[Etiology, Clinical Characteristics and Prognosis of Secondary Hemophagocytic Syndrome].

OBJECTIVE: To understand the etiology, clinical characteristics and prognosis of secondary hemophagocytic syndrome (HLH), so as to improve the understanding of HLH and reduce the rates of misdiagnosis and missed diagnosis of HLH. METHODS: A retrospective study was conducted to analyze the cause, clinical characteristics, laboratory findings, therapy and outcomes of 75 adult patients with secondary HLH admitted to our hospital from January 2015 to December 2021. Follow-up continued until the last discharge time. RESULTS: Among 75 patients, infection-related HLH was the most common (45.33%), followed by lymphoma-related HLH (17.33%). Fever was the most common clinical manifestation (97.67%). Laboratory indicators such as NK cell activity (98.31% low or absent), sCD25 (93.22% increased), and serum ferritin (94.44% elevated) had higher sensitivity in diagnosis. By comparing the clinical manifestations and laboratory indicators of HLH patients with different causes, sex, lymph node enlargement and bone marrow morphology were more valuable for the diagnosis of primary disease (all P <0.05). By comparing the treatment and clinical outcomes of HLH patients with different causes, the highest clinical remission rate (83.3%) was achieved in patients with autoimmune disease-related HLH treated with hormone+cyclosporine (P <0.05). The overall 12-month survival rate of all patients was 26.7%, in which the infection-related HLH was the lowest (14.7%) while autoimmune disease-related HLH was the highest (63.6%). CONCLUSION: The causes and clinical characteristics of adult secondary HLH are varied, with poor prognosis and heterogeneity in disease severity. It is important to identify HLH cause early for diagnosis and needed to further understand HLH.

Staphylococcus capitis: insights into epidemiology, virulence, and antimicrobial resistance of a clinically relevant bacterial species.

SUMMARYStaphylococcus capitis is divided into two subspecies, S. capitis subsp. ureolyticus (renamed urealyticus in 1992; ATCC 49326) and S. capitis subsp. capitis (ATCC 27840), and fits with the archetype of clinically relevant coagulase-negative staphylococci (CoNS). S. capitis is a commensal bacterium of the skin in humans, which must be considered an opportunistic pathogen of interest particularly as soon as it is identified in a clinically relevant specimen from an immunocompromised patient. Several studies have highlighted the potential determinants underlying S. capitis pathogenicity, resistance profiles, and virulence factors. In addition, mobile genetic element acquisitions and mutations contribute to S. capitis genome adaptation to its environment. Over the past decades, antibiotic resistance has been identified for S. capitis in almost all the families of the currently available antibiotics and is related to the emergence of multidrug-resistant clones of high clinical significance. The present review summarizes the current knowledge concerning the taxonomic position of S. capitis among staphylococci, the involvement of this species in human colonization and diseases, the virulence factors supporting its pathogenicity, and the phenotypic and genomic antimicrobial resistance profiles of this species.

Research progress of child athlete’s speech sound disorders

Child athletes with speech sound disorders may experience difficulties communicating with coaches, teammates, and others in sports-related contexts. To improve communication abilities and overall athletic performance, research has made progress in exploring the impact of speech therapy and exercise programs on child athletes with speech sound disorders. These programs aim to enhance neural connections between the brain regions responsible for speech production and motor skills needed for sports, as well as boost confidence in social situations. By utilizing advanced diagnostic tools, such as speech sound assessments and imaging techniques, researchers have identified new methods for identifying and treating speech sound disorders in child athletes. This paper reviews the recent research progress on child athlete's speech sound disorders, discussing the implications for speech therapy and exercise programs in sports training, as well as the potential for improved communication and athletic performance. (AU)

Inflammatory myofibroblastic tumor of the central nervous system: A case report.

