Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 12 de 12
Filter
1.
Pediatr Nephrol ; 36(6): 1597-1606, 2021 06.
Article in English | MEDLINE | ID: mdl-33394193

ABSTRACT

BACKGROUND: Management of acute kidney injury (AKI) in children with hemolytic uremic syndrome induced by a Shiga toxin-producing Escherichia coli infection (STEC-HUS) is supportive; however, 40 to 60% of cases need kidney replacement therapy (KRT). The aim of this study was to analyze procedure complications, especially peritonitis, and clinical outcomes in children with AKI secondary to STEC-HUS treated with acute PD. METHODS: This is a multicenter retrospective study conducted among thirty-seven Argentinian centers. We reviewed medical records of 389 children with STEC-HUS hospitalized between January 2015 and February 2019 that required PD. RESULTS: Complications associated with PD were catheter malfunction (n = 93, 24%), peritonitis (n = 75, 19%), fluid leaks (n = 45, 11.5%), bleeding events (n = 23, 6%), and hyperglycemia (n = 8, 2%). In the multivariate analysis, the use of antibiotic prophylaxis was independently associated with a decreased risk of peritonitis (hazard ratio 0.49, IC 95% 0.29-0.81; p = 0.001), and open-surgery catheter insertion was independently associated with a higher risk (hazard ratio 2.8, IC 95% 1.21-6.82; p = 0.001). Discontinuation of PD due to peritonitis, severe leak, or mechanical complications occurred in 3.8% of patients. No patient needed to be transitioned to other modality of KRT due to inefficacy of the technique. Mortality during the acute phase occurred in 2.8% patients due to extrarenal complications (neurological and cardiac involvement), not related to PD. CONCLUSIONS: Acute PD was a safe and effective method to manage AKI in children with STEC-HUS. Prophylactic antibiotics prior to insertion of the PD catheter should be considered to decrease the incidence of peritonitis.


Subject(s)
Acute Kidney Injury , Escherichia coli Infections , Hemolytic-Uremic Syndrome , Peritoneal Dialysis , Shiga-Toxigenic Escherichia coli , Acute Kidney Injury/epidemiology , Acute Kidney Injury/etiology , Acute Kidney Injury/therapy , Child , Escherichia coli Infections/complications , Escherichia coli Infections/epidemiology , Escherichia coli Infections/therapy , Hemolytic-Uremic Syndrome/complications , Hemolytic-Uremic Syndrome/epidemiology , Hemolytic-Uremic Syndrome/therapy , Humans , Peritoneal Dialysis/adverse effects , Peritonitis/epidemiology , Peritonitis/etiology , Retrospective Studies
2.
Pediatr Nephrol ; 35(1): 119-126, 2020 01.
Article in English | MEDLINE | ID: mdl-31673828

ABSTRACT

BACKGROUND: This study aimed to evaluate outcome of children on chronic peritoneal dialysis (PD) with a concurrent colostomy. METHODS: Patients were identified through the International Pediatric Peritoneal Dialysis Network (IPPN) registry. Matched controls were randomly selected from the registry. Data were collected through the IPPN database and a survey disseminated to all participating sites. RESULTS: Fifteen centers reported 20 children who received chronic PD with a co-existing colostomy. The most common cause of end stage kidney disease was congenital anomalies of the kidney and urinary tract (n = 16, 80%). The main reason for colostomy placement was anorectal malformation (n = 13, 65%). The median age at colostomy creation and PD catheter (PDC) insertion were 0.1 (IQR, 0-2.2) and 2.8 (IQR 0.2-18.8) months, respectively. The colostomies and PDCs were present together for a median 18 (IQR, 4.9-35.8) months. The median age at PDC placement in 46 controls was 3.4 (IQR, 0.2-7.4) months of age. Fourteen patients (70%) developed 39 episodes of peritonitis. The annualized peritonitis rate was significantly higher in the colostomy group (1.13 vs. 0.70 episodes per patient year; p = 0.02). Predominant causative microorganisms were Staphylococcus aureus (15%) and Pseudomonas aeruginosa (13%). There were 12 exit site infection (ESI) episodes reported exclusively in colostomy patients. Seven colostomy children (35%) died during their course of PD, in two cases due to peritonitis. CONCLUSION: Although feasible in children with a colostomy, chronic PD is associated with an increased risk of peritonitis and mortality. Continued efforts to reduce infection risk for this complex patient population are essential.


