Deshidratación causada por infección diarreica en niños: terapias y prevención

Las enfermedades diarreicas y sus complicaciones siguen siendo una causa importante de morbilidad y mortalidad en los niños, especialmente en los países en desarrollo. La diarrea se caracteriza por un aumento de la frecuencia y el volumen, y una disminución de la consistencia de las heces dentro de los estándares normales. Los patógenos varían entre los distintos escenarios mundiales en cuanto a desarrollo. La diarrea por rotavirus es el agente etiológico más importante implicado en la deshidratación grave por diarrea. Si bien es importante reconocer la causa microbiológica específica de la diarrea para aplicar el tratamiento adecuado, los aspectos preventivos más amplios presentados por la Organización Mundial de la Salud (OMS) indican los contribuyentes fundamentales a la carga masiva de enfermedad en los países en desarrollo. El manejo de un niño con diarrea aguda debe incluir una historia y un examen exhaustivo con evaluación del estado de hidratación, estado nutricional y evaluación clínica integral para cualquier complicación o enfermedad asociada. Los avances más recientes en el área de la enfermedad diarreica aguda incluyen la administración de suplementos de zinc y la solución de rehidratación oral (SRO) con osmolaridad reducida y vacunación contra el rotavirus

Guidelines for the use and interpretation of assays for monitoring autophagy

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. A key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process vs. those that measure flux through the autophagy pathway (i.e., the complete process); thus, a block in macroautophagy that results in autophagosome accumulation needs to be differentiated from stimuli that result in increased autophagic activity, defined as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (in most higher eukaryotes and some protists such as Dictyostelium) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the field understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field