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Resumen El granuloma aseptico facial idiopatico (GAFI) es una patologia especifica de la edad pediatrica caracterizada por la aparicion de nodulos rojizos asintomaticos en la region facial. Su etiopatogenia es aun motivo de discusion, aunque la literatura actual orienta a que se encontraria dentro del espectro de la rosacea infantil. Tiene una evolucion cronica pero benigna, y hay publicaciones que documentan la resolucion espontanea de las lesiones en menos de un ano. A pesar de no tener un tratamiento bien definido, se prefiere que sea conservador y se eviten las intervenciones agresivas.

Idiopathic facial aseptic granuloma is a pediatric skin condition involving asymptomatic reddish nodules. The etiology and pathogenesis is still under discussion, although the literature tends to place this condition within the spectrum of childhood rosaceas. The clinical course is chronic but benign, and cases have been reported to resolve spontaneously in less than a year. Even though no well-defined treatment has emerged, a conservative approach that avoids aggressive therapies is preferred.

Resumen: Introducción: La Dermatitis Flagelada es una patología infrecuente, con lesiones cutáneas caracterís ticas, que se desarrolla por el uso de Bleomicina. Clínicamente se presenta como maculas eritematosas o hiperpigmentadas de disposición lineal con patrón flagelar, en tronco y/o extremidades supe riores. Presenta evolución autolimitada por lo que su tratamiento varía desde conducta expectante hasta uso de corticoides tópicos u orales. Objetivo: Presentación de un caso clínico de Dermatitis flagelada secundaria a Bleomicina en paciente pediátrico con antecedentes de neoplasia de sistema nervioso central. Caso clínico: Escolar de 8 años, sexo femenino, con antecedentes de tumor prima rio de células germinales mixto intracraneal (selar y supraselar) y panhipopituitarismo secundario. Recibe tratamiento quimioterapéutico según protocolo PEB, con uso de Bleomicina EV por 3 días. A los 2 días posteriores, inicia prurito intermitente, asociado a máculas eritematosas y pigmentadas de distribución lineal, siguiendo patrón flagelado, con aislados signos de excoriación, en región abdo minal y dorso alto. Se indica tratamiento tópico con corticoides de moderada potencia por 10 días, con respuesta clínica satisfactoria. Conclusiones: Se debe tener una alta sospecha diagnóstica en pa cientes pediátricos con historia de administración previa del fármaco y aparición de lesiones cutáneas características, lo que permitirá una conducta adecuada respecto a su manejo y a la continuidad de la quimioterapia. Abstract: Introduction: Flagellated dermatitis is an infrequent pathology, with characteristic skin lesions, which is developed due to the use of bleomycin. Clinically it occurs as erythematous or hyperpigmented maculae of linear disposition with flagellar pattern, in trunk and/or upper extremities. It presents self-limited evolution, therefore, its treatment varies from expectant management to the use of topical or oral corticosteroids. Objective: Presentation of a clinical case of flagellated dermatitis secondary to bleomycin in a pediatric patient with history of central nervous system neoplasia. Clinical case: 8 years, schoolchild, female, with a history of primary intracranial mixed germ cell tumor (sellar and suprasellar) and secondary panhypopituitarism. She receives chemotherapeutic treatment according to the PEB protocol, with use of IV bleomycin during three days. After two days, intermittent pruritus begins, associated with erythematous and pigmented maculae of linear distribution, followed by a flagellated pattern, with isolated signs of excoriation, in the abdominal region and upper back. Topical treatment with mild potency corticosteroids is indicated for ten days, with a satisfactory clinical response. Conclusions: There should be a high diagnostic suspi cion in pediatric patients with a history of prior administration of the drug and the appearance of characteristic skin lesions, which will allow adequate behavior regarding its management and the continuity of chemotherapy.

