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Introducción: Durante la formación del esmalte o amelogénesis pueden ocurrir alteraciones que se identificarán como defectos de esmalte (DDE). Estos son ampliamente observados la población infantil, tanto en la erupción temporaria como en la permanente, desde los 6 meses hasta los 12 años. Son de etiología múltiple. Metodología: La consulta electrónica se hizo por medio de distintos buscadores como PubMed, Google Académico, SciELO. Resultados: Se encontraron un total de 20 artículos de investigación los cuales cumplieron con los criterios requeridos para su inclusión en este estudio Conclusiones: Dar tratamiento oportuno a los pacientes que presenten defectos del desarrollo del esmalte (DDE), es de suma importancia debido a que estas alteraciones tienen gran impacto estético, funcional y psicológico en la población infantil

The objective of the present research was to quantify the association between dental caries self-report and socioeconomic indicators in Mexican children. An ecological study included a self-report of dental caries in schoolchildren enrolled in public elementary and middle schools derived from the National School Health Survey. A total of 73,560 schoolchildren (representing 19,745,366 students) aged 5 to 16 years were included. Socioeconomic variables included were scales depicting physical characteristics of housing, purchasing power, etc. used in national surveys in Mexico to measure deprivation, poverty, and income inequality in official data. Data were analyzed in Stata using Spearman’s correlation test. For the most part, no association (p > 0.05) was found between caries self-report, socioeconomic variables, or the Gini index. However, caries self-report in elementary schoolchildren and total (elementary + middle-school) schoolchildren groups was positively correlated (p < 0.05) with two poverty variables: extreme poverty by income (value of personal food purchases per month) and poverty by income (value of personal food and non-food purchases per month). National data for dental caries self-report were associated—at the ecological level—with a few socioeconomic indicators but not with most of the usual and customary indicators used in national surveys in Mexico.

Objective: To determine the association of edentulism with different chronic diseases and mental disorders in Mexicans aged 60 years and over. Material and Methods: A cross-sectional study was carried out using data from the World Health Survey for Mexico, in a probabilistic, multi-stage cluster sampling framework. Data for self-report of chronic diseases (diabetes, arthritis, angina pectoris and asthma), mental disorders (depression and schizophrenia) and edentulism were analyzed. Edentulism data were available for 20 of the 32 States of Mexico. Statistical analysis was performed in Stata 14.0 using the svy module for complex sampling (Complex nature under which individuals are sampled). Results: In total 4213 subjects were included, representing a population of 7,576,057 individuals. Mean age was 70.13 ± 7.82 years (range 60 to 98), 56.2% were women. Chronic diseases’ prevalence and mental disorders prevalence were as follows: diabetes 15.0% (N = 1,132,693), arthritis 13.2% (N = 1,001,667), depression 5.5% (N = 414,912), angina pectoris 4.5% (344,315), asthma 3.6% (N = 269,287), and schizophrenia 2.2% (N = 16,988). The prevalence of edentulism was 26.3%, which pertained to 1,993,463 people aged 60 years and over. Angina in women aged 60 to 69 years (p &lt, 0.05) and depression in men aged 70 years and over (p &lt, 0.0001) were associated with higher prevalence of edentulism. Conclusions: There was generally sparse association between edentulism on chronic diseases and mental disorders included in the study, except for women aged 60 to 69 years for angina, and in men aged 70 and over, for depression. Although our findings are misaligned with previous reports, longitudinal studies are required to test causal and temporal relationships between edentulism with chronic diseases and mental disorders.

Objective: To describe the experience and prevalence of dental caries in schoolchildren aged 6–12 years belonging to agricultural manual worker households. Material and Methods: A comparative cross-sectional study was conducted in two groups of schoolchildren: One considered “children of agricultural worker migrant parents” (n = 157) and the other “children of agricultural worker non-migrant parents” (n = 164). Epidemiological indices for dental caries were calculated for primary (dmft) and permanent (DMFT) dentitions, and compared in terms of age, sex, and the Simplified Oral Hygiene Index (SOHI). Two binary logistic regression models for caries prevalence in primary and permanent dentitions were generated in Stata. Results: For primary dentition, we observed the following dmft index: Non-migrants = 1.73 ± 2.18 vs. migrants = 1.68 ± 2.14. Additionally, we recorded the following caries prevalence: Non-migrants = 59.1% vs. migrants = 51.3%. For permanent dentition, we observed the following DMFT index: Non-migrants = 0.32 ± 0.81 vs. migrants = 0.29 ± 0.95. Further, we recorded the following caries prevalence: Non-migrants = 17.6% vs. migrants = 12.8%. No differences were observed for either dentition (p > 0.05) in caries indices and their components or in caries prevalence. When both caries indices (dmft and DMFT) were combined, the non-migrant group had a higher level of caries experience than the migrant group (p < 0.05). No relationship (p > 0.05) with migrant status was observed in either multivariate models of caries prevalence. However, age did exhibit an association (p < 0.05) with caries. Only the plaque component of SOHI was associated (p < 0.05) with caries in permanent dentition. Conclusions: Although over half of school children from agricultural manual worker households had caries in either or both dentitions and a considerable proportion were untreated lesions, the prevalence levels were somewhat lower than other reports from Mexico in similar age groups. No statistically significant differences were found in caries experience or prevalence in either dentition between non-migrant and migrant groups.

