María Alonso

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Diego Aguirre

Universidad El Bosque

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Jordi Guardiola

Universitat de Barcelona

María Rodriguéz

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UNADMexico

Violeta Del Río

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Manuel Montero-Perez-Barquero

Universidad de Córdoba

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Papers by María Alonso

[Efficacy of exclusive enteral feeding as primary therapy for paediatric Crohn's disease]

Anales De Pediatria, 2009

CITATIONS 4 READS 38 5 authors, including:

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$Research paper thumbnail of [Low bone mineral density and other risk factors in prepubertal children with fracture of the distal forearm]$

[Low bone mineral density and other risk factors in prepubertal children with fracture of the distal forearm]

Anales De Pediatria, Aug 1, 2009

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P�rdida del lenguaje

An Pediatr, 2006

$Research paper thumbnail of Lavados col�nicos anter�grados para el estre�imiento refractario en ni�os sin encefalopat�a$

Lavados col�nicos anter�grados para el estre�imiento refractario en ni�os sin encefalopat�a

An Pediatr, 2009

Revisión retrospectiva de las cecostomías realizadas para lavados anterógrados colónicos. Doce ap... more Revisión retrospectiva de las cecostomías realizadas para lavados anterógrados colónicos. Doce apendicocecostomías desde enero de 2002 a febrero de 2008, 9 apendicostomías en pacientes con mielomeningocele y 3 cecostomías en niños con estreñimiento crónico no orgánico sin encefalopatía ni retraso mental. De los 9 primeros pacientes, de entre 3 y 13 años, 8 tuvieron muy buena evolución y uno requirió retirada por mal empleo familiar. A un niño de 7 años, por lo demás sano, con estreñimiento crónico desde los 10 meses, pese a laxantes múltiples (varias tandas de desimpactación y dilatación anal bajo anestesia), con estudio morfofuncional normal, se le realizó, hace 5 años, cecostomía; persistió cierta tendencia a impactación pero con buena calidad de vida. Otro niño, previamente sano, de 12 años de edad, presentaba incontinencia fecal diaria asociada a estreñimiento desde los 3 años, con manometría anorrectal normal y biopsia con leve displasia neuronal; se le realizó cecostomía hace 3 años, con mejoría evidente y menor trastorno emocional secundario. El último caso de cecostomía tenía 8 años, con cuadro similar al anterior y se realizó procedimiento endoscópico con botón de Chait, con lo que mejoró francamente el cuadro. La progresión del estreñimiento rebelde a edad adulta tiene un impacto negativo en la adaptación social y el estado emocional del paciente, y puede alterar la vida familiar. Los lavados anterógrados colónicos proporcionan independencia y mejoran la calidad de vida. Se necesitan realizar en más pacientes para poder establecer verdaderos datos de efectividad.A descriptive review of 12 patients who underwent appendicocecostomy or caecostomy for antegrade colonic lavage from January 2002 to February 2008. There were 9 appendicocecostomies performed patients from 3 to 13 years suffering from myelomeningocele, of which 8 of them had a very good outcome, with one case withdrawn due to poor use by the family. Three caecostomies were performed in non-mentally retarded constipated children. One was an otherwise healthy 7 year-old boy with hard stools since he was 10 months old, in spite of multiple laxative treatments, with normal morphology and function. He had a percutaneous caecostomy five years ago, with some improvement and a good quality of life, but still some occasional partial impactions. Another healthy 12 year-old boy with daily constipation associated faecal incontinence since he was 3 years old (normal manometry and rectal biopsy with signs of mild neuronal dysplasia) had a percutaneous caecostomy performed three years ago, with improvement in the faecal incontinence and better psychological outcome. The last caecostomy patient was an 8-year-old boy, with a similar clinical history and good progress in last three years after placing a Chait's button using an endoscopic procedure. Stubborn constipation continuing into adult life has a negative impact on the social and emotional adaptation of the paediatric patient, affecting family interactions. Antegrade colonic lavage allows independence and improves the quality of life in patients affected by recurrent faecal impactions. This technique needs to be performed on more patients to find out its true effectiveness.