Resumen: Introducción: La Dermatitis Flagelada es una patología infrecuente, con lesiones cutáneas caracterís ticas, que se desarrolla por el uso de Bleomicina. Clínicamente se presenta como maculas eritematosas o hiperpigmentadas de disposición lineal con patrón flagelar, en tronco y/o extremidades supe riores. Presenta evolución autolimitada por lo que su tratamiento varía desde conducta expectante hasta uso de corticoides tópicos u orales. Objetivo: Presentación de un caso clínico de Dermatitis flagelada secundaria a Bleomicina en paciente pediátrico con antecedentes de neoplasia de sistema nervioso central. Caso clínico: Escolar de 8 años, sexo femenino, con antecedentes de tumor prima rio de células germinales mixto intracraneal (selar y supraselar) y panhipopituitarismo secundario. Recibe tratamiento quimioterapéutico según protocolo PEB, con uso de Bleomicina EV por 3 días. A los 2 días posteriores, inicia prurito intermitente, asociado a máculas eritematosas y pigmentadas de distribución lineal, siguiendo patrón flagelado, con aislados signos de excoriación, en región abdo minal y dorso alto. Se indica tratamiento tópico con corticoides de moderada potencia por 10 días, con respuesta clínica satisfactoria. Conclusiones: Se debe tener una alta sospecha diagnóstica en pa cientes pediátricos con historia de administración previa del fármaco y aparición de lesiones cutáneas características, lo que permitirá una conducta adecuada respecto a su manejo y a la continuidad de la quimioterapia.

Flagellated dermatitis is an infrequent pathology, with characteristic skin lesions, which is developed due to the use of bleomycin. Clinically it occurs as erythematous or hyperpigmented maculae of linear disposition with flagellar pattern, in trunk and/or upper extremities. It presents self-limited evolution, therefore, its treatment varies from expectant management to the use of topical or oral corticosteroids.Presentation of a clinical case of flagellated dermatitis secondary to bleomycin in a pediatric patient with history of central nervous system neoplasia.8 years, schoolchild, female, with a history of primary intracranial mixed germ cell tumor (sellar and suprasellar) and secondary panhypopituitarism. She receives chemotherapeutic treatment according to the PEB protocol, with use of IV bleomycin during three days. After two days, intermittent pruritus begins, associated with erythematous and pigmented maculae of linear distribution, followed by a flagellated pattern, with isolated signs of excoriation, in the abdominal region and upper back. Topical treatment with mild potency corticosteroids is indicated for ten days, with a satisfactory clinical response.There should be a high diagnostic suspi cion in pediatric patients with a history of prior administration of the drug and the appearance of characteristic skin lesions, which will allow adequate behavior regarding its management and the continuity of chemotherapy.

La contaminazione da DDx, PCB, PBDE, Hg (mercurio) e As (arsenico) nei sedimenti e in organismi acquatici appartenenti a differenti livelli trofici (zooplancton, molluschi e pesci) è stata analizzata nel Lago Maggiore e nel Lago di Lugano, due laghi subalpini profondi. Scopo dell'analisi è stato evidenziare l'esistenza di sorgenti puntuali di contaminazione nei due ecosistemi lacustri, analizzare i trend temporali e spaziali e valutare le criticità in termini di superamenti di soglie di tossicità o qualità (Sediment Quality Guidelines - SQG - di MacDonald et al. (2000) per i sedimenti, i Quality Standards della Direttiva 2013/39/UE - QS - per il biota). Sono stati considerati i dati prodotti nell'ambito del Progetto CIPAIS (Commissione Internazionale per la Protezione delle Acque Italosvizzere) "Indagini sulle sostanze pericolose" nei due laghi relativi al periodo 2001-2015.

International audience; Risk assessments from the European Union and the World Health Organization report values for acute and chronic toxicity of Cr(III) to Daphnia magna in the range of 0.6mg/L to 111mg/L and 0.047mg/L to 3.4mg/L, respectively. To understand whether factors other than the use of different test media and data reporting contribute to this variability, the authors tested the acute (48-h) and chronic (21-d) toxicities of Cr(III) to D. magna according to Organisation for Economic Co-operation and Development (OECD) methods. Filterable (0.45-mu m) chromium concentrations were measured at 0h, 6h, 24h, and 48h, the latter value corresponding to the total duration of the acute tests and to the interval between medium renewals in chronic tests. In highly alkaline media (4.9meq/L), Cr concentrations decreased rapidly below the analytical detection limit, and no toxicity was observed. In less alkaline media (approximately 0.8meq/L), the decrease in filterable Cr concentrations was inversely proportional to the quantity of added Cr(III). The authors concluded that existing data likely underestimate the ecotoxicity of Cr(III) to D. magna. A reliable assessment of the hazard of Cr(III) to D. magna must consider that exposure concentrations can decrease markedly from the beginning to the end of a test and that medium alkalinity strongly influences the outcome of laboratory toxicity tests. Environ Toxicol Chem 2014;33:2280-2287. (c) 2014 SETAC