BACKGROUND: An inflammatory myofibroblastic tumor (IMT) occurring in the central nervous system is very rare, and thus its pathogenesis is unknown. This case report and literature review aimed to explore the pathogenesis, clinical features, imaging findings, pathological characteristics, immunohistochemical characteristics, diagnoses, treatments, and risks of postoperative recurrence of IMT in the central nervous system. CASE SUMMARY: A 67-year-old woman was admitted to the hospital with an exophthalmic protrusion and double vision in the left eye that had persisted for 3 mo. Magnetic resonance imaging (MRI) showed a 2.4 cm × 1.3 cm heterogeneous large mass in the bottom of the left anterior cranial fossa, which was closely related to the dura mater. Before surgery, we suspected the mass to be meningioma. The entire mass was successfully removed under neuronavigation and electrophysiological monitoring, and postoperative pathology indicated an IMT with extensive infiltration of chronic inflammatory cells and scattered multinucleated giant cells. Head MRI at the 3-mo follow-up showed that the tumor at the bottom of left anterior cranial fossa had been completely resected without recurrence. CONCLUSION: From the histological, immunohistochemical, and genetic analyses, the present case suggests that the pathogenesis of IMT-CNS is related to autoimmunity.

Fusobacterium nucleatum: The Opportunistic Pathogen of Periodontal and Peri-Implant Diseases.

Peri-implant diseases are considered to be a chronic destructive inflammatory destruction/damage occurring in soft and hard peri-implant tissues during the patient's perennial use after implant restoration and have attracted much attention because of their high incidence. Although most studies seem to suggest that the pathogenesis of peri-implant diseases is similar to that of periodontal diseases and that both begin with microbial infection, the specific mechanism of peri-implant diseases remains unclear. As an oral opportunistic pathogen, Fusobacterium nucleatum (F. nucleatum) has been demonstrated to be vital for the occurrence and development of many oral infectious diseases, especially periodontal diseases. More notably, the latest relevant studies suggest that F. nucleatum may contribute to the occurrence and development of peri-implant diseases. Considering the close connection between peri-implant diseases and periodontal diseases, a summary of the role of Fusobacterium nucleatum in periodontal diseases may provide more research directions and ideas for the peri-implantation mechanism. In this review, we summarize the effects of F. nucleatum on periodontal diseases by biofilm formation, host infection, and host response, and then we establish the relationship between periodontal and peri-implant diseases. Based on the above aspects, we discuss the importance and potential value of F. nucleatum in peri-implant diseases.

Low cardiac output syndrome after congenital heart disease surgery / 中国小儿急救医学

Low cardiac output syndrome (LCOS) is a common complication of patients with congenital heart disease after surgery, with a high mortality rate.The etiology and pathophysiological mechanisms of LCOS can vary widely.Better understanding of LCOS pathogenesis would allow for target prevention and therapeutic approaches, and thereby reducing the incidence and mortality of LCOS, as well as improving the prognosis of patients.

A case report of bladder malakoplakia in systemic sclerosis patient / 中华泌尿外科杂志

Systemic sclerosis is a rare and complex autoimmune disease, and malakoplakia is a rare chronic granulomatous inflammatory disease. Systemic sclerosis combined with malakoplakia is extremely rare. Diagnosis is difficult before surgery. It is easy to misdiagnose bladder malakoplakia as bladder tumor. This paper reports a middle-aged female patient with systemic sclerosis complicated with bladder malakoplakia. The main clinical manifestations were hematuria and bladder irritation, accompanied by severe diarrhea. Transurethral resection of bladder tumor was performed. Postoperative pathology proved that it was bladder malakoplakia. After the surgery, she continued to take low-dose prednisolone and methotrexate in the treatment of systemic sclerosis. The patient was followed up for 6 months.Transurethral cystoscopy was performed twice, and there was no recurrence.

First report of Corynespora cassicola causing black spot on Sarcandra glabra in China.

