Aedo Ollero, Ana Cristina Rodríguez Dehli, Lourdes Ibáñez Toda
      Introduction Since its approval by the European Medicines Agency, a great number of patients born small for gestational date have received recombinant growth hormone treatment in Spain. The aim of this study is to analyse its outcome in the setting of ordinary clinical practice. Methods Information was gathered from the registers of the assessment boards that authorise all growth hormone treatments prescribed in public hospitals in six autonomic communities (regions). Results Valid data from 974 patients was obtained. All of them complied with criteria established by the European Medicines Agency. Patients in the sample were smaller in length than weight at birth, with their median target height being below 1 standard deviation (SD), and 23% of them had been delivered prematurely. Treatment was started at 7.2±2.8 years (mean±SD). The mean patient height at start was −3.1±0.8 SD. They gained 0.7±0.2 SD in the first year, and 1.2±0.8 SD after two years. Final height was attained by 8% of the sample, reaching −1.4±0.7 SD. Conclusions These results are similar to other Spanish and international published studies, and are representative of the current practice in Spain. Despite treatment being started at a late age, adequate growth is observed in the short term and in the final height. Up to a 24% of patients show a poor response in the first year.

      PubDate: 2017-04-09T01:13:21Z
      DOI: 10.1016/j.anpede.2016.04.008
       
  • Drug syrups: Errors in drug labels with possible consequences in patients
           with hereditary fructose intolerance
    • Authors: Elsa Izquierdo-García; Ismael Escobar Rodríguez; José Manuel Moreno-Villares; Irene Iglesias Peinado
      Abstract: Publication date: Available online 5 April 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Elsa Izquierdo-García, Ismael Escobar Rodríguez, José Manuel Moreno-Villares, Irene Iglesias Peinado


      PubDate: 2017-04-09T01:13:21Z
      DOI: 10.1016/j.anpede.2017.03.004
       
  • Familial EXOSC3-related pontocerebellar hypoplasia
    • Authors: Anna Paola Di Giovambattista; Itxaropena Jácome Querejeta; Purificación Ventura Faci; Gerardo Rodríguez Martínez; Feliciano Ramos Fuentes
      Abstract: Publication date: Available online 5 April 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Anna Paola Di Giovambattista, Itxaropena Jácome Querejeta, Purificación Ventura Faci, Gerardo Rodríguez Martínez, Feliciano Ramos Fuentes


      PubDate: 2017-04-09T01:13:21Z
      DOI: 10.1016/j.anpede.2016.09.004
       
  • Surgical closure of patent ductus arteriosus in premature neonates: Does
           the surgical technique affect the outcome'
    • Authors: Alejandro Avila-Alvarez; Marta Serantes Lourido; Rebeca Barriga Bujan; Carolina Blanco Rodriguez; Francisco Portela-Torron; Victor Bautista-Hernandez
      Abstract: Publication date: Available online 5 April 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Alejandro Avila-Alvarez, Marta Serantes Lourido, Rebeca Barriga Bujan, Carolina Blanco Rodriguez, Francisco Portela-Torron, Victor Bautista-Hernandez
      Introduction Surgical closure of patent ductus arteriosus in premature neonates is an aggressive technique and is not free of complications. A study was designed with the aim of describing our experience with a less invasive technique, the extra-pleural approach via a posterior minithoracotomy, and to compare the results with the classic transpleural approach. Patients and methods A retrospective cohort study was conducted on premature neonates on whom surgical closure of the ductus was performed during a ten-year period (March 2005 to March 2015). A comparison was made of the acute complications, the outcomes on discharge, and follow-up, between the extra-pleural approach and the classic transpleural approach. The study included 48 patients, 30 in the classical approach and 18 in the extra-pleural group. Results The demographic and pre-operative characteristics were similar in both groups. No differences were found between the 2 groups in the incidence of acute post-operative complications (56.6 vs. 44.4%), on the dependence on oxygen at 36 weeks (33.3 vs. 55.5%), or in hospital mortality (10 vs. 16.6%). As regards the short-term progress, the extra-pleural group required fewer days until the withdrawal of supplementary oxygen (36.3 vs. 28.9) and until hospital discharge (67.5 vs. 53.2), although only the time until extubation achieved a statistically significant difference (11.5 vs. 2.7, p =.03). Conclusions The extra-plural approach by posterior minithoracotomy for the surgical closure of ductus in the premature infant is viable and could bring some clinical benefits in the short-term.

      PubDate: 2017-04-09T01:13:21Z
      DOI: 10.1016/j.anpede.2015.12.005
       
  • The little and large of pediatric obesity prevention
    • Authors: Manuel Moya
      Abstract: Publication date: Available online 4 April 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Manuel Moya


      PubDate: 2017-04-09T01:13:21Z
      DOI: 10.1016/j.anpede.2017.03.002
       
  • Criteria for hospital discharge of the healthy term newborn after delivery
    • Authors: Segundo Rite Gracia; Alejandro Pérez Muñuzuri; Ester Sanz López; José Luis Leante Castellanos; Isabel Benavente Fernández; César W. Ruiz Campillo; M. Dolores Sánchez Redondo; Manuel Sánchez Luna
      Abstract: Publication date: Available online 3 April 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Segundo Rite Gracia, Alejandro Pérez Muñuzuri, Ester Sanz López, José Luis Leante Castellanos, Isabel Benavente Fernández, César W. Ruiz Campillo, M. Dolores Sánchez Redondo, Manuel Sánchez Luna
      Criteria for newborn hospital discharge have to include physiological stability and family competence to provide newborn care at home. In this document, the Committee of Standards of the Spanish Society of Neonatology reviews the minimum criteria to be met before hospital discharge of a term newborn infant. We include a review of hospital discharge criteria for the late preterm infants, as these infants are often not hospitalised and remain with their mother after birth. A shortened hospital stay (less than 48h after delivery) for healthy term newborns can be considered, but it is not appropriate for every mother and newborn. Newborn infants discharged before 48h of age, should be examined within 3–4 days of life.

      PubDate: 2017-04-09T01:13:21Z
      DOI: 10.1016/j.anpede.2016.08.006
       
  • Kawasaki disease is more prevalent in rural areas of Catalonia (Spain)
    • Authors: Judith Sánchez-Manubens; Jordi Antón; Rosa Bou; Estibaliz Iglesias; Joan Calzada-Hernandez; Xavier Rodó; Josep-Antón Morguí
      Abstract: Publication date: Available online 3 April 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Judith Sánchez-Manubens, Jordi Antón, Rosa Bou, Estibaliz Iglesias, Joan Calzada-Hernandez, Xavier Rodó, Josep-Antón Morguí
      Introduction Kawasaki disease (KD) is an acute self-limited systemic vasculitis relatively common in childhood. The etiology of KD is still unknown, although clinical, laboratory and epidemiological features suggest an infectious origin or trigger. Differences on incidence between countries have been related to specific genetic factors, ethnicity, country of birth and some other sociocultural and environmental factors. We present a population-based study on incidence of KD in Catalonia (Spain), focusing on differences between patients in rural and non-rural areas of the region. Methods Observational population-based study including all Pediatric Units in Catalan hospitals, between 2004 and 2014. A 12-month (March 2013–March 2014) prospective collection of new cases of KD was carried out to determine the incidence of KD. The rest of the data was retrieved retrospectively. Results Data from 399 patients over the 10-year study period was analyzed. Among the total KD patients, 353 (88.5%) lived in non-rural areas and 46 (11.5%) in rural areas. It was found that there is a significant difference (p <0.001) between the percentage of rural population observed in patients with KD (11.5%), and the expected 5% of the Catalan population. Conclusion This is the first population-based study showing significant differences on KD incidence rates between rural and non-rural areas.