Eficacia del tratamiento nutricional primario en la enfermedad de Crohn pedi�trica

An Pediatr, 2008

El tratamiento nutricional primario (TNP), que consiste en la administración de dieta exclusiva c... more El tratamiento nutricional primario (TNP), que consiste en la administración de dieta exclusiva con fórmula enteral (polimérica, semielemental o elemental) durante un período no inferior a 6-8 semanas, ha demostrado ser efectivo para inducir la remisión clínica en niños afectados de enfermedad de Crohn. La remisión clínica no siempre conlleva la remisión histológica o la curación de la mucosa. La calprotectina fecal es un excelente marcador de la actividad inflamatoria intestinal y sus concentraciones se correlacionan estrechamente con el grado de inflamación de la mucosa intestinal.Se ha realizado un estudio prospectivo observacional en el que se incluyeron todos los pacientes menores de 14 años diagnosticados de enfermedad de Crohn entre enero de 2002 y octubre de 2007 que recibieron alimentación exclusiva con fórmula polimérica (Modulen IBD, Nestlé, Vevey, Suiza) durante su primer brote de enfermedad. Se establecieron controles clínicos (peso, talla, índice de masa corporal, índice de actividad de la enfermedad de Crohn pediátrica [PCDAI]) y determinaciones de calprotectina fecal al inicio, y a las 4 y 8 semanas de tratamiento. La remisión clínica se definió cuando el PCDAI era igual o inferior a 10. Se consideraron normales valores de calprotectina fecal inferiores a 50 μg/g de heces.Se incluyeron 14 pacientes (9 varones), con una edad media en el momento del diagnóstico de 10,74 ± 2,56 años. A las 4 semanas, el 71 % de los pacientes alcanzaron la remission clínica, que se acompañó de un descenso no significativo de las cifras de calprotectina fecal. A las 8 semanas, el 85 % de los pacientes logró la remisión clínica y los valores de calprotectina fecal habían descendido de forma significativa, aunque sin alcanzar concentraciones normales.El TNP administrado durante un período de 8 semanas puede inducir la remisión clínica y mejorar el grado de inflamación de la mucosa intestinal.The primary nutritional therapy (PNT), which consists in the administration of exclusive enteral formula feeds (polymeric, semi-elemental or elemental formula) for a period of no less than 6-8 weeks, has proven to be effective in inducing clinical remission in children with Crohn's disease. The clinical remission does not always include histological remission or cure of the mucosa. Faecal calprotectin is closely correlated with endoscopic and histological findings but is slightly associated with clinical activity scores.An observational prospective study including all patients under 14 years of age diagnosed with Crohn's disease between January 2002 and October 2007, and who were fed exclusively with polymeric formula (Modulen IBD, Nestle, Vevey, Switzerland) during the onset of the disease. Clinical controls were carried out (weight, height, body mass index [BMI) and the Paediatric Crohn's Disease Activity Index [PCDAI)) and faecal calprotectin was measured at the beginning and at weeks 4 and 8 of treatment. The clinical remission was defined as having a PCDAI less than or equal to 10. Faecal calprotectin values below 50 μg/g faeces were considered as normal.There were 14 patients (9 males), mean age at diagnosis of 10.74 ± 2.56 years. At week 4, 71 % of patients (10/14) had achieved clinical remission and a decrease in faecal calprotectin levels that was not significant. After 8 weeks, 85 % of our patients were in clinical remission and faecal calprotectin values had declined significantly without reaching normal levels.Primary nutritional therapy administered over a period of 8 weeks is capable of inducing clinical remission and improving the degree of inflammation of the intestinal mucosa.

