Revista Ecuatoriana de Pediatría

Artificial intelligence in medical practice: applications and considerations

Jonathan Víctor Lozada Pazmiño — 2025-08-29

Artificial intelligence (AI) is revolutionizing medical practice at multiple levels, from diagnosis to medication management optimization in primary and specialized care. This paper analyzes the functioning of AI, its implementation in clinical decision-making, and its impact on various medical specialties, such as imaging, ophthalmology, oncology, and cardiology. It also addresses its benefits, limitations, and the role of the convergence between human and artificial intelligence in modern medicine. It also discusses the challenges related to the acceptance of this technology by healthcare personnel and the need for regulation to ensure its safe and effective use in clinical practice.

Pancreas Divisum as a cause of pediatric acute recurrent pancreatitis: a case report

Andrea Cristina Restrepo Hincapie — 2025-08-29

Acute pancreatitis is a reversible inflammatory condition of the pancreatic parenchyma with a variable clinical course, since activation of pancreatic enzymes within the gland, leading to a tissue injury that can range from local involvement to life-threatening systemic compromise. Prevalence of childhood acute pancreatitis has been increasing during recent decades and pancreas divisum is considered one of the causes of acute recurrent pancreatitis. However, in some patients with this anomaly are asymptomatic. The clinical relevance of this anatomic variant remains controversial. We present the case of an 11-year-old female patient with a history of acute pancreatitis and subsequent diagnosis of pancreas divisum. This case report aims to describe the importance of early diagnosis of acute recurrent pancreatitis for timely intervention to limit the progression to chronic pancreatitis.

Ulcerative jejunitis, an unusual symptom of IgA vasculitis, in a pediatric patient

José Andrés Tutillo León — 2025-08-29

Immunoglobulin A vasculitis (IgA vasculitis) is the most common vasculitis, occurring in children and peaking between 4 and 6 years of age. Diagnosis is based on clinical manifestations in 95% of cases, based on the EULAR/PRINTO/PRES criteria, such as skin rashes along with other gastrointestinal, musculoskeletal, and renal disorders. Occasionally, an atypical presentation may occur, necessitating diagnosis by biopsy of the affected organ indicating IgA deposition. Treatment is conservative, as it is self-limiting in most cases and resolves within weeks. Mortality is related to long-term renal impairment.

Perinatal Asphyxia and Hypoxic-Ischemic Encephalopathy. A Systematic Review

Verónica Luisana Guzmán Pesántez — 2025-08-29

Hypoxic-ischemic encephalopathy (HIE) is the leading cause of acquired brain injury and disability in full-term neonates. It is estimated that while the incidence is 1 to 6 per 1,000 live births in developed countries, it can rise to 25 per 1,000 in developing countries, underscoring a significant global disparity. Perinatal asphyxia, defined as a severe impairment in gas exchange during the peripartum, intrapartum, or the first minutes after birth, can cause multi-system damage. This systematic review was conducted following the PRISMA 2020 statement guidelines to ensure transparency and quality. An exhaustive search was carried out in the biomedical databases Scopus and Web of Science. The study selection process involved a two-stage review to identify potentially relevant studies, and ultimately, 19 studies were included in the review. Perinatal asphyxia and HIE have been redefined as a complex syndrome with a multifactorial etiology. The reviewed evidence confirms that therapeutic hypothermia is an effective neuroprotective intervention in high-income countries, but its success is not universal and depends on the available support infrastructure, which explains the discrepancy in results in limited-resource settings. HIE is a multi-systemic syndrome, and the dysfunction of other organs is directly correlated with the neurological prognosis. Finally, multidisciplinary follow-up is essential to address the wide spectrum of long-term sequelae, such as cerebral palsy, epilepsy, and cognitive and learning deficits, which often manifest over time.

