New Resident Training Strategy Based on Gamification Techniques: An Escape Room on Sepsis in Children.

AIM: Adapting "escape rooms" for educational purposes is an innovative teaching method. The aim of this study was to ascertain the degree of learning of the residents. A secondary objective was to determine their degree of satisfaction. METHODS: A prospective, observational study took place in October 2019. A sepsis-based escape room was designed and carried out. A mix of paediatric medical residents and paediatric nursing residents were enrolled. A prior knowledge test was carried out, which was repeated right at the end of the escape room and then again three months later. Furthermore, all participants completed an anonymous post-study survey. RESULTS: We enrolled 48 residents, 79.2% of whom were women. The mean score for the pre-escape room exam was 7.85/9 (SD 1.65), that for the post-escape room exam was 8.75/9 (SD 0.53), and for the exam three months later, it was 8.30/9 (SD 0.94). Among the participants, 18.8% did not manage to leave before the established 60 min time limit. The results of the satisfaction survey showed high participant satisfaction. CONCLUSIONS: The escape room proved to be a valuable educational game that increased students' knowledge of sepsis management and showed a positive overall perceived value among the participants.

El Feng Shui de la atención integral y centrada en la persona como un proceso clave transversal / The Feng Shui of an integral and person-centered attention as a key transversal process

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Consens entre hospitals catalans per a l'abordatge dels episodis aparentment letals / Protocolo consensuado entre hospitales catalanes para el abordaje de los episodios aparentemente letales / Consensus of Catalan hospital for the management of apparent life-threatening events

Fonament: no existeixen documents de consens universalment acceptats sobre quin ha de ser el maneig de l'Episodi Aparentment Letal (EAL). Com a conseqüència, existeix una gran variabilitat en el seu abordatge. Objectiu: el Grup de Treball de la Mort Sobtada Infantil (GMSI) de la Societat Catalana de Pediatria es proposa consensuar amb els hospitals catalans un algoritme d'actuació. Mètode: el GMSI elabora un algoritme d'abordatge de l'EAL que no inclou els nounats ingressats en Unitats Neonatals. Participen professionals de diferents subespecialitats pediàtriques que formen part del grup. L'algoritme es basa en una revisió de la literatura i en el consens dels integrants del GMSI. Es contempla l'actuació a Urgències, els criteris d'ingrés i la indicació de proves complementàries. Es remet el mes de juliol del 2015 a 48 responsables de 40 hospitals catalans perquè el valorin. Resultats: es reben 21 respostes, que corresponen a 17 hospitals. Fins a 5 responsables accepten l'algoritme mentre que 16 fan comentaris o proposen modificacions. Totes les respostes són valorades pel GMSI i es realitzen canvis en l'algoritme. Conclusions: el GMSI aporta un algoritme de consens entre els diferents hospitals catalans que permetrà homogeneïtzar l'abordatge dels pacients amb EAL

Fundamento. No existen documentos de consenso universalmente aceptados sobre el manejo del Episodio Aparentemente Letal (EAL). Como consecuencia, existe una gran variabilidad en su abordaje. Objetivo. El Grupo de Trabajo de la Muerte Súbita Infantil (GMSI) de la Sociedad Catalana de Pediatría se propone consensuar con los hospitales catalanes un algoritmo de actuación. Método. El GMSI elabora un algoritmo de abordaje del EAL que no incluye a neonatos ingresados en Unidades Neonatales. Forman parte del grupo profesionales de diferentes subespecialidades pediátricas. El algoritmo se basa en una revisión de la literatura y en el consenso de los integrantes del GMSI. Se contempla la actuación en Urgencias, los criterios de ingreso y la indicación de pruebas complementarias. Se remite el mes de julio del 2015 a 48 responsables de 40 hospitales catalanes para que lo valoren. Resultados. Se reciben 21 respuestas, correspondientes a 17 hospitales. Un total de 5 responsables aceptan el algoritmo mientras que 16 hacen comentarios o proponen modificaciones. Todas las respuestas son valoradas por el GMSI y se realizan cambios en el algoritmo. Conclusiones. El GMSI aporta un algoritmo consensuado entre los diferentes hospitales catalanes que permitirá homogeneizar el abordaje de los pacientes con EAL (AU)

Background. There is no accepted consensus for the approach to apparent life-threatening events (ALTE), resulting in major variability in its management. Objective. The aim of the Apparent Life-Threatening Events Working Group (ALTEWG) of the Catalan Society of Pediatrics was to elaborate a consensus algorithm to be used in Catalan hospitals. Method. The ALTEWG designed an algorithm for the approach of ALTE that did not include newborns admitted in neonatal units. Professionals of different pediatric subspecialties participated in the development of the guidelines. The algorithm was based on a literature review and a consensus among the ALTEWG members, and included the management in the emergency room, admission criteria, and indication of diagnostic studies. The algorithm was sent to 48 professionals of 40 Catalan hospitals in July of 2015 for further discussion. Results. Twenty-one responses from 17 hospitals were received. Five responders accepted the algorithm, while 16 made comments or proposed modifications. The ALTEWG evaluated all the responses and some modifications to the algorithm were subsequently made. Conclusions. The ALTEWG elaborated a consensus algorithm among Catalan hospitals that will allow for the implementation of a homogeneous approach to patients with ALTE (AU)

Occult pneumonia in infants with high fever without source: a prospective multicenter study.

