Herpes Simplex Virus Esophagitis in an Immunocompetent Patient

We present the case of a 17-year-old patient with no known comorbidity or history who was admitted due to dysphagia. Endoscopy revealed ulcerated lesions in the distal esophagus that were positive for herpes simplex virus type 1 (HSV-1) on immunohistochemistry. An examination of HSV-1 esophagitis in the immunocompetent patient is made.

Se presenta el caso de un paciente de 17 años sin ninguna comorbilidad ni antecedente conocido que ingresó por disfagia. La endoscopia reveló lesiones ulceradas en el esófago distal que resultaron positivas para virus del herpes simple tipo 1 (VHS-1) en la inmunohistoquímica. Se hace una revisión de la esofagitis por VHS-1 en el paciente inmunocompetente.

Tuberculosis urogenital en un paciente con falla renal, estado del arte / Urogenital tuberculosis in a patient with kidney failure, state of the art

RESUMEN La tuberculosis es una enfermedad infecciosa y frecuente en países en vía de desarrollo. Esta puede causar una amplia variedad de complicaciones y presentaciones atípicas con alta morbimortalidad. De la forma genitourinaria se sospechada muy poco, razón por la cual su diagnóstico se hace, usualmente, de forma tardía o no se realiza. Esto conlleva a consecuencias muy graves en los pacientes, por ejemplo, la enfermedad renal crónica terminal. A continuación, se presenta un reporte de caso de una paciente con la anterior enfermedad, secundaria a una tuberculosis renal bilateral diagnosticada tardíamente y se realiza una revisión de la literatura sobre este tema.

SUMMARY Tuberculosis is a common infectious disease in developing countries, which can cause a variety of complications and atypical manifestations with high morbidity and mortality. The urogenital form is rarely suspected, resulting in delayed diagnosis or even no diagnosis, which can have serious consequences for the patients, such as chronic end-stage renal disease. We report on a patient with chronic end-stage renal failure caused by a delayed diagnosis of bilateral renal tuberculosis and a literature review on this topic.

Association between migration and physical activity of school-age children left behind in rural Mexico.

OBJECTIVES: The purpose of this study was to explore in rural communities of Mexico, the association between physical activity (PA) in school-age children and exposure to migration. METHODS: We measured PA through a questionnaire validated in school-age children and used in Mexican National Surveys. Migration status was measured as the number of years a family member had been in the US, and the amount of remittances that family member had sent to their household in Mexico. We used multivariable linear regression to measure the association between physical activity and migration. RESULTS: School-age children who had a migrant family member spent less time on PA per day, especially recreation activities, compared to school-age children without the migrating influence. Also, children who belonged to a family that received remittances and their migrant relative lived ≥ 5 years in US were less likely to engage in PA. CONCLUSIONS: Exposure to migration may predict reduction in PA in school-age children left behind in Mexican rural communities from the State of Morelos. These findings call for PA-tailored interventions that consider household migration characteristics.

Detección de bacterias contaminantes en huevos para consumo en Medellín y su área Metropolitana / Detection of contaminant bacteria in eggs for consumption in Medellín and its Metropolitan area / Detecção de bactérias contaminantes em ovos para consumo em Medellín e sua área metropolitana

Objetivo: buscar Salmonella y otras bacterias contaminantes en huevos comerciales. Métodos: Se muestrearonaleatoriamente 38 graneros expendedores de huevos de Medellín y Área Metropolitana, a su vez se escogieron al azar 6 huevos por granero para un total de 228 huevos estudiados. A cada huevo se le extrajeron 4 muestras, para un total de 912 muestras que se dividieron en grupos. Cada grupo de muestras fue procesado para cultivobacteriano y PCR para Salmonella. Resultados: Se aislaron Bacillus sp; Pseudomonas sp, Enterobacter sp, Serratia sp., Citrobacter sp., E. coli, Streptococcus viridans, Klebsiella sp., Staphylococcus sp., Aeromonas sp., Sarcinas sp., Acinetobacter sp, E. hermanii, Proteus y Stenotrophomonas maltophilia. Todos los cultivos y PCR fueron negativos para Salmonella. Conclusiones: Es importante conocer qué bacterias están contaminando los huevos comerciales, algunas de ellas potencialmente patógenas para los humanos, especialmente para niños, inmunocomprometidos y ancianos, como Aeromonas sp, E. coli y S. aureus. Con los resultados obtenidos se puede concluir que durante los meses Junio-Noviembre de 2007, periodo en el cual se recogió la muestra para este estudio no se detectó Salmonella en huevos comerciales de la ciudad de Medellín y Área Metropolitana.

