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Publisher: Elsevier   (Total: 3043 journals)

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Showing 1 - 200 of 3043 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 22, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 21, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 84, 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: 352, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (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   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 235, 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: 23, 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)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
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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: 4)
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: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 21)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 135, 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: 25, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
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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: 25, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 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: 11)
Advances in Digestive Medicine     Open Access   (Followers: 6)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 41, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 41, 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: 50, 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: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 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 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: 35, 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 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: 9)
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: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 22)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, 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: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 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: 15, 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: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 17)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 61)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 353, 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: 7, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 30, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 17)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 43, 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: 325, 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: 5, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 8, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 406, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 16, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 39, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 54, 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  
Algal Research     Partially Free   (Followers: 8, 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: 8, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 48, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 6)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 5)
American Heart J.     Hybrid Journal   (Followers: 49, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 39, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 8, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 15, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 31, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 25, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 32, 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: 233, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 58, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 5)
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: 25, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 26, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 22, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 34, 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: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 57, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 11)
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: 37, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 167, 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: 11)
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: 161, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (Followers: 1, SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

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Journal Cover Anales de Pediatría (English Edition)
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   ISSN (Print) 2341-2879
   Published by Elsevier Homepage  [3043 journals]
  • ANALES DE PEDIATRÍA: Achieving milestones
    • Authors: Empar Lurbe i Ferrer; Laia Alsina Manrique de Lara; Gonzalo Solís Sánchez
      Pages: 183 - 185
      Abstract: Publication date: October 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 4
      Author(s): Empar Lurbe i Ferrer, Laia Alsina Manrique de Lara, Gonzalo Solís Sánchez


      PubDate: 2017-09-30T16:17:36Z
      DOI: 10.1016/j.anpede.2017.07.002
       
  • The monophasic pattern in oral glucose tolerance test as a predictive risk
           factor of type 2 diabetes in obese paediatric patients
    • Authors: Aura D. Herrera-Martínez; Patricia Enes; María Martín-Frías; Belén Roldán; Rosa Yelmo; Raquel Barrio
      Pages: 211 - 217
      Abstract: Publication date: October 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 4
      Author(s): Aura D. Herrera-Martínez, Patricia Enes, María Martín-Frías, Belén Roldán, Rosa Yelmo, Raquel Barrio
      Introduction The onset of obesity at young ages is strongly associated with the early development of type 2 diabetes (T2D). The shape of the curves of glucose and insulin curves during an oral glucose tolerance test (OGTT) could predict the risk of developing T2D. Objective To analyse the morphology of the OGTT and determine T2D risk factors in a mainly Caucasian population of children and adolescents. Methods Observational retrospective study including 588 patients (309 males, 279 females) with a mean age of 11.1±2.8 years, and of whom 90.3% were Caucasian. Risk factors for T2D were compared in patients with a monophasic or biphasic pattern during the performance of an OGTT, as well as anthropometric and biochemical variables, insulin resistance, and beta-cell function. Results The shape of the glucose curve was monophasic in 50.2% of patients (50.8% male), biphasic in 48.5% (47.6% males), and indeterminate in 1.3%. The monophasic pattern showed lower insulin-sensitivity and worse beta-cell function. Patients with a biphasic pattern had a higher BMI, waist circumference, and blood pressure, although the results were not significant. Latin-American patients had significantly lower serum glucose levels with higher insulin levels during the OGTT. Conclusions The pattern of response to an OGTT reflects different metabolic phenotypes. Paediatric patients with a biphasic pattern have lower risk-profiling for T2D. OGTT would be useful to implement early intervention strategies in children and adolescents with obesity, in order to prevent the development of pre-diabetes or T2D.

      PubDate: 2017-09-30T16:17:36Z
      DOI: 10.1016/j.anpede.2017.08.003
       
  • Kawasaki disease is more prevalent in rural areas of Catalonia (Spain)
    • Authors: Judith Sánchez-Manubens; Jordi Antón; Rosa Bou; Estibaliz Iglesias; Joan Calzada-Hernandez; Xavier Rodó; Josep-Antón Morguí
      Pages: 226 - 231
      Abstract: Publication date: October 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 4
      Author(s): Judith Sánchez-Manubens, Jordi Antón, Rosa Bou, Estibaliz Iglesias, Joan Calzada-Hernandez, Xavier Rodó, Josep-Antón Morguí
      Introduction Kawasaki disease (KD) is an acute self-limited systemic vasculitis relatively common in childhood. The etiology of KD is still unknown, although clinical, laboratory and epidemiological features suggest an infectious origin or trigger. Differences on incidence between countries have been related to specific genetic factors, ethnicity, country of birth and some other sociocultural and environmental factors. We present a population-based study on incidence of KD in Catalonia (Spain), focusing on differences between patients in rural and non-rural areas of the region. Methods Observational population-based study including all Pediatric Units in Catalan hospitals, between 2004 and 2014. A 12-month (March 2013–March 2014) prospective collection of new cases of KD was carried out to determine the incidence of KD. The rest of the data was retrieved retrospectively. Results Data from 399 patients over the 10-year study period was analyzed. Among the total KD patients, 353 (88.5%) lived in non-rural areas and 46 (11.5%) in rural areas. It was found that there is a significant difference (p <0.001) between the percentage of rural population observed in patients with KD (11.5%), and the expected 5% of the Catalan population. Conclusion This is the first population-based study showing significant differences on KD incidence rates between rural and non-rural areas.

      PubDate: 2017-09-30T16:17:36Z
      DOI: 10.1016/j.anpede.2017.02.001
       
  • Acute gastroenteritis and enteric viruses: Impact on the detection of
           norovirus
    • Authors: Oihana Martínez Azcona; Lorena Vázquez Gómez; Paula Buyo Sánchez; Raquel Díaz Soto; Luz María Moldes Suárez
      Pages: 143 - 147
      Abstract: Publication date: September 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 3
      Author(s): Oihana Martínez Azcona, Lorena Vázquez Gómez, Paula Buyo Sánchez, Raquel Díaz Soto, Luz María Moldes Suárez
      Introduction Norovirus is the second cause of acute viral gastroenteritis in infants after rotavirus. However, its prevalence is underestimated because a specific diagnosis is not usually performed. The comparative study of microbiological diagnostics, performed before and after the implementation date of a test for detecting a particular microorganism, allows the estimation of the percentage of cases not properly diagnosed earlier (for non-implementation of the test) and those that would be left to diagnose if the test is removed. In this paper we study the epidemiology of acute gastroenteritis virus before and after the implantation of the Norovirus GI+GII CerTest. Material and methods An observational retrospective cohort study was conducted on patients under 15 years old with acute gastroenteritis, from January 2013 to April 2015. The sample was divided into two groups. In the first group, the search was limited to adenovirus and rotavirus, and in the second one, the determination of norovirus became part of the systematic diagnosis. The study included 604 patients, 313 in the first group and 291 in the second one. Results Demographic characteristics were similar in both groups. In the first group, 58/313 (18.5%) enteric viruses were identified and in the second group, 97/291 (33.3%). In the second group, 31 positive cases for norovirus were identified, but only 12 (4.1%) of them were positive exclusively for this virus. No significant differences were found in clinical features of intestinal viruses. Conclusions An actual increase of 4.1% was observed in the cases with an identified aetiological agent after implementing the Norovirus GI+GII CerTest diagnostic technique. The most common cause of acute gastroenteritis is rotavirus, closely followed by norovirus.

