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El objetivo fue examinar, desde una aproximación multi-informante, las medidas del Síndrome de Desconexión Cognitiva (SDC) de padres/madres e hijos/as y su relación con síntomas internalizantes y externalizantes. 279 niños/as (9-13 años), y sus padres/madres completaron las evaluaciones sobre SDC, la inatención del trastorno por déficit de atención e hiperactividad (TDAH) y otras medidas internalizadas y externalizadas. Los ítems de las tres medidas de SDC convergieron razonablemente bien en el factor SDC. Se aportaron pruebas discriminantes de la validez de las relaciones entre las puntuaciones de las pruebas y las medidas de los tres constructos diferentes (SDC, soledad y preferencia por la soledad). La asociación más estrecha estuvo entre la evaluación parental de las medidas de SDC con ansiedad y depresión, y entre inatención con hiperactividad/impulsividad y trastorno negativista desafiante. Se observó capacidad predictiva de la medida de SDC sobre la soledad y preferencia por estar solo autoinformadas. Se encontró una posible asociación entre la medida del SDC evaluado por padres/madres y sexo y edad de los niños. En conclusión, los datos apoyan la inclusión de medidas autoinformadas en la evaluación del SDC. Las medidas del SDC en niños se vinculan con medidas internalizantes y, la inatención con las externalizantes.(AU)

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Rectal swabs (122) from pediatric patients were analyzed by polymerase chain reaction (PCR) for the detection of EPEC and STEC. STEC isolates were tested for the presence of stx1, stx2, eae, saa and ehxA. All eae-positive samples were tested for the presence of bfpA, and antigen O was determined using the agglutination test. Int1 and Int2 were detected to identify the presence of integrons class 1 and 2, respectively. Escherichia coli was detected in 68% of the samples, of which 18.8% were STEC (2.45%) and EPEC (16.3%). Serogroups STEC O145 and EPEC O130, O113 and O157 were observed, while three strains were non-typable. None of the EPEC strains carrying tbfpA and class 1 and 2 integrons was detected in any of the samples. The results obtained are important considering the virulence profiles found in the isolated EPEC and STEC strains and the serogroups associated with disease in humans.

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BACKGROUND: Parental stress experienced in the context of caring for children with autism spectrum disorder (ASD) in preschool is significant and has been poorly studied; studies tend to focus on more advanced ages of children where parental symptomatology has become chronic. The current study sought to provide new empirical evidence on factors associated with parental stress. METHODS: An exhaustive search was conducted in four academic databases: CINAHL Complete, Medline Complete, Web of Science (WoS), and Scopus, limiting the articles to those published between 2017 and 2023. RESULTS: The sample obtained consisted of 24 selected articles, which were produced in 11 countries, and all were in English. In terms of content, the topics addressed were the manifestation of parental stress, factors of the child with ASD and their relationship with parental stress, factors of parents of children with ASD, family factors of parents of children with ASD, social factors of parents of children with ASD, parental stress and access to formal care services, and parental stress and specialized interventions. CONCLUSIONS: It is possible to affirm that research reports indicate that the general level of stress among parents of children with ASD is compared to their reference groups, both in relation to child-related stress and other stressors. The variables that affect parental stress exhibit a reciprocal influence among them, so interventions aimed at early childhood should incorporate both the children and their parental figures. This is in consideration of the impact that stress has on the mental health of parents, establishing that parents with better health have early access to support services during the early years of parenting, as well as in later years.

INTRODUCCIÓN: El estrés parental vivenciado en el contexto de cuidado de los niños con trastorno del espectro autistas en etapa preescolar es significativo y ha sido muy poco estudiado, las investigaciones tienden a focalizarse en edades de los niños más avanzada donde la sintomatología de los padres se ha cronificado. El objetivo de la presente investigación fue actualizar el corpus de evidencia empírica referida a los factores relacionados con el Estrés parental. MÉTODOS: Se realizó una búsqueda exhaustiva en cuatro bases de datos académicas: CINAHL Complete, Medline Complete, Web of Science (WoS) y Scopus, limitando los artículos publicados entre los años 2017 y 2023. RESULTADOS: La muestra obtenida fue de 24 artículos seleccionados, los cuales fueron producidos por 11 países todos de habla inglesa. En cuanto al contenido, los temas abordados son: La manifestación del estrés parental, factores del niño con TEA y su relación con el estrés parental, factores de los padres de los niños con TEA, factores familiares de los padres de los niños con TEA, factores sociales de los padres de los niños con TEA, estrés parental y acceso a los servicios formales de atención, y estrés parental e intervenciones especializadas. CONCLUSIONES: Es posible afirmar que las investigaciones reportan que el nivel general de estrés de los padres de niños con TEA es superior al de sus grupos de referencia, tanto en relación al estrés relacionado con el niño, como el que no. Las variables que afectan el estrés parental presentan una influencia recíproca entre éstas, por lo que las intervenciones dirigidas a la primera infancia deberían incorporar a los niños y a sus figuras parentales. Esto, en atención al impacto que el estrés presenta en la salud mental de los padres, estableciendo que los padres con mejor salud mental presentan mayor acceso temprano a los servicios de apoyo durante los primeros años de crianza, y en los años posteriores.

