Notes

Exosomes mediate LTB4 release in the course of neutrophil chemotaxis.
Food allergies affect mostly children in their first years of life. Epidemiological data obtained in Argentina are scarce.

To determine offending foods and describe the prevalence and characteristics of patients with food allergy in an Argentine pediatric population.

Observational, retrospective, crosssectional study on patients younger than 18 years.

A total of 321 patients were included; food allergy was confirmed in 64 % (207) of cases. An immunoglobulinE-mediated mechanism was observed in 53% (109); cow's milk protein allergy, in 68 % (140); egg allergy, in 20 % (41); and anaphylaxis as clinical manifestation, in 12 % (24). The overall prevalence of food allergy was 0.87 % (95 % confidence interval 0.7-0.9).

The overall prevalence of food allergy was 0.87%. Cow's milk was the main allergen, even among adolescents.
The overall prevalence of food allergy was 0.87%. Cow's milk was the main allergen, even among adolescents.
Iron-deficiency anemia is common in hemodialysis patients. Serum ferritin and transferrin saturation (TS) are used for its detection. The reticulocyte hemoglobin equivalent (RET-He) is a marker that is not altered by inflammatory conditions and directly reflects iron availability in the bone marrow.

To explore the diagnostic capability of RET-He to detect absolute iron deficiency and assess its correlation with traditional markers of iron deficiency.

Retrospective study comparing RET-He with ferritin and TS in children on hemodialysis seen at Hospital Garrahan between July 2016 and July 2019.

In 164 observations carried out in 40 children, a weak positive correlation was found between hemoglobin and RETHe (r = 0.35, p < 0.001), a significant positive correlation between TS and RET-He (r = 0.52, p < 0.001), a low negative correlation between hemoglobin and ferritin (r = -0.19, p = 0.02), and a lack of correlation between hemoglobin and TS (r = 0.05, p = 0.5). Anemia was observed in 50 %; iron-deficiency anemia was detected by traditional markers in 13 % and by RET-He in 44 %. RET-He showed a sensitivity of 90.9 % (95 % CI 57.1-99.5 %), a specificity of 74.5 % (95 % CI 66.7-81 %), a negative predictive value of 99.1 % (95 % CI 94.5-99.9 %), and a positive predictive value of 20.4 % (95 % CI 10.7-34.7 %) to detect iron-deficiency anemia with a cut-off value of 29 pg.

Despite its limited capability, the use of RET-He as a biomarker of iron deficiency increases the detection of iron-deficiency anemia in children on hemodialysis.
Despite its limited capability, the use of RET-He as a biomarker of iron deficiency increases the detection of iron-deficiency anemia in children on hemodialysis.
To investigate NEC frequency in premature infants and assess risk factors associated with disease-onset and progression to intestinal perforation.

Retrospective cohort in preterm neonates hospitalized between 2015 and 2018. Perinatal characteristics, clinical features, nutritional data and laboratory outcome were analyzed using SPSS-23 statistical package. Logistic regression was performed to analyze associated risk factors.

In 1428 neonates, the rate of developing NEC was 18.28 %. Conception with assisted reproductive technology, cesearean section and postnatal-steroids were associated with NEC (OR 4.056, 95 % CI 2.810-5.854, OR 1.961, 95 % CI 1.321-2.910, OR 6.422; 95 % CI 4.327-9.530). Timing of first enteral feeding was associated to developing NEC, but not to intestinal perforation (p < 0.001, p = 0.604). Forty-seven of 261 NEC patients (18 %) have developed intestinal perforation. Antenatal steroids showed to reduce severe consequences (p = 0.001). Timing of first enteral feeding and hemodynamically significant PDA were predisposing factors for NEC and low 5-minutes Apgar score for intestinal perforation. (OR 6.515; 95 % CI 5.011-8.470; OR 4.715; 95 % CI 2.717-8.183; OR 2.748; 95 % CI 1.100-6.866). Mortality was 9 %. Developing NEC increased risk of mortality by 2.192 times (95 % CI 1.469- 3.271); in intestinal perforation, mortality risk increased to 11.527 (95 % CI 6.293-21.115).

NEC frequency was 18.28 %. Intestinal perforation occurred in 18 % of NEC patients. PDA and delay in first enteral nutrition were predisposing factors for acquiring NEC and low 5-minutes Apgar scores for intestinal perforation.
NEC frequency was 18.28 %. Intestinal perforation occurred in 18 % of NEC patients. Epigenetics inhibitor PDA and delay in first enteral nutrition were predisposing factors for acquiring NEC and low 5-minutes Apgar scores for intestinal perforation.
The early detection of clinical deterioration in hospitalized patients helps to improve the quality of care. The pediatric early warning score (PEWS) system predicts such deterioration in the first 24 hours of administration. Prior studies support the use of these tools.

To assess the usefulness of the Brighton PEWS (B-PEWS) for the prediction of clinical deterioration among hospitalized children at a children's hospital in the Autonomous City of Buenos Aires.

Cross-sectional study. The medical records of all patients aged 1 month to 18 years admitted to any hospitalization ward between March 1st and August 31st, 2018 were included. Predictive outcome measure B-PEWS score (≤ 3 and ≥ 4 points). Outcome variable clinical deterioration in the first 24 hours. Categorical outcome measures were analyzed with the χ² test and screening values were estimated. The relative risk was used as a measure of association. A ROC curve analysis and an optimal cut-point analysis according to the Youden index were done considering the score in a continuous manner.

A total of 518 medical records were reviewed. Forty patients had clinical deterioration; the B-PEWS score was ≥ 4 in 37 patients and ≤ 3 in 3 (relative risk 56.36; 95 % confidence interval 17.76-178.89; p < 0.01). Sensitivity 92.5 %; specificity 88.3 %; positive predictive value 39.8 %; negative predictive value 99.3 %; positive likelihood ratio 7.91; negative likelihood ratio 0.08. AUC 0.94 (95 % confidence interval 0.89-0.98).

The B-PEWS demonstrated to be useful to predict clinical deterioration in hospitalized children.
The B-PEWS demonstrated to be useful to predict clinical deterioration in hospitalized children.
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