Publicación Oficial de la Asociación Española de Pediatría de Atención Primariahttp://pap.esenThu, 21 May 2026 10:14:44 UTCIntroduction: Chagas disease (ChD), endemic in 21 Latin American countries, has spread globally due to migratory movements. Spain is the European country with the highest number of cases, where vertical transmission is the main mechanism of infection. In 2024, the Spanish Ministry of Health developed a prenatal screening protocol for ChD; however, there is no unified pediatric protocol currently in place. Early diagnosis and treatment in childhood could reduce morbidity and mortality and prevent new cases of vertical transmission. Objective: to evaluate the implementation and results of a pilot Chagas disease screening program in the pediatric population of the province of Guadalajara, Spain. Material and methods: we carried out a prospective study (October 2022–December 2024) in primary care centers in the province of Guadalajara. A structured questionnaire was used to assess epidemiological characteristics and knowledge of the disease, and serological screening (ELISA/CLIA) was offered to children from endemic countries. We analyzed knowledge level, coverage, adherence, and perceived barriers. Results: a total of 588 children participated (47% of the target population), of whom 325 (55.3%) underwent serological testing. No positive cases were detected. Having seen the vector was significantly associated with knowing about the disease, but no variables were associated with screening adherence. Conclusions: pediatric screening for Chagas disease is feasible and enables early diagnosis. Identifying and addressing the barriers that limit participation in screening is essential to improve adherence and optimize detection and treatment in at-risk children. http://pap.es/articulo/14581/Mon, 09 Feb 2026 00:00:00 UTCObjectives: sudden infant death syndrome (SIDS) is a leading cause of death in infants under one year. Despite known preventive measures, parental knowledge is often insufficient. This study assessed parental level of knowledge about SIDS prevention at the first newborn check-up at the primary care center and analyzed whether parental educational level influenced this knowledge. Methods: we conducted a cross-sectional observational study in the Community of Madrid including 40 parents of newborns attending their first pediatric care appointment. A questionnaire was used to collect data on sociodemographic characteristics and knowledge about preventive measures against SIDS, completed on a voluntary basis. We analyzed differences based on educational attainment, number of children, type of hospital, and sex of the respondent. Results: 97.5% correctly identified the supine sleeping position. There was confusion regarding other measures, such as bed-sharing or the use of anti-roll devices. We found significant differences based on educational attainment (p = 0.008), with university-educated parents scoring higher. Mothers demonstrated better knowledge than fathers (p = 0.027). There were no significant differences based on the number of children or type of hospital. Conclusions: educational attainment is significantly associated with knowledge of preventive measures against SIDS. While most respondents recognized the correct sleeping position, there were still gaps in other areas, underscoring the need for tailored educational interventions in primary care, particularly aimed at less-educated parents. http://pap.es/articulo/14585/Wed, 25 Feb 2026 00:00:00 UTCIntroduction: body image begins to develop in childhood and is influenced by sociocultural factors. During preadolescence, a stage characterized by heightened sensitivity to social comparison and the internalization of beauty ideals, intensive social media use may constitute a risk factor for body dissatisfaction. This study aims to analyze the prevalence of body dissatisfaction among preadolescents and its possible relationship with social media use. Material and methods: an observational, cross-sectional, analytical, and descriptive study was conducted involving 171 preadolescents aged 9 to 12 years from the Munguía health area (Biscay). The Collins Figure Rating Scale was used to assess body perception and dissatisfaction, and validated questionnaires were administered to evaluate social media usage habits. Statistical analyses were performed using the chi-square test, Student t-test, ANOVA, or Kruskal-Wallis test according to the data distribution, along with effect sizes and concordance coefficients. Results: some degree of body dissatisfaction was reported by 56.1% of participants, with a higher prevalence among girls (p = 0.003) and children without siblings (p <0.001). While no significant association was found between general social media use and body dissatisfaction, we observed a moderate association with Instagram use (p = 0.011). Conclusions: we observed a high prevalence of body dissatisfaction in preadolescents, particularly among girls, and associated with Instagram use. These findings highlight the need for early preventive interventions that promote a positive body image and a critical approach to social media use. http://pap.es/articulo/14586/Wed, 25 Feb 2026 00:00:00 UTCPica, defined as the persistent ingestion of non-nutritive substances, is a clinical sign that, in pediatric patients, should raise