      PubDate: 2017-09-18T06:52:09Z
      DOI: 10.1016/j.anpede.2016.08.009
       
  • Early clinical trials in paediatric oncology in Spain: A nationwide
           perspective
    • Authors: Francisco Bautista; Soledad Gallego; Adela Cañete; Jaume Mora; Cristina Díaz de Heredia; Ofelia Cruz; José María Fernández; Susana Rives; Pablo Berlanga; Raquel Hladun; Antonio Juan Ribelles; Luis Madero; Manuel Ramírez; Rafael Fernández Delgado; Antonio Pérez-Martínez; Cristina Mata; Anna Llort; Javier Martín Broto; María Elena Cela; Gema Ramírez; Constantino Sábado; Tomás Acha; Itziar Astigarraga; Ana Sastre; Ascensión Muñoz; Mercedes Guibelalde; Lucas Moreno
      Pages: 155 - 163
      Abstract: Publication date: September 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 3
      Author(s): Francisco Bautista, Soledad Gallego, Adela Cañete, Jaume Mora, Cristina Díaz de Heredia, Ofelia Cruz, José María Fernández, Susana Rives, Pablo Berlanga, Raquel Hladun, Antonio Juan Ribelles, Luis Madero, Manuel Ramírez, Rafael Fernández Delgado, Antonio Pérez-Martínez, Cristina Mata, Anna Llort, Javier Martín Broto, María Elena Cela, Gema Ramírez, Constantino Sábado, Tomás Acha, Itziar Astigarraga, Ana Sastre, Ascensión Muñoz, Mercedes Guibelalde, Lucas Moreno
      Introduction Cancer is the leading cause of death between the first year of life and adolescence, and some types of diseases are still a major challenge in terms of cure. There is, therefore, a major need for new drugs. Recent findings in cancer biology open the door to the development of targeted therapies against individual molecular changes, as well as immunotherapy. Promising results in adult anti-cancer drug development have not yet been translated into paediatric clinical practice. A report is presented on the activity in early paediatric oncology trials (phase I–II) in Spain. Material and methods All members of the Spanish Society of Paediatric Haematology Oncology (SEHOP) were contacted in order to identify early clinical trials in paediatric cancer opened between 2005 and 2015. Results A total of 30 trials had been opened in this period: 21 (70%) in solid tumours, and 9 (30%) in malignant haemopathies. A total of 212 patients have been enrolled. The majority was industry sponsored (53%). Since 2010, four centres have joined the international consortium of Innovative Therapies for Children with Cancer (ITCC), which has as its aim to develop novel therapies for paediatric tumours. A significant number of new studies have opened since 2010, improving the treatment opportunities for our children. Results of recently closed trials show the contribution of Spanish investigators, the introduction of molecularly targeted agents, and their benefits. Conclusions The activity in clinical trials has increased in the years analysed. The SEHOP is committed to develop and participate in collaborative academic trials, in order to help in the advancement and optimisation of existing therapies in paediatric cancer.

      PubDate: 2017-09-18T06:52:09Z
      DOI: 10.1016/j.anpede.2016.07.007
       
  • Clinical observation: A safe alternative to radiology in infants with mild
           traumatic brain injury
    • Authors: David Muñoz-Santanach; Victoria Trenchs Sainz de la Maza; Sara Maya Gallego; Adriana Cuaresma González; Carles Luaces Cubells
      Pages: 164 - 169
      Abstract: Publication date: September 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 3
      Author(s): David Muñoz-Santanach, Victoria Trenchs Sainz de la Maza, Sara Maya Gallego, Adriana Cuaresma González, Carles Luaces Cubells
      Objective The protocol for the management of mild cranioencephalic trauma in the emergency department was changed in July 2013. The principal innovation was the replacement of systematic skull X-ray in infants with clinical observation. The aims of this study were to determine whether there was (1) a reduction in the ability to detect traumatic brain injury (TBI) in the initial visit to Emergency, and (2) a change in the number of requests for imaging tests and hospital admissions. Methodology This was a retrospective, descriptive, observational study. Two periods were established for the study: Period 1 (1/11/2011–30/10/2012), prior to the implementing of the new protocol, and Period 2 (1/11/2013–30/10/2014), following its implementation. The study included visits to the emergency department by children ≤2 years old for mild cranioencephalic trauma (Glasgow Scale modified for infants ≥14) of ≤24h onset. Results A total of 1,543 cases were included, of which 807 were from Period 1 and 736 from Period 2. No significant differences were observed as regards sex, age, mechanism, or risk of TBI. More cranial fractures were detected in Period 1 than in Period 2 (4.3% vs 0.5%; P <.001), without significant changes in the detection of TBI (0.4% vs 0.3%; P =1). However, there were more cranial X-rays (49.7% vs 2.7%; P <.001) and more ultrasounds (2.1% vs 0.4%; P <.001) carried out, and also fewer hospital admissions (8.3% vs 3.1%; P <.001). There were no significant differences in the number of computerised tomography scans carried out (2% vs 3%; P =.203). Conclusions The use of clinical observation as an alternative to cranial radiography leads to a reduction in the number of imaging tests and hospital admissions of infants with mild cranioencephalic trauma, without any reduction in the reliability of detecting TBI. This option helps to lower the exposure to radiation by the patient, and is also a more rational use of hospital resources.

      PubDate: 2017-09-18T06:52:09Z
      DOI: 10.1016/j.anpede.2016.09.010
       
  • Idiopathic intracranial hypertension: Experience over 25 years and a
           management protocol
    • Authors: Lorena Monge Galindo; Ruth Fernando Martínez; Cristina Fuertes Rodrigo; David Fustero de Miguel; Victoria Pueyo Royo; Juan Pablo García Iñiguez; Javier López-Pisón; José Luis Peña-Segura
      Pages: 78 - 86
      Abstract: Publication date: August 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 2
      Author(s): Lorena Monge Galindo, Ruth Fernando Martínez, Cristina Fuertes Rodrigo, David Fustero de Miguel, Victoria Pueyo Royo, Juan Pablo García Iñiguez, Javier López-Pisón, José Luis Peña-Segura
      Introduction We present our experience on idiopathic intracranial hypertension (IIH), before and after the introduction of a specific diagnosis and management protocol. Method A descriptive retrospective study was conducted on patients with IIH over a 25 year period (1990–2015), comparing the last 7 years (after introduction of the protocol) with the previous 18 years. Results Among the 18,865 patients evaluated, there were 54 cases of IIH (29 infants and 25 children). A comparison was made between the two time periods: 32 cases in 1990–2008—published in An Pediatr (Barc). 2009;71:400-6—, and 23 cases in 2008–2015. In post-protocol period, there were 13 patients aged between 3–10 months (62% males) with transient bulging fontanelle, and 10 aged between 2 and 14 years (50% males), with papilloedema. A total of 54% of infants had recently finished corticosteroid treatment for bronchitis. In the older children, there was one case associated with venous thrombosis caused by otomastoiditis, one case on corticosteroid treatment for angioma, and another case treated with growth hormone. Transfontanelle ultrasound was performed on all infants, and CT, MRI and angio-MRI was performed on every child. Lumbar puncture was performed on 2 infants in whom meningitis was suspected, and in all children. All patients progressed favourably, with treatment being started in 3 of them. One patient relapsed. Discussion Characteristics and outcomes of patients overlap every year. IIH usually has a favourable outcome, although it may be longer in children than in infants. It can cause serious visual disturbances, so close ophthalmological control is necessary. The protocol is useful to ease diagnostic decisions, monitoring, and treatment.

      PubDate: 2017-09-18T06:52:09Z
      DOI: 10.1016/j.anpede.2016.09.009
       
  • Cord blood procalcitonin in the assessment of early-onset neonatal sepsis
    • Authors: Olivia Oria de Rueda Salguero; José Beceiro Mosquera; Marta Barrionuevo González; María Jesús Ripalda Crespo; Cristina Olivas López de Soria
      Pages: 87 - 94
      Abstract: Publication date: August 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 2
      Author(s): Olivia Oria de Rueda Salguero, José Beceiro Mosquera, Marta Barrionuevo González, María Jesús Ripalda Crespo, Cristina Olivas López de Soria
      Introduction Early diagnosis of early-onset neonatal sepsis (EONS) is essential to reduce morbidity and mortality. Procalcitonin (PCT) in cord blood could provide a diagnosis of infected patients from birth. Objective To study the usefulness and safety of a procedure for the evaluation of newborns at risk of EONS, based on the determination of PCT in cord blood. Patients and methods Neonates with infectious risk factors, born in our hospital from October 2013 to January 2015 were included. They were processed according to an algorithm based on the values of cord blood procalcitonin (<0.6ng/mL versus ≥0.6ng/mL). They were later classified as proved infection, probable, or no infection. Results and conclusions Of the 2.519 infants born in the study period, 136 met inclusion criteria. None of 120 cases with PCT <0.6ng/mL in cord blood developed EONS (100% negative predictive value). On the other hand, of the 16 cases with PCT ≥0.6ng/mL, 10 were proven or probably infected (62.5% positive predictive value). The sensitivity of the PCT against infection was 100%, with a specificity of 95.2% (area under the receiver operator curve 0.969). The incidence of infection in the study group was 7.4%, and 26.1% in cases with maternal chorioamnionitis. 21 newborn (15.4%) received antibiotic therapy. The studied protocol has shown to be effective and safe to differentiate between patients with increased risk of developing an EONS, in those where the diagnostic and therapeutic approach was more interventionist, versus those with less likelihood of sepsis, who would benefit from a more conservative management.