Disestesia y lesiones tr�ficas del pie

An Pediatr, 2004

[Colectomy in paediatric patients with ulcerative colitis]

Anales De Pediatria, Feb 1, 2011

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[Progressive familial intrahepatic cholestasis type 3. An MDR3 defect]

Anales De Pediatria, Sep 1, 2008

An Pediatr (Barc). 2008;69(2):181-96 series publicadas, se presenta entre el 3,75 y el 6,6 % 4-8 ... more

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[Loss of language]

Anales De Pediatria, Oct 1, 2006

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Predicci�n de lesi�n histol�gica intestinal en pacientes pedi�tricos con enfermedad cel�aca

An Pediatr, 2011

Los marcadores séricos son de gran utilidad como indicadores de enfermedad celíaca (EC), si bien ... more Los marcadores séricos son de gran utilidad como indicadores de enfermedad celíaca (EC), si bien la biopsia intestinal sigue siendo el patrón oro para establecer el diagnóstico. La positividad de los anticuerpos antitransglutaminasa tisular humana de clase IgA (AATGt-IgA) y los anticuerpos antiendomisio IgA (AAE-IgA) se correlaciona con histología intestinal patológica. La atrofia vellositaria (Marsh 3) representa una característica fundamental para el diagnóstico de EC. El tipo correspondiente a Marsh 2 (hiperplasia críptica) es debatido como lesión propia de la EC.Comprobar el nivel de AATGt-IgA que corresponda a un valor predictivo positivo (VPP) de lesión histológica de 100% para el diagnóstico de EC.Serie de 120 pacientes menores de 14 años sin déficit de IgA sometidos a biopsia intestinal con serología positiva tanto a AATGt-IgA como AAE-IgA. Para los AATGt-IgA según recomendación del fabricante se consideran valores positivos cifras ≥ 16 U/ml. Se establece el VPP de AATGt-IgA a diferentes puntos de corte.La distribución de los hallazgos histológicos en relación con el punto de corte de AATGt-IgA pone de manifiesto el mayor número de lesiones patológicas a medida que aumenta los valores de AATGt-IgA. Con valores del punto de corte por encima de 7,5-10,6 se corresponde con Marsh 2 2,1% y Marsh 3 93,4%; por encima de 10,6 veces el punto de corte, todas las biopsias se catalogan como Marsh 3 (100%). El VPP considerando solo las lesiones Marsh 3 alcanza bajo valor (55%) con serología positiva a AATGt-IgA con valores comprendidos entre 16 y 67 U/ml (1 a 4,2 x punto de corte), y elevado valor (92%) para las concentraciones entre 68 y 118 U/ml (4,3 a 7,4 x punto de corte), y para los casos con 69-170 U/ml (7,5 a 10,6 x punto de corte) (93%). Por encima de 170 U/ml (> 10,6 x punto de corte) el VPP es 100%.El uso de valores superiores al punto de corte recomendado lógicamente debe mejorar aún más la especificidad del test y su VPP. En el 31,6% de los pacientes con positividad para AATGt-IgA y AAE-IgA (38/120) hubiera sido posible diagnosticar la enfermedad sin biopsia intestinal al contar con VPP de 100%. Como existen diversos kits comerciales con distintos puntos de corte, no es posible la estandarización de los resultados, por lo que hay que ser muy cautos para establecer recomendaciones basadas en los valores de AATGt-IgA.Serological markers are of great interest in coeliac disease (CD), although intestinal biopsy is still the gold standard for establishing the diagnosis. Tissue transglutaminase IgA antibodies (AATGt-IgA) and antiendomysial antibodies IgA (AAE-IgA) are closely correlated to intestinal damage observed in biopsies. Villous atrophy (Marsh 3) plays a major role in CD diagnosis. Marsh 2 stage (crypt hyperplasia) as a CD marker is still under debate.To ascertain an AATGt-IgA level that corresponds to a positive predictive value (PPV) of 100% for a histological CD diagnosis.A series of 120 patients younger than 14 years, non- IgA deficient, who underwent an intestinal biopsy and were positive for both serological markers (AATGt-IgA and AAE-IgA). For AATGt-IgA, according to the manufacturer's recommendations, a value greater than 16 IU/mL is considered as a positive value. The PPV of AATGt was determined for different cut-off points.The histological findings distribution is directly correlated to the AATGt-IgA cut-off point. When the cut-off point is set above 7.5-10.6 times the commercial reference value, there is a 2.1% of Marsh 2 lessions and 93.4% of Marsh 3; above 10.6 times the reference value, all biopsies where Marsh 3 (100%). The PPV that considers Marsh 3 is (93.4%). The PPV, for considering Marsh 3 is low (55%) when AATGt-IgA serology is positive with levels between 16 and 67 IU/ml (1-4.2 times the cut-off point) and a higher value (92%) for concentrations between 68 and 118 IU/ml (4.3-7.4 times) and for cases with 69-170 IU/ml (7.5-10.6 times); above 170 IU/ml (>10.6 times) PPV is 100%.The use of values higher than the recommended cut-off point must logically improve specificity and PPV. In 31.6% patients positive for AATGt-IgA and AAE-IgA (38/120) it would have been possible to diagnose the disease without intestinal biopsy as of the PPV was 100%. It is not possible to standardise results as there are different commercial kits with variable cut-off points, so we must be cautious when setting recommendations based on AATGt-IgA.

