Epidemiological and microbiological characteristics of S. aureus pediatric infections in Colombia 2018-2021, a national multicenter study (Staphylored Colombia).

Background: Staphylococcus aureus infections are a significant cause of morbidity and mortality in pediatric populations worldwide. The Staphylo Research Network conducted an extensive study on pediatric patients across Colombia from 2018 to 2021. The aim of this study was to describe the epidemiological and microbiological characteristics of S. aureus in this patient group. Methods: We analyzed S. aureus isolates from WHONET-reporting centers. An "event" was a positive culture isolation in a previously negative individual after 2 weeks. We studied center characteristics, age distribution, infection type, and antibiotic susceptibilities, comparing methicillin sensitive (MSSA) and resistant S. aureus (MRSA) isolates. Results: Isolates from 20 centers across 7 Colombian cities were included. Most centers (80%) served both adults and children, with 55% offering oncology services and 85% having a PICU. We registered 8,157 S. aureus culture isolations from 5,384 events (3,345 MSSA and 1,961 MRSA) in 4,821 patients, with a median age of 5 years. Blood (26.2%) and skin/soft tissue (18.6%) were the most common infection sources. Most isolates per event remained susceptible to oxacillin (63.2%), clindamycin (94.3%), and TMP-SMX (98.3%). MRSA prevalence varied by city (<0.001), with slightly higher rates observed in exclusively pediatric hospitals. In contrast, the MRSA rate was somewhat lower in centers with Antimicrobial Stewardship Program (ASP). MRSA was predominantly isolated from osteoarticular infections and multiple foci, while MSSA was more frequently associated with recurrent infections compared to MRSA. Conclusions: This is the largest study of pediatric S. aureus infections in Colombia. We found MSSA predominance, but resistance have important regional variations. S. aureus remains susceptible to other commonly used antibiotics such as TMP-SMX and clindamycin. Ongoing monitoring of S. aureus infections is vital for understanding their behavior in children. Prospective studies within the Staphylored LATAM are underway for a more comprehensive clinical and genetic characterization.

Severe adenovirus infection outbreak in Colombia: Experience from a tertiary pediatric hospital in 2022. / Brote de adenovirus grave en Colombia: experiencia de un hospital pediátrico de tercer nivel en 2022

Introduction. During the SARS-CoV-2 pandemic, many countries experienced decreased respiratory virus circulation, followed by an out-of-season outbreak. In a pediatric hospital in Colombia, we observed a surge in severe adenovirus infections, leading to concerns about the impact of eased public health restrictions and immune debt in children under five years old. Objective. To describe the clinical characteristics of patients with severe adenovirus infection in a pediatric hospital in Colombia. Materials and methods. We reviewed the data of 227 patients with severe adenovirus infection at the Fundación Hospital Pediátrico La Misericordia. Results. A total of 196 patients were included in this study. The median age was two years, and 62% were male. Adenoviruses were isolated from all patients' samples. Ninetyseven percent were admitted to the pediatric intensive care unit, 94% required respiratory support, and the in-hospital lethality rate was 11%. Conclusion. In 2022, there was an outbreak of severe adenovirus infections, affecting mainly children under five years of age, with higher-than-usual mortality.

Introducción. Durante la pandemia por SARS-CoV-2, muchos países evidenciaron una disminución en la circulación de virus respiratorios, seguida por un brote fuera de la temporada esperada. En un hospital de Colombia, se observó un aumento en los casos de infección grave por adenovirus, lo cual generó preocupación sobre el impacto que tuvo la disminución de los cuidados establecidos durante pandemia y la posible deuda inmunológica en niños menores de cinco años. Objetivo. Describir las características clínicas de los pacientes con infección grave por adenovirus en un hospital pediátrico de Colombia. Materiales y métodos. Se revisaron 227 pacientes con infección grave por adenovirus en la Fundación Hospital Pediátrico La Misericordia, desde el 1° de enero hasta el 31 de diciembre de 2022. Resultados. El estudio incluyó 196 casos. La edad media de los pacientes fue de dos años y el 62 % eran de sexo masculino. Los adenovirus se aislaron a partir de las muestras de todos los pacientes. El 97 % de los pacientes ingresó a la unidad de cuidados intensivos, el 94 % requirió soporte ventilatorio y la tasa de mortalidad fue del 11 %. Conclusiones. En el 2022 hubo un brote de adenovirus que afectó principalmente a los niños menores de cinco años, con una mortalidad mayor a lo reportado con anterioridad en Colombia.

A Protease-Responsive Polymer/Peptide Conjugate and Reversible Assembly of Silver Clusters for the Detection of Porphyromonas gingivalis Enzymatic Activity.

