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RESUMENLa pancreatitis aguda es una alteración inflamatoria del páncreas, caracterizada por dolor abdominal y elevación de las enzimas pancreáticas. La pancreatitis aguda necrosante es una complicación grave asociada a altas tasas de morbimortalidad en población adulta; en población pediátrica es una entidad poco frecuente, ocurre en menos del 1 % de los casos. Se ha visto asociada a múltiples etiologías, entre ellos agentes infecciosos como el virus de la Influenza A. En esta oportunidad reportamos un caso de un paciente de 21 meses de edad con virus Influenza A positivo que cursó con pancreatitis aguda.Palabras clave: pancreatitis, pancreatitis aguda necrotizante, Virus de la Influenza A. ABSTRACTThe acute pancreatitis is a sudden inflammation of the pancreas, characterized by abdominal pain and elevations of serum pancreatic enzymes. Necrotizing acute pancreatitis is a significant complication associated with high morbidity and mortality rate in adult population, nevertheless, in pediatric population it is exceptional. This happens in less than 1 % of cases. This has been associated to different etiologies some infectious agents such as A type of influenza virus. In this study we selected a case occurred to a 21 months old patient with type A influenza virus positive, who treated with acute pancreatitis.

ObjectiveTo assess the effectiveness of non-immersive virtual reality as a pain-distraction measure in children between the ages of 3-5 years undergoing painful injection procedures in an outpatient setting. DesignWe carried out a randomized, unmasked clinical trial in children undergoing venipuncture or intramuscular injection procedures. Patients were randomized to a distraction virtual reality video or standard care. After the procedure, three independent observers (parents, researchers, nursing staff) rated pain on the LLANTO pain scale. ResultsWe recruited 122 subjects, half of which were randomized to virtual reality. The median age was of approximately 5 years and the sample was balanced with regards to sex. Agreement between raters was high for all three types of observers, with Cohen Kappas over 0.79 in all cases. Bivariate analysis showed reductions in the risk of obtaining higher scores in the LLANTO scale. Linear regression models showed a reduction of approximately 3 points in the scale, regardless of the type of observer. These models were adjusted for sex, age, kind of procedure, use of prior analgesia, and recruitment center. ConclusionsNon-immersive virtual reality is an effective adjunctive therapy for the reduction of pain in children undergoing painful injection procedures in an outpatient setting. This strategy may be used to improve the quality of care in pediatric outpatient services.Trial Registration: ClinicalTrials.gov Identi er: NCT03985930 What Is KnownThe use of immersive virtual reality (VR) has been described as an effective adjunctive distraction method during painful procedures in children over 5 years.What is new: The utility of non-immersive VR in children below that age is not yet clear. This randomized clinical trial comparing non-immersive VR vs. standard care showed an average reduction of three points in the LLANTO pain scale favoring non-immersive VR. Non-immersive VR is an effective and inexpensive non-pharmacological technique that reduces fear and pain in pediatric patients.

Objective To assess the effectiveness of non-immersive virtual reality as a pain-distraction measure in children between the ages of 3–5 years undergoing painful injection procedures in an outpatient setting. Design We carried out a randomized, unmasked clinical trial in children undergoing venipuncture or intramuscular injection procedures. Patients were randomized to a distraction virtual reality video or standard care. After the procedure, three independent observers (parents, researchers, nursing staff) rated pain on the LLANTO pain scale. Results We recruited 122 subjects, half of which were randomized to virtual reality. The median age was of approximately 5 years and the sample was balanced with regards to sex. Agreement between raters was high for all three types of observers, with Cohen Kappas over 0.79 in all cases. Bivariate analysis showed reductions in the risk of obtaining higher scores in the LLANTO scale. Linear regression models showed a reduction of approximately 3 points in the scale, regardless of the type of observer. These models were adjusted for sex, age, kind of procedure, use of prior analgesia, and recruitment center. Conclusions Non-immersive virtual reality is an effective adjunctive therapy for the reduction of pain in children undergoing painful injection procedures in an outpatient setting. This strategy may be used to improve the quality of care in pediatric outpatient services. Trial Registration: ClinicalTrials.gov Identifier: NCT03985930