Parametric analysis of an integrated cardio-respiratory model in preterm newborns during apnea.

The analysis of the complex interactions involved in the acute physiological response to apnea-bradycardia events in preterm newborns remains a challenging task. This paper presents a novel integrated model of cardio-respiratory interactions, adapted to preterm newborns. A sensitivity analysis, based Morris' screening method, was applied to study the effects of physiological parameters on heart rate and desaturation, during the simulation of a 15-seconds apnea-bradycardia episode. The most sensitive parameters are associated with fundamental, integrative physiological mechanisms involving: (i) respiratory mechanics (intermediate airways and lung compliance), (ii) fraction of inspired oxygen, (iii) metabolic rates (oxygen consumption rate), (iv) heart rate regulation and (v) chemoreflex (gain). Results highlight the relevant influence of physiological variables, involved in preterm apnea-bradycardia events.

Side effects of different head and neck radiotherapy doses on wistar rat's behavior.

Radiotherapy (RT) is a common treatment for head and neck tumors. However, it causes several physical and behavioral side effects, and no study has assessed the emotional effects in rats. Therefore, the present study evaluated the influence of head and neck RT on the behavior and body weight gain in Wistar rats. Fifty-four male Wistar rats were allocated into six groups (n = 9) according to the irradiation dose, which was applied at the first day of the experiment: RT-7.5 (single dose of 7.5 Gy); RT-10 (single dose of 10 Gy); RT-15 (single dose of 15 Gy); RT-30 (single dose of 30 Gy); Control (without RT). The animals were irradiated in the region of the right face, and behavioral tests and weighing were performed on days one, seven, and 28. The open field and Y-maze tests were undertaken to analyze the animal's behavior. The dose of 30 Gy was lethal when applied to the head and neck region. The irradiated animals had less weight gain when compared to the control ones, but there was no statistical difference. In the open field and Y-maze tests, lower mobility of animals in the RT groups was observed both on day seven and at the end of the experiment (day 28) when compared to the control rats (p < 0.05). It was possible to conclude that the different doses of radiation induced depressive behavior in the animals, and that the weight gain tended to be lower in the irradiated groups, however, without statistical difference.

Dynamics of the Tachocline.

The solar tachocline is an internal region of the Sun possessing strong radial and latitudinal shears straddling the base of the convective envelope. Based on helioseismic inversions, the tachocline is known to be thin (less than 5% of the solar radius). Since the first theory of the solar tachocline in 1992, this thinness has not ceased to puzzle solar physicists. In this review, we lay out the grounds of our understanding of this fascinating region of the solar interior. We detail the various physical mechanisms at stake in the solar tachocline, and put a particular focus on the mechanisms that have been proposed to explain its thinness. We also examine the full range of MHD processes including waves and instabilities that are likely to occur in the tachocline, as well as their possible connection with active region patterns observed at the surface. We reflect on the most recent findings for each of them, and highlight the physical understanding that is still missing and that would allow the research community to understand, in a generic sense, how the solar tachocline and stellar tachocline are formed, are sustained, and evolve on secular timescales.

Simulations of Solar and Stellar Dynamos and Their Theoretical Interpretation.

We review the state of the art of three dimensional numerical simulations of solar and stellar dynamos. We summarize fundamental constraints of numerical modelling and the techniques to alleviate these restrictions. Brief summary of the relevant observations that the simulations seek to capture is given. We survey the current progress of simulations of solar convection and the resulting large-scale dynamo. We continue to studies that model the Sun at different ages and to studies of stars of different masses and evolutionary stages. Both simulations and observations indicate that rotation, measured by the Rossby number which is the ratio of rotation period and convective turnover time, is a key ingredient in setting the overall level and characteristics of magnetic activity. Finally, efforts to understand global 3D simulations in terms of mean-field dynamo theory are discussed.

Computational Simulation of Colorectal Cancer Biomarker Particle Mobility in a 3D Model.

