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Publisher: Elsevier   (Total: 3123 journals)

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Showing 1 - 200 of 3120 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 8)
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 26, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 90, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 30, 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: 379, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 26, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
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   (Followers: 1, SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 237, 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: 10, 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: 25, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
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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: 5)
Acute Pain     Full-text available via subscription   (Followers: 13)
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: 7)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 22)
Advanced Cement Based Materials     Full-text available via subscription   (Followers: 3)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 139, 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: 17, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, 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: 27, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 4)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 9, SJR: 1.054, h-index: 35)
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Advances in Applied Microbiology     Full-text available via subscription   (Followers: 23, 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: 6, SJR: 2.139, h-index: 42)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 4)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 13)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 26, 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: 9, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 29, 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 Dermatology     Full-text available via subscription   (Followers: 12)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 12)
Advances in Digestive Medicine     Open Access   (Followers: 7)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 6)
Advances in Drug Research     Full-text available via subscription   (Followers: 23)
Advances in Ecological Research     Full-text available via subscription   (Followers: 47, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 27, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 9)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 46, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 52, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 16)
Advances in Genetics     Full-text available via subscription   (Followers: 17, 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: 22, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 27)
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: 36, 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: 6)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 10)
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: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 6)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 5, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 23)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 9, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 2)
Advances in Organ Biology     Full-text available via subscription   (Followers: 2)
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: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 16, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, 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: 7)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 1.5, h-index: 62)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 6, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.1, h-index: 2)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 370, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 9, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 31, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 16)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 6, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 45, 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: 338, 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: 6, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 9, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 432, 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: 31, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 42, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 3)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 56, 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: 5, 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: 11, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 8)
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   (Followers: 1)
Algal Research     Partially Free   (Followers: 9, 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: 4, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 49, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 5)
American Heart J.     Hybrid Journal   (Followers: 48, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 48, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 42, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 9, 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: 26, 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: 45, 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: 208, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 61, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 6)
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: 24, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 27, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 26, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 36, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 6)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 60, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 14)
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: 4, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 36, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 171, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 12)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, 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: 176, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)

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Journal Cover Anales de Pediatría (English Edition)
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   ISSN (Print) 2341-2879
   Published by Elsevier Homepage  [3123 journals]
  • Acute liver failure related to inherited metabolic diseases in young
           children
    • Authors: Filipa Dias Costa; Rita Moinho; Sandra Ferreira; Paula Garcia; Luísa Diogo; Isabel Gonçalves; Carla Pinto
      Pages: 69 - 74
      Abstract: Publication date: February 2018
      Source:Anales de Pediatría (English Edition), Volume 88, Issue 2
      Author(s): Filipa Dias Costa, Rita Moinho, Sandra Ferreira, Paula Garcia, Luísa Diogo, Isabel Gonçalves, Carla Pinto
      Introduction Pediatric acute liver failure (ALF) due to inherited metabolic diseases (IMD) is a rare life-threatening condition with a poor prognosis. Early intervention may be lifesaving. Objective To describe clinical presentation, investigation and outcomes of ALF related to IMD in young children. Material and methods Retrospective review of the medical records of children aged up to 24 months, admitted to a tertiary pediatric and neonatal Intensive Care Unit during a 27-year period, fulfilling the ALF criteria, with documented metabolic etiology. Results From 34 ALF cases, 18 were related to IMD: galactosemia (4), mitochondrial DNA depletion syndrome (MDS) (3), ornithine transcarbamilase deficiency (3), congenital defects of glycosylation (2), tyrosinemia type 1 (2), long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (1), hereditary fructose intolerance (1), classic methylmalonic aciduria (1) and citrulinemia type 1 (1). The median age was 1.3 months. At least one previous suggestive sign/symptom of IMD (vomiting, failure to thrive, hypotonia or developmental delay) was observed in 67% of the cases. The most common physical signs at admission included: hepatomegaly (72%), jaundice (67%) and encephalopathy (44%). The peak laboratorial findings were: mean international normalizad ratio 4.5, median lactate 5mmol/L, mean bilirubin 201μmol/L, median alanine aminotransferase (ALT) 137UI/L and median ammonia 177μmol/L. One patient was submitted to liver transplant in ALF context (MSD). The mortality rate was 44%. Discussion The identification of IMD as a frequent cause of ALF allowed specific therapeutic measures and adequate family counseling. Particular clinical features and moderated ALT and bilirubin levels can lead to its suspicion.

      PubDate: 2018-02-03T07:39:03Z
      DOI: 10.1016/j.anpede.2017.03.003
       
  • 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
      Pages: 89 - 99
      Abstract: Publication date: February 2018
      Source:Anales de Pediatría (English Edition), Volume 88, Issue 2
      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: 2018-02-03T07:39:03Z
      DOI: 10.1016/j.anpede.2017.03.001
       
  • The challenge of complex chronicity and palliative care in paediatrics
    • Authors: Sergi Navarro Vilarrubí
      Pages: 1 - 2
      Abstract: Publication date: January 2018
      Source:Anales de Pediatría (English Edition), Volume 88, Issue 1
      Author(s): Sergi Navarro Vilarrubí


      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2017.11.004
       
  • Retrospective study of children referred from paediatric intensive care to
           palliative care: Why and for what
    • Authors: Alberto García-Salido; Paula Santos-Herranz; Verónica Puertas-Martín; María Ángeles García-Teresa; Ricardo Martino-Alba; Ana Serrano-González
      Pages: 3 - 11
      Abstract: Publication date: January 2018
      Source:Anales de Pediatría (English Edition), Volume 88, Issue 1
      Author(s): Alberto García-Salido, Paula Santos-Herranz, Verónica Puertas-Martín, María Ángeles García-Teresa, Ricardo Martino-Alba, Ana Serrano-González
      Introduction The creation of paediatric palliative care units (PPCU) could optimise the management of children with palliative focus after admission to a paediatric intensive care unit (PICU). This study describes the clinical and epidemiological characteristics of children referred from PICU to the PPCU of the Autonomous Community of Madrid (CAM). The overall treatment, relapses, re-admissions, and deaths, if occurred, are described. Patients and method A retrospective review was performed using the medical records from children transferred from the CAM paediatric intensive care units to the paediatric palliative care unit (1 March 2008–31 January 2015). Results A total of 41 patients were included (26 male/15 female) with a median age of 33 months (range 1–228). In the follow by the PPCU follow-up, the main approaches were respiratory (invasive ventilation with tracheostomy tube 8/41), nutritional (gastrostomy in 20/41), and pharmacological (anti-epileptics in 29/41 and 34/41 on antibiotic treatment). Hospital re-admission was required by 11/41 patients, with no re-admissions to PICU. Of the 13/41 patients who died, 9/13 were at home, with all of them accompanied by the primary caregivers and family, and only 1/9 with the presence of the home team. Conclusions The palliative approach at home is feasible in children, and the integration of PPCU could optimise the comprehensive care of previously critically ill children. It is necessary to achieve an optimal domiciliary care, and not just because of patient death. More observational, multicentre and prospective studies are needed to confirm these findings.

      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2017.11.003
       
  • Children's medically complex diseases unit. A model required in all our
           hospitals
    • Authors: Francisco José Climent Alcalá; Marta García Fernández de Villalta; Luis Escosa García; Aroa Rodríguez Alonso; Luis Adolfo Albajara Velasco
      Pages: 12 - 18
      Abstract: Publication date: January 2018
      Source:Anales de Pediatría (English Edition), Volume 88, Issue 1
      Author(s): Francisco José Climent Alcalá, Marta García Fernández de Villalta, Luis Escosa García, Aroa Rodríguez Alonso, Luis Adolfo Albajara Velasco
      Introduction The increase in survival of children with severe diseases has led to the rise of children with chronic diseases, sometimes with lifelong disabilities. In 2008, a unit for the specific care of medically complex children (MCC) was created in Hospital La Paz. Objectives To describe the work and care activities of this Unit. Patients and methods An analysis was performed on all discharge reports of the Unit between January 2014 and July 2016. Results The MCC Unit has 6 beds and a daily outpatient clinic. A total of 1.027 patients have been treated since the creation of the unit, with 243 from 2014. The median age was 24.2 months (IQ: 10.21–84.25). The large majority (92.59%) have multiple diseases, the most frequent chronic conditions observed were neurological (76.95%), gastrointestinal (63.78%), and respiratory diseases (61.72%). More than two-thirds (69.54%) of MCC are dependent on technology, 53.49% on respiratory support, and 35.80% on nutritional support. Hospital admission rates have increased annually. There have been 403 admissions since 2014, of which 8.93% were re-admissions within 30 days of hospital discharge. The median stay during 2014–2016 was 6 days (IQ: 3–14). The occupancy rate has been above 100% for this period. Currently, 210 patients remain on follow-up (86.42%), and 11 children (4.53%) were discharged to their referral hospitals. The mortality rate is 9.05% (22 deaths). The main condition of these 22 patients was neurological (9 patients). Infectious diseases were the leading cause of death. Conclusion MCC should be treated in specialised units in tertiary or high-level hospitals.