      PubDate: 2017-09-18T06:52:09Z
      DOI: 10.1016/j.anpede.2016.09.008
       
  • Urinary iodine levels and dairy consumption in pre-school children in
           Southwest Asturias (Spain)
    • Authors: Esther Arbesú Fernández; María Haydee Serrano Peraza; Hans Abdón Eguia Angeles; César Oliver Sotelo García; Claude Henrry Saint Jean; Nache Ismael Musa Martín
      Pages: 18 - 25
      Abstract: Publication date: July 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 1
      Author(s): Esther Arbesú Fernández, María Haydee Serrano Peraza, Hans Abdón Eguia Angeles, César Oliver Sotelo García, Claude Henrry Saint Jean, Nache Ismael Musa Martín
      Introduction For decades dairy products have been a major source of iodine. The purpose of this study was to determine the iodine nutritional status and its relationship with dairy consumption in pre-schooler children between 2 and 5 years old in a rural area with 27847 inhabitants. Patients and methods It was planned to study 200 participants, selected by random sampling, proportional to the size of the municipality, age, and sex. Parents provided urine samples to analyse urinary iodine, as well as the nutritional information through an interview. A glass of milk or a slice of cheese was considered as a ration, and a portion of other milk derivatives were considered as half rations. The nutritional status of iodine was interpreted with the median (P[percentile]50) of the urinary iodine levels, and iodine intake was estimated using the mean of ration/day of milk and dairy products, fish, and eggs. Results Of the total of 198 subjects that took part, 193 provided urine specimens for the determination of iodine levels. The mean dairy ration/day was 3.8 (SD:1.4). More than two-thirds (69.9%) drank ≥2 glasses of milk/day, and 88.1% consumed a dairy ration of another dairy product. The median urinary iodine level was 184μg/L, but was dependent on glasses of milk/day (282.5μg/L ≥ 4 glasses) and/or the type of milk (233.0μg/L in semi-skimmed). An intake of 117.4μg/day to 178.6μg/day of iodine was estimated, and that milk was the food which provided more iodine (89.9μg/day). Conclusions Iodine intake was adequate, although higher than necessary when four or more glasses of milk were consumed, and/or when the milk was skimmed. The consumption of dairy products should be monitored to prevent both excessive and deficient intake of iodine.

      PubDate: 2017-06-27T02:08:21Z
      DOI: 10.1016/j.anpede.2016.03.009
       
  • Five steps to decreasing nosocomial infections in very preterm newborns: A
           quasi-experimental study
    • Authors: Ana García González; José Luis Leante Castellanos; Carmen Fuentes Gutiérrez; José María Lloreda García; José Ramón Fernández Fructuoso; Elisabet Gómez Santos; Verónica García González
      Pages: 26 - 33
      Abstract: Publication date: July 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 1
      Author(s): Ana García González, José Luis Leante Castellanos, Carmen Fuentes Gutiérrez, José María Lloreda García, José Ramón Fernández Fructuoso, Elisabet Gómez Santos, Verónica García González
      Objectives An evaluation is made of the impact of a series of five interventions on the incidence of hospital-related infections in a level iii neonatal unit. Material and methods Quasi-experimental, pre-post intervention study, which included preterm infants weighing 1500g at birth or delivered at <32 weeks gestation, admitted in the 12 months before and after the measures were implemented (January 2014). The measures consisted of: optimising hand washing, following a protocol for insertion and handling of central intravenous catheters, encouraging breastfeeding; applying a protocol for rational antibiotic use, and establishing a surveillance system for multi-resistant bacteria. The primary endpoint was to assess the incidence of hospital-acquired infections before and after implementing the interventions. Results Thirty-three matched patients were included in each period. There was an incidence of 8.7 and 2.7 hospital-related infections/1000 hospital stay days in the pre- and post-intervention periods, respectively (P <.05). Additionally, patients in the treatment group showed a statistically-significant decrease in days on mechanical ventilation, use of blood products, and vasoactive drugs. Conclusions The strategy, based on implementing five specific measures in a unit with a high rate of hospital-related infections, proved effective in reducing their incidence. This reduction could contribute to lowering the use of mechanical ventilation, blood products, and vasoactive drugs.

      PubDate: 2017-09-18T06:52:09Z
      DOI: 10.1016/j.anpede.2016.06.009
       
  • Aetiology and outcomes of potentially serious infections in febrile
           infants less than 3 months old
    • Authors: Mercedes de la Torre; Nieves de Lucas; Roberto Velasco; Borja Gómez; Santiago Mintegi
      Pages: 42 - 49
      Abstract: Publication date: July 2017
      Source:Anales de Pediatría (English Edition), Volume 87, Issue 1
      Author(s): Mercedes de la Torre, Nieves de Lucas, Roberto Velasco, Borja Gómez, Santiago Mintegi
      Background Recent studies have shown changes in the aetiology of serious bacterial infections in febrile infants ≤90 days of age. The aim of this study was to describe the current microbiology and outcomes of these infections in Spain. Material and methods Sub-analysis of a prospective multicentre study focusing on febrile infants of less than 91 days of life, admitted between October 2011 and September 2013 to Emergency Departments of 19 Spanish hospitals, members of the Spanish Paediatric Emergency Research Group of the Spanish Society of Paediatric Emergencies (RISeuP/SPERG). Results The analysis included 3401 febrile infants ≤90 days of age with fever without source. There were 896 positive cultures: 766 urine (85.5%), 100 blood (11.2%), 18 cerebrospinal fluid (2%), 10 stool, and 2 umbilical cultures. Among the 3401 infants included, 784 (23%) were diagnosed with a serious bacterial infection, and 107 of them (3.1%) with an invasive infection. E. coli was the most common pathogen isolated from urine (628; 82%), blood (46; 46%), and cerebrospinal fluid cultures (7; 38.9%), followed by S. agalactiae that was isolated from 24 (24%) blood cultures and 3 (16.7%) cerebrospinal fluid cultures. There were only 2 L. monocytogenes infections. Four children died, and seven had severe complications. Conclusions Among infants ≤90 days of age with fever without source, E. coli was the most common pathogen isolated from urine, blood, and cerebrospinal fluid cultures.

      PubDate: 2017-09-18T06:52:09Z
      DOI: 10.1016/j.anpede.2016.07.004
       
  • Osteoarticular tuberculosis in paediatrics: A review of 20 years of cases
           in a tertiary hospital
    • Authors: María José Pérez Durán; Bárbara Moreno Sanz-Gadea; Teresa del Rosal Raves; María José Mellado Peña; Fernando Baquero-Artigao
      Abstract: Publication date: Available online 14 October 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): María José Pérez Durán, Bárbara Moreno Sanz-Gadea, Teresa del Rosal Raves, María José Mellado Peña, Fernando Baquero-Artigao


      PubDate: 2017-10-14T09:16:09Z
      DOI: 10.1016/j.anpede.2017.01.006
       
  • Guidelines for prevention, detection and management of hyperbilirubinaemia
           in newborns of 35 or more weeks of gestation
    • Authors: María Dolores Sánchez-Redondo Sánchez-Gabriel; José Luis Leante Castellanos; Isabel Benavente Fernández; Alejandro Pérez Muñuzuri; Segundo Rite Gracia; Cesar W. Ruiz Campillo; Ester Sanz López; Manuel Sánchez Luna
      Abstract: Publication date: Available online 14 October 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): María Dolores Sánchez-Redondo Sánchez-Gabriel, José Luis Leante Castellanos, Isabel Benavente Fernández, Alejandro Pérez Muñuzuri, Segundo Rite Gracia, Cesar W. Ruiz Campillo, Ester Sanz López, Manuel Sánchez Luna
      Hyperbilirubinaemia is one of the most frequent causes of hospital readmission during the first week of life. Its detection is still a big challenge, mainly due to the early discharge from the hospital that can be associated with a delay of the diagnosis. The identification of those newborns at risk of developing significant hyperbilirubinaemia is one of the main priorities in the public health care system. An approach to the management of newborn jaundice is presented in this article, following the recommendations based on the medical evidence and on the opinion of the Standards Committee of the Spanish Society of Neonatology.