We report the reversible aggregation of silver nanoparticle (AgNP) assemblies using the combination of a cationic arginine-based peptide and sulfur-capped polyethylene glycol (PEG). The formation and dissociation of the aggregates were studied by optical methods and electron microscopy. The dissociation of silver clusters depends on the peptide sequence and PEG size. A molecular weight of 1 kDa for PEG was optimal for the dissociation. The most important feature of this dissociation method is that it can operate in complex biofluids such as plasma, saliva, bile, urine, cell media, or even seawater without a significant decrease in performance. Moreover, the peptide-particle assemblies are highly stable and do not degrade (or express of loss of signal upon dissociation) when dried and resolubilized, frozen and thawed, or left in daylight for a month. Importantly, the dissociation capacity of PEG can be reduced via the conjugation of a peptide-cleavable substrate. The dissociation capacity is restored in the presence of an enzyme. Based on these findings, we designed a PEG-peptide hybrid molecule specific to the Porphyromonas gingivalis protease RgpB. Our motivation was that this bacterium is a key pathogen in periodontitis, and RgpB activity has been correlated with chronic diseases including Alzheimer's disease. The RgpB limit of detection was 100 pM RgpB in vitro. This system was used to measure RgpB in gingival crevicular fluid (GCF) samples with a detection rate of 40% with 0% false negatives versus PCR for P. gingivalis (n = 37). The combination of PEG-peptide and nanoparticles dissociation method allows the development of convenient protease sensing that can operate independently of the media composition.

Development of subunit selective substrates for Trichomonas vaginalis proteasome.

The protozoan parasite, Trichomonas vaginalis (Tv) causes trichomoniasis, the most common, non-viral, sexually transmitted infection in the world. Only two closely related drugs are approved for its treatment. The accelerating emergence of resistance to these drugs and lack of alternative treatment options poses an increasing threat to public health. There is an urgent need for novel effective anti-parasitic compounds. The proteasome is a critical enzyme for T. vaginalis survival and was validated as a drug target to treat trichomoniasis. However, to develop potent inhibitors of the T. vaginalis proteasome, it is essential that we understand which subunits should be targeted. Previously, we identified two fluorogenic substrates that were cleaved by T. vaginalis proteasome, however after isolating the enzyme complex and performing an in-depth substrate specificity study, we have now designed three fluorogenic reporter substrates that are each specific for one catalytic subunit. We screened a library of peptide epoxyketone inhibitors against the live parasite and evaluated which subunits are targeted by the top hits. Together we show that targeting of the ß5 subunit of T. vaginalis is sufficient to kill the parasite, however, targeting of ß5 plus either ß1 or ß2 results in improved potency.

Multisystem Inflammatory Syndrome in Children (MIS-C) temporally related to COVID-19: the experience at a pediatric reference hospital in Colombia / Síndrome inflamatória multissistêmica em criança associada à COVID-19: experiência em um hospital pediátrico de referência na Colômbia

Abstract Objective: This study aimed to describe the clinical characteristics and the different phenotypes of children with multisystem inflammatory syndrome in children (MIS-C) temporally related to COVID-19 and to evaluate the risk conditions that favored a greater severity of the disease during a 12-month period at a pediatric reference hospital in Colombia. Methods: A 12-month retrospective observational study of children under the age of 18 years who met criteria for MIS-C. Results: A total of 28 children presented MIS-C criteria. The median age was 7 years. Other than fever (100%) (onset 4 days prior to admission), the most frequent clinical features were gastrointestinal (86%) and mucocutaneous (61%). Notably, 14 (50%) children had Kawasaki-like symptoms. The most frequent echocardiographic abnormalities were pericardial effusion (64%), valvular involvement (68%), ventricular dysfunction (39%), and coronary artery abnormalities (29%). In addition, 75% had lymphopenia. All had at least one abnormal coagulation test. Most received intravenous immunoglobulin (89%), glucocorticoids (82%), vasopressors (54%), and antibiotics (64%). Notably, 61% had a more severe form of the disease and were admitted to an intensive care unit (median 4 days, mean 6 days); the severity predictors were patients with the inflammatory/MIS-C phenotype (OR 26.5; 95%CI 1.40-503.7; p=0.029) and rash (OR 14.7; 95%CI 1.2-178.7; p=0.034). Two patients had macrophage activation syndrome. Conclusions: Coronary artery abnormalities, ventricular dysfunction, and intensive care unit admission were frequent, which needs to highlight the importance of early clinical suspicion.

