Clinical and Laboratory Characteristics of Hemophagocytic Lymphohistiocytosis in Children With Severe Dengue During the 2019-2020 Outbreak in Southern Colombia.

BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is characterized by uncontrolled activation of inflammatory cells and an exaggerated release of cytokines. It can be triggered by different factors, including viruses, such as dengue. The objective of this study was to characterize the clinical and laboratory profiles of children with severe dengue and HLH, and to identify the risk factors for this clinical complication. METHODS: An analytical study was conducted in children with severe dengue who were treated in an intensive care unit between January 2019 and March 2020. Clinical and laboratory factors were compared between patients with and without HLH. RESULTS: HLH represented 13.4% (15/112) of children with severe dengue. Patients with HLH had a long-lasting fever (10.1 vs. 5.8 days; P = 0.012), low hemoglobin levels (7.6 vs. 10.8 g/dL; P = 0.000) and high aspartate aminotransferase values (4443 vs. 1061 U/L; P = 0.002), alanine transaminase (1433 vs. 487 U/L; P = 0.004), partial thromboplastin time (80.6 vs. 51.8 seconds; P = 0.010), prothrombin time (23.5 vs. 19.6 seconds; P = 0.024), triglycerides (333.7 vs. 223.2 mg/dL; P = 0.005), lactate dehydrogenase (4209 vs. 1947 U/L; P = 0.006), soluble CD25 (3488 vs. 1026 pg/mL; P = 0.014), and presented with higher frequency of myocarditis (66.7% vs. 38.3%; P = 0.048), hepatitis (5.3% vs. 1.3%; P = 0.014), bacterial coinfection (73.3% vs. 26.7%; P = 0.010) and fatal outcome (26% vs. 5%; P = 0.037). CONCLUSIONS: HLH is a serious life-threatening clinical complication of dengue virus infection that must be considered, particularly during outbreaks.

Beta-Lactam-Resistant Enterobacterales Isolated from Landfill Leachates.

Antibiotic resistance is one of the main challenges worldwide due to the high morbidity and mortality caused by infections produced by resistant bacteria. In Colombia, this problem has been studied mainly from the clinical perspective; however, it is scarcely studied in the leachates produced in landfills. The objective of this study was to detect, identify and determine the antibiotic sensitivity profile of Enterobacterales isolated from a leachate treatment plant located in Cali, Colombia. Detection was performed using selective culture media, bacterial identification using Matrix-Assisted Laser Desorption/Ionization-Time-Of-Flight (MALDI-TOF, bioMérieux) and by sequencing the gene coding for the 16S ribosomal RNA subunit when discrepancies were observed between phenotypic characteristics and MALDI-TOF. Antibiotic sensitivity profiling was determined using the automated VITEK®2 system (bioMérieux). Twenty-one isolates were obtained, of which Klebsiella pneumoniae was the most frequent (23.8%), and 34% of the isolates showed decreased sensitivity to beta-lactam antibiotics such as cefoxitin, ampicillin/sulbactam and piperacillin/tazobactam. These findings suggest that leachates from landfills could be a reservoir of pathogenic bacteria carrying antibiotic resistance determinants, so periodic microbiological characterization of these effluents should be performed, promoting the One Health approach.

Multisystemic Inflammatory Syndrome in Children From the South of Colombia: One Year of Experience.

Background: Multisystemic inflammatory syndrome in children (MIS-C) is one of the most severe presentations of COVID-19 infection in pediatrics. Currently, we have few studies that describe the characteristics of this condition in Colombian children. Objective: To describe the clinical and epidemiological characteristics of children hospitalized with MIS-C in Neiva, Colombia. Methods: Observational follow-up study of a cohort of children with MIS-C for 12 months (May 15, 2020, to May 30, 2021) in two hospitals in the city of Neiva. Epidemiological data, clinical characteristics, laboratory characteristics, cardiological evaluation, treatment, and clinical outcomes were analyzed. Results: We included 34 patients who met the diagnosis of MIS-C. The median age was 68 months. Some type of nutritional issue was observed by 43.75% of those under 5 years of age and by 27.78% of those over 5 years of age. Gastrointestinal symptoms were the most frequent, with vomiting, diarrhea, and abdominal pain being the most frequent by 79, 70, and 67%, respectively. By 77% of the patients, a history of SARS-COV-2 infection was documented through IgG. In the echocardiogram, 35.4% of the patients had systolic dysfunction, followed by coronary involvement by 35%. Conclusion: This study describes a series of cases of children with MIS-C in Colombia. Gastrointestinal manifestations were predominant. Mortality was high in comparison to other countries but similar to that reported in Colombia. This fact was associated with relevant pathological background. More training is required for physicians in order to have a better understanding of the disease so as to have an early diagnosis and timely treatment.

Hydrocarbon-degrading bacteria in Colombia: systematic review.

Petroleum industry activities worldwide have caused pollution and resulted in environmental degradation. Microorganisms with the potential to reduce pollutant levels by degradation processes have been reported, and bacteria are among such organisms. The first study on bacterial degradation in Colombia was published in 1996. The study isolated bacteria belonging to the Pseudomonas genus from hydrocarbon-polluted sediments. Since then, different reports on degrading bacteria have been published. The objective of this systematic review is to identify and analyze all the studies on hydrocarbon-degrading bacteria performed in Colombia. To accomplish this goal, a literature search was conducted. Inclusion and exclusion criteria were applied, and 37 relevant articles were obtained. We found that 2018 was the year with the largest number of publications in Colombia, and most frequently identified bacterial genera were Pseudomonas and Bacillus. Some studies showed that the degradation of hydrocarbons is more efficient when bacterial consortia are used rather than pure cultures. This study provides information about bacteria with the potential to degrade hydrocarbons in Colombia, which in turn will be a source of information for future studies in this field.