      PubDate: 2017-10-14T09:16:09Z
      DOI: 10.1016/j.anpede.2017.03.009
       
  • 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
      Abstract: Publication date: Available online 12 October 2017
      Source:Anales de Pediatría (English Edition)
      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: 2017-10-14T09:16:09Z
      DOI: 10.1016/j.anpede.2016.10.018
       
  • Description of an isoniazid-resistant tuberculosis outbreak in a block of
           apartments
    • Authors: Blanca Ruíz de Zárate; David Gomez-Pastrana; Elvira Pérez-Escolano; Carmen Aragón Fernández; María Dolores López Prieto
      Abstract: Publication date: Available online 7 October 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Blanca Ruíz de Zárate, David Gomez-Pastrana, Elvira Pérez-Escolano, Carmen Aragón Fernández, María Dolores López Prieto


      PubDate: 2017-10-14T09:16:09Z
      DOI: 10.1016/j.anpede.2017.03.010
       
  • 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
      Abstract: Publication date: Available online 4 October 2017
      Source:Anales de Pediatría (English Edition)
      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: 2017-10-07T08:32:59Z
      DOI: 10.1016/j.anpede.2016.12.005
       
  • 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
       
  • 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
      Abstract: Publication date: Available online 22 September 2017
      Source:Anales de Pediatría (English Edition)
      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: 2017-09-24T17:06:11Z
      DOI: 10.1016/j.anpede.2016.10.016
       
  • Recommendations for the unequivocal identification of the newborn
    • Authors: Ester Sanz López; Manuel Sánchez Luna; Segundo Rite Gracia; Isabel Benavente Fernández; José Luis Leante Castellanos; Alejandro Pérez Muñuzuri; César W. Ruiz Campillo; María Dolores Sánchez Redondo
      Abstract: Publication date: Available online 15 September 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Ester Sanz López, Manuel Sánchez Luna, Segundo Rite Gracia, Isabel Benavente Fernández, José Luis Leante Castellanos, Alejandro Pérez Muñuzuri, César W. Ruiz Campillo, María Dolores Sánchez Redondo
      Newborn identification is a legal right recognised by international and national laws. Moreover, improving the accuracy of correct patient identification is an important goal of patient safety solutions programmes. In this article, the Standards Committee of the Spanish Society of Neonatology establishes recommendations to ensure correct identification of the newborn whilst in hospital. Currently, the most reliable method of identification of the newborn is the combination of identification cord clamp and bracelets (mother bracelet, newborn bracelet and cord clamp with the same number and identical and exclusive barcode system for each newborn) and the collection of maternal and umbilical cord blood samples (for DNA testing only for identification purposes).

      PubDate: 2017-09-18T06:52:09Z
      DOI: 10.1016/j.anpede.2017.03.008
       
  • Recurrent scarlet fever: A common entity
    • Authors: Bárbara de Dios Javierre; María García Ventura; Marta Arrudi Moreno; César García Vera
      Abstract: Publication date: Available online 13 September 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Bárbara de Dios Javierre, María García Ventura, Marta Arrudi Moreno, César García Vera


      PubDate: 2017-09-18T06:52:09Z
      DOI: 10.1016/j.anpede.2017.01.005
       
  • Low bone mineral density in juvenile idiopathic arthritis: Prevalence and
           related factors
    • Authors: Rocío Galindo Zavala; Esmeralda Núñez Cuadros; Laura Martín Pedraz; Gisela Díaz-Cordovés Rego; Carlos Sierra Salinas; Antonio Urda Cardona
      Abstract: Publication date: Available online 12 September 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Rocío Galindo Zavala, Esmeralda Núñez Cuadros, Laura Martín Pedraz, Gisela Díaz-Cordovés Rego, Carlos Sierra Salinas, Antonio Urda Cardona
      Introduction Height adjustment is currently recommended for Z-score bone mineral density (BMD) assessed by dual energy X-ray absorptiometry. At present there are no studies that evaluate the prevalence of low BMD in paediatric patients with juvenile idiopathic arthritis (JIA) in Spain following current recommendations. Objectives To evaluate low BMD in JIA in paediatric patients with JIA in Spain following the latest recommendations, as well as to assess associated factors. Methods Observational cross-sectional study of Spanish JIA patients from 5 to 16 years-old, followed-up in a Paediatric Rheumatology Unit between July 2014 and July 2015. Anthropometric, clinical and treatment data were recorded. Dual energy X-ray absorptiometry, and bone metabolism parameters were collected, and a completed diet and exercise questionnaire was obtained. Results A total of 92 children participated. The population prevalence estimation of low BMD was less than 5% (95% CI). A significant positive correlation was found in the multiple linear regression analysis between the body mass index percentile (B: 0.021; P <.001) and lean mass index (B: 0.0002; P =.012), and BMD Z-score adjusted for height (Z-SAH). A significant negative correlation was found between fat mass index (B: −0.0001; P =.018) and serum type I collagen N-propeptide (B: −0.0006; P =.036) and Z-SAH. Conclusions Low BMD prevalence in JIA patients in our population is low. An adequate nutritional status and the prevalence of lean over fat mass seem to promote the acquisition of bone mass. Those JIA patients with lower BMD could be subjected to an increase of bone turnover.

      PubDate: 2017-09-18T06:52:09Z
      DOI: 10.1016/j.anpede.2016.12.004
       
  • More than 3 hours and less than 3 years: Safety of anaesthetic procedures
           
    • Authors: Julián Álvarez Escudero; Rosa María Paredes Esteban; Francisco José Cambra Lasaosa; Máximo Vento; Maite López Gil; Juan Carlos de Agustín Asencio; María Teresa Moral Pumarega
      Abstract: Publication date: Available online 11 September 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Julián Álvarez Escudero, Rosa María Paredes Esteban, Francisco José Cambra Lasaosa, Máximo Vento, Maite López Gil, Juan Carlos de Agustín Asencio, María Teresa Moral Pumarega
      An FDA alert in December 2016 on the safety of general anaesthesia and sedation in patients less than 3 years of age and pregnant women has raised doubts in relation to the attitude that professionals implicated in these procedures should adopt in relation to this specific group of patients. Confronted with this situation, the following medical scientific societies: Sociedad Española de Anestesia y Reanimación (SEDAR), Sociedad Española de Cirugía Pediátrica (SECP), Sociedad Española de Cuidados Intensivos Pediátricos (SECIP) y Sociedad Española de Neonatología (SENeo), have established a working group to analyse and clarify the safety of these techniques. In the present article we conclude that at present both general anaesthesia and profound sedation are considered safe procedures because there is no evidence of the opposite in studies with human beings. However, this ascertained safety should not obviate the problem which still needs to be followed with attention, especially in patients less than 3 years of age undergoing anaesthetic procedures for more than 3 hours or prolonged sedation in the Neonatal or Pediatric Intensive Care Units.

      PubDate: 2017-09-18T06:52:09Z
      DOI: 10.1016/j.anpede.2017.08.005
       
  • Diagnosis and treatment of acute pharyngitis—Is there any benefit on
           ten-day course of antibiotics'
    • Authors: Catarina Oliveira Pereira; Daniela Ramos; Patrícia Mação; Gustavo Januário; Luís Januário
      Abstract: Publication date: Available online 11 September 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Catarina Oliveira Pereira, Daniela Ramos, Patrícia Mação, Gustavo Januário, Luís Januário
      Introduction In group A streptococcal (GAS) pharyngitis, a ten-day course of amoxicillin is recommended. However, short-course treatments seem to be equally effective. The aim of this study was to retrospectively evaluate and compare the outcome of patients treated with 7-day course and 10-day course of amoxicillin. Materials and methods Retrospective analysis of all GAS pharyngitis admitted to a pediatric emergency department in 2014. Demographic variables, the application and results of the rapid antigenic diagnostic test (RADT), treatment, complications and return in the next 30 days were analyzed. Two groups were defined for comparative analysis according to the duration of treatment with amoxicillin: A) short-course (up to 7 days) and B) long-course (10 days). Results Were included 989 GAS pharyngitis. The median age was 5.2 years, 50.1% male. Amoxicillin was the most prescribed antibiotic (94.9%) with a median duration of 7 days. 10-day course therapy was prescribed in 31.9% of the cases. There were no differences between short and long-course treatment groups regarding age (p =0.600), gender (p =0.429) and complications (p =0.436). Considering the endpoint “return to the emergency department”, we concluded that up to 7 days of treatment was non-inferior to 10 days of treatment. Conclusion The most commonly prescribed antibiotic was amoxicillin, but a 10-day course was prescribed in few cases. In our analysis there seems to be no benefit with long-course treatments with amoxicillin in GAS pharyngitis.