Even though some methods for the detection of colorectal cancer have been used clinically, most of the techniques used do not consider the in situ detection of colorectal cancer (CRC) biomarkers, which would favor in vivo real-time monitoring of the carcinogenesis process and consequent studies of the disease. In order to give a scientific and computational framework ideal for the evaluation of diagnosis techniques based on the early detection of biomarker molecules modeled as spherical particles from the computational point of view, a computational representation of the rectum, stool and biomarker particles was developed. As consequence of the transport of stool, there was a displacement of CRC biomarker particles that entered the system as a result of the cellular apoptosis processes in polyps with a length lower than 1 cm, reaching a maximum velocity of 3.47×10-3 m/s. The biomarkers studied showed trajectories distant to regions of the polyp of origin in 1 min of simulation. The research results show that the biomarker particles for CRC respond to the variations in the movements of the stool with trajectories and speeds that depend on the location of the injury, which will allow locating the regions with the highest possibilities of catching particles through in situ measurement instruments in the future.

Factors Affecting Neurological Presentation and Severity in Pediatric Off-Highway Vehicle Accidents in Texas.

OBJECTIVES: The purpose was to evaluate the characteristics of off-highway vehicle (OHV) crashes correlated with neurological injury and accident severity in the pediatric population in El Paso, Texas. METHODS: A retrospective review of 213 patients who were victims of an OHV crash attended at a regional Level I trauma center from 2012 to 2020 was performed. OHVs were defined as vehicles designated for use outside public roads. Neurological outcomes included any traumatic brain injury (TBI) or a brain hemorrhage/hematoma. Severe injury was defined as a Glasgow Coma Scale less than 8, a length of stay longer than 7 days, a Pediatric Trauma Score lower than 8, and requiring pediatric intensive care unit admission. Bivariate and multivariate analyses by logistic regression models were conducted to determine the factors related to the neurological outcomes and accident severity. RESULTS: Of 213 OHV crash patients, 104 (48.8%) had TBI and 22 (10.3%) had brain hemorrhages or hematomas. Risk analyses demonstrated that children younger than age 6 years and occupants of recreational OHVs have a significantly higher risk of severe injuries. Off-highway motorcycles and all-terrain vehicles were risk factors for TBI, whereas helmets were a protective factor. CONCLUSIONS: OHVs are associated with both TBIs and severe injuries. Stricter laws requiring helmets and forbidding children younger than 6 to ride are required, as modifying these factors could reduce the incidence of OHV crashes and their complications.

Modeling Patient-Specific Desaturation Patterns in Sleep Apnea.

OBJECTIVE: The physiological mechanisms involved in cardio-respiratory responses to sleep apnea events are not yet fully elucidated. A model-based approach is proposed to analyse the acute desaturation response to obstructive apneas. METHODS: An integrated model of cardio-respiratory interactions was proposed and parameters were identified, using an evolutionary algorithm, on a database composed of 107 obstructive apneas acquired from 10 patients (HYPNOS clinical study). Unsupervised clustering was applied to the identified parameters in order to characterize the phenotype of each response to obstructive apneas. RESULTS: A close match was observed between simulated oxygen saturation ( SaO2) and experimental SaO2 in all identifications (median RMSE = 1.3892 %). Two clusters of parameters, associated with different dynamics related to sleep apnea and periodic breathing were obtained. CONCLUSION AND SIGNIFICANCE: The proposed patient and event-specific model-based analysis provides understanding on specific desaturation patterns, consequent to apnea events, with potential applications for personalized diagnosis and treatment.

