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Copyright of Revista Latinoamericana de Hipertension is the property of Revista Latinoamericana de Hipertension and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of the article is to evaluate and understand the feelings and attitudes of Brazilian physicians regarding the implementation of palliative care in pediatric patients. Between July 2018 and December 2019, 236 questionnaires were sent to physicians on the National Academy of Palliative Care roster. The data collected through the planned questionnaires were analyzed using the IRAMUTEQ programs (Interface de R pour les Analyzes Multidimensionnelles de Textes et de Questionnaires). From the analysis performed by IRAMUTEQ, a dendrogram containing words with p<0.05 was obtained. Feelings of sadness, anguish, relief, regret and fulfillment were perceived as relevant. Attitudes such as understanding, communication, instructing, treating well, strategy, and multiprofessional conferences were also described. Thus, it was observed that these professionals experience different contradictory feelings and make use of different strategies so that they do not harm the treatment carried out, in addition to maintaining a good relationship with the patient's family. In the present study, we demonstrate that there are intrinsic characteristics of pediatric palliative care that are a source of mixed feelings for medical professionals. In this context, challenges still exist and it is essential to conduct new studies that address this issue. Paying attention to these feelings promotes better management of palliative care in pediatrics. [ABSTRACT FROM AUTHOR]

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El objetivo del presente artículo es realizar una aproximación a la situación de la osteopatía pediátrica en España y proponer la creación de una mesa de diálogo inter y multidisciplinar que permita avanzar en su regulación y ordenación profesional. Actualmente no existe un estándar académico que regule este tipo de formación en nuestro país. La ausencia de regulación predispone a que haya una gran variedad de perfiles profesionales, con formaciones académicas dispares, practicando la osteopatía. Este hecho puede tener implicaciones sobre la seguridad y calidad de la atención que reciben los/las pacientes/usuarios/as, principalmente los grupos vulnerables y dependientes de la población, como son los/las menores de edad. La creación de una mesa de diálogo también permitiría clarificar la práctica profesional de la osteopatía pediátrica y cuál es su bien interno para con la sociedad española. El papel de la bioética puede ser importante a la hora de integrar diferentes voces.

Therapeutic monitoring of antibiotics and antifungals based on pharmacokinetic and pharmacodynamic (PK/PD) parameters is a strategy increasingly used for the optimization of therapy to improve efficacy, reduce the occurrence of toxicities, and prevent the selection of antimicrobial resistance, particularly in vulnerable patients including neonates and the critical or immunocompromised paediatric host.In neonates and children, infections account for a high percentage of hospital admissions, and anti-infectives are the most used drugs. However, paediatric PK/PD studies and the evidence regarding the efficacy and safety of some newly marketed antibiotics and antifungals—usually used off-label in paediatrics—to determine the optimal drug dosage regimens are limited. It is widely known that this population presents important differences in the PK parameters (especially in drug clearance and volume of distribution) in comparison with adults that may alter antimicrobial exposure and, therefore, compromise treatment success. In addition, paediatric patients are more susceptible to potential adverse drug effects and they need closer monitoring.The aim of this document, developed jointly by the Spanish Society of Hospital Pharmacy and the Spanish Society of Paediatric Infectious Diseases, is to describe the available evidence on the indications for therapeutic drug monitoring (TDM) of antibiotics and antifungals in newborn and paediatric patients, and to provide practical recommendations for TDM in routine clinical practice to optimise their dosing, efficacy and safety. Of antibiotics and antifungals in the paediatric population. Resumen: La monitorización terapéutica de antibióticos y antifúngicos en el paciente pediátrico, basada en parámetros farmacocinéticos y farmacodinámicos (PK/PD), es una estrategia cada vez más utilizada para la optimización del tratamiento de infecciones con el fin de mejorar la eficacia, reducir la aparición de toxicidades y prevenir la selección de resistencias antimicrobianas, especialmente en poblaciones vulnerables como neonatos, pacientes críticos o inmunodeprimidos.En la población neonatal y pediátrica, las infecciones representan un porcentaje elevado de los ingresos hospitalarios, siendo los antimicrobianos los fármacos más utilizados en este grupo poblacional. Sin embargo, establecer los regímenes posológicos óptimos en esta población es complejo debido a la menor evidencia respecto a la eficacia y seguridad de algunos antimicrobianos, especialmente en los de reciente comercialización que son utilizados habitualmente fuera de ficha técnica y al limitado número de estudios PK/PD disponibles en pediatría. Es bien conocido que el paciente pediátrico se caracteriza por presentar una serie de variaciones de los parámetros farmacocinéticos (como el aclaramiento o el volumen de distribución) debido a los propios cambios madurativos que pueden modificar la exposición a los antimicrobianos y comprometer el éxito del tratamiento. A su vez, es un grupo poblacional más susceptible a presentar potenciales efectos adversos a los fármacos, hecho que conlleva la necesidad de una monitorización más estricta.El objetivo de este documento de consenso, elaborado entre la Sociedad Española de Farmacia Hospitalaria (SEFH) y Sociedad Española de Infectología Pediátrica (SEIP), es describir la evidencia disponible sobre las indicaciones de la monitorización terapéutica de antibióticos y antifúngicos en pacientes neonatales y pediátricos, y proporcionar recomendaciones prácticas para su monitorización y ajuste de dosis, con el fin de optimizar el tratamiento, maximizando su eficacia y seguridad.