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Objetivo: La gingivitis espongiótica es una patología benigna poco común y una entidad clínica patológica poco frecuente que los odontólogos pueden observar durante la atención odontológica. Es importante conocer la misma para poder diagnosticarla adecuadamente, describir sus características clínicas y elaborar un plan para su tratamiento. El objetivo de este artículo es presentar un caso clínico de esta patología poco conocida, describir sus características y su manejo clínico. Caso clínico: Un niño de 7 años que ingresó derivado por su odontólogo a la cátedra de Estomatología de la Facultad de Odontología de la Universidad Nacional de Córdoba, Argentina, presentaba en la encía libre e insertada del maxilar superior una lesión con ausencia de sintomatología y evolución crónica, benigna y con cambios estéticos notorios. Se deriva a la cátedra de Periodoncia para realizar un tratamiento interdisciplinario. Tuvo una respuesta favorable al tratamiento de la lesión, y se realizó un seguimiento periódico de la misma evitando la técnica quirúrgica convencional para su tratamiento.(AU)

Aim: Spongiotic gingivitis is a rare benign pathology and a rare clinical pathological entity that dentists can observe during dental care. It is important to know it to be able to properly diagnose it, describe its clinical characteristics and develop a plan for its treatment. The aim of this article is to present a clinical case of this little-known pathology and describe its characteristics as well as its clinical management. Clinical case: A 7-yeard-old child who was referred by his dentist to the Department of Stomatology of the Faculty of Dentistry of the National University of Córdoba, Argentina, presented a lesion in the free and inserted gingiva of the upper jaw, with absence of symptoms and chronic, benign evolution with notable aesthetic changes. He is referred to the Periodontics department to perform interdisciplinary treatment. He had a favorable response to the treatment of the lesion, and a periodic follow-up was carried out, avoiding the conventional surgical technique for its treatment.(AU)

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Objetivo: Determinar la prevalencia de las anomalías dentomaxilares (ADM) y necesidad de tratamiento de ortodoncia en escolares de 6 años en cinco comunas en Chile. Material y método: Estudio de corte transversal, observacional y descriptivo. La muestra fue de 1102 escolares. Se realizaron exámenes clínicos aplicando la Guía de Referencia Clínica a Ortodoncia para Servicios Públicos de Salud, para determinar la prevalencia de las ADM y necesidad de tratamiento de ortodoncia. El análisis estadístico utilizó el programa STATA®, considerando estadísticamente significativo p 0.05. Resultados: 1102 escolares de 6 años fueron examinados, 48,8% niñas y 51,2% niños. La prevalencia de niño/as con anomalías dentomaxilares fue 59.1%. Las tres más prevalentes fueron: apiñamiento dentario o rotaciones (21,6%), resalte aumentado (17,6%) y overbite aumentado (15,9%). La necesidad de tratamiento de ortodoncia encontrada fue de 34,7% con evidente necesidad y un 25,3% con leve necesidad. Conclusión: Se evidencia la necesidad de incluir en las políticas públicas de salud oral, estrategias de diagnóstico y tratamiento temprano de ADM por su alta prevalencia.

Objective: To determine the prevalence of dento-maxillary anomalies (DMA) and the orthodontic treatment need in 6-year-old schoolchildren in five areas of Chile. Material and method: Cross-sectional, observational and descriptive study. The sample consisted of 1102 6-year-old schoolchildren. Clinical examinations were carried out applying the Clinical Reference Guide for Orthodontics in Public Health Services, to determine the prevalence of DMA and the need for orthodontic treatment. Statistical analysis used the STATA® program, considering p ≤ 0.05 statistically significant. Results: 1102 6-year-old children were examined, 48.8% were girls and 51.2% boys. The prevalence of children with DMA was 59.1%. The three most prevalent were: dental crowding or rotations (21.6%), increased overjet (17.6%), and increased overbite (15.9%). The orthodontic treatment need was 34.7% of patients with great need and 25.3% with moderate need. Conclusion: The need to include early diagnosis and treatment strategies for DMA in public oral health policies is evident due to its high prevalence.