Influência de diferentes doses de radiação no desenvolvimento de periodontite apical em ratos submetidos a radioterapia de cabeça e pescoço / Influence of different radiation doses on the development of apical periodontitis in rats submitted to head and neck radiotherapy

A periodontite apical (PA) é uma patologia comum, entretanto, poucos estudos foram realizados sobre a mesma após a radioterapia (RT). Portanto, o presente estudo avaliou a influência de diferentes doses de radiação no desenvolvimento de periodontite apical em ratos submetidos a radioterapia de cabeça e pescoço. Para essa avaliação, 54 ratos machos Wistar foram alocados em 6 grupos (n=9) de acordo com a dose de irradiação: RT-7,5 (dose única de 7,5 Gy); RT-10 (dose única de 10 Gy); RT-15 (dose única de 15 Gy); RT-30 (dose única de 30 Gy); Controle-PA (sem RT e indução de PA); Controle (sem RT e sem PA). Os animais foram irradiados na região da face direita e após 7 dias da realização da RT foi induzido a lesão periapical. Para indução de PA, as cavidades pulpares dos primeiros molares foram expostas ao meio bucal por 21 dias. As amostras da região apical dos primeiros molares foram submetidas a análises: a) análise comportamental por meio do campo aberto e labirinto; b) radiográfica e por microtomografia computadorizada, para medir a área e o volume da PA; c)histológica, para medir o grau de inflamação periapical; d)histomorfométrica para avaliar o nível de reabsorção óssea periapical. Os dados foram avaliados por testes estatísticos descritivos e inferenciais, conforme dados obtidos, segundo sua normalidade, em testes paramétricos e não paramétricos. Verificou-se que a dose de 30 Gy foi letal quando aplicada na região de cabeça e pescoço. Os animais tiveram menor ganho de peso quando submetidos a RT mas não houve diferença estatística em nenhum momento avaliado. Nas análises de campo aberto e labirinto verificou-se menor mobilidade dos animais dos grupos RT tanto no dia 7 como no final do experimento quando comparados aos controles (p<0,05). Na análise microtomográfica verificou-se que a PA foi maior nos grupos irradiados sendo que o grupo RT-15 apresentou a maior PA quando comparado aos demais (p<0,05). Conclui-se que a RT é um tratamento que induz um processo de estresse e depressão nos animais; quanto maior a dose utilizada, maior a PA desenvolvida nesses animais. A dose de 30Gy é letal quando utilizada na região de cabeça e pescoço e a dose de 15Gy mostrou maior volume de lesão periapical sendo a melhor dosagem a ser utilizada para estudos na Endodontia (AU).

Apical periodontitis (AP) is a common pathology, although few studies have been conducted on this one after radiotherapy (RT). Therefore, this project evaluates the influence of different radiation doses on the development of apical periodontitis in rats. For this evaluation, 54 male Wistar rats were allocated into 6 groups (n = 9) according to the irradiation dose: RT-7.5 (single dose of 7.5 Gy); RT-10 (10 Gy single dose); RT-15 (15 Gy single dose); RT-30 (30 Gy single dose); PA-Control (without RT and PA induction); Control (without RT and without PA). The animals were irradiated in the region of the right face and after 7 days of RT, a periapical lesion was induced. For PA induction, the pulp cavities of the first molars were exposed to the oral environment for 21 days. As the ones in the apical region of the first molars were submitted to analyses: a) behavioral analysis through the open field and Y-maze b) radiographic and computerized microtomography, to measure the area and the volume of the PA; c) histological, to measure the degree of periapical inflammation; d) histomorphometric to assess the level of periapical bone resorption. Data was obtained by descriptive and inferential statistical tests, according to data obtained, according to its normality, in parametric and non-parametric tests. It was found that the dose of 30 Gy was lethal when applied to the head and neck region. The animals had less weight gain when subjected to RT but there was no statistical difference at any time evaluated. In the open field and Y-maze analyses, lower mobility of animals in the RT groups was found both on day 7 and at the end of the experiment when compared to controls (p<0.05). The microtomographic analysis showed that the PA was higher in the irradiated groups, and the RT-15 group had the highest PA when compared to the others (p<0.05). It is concluded that RT is a treatment that induces a process of stress and depression in animals; the higher the dose used, the higher the BP developed in these animals. The 30Gy dose is lethal when used in the head and neck region and the 15Gy dose showed a greater volume of periapical lesion, being the best dose to be used for studies in Endodontics. (AU)

Sensitivity Analysis of a Cardio-respiratory Model in Preterm Newborns for the Study of Patent Ductus Arteriosus.