BACKGROUND: The prevalence of pneumonia in infants with high fever without source (FWS; temperature, > or =39.0 degrees C) and a white blood cell (WBC) count greater than 20 x 10(9)/L (occult pneumonia) has been reported to be 20% before the introduction of the 7-valent pneumococcal conjugated vaccine (PCV7). This is the main reason for carrying out chest x-ray (CXR) on infants with high FWS. The aims of this study were to establish the prevalence of occult pneumonia in well-appearing infants with high FWS (temperature, > or =39.0 degrees C) and a WBC count greater than 20 x 10(9)/L in the era of PCV7 and to analyze the value of WBC, absolute neutrophil count (ANC), and C-reactive protein (CRP) level as predictors of the risk of occult pneumonia in these patients. PATIENTS AND METHODS: We conducted a multicenter prospective study in 4 pediatric emergency departments including children younger than 36 months with FWS (temperature, > or =39.0 degrees C) and a WBC count higher than 20 x 10(9)/L on whom a CXR was performed in the absence of respiratory findings. Physicians completed a questionnaire when observing the infant, and the attending physician or, when in doubt, the radiologist interpreted the CXR. Multivariable binary logistic regression was used to estimate the adjusted relative influences of the aforementioned factors on the prevalence of radiological pneumonia. RESULTS: During an entire year (September 2006 to September 2007), we included 188 infants (aged 1-36 months; 56.2% were males) with high FWS and a WBC count greater than 20 x 10(9)/L (range, 20-44.7 x 10(9)/L) on whom a CXR was performed. Of the 188 chest radiographs obtained, 37 (19.7%) were interpreted by the radiologist. Consolidation in the chest radiographs was detected in 25 (13.3%). The probability of an infant with high FWS and WBC of 20 x 10(9)/L or greater having pneumonia was related to 3 of the studied variables: age, ANC, and serum CRP level. The incidence of pneumonia increased with age (odds ratio [OR] of 2.62 for infants >12 months; 95% confidence interval [95% CI], 1.04-6.60), CRP level greater than 100 mg/L (OR, 3.18; 95% CI, 1.19-8.51), and ANC greater than 20 x 10(9)/L (OR, 3.52; 95% CI, 1.37-9.06). White blood cell count was not predictive of occult pneumonia when ANC was taken into account. CONCLUSIONS: In the era of PCV7, the incidence of pneumonia in infants younger than 36 months with high FWS and WBC count greater than 20 x 10(9)/L seems to be lower than that previously reported. However, this is not a uniform group because the incidence of pneumonia increases in infants older than 12 months and with higher ANC and serum CRP level.

Nen de 8 anys amb exantema papulopetequial dolorós en mans i peus / No disponible

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The prevalence of GB virus C/hepatitis G virus RNA among healthy and HCV-infected Catalan children.

GB virus C (GBV-C) is a blood-borne flavivirus. The prevalence of GBV-C viremia among healthy adults is 0.5% to 4% and, to date, no disease has been definitely associated with GBV-C infection. We conducted a cross-sectional study to evaluate GBV-C viremia prevalence in a group of 327 healthy children with normal alanine amino transferase (ALT) levels (Group A) and elevated ALT levels (Group B) of unknown origin, and among 38 pediatric patients with mother-to-child-transmitted hepatitis C virus (HCV) infection (Group C). No statistically significant differences were observed between prevalences in Groups A and B (2.2% vs 6.7%, p = 0.06). None of the children in Groups A or B who tested positive for GBV-C RNA showed any clinical symptoms. The prevalence of GBV-C viremia in Group A was lower than for patients in Group C (2.2% vs 13.2%, p = 0.007); no differences were observed in HCV infection characteristics between those patients who were co-infected with GBV-C and those who were not. In conclusion, while GBV-C viremia is more frequent among HCV-infected pediatric patients, it is neither associated with liver disease nor has any influence on HCV-related chronic hepatitis.

Urgències pediàtriques: actualització sobre l’activitat assistencial i els recursos al nostre medi (2004) / No disponible

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Congenital cervical neuroblastoma.

Primary congenital cervical neuroblastomas are very rare. A history of upper aerodigestive compromise with Horner syndrome can be of value for the early diagnosis of this lesion. Congenital neuroblastomas usually have a favorable outcome. Like all the other clinically relevant groups of neuroblastomas, management should take into consideration the biological findings of each tumor, which predicts outcome than other clinical findings.