      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2017.04.004
       
  • Use of urine drug screening in the emergency department of a paediatric
           hospital
    • Authors: Núria Ferrer Bosch; Lidia Martínez Sánchez; Victoria Trenchs Sainz de la Maza; Jesús Velasco Rodríguez; Elsa García González; Carles Luaces Cubells
      Pages: 19 - 23
      Abstract: Publication date: January 2018
      Source:Anales de Pediatría (English Edition), Volume 88, Issue 1
      Author(s): Núria Ferrer Bosch, Lidia Martínez Sánchez, Victoria Trenchs Sainz de la Maza, Jesús Velasco Rodríguez, Elsa García González, Carles Luaces Cubells
      Objective To describe the situations in which urine drug screening is used in a Paediatric Emergency Department (ED). An analysis is also made on its potential usefulness on whether it changes the patient management, and if the results are confirmed by using specific techniques. Methodology A retrospective study was conducted on patients under the age of 18 attended in the ED during 2014 and in whom urine drug screening was requested. Depending on the potential capacity of the screening result to change patient management, two groups were defined (potentially useful and not potentially useful). Results Urine drug screening was performed on a total of 161 patients. The screening was considered not to be potentially useful in 87 (54.0%). This was because the clinical history already explained the symptoms the patient had in 55 (34.1%) patients, in 29 (18.0%) because the patient was asymptomatic, and in 3 (1.9%) because the suspected drug was not detectable in the screening. The drug screening results changed the patient management in 5 (3.1%) cases. A toxic substance was detected in 44 (27.3%). Two out of the 44 that were positive (2.1%) were re-tested by specific techniques, and presence of the toxic substance was ruled out in both of them (false positives). Conclusions Most of the drug screening tests are not justified, and it is very infrequent that they change patient management. It is very rare that the results are confirmed using more specific methods. Urine drug screening tests should be restricted to particular cases and if the result has legal implications, or if the patient denies using the drug, it should be followed by a specific toxicological study to provide a conclusive result.

      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2017.01.009
       
  • Functional and aesthetic evaluation of sacrococcygeal teratomas. Not
           everything ends with surgery
    • Authors: Vanesa Villamil; Oscar Girón Vallejo; María Fernández-Ibieta; Ángela Sánchez Sánchez; Paulo Y. Reyes Ríos; Irene Martínez Castaño; Javier Rojas-Ticona; Ramón Ruiz Pruneda; José I. Ruiz Jiménez
      Pages: 39 - 46
      Abstract: Publication date: January 2018
      Source:Anales de Pediatría (English Edition), Volume 88, Issue 1
      Author(s): Vanesa Villamil, Oscar Girón Vallejo, María Fernández-Ibieta, Ángela Sánchez Sánchez, Paulo Y. Reyes Ríos, Irene Martínez Castaño, Javier Rojas-Ticona, Ramón Ruiz Pruneda, José I. Ruiz Jiménez
      Introduction Sacrococcygeal teratoma is the most common solid neonatal tumour. The improvement in survival has meant that postoperative sequelae can be diagnosed and treated. The aim of this article is to evaluate the long-term outcomes of patients treated in our centre. Material and methods Records of patients treated for a sacrococcygeal teratoma in our hospital from 1977 to 2014 were retrospectively reviewed. Personal data was collected and a telephone questionnaire was used to assess long-term bowel and urinary habits, as well as an aesthetic and functional self-assessment. Results A total of 14 patients were treated during the study period, of whom 11 were females and 3 males, with a mean age at the time of the survey of 17 years (8 months to 37 years). Eight patients completed the questionnaire (57.1%). The mean age of the 8 patients was 23 years (4–37 years), of whom 37.5% were operated on due to a sacrococcygeal teratoma type I, 25% type II, 25% type III, and 12.5% type IV. Two of them (25%) had constipation, and one (12.5%) had faecal incontinence. Two (25%) patients suffered from recurrent urinary tract infections, and 3 (37.5%) patients had urinary incontinence. Five patients (62.5%) had a perception of being physically impaired, with limitation of their social life. Conclusions The incidence of constipation does not differ from that found in the literature. Faecal incontinence is slightly improved compared to what has been published. However, urinary tract infections and incontinence are more prevalent in our series. Five patients out of the eight that responded suffered from psychosocial problems, according to DAS-59 questionnaire. Patients with SCT require urological, bowel, and psychological counselling, until they have a complete functional and emotional development.

      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2017.03.013
       
  • Tuberculosis treatment for children: An update
    • Authors: María José Mellado Peña; Begoña Santiago García; Fernando Baquero-Artigao; David Moreno Pérez; Roi Piñeiro Pérez; Ana Méndez Echevarría; José Tomás Ramos Amador; David Gómez-Pastrana Durán; Antoni Noguera Julian
      Pages: 52.e1 - 52.e12
      Abstract: Publication date: January 2018
      Source:Anales de Pediatría (English Edition), Volume 88, Issue 1
      Author(s): María José Mellado Peña, Begoña Santiago García, Fernando Baquero-Artigao, David Moreno Pérez, Roi Piñeiro Pérez, Ana Méndez Echevarría, José Tomás Ramos Amador, David Gómez-Pastrana Durán, Antoni Noguera Julian
      Tuberculosis (TB) is the most important infectious disease all over the world, with a high morbidity and mortality. Paediatric tuberculosis has been a neglected epidemic, due to the difficulties in assessing its global impact, reduced incidence and lower infectivity compared to adults. In 2015, the WHO reported 1 million cases of paediatric TB and 169,000 deaths. In Europe, the emergence of MDR TB is a major concern, representing 16% of the new diagnosis in Eastern Europe. In 2014, it was estimated that about 219,000 children were infected by MDR-TB-strains in Europe, and 2120 developed the disease. Spain is the Western European country with more paediatric cases, with an incidence 4.3/100,000 inhabitants in 2014. Paediatric tuberculosis mortality in Spain is rare, but extra-pulmonary disease is associated with significant complications. The prevalence of paediatric drug resistant TB in Spain is over 4%, higher than the estimated incidence in adult population, representing mayor difficulties for therapeutic intervention. These data reveal that paediatric TB is still a Public Health priority in our country. The difficulties in diagnosis and the lack of optimal paediatric drug formulations are the major challenges for controlling the childhood's tuberculosis epidemic. A group of national paeditric TB experts has reviewed the international guidelines and the most recent evidences, and has established new recommendations for the management of paediatric TB contacts, latent infection and active TB disease, especially focused in drug resistant cases. This document replaces the former national guidelines from the Spanish Society for Pediatric Infectious Diseases, although the prior recommendations on the diagnosis remain valid.

      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2017.05.001
       
  • Immunisation schedule of the Spanish Association of Paediatrics: 2018
           recommendations
    • Authors: David Moreno-Pérez; Francisco José Álvarez García; Javier Álvarez Aldeán; María José Cilleruelo Ortega; María Garcés Sánchez; Nuria García Sánchez; Ángel Hernández Merino; María Méndez Hernández; Manuel Merino Moína; Abián Montesdeoca Melián; Jesús Ruiz-Contreras
      Pages: 53.e1 - 53.e9
      Abstract: Publication date: January 2018
      Source:Anales de Pediatría (English Edition), Volume 88, Issue 1
      Author(s): David Moreno-Pérez, Francisco José Álvarez García, Javier Álvarez Aldeán, María José Cilleruelo Ortega, María Garcés Sánchez, Nuria García Sánchez, Ángel Hernández Merino, María Méndez Hernández, Manuel Merino Moína, Abián Montesdeoca Melián, Jesús Ruiz-Contreras
      The Advisory Committee on Vaccines of the Spanish Association of Paediatrics annually publishes the immunisation schedule considered optimal for children resident in Spain, according to available evidence on current vaccines. Regarding funded immunisations, 2+1 strategy (2, 4, 11–12 months) with hexavalent (DTPa-IPV-Hib-HB) and 13-valent pneumococcal vaccines are recommended. Administration of the 6-year booster dose with DTPa is recommended, and a poliomyelitis dose for children who had received the 2+1 scheme, as well as Tdap vaccine for adolescents and pregnant women in every pregnancy 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). MMRV vaccine could be applied as the second dose if available. Coverage of human papillomavirus vaccination in girls aged 12 with a two dose scheme (0, 6 months) should be improved. Information and recommendation for male adolescents about potential beneficial effects of this immunisation should be provided as well. The new 9 genotypes vaccine is now available, expanding the coverage for both gender. Regarding non-funded immunisations, Committee on Vaccines of the Spanish Association of Paediatrics recommends meningococcal B vaccination, with a 3+1 schedule, and requests to be included in the National Immunisation Program. Tetravalent meningococcal vaccine (MenACWY) is recommended to adolescents (14–18 years) who are going to live in countries with systematic vaccination against ACWY serogroups, and people >6 weeks of age with risk factors or travellers to countries with very high incidence. Vaccination against rotavirus is recommended in all infants.