alarm about potential nutritional deficiencies. Although its association with iron-deficiency anemia is well-known, it can be a marker of more complex issues, especially in children with selective eating patterns. We present the case of a two-year-old girl with a history of a restrictive diet brought to a primary care clinic due to compulsive ingestion of paper. The physical examination revealed pallor and plateauing of the weight and height growth curves. The initial laboratory workup confirmed microcytic anemia with low iron stores. Despite initiating treatment with oral iron, the symptoms persisted, partly due to irregular adherence. A second evaluation six months later not only revealed ongoing iron deficiency but also a previously undetected folic acid deficiency. The final diagnosis was mixed-deficiency anemia in the context of a pediatric feeding disorder. This case highlights the importance of considering multiple nutritional deficiencies when the response to initial treatment is not as expected in a patient with dietary risk factors. http://pap.es/articulo/14572/Tue, 13 Jan 2026 00:00:00 UTCOnychomycosis is an uncommon fungal infection in the pediatric population, although there its incidence has increased in recent years. Consequently, primary care pediatricians should be familiar with the different presentations of onychomycosis, as well as the approach to its diagnosis and management. Within the group of onychomycoses, white superficial onychomycosis is a particularly uncommon subtype in childhood. For this reason, it is essential to recognize its clinical features and to perform an appropriate differential diagnosis to rule out other entities with a similar presentation. We present the clinical case of a male patient diagnosed with white superficial onychomycosis, describing his diagnostic evaluation and therapeutic management.http://pap.es/articulo/14573/Tue, 13 Jan 2026 00:00:00 UTCOnychomadesis is an uncommon condition in childhood, and its prevalence remains unclear. Its appearance often causes significant anxiety among caregivers, although it is usually a benign and self-limiting condition. Isolated cases of onychomadesis have been reported following viral infections, but it has also been described as a complication of autoimmune diseases (such as pemphigus vulgaris or alopecia areata), severe systemic disorders (including Guillain-Barré syndrome and Kawasaki disease), use of drugs (such as chemotherapy, antiepileptics, antibiotics, or retinoids), and in newborn infants following obstetric trauma or local fungal infections. In this report, we present two clinical cases illustrating different etiologies of onychomadesis (idiopathic and viral), highlighting the importance of a thorough history-taking to enable diagnosis through clinical assessment, thus avoiding unnecessary laboratory tests or diagnostic procedures. We also summarize the possible etiological mechanisms described in the literature, aiming to provide clinicians with a better foundation to guide future diagnosis. In both cases, we emphasize the value of communicating clearly with parents, as appropriate explanation helps to reassure caregivers and convey the benign, self-limiting nature of this condition.http://pap.es/articulo/14587/Mon, 09 Mar 2026 00:00:00 UTCSialolithiasis is an uncommon condition in childhood. The characteristic clinical presentation includes salivary gland masses and pain with eating. Imaging tests can be used for diagnostic confirmation. Conservative management is the first-line treatment; in the case it fails, there has been a trend toward minimally invasive treatments over traditional surgery in recent years. We present the case of a 9-year-old boy with submaxillitis secondary to sialolithiasis that had a favorable outcome with conservative management. http://pap.es/articulo/14588/Mon, 09 Mar 2026 00:00:00 UTCMajocchi granuloma is a rare form of deep dermatophytosis caused by fungal invasion of the hair follicle and dermis. While typically reported in adults, often after inappropriate topical corticosteroid use, its occurrence in infants is exceptional and represents a significant diagnostic challenge. We report the case of an infant with persistent erythematous-squamous plaques unresponsive to conventional topical therapies. The diagnosis was confirmed by fungal culture, with detection of dermatophyte growth. The patient achieved complete resolution with systemic terbinafine. This case underscores the importance of considering Majocchi granuloma in the differential diagnosis of chronic skin lesions in children and highlights the value of early recognition and prompt initiation of systemic antifungal therapy to avoid therapeutic delays. http://pap.es/articulo/14594/Fri, 20 Mar 2026 00:00:00 UTCCeliac crisis is a very rare and life-threatening complication of celiac disease. It usually occurs at the onset of celiac disease, but later occurrence is not uncommon. The age range for this condition is broad; most cases tend to occur in the first two years of life, although recent reviews place the median age at around 18 years, and cases have also been described in adults. While there are no well-defined diagnostic criteria for the pediatric population, it typically manifests as profuse diarrhea, frequently accompanied by significant dehydration, electrolyte imbalances, hypoalbuminemia, lethargy, malnutrition, and