Subject(s)
Colostomy/adverse effects , Kidney Failure, Chronic/therapy , Peritoneal Dialysis/adverse effects , Peritonitis/epidemiology , Urogenital Abnormalities/therapy , Vesico-Ureteral Reflux/therapy , Anti-Bacterial Agents/therapeutic use , Case-Control Studies , Catheters, Indwelling/adverse effects , Catheters, Indwelling/statistics & numerical data , Child , Child, Preschool , Colostomy/statistics & numerical data , Feasibility Studies , Female , Humans , Infant , Infant, Newborn , Kidney Failure, Chronic/etiology , Kidney Failure, Chronic/mortality , Male , Peritoneal Dialysis/statistics & numerical data , Peritonitis/drug therapy , Peritonitis/etiology , Pseudomonas aeruginosa/isolation & purification , Retrospective Studies , Staphylococcus aureus/isolation & purification , Urogenital Abnormalities/complications , Urogenital Abnormalities/mortality , Vesico-Ureteral Reflux/complications , Vesico-Ureteral Reflux/mortality
3.
Arch. argent. pediatr ; 115(5): 294-297, oct. 2017. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-887380

ABSTRACT

El absceso renal representa una patología infrecuente en el recién nacido. Puede presentar consecuencias graves: sepsis con alta mortalidad, cicatrices renales y riesgo de enfermedad renal crónica. Se reporta sobre un recién nacido con absceso renal unilateral a Staphylococcus aureus, con cuadro de septicemia, sin otro foco supurativo ni malformación urinaria, que evolucionó adecuadamente con antibióticos endovenosos, sin tratamiento quirúrgico, aunque con cicatrices renales como secuela. A partir de este caso, se analizan las estrategias de diagnóstico, tratamiento y seguimiento del absceso renal en un neonato y se destaca el diagnóstico precoz para evitar cicatrices renales.


Renal abscess is a rare disease in newborn, but severe consequences can occur: sepsis with high mortality, renal scar formation and risk of chronic renal failure. A neonate with unilateral renal abscess due to Staphylococcus aureus is reported, with septicemia, with no other suppurative focus, nor with urinary malformation, with good clinical evolution with intravenous antibiotics and without surgical treatment, but with renal scars sequel. From this case, the strategies of diagnosis, treatment and followup of the renal abscess in a neonate are analyzed, emphasizing the early diagnosis to avoid renal scars.


Subject(s)
Humans , Male , Infant, Newborn , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Abscess/diagnosis , Abscess/drug therapy , Kidney Diseases/microbiology , Kidney Diseases/diagnosis , Kidney Diseases/drug therapy
4.
Arch Argent Pediatr ; 115(5): e294-e297, 2017 Oct 01.
Article in Spanish | MEDLINE | ID: mdl-28895706

ABSTRACT

Renal abscess is a rare disease in newborn, but severe consequences can occur: sepsis with high mortality, renal scar formation and risk of chronic renal failure. A neonate with unilateral renal abscess due to Staphylococcus aureus is reported, with septicemia, with no other suppurative focus, nor with urinary malformation, with good clinical evolution with intravenous antibiotics and without surgical treatment, but with renal scars sequel. From this case, the strategies of diagnosis, treatment and followup of the renal abscess in a neonate are analyzed, emphasizing the early diagnosis to avoid renal scars.


El absceso renal representa una patología infrecuente en el recién nacido. Puede presentar consecuencias graves: sepsis con alta mortalidad, cicatrices renales y riesgo de enfermedad renal crónica. Se reporta sobre un recién nacido con absceso renal unilateral a Staphylococcus aureus, con cuadro de septicemia, sin otro foco supurativo ni malformación urinaria, que evolucionó adecuadamente con antibióticos endovenosos, sin tratamiento quirúrgico, aunque con cicatrices renales como secuela. A partir de este caso, se analizan las estrategias de diagnóstico, tratamiento y seguimiento del absceso renal en un neonato y se destaca el diagnóstico precoz para evitar cicatrices renales.


Subject(s)
Abscess , Kidney Diseases/microbiology , Staphylococcal Infections , Abscess/diagnosis , Abscess/drug therapy , Humans , Infant, Newborn , Kidney Diseases/diagnosis , Kidney Diseases/drug therapy , Male , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy
6.
Front Plant Sci ; 6: 341, 2015.
Article in English | MEDLINE | ID: mdl-26042133

ABSTRACT

Purple acid phosphatases (PAPs) play an important role in plant phosphorus nutrition, both by liberating phosphorus from organic sources in the soil and by modulating distribution within the plant throughout growth and development. Furthermore, members of the PAP protein family have been implicated in a broader role in plant mineral homeostasis, stress responses and development. We have identified 33 candidate PAP encoding gene models in the maize (Zea mays ssp. mays var. B73) reference genome. The maize Pap family includes a clear single-copy ortholog of the Arabidopsis gene AtPAP26, shown previously to encode both major intracellular and secreted acid phosphatase activities. Certain groups of PAPs present in Arabidopsis, however, are absent in maize, while the maize family contains a number of expansions, including a distinct radiation not present in Arabidopsis. Analysis of RNA-sequencing based transcriptome data revealed accumulation of maize Pap transcripts in multiple plant tissues at multiple stages of development, and increased accumulation of specific transcripts under low phosphorus availability. These data suggest the maize PAP family as a whole to have broad significance throughout the plant life cycle, while highlighting potential functional specialization of individual family members.