      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2017.11.001
       
  • Quality of initial trauma care in paediatrics
    • Authors: Vicente Ibáñez Pradas; Rut Pérez Montejano
      Pages: 337 - 342
      Abstract: Publication date: December 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 6
      Author(s): Vicente Ibáñez Pradas, Rut Pérez Montejano
      Introduction Trauma care in Spain is not provided in specific centres, which means that health professionals have limited contact to trauma patients. After the setting up of a training programme in paediatric trauma, the aim of this study was to evaluate the quality of the initial care provided to these patients before they were admitted to the paediatric intensive care unit (PICU) of a third level hospital (trauma centre), as an indirect measurement of the increase in the number of health professionals trained in trauma. Materials and methods Two cohorts of PICU admissions were reviewed, the first one during the four years immediately before the training courses started (Group 1, period 2001–2004), and the second one during the 4 years (Group 2, period 2012–2015) after nearly 500 professionals were trained. A record was made of the injury mechanism, attending professional, Glasgow coma score (GCS), and paediatric trauma score (PTS). Initial care quality was assessed using five indicators: use of cervical collar, vascular access, orotracheal intubation if GCS≤8, gastric decompression if PTS≤8, and number of actions carried out from the initial four recommended (neck control, provide oxygen, get vascular access, provide IV fluids). Compliance was compared between the 2 periods. A p <0.05 was considered statistically significant. Results A total of 218 patient records were analysed, 105 in Group 1, and 113 in Group 2. The groups showed differences both in injury mechanism and in initial care team. A shift in injury mechanism pattern was observed, with a decrease in car accidents (28% vs 6%; p <0.0001). Patients attended to in low complexity hospitals increased from 29.4% to 51.9% (p =0.008), and their severity decreased when assessed using the GCS≤8 (29.8% vs 13.5%; p =0.004), or PTS≤8 (48.5% vs 29.7%; p =0.005). As regards quality indicators, only the use of neck collar improved its compliance (17.3–32.7%; p =0.01). Patients who received no action in the initial care remained unchanged (19% vs 11%%; p =0.15). Conclusions Although there are limited improvements, the setting up of a training programme has not translated into better initial care for trauma patients in our area of influence. Trauma training should be complemented with other support measures in order to achieve a systematic application of the trauma care principles.

      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2017.02.008
       
  • Variability in enteral feeding practices of preterm infants among
           hospitals in the SEN1500 Spanish neonatal network
    • Authors: María Concepción Moreno Algarra; Verónica Fernández Romero; Tomás Sánchez Tamayo; María Gracia Espinosa Fernández; Enrique Salguero García
      Pages: 245 - 252
      Abstract: Publication date: November 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 5
      Author(s): María Concepción Moreno Algarra, Verónica Fernández Romero, Tomás Sánchez Tamayo, María Gracia Espinosa Fernández, Enrique Salguero García
      Introduction Proper nutrition is one of the primary objectives in the management of preterm infants. However, lack of evidence on the best strategy to achieve this objective has led to a great variability in feeding practices. This variability may be related to the differences in the incidence of complications, such as necrotising enterocolitis (NEC). Objective The aim of this study is to assess the variability in clinical practice regarding enteral feeding in SEN-1500 Spanish network. Method An observational study was conducted using a questionnaire sent out in 2013 requesting information about feeding very low birth weight (VLBW) neonates (bank milk, start time, trophic feeding, increases, fortifiers and probiotics). Results Responses were received from 60 of the 98 hospitals. The response rate was higher in centres with more than 50VLBW/year (30/31). Just over two-thirds (67%) have feeding protocols, and 52% refer to variability within their unit. A milk bank is available in 25% of the units. First feeding occurs fairly evenly throughout first 48h, although it is delayed in lower gestational ages, even when there is no haemodynamic failure. In addition to haemodynamic instability there are other situations when the start is delayed (absence of breast milk, CIR, altered umbilical flow, asphyxia), while it is rarely delayed by absence of meconium or maintain an umbilical catheter. Half of those under 25 weeks begin directly with progressive increases instead of trophic feeding. Increases rarely reach 30mL/kg/day. Almost all use fortification and vitamins. There was a significant use of probiotics at the time of the survey. Conclusions There is great variability in enteral nutrition policies in VLBW in Spain. Although some differences are justified by the lack of evidence, there are other interventions that have proven to be effective, such as evidence-based protocols or access to donor milk. Implementation in all the units could reduce the incidence of NEC and improve the nutritional status.

      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2016.09.012
       
  • The relationship between metabolic disorders and small for gestational age
           with idiopathic premature adrenarche
    • Authors: Francisco Javier Mejorado Molano; Laura Andrés Zallo; Marta Fornos Rodríguez; Pilar Pérez Segura; Teresa Gavela Pérez; María Luisa Sanz Calvo; Leandro Soriano Guillén
      Pages: 253 - 259
      Abstract: Publication date: November 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 5
      Author(s): Francisco Javier Mejorado Molano, Laura Andrés Zallo, Marta Fornos Rodríguez, Pilar Pérez Segura, Teresa Gavela Pérez, María Luisa Sanz Calvo, Leandro Soriano Guillén
      Background There is still controversy on the relationship between idiopathic premature adrenarche (IPA) and a history of small for gestational age, as well as the concomitant presence of obesity and other metabolic disturbances. An attempt is made to study these potential associations in a cohort of girls with IPA from our hospital. Patients and methods A descriptive cross-sectional study was conducted that included girls with a diagnosis of IPA from the Paediatric Department of the Fundación Jiménez Díaz (Madrid, Spain) between January 2007 and May 2015. A record was made of family and personal history with perinatal data, as well as anthropometric data and biochemical values at the time of diagnosis. Results Out of a total of 76 girls with IPA, 2.7% had a history of small for gestational age. When body mass index was analysed according to modified criteria of WHO 2007/Cole 2000, 11.8% were overweight, and 11.8% were obese at diagnosis. Using the criteria set by the Spanish Ministry of Health, 6.6% were overweight and 18.4% obese, with 21.2% of the girls being insulin resistance, and 13.95% having dyslipidaemia. None of them had hypertension. From a comparative analysis between normal and overweight and obesity IPA girls, the latter had significantly higher levels of triglycerides and insulin, a higher HOMA index, and lower levels of HDL cholesterol. Conclusions IPA girls included in the study do not have a higher prevalence of small for gestational age compared to the general population. Prevalence of overweight and obesity in girls with IPA is not higher than the prevalence in the normal population.

      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2016.10.018
       
  • Epidemiology of patients hospitalised due to bronchiolitis in the south of
           Europe: Analysis of the epidemics, 2010–2015
    • Authors: José Miguel Ramos-Fernández; Eva Pedrero-Segura; Mario Gutiérrez-Bedmar; Beatriz Delgado-Martín; Ana María Cordón-Martínez; David Moreno-Pérez; Antonio Urda-Cardona
      Pages: 260 - 268
      Abstract: Publication date: November 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 5
      Author(s): José Miguel Ramos-Fernández, Eva Pedrero-Segura, Mario Gutiérrez-Bedmar, Beatriz Delgado-Martín, Ana María Cordón-Martínez, David Moreno-Pérez, Antonio Urda-Cardona
      Introduction The renewal of clinical practice guidelines on acute bronchiolitis (AB) requires the re-assessment of the consequences of their implementation. An update is presented on the main clinical and epidemiological variables in patients hospitalised due to AB in Southern Europe and an analysis is made of the causes associated with longer hospital stay. Patients and method A retrospective study was conducted on patients admitted to hospital due to AB during 5 epidemics (2010–2015), with an analysis of the major clinical and epidemiological variables. A logistic regression analysis was performed on the factors associated with a longer hospital stay. Results The beginning of the epidemic occurred between the 4th week of September and the 3rd week of October. Of those children under 2 years (42530), 15.21% (6468 patients) attended paediatric emergency department due to having AB, and 2.36% (1006 patients) were admitted. Of these, 18.5% were premature, 12.2% had a birth weight <2300g, 21.1% were younger than 1 month, 10.8% consulted for associated apnoea, 31.1% had an intake <50%, and 13.1% had bacterial superinfection. These factors were independently associated with prolonged stay. The median length of stay was 5 days, and 8.5% of cases were admitted to a paediatric intensive care unit (PICU). Conclusions The beginning of the bronchiolitis epidemic showed a variability of up to 4 weeks in this region. Five years after implementing the new guidelines, the incidence of admissions was approximately 2.3%, and appeared stable compared to previous studies. The mean age of the patients decreased to 2.4 months, although with a similar proportion of PICU admissions of 8.5%. Independent factors associated with prolonged stay were: low birth weight, age less than one month, apnoea prior-to-admission, intake of less than 50%, and severe bacterial superinfection. Respiratory bacterial infection exceeded the prevalence of urinary tract infection.