Sarcandra glabra is an important Chinese medicinal plant, which was widely cultivated under forest in south China. Guangxi province is the main producing areas of this herb. In June 2019, a serious leaf disease was found causing severe defoliation in the S. glabra plantation under bamboo forest in Rongan country, Guangxi province (109°13'N''E). About 70% of the plants in the plantation (300 ha) showed the similar symptoms. Initially, circular lesions appeared on young leaves as black spots (about 1 to 2 mm). Then, the spots gradually enlarged usually with an obvious yellowish margin (6 to 8 mm). Finally, the lesions coalesced and formed irregular, black, and large necrotic areas, resulting in the leaf abscission. For pathogen isolation, small pieces of tissue (5×5 mm) taken from 25 diseased leaves were sterilized with 75% ethanol for 30 s, subsequently, soaked in 0.1% HgCl2 for 2 min, rinsed three times in sterile distilled water, dried, and then placed aseptically onto the potato dextrose agar (PDA) plates, and incubated at 28 °C (12 h/12 h light/dark). Three days later, the isolates were placed on a new PDA plate for subsequent purification and sporulation. 20 pure fungal isolates were obtained from single spores. Of which, 15 isolates showed similar morphological characteristics.The colonies on PDA were round, dense, gray edge and dark gray in center area. Conidia in culture were appeared light brown, cylindrical in shape, with 0 to 8 septa, and 55 to 165 µm × 5.2 to 13.5 µm in size (mean = 106.2 µm × 8.6 µm, n = 30). These morphological characteristics resemble those of Corynespora sp. (Berk. & M.A. Curtis) C.T. Wei (Ellis et al. 1971). A single-spore isolate (ZD5) was selected from the 15 fungal isolates for a subsequent molecular identification. The genes of internal transcribed spacer (ITS) of ribosomal DNA, ß-tublin, and actin were amplified with the primer pairs ITS-1/ITS-4 (White et al. 1990), ß-tubulin 2-Bt2a/Bt2b (Glass and Donaldson 1995), ACT-512F/ACT-783R (Carbone and Kohn 1999), respectively. And the ITS, ß-tublin, and actin sequences were deposited in the GenBank database with the accession numbers MW362446, MW367029, and MW533122. Blast analysis and neighbor-joining analysis based on ITS, ß-tublin, and actin sequences using MEGA 6 revealed that the isolate was placed in the same clade as C. cassicola with 100% bootstrap support. Pathogenicity test was performed on the two-year-old potted S. glabra. Six-mm-diameter mycelial plugs were attached to the healthy leaves of S. glabra for co-culture, while the control group was attached with PDA. All plants were covered with plastic bags for 2 days in order to maintain high humidity and cultured in a greenhouse at 28 °C with a 12-h/12-h light/dark cycle. The symptoms appeared 2 days after co-culture were identical to those observed in the field. The same fungus was re-isolated from the lesions, and further morphological characterization and molecular assays, as described above.The control leaves remained symptomless during the pathogenicity tests. According to the previous literatures, C. cassicola is a plant pathogenic fungus with a broad host range, which can damage diverse tropical plants including Salvia miltiorrhiza (Lu et al. 2019), Solanum americanum (Wagner and Louise 2019), Vitex rotundifolia (Yeh and Kirschner 2017), Cucumis sativus, Lycopersicon esculentum (Hsu et al. 2002), Carica papaya (Tsai et al. 2015),and so on. To our knowledge, this is the first report of C. cassicola causing leaf spot on S. glabra in China.

Syringomyelia and hydromyelia: Current understanding and neurosurgical management.