Abdominal manifestation of multisystemic inflammatory syndrome in children.

SUMMARY: Multisystemic inflammatory syndrome (MIS-C) can develop as a complication of SARS CoV-2 infection, involving the gastrointestinal system mainly by vasoconstriction, edema, glandular hyperplasia, and a procoagulant state leading to direct tissue injury. METHOD: ology: a series of cases including 8 patients with MIS-C treated in two highly complex institutions is presented. These patients, had abdominal symptoms of surgical management. RESULTS: The average age was 9.5 years and the most frequent symptoms were fever, abdominal pain, diarrhea (100%); in addition, 87.5% presented shock. The diagnosis of SARS CoV-2 was confirmed by RT-PCR test in 37.5%, antigen 12.5% and the rest of the patients showed IgM and IgG antibodies. In laboratories, the increase in acute phase reactants, Erythrocyte Sedimentation Rate (ESR), C-reactive protein, procalcitonin, as well as troponin, D dimer and proBNP, is highlighted. The surgical outcome documented 2 patients with a normal appendix, 3 patients with edematous appendicitis, and 3 patients with complicated appendicitis. CONCLUSIONS: patients with MIS-C display abdominal symptoms similar to those present in surgical emergencies and a non-negligible number of cases require surgical exploration. This condition poses a new differential diagnosis to the surgical abdomen in pediatric patients.

[Urban outbreak of leishmaniasis in Colombia]. / Brote urbano de leishmaniasis en Colombia.

OBJECTIVES: To describe the epidemiology, clinical characteristics and treatment of children with visceral Leishmaniasis in Neiva- Huila, from April to June 2012. METHODOLOGY: We performed a descriptive study of an outbreak of visceral leshmaniasis in children from the urban area of Neiva. RESULTS: There were seven cases in children younger than five years. All of them had prolonged fever, hepato-splenomegaly, severe anemia and leukopenia. Five were admitted with severe thrombocytopenia, without hemorrhagic manifestations. Six patients received first-line treatment with miltefosine, five of them had treatment failure requirirng therapy escalation to amphotericin B, two received liposomal amphotericin B and three deoxycholate amphotericin B. The main vector identified was the Lutzomyia gomezi and its main reservoir were canines. CONCLUSION: We describe the first visceral leishmaniasis outbreak in children living in an urban area, with no mortality. Most of the cases had a good response to amphotericin B.

OBJETIVOS: Describir las características epidemiológicas, clínicas y el tratamiento de niños con leishmaniasis visceral en Neiva, Huila. METODOLOGIA: Se realizó un estudio descriptivo del brote de leshmaniasis visceral en niños de la zona urbana de Neiva, Huila, entre los meses de abril a junio de 2012. RESULTADOS: Se presentaron siete casos, en niños menores de cinco años, con fiebre prolongada, hepato-esplenomegalia, anemia severa y leucopenia. Cinco ingresaron con trombocitopenia severa, sin manifestaciones hemorrágicas. Seis pacientes recibieron manejo de primera línea con miltefosine, cinco presentaron fracaso terapéutico y se escalonó tratamiento a anfotericina B, de los cuales dos recibieron anfotericina liposomal y tres anfotericina deoxicolato. El principal vector identificado fue la Lutzomyia gomezi y los reservoirios indentifiacados fueron caninos. CONCLUSIÓN: Se describe el primer brote de leishmaniasis visceral en zona urbana, en población pediátrica sin casos de mortalidad. La mayoría de los casos con buena respuesta a Anfotericina B.

Mosquito (Diptera: Culicidae) grouping based on larval habitat characteristics in high mountain ecosystems of Antioquia, Colombia.

Information about mosquito ecology in the high mountain ecosystems of the Neotropical region is sparse. In general, few genera and species have been reported in these ecosystems and there is no information available on habitats and the mosquitoes occupying them. In the present study, specimens collected from NW Colombia in HME were grouped using larval habitat data via an Operational Taxonomic Unit (OTU) determination. A total of 719 mosquitoes was analyzed belonging to 44 OTUs. The analysis considered habitat features and clustered the specimens into six groups from A-F. Five of these included species from different genera, suggesting common habitat requirements. Group E with four genera, seven subgenera, and six species occupied the highest areas (above 3,000 m), whereas three groups (B, D, F) were detected at lower altitudes (1,960-2,002 m). Bromeliads were the most common larval habitat, with 47% (335/719) of the specimens; five genera, six subgenera, and eight species were identified and classified into 66% (29/44) of the OTUs. This work showed some similarities to the habitat requirements and provides a grouping system that constitutes an important baseline for the classification of mosquito fauna from high mountain ecosystems according to altitude and larval habitat.

