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  1. Article ; Online: Emergency department evaluation of transplanted children with COVID-19.

    Barreiro Pérez, Sagrario / Molina Gutiérrez, Miguel Ángel / Antoñanzas Bernar, Valeria / Storch-de-Gracia, Pilar / Mesa García, Sofía

    The American journal of emergency medicine

    2023  Volume 77, Page(s) 87–90

    Abstract: Background: Children usually have an asymptomatic or mild course of SARS-CoV-2 infection, studies in immunocompromised patients have shown a different evolution. The aim of this study was to describe the clinical, laboratory, and radiologic ... ...

    Abstract Background: Children usually have an asymptomatic or mild course of SARS-CoV-2 infection, studies in immunocompromised patients have shown a different evolution. The aim of this study was to describe the clinical, laboratory, and radiologic manifestations of pediatric solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) patients testing positive for SARS-CoV-2.
    Methods: A multicenter retrospective, observational descriptive study was conducted in 3 tertiary hospitals in Madrid (Spain) between March 2020 and December 2022. Consecutive patients aged 0-18 attending the corresponding pediatric emergency departments with a positive result in the real-time polymerase chain reaction test or antigenic test to detect SARS-CoV-2 in the nasopharyngeal sample were included.
    Results: A total of 31 children were included in the study. Sixteen (51.6%) were patients with HSCT and 15 (48.3) were patients with SOT. The median time from transplantation to COVID-19 was 1.2 years (IQR:0.5-5.1). The SOT cohort included liver (n = 4, 12.9%), kidney (n = 4, 12.9%), heart (n = 3, 9.7%), multivisceral (n = 3, 9.7%), and lung (n = 1, 3.2%). Of the 31 patients, only one was asymptomatic. The most common symptom on presentation was fever (76.7%). Abnormalities were seen on chest X-ray in 8 (66.6%) of the 12 patients. There was no significant difference in clinical manifestations, lymphopenia and radiological findings regardless of the type of transplantation or immunosuppression status. Thirteen patients (41.9%) were hospitalized. There were no patient deaths.
    Conclusions: In our study, we found that the clinical course and outcome of SOT and HSCT pediatric patients with COVID-19 were generally favorable.
    MeSH term(s) Child ; Humans ; COVID-19/epidemiology ; Emergency Service, Hospital ; Organ Transplantation ; Real-Time Polymerase Chain Reaction ; Retrospective Studies ; SARS-CoV-2
    Language English
    Publishing date 2023-12-12
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Observational Study
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2023.12.007
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  2. Article ; Online: Emergency care for children refugees from the Russian-Ukrainian armed conflict.

    Milkova, Sonia / Antónanzas Bernar, Valeria / Molina Gutiérrez, Miguel Ángel / Storch-de-Gracia, Pilar / García-Ascaso, Marta Taida

    Anales de pediatria

    2022  

    Language English
    Publishing date 2022-11-29
    Publishing country Spain
    Document type Case Reports
    ZDB-ID 2830901-7
    ISSN 2341-2879 ; 2341-2879
    ISSN (online) 2341-2879
    ISSN 2341-2879
    DOI 10.1016/j.anpede.2022.10.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Comparison of amoxicillin administered twice and three times daily in children with acute otitis media.

    Storch-De-Gracia, Pilar / Antoñanzas-Bernar, Valeria / Vergara-Muñoz, Beatriz / Lamagrande-Casanova, Nuria / Di Campli-Zaghlul, Marianna / Suárez-Bustamante, María / Añón-Hidalgo, Juan / Maiques, Miguel

    European journal of pediatrics

    2023  Volume 182, Issue 12, Page(s) 5599–5605

    Abstract: To compare the effectiveness of amoxicillin administered in regimens of two or three daily doses in children with acute otitis media (AOM). As a secondary aim, we measured and compared treatment adherence between the two groups.A prospective ... ...

