Evolution of Child and Youth Mental Health in the Context of the COVID-19 Pandemic: A Longitudinal Analysis.

BACKGROUND: The COVID-19 pandemic generated uncertainty and disruption among the child and adolescent population. Multiple studies have documented a worsening of mental health following the pandemic. The main objective of this longitudinal study is to analyze the short-, medium-, and long-term evolution of the overall functioning of children and adolescents treated by a child and adolescent mental health team in the context of the COVID-19 pandemic. METHODS: 420 patients aged 3 to 18 were assessed using the Global Assessment of Functioning (GAF) scale at three time points: during the lockdown, three months later, and three years later. Differences based on gender, diagnosis, and time were analyzed. RESULTS: A significant improvement was observed in the short-term (three months) and long-term (three years) compared to the lockdown period. This improvement was maintained in all diagnostic subgroups except for mixed cases (severe mental pathology), which showed the least improvement. No significant differences were found between males and females. CONCLUSIONS: The child and adolescent population showed a greater capacity for adaptation to the lockdown than expected. Family support, decreased stress, and therapeutic intervention appear to have played an important role in improving mental health.

Efficacy of conduction hyperthermia in the treatment of non-muscle invasive bladder cancer: A systematic review.

INTRODUCTION: Intravesical treatment for non-muscle invasive bladder cancer (NMIBC) aims to reduce recurrences and stop progression. Hyperthermia-enhanced chemotherapy with devices like COMBAT BRS, Unithermia, and BR-TRG-I is a promising alternative to conventional Bacillus de Calmette Guerin (BCG) therapy. OBJECTIVE: To systematically review the efficacy of hyperthermia generated by conduction devices in the treatment of NMIBC. MATERIAL AND METHODS: The review followed the preferred reporting items for systematic reviews and meta-analyses guidelines. A search was performed in the PubMed, Cochrane Library, Scopus, and ClinicalTrials.gov databases. Two reviewers independently assessed the eligibility of candidate studies and abstracted data from studies that met the inclusion criteria. The primary endpoint was assessment of recurrence. Secondary objectives included evaluation of treatment progression and safety. RESULTS: Thirty studies meeting inclusion criteria underwent data extraction. In intermediate-risk NMIBC patients, COMBAT versus mitomycin C (MMC) in normothermia revealed no superiority in reducing recurrence or progression. High-risk NMIBC patients using COMBAT achieved similar or superior outcomes to BCG. BR-TRG-I demonstrated superior results over normothermia in intermediate- and high-risk NMIBC patients. Unithermia proved less effective than BCG in high-risk NMIBC. Progression outcomes were promising with COMBAT and BR-TRG-I, but comprehensive analysis was limited due to inconsistent assessment across studies. Adverse events were primarily mild-moderate, with some device-specific differences. CONCLUSIONS: Studies on conduction hyperthermia present great variability, which do not allow us to determine the superiority of 1 device over another in terms of recurrence, progression, and/or adverse effects. Further research with consistent administration protocols is crucial for definitive conclusions.

Mitochondrial complex I activity in microglia sustains neuroinflammation.

Sustained smouldering, or low-grade activation, of myeloid cells is a common hallmark of several chronic neurological diseases, including multiple sclerosis1. Distinct metabolic and mitochondrial features guide the activation and the diverse functional states of myeloid cells2. However, how these metabolic features act to perpetuate inflammation of the central nervous system is unclear. Here, using a multiomics approach, we identify a molecular signature that sustains the activation of microglia through mitochondrial complex I activity driving reverse electron transport and the production of reactive oxygen species. Mechanistically, blocking complex I in pro-inflammatory microglia protects the central nervous system against neurotoxic damage and improves functional outcomes in an animal disease model in vivo. Complex I activity in microglia is a potential therapeutic target to foster neuroprotection in chronic inflammatory disorders of the central nervous system3.

