Síndrome de intestino corto en niños: actualidades en su diagnóstico y manejo

ResumenEl síndrome de intestino corto (SIC) se refiere a la suma de alteraciones funcionales que resultan de una reducción crítica en la longitud del intestino, y que en ausencia de un tratamiento adecuado se manifiestan con diarrea crónica, deshidratación crónica, desnutrición, pérdida de peso, deficiencia de nutrimentos y electrolitos, así como falla para crecer que se presenta con mayor frecuencia durante el periodo neonatal. El objetivo de este artículo es realizar una revisión de la literatura médica sobre la definición, las causas más frecuentes de SIC así como entender la fisiopatología, los factores pronósticos y tratamiento.Se realizó una búsqueda de artículos en PubMed, considerando la información existente en niños con SIC de 20 años hasta la fecha, utilizando las palabras clave “síndrome de intestino corto”. De un total de 784 artículos potenciales, se realizó una selección de 82 artículos donde realizamos la revisión de la literatura médica. Los pacientes con SIC son todo un reto para su tratamiento, por lo que se debe establecer un manejo multidisciplinario enfocado en mantener un soporte nutricional óptimo que cubra las necesidades para crecimiento, desarrollo y asimismo, disminuir al máximo la presencia de complicaciones a corto, mediano y largo plazo. El diagnóstico y manejo de un niño con SIC, implica un equipo de profesionales expertos en el manejo gastroenterológico, pediátrico y nutricional. El pronóstico del niño estará en función al manejo oportuno, así como longitud de la resección intestinal y presencia o no de válvula ileocecal.AbstractShort bowel syndrome (SBS) refers to the sum of the functional alterations that are the result of a critical reduction in the length of the intestine, which in the absence of adequate treatment, presents as chronic diarrhea, chronic dehydration, malnutrition, weight loss, nutriment and electrolyte deficiency, along with a failure to grow that is present with greater frequency during the neonatal period. The aim was to carry out a review of the literature encompassing the definition and the most frequent causes of SBS, together with an understanding of its physiopathology, prognostic factors, and treatment.An Internet search of PubMed articles was carried out for the existing information published over the last 20 years on SBS in children, using the keywords “short bowel syndrome”. From a total of 784 potential articles, 82 articles were chosen for the literature review. The treatment of patients presenting with SBS is quite a challenge and therefore it is necessary to establish multidisciplinary management with a focus on maintaining optimal nutritional support that covers the necessities of growth and development and at the same time provides a maximum reduction of short, medium, and long-term complications. The diagnosis and treatment of a child with SBS require a team of professionals that are experts in gastroenterologic, pediatric, and nutritional management. The outcome for the child will be directly related to opportune management, as well as to the length of the intestinal resection and the presence or absence of the ileocecal valve

Chancelloria eros Walcott, 1920 (Chancelloriidae), Diagoniella Rauff, 1894 y espículas de esponjas hexactinéllidas (Porifera, Protospongiidae) del Cámbrico Medio de San José de Gracia, Sonora, México.

Escleritos aislados de Chancelloria eros Walcott, 1920, Diagoniella sp. y asociaciones de espículas hexactinéllidas-estauractinas y hexactina-pentactinas son descritas para el Cámbrico Medio de San José de Gracia, Sonora, México. El material procede de una secuencia sedimentaria marina de plataforma exterior, constituida principalmente por lutita intercalada con caliza, en asociación con fósiles representativos de la Biozona de Albertella como lo es Peronopsis bonnerensis Resser, 1938; Oryctocephalites walcotti Reeser, 1938; Elrathina antiqua Palmer y Halley, 1979 y Ogygopsis typicalis Resser, 1939; así como braquiópodos inarticulados. Chancelloria eros Walcott, 1920 ha sido reportada anteriormente para el Estado de Sonora, México, en el Cámbrico Medio de la Formación Arrojos, así como Chancelloria sp. en el Cámbrico Temprano de la Formación Puerto Blanco, en asociación con Kiwetinokia en Cerro Rajón en la región de Caborca. Siendo el presente el primer registro para San José de Gracia, Sonora central.Fil: Cuen R, Francisco J.. Universidad de Sonora; MéxicoFil: Beresi, Matilde Sylvia. Consejo Nacional de Investigaciones Científicas y Técnicas. Científico Tecnológico Mendoza. Instituto Argentino de Nivologia, Glaciologia y Ciencias Ambientales; ArgentinaFil: Montijo, A.. Universidad de Sonora; MéxicoFil: Buitrón, B. E.. Universidad Nacional Autónoma de México; MéxicoFil: Minjares, M. de la O.. Universidad de Sonora; Méxic