    Abstract To compare the effectiveness of amoxicillin administered in regimens of two or three daily doses in children with acute otitis media (AOM). As a secondary aim, we measured and compared treatment adherence between the two groups.A prospective observational study was conducted in the emergency department of a children's hospital.We recruited a total of 353 patients having a median age of 1.58 years. Twice-daily dosing was prescribed to 58%, while 42% received three doses per day. The clinical course of AOM was favourable in 92% of the patients who received two doses of amoxicillin and in 95% of those who received three doses (p = 0.25). Four patients (1%) had persistent symptoms beyond day 7. None developed intracranial complications. In the group receiving three doses daily, 31% reported difficulties with the dosing schedule, and 9.6% faced challenges when administering the medication at the specified volume, compared with 5.8% and 25% of those who received the two-dose regimen, respectively.  Conclusion: Twice-daily amoxicillin has similar efficacy to a three-dose daily regimen and can offer advantages for caregivers in terms of administration schedule. What is Known: • Amoxicillin given in two daily doses is as effective as a three doses regimen in the treatment of acute otitis media in children. • The lower the number of daily doses, the higher the adherence to a drug treatment. What is New: • Administration of amoxicillin in twice-daily doses may improve adherence, as it is less frequently associated with family-perceived problems with dosing schedules.
    MeSH term(s) Child ; Humans ; Infant ; Amoxicillin/adverse effects ; Acute Disease ; Drug Administration Schedule ; Otitis Media/drug therapy ; Drug Therapy, Combination ; Anti-Bacterial Agents/therapeutic use ; Treatment Outcome
    Chemical Substances Amoxicillin (804826J2HU) ; Anti-Bacterial Agents
    Language English
    Publishing date 2023-10-10
    Publishing country Germany
    Document type Observational Study ; Journal Article
    ZDB-ID 194196-3
    ISSN 1432-1076 ; 0340-6199 ; 0943-9676
    ISSN (online) 1432-1076
    ISSN 0340-6199 ; 0943-9676
    DOI 10.1007/s00431-023-05243-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Severity in pediatric type 1 diabetes mellitus debut during the COVID-19 pandemic.

    Güemes, María / Storch-de-Gracia, Pilar / Enriquez, Sara Vinagre / Martín-Rivada, Álvaro / Brabin, Anthony González / Argente, Jesús

    Journal of pediatric endocrinology & metabolism : JPEM

    2020  Volume 33, Issue 12, Page(s) 1601–1603

    MeSH term(s) Adolescent ; COVID-19/epidemiology ; Child ; Diabetes Mellitus, Type 1/diagnosis ; Diabetes Mellitus, Type 1/epidemiology ; Diabetes Mellitus, Type 1/therapy ; Diabetic Ketoacidosis/diagnosis ; Diabetic Ketoacidosis/epidemiology ; Diabetic Ketoacidosis/therapy ; Emergency Service, Hospital/statistics & numerical data ; Humans ; Pandemics ; Retrospective Studies ; SARS-CoV-2 ; Spain/epidemiology
    Language English
    Publishing date 2020-11-05
    Publishing country Germany
    Document type Letter ; Observational Study
    ZDB-ID 1231070-0
    ISSN 2191-0251 ; 0334-018X
    ISSN (online) 2191-0251
    ISSN 0334-018X
    DOI 10.1515/jpem-2020-0481
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Clinical spectrum and risk factors for complicated disease course in children admitted with SARS-CoV-2 infection.

    Storch-de-Gracia, Pilar / Leoz-Gordillo, Inés / Andina, David / Flores, Patricia / Villalobos, Enrique / Escalada-Pellitero, Silvia / Jiménez, Raquel

    Anales de pediatria

    2020  Volume 93, Issue 5, Page(s) 323–333

    Abstract: Introduction: At this time there are still major questions about the characteristics of disease caused by the new coronavirus (COVID-19) in children as well as factors associated with the development of severe forms of the disease.: Study design: ... ...