Objective. Search for Salmonella and other bacteria in commercial eggs. Methods. Thirty-eight neighborhood grocery stores in the city of Medellin and its Metropolitan area were chosen at random; also from each grocery store 6 eggs were selected randomly, for a total of 228 tested eggs. Four samples from every egg were taken, 912 samples in total,which were divided in groups. Every group of samples was cultured in bacteriological media and PCR for Salmonella was performed. Results. The bacterium isolated from the samples were: Bacillus sp., Pseudomonas sp., Enterobacter sp., Serratia sp., Citrobacter sp., E. coli, Streptococcus viridans, Klebsiella sp., Staphylococcus sp., Aeromonas sp., Sarcinas sp., Acinetobacter sp., E. hermanii, Proteus and Stenotrophomonas maltophilia. All cultures and PCR were negative for Salmonella. Conclusions. According to these results, the isolation of contaminating bacteria, such as Aeromonas sp, E. coli, and S. aureus, in commercial eggs is relevant since some of them are potentially pathogenic to humans, especially children, the immunocompromised and the elderly. We can conclude that from June to November 2007, the period during which the samples were taken for this current study, Salmonella was notdetected in commercial eggs in the city of Medellin and it’s Metropolitan Area.

Objetivo. Procurar Salmonella e outras bactérias em ovos comerciais. Métodos. Trinta e oito mercearias de bairroda cidade de Medellín e sua área metropolitana foram escolhidos aleatoriamente; também das mercearias, 6 ovos foram selecionados aleatoriamente, para um total de 228 ovos analisados. Quatro amostras de cada ovo foram tomadas, 912 amostras no total, que foram divididos em grupos. Cada grupo de amostras foi cultivada em meio bacteriológico e PCR para Salmonella foi realizada. Resultados. As bactérias isoladas das amostras foram: Bacillus sp.; Pseudomonas sp, Enterobacter sp, Serratia sp., Citrobacter sp., E. Coli, Streptococcus viridans, Klebsiella sp., Staphylococcus sp., Aeromonas sp., Sarcinas sp., Acinetobacter sp., E. Hermanji, Proteus e Stenotrophomonas maltophilia. Todas as culturas e o PCR foram negativas para Salmonella. Conclusões. É importante conhecer que as bactérias, como Aeromonas sp, E. coli e S. aureus, estão contaminando os ovos comerciais e alguns deles são potencialmente patogênicos para o homem, especialmente para crianças, imune-comprometidos e idosos. Com osresultados obtidos pode-se concluir que durante os meses de junho ao novembro de 2007, o período no qual foicolhidas as amostras pra o estudo atual, Salmonella não foi detectada em ovos comerciais na cidade de Medellín esua área metropolitana.

Tratamiento del niño obeso / Obese child treatment

La obesidad, en la niñez y la adolescencia, ha pasado de ser una enfermedad rara a una epidemia emergente, con consecuencias adversas en etapas ulteriores de la vida. En niños con sobrepeso y obesidad, se ha evidenciado incremento de la alteración del metabolismo de los carbohidratos, enfermedad cardiovascular, problemas psicosociales y trastornos alimentarios. El inicio de estrategias de prevención y tratamiento debe ser multidisciplinario, con la intervención no solo de profesionales de la salud sino de todos los involucrados en el ámbito escolar, familiar y gubernamental. Las razones por las que no se tiene éxito tienen que ver con factores culturales, creencias y prejuicios, pero también se relaciona con insuficiente preparación del personal involucrado en su manejo. El tratamiento de la obesidad no debe centrarse sólo en indicaciones de dieta y ejercicio, sino también de convencer al niño o adolescente, para lograr cambios en el área afectiva, lo más difícil de lograr en el ámbito educativo. La prevención constituye la mejor herramienta que contribuirá a modificar la historia natural de la enfermedad y evolución clínica desde etapas tempranas de la vida. En esta revisión, los profesionales de la salud encontrarán respuesta informada y recomendaciones a una serie de interrogantes que plantean la asistencia clínica cotidiana de obesidad en pediatría. La revisión fue desarrollada con la participación de expertos en las diferentes disciplinas de atención de este grupo de pacientes, con el objetivo de alcanzar el mayor impacto positivo en el manejo, tanto de prevención como de tratamiento de obesidad en pediatría.

Childhood obesity is not longer a rare disorder; it has become in a growing epidemic that result in serious consequences later on life. Children who had an excessive body weight have a higher prevalence of metabolic disorders, cardiovascular disease, psy-chosocial pathology and abnormal eating behaviors. Preventive and therapeutic programs against childhood obesity should be multifaceted, including the participation of health professionals, school teachers, relatives and the government. Multiple factors may limit the efficacy of such programs, including, cultural factors, prejudice, misbelieves and inadequate preparation of the personnel in charge. Obesity treatment extends beyond the prescription of the dietary plan and an exercise program. It should modify patient's attitudes and their ability to confront emotions. Prevention is the best approach to change the natural course of the disease. In this review, health professionals will find recommendations for the treatment of childhood obesity. This manuscript was prepared with the participation of several expert clinicians with complimentary points of view. The multi-disciplinary approach has the greater likelihood for being successful in this condition.