Resumo Objetivo: Descrever as características clínicas e os diferentes fenótipos de crianças com síndrome inflamatória multissistêmica na criança temporalmente relacionada com a COVID-19 (do inglês multisystem inflammatory syndrome in children — MIS-C) e avaliar as condições de risco que favorecem a maior gravidade da doença durante um período de 12 meses em um hospital pediátrico de referência na Colômbia. Métodos: Estudo retrospectivo de 12 meses de observação de crianças menores de 18 anos que cumprem os critérios para o MIS-C. Resultados: Vinte e oito crianças foram apresentadas com os critérios do MIS-C. A idade média era de sete anos, e 54% eram do sexo masculino. Para além da febre (100%) (com início quatro dias antes da admissão), as características clínicas mais frequentes eram gastrointestinais (86%) e mucocutâneas (61%). Quatorze crianças (50%) apresentavam sintomas semelhantes aos de Kawasaki. As anomalias ecocardiográficas mais frequentes foram derrame pericárdico (64%), envolvimento valvar (68%), disfunção ventricular (39%) e anomalias coronárias (29%). Tinham linfopenia 75% das crianças. Todas tinham algum teste de coagulação anormal. A maioria recebeu imunoglobulina intravenosa (89%), glucocorticoides (82%), vasopressores (54%) e antibióticos (64%). Tiveram envolvimento mais grave 61% dos pacientes, que precisaram ser internados em unidade de terapia intensiva (mediana de quatro dias, média de seis dias); os preditores de gravidade foram pacientes com fenótipo inflamatório/ MIS-C (odds ratio — OR 26,5; intervalo de confiança — IC95% 1,4-503,7; p=0,029) e erupção cutânea (OR 14,7; IC95% 1,2-178,7; p=0,034). Dois pacientes (7%) apresentavam síndrome de ativação macrofágica. Conclusões: Alteração da artéria coronária, disfunção ventricular e internação na unidade de terapia intensiva foram frequentes, o que nos alerta sobre a importância da suspeita clínica precoce.

Multisystem Inflammatory Syndrome in Children (MIS-C) temporally related to COVID-19: the experience at a pediatric reference hospital in Colombia.

OBJECTIVE: This study aimed to describe the clinical characteristics and the different phenotypes of children with multisystem inflammatory syndrome in children (MIS-C) temporally related to COVID-19 and to evaluate the risk conditions that favored a greater severity of the disease during a 12-month period at a pediatric reference hospital in Colombia. METHODS: A 12-month retrospective observational study of children under the age of 18 years who met criteria for MIS-C. RESULTS: A total of 28 children presented MIS-C criteria. The median age was 7 years. Other than fever (100%) (onset 4 days prior to admission), the most frequent clinical features were gastrointestinal (86%) and mucocutaneous (61%). Notably, 14 (50%) children had Kawasaki-like symptoms. The most frequent echocardiographic abnormalities were pericardial effusion (64%), valvular involvement (68%), ventricular dysfunction (39%), and coronary artery abnormalities (29%). In addition, 75% had lymphopenia. All had at least one abnormal coagulation test. Most received intravenous immunoglobulin (89%), glucocorticoids (82%), vasopressors (54%), and antibiotics (64%). Notably, 61% had a more severe form of the disease and were admitted to an intensive care unit (median 4 days, mean 6 days); the severity predictors were patients with the inflammatory/MIS-C phenotype (OR 26.5; 95%CI 1.40-503.7; p=0.029) and rash (OR 14.7; 95%CI 1.2-178.7; p=0.034). Two patients had macrophage activation syndrome. CONCLUSIONS: Coronary artery abnormalities, ventricular dysfunction, and intensive care unit admission were frequent, which needs to highlight the importance of early clinical suspicion.

Respiratory pathogens in children with acute lower respiratory infection detected through multiplex real-time PCR / Patógenos respiratorios en niños con infección respiratoria aguda baja detectados mediante PCR multiplex en tiempo real

Abstract Introduction: Acute respiratory infection in children has a high burden of disease. Detection of multiple micro -organisms through molecular testing of nasopharyngeal swab samples could change the paradigm of a single pathogen being the cause of respiratory disease in children and prove its usefulness in clinical practice. Objective: To characterize the pathogens identified in nasopharyngeal swab samples by means of multiplex realtime polymerase chain reaction (RT-PCR), as well as clinical variables and laboratory findings in children <5 years diagnosed with acute lower respiratory tract infection (ALRTI) and hospitalized in Bogotá D.C., Colombia. Materials and methods: Cross-sectional study conducted in 81 children hospitalized between September 2019 and March 2020 at the Clínica Cafam and in whom nasopharyngeal swab samples were collected for microbiological identification using the Allplex™ multiplex RT-PCR assay. Correlations between the number of pathogens and blood cells and C-reactive protein levels were determined by Spearman's rank correlation coefficient. Results: Patients' mean age was 17.23 months (±14.44), 54.32% were males, and 51.85% were young infants. A total of 149 microorganisms (60.40% viruses) were identified in 63 children (77.78%). Mixed infection and coinfection were reported in 48.15% and 11.11% of children, respectively. Regarding clinical findings, shortness of breath, upper airway obstruction, cough, fever and pharyngitis were the most common clinical signs and/or symptoms in patients with mixed infection (32.97%), coinfection (64.40%), mixed infection (29.78%), and absence of microorganism (22.00%), respectively. A negative correlation was observed between the number of leukocytes and the number of neutrophils and the number of microorganisms detected in the preschoolers group (r=-0.46; p =0.058 and r=-0.51; p =0.033, respectively). Furthermore, a positive correlation was found between monocyte count and the number of microorganisms detected (r=0.53; p =0.0096). Conclusion: Multiplex RT-PCR assay allowed the identification of microorganisms in most children, as well as cases of mixed infection and coinfection in more than half of the sample. In addition, clinical findings in these children were highly heterogeneous as per the assay result..