Colectom�a en pacientes pedi�tricos con colitis ulcerosa

An Pediatr, 2011

No son frecuentes los estudios descritos sobre fallo del tratamiento médico en colitis ulcerosa (... more No son frecuentes los estudios descritos sobre fallo del tratamiento médico en colitis ulcerosa (CU) que conduce a la realización de colectomía.Estudio retrospectivo desde 1984 hasta 2009 de pacientes diagnosticados de CU, menores de 14 años, sometidos a colectomía por falta de respuesta al tratamiento. Se clasifica en función de la cirugía en colectomía urgente y en electiva.Colectomía efectuada en 14 pacientes pediátricos, el 26,9% del total de pacientes diagnosticados de CU. Edad al diagnóstico 7,8 ± 4,0 años, inferior a 10 años en 8 casos y por debajo de 5 años en 5 pacientes. Todos los casos diagnosticados con menos de 5 años fueron colectomizados antes del sexto mes tras el diagnóstico. Se realiza una colectomía electiva en 5/14 y urgente en 9/14. Las complicaciones surgidas se dividen en precoces, por debajo de los 30 días tras colectomía, y tardías, pasado el primer mes. El tratamiento farmacológico en los casos de colectomía urgente abarca metilprednisolona por vía intravenosa (100%), tacrolimus por vía oral (55,5%), ciclosporina por vía oral/intravenoso (33,3%) e infliximab (33,3%). Los casos correspondientes a colectomía electiva corresponden al periodo 1985-1998.La influencia de la edad es determinante en el pronóstico. Todos los menores de 5 años diagnosticados de CU terminaron colectomizados. La indicación de colectomía urgente fue realizada tras falta de respuesta al tratamiento con corticoide por vía intravenosa en combinación con potente agente inmunomodulador (tacrolimus, ciclosporina, infliximab). Los casos correspondientes a colectomía electiva sucedieron en el período anterior a 1999, cuando la terapéutica con fármacos de segunda línea era muy infrecuente, con lo que la remisión era excepcional.There are not many studies published in the literature on failure of medical treatment in Ulcerative Colitis (UC) that leads to colectomy.Retrospective study of patients under 14 years diagnosed with UC from 1984 to 2009, who underwent colectomy due to lack of response to medical treatment. They are divided into urgent or elective surgery.Colectomy performed in 14 paediatric patients (26.9% of total UC patients). Age at diagnosis 7.8 ± 4.0 years, 8 of them younger than 10 years and 5 younger than 5 years. All cases diagnosed on patients less than 5 years of age required colectomy in the first 6 months after diagnosis. Elective colectomy was performed on 5/14 and urgent surgery in 9/14. The reported complications were divided into early (first 30 days after colectomy) and late. Pharmacological treatment in cases with urgent colectomy included methylprednisolone (100%), oral tacrolimus (55.5%), oral/intravenous cyclosporine (33.3%) and infliximab (33.3%). Cases of elective colectomy were all in the 1985–1998 period.The influence of age is a key factor for prognosis. All patients less than 5 year-old ended up with colectomy. The main indication for urgent surgery was lack of response to treatment with intravenous steroids combined with a potent immunomodulator (tacrolimus, cyclosporine, infliximab). All cases of elective colectomy were performed before 1999, when second line medical treatment was very uncommon, making remission unlikely.

