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        "resumen" => "<span class="elsevierStyleSectionTitle">Antecedentes</span><p class="elsevierStyleSimplePara elsevierViewall">La prevalencia de anemia en ni&#241;os de Santander &#40;Colombia&#41;&#44;est&#225; cercana al 28 &#37;&#44; pero las condiciones econ&#243;micas dificultan la realizaci&#243;n de hemoglobina en todos los ni&#241;os sospechosos de padecerla&#46; El signo de palidez palmar ha sido recomendado por la Organizaci&#243;n Mundial de Salud &#40;OMS&#41; y Organizaci&#243;n Panamericana de Salud &#40;OPS&#41; para el diagn&#243;stico de anemia en menores de 5 a&#241;os&#59; sin embargo&#44; el rendimiento de la prueba no se ha establecido en poblaciones de nuestro pa&#237;s&#46; Los objetivos del estudio fueron establecer el rendimiento de dicha prueba y determiner su reproducibilidad&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">El signo de palidez palmar fue evaluado en 167 ni&#241;os&#44; usuarios de un hospital de baja complejidad&#44; en una zona econ&#243;micamente deprimida de la ciudad de Bucaramanga&#46; Dos pediatras determinaron la presencia del signo&#44; seg&#250;n los criterios de la estrategia Atenci&#243;n Integrada a las Enfermedades Prevalentes de la Infancia&#44; propuestos por la OMS y la OPS&#46; El laboratorio de la instituci&#243;n determine la concentraci&#243;n de hemoglobina de cada uno de ellos&#46;A partir de estos datos se obtuvieron los valores de sensibilidad&#44;especificidad&#44; valor predictivo positivo y valor predictivo negativo&#46; Tambi&#233;n se estableci&#243; la concordancia entre los observadores&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La prevalencia de anemia&#44; en la muestra evaluada&#44; fue el 28&#44;74 &#37;&#44; la sensibilidad fue del 33&#44;33 &#37;&#44; la especificidad del 79&#44;83 &#37;&#44; el valor predictivo positivo del 40 &#37; y el valor predictivo negativo del 74&#44;80 &#37;&#46; La reproducibilidad de la prueba fue baja&#46; El rendimiento de la prueba mejor&#243; de manera sustancial cuando el punto de corte&#44; en concentraci&#243;n de hemoglobina&#44; se disminuy&#243; de 11 g&#47;dl&#44; que es el propuesto por OMS&#44; a 10&#44;5 g&#47;dl&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La anemia es frecuente en ni&#241;os menores de 5 a&#241;os de la ciudad de Bucaramanga &#40;Colombia&#41;&#46; El signo de palidez palmar es un recurso valioso para el diagn&#243;stico de anemia grave pero&#44; en los grados leve y moderado&#44; carece de la concordancia y tiene poco rendimiento&#46; Si se aceptan valores de corte inferiores&#44; en las cifras de hemoglobina para la determinaci&#243;n de anemia&#44; mejora la utilidad cl&#237;nica del signo&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p class="elsevierStyleSimplePara elsevierViewall">The prevalence of anemia in children from Santander &#40;Colombia&#41;&#44; is nearly 28 &#37;&#46; Economic conditions make it difficult to perform the hemoglobin test in all children with suspected anemia&#46; The palmar pallor sign has been recommended by the World Health Organization &#40;WHO&#41; and the Pan-American Health Organization for the diagnosis of anemia in children aged less than 5 years old&#59; however&#44; the yield of the test has not been established in Colombian communities&#46; The aims of the present study were to establish the efficiency of the test and to determine its reproducibility&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">The palmar pallor sign was evaluated in a sample of 167 children attending a low complexity hospital located in a deprived area of Bucaramanga city&#46; Two pediatricians determined the presence of the sign&#44; according to criteria from the &#8220;Integrated Management of Childhood Illness&#8221; strategy of the WHO and the Pan-American Health Organization&#46; A hospital laboratory determined the concentration of hemoglobin in each of the children&#46; Based on these data&#44; the sensitivity&#44; specificity&#44;positive predictive value and negative predictive value were determined and the agreement between observers was established&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The prevalence of anemia in the sample evaluated was 28&#46;74 &#37;&#46; Sensitivity was 33&#46;33 &#37;&#44; specificity was 79&#46;83 &#37;&#44; the positive predictive value was 40 &#37; and the negative predictive value was 74&#46;8 &#37;&#46; The reproducibility of the test was low&#46; The yield of the test substantially improved when the hemoglobin cut-off point was reduced from 11 g&#47;dl&#44; which is the value proposed by the WHO&#44; to 10&#46;5 g&#47;dl&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Anemia is frequent in children aged less than 5 years old in Bucaramanga city&#46; The Palmar pallor sign is a valuable tool for the diagnosis of severe anemia&#44; but is much less useful in mild or moderate anemia&#46; If the hemoglobin level proposed by the WHO were lower&#44; the palmar pallor sign would be more useful&#46;</p>"
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Originales
Validación del signo de palidez palmar para diagnóstico de anemia en niños de Bucaramanga (Colombia)
Validation of the palmar pallor sign in the diagnosis of anemia in children in bucaramanga (Colombia)
J. Cala Vecinoa, J.F. Latorre Latorrea,b,c,
Autor para correspondencia
jlatorre@bumanga.unab.edu.co

Correspondencia: Dr. J.F. Latorre Latorre. Universidad Autónoma de Bucaramanga. Facultad de Medicina. Campus el Bosque.Calle 48, 39-234. Bucaramanga. Colombia.
