RESUMO

BACKGROUND: Management of acute kidney injury (AKI) in children with hemolytic uremic syndrome induced by a Shiga toxin-producing Escherichia coli infection (STEC-HUS) is supportive; however, 40 to 60% of cases need kidney replacement therapy (KRT). The aim of this study was to analyze procedure complications, especially peritonitis, and clinical outcomes in children with AKI secondary to STEC-HUS treated with acute PD. METHODS: This is a multicenter retrospective study conducted among thirty-seven Argentinian centers. We reviewed medical records of 389 children with STEC-HUS hospitalized between January 2015 and February 2019 that required PD. RESULTS: Complications associated with PD were catheter malfunction (n = 93, 24%), peritonitis (n = 75, 19%), fluid leaks (n = 45, 11.5%), bleeding events (n = 23, 6%), and hyperglycemia (n = 8, 2%). In the multivariate analysis, the use of antibiotic prophylaxis was independently associated with a decreased risk of peritonitis (hazard ratio 0.49, IC 95% 0.29-0.81; p = 0.001), and open-surgery catheter insertion was independently associated with a higher risk (hazard ratio 2.8, IC 95% 1.21-6.82; p = 0.001). Discontinuation of PD due to peritonitis, severe leak, or mechanical complications occurred in 3.8% of patients. No patient needed to be transitioned to other modality of KRT due to inefficacy of the technique. Mortality during the acute phase occurred in 2.8% patients due to extrarenal complications (neurological and cardiac involvement), not related to PD. CONCLUSIONS: Acute PD was a safe and effective method to manage AKI in children with STEC-HUS. Prophylactic antibiotics prior to insertion of the PD catheter should be considered to decrease the incidence of peritonitis.

Assuntos

RESUMO

El absceso renal representa una patología infrecuente en el recién nacido. Puede presentar consecuencias graves: sepsis con alta mortalidad, cicatrices renales y riesgo de enfermedad renal crónica. Se reporta sobre un recién nacido con absceso renal unilateral a Staphylococcus aureus, con cuadro de septicemia, sin otro foco supurativo ni malformación urinaria, que evolucionó adecuadamente con antibióticos endovenosos, sin tratamiento quirúrgico, aunque con cicatrices renales como secuela. A partir de este caso, se analizan las estrategias de diagnóstico, tratamiento y seguimiento del absceso renal en un neonato y se destaca el diagnóstico precoz para evitar cicatrices renales.

Renal abscess is a rare disease in newborn, but severe consequences can occur: sepsis with high mortality, renal scar formation and risk of chronic renal failure. A neonate with unilateral renal abscess due to Staphylococcus aureus is reported, with septicemia, with no other suppurative focus, nor with urinary malformation, with good clinical evolution with intravenous antibiotics and without surgical treatment, but with renal scars sequel. From this case, the strategies of diagnosis, treatment and followup of the renal abscess in a neonate are analyzed, emphasizing the early diagnosis to avoid renal scars.

Assuntos

RESUMO

Renal abscess is a rare disease in newborn, but severe consequences can occur: sepsis with high mortality, renal scar formation and risk of chronic renal failure. A neonate with unilateral renal abscess due to Staphylococcus aureus is reported, with septicemia, with no other suppurative focus, nor with urinary malformation, with good clinical evolution with intravenous antibiotics and without surgical treatment, but with renal scars sequel. From this case, the strategies of diagnosis, treatment and followup of the renal abscess in a neonate are analyzed, emphasizing the early diagnosis to avoid renal scars.

El absceso renal representa una patología infrecuente en el recién nacido. Puede presentar consecuencias graves: sepsis con alta mortalidad, cicatrices renales y riesgo de enfermedad renal crónica. Se reporta sobre un recién nacido con absceso renal unilateral a Staphylococcus aureus, con cuadro de septicemia, sin otro foco supurativo ni malformación urinaria, que evolucionó adecuadamente con antibióticos endovenosos, sin tratamiento quirúrgico, aunque con cicatrices renales como secuela. A partir de este caso, se analizan las estrategias de diagnóstico, tratamiento y seguimiento del absceso renal en un neonato y se destaca el diagnóstico precoz para evitar cicatrices renales.

Assuntos

Assuntos

RESUMO

Purple acid phosphatases (PAPs) play an important role in plant phosphorus nutrition, both by liberating phosphorus from organic sources in the soil and by modulating distribution within the plant throughout growth and development. Furthermore, members of the PAP protein family have been implicated in a broader role in plant mineral homeostasis, stress responses and development. We have identified 33 candidate PAP encoding gene models in the maize (Zea mays ssp. mays var. B73) reference genome. The maize Pap family includes a clear single-copy ortholog of the Arabidopsis gene AtPAP26, shown previously to encode both major intracellular and secreted acid phosphatase activities. Certain groups of PAPs present in Arabidopsis, however, are absent in maize, while the maize family contains a number of expansions, including a distinct radiation not present in Arabidopsis. Analysis of RNA-sequencing based transcriptome data revealed accumulation of maize Pap transcripts in multiple plant tissues at multiple stages of development, and increased accumulation of specific transcripts under low phosphorus availability. These data suggest the maize PAP family as a whole to have broad significance throughout the plant life cycle, while highlighting potential functional specialization of individual family members.

RESUMO

In addition to acting as photoprotective compounds, carotenoids also serve as precursors in the biosynthesis of several phytohormones and proposed regulatory signals. Here, we report a signaling process derived from carotenoids that regulates early chloroplast and leaf development. Biosynthesis of the signal depends on ζ-carotene desaturase activity encoded by the ζ-CAROTENE DESATURASE (ZDS)/CHLOROPLAST BIOGENESIS5 (CLB5) gene in Arabidopsis thaliana. Unlike other carotenoid-deficient plants, zds/clb5 mutant alleles display profound alterations in leaf morphology and cellular differentiation as well as altered expression of many plastid- and nucleus-encoded genes. The leaf developmental phenotypes and gene expression alterations of zds/clb5/spc1/pde181 plants are rescued by inhibitors or mutations of phytoene desaturase, demonstrating that phytofluene and/or ζ-carotene are substrates for an unidentified signaling molecule. Our work further demonstrates that this signal is an apocarotenoid whose synthesis requires the activity of the carotenoid cleavage dioxygenase CCD4.

Assuntos

Assuntos

RESUMO

Se analiza la producción científica internacional de los investigadores del Sistema Nacional de Salud, sobre la base de los artículos que publicaron en revistas extranjeras entre 1989 y el primer semestre de 1991. Se consulta la base de datos MEDLINE, y se procesa la información que permite conocer las características de la autoría, la productividad institucional, la cantidad de trabajos producidos por año, la distribución temática, los países receptores de los manuscritos, y los idiomas en que aparecen los artículos. Se considera el presente estudio como punto de partida para emprender análisis con un mayor nivel de profundidad y obtener una visión más exacta de nuestro potencial investigativo

Assuntos