Obesity is currently considered a global epidemic, and its implications in mortality and morbidity in a paediatric patient and in adulthood are increasingly important. The objective of this article is to review in detail the definition of obesity according to age group, and, in turn, the epidemiology of this entity worldwide and in SouthAmerica. Available evidence about pathophysiology and, additionally, associated comorbidities are reported in some of the most important and clinically relevant body systems. The recommendations on pharmacological and nonpharmacological management through changes in lifestyle and relevant aspects of bariatric surgery in the paediatric population are also described.

The current COVID-19 pandemic has generated a series of changes in the daily routines of people, including children and teenagers, in an unprecedented way, which constitutes a global challenge in public health. Social isolation has been a prophylactic measure to prevent the spread of the virus, however, it has generated negative impacts on the physical and emotional health of parents, caregivers, children, and teenagers around the world. Our objective was to evaluate the effects of confinement caused by the COVID19 pandemic at the level of nutritional status, dietary and behavioral patterns of elementary school children and teenagers in a small town of Colombia. Anthropometric parameters such as BMI Z score, waist circumference and waist / height ratio were evaluated in 266 school children and teenagers. A questionnaire with sociodemographic, clinical and lifestyle characteristics and the KIDMED were applied to learn about nutritional aspects. A total of 102 students (38.3%) were classified as having altered nutritional status, being 39 (14.7%) classified with overweight, and 36 (13.5%) with obesity. The prevalence of high adherence to the Mediterranean diet was 12%, 95% CI (0.08-0.16). Overweight was more prevalent in women (26/39, 66.7%) (p = 0.0439), and obesity was discreetly more frequent in men (19/36, 52.7%) (p = 0.7193). We observed a worrying nutritional, dietary and behavioral situation in the children and teenagers studied during the confinement associated with the covid 19 pandemic. This unveils the need to establish strategies and / or public policies in our town that help to promote an adequate biopsychosocial development of the pediatric patient and their family group.

Fungal endocarditis (FE) is a rare infection in pediatrics which accounts for 5% of the cases of infective endocarditis. This pathology affects immunosuppressed patients in a greater proportion. We present an immunocompetent 7- year-old female with a history of multiple cardiac surgeries who developed fungal endocarditis due to Aspergillus flavus. The histology study showed liquefactive necrosis and septate hyphae of Aspergillus sp type. The clinical outcome was favorable and the ambulatory follow-up after 12 months showed no new complications.

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Presentación de casos clínicos RESUMENLa sarcoidosis es una enfermedad inflamatoria granulomatosa de etiología desconocida, evidenciada con mayor frecuencia en adultos jóvenes, que puede comprometer diversos órganos, principalmente, el pulmón, los ganglios linfáticos, los ojos y la piel. La presencia de dicha enfermedad en la población pediátrica es poco frecuente y su denominación en pediatría se realiza basada en la edad y las manifestaciones clínicas del paciente. El objetivo del siguiente reporte es presentar un caso de sarcoidosis sistémica en un paciente adolescente sin compromiso pulmonar, con manifestaciones extrapulmonares graves. Se trata de un paciente de 15 años, quien debutó con síntomas inespecíficos (emesis, pérdida de peso). Estudios radiológicos, sin compromiso pulmonar aparente; sin embargo, con presencia de hallazgos sugestivos de histiocitosis de células de Langerhans. Se realizó un estudio histopatológico de componente óseo y linfático, cuyo resultado evidenció la presencia de una enfermedad granulomatosa crónica no necrotizante tipo sarcoidosis. La sarcoidosis infantil es una entidad rara y difícil de diagnosticar, dada, principalmente, la ausencia de biomarcadores específicos para su diagnóstico. Palabras clave: sarcoidosis, enfermedad pulmonar, niño, diagnóstico. ABSTRACTSarcoidosis is a granulomatous inflammatory disease of unknown etiology, evidenced most often in young adults, which can compromise several organs, mainly lung, lymph nodes, eyes and skin. The presence of the disease in pediatric population is rare. Denomination in pediatrics is made based on age and clinical manifestations of the patient. The aim of this report is to present a case of systemic sarcoidosis in a pediatric patient without lung involvement with severe extrapulmonary manifestations.Sarcoidosis sistémica: un reto diagnóstico en pediatría. Reporte de un caso Systemic sarcoidosis: a diagnostic challenge in pediatrics. Case reportFifteen year old patient who debuted with nonspecific symptoms (emesis, weight loss). Radiographic studies without lung involvement but with findings suggestive of Langerhans cell histiocytosis; however, histopathological report (bone and lymph) showed the presence of chronic granulomatous nonnecrotizing disease, sarcoidosis type. Childhood sarcoidosis is a rare and difficult entity to diagnose, mainly by the lack of specific biomarkers for diagnosis.