ABSTRACT
Tuberculosis (TB) in the pediatric population is a major challenge. Our objective was to describe the clinical and microbiological characteristics, radiological patterns, and treatment outcomes of children and adolescents (from 1 month to 17 years) with community-acquired pneumonia (CAP) caused by TB. We performed a prospective cohort study of a pediatric population between 1 month and 17 years of age and hospitalized in Medellín, Colombia, with the diagnosis of radiologically confirmed CAP that had ≤ 15 days of symptoms. The mycobacterial culture of induced sputum was used for the bacteriological confirmation; the history of TB contact, a tuberculin skin test, and clinical improvement with treatment were used to identify microbiologically negative TB cases. Among 499 children with CAP, TB was diagnosed in 12 (2.4%), of which 10 had less than 8 days of a cough, 10 had alveolar opacities, 9 were younger than 5 years old, and 2 had close contact with a TB patient. Among the TB cases, 50% (6) had microbiological confirmation, 8 had viral and/or bacterial confirmation, one patient had multidrug-resistant TB, and 10/12 had non-severe pneumonia. In countries with an intermediate TB burden, Mycobacterium tuberculosis should be included in the etiological differential diagnosis (as a cause or coinfection) of both pneumonia and severe CAP in the pediatric population.
ABSTRACT
OBJECTIVES: This study aimed to evaluate the utility of induced sputum (IS) for the diagnosis of community-acquired pneumonia (CAP) in pediatric population. METHODS: This cross-sectional study included pediatric population aged between 1 month and 17 years who were hospitalized with a diagnosis of CAP in 13 hospitals in Colombia, in whom an IS sample was obtained. Gram staining, aerobic bacterial and mycobacterial culture tests, and polymerase chain reaction (PCR) for 6 atypical bacteria and 15 respiratory viruses were performed. We evaluated the quality of IS samples. RESULTS: IS samples were collected in 516 of 525 children included in this study. The median age was 32 months, 38.6% were younger than 2 years, and 40.9% were between 2 and 5 years. Two patients had transient hypoxemia during the procedure. The quality of the IS obtained was good in 48.4% and intermediate in 24.5%. Identification of a respiratory pathogen was achieved with an IS sample (with Gram staining, culture test, and PCR) in 372 of 516 children with CAP. CONCLUSION: Our study shows that IS is an adequate sample for the diagnosis of CAP in pediatric population that required hospitalization. The procedure was safe, well tolerated, and with better diagnostic yields compared with the rest of the samples obtained.
Subject(s)
Community-Acquired Infections , Pneumonia , Adolescent , Bacteria , Child , Child, Preschool , Community-Acquired Infections/microbiology , Cross-Sectional Studies , Humans , Infant , Pneumonia/diagnosis , Sputum/microbiologyABSTRACT
Wilms' tumor is childhood's most common renal tumor, and its presentation in the adult age is extremely rare. Due to the low frequency in adults, no standard management guidelines are available for this population, also the natural history of the disease and management is unclear. We present a case report of a 31-year-old woman with metastatic Wilms' tumor, with lymph node, lung and liver involvement; systemic treatment with chemotherapy was started, with complete clinical response. Finally, a literature review is performed to showcase the differences in the clinical course, prognosis, and treatment alternatives, in adult disease compared to childhood.
ABSTRACT
Los trabajos sobre aprendizaje asociativo en modelos biológicos simples han involucrado los mecanismos de facilitación heterosináptica, modulación y aumento de la eficacia de las vías que participan en el procesamiento de los estímulos utilizados experimentalmente. El presente trabajo busca mejorar la eficacia de los circuitos implicados en un modelo de condicionamiento aversivo, en un sistema más complejo como lo es el Hipocampo de la rata Wistar y evaluar el efecto sobre los procesos de aprendizaje. Para ello se utilizan 3 grupos de experimentales, uno recibe inyección intrehipocámpica de cafeina y solución salina, otro es inyectado solamente con solución salina en hipocampo y el tercer grupo no recibe ningún manejo farmacológico. Los resultados muestran entre otras cosas un comportamiento caracterizable matemáticamente, dos fases del proceso de aprendizaje y un aumento notorio de la eficacia de la primera fase del aprendizaje por la cafeina. Se postula la alta posibilidad de que en el grupo con cafeina hayn participado los mismos procesos descritos por Eccles, Byrne y otros en sus modelos con la Aplysia