This paper proposes an integrated model of cardio-respiratory interactions in preterm newborns, focused on the study of the patent ductus arteriosus (PDA). A formal model parameter sensitivity analysis on blood flow through the PDA is performed. Results show that the proposed model is capable of simulating hemodynamics in right-to-left and left-to-right shunts. For both configurations, the most significant parameters are associated with mechanical ventricular properties and circulatory parameters related to left ventricle loading conditions. These results highlight important physiological mechanisms involved in PDA and provide key information towards the definition of patient-specific parameters.

Parametric Analysis of an Integrated Model of Cardio-respiratory Interactions in Adults in the Context of Obstructive Sleep Apnea.

An original integrated model of cardio-respiratory interactions is presented in this paper with the objective of studying the acute physiological responses evoked by obstructive sleep apnea events in adults. A comprehensive sensitivity analysis of the model is proposed during the simulation of a 20 s obstructive apnea episode using the Morris' screening method and local sensitivity analysis. The more relevant parameters are related to the following mechanisms of the physiology: (i) the fraction of oxygen in inspired air, (ii) metabolic rates (oxygen consumption rate, CO2 production rate); (iii) chemoreflex (gains and time constants) (iv) respiratory mechanics (lung compliance and unstressed volume of air in the alveoli). These results highlight significant physiological variables that may be particularly useful for the development of novel diagnostic and therapeutic strategies, integrating a virtual patient approach.

Consenso colombiano de expertos sobre recomendaciones informadas en la evidencia para la prevención, el diagnóstico y el manejo de la lesión renal aguda por SARS-CoV-2/COVID-19 / Colombian consensus of experts on recommendations informed in the evidence for the prevention, diagnosis and management of acute kidney injury by SARS-CoV-2/COVID-19

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Abstract Introduction: Acute kidney injury is a frequent complication in patients with COVID-19 and its occurrence is a potential indicator of multi-organ dysfunction and disease severity. Objective: Develop, through an expert consensus, evidence-based recommendations for the prevention, diagnosis, and management of acute kidney injury in patients with SARS CoV2 / COVID-19 infection. Materials and methods: Based on a rapid systematic review in Embase and Pubmed databases and documents from scientific societies, we made preliminary recommendations and consulted with an expert group through an online tool. Then we defined agreement after at least 70 % consensus approval. Quality evidence was evaluated according to the type of document included. The strength of the recommendations was graded as strong or weak. Results: Fifty clinical experts declared their conflict of interest; the consultation took place between May 2 and 29, 2020. The range of agreement ranged from 75.5 % to 100 %. Recommendations for prevention, diagnosis and management of acute kidney injury in patients with SARS CoV2 infection are presented. Conclusions: Although the good quality information available regarding acute kidney injury in patients with COVID-19 is scarce, the recommendations of clinical experts will guide clinical decision-making and strategies around patients with this complication, guaranteeing care focused on the people, with high quality standards, and the generation of safety, health and wellness policies for multidisciplinary care teams.

Consenso colombiano de expertos sobre recomendaciones informadas en la evidencia para la prevención, el diagnóstico y el manejo de la infección por SARS-CoV-2/COVID-19 en pacientes con Enfermedad Renal Crónica en diálisis / Colombian Expert Consensus on Evidence-Informed Recommendations for the Prevention, Diagnosis, and Management of SARS-CoV-2 / COVID-19 Infection in Patients with Chronic Kidney Disease on Dialysis

