Detección de genes que codifican hemolisinas en cepas de Staphylococcus aureus aisladas en pantallas de teléfonos móviles de estudiantes de último año de odontología en Cuenca-Ecuador, 2020-2021 / Detection of hemolysin-encoding genes in Staphylococcus aureus strains isolated from cell phone screens of senior dental students in Cuenca-Ecuador, 2020-2021

Staphylococcus aureus es la especie más común implicada en las enfermedades infecciosas que causan morbilidad y mortalidad a nivel mundial. Posee los genes hla, hlb, hld, hlg, hlg-v que codifican para hemolisinas. Las hemolisinas son reconocidas como un factor de virulencia potencial que ataca a la membrana y produce destrucción de las plaquetas y necrosis. Tienen la capacidad de sobrevivir por largos periodos en superficies inertes como en pantallas de teléfonos móviles. Estudio observacional de tipo transversal descriptivo. Se aislaron en un estudio previo 16 cepas de Staphylococcus aureus a partir de 92 muestras de pantallas de teléfonos móviles de estudiantes de odontología. Se utilizó la técnica de reacción en cadena de la polimerasa para detectar los genes que codifican para hemolisinas. El gen hla se detectó en 75% (12/16) de cepas de Staphylococcus aureus, hlb en 25% (4/16), hld 75% (12/16), hlg 75% (12/16), hlg-v 13% (2/16). Este estudio evidencia el alto porcentaje de cepas virulentas que poseen genes que codifican para hemolisinas en pantallas de teléfonos móviles, lo que puede contribuir a la diseminación de este patógeno. Es imperioso implementar medidas para la desinfección de teléfonos móviles (AU)

Staphylococcus aureus is the most common species implicated in infectious diseases causing morbidity and mortality worldwide. It has the hla, hlb, hld, hlg, hlg-v genes encoding for hemolysins. Hemolysins are recognized as a potential virulence factor that attacks the membrane and causes platelet destruction and necrosis. They have the ability to survive for long periods on inert surfaces such as cell phone screens. Observational descriptive cross-sectional study. Sixteen strains of Staphylococcus aureus were isolated in a previous study from 92 samples of cell phone screens of dental students; the polymerase chain reaction technique was used to detect genes coding for hemolysins. The hla gene was detected in 75% (12/16) of Staphylococcus aureus strains, hlb in 25% (4/16), hld 75% (12/16), hlg 75% (12/16), hlg-v 13 % (2/16). This study evidences the high percentage of virulent strains that possess genes encoding for hemolysins in cell phone screens, which may contribute to the dissemination of this pathogen. It is imperative to implement measures for the disinfection of cell phones (AU)

Frecuencia y susceptibilidad a penicilina y meticilina de aislamientos ambientales de Staphylococcus aureus en un hospital de Cuenca / Frequency and susceptibility to penicillin and methicillin of Staphylococcus aureus environmental isolations at a Cuenca´s hospital

Staphylococcus aureus es un patógeno asociado con infecciones intrahospitalarias comúnmente hallado en las fosas nasales y las manos del personal de salud; así como, en superficies ambientales, las cuales se convierten en potenciales reservorios y vehículos de transmisión de infecciones. En este estudio se analizó la frecuencia y la susceptibilidad a penicilina y meticilina de aislamientos ambientales de S. aureus en un hospital de Cuenca. Se recolectaron 50 muestras (30 de dos quirófanos y 20 de la sala de cuidados intensivos). S. aureus se identificó por pruebas fenotípicas y detección molecular del gen nuc. La susceptibilidad a meticilina y penicilina se determinó por el método de difusión del disco en agar y los genes blaZ y mecA por reacción en cadena de la polimerasa. La frecuencia de S. aureus fue de 6% (3/50 cepas). La resistencia a penicilina y meticilina fue de 66,6% (2/3 cepas). Los genes blaZ y mecA se detectaron en las dos cepas resistentes a penicilina y meticilina. La baja frecuencia de S. aureus puede estar relacionada con los ambientes analizados; ya que, las superficies muestreadas son áreas donde se hace énfasis en la aplicación de protocolos de higiene y desinfección para asegurar una adecuada descontaminación