      PubDate: 2017-09-18T06:52:09Z
      DOI: 10.1016/j.anpede.2017.07.001
       
  • Evaluation of an Xpert EV (Cepheid®) molecular diagnostic technique
           for enteroviral meningitis
    • Authors: Natalia Alonso Pérez; Belén Sagastizabal Cardelus; Luis Manuel Prieto Tato; Sara Guillén Martín; Ana González Torralba; Isabel García Bermejo; José Tomás Ramos Amador
      Abstract: Publication date: Available online 26 August 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Natalia Alonso Pérez, Belén Sagastizabal Cardelus, Luis Manuel Prieto Tato, Sara Guillén Martín, Ana González Torralba, Isabel García Bermejo, José Tomás Ramos Amador
      Introduction Polymerase chain reaction (PCR) assays have shown to be useful and quick for the diagnosis of enterovirus in aseptic meningitis. The aim of our study was to analyse the changes in clinical practice after the introduction of a real-time polymerase chain reaction (RT-PCR) technique using the Xpert EV (Cepheid®) assay for the qualitative detection of enterovirus RNA in cerebrospinal fluid specimens from children with suspected viral meningitis. Methods A retrospective study was performed in children older than 1 year, diagnosed with enterovirus meningitis in a third level hospital from November 2006 to February 2013. The first period, before the availability of Xpert EV (Cepheid®) (Group 1, November 2006–August 2010) was compared with the later period (Group 2, September 2010–February 2013). Clinical characteristics, the mean length of stay, and the cost per inpatient cases, were compared between the 2 periods. Results Forty-one patients (60.9% male) were included, with a median age of 64 months (interquartile range 28–96). Twenty-six patients (63.4%) were included in Group 2. There were non-statistically significant differences in the epidemiological, disease severity, and laboratory characteristics between both periods of study. A significant difference was observed in the mean length of stay, with it being shorter in Group 2 (48h vs 40.5h, P =.039), and a significant lower inpatient cost per case (€779.77 vs €656.05, P <.05). Conclusion Xpert EV (Cepheid®) assay was useful for decreasing the length of hospital stay and the costs associated with hospitalization in children with enterovirus meningitis.

      PubDate: 2017-09-18T06:52:09Z
      DOI: 10.1016/j.anpede.2016.09.011
       
  • Improving patient safety: Usefulness of safety checklists in a neonatal
           unit
    • Authors: María Arriaga Redondo; Ester Sanz López; Ana Rodríguez Sánchez de la Blanca; Itziar Marsinyach Ros; Laura Collados Gómez; Alicia Díaz Redondo; Manuel Sánchez Luna
      Abstract: Publication date: Available online 9 September 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): María Arriaga Redondo, Ester Sanz López, Ana Rodríguez Sánchez de la Blanca, Itziar Marsinyach Ros, Laura Collados Gómez, Alicia Díaz Redondo, Manuel Sánchez Luna
      Introduction Due to the complexity and characteristics of their patients, neonatal units are risk areas for the development of adverse events (AE). For this reason, there is a need to introduce and implement some tools and strategies that will help to improve the safety of the neonatal patient. Safety check-lists have shown to be a useful tool in other health areas but they are not sufficiently developed in Neonatal Units. Material and methods A quasi-experimental prospective study was conducted on the design and implementation of the use of a checklist and evaluation of its usefulness for detecting incidents. The satisfaction of the health professionals on using the checklist tool was also assessed. Results The compliance rate in the neonatal intensive care unit (NICU) was 56.5%, with 4.03 incidents per patient being detected. One incident was detected for every 5.3 checklists used. The most frequent detected incidents were those related to medication, followed by inadequate alarm thresholds, adjustments of the monitors, and medication pumps. The large majority (75%) of the NICU health professionals considered the checklist useful or very useful, and 68.75% considered that its use had managed to avoid an AE. The overall satisfaction was 83.33% for the professionals with less than 5 years working experience, and 44.4% of the professionals with more than 5 years of experience were pleased or very pleased. Conclusion The checklists have shown to be a useful tool for the detection of incidents, especially in NICU, with a positive assessment from the health professionals of the unit.

      PubDate: 2017-09-12T06:12:20Z
      DOI: 10.1016/j.anpede.2017.08.004
       
  • President of Asociación Española de Pediatría
    • Authors: Mellado
      Abstract: Publication date: Available online 2 September 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): María José Mellado


      PubDate: 2017-09-06T05:43:18Z
       
  • Cardiac arrest resuscitation protocols in hospitals: A pending task
    • Authors: Jesús López-Herce; Ignacio Manrique; Angel Carrillo
      Abstract: Publication date: Available online 31 August 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Jesús López-Herce, Ignacio Manrique, Angel Carrillo


      PubDate: 2017-09-06T05:43:18Z
      DOI: 10.1016/j.anpede.2017.01.004
       
  • Supraventricular tachycardia in newborns and its association with
           gastroesophageal reflux disease
    • Authors: Ángeles Fuertes; Ayham Alshweki; Alejandro Pérez-Muñuzuri; María-Luz Couce
      Abstract: Publication date: Available online 31 August 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Ángeles Fuertes, Ayham Alshweki, Alejandro Pérez-Muñuzuri, María-Luz Couce
      Introduction Supraventricular tachycardia (SVT) is the most common arrhythmia in the neonatal period, but its association with other triggering processes is not well established. The aim of the study was to analyse the possible relationship between neonatal SVT and gastroesophageal reflux disease (GERD), a condition which was recently linked to atrial arrhythmias. Material and methods A retrospective longitudinal descriptive study was conducted over a period of 5 years on newborns who were diagnosed with SVT in a level III neonatal unit, assessing morphological aspects, associated symptoms, and treatments received. Its association with GERD and the impact of this on SVT was studied. Results Eighteen patients (1.2 per 1000 newborns) were diagnosed with SVT. Fifty percent of them were combined with clinically significant GERD (P =.01), and all of them received drug treatment. The average time of control of SVT without GERD since diagnosis was 6 days (95% CI: 2.16–9.84, with a median of 3) and 7.6 days when both pathologies were present (95% CI: 4.14–10.9, with a median of 7) (P =.024). Conclusions Patients with SVT in the neonatal period frequently have GERD, and this combination leads to more difficulty in controlling the tachycardia. The reflux could act as a trigger or perpetuator of arrhythmia, therefore it is important to find and treat GERD in infants with SVT.

      PubDate: 2017-09-06T05:43:18Z
      DOI: 10.1016/j.anpede.2016.10.015
       
  • Anales de Pediatría: Onward and upward
    • Authors: Corsino Rey Galán; Laia Alsina Manrique de Lara; Montserrat Antón Gamero; Alfredo Cano Garcinuño; Gonzalo Solís Sánchez
      Abstract: Publication date: Available online 30 August 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Corsino Rey Galán, Laia Alsina Manrique de Lara, Montserrat Antón Gamero, Alfredo Cano Garcinuño, Gonzalo Solís Sánchez


      PubDate: 2017-08-31T02:42:31Z
      DOI: 10.1016/j.anpede.2017.08.001
       
  • Real-time safety audits in a neonatal unit
    • Authors: Elena Bergon-Sendin; María del Carmen Perez-Grande; David Lora-Pablos; Ana Melgar-Bonis; Noelia Ureta-Velasco; María Teresa Moral-Pumarega; Carmen Rosa Pallas-Alonso
      Abstract: Publication date: Available online 17 August 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Elena Bergon-Sendin, María del Carmen Perez-Grande, David Lora-Pablos, Ana Melgar-Bonis, Noelia Ureta-Velasco, María Teresa Moral-Pumarega, Carmen Rosa Pallas-Alonso
      Background Random audits are a safety tool to help in the prevention of adverse events, but they have not been widely used in hospitals. The aim of the study was to determine, through random safety audits, whether the information and material required for resuscitation were available for each patient in a neonatal intensive care unit and determine if factors related to the patient, time or location affect the implementation of the recommendations. Material and methods Prospective observational study conducted in a level III-C neonatal intensive care unit during the year 2012. The evaluation of written information on the endotracheal tube, mask and ambu bag prepared of each patient and laryngoscopes of the emergency trolley were included within a broader audit of technological resources and study procedures. The technological resources and procedures were randomly selected twice a week for audit. Appropriate overall use was defined when all evaluated variables were correctly programmed in the same procedure. Results A total of 296 audits were performed. The kappa coefficient of inter-observer agreement was 0.93. The rate of appropriate overall use of written information and material required for resuscitation was 62.50% (185/296). Mask and ambu bag prepared for each patient was the variable with better compliance (97.3%, P =.001). Significant differences were found with improved usage during weekends vs. working-day (73.97 vs. 58.74%, P =.01), and the rest of the year vs. 3rd quarter (66.06 vs. 52%, P =.02). Conclusions Only in 62.5% of cases was the information and the material necessary to attend to a critical situation urgently easily available. Opportunities for improvement were identified through the audits.

