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Objective To analyze the resistance to antimicrobials in clinical isolates from pediatric patients in Mexico. Methods Susceptibility data from relevant specimens were collected in the pediatric population over 6 months from 25 centers from 17 states of Mexico and analyzed using the WHONET 5.6 software. Data were stratified into three age groups: younger than 2 years, 2 to 6 years, and 6 to 18 years. Results For Escherichia coli , the infant/toddler group had higher resistance rates to ampicillin, ampicillin-sulbactam, cefuroxime, cefepime, gentamicin, quinolones (p < 0.001), amoxicillin/clavulanic acid (p = 0.003), and ceftazidime (p = 0.004) than the other two age groups. Additionally, a high proportion of extended-spectrum β-lactamase (ESBL)-producing isolates for E. coli (75.3%) was detected in this age group. Comparable results were observed for Klebsiella pneumoniae , with higher resistance to ampicillin-sulbactam, ceftazidime, gentamicin, cefepime, trimethoprim-sulfamethoxazole, carbapenems (p = 0.001) and amoxicillin/clavulanic acid (p = 0.023) in the infant/toddler group. Moreover, a high proportion of ESBL producers (76%) was detected in this age group. Regarding wards, E. coli and K. pneumoniae had the highest carbapenem resistance in the ICU area, and Acinetobacter baumannii had the highest carbapenem resistance in medical wards. Conclusion High antibiotic resistance rates were detected in the infant/toddler group. This report presents baseline data for future prospective surveillance studies of antimicrobial resistance in pediatric patients in Mexico. [ABSTRACT FROM AUTHOR]

Background: Altitude influences bicarbonate levels, it is a variable that is hardly considered in diagnosing Renal Tubular Acidosis (RTA), so it should be a factor to consider when diagnosing this pathology, especially at 2250 mts over the sea level as it is the case of Mexico City. RTA is most often misdiagnosed. Regarding of this, the present study established reference limits for bicarbonate levels in healthy children without pathologies associated with alterations in the acid-base balance in Mexico City and it´s metropolitan area., Methods: A total of 267 healthy pediatric patients were included, within normal estimated glomerular filtration rate (eGFR), and without any associated pathology of any alteration in the acid-base balance., Results: Compared to older children, children younger than two years of age showed statistically higher levels of calcemia and cystatin C. On the other hand, this same group showed lower values of creatininemia, pCO 2 , and HCO 3 - . Percentile 50 of bicarbonate in children under two years of age were 19.9 mEq/L and 21.9 mEq/L in those over that age. A correlation was identified between HCO 3 - levels and pCO 2 (r = 0.68; p < 0.001)., Conclusions: In the study population, an effect of altitude on blood levels of pCO 2 and HCO3- was observed., (© 2024. The Author(s).)

Hepatitis A virus (HAV) and hepatitis E virus (HEV) cause most of the global burden of viral hepatitis. Geographical and seasonal patterns contribute to the epidemiological status of infectious diseases. The extent of these features in the setting of HAV and HEV infections has not been analyzed in detail. This point is important in highly endemic countries of both viruses, where the pediatric population is at high risk of contracting these infections. A comparison between the frequency of antibodies to HAV and HEV and viral RNA detection in serum samples from pediatric patients with acute hepatitis from South and West Mexico was performed. All samples were positive for HAV mono-infection, which was most frequently detected in the metropolitan areas during the rainy season in the South (90%) and all year round in the West (42%). No HEV mono-infection was detected in the studied regions. A 58% frequency for HAV/HEV co-infection was found in the West, predominantly in the metropolitan areas during the rainy months. A 10% frequency for co-infection broadly distributed in the South throughout the year was also found. Our findings underscore that the distribution of HAV and HEV infections varies through the year and differs among Mexico's distinct geographical regions. [ABSTRACT FROM AUTHOR]

Introduction and objectives: Cases of viral hepatitis reported in Mexico are typically identified as hepatitis A, B and C. However, unspecified cases are reported annually. Hepatitis E virus (HEV) is an emergent agent that causes a self-limiting infection that can evolve to chronic in immunosuppressed individuals. In Mexico, HEV genotype 2 is considered endemic, though it's the prevalence is not well known. Therefore, the present study was designed to determine the prevalence of HEV among patients at the "Hospital Infantil de Mexico Federico Gomez". Materials and methods: The study included 99 patients, anti-HEV antibody (IgG and IgM) were detected by indirect ELISA and viral genome was identified using RT-PCR technique. Two PCR products of positive cases were sequenced. Results: ELISA results were positive in 3% and 6%, for IgG and IgM respectively, 54.5% prevalence was found by PCR. Low lymphocyte count (p < 0.05) and malnutrition (p < 0.005) were significant factors for high PCR prevalence and could increase the possibility of infection. Two samples were sequenced and confirmed the presence of HEV genotype 3. Conclusions: This report reveals the incidence of HEV in pediatric patients in Mexico. Moreover, the identification of HEV genotype 3 in human samples suggests a potential zoonotic risk that requires further research. [ABSTRACT FROM AUTHOR]

