RESUMO
Osteoporosis should be considered in children with severe chronic diseases or in association with some genetic diseases that bear an increased risk of bone fragility. Primary osteoporosis is an entity in which emerging aetiologies are being recognized. Its association with congenital retinal folds should guide the diagnosis to the Osteoporosis-Pseudoglioma syndrome (OMIM 259770), a rare disease (prevalence of 1/2 000 000), caused by the loss of function of the protein LRP5 (low-density lipoprotein receptor-related protein 5) resulting in the alteration of the Wnt/ß-catenin signalling pathway. We report the case of a child with congenital retinal folds, progressive loss of vision and multiple fractures whose clinical, biochemical and genetic studies confirmed the diagnosis of primary osteoporosis due to a novel homozygous inactivating variant in LRP5.
La osteoporosis es un trastorno para tener en cuenta en niños con patologías crónicas graves o con algunas enfermedades genéticas que predisponen al incremento de la fragilidad ósea. La osteoporosis primaria es una entidad con etiologías emergentes y puede ocurrir en forma sindrómica. La asociación con pliegues retinianos congénitos debe orientar al diagnóstico de osteoporosis-pseudoglioma (OMIM 259770), síndrome poco frecuente (prevalencia de 1/2 000 000), que se origina por la pérdida de función de la proteína LRP5 (low-density lipoprotein receptor-related protein 5) y compromete la vía de señalización de Wnt/ß-catenina. Se presenta el caso de un niño con pliegues retinianos congénitos, ceguera progresiva y múltiples fracturas cuyo estudio clínico, bioquímico y genético confirmó el diagnóstico de osteoporosis primaria debido a una nueva variante inactivante en el gen LRP5 en homocigosis.
Assuntos
Osteogênese Imperfeita/diagnóstico , Criança , Marcadores Genéticos , Testes Genéticos , Homozigoto , Humanos , Proteína-5 Relacionada a Receptor de Lipoproteína de Baixa Densidade/genética , Masculino , Mutação , Osteogênese Imperfeita/genéticaRESUMO
BACKGROUND: Measurements of inspiratory capacity (IC) and vital capacity (VC) are used to recognize dynamic hyperinflation, but appropriate reference values are required to achieve accurate clinical interpretations. Altitude above sea level is a potential determining factor for lung volumes, including IC and VC. OBJECTIVE: To describe IC and VC for healthy people who live in Mexico City at an altitude of 2,240 m above sea level. METHODS: Healthy subjects ages 9-81 y completed slow spirometry by following 2005 American Thoracic Society/European Respiratory Society standards. Once associations were explored, linear regression models were constructed and values were compared with those from previously published equations. RESULTS: A total of 441 healthy subjects (55.1% women) participated. The mean age was 32 y (minimum age, 9 y; maximum age, 81 y). IC and VC measurements were associated with sex, age, height, and weight. An accelerated increase in IC and VC was evident from 9 to 20 y of age, followed by a gradual decrease in both sexes. In general, IC was higher in our population than predicted by previously published reference equations. CONCLUSIONS: IC in healthy people at 2,240 m above sea level was higher than that of previous reports about European and Latin-American subjects of the same height, sex, and age who were at sea level. The present study provided robust reference values for persons who lived at a moderate altitude.
Assuntos
Capacidade Inspiratória/fisiologia , Espirometria/estatística & dados numéricos , Capacidade Vital/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Altitude , Estatura , Peso Corporal , Criança , Feminino , Voluntários Saudáveis , Humanos , Modelos Lineares , Masculino , México , Pessoa de Meia-Idade , Valores de Referência , Adulto JovemRESUMO
La osteoporosis es un trastorno para tener en cuenta en niños con patologías crónicas graves o con algunas enfermedades genéticas que predisponen al incremento de la fragilidad ósea. La osteoporosis primaria es una entidad con etiologías emergentes y puede ocurrir en forma sindrómica. La asociación con pliegues retinianos congénitos debe orientar al diagnóstico de osteoporosis-pseudoglioma (OMIM 259770), síndrome poco frecuente (prevalencia de 1/2000000), que se origina por la pérdida de función de la proteína LRP5 (low-density lipoprotein receptor-related protein 5) y compromete la vía de señalización de Wnt/ß-catenina. Se presenta el caso de un niño con pliegues retinianos congénitos, ceguera progresiva y múltiples fracturas cuyo estudio clínico, bioquímico y genético confirmó el diagnóstico de osteoporosis primaria debido a una nueva variante inactivante en el gen LRP5 en homocigosis
Osteoporosis should be considered in children with severe chronic diseases or in association with some genetic diseases that bear an increased risk of bone fragility. Primary osteoporosis is an entity in which emerging aetiologies are being recognized. Its association with congenital retinal folds should guide the diagnosis to the Osteoporosis-Pseudoglioma syndrome (OMIM 259770), a rare disease (prevalence of 1/2000000), caused by the loss of function of the protein LRP5 (low-density lipoprotein receptor-related protein 5) resulting in the alteration of the Wnt/ß-catenin signalling pathway. We report the case of a child with congenital retinal folds, progressive loss of vision and multiple fractures whose clinical, biochemical and genetic studies confirmed the diagnosis of primary osteoporosis due to a novel homozygous inactivating variant in LRP5
Assuntos
Humanos , Masculino , Criança , Osteoporose/diagnóstico , Osteoporose/terapia , Cegueira , Fraturas MúltiplasRESUMO
RESUMEN Objetivo. Identificar Escherichia coli O157:H7 presente en heces diarreicas de rumiantes lactantes con síndrome diarreico y seguridad de ingesta de calostro. Materiales y métodos. Se realizó un muestreo de 316 rumiantes durante el período de agosto 2015 a marzo 2016 en los municipios de Río Grande, General Enrique Estrada, Morelos y Calera de Víctor Rosales del estado de Zacatecas, 67 de bovinos, 183 de ovinos y 66 de caprinos. Resultados. Se identificaron en medio cromogénico CHROMagarTM: 260 coliformes, 78 Escherichia coli O157:H7, 16 Proteus spp., y 25 colonias de bacterias sin identificar con este medio, encontrándose una incidencia de Escherichia coli O157:H7 de 22.03% en los cuatro municipios. Conclusiones. Escherichia coli O157:H7 es la segunda bacteria encontrada en heces de rumiantes con un 22% de incidencia, la cual es un factor de riesgo de muerte en rumiantes lactantes (menos de 21 días de nacidos) causando pérdidas económicas y riesgo para la salud de la población del estado de Zacatecas.
ABSTRACT Objective. To identify Escherichia coli 0157:H7 present in diarrheal feces of lactating ruminants with diarrheal syndrome and safety of colostrum intake. Materials and methods. A feces sampling of 316 ruminants was carried out during the period of August 2015 to March 2016 in the municipalities of Río Grande, General Enrique Estrada, Morelos and Calera de Victor Rosales of the state of Zacatecas, obtained from 67 cattle, 183 sheep and 66 goats. Results. The following were identified in CHROMagarTM chromogenic medium: 260 coliforms, 78 Escherichia coli 0157:H7, 16 Proteus spp. and 25 colonies of unidentified bacteria, finding an incidence of Escherichia coli 0157:H7 of 22.03% in the four municipalities. Conclusions. Escherichia coli 0157:H7 is the second bacteria found in ruminant feces with an incidence of 22%, which is a mortality risk factor in lactating ruminants (less than 21 days old), causing economic loss and health risk for the population of the state of Zacatecas.