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La dislexia es un trastorno del aprendizaje que afecta la capacidad de los niños para leer, escribir y procesar información de manera adecuada, tradicionalmente se ha creído que en contexto escolar son los psicopedagogos los encargados de lidiar con este trastorno y tratar de mejorarlo. Sin embargo, se ha demostrado que las actividades físicas pueden, de forma consciente y organizada, contribuir de modo significativo a tratar esta condición. Es por ello que el objetivo de este trabajo fue proponer un sistema de actividades físico-deportivas para contribuir al tratamiento de la dislexia en alumnos de la escuela unidocente "Francisco de Orellana", en Paztaza, Ecuador. Para lograr este propósito, se utilizaron métodos empíricos tales como la observación, la encuesta, la entrevista, además de diferentes pruebas que se aplicaron para determinar la veracidad de la condición disléxica. Después de corroborar las dificultades encontradas en el diagnóstico y de las potencialidades consultadas en los referentes teóricos sobre el tema, se elaboró un sistema de actividades físico-deportivas que se incluyeron en las sesiones de trabajo del profesor de Educación Física y tuvieron el apoyo de los profesores, directivos y padres, así como un satisfactorio nivel de aceptación práctica, lo que influyó significativamente en el mejoramiento de las dificultades en el aprendizaje de estos alumnos y la relación con sus compañeros de clase.

A dislexia é um distúrbio de aprendizagem que afeta a capacidade das crianças de ler, escrever e processar informações de maneira adequada. Tradicionalmente, acredita-se que, no contexto escolar, os psicólogos educacionais são os responsáveis ​​​​por lidar com esse distúrbio e tentar melhorá-lo. Contudo, foi demonstrado que as atividades físicas podem, de forma consciente e organizada, contribuir significativamente para o tratamento desta condição. Por isso o objetivo deste trabalho foi propor um sistema de atividades físico-esportivas para contribuir no tratamento da dislexia em alunos da escola monoprofessora "Francisco de Orellana", em Paztaza, Equador. Para atingir este objetivo, foram utilizados métodos empíricos como observação, inquérito, entrevista, bem como diversos testes que foram aplicados para determinar a veracidade da condição disléxica. Após corroborar as dificuldades encontradas no diagnóstico e as potencialidades consultadas nos referenciais teóricos sobre o tema, foi desenvolvido um sistema de atividades físico-esportivas que foram incluídas nas sessões de trabalho do professor de Educação Física e contaram com o apoio dos professores, diretores e pais, bem como um nível satisfatório de aceitação prática, o que influenciou significativamente na melhora das dificuldades de aprendizagem desses alunos e no relacionamento com os colegas.

Dyslexia is a learning disorder that affects children's ability to read, write and process information appropriately. It has traditionally been believed that in the school context, educational psychologists are in charge of dealing with this disorder and trying to improve it. However, it has been shown that physical activities can, in a conscious and organized way, contribute significantly to treating this condition. That is why the objective of this work was to propose a system of physical-sports activities to contribute to the treatment of dyslexia in students of the "Francisco de Orellana" single-teacher school, in Paztaza, Ecuador. To achieve this purpose, empirical methods such as observation, survey, interview, as well as different tests that were applied to determine the veracity of the dyslexic condition were used. After corroborating the difficulties found in the diagnosis and the potential consulted in the theoretical references on the subject, a system of physical-sports activities was developed that were included in the work sessions of the Physical Education teacher and had the support of the teachers, directors and parents, as well as a satisfactory level of practical acceptance, which significantly influenced the improvement of these students' learning difficulties and their relationships with their classmates.

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Communimetric screening tools help clinicians identify and communicate their patient's areas of need and the corresponding level of action. However, few tools exist to identify mental health (MH) and developmental needs in young children. We aimed to implement and evaluate a new communimetric MH and developmental screening tool for children under 6 (HEADS-ED Under 6) in a community MH agency in Ontario, Canada. Using a prospective cohort design, we explored how intake workers used the HEADS-ED Under 6 screening tool from November 2019 to March 2021. 94.5% of children (n = 535/566) were screened with the HEADS-ED at intake. Total HEADS-ED scores and domains were used to inform the intensity of recommended services. Three clinical domains (Eating & sleeping, Development, speech/language/motor, and Emotions & behaviors) also independently predicted a priority recommendation. The tool showed good concordance with the InterRAI Early Years for children under 4 years old. The HEADS-ED Under 6 was a brief, easy, and valid screening tool, and can be used to identify important MH and developmental domains early, rate level of action/impairment, communicate severity of needs, and help determine intensity of service required.