Impacto del tamaño tumoral y la invasión de la rete testis en la supervivencia libre de progresión de nuestros pacientes con seminoma testicular en estadio I. Estudio observacional retrospectivo en un hospital de referencia y revisión bibliográfica / Evaluation of tumour size and rete testis invasion in progression free survival of our patients with stage i testicular seminoma. A retrospective observational study of a reference hospital center and literature review

Introducción El objetivo de este estudio fue evaluar el impacto del tamaño tumoral y la invasión de la rete testis en la supervivencia libre de progresión de nuestros pacientes con seminoma testicular en estadio I. También se llevó a cabo una revisión bibliográfica. Material y métodos Se realizó un estudio observacional retrospectivo incluyendo a los pacientes con seminoma en estadio I entre enero de 2010 y julio de 2022. Se compararon los pacientes sin factores de pronóstico favorable (Grupo A) con pacientes que presentaban factores de pronóstico desfavorable (Grupo B). Se utilizaron curvas de Kaplan-Meier y pruebas de log-rank para comparar la supervivencia libre de progresión (SLP) entre estos grupos. La significación estadística se consideró a p ≤ 0,05. Resultados Se incluyeron 55 pacientes en este estudio. Veinte pacientes (36,4%) tenían un pronóstico favorable (grupo A) y 35 (63,6%) presentaban factores de pronóstico desfavorable (grupo B). La edad media fue similar en ambos grupos (media ± desviación estándar), 38,62 ± 9,04 años. El tiempo medio de seguimiento fue de 63,5 ± 33,6 meses. Todos los pacientes del grupo A y 25,7% de los pacientes del grupo B se sometieron a vigilancia activa (VA). Veintiséis pacientes (74,3%) del grupo B fueron tratados con un ciclo de carboplatino adyuvante. Tres pacientes sufrieron recidiva en ganglios retroperitoneales (10,3%), todos tratados con tres ciclos de bleomicina, etopósido, y cisplatino (BEP), presentando remisión completa de la enfermedad. No se encontraron diferencias estadísticamente significativas en la SLP entre los grupos A y B (log-rank p = 0,317). Conclusiones La individualización del tratamiento adyuvante en el seminoma estadio I es esencial para evitar los efectos adversos derivados del mismo. (AU)

Introduction The aim of this study was to evaluate the impact of tumour size and rete testis invasion in progression free survival of our patients with stage I testicular seminoma. A literature review is also made. Material and methods A retrospective observational study was performed. We included patients with stage I seminoma between January 2010 and July 2022. Patients without factors of poor prognostic –Group A– were compared with patients with factors of poor prognostic –Group B–. Kaplan-Meier curves and log-rank testing were used to compare progression free survival (PFS) between these groups. Statistical significance was considered at P ≤ .05. Results 55 patients were included in this study. 20 patients (36.4%) were of good prognostic –Group A– and 35 (63.6%) had factors of poor prognostic –Group B–. The mean age was similar in both groups (mean ± standard deviation), 38.62 ± 9.04 years. The mean follow-up time was 63.5 ± 33.6 months. All the patients in group A and 25.7% of the patients in group B underwent active surveillance (AS). 26 patients (74.3%) of the patients in Group B were treated with one cycle of adyuvant carboplatin. Three patients suffered a relapse with retroperitoneal lymph nodes (10.3%), all of them were treated with three cycles of BEP, with a complete response of the disease. No statistical significant differences were found in PFS between Group A and B (log Rank P = .317). Conclusions Individualization of adjuvant treatment in stage I seminoma is important, avoiding the adverse effects derived from them. (AU)

Agitación o delirio postoperatorio en pediatría. ¿Qué sabemos y cómo evitarlo? / Postoperative agitation or delirium in paediatric patients. What we know and how to avoid it

Se denomina agitación o delirio postoperatorio al estado de alteración de la conciencia que se presenta tras la cirugía y que afecta especialmente al paciente pediátrico. Presenta una incidencia nada despreciable, alcanzando el 80% de los casos en determinados estudios. Frecuentemente es confundido con otras entidades clínicas, por lo que se ha validado una escala que facilita su diagnóstico. Entre sus factores de riesgo destaca la edad inferior a 5años, la presencia de dolor tras la cirugía y, especialmente, la ansiedad intensa preoperatoria. El delirio postoperatorio se presenta como un evento adverso tras una intervención quirúrgica y tiene influencia en la seguridad del paciente, aumentando considerablemente su comorbilidad. Es fundamental reconocer la entidad, así como sus factores de riesgo, para aplicar medidas de prevención eficaces que disminuyan su incidencia y su intensidad cuando esta se presenta. (AU)

The state of altered consciousness that occurs after surgery, particularly in paediatric patients, is called emergence delirium or postoperative agitation, and some studies report an incidence of up to 80%. This high incidence is due to clinicians frequently mistaking this phenomenon for other clinical entities, and to avoid this confusion a scale has been validated to facilitate diagnosis. The main risk factors include age under 5years, postoperative pain, and particularly, intense preoperative anxiety. Paediatric emergence delirium is an adverse postoperative event that significantly increases comorbidity. It is essential to recognize this entity and its risk factors in order to apply effective preventive measures to reduce both incidence and intensity. (AU)

Postoperative agitation or delirium in paediatric patients. What we know and how to avoid it.