Resumen Introducción. La infección respiratoria aguda en niños tiene una alta carga de enfermedad. La detección de múltiples microorganismos a través de pruebas moleculares en hisopados nasales podría cambiar el paradigma de patógeno único causal de enfermedad respiratoria en niños y ser de utilidad en la práctica clínica. Objetivo. Caracterizar los patógenos identificados mediante la técnica de reacción en cadena de polimerasa multiplex en tiempo real (RT-PCR) en hisopado nasal, así como las variables clínicas y los resultados de laboratorio en niños <5 años diagnosticados con infección respiratoria aguda baja (IRAB) y hospitalizados en Bogotá D.C., Colombia. Materiales y métodos. Estudio transversal realizado en 81 niños hospitalizados entre septiembre de 2019 y marzo de 2020 en la clínica Cafam y en quienes se hizo hisopado nasal para realizar la identificación microbiològica mediante la prueba RT-PCR multiplex Allplex. Las correlaciones entre el número de patógenos y los niveles de células del hemograma y el nivel de proteína C reactiva se determinaron mediante el coeficiente de correlación de Spearman. Resultados. La edad promedio fue 17.23 meses (±14.44), 54.32% fueron varones y 51.85%, lactantes menores. Se identificaron 149 microorganismos (60.40% virus) en 63 niños (77.78%). Hubo infección mixta en el 48.15% y coinfección en 11.11% de los niños. Respecto a los hallazgos clínicos, la dificultad respiratoria, la obstrucción de la vía respiratoria alta, la tos, la fiebre y la faringitis fueron más comunes en los casos de infección mixta (32.97%), ausencia de microorganismo (16.00%), coinfección (64.40%), infección mixta (29.78%) y ausencia de microorganismo (22.00%), respectivamente. Se observó una correlación negativa entre el número de leucocitos y neutrófilos y el número de microorganismos detectados en preescolares (r=-0.46; p=0.058 y r=-0.51; p=0.033) y una positiva entre el recuento de monocitos y el número de microorganismos detectados (r=0.53; p =0.0096). Conclusión. La prueba RT-PCR multiplex permitió identificar microorganismos en la mayoría de niños, así como casos de infección mixta y coinfección en más de la mitad de la muestra. Además, los hallazgos clínicos fueron altamente heterogéneos entre los niños según el resultado de la prueba.

Tuberculosis of the ribcage by dissemination of Koch bacilli.

INTRODUCTION: Tuberculosis (TB) is an infectious, transmissible and immune disease caused by the Mycobacterium tuberculosis-complex (MTBC). Although osteoarticular tuberculosis (OATB) has been widely described, the ribcage variety remains a rare form. CASE REPORT: A thirteen-month-old male and a twenty-month-old female, both with pain and increased volume of anterolateral left rib cage were described. Physical examination revealed the presence of a soft consistent mass at the level of the 9th and 5th costal arches in the male and female patients respectively. Upon clinical evaluation, tuberculosis was suspected, which was confirmed by X-ray and histopathological studies. After confirmation, the management, based on anti-tuberculosis therapy was started as follows: nine months of anti-tuberculosis therapy for the male patient and fourteen months for the female. The outcomes were favorable for both patients. However, further interventions, consisting of abscess drainage in the male patient and excisional biopsy in the female patient were necessary. With these therapeutic interventions, to date, the patients are without any evidence of active TB.

Subjetividade e espaço: análises com Michel Foucault / Subjectivity and space: analysis with Michel Foucault / Subjetividad y espacio: análisis con Michel Foucault

O artigo é um ensaio sobre o conceito de espaço e o de subjetividade nos trabalhos de Michel Foucault, articulando Psicologia, História e Filosofia, sendo um dos objetivos é analisar como o espaço foi abordado ao longo do trabalho de Foucault. Um ponto relevante é a interrogação sobre espaço como objeto exclusivo da Geografia ou de qualquer outro saber e da problemática das estratégias de poder no espaço e na criação de modos de viver, sentir e pensar. Os mecanismos de controle são acionados e se dirigem aos corpos, visando estabelecer e traçar limites nas relações móveis das forças no campo da formação da subjetividade assujeitada. Busca-se concluir o artigo com uma análise inquietante da importância do conceito de espaço e propõe-se a ruptura das fronteiras disciplinares para operar uma analítica do poder, saber e subjetividade no jogo estratégico dos poderes e dos discursos, em arquivos e por meio das instituições.

