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Resid Pediátr. 2026;16(1):1-1

DOI: 10.25060/residpediatr-2026.v16n1-editorial

15 Million Accesses: A Trajectory of Excellence and Commitment to Pediatrics

15 Million Accesses: A Trajectory of Excellence and Commitment to Pediatrics

Marilene Crispino¹; Clemax Sant'Anna¹

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Resid Pediátr. 2026;16(1):1-11

DOI: 10.25060/residpediatr-2026-1427

Efficacy and safety of medicinal Cannabis use in autism spectrum disorder: an integrative review

Efficacy and safety of medicinal Cannabis use in autism spectrum disorder: an integrative review

Poliana Cristina Carmona Molinari¹; Laize Rodrigues Boulhosa Pires²; Vanessa Medeiros Bezerra²; Lays Carvalho Cardoso de Mello²

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INTRODUCTION: Autism Spectrum Disorder (ASD) is a complex neuropsychomotor disorder characterized by restricted and repetitive behaviors, sensory sensitivity, and impairment in social communication and language. It represents significant challenges for patients, their families, and health systems, often requiring a broad multidisciplinary approach for its management. Traditional interventions, such as behavioral therapy and pharmacological treatments, have varying levels of efficacy. In this scenario, there is a growing interest in the Cannabis sativa plant for the treatment and control of ASD symptoms. OBJECTIVE: To evaluate the evidence related to the efficacy and safety of cannabis use in the treatment of ASD symptoms. METHOD: An integrative review was carried out in the Pubmed, LILACS, and Cochrane Library databases, of articles published in the last 5 years. RESULTS: The sample consisted of 13 articles. The findings suggest that cannabis, especially cannabidiol, may result in improvements in ASD symptoms such as restlessness, irritability, stereotypic behaviors, social interaction, and emotional regulation, varying according to individual characteristics and the severity of this disorder. CONCLUSION: CBD may improve ASD symptoms, especially when combined with low doses of tetrahydrocannabinol (THC). However, to validate these findings, more rigorous studies such as double-blind randomized clinical trials are needed. Despite the promising results, the lack of conclusive data on safety and efficacy prevents cannabis from being recommended as a standard treatment for ASD symptoms, but it reveals significant potential to improve symptoms and quality of life of patients.

Keywords: Keywords: Cannabis; Autism Spectrum Disorder; Child; Cannabidiol; Pediatrics

Resid Pediátr. 2026;16(1):1-6

DOI: 10.25060/residpediatr-2026-1397

Efficacy of ketamine in pediatric sedoanalgesia for orotracheal intubation: a systematic review

Efficacy of ketamine in pediatric sedoanalgesia for orotracheal intubation: a systematic review

Isabelle Cadore Galli¹; Juliana Vidotti de Jesus¹; Carlos Roberto Calil Anunciação¹; Gelson Felisberto Miranda Junior¹; Jonathan Monteiro Martins de Mello¹; Luisa Fontes Cury Roder¹; Mariana Vidotti de Jesus²; Priscila Analu da Silva Previato¹; Raul José do Nascimento Moreira¹; Ruan Silva Barros¹; Victor Nahuel Carruesco¹

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OBJECTIVE: To compare the efficacy and effects of ketamine administration with other drugs for sedoanalgesia during orotracheal intubation in hospitalized pediatric patients. METHOD: A systematic review in English and Portuguese was conducted using the PUBMED/MEDLINE and LILACS databases. The descriptors “Ketamine” AND “Fentanyl” AND “Propofol” AND “Midazolam” AND “Children” were used. After applying the inclusion and exclusion criteria, 114 articles were initially selected for analysis, resulting in the inclusion of 11 articles for data extraction. RESULTS: The study included 7,868 individuals aged 0 to 18 years. Intranasal ketamine administration was found to be an excellent alternative in cases where opioid use is contraindicated. When compared with sevoflurane for agitation prevention, sevoflurane was found to be unsafe, whereas the combination of intranasal ketamine with midazolam showed better effects on anesthetic induction and recovery. Additionally, one study revealed that the combination of ketamine with fentanyl increased blood pressure and relative risk up to 30 minutes after laryngeal mask insertion, although it provided more stable hemodynamic parameters and advantageous effects on patient recovery. CONCLUSION: The efficacy of ketamine may vary depending on the route of administration and dosage used, with the nebulized form at doses between 1.5 mg/kg and 2 mg/kg demonstrating the greatest efficacy. Thus, ketamine is an effective, safe, and versatile option for orotracheal intubation in pediatric patients, representing a viable non-opioid alternative with a favorable safety profile.