Syringomyelia is a rare disorder in which a fluid-filled cyst forms within the spinal cord, resulting in myelopathy. Meanwhile, the abnormal dilatation of the central canal is referred to as hydromyelia or slit-like syrinx. The most prevailing classification is based on anatomical features and pathogeny rather than pathophysiological mechanisms. It is usual to distinguish foraminal syringomyelia related mainly to abnormalities at the craniocervical junction, non-foraminal syringomyelia dealing with any cause of arachnoiditis (infection, inflammation, trauma…) and more rarely syringomyelia associated with intramedullary tumors. Although many pathophysiological theories have been argued over time, the prevailing one is that disturbances in cerebrospinal fluid (CSF) flow in the sub-arachnoid spaces disrupt flow velocity leading to the syrinx. Symptoms of paralysis, sensory loss and chronic pain commonly develop during the third/fourth decades of life. The natural history of syringomyelia is typically one of gradual, stepwise neurological deterioration extending over many years. Diagnosis is based on magnetic resonance imaging (MRI) including excellent morphological sequences (T1-, T2-, FLAIR-, T2*-, enhanced T1-) and dynamic MRI with careful study of CSF velocity (CISS, cine-MR sequences). Surgical management is at first dedicated to treat the cause of the syringomyelia, mainly to re-establish a physiological CSF pathway in the subarachnoid spaces. Mostly, the surgical goal is to enlarge the craniocervical junction with duraplasty. Other surgical strategies such as arachnoidolysis or shunt procedures are performed based on the pathogenic mechanisms or as second-line treatment. Medical treatments are also necessary as chronic pain is the main long-lasting symptom. As evolutive syringomyelia is a severe disease with a high impact on quality of life, it is recommended to treat without delay. There is no evidence for surgery for incidental asymptomatic syringomyelia or hydromyelia. Finally, syringomyelia associated with intramedullary tumors resolves spontaneously after tumor resection. Syringomyelia is a rare disease, which requires a dedicated multidisciplinary approach, emphasizing the need for a nationwide scientific organization so as to offer optimal care to the patient.

Coagulation factor XII deficiency: Clinical report of 7 patients and literature review / 中国输血杂志

【Objective】 To retrospectively analyze the clinical manifestations and laboratory characteristics of 7 patients with coagulation factor Ⅻ deficiency in our hospital from February 2016 to January 2020 in order to improve the understanding of diagnosis and treatment for the diseases. 【Methods】 The clinical data of 7 patients with coagulation factor Ⅻ deficiency were analyzed, and related literatures were reviewed. 【Results】 All the 7 patients showed significantly prolonged APTT without bleeding or thrombosis. Among them, 1 had a positive family history, and 1 acquired coagulation factor Ⅻ deficiency secondary to the tumor. 【Conclusion】 It is very necessary to comprehensively screen related internal and external coagulation factors and acquired factors in patients with prolonged APTT but no bleeding, so as to avoid missed diagnosis, misdiagnosis and over treatment.

Latest progress of study on etiology of myopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#In recent years, with the development of social economy, the progress of science and technology and the change of life style, the prevalence of myopia has increased year by year and has a younger trend, and with the outbreak of COVID-19, children and adolescents attending short-distance online classes for a long time has accelerated the occurrence and development of myopia. Visual impairment caused by myopia and serious complications caused by high myopia have seriously affected people's quality of life, study and work. Therefore, the World Health Organization, the International Association for the Prevention of Blindness and China's health departments have put the prevention and control of myopia among children and adolescents on the agenda. However, the etiology is complex, and now it is considered to be related to genetic, environmental and other factors, which is briefly discussed in this review.

SARS-CoV-2 Codon Usage Bias Downregulates Host Expressed Genes With Similar Codon Usage.

Severe acute respiratory syndrome has spread quickly throughout the world and was declared a pandemic by the World Health Organization (WHO). The pathogenic agent is a new coronavirus (SARS-CoV-2) that infects pulmonary cells with great effectiveness. In this study we focus on the codon composition for the viral protein synthesis and its relationship with the protein synthesis of the host. Our analysis reveals that SARS-CoV-2 preferred codons have poor representation of G or C nucleotides in the third position, a characteristic which could result in an unbalance in the tRNAs pools of the infected cells with serious implications in host protein synthesis. By integrating this observation with proteomic data from infected cells, we observe a reduced translation rate of host proteins associated with highly expressed genes and that they share the codon usage bias of the virus. The functional analysis of these genes suggests that this mechanism of epistasis can contribute to understanding how this virus evades the immune response and the etiology of some deleterious collateral effect as a result of the viral replication. In this manner, our finding contributes to the understanding of the SARS-CoV-2 pathogeny and could be useful for the design of a vaccine based on the live attenuated strategy.