Staphylococcus aureus is a pathogen associated with intrahospital infections commonly found in the nasal cavities and the hands of health personnel, as well as, on environmental surfaces; which become potential reservoirs and transmission vehicles of infections. In this study the frequency and susceptibility to penicillin and methicillin of environmental isolates of S. aureus in a hospital to Cuenca were analyzed. 50 samples (30 of two operating room and 20 of the intensive care room) were collected. S. aureus was identified by phenotypic tests and molecular detection of the nuc gene. The susceptibility to methicillin and penicillin was determined by agar disc diffusion method and the blaZ and mecA genes by polymerase chain reaction. The frequency of S. aureus was 6% (3/50 strains). Resistance to penicillin and methicillin was 66.6% (2/3 strains). The blaZ and mecA genes were detected in the two strains resistant to penicillin and methicillin. The low frequency of S. aureus may be related to the environments analyzed; because the surfaces sampled are areas where emphasis is placed on the application of hygiene and disinfection protocols for ensure adequate decontamination

Clasificación de los estudios médicos y análisis de la literatura médica publicada / Classification of medical studies and analysis of published medical literature

La aproximación del médico práctico a la literatura científica no es sencilla. No hemos tenido una formación sistemática en tal sentido, y la disponibilidad de la literatura, que en una época pasada era muy dificultosa, ha evolucionado a una abundancia de publicaciones muy difícil de abarcar, llegando en muchas ocasiones a saturarnos de información, la cual no siempre nos resulta útil en su totalidad. Este trabajo está orientado a compartir una forma de leer los trabajos científicos para extraer información que pueda ser útil en la práctica clínica, a través de una serie de preguntas que debemos de formularnos al tener de frente una publicación científica, logrando analizar de forma secuencial la validez interna del estudio, evaluar los resultados, y determinar la aplicabilidad del mismo a la práctica clínica diaria...(AU)

Incidencia de patología salival sintomática aleada en pacientes tratados con yodo radioactivo por cáncer diferenciado de tiroides / Incidence of sympthomatic salivary disease in patients with differentiated thyroid cancer treated with radioactive iodine

Background: The radioactive iodine therapy for differentiated thyroid cancer can produce severe and frequent salivary symptoms, during the treatment or later. Aim: To analyze the incidence, severity and charactheristics of the salivary signs and symptoms in these patients. Patients and Method: Retrospective and descriptive analisis of 106 patients with confirmed diagnosis of differentiated thyroid cancer, treated with surgery and radioactive iodine, that completed a telephonic survey for the evaluation of salivary symptoms. Results: 26 (24.52 percent) patients presented with salivary symptoms or signs after the radioactive iodine therapy (mean 5 months). The average doses of I 131 was 128,5 mCi. Xerostomy, pain, xeroftalmy, inflammation, sialoadenitis and dysgeusia, were the most frequent clinical symptoms. Conclusions: After radioactive iodine therapy the salivary symptoms and signs incidence is high. We conclude that the indication for this treatment must be selective, but in accordance with the oncological risk of each patient.

Introducción: El tratamiento con yodo radioactivo en el tratamiento del cáncer diferenciado de tiroides puede originar síntomas alejados de origen salival. Éstos pueden llegar a ser intensos y frecuentes. Objetivo: Conocer la incidencia, características e intensidad de dichos síntomas. Material y Método: Revisión retrospectiva y análisis descriptivo de 106 pacientes con diagnóstico definitivo y anatomopatológico de cáncer diferenciado de tiroides, tratados con yodo radioactivo, que contestaron una encuesta telefónica especialmente diseñada para evaluación de patología salival. Resultados: Veintiséis (24,52 por ciento) pacientes presentaron y consultaron por síntomas y/o signos alejados (promedio 5 meses) de la terapia ablativa, de origen salival. La dosis promedio fue de 128,5 mCi de I 131. Los síntomas más frecuentes fueron xerostomía, dolor, xeroftalmia, inflamación, sialoadenitis y alteración del gusto. Discusión: La incidencia de signos y síntomas salivales alejados en pacientes tratados con I 131 es alta y justificaría a nuestro juicio su indicación selectiva, de acuerdo a los riesgos de recurrencia tumoral de cada paciente.