      PubDate: 2017-04-09T01:13:21Z
      DOI: 10.1016/j.anpede.2017.02.001
       
  • Use of levetiracetam in neonatal seizures
    • Authors: Jose Maria Lloreda-García; Jose Ramón Fernández-Fructuoso; Elisabeth Gómez-Santos; Ana García-González; Jose Luis Leante-Castellanos
      Abstract: Publication date: Available online 24 March 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Jose Maria Lloreda-García, Jose Ramón Fernández-Fructuoso, Elisabeth Gómez-Santos, Ana García-González, Jose Luis Leante-Castellanos


      PubDate: 2017-03-26T21:05:50Z
      DOI: 10.1016/j.anpede.2016.08.005
       
  • Hypovitaminosis D and associated factors in 4-year old children in
           northern Spain
    • Authors: Ana Cristina Rodríguez-Dehli; Isolina Riaño-Galán; Ana Fernández-Somoano; Eva María Navarrete-Muñoz; Mercedes Espada; Jesús Vioque; Adonina Tardón
      Abstract: Publication date: Available online 15 March 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Ana Cristina Rodríguez-Dehli, Isolina Riaño-Galán, Ana Fernández-Somoano, Eva María Navarrete-Muñoz, Mercedes Espada, Jesús Vioque, Adonina Tardón
      Introduction Vitamin D is an essential prohormone in calcium and phosphorus homeostasis. Recent studies show a high frequency of insufficiency/deficiency of vitamin D in the general population worldwide. Our objective was to estimate the prevalence of circulating vitamin D [25(OH)D3] deficiency and insufficiency in children and examine the associated factors. Material and methods A total of 283 children, participants in the cohort INMA-Asturias, were studied. The 25(OH)D3 concentrations were quantified by high performance liquid chromatography. The prevalence of deficiency [25(OH)D3<20ng/mL] and insufficiency [20–29.9ng/mL] of vitamin D was estimated. Distribution of 25(OH)D3 for month of extraction of specimen, ingestion, and other factors were analysed. Results The mean 25(OH)D3 was 20.1ng/mL (range 2.7–49.8), with 8.8% ≥30ng/mL, 38.5% from 20 to 20.9ng/mL, and 52.7%<20ng/mL. Seasonal variation was found, with lower values in winter. There was no relationship between plasma levels and intake of vitamin D (median 2.7μg/day, range 0.81–12.62), time outdoors (mean 3h, range: 0:21–6:55), or BMI or gender, but there was one found with the mother's levels during gestation. Conclusions There is a high prevalence of vitamin D deficiency/insufficiency in children at 4 years. Solar exposure might not be enough in our region. Healthy children should be encouraged to follow adequate outdoor activities with associated sun exposure. Due to the deficit of intake in childhood, recommendations are needed about a varied diet with vitamin D-containing foods in this age group, especially during the winter, and assessing the need of vitamin D supplementation in children at risk.

      PubDate: 2017-03-15T20:13:17Z
      DOI: 10.1016/j.anpede.2016.02.006
       
  • Childhood obesity: Prevention or treatment'
    • Authors: Juan
      Abstract: Publication date: Available online 14 March 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Juan J. Díaz Martín


      PubDate: 2017-03-15T20:13:17Z
       
  • Invasive meningococcal disease in Navarra in the era of a meningococcal C
           vaccine
    • Authors: Desirée Morales; Laura Moreno; Mercedes Herranz; Enrique Bernaola; Iván Martínez-Baz; Jesús Castilla
      Abstract: Publication date: Available online 9 March 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Desirée Morales, Laura Moreno, Mercedes Herranz, Enrique Bernaola, Iván Martínez-Baz, Jesús Castilla
      Introduction Systematic childhood vaccination against meningococcus C has had a considerable impact on meningococcal invasive disease (MID). The aim of this study is to perform an analysis on the epidemiology, the clinical features, and the factors associated with a worse prognosis of MID, in the era of a meningococcal C vaccine. Material and methods The study included confirmed cases of MID in children less than 15 years of age in Navarra, Spain, between 2008 and 2014. The risk of death or permanent sequelae was evaluated according to the presence of clinical features and analytical parameters at diagnosis. Results The average annual incidence was 7.9 cases per 100000 children, with the highest attack rate in children <1 year. Of 53 cases analysed, 87% were due to meningococcus B. Fever (100%), rash (91%), and elevation of procalcitonin (94%) were the most frequent findings at diagnosis. Some sign of shock was observed in 70% upon arrival at the hospital. The case-fatality rate was 3.8% and 10% survived with permanent sequelae. Glasgow coma scale <15 (odds ratio [OR]=9.2), seizure (OR=8.3), sepsis without meningitis (OR=9.1), thrombocytopenia (OR=30.5), and disseminated intravascular coagulation (OR=10.9) showed a greater association with a worse prognosis. Conclusion The MID continues to be a significant cause of morbidity and mortality in children. Therefore, new advances are needed in the prevention, early diagnosis, and detection of the factors associated with poor prognosis.

      PubDate: 2017-03-15T20:13:17Z
      DOI: 10.1016/j.anpede.2015.12.004
       
  • Clinical interventions in overweight and obesity: A systematic literature
           review 2009–2014
    • Authors: Luis Rajmil; Joan Bel; Rosa Clofent; Carmen Cabezas; Conxa Castell; Mireia Espallargues
      Abstract: Publication date: Available online 8 March 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Luis Rajmil, Joan Bel, Rosa Clofent, Carmen Cabezas, Conxa Castell, Mireia Espallargues
      Objective To update the literature review on the effectiveness of clinical interventions on childhood obesity, proposed in Clinical Practice Guidelines, excluding prevention and pharmacological and surgical treatments. Method A systematic review was carried out in electronic databases of the Cochrane Database of Systematic Reviews (The Cochrane Library), MEDLINE, and SCOPUS, replicating the search for the Clinical Practice Guidelines, from 2009 to 2014. The Clinical Practice Guidelines of National Institutes for Health and Care Excellence were taken as a reference. Systematic reviews were given priority, and the quality of the studies was assessed. Results Out of a total of 3.703 documents initially identified, 48 were finally included. Studies showed great heterogeneity in the type and duration of interventions, and in outcome measures. Adherence to treatment was, in general, low. Multi-component interventions including diet, physical activity, sedentary lifestyle, and behaviour changes, involving the family, and starting at early ages, were the most effective for reducing body mass index. There is no consensus on criteria for referral to specialised care. Conclusions It is recommended to implement multi-component programs conducted by professionals with previous training, involving the family, and addressing behavioural, individual and socio-demographic aspects. Lack of adherence is one of the reasons for failure of interventions. Diagnostic and referral criteria, the outcome measures, and the type and duration of interventions need to be improved and standardised.

      PubDate: 2017-03-09T14:46:32Z
      DOI: 10.1016/j.anpede.2016.03.013
       
  • Light and noise: Environmental factors in intensive care units
    • Authors: Alejandro Bosch; Anna Falcó; Marta Santaolalla; María Carmen Dominguez; Iolanda Jordan
      Abstract: Publication date: Available online 7 March 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Alejandro Bosch, Anna Falcó, Marta Santaolalla, María Carmen Dominguez, Iolanda Jordan


      PubDate: 2017-03-09T14:46:32Z
      DOI: 10.1016/j.anpede.2016.07.003
       
  • Neopterin levels and systemic inflammatory response syndrome in pediatric
           critically ill patients
    • Authors: Raquel Gil-Gómez; Javier Blasco-Alonso; Pilar Sánchez-Yáñez; Vanessa Rosa-Camacho; Guillermo Milano
      Abstract: Publication date: Available online 6 March 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Raquel Gil-Gómez, Javier Blasco-Alonso, Pilar Sánchez-Yáñez, Vanessa Rosa-Camacho, Guillermo Milano
      Introduction Neopterin and biopterin are subproducts of redox reactions, which act as cofactor of enzymes responsible for nitric oxide production. We hypothesized that plasma neopterin suffers different evolution during the first days of a critically ill child. Methods Single-center prospective observational study in patients 7 days to 14 years admitted to our PICU and that met SIRS criteria. Neopterin and biopterin levels as well as other acute phase reactants were collected at admission and at 24h. Results A total of 28 patients were included, 78.9% male, median age 5.04 years (interquartile range [IQR] 1.47–10.26), PRISM II 2.0% (IQR 1.1–5.0). Mechanical ventilation (MV) in 90% of patients, median duration of 6.0h (IQR 3.7–102.0); median PICU length of stay 5.0 days (IQR 2.7–18.7), maximum VIS through 0 (IQR 0–14). Baseline neopterin level 2.3±1.2nmol/l and at 24h 2.3±1.4nmol/l. Baseline biopterin is 1.3±0.5nmol/l and 1.4±0.4nmol/l at 24h. Neopterin levels significantly higher in patients with PICU length of stay >6 days (p = .02), patients who needed MV >24h (p = .023) and those who developed complications (p = .05). Neopterin correlates directly and statistically significant with the duration of MV (rho = .6, p = .011), PICU length of stay (rho = .75, p <.0001) and VIS (rho = .73, p = .001). Additionally, biopterin directly correlates with the PRISM (rho = .61, p = .008). Discussion There is a higher neopterin level when longer PICU stay, higher VIS score, longer MV and occurrence of complications, pointing at the involvement of an activation of the cellular immune system.

