En niños con dermatitis atópica moderada-grave el uso de probióticos puede ser de utilidad para disminuir su intensidad
González de Dios J, Perdikidis Olivieri L. En niños con dermatitis atópica moderada-grave el uso de probióticos puede ser de utilidad para disminuir su intensidad. Evid Pediatr. 2006;2:8.En recién nacidos con alto riesgo de atopia, la suplementación con prebióticos de la fórmula adaptada parece disminuir la aparición de dermatitis atópica
González de Dios J, Perdikidis Olivieri L. En recién nacidos con alto riesgo de atopia, la suplementación con prebióticos de la fórmula adaptada parece disminuir la aparición de dermatitis atópica. Evid Pediatr. 2007;3:11.El tratamiento con aire caliente durante tiempo prolongado podría ser efectivo como terapia no medicamentosa para la pediculosis del cuero cabelludo
Ibáñez Pradas V, García Vera C. El tratamiento con aire caliente durante tiempo prolongado podría ser efectivo como terapia no medicamentosa para la pediculosis del cuero cabelludo. Evid Pediatr. 2007;3:19.La administración preventiva de Lactobacillus GG al final de la gestación y al lactante no disminuye la presencia de dermatitis atópica en hijos de familias de riesgo
Aizpurua Galdeano P, García Vera C. La administración preventiva de Lactobacillus GG al final de la gestación y al lactante no disminuye la presencia de dermatitis atópica en hijos de familias de riesgo. Evid Pediatr. 2008;4:55.Inhibidores tópicos de la calcineurina en la dermatitis atópica: revisión sistemática y metanálisis
Aizpurua Galdeano P. Inhibidores tópicos de la calcineurina en la dermatitis atópica: revisión sistemática y metanálisis. Evid Pediatr. 2010;6:41. Traducción autorizada de: Centre of Reviews and Dissemination (CRD) Topical calcineurin inhibitors in atopic dermatitis: a systematic review and meta-analysis. University of York. Database of Abstracts of Review of Effects web site (DARE) Documento número: 12009104362 [en línea] [Fecha de actualización: 2009; fecha de consulta: 05-04-2010].
Disponible en:
http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12009104362Probióticos y prebióticos en la dermatitis atópica: revisión de los antecedentes teóricos y de la evidencia clínica
Esparza Olcina MJ. Probióticos y prebióticos en la dermatitis atópica: revisión de los antecedentes teóricos y de la evidencia clínica. Evid Pediatr. 2011;7:25. Traducción autorizada de: Centre of Reviews and Dissemination (CRD). Probiotics and prebiotics in atopic dermatitis: review of the theoretical background and clinical evidence. University of York. Database of Abstracts of Review of Effects web site (DARE). Documento número: 12010003317 [en línea] [fecha de actualización: 2010; fecha de consulta: 15-12-2010]. Disponible en: www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12010003317.
Revisiones bibliográficas. Documentación científica en Ortopedia y Traumatología, medicina deportiva, artroscopia, artroplastia y de todas las patologías del sistema Músculo-Esquelético
sábado, 19 de febrero de 2011
Todos los artículos sobre dermatología pediátrica
Manejo de la otitis media aguda: actualización
Manejo de la otitis media aguda: actualización
Artículo original: Management of acute otitis media: update
Autores: Shekelle PG, Takata G, Newberry SJ, y colaboradores.
Revista: Evidence Report/Technology Assessment No. 198. (Prepared by the Southern California Evidence-Based Practice Center under Contract No. 290 2007 10056 I). Rockville, MD: Agency for Healthcare Research and Quality. November 2010.
INTRODUCCIÓN
La otitis Media aguda (OMA) es la más frecuente infección en la niñez para la cual se prescriben antibióticos en los Estados Unidos. Esta actualización de una Revisión publicada originalmente en 2001 tuvo como objetivo sintetizar la evidencia acerca del diagnóstico y el Tratamiento de la OMA no complicada y del enfoque terapéutico de la OMA recurrente, así como evaluar el impacto de la vacuna heptavalente anti-neumocóccica sobre la microbiología de la OMA.