Subclinical concentrations of chlorhexidine inhibit gelatinase activity of carious dentine in vitro.

BACKGROUND: There is evidence that dentine matrix gelatinases are involved in the destruction of carious dentine after demineralization by bacterial acids. It has also been observed that chlorhexidine, in very low concentrations, inhibits the activity of these enzymes in mammalian cells. The goal of this study was to determine if the gelatinase activity of carious dentine may be inhibited by chlorhexidine in clinical use concentrations. METHODS: Gelatinolytic activity was evaluated through zymography and identified by Western blot. The inhibitory effects of chlorhexidine at concentrations of 0.01%, 0.04%, 0.08% and 1% on the enzymatic activity of softened carious dentine samples were determined. RESULTS: In carious dentine, five bands of gelatinolytic activity were detected, with molecular sizes of 86, 75, 38, 33 and 32 kDa. The two bands of the greatest molecular size corresponded to latent and active metalloproteinase-9, respectively. Concentrations of chlorhexidine that were greater than or equal to 0.04% were sufficient to inhibit gelatinolytic activity in the observed bands of carious dentine. CONCLUSIONS: These results support the use of chlorhexidine in clinical use concentrations for the treatment and control of dentine caries. Our study demonstrates for the first time the inhibitory effect of chlorhexidine on gelatinases from carious human dentine.

Hiperparatiroidismo primario de origen multiglandular con glándula paratiroides intratiroídea hiperfuncionante / Multiglandular primary hyperparathyroidism with a hyperfunctional intrathyroid gland: case report

We report a 56 years old female, admitted to the hospital for the study of general weakness, constipation, a recent radial fracture, hypercalcemia of 18 mg/dl, hypophosphatemia of 1.2 meq/dl and a serum parathormone (PTH) of 995 pg/ml. A thyroid ultrasound disclosed a nodule of 6 cm diameter. Following emergency management and normalization of the hypercalcemia, that patient was subjected to a total thyroidectomy and parathyroidectomy. The pathological study of the surgical piece showed a multiglandular hyperplasia of the parathyroid glands. One of these was located inside the left thyroid lobe.

Se presenta el caso de una paciente de 56 años que ingresó al hospital por una historia caracterizada por decaimiento, constipación, fractura reciente de radio, hipercalcemia de 18 mg/dl, hipofosfemia de 1,2 meq/ dl y elevación de paratohormona de 995 pg/ml. Además, presentaba un nódulo tiroídeo de 6 cm. Posterior al tratamiento médico de la hipercalcemia, se realizó el tratamiento quirúrgico con el diagnóstico definitivo de hiperplasia paratiroídea multiglandular con una de ellas en ubicación intratiroídea.

Reporte de reacciones adversas a medicamentos con compromiso mucocutáneo en el Hospital Clínico Universidad de Chile durante los años 2004-2010 / Report of adverse reactions to medecines with mucocutáneo commitment in the Hospital Clínico Universidad de Chile during years 2004-2010

Adverse drug reactions (ADRs) are responsible for up to 10percent of hospital admissions worldwide; within them, that mucocutaneous reactions are the most common represented 30percent of the total. The aim of this study was to analyze 119 reports of ADRs recorded in the Pharmacy Department of University of Chile Clinical Hospital in the period 2004-2010 by gender, age, most frequent clinical presentations, drugs and health personnel linked to the notification. In addition, we tried to quantify the relative importance of mucocutaneous reactions in the total of reported ADRs. ADRs were more common in women (56.3percent). The average age was 52.84 years + / - 7.77, 52.07 + / - 10.6 for women and 53.84 + / - 13.43 for men without significant differences (p = 0.85). According to the clinical presentation, mucocutaneous reactions were the most frequent (31.1percent) followed by hematological (25.2percent). The drugs involved were chemotherapy (68.9percent), antibiotics (5.9percent) and NSAIDs, nonsteroidal anti-inflammatory drugs, (4.2percent). In health personnel linked to the notification, we found the association medical / pharmaceutical chemist was the most frequent (40.3percent), followed by a pharmaceutical chemist (33.6percent). In mucocutaneous ADRs we observed a mean age of 54.65 + / - 9.19 years and female predominance (62.2percent). According to the clinical dermatology, we observed a prevalence of skin rash (35.1percent), mucositis (21.6percent), facial erythema (16.2percent) and pruritus (16.2percent). The drugs involved were chemotherapy (78.4percent), antibiotics (8percent), antiretroviral therapy (5percent) and opioids (5percent). Finally, we found that according to time of onset, delayed reactions were the most frequent (43.2percent).