    Abstract Introduction: At this time there are still major questions about the characteristics of disease caused by the new coronavirus (COVID-19) in children as well as factors associated with the development of severe forms of the disease.
    Study design: Retrospective study including patients under 18 years of age admitted with SARS-CoV-2 infection from March 1 to April 30, 2020. Infection was confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) or antibody testing. We describe the epidemiological and clinical data, laboratory and imaging findings, as well as treatment and outcome in these patients. In light of these findings, patients were classified into two severity groups and then compared.
    Results: Thirty-nine children were included, with a median age of 9 years (range 12 days-16 years); 23 were boys. Cases with uncomplicated disease course (24) mostly presented to the emergency department (ED) with fever and/or respiratory symptoms without significant alterations in laboratory findings. Of the 15 children with a complicated course, 12 developed shock. In addition to fever, they frequently presented altered appearance, extreme tachycardia, abdominal pain, vomiting, diarrhea, rash, and/or conjunctival hyperemia. They also showed greater lymphopenia (
    Conclusions: SARS-CoV-2 infection in admitted children presents with great clinical variability. When provided supportive care, patients with predominant respiratory symptoms without altered laboratory-test results generally have an uncomplicated course. Patients with complicated disease present mainly with fever and abdominal and/or mucocutaneous symptoms. Most develop shock. Elevation of inflammatory markers may allow for early detection and the final outcome is good.
    Keywords covid19
    Language English
    Publishing date 2020-10-15
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 2830901-7
    ISSN 2341-2879 ; 2341-2879
    ISSN (online) 2341-2879
    ISSN 2341-2879
    DOI 10.1016/j.anpede.2020.07.005
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  6. Article ; Online: Espectro clínico y factores de riesgo de enfermedad complicada en niños ingresados con infección por SARS-CoV-2.

    Storch-de-Gracia, Pilar / Leoz-Gordillo, Inés / Andina, David / Flores, Patricia / Villalobos, Enrique / Escalada-Pellitero, Silvia / Jiménez, Raquel

    Anales de pediatria

    2020  Volume 93, Issue 5, Page(s) 323–333

    Abstract: Introduction: At this time there are still major questions about the characteristics of disease caused by the new coronavirus (COVID-19) in children as well as factors associated with the development of severe forms of the disease.: Study design: ... ...

    Title translation Clinical spectrum and risk factors for complicated disease course in children admitted with SARS-CoV-2 infection.
    Abstract Introduction: At this time there are still major questions about the characteristics of disease caused by the new coronavirus (COVID-19) in children as well as factors associated with the development of severe forms of the disease.
    Study design: Retrospective study including patients under 18 years of age admitted with SARS-CoV-2 infection from March 1 to April 30, 2020. Infection was confirmed by realtime reverse transcriptase-polymerase chain reaction (RT-PCR) or antibody testing. We describe the epidemiological and clinical data, laboratory and imaging findings, as well as treatment and outcome in these patients. In light of these findings, patients were classified into two severity groups and then compared.
    Results: Thirty-nine children were included, with a median age of 9 years (range 12 days-16 years); 23 were boys. Cases with uncomplicated disease course (24) mostly presented to the emergency department (ED) with fever and/or respiratory symptoms without significant alterations in laboratory findings. Of the 15 children with a complicated course, 12 developed shock. In addition to fever, they frequently presented altered appearance, extreme tachycardia, abdominal pain, vomiting, diarrhea, rash, and/or conjunctival hyperemia. They also showed greater lymphopenia (p = 0.001), elevated neutrophil/lymphocyte ratio (p = 0.001), C-reactive protein (p < 0.001), procalcitonin (p = 0.001), D-dimer (p < 0.001), and ferritin (p < 0.001).
    Conclusions: SARS-CoV-2 infection in admitted children presents with great clinical variability. When provided supportive care, patients with predominant respiratory symptoms without altered laboratory-test results generally have an uncomplicated course. Patients with complicated disease present mainly with fever and abdominal and/or mucocutaneous symptoms. Most develop shock. Elevation of inflammatory markers may allow for early detection and the final outcome is good.
    MeSH term(s) Adolescent ; Betacoronavirus/isolation & purification ; COVID-19 ; COVID-19 Testing ; Child ; Child, Preschool ; Clinical Laboratory Techniques ; Coronavirus Infections/complications ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Female ; Hospitalization ; Humans ; Infant ; Infant, Newborn ; Male ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; Prognosis ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index ; Spain/epidemiology
    Keywords covid19
    Language Spanish
    Publishing date 2020-08-31
    Publishing country Spain
    Document type Journal Article ; Observational Study
    ZDB-ID 2830901-7
    ISSN 2341-2879 ; 2341-2879
    ISSN (online) 2341-2879
    ISSN 2341-2879
    DOI 10.1016/j.anpedi.2020.07.025
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  7. Article ; Online: Invasive bacterial infection in children with fever and petechial rash in the emergency department: a national prospective observational study.