Objective: The aim of the study was to describe how physical exercise affects metabolic control, insulin requirements and carbohydrate intake in children who use hybrid closed-loop systems. Methods: Cross-sectional study design. The sample included 21 children and adolescents diagnosed with type 1 diabetes. During the study, participants were monitored for a period of 7 days to gather comprehensive data on these factors. Results: Nine participants (42.9%) had switched to exercise mode to raise the target glucose temporarily to 150 mg/dL. The HbA1c values ranged from 5.5% to 7.9% (median, 6.5%; IQR, 0.75). The percentage of time within the target range of 70−180 mg/dL was similar; however, there was an increased duration of hyperglycaemia and more autocorrections on exercise days. The time spent in severe hyperglycaemia (>250 mg/dL) increased by 2.7% in exercise compared to non-exercise days (P = .02). It is worth noting that hypoglycaemic episodes did not increase during the exercise days compared with non-exercise days. Conclusion: The hybrid closed-loop system was effective and safe in children and adolescents with type 1 diabetes during the performance of competitive sports in real life. Resumen: Objetivo: El objetivo de este estudio es describir cómo el ejercicio físico afecta el control metabólico, las necesidades de insulina y el consumo de carbohidratos en niños usuarios de un sistema híbrido de circuito cerrado. Métodos: Diseño de estudio transversal. Se reclutaron veintiún niños y adolescentes diagnosticados con diabetes tipo 1. Durante el estudio, los participantes fueron monitoreados durante un período de 7 días para recopilar datos completos sobre estos factores. Resultados: Nueve participantes (42,9%) habían activado el modo de ejercicio, para elevar temporalmente la glucosa objetivo a 150 mg/dL. La HbA1c osciló entre 5,5% y 7,9% (mediana 6,5%, IQR 0,75). El porcentaje de tiempo dentro del rango de 70−180 mg/dL fue similar; sin embargo, hubo una mayor duración de la hiperglucemia y más autocorrecciones en los días en que se realizó ejercicio. El porcentaje de tiempo en hiperglucemia grave (>250 mg/dL) fue 2,7 mayor durante el ejercicio versus los días sin ejercicio (p = 0,02). En particular, los episodios de hipoglucemia no aumentaron durante los días de práctica de ejercicio, en comparación con los días sin ejercicio. Conclusiones: El sistema híbrido de circuito cerrado fue efectivo y seguro en niños y adolescentes diagnosticados con diabetes tipo 1 durante ejercicios físicos competitivos en la vida real.

Background and purpose: Open reduction is rarely performed in pediatric supracondylar humerus fractures. However, clear evidence is lacking regarding the optimal open approach to achieve satisfactory results. The anterior approach provides direct visualization of the fracture and excellent exposure to neurovascular structures, although its utilization is less common. The objective of this study was to review the indications, outcomes, and complications associated with the anterior approach for open reduction of these fractures. Methods: Our protocol was registered at PROSPERO: CRD42023446923. MEDLINE/PubMed, Embase, Web of Science, Clinicaltrials.gov, and Cochrane Library were searched from database inception to search date (December 2023) and screened in duplicate for relevant studies. Data were collected regarding patient demographics, indications for open reduction, Flynn's functional and cosmetic outcomes, and complications. Study quality was assessed using the Methodological Index for Non-Randomized Studies Criteria. Results: A total of 19 studies involving 483 patients were included. One study was classified as Level 2 evidence, ten as Level 3, and eight as Level 4. The mean MINORS score was 13.05 ± 3.47. The primary indication for open reduction was failed closed reduction, observed in 46% of patients. 97.7% and 98.6% of patients achieved Flynn's functional and cosmetic satisfactory results, respectively. The postsurgical neurovascular injury rate was 1.4%. One patient required reintervention. Conclusion: The anterior approach is safe and effective for managing pediatric supracondylar humerus fractures requiring open reduction. Level of evidence: Systematic review of Level 2–4 evidence studies. Resumen: Antecedentes y objetivo: La reducción abierta rara vez es necesaria en las fracturas supracondíleas de húmero pediátrica. Sin embargo, falta evidencia sobre cuál es el abordaje óptimo para obtener resultados satisfactorios. El abordaje anterior facilita una visión directa de la fractura y una excelente exposición de las estructuras neurovasculares, aunque su uso es poco común. El objetivo de este estudio fue revisar las indicaciones, resultados y complicaciones asociadas con el abordaje anterior para la reducción abierta de estas fracturas. Métodos: Nuestro protocolo se registró en PROSPERO: CRD42023446923. La búsqueda se realizó en MEDLINE/PubMed, Embase, Web of Science, Clinicaltrials.gov y Cochrane Library, desde inicios hasta diciembre de 2023. Se realizó screening por duplicado. Se recogieron datos demográficos, indicaciones para el abordaje abierto, puntuación de Flynn funcional y estética y complicaciones. La calidad de los estudios se evaluó con Methodological Index for Non-Randomized Studies Criteria (MINORS). Resultados: Se incluyeron 19 estudios que agrupaban a 483 pacientes. Un estudio se clasificó con nivel de evidencia 2, 10 con nivel 3, y 8 con nivel 4. La puntuación media MINORS fue 13,05 ± 3,47. La indicación principal para el abordaje abierto fue el fracaso de la reducción cerrada, reportada en 46% de pacientes. El 97,7% y 98,6% de los pacientes lograron un Flynn funcional y cosmético satisfactorio, respectivamente. La tasa de lesiones neurovasculares postquirúrgicas fue 1,4%. Un paciente fue reintervenido. Conclusiones: El abordaje anterior es seguro y efectivo en el maneco de fracturas supracondíleas de húmero pediátricas cuando se requiera un abordaje abierto. Nivel de evidencia: Revisión sistemática de estudios con nivel de evidencia 2-4.