      PubDate: 2017-08-20T19:45:40Z
      DOI: 10.1016/j.anpede.2016.08.010
       
  • Drugs use in pregnancy in the Valencia Region and the risk of congenital
           anomalies
    • Authors: Clara Cavero-Carbonell; Silvia Gimeno-Martos; Lucía Páramo-Rodríguez; María José Rabanaque-Hernández; Carmen Martos-Jiménez; Óscar Zurriaga
      Abstract: Publication date: Available online 12 August 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Clara Cavero-Carbonell, Silvia Gimeno-Martos, Lucía Páramo-Rodríguez, María José Rabanaque-Hernández, Carmen Martos-Jiménez, Óscar Zurriaga
      Background Despite the potential risks of drug use during pregnancy, consumption has increased in recent decades. Objective To identify the risk of congenital anomalies (CA) associated with the use of drugs in primary care in pregnant women resident in the Valencia Region. Methods A case-control study, considering a case as a less than one year old live birth in 2009–2010, diagnosed with a CA and resident in the Valencia Region, obtained from the CA population-based registry. Controls were selected from the Metabolic Disease Registry, and the drugs prescribed and dispensed from the Integral Management of Pharmaceutical Services. Crude odds ratio (OR) was calculated with its 95% confidence intervals and adjusted OR was calculated using logistic regression. Results A total of 1.913 cases and 3.826 controls were identified. The most frequently used drug groups were those acting on the musculoskeletal, nervous and respiratory systems, on the blood and blood forming organs, and anti-infection drugs. The most common drugs used were ibuprofen, dexketoprofen, paracetamol, amoxicillin, ferrous sulphate, and a combination of folic acid. A significantly increased risk of CA was identified for drugs acting on the musculoskeletal system (adjusted OR 1.14 [95% confidence interval 1.02–1.28]). A significantly decreased risk was observed for drugs acting on the blood and blood forming organs (adjusted OR 0.87 [95% confidence interval 0.78–0.98]). Conclusions Associations between drugs and CA in pregnant women resident in the Valencia Region have been identified for drugs that act as risk factors of CA, and for drugs that act as protective factors of CA.

      PubDate: 2017-08-20T19:45:40Z
      DOI: 10.1016/j.anpede.2016.08.011
       
  • Early kidney damage in patients born with unilateral renal agenesis
    • Authors: Ana Castellano-Martinez; Moises Rodriguez-Gonzalez; Virginia Roldan-Cano
      Abstract: Publication date: Available online 12 August 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Ana Castellano-Martinez, Moises Rodriguez-Gonzalez, Virginia Roldan-Cano


      PubDate: 2017-08-20T19:45:40Z
      DOI: 10.1016/j.anpede.2016.10.014
       
  • Views of the Spanish Paediatric Association Bioethics Committee on the
           refusal of essential and non-essential treatment in minors
    • Authors: Marta Sánchez Jacob; María Tasso Cereceda; Carmen Martínez González; Federico de Montalvo Jááskeläinem; Isolina Riaño Galán
      Abstract: Publication date: Available online 6 August 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Marta Sánchez Jacob, María Tasso Cereceda, Carmen Martínez González, Federico de Montalvo Jááskeläinem, Isolina Riaño Galán
      The conflicts that arise when minors or their legal representatives refuse to receive medical treatment considered necessary by the paediatrician pose a serious ethical dilemma and also have a considerable emotional impact. In order to adequately tackle this rejection of medical treatment, there is to identify and attempt to understand the arguments of the people involved, to consider the context in each individual case and be conversant with the procedure to follow in life-threatening scenarios, taking into account bioethical considerations and the legal framework.

      PubDate: 2017-08-10T19:12:42Z
      DOI: 10.1016/j.anpede.2016.11.006
       
  • Genetic predisposition to childhood cancer
    • Authors: Pilar Carrasco Salas; Pablo Lapunzina; Antonio Pérez-Martínez
      Abstract: Publication date: Available online 2 August 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Pilar Carrasco Salas, Pablo Lapunzina, Antonio Pérez-Martínez


      PubDate: 2017-08-10T19:12:42Z
      DOI: 10.1016/j.anpede.2017.01.003
       
  • Acute bacterial gastroenteritis: 729 cases recruited by a Primary Care
           national network
    • Authors: César García Vera; María García Ventura; Guadalupe del Castillo Aguas; Begoña Domínguez Aurrecoechea; María Jesús Esparza Olcina; Ana Martínez Rubio; José María Mengual Gil
      Abstract: Publication date: Available online 31 July 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): César García Vera, María García Ventura, Guadalupe del Castillo Aguas, Begoña Domínguez Aurrecoechea, María Jesús Esparza Olcina, Ana Martínez Rubio, José María Mengual Gil
      Objective To determine the main clinical and epidemiological features of bacterial gastroenteritis in our environment. Patients and methods An observational study of a Spanish population in 17 Autonomous Communities. Questionnaires of children with a stool positive culture to bacteria were collected over a one year period. A bivariate analysis was performed on the variables involved, as well as two multivariate models (for antibiotic treatment variables, and comparison Campylobacter/Salmonella). Results A total of 729 bacterial gastroenteritis episodes were recorded in the 17 Spanish autonomous regions, of which 41.2% were girls and 58.8% boys. The median age was 3.41 years old (interquartile range 1.55–6.72). The bacteria isolated were 59.9% Campylobacter, 31.8% non-Typhi Salmonella, 2.7% Aeromonas, 2.4% Yersinia, and 1.5% had more than one strain. Most infections (70%) were direct contacts, and food poisoning was less probable (25.9%). Salmonella is significantly less frequent than Campylobacter in children under the age of 3 years (adjusted OR 0.61; 95% CI: 0.43–0.86; P =.005), and Campylobacter is more frequent in rural areas (adjusted OR 1.48; 95% CI: 1.07–2.07; P =.012). Antibiotic was prescribed in 33.2% of cases. There was a greater significant difference if stools contained blood or mucus (adjusted OR 1.53; 95% CI: 1.04–2.27; P =.031), if the symptoms lasted more than 7days (adjusted OR 2.81; 95% CI: 2.01–3.93; P <.000), or if the child was admitted to hospital (adjusted OR 1.95; 95% CI: 1.08–3.52; P =.027). Conclusions The aetiology of bacterial diarrhoea in paediatrics is typical of that of a developed country. The transmission mechanism is mainly direct, and more cases than appropriate are treated with antibiotics.

      PubDate: 2017-08-01T10:30:50Z
      DOI: 10.1016/j.anpede.2016.04.011
       
  • Experience with junctional atrioventricular reciprocating tachycardia
    • Authors: Lidia Cardiel Valiente; Ariadna Ayerza Casas; Marta López Ramón; Lorenzo Jiménez Montañes; Georgia Sarquella-Brugada
      Abstract: Publication date: Available online 25 July 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Lidia Cardiel Valiente, Ariadna Ayerza Casas, Marta López Ramón, Lorenzo Jiménez Montañes, Georgia Sarquella-Brugada


      PubDate: 2017-08-01T10:30:50Z
      DOI: 10.1016/j.anpede.2016.12.003
       
  • Two siblings with acute lymphoblastic leukaemia: Chance or genetics'
    • Authors: Elena Carceller; David Ruano; Luis Madero López; Álvaro Lassaletta
      Abstract: Publication date: Available online 21 July 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Elena Carceller, David Ruano, Luis Madero López, Álvaro Lassaletta


