[Central nervous system infection by Bartonella henselae associated with a choroid plexus papilloma]. / Infección por Bartonella henselae con compromiso de sistema nervioso central, asociado a un papiloma del plexo coroídeo.

Bartonella henselae infection is a prevalent illness in Chile. It presents generally as a cat scratch disease or as a prolonged fever syndrome. There are atypical manifestations, which include central nervous system, bone, cardiac and hepato-esplenic compromised. We present an adolescent case with a history of fever, vomiting and ataxia, whose diagnosis was a central nervous system infection by Bartonella henselae associated with a choroid plexus papilloma. This case corresponds to an unusual presentation, with a challenging diagnosis. It is controversial whether to treat this patient, which antimicrobial is the right choice and how long the treatment should be.

Infección por Bartonella henselae con compromiso de sistema nervioso central, asociado a un papiloma del plexo coroídeo / Central nervous system infection by Bartonella henselae associated with a choroid plexus papilloma

Resumen La infección por Bartonella henselae es una enfermedad prevalente en nuestro país. En general, se presenta como la enfermedad por arañazo de gato o un síndrome febril prolongado. Existen manifestaciones atípicas dentro de las cuales está el compromiso óseo, cardíaco, hepatoesplénico y del sistema nervioso central. Se presenta el caso de una adolescente con historia de vómitos, fiebre y ataxia, en que se diagnosticó una infección por Bartonella henselae con compromiso del sistema nervioso central, asociada a un papiloma del plexo coroídeo. Este caso corresponde a una presentación inusual, de difícil diagnóstico. Su tratamiento es motivo de controversia, tanto en si es necesario tratar, la elección del antimicrobiano, como su duración.

Bartonella henselae infection is a prevalent illness in Chile. It presents generally as a cat scratch disease or as a prolonged fever syndrome. There are atypical manifestations, which include central nervous system, bone, cardiac and hepato-esplenic compromised. We present an adolescent case with a history of fever, vomiting and ataxia, whose diagnosis was a central nervous system infection by Bartonella henselae associated with a choroid plexus papilloma. This case corresponds to an unusual presentation, with a challenging diagnosis. It is controversial whether to treat this patient, which antimicrobial is the right choice and how long the treatment should be.

[Incidence of admissions due to pneumonia in children under 24 months old before and after the introduction of the 10-valent pneumococcal conjugate vaccine into the National Immunization Program of Chile]. / Incidencia de egresos por neumonía en niños menores de 24 meses antes y después de la implementación de la vacuna conjugada antineumocócica 10-valente en el Programa Nacional de Inmunizaciones de Chile.

INTRODUCTION: Streptococcus pneumoniae is the leading cause of bacterial pneumonia in children, especially in the hospitalized population. The 10-valent pneumococcal vaccine was included in the National Immunization Program of Chile in 2011. This study aims to evaluate the incidence of pneumonia in hospitalized children<24 months of age in the Luis Calvo Mackenna Hospital before and after the introduction of the pneumococcal vaccine into the National Immunization Program. PATIENTS AND METHODS: Passive surveillance study. Patients<24 months with discharge diagnosis of bacterial pneumonia from Luis Calvo Mackenna Hospital were studied between 2009 and 2013. Data were obtained from the Luis Calvo Mackenna Hospital's Statistical Service. The incidence of pneumonia was evaluated in the pre-vaccination period (2009-2010) and in the post-vaccination period (2012-2013). RESULTS: During the study period, an average of 4,321 discharges/year was observed in children<24 months (range: 3,587-4,702), with a significant decrease from pre- to post-vaccination vaccine period (4,644 vs 4,013, P<.001). The average incidence of pneumonia ranged from 3.4/100,000 to 1.5/100,000 in the pre- and post-vaccine period, respectively (P=.009), with an annual mean of 157 cases of pneumonia in the pre- vaccine period, and 62 cases in the postvaccine period (P<.001) and a decrease in incidence between the two periods of 56%. CONCLUSION: This study confirms information previously obtained in other countries, which show a decrease in the incidence of pneumonia associated with the implementation of a pneumococcal vaccine at the population level. Ongoing surveillance is required to evaluate if this effect is maintained over time and expands to older populations.