Cáncer medular de tiroides esporádico de curso agresivo, en un adolescente varón / Madullary thyroid cancer in a 14 years old male: case report

Medullary thyroid cancer can appear sporadically or as part of a multiple endocrine neoplasia type 2A or 2B. In both conditions, it is associated with mutations of proto oncogene RET (rearranged during transfection). We report a 14 years old male presenting with a bone lesion in the skull followed by a hard cevical mass. A CAT scan showed an invasive thyroid nodule with involvement of regional lymph nodes , osteolytic lesions in skull, spine and ribs and liver metastases. Serum calcitonin was markedly elevated (9752 pg/ml, normal below 14 pg/ml). Fine needle biopsy showed a medullary thyroid carcinoma and the patient was subjected to a total thyroidectomy and radical cervical dissection. In the postoperative period the patient required calcium and vitamin D supplementation. Serum calcitonin 15 days after surgery was 11.692 pg/ml. Palliative radiotherapy was indicated for spine pain. A percutaneous gastrostomy was indication for nutritional support. The molecular study did not detect mutations of RET gene between exons 10 and 16.

[Small intestine bacterial overgrowth in patients with chronic pancreatitis]. / Sobrecrecimiento bacteriano intestinal en pacientes con pancreatitis crónica.

BACKGROUND: Previous reports describe 30-40% of small intestine bacterial overgrowth (SIBO) in patients with chronic pancreatitis (CP), SIBO is a cause of persistent symptoms in this group of patients even when they are treated with pancreatic enzymes. AIM: To asses the frequency of SIBO in patients with CP. PATIENTS AND METHODS: We studied 14 patients with CP using an hydrogen breath test with lactulose to detect SIBO, a nonabsorbable carbohydrate, whose results are not influenced by the presence of exocrine insufficiency. Main symptoms and signs were bloating in 9 (64%), recurrent abdominal pain in 8 (57%), intermittent diarrhea in 5 (36%) and steatorrhea in 5 (36%). At the same time we studied a healthy control group paired by age and sex. RESULTS: SIBO was present in 13 of 14 patients with CP (92%) and in 1 of 14 controls (p<0.001). The only patient with CP and without SIBO was recently diagnosed and had minimal morphologic alterations in computed tomography and endoscopic pancreatography. CONCLUSIONS: SIBO is common in CP and may be responsible for persistent symptoms. Proper diagnosis and treatment could alleviate symptoms and improve quality of Ufe.

Sobrecrecimiento bacteriano intestinal en pacientes con pancreatitis crónica / Small intestine bacterial overgrowth in patients with chronic pancreatitis

Background: Previous reports describe 30-40 percent of small intestine bacterial overgrowth (SIBO) in patients with chronic pancreatitis (CP), SIBO is a cause of persistent symptoms in this group of patients even when they are treated with pancreatic enzymes. Aim: To asses the frequency of SIBO in patients with CP. Patients and methods: We studied 14 patients with CP using an hydrogen breath test with lactulose to detect SIBO, a nonabsorbable carbohydrate, whose results are not influenced by the presence of exocrine insufficiency. Main symptoms and signs were bloating in 9 (64 percent), recurrent abdominal pain in 8 (57 percent), intermittent diarrhea in 5 (36 percent) and steatorrhea in 5 (36 percent). At the same time we studied a healthy control group paired by age and sex. Results: SIBO was present in 13 of 14 patients with CP (92 percent) and in 1 of 14 controls (p<0.001). The only patient with CP and without SIBO was recently diagnosed and had minimal morphologic alterations in computed tomography and endoscopic pancreatography Conclusions: SIBO is common in CP and may be responsible for persistent symptoms. Proper diagnosis and treatment could alleviate symptoms and improve quality of life.