The article is an essay on the concept of space and that of subjectivity in the works of Michel Foucault, articulating Psychology, History and Philosophy. One of the objectives is to analyze how the space was approached, throughout the work of Foucault. A relevant point is the question about space as the exclusive object of Geography or any other knowledge and the problematic of strategies of power in space and the creation of ways of living, feeling and thinking. The control mechanisms are activated and directed to the bodies, aiming to establish and draw limits in the mobile relations of the forces in the field of subjectivity formation. The paper seeks to conclude the article with a disturbing analysis of the importance of the concept of space and proposes the rupture of the disciplinary boundaries to operate an analytic of power, knowledge and subjectivity in the strategic game of powers and discourses, in archives and through institutions.

El artículo es un ensayo sobre el concepto de espacio y el de subjetividad en los trabajos de Michel Foucault, articulando Psicología, Historia y Filosofía. Uno de los objetivos es analizar cómo el espacio fue abordado, a lo largo del trabajo de Foucault. Un punto relevante es la interrogación sobre espacio como objeto exclusivo de la Geografía o de cualquier otro saber y de la problemática de las estrategias de poder en el espacio y en la creación de modos de vivir, sentir y pensar. Los mecanismos de control son accionados y se dirigen a los cuerpos, buscando establecer y trazar límites en las relaciones móviles de las fuerzas en el campo de la formación de la subjetividad asujetada. Se busca concluir el artículo con un análisis inquietante de la importancia del concepto de espacio y se propone la ruptura de las fronteras disciplinares para operar una analítica del poder, saber y subjetividad en el juego estratégico de los poderes y de los discursos, en archivos y por medio instituciones.

Psiquiatria, segregação e punições: análises a partir de Michel Foucault / Psychiatry, segregation and punishments: analyzes from Michel Foucault

OBJETIVOS: Este artigo visa, por meio de um ensaio teórico, pensar relações entre Psiquiatria, espaços de segregação nos estudos de Foucault, a partir de cursos, conferências, entrevistas, aulas, livros e por meio de alguns comentadores de Michel Foucault, no Brasil. MÉTODOS: Analisar os espaços de controle dos corpos em hospitais e prisões fez parte dos objetivos deste texto, considerando uma análise conceitual como metodologia. As práticas punitivas e psiquiátricas são entrecruzadas nesta analítica sob o eixo das relações de poder e saber ligadas ao espaço. CONCLUSÕES PROVISÓRIAS: Problematizar este campo de uma história política da verdade, no presente, é um ponto de preocupação e ativação da escrita operatória deste artigo com análises teórico-conceituais com a interface da Psiquiatria com os espaços de segregação, internação e aprisionamento.

OBJECTIVES: This article aims, through a theoretical essay, to think about relations between Psychiatry, spaces of segregation in Foucault's studies, from courses, conferences, interviews, classes, books, and through some commentators by Michel Foucault, in Brazil. METHODS: Analyzing the control spaces of bodies in hospitals and prisons as part of the objectives of this text, considering a conceptual analysis as a methodology. Punitive and psychiatric practices are intertwined in this analysis under the axis of power and knowledge relations linked to space. PROVISIONAL CONCLUSIONS: To problematize this field of the political history of truth, at present, is a point of concern and activation of the operative writing of this article with theoreticalconceptual analyzes with the interface of Psychiatry with the spaces of segregation, hospitalization, and imprisonment.

Glyceridic and Unsaponifiable Components of Microencapsulated Sacha Inchi (Plukenetia huayllabambana L. and Plukenetia volubilis L.) Edible Oils.

Sacha inchi (Plukenetia huayllabambana L. and Plukenetia volubilis L.) edible oils were microencapsulated and the lipid fraction of the microparticles was characterized. Hi-cap®, Capsule®, Arabic gum, and the binary combination of Arabic gum + maltodextrin and the ternary combination of Arabic gum + maltodextrin + whey protein isolate, were used as coating materials for the encapsulation process using spray-drying. The surface and the total oils obtained from the microparticles were evaluated in terms of fatty acid composition, minor glyceride polar compounds, polymers, oxidized triglycerides, diglycerides, monoglycerides, and free fatty acids, along with their unsaponifiable components, sterols, and tocopherols. Differences between the original oils and the microencapsulated ones were determined. The most remarkable results included the presence of polymers when there were none in the original oils, the slight loss in ω3-fatty acids, up to 6%, the loss in tocopherols, in some of the cases around 30%, the maintaining of the phytosterol in their initial levels and the presence of cholesterol in the oils encapsulated with whey protein isolate.