Incidencia de egresos por neumonía en niños menores de 24 meses antes y después de la implementación de la vacuna conjugada antineumocócica 10-valente en el Programa Nacional de Inmunizaciones de Chile / Incidence of admissions due to pneumonia in children under 24 months old before and after the introduction of the 10-valent pneumococcal conjugate vaccine into the National Immunization Program of Chile

Introducción: Streptococcus pneumoniae es la primera causa de neumonía bacteriana en niños, principalmente en hospitalizados. La vacuna antineumocócica 10-valente fue introducida al Programa Nacional de Inmunizaciones de Chile el año 2011. El objetivo de este estudio fue determinar la incidencia de egresos por neumonía en niños < 24 meses en el Hospital Dr. Luis Calvo Mackenna, Santiago, Chile, antes y después de la implementación de vacuna antineumocócica 10-valente en el Programa Nacional de Inmunizaciones. Pacientes y método: Estudio de vigilancia pasiva; se estudiaron los pacientes < 24 meses egresados desde el Hospital Dr. Luis Calvo Mackenna entre los años 2009-2013 con diagnóstico de neumonía bacteriana. Los datos fueron obtenidos desde el Servicio de Estadística del Hospital Dr. Luis Calvo Mackenna. Se evaluó la incidencia de neumonía durante el período prevacuna (2009-2010) y posvacuna (2012-2013). Resultados: Durante el período de estudio se observó un promedio de 4.321 egresos/año en niños < 24 meses (rango: 3.587-4.702), con una disminución significativa desde el período pre- al posvacuna (4.644 versus 4.013; p < 0,001). La incidencia media de egresos por neumonía varió de 3,4/100.000 a 1,5/100.000 en el período pre- y posvacuna, respectivamente (p = 0,009), con un promedio anual de casos de neumonía de 157 en el primer período y de 62 en el segundo (p < 0,001) y una disminución de incidencia entre ambos períodos del 56%. Conclusión: Este estudio corrobora la información obtenida en otros países, mostrando una disminución en la incidencia de neumonía al implementar la vacuna antineumocócica a nivel poblacional. Es necesaria una vigilancia permanente para evaluar si este efecto se mantiene en el tiempo y se expande a poblaciones de mayor edad.

Introduction: Streptococcus pneumoniae is the leading cause of bacterial pneumonia in children, especially in the hospitalized population. The 10-valent pneumococcal vaccine was included in the National Immunization Program of Chile in 2011. This study aims to evaluate the incidence of pneumonia in hospitalized children < 24 months of age in the Luis Calvo Mackenna Hospital before and after the introduction of the pneumococcal vaccine into the National Immunization Program. Patients and methods: Passive surveillance study. Patients < 24 months with discharge diagnosis of bacterial pneumonia from Luis Calvo Mackenna Hospital were studied between 2009 and 2013. Data were obtained from the Luis Calvo Mackenna Hospital's Statistical Service. The incidence of pneumonia was evaluated in the pre-vaccination period (2009-2010) and in the post-vaccination period (2012-2013). Results: During the study period, an average of 4,321 discharges/year was observed in children < 24 months (range: 3,587-4,702), with a significant decrease from pre- to post-vaccination vaccine period (4,644 vs 4,013, P < .001). The average incidence of pneumonia ranged from 3.4/100,000 to 1.5/100,000 in the pre- and post-vaccine period, respectively (P = .009), with an annual mean of 157 cases of pneumonia in the pre-vaccine period, and 62 cases in the postvaccine period (P < .001) and a decrease in incidence between the two periods of 56%. Conclusion: This study confirms information previously obtained in other countries, which show a decrease in the incidence of pneumonia associated with the implementation of a pneumococcal vaccine at the population level. Ongoing surveillance is required to evaluate if this effect is maintained over time and expands to older populations.

Quantum quench of an atomic Mott insulator.

We study quenches across the Bose-Hubbard Mott-insulator-to-superfluid quantum phase transition by using an ultracold atomic gas trapped in an optical lattice. Quenching from the Mott insulator to the superfluid phase is accomplished by continuously tuning the ratio of Hubbard tunneling to interaction energy. Excitations of the condensate formed after the quench are measured by using time-of-flight imaging. We observe that the degree of excitation is proportional to the fraction of atoms that cross the phase boundary and that the quantity of excitations and energy produced during the quench have a power-law dependence on the quench rate. These phenomena suggest an excitation process analogous to the Kibble-Zurek mechanism for defect generation in nonequilibrium classical phase transitions.