Brote urbano de leishmaniasis en Colombia / Urban outbreak of leishmaniasis in Colombia

RESUMEN Objetivos Describir las características epidemiológicas, clínicas y el tratamiento de niños con leishmaniasis visceral en Neiva, Huila. Metodologia Se realizó un estudio descriptivo del brote de leshmaniasis visceral en niños de la zona urbana de Neiva, Huila, entre los meses de abril a junio de 2012. Resultados Se presentaron siete casos, en niños menores de cinco años, con fiebre prolongada, hepato-esplenomegalia, anemia severa y leucopenia. Cinco ingresaron con trombocitopenia severa, sin manifestaciones hemorrágicas. Seis pacientes recibieron manejo de primera línea con miltefosine, cinco presentaron fracaso terapéutico y se escalonó tratamiento a anfotericina B, de los cuales dos recibieron anfotericina liposomal y tres anfotericina deoxicolato. El principal vector identificado fue la Lutzomyia gomezi y los reservoirios indentifiacados fueron caninos. Conclusión Se describe el primer brote de leishmaniasis visceral en zona urbana, en población pediátrica sin casos de mortalidad. La mayoría de los casos con buena respuesta a Anfotericina B.(AU)

ABSTRACT Objectives To describe the epidemiology, clinical characteristics and treatment of children with visceral Leishmaniasis in Neiva- Huila, from April to June 2012. Methodology We performed a descriptive study of an outbreak of visceral leshmaniasis in children from the urban area of Neiva. Results There were seven cases in children younger than five years. All of them had prolonged fever, hepato-splenomegaly, severe anemia and leukopenia. Five were admitted with severe thrombocytopenia, without hemorrhagic manifestations. Six patients received first-line treatment with miltefosine, five of them had treatment failure requirirng therapy escalation to amphotericin B, two received liposomal amphotericin B and three deoxycholate amphotericin B. The main vector identified was the Lutzomyia gomezi and its main reservoir were canines. Conclusion We describe the first visceral leishmaniasis outbreak in children living in an urban area, with no mortality. Most of the cases had a good response to amphotericin B.(AU)

Potential for rapid antibody detection to identify tuberculous cattle with non-reactive tuberculin skin test results.

BACKGROUND: Bovine tuberculosis (TB) control programs generally rely on the tuberculin skin test (TST) for ante-mortem detection of Mycobacterium bovis-infected cattle. RESULTS: Present findings demonstrate that a rapid antibody test based on Dual-Path Platform (DPP®) technology, when applied 1-3 weeks after TST, detected 9 of 11 and 34 of 52 TST non-reactive yet M. bovis-infected cattle from the US and GB, respectively. The specificity of the assay ranged from 98.9% (n = 92, US) to 96.0% (n = 50, GB) with samples from TB-free herds. Multi-antigen print immunoassay (MAPIA) revealed the presence of antibodies to multiple antigens of M. bovis in sera from TST non-reactors diagnosed with TB. CONCLUSIONS: Thus, use of serologic assays in series with TST can identify a significant number of TST non-reactive tuberculous cattle for more efficient removal from TB-affected herds.

La resistina se asocia con la proteína C reactiva y marcadores de riesgo cardiovascular en niños obesos / Resistin is associated with C reactive protein and cardiovascular risk markers in obese children / A resistina associa-se à proteína C reativa e aos marcadores de risco cardiovascular em crianças obesas

El objetivo del trabajo fue evaluar los niveles de resistina sérica y su asociación con la proteína C reactiva (PCR-hs), óxido nítrico (NO) y lípidos plasmáticos (LP) en sujetos de edad pediátrica. Participaron 366 niños y adolescentes (10-16 años), agrupados en eutróficos (n=162) y obesos (n=204). Se les estudió peso, talla, circunferencia de la cintura, resistina sérica, glucosa e insulina basal, LP, NO, PCR-hs, malondialdehído y tensión arterial. Se calculó el IMC, el índice cintura-talla (IC/T) y el HOMA-IR. Se utilizaron las pruebas t de Student, ANOVA, U de Mann y Whitney o Kruskal- Wallis para comparar entre grupos y la correlación de Spearman para determinar asociación entre variables. Los obesos masculinos presentaron niveles superiores de resistina (p<0,05). El género femenino presentó valores más altos de resistina en eutróficos (p=0,012) y con IC/T normal (p=0,011). A mayor concentración de resistina los eutróficos presentaron niveles más altos de triacilglicéridos, pero los obesos mostraron niveles más bajos de triacilglicéridos, HDLc y NO, más altos de PCR-hs y mayor IMC. Los resultados sugieren que la resistina podría ser un factor de riesgo para la enfermedad cardiovascular por su asociación positiva con la PCR-hs e inversa con el NO y la HDLc, parámetros involucrados en la inflamación y la disfunción endotelial.

The aim of this study was to evaluate seric levels of resitin and their association with high-sensitivity C Reactive Protein (hs-CRP), nitric oxide (NO) and plasmatic lipids (PL) in a pediatric age population. A total of 366 children and adolescents (between 10-16 years old) participated, and were grouped into eutrophic (n=162) and obese (n=204). Weight, height, waist circumference, resistin, fasting blood glucose and insulin levels, PL, hs-CRP, NO, malondialdehyde and blood pressure were measured. BMI, waist to height ratio (W/HR) and HOMA-IR were calculated. T-student, ANOVA, Mann-Whitney U-value or Kruskal-Wallis were used to compare between groups and Spearman correlation was used to determine association among variables. Male obese subjects showed higher resistin levels (p<0.05). Female subjects showed higher resistin values in the eutrophic group (p=0.012) and in the normal W/HR (p=0.011). At higher levels of resistin, the eutrophic group showed higher levels of triacylglycerides, but the obese group showed lower triacylglycerides, HDLc and NO levels and higher hs-CRP levels and BMI. These results suggest that resistin could be a risk factor for cardiovascular disease because of its positive association with hs-CRP and inverse association with NO and HDLc, parameters involved in inflammation and endothelial dysfunction.

