[Acute pancreatitis in children]. / Pancreatitis aguda en la infancia.

INTRODUCTION: Lately, there has been an increase in incidence of acute pancreatitis in childhood. Fortunately, 80% of cases are mild and do not require surgical approach. Several etiologic factors have been implicated, such as infections, trauma, congenital anomalies, drugs, biliary diseases. The aim of this study was to assess etiology, clinical features and outcomes of children with acute pancreatitis treated at our center. MATERIALS AND METHODS: A retrospective chart review of our cases of acute pancreatitis in patients younger than 16 years old was performed. RESULTS: 24 cases of acute pancreatitis were found from 1998 to 2010. Mean age was 8.75 years. There were 7 boys and 17 girls. The main clinical manifestations were abdominal pain, vomiting and abdominal distention. Mean amylase level was 1565 UI/L. There was one patient with normal serum amylase levels. Serum lipase was required in two patients (239 UI/L and 5,980 UI/L). Ultrasound showed pancreatic lesion in 79.2% of cases. Severe pancreatitis was presented in two cases, due to renal failure and pancreatic necrosis. Surgery was performed in 6 cases (3 cholecystectomies, 1 choledocal cyst resection, 1 percutaneous pseudocyst drainage and 1 necrosectomy) Pancreatic complications were found in 20.8% of cases (4 pseudocysts y 1 pancretic necrosis) Several causes were found: idiophatic, secondary to ERCP, congenital anomalies, drugs, infections, biliary disease and trauma. Mean hospital stay was 25.65 days. There were no deaths due to acute pancreatitis. CONCLUSIONS: There are several causes of acute pancreatitis in children. Some cases may present normoamilasemia, situation, in which serum lipase and clinical and radiological criteria are pivotal. Prospective studies evaluating etiological factors and incidence are required.

Pancreatitis aguda en la infancia / Acute pancreatitis in children

Introducción. La pancreatitis aguda en la infancia ha presentado un incremento en su incidencia. El 80% de los casos es leve y no requiere cirugía. Su etiología es diversa, destacándose los casos secundarios a traumatismos, infecciones, anomalías estructurales y medicamentos. El objetivo del presente estudio fue determinar la distribución etiológica, las características clínicas y los resultados de los casos de pancreatitis aguda en los niños tratados en nuestro centro. Materiales y métodos. Se efectuó una revisión retrospectiva de los casos de pancreatitis aguda en pacientes menores de 16 años atendidos en nuestro hospital entre los años 1998 a 2010. Resultados. Se presentaron 24 casos de pancreatitis aguda durante un período de 12 años. La edad media fue de 8,75 años. El síntoma principal fue dolor abdominal, seguido de vómitos y distensión abdominal. El valor medio de amilasa al inicio del episodio fue de 1.565 UI/L. Una paciente presentó pancreatitis aguda con normoamilasemia. El 79,2% de los casos tuvieron hallazgos ecográficos compatibles con pancreatitis aguda y seis casos requirieron intervención quirúrgica. El porcentaje de complicaciones pancreáticas fue del 20,8%. La distribución etiológica fue múltiple, siendo la idiopática la más común, seguida de secundaria a colangiopancreatografía, a malformaciones congénitas y de origen medicamentoso. No hubo mortalidad atribuible a la pancreatitis aguda. Conclusiones. La pancreatitis aguda en la infancia presenta una etiología muy variada. Algunos casos pueden debutar con normoamilasemia, situación en la que la determinación de la lipasa sérica es fundamental. Se requieren estudios prospectivos para evaluar la distribución etiológica y la incidencia de la pancreatitis aguda en la infancia (AU)

Introduction. Lately, there has been an increase in incidence of acute pancreatitis in childhood. Fortunately, 80% of cases are mild and do not require surgical approach. Several etiologic factors have been implicated, such as infections, trauma, congenital anomalies, drugs, biliary diseases. The aim of this study was to assess etiology, clinical features and outcomes of children with acute pancreatitis treated at our center. Materials and methods. A retrospective chart review of our cases of acute pancreatitis in patients younger than 16 years old was performed. Results. 24 cases of acute pancreatitis were found from 1998 to 2010. Mean age was 8.75 years. There were 7 boys and 17 girls. The main clinical manifestations were abdominal pain, vomiting and abdominal distention. Mean amylase level was 1565 UI/L. There was one patient with normal serum amylase levels. Serum lipase was required in two patients (239 UI/L and 5,980 UI/L). Ultrasound showed pancreatic lesion in 79.2% of cases. Severe pancreatitis was presented in two cases, due to renal failure and pancreatic necrosis. Surgery was performed in 6 cases (3 cholecystectomies, 1 choledocal cyst resection, 1 percutaneous pseudocyst drainage and 1 necrosectomy) Pancreatic complications were found in 20.8% of cases (4 pseudocysts y 1 pancretic necrosis) Several causes were found: idiophatic, secondary to ERCP, congenital anomalies, drugs, infections, biliary disease and trauma. Mean hospital stay was 25.65 days. There were no deaths due to acute pancreatitis. Conclusions. There are several causes of acute pancreatitis in children. Some cases may present normoamilasemia, situation, in which serum lipase and clinical and radiological criteria are pivotal. Prospective studies evaluating etiological factors and incidence are required (AU)

Relevance of N-acyl-L-homoserine lactone production by Yersinia enterocolitica in fresh foods.