Introdução: A referenciação hospitalar, cumprindo critérios bem estabelecidos e seguindo parâmetros de qualidade, permite uma melhor gestão de recursos humanos e económicos. O nosso objetivo foi caraterizar a referenciação à consulta hospitalar em idade pediátrica de uma Unidade de Saúde Familiar pertencente ao Agrupamento de Centros de Saúde do Grande Porto III, durante o ano de 2019. Material e métodos: Estudo retrospetivo e descritivo que incluiu indivíduos em idade pediátrica, que frequentaram as consultas de Saúde Infantil e Juvenil desta Unidade de Saúde Familiar, durante o ano de 2019 e que foram referenciados a consulta hospitalar via AlertP1®. Resultados: A taxa de referenciação global foi de 11,1%, 40,3% no grupo etário com idade superior a nove anos. As consultas hospitalares mais solicitadas foram as das áreas cirúrgicas/médico--cirúrgicas. 88,9% foram motivadas por patologias do foro somático (vs 11,1% do foro do desenvolvimento). Verificou-se uma associação estatisticamente significativa entre entidade de quem partiu a iniciativa para a necessidade de referenciação e motivo da referenciação, sendo as patologias do desenvolvimento/comportamento maioritariamente sinalizadas pela Escola/Infantário. Quanto à qualidade das referenciações, a maioria foi classificada como “Aceitável”, com uma correlação positiva entre anos de prática clínica e má qualidade das referenciações. Verificamos que mais de 50% das consultas não respeitaram os 120 dias admitidos para uma referenciação de prioridade normal fixados pela portaria que regula a “Consulta a Tempo e Horas”. Conclusão: A nossa taxa de referenciação foi superior à observada por outros autores, com 5,2% dos pedidos a serem recusados.

Introduction and aim: SARS-CoV-2 emerged in 2019 and had a huge impact on the world. The area of endoscopy suffered great changes, causing a reduction in the number of procedures and its indications. The aim of our study was to compare the quantity, indication, and type of procedures in 2019 with those in 2020. Method: A retrospective, observational, analytic, and cross-sectional study was conducted, obtaining information from the endoscopy registry. The STROBE checklist was employed. Statistical analysis: The quantitative variables were analyzed with descriptive statistics (measures of central tendency and dispersion) and the categorical variables with frequencies and percentages. The quantitative variables were compared, using the Student’s t test/Mann–Whitney U test, and the categorical variables with contingency tables, using the Fisher’s exact test. Results: In 2019, a total of 277 procedures were performed, compared with 139 in 2020. Mean patient age was 98.53 months (61.46 SD) in 2019 and 77.02 months (59.81 SD) in 2020; 352 diagnostic procedures and 136 therapeutic procedures were carried out in 2019, compared with 51 diagnostic procedures and 88 therapeutic procedures in 2020. The number of diagnostic and therapeutic procedures were inverted (72.1%–36.7% and 27.9%–63.3%, respectively) (p

Objetivo: conocer el papel de la atención de enfermería en los cuidados paliativos para mejorar la calidad asistencial del niño con un proceso oncológico. Método: revisión bibliográfica de la literatura mediante la búsqueda en las bases de datos PubMed, la Biblioteca Cochrane Plus, la Biblioteca Virtual de Salud, Scopus y Web Of Science. Los descriptores de los tesauros DeCS y MeSH se unieron mediante los operadores booleanos AND y OR. Resultados: tras la búsqueda se obtuvieron 305 artículos, incluyendo finalmente 13 artículos para realizar la revisión tras la aplicación de los criterios de selección. La Biblioteca Virtual de Salud fue la base de datos con mayor número de artículos incluidos (n=6). Los estudios cualitativos fueron los más predominantes con un total de 9 artículos incluidos (69,23%). Conclusiones: la atención de enfermería influye en la calidad asistencial de los cuidados paliativos de los niños con un proceso oncológico, ya que es el personal que más tiempo pasa con los pacientes. Existen diversos factores que influyen en la calidad de los cuidados paliativos pediátricos como es el control del dolor, así como diferentes barreras que dificultan la integración de los cuidados paliativos pediátricos, encontrando entre ellas la falta de formación del personal de enfermería.

Mycoplasma pneumoniae (M. pneumoniae) is a bacterium with particular characteristics that give rise to a broad clinical spectrum, being respiratory infection the most frequent presentation. Infection by M. pneumoniae occurs in cyclical epidemics, and paediatricians in Spain have noticed an increase in cases since January 2024, establishing hospital registers to collect surveillance data (as it is not a notifiable disease in Spain). The diagnosis of infection by M. pneumoniae is made through serological testing and/or the detection of genetic material by means of polymerase chain reaction (PCR). Neither methods can differentiate between colonization and active infection, so a precise diagnosis is not possible and testing should only be requested in the case of high clinical suspicion. The role of antibiotherapy in infection by M. pneumoniae in its different clinical variants is not well defined. Most infections are self-limiting and mild, and there is insufficient evidence to support the use of antibiotherapy in these cases. Antibiotic treatment is justified in patients with risk factors for the development of severe disease (Down syndrome, anatomical or functional asplenia, immunosuppression), in hospitalized patients with respiratory infection and in patients with moderate or severe extrapulmonary forms. Taking into account aspects concerning the rational use of antimicrobials, the treatment of choice would be clarithromycin, with azithromycin as an alternative, reserving the use of doxycycline and levofloxacin for cases of antimicrobial resistance and/or infections of the central nervous system. Resumen: Mycoplasma pneumoniae (MP) es una bacteria con características peculiares que produce un amplio espectro de manifestaciones clínicas siendo la infección respiratoria la más frecuente de ellas. Se presenta en epidemias cíclicas, percibiendo los pediatras en España un incremento de casos desde enero del 2024, poniéndose en marcha registros hospitalarios (no es una enfermedad con declaración obligatoria en nuestro medio). El diagnóstico de la infección por MP se realiza mediante la determinación de serologías y/o la detección de material genético mediante reacción en cadena de polimerasa (PCR). Ambas son incapaces de diferenciar la colonización de la infección activa, por lo cual el diagnóstico preciso no es posible y deben solicitarse sólo en caso de alta sospecha clínica. El papel del tratamiento antibiótico en la infección por MP en sus diferentes variantes clínicas no está bien definido. La mayoría de las infecciones son autolimitadas y leves, sin evidencia suficiente en favor de la antibioterapia en estos casos. El tratamiento antibiótico estaría justificado en pacientes con factores de riesgo para desarrollo de formas graves (Síndrome de Down, asplenia anatómica o funcional, inmunodepresión), en pacientes hospitalizados con infección respiratoria y en pacientes con formas extrapulmonares moderadas o graves. Considerando aspectos referentes a la optimización del uso de antimicrobianos, el tratamiento de elección sería claritromicina, siendo alternativo el uso de azitromicina; y reservando el uso de doxiciclina y levofloxacino para los casos de resistencias antimicrobianas y/o infecciones del sistema nervioso central.