Keywords: Intubation; Intratracheal; Child; Adolescent; Ketamine; Anesthetics; Hospitalization

Resid Pediátr. 2026;16(1):1-7

DOI: 10.25060/residpediatr-2026-1391

Prevalence of overweight and risk factors associated with obesity and metabolic syndrome among adolescents in a tertiary hospital in the Federal District

Prevalence of overweight and risk factors associated with obesity and metabolic syndrome among adolescents in a tertiary hospital in the Federal District

Ana Carolina Sales Jreige¹; Marilucia Rocha de Almeida Picanço¹; Wesley Soares Pires²; Tiago da Rocha Araújo²

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OBJECTIVE: To assess the prevalence of obesity and metabolic syndrome, as well as their respective risk factors, in adolescents attending a reference service in the Federal District. METHOD: The sample consisted of 47 adolescents aged 10 to 17 years. Nutritional status was classified using the body mass index (BMI) for age established by the World Health Organization. RESULTS: The sample consisted of 47 adolescents, of whom 23 (48.94%) were eutrophic, 12 (25.53%) were overweight, 8 (17.02%) were obese, and 4 (8.51%) were underweight. Among them, 21.28% had abdominal obesity, and 38.30% had high blood pressure. Of the 32 adolescents who underwent laboratory tests, the following average results were obtained: blood glucose of 87.27 mg/dL, total cholesterol of 154.09 mg/dL, HDL of 47.87 mg/dL, and triglycerides of 71.52 mg/dL. Metabolic syndrome was not diagnosed in any of the participants, but obesity and other risk factors were identified, such as increased waist circumference and hypertension. All obese adolescents had at least one risk factor present. CONCLUSION: No cases of metabolic syndrome were found in the studied population based on the established criteria. However, it is important to note that the sample size could have been a significant factor influencing the results. Therefore, further studies with a larger sample size are necessary.

Keywords: Adolescent; Metabolic syndrome; Risk factors; Obesity

Resid Pediátr. 2026;16(1):1-6

DOI: 10.25060/residpediatr-2026-1416

Neurocardiogenic syncope in children: head-up Tilt Test response evaluation

Neurocardiogenic syncope in children: head-up Tilt Test response evaluation

Letícia Bergo Veronesi¹; Rossano Cesar Bonatto²; Nathália Rocha da Silva³; Carlos Roberto Padovani³

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INTRODUCTION: Syncope is a sudden and transient loss of consciousness associated with the loss of postural tone followed by spontaneous recovery. Vasovagal (neurocardiogenic) syncope is the most common one in children. The head-up Tilt Test is used as one of the diagnostic criteria and can have three different types of response: a vasovagal one (either vasodepressor, cardioinhibitory or mixed types), a dysautonomic one, and orthostatic postural tachycardia syndrome. METHODS: Cross-sectional, observational clinical study with data collection from the electronic medical records of children and adolescents diagnosed with syncope submitted to the head-up tilt test in a tertiary hospital. The significance level was 5%. RESULTS: Syncope was clinically diagnosed in 378 patients, and 209 (55.3%) of them were submitted to the head-up tilt test. A total of 212 tests were performed, with a statistically significant predominance of negative results (58.8%). The neurocardiogenic response (89.5%) prevailed over dysautonomia and orthostatic postural tachycardia syndrome. The vasodepressor type response was more frequent than the mixed response, which was more frequent than the cardioinhibitory response. The median age was higher in patients undergoing the head-up tilt test (152.5 months x 115.4 months; p<0.05), as well as in those who had a positive result (170.7 months x 138.8 months; p<0.05). CONCLUSION: Most patients had a negative result, revealing that the exam was performed without proper indication for more than half of them. The indication for the head-up tilt test needs to be based on more objective criteria, otherwise it is an unnecessary and costly practice.