Resumen Introducción: Las personas con diálisis de mantenimiento se consideran una población en alto riesgo de infección por SARS-CoV-2, complicaciones y muerte. La periodicidad de la diálisis, la organización y la demanda en las unidades de diálisis y las limitaciones de alfabetización en salud poblacional limitan el cumplimiento del aislamiento y el distanciamiento social. Objetivo: Desarrollar, mediante un consenso de expertos, recomendaciones informadas en evidencia para la prevención, el diagnóstico y el manejo de la infección por SARS-CoV-2/COVID-19 en pacientes con enfermedad renal crónica. Materiales y métodos: Se realizó una revisión rápida de literatura en Pubmed, Embase y sociedades científicas. La calidad de evidencia fue evaluada según el tipo de estudio incluido. El acuerdo se definió para cada recomendación con umbral de al menos 70% de aprobación. La fuerza de las recomendaciones fue graduada como fuerte o débil. Resultados: El colectivo fue consultado entre el 17 y 19 de mayo de 2020. Se obtuvo respuesta de 44 expertos clínicos que declararon conflicto de interés previo a la consulta. El acuerdo de las recomendaciones estuvo entre 70,5 y 100%. Se presentan las recomendaciones de un colectivo experto para la prevención, el diagnóstico y el manejo de infección por SARS-CoV-2/COVID-19 en pacientes con enfermedad renal crónica. Conclusión: Debido a la reciente aparición de la infección por SARS-CoV-2 y las incertidumbres respecto a la prevención, el diagnóstico y el manejo, las recomendaciones presentadas se conciben como un estándar colombiano que permita garantizar un cuidado centrado en las personas con enfermedad renal crónica y la protección de los profesionales de la salud.

Abstract Introduction: People with chronic dialysis are considered a population at high risk of SARS CoV2 infection and its derived complications and death. The need to go to strict dialysis schedules, the high demand in the kidney facilities and the difficulties derived from the time and space organization in the rooms in the face to the pandemic added to the difficult learning, teaching and adapting new protocols manifest the needed of standard recommendation according to this problem in people who couldn't have an ideal isolation. Objective: Develop through an expert consensus, evidence-informed recommendations for the prevention, diagnosis, and management of SARS-CoV-2/COVID-19 infection in patients with chronic kidney disease on Dialysis. Materials and methods: We carried out a quick literature review, PubMed, Embase and scientific societies were consulted. The quality of the evidence was considered according to the type of study included. The agreement threshold defined for each recommendation was > 70% approval among experts. The strength of the recommendations was rated as strong or weak. Results: Between May 17 and 19, 2020, was conformed a team of 44 clinical experts who declared their interest conflict prior to the consultation. The agreement of the recommendations was between 70.5% and 100%. The recommendations were separated in prevention, early identification, and diagnostic, isolation in hemodialysis facilities and peritoneal dialysis, and team protection. Ethical considerations also were included. Conclusion: Due to the recent appearance of SARS-CoV-2 infection and the uncertainties regarding prevention, diagnosis and management, the recommendations presented are conceived as a Colombian standard that allows guaranteeing focused care for people with chronic kidney disease and the protection of health team.

Predicting the evolution of the COVID-19 epidemic with the A-SIR model: Lombardy, Italy and São Paulo state, Brazil.

The presence of a large number of infected individuals with few or no symptoms is an important epidemiological difficulty and the main mathematical feature of COVID-19. The A-SIR model, i.e. a SIR (Susceptible-Infected-Removed) model with a compartment for infected individuals with no symptoms or few symptoms was proposed by Gaeta (2020). In this paper we investigate a slightly generalized version of the same model and propose a scheme for fitting the parameters of the model to real data using the time series only of the deceased individuals. The scheme is applied to the concrete cases of Lombardy, Italy and São Paulo state, Brazil, showing different aspects of the epidemic. In both cases we see strong evidence that the adoption of social distancing measures contributed to a slower increase in the number of deceased individuals when compared to the baseline of no reduction in the infection rate. Both for Lombardy and São Paulo we show that we may have good fits to the data up to the present, but with very large differences in the future behavior. The reasons behind such disparate outcomes are the uncertainty on the value of a key parameter, the probability that an infected individual is fully symptomatic, and on the intensity of the social distancing measures adopted. This conclusion enforces the necessity of trying to determine the real number of infected individuals in a population, symptomatic or asymptomatic.