INTRODUCTION: In the last twenty-five years, various questionnaires have been developed to study eating disorders in pediatrics, useful for research purposes, but not very applicable in the daily pediatric clinic, as they require a long time to complete them. OBJECTIVE: Determine the validity and reliability of the Montreal Children's Hospital Feeding Scale (MCH-FS) to be able to use this scale in Mexican children from 6 months to 6 years and 11 months. MATERIAL AND METHODS: The sample was non-probabilistic consisting of 245 infants with an age range of 6 months to 6 years of age, from Mexico City and the metropolitan area. Two groups were formed: clinical and control that came from different institutions: 1) private health n=65 cases, 2) public assistance institution n=59 cases, 3) Cleft lip and palate clinic n=43 cases, 4) autism Clinic n=12 cases and 5) Private School n= 66 cases. The primary family member answered each question in the questionnaire according to the kind of eating behavior. RESULTS: An adequate internal consistency of the instrument was observed, and the exploratory factorial analysis showed two factors: 1) Parental strategies and 2) eating problems presenting a good adjustment of the data. CONCLUSION: This study demonstrates that MCH-FS is a useful tool to detect feeding disorders in Mexican children [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Tecnología, Ciencia & Educación is the property of Centro de Estudios Financieros SL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To determine the relationship between knowledge and identification of palliative care (PC) needs among medical specialists at the Instituto Nacional de Salud del Niño (INSN - National Institute of Child Health) in Breña, Lima, Peru, in July 2023. Materials and methods: A cross-sectional, analytical and observational study was conducted. Results: The study included 180 medical specialists, with 34.40 % aged between 30 and 39 years and 51.00 % being women. The majority had a medical specialty (pediatrics), with intensive care medicine being the most frequent subspecialty. Only 12.00 % of the participants had received prior PC training. The average global PC knowledge score was 11.65 ± 2.83. Qualitatively, most participants rated their knowledge as intermediate and demonstrated an adequate level of identification of pediatric palliative care (PPC) needs. The average score in the questionnaire for identifying patients with PPC needs was 3.53 ± 0.93. All participants with prior PPC training showed adequate identification of PPC needs. The global knowledge score was higher among those who adequately identified PPC needs compared to those who did not (median 12 [IQR: 10-14] vs. median 11 [IQR: 8-2]; p: 0.0068). Likewise, the theoretical and legal domain scores were higher in those with adequate identification of PPC needs. Conclusions: Most participants rated their knowledge at an intermediate level, with ethics scoring the lowest among domains. The majority demonstrated an adequate ability to identify PPC needs. A significant but weak correlation was found between the global PC knowledge score and the identification of PPC needs, as well as between the legal domain and the identification of PPC needs. These findings support the implementation of PPC training programs for medical specialists focusing on both theoretical knowledge and practical skills. [ABSTRACT FROM AUTHOR]

Introduction and objective: The association of vestibular symptoms in patients with migraine is more frequent than in the general population. In childhood, one of the most common causes of dizziness is vestibular migraine, which due to its variety of symptoms is often the object of study by various specialties. The purpose of this article is to perform a bibliographic review that allows us to familiarize ourselves with this pathology. Method: A bibliographic review of the articles published in the main databases ((PubMed) Medline, UpToDate, Elsevier, Cochrane Library, Science Direct) was conducted, selecting the most relevant articles according to type of study and year of publication. Results: Vestibular migraine is a diagnosis to consider in the evaluation of the pediatric patient, given its prevalence and the spectrum of differential diagnosis to which it belongs. Discussion: Vestibular migraine in childhood has an unknown prevalence and is defined by the presence of headache with migraine characteristics, accompanied by vestibular symptoms, before, during or after the migraine attack. Its diagnosis is made using the new diagnostic criteria published by the ICVD (International Classification of Vestibular Disorders) in 2021 and does not require other tests for its diagnosis. So far, there is no specific treatment, and the existing one is based on the control of the symptoms of the migraine attack. Conclusions: One of the most frequent causes of dizziness in children is vestibular migraine, which, as of 2021, has its own diagnostic criteria, together with a spectrum of diseases with which a differential diagnosis must be made. Despite the studies conducted, there is no standardized treatment for this pathology. [ABSTRACT FROM AUTHOR]

Introduction: Due to the very high prevalence of mental pathology in early life (up to 20%), correct diagnosis and immediate treatment in early life is a global health priority. Objective: The aim of this study was to evaluate the degree of validity of the diagnoses of ADHD and ASD made in Primary Health Care Services (PHCS), comparing them with definitive diagnoses issued in the Child and Adolescent Mental Health Units (CAMHU). Methodology: 183 patients were included in this study, being referred from Primary Health Care (PHC) to Vecindario's CAMHU, in Gran Canaria, Spain. Evaluation was retrospective and included the following variables: age, sex, perinatal history, adopted minor, family psychiatric history, referring physician's diagnosis of suspicion, definitive diagnosis in the CAMHU, subsequent follow-up and psychopharmacological treatment. To analyze the degree of quality of the referrals, we calculated the percentage of cases that matched the suspected diagnosis of the referring physicians (pediatricians or general practitioners (GP)) and the definitive confirmation diagnosis (issued by the child and adolescent psychiatrist). Results: 75.4% of the sample were males, with a mean age of 8.22 years, 7.7% had a perinatal history, and 17.5% had a family psychiatric history. 65.6% of them were referred with a suspected diagnosis of ADHD, 62.7% were confirmed and 26.27% were rejected. 31.7% were referred to the CAMHU with a suspected diagnosis of ASD. This entity was confirmed in 75.8% and rejected in 10.3%; 5.1% of them were finally diagnosed with ADHD. Only 2.7% were referred for a combined suspicion of ADHD and ASD, but 9.8% of children were finally diagnosed with both diagnoses (ADHD and ASD) concomitantly. Conclusion: The validity of the diagnostic suspicions made in the PHCS was very high: 62.7% for ADHD and 75.8% for ASD; obtaining notably higher percentages than in previous studies. [ABSTRACT FROM AUTHOR]

