Chronic renal failure in pediatrics 1996. Chilean survey.

The Nephrology Branch of the Chilean Pediatric Society has greatly influenced the development of government health plans regarding the management and care of patients under 18 years with chronic renal failure (CRF). In order to assess the status of children with CRF in Chile up to 1996, a questionnaire was sent to all pediatric nephrologists in charge of those children. The total sample was of 227 patients under 18 years, giving a national prevalence of 42.5 and an incidence of 5.7 per million inhabitants; of these patients, 50.7% were male, 58.6% over 10 years and 15% younger than 5 years. The most frequent etiologies of CRF were: obstructive uropathy, 18.1%; hypo/dysplasia, 16.7%; reflux nephropathy, 16.7%; and glomerulopathies, 16.3%. Although 48% of patients were on conservative medical treatment, 42.2% of these were in end-stage renal disease, 22.9% were on dialysis, and 29.1% had undergone renal transplantation. Of the dialysis group, 75% were on peritoneal dialysis. Of the transplanted children, 78.8% had normal renal function, but 16.7% returned to dialysis. Three-year graft survival and patient survival were 68% and 94%, respectively.

[Enzymatic mechanisms of resistance to aminoglycoside antibiotics in gram negative bacilli from Chilean hospitals]. / Mecanismos enzimáticos de resistencia a antibióticos aminoglicósidos en bacilos gram negativos de hospitales chilenos.

The presence of aminoglycoside modifying enzymes (AMEs) has been investigated, by an agar diffusion method, in 344 strains of aminoglycoside-resistant Gram negative bacilli isolated in different Chilean hospitals. Most of the strains exhibited a combination of enzymatic mechanism of resistance, but two acetylating (AAC(3)II and AAC(6')I) and one phosphorylating (APH(3')I) enzymes were the main mechanism detected in the strains. A significant increase in the frequency of strains producing AAC(6')I, possible due to wide use of amikacin, has been found when results were compared with those of a report published in 1985.

[Anemia associated with acute post streptococcal glomerulonephritis]. / La anemia de la glomerulonefritis aguda post-estreptocócica.

Thirty-three children with post-streptococcal acute glomerulonephritis, age mean: 8.3 years (range: 6 - 12) were studied prospectively. Mean initial hematocrit (Hct) was 31.6% with 90% showing Hct under the normal lower limit for this age group. Reticulocyte index (RI) was < 0.5 in half of the cases. Serum iron concentration, total iron binding capacity (TIBC) and percentage of transferrin saturation were normal for this age group although 75% of the children had increased serum ferritin levels. At the time of discharge, Hct increased to 35.1% but 44% still had anemia. Hct increased spontaneously for 105 days stabilizing at 38%. Based on Hct changes, 3 groups were defined: Group I (3 individuals): normal upon discharge; Group II (19): partial recovery at discharge, slow recovery stabilizing after 105 days; Group III (11): lower Hct, slower recovery but with RI significantly higher than group II (0.96 vs 0.45 p < 0.01). Our data suggest that although hemodilution is present in all, it may be considered the solely factor only in 3 cases (Group I). In group II, evidence of bone marrow depression was indicated by the low RI. On the other hand, the intense anemia that could not be justified only by hemodilution and marrow depression in group III, suggests other pathogenic factors.

A diallel analysis of gregarious oviposition in Drosophila melanogaster.

Drosophila females exhibit gregarious oviposition. This behaviour was analysed by a diallel cross. The trait shows considerable additive genetic variation and a significant dominant effect. A variance and covariance analysis suggests that ebony and taxi strains contain the most dominant alleles. Some maternal effect may also be present. This genetical architecture is in line with previous studies of selection and hybridization of the lines selected for high and low gregarious oviposition in Drosophila melanogaster females.

Herpes simplex virus and cytomegalovirus in pregnant Chilean university students.

Virus isolation tests were performed during the first, second, and third trimesters of pregnancy on a group of 163 students who received prenatal care at the University of Chile's Student Medical and Dental Service to determine the possible existence of genital herpes or cytomegalovirus infections. Vaginal secretion samples tested for herpes simplex virus (HSV) and urine samples tested for cytomegalovirus (CMV) were inoculated onto cell cultures and examined by immunofluorescent procedures using monoclonal antibodies. HSV was detected in five subjects, only one of whom had herpetic lesions, and was identified as type 2 in all cases. Cytomegalovirus was detected in seven subjects.

[Herpes simplex virus and cytomegalovirus in pregnant Chilean university students]. / Virus del herpes simple y citomegalovirus en universitarias chilenas embarazadas.

Virus isolation tests were performed on a group of 163 students who received prenatal care at the Student Medical and Dental Service at the University of Chile (Santiago) during the 1st, 2nd, and 3rd trimesters of pregnancy to determine the possible existence of genital herpes infection (isolation from vaginal secretions) or cytomegalovirus infection (isolation from urine). The samples were inoculated on cell cultures and were then studied using immunofluorescence with monoclonal antibodies. The herpes simplex virus (HSV) was detected in the vaginal secretions of 5 pregnant women, only one of whom had herpes lesions; in all these cases, the virus isolated was HSV type 2. Cytomegalovirus was detected in 7 of the pregnant women.