Emergence delirium or postoperative agitation is the name given to the state of altered consciousness that occurs after surgery and especially affects pediatric patients. Its incidence is not negligible, reaching 80% of cases in certain studies. It is frequently confused with other clinical entities, for which reason a scale has been validated to facilitate its diagnosis. Risk factors include age under 5 years, the presence of pain after surgery and especially intense preoperative anxiety. Pediatric emergence delirium presents as an adverse event after surgery and influences patient safety by significantly increasing patient comorbidity. It is essential to recognize the entity, as well as its risk factors, in order to apply effective preventive measures to reduce its incidence and intensity when it occurs.

Evaluation of tumour size and rete testis invasion in progression free survival of our patients with stage i testicular seminoma. A retrospective observational study of a reference hospital center and literature review.

INTRODUCTION: The aim of this study was to evaluate the impact of tumour size and rete testis invasion in progression free survival of our patients with stage I testicular seminoma. A literature review is also made. MATERIAL AND METHODS: A retrospective observational study was performed. We included patients with stage I seminoma between January 2010 and July 2022. Patients without factors of poor prognostic -Group A- were compared with patients with factors of poor prognostic -Group B-. Kaplan-Meier curves and log-rank testing were used to compare progression free survival (PFS) between these groups. Statistical significance was considered at P≤.05. RESULTS: 55 patients were included in this study. 20 patients (36.4%) were of good prognostic -Group A- and 35 (63.6%) had factors of poor prognostic -Group B-. The mean age was similar in both groups (mean±standard deviation), 38.62±9.04 years. The mean follow-up time was 63.5±33.6 months. All the patients in group A and 25.7% of the patients in group B underwent active surveillance (AS). 26 patients (74.3%) of the patients in Group B were treated with one cycle of adyuvant carboplatin. Three patients suffered a relapse with retroperitoneal lymph nodes (10.3%), all of them were treated with three cycles of BEP, with a complete response of the disease. No statistical significant differences were found in PFS between Group A and B (log Rank P=.317). CONCLUSION: Individualization of adjuvant treatment in stage I seminoma is important, avoiding the adverse effects derived from them.

Prostate health index (PHI) as an accurate prostate cancer predictor.

PURPOSE: This study aims to compare the ability of the PHI versus tPSA test to predict the presence of PCa in our population. METHODS: A prospective observational study was performed. We included patients with tPSA ≥ 2.5 ng/ml, biopsy naïve or previous negative biopsy, undergoing a blood test, which includes tPSA, fPSA, and p2PSA, and a prostate biopsy between March 2019 and March 2022. Patients with PCa found in the biopsy-Group A-were compared with patients with a negative biopsy result-Group B. Diagnostic accuracy of tPSA and PHI was assessed by receiver operating characteristic [ROC] curves and logistic regression. RESULTS: 140 men were included. Fifty-seven (40.7%) had a positive prostate biopsy result (Group A), and 83 (59.3%) had a negative biopsy result (Group B). The mean age was similar in both groups (mean ± standard deviation), 66.86 ± 6.61 years. No difference was found in the tPSA value between the groups (Group A PSA: 6.11 ng/ml (3.56-17.01); Group B: 6.42 ng/ml (2.46-19.45), p = 0.41). The mean value of PHI was statistically different between groups (Group A 65.50 (29-146) vs. Group B 48 (16-233), p = 0.0001). The area under the curve 0.44 for tPSA and 0.77 for PHI. The multivariate logistic regression model applied to PHI showed a significant increase in its predictive accuracy: 72.14% in the model without PHI, 76.09% with PHI. CONCLUSION: The PHI test improves PCa detection compared to tPSA in our population.

Postnatal genetic and neurodevelopmental assessment in infants born at term with severely low birth weight of non-placental origin.