even coagulopathy. It is believed that there are triggering factors, such as intercurrent infections, vaccination, surgery, or dietary indiscretions. The management includes supportive care to correct dehydration, electrolyte imbalances and malnutrition, and may initially require corticosteroid therapy or total parenteral nutrition, with early and gradual reintroduction of enteral nutrition to avoid refeeding syndrome. http://pap.es/articulo/14574/Thu, 15 Jan 2026 00:00:00 UTCUnintentional injury in children due to accidents in the home constitutes a significant public health problem in Spain, as it is one of the leading causes of morbidity and mortality in children aged less than 14 years, especially in the first years of life. The risk factors include not only the age and developmental level of the child, but also the physical characteristics of the home and the supervision by caregivers. The PrevInfad group has updated its recommendations for the prevention of pediatric unintentional home injuries. The article published by the group explains the rationale for each of the recommendations, developed in a process encompassing the formulation of structured clinical questions, a literature search, the selection of the most relevant studies and the appraisal of the evidence. In conclusion, the group recommends: a) providing guidance on the prevention of pediatric home injuries at the primary care level; b) implementing protective measures to decrease the morbidity and mortality due to pediatric unintentional injuries; and c) refraining from using baby walkers. http://pap.es/articulo/14579/Fri, 23 Jan 2026 00:00:00 UTCAuthors’ conclusions: umbilical cord blood transfusion is safe and provides benefits for improving gross motor function in some children with cerebral palsy, especially younger children with milder cerebral palsy. Reviewers' comment: while promising, umbilical cord blood transfusion in childhood cerebral palsy is of questionable long-term safety and offers only uncertain gross motor function benefits to select children (under 5 years of age with mild cerebral palsy) and at high doses of total nucleated cells. At present, in our opinion, a general recommendation cannot be made. http://pap.es/articulo/14591/Wed, 11 Mar 2026 00:00:00 UTCThe “Cine y Pediatría” project, established in 2010, advocates for the use of film as a fundamental tool for teaching and humanizing clinical practice. This article compiles and analyzes an extensive selection of films centered on the educational ecosystem, exploring the relationship between teacher, student, and classroom as a microcosm of society. The study classifies cinematic production into three main geographical axes. United States cinema, characterized by epic and individualistic narratives where charismatic teachers act as agents of redemption within contexts of social conflict. French cinema, adopting a realistic and choral tone to analyze the school as a complex institution facing cultural diversity and structural inequalities. Spanish cinema, where the classroom serves as a space shaped by historical memory and generational tensions.Films from many other countries are also analyzed. Through iconic works such as Dead Poets Society, Les Choristes, La lengua de las mariposas, and Goodbye, Mr. Chips, the article highlights cinema's role in visualizing student vulnerability and the teacher's capacity as a catalyst for resilience. It concludes that the seventh art is an invaluable therapeutic and pedagogical tool for pediatricians, allowing for deep reflection on emotional influence in younger generations and the defense of children's rights in the face of adversity. http://pap.es/articulo/14597/Tue, 24 Mar 2026 00:00:00 UTCPediatric palliative care (PCC) represents a comprehensive approach aimed at improving the quality of life of children with life-threatening or life-limiting conditions and their families, from the moment of diagnosis and throughout the entire course of the illness. Despite growing evidence, it remains a frequently misunderstood field, often incorrectly associated with end-of-life care, withdrawal of treatment, or an unavoidable emotional burden for healthcare professionals. This article presents a narrative and reflective review of the literature on PCC, with the aim of offering a clinical and human-centered perspective on this model of care. Five key pillars are addressed: compassion satisfaction as the reward of caring, the close relationship with families building trust, the technical and humanistic challenge of clinical practice, the comprehensive approach that embraces all dimensions of life, and the diversity of work across multiple care settings. Available evidence shows that pediatric palliative care can provide a strong sense of professional meaning and vocation when delivered within interdisciplinary teams and supported by adequate training. Early integration of palliative care also facilitates more coordinated, continuous, and needs-centered care for children and their families. Promoting a more accurate understanding of pediatric palliative care is essential to dismantle persistent misconceptions, foster its integration into routine pediatric practice, and advance a model of pediatrics that seeks not only to cure, but also to care and accompany. http://pap.es/articulo/14593/Fri, 20 Mar 2026 00:00:00 UTC