[Advances of the treatments and diagnosis for sensory laryngeal neuropathy].

Sensory laryngeal neuropathy（SLN） is a kind of peripheral neuropathy presenting globus pharyngeus, chronic cough, increased mucus, dry throat, sore throat, frequent clearing of the throat, etc. When the sensory nerve of the larynx is affected by chemical, biological, mechanical or nutritional factors. Because of its nonspecific signs and symptoms, SLN is easy to be misdiagnosed as chronic pharyngitis or laryngopharyngeal reflux disease. SLN was came up to ENT physician in recent years and there are rare systematic reports currently, therefore, this review aims to summarize the etiology, clinical manifestations, diagnosis and treatment of SLN, to raise awareness of this disease among our colleagues.

Uterine incision dehiscence 3 mo after cesarean section causing massive bleeding: A case report.

BACKGROUND: The traditional definition of late postpartum hemorrhage is a massive uterine hemorrhage from 24 h after delivery to the puerperal period. Here, we report a case of late postpartum hemorrhage that occurred 3 mo after cesarean section and endangered the patient's life. The cause of the case we are reporting was poor incision healing. By reporting this case, we hope to make doctors aware that late postpartum hemorrhage due to poor incision healing may happen as late as 3 mo after cesarean section. CASE SUMMARY: A 31-year-old woman complained of acute, severe vaginal bleeding for 1 h; the patient had a history of cesarean section 3 mo prior. After receiving anti-inflammatory treatment, fluid supplementation, blood transfusion, oxytocin administration, and hemostatic treatment, the vaginal bleeding ceased, and the patient's clinical status improved. Unfortunately, she experienced recurrent massive vaginal bleeding, and uterine contractile agents did not decrease the persistent bleeding. To save the patient's life, she was admitted for emergency laparotomy. At exploratory laparotomy, dehiscence and necrosis of the previous cesarean section scar were noted; the dehiscence penetrated through the entire thickness of the uterine muscle wall and extended to the left uterine artery. Ultimately, we performed a total hysterectomy. CONCLUSION: Late postpartum hemorrhage due to poor incision healing after cesarean section may occur in the 3 mo after cesarean section or even later. Therefore, obstetricians-gynecologists should monitor for this potential complication in all patients post-cesarean section. Such hemorrhages can be severe enough to endanger the patient's life.

Pathogenic potential of Brucella ovis field isolates with different genotypic profile and protection provided by the vaccine strain B. ovis ΔabcBA against B. ovis field isolates in mice / Vacina viva atenuada Brucella ovis Δ abcBA encapsulada protege camundongos frente a desafios de B. ovis isoladas de campo

Brucella ovis causes economic and reproductive losses in sheep herds. The goal of this study was to characterize infection with B. ovis field isolates in a murine model, and to evaluate protection induced by the candidate vaccine strain B. ovis ΔabcBA in mice challenged with these field isolates. B. ovis field strains were able to colonize and cause lesions in the liver and spleen of infected mice. After an initial screening, two strains were selected for further characterization (B. ovis 94 AV and B. ovis 266 L). Both strains had in vitro growth kinetics that was similar to that of the reference strain B. ovis ATCC 25840. Vaccination with B. ovis ΔabcBA encapsulated with 1% alginate was protective against the challenge with field strains, with the following protection indexes: 0.751, 1.736, and 2.746, for mice challenged with B. ovis ATCC25840, B. ovis 94 AV, and B. ovis 266 L, respectively. In conclusion, these results demonstrated that B. ovis field strains were capable of infecting and inducing lesions in experimentally infected mice. The attenuated vaccine strain B. ovis ΔabcBA induced protection in mice challenged with different B. ovis field isolates, resulting in higher protection indexes against more pathogenic strains.(AU)