Surgery is a key pillar in medical care, and both the surgical as well as the anesthetic components are essential within the health systems in countries of all levels of development. Every year, close to 230 million surgical procedures are performed worldwide, with pediatric surgery being representative, as around 85% of children require a surgical procedure. However, the issue of education and training of the people involved in pediatric surgery who can provide safe surgical and anesthetic care in medium and low income countries has been absent from the global health debate. The development of anesthesia in pediatrics faces many challenges: it is a relatively new specialty, it has to deal with clinical challenges associated with anatomical, physiological, psychological and procedure-related differences, while it faces the reality of few training opportunities which results in a limited number of duly trained and qualified specialists in pediatric anesthesiology. In Latin America, the possibility of applying to a specialization in pediatric anesthesia is limited. In particular in Colombia it has not been possible to establish a pediatric anesthesia subspecialty, creating the need to promote formal and informal training in this discipline in order to ensure that safe, good quality anesthetic care is provided to children. This article describes the development of pediatric anesthesia training in the world and in Colombia, highlighting the relationship between the incidence of anesthetic complications and the need for training in this discipline. [ABSTRACT FROM AUTHOR]

Background: Vascular malformations (VaMs) are caused by errors in vascular morphogenesis. Diagnosis and treatment can be complex. Few specialized centers care for these patients, and limited literature exists regarding their characteristics and clinical course. The vascular anomalies clinic (VAC) at the Instituto Nacional de Pediatría (National Institute for Pediatrics) is a multidisciplinary team and has been a reference center for patients with VaMs since 2012. We sought to describe the characteristics of patients cared for at the VAC, types of VaMs, treatments used, and clinical course. Methods: This was a descriptive, observational, retrospective, and cross-sectional study conducted from 2012 to 2022. Results: We included 435 patients with VaMs; the median age of presentation was 1 month. The most frequent signs and symptoms were increased volume (97.2%), superficial color change (65.5%), and pain (43.3%). The most common VaMs were lymphatic (36.7%) and venolymphatic (18.3%). Sclerotherapy was the most frequent treatment (73.4%), followed by medical treatment with sirolimus (18.5%); response to both was excellent/good in > 85% of cases. Conclusion: In this retrospective study of children with VaMs, we found that low-flow malformations were the most common, and sclerotherapy and sirolimus were the most frequently used treatments. The therapeutic response was excellent/good in most cases. [ABSTRACT FROM AUTHOR]

In 2015, ceftazidime/avibactam (CZA) was approved for the treatment of complicated infections: urinary, intra-abdominal and hospital-acquired pneumonias caused by multidrug-resistant Gram-negative bacilli. Its approval for pediatric use was in 2019. Despite its initial effectiveness, resistance to CZA has been increasing, reaching 10% globally. This article provides a comprehensive review of the mechanisms of action of CZA. The main resistance mechanism to this antimicrobial, such as mutations in KPC carbapenemase and extended-spectrum beta-lactamases (ESBLs), overexpression of efflux pumps, and porin modification, are detailed. Experimental research is also reviewed to understand the causes of this phenomenon and the emergence of resistance during treatment with CZA is highlighted, underlining the importance of the epidemiology of this resistance to determine the cases in which CZA is the best therapeutic option. [ABSTRACT FROM AUTHOR]

Objective: The objective is to expose the cardiovascular alterations in patients diagnosed with pediatric inflammatory multisystem syndrome (PIMS) associated with COVID-19 during the SARS-CoV-2 pandemic, in order to understand the disease, its evolution, and optimal management upon diagnosis. Method: Retrospective, observational, cross-sectional analytical study of patients diagnosed with PIMS according to the criteria of the World Health Organization at the National Institute of Pediatrics, from March 2020 to December 2021. Results: During the study period, 77 patients with PIMS were diagnosed. The results showed correlation between the shock state and alteration of laboratory markers (platelets 144217.29 ± 139321.6 µL [p < 0.001], procalcitonin 27.37 ± 38.37 ng/ml [p = 0.05] and ferritin 1937.87 ± 2562.63 [p < 0.001]). The ventricular function in patients with shock was significantly lower compared to those without shock (49.6 ± 9.1% vs. 58.1 ± 8.4 %; t-Student p < 0.001), as well as injury to the left coronary artery (p = 0.02). There is a correlation between NT-proBNP and ventricular dysfunction (Kruskal-Wallis p = 0.007). Statistical significance was found in the association between death, elevation of inflammatory markers and ventricular dysfunction (p < 0.001). Conclusions: The cardiovascular alterations observed, in order of frequency, were pericardial effusion (25.7%), myocarditis (15%), mild ventricular dysfunction (13.5%) and small coronary aneurysm with predominance of the left coronary artery and the anterior descending one. [ABSTRACT FROM AUTHOR]

