Predictors of Response to Exclusive Enteral Nutrition in Newly Diagnosed Crohn´s Disease in Children: PRESENCE Study from SEGHNP

Exclusive enteral nutrition (EEN) has been shown to be more effective than corticosteroids in achieving mucosal healing in children with Crohn´s disease (CD) without the adverse effects of these drugs. The aims of this study were to determine the efficacy of EEN in terms of inducing clinical remission in children newly diagnosed with CD, to describe the predictive factors of response to EEN and the need for treatment with biological agents during the first 12 months of the disease. We conducted an observational retrospective multicentre study that included paediatric patients newly diagnosed with CD between 2014–2016 who underwent EEN. Two hundred and twenty-two patients (140 males) from 35 paediatric centres were included, with a mean age at diagnosis of 11.6 ± 2.5 years. The median EEN duration was 8 weeks (IQR 6.6–8.5), and 184 of the patients (83%) achieved clinical remission (weighted paediatric Crohn’s Disease activity index [wPCDAI] 15 mg/L and ileal involvement tended to respond better to EEN. EEN administered for 6–8 weeks is effective for inducing clinical remission. Due to the high response rate in our series, EEN should be used as the first-line therapy in luminal paediatric Crohn’s disease regardless of the location of disease and disease activityS

Morbimortalidad en una cohorte de recién nacidos menores de 1500 gramos: análisis comparativo

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Pediatría, leída el 08-02-2016El aumento del número de RNMBP asociado a una mayor supervivencia de los mismos conlleva un riesgo inherente de secuelas en los supervivientes. Las tasas de mortalidad y secuelas son mayores a medida que disminuye la edad gestacional y el peso de estos recién nacidos. En las bases de datos neonatales, como la Vermont Oxford Network (VON) o la SEN 1500 se recogen datos epidemiológicos y clínicos que permiten realizar estudios de morbimortalidad neonatal, identificar factores pronósticos y establecer la variabilidad intercentros. Material y métodos. Ventajas y sesgos del estudio Se analizaron con el programa SPSS 20.0 los datos de morbimortalidad de 620 menores de 1500 gramos de nuestro centro, y los de un grupo de 15 hospitales similares del grupo SEN 1500 (12031 RNMBP). Los resultados fueron estratificados (peso al nacimiento, edad gestacional, y crecimiento intrauterino restringido o no) y expuestos en tablas comparativas (Hospital Clínico San Carlos vs SEN 1500) expresando las frecuencias absolutas y relativas, con medias y desviación estándar o medianas con rango intercuartílico. También se realizaron gráficos radiales para posicionar nuestros resultados en el contexto del resto de hospitales del estudio (“Benchmarking”) y un análisis multivariante de mortalidad. Para mejorar la validez interna y evitar el sesgo de selección, se incluyó el 100% de pacientes reclutados prospectivamente en la base de datos durante 2002-2012, a excepción de los años 2010 y 2011 en los que no se registraron pacientes...The rates of VLBW are increasing and the survival in these neonates are increasing too, so consequently there is a high risk of sequelae in survivors. The mortality and morbidity are higher with decreasing gestational age and weight of these infants. Epidemiological and clinical data from neonatal bases, such as Vermont Oxford Network (VON) and the SEN 1500, can be used to identify morbidity and morbility risk factors and the variability between centers. Materials and Methods. Advantages and biases An analysis of prospectively collected data in SEN 1500 about morbidity and mortality in newborns less than 1500 was performed. SPSS 20.0 software was used. 620 VLBW from HCSC and 12031 from SEN 1500 group (15 centers) were included. The results were stratified (birth weight, gestational age and intrauterine growth restricted or unrestricted) and exposed in comparative tables (HCSC vs SEN 1500). Absolute and relative frequencies, means and standard desviations or medians with interquartile range were expressed. Radar charts were also made to position our results in the context of other hospitals in the study ("Benchmarking"). A multivariate analysis of mortality was performed too. Data from 100 % patients during 2002-2012 were included to improve internal validity and to avoid selection bias; 2010-2011 no patients were reported. For avoid misclassification bias data variables were collected by standardized SEN 1500 protocol. It was considered a good precision and high external validity because of large sample size and selected SEN 1500 centers...Depto. de Salud Pública y Materno - InfantilFac. de MedicinaTRUEunpu

Oropharyngeal dysphagia, an underestimated disorder in pediatrics

Oropharyngeal dysphagia is a rather frequent clinical entity in patients with neurological problems that can lead to serious complications such as aspiration pneumonia and other disorders like dehydration or malnutrition due to feeding difficulties. It should be suspected in children with splitting of food intake or prolonged feeding, coughing or choking during feeding, continuous drooling or repeated respiratory symptoms. For the diagnosis, apart from the examination of swallowing, additional tests can be run like the water-swallowing test, the viscosity-volume test (which determines what kind of texture and how much volume the patient is able to tolerate), a fiberoptic endoscopy of swallowing or a videofluoroscopic swallow study, which is the gold standard for the study of swallowing disorders. It requires a multidisciplinary approach to guarantee an adequate intake of fluids and nutrients with minimal risk of aspiration. If these two conditions cannot be met, a gastrostomy feeding may be necessary

Revolution: Museo de las estrellas un paseo por la fama : Hollywood

Convocatoria proyectos de innovación de Extremadura 2020/2021Se describe un proyecto llevado a cabo entre 13 centros educativos extremeños que consistió en desarrollar cinco unidades de trabajo gamificadas, cinco historias detectivescas con misterios por resolver, donde se ponían a prueba las habilidades de lógica, la capacidad de observación, de concentración y de atención de los alumnos. Los objetivos principales de la propuesta fueron: promover la puesta en práctica de proyectos intercentros; impulsar pedagogías activas; desarrollar la competencia digital a través del uso de las pedagogías emergentes lo que ha permitido llevar a cabo una enseñanza presencial, híbrida y virtual y atender a la diversidadExtremaduraES