      PubDate: 2017-03-09T14:46:32Z
      DOI: 10.1016/j.anpede.2017.02.002
       
  • Management of gastroesophageal reflux in children. Single centre
           experience in conventional and laparoscopic Nissen fundoplication in the
           last 15 years
    • Authors: Josué Eduardo Betancourth-Alvarenga; José Ignacio Garrido Pérez; Aurora Lucía Castillo Fernández; Francisco Javier Murcia Pascual; Miguel Ángel Cárdenas Elias; Álvaro Escassi Gil; Rosa María Paredes-Esteban
      Abstract: Publication date: Available online 3 March 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Josué Eduardo Betancourth-Alvarenga, José Ignacio Garrido Pérez, Aurora Lucía Castillo Fernández, Francisco Javier Murcia Pascual, Miguel Ángel Cárdenas Elias, Álvaro Escassi Gil, Rosa María Paredes-Esteban
      Introduction Nissen fundoplication (NF) is the most used and effective technique for the treatment of gastroesophageal reflux in children. The laparoscopic approach (LNF) is safe, with low morbidity and high success rate, although some cases require a conventional approach (CNF). The aim of the study is to compare the results between LNF and CNF in our centre. Material and methods A retrospective review was performed on patients <14 years after NF between 2000 and 2015. A comparison was made of the complications, hospital stay, and follow-up for both approaches. Results Of the total 75 NF performed, 49 (65.3%) were LNF, 23 (30.7%) CNF, and 3 (4.0%) reconversions. Concomitant laparoscopic gastrostomy was performed in 10.7%, and open gastrostomy in 5.3% of cases. Prior to NF, 10.7% had a gastrostomy. The mean age was 4 years and 68.7% were male. Of the diagnoses, 36% had encephalopathy, 14.7% hiatal hernia, 5.4% oesophageal atresia, and 5.4% an acute life-threatening event. No differences were found in operation time. More than two-thirds (36%) had complications, which were more frequent in the CNF (OR=3.30, 95% CI: 1.1–9.6). The hospital-stay decreased by 9 days in the LNF (95% CI: 5.5–13.5). Mean follow-up was 26 months (95% CI: 20.9–31.6). Mortality during follow-up was of 5.3% (5 respiratory failure, 1 sudden cardiac death, and 2 due to complications of the encephalopathy), 4.2% required re-fundoplication, 15.8% had symptomatic improvement, and 64.0% had absence of symptoms. Conclusions The LNF is an effective technique for the treatment of gastroesophageal reflux, with lower morbidity and shorter hospital stay than CNF. It is recommended as the first surgical option.

      PubDate: 2017-03-09T14:46:32Z
      DOI: 10.1016/j.anpede.2015.12.003
       
  • The latest in paediatric resuscitation recommendations
    • Authors: Jesús López-Herce; Antonio Rodríguez; Angel Carrillo; Nieves de Lucas; Custodio Calvo; Eva Civantos; Eva Suárez; Sara Pons; Ignacio Manrique
      Abstract: Publication date: Available online 1 March 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Jesús López-Herce, Antonio Rodríguez, Angel Carrillo, Nieves de Lucas, Custodio Calvo, Eva Civantos, Eva Suárez, Sara Pons, Ignacio Manrique
      Cardiac arrest has a high mortality in children. To improve the performance of cardiopulmonary resuscitation, it is essential to disseminate the international recommendations and the training of health professionals and the general population in resuscitation. This article summarises the 2015 European Paediatric Cardiopulmonary Resuscitation recommendations, which are based on a review of the advances in cardiopulmonary resuscitation and consensus in the science and treatment by the International Council on Resuscitation. The Spanish Paediatric Cardiopulmonary Resuscitation recommendations, developed by the Spanish Group of Paediatric and Neonatal Resuscitation, are an adaptation of the European recommendations, and will be used for training health professionals and the general population in resuscitation. This article highlights the main changes from the previous 2010 recommendations on prevention of cardiac arrest, the diagnosis of cardiac arrest, basic life support, advanced life support and post-resuscitation care, as well as reviewing the algorithms of treatment of basic life support, obstruction of the airway and advanced life support.

      PubDate: 2017-03-02T20:55:47Z
      DOI: 10.1016/j.anpede.2016.11.003
       
  • Emergency department consultations due to foreign body ingestion
    • Authors: Ana Lobeiras; Amaia Zugazabeitia; Nerea Uribarri; Santiago Mintegi
      Abstract: Publication date: Available online 1 March 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Ana Lobeiras, Amaia Zugazabeitia, Nerea Uribarri, Santiago Mintegi
      Introduction Foreign body (FB) ingestion is an uncommon reason for going to the Paediatric Emergency Department (PED). The aim of this study was to assess the clinical and epidemiological characteristics of foreign body ingestion and the management of these patients. Patients and methods Retrospective study, including children under 14 years old with suspected foreign body ingestion seen in the PED between 2010 and 2013. An analysis was made of the circumstances of the FB ingestion, its management in the PED, and patient outcomes. Results Of the 226.666 presentations recorded, 1.608 (0.7%) were for a FB, 970 corresponding to ingestion of mainly fish bones (367, 38.7%) and coins (181, 18.7%), except in children under 1 year (plastic objects). The median age was 4.7 years, with boys being more common in those older than 4 years (58.5%). A total of 557 patients (57.3%) reported some symptom, and complementary tests were performed in 414 (42.7%). Another specialist was called in 315 (32.4%) cases, mainly from Ear, Nose and Throat (fish bones) or Surgery (coins). The FB was removed in 305 (31.4%) cases, which were mostly fish bones or sunflower seeds. Seventy-one patients (7.3%) were admitted, especially ingestion of fish bones or coins. No patient died. Discussion Ingestion of fish bones or coins by young children is a relatively common presentation in the PED, and it is associated with frequent medical interventions. Although the overall prognosis is good, improving the health education of the population should be considered to reduce the frequency of these episodes.