Keywords: Tilt-Table Test; Pediatrics; Syncope; Vasovagal

Resid Pediátr. 2020;10(2):1-8

DOI: 10.25060/residpediatr-2020.v10n2-324

Cutaneous manifestations of COVID-19 in children: literature review

Cutaneous manifestations of COVID-19 in children: literature review

Gabriela Roncada Haddad¹; Paulo Gonçalves Martin²; Joelma Gonçalves Martin³

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198668

OBJECTIVES: The COVID-19 pandemic currently represents a major challenge. The lungs are the main site of infection, with symptoms ranging from mild to lethal respiratory distress, in addition to involvement of various organs or systems. The pediatric population seems to be affected lesser and less severely, with the majority of cases described as asymptomatic, mild or moderate. Several cases have cutaneous manifestations. The purpose of this article is to review the findings described in the literature, particularly in the pediatric group, helping us to understand the disease and clinical suspicion.
METHODS: Articles published since the beginning of the pandemic were searched through the PubMed database.
RESULTS: Among the reports of skin manifestations, the most common finding was the maculopapular rash, followed by papulovesicular lesions varicella-like and urticariform lesions. There was also the description of purpuric acral lesions, livedo reticularis and petechiae. The described lesions mainly affected the trunk, hands and feet.
CONCLUSION: The cutaneous findings of COVID-19 are similar to those found in other viral diseases. There is also the possibility that the lesions are due to the various medications that, particularly, patients with more severe clinical conditions use. We must also pay attention to the possibility of the initial manifestation of the disease being cutaneous. The authors warn of the possibility that patients in the pediatric group have skin lesions as a single manifestation or accompanied by mild symptoms, and that these may be similar to other diseases common in childhood.

Keywords: Coronavirus Infections. Skin Manifestations. Review.

Resid Pediátr. 2021;11(3):1-4

DOI: 10.25060/residpediatr-2021.v11n3-223

Teenager with Edwards’ syndrome: a rare case report

Teenager with Edwards’ syndrome: a rare case report

Igor Soares Trindade¹; Marise Vilas Boas Pescador¹

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198666

Edwards’ syndrome is a severe genetic disease (chromosome 18 trisomy) that has a very restrict prognosis, resulting in premature death of the carrier. This study aims to report a case of survival of 12 years old girl diagnosed in the first months of life, her clinical evolution and the treatments performed by it. The multidisciplinary treatment performed by the adolescent since the first months of life shows the importance of this approach to improve the quality of life of patients with this syndrome.

Keywords: Edwards’ Syndrome, Prognosis, Quality of Life.

Resid Pediátr. 2020;10(3):1-5

DOI: 10.25060/residpediatr-2020.v10n3-90

Acute benign myositis of childhood: Results of a prospective study performed in a pediatric emergency department

Acute benign myositis of childhood: Results of a prospective study performed in a pediatric emergency department

Vanuza Maria Rosa¹; Gabriela de Sio Puetter Kuzma¹; Luana Alves Miranda Hornung¹; Márcia Bandeira²

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193878

OBJECTIVE: Benign acute childhood myositis is characterized by acute musculoskeletal involvement leading to transient limitations on deambulation followed by a viral illness. Our study objective to evaluate clinical and laboratory features of patients in a pediatric emergency department.
METHODS: We conducted a prospective study in patients with symptoms and laboratory findings compatible with viral myositis in the period of August 2017 to August 2018.
RESULTS: We assessed 20 patients in the period of twelve months. The mean age was 8,25 years. Of these, 83,3% had infectious symptoms in the week before the musculoskeletal involvement. By the time of the diagnosis, the symptoms were: calf pain, reluctance to walk, gait abnormality, diffuse myalgia and calf weakness. The most relevant laboratory finding was the elevation of CPK (mean 3359,556U/L) level, followed by AST (mean 131U/L) and ALT (mean 64,66U/L) elevation. The mean time for symptom relief was 3 days and in 7 days all exams were normal.
CONCLUSION: Though the exact incidence of this condition remains undetermined, the lower extremity pain and the gait abnormality is of concern of both parents and health care providers. We emphasize the importance of knowing this condition to avoid unnecessary exams and the delay in the diagnosis of severe conditions.

Keywords: Myositis, Myalgia, Child, Pediatric

Resid Pediátr. 2017;7(1):39-41

DOI: https://doi.org/10.25060/residpediatr-2017.v7n1-09

Bioethical principles

Bioethical principles

Carlindo de Souza Machado e Silva Filho¹

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184674

Resid Pediátr. 2022;12(1):1-4

DOI: 10.25060/residpediatr-2022.v12n1-433

ODD: behavioural perspectives and their association with ADHD and CT

ODD: behavioural perspectives and their association with ADHD and CT

Taynara Souza Silva¹; Julia Sachetin Fontoura¹; Viviane Araújo e Silva de Carvalho²; Glenia Arantes Maia¹

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183753

Oppositional Defiant Disorder (ODD) is characterized by impulse and conduct control disorders and aggressive behavior. It is often associated with other disorders, especially conduct disorder (CT) and attention deficit hyperactivity disorder (ADHD). This is an integrative review of medical literature of a qualitative nature, which aims to present what are the perspectives for a patient with OCD and its main associations: CT and ADHD. These psychopathologies directly influence the personal and professional relationships of individuals and are associated with a greater propensity to aggression, crime and theft when not controlled. Therefore, it is essential to diagnose these disorders and promote the necessary interventions.