Background and Aims It has been demonstrated that heterozygote and homozygote thiopurine S-methyltransferase ( TPMT ) mutant allele carriers are at high risk to develop severe and potentially fatal hematopoietic toxicity after treatment with standard doses of 6-mercaptopurine (6-MP) and methotrexate (MX). Those drugs are the backbone of acute lymphoblastic leukemia (ALL) and several autoimmune disease treatments. We undertook this study to determine the frequency of the TPMT deficient alleles in children with ALL and non-ALL subjects from Mexico City and Yucatan, Mexico. Methods We included 849 unrelated subjects, of which 368 ALL children and 342 non-ALL subjects were from Mexico City, and 60 ALL cases and 79 non-ALL individuals were from Yucatan. Genotyping of the rs1800462, rs1800460 and rs1142345 SNPs was performed by 5′exonuclease technique using TaqMan probes (Life Technologies Foster City, CA). Results The mutant TPMT alleles were present in 4.8% (81/1698 chromosomes) and only 0.2% were homozygote TPMT*3A/TPMT*3A . We did not find statistically significant differences in the distribution of the mutant alleles between patients from Mexico City and Yucatan in either ALL cases or non-ALL. Nonetheless, the TPMT*3C frequency in ALL patients was higher than non-ALL subjects ( p = 0.03). To note, the null homozygous TPMT*3A/TPMT*3A genotype was found in 2.5% of the non-ALL subjects. Conclusions TPMT mutant alleles did not exhibit differential distribution between both evaluated populations; however, TPMT*3C is overrepresented in ALL cases in comparison with non-ALL group. Assessing the TPMT mutant alleles could benefit the ALL children and those undergoing 6-MP and MX treatment. [ABSTRACT FROM AUTHOR]

Introduction: Pediatric cancer in Mexico continues to be a health problem with an average 5-year global survival rate of 60%. Solid tumors take third place behind leukemias/ lymphomas and brain tumors, with localized advance staging found at the time of diagnosis in 2/3 of cases. The incidence of metastasis to the lung in this group of patients is found in 25% of the cases. Traditionally, surgery is the treatment of choice. However, we find patients with several resections or whose localization calls for pneumonectomy, which impacts on quality of life. The use of radiotherapy in general is omitted as far as possible in the pediatric population which is the reason that SBRT case reports is scarce. Hypothesis: Pioneering institutional experience in SABR management of oligometastatic illness in pediatric populations in Mexico Material and methods: At the ABC Medical Center, between May 2019 and November 2021, we have treated 6 patients with diagnosis of stage IV oligometastatic sarcoma with a total of 8 treated lesions: lung (4), spine (4). All were treated with SABR, Novalis Tx equipment with 18-60Gy/1-8 (fr) fractions. Results: Follow-up has been 6.5 months The average age of our population was 12 years (range 6-14), two female and 4 males. The diagnoses were: Ewing Sarcoma (3), adrenal carcinoma (1), Triton Tumor (1), carcinoid tumor (1). The total doses used were 30Gy: SRS technique 18 Gy/1fr. or 27Gy/3fr. and SBRT technique 30-50Gy/5fr. and 60 Gy/8fr. fractioning. Tolerance of the treatment was good: no patient presented toxicity greater than 3-4 toxicity >grade 3-4. Treatment response: 1 complete response, 4 partial response, 2 stables, 1 progression. Mean survival time was 17.3 months. Conclusions: The use of SBRT is feasible and able to be reproduced in pediatric patients. It is well tolerated, allows for less invasive management and has a positive impact on the quality of life of patients with oligometastatic tumors. [ABSTRACT FROM AUTHOR]

Background: Acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) are infrequent clinical entities in pediatric patients, as less than 8% of the literature mentions this population. This study aimed to describe the clinical and paraclinical profile, and the etiology related to patients with ARP and CP attended at a tertiary-level healthcare institute in Mexico., Methods: We conducted a retrospective study from medical records of patients with ARP and CP attended between 2010 and 2020, analyzing the clinical characteristics, imaging studies, and the etiology associated with each patient., Results: We analyzed 25 patients: 17 were diagnosed with ARP, and eight with CP. The main etiology identified was an anatomical alteration of the pancreatic duct (32%); pancreas divisum was the most prevalent condition. In 48% of the population, the etiology was not identified. The group with CP was higher in frequency for calcifications and dilation of the pancreatic duct (p < 0.005) compared to the ARP group., Conclusions: The main etiology for ARP and CP was an anatomical alteration of the pancreatic duct; however, in almost half of the cases, no established cause was identified. Although comparing our results with those offered by large cohorts such as the INSPPIRE group can be complex, we found relevant similarities. Currently, the data obtained from this first descriptive study are the foundation for future research in the field of Mexican pediatric pancreatology., (Copyright: © 2023 Permanyer.)