Les outils de dépistage communimétrique aident les cliniciens à identifier et à communicer les besoins et le niveau d'action correspondant de leur patient. Cependant il existe peu d'outil pour identifier les besoins en Santé Mentale (SM en français) et les besoins développentaux chez les jeunes enfants. Nous nous sommes donné pour but d'appliquer et d'évaluer un nouveal outil communimétrique de SM et développemental pour les enfants de moins de 6 ans (HEADS­ED de moins de 6 ans) dans une agence communautaire de SM dans l'Ontario au Canada. En utilisant une conception de cohorte prospective nous avons exploré la manière dont les préposés à l'accueil ont utilisé le HEADS­ED de moins de six ans de novembre 219 à mars 2021. 94,5% des enfants (n = 535­566) ont été dépister avec le HEADS­ED à l'accueil. Tous les scores et domaines HEADS­ED ont été utilisé pour éclairer l'intensité des services recommandés. Trois domaines cliniques (Manger et dormir, Développement/parole/langage/moteur, et les Emotions, comportements ont aussi prédit une recommandation de priorité indépendamment. L'outil a fait preuve d'une bonne concordance avec le InterRAI Early Years pour les enfants de moins de 4 ans. Le HEADS­ED de moins de 6 ans s'est avéré être un outil de dépistage valide, bref et facile, et peut être utiliser pour identifier des domaines de SM et des domaines du développement importants tôt, d'évaluer un niveau d'action/de dépréciation, de communiquer la sévérité de besoins, et aider à déterminer l'intensité des services requis. Kommunimetrische Screening­Instrumente helfen klinisch Tätigen dabei, die Bedürfnisse ihrer Patienten zu erkennen, zu kommunizieren und die entsprechenden Maßnahmen zu ergreifen. Es gibt jedoch nur wenige Instrumente welche die Bedürfnisse von Kleinkindern hinsichtlich ihrer psychischen Gesundheit und Entwicklung ermitteln. Unser Ziel war es, ein neues kommunimetrisches Screening­Instrument für die psychische Gesundheit und Entwicklung von Kindern unter 6 Jahren (HEADS­ED unter 6 Jahren) in einer kommunalen Einrichtung der psychischen Gesundheitsversorgung in Ontario, Kanada, einzuführen und zu evaluieren. In einer prospektiven Kohortenstudie untersuchten wir von November 2019 bis März 2021 wie die Mitarbeitenden der Einrichtung bei Aufnahmen das HEADS­ED­Screening­Tool für Kinder unter 6 Jahren einsetzten. 94,5 % der Kinder (n = 535/566) wurden bei Aufnahme mit dem HEADS­ED gescreent. Die HEADS­ED­Gesamtergebnisse und ­Domänen wurden verwendet, um die Intensität der empfohlenen Gesundheitsleistungen zu bestimmen. Ebenfalls sagten drei klinische Domänen (Essen und Schlafen, Entwicklung/Sprechen/Sprache/Motorik und Emotionen/Verhaltensweisen) unabhängig voneinander eine prioritäre Empfehlung voraus. Das Instrument zeigte eine gute Übereinstimmung mit dem InterRAI Early Years für Kinder unter 4 Jahren. Das HEADS­ED für Kinder unter 6 Jahren erwies sich als ein kurzes, einfaches und valides Screening­Instrument, das eingesetzt werden kann, um frühzeitig wichtige Bereiche psychischer Gesundheit und Entwicklung zu identifizieren, das Ausmaß von Interventionen/Beeinträchtigungen einzuschätzen, die Stärke dahingehender Bedürfnisse mitzuteilen und die notwendige Intensität von Gesundheitsleistungen zu bestimmen. コミュニメトリックスクリーニングツールは、臨床医が患者の必要な領域とそれに対応する行動レベルを特定し、伝えるのに役立つ。しかし、幼児のメンタルヘルス(MH)と発達のニーズを特定するツールはほとんど存在しない。本研究は、カナダ・オンタリオ州の地域MH機関において、6歳未満児を対象とした新しいコミュニメトリックMHおよび発達スクリーニングツール(HEADS­ED under 6)の導入および評価を目的とした。前向きコホートデザインを用いて、2019å¹´11月から2021å¹´3月に、インテイク担当者が6歳未満児スクリーニングツールHEADS­EDをどのように使用したかを調査した。94.5％の子ども(n = 535/566)がインテーク時にHEADS­EDでスクリーニングを受けた。HEADS­EDの総スコアと領域は、推奨されるサービスの程度を知るために使用された。また、3つの臨床領域(食欲と睡眠、発達・発語・言語・運動、感情/行動)が、個別の優先順位を予測した。このツールは、4歳未満児を対象とするInterRAI Early Yearsと良好な一致を示した。HEADS­ED Under 6は、簡潔で、簡単で、有効なスクリーニングツールであり、早期に重要な精神保健および発達領域を特定し、活動/障害のレベルを評価し、ニーズの重症度を伝え、必要なサービスの強度を決定するために使用することができる。.

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The management of urinary tract infection (UTI) in infants and children has changed significantly over the past few decades based on scientific evidence that questioned the efficacy of strategies used to prevent kidney injury and subsequent progression to chronic kidney disease, which is very unlikely in most paediatric cases. However, there is still substantial heterogeneity in its management and uncertainty regarding the diagnosis, indication of imaging tests, treatment or follow-up in these patients. The Spanish clinical practice guideline has been updated through the review of the literature published since 2009 and a rigorous evaluation of current clinical practice aspects, taking into account the evidence on the benefits of each intervention in addition to its risks and drawbacks to attempt to provide more precise recommendations.