Colestasis intrahep�tica familiar progresiva tipo 3. Defecto de MDR3

An Pediatr, 2008

Ahogamientos y casi ahogamientos en ni�os

An Pediatr, 2005

Los accidentes por sumersión siguen causando importante morbimortalidad en niños. Se realiza un e... more Los accidentes por sumersión siguen causando importante morbimortalidad en niños. Se realiza un estudio retrospective para identificar los factores pronósticos asociados a la evolución clínica de niños con accidente por sumergimiento, que puedan servir de ayuda para tomar decisiones terapéuticas, comparándolos con otros datos publicados.Estudio retrospectivo mediante revisión de las historias clínicas de los casos atendidos por accidente por sumergimiento entre enero de 1995 y abril de 2003. Los datos analizados se refieren al paciente, el accidente, situación clínica en Urgencias y unidades donde ingresan en el hospital, valorando la evolución final de cada caso.Se han incluido 62 pacientes, presentando mala evolución 12 (7 fallecimientos y 5 secuelas permanentes). Han resultado significativos, como datos de mal pronóstico,edad igual o superior a 4 años, sexo femenino, tiempo inmersión 5 min o más y, a la llegada al hospital: cianosis inicial que persistía en Urgencias; parada cardíaca, apnea o distrés grave, hipotermia (temperatura < 35 °C), acidosis metabólica (pH < 7,10) y afección neurológica (Glasgow 3; Conn C; pupilas midriáticas y arreactivas).La evolución final del paciente está estrechamente relacionada con la situación clínica a su llegada al hospital.Aunque disponemos de datos orientativos sobre la evolución posterior del paciente casi ahogado, se carece de modelos predictivos precoces que permitan vaticinar la evolución del paciente y, por lo tanto, orientar en la actitud a tomar en las medidas iniciales de reanimación y mantenimiento posterior.Immersion accidents are still an important cause of morbidity and mortality in children. We performed a retrospective study to identify the prognostic factors associated with outcome in children who experience neardrowning,which could serve to guide decision-making.Our data were compared with other published data.The medical records of children treated for near-drowning in our hospital from January 1995 to April 2003 were reviewed. The data analyzed referred to the patient,the accident, the patient's clinical status in the emergency unit, the unit to which the patient was admitted, and outcome.Sixty-two patients were included. Of these, outcome was bad in 12 (death in seven and irreversible sequelae in five). Statistically significant predictors of bad prognosis were age ≥ 4 years, female sex, immersion time ≥ 5 min,cyanosis in the emergency room, cardiac arrest, apnea or severe distress, hypothermia (core temperature < 35 °C),metabolic acidosis (pH ≤ 7.10) and neurologic damage (Glasgow coma Scale score 3; Conn C; nonreactive and mydriatic pupils) on arrival at the hospital.Outcome is closely related to the patient's clinical status on arrival at the hospital. Although data that can serve as a guide to the final outcome of the nearlydrowned patient are available, early models to predict the final clinical results of each case, which could be used to guide initial resuscitation and subsequent treatment,are lacking.

[Allergic colitis in exclusively breast-fed infants]

Anales de pediatría (Barcelona, Spain : 2003), 2006

Eosinophilic colitis is induced by antigens present in cow's milk proteins in formula or huma... more Eosinophilic colitis is induced by antigens present in cow's milk proteins in formula or human milk. In the last few years, an increasing number of cases have been diagnosed in exclusively breast-fed infants. We performed a retrospective study of 13 infants diagnosed with allergic colitis in our unit between January 1997 and January 2004. All the infants had been exclusively breast-fed. In all patients, initial symptoms were digestive (12 with mucus and bloody stools). Onset of symptoms occurred at 0-3 months in 77 %. Laboratory data of the allergic compound were negative. The main locations were the descending and sigmoid colon (75 %). Biopsy demonstrated acute inflammation, with neutrophil infiltration and an increase in eosinophils. In all patients, initial treatment consisted of exclusion of cow's milk proteins from the mother's diet. Ten of the 13 patients showed no improvement, requiring exclusive administration of protein-free hydrolyzate. In 3 infants, breastfeed...

