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Antecedentes: los hemangiomas infantiles son los tumores vasculares benignos más frecuentes en la infancia, siendo su localización más habitual la cabeza y el cuello, representando el 50 % de las masas que afectan a la glándula parótida. Debido al rápido crecimiento expansivo de estas lesiones, pueden aparecer complicaciones significativas, como pérdida de la función del órgano o desfiguración permanente, por lo que la intervención terapéutica precoz es de gran importancia para minimizar estos efectos indeseables. Reporte de caso: presentamos dos casos de pacientes con hemangioma parotídeo tratados con propranolol, con resultados muy favorables, y con escasas o nulas reacciones adversas. Conclusiones: actualmente, el propranolol oral está considerado como el fármaco de primera elección en el tratamiento de los hemangiomas parotídeos, mostrando un adecuado perfil de seguridad y una excelente eficacia.

Infants 3 months with minor head trauma (MHT) are a particularly vulnerable group, though few studies have focused specifically on these patients. We aimed to evaluate the application of the PECARN prediction rule, designed for clinically important traumatic brain injury (ciTBI) in children 2 years in infants 3 months, and create a specific prediction rule for this population. We conducted a prospective multicenter observational study in 13 pediatric emergency departments (PEDs) in Spain. The PECARN rule was applied to all patients. A new specific prediction rule for infants 3 months of age was created. The main outcome measures were (1) ciTBI, (2) TBI evidenced on computed tomography (CT) scan, and (3) isolated skull fracture (ISF). Telephone follow-up was conducted for all patients over the 4 weeks after the initial PED visit. Of 21,981 children with MHT, 366 (1.7%) were 3 months old and 195 (53.3%) underwent neuroimaging, including 37 (10.1%) with CT scan. The sensitivity and negative predictive value (NPV) of the PECARN prediction rule for ciTBI were 100% (95% CI, 20.7-100) and 99.7% (95% CI, 98.4-100%), respectively. Of the 230 infants (62.8%) who met the PECARN low-risk criteria, none had ciTBI, 1 (0.4% overall, 95% CI, 0-2.4) had TBI on CT, and 2 (0.9% overall; 95% CI, 0.1-3.1) had an ISF. Among the 136 infants (37.2%) who did not meet the PECARN low-risk criteria, 1 (0.3% overall; 95% CI, 0-1.5) had ciTBI, 11 (8.1% overall; 95% CI, 4.1-14.0) had TBI on CT, and 18 (13.2% overall; 95% CI, 8-20.1) had an ISF. The sensitivity and NPV of the Spanish prediction rule for ciTBI were 100% (95% CI, 20.7-100) and 100% (95% CI, 98.4-100%), respectively. No infants in the registry developed complications during follow-up.The PECARN rule for infants 2 years old accurately identified infants 3 months old at low risk for ciTBI in our population, although the adapted Spanish rule presented here could be even more accurate.• Infants younger than 3 months are vulnerable to minor blunt head trauma due to their age and to difficulties in assessing the subtle symptoms and minimal physical findings detected on examination. • A low threshold for CT scan is recommended in this population.• PECARN rule for infants2 years old is an adequate tool with which to identify infants3 months old at low risk for clinically important traumatic brain injury. • Spanish rule could identify even more low-risk infants without overlooking important outcomes but it should be validated to confirm its predictive capacity.