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INTRODUCTION AND OBJECTIVES: Selective serotonin reuptake inhibitors (SSRIs) are medications used in child and adolescent psychiatry mainly for the treatment of depression, anxiety and obsessive compulsive disorder. In general, these medications are safe and well tolerated. However, they can cause adverse effects such as activation syndrome, which if not identified can negatively affect adherence and response to treatment. Activation syndrome has received little attention and can be difficult to recognise due to the lack of a clear definition and objective diagnostic measures, and also because it can be confused with a worsening of the psychiatric disorder or mania triggered by the antidepressants. For all the above, it is important that professionals who prescribe antidepressants in the paediatric population are able to identify and manage activation syndrome when it occurs. Our aim was to carry out a narrative review of activation syndrome in children and adolescents treated with SSRIs in terms of definition, prevalence, pathophysiology, associated factors, relationship with suicide risk, management strategies and recommendations for reducing the risk of suicidal behaviours when using antidepressants in this population. METHODS: We performed a non-systematic narrative review of activation syndrome in children and adolescents which involved finding information in PubMed, Ovid, EBSCO, ProQuest and Embase. Review articles, prospective and retrospective investigations, systematic reviews, meta-analyses and other articles related to activation syndrome in children and adolescents were selected. The search was limited to studies published in English and Spanish that involved children and adolescents and no limits were applied to the publication date or study design. RESULTS: A total of 62 articles were included, 61 of them in English. The results were grouped into the following topics: definition; prevalence; pathophysiology; associated factors; relationship with suicide risk; management strategies; and recommendations for reducing the risk of suicidal behaviours when using antidepressants in this population. Activation syndrome refers to a set of symptoms consisting of impulsiveness, restlessness, increased activity, insomnia, irritability, disinhibition and agitation. This syndrome is poorly characterised in terms of its definition, prevalence, risk factors and pathophysiology, a situation that limits its recognition and evaluation. There are many factors that predispose the development of the syndrome such as age, differences in brain development in the paediatric population, the characteristics of the patient or the antidepressant, disorders of neurological development, and the doses and plasma levels of the medications. It has been thought that activation syndrome may be related to suicidal tendencies. However, the evidence in support of this link is inconsistent and further studies are therefore necessary. CONCLUSIONS: Activation syndrome with SSRI is a particularly important adverse effect in children and adolescents and, when it occurs, can cause lack of adherence to or discontinuation of treatment. Strict vigilance is therefore recommended during the use of these medications.

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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.

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PURPOSE: To provide data on the most frequent causes, main characteristics, management, and outcomes of pediatric choroidal neovascularization (CNV) in a major tertiary referral hospital for children, together with a review of the current literature. METHODS: Case series including children diagnosed with CNV between 2008 and 2023. Age, sex, date of diagnosis, CNV etiology, CNV localization, treatment with anti-vascular endothelial growth factor (VEGF), and ophthalmological examination data at diagnosis and after one year of follow-up were recorded. RESULTS: 42 eyes (31 patients) were included. Best's disease (35.5%) was the most frequent etiology, followed by intraocular inflammation (25.8%). Most neovascular membranes (78.6%) were located within 1 disc diameter of the fovea centre. 78.6% of eyes received anti-VEGF treatment. Mean visual acuity (VA) significantly improved from logMAR 0.57 to 0.31 after one year of follow-up. CONCLUSION: CNV in children is a serious condition with severe ophthalmological consequences. Although certain patients may spontaneously improve or maintain good VA without treatment, in many others anti-VEGF treatment may lead to significant visual improvement. VA impairment, signs of exudative CNV on OCT images and the location of CNV seem to be the most important features in the decision to treat or not to treat these patients.

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Background: During the post-World War II occupation of Austria, approximately 20,000-30,000 'children born of war' (CBOW), also called occupation children were born through intimate contacts between Austrian women and occupation soldiers. Research on other CBOW populations indicates that CBOW mostly grow up under difficult conditions, sometimes with strong long-term mental health consequences.Objective: To examine whether comparable psychosocial consequences can be found in Austrian occupation children (AOC), a first quantitative study was carried out.Method: Child maltreatment, post-traumatic stress disorder, depression and somatization, and general life satisfaction were assessed in a sample of 98 AOC using self-report instruments. Results were compared to a sample of German occupation children (GOC; N = 146).Results: High prevalence of above threshold full (10.2%) and partial (14.3%) PTSD, somatic (16.3%) and depressive (11.1%) symptomatology were found in AOC. They were at high risk of child maltreatment (e.g. emotional abuse: 53.6%), which was associated with current symptomatology. Notably, AOC tended to report high levels of general life satisfaction. No differences were found between GOC and AOC.Conclusions: Findings highlight the complex and long-term effects of developmental conditions and childhood maltreatment on mental health of CBOW, even decades later. Findings of high life satisfaction provide evidence of resilience and maturation processes across the lifespan.