Keywords: Attention Deficit and Disruptive Behavior Disorders, Disruptive, Impulse Control, and Conduct Disorders, Attention Deficit Disorder with Hyperactivity.

Resid Pediátr. 2017;7(2):69-72

DOI: https://doi.org/10.25060/residpediatr-2017.v7n2-04

Acute urticaria as a manifestation of viral infections in childhood

Acute urticaria as a manifestation of viral infections in childhood

Bruna Piassi Guaitolini¹; Priscilla Filippo Alvim de Minas Santos²; Gabriela Dias³; Denise Pedrazzi⁴; Eduardo Costa⁵

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13895

OBJECTIVE: To report serial cases of acute urticarial associated with viral infections.
MATERIAL AND METHODS: Serial report cases of children diagnosed with acute urticaria associated with viral infections and literature review.
RESULTS: Seven patients were evaluated, three of them female, with an average age of 3 years. Three patients had urticarial lesions, without other associated symptoms. The remaining patients presented a previous characteristic of upper airways. All were evaluated in emergency service, medicated with antihistamines and referenced for evaluation by specialist in allergy and immunology. The urticaria remission period ranged from 5 to 15 days. In the diagnostic investigation, two children presented reactive IgM for Parvovirus B19, three presented reactive IgM for Epstein Barr virus (EBV), one presented reactive IgM for EBV and for Herpes Simplex virus I and II, and one had reactive IgM for Herpes Simplex I and II.
CONCLUSION: Acute urticaria is a commom childhood disease with detailed clinical history and physical examination essential for the etiological diagnosis. The pediatrician should be aware of the main triggering factors, including viral infections.

Keywords: urticaria, child, viruses.

Resid Pediátr. 2018;8(1):27-37

DOI: 10.25060/residpediatr-2018.v8n1-04

The main questions of pediatricians about children and adolescents with tuberculosis

The main questions of pediatricians about children and adolescents with tuberculosis

Rosana Alves¹; Sabrina Marini Araujo Saar²; Clemax Couto Sant’Anna³

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11735

OBJECTIVE: Childhood tuberculosis (TB) is a matter of great importance that led pediatricians to have great difficulties on dealing with several aspects of the disease and the TB latent infection (TBLI). We try to find out what these difficulties are to promote means of disseminating information.
METHODS: This article consolidated the most frequent questions about children and adolescents with TB made by pediatricians during eight Brazilian Pediatrics Congresses, and of Pediatric Pulmonology Congress within a 12-year period, from 2003 to 2015.
RESULTS: About 200 related questions were recorded by authors, such as: diagnosis of symptomatic child or with TBLI (60%); BCG vaccination (10%); Tuberculin Skin Test (TST) and other diagnosis methods (10%); treatment (10%); approach to TB-contact newborns (5%); and preventive measures for Health Care Professionals (5%). The most frequent 25 questions involving all these queries were selected, such as: “How to investigate and treat TB and ILTB?”; “What should be done if there is no BCG scar?”; “What does Xpert MTB/RIF mean?”; “TB treatment was changed?”; “What should be done with TB-contact newborns?”; “How to protect Health Care Professionals against TB?”.
CONCLUSION: The same questions remained for years, changing when there were also changes in standards for tuberculosis control, such as a new diagnostic test or treatment change. The answers were organized in easy-to-read texts as a didactic material to enhance professionals’ performance in the fight against TB.

Keywords: tuberculosis, child, adolescent, knowledge, pediatrics.