    Storch-De-Gracia, Pilar / Fernández, Jose Luis / Velasco, Roberto / Saez, Itsaso / Rodrigo, Rocío / Yañez, Sandra / Castellarnau, Ester / Gil, Elena / Del Rio, Patricia / Garrido, Estíbaliz / Castaño, Antón / Perez, Álvaro / Cabrerizo, María / Hernández, María / Pérez, Juan Jesús / de la Torre, María José / Nadal, Gemma / Martínez, Javier / Sánchez-Tatay, Victoria

    Archives of disease in childhood

    2023  Volume 108, Issue 6, Page(s) 445–450

    Abstract: Objective: To determine the incidence and clinical predictors of invasive bacterial infection (IBI) in well-appearing children who present to the emergency department (ED) with fever and petechiae.: Design: A prospective, observational, multicentre ... ...

    Abstract Objective: To determine the incidence and clinical predictors of invasive bacterial infection (IBI) in well-appearing children who present to the emergency department (ED) with fever and petechiae.
    Design: A prospective, observational, multicentre study was conducted in 18 hospitals between November 2017 and October 2019.
    Patients: A total of 688 patients were recruited.
    Main outcome measures: The primary outcome was the presence of IBI. Clinical features and laboratory test results were described and related to the presence of IBI.
    Results: Ten IBIs were found (1.5%), comprising eight cases of meningococcal disease and two of occult pneumococcal bacteraemia. Median age was 26.2 months (IQR 15.3-51.2). Blood samples were obtained from 575 patients (83.3%). Patients with an IBI had a shorter time from fever to ED visit (13.5 hours vs 24 hours) and between fever and rash onset (3.5 hours vs 24 hours). Values for absolute leucocyte count, total neutrophil count, C reactive protein and procalcitonin were significantly higher in patients with an IBI. Significantly fewer patients with a favourable clinical status while in the observation unit were found to have an IBI (2/408 patients, 0.5%) than when clinical status was unfavourable (3/18, 16.7%).
    Conclusions: The incidence of IBI among children with fever and petechial rash is lower than previously reported (1.5%). The time from fever to ED visit and to rash onset was shorter in patients with an IBI. Patients with a favourable clinical course during observation in the ED are at lower risk of IBI.
    MeSH term(s) Humans ; Child ; Infant ; Child, Preschool ; Prospective Studies ; Bacterial Infections/epidemiology ; Fever/etiology ; Fever/microbiology ; Streptococcal Infections ; Emergency Service, Hospital ; Purpura/diagnosis ; Purpura/epidemiology ; Purpura/etiology ; Exanthema/epidemiology ; Exanthema/etiology
    Language English
    Publishing date 2023-04-04
    Publishing country England
    Document type Observational Study ; Multicenter Study ; Journal Article
    ZDB-ID 524-1
    ISSN 1468-2044 ; 0003-9888 ; 1359-2998
    ISSN (online) 1468-2044
    ISSN 0003-9888 ; 1359-2998
    DOI 10.1136/archdischild-2022-325281
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  8. Article ; Online: Clinical spectrum and risk factors for complicated disease course in children admitted with SARS-CoV-2 infection