Brucella ovis é responsável por perdas econômicas e reprodutivas em rebanhos ovinos. O objetivo deste trabalho foi caracterizar a infecção com as cepas isoladas de campo de B. ovis em modelo murino e avaliar a eficiência vacinal da mutante B. ovis ΔabcAB para proteção contra desafio com as cepas isoladas de campo. Foram utilizadas sete cepas isoladas de campo foram capazes de colonizar e provocar lesões no fígado e no baço de camundongos após sete dias pós-infecção. Após triagem, duas cepas foram selecionadas para a melhor caracterização (B. ovis 94 AV and B. ovis 266L). Ambas apresentaram crescimento em placa de cultivo semelhante ao da cepa de referência B. ovis ATCC 25840. A vacinação com a cepa de Brucella ovis ΔabcBA encapsulada com alginato a 1% foi capaz de proteger camundongos desafiados com as cepas isoladas de campo, com os seguintes índices de proteção: 0,751, 1,736 e 2,746, para camundongos desafiados com B. ovis ATCC 25840, B. ovis 94 AV e B. ovis 266 L, respectivamente. Estes resultados demonstraram que as cepas isoladas de campo de B. ovis são capazes de infectar e induzir lesão em camundongos experimentalmente infectados. O uso da cepa mutante atenuada B. ovis ΔabcBA para vacinação de fêmeas C57BL/6 desafiados com diferentes cepas de B. ovis induziu proteção nos camundongos desafiados com diferentes cepas de B. ovis. Deste modo, mostrando-se eficiente na proteção das cepas de campo de B. ovis.(AU)

Research progress of dry eye with meibomian gland dysfunction / 国际眼科杂志(Guoji Yanke Zazhi)

@#Meibomian gland dysfunction(MGD)is a general term for various abnormal meibomian glands. Meibomian gland secretes meibomian ester to moisten the eye surface and maintain the stability of tear film. In this article, the etiology, pathology and related treatment of meibomian gland dysfunction were reviewed by referring to related literatures.

Cationic antimicrobial peptides and periodontal physiopathology: A systematic review.

The purpose of this systematic review was to establish if patients suffering from periodontal diseases present differences in the expression or production of cationic antimicrobial peptides in saliva, gingival fluid, and periodontal tissues. Periodontal diseases are among the most common chronic diseases worldwide and share similar etiological or risk factors (genetic and/or environmental) with other systemic disorders. Over the last decade, an increasing number of publications have suggested the implication of antimicrobial peptides (AMPs) in periodontal and oral tissues conditions. Literature searches were conducted through MEDLINE-PubMed and EMBASE databases which identified 1267 publications. Only clinical studies that focused on assays of the expression and/or production of AMPs in human adult oral fluids (gingival crevicular fluid or saliva) or in oral tissues were retained and finally seventy-four publications meeting inclusion criteria were included. Cathelicidin, α- and ß-defensins 1-3 are the most documented AMPs regarding periodontal status. Significant correlations between clinical periodontal indexes (PD, CAL) and/or bacteriological index and LL37 level were retrieved. Data remain inconsistent between the studies for hBDs mainly due to heterogeneity of the results, periodontal disease diagnostic criteria and assaying technique employed. Given their role in innate immunity and their antimicrobial functions, LL-37 and α-defensins may be eligible as periodontal clinical biomarkers and could be an interesting way for therapeutic development.

Intraoperative Finding of an Anterior Communicating Artery Blister-Like Aneurysm During a Primary Craniopharyngioma Resection: Accidental or Incidental?