Background: Women are the primary caregivers of children in palliative care. Research has shown that the presence of intimate partner violence at home exacerbates the vulnerability of the caregiver. Current statistics indicate a high prevalence of violence in Mexico present in the intersectionality between intimate partner violence and the role of the primary caregiver. This study aimed to describe the frequency of intimate partner violence among primary palliative caregivers at the Hospital Infantil de México Federico Gómez., Methods: We conducted a cross-sectional and prospective study with convenience sampling; no sample calculation was performed. All female primary caregivers of children in the palliative care unit were invited to participate. The Scale of Violence and Index of Severity of Violence was used as the measuring instrument., Results: One hundred women participated in the study by submitting their survey in a designated mailbox. No sociodemographic data or patient diagnoses were collected. The frequency of intimate partner violence was 28%, of which 16% were considered severe cases. Women reported psychological violence (36%), sexual violence (23%), and physical violence (22%)., Conclusions: Almost one-third of female primary caregivers of pediatric patients at the Hospital Infantil de México Federico Gómez have been victims of some form of violence by current partners. This study highlights a previously unreported problem and opens the door for studies to correlate intimate partner violence among primary caregivers and the quality of life of children in palliative care., (Copyright: © 2023 Permanyer.)

Objective To evaluate the association between carotid intima-media thickness, buccodental status, and glycemic control in patients with type 1 diabetes. Methods Cross-sectional study with consecutive cases attended in an outpatient clinic (n = 69). Medical and clinical dental history, HbA1c, lipid profile, treatment period, and daily insulin dosage were recorded. Sociodemographic data and anthropometrical measurements were obtained by standardized questionnaire. Doppler real-time ultrasound was performed by a single experienced vascular radiologist blinded to the study. Assessment of buccodental status was done by the Maxillofacial Unit of the Pediatrics Hospital, and an oral scrape culture was collected. Results The mean age was 11.7 ± 3.0 years, with diabetes 5.1 ± 3.3 years. Mean HbA1c was 8.5 ± 1.7%. Primary teeth were present in 52.2% and bacterial plaque in 94.2%. Buccodental conditions featured caries (63.8%), gingivitis (84%), and enamel demineralization (26.1%): white spot lesions (18.8%) and cavitated lesions (7.3%). Bacteria associated with caries were found in 44.1%. Patients in the highest HbA1c tertile (>8.5%) had greater frequency of buccodental conditions and were positive for Streptococcus mutans and Candida albicans; also, cIMT increased and vessel compliance decreased compared to those in the lowest tertile (<7.0%) (p < 0.05). Conclusions More buccodental conditions and carotid intima-media thickness increase appeared in the patients with HbA1c level > 8.5%, suggesting onset of atherosclerosis. The correlation between buccodental status and HbA1c values may indicate the connection between inflammatory states of atherosclerosis and type 1 diabetes. [ABSTRACT FROM AUTHOR]

Background: Baja California, Mexico, ranks fourth nationally in reported cases of HIV/AIDS. Since paediatric patients are the most vulnerable population, the dentist must do a well-timed diagnosis and channel them for adequate care. Objective: To describe the most frequent dental and oral mucosa alterations associated with HIV/AIDS in diagnosed pediatric patients from Baja California. Methods: A cross-sectional clinical study was carried out with pediatric patients diagnosed with HIV/AID before age 12, who were registered at Epidemiology Departments of the state until August 2006. A questionnaire including socio-demographic variables, family history, pathology, CD4 and viral load levels was applied. Later, calibrated observers registering the indicators determined by the WHO performed intraoral and extraoral examination. When an oral alteration associated with HIV/AIDS was identified, tissues smears were obtained. Results: 46 HIV positive patients with a mean of 6.4 ± 4.4 years of age were examined. 57% were male, 50% were in light symptomatic clinical category and 67% did not have suppression, 50% reported a history of hospitalizations for diseases such as Tuberculosis and Pneumonia, 63% had caries and 44% oral mucosal lesions, of which oral candidiasis was the most frequent. The DMF-T index was 5.2 ± 4.9. Conclusion: The population studied presented lesions associated with HIV/AIDS; they may be markers of immune status in which they are, so that immediate oral care, supervision and monitoring must accompany immunosuppression therapy. [ABSTRACT FROM AUTHOR]