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[Drowning in pediatric patients]

Anales de pediatría (Barcelona, Spain : 2003), 2005

Immersion accidents are still an important cause of morbidity and mortality in children. We perfo... more Immersion accidents are still an important cause of morbidity and mortality in children. We performed a retrospective study to identify the prognostic factors associated with outcome in children who experience near-drowning, which could serve to guide decision-making. Our data were compared with other published data. The medical records of children treated for near-drowning in our hospital from January 1995 to April 2003 were reviewed. The data analyzed referred to the patient, the accident, the patient's clinical status in the emergency unit, the unit to which the patient was admitted, and outcome. Sixty-two patients were included. Of these, outcome was bad in 12 (death in seven and irreversible sequelae in five). Statistically significant predictors of bad prognosis were age > or = 4 years, female sex, immersion time > or = 5 min, cyanosis in the emergency room, cardiac arrest, apnea or severe distress, hypothermia (core temperature < 35 degrees C), metabolic acidosis...

[Primary pulmonary hypertension: Treatment with inhaled iloprost]

Anales españoles de pediatría, 2002

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Oral tacrolimus for pediatric steroid-resistant ulcerative colitis

Journal of Crohn's and Colitis, 2014

Background: Ulcerative colitis (UC) occurring during childhood is generally extensive and is asso... more Background: Ulcerative colitis (UC) occurring during childhood is generally extensive and is associated with severe flares that may require intravenous steroid treatment. In cases of corticosteroid resistance is necessary to introduce a second-line treatment to avoid or delay surgery. Aims: To describe the efficacy and safety of oral tacrolimus for the treatment of severe steroid-resistant UC. Methods: We performed a retrospective study that included all patients under age 18 suffering from severe steroid-resistant UC treated with oral tacrolimus during the period January 1998 to October 2012 and with a follow-up period after treatment of 24 months or more. Results: A total of ten patients were included. The age at baseline was 9.4 ± 4.9 years, and the time from diagnosis was 1.3 months (IQR, 1-5.7). Seven of the patients were in their first flare of disease. All of them received an oral dose of 0.12 mg/kg/day of tacrolimus divided in two doses. Trough plasma levels of tacrolimus were maintained between 4 and 13 ng/ml. Response was seen in 5/10 patients at 12 months, colectomy was eventually performed in 60% of patients during the follow-up period. Conclusions: Tacrolimus is useful in inducing remission in patients with severe steroid-resistant UC, preventing or delaying colectomy, and allowing the patient and family to prepare for a probable surgery. Tacrolimus may also be used as a treatment bridge for corticosteroid-dependent patients until the new maintenance therapy takes effect.

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P376 Register of Paediatric Home Enteral Nutrition (Phen) of Spanish Society for Paediatric Gastroenterology, Hepatology and Nutrition from 2003 to 2007

Clinical Nutrition Supplements, 2008

Rationale: To compare differences in classification of child nutritional status and the prevalenc... more Rationale: To compare differences in classification of child nutritional status and the prevalence of underweight and stunting in a selected population (children with feeding disorders) between the WHO 2006 child growth standards and the usual child growth charts used in Spain (Hernández, M. et al, 1985). Methods: Weight, length or height and body mass index (BMI) were recorded in 102 children from 3 to 60 months. Head circumference (HC) was recorded in 58 of them. Corresponding Z scores were calculated for these data for the two different references and were compared with paired-samples t test. Children with a height/length-forage or weight-for-age below 2 standard deviations (sd) of the corresponding reference median (Z-score 2) were classified as stunted or underweight-for-age respectively. Microcefaly was defined as a value of HC below 2sd of the reference median (Z-score 2). Results: Compared with Spanish charts, the values of length/height-for-age Z-scores was significantly lower (p < 0.001), and the values of HC and BMI-for-age Z-scores were significantly higher (p < 0.001) using the WHO standards. There was no difference in values of weight-for-age Z-scores between the two references. The proportion of underweight children was similar in both. The proportion of children being stunted was highest with the WHO standards (39.6%) compared with Spanish charts (26.7%). Microcefaly prevalence was highest using Hernández charts (22.4%) compared with WHO standards (12.1%). The relation between weight and length/height using BMI Z-score was below 2sd in 30.7% for WHO standards versus 50.5% for Spanish charts. Conclusion: There are differences statistically significant in values of length/height, HC and BMI Z-scores using WHO standards versus usual Spanish charts in children with feeding problems. The values of weight Z-scores are similar in both. This may have implications for the clinical practice.

