Guía de práctica clínica Ibero-Latinoamericana sobre la esofagitis cáustica en Pediatría: Aspectos terapéuticos (2ª. Parte)

Pierre, Reinaldo; Neri, Sandra; Contreras, Mónica; Vázquez, Rodrigo; Ramirez, Luis C.; Riveros, Juan P.; Rondón, Lisset; Casasnovas, Adolfo Bautista; Rodríguez‐Herrera, Alfonso; Navalón, María; Soto, Pilar; Iglesias, Claudio; Fernández, Giselle; Dias, Jorge Amil; Ruiz, Carlos J.; Spolidoro, José Vicente Noronha; Jorge, Juan; Vila, V.

doi:10.32641/rchped.v91i2.1289

Cited by 8 publications

(14 citation statements)

References 52 publications

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“…Also, we found that if children were asymptomatic, they did not have severe esophageal lesions; only a small proportion of children without oral lesions (n = 3) had severe esophageal lesions. These findings differ from the series published by Temiz et al 16 , who reported that 12-26% of asymptomatic children show severe lesions on endoscopic evaluation. Therefore, it is recommended to perform upper endoscopy in patients with a history of caustic ingestion, even if they are asymptomatic 1,16 .…”

Section: Discussioncontrasting

confidence: 99%

“…These findings differ from the series published by Temiz et al 16 , who reported that 12-26% of asymptomatic children show severe lesions on endoscopic evaluation. Therefore, it is recommended to perform upper endoscopy in patients with a history of caustic ingestion, even if they are asymptomatic 1,16 .…”

Section: Discussioncontrasting

confidence: 99%

“…Endoscopy is not recommended more than four days after ingestion, as it increases the risk of esophageal perforation 19 . Currently, the Ibero-Latin American Clinical Practice Guide (Guía de Práctica Clínica Ibero-Latinoamericana) on caustic esophagitis in pediatrics recommends performing this study in the first 24 to 48 hours 1,16 . Endoscopic evaluation is performed during the first 72 hours in the Endoscopy Service of the Hospital Infantil de México Federico Gómez.…”

Section: Discussionmentioning

confidence: 99%

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Importance of early endoscopic and clinical evaluation of children with caustics ingestion

Almanza-Miranda¹,

Blanco-Rodríguez²,

Penchyna-Grub³

et al. 2021

BMHIM

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Background: Accidental ingestion of caustics in pediatrics continues to be a frequent problem that can lead to severe injuries and permanent sequelae that require esophageal rehabilitation programs. This study aimed to describe the medical care experience of children who ingested caustic substances in a tertiary hospital in Mexico City. Methods: We conducted a descriptive and analytical study. We described age, sex, type of caustics, clinical and endoscopic findings, and the radiological evolution of 284 patients who arrived during the acute phase. Results: The records of 336 children with a history of caustic ingestion were reviewed. The median age was 1.7 years, and the predominant sex was male. Caustic soda was the most accidentally ingested substance. We found an association between the severity of the esophageal injury with the presence of more than four symptoms at diagnosis (χ², p < 0.001) and with the finding of oral lesions, sialorrhea, and vomiting (χ², p < 0.05). Forty percent (n = 114) showed normal gastrointestinal endoscopy. Conclusions: In children with caustic ingestion, upper gastrointestinal endoscopy should be performed within 72 hours to evaluate the extent of the lesions. In this study, we found that more than four symptoms at admission, and oral lesions, sialorrhea, and vomiting are associated with the severity of the esophageal injury.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Importance of early endoscopic and clinical evaluation of children with caustics ingestion

Almanza-Miranda¹,

Blanco-Rodríguez²,

Penchyna-Grub³

et al. 2021

BMHIM

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“…En pediatría existe evidencia limitada sobre su uso, debido a la poca casuística por uso ocasional, sustentándose en series retrospectivas de casos y opinión de expertos 21 . Tampoco se han desarrollado dispositivos específicos, lo que hace que los stent de adultos no se puedan utilizar en lactantes, por su gran tamaño, siendo ésta la población más afectada.…”