FUENTES DE INFORMACIÓN
Se identificaron estudios mediante búsquedas en PubMed, Web of Science y las bases de datos de la Cochrane Library, entre enero de 1998 y julio de 2010. Además se revisaron las listas de referencias de los artículos seleccionados. No se aplicaron restricciones en el lenguaje de publicación.
SELECCIÓN DE ESTUDIOS
Fueron seleccionados estudios consistentes en ensayos clínicos randomizados (aleatorizados) y controlados y revisiones sistemáticas sobre el diagnóstico y el Tratamiento de la OMA no complicada y la recurrente.
EXTRACCIÓN DE DATOS
Se extrajeron los datos demográficos y clínicos pertinentes. Las principales medidas de evolución fueron la respuesta terapéutica y los eventos adversos.
PRINCIPALES RESULTADOS
Satisficieron los criterios estipulados 44 ensayos no incluidos en la Revisión previa de 2001. A continuación se indican los resultados obtenidos.
-- Fueron hallados pocos estudios que examinaran la Precisión de las herramientas diagnósticas para la OMA.
-- Desde la introducción de la vacuna pentavalente anti-neumocóccica, la microbiología de la OMA ha variado considerablemente, y se observa un descenso en la Prevalencia del neumococo, con un incremento en los casos de OMA debidos a Haemophilus influenzae.
-- En los casos de OMA no complicada, los análisis sumarios indicaron que se necesitaría tratar a 9 niños (Intervalo de confianza [IC] del 95% entre 6 y 20) con ampicilina o amoxicilina en lugar de Placebo para notar una diferencia en la Tasa de éxito clínico.
-- Sin embargo, entre cuatro estudios de enfoques de Tratamiento diferido para la OMA no complicada, dos demostraron mayores tasas de éxito con la terapia antibiótica inmediata, mientras que otros dos evidenciaron lo opuesto.
-- Los autores no pueden extraer conclusiones definitivas sobre la Efectividad comparativa de diferentes antibióticos en niños con OMA recurrente.
-- En casos de OMA recurrente, la administración a largo plazo de antibióticos disminuye los episodios de 3 a 1,5 por cada 12 meses de Tratamiento por cada niño afectado (IC del 95% entre 1,2 y 2,1).
CONCLUSIÓN
Existe evidencia insuficiente acerca de la Efectividad comparativa de diferentes regímenes de Tratamiento para los varios subgrupos de niños con otitis Media aguda no complicada. Se requieren estudios adicionales, de alta Calidad, al respecto.
Fuente: RIMA NESTLE
Jeringa micro vibrador (SMV) un nuevo dispositivo que se introduce en la odontología para aliviar el dolor y la ansiedad de las inyecciones intraorales, y un estudio comparativo con un dispositivo similar
Jeringa micro vibrador (SMV) un nuevo dispositivo que se introduce en la odontología para aliviar el dolor y la ansiedad de las inyecciones intraorales, y un estudio comparativo con un dispositivo similar. |
Syringe micro vibrator (SMV) a new device being introduced in dentistry to alleviate pain and anxiety of intraoral injections, and a comparative study with a similar device. Shahidi Bonjar AH. Student of Dentistry, Students Research Committee, School of Dentistry, Shahid Beheshti Medical University, Evin, Tehran 1983963113, Iran.shahidiah@gmail.com. Ann Surg Innov Res. 2011 Jan 7;5(1):1. Abstract BACKGROUND: Neurologically, it is proven that stimulation of larger diameter fibers - e.g. using appropriate coldness, warmth, rubbing, pressure or vibration- can close the neural "gate" so that the central perception of itch and pain is reduced. This fact is based upon "Gate-control" theory of Melzack and Wall. PRESENTATION OF THE HYPOTHESIS: Syringe Micro Vibrator is a new design being introduced for the first time in the field of Dentistry. This device is a promising breakthrough in pain and anxiety management and may deliver solution for clinicians plagued with patient pain phobia. It has an off-set rotating micro vibration creator with ultra high frequency and ultra low altitude that can be easily placed on any standard dental syringe and some disposable syringes. This device was registered as an invention in dentistry and received Iran National Patent number