Introduction. One of the most common pathologies of the pericardium is pericarditis, which can present as acute, subacute or chronic pericarditis, pericardial effusion, cardiac tamponade or constrictive pericarditis. However, it is a rare condition in the pediatric population. Methods. A series of cases of patients with pericarditis who were taken to pericardiotomy, pericardial drainage and anterior partial pericardiectomy, between July 2014 and June 2023 is presented. Demographic and clinical variables were collected, microbiological isolates and the management received were evaluated. Results. A total of 12 patients underwent minimally invasive surgical management; of these, 58% belonged to indigenous communities and lived in rural areas. Half had associated pneumonia. In most cases, no microbiological isolation was obtained. Conclusion. The need for surgical management is determined by the impact on the hemodynamic variables related to the effusion and pericardial compromise. Partial pericardiectomy by thoracoscopy is an alternative in these cases. [ABSTRACT FROM AUTHOR]

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Introducción: La cirugía laparoscópica en pediatría ha incrementado su adopción debido a sus beneficios, como menor trauma quirúrgico y recuperación más rápida, pero también presenta desafíos únicos, incluyendo la anatomía específica de los pacientes pediátricos y la necesidad de entrenamiento del equipo quirúrgico. Este estudio tuvo como objetivo desarrollar una guía práctica para estandarizar procedimientos en la fase inicial de intervenciones laparoscópicas en pacientes pediátricos, mejorando así la seguridad del paciente y la eficiencia del equipo quirúrgico. Métodos: Se realizó un estudio prospectivo, multicéntrico y de diseño cualitativo, basado en encuestas a cirujanos pediátricos con experiencia en laparoscopia. Se creó un listado de verificación, el cual fue validado por un panel de expertos. Resultados: Hubo consenso unánime entre los expertos sobre la importancia de revisar la historia clínica y realizar evaluaciones preoperatorias detalladas. Se identificaron ítems para una lista de verificación que incluyó: la identidad del paciente, preparación del entorno quirúrgico y verificación de equipos y materiales. La guía final se elaboró a partir de la retroalimentación recibida y se diseñó para ser fácilmente aplicable en entornos de quirófano tanto electivos como de emergencia. Conclusiones: La implementación de una guía práctica y un listado de verificación para la fase inicial de cirugía laparoscópica en pediatría puede reducir eventos adversos, optimizando el tiempo quirúrgico, la comunicación y el trabajo en equipo en el quirófano.

Introducción: las encefalopatías epilépticas y del desarrollo causan un impacto en el neurodesarrollo de la población pediatrica, por lo que la medicina de precisión hace imperante la etiología a través de la identificación genética. Métodos: este estudio clínico, observacional descriptivo, con componente asociativo y de carácter retrospectivo tiene como objetivo general evaluar la asociación entre las encefalopatías epilépticas y las mutaciones genéticas en un grupo de pacientes que acuden a la consulta de neuropediatría del Centro Médico Docente La Trinidad. Resultados: se evaluaron los antecedentes familiares, datos clínicos, genéticos, farmacológicos, electroencefalograma y neuroimagen que experimentaron los pacientes en los primeros 4 años de vida, diagnosticados y seguidos en Centro Médico Docente La Trinidad. Se incluyeron 15 pacientes (7 con variantes patógenas, 2 con variante probablemente patógena y 6 con variantes de significado incierto) mediante la secuenciación del exoma. Se encontró un mayor porcentaje asociado al debut con crisis clónicas de inicio focal y resistencia a los medicamentos en su seguimiento. El mayor hallazgo del examen neurológico fue trastornos de la tonicidad muscular (hipotonía), con una muestra total que presentó retraso global en el desarrollo. Conclusiones: las epilepsias genéticas de aparición temprana demuestran un espectro fenotípico y genotípico muy amplio, por lo que el reconocimiento clínico y genético de esta entidad facilita el manejo y evolución temprana de la epilepsia.

La dosificación de medicamentos en emergencias pediátricas es una práctica común pero desafiante, ya que errores en el cálculo de dosis pueden empeorar el estado clínico del paciente. El proceso matemático involucrado introduce una fuente de error significativa, especialmente en situaciones de estrés. Una solución propuesta es la dosificación basada en la estatura, ya que es más fácil de medir en pacientes gravemente enfermos y en posición supina. El objetivo de este estudio fue verificar si los sistemas de dosificación en emergencia pediátrica basados en la relación talla/peso son precisos en una población pediátrica venezolana. El estudio fue clínico, epidemiológico, descriptivo y de corte transversal. Se incluyeron pacientes de 1 a 5 años que acudieron a consultas externas y servicios de emergencia pediátrica en distintos centros de salud. El muestreo fue aleatorio simple. Los resultados mostraron que la estimación del peso a partir de fórmulas puede causar errores significativos, lo que puede llevar a una dosificación incorrecta de medicamentos y otros procedimientos médicos. El uso de cintas para estimar peso resultó en dosificación, hidratación y uso de equipos como tubos endotraqueales diferentes a los necesarios según el peso real, especialmente en pacientes desnutridos. Se concluye que, aunque los métodos basados en talla pueden ser útiles, son más precisos en poblaciones con peso y talla cercanos a la normalidad, por lo que deben aplicarse con cautela en casos extremos.

Objetivo: Medir el grado de fiabilidad de la construcción de nuevos ítems y la adaptación de la escala Brighton Paediatric Early Warning Score para niños oncológicos. Método: Estudio metodológico para analizar la equivalencia de contenido interjueces en cuanto a la inclusión de ítems en la escala para detectar el deterioro clínico precoz en niños oncológicos, a saber: signos de hemorragia, cambios de temperatura y presencia de mucositis grado III/IV. Para el análisis se utilizaron el Coeficiente de Correlación Intraclase y el Alfa de Cronbach, considerando un valor ≥0,750. Resultados: Los ítems sugeridos para inclusión fueron mantenidos, con pequeñas modificaciones en las puntuaciones, de acuerdo con las sugerencias de los jueces. Treinta enfermeros (86,1%) y seis médicos (13,9%) de Brasil evaluaron la escala, obteniendo un coeficiente de correlación intraclase de 0,823. Conclusión: El instrumento demostró ser adecuado, con relevancia teórica y aplicación práctica para la detección precoz del deterioro clínico en niños oncológicos. Para ello, contribuye a la identificación oportuna por parte del equipo, minimizando los desenlaces desfavorables.