Steric hindrance in the upper 50 kDa domain of the motor Myo2p leads to cytokinesis defects in fission yeast

Cytokinesis in many eukaryotes requires a contractile actomyosin ring that is placed at the division site. In fission yeast, which is an attractive organism for the study of cytokinesis, actomyosin ring assembly and contraction requires the myosin II heavy chain Myo2p. Although myo2-E1, a temperature-sensitive mutant defective in the upper 50 kDa domain of Myo2p, has been studied extensively, the molecular basis of the cytokinesis defect is not understood. Here, we isolate myo2-E1-Sup2, an intragenic suppressor that contains the original mutation in myo2-E1 (G345R) and a second mutation in the upper 50 kDa domain (Y297C). Unlike myo2-E1-Sup1, a previously characterized myo2-E1 suppressor, myo2-E1-Sup2 reverses actomyosin ring contraction defects in vitro and in vivo. Structural analysis of available myosin motor domain conformations suggests that a steric clash in myo2-E1, which is caused by the replacement of a glycine with a bulky arginine, is relieved in myo2-E1-Sup2 by mutation of a tyrosine to a smaller cysteine. Our work provides insight into the function of the upper 50 kDa domain of Myo2p, informs a molecular basis for the cytokinesis defect in myo2-E1, and may be relevant to the understanding of certain cardiomyopathies

Linfangiectasia intestinal primaria: 20 años de experiencia en el Instituto Nacional de Pediatría

ResumenAntecedentesLa linfangiectasia intestinal primaria es una enfermedad congénita rara descrita por Waldmann en 1961, y que es consecuencia de una obstrucción del drenaje linfático del intestino delgado con dilatación secundaria de los vasos linfáticos, que distorsionan la arquitectura de las vellosidades ocasionando pérdida de linfa hacia la luz intestinal,dando como resultado una enteropatía perdedora de proteínas y malabsorción de nutrimentos.ObjetivoDescribir las características clínicas, bioquímicas, radiológicas, endoscópicas e histológicas en niños con linfangiectasia intestinal primaria.MétodoEstudio observacional, descriptivo, transversal y retrospectivo de niños con linfangiectasia intestinal primaria que fueron vistos en el Servicio de Gastroenterología y Nutrición del Instituto Nacional de Pediatría desde el 1 de enero de 1992 al 30 de septiembre de 2012, en donde se revisaron los expedientes clínicos de los niños con este diagnóstico.ResultadosSe encontraron 4 pacientes con linfangiectasia intestinal primaria, 3 de ellos diagnosticados antes de los 3 años; todos se presentaron con diarrea crónica, edema, linfopenia, hipocalcemia, hipoalbuminemia e hipogammaglobulinemia, y en 3 pacientes, con hipocolesterolemia, y con tránsito intestinal, endoscopia y biopsias intestinales características de esta enfermedad.ConclusionesLa linfangiectasia intestinal debe sospecharse ante un cuadro de diarrea crónica, enteropatía perdedora de proteínas, que se acompaña de edema a cualquier nivel, así como hipoalbuminemia, hipocalcemia, linfopenia, hipogammaglobulinemia e hipocolesterolemia como los principales hallazgos bioquímicos de esta entidad. Ante esta enfermedad debe realizarse estudio de serie esofagogastroduodenal con tránsito intestinal y endoscopia con toma de biopsias a nivel de duodeno. El tratamiento incluye dieta y administración periódica de albúmina y gammaglobulina.AbstractBackgroundPrimary intestinal lymphangiectasia is a rare congenital disease described by Waldmann in 1961 that is a consequence of obstruction of the lymphatic drainage of the small bowel with secondary lymph vessel dilation. This distorts the architecture of the villi and causes a leakage of lymph into the intestinal lumen, resulting in protein-losing enteropathy and malabsorption.AimTo describe the clinical, biochemical, radiologic, endoscopic, and histologic characteristics in children with primary intestinal lymphangiectasia.MethodA retrospective observational, descriptive, cross-sectional study was conducted that reviewed the case records of children diagnosed with primary intestinal lymphangiectasia that were seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatría within the time frame of January 1, 1992 to September 30, 2012.ResultsFour patients were found that presented with primary intestinal lymphangiectasia. Three of them had been diagnosed before 3 years of age. All the patients presented with chronic diarrhea, edema, lymphopenia, hypocalcemia, and hypogammaglobulinemia, and 3 patients presented with hypocholesterolemia. Bowel transit time, endoscopy, and intestinal biopsies were characteristic of this pathology.ConclusionsIntestinal lymphangiectasia should be suspected when there is a clinical picture of chronic diarrhea and protein-losing enteropathy accompanied with edema at any level, as well as hypoalbuminemia, hypocalcemia, lymphopenia, hypogammaglobulinemia, and hypocholesterolemia, which are the main biochemical findings of this pathology. All children presenting with intestinal lymphangiectasia should undergo an upper gastrointestinal series with bowel transit time and endoscopy with biopsies taken at the level of the duodenum. Treatment includes diet and the periodic administration of albumin and gamma globulin