Case Report: Chest Wall Tuberculosis without Pulmonary Involvement in Three Pediatric Immunocompetent Patients.

Primary rib cage tuberculosis (TB) is an infrequent form of presentation and represents 1% of all cases of osteoarticular TB. We report three cases of children who were previously healthy and who began with swelling of the anterior surface of the rib as initial manifestation of TB. The most important clinical presentations in this series were swelling and pain, with lytic lesions and a soft tissue mass in image studies simulating oncologic pathologies. Because none of the cases had positive epidemiological contact, TB was initially not considered, so the delay in diagnosis from the onset of symptoms was 4, 1, and 2 months, respectively. The diagnosis was made through histomorphological analyses. Treatment was administered during 12, 10, and 9 months. Posttreatment studies did not show any evidence of extrapulmonary TB and until date, the patients remained without relapse or active disease. The findings in our cases illustrate that the diagnosis of chest wall TB should be suspected in all patients from endemic areas who present rib injury.

Osteitis secondary to BCG vaccine in immunocompetent patients: Three case reports.

RATIONALE: Osteitis corresponds to a rare but potentially serious complication reported in pediatric population after the application of the Bacillus Calmette-Guerin (BCG) vaccine. In the present study, 3 clinical cases associated with this entity are reported. PATIENT CONCERNS: The 1st case corresponds to a 1-year-old female patient who presented an increase in the volume of the right pelvic limb after BCG application. The second case is a 2-year-old male who began with an increase in volume, overactive gait and pain at the level of the left knee on walking that began after a trauma in the left low limb. The 3rd case corresponds to a 3-year-old patient who started with intense pain and limitation for ambulation. DIAGNOSIS: Both the radiographical and histological studies presented data suggestive of infection by Mycobacterium tuberculosis complex, corroborated through biopsy and genotyping analysis with the isolation of Mycobacterium bovis as the causal agent. INTERVENTIONS: The basic treatment scheme was based on Ethambutol, Rifampicin, Pyrazinamide, and Isoniazid. When M. bovis was typified, clarithromycin was added in the treatment. OUTCOMES: Osteitis secondary to BCG vaccine usually has a favorable evolution, especially in immunocompetent patients. LESSONS: It was possible to confirm the association of BCG vaccine with the clinical picture of the patients who presented improvement after the start of antimicrobial management. Osteitis secondary to BCG vaccine usually presents a favorable evolution, especially in immunocompetent patients; however, the involvement of joint, growth discs and vertebrae increases the risk of presenting long-term sequels.

Bronchopulmonary infection by Lophomonas blattarum in a pediatric patient after hematopoietic progenitor cell transplantation: first report in Mexico.

Lophomonas blattarum is a multiflagellated protozoon which parasitizes the gut of termites and cockroaches. Although L. blattarum infection is rare, it can affect lung, maxillary sinuses and genitourinary tract. The presentation of bronchopulmonary lophomonas includes nonspecific symptoms such as fever, cough and dyspnea. Diagnosis is based on identification of living protozoan forms in fresh samples from respiratory secretions (bronchoalveolar lavage). We report the case of a 2-year-old male with a history of severe combined immunodeficiency (T-, B-, NK-), post-hematopoietic stem cell transplant and full immune reconstitution 12 months following a successful transplant who thereafter presented lophomonas.

Linezolid-associated optic neuropathy in a pediatric patient with Mycobacterium nonchromogenicum: A case report.

BACKGROUND: Toxic optic neuropathies are alterations of the optic nerve and can be caused by environmental, pharmacological, or nutritional agents. CASE: It is about a 7-year-old male patient, a native of the State of Mexico, Mexico who was diagnosed with cervical mycobacterial lymphadenitis that required management with linezolid. OBSERVATIONS: After 7 months of treatment, visual acuity of the left eye decreased and was accompanied by headache. Neuroinfection and other central nervous system affections were discarded. An adverse effect related to treatment with linezolid was suspected, and linezolid was suspended. The symptoms subsided after discontinuation; however, the patient continued to show decreased visual acuity of the left eye, assessed by his ability to count 2 fingers. The right eye remained unaffected. CONCLUSIONS: Neurotoxicity can be decreased by reducing the total dose of linezolid or by administrating it in an intermittent form. To avoid progression and loss of vision, we suggest frequent periodic ophthalmological evaluation in patients treated with linezolid.