Early parathyroid MIBI SPECT imaging in the diagnosis of persistent hyperparathyroidism.

We present a case that demonstrates the utility of early SPECT images associated with fusion images with MRI for presurgical localization in a case of persistent hyperparathyroidism after a first surgery. Three years after that surgery, severe hypercalcemia (14.7 mg/dL) and elevated parathormone (PTH) (944 pg/mL) were detected. MRI and SPECT parathyroid scintigraphy showed an abnormal parathyroid lesion localized behind the inferior pole of the thyroid right lobe. At surgical reexploration a right inferior parathyroid adenoma was removed (258 mg). However, intraoperative PTH remained high and a total thyroidectomy was performed looking for an intrathyroid lesion. After that, the elevated PTH persisted and an ectopic parathyroid gland was identified in the tracheoesophageal groove (958 mg), corresponding with the lesion seen on the fusion image of MRI and SPECT. After removal of this lesion, the PTH dropped to 85%.

Patterns and variability in electrophoretic polypeptide profiles of human saliva in a healthy population

Electrophoretic polypeptide profiles of normal human saliva differ markedly between different reports. Since both methodological variations and polymorphism may explain these differences, in this study we aimed to establish whether or not the salivary electrophoretic polypeptide profiles of subjects from a healthy population share discrete molecular features. To this end, parotid, submandibular/sublingual and whole salivas were collected separately from each of 40 young and 34 elderly clinically healthy adults and processed for SDS-polyacrylamide gel electrophoresis and Coomassie blue staining. Each type of glandular saliva displayed a different group of invariant (i.e. present in every subject) electrophoretic polypeptide bands while whole saliva showed a profile that reflected mostly the combined contribution of the major salivary glands. Some minor variant (i.e. absent in some subjects) bands were identified in each type of saliva. Regarding those interindividual variations, no ageor sex-dependence was appreciated. Altogether, these results demonstrate the occurrence of distinctive electrophoretic polypeptide patterns, in addition to some minor variations, for each type of normal saliva, thus providing a background for further populational studies on salivary polypeptide profiles (AU)

Los perfiles electroforéticos de la saliva humana normal publicados presentan marcadas diferencias. Puesto que estas diferencias podrían deberse a polimorfismo poblacional o a variaciones metodológicas, en el presente estudio pretendemos determinar si los perfiles polipeptídicos electroforéticos salivales de una población sana comparten rasgos moleculares. Con este propósito, se colectó saliva parotídea, saliva submandibular/sublingual y saliva total de 40 sujetos adultos jóvenes y 34 sujetos adultos mayores, clínicamente sanos. Las muestras de saliva fueron sometidas a fraccionamiento electroforético en geles de poliacrilamida-SDS y reveladas por tinción con azul de Coomassie. Cada tipo de saliva glandular presentó un grupo característico de bandas polipeptídicas invariables (presentes en todos los sujetos). En la saliva total se pudo observar un perfil que reflejaba principalmente la contribución proteica de las glándulas salivales mayores. En todos los tipos salivales analizados, se pudo observar algunos polipéptidos variables (ausentes en algunos sujetos). Estas variaciones interindividuales no se relacionaron con el sexo o la edad de los individuos. El conjunto de los resultados demuestra la existencia de patrones polipeptídicos distintivos para cada tipo salival junto con la presencia de algunos pocos rasgos variantes en condiciones de normalidad, lo que podría servir de base en futuros estudios poblacionales sobre perfiles polipeptídicos salivales (AU)

Patterns and variability in electrophoretic polypeptide profiles of human saliva in a healthy population.

Electrophoretic polypeptide profiles of normal human saliva differ markedly between different reports. Since both methodological variations and polymorphism may explain these differences, in this study we aimed to establish whether or not the salivary electrophoretic polypeptide profiles of subjects from a healthy population share discrete molecular features. To this end, parotid, submandibular/sublingual and whole salivas were collected separately from each of 40 young and 34 elderly clinically healthy adults and processed for SDS-polyacrylamide gel electrophoresis and Coomassie blue staining. Each type of glandular saliva displayed a different group of invariant (i.e. present in every subject) electrophoretic polypeptide bands while whole saliva showed a profile that reflected mostly the combined contribution of the major salivary glands. Some minor variant (i.e. absent in some subjects) bands were identified in each type of saliva. Regarding those interindividual variations, no age- or sex-dependence was appreciated. Altogether, these results demonstrate the occurrence of distinctive electrophoretic polypeptide patterns, in addition to some minor variations, for each type of normal saliva, thus providing a background for further populational studies on salivary polypeptide profiles.