    Storch-de-Gracia, Pilar / Leoz-Gordillo, Inés / Andina, David / Flores, Patricia / Villalobos, Enrique / Escalada-Pellitero, Silvia / Jiménez, Raquel

    Anales de Pediatría (English Edition) ; ISSN 2341-2879

    2020  

    Keywords covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    DOI 10.1016/j.anpede.2020.07.005
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Espectro clínico y factores de riesgo de enfermedad complicada en niños ingresados con infección por SARS-CoV-2

    Storch-de-Gracia, Pilar / Leoz-Gordillo, Inés / Andina, David / Flores, Patricia / Villalobos, Enrique / Escalada-Pellitero, Silvia / Jiménez, Raquel

    Anales de Pediatría

    2020  Volume 93, Issue 5, Page(s) 323–333

    Keywords Pediatrics, Perinatology, and Child Health ; covid19
    Language Spanish
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 2102669-5
    ISSN 1695-4033
    ISSN 1695-4033
    DOI 10.1016/j.anpedi.2020.07.025
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article: Espectro clínico y factores de riesgo de enfermedad complicada en niños ingresados con infección por SARS-CoV-2./ [Clinical spectrum and risk factors for complicated disease course in children admitted with SARS-CoV-2 infection]

    Storch-de-Gracia, Pilar / Leoz-Gordillo, Inés / Andina, David / Flores, Patricia / Villalobos, Enrique / Escalada-Pellitero, Silvia / Jiménez, Raquel

    An Pediatr (Barc)

    Abstract: INTRODUCTION: At this time there are still major questions about the characteristics of disease caused by the new coronavirus (COVID-19) in children as well as factors associated with the development of severe forms of the disease. STUDY DESIGN: ... ...

    Abstract INTRODUCTION: At this time there are still major questions about the characteristics of disease caused by the new coronavirus (COVID-19) in children as well as factors associated with the development of severe forms of the disease. STUDY DESIGN: Retrospective study including patients under 18 years of age admitted with SARS-CoV-2 infection from March 1 to April 30, 2020. Infection was confirmed by realtime reverse transcriptase-polymerase chain reaction (RT-PCR) or antibody testing. We describe the epidemiological and clinical data, laboratory and imaging findings, as well as treatment and outcome in these patients. In light of these findings, patients were classified into two severity groups and then compared. RESULTS: Thirty-nine children were included, with a median age of 9 years (range 12 days-16 years); 23 were boys. Cases with uncomplicated disease course (24) mostly presented to the emergency department (ED) with fever and/or respiratory symptoms without significant alterations in laboratory findings. Of the 15 children with a complicated course, 12 developed shock. In addition to fever, they frequently presented altered appearance, extreme tachycardia, abdominal pain, vomiting, diarrhea, rash, and/or conjunctival hyperemia. They also showed greater lymphopenia (p = 0.001), elevated neutrophil/lymphocyte ratio (p = 0.001), C-reactive protein (p < 0.001), procalcitonin (p = 0.001), D-dimer (p < 0.001), and ferritin (p < 0.001). CONCLUSIONS: SARS-CoV-2 infection in admitted children presents with great clinical variability. When provided supportive care, patients with predominant respiratory symptoms without altered laboratory-test results generally have an uncomplicated course. Patients with complicated disease present mainly with fever and abdominal and/or mucocutaneous symptoms. Most develop shock. Elevation of inflammatory markers may allow for early detection and the final outcome is good.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #734952
    Database COVID19

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