AIMS: Determination of the food matrix impact on the potential for N-acyl-L-homoserine lactones (AHLs) production by Yersinia enterocolitica. METHODS AND RESULTS: Induction and inhibition of a sensor strain and a fluorescent assay were used to investigate Y. enterocolitica AHL production in artificial media, as well as in different food extracts. All Y. enterocolitica strains tested produced AHLs in artificial media. Thin Layer Chromatography analysis of Y. enterocolitica strains indicated the production of 3-oxo-hexanoyl homoserine lactone and hexanoyl homoserine lactone. Yersinia enterocolitica produced AHL principally in fish and meat extracts. CONCLUSIONS: AHL production by Y. enterocolitica was observed in products of animal origin, but were inhibited by some vegetables extracts. SIGNIFICANCE AND IMPACT OF THE STUDY: This study suggests that quorum sensing systems in Y. enterocolitica is significant in foods but depends upon the type of food. Determination of physiological functions in Y. enterocolitica which are regulated by quorum sensing and their relation to the production of AHLs in foods need to be further assessed.

Effect of temperature and glucose concentration on the N-butanoyl-L-homoserine lactone production by Aeromonas hydrophila.

N-butanoyl-L-homoserine lactone (C4-HSL) production by Aeromonas hydrophila 519 has been established. C4-HSL production at 22 and 30 degrees C was found after 20-24 h of incubation corresponding to a population density of ca. 10(8)-10(9) cfu/ml, respectively. Reduced C4-HSL production was noted after 72 h of incubation at 12 degrees C when the culture reached ca. 10(9) cfu/ml. No C4-HSL production was detected at 37 degrees C, although a dense population was obtained. In LB broth supplemented with 0.1% and 0.5% glucose, C4-HSL production was noted whereas with 1% glucose no C4-HSL was detected although a high colony count was obtained. In the latter culture residual levels of glucose (0.65%) were found after 43 h whereas in the 0.1% and 0.5% supplemented LB, glucose was quickly consumed which may have stimulated C4-HSL production. In conclusion, the present study shows an effect of environmental conditions (temperature, glucose concentration) on the C4-HSL production and warrants further investigation to elucidate the effect of external conditions on production of AHL signal molecules to reveal the relevance of quorum sensing in, e.g. foods.

Influence of food system conditions on N-acyl-L-homoserine lactones production by Aeromonas spp.

Eleven of 13 Aeromonas strains were shown to produce AHLs. Results of TLC showed that N-butanoyl-L-homoserine lactone (C4-HSL) was the main AHL produced in LB medium at 30 degrees C. The influence of different carbon sources, temperature, pH values and salt concentrations on AHL production was determined in eight A. hydrophila and one A. caviae strain. Additionally a quantitative study of C4-HSL production by A. hydrophila strain 519 under different conditions was performed. Positive results were found in the AHL induction assay for some Aeromonas strains in cultures in LB agar incubated at 12 degrees C after 72-96 h. The induction of the sensor strains by Aeromonas spp. occurred in LB medium supplemented with all carbon sources in a concentration of 0.5%. The production of C4-HSL by A. hydrophila 519 was found until 3.5% (w/v) of NaCl. For pHs close to the neutrality the C4-HSL production by A. hydrophila was evident after 24-48 h of incubation. A. hydrophila 519 produced C4-HSL under anaerobic conditions. Also, the AHL production by Aeromonas strains was studied in simulate agar of shrimp, fish and some vegetables. The production of AHLs was evident by almost all the test strains in shrimp simulated agar. In fish agar only for one of three fish species tested, positive results were found. Induction assay in vegetables simulated agar showed principally negative results, probably because of the presence of inhibitory compounds in these vegetables.

Mold occurrence and aflatoxin B(1) and fumonisin B(1) determination in corn samples in Venezuela.

Fumonisins are mycotoxins produced mainly by Fusarium moniliforme and Fusarium proliferatum, which have been associated with several animal and human diseases. Aflatoxins are hepatotoxic, mutagenic, and teratogenic metabolites produced by Aspergillus flavus and Aspergillus parasiticus. Both have been reported at high levels in corn. This study was pursued to determine mold, aflatoxin B(1) (AFTB(1)), and fumonisin B(1) (FB(1)) levels in white and yellow corn. Mold levels were determined using potato dextrose agar and identification of the main genus of molds present in corn, AFTB(1) levels by immunoaffinity chromatography, and FB(1) levels by a Bond-Elut SAX cartridge and HPLC. AFTB(1) an