      PubDate: 2017-03-02T20:55:47Z
      DOI: 10.1016/j.anpede.2015.11.014
       
  • High incidence of type 1 diabetes in the immigrant population of Osona and
           Baix Camp
    • Authors: Meritxell Torrabías-Rodas; Albert Feliu-Rovira; Ines Porcar-Cardona; Jacint Altimiras-Roset
      Abstract: Publication date: Available online 27 February 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Meritxell Torrabías-Rodas, Albert Feliu-Rovira, Ines Porcar-Cardona, Jacint Altimiras-Roset
      Introduction It has been postulated that migration could act as a modifying factor in the incidence of type 1 diabetes mellitus (T1DM), so the aim of this study is to determine if there are differences in the incidence of T1DM by origin. Material and methods Retrospective study of cases of T1DM onset in the population younger than 19 years old in Osona and Baix Camp between 2000 and 2012, using the medical histories of endocrinology units of the health centres and demographics from Catalonia Statistical Institute as sources. Results The child population in Osona and Baix Camp increased by 36.6%, with 18.9% in the local population, and 482% in the immigrant population, and most of this increase (90%) in the Maghreb immigrant group. A total of 118 diabetics onset were found, 66.9% in the local population, 32.2% Maghrebi population, and 0.9% in children from other countries, with a total incidence rate of 14.4 cases per 100,000 population/year (c/105p-y). The incidence is higher in the Maghrebi population compared to the local population, 37.1 vs 11.2 c/105p-y (P <.001), and in children under 5 years compared to the 5–18 years group, 18.9 vs 12.5 c/105p-y (P <.05), with no differences between sexes (P >.05). The relative risk is 3.1 for the Maghrebi population, and 1.5 for children under 5 years. Conclusions The total incidence of T1DM remains stable, but is higher in the Maghrebi than in the local population, and in children under 5 years compared to 5–18 years group. These results open a study field of which risk factors could be affecting this immigrant population in their destination countries.

      PubDate: 2017-03-02T20:55:47Z
      DOI: 10.1016/j.anpede.2015.10.027
       
  • In vitro activity of azithromycin in faecal isolates of Aeromonas
           hydrophila
    • Authors: Jorge Jover-García; Virginia Pérez-Doñate; Javier Colomina-Rodríguez
      Abstract: Publication date: Available online 17 February 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Jorge Jover-García, Virginia Pérez-Doñate, Javier Colomina-Rodríguez


      PubDate: 2017-02-23T20:26:04Z
      DOI: 10.1016/j.anpede.2016.06.004
       
  • A prospective study to assess the burden of influenza-related
           hospitalizations and emergency department visits among children in Bilbao,
           Spain (2010–2011)
    • Authors: Naiara Ortiz-Lana; Elisa Garrote; Javier Arístegui; Joseba Rementeria; Juan-Antonio García-Martínez; Cynthia McCoig; Pilar García-Corbeira; Raghavendra Devadiga; Mónica Tafalla
      Abstract: Publication date: Available online 16 February 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Naiara Ortiz-Lana, Elisa Garrote, Javier Arístegui, Joseba Rementeria, Juan-Antonio García-Martínez, Cynthia McCoig, Pilar García-Corbeira, Raghavendra Devadiga, Mónica Tafalla
      Introduction This study was undertaken to estimate the burden of morbidity associated with laboratory-confirmed influenza in children below 15 years of age. Patients and methods Children presenting with acute respiratory infection and/or isolated fever at the Basurto University Hospital, Bilbao, Spain between November 2010 and May 2011 were included in this study (NCT01592799). Two nasopharyngeal secretion samples were taken from each; one for a rapid influenza diagnostic test in the emergency department, and the second for laboratory analysis using real-time polymerase chain reaction and viral culture. Results A total of 501 children were recruited, of whom 91 were hospitalized. Influenza diagnosis was confirmed in 131 children (26.1%); 120 of 410 (29.3%) treated as outpatients and 11 of 91 (12.1%) hospitalized children. A total of 370 of 501 children (73.9%) had no laboratory test positive for influenza. The proportion of subjects with other respiratory viruses was 145/501 (28.9%) cases and co-infection with the influenza virus plus another respiratory virus was detected in 7/501 (1.4%) cases. Influenza virus types were: A (H1N1 and H3N2) 53.2% (67/126); B (Victoria and Yamagata) 46.0% (58/126); A+B 0.8% (1/126). The median direct medical costs associated with each case of laboratory-confirmed influenza was € 177.00 (N =131). No significant differences were observed between the medical costs associated with influenza A and B. Conclusion Almost half of the cases were influenza virus B type. The administration of a vaccine containing influenza A and B types to children below 15 years of age might reduce the overall burden of the illness.

      PubDate: 2017-02-16T19:24:06Z
      DOI: 10.1016/j.anpede.2017.01.002
       
  • Insomnia in children and adolescents. A consensus document
    • Authors: Gonzalo Pin Arboledas; Víctor Soto Insuga; María José Jurado Luque; Cleofé Ferrández Gomariz; Inés Hidalgo Vicario; Amalia Lluch Rosello; Pedro Javier Rodríguez Hernández; Juan Antonio Madrid
      Abstract: Publication date: Available online 7 February 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Gonzalo Pin Arboledas, Víctor Soto Insuga, María José Jurado Luque, Cleofé Ferrández Gomariz, Inés Hidalgo Vicario, Amalia Lluch Rosello, Pedro Javier Rodríguez Hernández, Juan Antonio Madrid
      Insomnia is very common during childhood (30% of children under 5), and causes a serious cognitive and emotional consequence in learning, as well as significant medical comorbidity. It also affects the quality of life, not only of the child, but also of the whole family. Paediatrician training in its diagnosis and treatment is usually poor. For this reason a consensus document is presented on the management of insomnia in children and adolescents. This has been developed by members of the Spanish Paediatrics Association, the Spanish Sleep Society, the Spanish Society of Paediatric Outpatient and Primary Care, the Spanish Adolescent Medicine Society, the Spanish Child and Adolescent Society, and the Spanish Paediatric Neurology Society. This group suggests that diagnosis must be clinical and complementary tests will only be required in doubtful cases or when a differential diagnosis is needed. Likewise, treatment should be mainly based on cognitive-behavioural therapy and the modification of sleeping habits. Using medicines and other substances to make the sleep easier is currently quite common, even although there are no clinical guidelines to support this.

      PubDate: 2017-02-11T03:56:32Z
      DOI: 10.1016/j.anpede.2016.06.002
       
  • Bone marrow transplant in patients with sickle cell anaemia. Experience in
           one centre
    • Authors: Marina García Morin; Elena Cela; Carmen Garrido; Eduardo Bardón Cancho; Alejandra Aguado del Hoyo; Cristina Pascual; Ana Pérez-Corral; Cristina Beléndez
      Abstract: Publication date: Available online 5 February 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Marina García Morin, Elena Cela, Carmen Garrido, Eduardo Bardón Cancho, Alejandra Aguado del Hoyo, Cristina Pascual, Ana Pérez-Corral, Cristina Beléndez
      Introduction Sickle cell disease (SCD), despite the improvement in the medical management, is still associated with severe morbidity and decreased survival. Allogenic hematopoietic stem cell transplantation (Allo-HSCT) currently provides the only curative therapy. A report is presented on our experience in children with SCD, who underwent Allo-HSCT in a single centre. Material and method A single centre descriptive study was conducted on patients with SCD who underwent a bone marrow transplant from an HLA-identical sibling donor between January 2010 and December 2014. Epidemiological, clinical and analytical parameters were collected with a follow-up to December 2015. Data are presented as frequencies, percentages, and medians (range). Results Allo-HCST was performed in 11 patients (8 males) with a median age of 7 years (2–13), all of them with comorbidity prior to the HCST. A stable graft was achieved in 10 out of 11 patients, 9 of them with complete donor chimerism, and one patient with stable mixed chimerism after 1 year of allo-HSCT. One patient has secondary graft failure with re-appearance of symptoms associated with SCD on day 180. Complications of Allo-HSCT are: arterial hypertension 7/11, acute renal failure 3/11, CMV reactivation 9/11, neurological complications 4/11 (subarachnoid haemorrhage, seizure), and acute graft versus host disease (aGVHD) of the skin 6/11, one of whom developed grade IV intestinal aGVHD, causing his death (day 51). None of the patients developed chronic GVHD. The overall survival and event-free survival was 90.9% and 81.9%, respectively, with a median follow-up of 3.1 (1–5.7) years. Conclusions Allo-HSCT, the only curative therapy, remains associated with morbidity. There was a transplant related mortality in our study, consistent with multicentre studies (1/11), and with aGVHD being the main cause. Other problems still include graft failure (1/11), and neurological complications (4/11), although the permanent sequelae are mild.