of 63765. TESTING THE HYPOTHESIS: By creating micro vibration, this device would be effective in reducing the pain and anxiety confronted with most types of intraoral injections as palatal, mandibular block, intraligamental and local infiltration. From the aspect of the patient pain management, this device contributes both physiologically (based on Gate Control Theory of pain) and psychologically (based on the device function as will be explained by dentist to the patient as a modern pain reducing technology). From the aspect of clinician, SMV motor provides vibrations with ultra high frequency to alleviate pain, but since it has ultra low vibration altitude, it has no adverse effect on the clinician dexterity and accuracy during injection and it does not interfere with pin point localization of injection site. IMPLICATIONS OF THE HYPOTHESIS: Upon mounting on a conventional dental anesthesia injection syringe, SMV is switched on and the clinician then uses normal injection technique to administer the anesthetic. This device is not only a useful accessory device for ordinary patients, but also more useful for pediatric patients and those who have a phobia of intraoral injection or pain Enlace para bajar el artículo en PDF |
| El efecto de la anestesia local en la calidad de las características de recuperación después de la rehabilitación dental bajo anestesia general en niños |
The effect of local anesthetic on quality of recovery characteristics following dental rehabilitation under general anesthesia in children. Townsend JA, Ganzberg S, Thikkurissy S. LSU School of Dentistry, Department of Pediatric Dentistry, New Orleans, Louisiana 70119, USA. jtown2@lsuhsc.edu Anesth Prog. 2009 Winter;56(4):115-22. Abstract This study is a randomized, prospective, double-blind study to evaluate the effects of the combination of local anesthetics and an intravenous nonsteroidal anti-inflammatory drug (NSAID) vs NSAID alone on quality of recovery following dental rehabilitation under general anesthesia (GA). Twenty-seven healthy children aged 3-5.5 years underwent dental rehabilitation under GA. Fifteen children in the experimental group received oral infiltration of local anesthetic in addition to intravenous ketorolac tromethamine, while 12 children in the control group received intravenous ketorolac tromethamine alone for postoperative pain management. Pain behaviors were evaluated immediately postoperatively using a FLACC scale and 4 hours postoperatively by self-report using various scales. Parents reported perception of child pain and comfort and any occurrences of postoperative cheek biting. The use of intraoral infiltration local anesthesia for complete dental rehabilitation under general anesthesia for children aged 3-5.5 years did not result in improved pain behaviors in the postanesthesia care unit (PACU), nor did it result in improved pain behaviors 4-6 hours postoperatively as measured by the FLACC scale, FACES scale, and subjective reports of parents or a PACU nurse. Those children receiving local anesthesia had a higher incidence of negative symptoms related to local anesthetic administration, including a higher incidence of lip and cheek biting, which was of clinical importance, but not statistically significant. Infiltration of local anesthetic for dental rehabilitation under general anesthesia did not improve quality of recovery in children aged 3-5.5 years. Enlace para bajar el artículo en PDF |
Un ensayo controlado aleatorio que compara técnicas de anestesia mandibular local en niños que recibieron sedación con óxido nitroso y oxígeno |