Austrian occupation children show a notable vulnerability to childhood maltreatment and its long-term consequences, including a high prevalence of above threshold PTSD, somatic, and depressive symptomatology.Findings on the psychosocial consequences of growing up as occupation children in Austria after World War II are consistent with previous studies in similar populations and can be generalized as more or less typical common experiences of children born of war.Despite psychological distress, occupation children showed surprising levels of life satisfaction, suggesting potential resilience.

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Background: International research has established that children and adolescents are at high risk for being exposed to violence. A systematic review published in 2023 recommended six child and adolescent self-report violence against children (VAC) measures, based on their psychometric properties, in a systematic COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) review. However, the degree of overlap and heterogeneity was not part of the analysis.Objective: To compare the six measures with respect to item overlap and differences concerning specification of exposure dimensions.Method: A content analysis of the original 174 items resulted in a reduction to 38 unique items. These items were organized visually in a co-occurrence circle using an adapted version of Fried's R code. Furthermore, a pairwise comparison of event lists was performed using the Jaccard index.Results: There was a modest overlap among the six measures. Only one item was present in all six measures, only two items were present in four measures, and 78% of the items were present in just one or two measures. The overall overlap between the six measures was 25%.Conclusions: The lack of overlap among measures reflects a heterogeneity of definitions and purposes. It also impedes progress in research, as comparisons between various studies are difficult to make in a valid and reliable way. The lack of consensus also delays efficient political initiatives, because solid, consensual knowledge about the prevalence of VAC does not exist.

Violence against children (VAC) is a high political and professional priority. A recent systematic review recommended six self-report measures based on their psychometric qualities.The VAC items were very diverse. A content analysis reduced the original 174 items to 38 unique items. A Jaccard index showed an overlap of 25%.The lack of consensus in definitions and applied measures impedes progress in research and delays important political, prophylactic initiatives.

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Objective. To analyze the duties of wet nurses at the Hospital Real in Santiago de Compostela (Spain). The secondary objectives were to compare the mortality rate and distribution by parish of the foundlings under the care of the Royal House between 1803 and 1808; and to determine the origin of the Galician foundlings who participated in the Royal Philanthropic Expedition of the Smallpox Vaccine in 1803. Methods. Historiographic study that analyzed sorted and not sorted in series indirect positional and quantitative historical sources.Results. The duties of wet nurses during the studied period were to provide basic care and cultural instruction. The mortality rate of foundlings fluctuated during that period and their distribution by parish (functional unit of healthcare services at that time) was similar in those years, with a predominance in the provinces of A Coruña and Pontevedra. A total of 5 Galician foundlings from the House analyzed were part of the smallpox vaccine expedition, their names were Juan Antonio, Jacinto, Gerónimo María, Francisco Florencio and Juan Francisco. Conclusion. During the observed period the wet nurses of the Hospital Real of Santiago de Compostela were in charge of pediatric care. Wet nurses were vital in the role of keeping the foundlings alive and can be considered as one of the forerunners of the pediatric nurse profession at that time.

Objetivo. analizar las funciones que realizaban las amas de leche en el Hospital Real de Santiago de Compostela (España). Los objetivos secundarios han sido: comparar la mortalidad y distribución por parroquias de los niños expósitos a cargo de la Real Casa entre 1803 y 1808, determinar la procedencia de los niños expósitos gallegos que participaron en la Real Expedición Filantrópica de la Vacuna de la viruela en 1803. Métodos. Estudio historiográfico que analizó fuentes históricas posicionales indirectas y cuantitativas seriadas y no seriadas. Resultados. las funciones de las nodrizas durante el período de estudio eran proporcionar los cuidados básicos e instrucción cultural; la mortalidad de los expósitos sufrió oscilaciones a lo largo del período analizado. La distribución por parroquias (unidad funcional de las áreas de salud en la época) fue similar en estos años, con predominancia de las provincias de A Coruña y Pontevedra. Un total de 5 niños expósitos gallegos de la Casa analizada han participado en la expedición filantrópica de la viruela, sus nombres fueron: Juan Antonio, Jacinto, Gerónimo María, Francisco Florencio y Juan Francisco. Conclusión. Durante el período de observación, las amas de leche del Hospital Real de Santiago de Compostela realizaban cuidados pediátricos. Las nodrizas cumplieron un rol fundamental para el mantenimiento con vida de los niños expósitos y pueden ser consideradas como una de las figuras precursoras de la profesión enfermera pediátrica en la época.

