Pediatric palliative care requires a comprehensive approach that addresses psychological, social, and spiritual needs. Effective communication is one of the key tools available to healthcare professionals to meet these needs. This article summarizes the lecture presented at the SCCALP Spring Meeting held on April 17-18, 2026. Practical aspects of communication with families, pediatric patients, and adolescents are reviewed, together with strategies aimed at promoting clear, empathetic, and emotionally tailored communication. The article also discusses the delivery of bad news using the EPICEE protocol and reflects on the emotional impact that these situations may have on healthcare professionals. Training in communication skills and interdisciplinary teamwork are essential tools for providing comprehensive care focused on supporting and accompanying patients and their families throughout the course of illness.
The recent creation of the Child and Adolescent Psychiatry specialty responds to a growing body of knowledge about child and adolescent mental health, as well as a significant increase in the prevalence of various psychiatric disorders and pathologies in this age group. Therefore, the following is a review of basic concepts regarding neurotransmission and the most frequently used psychotropic medications, describing their potential uses, most common adverse effects, considerations, and con-clusions. This text aims to enable pediatricians in both primary care and hospital settings to use these medications, providing solid evidence and greater safety in the care of psychiatric patients.
Introduction/objective. Pediatric palliative care (PPC) is a comprehensive care model for children and adolescents with life-limiting or life-threatening conditions and their families. Despite regulatory and healthcare advances, significant gaps remain in its implementation, alongside a general lack of awareness among pediatric professionals. This review aims to provide an updated overview of the fundamentals, epidemiology, specificities, and essential clinical and ethical aspects of PPC. Development. The definition and conceptual framework of PPC, epidemiology, and classification of eligible conditions according to the Association for Children’s Palliative Care (ACT) groups are reviewed. The unique characteristics distinguishing PPC from adult palliative care, the integrated care model from diagnosis onwards, symptom management with particular focus on pain, communication principles, and advance care planning are analyzed. End-of-life care, bereavement support, and professional self-care are also addressed. Conclusions. PPC is a right for every child with a life-limiting condition. Its early integration improves the quality of life of both the patient and the family. It is essential that every pediatrician understands the basic principles of PPC to ensure adequate care.
Introduction. Phakomatoses comprise a heterogeneous group of genetically determined neurocutaneous disorders that primarily affect the skin and central nervous system. Their importance in pediatrics lies in the early detection of cutaneous signs that act as markers of underlying neurological disease. These conditions show variable progression, with manifestations that may include epilepsy, developmental delay, vascular abnormalities, and an increased risk of neoplasia. Management requires a comprehensive clinical evaluation and multidisciplinary follow-up. Neurocutaneous disorders. Congenital melanosis is characterized by extensive pigmented nevi with possible leptomeningeal involvement, associated with a risk of melanoma and neurological complications. Incontinentia pigmenti, an X-linked dominant disorder, presents with evolving skin lesions and may be accompanied by neurological and ocular abnormalities. Sturge-Weber syndrome features facial angiomas in the trigeminal distribution and leptomeningeal vascular malformations, frequently associated with epilepsy and cognitive impairment. Tuberous sclerosis complex is distinguished by multisystem hamartomas, early-onset epilepsy, and neurodevelopmental disorders. Neurofibromatosis type 1, the most common neurocutaneous disorder, manifests with café-au-lait spots, neurofibromas, learning difficulties, development of nervous system tumors, and osteoarticular abnormalities. Conclusions. Early recognition of phakomatoses allows the implementation of appropriate surveillance and timely treatment, improving prognosis. Detailed clinical evaluation, imaging studies, and genetic testing are essential. Management should be individualized, with emphasis on neuropediatric follow-up and family support.
Introduction. The Ecuadorian healthcare system is divided into levels according to the complexity and reso- lution of cases, which seeks to ensure timely and effective care, although it faces operational limitations due to overdemand on hospitals and limited capacity for resolution in primary care. Objective. To identify the main causes of referral from primary care to pediatric consultation at a general hospital in Ecuador, evaluating its effectiveness and compliance. Methodology. A descriptive, retrospective study was conducted using an anonymized matrix, which included all patients under 15 years of age referred between January 2023 and June 2024. Demographic, clinical, and operational variables were analyzed using descriptive statistics. Results. A total of 1,028 referrals were analyzed, of which 58% were male and 46.7% were children between the ages of 1 and 5; 92% came from urban areas, and 66.6% were referred by general practitioners. The five main reasons for referral were: malnutrition (13.2%), hip dysplasia (10.6%), language disorders (9.4%), phimosis (2.8%), and heart murmur (2.5%). Only 60.7% of those who requested appointments attended the consultation, and the average waiting time was 9.3 days. Conclusion. The system showed high scheduling rates (89.3%) and short waiting times (9.3 days), although only 60.7% completed the consultation. The main causes of referral reflect the epidemiological profile and limitations of primary care. The assessment of appropriateness should be interpreted with caution due to limitations in the registry and lack of standardized criteria.