      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2016.10.016
       
  • Continuous subcutaneous insulin infusion in children less than 6
           years-old: Long-term progress
    • Authors: Esmeralda Colino; María Martín Frías; Belén Roldán; María Ángeles Álvarez; Rosa Yelmo; Raquel Barrio
      Pages: 276 - 283
      Abstract: Publication date: November 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 5
      Author(s): Esmeralda Colino, María Martín Frías, Belén Roldán, María Ángeles Álvarez, Rosa Yelmo, Raquel Barrio
      Objective The aims of the study are to evaluate the efficacy and safety of continuous subcutaneous insulin infusion (CSII) treatment in pre-school children with type I diabetes, and to assess whether the criteria of good metabolic control are achieved. Method A review was performed on the medical charts of patient's <6 years of age who started CSII treatment between 2003 and 2014. The cohort consisted of 27 patients (mean age 4 (2.9–4.7) years, 56% males). An analysis was made including the age at onset, type I diabetes duration, HbA1c (HPLC, Menarini, normal value 5.1±0.31%), insulin dose (IU/kg/day), number of capillary blood glucose measurements, number of baseline processes per day, % baseline/total insulin (B/TI), insulin ratios (I/HC) at different meals, severe hypoglycaemia (HS episodes/100 patients years), DKA events, percentages of normal blood glucose (70–180mg/dL), hyperglycaemia (>180mg/dL), and hypoglycaemia (<70mg/dL), mean blood glucose, standard deviation and coefficient of variation ((SD/mean glucose)×100). Statistical analysis was performed using SPSS. Results HbA1c decreased from 6.9% (6.7–7.5) to 6.8% (6.4–7.1) after one year of CSII. Afterwards, it remained under 6.8% during the follow-up (median 5 years [3–6]). Prior to CSII, 74% of children had HbA1c levels <7.5%. It increased to 96% after one year of CSII. Median blood glucose measurements/day was 10 (9–11). Total insulin dose did not change significantly. During the follow-up, there was one episode of DKA and one episode of HS. I/HC at breakfast were higher than at other meals (0.92 vs. 0.55, 0.6 and 0.5, respectively). Conclusions CSII is effective and safe in pre-school children. It allows good metabolic control (based on Society for Paediatric and Adolescent Diabetes/American Diabetes Association criteria) to be achieved and maintained for long periods of time without an increase in adverse events.

      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2016.12.007
       
  • Repeated poisoning episodes: Alarm sign of risk situations
    • Authors: Elsa García González; Victoria Trenchs Sainz de la Maza; Lidia Martínez Sánchez; Nuria Ferrer Bosch; Carles Luaces Cubells
      Pages: 284 - 288
      Abstract: Publication date: November 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 5
      Author(s): Elsa García González, Victoria Trenchs Sainz de la Maza, Lidia Martínez Sánchez, Nuria Ferrer Bosch, Carles Luaces Cubells
      Introduction Prevention is an essential aspect in paediatric poisonings, especially when recurrent episodes are detected. The aims of this article are to detect the recurrence rate for suspected poisoning in emergency consultations, as well as to identify the cases in which specific preventive measures are indicated, and to determine whether the creation of a specific item for recurrent episodes in the computerised medical records system facilitates its detection. Material and methods A retrospective study was conducted on patients less than 18 years of age treated in the emergency room due to suspected poisoning during 2013 and 2014. Patients were divided according to the presence or absence of previous episodes. From January 2014, a specific item is present in the computerised medical records of the poisoned patient, where the history of previous episodes is registered. The preventive measures used between both groups were compared. Results A total of 731 consultations were recorded for suspected poisoning. A history of previous episodes was detected in 9% of cases. Medical injury reports and follow-up in outpatient clinics were more often performed in patients with recurrent episodes than in patients without them (28.8% vs 18.0%, P =.034, and 65.2% vs. 18.8%, P <.001, respectively). In 2013, the recurrence rate was 5.9% vs 12% in 2014 (P =.004). Conclusions The recurrence rate observed is significant. Although preventive measures are more frequently indicated in these patients, their application is low. The creation of a specific item for recurrent episodes in a computerised medical records system facilitates their detection.

      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2016.12.005
       
  • Collagenous gastritis: An unusual atypical form in a male infant
    • Authors: Carmen Lázaro de Lucas; Laura Tesouro Rodríguez; Lorena Nélida Magallares García; Eva Martínez-Ojinaga Nodal; Esther Ramos Boluda
      Abstract: Publication date: Available online 12 February 2018
      Source:Anales de Pediatría (English Edition)
      Author(s): Carmen Lázaro de Lucas, Laura Tesouro Rodríguez, Lorena Nélida Magallares García, Eva Martínez-Ojinaga Nodal, Esther Ramos Boluda


      PubDate: 2018-02-13T08:17:53Z
      DOI: 10.1016/j.anpede.2017.05.003
       
  • Challenges and opportunities in the vertical transmission of Chagas
           disease
    • Authors: María Isabel González-Tomé; Milagros García López-Hortelano; Laura Fregonese
      Abstract: Publication date: Available online 9 February 2018
      Source:Anales de Pediatría (English Edition)
      Author(s): María Isabel González-Tomé, Milagros García López-Hortelano, Laura Fregonese


      PubDate: 2018-02-13T08:17:53Z
      DOI: 10.1016/j.anpede.2018.01.001
       
  • Apnoea in infants with bronchiolitis: Incidence and risk factors for a
           prediction model
    • Authors: José Miguel Ramos-Fernández; David Moreno-Pérez; Mario Gutiérrez-Bedmar; María Ramírez-Álvarez; Yasmina Martínez García; Lourdes Artacho-González; Antonio Urda-Cardona
      Abstract: Publication date: Available online 4 February 2018
      Source:Anales de Pediatría (English Edition)
      Author(s): José Miguel Ramos-Fernández, David Moreno-Pérez, Mario Gutiérrez-Bedmar, María Ramírez-Álvarez, Yasmina Martínez García, Lourdes Artacho-González, Antonio Urda-Cardona
      Introduction The presence of apnoea in acute bronchiolitis (AB) varies between 1.2% and 28.8%, depending on the series, and is one of its most fearsome complications. The aim of this study is to determine the incidence of apnoea in hospitalised patients diagnosed with AB, and to define their associated risk factors in order to construct a prediction model. Patients and method A retrospective observational study of patients admitted to a tertiary hospital in the last 5 years with a diagnosis of AB, according to the classic criteria. Data was collected on the frequency of apnoea and related clinical variables to find risk factors in a binary logistic regression model for the prediction of apnoea. A ROC curve was developed with the model. Results Apnoea was recorded during the admission of 53 (4.4%) patients out of a total of 1.197 cases found. The risk factors included in the equation were: female (OR 0.6, 95% CI: 0.27–1.37), caesarean delivery (OR: 3.44, 95% CI: 1.5–7.7), postmenstrual age ≤43 weeks (OR: 6.62, 95% CI: 2.38–18.7), fever (OR: 0.33, 95% CI: 0.09–1.97), low birth weight (OR: 5.93, 95% CI: 2.23–7.67), apnoea observed by caregivers before admission (OR: 5.93, 95% CI: 2.64–13.3), and severe bacterial infection (OR: 3.98, 95% CI: 1.68–9.46). The optimal sensitivity and specificity of the model in the ROC curve was 0.842 and 0.846, respectively (P <.001). Conclusions The incidence of apnoea during admission was 4.4 per 100 admissions of AB and year. The estimated prediction model equation may be of help to the clinician in order to classify patients with increased risk of apnoea during admission due to AB.

      PubDate: 2018-02-13T08:17:53Z
      DOI: 10.1016/j.anpede.2017.03.016
       
  • Wilms’ tumour: A review of 15 years recent experience
    • Authors: Laura Illade; Carmen Hernandez-Marques; Maria Cormenzana; Alvaro Lassaletta; Maitane Andión Catalán; David Ruano; Victoria Fioravantti; Luis Madero López
      Abstract: Publication date: Available online 3 February 2018
      Source:Anales de Pediatría (English Edition)
      Author(s): Laura Illade, Carmen Hernandez-Marques, Maria Cormenzana, Alvaro Lassaletta, Maitane Andión Catalán, David Ruano, Victoria Fioravantti, Luis Madero López
      Introduction Wilms’ tumour is the most frequent renal tumour in children. Multi-modal treatment includes chemotherapy and surgery, with or without radiotherapy. The survival is excellent, with rates exceeding 90%. A review is presented on our experience over the last 15 years of treating Wilms’ tumour in Hospital Niño Jesús, Madrid. Patients and methods A retrospective study was conducted on 40 consecutive paediatric patients diagnosed with nephroblastoma between 2002 and 2016 in the Hospital Niño Jesús in Madrid. The clinical characteristics, diagnostic methods, treatment, and follow-up were analysed. Results Of the 40 patients, 23 were boys, with a median age at diagnosis of 2.5 years (range, 4 months–15 years). Three patients underwent initial nephrectomy, three received a fine needle aspiration biopsy, followed by chemotherapy, and 34 patients started pre-operative chemotherapy directly. The median follow-up of the patients was 6.75 years (range, 10 months–13.92 years). Two patients died from disease progression. There were no treatment-related deaths. Overall survival and event-free survival at 5 years was 94.6±3.7% and 89.4±5%, respectively. Conclusion Wilms’ tumour treatment is a success of modern medicine, currently achieving a survival rate of 95% in our series.

