FATAL GROUP A STREPTOCOCCAL TOXIC SHOCK-LIKE SYNDROME IN A CHILD WITH VARICELLA: REPORT OF THE FIRST WELL DOCUMENTED CASE WITH DETECTION OF THE GENETIC SEQUENCES THAT CODE FOR EXOTOXINS SPE A AND B, IN SÃO PAULO, BRAZIL

A previously healthy seven-year-old boy was admitted to the intensive care unit because of toxaemia associated with varicella. He rapidly developed shock and multisystem organ failure associated with the appearance of a deep-seated soft tissue infection and, despite aggressive treatment, died on hospital day 4. An M-non-typable, spe A and spe B positive Group A Streptococcus was cultured from a deep soft tissue aspirate. The criteria for defining Streptococcal toxic shock-like syndrome were fulfilled. The authors discuss the clinical and pathophysiological aspects of this disease as well as some unusual clinical findings related to this case.

Averting the legacy of kidney disease - focus on childhood

World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD) in childhood differs from that in adults, in that the largest diagnostic group among children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease as a consequence of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertension and CKD in later childhood or in adult life. Children born early or who are small-for-date newborns have relatively increased risk for the development of CKD later in life. Persons with a high-risk birth and early childhood history should be watched closely in order to help detect early signs of kidney disease in time to provide effective prevention or treatment. Successful therapy is feasible for advanced CKD in childhood; there is evidence that children fare better than adults, if they receive kidney replacement therapy including dialysis and transplantation, although only a minority of children may require this ultimate intervention. Because there are disparities in access to care, effort is needed so that children with kidney disease, wherever they live, may be treated effectively, irrespective of their geographic or economic circumstances. Our hope is that the World Kidney Day will inform the general public, policy makers and caregivers about the needs and possibilities surrounding kidney disease in childhood.

Efeito de danos mecânicos, da redução de temperatura e 1-MCP no metabolismo pós-colheita de brócolis Legacy

O etileno acelera o metabolismo pós-colheita de brócolis, e sua síntese é induzida por danos mecânicos e pelo aumento da temperatura. Para testar esta hipótese, foram realizados 03 experimentos. No primeiro, avaliou-se o efeito do dano mecânico na produção do etileno; no segundo, estudou-se o efeito do armazenamento refrigerado; e, no terceiro, o efeito do 1-MCP no metabolismo e conservação de brócolis. Os resultados mostraram que o dano mecânico aumenta significativamente a produção do etileno, passando de 0,25 a 501,83 mL.h-1 g-1, duas horas após a aplicação do tratamento. Já, no tratamento controle, os incrementos foram menores, passando de 0,27 para 203,13 mL.h-1 g-1. Durante o armazenamento, observou-se que a deterioração ocorreu mais rapidamente no tratamento controle (20-22 °C), com intenso amarelecimento, degradação de clorofilas e formação de odor desagradável. Os brócolis armazenados a 0-2 e a 5-7 °C mantiveram boa qualidade por 12 dias. A aplicação de 1-MCP não contribuiu para prolongar a vida-de-prateleira de brócolis Legacy a 20-22 °C, não tendo havido efeito na preservação da coloração esverdeada, nem na prevenção da degradação de clorofilas.