O objetivo da pesquisa foi avaliar os níveis séricos de resistina sérica e sua associação com a proteína C-reativa (PCR-hs), óxido nítrico (NO) e lipídios plasmáticos (LP) em crianças e adolescentes. O estudo envolveu 366 crianças e adolescentes (10-16 anos), agrupados em eutróficos (n=162) e obesos (n=204). Os sujeitos foram estudados em relação ao peso, altura, circunferência da cintura, resistina sérica, glicose e insulina basal, LP, NO, PCR-hs, malondialdeído e pressão arterial. Os IMC, índice cintura-altura (IC/A) e HOMA-IR foram calculados. Foram utilizados os Testes t de Student, ANOVA, U de Mann e Whitney ou Kruskal-Wallis para comparar entre os grupos e a correlação de Spearman para verificar a associação entre variáveis. Os obesos masculinos mostraram níveis mais elevados de resistina (p<0,05). O sexo feminino apresentou valores mais altos de resistina em eutróficos (p=0,012) e com IC/T normal (p=0,011). À maior concentração de resistina, os eutróficos apresentaram maiores níveis de triacilglicerídeos, mas os obesos apresentaram níveis mais baixos de triacilglicerídeos, HDLc e NO, mais altos de PCR-hs e maior IMC. Os resultados sugerem que a resistina poderia ser um fator de risco para a doença cardiovascular devido à sua associação positiva com a PCR-hs e inversa com o NO e a HDLc, parâmetros envolvidos na inflamação e disfunção endotelial.

Molecular operational taxonomic units of mosquitoes (Diptera: Culicidae) collected in high Andean mountain ecosystems of Antioquia, Colombia.

Accurate taxonomic identification of highland mosquito species may be complicated because of the lack of comprehensive regional morphological keys and taxonomic specialists, particularly for mosquitoes of medical or ecological importance. We applied a multi-locus approach to explore the diversity of genera/species collected, to define the Molecular Operational Taxonomic Units (MOTUs) and to perform phylogenetic clustering. Twenty MOTUs and three single sequences were revealed from 78 concatenated cox1 + ITS2 sequences, and the species name was allocated for five of these. This study provides molecular taxonomic information of culicid fauna present in high Andean mountain ecosystems in Antioquia, Colombia. However, future morphological and integrative taxonomic studies should be conducted to achieve the specific identity of all detected MOTUs.

Valores de referencia de hierro, yodo, zinc, selenio, cobre, molibdeno, vitamina C, vitamina E, vitamina K, carotenoides y polifenoles para la población venezolana / Reference values of iron, iodine, zinc, selenium, copper, molybdenum, vitamin C, vitamin E, vitamin K, carotenoids and polyphenols for the Venezuelan population

Esta revisión de las recomendaciones de energía y nutrientes para la población Venezolana presenta los valores de hierro, yodo, zinc, selenio, cobre, molibdeno, vitamina C, vitamina E, vitamina K, carotenoides y polifenoles. Se adoptan definiciones internacionales de Ingestas Dietéticas de Referencia (DRIs por Dietary Reference Intakes) que incluyen: Ingesta Dietética Recomendada (RDA), Requerimiento Promedio Estimado (EAR), Ingesta Adecuada (AI) y Niveles de Ingesta Máximos Tolerables (UL). Las RDA para hierro: 11 mg/día para < 1 año, 7-10 mg/día niños, 8-11 mg/día para hombres, 8-18 mg/día para mujeres y 27 mg/día para embarazadas. RDA Yodo: 110-130 mg/ día recién nacidos, 90-120 mg/día niños y adolescentes y 150 mg/ día adultos, 220 mg/día embarazo y 290 mg/día lactancia. RDA Zinc: 2-3 mg/día < 1 año, 3-5 mg/día niños, 8-11 mg/día adolescentes y hombres, 8-9 mg/día adolescentes y mujeres, 12 mg/ día para embarazadas y 13 mg/día durante la lactancia. RDA Vitamina C: 40-50 mg/día recién nacidos, 15-45 mg/día niños, 75 mg/día adolescentes masculinos, 65 mg/día adolescentes femeninas, 90 mg/día hombres y 75 mg/día mujeres, 80-85 mg/día embarazadas y lactancia 115-120 mg/día. También se presentan valores de cobre, selenio, molibdeno, vitaminas E, K, carotenoides y polifenoles. Estas recomendaciones contribuirán al diseño de políticas adecuadas y eficientes que puedan ayudar a evitar o a tratar las consecuencias derivadas de la deficiencia o el exceso de estos nutrientes.