      PubDate: 2018-02-03T07:39:03Z
      DOI: 10.1016/j.anpede.2017.03.019
       
  • Risk of developmental dysplasia of the hip in patients subjected to the
           external cephalic version
    • Authors: Nerea Sarmiento Carrera; Eva González Colmenero; José Luis Vázquez Castelo; Ana Concheiro Guisán; Emilio Couceiro Naveira; José Ramón Fernández Lorenzo
      Abstract: Publication date: Available online 3 February 2018
      Source:Anales de Pediatría (English Edition)
      Author(s): Nerea Sarmiento Carrera, Eva González Colmenero, José Luis Vázquez Castelo, Ana Concheiro Guisán, Emilio Couceiro Naveira, José Ramón Fernández Lorenzo
      Introduction Developmental dysplasia of the hip (DDH) refers to the spectrum of abnormalities of maturation and development of the hip. Breech presentation is associated with DDH. This risk factor can be modified by external cephalic version (ECV). The aim of this study is to evaluate the incidence of DDH in patients who successfully underwent ECV, as well as to evaluate need for these children (breech for a period during gestation) to be included in the DDH screening protocol. Material and methods A prospective cohort study was conducted in the Hospital Universitario de Vigo from January 1, 2015 to December 31, 2015. It included children born in cephalic presentation after a successful ECV, as well as children born in breech presentation. They all were screened for DDH by ultrasound examination of the hip. Results Out of a total of 122 newborns included in the study, ECV was attempted on 67 (54.9%), of which 35 (52.2%) were successful. Out of the 14 children diagnosed with DDH, 3 of those born in cephalic presentation after a successful ECV were found to be normal on physical examination. Conclusions Successful ECV is associated with a lower incidence of DDH as regards breech presentation. However, these patients should be included in the DDH screening protocol for the early detection of this disorder.

      PubDate: 2018-02-03T07:39:03Z
      DOI: 10.1016/j.anpede.2017.03.017
       
  • Quality of life heart-disease children who have suffered from an arterial
           ischaemic stroke
    • Authors: María Vázquez López; Pedro Castro de Castro; Nuria Gil Villanueva; Andrés José Alcaraz Romero; Samuel Ignacio Pascual Pascual
      Abstract: Publication date: Available online 3 February 2018
      Source:Anales de Pediatría (English Edition)
      Author(s): María Vázquez López, Pedro Castro de Castro, Nuria Gil Villanueva, Andrés José Alcaraz Romero, Samuel Ignacio Pascual Pascual


      PubDate: 2018-02-03T07:39:03Z
      DOI: 10.1016/j.anpede.2017.04.008
       
  • Jarcho-Levin and Rokitansky syndromes. An excepcional association
    • Authors: Rebeca Barriga Buján; Alba Muinelo Segade; Ana Prado-Carro; Pedro González Herranz; Rafaela Soler Fernández
      Abstract: Publication date: Available online 3 February 2018
      Source:Anales de Pediatría (English Edition)
      Author(s): Rebeca Barriga Buján, Alba Muinelo Segade, Ana Prado-Carro, Pedro González Herranz, Rafaela Soler Fernández


      PubDate: 2018-02-03T07:39:03Z
      DOI: 10.1016/j.anpede.2017.03.018
       
  • Analysis of prenatal abuse in Catalonia between the years 2011 and 2014
    • Authors: Jordi Garcia Garcia; Elena Campistol Mas; María Ángeles López-Vilchez; María José Morcillo Buscato; Antonio Mur Sierra
      Abstract: Publication date: Available online 2 February 2018
      Source:Anales de Pediatría (English Edition)
      Author(s): Jordi Garcia Garcia, Elena Campistol Mas, María Ángeles López-Vilchez, María José Morcillo Buscato, Antonio Mur Sierra
      Introduction Foetal abuse is that intentional or negligent act that causes a harmful effect to the foetus. It is a type of abuse difficult to diagnose and handle. Some indicators of suspicion are the absence of gestational control, the maternal consumption of toxic substances, or the problematic maternal social environment. Objective To analyse the cases of foetal abuse registered in Catalonia between 2011 and 2014 to identify the risk profile. Methods A cross-sectional descriptive study was conducted on a sample of 222 cases of prenatal abuse registered in Catalonia between 2011 and 2014. Results The mean maternal age was 28.11 years, with 63% of Spanish nationality, 76% were unemployed, 60% had not followed correct gestational control, 76% had previous pregnancy interruptions, 20% reported to have been mistreated by the partner, had history of social problems (76% social intervention, 30.5% previous child retention, 13% custody of the mother by the administration, 7% deprivation of liberty), with high rates of mother-to-child transmission of infection (HIV 4.95%, HCV 9%, HIV+HCV co-infection 1.8%), and 73% reported toxic use (in order of frequency, cannabis, cocaine and heroin). In newborns, the rate of prematurity (26.3%) is highlighted, as well as the diagnosis of withdrawal syndrome in 34 cases. Just over half (51.6%) of the infants are currently with their mother. Conclusions In our reference population with a diagnosis of prenatal abuse, there are high rates of maternal toxic consumption, HIV-HCV infection, unemployment, history of previous social intervention, and poor gestational control.

      PubDate: 2018-02-03T07:39:03Z
      DOI: 10.1016/j.anpede.2017.04.007
       
  • Challenges in childhood liver transplantation in innate errors of
           metabolism
    • Abstract: Publication date: Available online 17 January 2018
      Source:Anales de Pediatría (English Edition)
      Author(s): Jesús Jiménez Gómez


      PubDate: 2018-01-23T06:51:21Z
       
  • Aetiology, outcomes and prognostic indicators of paediatric acute liver
           failure
    • Authors: Juan José Gilbert Pérez; Belén Jordano Moreno; Mónica Rodríguez Salas
      Abstract: Publication date: Available online 10 January 2018
      Source:Anales de Pediatría (English Edition)
      Author(s): Juan José Gilbert Pérez, Belén Jordano Moreno, Mónica Rodríguez Salas
      Introduction Acute liver failure (ALF) is a multisystem disease with severe impairment of liver function of acute onset. The Paediatric End-stage Liver Disease (PELD) score is used as a predictor of mortality in chronic liver disease, however experience is limited in ALF. Objectives To evaluate the aetiology and outcomes of children with ALF in a Children's Liver Transplant Centre, and to investigate the validity of PELD as a prognostic indicator. Patients and methods A retrospective study was conducted on patients diagnosed with ALF in our hospital from 2000 to 2013 using the criteria of the Paediatric ALF Study Group. Results The study included 49 patients with an age range 0–14years. The most frequent aetiologies were: indeterminate (36.7%) and metabolic (26.5%). Liver transplant (LT) was required by 42.8%, and there were 16.3% deaths. Patients with higher levels of bilirubin, INR, or encephalopathy were more likely to require a liver transplant, yielding an OR for INR 1.93. A cut-off of 27 in the PELD score according to the ROC curve showed a sensitivity of 86% and a specificity of 85%, predicting a worse outcome (AUC: 0.90; P <.001). The survival of patients with ALF without transplantation seems more likely in those who have low values of PELD and absence of encephalopathy, with a RR of 0.326. Conclusions ALF patients with a high PELD score and the presence of encephalopathy had worse outcomes. The PELD score could be a useful tool to establish the optimum time for inclusion in the transplant list, however further studies are still needed.