Introducción. La mortalidad perinatal y neonatal tardía es una prioridad en salud pública. Evaluar los sistemas de vigilancia es esencial para verificar si cumplen con sus objetivos. Objetivo. Evaluar el desempeño del sistema de vigilancia de la mortalidad perinatal y neonatal tardía en Colombia. Metodología. Se realizó un estudio descriptivo de corte transversal y analítico, según la metodología de los Centros para el Control y la Prevención de Enfermedades de los Estados Unidos para la evaluación de sistemas de vigilancia en salud pública. En el componente cuantitativo, se analizaron las bases de datos del Sistema de Vigilancia en Salud Pública y del Registro Único de Afiliados de Colombia del año 2021, para verificar la calidad de los datos, la sensibilidad, el valor predictivo positivo, la especificidad y la oportunidad. Además, se aplicó una encuesta de percepción a distintos niveles de atención para evaluar los atributos de simplicidad, flexibilidad, aceptabilidad, oportunidad y utilidad del sistema. Los datos recolectados se procesaron en Microsoft Excel® y se analizaron en el software estadístico R® para calcular estadísticas descriptivas y de frecuencia. Resultados. Se analizaron 9905 registros en el Sistema de Vigilancia en Salud Pública 560; se reportó una sensibilidad del 95,8%, un valor predictivo positivo del 95,5% y una especificidad del 34,9%. En la evaluación cualitativa del sistema participaron 471 profesionales de diferentes regiones de Colombia. Los atributos de simplicidad, flexibilidad y aceptabilidad mostraron un buen desempeño, mientras que el atributo de oportunidad fue clasificado como aceptable. Conclusiones. El sistema de vigilancia para la mortalidad perinatal y neonatal tardía en Colombia (Sivigila evento 560) es confiable, útil para registrar y reportar muertes neonatales y perinatales y facilita el análisis de causas y variaciones del evento. De esta manera contribuye a la formulación de acciones en salud pública.

Resumen Introducción. Las malformaciones arteriovenosas (MAV) son anomalías infrecuentes que ocurren en aproximadamente 0.1% de la población general. Las MAV cerebrales suelen ser asintomáticas, pero las manifestaciones clínicas más comunes incluyen hemorragia intracerebral no traumática, siendo esta una de las complicaciones con mayor carga de morbimortalidad; estas MAV tienen una prevalencia del 0.02% en población pediátrica. Presentación del caso. Niña de 5 años, previamente sana, quien fue llevada a un servicio de urgencias por dolor cervical asociado a síntomas neurológicos. La tomografía computarizada cerebral reportó hemorragia intraventricular, por lo que se realizó una ventriculostomía en la cual se colocó un catéter externo para iniciar drenaje. En la panangiografía realizada por parte del servicio de radiología intervencionista se observó un nido capilar arteriovenoso tipo II según la escala de Spetzler Martin en el plexo coroideo no candidato a manejo endovascular. Un año después del diagnóstico inicial se realizó la resección quirúrgica de la MAV de manera exitosa y la paciente evolucionó satisfactoriamente. Conclusión. Las MAV cerebrales son raras y su diagnóstico y tratamiento dependen de la experiencia médica debido a la limitada literatura disponible sobre el tema. Por tanto, realizar estudios de imagen ante síntomas neurológicos inespecíficos es de gran importancia para lograr un diagnóstico oportuno e instaurar el tratamiento adecuado, evitando así desenlaces adversos.

Introducción. Las estadísticas mundiales demuestran que las quemaduras ocurren principalmente en mujeres y niños, siendo estos últimos más propensos por su curiosidad ya que esta favorece la exposición a diversos riesgos de quemadura. Objetivo. Identificar las características epidemiológicas, clínicas y de manejo de rehabilitación en niños quemados atendidos en una unidad de quemados de un hospital de alta complejidad de Medellín, Colombia. Métodos. Estudio descriptivo retrospectivo realizado en 710 pacientes quemados menores de 14 años que recibieron manejo hospitalario en el Hospital Infantil de San Vicente Fundación Medellín entre 2018 y 2020. Se registraron datos sobre: edad, sexo, causa de la quemadura, extensión de la quemadura, tiempo de estancia hospitalaria, cirugías, ortesis, presoterapia, funcionalidad, entre otras. Resultados. El 58,6% de los participantes eran de sexo masculino y las medianas de edad, superficie corporal comprometida y estancia hospitalaria fueron de 24 meses, 6% y 12 días, respectivamente. La principal causa de quemadura fue por líquidos calientes (73,2%). 70,7% de los participantes presentaron quemaduras de segundo grado profundo. En 89,4% las quemaduras se presentaron en áreas especiales: en 32,8%, en la cara, y en 7,3%, en los genitales. Asimismo, 2% requirieron manejo en la unidad de cuidados intensivos, 23,1% necesitaron cirugía, 95,4% fueron tratados por fisioterapia y 93,4% recibieron atención por medicina física y rehabilitación. Además, 86,9% requirieron presoterapia y 11,5%, ortesis. 95,3% mejoraron en el posicionamiento, 95,6% mostraron mejoría en los conocimientos de los pacientes y cuidadores, en 94,9% mejoro la funcionalidad y en 18% mejoró la independencia. Conclusiones. Las quemaduras en población pediátrica requieren un manejo integral y multidisciplinario que incluya la rehabilitación como parte de la primera línea de atención y otras especialidades que permitan la atención integral del paciente para prevenir compromisos funcionales y favorecer el reintegro social.

