Pediatric Oncology Palliative Care Programs in Central America: Pathways to Success.

Palliative care offers children who have life-limiting and life-threatening oncologic illnesses and their families improved quality of life. In some instances, impeccable symptom control can lead to improved survival. Cultural and financial barriers to palliative care in oncology patients occur in all countries, and those located in Central America are no exception.

Latin American Consensus on the Management of Sepsis in Children: Sociedad Latinoamericana de Cuidados Intensivos Pediátricos [Latin American Pediatric Intensive Care Society] (SLACIP) Task Force: Executive Summary.

The aim of this study was to develop evidence-based recommendations for the diagnosis and treatment of sepsis in children in low- and middle-income countries (LMICs), more specifically in Latin America. A panel was formed consisting of 27 experts with experience in the treatment of pediatric sepsis and two methodologists working in Latin American countries. The experts were organized into 10 nominal groups, each coordinated by a member.

Willingness to Get a COVID-19 Vaccine and Its Potential Predictors in Costa Rica: A Cross-Sectional Study.

Since 2020, the COVID-19 pandemic has had a significant impact on morbidity and mortality around the world. As one of the most successful and cost-effective health interventions for preventing infectious diseases, immunization against SARS-CoV-2, is at the moment the most effective strategy for controlling the current pandemic. Despite the high vaccine acceptance rates that countries such as Costa Rica have shown in the past, the public acceptance of the COVID-19 vaccine is still uncertain.

Streptococcus equi subspecies zooepidemicus Meningitis, Septicemia, and Brain Infarcts in a Costa Rican Infant.

, an equine commensal bacterium, is a rare etiology of septicemia and meningoencephalitis in humans and is extremely infrequent in children. Scarce literature has been published about its clinical presentation, treatment and outcomes in infants. Here, we describe a case of septicemia and meningoencephalitis in a five-month-old Costa Rican infant that was confirmed by peripheral blood and cerebrospinal fluid (CSF) cultures in a regional hospital of the Pacific coast of Costa Rica who developed multiple ischemic cerebral infarcts secondary to infectious vasculitis, a subdural empyema and serious neurological sequelae.

Use of Meropenem in a Tertiary Pediatric Hospital in Costa Rica and Its Role in the Era of Antimicrobial Stewardship.

Background Understanding antibiotic profiles and their resistance patterns can improve hospital quality care and optimize clinical outcomes. This paper characterizes the use of meropenem in the National Children's Hospital of Caja Costarricense del Seguro Social (CCSS) in Costa Rica, and its role in antibiotic stewardship. Methods This is a retrospective observational study from hospitalized patients under 13 years of age that received meropenem as part of their treatment.

Acute Abdomen and Appendicitis in 1010 Pediatric Patients With COVID-19 or MIS-C: A Multinational Experience from Latin America.

Background: To date, there are only sporadic reports of acute abdomen and appendicitis in children with coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C).

Methods: Children 17 years of age or younger assessed in 5 Latin American countries with a diagnosis of microbiologically confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and children fulfilling MIS-C definition were included. For children with acute abdomen, we investigate main radiologic patterns, surgical treatment and intraoperative findings, outcomes.

Validation of the Pediatric Canadian Triage and Acuity Scale at the Emergency Department of a Tertiary Children's Hospital in Costa Rica.

Background: The Pediatric Canadian Triage and Acuity Scale (PedCTAS) is a recognized system that prioritizes care by the severity of illness. The goal of this study was to describe and analyze the results from the implementation of the PedCTAS in a tertiary children's hospital in Costa Rica.

Methods: This was a retrospective observational study of children presenting to the emergency department (ED) from 1st January to 31st December of 2019 in the only children's hospital in Costa Rica.

[Secondary hemophagocytic lymphohistiocytosis and cytokine release syndrome in COVID-19, the same or different entities?].

Background: Excessive release of cytokines in severe COVID-19 resembles secondary hemophagocytic lymphohistiocytosis (sHLH).

Aim: To compare the clinical and laboratory characteristics between sHLH and cytokine release syndrome (CRS) in COVID-19.

Methods: A review of articles in the PubMed database was performed, using the following keywords "HLH and COVID", "HScore in COVID".

Treatment of Multisystem Inflammatory Syndrome in Children.

Background: Evidence is urgently needed to support treatment decisions for children with multisystem inflammatory syndrome (MIS-C) associated with severe acute respiratory syndrome coronavirus 2.

Methods: We performed an international observational cohort study of clinical and outcome data regarding suspected MIS-C that had been uploaded by physicians onto a Web-based database. We used inverse-probability weighting and generalized linear models to evaluate intravenous immune globulin (IVIG) as a reference, as compared with IVIG plus glucocorticoids and glucocorticoids alone.