CALIFA, the Calar Alto Legacy Integral Field Area survey: I. Survey presentation

We present here the Calar Alto Legacy Integral Field Area (CALIFA) survey, which has been designed to provide a first step in this direction.We summarize the survey goals and design, including sample selection and observational strategy.We also showcase the data taken during the first observing runs (June/July 2010) and outline the reduction pipeline, quality control schemes and general characteristics of the reduced data. This survey is obtaining spatially resolved spectroscopic information of a diameter selected sample of $\sim600$ galaxies in the Local Universe (0.005< z <0.03). CALIFA has been designed to allow the building of two-dimensional maps of the following quantities: (a) stellar populations: ages and metallicities; (b) ionized gas: distribution, excitation mechanism and chemical abundances; and (c) kinematic properties: both from stellar and ionized gas components. CALIFA uses the PPAK Integral Field Unit (IFU), with a hexagonal field-of-view of \sim1.3\sq\arcmin', with a 100% covering factor by adopting a three-pointing dithering scheme. The optical wavelength range is covered from 3700 to 7000 {\AA}, using two overlapping setups (V500 and V1200), with different resolutions: R\sim850 and R\sim1650, respectively. CALIFA is a legacy survey, intended for the community. The reduced data will be released, once the quality has been guaranteed. The analyzed data fulfill the expectations of the original observing proposal, on the basis of a set of quality checks and exploratory analysis. We conclude from this first look at the data that CALIFA will be an important resource for archaeological studies of galaxies in the Local Universe.Comment: 32 pages, 29 figures, Accepted for publishing in Astronomy and Astrophysic

