Aplicabilidad del método bacterial Pneumonía Score para predicción de etiología bacteriana o viral de neumonía en niños de un mes a menores de cinco años ingresados en el Hospital Nacional de Niños Benjamín Bloom en el periodo de Enero-Diciembre del año 2015

A nivel mundial las infecciones respiratorias agudas son de gran importancia en materia de salud pública, en la actualidad estadísticamente son una de las principales causas de morbimortalidad en niños menores de cinco años en los países en vías de desarrollo; representando así las neumonías entre el 80-90% de las causas de morbimortalidad en dicho grupo etario. El objetivo es aplicar la escala Bacterial Pneumoniae Score BPS (Figura 1) para predecir la etiología de neumonía en niños entre las edades de un mes a menores de cinco años ingresados en el Hospital Nacional de Niños Benjamín Bloom en el periodo comprendido entre enero 2015- diciembre año 2015. Es un estudio observacional, retrospectivo de evaluación de una prueba diagnóstica, en el periodo enero a diciembre del año 2015, se incluyeron 64 pacientes de un mes a menores de cinco años de edad ingresados por neumonía con diagnostico etiológico confirmado (bacteriano o viral) se excluyó los pacientes con inmunosupresión, etapa neonatal, con antecedente de ingreso por otros motivos una semana previa, cuadro de enfermedad pulmonar crónica, cardiópatas, broncodisplasicos, enfermedad por reflujo gastroesofágico(ERGE) e infecciones mixtas al momento del diagnóstico etiológico. Se tomó en cuenta datos al ingreso de temperatura, edad, resultado de hemograma y evaluación de radiografía de tórax sometiendo con estos datos al cálculo de BPS (intervalo de -3 a 15 puntos) donde un valor mayor o igual a cuatro sugiere etiología bacteriana. Se realizó el análisis estadístico y determinación de resultados, a través de una matriz en EXCEL y el analizador EPIDAT 3.1. Se incluyeron 64 pacientes con edades entre 1 y 60 meses (82% etiología viral y 18% bacteriana). Un valor de BPS ≥ 4 mostro sensibilidad: 90.9%, especificidad: 88.68%, valor predictivo positivo: 62.5%, y valor predictivo negativo: 97.9%. Conclusiones. El BPS en el presente estudio presenta un índice predictor importante para identificar la mayoría de neumonías que deben ser tratadas o no con antibiótico

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Advanced Optical Microscopy: Unveiling Functional Insights Regarding a Novel <i>PPP2R1A</i> Variant and Its Unreported Phenotype

The number of genes implicated in neurodevelopmental conditions is rapidly growing. Recently, variants in PPP2R1A have been associated with syndromic intellectual disability and a consistent, but still expanding, phenotype. The PPP2R1A gene encodes a protein subunit of the serine/threonine protein phosphatase 2A enzyme, which plays a critical role in cellular function. We report an individual showing pontocerebellar hypoplasia (PCH), microcephaly, optic and peripheral nerve abnormalities, and an absence of typical features like epilepsy and an abnormal corpus callosum. He bears an unreported variant in an atypical region of PPP2R1A. In silico studies, functional analysis using immunofluorescence, and super-resolution microscopy techniques were performed to investigate the pathogenicity of the variant. This analysis involved a comparative analysis of the patient’s fibroblasts with both healthy control cells and cells from an individual with the previously described phenotype. The results showed reduced expression of PPP2R1A and the presence of aberrant protein aggregates in the patient’s fibroblasts, supporting the pathogenicity of the variant. These findings suggest a potential association between PPP2R1A variants and PCH, expanding the clinical spectrum of PPP2R1A-related neurodevelopmental disorder. Further studies and descriptions of additional patients are needed to fully understand the genotype–phenotype correlation and the underlying mechanisms of this novel phenotype