Medicina nuclear en el estudio de patología nefrourológica pediátrica / Nuclear medicine in the study of nephrourologic pediatric pathology

Los procedimientos centigráficos permiten el estudio funcional de patologías renales y urológicas, complementando otros estudios por imágenes, tanto en el diagnóstico como seguimiento postratamiento médico o quirúrgico. En este artículo se revisan las principales indicaciones y ventajas de cada uno de los exámenes cintigráficos susceptibles de ser usados en pacientes pediátricos.

Actividad del citocromo P450 y su alteración en diversas patologías / Cytochrome P450 activity and its alteration in different diseases

Cytochrome P450 (CYP) enzymes participate in the metabolism of a variety of naturally occurring and foreign compounds by reactions requiring NADPH and O2. The diversity of reactions catalyzed and its extensive substrate specificity render CYP enzymes as one of the most versatile known catalysts. Individual members of the CYP superfamily are expressed in almost every cell type in the body. As compared to hepatic enzymes, the regulation of human extrahepatic CYPs has not been so well studied. In general, the levels of some hepatic CYP enzymes are depressed by diseases, causing potential and documented impairment of drug clearence and clinical drug toxicity. However, modulation of CYPs is enzyme selective and this selectivity differs in different diseases. This article reviews some basic concepts about CYP and its regulation in some disease states such as hypertension, diabetes, obesity and hepatic, infectious and inflammatory diseases (Rev Méd Chile 2004; 132: 85-94).

Estudio comparativo del consumo crónico de vino tinto sobre la expresión y la actividad del citocromo P450 en Hígado y riñon de rata / Comparative study of chronic red wine consumption on the expression and activity of the cytochrome p-450 in trat and kidney

El metabolismo del etanol involucra la participación de isoenzimas del citocromo P450 (CYP), principalmente con la contribución de la isoenzima 2E1 (CYP 2E1), cuya actividad es inducida por la exposición crónica al alcohol. El metabolismo etílico está relacionado con la producción de especies reactivas de oxígeno (ROS), responsables de la generación de estrés oxidativo. Por otra parte, se ha sugerido que los antioxidantes contenidos en el vino ejercerían un efecto protector contra la injuria oxidativa. El objetivo de este estudio fue comparar el efecto del consumo moderado de vino tinto sobre la expresión y la actividad del CYP 2E1 en hígado y riñón de rata. Ratas macho adultas fueron tratadas con agua (control), etanol (12,5 por ciento), vino tinto (12,5 por ciento de etanol) o vino tinto desalcoholizado por 10 semanas. El contenido de CYP total y CYP 2E1 fue evaluado en la fracción microsomal de riñón e hígado. La oxidación del etanol y p-nitrofenol fue tomada como índice de actividad de CYP 2E1, analizándose la contribución relativa de etanol y componentes no alcohólicos del vino. El etanol aumentó los contenidos de CYP total y CYP 2E1, así como la hidroxilación del p-nitrofenol y la oxidación del etanol tanto en hígado como en riñón. Esos efectos fueron atenuados por la administración de vino tinto. Con esta información es posible sugerir que los componentes no alcohólicos del vino tinto son capaces de modular el aumento en la expresión y la actividad del CYP 2E1 de hígado y riñón de la rata inducida por etanol

Hidronefrosis del recién nacido: cintigrafia renal dinámica con Tc99m MAG3 durante el primer mes de vida / Dynamic renal scintigraphy with Tc99 MAG3 for the diagnosis of newborn hydronephrosis

