A rural worker infected with a bovine-prevalent genotype of Campylobacter fetus subsp. fetus supports zoonotic transmission and inconsistency of MLST and whole-genome typing.

Whole-genome characterisation in clinical microbiology enables to detect trends in infection dynamics and disease transmission. Here, we report a case of bacteraemia due to Campylobacter fetus subsp. fetus in a rural worker under cancer treatment that was diagnosed with cellulitis; the patient was treated with antibiotics and recovered. The routine typing methods were not able to identify the microorganism causing the infection, so it was further analysed by molecular methods and whole-genome sequencing. The multi-locus sequence typing (MLST) revealed the presence of the bovine-associated ST-4 genotype. Whole-genome comparisons with other C. fetus strains revealed an inconsistent phylogenetic position based on the core genome, discordant with previous ST-4 strains. To the best of our knowledge, this is the first C. fetus subsp. fetus carrying the ST-4 isolated from humans and represents a probable case of zoonotic transmission from cattle.

[Results of a therapeutic strategy against monosymptomatic nocturnal enuresis]. / Resultados de una estrategia terapéutica frente a la enuresis nocturna monosintomática.

BACKGROUND: There are many therapeutic options against enuresis. OBJECTIVE: To evaluate several therapies introduced progressively to treat monosymptomatic nocturnal enuresis. METHODS: Eighty-four patients, aged 6 to 14 years old, were studied. The 67 year olds were treated with desmopressin and oxybutynin was added in nonresponders. If enuresis persisted, Alarm was given. Children over 7 years of age were randomly divided and treated with Alarm or Alarm plus desmopressin. Nonresponders were treated with desmopressin alone. RESULTS: In children aged 6-7 years the cumulative response was 72%. Those who wetted themselves less responded to desmopressin. In children over 7 years of age, response to Alarm was 73.3% and response to Alarm plus desmopressin was 58.6%. In nonresponders the cumulative response after desmopressin treatment increased to 80% and 62% respectively. CONCLUSIONS: In the group of 6 to 7 year-olds desmopressin was indicated as first line therapy. Treatment efficacy was increased by adding oxybutynin especially in the children who wetted themselves the most. In children over 7 years of age Alarm was the most effective treatment and relapses were fewer. No advantages were observed with the combination of Alarm and desmopressin in our protocol.

[Nutritional study of children with oncologic diseases]. / Estudio nutricional en niños oncológicos.

From October 1989 to June 1990 we have evaluated at diagnosis and after six months of treatment the nutritional status of 21 oncologic patients younger than 14 years. At diagnosis, 14% of the children showed slight malnutrition on anthropometric evaluation, although there were biochemical data of protein malnutrition in 47% of the cases. Children with abnormal anthropometric measurements and those with a high risk of becoming malnourished (infants with advanced abdominal diseases) were given dietary supplements. In the follow-up evaluation, 90% of the patients showed normal somatic indexes and 76% showed recuperation in their protein values. The recovery of the nutritional status was most important in the group of patients with Acute Lymphoblastic Leukemia.

[Treatment of idiopathic nephrotic syndrome with cyclosporin A]. / Tratamiento del síndrome nefrótico idiopático con ciclosporina A.

OBJECTIVE: Cyclosporin A (CyA) has been used in steroid-dependent and steroid-resistant nephrotic syndrome (NS) with the aim to prolong or to induce remission, respectively. PATIENTS AND METHODS: The efficacy and side-effects of CyA therapy were evaluated in 25 children with idiopathic NS. Twelve patients had steroid-dependent NS and 13 patients had steroid-resistant NS. In all cases, CyA was given as a third alternative drug, once therapies with prednisone and alkylating agents had failed. In steroid-resistant patients CyA administration was always associated with low-dose prednisone. RESULTS: All 12 patients with steroid-dependent NS entered into remission during CyA administration, but 7 patients relapsed when the drug was withdrawn or tapered and 7 of 8 patients requiring long-term therapy continued to present new relapses. Prednisone requirement was lower and growth velocity higher during the year on CyA therapy than during the year preceding CyA therapy. Only 5 of the 13 patients with steroid-resistant NS had a complete remission. Three of these patients relapsed upon cessation of therapy, but these relapses became steroid-sensitive. Clinical side-effects (hirsutism, gum hyperplasia, arterial hypertension) were only observed in a few patients. Biochemical side-effects (hyperuricemia, hypomagnesemia) were more frequently observed, but always reverted upon cessation of therapy. The development of osteosarcoma in one patient may represent a coincidental finding. CONCLUSIONS: The results suggest that CyA therapy is capable of inducing remission in all patients with steroid-dependent NS and in about one third of patients with steroid-resistant NS. However, most patients relapse when the CyA is stopped and require long-term therapy, often associated with administration of predisone.