Resid Pediátr. 2021;11(3):1-5

DOI: 10.25060/residpediatr-2021.v11n3-186

Treatment of acute viral bronchiolitis

Treatment of acute viral bronchiolitis

Carla Cristiane Dall’ Olio¹; Maria de Fatima Pombo Sant’ Anna²; Clemax Couto Sant’ Anna³

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11572

INTRODUCTION: Acute viral bronchiolitis (AVB) is one of the main respiratory infections in infants. Available information on the treatment of AVB in children under 2 years is reported, based on the most recent scientific evidence published in the literature.
METHODS: Simple non-systematic review was performed on PubMed and Cochrane sites using the terms “bronchiolitis”, “viral bronchiolitis”, “infant” and “treatment” in Portuguese. In the English language, the terms were “bronchiolitis”, “viral bronchiolitis”, “infant”, and “drug therapy”. The search period was 15 years, from 2004 to 2019. The materials obtained had the title and abstract read; when the documents reported more recent evidence on the subject, they were read in full.
RESULTS: In the databases cited there were 1,091 non-systematic reviews, 113 clinical protocols, 3 editorials, 243 articles. The currently most accepted treatments for AVB are oxygen supplementation in the presence of hypoxemia and noninvasive or invasive ventilatory support, according to the severity of respiratory failure.
DISCUSSION: Increased knowledge about the pathophysiology of AVB has allowed us to review the treatments used in the past and now. The treatment of AVB deserves reflection and new intervention proposals, since current scientific evidence levels do not support the use of corticosteroids and beta 2 adrenergic, routine practices of pediatricians. Clinical stabilization of the patient, oxygen therapy and ventilatory support are recommended.

Keywords: Bronchiolitis, Bronchiolitis, Viral, Infant, Drug Therapy.

Resid Pediátr. 2015;5(3):122-127

Hypoxemia as a predictor of severity in hospitalized patients with pneumonia

Hypoxemia as a predictor of severity in hospitalized patients with pneumonia

Maria Anáide Zacchê de Sá Abreu e Lima¹; Luiza Menezes Vieira de Mello²; George Henrique Cordeiro Serra¹; Débora Ellen Pessoa Lima³; Eduardo Jorge da Fonseca Lima⁴

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11104

OBJECTIVES: To analyze the presence of hypoxemia on admission of patients with pneumonia, correlating with the unsatisfactory clinical evolution and appearance of complications.
METHODS: Serie of cases study with 120 patients, aged between one month and five years, hospitalized for pneumonia in 2012 in a referral hospital in Recife. We analyzed demographic, clinical and final outcome variables. The diagnosis of pneumonia was based on clinical and radiological criteria. Hypoxemia was considered when the oxygen saturation was < 92% and/or there was need for oxygen during hospitalization.
RESULTS: Of the sample, 58 patients (48.3%) admitted with pneumonia presented hypoxia. 48 children (40%) had less than 1 year old and only 33 (27.5%) were older than two years. The frequency of low birth weight was 16% and the association of this variable with hypoxia was significant (p < 02).Prematurity was found in 10.6%.105 patients (87.5%) were classified as severe pneumonia or very severe. Pleural effusion occurred in 30 patients and of these, 18 (60%) had hypoxia. The mostly used oxygen form was the Venturi mask (48%).The duration of hospitalization was up 90.8% in 7 days. It was necessary to transfer 3 patients (2.5%) to ICU and mortality rate was 2.5%.
CONCLUSIONS: Pneumonia needs a proper handling during hospitalization. The study stressed the importance of holding the saturation measurement on admission and reinforces their use in routine, because hypoxia may be a predictor of unfavorable clinical evolution.

Keywords: pneumonia, oximetry, clinical evolution, patient acuity.

Resid Pediátr. 2019;9(3):28

DOI: 10.25060/residpediatr-2019.v9n3-33

Maintenance fluid therapy in sick children: state of art

Maintenance fluid therapy in sick children: state of art

Emannuely Juliani Souza Izidoro¹; Adriana Koliski¹

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10259

Intravenous fluids are frequently used in pediatrics, but they have been associated with significant adverse effects. Understanding the composition of fluids prescribed and administering them at the appropriate infusion rate is essential for a safe prescription. The use of isotonic fluids can reduce the risk of hyponatremia, reducing infant morbidity and mortality as well. However, recent literature shows a higher incidence of acid-base balance disorders and a risk of acute renal injury with isotonic solutions, proposing the use of balanced fluids to minimize these damages. This narrative review aims to verify current recommendations about assessment and management of intravenous fluids in acutely ill child, as well as the recognition of maintenance therapy adverse effects. It was concluded that the intravenous fluids prescription is like the medicines prescription, and their risks must be considered and monitored continuously.

Keywords: Child Care, Fluid Therapy, adverse effects. Infusions, Intravenous.