Section: Discussionunclassified

Stent para el manejo de las Estenosis Esofágicas por cáusticos en pediatría

et al. 2021

Andes pediatr

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La estenosis esofágica es una de las complicaciones más graves de la ingestión de cáusticos en niños, pudiendo ocasionalmente recurrir o ser refractaria al manejo con dilataciones repetidas.Objetivo: Presentar un caso de la utilización de stent metálico cubierto con silicona en un niño con estenosis esofágica recurrente secundaria a la ingestión por cáusticos.Caso Clínico: Niño de 6 años con ingestión accidental de cáustico, con evidencia de esofagitis Zargar 3A en las tres porciones del esófago y una úlcera gástrica prepilórica de 3 cm que recibió tratamiento inicial con antibiótico y esteroides. A los 21 días cursa con disminución de la luz esofágica en relación con proceso cicatricial, la cual requirió dilataciones seriadas. Posteriormente desarrolló una estenosis puntiforme, por lo que se decidió la inserción de dos stent esofágicos metálicos recubiertos con silicona, los cuales se mantuvieron por 4 meses, sin nuevos episodios de estenosis.Conclusiones: El stent metálico con cubierta de silicona es una alternativa para el tratamiento de estenosis esofágica recurrente por cáusticos en niños.

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“…Sometimes, as in the case of aminoglycosides, the rate of penetration into the biofilm is slower than the half-life of the antibiotic, or even the treatment time itself [ 22 ]. They are also favored by the increased transmission of resistance genes, changes in pH that can inactivate the antibiotic, expression of expulsion pumps, or the presence of metabolically inactive cells, which allow them to tolerate situations of extracellular stress by inactivating the sites of antibiotic action [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Differences in Virulence Factors and Antimicrobial Susceptibility of Uropathogenic Enterococcus spp. Strains in a Rural Area of Uganda and a Spanish Secondary Hospital

et al. 2023

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Enterococcus faecalis and Enterococcus faecium have become two of the most important agents of nosocomial diseases due to their constantly growing resistance. Enterococcal infections are associated with biofilms, which are intrinsically sensitive to antimicrobials. The main goal of this study was to compare and relate their capacity to form biofilm and their antimicrobial sensitivity, as well as their virulence factors and their implicated genes, of strains isolated from patients with urinary tract infection (UTI) in a rural hospital in Uganda and a secondary hospital in Spain. A prospective study was conducted with 104 strains of E. faecalis and E. faecium isolated from patients with suspected UTI and who presented leukocyturia at the Saint Joseph Kitgum hospital (Uganda) and at the Hospital Universitario Principe de Asturias (Spain). All microorganisms were identified in Spain by MALDI-TOF mass spectrometry. Antimicrobial susceptibility studies were carried out using the Vitek® 2 system (Biomériux, France). The biofilm formation capacity was studied by photospectrometry. Phenotypic and genotypic virulence factors were studied in all cases by PCR or expression techniques. In Uganda, we found a higher incidence of E. faecium (65.3%, n = 32), contrary to the situation found in Spain where most of the bacteria found belonged to E. faecalis (92.7%, n = 51). All E. faecalis strains were found to have very low levels of resistance to ampicillin, imipenem, and nitrofurantoin. However, E. faecium exhibited more than 25% resistance to these antibiotics. Although the esp gene has been shown in the results obtained to be an important initial agent in biofilm formation, we have also demonstrated in this study the intervention of other genes when esp is not present, such as the ace1 gene. No statistically significant relationships were found between the presence of agg and gelE genes and increased biofilm formation. The significant difference between the incidence of E. faecalis and E. faecium and biofilm formation, between samples from Spain and Uganda, shows us very different profiles between countries.

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Guía de práctica clínica Ibero-Latinoamericana sobre la esofagitis cáustica en Pediatría: Aspectos terapéuticos (2ª. Parte)

Cited by 8 publications

References 52 publications

Importance of early endoscopic and clinical evaluation of children with caustics ingestion

Importance of early endoscopic and clinical evaluation of children with caustics ingestion

Stent para el manejo de las Estenosis Esofágicas por cáusticos en pediatría

Differences in Virulence Factors and Antimicrobial Susceptibility of Uropathogenic Enterococcus spp. Strains in a Rural Area of Uganda and a Spanish Secondary Hospital

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