      PubDate: 2017-07-24T08:28:08Z
      DOI: 10.1016/j.anpede.2017.03.007
       
  • Vitamin D deficiency and morbimortality in critically ill paediatric
           patients
    • Authors: Patricia García-Soler; Antonio Morales-Martínez; Vanessa Rosa-Camacho; Juan Antonio Lillo-Muñoz; Guillermo Milano-Manso
      Abstract: Publication date: Available online 14 July 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Patricia García-Soler, Antonio Morales-Martínez, Vanessa Rosa-Camacho, Juan Antonio Lillo-Muñoz, Guillermo Milano-Manso
      Objectives To determine the prevalence and risks factors of vitamin D deficiency, as well as its relationship with morbidity and mortality in a PICU. Materials and methods An observational prospective study in a tertiary children's University Hospital PICU conducted in two phases: I: Cohorts study, and II: prevalence study. The study included 340 critically ill children with ages comprising 6 months to 16 years old. Exclusion criteria: Chronic kidney disease, known parathyroid disorders, and vitamin D supplementation. Total 25-hydroxyvitamin D [25(OH)D] was measured in the first 48h of admission to a PICU. Parathormone, calcium, phosphate, blood gases, blood count, C-reactive protein, and procalcitonin were also analysed. A record was also made of demographic features, characteristics of the episode, and complications during the PICU stay. Results The overall prevalence rate of vitamin D deficiency was 43.8%, with a mean of 22.28 (95% CI 21.15–23.41)ng/mL. Patients with vitamin D deficiency were older (61 vs 47 months, P =0.039), had parents with a higher level of academic studies (36.5% vs 20%, P =0.016), were admitted more often in winter and spring, had a higher PRISM-III (6.8 vs 5.1, P =0.037), a longer PICU stay (3 vs 2 days, P =0.001), and higher morbidity (61.1% vs 30.4%, P <0.001) than the patients with sufficient levels of 25(OH)D. Patients who died had lower levels of 25(OH)D (14±8.81ng/mL vs 22.53±10.53ng/mL, P =0.012). Adjusted OR for morbidity was 5.44 (95% CI; 2.5–11.6). Conclusions Vitamin D deficiency is frequent in critically ill children, and it is related to both morbidity and mortality, although it remains unclear whether it is a causal relationship or it is simply a marker of severity in different clinical situations.

      PubDate: 2017-07-15T07:37:18Z
      DOI: 10.1016/j.anpede.2016.09.007
       
  • Neuropsychological performance in neurofibromatosis type 1
    • Authors: Lilia Hernández del Castillo; Antonio Martínez Bermejo; José Antonio Portellano Pérez; Pilar Tirado Requero; Alexandra Garriz Luis; Ramón Velázquez Fragua
      Abstract: Publication date: Available online 12 July 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Lilia Hernández del Castillo, Antonio Martínez Bermejo, José Antonio Portellano Pérez, Pilar Tirado Requero, Alexandra Garriz Luis, Ramón Velázquez Fragua
      Introduction Neurofibromatosis type 1 (NF1) is a genetic disorder with various clinical manifestations that affect the peripheral and central nervous system, as well as the skin, bones and endocrine and vascular system. There is still insufficient knowledge of neuropsychological effects of NF1 on children, and there is some controversy about the cognitive deficits that defines the cognitive profile of patients affected by this disorder. Aims In this study an analysis is made of the neuropsychological performance of a group of patients affected by NF1, compared with a control group of healthy children. Subjects and method A comparison was made between the neuropsychological performance of a group of 23 boys and girls with a mean age of 8.7 years (+/−1.39) and diagnosed with NF1, and a control group consisting of 21 healthy children, with mean age of 8.9 years (+/−1.41) and with similar socio-demographic characteristics. The Wechsler Intelligence Scale for Children (WISC) was applied to evaluate the subjects of both groups. Results The group of patients affected with NF1 showed a lower performance in every primary index of WISC IV: Verbal Comprehension Index, Fluid Reasoning Index, Working Memory Index, Processing Speed Index, and full scale IQ. Only in two subscales were no statistically significant differences observed: similarities and coding. Conclusion The results show subtle and generalised neuropsychological alterations in the sample of children affected with NF1, which affect most of cognitive domains that have been evaluated. Proper specific and early neuropsychological treatment should be provided in order to prevent the high risk for these children of presenting learning difficulties and school failure.

      PubDate: 2017-07-15T07:37:18Z
      DOI: 10.1016/j.anpede.2016.07.006
       
  • Recommendations for the diagnosis and treatment of classic forms of
           21-hydroxylase-deficient congenital adrenal hyperplasia
    • Authors: Amparo Rodríguez; Begoña Ezquieta; José Igancio Labarta; María Clemente; Rafael Espino; Amaia Rodriguez; Aranzazu Escribano
      Abstract: Publication date: Available online 11 July 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Amparo Rodríguez, Begoña Ezquieta, José Igancio Labarta, María Clemente, Rafael Espino, Amaia Rodriguez, Aranzazu Escribano
      Congenital adrenal hyperplasia due to 21-hydroxylase deficiency is an autosomal recessive disorder caused by mutations in the CYP21A2 gene. Cortisol and aldosterone synthesis are impaired in the classic forms (adrenal insufficiency and salt-wasting crisis). Females affected are virilised at birth, and are at risk for genital ambiguity. In this article, we give recommendations for an early as possible diagnosis and an appropriate and individualised treatment. A patient and family genetic study is essential for the diagnosis of the patient, and allows genetic counselling, as well as a prenatal diagnosis and treatment for future pregnancy.

      PubDate: 2017-07-15T07:37:18Z
      DOI: 10.1016/j.anpede.2016.12.002
       
  • Clinical impact of translocation t(7;15) (p22;q26) on several family
           members
    • Authors: Victoria Caballero Pérez; Francisco Javier López-Pisón; María Dolores Miramar Gallart; Alejandro González Álvarez; María Concepción García Jiménez
      Abstract: Publication date: Available online 8 July 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Victoria Caballero Pérez, Francisco Javier López-Pisón, María Dolores Miramar Gallart, Alejandro González Álvarez, María Concepción García Jiménez


      PubDate: 2017-07-15T07:37:18Z
      DOI: 10.1016/j.anpede.2016.11.005
       
  • Respiratory viral infections in a cohort of children during the first year
           of life and their role in the development of wheezing
    • Authors: Cristina Calvo; Isabel Aguado; María Luz García-García; Esther Ruiz-Chercoles; Eloisa Díaz-Martinez; Rosa María Albañil; Olga Campelo; Antonio Olivas; Luisa Muñóz-Gonzalez; Francisco Pozo; Rosa Fernandez-Arroyo; Adelaida Fernandez-Rincón; Ana Calderon; Inmaculada Casas
      Abstract: Publication date: Available online 6 July 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Cristina Calvo, Isabel Aguado, María Luz García-García, Esther Ruiz-Chercoles, Eloisa Díaz-Martinez, Rosa María Albañil, Olga Campelo, Antonio Olivas, Luisa Muñóz-Gonzalez, Francisco Pozo, Rosa Fernandez-Arroyo, Adelaida Fernandez-Rincón, Ana Calderon, Inmaculada Casas
      Introduction It is known that infants with viral respiratory infections severe enough to require hospital admission have a high risk of developing recurrent wheezing. Few data have been published on unselected populations. The main aim of this study was to analyse symptomatic and asymptomatic respiratory viral infections during the first year of life in a cohort of infants, recruited at birth, and the development of recurrent wheezing. Patients and methods A total of 302 newborns were recruited. A nasopharyngeal aspirate was taken when the patients had a respiratory infection, as well as in the visits for vaccination at 2, 4, 6, and 12 months. RT-nested PCR assays were performed to detect 16 viruses. Results A total of 1293 samples were analysed (1005 healthy controls and 288 respiratory infections). Samples taken during routine check-ups were positive in 30.8% of cases, while those with respiratory infection were positive in 77.8%, P <.001 (OR: 3, 95% CI: 2.4–3.8). A total of 239 (79%) infants had at least 1 positive respiratory viral infection detected. The most frequent virus (71%) was rhinovirus (RV). Recurrent wheezing was found in 27 (11%) children during their first year of life (1.2 episodes, SD 2.9). Recurrent wheezing was present in 58.3% of patients admitted to hospital during their first viral infection, vs. 8.6% of infants when the first infection was mild or who had asymptomatic viral detection, P <.001 (OR: 2.18; 95% CI: 1.05–4.5). Conclusions In our series, severe respiratory infections leading to hospitalisation in the first months of life are risk factors for developing wheezing, but not in the case of mild RV infections.