The review on iron, iodine, zinc, selenium, copper, molybdenum, vitamin C, vitamin E, vitamin K, carotenoids and polyphenols recommendations for Venezuela comprise the definitions adopted worldwide known as Dietary Reference Intakes (DRIs) that include Recommended Dietary Allowance (RDA), Estimated Average Requirement (EAR), Adequate Intake (AI) and Tolerable Upper Intake Levels (UL). The RDA for iron: 11 mg/day for infants < 1 year of age, 7 - 10 mg/day for children, 8-11 mg/day for males, 8-18 mg/day for females and 27 mg/day during pregnancy. RDA for iodine: 110-130 mg/day for infants, 90-120 mg/ day for children and adolescents, 150 mg/day for adults, 220 mg/ day for pregnancy and 290 mg/day during lactation. RDA Zinc: 2-3 mg/day for infants, 3-5 mg/day for children, 8-11 mg/day for male adolescents and adults, 8-9 mg/day for female adolescents and adults, 12 mg/day during pregnancy and 13 mg/day for lactation. RDA Vitamin C: 40-50 mg/day for infants, 15-45 mg/ day for children, 75 mg/day for male adolescents, 65 mg/day for female adolescents, 90 mg/day for adult males, 75 mg/day for adult females, 80-85 mg/day during pregnancy and 115-120 mg/ day during lactation. Recommendations for copper, selenium, molybdenum, vitamins E, K, carotenoids and polyphenols are also presented. These recommendations will help to design adequate and efficient policies that could help to avoid or to treat the consequences derived from the deficiency or the excess of these nutrients.

Alteraciones bioquímicas como marcadores predictores de gravedad en pacientes con fiebre por dengue / Biochemical alterations as prediction markers for the severity of illness in dengue fever patients

Introducción. El dengue es la infección transmitida por mosquitos más importante en el mundo. Existe información de que las alteraciones bioquímicas pueden utilizarse como herramientas predictoras de gravedad del dengue. Objetivo. Evaluar las alteraciones bioquímicas como posibles marcadores predictores de gravedad del dengue. Materiales y métodos. Se llevó a cabo un estudio de casos y controles anidado en una cohorte. Se seleccionaron al azar 125 casos con dengue grave y 120 controles con dengue no grave para evaluar los niveles séricos de lactato-deshidrogenasa (LDH), creatina cinasa (CK), proteína C reactiva (PCR) y albúmina, en sueros obtenidos en las primeras horas de la enfermedad. Para evaluar el valor diagnóstico de cada biomarcador, se establecieron puntos de corte con una sensibilidad del 90 % en la detección de casos graves. Resultados. Se observó una asociación entre los niveles de PCR por debajo de 9,8 mg/l (OR=0,04; IC 95% =0,02-0,08 ; p=0,000), de LDH inferiores a 400 U/L (OR=0,49; IC 95% =0,24-1,02; p=0,053) y de albúmina menor de 4 mg/dl (OR=3,46; IC 95% =1,96-6,12; p=0,000), con la gravedad del dengue. En contraste, los niveles de la CK no mostraron asociación con la gravedad de la enfermedad. Conclusiones. Los hallazgos de nuestro estudio sugieren una asociación de los niveles de PCR, LDH y albúmina con la gravedad del dengue. Estas pruebas bioquímicas podrían ser utilizadas como herramientas predictoras del curso clínico de la infección.

Introduction: Dengue is the most important mosquito-borne infection in the world. There is evidence supporting the use of biochemical alterations as prediction tools for severity of illness in dengue. Objective: To evaluate biochemical alterations as potential prediction markers for severity in dengue. Materials and methods: This was a case-control study nested in a cohort. We randomly selected 125 severe dengue cases and 120 controls with non-severe dengue for measuring LDH, CK, CRP and albumin serum levels using acute phase sera. To evaluate the predictive value for each biomarker, we established cut-off points with 90% sensitivity in detecting severe cases. Results: There was association among the CRP levels < 9.8 mg/L (OR=0.04; 95%CI=0.02-0.08; p=0.000), <400 U/L LDH levels (OR=0.49; 95%CI=0.24-1.02; p=0.053) and <4 mg/dl albumin levels (OR=3.46; 95%CI=1.96-6.12; p=0.000) with the severity of dengue. In contrast, the CK levels showed no association with the severity of the disease. Conclusions: Our findings suggest an association of CRP, LDH and albumin levels with the severity of dengue. These biochemical tests could be used as predictive tools in the clinical course of the infection.

[Reference values of iron, iodine, zinc, selenium, copper, molybdenum, vitamin C, vitamin E, vitamin K, carotenoids and polyphenols for the Venezuelan population]. / Valores de referencia de hierro, yodo, zinc, selenio, cobre, molibdeno, vitamina C, vitamina E, vitamina K, carotenoides y polifenoles para la población venezolana.