7.
Plant Cell ; 26(6): 2524-2537, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24907342

ABSTRACT

In addition to acting as photoprotective compounds, carotenoids also serve as precursors in the biosynthesis of several phytohormones and proposed regulatory signals. Here, we report a signaling process derived from carotenoids that regulates early chloroplast and leaf development. Biosynthesis of the signal depends on ζ-carotene desaturase activity encoded by the ζ-CAROTENE DESATURASE (ZDS)/CHLOROPLAST BIOGENESIS5 (CLB5) gene in Arabidopsis thaliana. Unlike other carotenoid-deficient plants, zds/clb5 mutant alleles display profound alterations in leaf morphology and cellular differentiation as well as altered expression of many plastid- and nucleus-encoded genes. The leaf developmental phenotypes and gene expression alterations of zds/clb5/spc1/pde181 plants are rescued by inhibitors or mutations of phytoene desaturase, demonstrating that phytofluene and/or ζ-carotene are substrates for an unidentified signaling molecule. Our work further demonstrates that this signal is an apocarotenoid whose synthesis requires the activity of the carotenoid cleavage dioxygenase CCD4.

8.
Ann Bot ; 110(6): 1253-60, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22975286

ABSTRACT

BACKGROUND AND AIMS: Prolonged storage generally reduces seed viability and vigour, although the rate of deterioration varies among species and environmental conditions. Here, we suggest a possible ageing molecular marker: At3g08030 mRNA. At3g08030 is a member of the DUF642 highly conserved family of cell-wall-associated proteins that is specific for spermatophytes. METHODS: At3g08030 expression was performed by RT-PCR and qRT-PCR analysis in seed samples differing in their rate of germination and final germination following a matrix priming and/or controlled deterioration (rapid ageing) treatment. KEY RESULTS: The At3g08030 gene transcript was present during the entire Arabidopsis thaliana plant life cycle and in seeds, during maturation, the ripening period and after germination. Matrix priming treatment increased the rate of germination of control seeds and seeds aged by controlled deterioration. Priming treatments also increased At3g08030 expression. To determine whether the orthologues of this gene are also age markers in other plant species, At3g08030 was cloned in two wild species, Ceiba aesculifolia and Wigandia urens. As in A. thaliana, the At3g08030 transcript was not present in aged seeds of the tested species but was present in recently shed seeds. A reduction in germination performance of the aged seeds under salt stress was determined by germination assays. CONCLUSIONS: At3g08030 mRNA detection in a dry seed lot has potential for use as a molecular marker for germination performance in a variety of plant species.


Subject(s)
Arabidopsis Proteins/genetics , Arabidopsis/genetics , Ceiba/genetics , Germination/genetics , Hydrophyllaceae/genetics , Seeds/genetics , Arabidopsis/drug effects , Arabidopsis/physiology , Base Sequence , Carrier Proteins/genetics , Ceiba/drug effects , Ceiba/physiology , Flowers/genetics , Gene Expression Regulation, Plant , Genetic Markers , Germination/drug effects , Hot Temperature , Hydrophyllaceae/drug effects , Hydrophyllaceae/physiology , Molecular Sequence Data , Plant Leaves/genetics , RNA, Messenger/genetics , RNA, Plant/genetics , Real-Time Polymerase Chain Reaction , Seedlings/genetics , Seeds/drug effects , Seeds/physiology , Sequence Alignment , Sodium Chloride/pharmacology , Time Factors
11.
Rev. cuba. salud pública ; 18(2): 124-32, jul.-dic. 1992. ilus, tab
Article in Spanish | LILACS | ID: lil-120902

ABSTRACT

Se analiza la producción científica internacional de los investigadores del Sistema Nacional de Salud, sobre la base de los artículos que publicaron en revistas extranjeras entre 1989 y el primer semestre de 1991. Se consulta la base de datos MEDLINE, y se procesa la información que permite conocer las características de la autoría, la productividad institucional, la cantidad de trabajos producidos por año, la distribución temática, los países receptores de los manuscritos, y los idiomas en que aparecen los artículos. Se considera el presente estudio como punto de partida para emprender análisis con un mayor nivel de profundidad y obtener una visión más exacta de nuestro potencial investigativo


Subject(s)
Periodical , Research
12.
Rev. cuba. salud pública ; 18(2): 124-32, jul.-dic. 1992. ilus, tab
Article in Spanish | CUMED | ID: cum-4983

ABSTRACT

Se analiza la producción científica internacional de los investigadores del Sistema Nacional de Salud, sobre la base de los artículos que publicaron en revistas extranjeras entre 1989 y el primer semestre de 1991. Se consulta la base de datos MEDLINE, y se procesa la información que permite conocer las características de la autoría, la productividad institucional, la cantidad de trabajos producidos por año, la distribución temática, los países receptores de los manuscritos, y los idiomas en que aparecen los artículos. Se considera el presente estudio como punto de partida para emprender análisis con un mayor nivel de profundidad y obtener una visión más exacta de nuestro potencial investigativo


Subject(s)
Research , Periodical
SELECTION OF CITATIONS
SEARCH DETAIL
...