      PubDate: 2017-02-11T03:56:32Z
      DOI: 10.1016/j.anpede.2016.03.012
       
  • Risks factors associated with intra-partum foetal mortality in pre-term
           infants
    • Authors: Susana Zeballos Sarrato; Sonia Villar Castro; Cristina Ramos Navarro; Gonzalo Zeballos Sarrato; Manuel Sánchez Luna
      Abstract: Publication date: Available online 4 February 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Susana Zeballos Sarrato, Sonia Villar Castro, Cristina Ramos Navarro, Gonzalo Zeballos Sarrato, Manuel Sánchez Luna
      Introduction Pre-term delivery is one of the leading causes of foetal and perinatal mortality. However, perinatal risk factors associated with intra-partum foetal death in preterm deliveries have not been well studied. Objective To analyse foetal mortality and perinatal risk factors associated with intra-partum foetal mortality in pregnancies of less than 32 weeks gestational age. Material and methods The study included all preterm deliveries between 22 and 31 +1 weeks gestational age (WGA), born in a tertiary-referral hospital, over a period of 7 years (2008–2014). A logistic regression model was used to identify perinatal risk factors associated with intra-partum foetal mortality (foetal malformations and chromosomal abnormalities were excluded). Results During the study period, the overall foetal mortality was 63.1% (106/168) (≥22 weeks of gestation) and occurred in pregnancies of less than 32 WGA. A total of 882 deliveries between 22 and 31+6 weeks of gestation were included for analysis. The rate of foetal mortality was 11.3% (100/882). The rate of intra-partum foetal death was 2.6% (23/882), with 78.2% (18/23) of these cases occurring in hospitalised pregnancies. It was found that Assisted Reproductive Techniques, abnormal foetal ultrasound, no administration of antenatal steroids, lower gestational age, and small for gestational age, were independent risk factors associated with intra-partum foetal mortality. Conclusion This study showed that there is a significant percentage intra-partum foetal mortality in infants between 22 and 31+6 WGA. The analysis of intrapartum mortality and risk factors associated with this mortality is of clinical and epidemiological interest to optimise perinatal care and improve survival of preterm infants.

      PubDate: 2017-02-04T23:49:12Z
      DOI: 10.1016/j.anpede.2016.04.007
       
  • Periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome: A
           study and follow-up of 16 cases
    • Authors: Alba Muinelo Segade; Leticia Vila Sexto
      Abstract: Publication date: Available online 4 February 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Alba Muinelo Segade, Leticia Vila Sexto


      PubDate: 2017-02-04T23:49:12Z
      DOI: 10.1016/j.anpede.2016.07.002
       
  • Enterovirus and neurological complications
    • Authors: Alfons Macaya; Ana Felipe-Rucián
      Abstract: Publication date: Available online 4 February 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Alfons Macaya, Ana Felipe-Rucián


      PubDate: 2017-02-04T23:49:12Z
      DOI: 10.1016/j.anpede.2017.01.001
       
  • Koolen de Vries syndrome: A challenge in clinical practice
    • Authors: María Moreno Samos; Esther Eugenia Moreno Medinilla; Jacinto Luis Martínez Antón; Antonio Urda Cardona
      Abstract: Publication date: Available online 3 February 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): María Moreno Samos, Esther Eugenia Moreno Medinilla, Jacinto Luis Martínez Antón, Antonio Urda Cardona


      PubDate: 2017-02-04T23:49:12Z
      DOI: 10.1016/j.anpede.2016.06.003
       
  • Ethical attitudes of intensive care paediatricians as regards patients
           with spinal muscular atrophy type 1
    • Authors: María Carmen Agra Tuñas; Ramón Hernández Rastrollo; Arturo Hernández González; Carmen Ramil Fraga; Francisco J. Cambra Lasaosa; Sebastián Quintero Otero; Angela Ruiz Extremera; Antonio Rodríguez Núñez
      Abstract: Publication date: Available online 31 January 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): María Carmen Agra Tuñas, Ramón Hernández Rastrollo, Arturo Hernández González, Carmen Ramil Fraga, Francisco J. Cambra Lasaosa, Sebastián Quintero Otero, Angela Ruiz Extremera, Antonio Rodríguez Núñez
      Introduction Spinal muscular atrophy type 1 (SMA-1) is a progressive and fatal disease that leads to ethical problems for Paediatric professionals. Our objective was to determine the ethical options of Paediatric Intensive Care Unit (PICU) paediatricians as regards a child with SMA-1 and respiratory failure. Material and methods A cross-sectional descriptive study was conducted using an anonymous questionnaire sent to PICUs in Spain (which can be accessed through the Spanish Society of Paediatric Critical Care web page). Results Of the 124 responses analysed, 70% were from women, 51% younger than 40 years, 54% from a PICU with more than 10 beds, 69% with prior experience in such cases, and 53% with religious beliefs. In the last patient cared for, most paediatricians opted for non-invasive mechanical ventilation (NIV) and limitation of therapeutic effort (LTE) in case of NIV failure. Confronted with a future hypothetical case, half of paediatricians would opt for the same plan (NIV+LTE), and 74% would support the family's decision, even in case of disagreement. Age, prior experience and sex were not related to the preferred options. Paediatricians with religious beliefs were less in favour of initial LTE. Less than two-thirds (63%) scored the quality of life of a child with SMA-1 and invasive mechanical ventilation as very poor. Conclusions Faced with child with SMA-1 and respiratory failure, most paediatricians are in favour of initiating NIV and LTE when such support is insufficient, but they would accept the family's decision, even in case of disagreement.

      PubDate: 2017-02-04T23:49:12Z
      DOI: 10.1016/j.anpede.2016.01.013
       
  • Para-phenylenediamine allergic contact dermatitis due to henna tattoos in
           a child and adolescent population
    • Authors: José María Ortiz Salvador; Altea Esteve Martínez; Daniela Subiabre Ferrer; Ana Mercedes Victoria Martínez; Jesús de la Cuadra Oyanguren; Violeta Zaragoza Ninet
      Abstract: Publication date: Available online 29 January 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): José María Ortiz Salvador, Altea Esteve Martínez, Daniela Subiabre Ferrer, Ana Mercedes Victoria Martínez, Jesús de la Cuadra Oyanguren, Violeta Zaragoza Ninet
      Introduction Henna tattoos are a very common practice in the adolescent population. Henna is very often admixed with para-phenylenediamine (PPDA) to improve the appearance of the tattoo. PPDA is a potent allergen, and is a frequent cause of allergic contact dermatitis (ACD). Material and method A study was conducted on the results of 726 consecutive children who had been patch tested in the University General Hospital Consortium of Valencia between 1980 and 2015. Results Almost half (49.7%; (361 cases) of the children had one or more positive patch test findings, with 4.7% (34) being allergic to PPDA. Mean age of patients allergic to PPDA was 12.4 years, and 44.2% were male. There were 2 cases (5.9%) of atopic dermatitis. Of the positive reactions, 73.5% were considered to be current clinically relevant. The sensitisation origin was a Henna tattoo in 50% of cases. Conclusion PPDA sensitisation is relatively common in the child and adolescent population. The most frequent origin is the performing of Henna tattoos adulterated with PPDA. Adolescents are at the higher risk of developing ACD due to Henna tattoos. Henna tattooing should be strongly discouraged in children.

