ABSTRACT
BACKGROUND/OBJECTIVES: The home enteral nutrition (HEN) provides nutritional support to children with chronic diseases who are nutritionally compromised and allows them to be discharged more quickly from hospitals. In 2003, a web-based registry (Nutrición Enteral Pediátrica Ambulatoria y Domiciliaria, Pediatric Ambulatory and Home Enteral Nutrition -NEPAD-) was created with the objective of gathering information about pediatric HEN practices in Spain. AIM: The aim of this study was to report the implementation of the NEPAD (Nutrición Enteral Pediátrica Ambulatoria y Domiciliaria, Pediatric Ambulatory and Home Enteral Nutrition) registry of pediatric HEN in Spain and to analyze data evolution trends from 2003 to 2010. SUBJECTS/METHODS: The data from the Spanish NEPAD registry were analyzed according to the following variables: demographic data, diagnosis, indication for HEN, nutritional support regime and administration route. RESULTS: Over the study period, 952 patients (1048 episodes) from 20 Spanish hospitals were included in the NEPAD registry. The most frequent indication for HEN was decreased oral intake (64%), and neurological disease was the most prevalent illness. HEN was delivered via a nasogastric tube in 573 episodes (54.7%), by gastrostomy in 375 episodes (35.8%), oral feeding in 77 episodes (7.3%) and by jejunal access in 23 episodes (2.2%). Significant differences in the mode of administration were observed based on the pathology of the child (χ(2), P<0.0001). The cyclic feeding was the most widely used technique for the administration of HEN. Most of the patients used a pump and a polymeric formula. Transition to oral feeding was the primary reason for discontinuation of this type of support. CONCLUSIONS: Since the NEPAD registry was established in Spain, the number of documented patients has increased more than 25-fold. Many children with chronic illness benefit from HEN, mainly those suffering from neurological diseases.
Subject(s)
Enteral Nutrition/statistics & numerical data , Registries , White People , Child , Child Nutritional Physiological Phenomena , Child, Preschool , Enteral Nutrition/trends , Female , Gastrostomy , Hospitals , Humans , Infant , Internet , Intubation, Gastrointestinal , Male , Nervous System Diseases/diet therapy , Parenteral Nutrition, Home , Patient Discharge , Prospective Studies , SpainABSTRACT
El dolor abdominal es un síntoma frecuente en la infancia que puede aparecer hasta en un 10-15% de los niños siendo la patología de la vesícula biliar responsable de un pequeño porcentaje de los casos. Es difícil conocer la prevalencia exacta de la litiasis biliar en niños porque muchos pacientes están asintomáticos y la gran difusión de la ecografía ha sido la que ha permitido establecerla mejor. Al igual que en adultos los tres tipos principales de cálculos biliares son de colesterol, pigmento negro y pigmento marrón, cada uno asociado con diferentes enfermedades. La forma de presentación de la patología biliar depende de la enfermedad asociada, siendo lo más frecuente la aparición de síntomas biliares. La ecografía abdominal se considera la prueba de imagen de elección para el diagnóstico y seguimiento. Tras el diagnóstico la actitud terapéutica varia según la sintomatología y puede ir desde un seguimiento clínico periódico, hasta tratamiento médico con ácido ursodesoxicólico o cirugía, siendo la colecistectomía laparoscopia la técnica de elección (AU)
Abdominal pain has been reported to occur in 10-15% of children but the presence of gallstones is the cause of very few cases. Ascertaining the true prevalence of gallbladder stones in children is difficult because many patients are asymptomatic. The introduction of ultrasonography allowed noninvasive screening for gallstone disease and therefore a more accurate estimate of prevalence. As in adults there are three major types of stones: cholesterol, black pigment and brown pigment each type associated with different diseases. The presentation of gallbladder disease depends on the underlying disease and the most frequent clinical presentation is with biliary symptoms. The ultrasonography is firmly established as the gold standard diagnostic procedure. After the diagnosis patients can be followed clinically without other treatment because the benign course of gallstones in children, also medical treatment with ursodeoxycholic acid is indicated in oligsymptomatic patients. Laparoscopic cholecytectomy is the procedure of choice in children requiring cholecystectomy, mainly in patients with underlying diseases (AU)
Subject(s)
Humans , Male , Child , Cholelithiasis/diagnosis , Abdominal Pain/etiology , Cholelithiasis/drug therapy , Cholelithiasis/surgery , Abdominal Pain/diagnosis , Cholecystectomy , Ursodeoxycholic Acid/therapeutic useABSTRACT
La sífilis congénita es una enfermedad rara pero importante que, aunque es prevenible, continúa siendo en muchas partes del mundo un problema de salud pública. Presentamos un caso de sífilis congénita en una lactante de 5 meses, que debutó con hepatoesplenomegalia y alteraciones óseas, para recordar que la sífilis congénita todavía sigue existiendo en los países desarrollados y destacar la importancia de unos adecuados programas de cribado prenatal (AU)
Congenital syphilis is a rare and serious disease that although preventable continues to be a major health care problem. We report a case of congenital syphilis in an infant with hepatosplenomegaly and bone alterations, to emphasize that congenital syphilis still exists in developed countries. It is very important the implementation of prenatal care delivery systems (AU)