La úlcera genital aguda (UGA) o úlcera de Lipschütz constituye una infrecuente entidad clínica caracterizada por la aparición de úlceras genitales en niñas y adolescentes que no han iniciado su actividad sexual. El cuadro es de inicio agudo, con formación de úlceras dolorosas habitualmente precedidas en su aparición por manifestaciones sistémicas tales como fiebre, cefalea, astenia, adinamia, mialgias y adenopatías inguinales, y donde el estudio microbiológico de la lesión descarta un posible origen infeccioso. A pesar de presentar un cuadro clínico característico, esta enfermedad constituye una entidad poco conocida y por tanto subdiagnosticada, motivo por el cual presentamos el caso de una paciente de 10 años con diagnóstico de UGA realizado en el Departamento de Dermatología de la Pontificia Universidad Católica de Chile. Acute genital ulcer (AGU) or Lipschütz ulcer is a rare clinical entity characterized by the appearance of genital ulcers in children and adolescents who have not initiated sexual activity. The picture is of acute onset, with formation of painful ulcers on their occurrence usually preceded by systemic manifestations such as fever, headache, fatigue, weakness, muscle pain and inguinal lymphadenopathy, and where the microbiological study of injury rule out a possible infectious origin. Despite presenting a characteristic clinical picture, this disease is a little known entity and under diagnosed, we present the case of a 10 years old girl diagnosed with UGA conducted at the Department of Dermatology, Catholic University of Chile.

La ulcera genital aguda (UGA) o ulcera de Lipschutz constituye una infrecuente entidad clinica caracterizada por la aparicion de ulceras genitales en ninas y adolescentes que no han iniciado su actividad sexual. El cuadro es de inicio agudo, con formacion de ulceras dolorosas habitualmente precedidas en su aparicion por manifestaciones sistemicas tales como fiebre, cefalea, astenia, adinamia, mialgias y adenopatias inguinales, y donde el estudio microbiologico de la lesion descarta un posible origen infeccioso. A pesar de presentar un cuadro clinico caracteristico, esta enfermedad constituye una entidad poco conocida y por tanto subdiagnosticada, motivo por el cual presentamos el caso de una paciente de 10 anos con diagnostico de UGA realizado en el Departamento de Dermatologia de la Pontificia Universidad Catolica de Chile.

According to medical literature, nasal carriage of Staphylococcus aureus in pediatric age in the general population ranges between 10 and 40 %, not being clearly established in children with cancer. In order to determine the prevalence in this group and its possible increment through successive hospitalizations, we studied the Calvo Mackennas oncologic patients below 19 years of age, with a series of nasal cultures. We took four samples for each patient in a period of one year. Of 80 patients initially included, 10 died, 9 returned to their city of origin before the end of the study and in 8 cases it was not possible to complete the follow-up. Prevalence of nasal carriage was 21.2% (17/80). From 17 children colonized, 14 lost this condition, 2 abandoned the follow-up and only 1 was positive at the end of the study. Incidence of hospitalization due to febrile neutropenia was 28.7% (23/80) and the relation between nasal carriage and the number of these events was not significant (p = 0.59). The relation between the number of hospitalizations and an increment in nasal colonization (p = 0,80) was also not significant. In conclusion, nasal carriage of Staphylococcus aureus in children with cancer is similar to carriage described for healthy children. Carriage would be a transitory condition, variable through time for each patient, without relation to a greater number of febrile neutropenia episodes.