BACKGROUND: The presence of an anterior communicating artery blister-like aneurysm in the setting of a craniopharyngioma has never been reported to our knowledge. CASE DESCRIPTION: This patient was admitted to our service for an untreated craniopharyngioma resection. An anterior interhemispheric approach with right frontal craniotomy was performed and a blister-like aneurysm of the anterior communicating artery was found during the surgery. After the tumor was completely resected, a suturing technique was used for the aneurysm. In this article, we are going to present this rare case and discuss the potential pathogeny of the aneurysm. CONCLUSIONS: We hypothesized that cystic craniopharyngioma may rupture spontaneously. The cystic fluid accumulated in the lower subarachnoid space due to gravity, and it may lead to local vascular cytotoxic and inflammatory reactions which may result in the vascular wall remodeling and lead to the reconstructed vascular wall weakness.

First report of isolation and complete genome of Vibrio rotiferianus strain SSVR1601 from cage-cultured black rockfish (Sebastes schlegelii) associated with skin ulcer.

Vibrio rotiferianus is an important marine pathogen of various aquatic organisms and can be found widely distributed in the marine environment. To further characterize this pathogen, the pathogenic properties and genome of V. rotiferianus SSVR1601 isolated from Sebastes schlegelii with skin ulcer were analysed. SSVR1601 was shown to be short rod-shaped cell with a single polar flagellum. Different degrees of pathological changes in fish kidney, intestine, gills and liver were observed after SSVR1601 challenge. The SSVR1601 genome consists of two chromosomes and two plasmids with a total of 5,717,113 bp, 42.04%-44.93% GC content, 5,269 predicted CDSs, 134 tRNAs and 40 rRNAs. The common virulence factors including OMPs, haemolysin, flagellin, DNase, entF, algU, tcpI, acfB and rfaD were found in strain SSVR1601. Furthermore, factors responsible for iron uptake (fur, fepC and ccmC) and types II, IV and VI secretion systems were detected, which are likely responsible for the pathogenicity of SSVR1601. The antimicrobial resistance genes, bacA, tet34 and norM, were detected based on Antibiotic Resistance Genes Database. The phylogenetic analysis revealed SSVR1601 to be most closely related to V. rotiferianus strains CAIM577 and B64D1.

Litiasis urinaria en pediatria / Urinary lithiasis in pediatrics

Resumen La litiasis renal es una entidad infrecuente en la infancia y su incidencia va en aumento en los países desarrollados. Afecta más a los individuos de raza blanca que a los afroamericanos en una proporción 4:1, con predominio del sexo masculino. Existen factores geográficos, raciales, genéticos implicados en su patogenia, que depende también de factores fisicoquímicos (eliminación renal de agua y solutos, pH urinario, equilibrio entre factores estimulantes/inhibidores de la cristalización), alteraciones anatómicas, infecciones y cambios socioeconómicos; los cuales a lo largo del tiempo han producido cambios en los hábitos dietéticos, lo que ha modificado la frecuencia, composición química y localización de los cálculos. A pesar de su rareza se debe pensar en la litiasis, con el fin de evitar un daño renal irreversible. La disponibilidad de terapia menos agresiva ha reducido a un 5% las indicaciones quirúrgicas, abriendo nuevas perspectivas en el tratamiento de la urolitiasis en la infancia.

Abstract Renal lithiasis is an infrequent entity in childhood, and its incidence has decreased in developed countries. Affects white individuals more than African Americans in a 4: 1 ratio, with a predominance of males. There are geographic, racial, genetic factors involved in its pathogenesis, which also depends on physicochemical factors (renal elimination of water and solutes, urinary pH, balance between stimulating factors/inhibitors of crystallization), anatomical alterations, infections and socioeconomic changes. Over time, changes have occurred in dietary habits, which has changed the frequency, chemical composition and location of the stones. Despite its rarity, lithiasis must be considered in order to avoid irreversible kidney damage. The availability of less aggressive therapy has reduced surgical indications to 5%, opening new perspectives in the treatment of urolithiasis in childhood. The present article constitutes a bibliographic review about the organophosphorus intoxication, its clinical manifestations, diagnosis and treatment.