El SARS-CoV-2; COVID-19 y sus consecuencias nutricio-psicológicas en niños / SARS-CoV-2; COVID-19 and its nutritional-psychological consequences in children

La actual pandemia, fue iniciada por la aparición de brotes de neumonía atípica en los alrededores de la ciudad de Wuhan, provincia de Hubei en China, ocasionadas por un coronavirus, el SARS-CoV-2/COVID-19. La enfermedad de este virus es una entidad desconocida, que actualmente genera una serie de incógnitas y misterios a su alrededor, una de ellas es su origen, lo que ha ocasionado que no haya aun información concreta sobre su patogenia y sobre todo su mecanismo de transmisión en ciertos grupos de edad, como lo son los niños. Objetivo: Describir la Incidencia, mecanismo de transmisión y consecuencias a nivel nutricio y psicológico del SARS-CoV2/COVID-19 en niños. Metodología: Se realizó una revisión sistemática de información acerca de la trasmisión y mecanismo patógeno de SARS-CoV-2 en niños de 7 y 14 años, en buscadores como Crossref, PubMed, y revistas indexadas en SciELO, empleando palabras clave como: niños, SARS-CoV-2/COVID-19, transmisión, incidencia. Dado que las consecuencias son muy diversas en la salud de los niños, se hace más hincapié en aspectos como el impacto negativo a nivel nutricional y psicológico. Resultados: Los casos de SARS-CoV-2 y/o COVID-19 solo han llegado a alcanzar el 2.02% de los casos confirmados en México, en su mayoría sintomáticos, sin necesidad de hospitalización. Quizá se pueda deber a que en los niños se presenta una expresión menor de receptores de ACE2, respuesta innata inmunológica, mayor presencia de IGM, escasas comorbilidades, nutricionalmente el impacto mayor es en niños con obesidad y a nivel psicológico muy probablemente por el confinamiento y el impacto de no poder contar con educación escolar.(AU)

The current pandemic was started by the appearance of outbreaks of atypical pneumonia in the surroundings of the city of Wuhan, Hubei province in China, caused by a coronavirus, SARS-CoV-2, The disease of this virus is an unknown entity, which currently generates a series of unknowns and mysteries around it, one of them is its origin, which has caused that there is still no concrete information about its pathogenesis and especially its transmission mechanism in certain age groups, such as children. Aim: Describe the incidence, transmission mechanism, and nutritional and psychological consequences of SARS-CoV2 / COVID-19 in children. Methodology: A systematic review of information about the transmission and pathogenic mechanism of SARS-CoV-2 in children aged 7 and 14 years was carried out, in search engines such as Crosref, PubMed, and journals indexed in SciELO, using keywords such as: children, SARS- CoV-2, COVID-19, transmission, incidence. Given that the consequences are very diverse in the health of children, more emphasis is placed on aspects such as the negative impact on a nutritional and psychological level. Results: Cases of SARS-CoV-2 and / or COVID-19 have only reached 2.02% of confirmed cases in Mexico, mostly symptomatic, without the need for hospitalization. It may be due to the fact that children have a lower expression of ACE2 receptors, an inatural immune response, a greater presence of IGM, few comorbidities, nutritionally the greatest impact is in children with obesity and on a psychological level, most likely due to confinement and impact of not being able to have a school education.(AU)

Hemorrhagic cystitis after hematopoietic stem cell transplantation: A challenge for the pediatric urologist.