, O.L. Segovia Moralesa,c, R. Méndez Serranoa, C. Sandoval Gómeza,b
a Departamento de Pediatría Universidad Autónoma de Bucaramanga. Colombia
b Línea de Epidemiología UNAB. Colombia
c Departamento de Pediatría Universidad Industrialde Santander. Colombia
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            0 => "Ni&#241;os"
            1 => "Palidez palmar"
            2 => "Anemia"
            3 => "Validaci&#243;n"
            4 => "Pruebas diagn&#243;sticas"
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            0 => "Children"
            1 => "Palmar pallor"
            2 => "Anemia"
            3 => "Validity"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Antecedentes</span><p class="elsevierStyleSimplePara elsevierViewall">La prevalencia de anemia en ni&#241;os de Santander &#40;Colombia&#41;&#44;est&#225; cercana al 28 &#37;&#44; pero las condiciones econ&#243;micas dificultan la realizaci&#243;n de hemoglobina en todos los ni&#241;os sospechosos de padecerla&#46; El signo de palidez palmar ha sido recomendado por la Organizaci&#243;n Mundial de Salud &#40;OMS&#41; y Organizaci&#243;n Panamericana de Salud &#40;OPS&#41; para el diagn&#243;stico de anemia en menores de 5 a&#241;os&#59; sin embargo&#44; el rendimiento de la prueba no se ha establecido en poblaciones de nuestro pa&#237;s&#46; Los objetivos del estudio fueron establecer el rendimiento de dicha prueba y determiner su reproducibilidad&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">El signo de palidez palmar fue evaluado en 167 ni&#241;os&#44; usuarios de un hospital de baja complejidad&#44; en una zona econ&#243;micamente deprimida de la ciudad de Bucaramanga&#46; Dos pediatras determinaron la presencia del signo&#44; seg&#250;n los criterios de la estrategia Atenci&#243;n Integrada a las Enfermedades Prevalentes de la Infancia&#44; propuestos por la OMS y la OPS&#46; El laboratorio de la instituci&#243;n determine la concentraci&#243;n de hemoglobina de cada uno de ellos&#46;A partir de estos datos se obtuvieron los valores de sensibilidad&#44;especificidad&#44; valor predictivo positivo y valor predictivo negativo&#46; Tambi&#233;n se estableci&#243; la concordancia entre los observadores&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La prevalencia de anemia&#44; en la muestra evaluada&#44; fue el 28&#44;74 &#37;&#44; la sensibilidad fue del 33&#44;33 &#37;&#44; la especificidad del 79&#44;83 &#37;&#44; el valor predictivo positivo del 40 &#37; y el valor predictivo negativo del 74&#44;80 &#37;&#46; La reproducibilidad de la prueba fue baja&#46; El rendimiento de la prueba mejor&#243; de manera sustancial cuando el punto de corte&#44; en concentraci&#243;n de hemoglobina&#44; se disminuy&#243; de 11 g&#47;dl&#44; que es el propuesto por OMS&#44; a 10&#44;5 g&#47;dl&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La anemia es frecuente en ni&#241;os menores de 5 a&#241;os de la ciudad de Bucaramanga &#40;Colombia&#41;&#46; El signo de palidez palmar es un recurso valioso para el diagn&#243;stico de anemia grave pero&#44; en los grados leve y moderado&#44; carece de la concordancia y tiene poco rendimiento&#46; Si se aceptan valores de corte inferiores&#44; en las cifras de hemoglobina para la determinaci&#243;n de anemia&#44; mejora la utilidad cl&#237;nica del signo&#46;</p>"
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      "en" => array:1 [