A randomized controlled trial comparing mandibular local anesthesia techniques in children receiving nitrous oxide-oxygen sedation. Naidu S, Loughlin P, Coldwell SE, Noonan CJ, Milgrom P. Department of Dental Public Health Sciences, University of Washington, Seattle, Washington 98195-7475, USA. Anesth Prog. 2004;51(1):19-23. Abstract The aim of this study was to test the hypothesis that dental pain control using infiltration/intrapapillary injection was less effective than inferior alveolar block/long buccal infiltration anesthesia in children. A total of 101 healthy children, aged 5-8 years, who had no contraindication for local anesthetic and who needed a pulpotomy treatment and stainless steel crown placement in a lower primary molar were studied. A 2-group randomized blinded controlled design was employed comparing the 2 local anesthesia techniques using 2% lidocaine, 1:100,000 epinephrine. All children were given 40% nitrous oxide. Children self-reported pain using the Color Analogue Scale. The study was conducted in a private pediatric dental practice in Mount Vernon, Wash. Overall pain levels reported by the children were low, and there were no differences between conditions at any point in the procedure. Pain reports for clamp placement were block/long buccal 2.8 and infiltration/intrapapillary 1.9 (P = .1). Pain reports for drilling were block/long buccal 2.0 and infiltration/intrapapillary 1.8 (P = .7). Nine percent of children required supplementary local anesthetic: 4 of 52 (7.7%) in the block/long buccal group and 5 of 49 (10.2%) in the infiltration/intrapapillary group (P = .07). The hypothesis that block/long buccal would be more effective than infiltration/intrapapillary was not supported. There was no difference in pain control effectiveness between infiltration/intrapapillary injection and inferior alveolar block/long buccal infiltration using 2% lidocaine with 1:100,000 epinephrine when mandibular primary molars received pulpotomy treatment and stainless steel crowns. Enlace para bajar el artículo en PDF |
On the Cover of Sunday's Book Review
On the Cover of Sunday's Book Review
'A Widow's Story: A Memoir'
By JOYCE CAROL OATES
Reviewed by ANN HULBERT
Joyce Carol Oates's memoir of her husband's death is more painfully self-revelatory than anything she dared produce as a fiction writer or critic.
'Widow: Stories'
By MICHELLE LATIOLAIS
Reviewed by LEAH HAGER COHEN
These stories present a world wrapped in spiked barbed wire, while also containing passages of searing tenderness.
Also in the Book Review
'When the Killing's Done'
By T. CORAGHESSAN BOYLE
Reviewed by BARBARA KINGSOLVER
A habitat restorer and an animal lover square off in T. C. Boyle's rollicking novel set in California's Channel Islands.
Poetry, Prose and Letters
By ELIZABETH BISHOP
Reviewed by WILLIAM LOGAN
Three new collections illuminate the life and work of Elizabeth Bishop, including her time as a poet for The New Yorker.
VISUALS
Irreverence You Can Almost Touch
By STEVEN HELLER
Visual histories of fanzines, horror magazines and banned comics, and of the Italian shelter magazine Abitare.
'The Hemlock Cup'
By BETTANY HUGHES
Reviewed by WALTER ISAACSON
Bettany Hughes examines the life and death of Socrates, and the city that nurtured and killed him.
'The Old Romantic'
By LOUISE DEAN
Reviewed by SYLVIA BROWNRIGG
An acerbic comic novel about an old divorced couple gradually finding a spark of reconnection.
'Revolution: The Year I Fell in Love and Went to Join the War'
By DEB OLIN UNFERTH
Reviewed by JULIA SCHEERES
The author, 18 and in love, dropped out of college and headed for Central America to hunt for a revolution.
'West of Here'
By JONATHAN EVISON
Reviewed by MIKE PEED
Jonathan Evison's panoramic novel contrasts a group of visionary settlers with their
Guía de práctica clínica para la constipación en pediatría
Guía de práctica clínica para la constipación en pediatría
Múltiples factores contribuyen al desarrollo de constipación en los niños.
Causas desde psicológicas hasta alimentarias pueden ser halladas como presuntos responsables del problema.
Se estima que un 3% de las consultas pediátricas se producen por esta inquietud.
El documento revisa y actualiza los documentos anteriores, publicados hasta 2006.
Artículo: Clinical practice guidelines for pediatric constipation
Autor: Beverly J. Greenwald
Revista: Journal of the American Academy of Nurse Practitioners 22 (2010) 332–338
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