OBJECTIVE: Hemorrhagic cystitis (HC) is a serious event that can occur after hematopoietic stem cell transplantation (HSCT). Treatment goals are primarily to preserve life, and then the functionality of the bladder. There is no standard therapeutic approach for HC. Described treatment options provide low success rates and are related to potential life-threatening side effects. The aim of this study was to describe our experience in treatment of HC following HSCT. PATIENTS AND METHODS: This was a retrospective study of patients with HC treated at our institution between January 2010 and October 2016. We analyzed demographics, underlying diagnosis, and treatment modalities. RESULTS: We treated 39 patients with HC. Mean age was 9.4 years (SD 4.20) and 64% were males. Acute leukemia was the most common underlying diagnosis in 27 (69%). Mean time from HSCT to HC onset was 55.46 days (SD 112.35). HC grades were: I (3), II (21), III (8), and IV (7). BK-viuria was present in 34 patients (87.2%). Non-invasive treatment was performed in 28 patients (71.8%). The remaining 11 (28.2%) required urological intervention (all high-grade), consisting of bladder irrigation in all of these. Additional treatments consisted of: intravesical cidofovir (4), intravesical sodium hyaluronate (5), cystoscopy and clot evacuation (4), selective angioembolization (2), percutaneous nephrostomy (1), and open extraction of bladder clots and cutaneous cystotomy (1). Overall, eight patients (20.5%) died as a result of the malignancy (3 in the urological intervention group), and of these four had active HC at death. Mean follow-up was 36.2 months (SD 24.9). CONCLUSION: HC is associated with high morbidity and mortality. Treatment should be individualized and designed to prioritize survival. However, bladder function should be preserved for the future.

Calling behaviour under climate change: geographical and seasonal variation of calling temperatures in ectotherms.

Calling behaviour is strongly temperature-dependent and critical for sexual selection and reproduction in a variety of ectothermic taxa, including anuran amphibians, which are the most globally threatened vertebrates. However, few studies have explored how species respond to distinct thermal environments at time of displaying calling behaviour, and thus it is still unknown whether ongoing climate change might compromise the performance of calling activity in ectotherms. Here, we used new audio-trapping techniques (automated sound recording and detection systems) between 2006 and 2009 to examine annual calling temperatures of five temperate anurans and their patterns of geographical and seasonal variation at the thermal extremes of species ranges, providing insights into the thermal breadths of calling activity of species, and the mechanisms that enable ectotherms to adjust to changing thermal environments. All species showed wide thermal breadths during calling behaviour (above 15 °C) and increases in calling temperatures in extremely warm populations and seasons. Thereby, calling temperatures differed both geographically and seasonally, both in terrestrial and aquatic species, and were 8-22 °C below the specific upper critical thermal limits (CTmax ) and strongly associated with the potential temperatures of each thermal environment (operative temperatures during the potential period of breeding). This suggests that calling behaviour in ectotherms may take place at population-specific thermal ranges, diverging when species are subjected to distinct thermal environments, and might imply plasticity of thermal adjustment mechanisms (seasonal and developmental acclimation) that supply species with means of coping with climate change. Furthermore, the thermal thresholds of calling at the onset of the breeding season were dissimilar between conspecific populations, suggesting that other factors besides temperature are needed to trigger the onset of reproduction. Our findings imply that global warming would not directly inhibit calling behaviour in the study species, although might affect other temperature-dependent features of their acoustic communication system.

Minilazo hemostático de polipectomía en enfermedad de von Willebrand / Polypectomy Minilazo hemostatic von Willebrand disease

Presentamos la historia clínica de un paciente de 52 años, portador de Enfermedad de von Willebrand, hospitalizado por un cuadro de hemorragia digestiva baja, que cedió espontáneamente. En la colonoscopia se detectó en sigmoides una lesión elevada grande con pedículo grueso. Tres horas antes de la polipectomía se le transfundió 6 unidades de crioprecipitado, además recibió ácido tranexámico por vía oral; por seguridad se decidió usar un minilazo (endo-loop) oval denylon, que se ajustó en la base del pedículo, y por encima se realizó el corte con asa de alambre y equipo de electrocoagulación. La evolución fue buena, no presentó ninguna complicación.

We report a 52 year-old man with von Willebrand disease and lower digestive hemorrhage secondary to large pedunculated polyp in the sigmoid color. He gave tranexamic acid and transfusion of 6 units of cryoprecipitate three hours before the polypectomy. We used a detachable snare (nylon end-loop) that allowed endoscopic ligation of the stalk of a large pedunculated polyp. A diathermic snare was then used to sever the stalk of the polyp above the tightened loop. No bleeding occurred during or after proceeding. The mini-detachable snare is a device that provides safe and effective hemostasis during removal of large polyps.