        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p class="elsevierStyleSimplePara elsevierViewall">The prevalence of anemia in children from Santander &#40;Colombia&#41;&#44; is nearly 28 &#37;&#46; Economic conditions make it difficult to perform the hemoglobin test in all children with suspected anemia&#46; The palmar pallor sign has been recommended by the World Health Organization &#40;WHO&#41; and the Pan-American Health Organization for the diagnosis of anemia in children aged less than 5 years old&#59; however&#44; the yield of the test has not been established in Colombian communities&#46; The aims of the present study were to establish the efficiency of the test and to determine its reproducibility&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">The palmar pallor sign was evaluated in a sample of 167 children attending a low complexity hospital located in a deprived area of Bucaramanga city&#46; Two pediatricians determined the presence of the sign&#44; according to criteria from the &#8220;Integrated Management of Childhood Illness&#8221; strategy of the WHO and the Pan-American Health Organization&#46; A hospital laboratory determined the concentration of hemoglobin in each of the children&#46; Based on these data&#44; the sensitivity&#44; specificity&#44;positive predictive value and negative predictive value were determined and the agreement between observers was established&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The prevalence of anemia in the sample evaluated was 28&#46;74 &#37;&#46; Sensitivity was 33&#46;33 &#37;&#44; specificity was 79&#46;83 &#37;&#44; the positive predictive value was 40 &#37; and the negative predictive value was 74&#46;8 &#37;&#46; The reproducibility of the test was low&#46; The yield of the test substantially improved when the hemoglobin cut-off point was reduced from 11 g&#47;dl&#44; which is the value proposed by the WHO&#44; to 10&#46;5 g&#47;dl&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Anemia is frequent in children aged less than 5 years old in Bucaramanga city&#46; The Palmar pallor sign is a valuable tool for the diagnosis of severe anemia&#44; but is much less useful in mild or moderate anemia&#46; If the hemoglobin level proposed by the WHO were lower&#44; the palmar pallor sign would be more useful&#46;</p>"
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ISSN: 16954033
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2017 Mayo 22 56 78
2017 Abril 11 46 57
2017 Marzo 11 37 48
2017 Febrero 7 59 66
2017 Enero 25 36 61
2016 Diciembre 15 34 49
2016 Noviembre 23 61 84
2016 Octubre 32 77 109
2016 Septiembre 21 73 94
2016 Agosto 71 57 128
2016 Julio 51 73 124
2016 Abril 0 32 32
2016 Marzo 1 0 1
2015 Diciembre 2 0 2
2015 Noviembre 1 0 1
2015 Octubre 2 42 44
2015 Septiembre 4 0 4
2015 Agosto 4 40 44
2015 Julio 13 49 62
2015 Junio 15 22 37
2015 Mayo 17 39 56
2015 Abril 27 52 79
2015 Marzo 21 36 57
2015 Febrero 12 61 73
2015 Enero 27 2 29
2014 Diciembre 39 4 43
2014 Noviembre 22 8 30
2014 Octubre 39 8 47
2014 Septiembre 35 10 45
2014 Agosto 42 4 46
2014 Julio 60 3 63
2014 Junio 86 5 91
2014 Mayo 117 2 119
2014 Abril 93 6 99
2014 Marzo 92 8 100
2014 Febrero 80 30 110
2014 Enero 97 18 115
2013 Diciembre 93 14 107
2013 Noviembre 102 7 109
2013 Octubre 95 20 115
2013 Septiembre 76 37 113
2013 Agosto 99 28 127
2013 Julio 65 5 70
2013 Junio 5 6 11
2013 Mayo 6 2 8
2013 Abril 8 2 10
2013 Marzo 7 2 9
2013 Febrero 22 1 23
2013 Enero 27 2 29
2012 Diciembre 22 0 22
2012 Noviembre 20 1 21
2012 Octubre 15 0 15
2012 Septiembre 0 1 1
2005 Diciembre 3354 0 3354
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