Influence of carbonated substances consumed by adolescents and children on the degradation of resinous sealants: in vitro study

Diana Carolina Ortiz Fienco — 2024-08-30

For the prevention of caries dental, pit and fissure sealants based on fluid resins are used. Currently, there is a high prevalence of carbonated beverage consumption among children and adolescents, which has consequences for dental tissues and restorative materials. The objective was to determine the influence of contact with common carbonated beverages in the Ecuadorian child and adolescent population on resinous sealants in relation to their roughness, color and weight. An experimental in vitro study was conducted. 18 resinous sealant discs constructed from fluid viscosity composite resin were used and divided into three groups of 6 blocks each. The control group was kept in contact with saline solution and two experimental groups were subjected to two types of carbonated beverages for different periods of time, to evaluate the influence of the latter on the degradation of the resinous material considering their roughness, color and weight of these resinous sealants. The results obtained showed significant changes in the color of the resin discs used in both the black glue group (p = 0.014) and the clear glue group (p = 0.014), and among the three groups (p = 0.000), but not in the weight and roughness variables. Carbonated beverages have the potential to damage the integrity of restorative materials due to their highly acidic composition, which may compromise efforts to prevent dental caries through the application of pit and fissure sealants.

Prevalence and epidemiological characterization of congenital syphilis at the San Luis de Otavalo Basic Hospital: A descriptive study based on data, not reports

Diana Flores Yépez — 2025-08-31

Introduction: Congenital syphilis (CS), which is the result of fetal infection by Treponema pallidum, despite being an ancient disease, still continues to affect children around the world; Most cases develop because the mother did not receive prenatal care or received insufficient treatment for syphilis before or during pregnancy. Objective: To describe the prevalence of congenital syphilis and the epidemiological characteristics of patients admitted to the Pediatrics-Neonatology area of the San Luis de Otavalo Basic Hospital (HSLO), as well as their mothers during the period 2020 - 2024. Additionally, the cases of congenital syphilis and the type of trend presented at the level of the province of Imbabura and at the national level are listed. Methodology: An observational, descriptive, and retrospective study was conducted. Data were obtained from the physical and electronic medical records of children diagnosed with CS at the San Luis de Otavalo Basic Hospital during the period 2020-2024. Data on the number of CS cases at the national and provincial levels were also obtained from the National Institute of Statistics and Census (INEC). The variables analyzed were sex, gestational age at birth, birth weight, and newborn symptoms, as well as age, ethnicity, marital status, educational level, and number of follow-ups among their mothers. SPSS v. 30 and Excel 2019 were used for data processing and analysis. The descriptive analysis included prevalence calculations for the cases presented, as well as a description of the sociodemographic characteristics of the patients and their mothers. Additionally, trends in congenital syphilis cases at the national level and in the province of Imbabura are presented. Results: During the period 2020-2024 at the San Luis de Otavalo Basic Hospital, 6,838 births occurred, 16 of which were diagnosed with CS, which represented a prevalence of 0.23%, 63% were men and 37% women, 100% of them were born full-term and with adequate weight; Regarding the symptoms, it was observed that only 16% (1 case) presented symptoms compatible with CS (prolonged jaundice). When referring to their mothers, it was observed that 50% were of Ecuadorian nationality, followed by Venezuelan and Colombian women with 38 and 12% respectively; 69% self-identified as mestizo and 31% as indigenous; If we talk about marital status, 37% were reported as single and in a common-law union each, with married women representing 25%; When speaking of educational level, 56% of these women completed basic education and 44% are high school graduates. An interesting and at the same time worrying fact is the number of prenatal check-ups: 38% of the women studied had 5 prenatal check-ups, the remaining 68% reported fewer than 5 check-ups during their pregnancy. To conclude, there is an upward trend in SC cases occurring nationally and in the province of Imbabura. Conclusions: Congenital syphilis is a disease that at San Luis Otavalo Basic Hospital presented a prevalence of 0.23% during the period 2020-2024. All 16 patients were full-term newborns with adequate birth weight, and only 1 of them presented symptoms (prolonged jaundice). Their mothers, both mostly Ecuadorian and foreign, self-identified as mestizo and indigenous, and most of them were under 33 years old with basic and high school education levels; It is striking that more than half of them did not receive the minimum prenatal checkups recommended by the World Health Organization (WHO). Additionally, reported cases of congenital syphilis in the province of Imbabura and nationwide have been on the rise.