Objetivo. Analisar as funções desempenhadas pelas nutrizes no Hospital Real de Santiago de Compostela (Espanha). Os objetivos secundários foram: comparar a mortalidade e distribuição por freguesia dos enjeitados responsáveis pela Casa Real entre 1803 e 1808, determinar a origem dos enjeitados galegos que participaram na Real Expedição Filantrópica da Vacina contra a Varíola em 1803. Métodos. Estudo historiográfico que analisou fontes históricas posicionais indiretas e quantitativas seriadas e não seriadas. Resultados. As funções das amas de leite durante o período do estudo eram fornecer cuidados básicos e instrução cultural; A mortalidade dos enjeitados oscilou ao longo do período analisado. A distribuição por freguesias (unidade funcional das áreas de saúde da época) foi semelhante nestes anos, com predominância das províncias da Corunha e Pontevedra. Na expedição filantrópica contra a varíola participaram um total de 5 crianças galegas da Casa analisada, os seus nomes eram: Juan Antônio, Jacinto, Gerônimo María, Francisco Florencio e Juan Francisco. Conclusão. Durante o período de observação, as nutrizes do Hospital Real de Santiago de Compostela prestaram cuidados pediátricos. As amas de leite desempenharam um papel fundamental na manutenção da vida dos enjeitados e podem ser consideradas uma das figuras precursoras da profissão de enfermagem pediátrica da época.

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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.

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Background: The implementation trial BESTFORCAN aims to evaluate the dissemination of Trauma-Focused Behavioural Therapy (TF-CBT) for children and adolescents in Germany with posttraumatic stress symptoms (PTSS) after child abuse and neglect (CAN) with a focus on supervision.Objective: This update to the study protocol outlines changes made due to practical reasons in the course of the ongoing trial while maintaining methodological quality.Method: The amendments to the original study protocol comprise (1) a more refined operationalisation of the primary outcome sufficiently adherent TF-CBT therapy (SATT), (2) changes in the study sites and (3) additional inclusion of one post-gradual psychotherapy training institute.Discussion: The adaptions to the original study protocol ensured high methodological quality through the transparent presentation of protocol modification: ensuring the recruitment of participating psychotherapists in training by including a further post-gradual training institute as well as an adaption of the measurement of SATT with high external validity. The objectives, diagnostic set, and secondary outcomes remained unimpaired by the amendment. Therefore, we expect the trial to provide evidence for the effect of model-specific trauma-focused supervision on the implementation outcomes of TF-CBT as compared to supervision as usual.Trial registration: German Clinical Trials Register identifier: DRKS00020516..

Update to the study protocol of the trial BESTFORCAN that investigates the implementation of trauma-focused behavioural therapy for children and adolescents with posttraumatic stress symptoms following abuse with a focus on the role of supervision.Adaptions have been made regarding the specification of the definition of sufficiently adherent intervention, relocation of the data-handling centre and the recruitment of one additional psychotherapy institute.The adaptions have no impact on the objectives, diagnostic set, secondary outcomes, or processes of data handling.

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Atopic dermatitis (AD) is a chronic, inflammatory skin disease affecting all age groups, particularly children. This systematic review provides an overview of the humanistic and economic disease burden in the pediatric population with AD in Spain. The evidence, collected from 11 observational studies published over the past 10 years, exhibits the most common characteristics of the patients, disease burden, patient-reported outcomes, use of resources, and treatment patterns. The burden of AD extends beyond physical symptoms, with associated comorbidities such as asthma and impaired health-related quality of life and mental health disorders, particularly in severe cases. Traditional therapies, primarily topical corticosteroids, face adherence and efficacy challenges. Despite promising innovative treatments and available biological therapies, their use is still limited in the pediatric population. The findings of the present review highlight the scarce scientific evidence on the economic burden of pediatric AD, as well as the most updated humanistic evidence on this disease. At the same time, the need for individualized care and innovative therapeutic interventions to address the multifaceted challenges of pediatric AD in Spain is evident.

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Las fracturas con hundimiento de cráneo sin una explicación clara sobre su origen orientan al traumatismo con un objeto romo y a la sospecha de maltrato infantil. En el caso de los bebés recién nacidos, su corta edad es un factor de vulnerabilidad y obliga a una exhaustiva evaluación. Ante la sospecha de maltrato infantil, resulta importante evaluar los diagnósticos diferenciales para realizar la intervención más adecuada posible. Es necesario evitar tanto intervenciones excesivas como omitir la intervención que sea necesaria. Las fracturas craneales deprimidas congénitas, descritas como "fracturas pingpong", son raras (0,3 a 2/10 000 partos). Pueden aparecer sin antecedentes traumáticos o en partos instrumentalizados. Se describe en este artículo el caso de un recién nacido con una fractura ping-pong como ejemplo de una fractura no intencional.

Depressed skull fractures without a clear explanation as to their origin point to trauma with a blunt object and suspected child abuse. In the case of newborn infants, their young age is a vulnerability factor and requires an exhaustive assessment. When child abuse is suspected, an assessment of the differential diagnoses is required to make the most appropriate intervention possible. Both an excessive intervention and an omission of a necessary intervention should be avoided. Congenital depressed skull fractures, described as "ping-pong fractures", are rare (0.3 to 2/10 000 births). They may appear without any trauma history or in instrumentalized childbirth. Here we describe the case of a newborn infant with a ping-pong fracture as an example of an accidental fracture.