The review on iron, iodine, zinc, selenium, copper, molybdenum, vitamin C, vitamin E, vitamin K, carotenoids and polyphenols recommendations for Venezuela comprise the definitions adopted worldwide known as Dietary Reference Intakes (DRIs) that include Recommended Dietary Allowance (RDA), Estimated Average Requirement (EAR), Adequate Intake (AI) and Tolerable Upper Intake Levels (UL). The RDA for iron: 11 mg/day for infants < 1 year of age, 7-10 mg/day for children, 8-11 mg/day for males, 8-18 mg/day for females and 27 mg/day during pregnancy. RDA for iodine: 110-130 microg/day for infants, 90-120 microg/ day for children and adolescents, 150 microg/day for adults, 220 microg/ day for pregnancy and 290 microg/day during lactation. RDA Zinc: 2-3 mg/day for infants, 3-5 mg/day for children, 8-11 mg/day for male adolescents and adults, 8-9 mg/day for female adolescents and adults, 12 mg/day during pregnancy and 13 mg/day for lactation. RDA Vitamin C: 40-50 mg/day for infants, 15-45 mg/ day for children, 75 mg/day for male adolescents, 65 mg/day for female adolescents, 90 mg/day for adult males, 75 mg/day for adult females, 80-85 mg/day during pregnancy and 115-120 mg/day during lactation. Recommendations for copper, selenium, molybdenum, vitamins E, K, carotenoids and polyphenols are also presented. These recommendations will help to design adequate and efficient policies that could help to avoid or to treat the consequences derived from the deficiency or the excess of these nutrients.

[Biochemical alterations as prediction markers for the severity of illness in dengue fever patients]. / Alteraciones bioquímicas como marcadores predictores de gravedad en pacientes con fiebre por dengue.

INTRODUCTION: Dengue is the most important mosquito-borne infection in the world. There is evidence supporting the use of biochemical alterations as prediction tools for severity of illness in dengue. OBJECTIVE: To evaluate biochemical alterations as potential prediction markers for severity in dengue. MATERIALS AND METHODS: This was a case-control study nested in a cohort. We randomly selected 125 severe dengue cases and 120 controls with non-severe dengue for measuring LDH, CK, CRP and albumin serum levels using acute phase sera. To evaluate the predictive value for each biomarker, we established cut-off points with 90% sensitivity in detecting severe cases. RESULTS: There was association among the CRP levels < 9.8 mg/L (OR=0.04; 95%CI=0.02-0.08; p=0.000), <400 U/L LDH levels (OR=0.49; 95%CI=0.24-1.02; p=0.053) and <4 mg/dl albumin levels (OR=3.46; 95%CI=1.96-6.12; p=0.000) with the severity of dengue. In contrast, the CK levels showed no association with the severity of the disease. CONCLUSIONS: Our findings suggest an association of CRP, LDH and albumin levels with the severity of dengue. These biochemical tests could be used as predictive tools in the clinical course of the infection.

Percentiles de circunferencia de cintura en niños y adolescentes del municipio maracaibo del estado zulia: venezuela / Waist circumference percentiles in children and adolescents of Maracaibo municipality of zulia state: venezuela

El exceso de grasa visceral constituye un importante predictor de riesgo metabólico y cardiovascular en niños y adolescentes, y la circunferencia de cintura (CC) es la mejor variable antropométrica que la estima. El objetivo de este estudio fue estimar los percentiles de circunferencia de cintura específicos por edad y género para niños y adolescentes, utilizando una muestra obtenida del Municipio Maracaibo del Estado Zulia, Venezuela. Se analizó una muestra de 1787 niños y adolescentes (884 del género masculino y 903 del género femenino) con edades comprendidas entre 2 y 18 años, seleccionados por muestreo aleatorio por conglomerado. A cada individuo se le realizó un examen físico y evaluación antropométrica para confirmar su estado de salud. Para la construcción de las curvas suavizadas de los percentiles de CC se utilizó el método LMS. La media de la circunferencia de cintura aumentó con la edad, y se mantuvo similar en ambos géneros hasta la edad de 8 años, despues de los cuales comenzó a verse un ligero incremento en el género masculino. Los valores de CC en cada percentil se incrementaron con la edad. Al compararlo con otros países, los valores de CC en el percentil 50 para ambos grupos, se mostraron cercanos pero levemente superiores a los valores registrados por Colombia, Canadá, USA, Hong Kong y Londres hasta la edad de 9 años, a partir de la cual se evidencia un incremento constante en promedio de 2,5 cm de un año a otro. Las curvas de ambos géneros se acercan suficientemente a las curvas que dibuja USA. Sin embargo, se observó un aumento en los valores de CC en el grupo masculino desde los 10 años en adelante, comparado con los otros países, incluso USA. Estas primeras estimaciones de percentiles de CC y sus curvas correspondientes para niños y adolescentes del Municipio Maracaibo, permitirá identificar individuos con obesidad abdominal (una vez establecidos los puntos de corte en futuras investigaciones); y así definir no solo las estrategias de atención, sino también las de prevención de riesgo cardiovascular y metabólico en este grupo vulnerable(AU)

The excess of visceral fat constitutes important predictor of metabolic and cardiovascular risk in children and adolescents, and the waist circumference (WC) is the best anthropometric variable to estimate it. The objective was to estimate the specific WC percentiles by age and gender for children and adolescents, using data obtained from Maracaibo Municipality of Zulia State, Venezuela. For this purpose, a sample of 1787 children and adolescents (884 boys and 903 girls) from 2 until 18 years old, were selected by conglomerate random sampling. A complete physical examination and anthropometric evaluation was performed to each patient to confirm their healthy state. Construction of the smoothed centile curves was performed using the LMS method. Mean WC increased with age, with the values being similar between males and females until 8 years old, after which values are slightly higher in males. For both genders, the values of WC in each percentile increased with the age. Compared with other countries, our values of WC in percentile 50 for both groups were similar, but slightly superior to the values registered by Colombia, Canada, USA, Hong Kong and London until age 9, after this age a constant increase in average of 2.5 cm from one year to another was observed. Both gender curves approach the USA curves. Nevertheless, an increase in the values of WC in the male group from the 10 years was observed, compared with the other countries, even USA. These first estimations of percentiles of WC and their corresponding curves for children and adolescents from Maracaibo Municipality, will allow to identify subjects with abdominal obesity (after cut-off points are established in future investigations) and thus to define not only the strategies for attention, but also for prevention cardiovascular and metabolic risk in this vulnerable group(AU)