      PubDate: 2017-01-29T22:42:18Z
      DOI: 10.1016/j.anpede.2016.02.005
       
  • Lymphadenitis due to non-tuberculous mycobacteria: Experience over 15
           years
    • Authors: Ignacio Ruiz del Olmo Izuzquiza; Matilde Bustillo Alonso; María Luisa Monforte Cirac; Pedro Burgués Prades; Carmelo Guerrero Laleona
      Abstract: Publication date: Available online 24 January 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Ignacio Ruiz del Olmo Izuzquiza, Matilde Bustillo Alonso, María Luisa Monforte Cirac, Pedro Burgués Prades, Carmelo Guerrero Laleona
      Objective To study the epidemiology, clinical features, diagnosis, therapeutic management, and outcome of non-tuberculous mycobacterial lymphadenitis in a paediatric population of Aragón (Spain). Material and methods A retrospective study was conducted on patients under 15 years-old diagnosed with non-tuberculous mycobacterial lymphadenitis between the years 2000 and 2015. Inclusion criteria: patients with lymphadenitis and positive culture. Quantitative values are shown as mean, rank, and standard deviation, and qualitative data as frequencies. Results Twenty-seven cases were registered, with a mean age of presentation of 39.9 months (range 10 months–8 years). The mean time between the symptoms onset and first consultation was 1.7±1.1 months. The most frequent location was sub-maxilar in 17/27 cases (63%), on the right side in 59.3%, and size 2.96±1.26cm. Fistulae were observed in 16/27 cases. Tuberculin test was greater than 10mm in 7/24 (29.1%). Microbiological cultures were positive for Mycobacterium avium in 14/27 (51.9%), Mycobacterium intracellulare 3/27 (11.1%), and Mycobacterium lentiflavum 3/27 (11.1%). Combined treatment of antibiotics and surgery was given in 16/27 cases (59.8%), medical treatment only in 7/27 (25.9%), and surgical exeresis alone in 4/27 (14.8%). Two patients required a new surgery, and one showed severe neutropenia secondary to rifabutin. Only one case (3.7%) suffered from temporary facial palsy as sequel. Conclusions The most frequent treatment was the combination of antibiotics and surgery. Delay in diagnosis seemed to be responsible for the limited number of exeresis as first option, only one for every seven patients.

      PubDate: 2017-01-29T22:42:18Z
      DOI: 10.1016/j.anpede.2016.03.011
       
  • Prenatal treatment with magnesium sulphate: Initial clinical outcomes in
           pre-term infants less than 29 weeks and correlation with neonatal
           magnesium levels
    • Authors: Laura García Alonso; Marcelino Pumarada Prieto; Eva González Colmenero; Ana Concheiro Guisán; María Suárez Albo; Cristina Durán Fernández-Feijoo; Luisa González Durán; José Ramón Fernández Lorenzo
      Abstract: Publication date: Available online 24 January 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Laura García Alonso, Marcelino Pumarada Prieto, Eva González Colmenero, Ana Concheiro Guisán, María Suárez Albo, Cristina Durán Fernández-Feijoo, Luisa González Durán, José Ramón Fernández Lorenzo
      Introduction Antenatal magnesium sulphate (MgSO4) administration has shown to be effective in minimising cerebral palsy and severe motor dysfunction at the age of 2 years. The aim of this study is to analyse the initial clinical outcome of preterm neonates less than 29 weeks who have received prenatal MgSO4, as well as to determine the relationship between the magnesium dose delivered to the mother and the magnesium concentration in the neonates. Material and methods A prospective cohort study was conducted on neonates of less than 29 weeks gestation admitted to the Neonatal Intensive Care Unit (NICU) of Hospital Universitario de Vigo from December 2012 to July 2015. Comparative analysis was performed on the perinatal outcomes, neonatal morbidity, mortality, and magnesium levels between the groups of neonates exposed to magnesium sulphate and the control group. Results A total of 42 neonates were included in the study. The mothers of 28 of them had received MgSO4 as a neuroprotective agent. Statistical significance was obtained in the mortality variable. There were no significant differences in the rest of studied variables. There was a significant correlation between the full dose of MgSO4 received by the mother and the levels of magnesium in the neonate in the first 24h of life (r 2 0.436; P <0.001). Conclusions A lower mortality was observed in the group that had been exposed to MgSO4. No significant side effects were found as a result of administering of MgSO4. The MgSO4 dose received by mother has a linear relationship with the magnesium levels obtained in neonates.

      PubDate: 2017-01-29T22:42:18Z
      DOI: 10.1016/j.anpede.2016.04.006
       
  • Human growth hormone and Turner syndrome
    • Authors: Silvia Beatriz Sánchez Marco; Antonio de Arriba Muñoz; Marta Ferrer Lozano; José Ignacio Labarta Aizpún; Jesús María Garagorri Otero
      Abstract: Publication date: Available online 16 January 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Silvia Beatriz Sánchez Marco, Antonio de Arriba Muñoz, Marta Ferrer Lozano, José Ignacio Labarta Aizpún, Jesús María Garagorri Otero
      Objective The evaluation of clinical and analytical parameters as predictors of the final growth response in Turner syndrome patients treated with growth hormone. Material and methods A retrospective study was performed on 25 girls with Turner syndrome (17 treated with growth hormone), followed-up until adult height. Auxological, analytical, genetic and pharmacological parameters were collected. A descriptive and analytical study was conducted to evaluate short (12 months) and long term response to treatment with growth hormone. Results A favourable treatment response was shown during the first year of treatment in terms of height velocity gain in 66.6% of cases (height-gain velocity >3cm/year). A favourable long-term treatment response was also observed in terms of adult height, which increased by 42.82±21.23cm (1.25±0.76 SDS), with an adult height gain of 9.59±5.39cm (1.68±1.51 SDS). Conclusions Predictors of good response to growth hormone treatment are: (A) initial growth hormone dose, (B) time on growth hormone treatment until starting oestrogen therapy, (C) increased IGF1 and IGFBP-3 levels in the first year of treatment, and (D) height gain velocity in the first year of treatment.

      PubDate: 2017-01-22T22:02:16Z
      DOI: 10.1016/j.anpede.2016.02.004
       
  • Immunisation schedule of the Spanish Association of Paediatrics: 2017
           recommendations
    • Authors: David Moreno-Pérez; Francisco José Álvarez García; Javier Arístegui Fernández; María José Cilleruelo Ortega; José María Corretger Rauet; Nuria García Sánchez; Ángel Hernández Merino; Teresa Hernández-Sampelayo Matos; Manuel Merino Moína; Luis Ortigosa del Castillo; Jesús Ruiz-Contreras
      Abstract: Publication date: Available online 13 January 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): David Moreno-Pérez, Francisco José Álvarez García, Javier Arístegui Fernández, María José Cilleruelo Ortega, José María Corretger Rauet, Nuria García Sánchez, Ángel Hernández Merino, Teresa Hernández-Sampelayo Matos, Manuel Merino Moína, Luis Ortigosa del Castillo, Jesús Ruiz-Contreras
      The Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAV-AEP) annually publishes the immunisation schedule which, in our opinion, is considered optimal for children resident in Spain, taking into account the evidence available on current vaccines. Pneumococcal and varicella immunisation in early childhood is already included in all funded vaccines present in the regional immunisation programmes. Furthermore, this committee establishes recommendations on vaccines not included in official calendars (non-funded immunisations), such as rotavirus, meningococcal B, and meningococcal ACWY. As regards funded immunisations, 2+1 strategy (2, 4, 11–12 months) with hexavalent (DTaP-IPV-Hib-HB) and 13-valent pneumococcal vaccines is recommended. Administration of the 6-year booster dose with DTaP is recommended, as well as a poliomyelitis dose for children who had received the 2+1 scheme, with the Tdap vaccine for adolescents and pregnant women between 27 and 32 weeks gestation. The two-dose scheme should be used for MMR (12 months and 2–4 years) and varicella (15 months and 2–4 years). Coverage of human papillomavirus vaccination in girls aged 12 with a two-dose scheme (0, 6 months) should be improved. Information and recommendations for male adolescents about potential beneficial effects of the tetravalent HPV vaccine should also be provided. ACWY meningococcal vaccine is the optimal choice in adolescents. For recommended unfunded immunisations, the CAV-AEP recommends the administration of meningococcal B vaccine, due to the current availability in Spanish community pharmacies, with a 3+1 scheme. CAV-AEP requests the incorporation of this vaccine in the funded unified schedule. Vaccination against rotavirus is recommended in all infants.