Non-lupus full house nephropathy in pediatrics: Case reports / Nefropatía full house no lúpica en pediatría: reporte de dos casos.

Full house nephropathy is defined as the simultaneous detection of IgA, IgG, IgM, C3, and C1q deposits by immunofluorescence, usually indicating lupus nephritis. There are patients with this immunofluorescence pattern, but with negative autoantibody serology, which means they cannot be diagnosed with systemic lupus erythematosus. Patients presenting with full house nephropathy but no other criteria for lupus are diagnosed as having nonlupus full house nephropathy. Here, we describe two cases: A male patient who debuted with rapidly progressive glomerulonephritis and a female patient with nephrotic syndrome. Both had negative autoantibody serology, findings in the renal biopsy of class IV lupus nephritis and afull house immunofluorescence pattern. Histological findings in non-lupus full house nephropathy are similar to those in lupus nephritis and, probably, similar physiopathological bases. However, prospective studies are needed to determine risk factors and the renal prognosis and to make suggestions for specific treatments.

La nefropatía full house se refiere a la detección simultánea de depósitos de IgA, IgG, IgM, C3 y C1q en la inmunofluorescencia, lo que generalmente indica la presencia de nefritis lúpica. Hay pacientes con este patrón de inmunofluorescencia, pero con serología negativa para autoanticuerpos, por lo que no se les puede diagnosticar un lupus eritematoso sistémico. Este tipo de nefropatía, en la que no se presentan otros criterios para lupus, se denomina nefropatía full house no lúpica. En esta presentación, se describen dos casos: un paciente que ingresó con una glomerulonefritis rápidamente progresiva y una paciente con síndrome nefrótico, ambos con serología negativa para autoanticuerpos, hallazgos en la biopsia renal indicativos de nefritis lúpica de clase IV y un patrón full house en la inmunofluorescencia. La nefropatía full house no lúpica tiene rasgos histológicos similares a los de la nefritis lúpica y, probablemente, sus bases fisiopatológicas son parecidas. Sin embargo, se necesitan estudios prospectivos para conocer los factores de riesgo y el pronóstico renal, y poder hacer sugerencias sobre tratamientos específicos.

Bovine Interferon-Tau Activates Type I interferon-Associated Janus-signal Transducer in HPV16-positive Tumor Cell.

The mechanisms of signal transduction by interferon-tau (IFN-τ) are widely known during the gestation of ruminants. In trophoblast cells, IFN-τ involves the activation of the JAK-STAT pathway, and it can have effects on other cell types, such as tumor cells. Here we report that the HPV16-positive BMK-16/myc cell treated with ovine IFN-τ, results in the activation of the canonical JAK-STAT and non-canonical JAK-STAT pathway. The MAPK signaling pathway was activated, we detected the proteins MEK1, MEK2, Raf1, STAT3, STA4, STAT5 and STAT6. Moreover, IFN-τ induced the expression of MHC Class I, MX and IP10 in the tumor cells and this response may be associated with the viral replication and with the anti-proliferative and the immunoregulatory effects of IFN-τ.

Kinesthetic stimulation for obstructive sleep apnea syndrome: An "on-off" proof of concept trial.

Obstructive sleep apnea (OSA) occurs when the upper airway narrows or collapses due to the loss of upper airway muscle activation at sleep onset. This study investigated the effectiveness of triggered kinesthetic stimulation in patients with OSA. This proof-of-concept, open-label, multicenter prospective study was conducted on 24 patients with severe OSA. During a one night evaluation, kinesthetic stimulation was intermittently delivered in 30 minute periods. The duration of apneas and hypopneas during Stim on and Stim off periods were compared. Five hospital-based university centers in France participated. Sleep studies were evaluated by a single scorer at a core laboratory (CHU Grenoble). Results show that during the Stim on phases, statistically significant decreases in durations of apneas and hypopneas were observed in 56% and 46% of patients, respectively. Overall, 75% of patients showed an improvement in apneas or hypopneas durations. The mean reduction in durations for patients with a significant decrease was 4.86 seconds for apneas and 6.00 seconds for hypopneas. This proof of concept study is the first to identify kinesthetic stimulation as a potentially effective therapy for OSA. These data justify evaluation in a controlled study.