Acute respiratory distress syndrome (ARDS) is a frequent pathology in intensive care units, as a consequence of pulmonary or systemic disease. The mortality rate is elevated even though there are advances in mechanical ventilation and a better understanding of its pathophysiology . Alternative treatments, for example exogenous surfactant have been used in its management. However, various studies have shown its benefits and its possible adverse effects have not been clearly established. Due to the favorable results since its inception in the use in neonates with hyaline membrane disease, the possibility of it being used in pediatric patients with acute pulmonary lesions and specifically in ARDS has emerged. This article analyzes the use of exogenous surfactant as another therapeutic tool in this type of patients. [ABSTRACT FROM AUTHOR]

Objective: Determine the histopathological and clinical characteristics of patients diagnosed with meningiomas and to establish the frequency of these tumors in the pediatric population Mexican. Determine the NF1/2 frequency in meningioma pediatric., Methods: Samples from the histopathology file were reviewed, and from the complete clinical file the following patient data was reviewed: age, gender, diagnosis, diagnosis year, surgical resection, location, tumor size, symptoms, and family background. The frequency of NF1/2 in pediatric meningioma was reviewed in literature., Results: Forty-four de novo cases were collected from pediatric patients; 19 were female patients and 25 males. The most frequent histological subtype was transitional meningioma. Of all the cases, 75% had a supratentorial localization and 20% had an extramedullary intrarachidian localization. Some clinical manifestations included seizures, paresis, headache, and visual disturbances., Conclusion: There is a low incidence of meningiomas in the pediatric population, more than 70% are Grade I, and they have supratentorial localization., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Introduction: Diagnosis and management of congenital and traumatic articular ailments carry an additional problem in young people. Arthroscopy has improved treatment of these injuries, which are more frequent., Objective: To describe the experience of arthroscopic handling in pediatric patients affected with knee disease, managed at a third level hospital in Puebla, Mexico., Material and Methods: Descriptive, retrospective, cross sectional study performed in patients having knee disease, admitted at Unidad Médica de Alta Especialidad Hospital de Traumatología y Ortopedia Puebla, from March first, 2015 to February 28th, 2018. Lysholm and IKDC functional scales and Tegner functional satisfaction scale were applied at zero, six and twelve months. Student's t and Wilcoxon tests were used., Results: 29 young ones of five to 17 years of age became recruited, slightly more women (62.06%). The most frequently affected limb was the left one, with 55.17%. The disorders found are: discoid meniscus, harm of the anterior cruciate ligament, idiopathic inflammatory synovitis, tumor, meniscal injury, chondral damage, patellar hyperlaxity. Lysholm and IKDC registered improvement from the first semester. Tegner registered their ability to go back to previous daily occupations. On the Lysholm scale, there was improvement at six months. On the Tegner scale there was complete incorporation to their activities (previous to the presentation and surgical intervention). At six months subsequent to treatment, the IKDC evidenced improvement and recovery, and reintegration to their activities. Statistically significant differences (p 0.01) resulted, in measurements at zero, six and 12 months., Conclusions: Congenital and traumatic illnesses were found, the latter ones sports related. Arthroscopic approach registered positive functional results in these children.

Introduction and Aims: Graft-versus-host disease (GVHD) is a common multisystemic complication of allogeneic hematopoietic cell transplantation. The most frequent presentations of graft-versus-host disease involve the skin, the gastrointestinal tract, and the liver. The aim of the present study was to know the frequency of gastrointestinal tract and liver GVHD and the characteristics of disease presentation in pediatric patients that underwent hematopoietic stem cell transplantation (HSCT) at a tertiary care hospital center in Mexico City., Material and Methods: A retrospective study was carried out, utilizing the case records of patients that underwent HSCT in 2015, to determine the frequency of GVHD in pediatric patients at a Mexican tertiary care hospital center., Results: In 2015, 16 HSCT were performed, 11 of which were carried out in males (68%). Only 3 patients developed graft-versus-host disease (18.7%). One patient presented with skin and liver GVHD and 2 patients presented with gastrointestinal tract and liver GVHD, which was the most frequent type., Conclusions: HSCT is still an uncommon procedure in Mexico and there is a lower frequency of gastrointestinal tract and liver GVHD than that reported in other studies. Most certainly, there will be an increase in this type of patient and risk factors in the Mexican population must still be determined to help predict the onset of GVHD., (Copyright © 2018 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.)