OBJECTIVE: To determine the frequency of genetic syndromes and childhood neurodevelopmental impairment in non-malformed infants born at term with severely low birth weight and no evidence of placental insufficiency. METHODS: This case series was constructed from the data of infants delivered at term between 2013 and 2018 with severely low birth weight, defined as birth weight more than 2.5 SD below the mean, with normal maternal and fetal Doppler (umbilical artery, fetal middle cerebral artery, cerebroplacental ratio and uterine artery) and no maternal hypertensive disorder during pregnancy or fetal structural anomaly on prenatal ultrasound examination. Clinical exome sequencing and copy number variation (CNV) analysis were performed using DNA extracted from the children's saliva. Cognitive and psychomotor development was evaluated using the Bayley Scales of Infant and Toddler Development, 3rd edition or the Wechsler Intelligence Scale for Children, 5th edition tests, according to the child's age at testing. RESULTS: Among the 36 405 infants born within the study period, 274 (0.75%) had a birth weight below -2.5 SD, of whom 98 met the inclusion criteria. Among the 63 families contacted, seven (11%) reported a postnatal diagnosis of a genetic syndrome and a further 18 consented to participate in the study. Median gestational age at delivery was 38.0 (interquartile range (IQR), 37.3-38.5) weeks and median birth weight was 2020 (IQR, 1908-2248) g. All 18 children showed a normal result on clinical exome sequencing and CNV analysis, but six (33%) obtained a low score on neurodevelopmental testing. CONCLUSION: Non-malformed severely small term infants with no clinical or Doppler signs of placental insufficiency present a high rate of genetic syndromes and neurodevelopmental impairment during childhood. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Characterization of a Ferryl Flip in Electronically Tuned Nonheme Complexes. Consequences in Hydrogen Atom Transfer Reactivity.

Two oxoiron(IV) isomers (R 2a and R 2b) of general formula [FeIV (O)(R PyNMe3 )(CH3 CN)]2+ are obtained by reaction of their iron(II) precursor with NBu4 IO4 . The two isomers differ in the position of the oxo ligand, cis and trans to the pyridine donor. The mechanism of isomerization between R 2a and R 2b has been determined by kinetic and computational analyses uncovering an unprecedented path for interconversion of geometrical oxoiron(IV) isomers. The activity of the two oxoiron(IV) isomers in hydrogen atom transfer (HAT) reactions shows that R 2a reacts one order of magnitude faster than R 2b, which is explained by a repulsive noncovalent interaction between the ligand and the substrate in R 2b. Interestingly, the electronic properties of the R substituent in the ligand pyridine ring do not have a significant effect on reaction rates. Overall, the intrinsic structural aspects of each isomer define their relative HAT reactivity, overcoming changes in electronic properties of the ligand.

Consideraciones anestésicas para cesárea electiva en una paciente con quiste de Tarlov gigante / Anaesthetic considerations for elective cesarean section in a patient with a giant Tarlov cyst

Los quistes de Tarlov son una dilatación patológica de las meninges. Su incidencia es más frecuente en mujeres de edades comprendidas entre 30 y 50 años. La prueba de imagen de elección para su diagnóstico es la RM. De etiología desconocida, la mayoría de los casos son asintomáticos, pero pueden manifestarse síntomas de irritación radicular, entre otros. Las posibilidades terapéuticas son múltiples, reservando la escisión quirúrgica como último escalón. Presentamos un caso en el que se realiza con éxito una anestesia raquídea para una cesárea electiva en una paciente con un quiste de Tarlov gigante, pero con potencial compromiso de la vía aérea, en la que la que los riesgos de una anestesia general podrían estar aumentados. El manejo anestésico presenta un desafío para el anestesiólogo, especialmente en situaciones en las que el paciente presente un riesgo anestésico aumentado para la anestesia general, como es el caso de la paciente obstétrica.(AU)

Tarlov cysts are a pathological dilatation of the meninges. Their incidence is more frequent in women between 30 and 50 years of age. The imaging test of choice for diagnosis is MRI. Of unknown etiology, most cases are asymptomatic, but symptoms of radicular irritation, among others, may occur. The therapeutic possibilities are multiple, reserving surgical excision as the last option. We report a case of successful spinal anaesthesia for elective cesarean section in a patient with a giant Tarlov cyst but with potential airway compromise, in whom the risks of general anaesthesia would be increased. Anaesthetic management presents a challenge for the anesthesiologist, especially in situations where the patient presents an increased anaesthetic risk for general anaesthesia, as is the case in the obstetric patient.(AU)

Anaesthetic considerations for elective cesarean section in a patient with a giant Tarlov cyst.