According to medical literature, nasal carriage of Staphylococcus aureus in pediatric age in the general population ranges between 10 and 40 %, not being clearly established in children with cancer. In order to determine the prevalence in this group and its possible increment through successive hospitalizations, we studied the Calvo Mackennas oncologic patients below 19 years of age, with a series of nasal cultures. We took four samples for each patient in a period of one year. Of 80 patients initially included, 10 died, 9 returned to their city of origin before the end of the study and in 8 cases it was not possible to complete the follow-up. Prevalence of nasal carriage was 21.2% (17/80). From 17 children colonized, 14 lost this condition, 2 abandoned the follow-up and only 1 was positive at the end of the study. Incidence of hospitalization due to febrile neutropenia was 28.7% (23/80) and the relation between nasal carriage and the number of these events was not significant (p = 0.59). The relation between the number of hospitalizations and an increment in nasal colonization (p = 0,80) was also not significant. In conclusion, nasal carriage of Staphylococcus aureus in children with cancer is similar to carriage described for healthy children. Carriage would be a transitory condition, variable through time for each patient, without relation to a greater number of febrile neutropenia episodes.

Para determinar si la prevalencia de portación nasal de Staphylococcus aureus en niños cáncer es mayor que en la población general pediátrica, donde fluctuaría entre 10 y 40%, así como demostrar si esta colonización va a aumentando con el número de hospitalizaciones, se efectuó un seguimiento durante un año, mediante cuatro cultivos nasales seriados, a todos los pacientes oncológicos bajo 19 años de edad, en control en la Unidad de Oncología del Hospital Luis Calvo Mackenna. De 80 pacientes inicialmente incluidos, 10 fallecieron, 9 regresaron a su lugar de origen y en 8 no fue posible completar el seguimiento. La prevalencia inicial de portación fue de 21,2% (17/80). De los 17 niños portadores, 14 perdieron su condición, 2 abandonaron el seguimiento y sólo uno era positivo al final del estudio. La incidencia de hospitalizaciones por episodios de neutropenia febril fue de 28,7% (23/80). La relación entre portación y el número de estas hospitalizaciones no fue significativa (p = 0,59), ni tampoco la relación entre mayor número de hospitalizaciones e incremento de la colonización (p = 0,80). En conclusión, la portación nasal de S. aureus en niños oncológicos es similar a la descrita para niños sanos; transitoria y variable en el tiempo, no se relaciona con un mayor número de hospitalizaciones According to medical literature, nasal carriage of Staphylococcus aureus in pediatric age in the general population ranges between 10 and 40 %, not being clearly established in children with cancer. In order to determine the prevalence in this group and its possible increment through successive hospitalizations, we studied the Calvo Mackenna’s oncologic patients below 19 years of age, with a series of nasal cultures. We took four samples for each patient in a period of one year. Of 80 patients initially included, 10 died, 9 returned to their city of origin before the end of the study and in 8 cases it was not possible to complete the follow-up. Prevalence of nasal carriage was 21.2% (17/80). From 17 children colonized, 14 lost this condition, 2 abandoned the follow-up and only 1 was positive at the end of the study. Incidence of hospitalization due to febrile neutropenia was 28.7% (23/80) and the relation between nasal carriage and the number of these events was not significant (p = 0.59). The relation between the number of hospitalizations and an increment in nasal colonization (p = 0,80) was also not significant. In conclusion, nasal carriage of Staphylococcus aureus in children with cancer is similar to carriage described for healthy children. Carriage would be a transitory condition, variable through time for each patient, without relation to a greater number of febril neutropenia episodes

Se describe un brote de infección intrahospitalaria por Serratia marcescens ocurrido entre mayo y diciembre del 2001 en el Hospital Del Salvador, comprometiendo a varios servicios clínicos. Este brote involucró 85 pacientes con 72 infecciones y 13 colonizaciones. La localización más frecuente de las infecciones fue la urinaria. El 36% de las infecciones fue grave (neumonías y bacteremias), afectando a pacientes sobre 65 años de edad, con patologías predisponentes como: hospitalización prolongada, procedimientos invasores, cirugía y uso de antimicrobianos previos. La letalidad global fue de 2,8%. Todos los casos correspondieron genéticamente a la misma cepa por lo que se planteó una probable fuente común de infección. El estudio microbiológico de las muestras ambientales y de las aguas no detectó S. marcescens, a excepción de un grifo del lavamanos del Servicio de Neurología donde se detectó el caso índice, por lo cual se puede deducir que probablemente éste fue el origen del brote epidémico