      PubDate: 2017-01-15T21:28:03Z
      DOI: 10.1016/j.anpede.2016.10.009
       
  • Frequent users in paediatric emergency departments. Who are they' Why
           do they consult'
    • Authors: Arístides Rivas García; Gema Manrique Martín; Laura Butragueño Laiseca; Sofía Mesa García; Alfonso Campos Segura; Vanessa Fernández Iglesia; Rubén Moreno Sánchez; Juan Mariano Aguilar Mulet
      Abstract: Publication date: Available online 11 January 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Arístides Rivas García, Gema Manrique Martín, Laura Butragueño Laiseca, Sofía Mesa García, Alfonso Campos Segura, Vanessa Fernández Iglesia, Rubén Moreno Sánchez, Juan Mariano Aguilar Mulet
      Objective To determine the prevalence of frequent Paediatric Emergency Departments users and to analyse their characteristics, comparing initial consultations and re-consultations. Methods This is a multicentre retrospective cohort study of all patients who made 10 or more visits to the Paediatric Emergency Departments of 5 public hospitals between 1 January 2013 and 31 December 2013. An analysis was performed on the patient demographics and clinical data of the first consultation and consecutive re-consultations. Results Frequent users represented 0.60% (95% CI: 0.56–0.64%) of Emergency Department users, and accounted for 3.93% (95% CI: 3.47–4.39%) of all visits. The most numerous age group consisted of children under 2 years old (66.6%). Frequent users distributed their visits throughout the year (62.3%; P <.001), and did not have a chronic condition associated with their chief complaint (86.4%; P <.001). They were usually classified as non-urgent or less urgent in triage (3186 vs. 1812; P <.001), and often did not require any intervention, such as complementary tests (79.4%) or observation/treatment (60%). Admission rate was similar to the general paediatric population (5.3%). Re-consultations represented 27% of these patient visits, mostly related to persistence of symptoms (56.3%), with 13.8% of them consulting their Primary Care physician before seeking successive medical attention in the Paediatric Emergency Department. Conclusions Paediatric frequent users often ask for medical care in the Emergency Department before consulting their Primary Care physician. They present with less urgent processes and do not systematically need diagnostic or therapeutic interventions. Re-consultations make up a significant number of visits, in which more interventions are done and more children are admitted.

      PubDate: 2017-01-15T21:28:03Z
      DOI: 10.1016/j.anpede.2016.03.010
       
  • Urinary iodine levels and dairy consumption in pre-school children in
           Southwest Asturias (Spain)
    • Authors: Esther Arbesú Fernández; María Haydee Serrano Peraza; Hans Abdón Eguia Angeles; César Oliver Sotelo García; Claude Henrry Saint Jean; Nache Ismael Musa Martín
      Abstract: Publication date: Available online 9 January 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Esther Arbesú Fernández, María Haydee Serrano Peraza, Hans Abdón Eguia Angeles, César Oliver Sotelo García, Claude Henrry Saint Jean, Nache Ismael Musa Martín
      Introduction For decades dairy products have been a major source of iodine. The purpose of this study was to determine the iodine nutritional status and its relationship with dairy consumption in pre-schooler children between 2 and 5 years old in a rural area with 27847 inhabitants. Patients and methods It was planned to study 200 participants, selected by random sampling, proportional to the size of the municipality, age, and sex. Parents provided urine samples to analyse urinary iodine, as well as the nutritional information through an interview. A glass of milk or a slice of cheese was considered as a ration, and a portion of other milk derivatives were considered as half rations. The nutritional status of iodine was interpreted with the median (P[percentile]50) of the urinary iodine levels, and iodine intake was estimated using the mean of ration/day of milk and dairy products, fish, and eggs. Results Of the total of 198 subjects that took part, 193 provided urine specimens for the determination of iodine levels. The mean dairy ration/day was 3.8 (SD:1.4). More than two-thirds (69.9%) drank ≥2 glasses of milk/day, and 88.1% consumed a dairy ration of another dairy product. The median urinary iodine level was 184μg/L, but was dependent on glasses of milk/day (282.5μg/L ≥ 4 glasses) and/or the type of milk (233.0μg/L in semi-skimmed). An intake of 117.4μg/day to 178.6μg/day of iodine was estimated, and that milk was the food which provided more iodine (89.9μg/day). Conclusions Iodine intake was adequate, although higher than necessary when four or more glasses of milk were consumed, and/or when the milk was skimmed. The consumption of dairy products should be monitored to prevent both excessive and deficient intake of iodine.

      PubDate: 2017-01-15T21:28:03Z
      DOI: 10.1016/j.anpede.2016.03.009
       
  • Prenatal exposure to metamphetamine «shabu»
    • Authors: Cristina Manzano Varo; M. Ángeles López-Vílchez; Lucía Román Eyo; Jordi García García; Antonio Mur Sierra
      Abstract: Publication date: Available online 30 December 2016
      Source:Anales de Pediatría (English Edition)
      Author(s): Cristina Manzano Varo, M. Ángeles López-Vílchez, Lucía Román Eyo, Jordi García García, Antonio Mur Sierra


      PubDate: 2017-01-07T20:51:38Z
      DOI: 10.1016/j.anpede.2016.05.004
       
  • Paediatric emergencies: Two ideas for reflection..., two challenges
    • Authors: Carles Luaces Cubells
      Abstract: Publication date: Available online 28 December 2016
      Source:Anales de Pediatría (English Edition)
      Author(s): Carles Luaces Cubells


      PubDate: 2017-01-07T20:51:38Z
      DOI: 10.1016/j.anpede.2016.10.010
       
  • Patient experience in emergency departments: What do children and
           adolescents think?
    • Authors: Cristina Parra Cotanda; Alba Vergés Castells; Núria Carreras Blesa; Victoria Trenchs Sainz de la Maza; Carles Luaces Cubells
      Abstract: Publication date: Available online 28 December 2016
      Source:Anales de Pediatría (English Edition)
      Author(s): Cristina Parra Cotanda, Alba Vergés Castells, Núria Carreras Blesa, Victoria Trenchs Sainz de la Maza, Carles Luaces Cubells
      Introduction Improving patient experience must become a priority in paediatric emergency departments. This experience is often studied by surveying parents, and not children directly. The aim of this study was to assess the patient experience of children attended in a Paediatric Emergency Department (PED). Patients and methods A prospective descriptive study was conducted using a survey based on the Picker questionnaire on the patient experience. From January to May 2014, children 8–17 years seen in the Paediatric Emergency Department and admitted to the hospital were asked to complete the questionnaires anonymously, within 24h of admission. Results A total of 217 patients completed the survey. The responses showed that 19.4% had to wait longer than expected, with 46.2% saying that there was not enough for children of their age group to do while waiting to be seen. As regards care and treatment, 4.6% of participants said staff did not fully explain what they were doing, and 23% said that they were not given enough privacy when being examined. Overall, 99.1% of patients said that they were well treated. Conclusions Overall patient experience in the PED was positive. Some aspects have to be improved (activities in the waiting room, and privacy during the examination).