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$Research paper thumbnail of Disminución de la densidad mineral ósea y otros factores de riesgo en niños prepuberales con fractura del antebrazo distal$

Disminución de la densidad mineral ósea y otros factores de riesgo en niños prepuberales con fractura del antebrazo distal

Anales de Pediatría, 2009

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Pérdida del lenguaje

Anales de Pediatría, 2006

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[Efficacy of exclusive enteral feeding as primary therapy for paediatric Crohn's disease]

Anales De Pediatria, 2009

CITATIONS 4 READS 38 5 authors, including:

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$Research paper thumbnail of [Low bone mineral density and other risk factors in prepubertal children with fracture of the distal forearm]$

[Low bone mineral density and other risk factors in prepubertal children with fracture of the distal forearm]

Anales De Pediatria, Aug 1, 2009

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P�rdida del lenguaje

An Pediatr, 2006

$Research paper thumbnail of Lavados col�nicos anter�grados para el estre�imiento refractario en ni�os sin encefalopat�a$

Lavados col�nicos anter�grados para el estre�imiento refractario en ni�os sin encefalopat�a

An Pediatr, 2009

Eficacia del tratamiento nutricional primario en la enfermedad de Crohn pedi�trica

An Pediatr, 2008

Disestesia y lesiones tr�ficas del pie

An Pediatr, 2004

[Colectomy in paediatric patients with ulcerative colitis]

Anales De Pediatria, Feb 1, 2011

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[Progressive familial intrahepatic cholestasis type 3. An MDR3 defect]

Anales De Pediatria, Sep 1, 2008

An Pediatr (Barc). 2008;69(2):181-96 series publicadas, se presenta entre el 3,75 y el 6,6 % 4-8 ... more

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[Loss of language]

Anales De Pediatria, Oct 1, 2006

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Predicci�n de lesi�n histol�gica intestinal en pacientes pedi�tricos con enfermedad cel�aca

An Pediatr, 2011

Colectom�a en pacientes pedi�tricos con colitis ulcerosa

An Pediatr, 2011

Colestasis intrahep�tica familiar progresiva tipo 3. Defecto de MDR3

An Pediatr, 2008

Ahogamientos y casi ahogamientos en ni�os

An Pediatr, 2005

[Allergic colitis in exclusively breast-fed infants]

Anales de pediatría (Barcelona, Spain : 2003), 2006

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[Drowning in pediatric patients]

Anales de pediatría (Barcelona, Spain : 2003), 2005

[Primary pulmonary hypertension: Treatment with inhaled iloprost]

Anales españoles de pediatría, 2002

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Oral tacrolimus for pediatric steroid-resistant ulcerative colitis

Journal of Crohn's and Colitis, 2014

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P376 Register of Paediatric Home Enteral Nutrition (Phen) of Spanish Society for Paediatric Gastroenterology, Hepatology and Nutrition from 2003 to 2007

Clinical Nutrition Supplements, 2008

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$Research paper thumbnail of Disminución de la densidad mineral ósea y otros factores de riesgo en niños prepuberales con fractura del antebrazo distal$

Disminución de la densidad mineral ósea y otros factores de riesgo en niños prepuberales con fractura del antebrazo distal

Anales de Pediatría, 2009

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Pérdida del lenguaje

Anales de Pediatría, 2006

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