Tarlov cysts are a pathological dilatation of the meninges. Their incidence is more frequent in women between 30 and 50 years of age. The imaging test of choice for diagnosis is MRI. Of unknown etiology, most cases are asymptomatic, but symptoms of radicular irritation, among others, may occur. The therapeutic possibilities are multiple, reserving surgical excision as the last option. We report a case of successful spinal anaesthesia for elective cesarean section in a patient with a giant Tarlov cyst but with potential airway compromise, in whom the risks of general anaesthesia would be increased. Anaesthetic management presents a challenge for the anesthesiologist, especially in situations where the patient presents an increased anaesthetic risk for general anaesthesia, as is the case in the obstetric patient.

Intraoperative irradiation in breast cancer: preliminary results in 80 patients as partial breast irradiation or anticipated boost prior to hypo-fractionated whole breast irradiation.

PURPOSE: To present the first results of intraoperative irradiation (IORT) in breast cancer with a low-energy photon system used as partial breast irradiation (PBI) or as an anticipated boost before whole breast hypo-fractionated irradiation (IORT + WBI), concerning tolerance, side effects, quality of life, and patient-reported outcomes. MATERIALS AND METHODS: Eighty patients treated with an Intrabeam® system of 50 kV X-rays received a 20 Gy dose intraoperatively were included. Moderate daily hypofractionation of 2.7 Gy in 15 fractions up to 40.5 Gy was administered if high-risk factors were present. Acute post-operative toxicity, surgery complications, chronic toxicity, patient-reported cosmesis and Breast-Q questionnaire were performed at follow-up visits. RESULTS: Thirty-one patients were treated as PBI and the remaining 49 as IORT + WBI. Only the IORT + WBI group presented acute toxicity, mainly mild acute dermatitis (11 patients) and one subacute mastitis. A total of 20 patients presented fibrosis (18 patients grade I, 2 patients grade II), 15 (30.5%) patients in the IORT + WBI group and 3 (9.6%) patients in the group of PBI. The cosmesis evaluation in 73 patients resulted poor, fair, good or excellent in 2, 7, 38 and 26 patients, respectively. In PBI group Breast-Q scored higher, especially in terms of their psychosocial well-being (78 vs 65) and satisfaction with radiation-induced toxicity (77 vs 72, respectively) compared to IORT + WBI group. CONCLUSION: IORT is a well-tolerated procedure with low toxicity, good cosmesis and favorable patient-reported outcomes mainly when administered as PBI.

A Medium-Term Field Experiment to Study the Effect of Managing Soil Chemical Properties on Fusarium Wilt in Banana (Musa AAA).

Fusarium oxysporum f. sp. cubense (Foc) is a soil-borne fungus causing Fusarium wilt (FW) in banana. It is practically impossible to eradicate Foc in soils. Our understanding of soil-Foc-banana interactions is hampered by inconsistent research results caused by agro-ecological variability and the complexity of the soil system. This study aimed to evaluate the options to manage soil chemical properties to reduce disease expression and maintain banana production. The expression of FW (Foc Race 1) and the agronomic performance of the Gros Michel (Musa AAA) banana were evaluated in two medium-term factorial field experiments at representative locations in the Costa Rican banana region. In the experiments, five soil chemical properties (pH, N, Ca, Mg, and Mn) were managed to achieve a low and a high level. Plant mortality caused by FW, soil fertility, plant nutrition, and agronomic performance were monitored during four crop cycles. After the first crop cycle, the treatments started to present differences in plant mortality. There was a significant rise of plant mortality after the second crop cycle resulting in a cumulative plant mortality exceeding 60% in both experiments. A lower soil pH consistently resulted in significantly higher plant mortality. The interactions between soil properties (pH-N, pH-CaMg, pH-Mn, N-Mn, and CaMg-Mn) also influenced plant mortality. Soil N was the most significant treatment affecting leaf nutrient concentrations, bunch weight, and clusters per bunch. The experiments confirmed the potential role of soil management in FW expression in banana. Our results suggest that the management of soil chemical properties in the conditions here studied may help to reduce the expression rate of FW, but not to control the disease in the long run.

Assessing the viability of recovered phosphorus from eutrophicated aquatic ecosystems as a liquid fertilizer.