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Introducción: La violencia intrafamiliar es uno de los problemas de salud más frecuentes en la actualidad, no siempre se denuncia, ya que el miedo prevalece en las personas agredi- das. Objetivo: Describir los efectos de la violencia intrafamiliar en edades pediátricas. Método: Se realizó un estudio descriptivo, retrospectivo en el Hospital Provincial Hermanos Cordové, durante los meses de enero 2021 a enero 2022. La población fue de 213 expedientes aplicando muestreo intencional, se seleccionaron 91 expedientes de pacientes que asistieron en el período indicado; siendo motivo de consulta que su condición fuese causada o consecuencia de la violencia intrafamiliar. Las variables medidas: edad, sexo, tipo de violencia contra el infante y las consecuencias. Se aplicó estadística descriptiva para en análisis de los datos. Resultados: En 47.2% (43) predominó la violencia física, 67% (61) era del sexo femenino, y 51.7% (47) pertenecía al grupo etario de 15-19 años. Las consecuencias encontradas fueron: la difi- cultad para conciliar el sueño y los trastornos de alimentación en pacientes preescolares (1-4 años) 7.7% (7), la agresividad 16.4% (15) para el grupo de escolares (5-14), la inapetencia y anorexia en los adolescentes (15-19) 23.0%(21). Discusión: Los pacientes afectados por violencia pueden presentar agresividad, dificultad para socializar y expresarse, así como manifestar dificultad en el aprendizaje producto de los daños en el desarrollo motor, psíquico e intelectual. Se ve reducida la autoestima en el afectado y proble- mas en la alimentación o el sueño...(AU)

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Abstract Background: HIV-infected children have a higher risk of presenting infections, including the hepatitis A virus (HAV). The inactivated HAV vaccine is immunogenic in immunocompetent hosts; however, there are insufficient studies on the duration of seroprotection in HIV-infected children. Methods: An analytical cohort study was conducted. HIV-1-infected children who received the inactivated HAV vaccine (2 doses) were included. Blood samples were taken for antibody measurement, the first one 28 days after the second dose and another 7 years after the vaccination schedule. Information on viral load, immunological category, weight, height, and response to antiretroviral treatment from diagnosis to the last assessment was obtained. Results: 19 patients were included, with a mean age of 12.6 years (SD ± 2.29). 58% were male. 80% of the patients presented protective immunoglobulin G antibodies against HAV 7-year post-vaccination. The antibody concentration was found to be between 13 and 80 mIU/mL (median of 80 mIU/mL). 52% showed some degree of immunosuppression. There was no statistically significant relationship between the presence of seroprotection and viral load, treatment failure, immunological category, and malnutrition. Twelve patients presented with antiretroviral treatment failure, and in 33% of them, the antibodies did not offer satisfactory seroprotection. Conclusion: 7-year post-vaccination, 80% of HIV-infected children maintain seroprotection titers against HAV.

Resumen Introducción: Los niños infectados por el virus de la inmunodeficiencia humana (VIH) tienen mayor riesgo de presentar infecciones, incluyendo hepatitis por virus A (VHA). La vacuna inactivada contra el VHA es inmunógena en el huésped inmunocompetente. No hay estudios suficientes sobre el tiempo de seroprotección en niños infectados por el VIH. Método: Estudio de cohorte, analítico. Se incluyeron niños con infección por VIH-1 que recibieron la vacuna inactivada contra el VHA (dos dosis). Se les tomaron muestras sanguíneas para medición de anticuerpos, una 28 días después de la segunda dosis y otra 7 años después del esquema de vacunación. Se obtuvo información de carga viral, categoría inmunológica, peso y talla, y respuesta al tratamiento antirretroviral desde el diagnóstico hasta la última valoración. Resultados: Se incluyeron 19 pacientes con una edad media de 12.6 años (± 2.29). El 58% fueron del sexo masculino. El 80% de los pacientes presentaron anticuerpos immunoglobulin G (IgG) contra el VHA protectores a los 7 años de la vacunación. La concentración de anticuerpos se encontró entre 13 y 80 mUI/ml (mediana: 80 mUI/ml). El 52% mostraron algún grado de inmunosupresión. No existe relación estadísticamente significativa entre la presencia de seroprotección y la carga viral, la falla al tratamiento, la categoría inmunológica ni la desnutrición. Doce pacientes presentaron falla al tratamiento antirretroviral; en el 33% de ellos los anticuerpos no ofrecían seroprotección satisfactoria. Conclusiones: A 7 años posvacunación, el 80% de los niños con VIH mantienen títulos de seroprotección frente al VHA.