Coronary Artery Dilation in Children with Febrile Exanthematous Illness without Criteria for Kawasaki Disease / Dilatação das Artérias Coronárias em Crianças com Doença Exantemática Febril sem Critérios para a Doença de Kawasaki

Abstract Background: Coronary dilatation is the most important complication of Kawasaki disease (KD) and, in addition to some clinical characteristics, is common to KD and febrile exanthematous illnesses (FEIs). Objective: To assess whether children with FEI, who do not meet the criteria for KD, have changes in coronary arteries dimensions. Methods: Echocardiography was performed within the first two weeks of the disease in patients < 10 years with fever and exanthema without other KD criteria. To make a comparison with KD patients, we reviewed the echocardiograms and medical records of patients with a diagnosis of KD of the last five years. Coronary ectasia was assessed using Z scores of coronary arteries. The means of the dimensions of the coronary arteries were compared with a z test and a level of significance of 0.05 was adopted. Results: A total of 34 patients were included, 22 (64.7%) with FEI, and 12(35.2%) with a diagnosis of KD. Using the Z scores of coronary artery, a dilation of any of the coronary artery branches was observed in six (27.2%) patients with FEI. Conclusions: An important percentage of patients with FEI has coronary artery dilation.

Resumo Fundamento: A dilatação das artérias coronárias é a principal complicação da Doença de Kawasaki (DK) e, além de algumas características clínicas, é comum à DK e a doenças exantemáticas febris (DEFs). Objetivo: Avaliar se crianças com DEF e que não têm critério para DK apresentam alterações nas dimensões das artérias coronárias. Métodos: Foi realizada ecocardiografia nas primeiras duas semanas da doença em crianças com idade inferior a 10 anos, que apresentaram febre e exantema e nenhum outro critério de DK. Para comparar com pacientes com DK, fizemos a revisão de ecocardiogramas e prontuários médicos de pacientes com diagnóstico de DK dos últimos cinco anos. Ectasia coronária foi avaliada usando escore Z das artérias coronárias. As médias das dimensões das artérias coronárias foram comparadas pelo teste z, e um nível de significância de 0,05 foi adotado. Resultados: Foram incluídos no estudo 34 pacientes, 22 (64,7%) com diagnóstico de DEF e 12 (35,2%) com diagnóstico de DK. Usando o escore Z das artérias coronárias, observou-se dilatação em algum dos ramos da artéria coronária em seis (27,2%) pacientes com DEF. Conclusão: Uma porcentagem importante dos pacientes com DEFs apresenta dilatação das artérias coronárias.

Aprovechamiento de los ambientes reducidos para la producción de organismos acuáticos susceptibles a cultivo, para el consumo humano / Reduced environments for production of culture susceptible aquatic organisms for human consumption

Anoxic sediments favor sulfate reducing bacteria proliferation, main characteristic of reduced environments, which are used for crustaceous culture. In Mexico, it has been reported the presence of anoxic sediments in the channels of Xochimilco, reduced environment that could be used for culture of organisms, like crayfish (Cambarellus montezumae). The aim of this study was to prove that reduced environments can be used for the production of culture susceptible aquatic organisms for human consumption. Apatlaco and Cuemanco channels are characterized as reduced environments, its water and sediment physicochemical parameters were evaluated; heavy metals in sediment and organisms were assessed; presence and sanitary quality of crayfish was proven, through qualitative and quantitative analysis of its bacteria charge; nutritional quality of crayfish was determined, by proximal chemical analysis. It was proven that the channels of Xochimilco fulfill the reduced environment characteristics, presence of crayfish C. montezumae in these channels was verified, it was shown that the levels of heavy metals and bacteria charge recorded, do not exceed the maximum allowed limits for edible crustaceous, important protein source for human consumption. Based on the previous, it is affirmed that reduced environments can be used for culture of edible aquatic species.

Los sedimentos anóxicos propician proliferación de bacterias sulfato-reductoras, característica principal de los ambientes reducidos, que se aprovechan para el cultivo de crustáceos. En México se ha notificado presencia de sedimentos anóxicos en los canales de Xochimilco, ambiente reducido, que podrían aprovecharse para el cultivo de organismos, como el acocil (Cambarellus montezumae). El objetivo del presente estudio fue probar que los ambientes reducidos pueden ser útiles para la producción de organismos acuáticos susceptibles de cultivo, y además, para consumo humano. Se caracterizaron los canales Apatlaco y Cuemanco como ambientes reducidos, se evaluaron parámetros fisicoquímicos del agua y sedimento; se determinaron metales pesados en sedimento y organismo; se comprobó la presencia y calidad sanitaria del acocil, a través de los análisis cualitativo y cuantitativo de su carga bacteriana; se determinó la calidad nutrimental de los acociles por medio de análisis químico proximal. Se probó que los canales de Xochimilco cumplen con las características de ambiente reducido, en el que se comprobó presencia del acocil (C. montezumae). Se demostró que los niveles de metales pesados y carga bacteriana registrados no superan los límites máximos permisibles para crustáceos comestibles, fuente importante de proteínas para el consumo humano. Con base en lo anterior se afirma que los ambientes reducidos pueden ser aprovechados para el cultivo de especies acuáticas comestibles.