      PubDate: 2018-01-14T06:16:18Z
      DOI: 10.1016/j.anpede.2017.02.012
       
  • Rumination syndrome: Diagnostic and therapeutic difficulties of a not so
           uncommon disorder
    • Authors: Aida Giménez Casado; María José López Liñán; Elisabeth Barba Orozco; Anna Accarino Garaventa; Marina Álvarez Beltrán; Fernando Azpiroz Vidaur; Oscar Segarra Cantón
      Abstract: Publication date: Available online 3 January 2018
      Source:Anales de Pediatría (English Edition)
      Author(s): Aida Giménez Casado, María José López Liñán, Elisabeth Barba Orozco, Anna Accarino Garaventa, Marina Álvarez Beltrán, Fernando Azpiroz Vidaur, Oscar Segarra Cantón
      Introduction Rumination syndrome is an uncommon gastrointestinal functional disorder that may be difficult to diagnose, as not many physicians are aware of this condition. In many cases, patients undergo numerous tests and are prescribed several treatments based on erroneous diagnoses. When the correct diagnosis is eventually made, therapy for the syndrome can be difficult and complex because of its multifactorial nature. The aim of this study was to present our experience with this condition, by presenting an analysis of the clinical, diagnostic, and therapeutic data of our patients. Patients and method A prospective and retrospective study was conducted on all cases of rumination syndrome diagnosed between January 2010 and May 2016 in patients attending the Paediatric Gastroenterology Departments of two hospitals: Consorci Sanitari de Terrassa and Hospital Materno-Infantil Vall d’Hebron (Barcelona, Spain). Results The analysis included 12 patients, with a mean age at the onset of symptoms of 9 years and 1 month, and the mean time period to make the diagnosis was 2 years and 3 months. A mean of 8.1 complementary tests were carried out before establishing the diagnosis. In 10 of the 12 patients, some type of treatment had been given before the diagnosis of rumination syndrome, but was unsuccessful in all cases. Ten of our patients underwent the novel, experimental biofeedback therapy. Conclusions Due to the limited knowledge of this condition among attending professionals in terms of the clinical presentation, diagnosis, and treatment, patients with rumination syndrome are often misdiagnosed and undergo numerous avoidable complementary tests, and invasive, costly treatments.

      PubDate: 2018-01-14T06:16:18Z
      DOI: 10.1016/j.anpede.2017.03.014
       
  • Streptococcus pyogenes infection in paediatrics: from pharyngotonsillitis
           to invasive infections
    • Authors: David Espadas-Maciá; Eva María Flor Macián; Rafael Borrás; Sandrine Poujois Gisbert; Juan Ignacio Muñoz Bonet
      Abstract: Publication date: Available online 30 December 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): David Espadas-Maciá, Eva María Flor Macián, Rafael Borrás, Sandrine Poujois Gisbert, Juan Ignacio Muñoz Bonet
      Background Streptococcus pyogenes or Group A Streptococci (GAS) cause many infections in infancy. Changes in its epidemiology have been described in recent years, including an increase in invasive infections (iGAS). Methods A retrospective-descriptive study was conducted on children less than 15-years-old, with GAS infections, in particular iGAS, and their complications from February 2004 to April 2014. Results A total of 2192 positive cultures were obtained of which 92.7% were pharyngeal cultures. Twenty-nine patients were admitted to hospital: 4 with suppurative complications, 7 post-infective, 14 iGAS, and 4 probable iGAS cases. There were no differences in the frequency of GAS isolations/year. Non-invasive isolates were more frequent in winter and spring (P <.001), and 68.3% were in patients younger than 5 years. The incidence of iGAS was 2.1/100000 children/year. There was no seasonality, and it was more frequent in younger children (P =.039). The most common diagnosis was pneumonia (6/14). Eight patients required intensive care. They were treated empirically with second or third-generation cephalosporin or with intravenous penicillin, and pneumonia required longer treatment times (P =.016). All GAS isolates were sensitive to penicillin, and 10.6% were resistant to erythromycin. The time spent in hospital was longer for iGAS than other cases (P =.028). No patients died. Conclusions Pharyngotonsillitis caused by GAS is common in childhood, and its incidence is increasing in children younger than 5 years. At the moment, post-infectious complications are rare. Invasive infections are the most severe forms of presentation, and are more common in younger children.

      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2017.02.013
       
  • Brachydactyly type C due to a nonsense mutation in the GDF5 gene
    • Authors: Lourdes Travieso-Suárez; Arrate Pereda; Jesús Pozo-Román; Guiomar Pérez de Nanclares; Jesús Argente
      Abstract: Publication date: Available online 30 December 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Lourdes Travieso-Suárez, Arrate Pereda, Jesús Pozo-Román, Guiomar Pérez de Nanclares, Jesús Argente


      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2017.03.015
       
  • Pulse oximetry screening of critical congenital heart defects in the
           neonatal period. The Spanish National Neonatal Society recommendation
    • Authors: Manuel Sánchez Luna; Alejandro Pérez Muñuzuri; Ester Sanz López; José Luis Leante Castellanos; Isabel Benavente Fernández; César W. Ruiz Campillo; M. Dolores Sánchez Redondo; Máximo Vento Torres; Segundo Rite Gracia
      Abstract: Publication date: Available online 29 December 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Manuel Sánchez Luna, Alejandro Pérez Muñuzuri, Ester Sanz López, José Luis Leante Castellanos, Isabel Benavente Fernández, César W. Ruiz Campillo, M. Dolores Sánchez Redondo, Máximo Vento Torres, Segundo Rite Gracia
      Due to its severity, as well as the consequences of a late diagnosis, critical congenital heart defects (CCHD) represent a challenging situation, making an early diagnosis necessary and ideally before symptoms appear when circulatory collapse or death of the newborn can occur. Due to this, a prenatal and very early postnatal diagnosis is very important. Prenatal ultrasound screening and physical examination of the newborn can miss a considerable number of CCHD cases. Pulse oximetry screening has been demonstrated to be an effective, non-invasive, inexpensive, and well accepted tool in the early diagnosis of CCHD. The Spanish National Society of Neonatology, through its Standards Committee, and based on the current evidence, recommend the implementation of pulse oximetry screening of CCHD in Spain, and then to offer the best therapy possible to these newborn infants.

      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpede.2017.06.001
       
  • The vomiting infant: When should intestinal volvulus be suspected'
    • Authors: Bárbara Moreno Sanz-Gadea; Clara Udaondo Gascón; Margarita Sellers Carrera; Julia Martín Sánchez; María de Ceano-Vivas La Calle
      Abstract: Publication date: Available online 28 December 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Bárbara Moreno Sanz-Gadea, Clara Udaondo Gascón, Margarita Sellers Carrera, Julia Martín Sánchez, María de Ceano-Vivas La Calle


      PubDate: 2018-01-03T08:07:21Z
      DOI: 10.1016/j.anpedi.2017.04.006
       
  • How can we improve the care of paediatric trauma'
    • Authors: María Isabel Iglesias-Bouzas; Ana Serrano González
      Pages: 299 - 300
      Abstract: Publication date: December 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 6
      Author(s): María Isabel Iglesias-Bouzas, Ana Serrano González


      PubDate: 2017-12-08T01:05:54Z
      DOI: 10.1016/j.anpede.2017.10.001
       
  • 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
      Pages: 311 - 319
      Abstract: Publication date: December 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 6
      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: 2017-12-08T01:05:54Z
      DOI: 10.1016/j.anpede.2017.01.002
       
  • 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
      Pages: 343 - 349
      Abstract: Publication date: December 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 6
      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: 2017-12-08T01:05:54Z
      DOI: 10.1016/j.anpede.2017.02.002
       
  • 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
      Pages: 351 - 353
      Abstract: Publication date: December 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 6
      Author(s): Elsa Izquierdo-García, Ismael Escobar Rodríguez, José Manuel Moreno-Villares, Irene Iglesias Peinado


      PubDate: 2017-12-08T01:05:54Z
      DOI: 10.1016/j.anpede.2017.03.004
       
  • The little and large of pediatric obesity prevention
    • Authors: Manuel Moya
      Pages: 243 - 244
      Abstract: Publication date: November 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 5
      Author(s): Manuel Moya


      PubDate: 2017-11-03T22:54:56Z
      DOI: 10.1016/j.anpede.2017.03.002
       
  • Analysis of the clinical features of infections caused by enterovirus A71
           (EV-A71) in Balearic Islands
    • Authors: Jordi Reina; María Cabrerizo; Francesc Ferrés
      Pages: 289 - 290
      Abstract: Publication date: November 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 5
      Author(s): Jordi Reina, María Cabrerizo, Francesc Ferrés