Adolescentes e uso de drogas na visão do UNICEF / Teens and use of drugs for UNICEF / Adolescentes y consumo de drogas para el UNICEF

Este artigo objetivou apresentar resultados de pesquisa sobre documentos do Fundo das Nações Unidas para a Infância (UNICEF), referentes ao tema adolescentes e drogas. Como metodologia, foi realizada uma análise histórica documental, a partir de ferramentas teóricas e metodológicas da História Cultural e da Psicologia Social e Institucional, as quais constituíram os arcabouços deste trabalho. Entre os documentos selecionados da página do UNICEF na internet, durante o período da Nova República brasileira, desde a aprovação do Estatuto da Criança e do Adolescente, em 1990, até 2012, estão relatórios específicos sobre a situação da adolescência brasileira. Foram trabalhadas práticas acionadas por essa agência multilateral frente à questão das drogas e dos adolescentes, sendointerrogadas e analisadas em seus efeitos e delineamentos, na garantia dedireitos desse segmento social. Entre os resultados, é possível destacar a tentativa do UNICEF em afirmar uma visão de vulnerabilidade dos adolescentes face às drogas e um conjunto de recomendações ao Brasil para lidar com essa situação. (AU)

This article aimed to present research findings on the United Nations Funddocuments for Children (UNICEF) on the topic teenagers and drugs. Themethodology documentary historical analysis from theoretical andmethodological tools of cultural history and social psychology andinstitutional frameworks were this work was performed. Among the selecteddocuments, the UNICEF website, during the period of the New Brazilian Republic, since the adoption of the Statute of Children and Adolescents, in 1990 through 2012, are specific reports on the situation of Brazilian teens. Practices were worked triggered by this multilateral agency opposite the issue of drugs and adolescents, being interrogated and analyzed in its effectsand designs in ensuring rights of this social group. Among the results, it ispossible to highlight UNICEF's attempt to assert a vision vulnerability of adolescents in drug and a set of recommendations to Brazil to give you this. (AU)

Este artículo tuvo como objetivo presentar resultados de investigacionessobre los documentos del Fondo de las Naciones Unidas para la Infancia (UNICEF) en los adolescentes tema y drogas. El análisis histórico documental metodología de herramientas teóricas y metodológicas de la historia cultural y la psicología social y los marcos institucionales se llevó a cabo este trabajo. Entre los documentos seleccionados, la página web de UNICEF, durante el período de la Nueva República de Brasil, desde la aprobación del Estatuto de la, Niñez y Adolescencia, en el año 1990 hasta el año 2012 son informes específicos sobre la situación de los adolescentes brasileños. Prácticas fueron trabajados disparados por este organismo multilateral frente a la cuestión de las drogas y los adolescentes, siendo interrogados y analizados en sus efectos y diseños en garantía de los derechos de este grupo social. Entre los resultados, es posible destacar el intento de UNICEF para hacer valer una vulnerabilidad de la visión de los adolescentes en las drogas y un conjunto de recomendaciones a Brasil para darte esto. (AU)

Adolescentes e uso de drogas na visão do UNICEF / Teens and use of drugs for UNICEF / Adolescentes y consumo de drogas para el UNICEF

Este artigo objetivou apresentar resultados de pesquisa sobre documentos do Fundo das Nações Unidas para a Infância (UNICEF), referentes ao tema adolescentes e drogas. Como metodologia, foi realizada uma análise histórica documental, a partir de ferramentas teóricas e metodológicas da História Cultural e da Psicologia Social e Institucional, as quais constituíram os arcabouços deste trabalho. Entre os documentos selecionados da página do UNICEF na internet, durante o período da Nova República brasileira, desde a aprovação do Estatuto da Criança e do Adolescente, em 1990, até 2012, estão relatórios específicos sobre a situação da adolescência brasileira. Foram trabalhadas práticas acionadas por essa agência multilateral frente à questão das drogas e dos adolescentes, sendo interrogadas e analisadas em seus efeitos e delineamentos, na garantia de direitos desse segmento social. Entre os resultados, é possível destacar a tentativa do UNICEF em afirmar uma visão de vulnerabilidade dos adolescentes face às drogas e um conjunto de recomendações ao Brasil para lidar com essa situação.

This article aimed to present research findings on the United Nations Fund documents for Children (UNICEF) on the topic teenagers and drugs. The methodology documentary historical analysis from theoretical andmethodological tools of cultural history and social psychology andinstitutional frameworks were this work was performed. Among the selecteddocuments, the UNICEF website, during the period of the New Brazilian Republic, since the adoption of the Statute of Children and Adolescents, in 1990 through 2012, are specific reports on the situation of Brazilian teens. Practices were worked triggered by this multilateral agency opposite the issue of drugs and adolescents, being interrogated and analyzed in its effectsand designs in ensuring rights of this social group. Among the results, it ispossible to highlight UNICEF's attempt to assert a vision vulnerability of adolescents in drug and a set of recommendations to Brazil to give you this.