One of the most important worldwide environmental challenges is the alteration of the biogeochemical cycle of phosphorus (P). P is globally exported from terrestrial to aquatic ecosystems, causing the eutrophication of the receiving waters. In this context, magnetic microparticles (MPs) have been recently proposed for trapping P in natural eutrophicated ecosystems, as well as in treated wastewaters. The main advantage of using MPs is that both P and MPs can be recovered from the treated water. Thus, the working hypothesis of the present study is that P can be desorbed from P-loaded MPs and recovered P can be later used as a fertilizer. To test this hypothesis, the best working conditions for desorbing P from P-loaded MPs were identified; then, an experiment with different plant nutrient solutions (neutralized solutions containing recovered P and an unfertilized control) was carried out with three different plant species: Ocimum basilicum L., Cucumis sativus L. and Cucumis melo L. Finally, germination, height, root and shoot biomass and P concentration in root and shoot were compared among treatments. Our results show that the best conditions for P desorption from P-loaded MPs occurred when using 0.1 M NH4OH and using H3PO4 for neutralizing pH. The greenhouse fertirrigation pot experiment showed that the neutralized solution containing desorbed P from P-loaded MPs can be used as a liquid fertilizer, since its combination with macro and microelements significantly increased plant height, growth rate, shoot and root biomass and shoot and root P concentration. As a result, MPs can be proposed to be used for counteracting the widespread and coupled problems of the exhaustion of the P reserves and the eutrophication of aquatic ecosystems.

Epidemiología de la litiasis urinaria en el mundo y en España / Urinary stone epidemiology in Spain and worldwide

La litiasis urinaria es una patología cuya incidencia y prevalencia van en aumento tanto en países desarrollados como países subdesarrollados. De forma global, en Estados Unidos se ha visto incrementada su prevalencia del 3,2% en 1980 hasta el 10,1% en 2014. En España, este aumento también ha sido significativo, desde el 5% en 2005 hasta el 14,6% en 2016. En el resto del mundo sucede de forma similar, donde se observa un incremento medio en los últimos 15-20 años del 5-7% aproximadamente. La década de la vida entre los 40-60 años suele ser la de mayor incidencia de litiasis. En cuanto a sexo, en los últimos años ha existido una tendencia cada vez mayor en la mujer, asociada al cambio de dieta y la obesidad, fundamentalmente y actualmente no existen prácticamente diferencias entre sexos. Es una enfermedad más frecuente en el mundo occidental, aunque existen países del Oriente Medio como Arabia Saudí en donde la prevalencia es muy elevada, en torno al 20%. En cuanto a la composición litiásica, la de oxalato cálcico sigue siendo la más frecuente en torno al 70-80% con un incremento en los últimos años de la litiasis de ácido úrico y un descenso en la litiasis infectiva. En relación a la aparición de esta patología en los niños, es poco frecuente en los primeros años de vida, siendo más prevalente a partir de los 12-13 años e incrementándose en la adolescencia. Suele ser más frecuente en niñas que en niños y en la raza caucásica respecto a los afroamericanos. No existen diferencias en cuanto a la composición litiásica con respecto a los adultos, siendo el oxalato cálcico el compuesto más frecuente, pero con una prevalencia del 50-60%. Sin embargo, las causas y factores etiopatogénicos en los niños están peor estudiados y son menos conocidos que en los adultos

Urinary stones is a pathology whose incidence and prevalence are increasing in developed and underdeveloped countries. Overall, in the United States the prevalence has been increased from 3.2% in 1980 to 10.1% in 2014. In Spain, this increase has also been significant, from 5% in 2005 to 14.6% in 2016. In the rest of the world happens in a similar way, where an average increase is observed in the last 15-20 years of approximately 5-7%. The decade of life between 40-60 years is usually the highest incidence of stones. Regarding sex, in recent years there has been a growing in women, associated with a change in diet and obesity, and currently there are no differences between sex. It is a more frequent disease in the Western world, although there are countries in the Middle East such as Saudi Arabia where the prevalence is very high, around 20%. Respect the lithiasis composition, calcium oxalate continues to be the most frequent around 70-80%, with an increase in uric acid lithiasis in recent years and a decrease in infective lithiasis. In relation to the appearance of this pathology in children, it is rare in the first years of life, being more prevalent from 12-13 years of age and increasing in adolescence. It is usually more common in girls than in boys and in the Caucasian race compared to African Americans. There are no differences in lithiasic composition with respect to adults, calcium oxalate being the most frequent composition, but with a prevalence of 50-60%. However, the causes and etiopathogenic factors in children are less studied and well known than in adults