Evaluación del estado nutricional en pacientes pediátricos institucionalizados con VIH/SIDA / Assessment of nutritional status in institutionalized pediatric patients with HIV/AIDS

Introducción. La inmunosupresión progresiva y profunda generada por el VIH/SIDA hace que el organismo sea más vulnerable a las infecciones oportunistas, así como también a los episodios clínicos y complicaciones asociadas, que con frecuencia tienen un enorme efecto en el estado nutricional del individuo. Nuestro objetivo fue determinar el estado nutricional de los pacientes pediátricos con VIH/SIDA. Metodología. El estudio fue descriptivo y transversal, donde participaron 60 pacientes con edades comprendidas entre 1-13 años, de ambos sexos, atendidos por la Fundación Innocens de Maracaibo. Se realizó una evaluación nutricional con la toma de medidas antropométricas, y se registraron los valores de hematología, bioquímica sanguínea y evaluación dietética. Resultados. El análisis nutricional antropométrico según el IMC arrojó que el 60% de los niños tiene un diagnóstico normal, con mayor prevalencia en los varones. Los niveles plasmáticos de triacilglicéridos (134,43 ± 66,04mg/dl) fueron más altos que los valores deseables para los grupos etarios, mientras que los valores de HDL-c (34,12 ± 12,22 mg/dl) fueron más bajos. Así mismo los valores de hemoglobina fueron bajos en todos los grupos de edades (11,25 ± 1,26, g/dL). El estudio dietético evidenció una baja adecuación de calorías y de nutrientes para todos los grupos etarios. Conclusión. Un importante número de los pacientes pediátricos con SIDA atendidos por la Fundación Innocens tienen un deterioro del estado nutricional, lo que amerita la implementación de un programa de atención nutricional integral, a fin de contribuir con el mejoramiento de la calidad de vida de estos pacientes.

Introduction: Progressive and profound immunosuppression caused by HIV/AIDS makes the body more vulnerable to opportunistic infections as well as the associated clinical events and complications that often have a huge effect on the nutritional status of the individual. Our objective was to determine the nutritional status of pediatric patients with HIV/AIDS. Methodology: We conducted a descriptive cross-sectional study that included 60 patients aged 1-13 of both sexes who received care from the Fundación Innocens in Maracaibo, Venezuela. Nutritional assessment was done by anthropometric measurement while hematology, blood biochemistry, and dietary assessment data were also recorded. Results:Anthropometric nutritional analysis by BMI diagnosed 60% of children as normal, with higher prevalence in males. Plasma levels of triglycerides (134.43 ± 66.04 mg/dl) were higher than values desirable for the relevant age groups while HDL-C levels (34.12 ± 12.22 mg/dl) were lower. Hemoglobin levels were also low in all age groups (11.25 ± 1.26 g/dL). The dietary study showed a low dietary adequacy of calories and nutrients for all age groups. Conclusion: A significant number of pediatric AIDS patients cared for by the Fundación Innocens show impaired nutritional status that warrants the implementation of a comprehensive nutritional care program to help improve the quality of life of these patients.

[Isolation and identification of Malassezia species isolated from healthy skin of malnourished and eutrophic children cared for in daycare centers in Venezuela]. / Aislamiento e identificación de especies del género Malassezia en piel sana de niños desnutridos y eutróficos de multihogares de cuidado diario.

The Malassezia genus contains a group of lipophilic yeasts that form part of the normal microbiota of human and animals skins. The presence of Malassezia species was studied on healthy skin in children, who attended day care centers, located in Maracaibo, Zulia state, Venezuela. Children without skin lesions that were anthropometrically classified as malnourished (48) and eutrophics (40), were studied. Samples were taken from different anatomic regions with a transparent plastic tape. The direct examination was done using blue methylene (0.25%) and then, samples were cultivated in Dixon medium with antibiotic. The identification of the isolated yeasts was done by classical methodology. The results obtained indicate that malnourished and eutrophics children were positive to Malassezia in relatively high prevalences (66.6% and 65.0% respectively). It is worthy of notice that M. furfur was predominantly present in malnourished children (77%). It was isolated from all the anatomic locations in both groups of children. M. slooffiae was mainly located in the back of the eutrophic children. M. furfur was isolated preferently in malnourished male children, while in the eutrophic children, it was observed in females. It was demonstrated that M. furfur was predominantly present in the healthy skin of malnourished and eutrophic children.

