Osteomielitis aguda y crónica: 10 años de estudio en pacientes pediátricos: Hospital de Niños J.M. de Los Ríos Caracas Venezuela / Acute and chronic osteomyelitis: 10 years of study in pediatric patients: Hospital de Niños

La osteomielitis constituye un proceso inflamatorio común del hueso. Existen factores que influyen en la incidencia y etiología tales como: estado inmunologógico, edad, sexo, traumatismo locales o enfermedades de base. A pesar de su relativa baja frecuencia es una de las principales causas infecciosas de hospitalización prolongada. Describir las características de pacientes con diagnóstico de osteomielitis egresados del Hospital de Niños J.M. de Los Ríos (HJMR) y establacer prevalencia según egresos hospitalarios. Estudio retrospectivo mediante revisión de historias médicas, descriptivo en menores de 18 años con diagnóstico de osteomielitis del Hospital de Niños "J.M. de Los Ríos", período diciembre 1998 - diciembre 2008. Análisis estadístico: medidas tendencias central y Chi cuadrado. Se revisaron 72 historias, 65,3% (47/72) masculino y 34,7% (25/72) femenino. Prevalencia de 0,14 por cada 100 egresados. Según edad 8,33% (6/72) lactantes menores 5,56% (4/72) lactantes mayores, 29% (20/72) preescolares, 29% (20/72) escolares y 27,8% (20/72) adolescentes. Promedio días hospitalización fue 42,5 ± 20,75. El 27,8% (20/72) presentaba alguna patología de base. Sitios afectados 37,5% (27/72) fémur, 23% (17/72) tibia, 6,9% (5/72) calcáneo, 6,94% (5/72) cadera y otros lugares 25% (18/72). En 45,83% (33/72) se realizó limpieza quirúrgica, en promedio a los 26,% días del ingreso (DE ± 33). el 62,5% (45/72) fueron ostemielitis agudas y 37,5% (27/72) crónica. El aislamiento micronbiológicos se logró con mayor frecuencia en el grupo de pacientes con osteomielitis crónica (P < 0,05). Un 11,11% (8/72) presentó algún tipo de secuela y 12,5% (9/72) infección nosocomial. La osteomielitis en niños tiene una prevalencia relativamente baja, pero genera hospitalizaciones prolongadas con importantes complicaciones médicas y quirúrgicas.

Osteomyelitis represents a common inflammatory process of the bone. Immnologic status, age , sex, traumatic lesions and co morbidities influence the etiology and comorbidities influence the etiology and incidence of the disease. It is one of the most important infectious causing prolonged hospitalizations. Describe the characteristics of children with osteomyelitis from J.M. de Los Ríos Children`s Hospital and calculate its prevalence. Retrospective and descriptive study through medical charts revision, including patients less than 18 years old with osteomyelitis as discharged diagnostic at Children Hospital J.M. de Los Ríos between December 1998 - December 2008. Seventy two chart were revised, 65.3% (47/72) male and 34.7% (25/72) female. The prevalence by 100 dischages by age was 8.3% (6/72) infants, 5.6% (4/72) children, 29% (20/72) pre-school children, 29% (20/72) scholer children, and 27.8% (20/72) adolescents. The average hospitalization time was 42.63 ± 20.75. Twenty of 77 children (27.8%) presented with some co morbidities. The affected bones were: 37.5% (27/72) femur, 23% (17/72) tepid bone, 6.9% (5/72) calcaneus, 6.9% (5/72) hip and others 25% (18/72). In 45.8% (33/72) the resolution was surgery, with an average of 26.5 days of hospitak stay (DE ± 24.33); 62.5% (45/72) were acute osteomyelitis, and 37.5% (27/72) chronic. The microbiologic diagnostic was more frequent in the group of chronic (p < 0.05). Sequel were present in 11% (8/72), and nosocomial infection in 12.5% (9/72). Osteomyelitis children has a relative small prevalence, but it generates prolonged hospitalizations with important complications.

Use of a CO2 electrode to monitor fermentations that use xenobiotic compounds as source of carbon

Bacterial strains were isolated from contaminated waters, mud or soils. They are capable of growing in mineral medium with different chemicals as carbon source, such as aliphatic or aromatic hydrocarbons and polychlorinated biphenyls (PCBs). Most of these strains tolerate high concentrations (up to 30 v/v) of the xenobiotic substrates. This is particularly important for the development of fermenting processes to treat effluents or residues with a high content of contaminating compounds. An ion-specific potentiometric electrode (CO2) has been developed to measure CO2 production continuously. When the different strains were incubated in a mineral medium and in the presence of the corresponding substrate, a parallel between growth, substrate consumption and CO2 production was found. The developed system is suggested as an efficient and economical alternative to evaluate the potential of biodegradation by different microorganisms.

Enfermedad de Gaucher tipo 1: reporte del tratamiento enzim tico en dos hermanos / Gaucher's disease type 1: report of enzymatic treatment in two broters

La enfermedad de Gaucher es un trastorno hereditario, causado por la deficiencia de la enzima glucocerebrosidasa, producida en los lisosomas. Esta enzima participa en el metabolismo del glucolípido cerebrósido; su deficiencia provoca la acumulación de éste en los macrófagos; dichas células se han denominado células de Gaucher y se acumulan en hígado, bazo y médula ósea. Se presenta el caso de dos hermanos con enfermedad de Gaucher tipo 1; con terapia de reemplazo enzimático a base de imiglucerase (cerezyme) endovenoso durante un año, lo que revirtió los síntomas de la enfermedad de Gaucher. La imiglucerase inyectable es una forma modificada de la enzima glucocerebrosidasa, producto obtenido por ingeniería genética, indicada en pacientes con diagnóstico de enfermedad de Gaucher tipo 1.1,2

Assessment of sensorial oral stimulation in infants with suck feeding disabilities.

A non-randomized single blind study was undertaken to determine the clinical and physiological changes in suck feeding after sensorial oral stimulation, in fourteen patients age 9 to 210 days old with sucking alterations. Patients lacked at least one of the five oral reflexes, plus two or more abnormal sucking sings or at least one abnormal sucking sign, plus two or more abnormal oral reflexes. Oral sensorial therapy was performed thrice daily for five days. The number of absent oral reflexes, number of abnormal sucking signs, volume of milk for nursing and sucking rate, were registered. Differences of medians were tested using Freidman's test and differential of proportions using Cochran's Q test. After therapy, oral reflexes were recovered (2, 0-4 vs. 5,5-5, p = 0.0000, median rank of absence oral reflexes) and the number of abnormal sucking signs decreased (6,1-9 vs. 1, 0-4; p = 0.0000). There were statistically significant improvements in patients who had lost launch up nipple ability (p = 0.005), delay at the beginning of sucking (p = 0.0022), drawing of milk from the mouth (p = 0.0001), cyanosis (p = 0.0084), weaning (p = 0.0004) and prolonged sucking (p = 0.0038). Even in patients with moderate improvement, no statistical differences were observed in nipple rooting (p = 0.09) and coughing (p = 0.09). No changes were observed in patients who had cried (p = 0.31) and spitted (p = 0.51) during feeding. At the end of therapy, volumes of consumed milk were increased at each feeding (10 ml, 0-40 vs. 50 ml, 25-60; p = 0.0001). Sucking rates also increased (22 sucks/minute, 10-35 vs. 40.5, 35-48; p = 0.0044). Oral sensorial and motor stimulation normalise oral motor reflexes, diminish the clinical abnormal sucking signs and increase milk volumes ingested for nursing.