Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)
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Multicenter Study
[Clinicoepidemiological characteristics of community-acquired pneumonia in children aged less than 6 years old].
Acute respiratory infections are an important cause of consultations in primary care and hospitals. Most published epidemiological studies have analyzed pneumonia in hospitals and very few include information on primary care. ⋯ In our milieu, the diagnosis and treatment of community-acquired pneumonia is usually carried out in primary care and the incidence is high. Although most patients do not require hospitalization, etiological diagnosis of community-acquired pneumonia and optimal antibiotic therapy remain difficult goals to achieve.
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To assess the validity of the Pediatric Risk of Mortality score (PRISM), the Pediatric Index of Mortality (PIM) and the PIM 2 in two Spanish pediatric intensive care units. ⋯ PIM and PIM 2 showed better discrimination and calibration than PRISM in a heterogeneous group of children in Spanish critical care units. However, these results should be confirmed in a larger study.
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Control of blood ketone levels and glycemia is advisable in certain situations in type 1 diabetic children and adolescents. The aims of this study were to assess the relationship between glycemia, ketonemia and ketonuria in children and adolescents in a summer camp under different conditions (fasting, casual hyperglycemia, moderate physical exercise) and to assess the utility of ketonemia determinations in diabetes control during this time. ⋯ Measurement of glycemia together with ketonemia in a summer camp allows reliable follow-up of glycemic control to be performed. Ketonemia usually occurred before breakfast in parallel with slightly elevated glycemia, but resolved quickly. Moderate physical activity for 45 minutes does not seem to significantly increase blood ketones if metabolic control is normal. beta -HB is a useful parameter to determine whether moderate physical exercise is advisable or not. The lack of urinary ketone tests due to the difficulties of obtaining a sample can currently be solved by blood ketone measurement.
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To study energy expenditure (EE) in critically ill infants and children and its correlation with clinical characteristics, treatment, nutrition, caloric intake, and predicted energy expenditure calculated through theoretical formulas. ⋯ Wide individual variability in EE was found in critically ill infants and children. Predictive equations did not accurately estimate EE. Indirect calorimetry measured by a specific module is a simple method that could allow generalized use of EE measurement in critically ill pediatric patients undergoing mechanical ventilation.