Aislamiento e identificación de especies del género Malassezia en piel sana de niños desnutridos y eutróficos de multihogares de cuidado diario / Isolation and identification of Malassezia species isolated of healthy skin of malnourished and eutrophic children attended in day care centers in Venezuela

El género Malassezia comprende un grupo de levaduras lipofílicas, integrantes de la microbiota normal de la piel del hombre y de animales. Se estudió la presencia de especies de Malassezia en piel sana de niños, que asistían a multihogares de cuidado diario de la ciudad de Maracaibo, estado Zulia, Venezuela. La evaluación antropométrica permitió el diagnóstico de niños desnutridos (n = 48) y eutróficos (n = 40). Estos niños, entre 1 y 6 años de edad, que no presentaban lesiones en la piel, se seleccionaron para el estudio. Las muestras de la piel se tomaron de distintas regiones anatómicas. Se empleó el método de la impronta con cinta plástica transparente. Se realizó un examen directo con azul de metileno (0,25%) y se cultivó en el medio Dixon con antibiótico. La identificación de los aislados se hizo según la metodología clásica. Los resultados indican que los niños desnutridos y eutróficos presentaron una colonización por Malassezia en un elevado porcentaje (66,6% y 65,0%, respectivamente). Se observó en los desnutridos un predominio significativo de M. furfur (77,0%). Esta especie se aisló en todas las localizaciones, tanto en los desnutridos como en los eutróficos, mientras que M. slooffiae predominó en la espalda en los eutróficos. Por otra parte, se observó en los desnutridos un predominio significativo de M. furfur en el sexo masculino y en los eutróficos en el femenino. Esta investigación demostró el predominio de M. furfur en piel sana de niños desnutridos y eutróficos.

The Malassezia genus contains a group of lipophilic yeasts that form part of the normal microbiota of human and animals skins. The presence of Malassezia species was studied on healthy skin in children, who attended day care centers, located in Maracaibo, Zulia state, Venezuela. Children without skin lesions that were anthropometrically classified as malnourished (48) and eutrophics (40), were studied. Samples were taken from different anatomic regions with a transparent plastic tape. The direct examination was done using blue methylene (0.25%) and then, samples were cultivated in Dixon medium with antibiotic. The identification of the isolated yeasts was done by classical methodology. The results obtained indicate that malnourished and eutrophics children were positive to Malassezia in relatively high prevalences (66.6% and 65.0% respectively). It is worthy of notice that M. furfur was predominantly present in malnourished children (77%). It was isolated from all the anatomic locations in both groups of children. M. slooffiae was mainly located in the back of the eutrophic children. M. furfur was isolated preferently in malnourished male children, while in the eutrophic children, it was observed in females. It was demonstrated that M. furfur was predominantly present in the healthy skin of malnourished and eutrophic children.

Citocinas TH2 (IL 4e IL10) en el niño desnutrido: Universidad del Zulia: Maracaibo-Venezuela / TH2 cytokines (IL 4e IL 10) in the malnourished child: Universidad del Zulia: Maracaibo-Venezuela

Determinar las concentraciones séricas de citocinas Th2 (IL4 e IL10), en niños desnutridos y eutróficos sin infección, en edades comprendidas entre 6 meses y 6 años. Se seleccionaron 89 niños; 64 niños con algún grado de desnutrición (leve, moderada y grave) y 25 niños eutróficos. Las citocinas se midieron en sangre periférica utilizando el método de ELISA doble sandwich. Para el análisis estadístico se utilizo el test de ANOVA con post test de Tukey. Se presentan como media + DE. La IL4 mostró en el grupo de desnutridos, niveles más elevados: leves (0.46 ± 0.04 pg/ml), moderados (0.48 ± 0.10 pg/ml) y graves (0.55 ± 0.006 pg/ml), presentando cada grupo diferencias significativas p < 0.001 en relación con el grupo control (0.37 ± 0.004 pg/ml). También hubo diferencias significativas entre los grupos de desnutridos leves y moderados con los graves p < 0.001. La IL10 mostró diferencias significativas entre los desnutridos moderados (9.91 ± 3.17 pg/ml) y graves (10.88 ± 5.13 pg/ml) con el grupo control (6.53 ± 2.59 pg/ml) p < 0.01. Los valores elevados de IL4 e IL10 en el niño desnutrido son consecuencia de un daño en la capacidad de activación de las células inmunitarias en los mismos, sumándose el grado de infestación parasitaria con helmintos que presentan, que condiciona la elevación de IL4.

To determine the cytokine serum measurements Th2 (IL4 and IL10), in malnourished children and eutrophic without infection, in ages understood between 6 months and 6 years. 89 children were selected; 64 children with some grade of malnourishment (mild, moderate and severe) and 25 eutrophic children. The cytokines was measured in outlying blood using ELISA'S double sandwich method. For the statistical analysis we use the test of ANOVA with post test of Tukey. They are presented like Mean + SD. The IL4 showed in the group of malnourished, higher levels: mild (0.46 ± 0.04 pg/ml), moderate (0.48 ± 0.10 pg/ml) and severe (0.55 ± 0.006 pg/ml), presenting each group significant differences (p < 0.001) in relation with the control group (0.37 ± 0.004 pg/ml). There were also significant differences among the groups of mild malnourished and moderate with the severe ones p < 0.001. The IL10 showed significant differences among the moderate malnourished (9.91 ± 3.17 pg/ml) and the severe (10.88 ± 5.13 pg/ml) with the control group (6.53 ± 2.59 pg/ml) (p < 0.01). The high values of IL4 and IL10 in the malnourished children are consequence of damage in the capacity of activation of the immune cells in the same ones, being added the grade of parasitic infection with worms that present that conditions the rise of IL4.