Este artículo tuvo como objetivo presentar resultados de investigaciones sobre los documentos del Fondo de las Naciones Unidas para la Infancia (UNICEF) en los adolescentes tema y drogas. El análisis histórico documental metodología de herramientas teóricas y metodológicas de la historia cultural y la psicología social y los marcos institucionales se llevó a cabo este trabajo. Entre los documentos seleccionados, la página web de UNICEF, durante el período de la Nueva República de Brasil, desde la aprobación del Estatuto de la, Niñez y Adolescencia, en el año 1990 hasta el año 2012 son informes específicos sobre la situación de los adolescentes brasileños. Prácticas fueron trabajados disparados por este organismo multilateral frente a la cuestión de las drogas y los adolescentes, siendo interrogados y analizados en sus efectos y diseños en garantía de los derechos de este grupo social. Entre los resultados, es posible destacar el intento de UNICEF para hacer valer una vulnerabilidad de la visión de los adolescentes en las drogas y un conjunto de recomendaciones a Brasil para darte esto.

Health related quality of life and mental health in children with SCI/D from Neiva, Colombia.

OBJECTIVE: To date, no research has been published on the health related quality of life (HRQOL) and mental health of children with spinal cord injury and disorders (SCI/D) in Latin America, although limited previous research in Western countries has demonstrated the debilitating and chronic nature of these conditions in children. The aim was to examine the connections between HRQOL and mental health in children with SCI/D from Neiva, Colombia. STUDY DESIGN: Thirty children (8- 17 years) were recruited from the Hospital Universatario Hernando Mocaleano Perdomo in Neiva, Colombia. Participants completed self-report measures administered verbally by trained research staff. RESULTS: A correlation matrix generally suggested that higher HRQOL was robustly associated with better mental health. A series of multiple regressions found that HRQOL explained 50.5% of the variance in children's depression, 31.5% of the variance in worry, and 41.9% of the variance in social anxiety. Within these regressions, emotional and social functioning were uniquely associated with depression, and emotional functioning was uniquely associated with social anxiety. CONCLUSION: This is the first published study to examine psychosocial outcomes in children with SCI/D in Latin America, and its findings suggest that future research and interventions for children with SCI/D in Colombia - and possibly in other regions of Latin America - would benefit from emphasizing emotional and social functioning.

Psychological Functioning in Youth With Spina Bifida Living in Colombia, South America.

OBJECTIVE: No studies have examined psychological functioning among youth with spina bifida (SB) living in a developing country where access to mental health resources is often scarce. This study compared self-reported psychological functioning between youth with SB living in Colombia, South America, and a demographically matched comparison group of healthy Colombian children. METHODS: 22 children with SB and 22 comparison children completed assessments of depression and anxiety. Most (68.81%) participants were male, and the sample had a mean age of 13.25 years (SD = 2.65 years). RESULTS: Results revealed that children with SB reported greater total symptoms of depression (p < .05), but fewer worry-related symptoms of anxiety (p < .05). In addition, mean total scores for both depression and anxiety were in the nonclinical range for youth with SB. CONCLUSIONS: These findings highlight the need for targeted mental health (i.e., depression) services for poor children with SB living in Colombia.

Decreased nocturnal melatonin levels during acute myocardial infarction.

Acute myocardial infarction is accompanied by an increase in cellular oxidative stress in the pericardial coverings of the heart. Melatonin is a highly potent and efficient radical scavenger. Little research has been carried out concerning the relationship between this antioxidant and acute myocardial infarction in humans. In this work, serum levels of melatonin and parameters of oxidative stress, such as glutathione peroxidase and lipid peroxidation levels were examined in light/dark periods in patients with acute myocardial infarction. Twenty-five patients diagnosed with acute myocardial infarction were studied and 25 patients with no evidence of coronary artery disease served as controls. Venous blood samples were obtained from the patients and control subjects to determine melatonin, glutathione peroxidase and lipid peroxidation; the samples were collected at 10:00 hr (light period) and 03:00 hr (dark period) in the first 24 hr after admission to the coronary care unit. Our results demonstrate the existence of differences between changes in melatonin levels in control subjects and acute myocardial infarction patients, revealing a reduced nocturnal elevation in the acute myocardial infarction group. Glutathione peroxidase levels were lower after acute myocardial infarction and did not show diurnal variations. In the control group, lipid peroxidation levels presented a light/dark pattern but in the acute myocardial infarction group diurnal variations of this parameter were lost. Our data show that acute myocardial infarction is associated with a nocturnal serum melatonin deficit as well as increased oxidative stress, suggesting that melatonin is, at least in part, depleted during the dark phase to reduce the free radicals formed in acute myocardial infarction.