Knotless choledochorraphy with barbed suture, safe and feasible.

PURPOSE: To describe the safety and feasibility of a running continuous unidirectional barbed suture (V-Loc, Covidien, Mansfield, MA) for primary common bile duct closure while performing laparoscopic common bile duct exploration (LCBDE). INTRODUCTION: LCBDE is nowadays the best approach for treating complex common bile duct lithiasis or cases where the endoscopic retrograde cholangiopancreatography has failed. It is clear that the primary closure of the common bile duct must be preferred over the T-tube drainage. The actual technical aspects offer room for improvement. We present our experience with barbed suture, for which recently, various fields of surgery have become interested in and which now has a series of studies that support it for several uses. METHODS: Between July 2012 and July 2014, 54 consecutive patients with bile duct stones underwent LCBDE by a single surgeon. Perioperative outcomes and 30-day complications were recorded. RESULTS: Upon the completion of the exploration, 50 patients had primary common bile duct closure using knotless unidirectional barbed 3-0 V-Loc 90 suture, and 4 patients were excluded. All of the sutures were performed without knot tying. The procedure in all patients was successfully performed with no intraoperative complications. There were no bile leaks in the 50 patients or other postoperative complications such as infection, need for reintervention or death. CONCLUSION: The use of unidirectional knotless barbed suture (V-Loc 90) is safe, feasible and effective on LCBDE for primary common bile duct closure. The biliary leak rate is acceptably low and comparable to the rate reported in the literature. This report is our initial experience that needs further clinical trials.

Nephritic syndrome associated to skin infection, hepatitis A, and pneumonia: a case report / Síndrome nefrítico asociado con infección cutánea, hepatitis A y neumonía: informe de un caso

Introduction: Glomerulonephritis is the most common cause of acute and chronic renal disease. The prototype of acute glomerulonephritis is acute post-infectious glomerulonephritis. Recently, increased cases of glomerulopathy have been associated with bacterial, viral, and other infections. Acute nephritic syndrome is part of glomerulonephritis with an acute beginning, characterized by hematuria, hypertension, edema, and oliguria due to the reduction of glomerular filtration reflected in an increase of nitrogen compounds.Development: This paper shows a male infant at 2 years and 7 months of age with nephritic syndrome associated to a skin infection, pneumonia, and hepatitis A virus infection. Conclusion: Acute glomerulonephritis may be associated to streptococcus or another coincidental infection. Children with skin infection, hepatitis A, or pneumonia who reveal abnormal urinalysis, hypertension, azotemia, or oliguria should be evaluated for concomitant glomerulonephritis.

Introducción: La glomerulonefritis es la causa más frecuente de enfermedad renal aguda y crónica. El prototipo de la glomerulonefritis aguda es la glomerulonefritis aguda post-infecciosa. Recientemente, se ha asociado un aumento en la cantidad de glomerulopatías con infecciones bacterianas, virales y otras. El síndrome nefrítico agudo hace parte de las glomerulonefritis de comienzo agudo, caracterizado por hematuria, hipertensión arterial, edema, oliguria y disminución de la filtración glomerular con la retención de productos azoados.Desarrollo: Se presenta un niño de 2 años y 7 meses de edad con síndrome nefrítico asociado con infección cutánea, neumonía e infección por virus de la hepatitis A. Conclusión: La glomerulonefritis aguda puede estar asociada con estreptococo solamente o con otra infección coincidental. Los niños con infección cutánea, hepatitis viral o neumonía, que hayan presentando anormalidades en el uro análisis, hipertensión, azohemia u oliguria, se deben evaluar para glomerulonefritis asociada.