Purpose. Specific knowledge of the features of minor head trauma in infants is necessary to develop appropriate preventive strategies and adjust clinical management in pediatric emergency departments (PEDs). The aim of this study is to describe the epidemiology of minor blunt head trauma in infants Methods. We performed a prospective study of infants evaluated in any of 13 Spanish PEDs within 24 hours of a minor head trauma (Glasgow Coma Scale scores of 14-15) between May 2017 and November 2020. Telephone follow-up was conducted for all patients over the 4 weeks after the initial PED visit. Results. Of 1,150,255 visits recorded, 21,981 children (1.9%) sustained a head injury, 386 of whom (0.03%) were under 3 months old. Among the 369 patients who met the inclusion criteria (0.03%), 206 (56.3%) were male. The main causes of trauma were fall-related (298; 80.8%), either from furniture (138/298; 46.3%), strollers (92/298; 30.9%), or a caregiver’s arms (61/298; 20.5%). Most infants were asymptomatic (317; 85.9%) and showed no signs of injury on physical exam (210; 56.9%). Imaging studies were performed in 195 patients (52.8%): 37 (10.0%) underwent computed tomography (CT) scan, 162 (43.9%) X-ray, and 22 (6.0%) ultrasound. A clinically important traumatic brain injury (ciTBI) occurred in 1 infant (0.3% overall; 95% CI, 0-1.5), TBI was evidenced on CT scan in 12 (3.3% overall; 95% CI, 1.7-5.7), and 20 infants had an isolated skull fracture (5.5% overall; 95% CI, 3.4-8.3). All outcomes were caused by falls onto hard surfaces.Conclusions. Most head injuries in infants younger than 3 months are benign, and the rate of ciTBI is low. Prevention strategies should focus on falls onto hard surfaces from furniture, strollers, and caregivers’ arms. Optimizing imaging studies should be a priority in this population.

Specific knowledge of the features of minor head trauma in infants is necessary to develop appropriate preventive strategies and adjust clinical management in pediatric emergency departments (PEDs). The aim of this study is to describe the epidemiology of minor blunt head trauma in infants 3 months who present to PEDs. We performed a prospective study of infants evaluated in any of 13 Spanish PEDs within 24 h of a minor head trauma (Glasgow Coma Scale scores of 14-15) between May 2017 and November 2020. Telephone follow-up was conducted for all patients over the 4 weeks after the initial PED visit. Of 1,150,255 visits recorded, 21,981 children (1.9%) sustained a head injury, 386 of whom (0.03%) were under 3 months old. Among the 369 patients who met the inclusion criteria (0.03%), 206 (56.3%) were male. The main causes of trauma were fall-related (298; 80.8%), either from furniture (138/298; 46.3%), strollers (92/298; 30.9%), or a caregiver's arms (61/298; 20.5%). Most infants were asymptomatic (317; 85.9%) and showed no signs of injury on physical exam (210; 56.9%). Imaging studies were performed in 195 patients (52.8%): 37 (10.0%) underwent computed tomography (CT) scan, 162 (43.9%) X-ray, and 22 (6.0%) ultrasound. A clinically important traumatic brain injury (ciTBI) occurred in 1 infant (0.3% overall; 95% CI, 0-1.5), TBI was evidenced on CT scan in 12 (3.3% overall; 95% CI, 1.7-5.7), and 20 infants had an isolated skull fracture (5.5% overall; 95% CI, 3.4-8.3). All outcomes were caused by falls onto hard surfaces. Most head injuries in infants younger than 3 months are benign, and the rate of ciTBI is low. Prevention strategies should focus on falls onto hard surfaces from furniture, strollers, and caregivers' arms. Optimizing imaging studies should be a priority in this population.• Infants younger than 3 months are vulnerable to minor blunt head trauma due to their age and to difficulties in assessing the subtle symptoms and minimal physical findings detected on examination. • A low threshold for CT scan is recommended in this population.• Most cases of blunt head trauma in infants younger than 3 months have good outcomes, and the rate of clinically important traumatic brain injury is low. • Optimizing imaging studies should be a priority in this population, avoiding X-ray examinations and reducing unnecessary CT scans.