      PubDate: 2017-07-15T07:37:18Z
      DOI: 10.1016/j.anpede.2016.08.008
       
  • Virus and wheezing in infants. Certainties or doubts'
    • Authors: Alfredo Cano Garcinuño
      Abstract: Publication date: Available online 5 July 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Alfredo Cano Garcinuño


      PubDate: 2017-07-06T05:19:11Z
      DOI: 10.1016/j.anpede.2017.02.005
       
  • Toxic shock syndrome in a paediatric intensive care unit over the last 15
           years
    • Authors: Laura Butragueño Laiseca; Marina García Morín; Estíbaliz Barredo Valderrama; Andrés J. Alcaraz Romero
      Abstract: Publication date: Available online 5 July 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Laura Butragueño Laiseca, Marina García Morín, Estíbaliz Barredo Valderrama, Andrés J. Alcaraz Romero


      PubDate: 2017-07-06T05:19:11Z
      DOI: 10.1016/j.anpede.2016.10.013
       
  • Giant coronary aneurysms in infants with Kawasaki disease
    • Authors: Antonio Sánchez Andrés; Inmaculada Salvador Mercader; Julia Seller Moya; José Ignacio Carrasco Moreno
      Abstract: Publication date: Available online 28 June 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Antonio Sánchez Andrés, Inmaculada Salvador Mercader, Julia Seller Moya, José Ignacio Carrasco Moreno
      Introduction Kawasaki disease (KD) is an acute vasculitis of unknown origin and predominant in males. The long-term effects of the disease depend on whether there are coronary lesions, particularly aneurysms. The prognosis of patients with giant aneurysms is very poor due to their natural progression to coronary thrombosis or severe obstructive lesions. Objectives A series of 8 cases is presented where the epidemiology and diagnostic methods are described. The treatment of the acute and long-term cardiovascular sequelae is also reviewed. Methods A descriptive analysis was conducted on patients admitted to the Paediatric Cardiology Unit of La Fe University Hospital (Valencia) with KD and a coronary lesion. Results More than one artery was involved in all patients. Although early diagnosis was established in only two cases, none of the patients had severe impairment of ventricular function during the acute phase. Treatment included intravenous gammaglobulin and acetylsalicylic acid at anti-inflammatory doses during the acute phase. A combination of dual antiplatelet therapy and corticosteroids was given in cases of coronary thrombosis. The silent aneurysms continue to persist. Conclusions KD is the most common cause of acquired heart disease in children. The delay in diagnosis is associated with a greater likelihood of coronary lesions that could increase the risk of cardiovascular events in adulthood. Thus, this subgroup requires close clinical monitoring for a better control of cardiovascular risk factors over time.

      PubDate: 2017-07-06T05:19:11Z
      DOI: 10.1016/j.anpede.2016.07.005
       
  • Fever without source in infants less than 3 months of age. What's new'
    • Authors: Cristina Calvo; María de Ceano-Vivas
      Abstract: Publication date: Available online 16 June 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Cristina Calvo, María de Ceano-Vivas


      PubDate: 2017-06-19T22:49:21Z
      DOI: 10.1016/j.anpede.2017.02.004
       
  • Elevated thyroid hormone levels following low molecular weight heparin
           administration
    • Authors: Iñigo de Noriega Echevarría; Alberto García-Salido; M. Teresa Muñoz-Calvo; Jesús Argente
      Abstract: Publication date: Available online 15 June 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Iñigo de Noriega Echevarría, Alberto García-Salido, M. Teresa Muñoz-Calvo, Jesús Argente


      PubDate: 2017-06-19T22:49:21Z
      DOI: 10.1016/j.anpede.2016.09.006
       
  • Cultural adaptation to Spanish and assessment of an Adolescent Peer
           Relationships Tool for detecting school bullying: Preliminary study of the
           psychometric properties
    • Authors: J.J. Gascón-Cánovas; J.R. Russo De León; A. Cózar Fernandez; J.M. Heredia Calzado
      Abstract: Publication date: Available online 31 May 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): J.J. Gascón-Cánovas, J.R. Russo De León, A. Cózar Fernandez, J.M. Heredia Calzado
      Background and objectives School bullying is a growing problem. The current study is aimed at culturally adapting and assessing the psychometric properties of a brief scale to measure bullying. Material and methods A cross-cultural adaptation of the brief scale—Adolescent Peer Relations Instrument-Bullying (APRI)—was performed using the translation and back-translation technique. The Spanish version of APRI questionnaire was administered to a sample of 1428 schoolchildren aged 12–14years in the region of Mar Menor in Murcia (Spain). Exploratory factor analysis, with oblique rotation, was used to assess the validity of the internal structure, the Cronbach's alpha to analyse their consistency, and the Kruskal–Wallis test to check their ability to discriminate between subjects with varying degrees of bullying according to Kidscreen-52 scale of social acceptability. Results Two factors were identified in the adapted version of APRI (physical victimisation and verbal/social victimisation), similar to those in the original scale. The questionnaire has high internal consistency (Cronbach's alpha=0.94) and discrimination capacity (P <.01), with significant effect sizes between degrees of bullying. Conclusions The internal structure of the APRI Spanish version is similar to the original, and its scores confirm high reliability and construct validity. Further studies need to be performed with broader age ranges and confirmatory analysis techniques, to ratify the equivalence of the adapted version with the original version.

      PubDate: 2017-06-04T18:33:33Z
      DOI: 10.1016/j.anpede.2015.12.008
       
  • Multiple organ failure after spontaneous return of circulation in cardiac
           arrest in children
    • Authors: Tania Carbayo; Alba de la Mata; Marina Sánchez; Jesús López-Herce; Jimena del Castillo; Angel Carrillo
      Abstract: Publication date: Available online 27 May 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Tania Carbayo, Alba de la Mata, Marina Sánchez, Jesús López-Herce, Jimena del Castillo, Angel Carrillo
      Objective To assess the frequency of the multiple organ failure and the prognostic value of multiple organ failure scores in children who have recovered from an in-hospital cardiac arrest. Patients and methods A single centre, observational, and retrospective study was conducted on children between 1 month and 16 years old who suffered an in-hospital cardiac arrest and achieved return of spontaneous circulation (ROSC). In the first 24–48h and between the fifth and the seventh day after ROSC, a record was made of the scores on paediatric severity (PRISM and PIM II) and multiple organ failure scales (PELOD and P-MODS), along with the clinical and analytical data, and including monitoring and treatment, mortality and cause of death. Results Of the total of 41 children studied, 70.7% were male, and the median age was 38 months. The overall mortality during admission was 41.5%, with 14.6% dying in the first 48h, and 7.6% in the following 3–5 days. In the first 48h, clinical severity and multiple organ failure scores were higher in the patients that died than in survivors (PRISM 29 vs. 21) p =0.125, PIM II (26.8% vs. 9.2%) p =0.02, PELOD (21 vs. 12) p =0.005, and P-MODS (9 vs. 6) p =0.001. Between the fifth and seventh day, the scores on the four scales were also higher in patients who died, but only those of the PELOD (20.5 vs. 11) p =0.002 and P-MODS (6.5 vs. 3) p =0.003 reached statistical significance. Conclusions Mortality in children after return of spontaneous circulation after cardiac arrest is high. The multiple organ failure after return of spontaneous circulation after cardiac arrest in children is associated with increased mortality.

      PubDate: 2017-05-30T17:18:13Z
      DOI: 10.1016/j.anpede.2016.06.008
       
  • Current situation on fertility preservation in cancer patients in Spain:
           Level of knowledge, information, and professional involvement
    • Authors: Carmen Garrido-Colino; Alvaro Lassaletta; María Ángeles Vazquez; Aizpea Echevarria; Ignacio Gutierrez; Maitane Andión; Pablo Berlanga
      Abstract: Publication date: Available online 25 May 2017
      Source:Anales de Pediatría (English Edition)
      Author(s): Carmen Garrido-Colino, Alvaro Lassaletta, María Ángeles Vazquez, Aizpea Echevarria, Ignacio Gutierrez, Maitane Andión, Pablo Berlanga
      Introduction The estimated risks of infertility in childhood cancer due to radiation, chemotherapy and surgery are well known. The involvement of professionals and advances in the different methods of preservation are increasing. However, many patients do not receive information or perform any method of preservation. Material Questionnaires to paediatric onco-haematology institutions throughout Spain. The questionnaire consisted of 22 questions assessing their usual practices and knowledge about fertility preservation. Results Fifty members of the Spanish Society of Paediatric Haematology and Oncology, representing 24 of 43 centres, responded. These represented 82% of centres that treated higher numbers of patients. The effect of treatment on fertility was known by 78% of those who responded, with 76% admitting not knowing any guideline on fertility in children or adolescents. As for the ideal time and place to inform the patient and/or family, only 14% thought it should be done in the same cancer diagnosis interview. In clinical practice, 12% of those surveyed never referred patients to Human Reproduction Units, another 12% only did so if the patients showed interest, and 38% only refer patients in puberty. Just over one-third (34%) of those referrals were going to receive highly gonadotoxic treatment. Conclusions There are clear differences between pre-puberty and puberty patients. The frequency with which some method of fertility preservation is performed in patients is low. All respondents believe that the existence of national guidelines on the matter would be of interest.

      PubDate: 2017-05-30T17:18:13Z
      DOI: 10.1016/j.anpede.2016.04.010
       
 
 
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