[Characteristics of herpes genitalis in university women]. / Características del herpes genital en mujeres universitarias.

We analyzed 33 patients with herpes genitalis diagnosed at a student medical outpatient facility. 42% corresponded to a first herpetic infection. The HSV-1 was present in 43% of cases, the HSV-2 in the rest. Recurrence of infection was present in 39.5% of patients, 70% of them due to HSV-2. There was a relatively high rate of asymptomatic couples who were the source of primary herpetic infection.

[A combination of ampicillin and sulbactam: effect on aerobic and anaerobic gram-negative bacteria]. / Asociación ampicilina y sulbactam: actividad sobre bacilos gram negativos aerobios y anaerobios.

The antibacterial activity of the association of ampicillin and sulbactam (2:1) upon strains of aerobic and anaerobic Gram negative agents was assayed. Inhibition of B-lactamases from intact and disrupted cells of some selected strains by sulbactam was also determined. Susceptibility was found in 34% and partial inhibition in 48%; 18% were fully resistant. Synergy between ampicillin and sulbactam was found upon ampicillin susceptible strains. This effect might reflect higher degree of binding of the inhibitor to PBP's in the absence of a trapping effect produced by B-lactamases. Anaerobic microorganisms were found to be highly susceptible to this association of B-lactams. Adequate penetration of the inhibitor into periplasmic space of Gram negative bacilli was deduced by the similar decrease of B-lactamase activity observed in intact and disrupted cells treated with sulbactam.

[Genital herpes infection in Chilean female university students]. / Infección genital herpética en estudiantes universitarias Chilenas.

This article reports on the prevalence of genital herpes infection in a sample of 635 female university students who were seen at the Gynecology Center of the University of Chile Student Medical Service. Viral isolation of genital secretions yielded 18 students (2.8%) with positive results, of whom 28% were asymptomatic shedders. Of the positive cases, 61% were clinically classified as recurrent and 39% as first episodes of genital herpes. Fluorescent monoclonal antibody typing of the isolated strains revealed that 72% were herpes simplex type 2 and 28% were type 1. The results confirm the importance of type 2 virus in genital herpes infections. They also point to asymptomatic shedders as a potential source of infection, and show the importance of a history of genital herpes in the identification of this population.

[Blood pressure measurement with Doppler in normal newborn infants and infants]. / Medición de presión arterial con Doppler en recién nacidos y lactantes normales.

Systolic blood pressure (SBP) was measured by Doppler method in an aleatory sample of 251 healthy children from south-east Santiago Chile (131 females and 120 males) which were divided by age in five groups: 0 to 28 days (n = 5) 1 to 5 months (n = 48), 6 to 11 months (n = 48), 12 to 17 months (n = 46) and 18 to 24 months (n = 45). Great dispersion of SBP values occurred among newborn infants (range 85 to 125) in comparison with groups 1 to 5 months (105 to 130), 6 to 11 months (118 to 130). Fifty and 95 percentiles were, respectively, 107 to 125; 116 to 130; 121 to 130; 118 to 130 and 120 to 130. These values were greater than those obtained by sphygmomanometry in a similar matched group of children.

Bacteriological studies with ampicillin/sulbactam on selected strains of gram-negative bacteria.

Antibacterial activity of sulbactam or ampicillin alone and in combination on ampicillin-resistant, beta-lactamase-producing Gram-negative bacteria (Citrobacter freundii and Escherichia coli) was studied. Inhibition of beta-lactamase activity by sulbactam was investigated using intact and disrupted cells. Minimal inhibitory concentrations of ampicillin were high but decreased significantly in the presence of sulbactam. Similar enzyme inhibition was observed with intact and disrupted bacterial cells, thus indicating efficient penetration by sulbactam into the periplasmic space. Bacterial killing was achieved in approximately 4 hrs with ampicillin/sulbactam at concentrations that neither killed nor inhibited the same strains when the drugs were used alone. Sulbactam was more effective against plasmid-cured strain of E. coli than the same plasmid-containing organism.

Sindrome hemolitico uremico. / Hemolytic uremic syndrome

Se realizo un estudio retrospectivo en 14 lactantes hospitalizados en el Servicio de Pediatria del Hospital Sotero del Rio, durante el periodo Enero 1979 a Marzo 1983, dados de alta con diagnostico de S.H.U. Efectuamos en analisis de los parametros clinicos y de laboatorio en cada uno de los pacientes, ademas de discutir el manejo terapeutico, indicaciones de dialisis y sus complicaciones. Se incluye la descripcion de un caso clinico como prototipo de sindrome. Proponemos la dialisis peritoneal precoz para el tratamiento del S.H.U.guiados por la evolucion de la anuria. Se analiza finalmente los actuales conceptos etiopatogenicos de sindrome