BCG Scar Local Skin Inflammation as a Novel Reaction Following mRNA COVID-19 Vaccines in Two International Healthcare Workers.

Bacillus Calmette-Guérin (BCG) local scar inflammatory reactions have been mostly associated with Kawasaki disease in children and less commonly with other viral infections (i.e., measles).

Carriage of two carbapenem-resistance genes in Pseudomonas aeruginosa isolated from hospital-acquired infections in children from Costa Rica: the importance of local epidemiology.

Background: The assessment of Hospital-acquired infections due to multidrug-resistant bacteria involves the use of a variety of commercial and laboratory-developed tests to detect antimicrobial resistance genes in bacterial pathogens; however, few are evaluated for use in low- and middle-income countries.

Methods: We used whole-genome sequencing, rapid commercial molecular tests, laboratory-developed tests and routine culture testing.

Results: We identified the carriage of the metallo-β-lactamase bla and bla alleles in Carbapenem-Resistant Pseudomonas aeruginosa infections among children in Costa Rica.

SARS-CoV-2 genomic surveillance in Costa Rica: Evidence of a divergent population and an increased detection of a spike T1117I mutation.

Genome sequencing is a key strategy in the surveillance of SARS-CoV-2, the virus responsible for the COVID-19 pandemic. Latin America is the hardest-hit region of the world, accumulating almost 20% of COVID-19 cases worldwide. In Costa Rica, from the first detected case on March 6th to December 31st almost 170,000 cases have been reported.

High rates of antibiotic prescriptions in children with COVID-19 or multisystem inflammatory syndrome: A multinational experience in 990 cases from Latin America.

Aim: This study aims to assess rates of antibiotic prescriptions and its determinants in in children with COVID-19 or Multisystem Inflammatory Syndrome (MIS-C).

Methods: Children <18 years-old assessed in five Latin Americas countries with a diagnosis of COVID-19 or MIS-C were enrolled. Antibiotic prescriptions and factors associated with their use were assessed.

Epidemiological and clinical profile between influenza A and B virus in Costa Rican children.

Objective: We aimed to evaluate the clinical and epidemiological behavior of influenza type A versus type B and analyze if there was any correlation or differences between the characteristics of both groups.

Methods: An observational, retrospective, descriptive, and population-based study based of children who were hospitalized at the only national pediatric hospital of Costa Rica from January 1, 2010 to December 31, 2018 and had a confirmed influenza virus infection.

Results: 336 patients were analyzed.

The Fifth International Neonatal and Maternal Immunization Symposium (INMIS 2019): Securing Protection for the Next Generation.

Despite significant progress in reaching some milestones of the United Nations Sustainable Development Goals, neonatal and early infant morbidity and mortality remain high, and maternal health remains suboptimal in many countries. Novel and improved preventative strategies with the potential to benefit pregnant women and their infants are needed, with maternal and neonatal immunization representing effective approaches. Experts from immunology, vaccinology, infectious diseases, clinicians, industry, public health, and vaccine-related social sciences convened at the 5th International Neonatal and Maternal Immunization Symposium (INMIS) in Vancouver, Canada, from 15 to 17 September 2019.

Childhood Asthma: Low and Middle-Income Countries Perspective.

Our aim is to review current asthma epidemiology, achievements from the last 10 years, and persistent challenges of asthma management and control in low-middle income countries (LMICs). Despite global efforts, asthma continues to be an important public health problem worldwide, particularly in poorly resourced settings. Several epidemiological studies in the last decades have shown significant variability in the prevalence of asthma globally, but generally a marked increase in LMICs resulting in significant morbidity and mortality.

Pediatric Critical Care Transport: Survey of Current State in Latin America. Latin American Society of Pediatric Intensive Care Transport Committee.

Methods: An electronic, anonymous, multicenter survey housed by Monkey Survey was sent to physicians in LA and included questions about hospital and pediatric critical transport, resources available and level of car. Nineteen Latin-American countries were asked to complete the survey.

Results: A total of 212 surveys were analyzed, achieving a representativity of 19 LA countries, being most participants (59.

Bioethical Implications in Vaccine Development, a COVID-19 Challenge.

Introduction In the last 18 years, on three occasions, coronavirus has represented a challenge for global health. Between 2002 and 2003 with Severe Acute Respiratory Syndrome, in 2012 with Middle East Respiratory Syndrome, and since the end of 2019 with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the coronavirus disease 2019 (COVID-19) pandemic, which has challenged health care models and the way of doing research, placing bioethics at the center of discussion.  Methods On August 19, 2020, a webinar organized by the Research Institute of Medical Science (IICIMED, for its acronym in Spanish), entitled 'Bioethical Implications in Vaccine Development, a COVID-19 Challenge' took place.