Background: The early and accurate diagnosis of obstructive uropathy in the newborn, prevents secondary complications and kidney damage. Aim: To study the usefulness of Tc99M MAG3 diuretic renogram in newborns with hydronephrosis. Material and methods : Forty newborns, aged 1 to 30 days, with hydronephrosis, were studied. A Tc99M MAG3 diuretic renogram (DR) was done and its results were compared with clinical features and other imaging studies. Each kidney and its ureter, were considered a renal unit. Results: Seventy six renal units were evaluated. Twenty six were normal on prenatal ultrasound examination and DR. In 11 of the 50 renal units with hydronephrosis, renal function was impaired. Thus, it was impossible to obtain an excretory curve. In 17 of the 39 remaining renal units, the absence of obstructive uropathy was demonstrated clinically. In 16 of these, the DR showed absence of obstruction. In 20 of 21 renal units with confirmed obstructive uropathy, DR showed an obstructive pattern. Conclusions : In newborns, there is an adequate Tc99M MAG3 uptake and diuretic response. Thus, DR becomes a good functional assessment method in newborns with hydronephrosis

Factores de riesgo de daño renal permanente en niños con infección del tracto urinario / Risk factors for permanent kidney damage in children with urinary tract infection

Background: In children, urinary tract infection (UTI) is a very common disease, and can cause permanent kidney damage. Aim: To determine risk factors for permanent kidney damage, in children with UTI. Patients and methods: In 337 children with UTI (237 female, mean age 4,2 years) a static renal scintigraphy was performed to assess the presence of permanent kidney damage. The history of vesicoureteral reflux and number of episodes of UTI was obtained. Results: One hundred three children had a history of one episode of infection and the rest had recurrent infections. Permanent kidney damage was observed in 161 children (48 percent). This damage was observed in 39 percent of children of less than one year of age, in 43 percent of children aged 1 to 5 years of age and in 58 percent of children older than 5 years (p=0.02). Sixty three percent of 122 children with vesicoureteral reflux had permanent kidney damage, compared with 27 percent of children without this condition (p <0.001). Likewise, damage was observed in 36 percent of children with one episode of infection and 47 percent of children with recurrent infections (p <0.01). No gender differences were observed. Conclusions: Vesicoureteral reflux, recurrence of UTI and age are associated with permanent renal damage in children with UTI

Parámetros clínicos y radiológicos de pacientes con tromboembolismo pulmonar diagnosticado a través de cintigrafías de ventilación / perfusión de alta probabilidad / Clinical and radiological parameters of patients with lung thromboembolism, diagnosed by high probability ventilation / perfusion scintigraphies

Introducción: el tromboembolismo pulmonar (TEP) es una patología compleja y de difícil enfrentamiento para el clínico, por lo que el uso de métodos de diagnóstico por imágenes se han incluido desde hace décadas en los algoritmos diagnósticos. Objetivos: establecer los parámetros clínicos y radiológicos presentes en pacientes con tromboembolismo pulmonar diagnosticado a través de cintigrafías de ventilación perfusión de alta probabilidad. Materiales y métodos: se estudió 91 pacientes a quienes se les realizó estudios cintigráficos V/Q por sospecha de TEP. Sólo se consideraron aquellas cintigrafías informadas como de alta o baja probabilidad para TEP. El promedio de edad fue de 63,1 años (rango: 20 - 89 años), 43 hombres y 48 mujeres. Resultados: existió significancia estadística para cuatro parámetros: hemoptisis (p=0,01, razón de chance=8,925), taquicardia (p=0,02, razón de chance=3,5), dolor toráxico (p=0,01, razón de chance =1,87) y la condición del postoperatorio reciente (p=0,02, razón de chance=2,762). Destacó la ausencia de hallazgos positivos en la radiografía de tórax, ya que en la gran mayoría de los casos se obtuvo una imagen normal (70,7 por ciento con valor p<0,0001). Discusión: los parámetros clínicos y radiológicos encontrados en los pacientes a los cuales se les realiza diagnóstico de TEP a través de cintigrafía V/Q fueron: dolor toráxico, hemoptisis, antecedente de postoperatorio reciente y radiografía de tórax normal. Esto es importante, ya que ayudaria a elegir al grupo de pacientes en que la cintigrafía V/Q alcanzará su mayor rendimiento