      PubDate: 2017-11-03T22:54:56Z
      DOI: 10.1016/j.anpede.2016.12.006
       
  • Epidemiological and clinical characteristics of infants admitted to
           hospital due to human parechovirus infections: A prospective study in
           Spain
    • Authors: Fernando Martín del Valle; Cristina Calvo; Inés Martinez-Rienda; Amaia Cilla; María P. Romero; Ana Isabel Menasalvas; Leticia Reis-Iglesias; Diana Roda; María J. Pena; Nuria Rabella; María del Mar Portugués de la Red; Gregoria Megías; Antonio Moreno-Docón; Almudena Otero; María Cabrerizo
      Abstract: Publication date: Available online 21 December 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Fernando Martín del Valle, Cristina Calvo, Inés Martinez-Rienda, Amaia Cilla, María P. Romero, Ana Isabel Menasalvas, Leticia Reis-Iglesias, Diana Roda, María J. Pena, Nuria Rabella, María del Mar Portugués de la Red, Gregoria Megías, Antonio Moreno-Docón, Almudena Otero, María Cabrerizo
      Introduction Human parechovirus (HPeV) is one of the recently described picornaviridae viruses that have been associated with fever without source (FWS), clinical sepsis, gastroenteritis, meningitis, or encephalitis in very young infants. The aim of this study is to describe the epidemiology and clinical features of these viruses. Patients and methods A prospective multicentre 3-year study was conducted in 12 hospitals in Spain. Out of 850 specimens examined, 47 were positive (5.52%), with HPeV-3 being the most frequent (29 cases). Infections occurred throughout the year, but mainly in May and July, and a biennial distribution was observed. More than half (57%) were neonates, and only 2 children were older than 3 months. Fever was present in all children, with irritability in 45%, rash in 18.6%, and diarrhoea in 14%. The results of biochemical tests were all in normal range. The most common final diagnosis was FWS (61%), followed by clinical sepsis (29%). Up to 29% of infants were admitted to the intensive care unit, but only one patient had sequelae. Results Out of 850 specimens examined, 47 were positive (5.52%) for HPeV, with HPeV-3 being the most frequent (29 cases). Infections occurred throughout the year, but mainly in May and July, and a biennial distribution was observed. More than half (57%) were neonates, and only 2 children were older than 3 months. Fever was present in all children, with irritability in 45%, rash in 18.6%, and diarrhoea in 14%. The results of biochemical tests were all in normal range. The most common final diagnosis was FWS (61%), followed by clinical sepsis (29%). Up to 29% of infants were admitted to the intensive care unit, but only one patient had sequelae. Conclusions HPeV circulates in our country, mainly during spring and summer, and affects young infants with a FWS and clinical sepsis. Molecular diagnostic techniques in all hospitals could help in improving the management of patients with these infections.

      PubDate: 2017-12-26T17:13:05Z
      DOI: 10.1016/j.anpede.2017.02.010
       
  • Haematopoietic stem cell transplantation in pyruvate kinase deficiency:
           When is it indicated'
    • Authors: Paula Pérez-Albert; María Guillen; Marta Prudencio; Marta Gonzalez-Vicent; Julián Sevilla
      Abstract: Publication date: Available online 20 December 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Paula Pérez-Albert, María Guillen, Marta Prudencio, Marta Gonzalez-Vicent, Julián Sevilla


      PubDate: 2017-12-26T17:13:05Z
      DOI: 10.1016/j.anpede.2017.02.011
       
  • Neonatal epidural haematoma. Presentation of 3 cases and a literature
           review
    • Authors: Rebeca Gregorio-Hernández; Marta González-Valcarcel; Ana Belén Escobar-Izquierdo; Yolanda López-Lozano; Ana Cabada-Del Río
      Abstract: Publication date: Available online 6 December 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Rebeca Gregorio-Hernández, Marta González-Valcarcel, Ana Belén Escobar-Izquierdo, Yolanda López-Lozano, Ana Cabada-Del Río


      PubDate: 2017-12-08T01:05:54Z
      DOI: 10.1016/j.anpede.2017.01.010
       
  • Validation and reliability study of the parent concerns about surgery
           questionnaire: What worries parents'
    • Authors: Alberto Gironés Muriel; Ana Campos Segovia; Patricia Ríos Gómez
      Abstract: Publication date: Available online 26 November 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Alberto Gironés Muriel, Ana Campos Segovia, Patricia Ríos Gómez
      Introduction The study of mediating variables and psychological responses to child surgery involves the evaluation of both the patient and the parents as it regards different stressors. Objective To have a reliable and reproducible valid evaluation tool that assesses the level of paternal involvement in relation to different stressors in the setting of surgery. Materials and method A self-report questionnaire study was completed by 123 subjects of both sexes, subdivided into 2populations, due to their relationship with the hospital setting. The items were determined by a group of experts and analysed using the Lawshe validity index to determine a first validity of content. Subsequently, the reliability of the tool was determined by an item-re-item analysis of the 2 sub-populations. A factorial analysis was performed to analyse the construct validity with the maximum likelihood and rotation of varimax type factors. Results A questionnaire of paternal concern was offered, consisting of 21 items with a Cronbach coefficient of 0.97, giving good precision and stability. The posterior factor analysis gives an adequate validity to the questionnaire, with the determination of 10 common stressors that cover 74.08% of the common and non-common variance of the questionnaire. Conclusion The proposed questionnaire is reliable, valid and easy-to-apply and is developed to assess the level of paternal concern about the surgery of a child and to be able to apply measures and programs through the prior assessment of these elements.

      PubDate: 2017-11-27T08:52:26Z
      DOI: 10.1016/j.anpede.2017.01.007
       
  • Management and prognosis of intestinal epithelial dysplasia
    • Authors: Laura Tesouro Rodríguez; Carmen Lázaro de Lucas; Lorena Nélida Magallares García; Eva Martínez-Ojinaga Nodal; Esther Ramos Boluda
      Abstract: Publication date: Available online 26 November 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Laura Tesouro Rodríguez, Carmen Lázaro de Lucas, Lorena Nélida Magallares García, Eva Martínez-Ojinaga Nodal, Esther Ramos Boluda


      PubDate: 2017-11-27T08:52:26Z
      DOI: 10.1016/j.anpede.2017.02.009
       
  • Oral methadone for the management of difficult to control pain in Fabry
           disease
    • Authors: Moisés Leyva Carmona; Sara Gómez Bueno; Lucia Ruiz Tudela; Javier Aguirre Rodríguez; Fernando Sanchez
      Abstract: Publication date: Available online 26 November 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Moisés Leyva Carmona, Sara Gómez Bueno, Lucia Ruiz Tudela, Javier Aguirre Rodríguez, Fernando Sanchez


      PubDate: 2017-11-27T08:52:26Z
      DOI: 10.1016/j.anpede.2016.11.007
       
  • Appendicitis versus non-specific acute abdominal pain: Paediatric
           Appendicitis Score evaluation
    • Authors: Marcos Prada Arias; Angel Salgado Barreira; Margarita Montero Sánchez; Pilar Fernández Eire; Silvia García Saavedra; Javier Gómez Veiras; José Ramón Fernández Lorenzo
      Abstract: Publication date: Available online 21 November 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Marcos Prada Arias, Angel Salgado Barreira, Margarita Montero Sánchez, Pilar Fernández Eire, Silvia García Saavedra, Javier Gómez Veiras, José Ramón Fernández Lorenzo
      Introduction Non-specific acute abdominal pain is the most common process requiring differential diagnosis with appendicitis in clinical practice. The aim of this study was to assess the Paediatric Appendicitis Score in differentiating between these two entities. Material and methods All patients admitted due to suspicion of appendicitis were prospectively evaluated in our hospital over a two-year period. Cases of non-specific acute abdominal pain and appendicitis were enrolled in the study. Several variables were collected, including Score variables and C-reactive protein levels. Descriptive, univariate and multivariate analyses and diagnostic accuracy studies (ROC curves) were performed. Results A total of 275 patients were studied, in which there were 143 cases of non-specific acute abdominal pain and 132 cases of appendicitis. Temperature and right iliac fossa tenderness on palpation were the variables without statistically significant differences, and with no discrimination power between groups. Pain on coughing, hopping, and/or percussion tenderness in the right lower quadrant was the variable with greater association with appendicitis. The Score correctly stratified the patients into risk groups. Substitution of temperature for C-reactive protein in the Score increased diagnostic accuracy, although with no statistically significant differences. Conclusions The Paediatric Appendicitis Score helps in differential diagnosis between appendicitis and non-specific acute abdominal pain. It would be advisable to replace the temperature in the Score, since it has no discrimination power between these groups. C-reactive protein at a cut-off value of 25.5mg/L value could be used instead.

      PubDate: 2017-11-27T08:52:26Z
      DOI: 10.1016/j.anpede.2017.01.008
       
  • Influence of postcode on paediatric admissions in Seville
    • Authors: Sebastián Tornero Patricio; Liliana Charris-Castro; Mercedes Granero Asencio; Antonio Daponte Codina
      Abstract: Publication date: Available online 12 November 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Sebastián Tornero Patricio, Liliana Charris-Castro, Mercedes Granero Asencio, Antonio Daponte Codina
      Introduction The postcode (where the home is situated) is an indicator of socioeconomic status and is associated with morbidity, mortality, and the use of health services. The aim of this study was to analyze its effects on paediatric admissions and to determine the rates of the most common causes of paediatric admissions in Seville. Matherials and methods Observational cross-sectional study with two analysis units: under 15 year-old “admissions” in public hospitals in Seville (n =2660) and “city districts” of Seville (n =11). The independent variable analyzed was whether the postcode of the admitted patients was within a Regional Government designated “area with social transformation needs”. The analysis of the admissions was performed using X 2-test, Fisher test and Student-t test, with the description of rates using the calculation of crude and specific rates, and by rate ratio. Results Children living in districts with a lower socioeconomic status were on average 7 months younger (p <0.001), and they were significantly more likely to be admitted via the emergency department (p <0.001). There was no statistical difference detected in either the length of hospital stay or mortality. The crude admission rate ratio was higher in districts with a lower socioeconomic status (1.8), with a higher specific rate ratio detected in admissions due to asthma, respiratory infections, inguinal hernia, and epilepsy/convulsions. Conclusions Paediatric hospital admission rates of the main diagnoses were higher in districts with a lower socioeconomic status. Children living in these districts were more likely to be admitted younger and via the emergency department.