Aunque diversos estudios señalan las consecuencias psicológicas negativas de la pandemia por CO- VID-19 en los profesionales de la salud, pocos se centran en la experiencia de los pediatras. Objetivo: evaluar el estado de ansiedad de los pediatras tras la primera oleada e identificar posibles factores relacionados. Material y Método: Estudio de encuestas transversales enviado a pediatras españoles a través del listado de la Asociación Española de Pediatras. Se recogieron datos demográficos, socio-fa- miliares, laborales, autopercepción emocional, síntomas psicosomáticos, consumo de tabaco, alcohol y fármacos psicótropos. Se incluyó la escala Ansiedad Estado-Rasgo (STAI), y se estudió su asociación con variables cualitativas y cuantitativas de la muestra. Resultados: Se registraron 440 encuestas. Una media del 42,2% de los participantes expresó algún síntoma de ansiedad moderado-intenso según la escala Ansiedad-Estado y del 26,9% según la escala Ansiedad-Rasgo. El aislamiento en domicilio se relacionó con una mayor puntuación en ambas escalas. Además, el cambio en la situación laboral del conviviente supuso una puntuación mayor en la escala Ansiedad-Estado. El 41,1% de los encuestados clasificaron el impacto psicológico sufrido como leve, el 50% como moderado y el 8,9% como grave. El 71,8% de los participantes manifestaron algún síntoma psicosomático, con una asociación lineal entre la concurrencia de síntomas y mayores puntuaciones en las dos escalas. Conclusiones: Tras la primera ola por COVID-19 los pediatras han sufrido ansiedad, lo que les ha generado malestar físico y emocional. Las situaciones personales fueron la principal fuente de preocupación. Así mismo, la presencia de varios síntomas somáticos se asoció a mayores niveles de ansiedad.

Introduction: Previous studies have demonstrated that COVID-19 pandemic has had negative psychological consequences in healthcare professionals, however, few of them concentrate on pediatricians’ experience. The aim of this study is to evaluate anxiety among spanish pediatricians after the first COVID-19 wave as well as to identify possible risk factors. Material and Methods: A transversal and multicentric study of questionnaires was designed. Demographic, socio-familiar and laboral information was collected, as well as emotional self perception information, psychosomatic symptoms, tobacco consumption and psychotropic treatment. Participants fulfilled the State-Trait Anxiety Inventory (STAI). Results: 440 questionnaires were registered. Globally, 42.2% of the participants expressed moderate-intense anxiety symptomatology according to the Anxiety-State scale and 26.8% in the Anxiety-Trait scale. Domiciliary isolation was associated with a higher score in both scales. Changes in the cohabitants’ working situation was associated with a higher score in the Anxiety-State scale. With respect to the psychological impact perceived by participants during pandemic situation, 41.1% classified it as mild, 50% as moderate, and 8.9% as severe. Up to 71.8% of the participants suffered psychosomatic symptoms. A linear association was found between suffering from multiple psychosomatic symptoms and higher scores in both scales. Conclusions: After the first pandemic wave pediatricians have suffered anxiety, which has caused physical and emotional discomfort. Personal circumstances have been the main worry of medical staff. Coexistence of various psychosomatic symptoms has been associated with higher anxiety levels.

Resumen: Objetivos: Describir y analizar las lesiones asociadas a caídas en los menores de un año, la actuación durante su atención en urgencias, los medios empleados en su manejo y los factores que condicionan un mayor uso de los mismos. Material y métodos: Estudio multicéntrico, descriptivo y analítico. Se incluyeron los menores de un año que habían acudido por caídas al servicio de urgencias de 8 hospitales integrantes del Grupo de Trabajo de Lesiones no Intencionadas de la Sociedad Española de Urgencias Pediátricas. Se recogieron datos sobre las circunstancias previas a la llegada a urgencias, las lesiones observadas, la actuación en urgencias y los medios empleados durante su manejo. Resultados: Se identificaron 1.022 pacientes, un 0,35% de las urgencias atendidas (IC 95%: 0,348-0,352). La localización más frecuente del traumatismo fue craneal (58%). La indicación de radiografía de cráneo (31,8%) se relacionó con hematomas o signos de fractura en la exploración física (p 100 cm (P 50 cm and age

Objectives: A study was performed in order to describe injuries associated with falls in children aged 100 cm (p 50 cm and age