      PubDate: 2016-12-28T19:36:34Z
      DOI: 10.1016/j.anpede.2016.04.005
       
  • Renal scarring in children under 36 months hospitalised for acute
           pyelonephritis
    • Authors: Begoña Rodríguez-Azor; José Miguel Ramos-Fernández; Sonia Sánchiz-Cárdenas; Ana Cordón-Martínez; Begoña Carazo-Gallego; David Moreno-Pérez; Antonio Urda-Cardona
      Abstract: Publication date: Available online 27 December 2016
      Source:Anales de Pediatría (English Edition)
      Author(s): Begoña Rodríguez-Azor, José Miguel Ramos-Fernández, Sonia Sánchiz-Cárdenas, Ana Cordón-Martínez, Begoña Carazo-Gallego, David Moreno-Pérez, Antonio Urda-Cardona
      Introduction Acute pyelonephritis (APN) is one of the most common causes of serious bacterial infection in infants. Renal scarring is the most prevalent long-term complication. Objectives To review the incidence of renal scarring within 6 months after an episode of APN in children under 36 months and its relationship with imaging studies, clinical settings, and bacteriology. Method A retrospective study of previously healthy patients aged one to 36 months, admitted for a first episode of APN, with a minimum follow-up of 6 months. Demographic and clinical variables were collected along with bacteriology, renal and bladder ultrasound scan, voiding cystourethrography, DMSA-scintigraphy, and re-infection events. Results A total of 125 patients were included in the study, of which 60% were male, the large majority (92%) febrile, and due to Escherichia coli (74.6%). There was a history of prenatal ultrasound scan changes in 15.4%. Ultrasound scan found dilation of the urinary tract in 22.1%. Voiding cystourethrography was performed on 70 patients: 54.3% no abnormalities, 12.8% vesicoureteral reflux (VUR) grade i-iii, and 32.9% iv-v grade VUR. Six patients had iv-v grade VUR with a normal ultrasound scan. Adherence to DMSA-scintigraphy at 6 months was only 61% of that indicated. Renal scarring was found in 44.3% of those in which it was performed (60 cases). Conclusions Almost half (44%) DMSA-scintigraphy in children aged one to 36 months hospitalised for APN show renal scarring at 6 months, which was found to be associated with the re-infection events and the iv-v grade VUR. There was no relationship between scarring and the bacteriology or the elevations of inflammatory biochemical markers.

      PubDate: 2016-12-28T19:36:34Z
      DOI: 10.1016/j.anpede.2016.03.008
       
  • Adolescent tuberculosis: A challenge and opportunity to prevent community
           transmission
    • Authors: Adriana Margarit; Sílvia Simó; Librada Rozas; Àngela Deyà-Martínez; Irene Barrabeig; Amadéu Gené; Clàudia Fortuny; Antoni Noguera-Julian
      Abstract: Publication date: Available online 27 December 2016
      Source:Anales de Pediatría (English Edition)
      Author(s): Adriana Margarit, Sílvia Simó, Librada Rozas, Àngela Deyà-Martínez, Irene Barrabeig, Amadéu Gené, Clàudia Fortuny, Antoni Noguera-Julian
      Introduction Adolescents may present with adult-type pulmonary tuberculosis (TB), including cavity disease in upper lobes and smear-positive sputum, which involves a significant transmission risk for social and family contacts. Patients and methods A retrospective (2007–2012) observational study of a case series of TB was conducted in children and adolescents (<18 years) in a paediatric referral centre in Barcelona. Patients aged ≤12 and >12 years at diagnosis were compared. Results The series consisted of 124 patients (56.5% males, median age: 4.0 years). In half of the cases, the patient was of immigrant origin and TB was diagnosed after clinical–radiological suspicion, intra-thoracic disease being the most common (91.9%). Cultures yielded positive results in one third of cases (37.9%) and isolates were sensitive to oral first-line anti-TB agents in 100%. Median (interquartile range) duration of treatment was 6 (6–9) months, directly observed therapy was needed in 10 patients, and there was a satisfactory outcome after treatment in 98.4%. Among adolescents, TB was more prevalent in females (63.2%) and immigrant patients (68.4%), comorbidity at diagnosis and lung cavity forms were more common, and the source case was identified only in 21.1% of the patients. Conclusion Adult-type pulmonary TB is common among adolescents, may be associated with underlying medical conditions, and is often diagnosed late, posing a significant transmission risk to the community.

      PubDate: 2016-12-28T19:36:34Z
      DOI: 10.1016/j.anpede.2016.03.007
       
  • Persistent Müllerian duct syndrome due to a mutation in the
           anti-Müllerian hormone receptor gene (AMHR2)
    • Authors: M. Eugenia Orós-Millán; M. Teresa Muñoz-Calvo; Mirian Y. Nishi; Berenice Bilharinho Mendonca; Jesús Argente
      Abstract: Publication date: Available online 27 December 2016
      Source:Anales de Pediatría (English Edition)
      Author(s): M. Eugenia Orós-Millán, M. Teresa Muñoz-Calvo, Mirian Y. Nishi, Berenice Bilharinho Mendonca, Jesús Argente


      PubDate: 2016-12-28T19:36:34Z
      DOI: 10.1016/j.anpede.2016.06.001
       
  • Study on growth hormone treatment in small for gestational age children
    • Authors: Julia Sánchez Zahonero; María José López García
      Abstract: Publication date: Available online 27 December 2016
      Source:Anales de Pediatría (English Edition)
      Author(s): Julia Sánchez Zahonero, María José López García
      Objective To analyse the effectiveness of growth hormone (GH) therapy in short-stature children born small for gestational age (SGA) without catch-up growth (height at the beginning of treatment<−2.5 SDS), in Valencia (Spain), between 01/01/2003 and 12/31/2013; and to compare our findings with previously published data. Materials and methods Anthropometric data from the SGA children were obtained from the database of the “Ministry of Health of Valencia”. These data were retrospectively reviewed. Results A total of 115 SGA children, with a mean age of 8.10±2.75 years and height of −3.14±0.59 SDS started treatment (dose: 0.035±0.004mg/kg/day) between January 1st, 2003 and March 31st, 2013. After 2 years of therapy (n =115, age: 10.50±2.72 years) the height SDS was −2.11±0.66; and after 4 years (n =96, age: 12.65±2.46 years) of −1.76±0.75 SDS. This latest improvement in stature matches ages at which the growth spurt usually occurs. Only 35 out of 115 children reached adult height, although impaired (−2.22±0.86 SDS), and failed to achieve their target height (−1.72±0.75 SDS). However, this sub-group grew to near the height of the shorter parent (−1.95±1.28 SDS), and 42.9% of these 35 cases increased their stature by more than 1 SDS. Conclusions The studied sample did not achieve satisfactory growth results, as in other published series. Our findings might be improved by starting treatment earlier, and with doses individualised according to patient characteristics.

      PubDate: 2016-12-28T19:36:34Z
      DOI: 10.1016/j.anpede.2016.02.003
       
  • Contribution of oxygen in neonatal resuscitation
    • Authors: Vento
      Abstract: Publication date: Available online 6 December 2016
      Source:Anales de Pediatría (English Edition)
      Author(s): Máximo Vento


      PubDate: 2016-12-06T14:32:42Z
       
  • Community acquired acute respiratory infections caused by enterovirus D68
           (EV-D68)
    • Authors: Jordi Reina; María Cabrerizo; Francesc Ferrés
      Abstract: Publication date: Available online 26 November 2016
      Source:Anales de Pediatría (English Edition)
      Author(s): Jordi Reina, María Cabrerizo, Francesc Ferrés


      PubDate: 2016-11-29T13:59:36Z
      DOI: 10.1016/j.anpede.2016.11.001
       
  • Spanish Society of Paediatric Infectious Diseases, Spanish Society of
           Paediatric Clinical Immunology and Allergy, Spanish Association of
           Paediatric Primary Care, and the Spanish Society of Extra-hospital
           Paediatrics and Primary Health Care consensus document on antibiotic
           treatment in penicillin or amoxicillin allergy
    • Authors: Fernando Baquero-Artigao; Antonio Michavila; Ángeles Suárez-Rodriguez; Anselmo Hernandez; Leticia Martínez-Campos; Cristina Calvo
      Abstract: Publication date: Available online 15 November 2016
      Source:Anales de Pediatría (English Edition)
      Author(s): Fernando Baquero-Artigao, Antonio Michavila, Ángeles Suárez-Rodriguez, Anselmo Hernandez, Leticia Martínez-Campos, Cristina Calvo
      The suspected allergy to beta-lactam antibiotics, especially penicillin and amoxicillin, is the most frequent reason for consultation in Child Allergy Units. In this consensus document, the clinical and diagnostic criteria of allergic reactions are described, as well as alternative antibiotic treatment for the most common infections diagnosed in paediatrics for patients with known or suspected allergy.

      PubDate: 2016-11-22T10:03:21Z
      DOI: 10.1016/j.anpede.2016.10.005
       
 
 
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