      PubDate: 2017-11-17T08:14:45Z
      DOI: 10.1016/j.anpede.2016.12.008
       
  • Postnatal growth at hospital discharge in extremely premature newborns in
           Spain
    • Authors: Fermín García-Muñoz Rodrigo; Josep Figueras Aloy; Pedro Saavedra Santana; Alfredo García-Alix
      Abstract: Publication date: Available online 6 November 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Fermín García-Muñoz Rodrigo, Josep Figueras Aloy, Pedro Saavedra Santana, Alfredo García-Alix
      Introduction Postnatal growth restriction is considered a universal problem in extremely premature infants (EPI), and causes great concern due to the possible relationship between nutrition, sub-optimal postnatal growth, and neurodevelopment delay. Objectives To describe the weight gain in EPI and to determine the changes in the length and head circumference (HC) at hospital discharge in survivors. Patients and methods The study included 4520 Caucasian EPI from single pregnancies and without severe malformations, born in the centres participating in the Spanish SEN1500 network (2002–2011). The weight was recorded at birth, 28 days, 36 weeks post-menstrual age (PMA), and at discharge. The length and HC were measured at birth and at discharge. Results The rate of weight gain (exponential method) was 8.0g/kg/day (birth to 28 days); 14.3g/kg/day (28 days to 36 weeks); and 11.7g/kg/day (36 weeks to discharge). At discharge, postnatal growth restriction was greater for length (z-score between −1.78 and −2.42, depending on GA), followed by weight (−1.67 to −1.79), and HC (−0.69 to −0.81). Conclusions Weight gain in the first weeks after birth is slow in EPI, and they exhibit an almost universal postnatal growth restriction that involves mainly length and weight. In addition to weight, a close control of longitudinal growth and HC are essential for nutritional assessment and detection of patients at risk for poor growth and neurodevelopment after hospital discharge.

      PubDate: 2017-11-10T22:25:15Z
      DOI: 10.1016/j.anpede.2016.10.019
       
  • Pyomyositis in a non-tropical area. 12 years of cased-based experience
    • Authors: Beatriz González Gómez; Manuel Vargas Pérez; Teresa del Rosal Rabes; Franciso Javier Aracil Santos; Fernando Baquero-Artigao
      Abstract: Publication date: Available online 6 November 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Beatriz González Gómez, Manuel Vargas Pérez, Teresa del Rosal Rabes, Franciso Javier Aracil Santos, Fernando Baquero-Artigao


      PubDate: 2017-11-10T22:25:15Z
      DOI: 10.1016/j.anpede.2017.03.012
       
  • Construction of a diagnostic prediction model of severe bacterial
           infection in febrile infants under 3 months old
    • Authors: Enrique Villalobos Pinto; Marciano Sánchez-Bayle
      Abstract: Publication date: Available online 3 November 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Enrique Villalobos Pinto, Marciano Sánchez-Bayle
      Introduction Fever is a common cause of paediatric admissions in emergency departments. An aetiological diagnosis is difficult to obtain in those less than 3 months of age, as they tend to have a higher rate of serious bacterial infection (SBI). The aim of this study is to find a predictor index of SBI in children under 3 months old with fever of unknown origin. Methods A study was conducted on all children under 3 months of age with fever admitted to hospital, with additional tests being performed according to the clinical protocol. Rochester criteria for identifying febrile infants at low risk for SBI were also analysed. A predictive model for SBI and positive cultures was designed, including the following variables in the maximum model: C-reactive protein (CRP), procalcitonin (PCT), and meeting not less than four of the Rochester criteria. Results A total of 702 subjects were included, of which 22.64% had an SBI and 20.65% had positive cultures. Children who had SBI and a positive culture showed higher values of white cells, total neutrophils, CRP and PCT. A statistical significance was observed with less than 4 Rochester criteria, CRP and PCT levels, an SBI (area under the curve [AUC] 0.877), or for positive cultures (AUC 0.888). Using regression analysis a predictive index was calculated for SBI or a positive culture, with a sensitivity of 87.7 and 91%, a specificity of 70.1 and 87.7%, an LR+ of 2.93 and 3.62, and a LR− of 0.17 and 0.10, respectively. Conclusions The predictive models are valid and slightly improve the validity of the Rochester criteria for positive culture in children less than 3 months admitted with fever.

      PubDate: 2017-11-10T22:25:15Z
      DOI: 10.1016/j.anpede.2017.02.007
       
  • Bioethics in end-of-life decisions in neonatology: Unresolved issues
    • Authors: Juan Arnaez; Juan Carlos Tejedor; Sonia Caserío; María Teresa Montes; María Teresa Moral; Javier González de Dios; Alfredo García-Alix
      Abstract: Publication date: Available online 2 November 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Juan Arnaez, Juan Carlos Tejedor, Sonia Caserío, María Teresa Montes, María Teresa Moral, Javier González de Dios, Alfredo García-Alix
      This document is the result of previous work carried out by different expert groups and submitted to multidisciplinary debate at a conference about controversial, deficient, or new aspects in the field of neonatal palliative care, such as: 1) the deliberative decision-making process, 2) hospital and domiciliary palliative care, 3) donation after controlled cardiac death, and 4) moral stress in professionals. The most relevant conclusions were: the need to instruct professionals in bioethics and in the deliberative method to facilitate thorough and reasonable decision-making; the lack of development in the field of perinatal palliative care and domiciliary palliative care in hospitals that attend newborns; the need to provide neonatal units with resources that help train professionals in communication skills and in the management of moral distress, as well as delineate operational procedure and guidelines for neonatal organ donation.

      PubDate: 2017-11-03T22:54:56Z
      DOI: 10.1016/j.anpede.2017.03.011
       
  • Role of nuclear medicine in the differential diagnosis of bone infarction
           and osteomyelitis in drepanocytosis
    • Authors: Cristina Sandoval-Moreno; Lourdes Castillejos-Rodríguez; M. Pilar García-Alonso; Bárbara Rubio-Gribble; Francisco Javier Penín-González
      Abstract: Publication date: Available online 18 October 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Cristina Sandoval-Moreno, Lourdes Castillejos-Rodríguez, M. Pilar García-Alonso, Bárbara Rubio-Gribble, Francisco Javier Penín-González


      PubDate: 2017-10-21T09:56:04Z
      DOI: 10.1016/j.anpede.2017.02.006
       
  • Falls in less than one year-old infants: Management in the emergency
           department
    • Authors: Elena Rubio García; Ana Jiménez de Domingo; Rafael Marañon Pardillo; Miriam Triviño Rodríguez; Luis Alberto Frontado Haiek; Nuria Gilabert Iriondo; Francesc Ripoll Oliveras; Cristina Remón García; Gloria Estopiña Ferrer; Cristina Muñoz López
      Abstract: Publication date: Available online 28 September 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Elena Rubio García, Ana Jiménez de Domingo, Rafael Marañon Pardillo, Miriam Triviño Rodríguez, Luis Alberto Frontado Haiek, Nuria Gilabert Iriondo, Francesc Ripoll Oliveras, Cristina Remón García, Gloria Estopiña Ferrer, Cristina Muñoz López
      Objectives A study was performed in order to describe injuries associated with falls in children aged <1 year who attended the emergency department. The approaches used were examined, as well as the factors associated with the greater use of these approaches, and the management of the patient. Patients and methods This was a multicentre, descriptive and analytical study that included all patients aged <1 year who had experienced a fall for which they attended the emergency departments of one of 8 Spanish Hospitals belonging to the “Unintentional Paediatric Injury Working Group” of the Spanish Paediatric Society. A record was made of the data regarding the visit, circumstances before arrival at the hospital, injuries observed, and the diagnostic and therapeutic approaches used. Results A total of 1022 patients had experienced falls, that is, 0.35% of the emergencies attended in the study hospitals (95% CI, 0.348–0.352). The most commonly affected part was the head (58%). Cranial radiography was ordered in 31.8% of cases, and was associated with the presence of bruising or signs of fracture on examination (p <0.001), falls from heights >100cm (p <0.001), and age <3 months (p =0.004). Minor head injury was the most common finding (85.6%), followed by fractures, especially cranial fractures (7.1%), which were associated with bruising or signs of fracture on examination (p <0.001), and age <3 months (p <0.001). Six percent of the patients required admission to hospital. The risk factors for hospital admission in this group were falls from heights >50cm and age <3 months. Conclusions Injuries after falls in infants aged <1 year are commonly due to head trauma and frequently require additional diagnostic tests.

      PubDate: 2017-09-30T16:17:36Z
      DOI: 10.1016/j.anpede.2016.10.017
       
 
 
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