El auge de las nuevas tecnologías de la información y las comunicaciones ha impactado significativamente en todas las esferas de la vida del ser humano. La educación no es ajena a estas transformaciones digitales. Los recursos educativos digitales son herramientas que le permiten al docente y al estudiante interactuar con los contenidos de una forma amena y sencilla. Estos recursos son de uso extendido en las diversas enseñanzas. En la formación de los residentes de pediatría del Hospital Docente José Luis Miranda no se hace un uso efectivo y extensivo de los recursos educativos digitales. Existe resistencia al uso de estos por parte de los profesores y cierto desconocimiento por parte de los estudiantes. Partiendo de estas premisas se realiza un análisis del uso de Recursos Educativos Digitales en dicha institución como apoyo a la formación de las nuevas generaciones de pediatras. Para realizar este análisis se realizaron entrevistas, encuestas, observación y consulta a especialistas. Los resultados obtenidos permitieron determinar la necesidad de crear una estrategia para la creación de Recursos Educativos Digitales que apoyen la formación de los residentes de pediatría.

Introdução: Este artigo descreve as características de crianças com tuberculose (TB) do sistema nervoso central (SNC), uma forma grave de TB extrapulmonar. Método: Estudo observacional e descritivo de 11 casos diagnosticados em um hospital de referência no sul do Brasil. Resultados: A faixa etária mais acometida no estudo foi de 0 a 2 anos sendo a maioria do sexo masculino e de áreas urbanas. Os sintomas mais comuns relatados foram febre persistente e vômitos. Os exames complementares mais utilizados foram tomografia computadorizada crânio com o achado frequente de hidrocefalia comunicante e análise do líquor achados de pleocitose, hipoglicorraquia e hiperproteinorraquia. As bacterioscopias e culturas foram negativas. Discussão e Conclusão: O diagnóstico rápido e preciso é um desafio devido aos sintomas inespecíficos que mimetizam doenças de menor gravidade, sendo o método Xpert MTB/RIF eficaz para diagnóstico dentre os métodos moleculares. O tratamento requer o uso de tuberculostáticos e corticoterapia associada. A vacina BCG tem efeito protetor contra a TB de SNC, sendo necessário o fortalecimento do SUS para manutenção e melhoria dos programas de vacinação.

Las enfermedades quísticas renales son condiciones frecuentes cuya etiología puede ser muy heterogénea, por lo que se requiere un adecuado abordaje para su diagnóstico y manejo. El objetivo de este trabajo fue ilustrar parte del espectro de la enfermedad renal quística por medio de casos clínicos manejados en la Fundación Valle del Lili. Se describen 11 casos clínicos que incluyen enfermedades como displasia multiquística renal, enfermedad poliquística renal autosómica dominante y autosómica recesiva, entre otras. Las enfermedades quísticas renales varían en su presentación clínica, historia natural, hallazgos imagenológicos, bases genéticas y fisiopatológicas, por consiguiente, el enfoque diagnóstico y el manejo integral se debe realizar de forma individualizada y con un abordaje multidisciplinario.

Introduction and objectives: In recent years, there has been an increase in the number of children with tracheostomies. The objective was to describe the characteristics of paediatric patients with a tracheostomy followed up by the Department of Palliative Care and Chronic Medically Complex Illness (DPCCMCI) of a tertiary care hospital. Methods: Single-centre retrospective observational study in patients aged less than 18 years with a tracheostomy followed up by the PCCCPS of a tertiary care hospital (November 2020-June 2022). We analysed epidemiological, clinical, microbiological and social data by reviewing the health records. Results: The sample included 44 tracheostomized patients. The most frequent underlying disease was acquired upper airway disease (20.5%). The most common indication for tracheostomy was upper airway obstruction (66%). Bacterial isolates were detected in 84% of the tracheal aspirates, among which P. aeruginosa was the most frequent (56.8%). The most frequently prescribed antibiotic was ciprofloxacin (84%). In addition, 18.1% of the patients received at least 1 course of intravenous antibiotherapy and 29.5% received more than 3 systemic antibiotic regimens in the past 20 months. Fifty-nine percent of the children were schooled: 38.6% attended a regular school, 15.9% a special needs school and 4.5% were home-schooled. We identified social difficulties in 53.7%. Also, 22.7% of the families received financial support to care for a child with severe illness. Conclusions: Because of the complexity of caring for tracheostomized children, integral and coordinated management is essential. Schooling is possible and safe if caregivers are trained. Resumen: Introducción y objetivos: En los últimos años se ha objetivado un incremento de niños portadores de traqueostomía. El objetivo del estudio es describir las características de los pacientes pediátricos traqueostomizados en seguimiento por el SAPPCC de un hospital de tercer nivel. Métodos: Estudio unicéntrico, observacional y retrospectivo que incluyó pacientes ≤18 años portadores de traqueostomía atendidos por el SAPPCC de un hospital de tercer nivel (noviembre 2020-junio 2022). Se analizaron datos epidemiológicos, clínicos, microbiológicos y sociales mediante la revisión de la historia clínica. Resultados: Se incluyeron 44 pacientes traqueostomizados. La patología de base más frecuente fue la patología de vía aérea superior adquirida (20,5%), siendo la obstrucción de vía aérea superior (66%) la indicación más frecuente de traqueostomía. El 84% presentaron aislamientos bacterianos en aspirado traqueal y P.aeruginosa (56,8%) fue el microorganismo más frecuentemente aislado. El antibiótico sistémico más prescrito fue el ciprofloxacino (84%). Un 18,1% de los pacientes recibió como mínimo una tanda de antibioterapia endovenosa y un 29,5% recibieron más de 3 pautas de antibiótico sistémico en los últimos 20 meses. Un 59% de los niños estaban escolarizados: 38,6% en escuela ordinaria, 15,9% en escuela de educación especial y 4,5% en domicilio. Se identificó familia en crisis en el 53,7% de los pacientes y un 22,7% de las familias disponían de la prestación por Cuidado de Menores con Enfermedad Grave. Conclusiones: Dada la complejidad de los niños traqueostomizados, es fundamental un manejo intergral y coordinado. La escolarización es posible y segura si se capacita a sus cuidadores/enfermeras escolares.