Consenso mexicano sobre probióticos en gastroenterología

Introducción: El uso de los probióticos es común en la práctica clínica. Existe un número signi-ficativo de estudios que apoyan la eficacia de los probióticos en algunos trastornos digestivos.Sin embargo, el desconocimiento de la evidencia científica y las diferentes presentaciones ycomposiciones microbianas de los probióticos disponibles dificultan su prescripción.Objetivo: Proveer al clínico de una revisión consensuada sobre los probióticos y recomendacio-nes de su uso en gastroenterología.Material y métodos: Se seleccionaron los ensayos clínicos controlados, metaanálisis y revisio-nes sistemáticas publicados hasta 2015, usando los términos MESH: probiotics, gastrointestinaldiseases, humans, adults and children. Se utilizó la metodología Delphi. Diecisiete gastroente-rólogos de adultos y 12 de ni˜nos elaboraron enunciados los cuales fueron votados hasta obteneracuerdo > 70%. Para cada enunciado se evaluó el nivel de evidencia basado en el sistema GRADE.Resultados y conclusiones: Se generaron 11 enunciados sobre conceptos generales de probió-ticos y 27 enunciados sobre uso de probióticos en enfermedades gastrointestinales tanto enni˜nos como en adultos. El grupo de consenso recomienda el uso de probióticos en las siguientescondiciones clínicas: prevención de la diarrea asociada a antibióticos, tratamiento de la diarreaaguda infecciosa, prevención de infección por Clostridium difficile y enterocolitis necrosante,para disminuir los eventos adversos de la terapia de erradicación del Helicobacter pylori, elalivio de los síntomas del síndrome de intestino irritable, en el estre˜nimiento funcional deladulto, para inducir y mantener la remisión en pacientes con colitis ulcerosa crónica idiopáticay pouchitis, y en la encefalopatía hepática oculta y manifiesta.© 2016 Asociaci´on Mexicana de Gastroenterolog´ıa. Publicado por Masson Doyma M´exico S.A.Este es un art´ıculo Open Access bajo la licencia CC BY-NC-ND (http://creativecommons.org/licenses/by-nc-nd/4.0/). ASTRACT Introduction: Probiotics are frequently prescribed in clinical practice. Their efficacy in treatinggastrointestinal disorders is supported by a significant number of clinical trials. However, thecorrect prescription of these agents is hampered due to a lack of knowledge of the scientificevidence and to the different presentations and microbial compositions of the probiotics thatare currently available.Aim: To provide the clinician with a consensus review of probiotics and recommendations fortheir use in gastroenterology.Materials and methods: Controlled clinical trials, meta-analyses, and systematic reviewspublished up to 2015 were selected, using the MESH terms: probiotics, gastrointestinal diseases,humans, adults, AND children. The Delphi method was employed. Eighteen gastroenterologiststreating adult patients and 14 pediatric gastroenterologists formulated statements that werevoted on until agreement > 70% was reached. The level of evidence based on the GRADE systemwas evaluated for each statement.Results and conclusions: Eleven statements on the general concepts of probiotics and 27 sta-tements on the use of probiotics in gastrointestinal diseases in both adults and children wereformulated. The consensus group recommends the use of probiotics under the following clini-cal conditions: the prevention of diarrhea associated with antibiotics, the treatment of acuteinfectious diarrhea, the prevention of Clostridium difficile infection and necrotizing enteroco-litis, the reduction of adverse events from Helicobacter pylori eradication therapy, relief fromirritable bowel syndrome symptoms, the treatment of functional constipation in the adult, and the induction and maintenance of remission in patients with ulcerative colitis and pouchitis,and the treatment of covert and overt hepatic encephalopathy.© 2016 Asociaci´on Mexicana de Gastroenterolog´ıa. Published by Masson Doyma M´exico S.A. Thisis an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Production of α-amylase by solid state fermentation by Rhizopus oryzae

A thermotolerant strain of Rhizopus oryzae was grown in three agro-industrial by-products: brewers’ rice, corn grits and wheat bran. Different substrates, cultivation time, moisture content, additional nitrogen sources, pH and temperature of incubation were evaluated aiming to optimize growing conditions. The highest enzymatic activity was observed after 24 h of cultivation using wheat bran as substrate with the following salt solutions: NH4NO3, MgSO4.7H2O and (NH4)2SO4 0.1% at temperature of 35°C. It was observed that changes in the pH range 4.0-6.0 did not significantly affect α-amylase activity. The optimum operation conditions were 75°C and pH 4.5. The enzymes remained stable at 75°C in the absence of substrate for 25 min.Key words: Starch hydrolysis, fermentation parameters, amylolytic enzyme

Power TAC 2012: Agent Technologies for the Smart Grid

Intelligent agents are a critical technology in managing the increasingly complex and decentralized energy systems that are evolving. These technologies, often called the smart grid, have the potential to improve the efficiency and reliability of future energy markets. This project focuses on developing a trading agent to compete in the 2012 Power TAC game, a new scenario this year that is part of the annual Trading Agent Competition. Modeling a liberalized retail electrical energy market, Power TAC is a simulation in which competing trading agents or brokers offer energy services to customers via tariff contracts. The brokers must also serve their customers by buying and selling energy in the wholesale and retail markets. Our agent design uses a feedback control mechanism to coordinate the agent’s actions across different markets and maintain the necessary energy balance. The agent predicts future energy supply and demand conditions based on its portfolio, and, if necessary, applies corrective actions. In the retail market, the agent can create and modify tariff offers to customers to increase or decrease demand, while in the wholesale market the agent can negotiate with suppliers to buy additional energy. The results of the competition and the design of agent strategies will help policy makers create institutions that produce the intended incentives for energy customers and consumers, and help to validate intelligent automation technologies for next-generation energy markets