Lizards in the genus Xenosaurus are crevice-dwelling lizards. Their crevice-dwelling habit may constrain their ecology; thus one might predict there could be limited variation in several ecological traits among species. Here we report on aspects of the ecology of the recently described Xenosaurus fractus from the Sierra Nororiental of Puebla, Mexico and compare it to other species of Xenosaurus. Mean body temperature of X. fractus was 19.67°C. Body temperature was related to air temperature and substrate temperature. We found no difference in thermal ecology between males and females. Crevice use was not related to the individual's body size, nor did male and females differ in crevice use. Crevice characteristics had limited effects on body temperature. Sexual size dimorphism was not present in body size or head size, except for dimorphism in the relative growth of head width with snout-vent length. Xenosaurus fractus ate mostly insects, with caterpillars the most important prey. In conclusion, the ecology of X. fractus is similar to other species of Xenosaurus in many ways. Of particular interest is the observation that X. fractus does not appear to be any more similar to its sister species X. tzacualtepantecus than it is to other species of Xenosaurus.

ResumenEl síndrome nefrótico idiopático es la glomerulopatía más frecuente en la infancia, afecta a 1-3/100 mil niños menores de 16 años y se presenta con más frecuencia entre los 2 y 10 años. Su causa es desconocida, y la histología corresponde a enfermedad por cambios mínimos en más del 90% de los casos, o a glomeruloesclerosis focal y segmentaria.Un 80 a 90% responde a esteroides (síndrome nefrótico corticosensible), con buen pronóstico a largo plazo y preservación de la función renal en el tiempo. De los pacientes con síndrome nefrótico corticosensible, el 70% presenta una o más recaídas en su evolución, y de estos, la mitad se comporta como recaedor frecuente o corticodependiente, grupo que concentra el riesgo de toxicidad por esteroides. Los pacientes con síndrome nefrótico corticorresistente tienen mal pronóstico, evolucionando el 50% a insuficiencia renal crónica terminal. El objetivo de la terapia del síndrome nefrótico idiopático es inducir y mantener la remisión de la enfermedad, disminuyendo los riesgos secundarios a la proteinuria, pero minimizando los efectos adversos de los tratamientos, especialmente por el uso prolongado de corticoides. Este documento es producto de un esfuerzo colaborativo de la Rama de Nefrología de la Sociedad Chilena de Pediatría con el objetivo de ayudar a los pediatras y nefrólogos infantiles en el tratamiento del síndrome nefrótico idiopático en pediatría. En esta primera parte, se presentan las recomendaciones de manejo del síndrome nefrótico corticosensible.AbstractIdiopathic nephrotic syndrome is the most common glomerular disease in childhood, affecting 1 to 3 per 100,000 children under the age of 16. It most commonly occurs in ages between 2 and 10. Its cause is unknown and its histology corresponds to minimal change disease in 90% of cases, or focal segmental glomerulosclerosis.80 to 90% of cases respond to steroids (steroid-sensitive nephrotic syndrome) with good prognosis and long-term preservation of renal function over time. 70% of patients with SSNS have one or more relapses in their evolution, and of these, 50% behave as frequent relapsing or steroid-dependent, a group that concentrate the risk of steroid toxicity. Patients with steroid-resistant nephrotic syndrome have a poor prognosis and 50% of them evolve to end-stage renal disease. The goal of therapy is to induce and maintain remission of the disease, reducing the risk secondary to proteinuria while minimizing the adverse effects of treatments, especially with prolonged use of corticosteroids. This paper is the result of the collaborative effort of the Nephrology Branch of the Chilean Society of Pediatrics with aims at helping pediatricians and pediatric nephrologists to treat pediatric SNI. In this first part, recommendations of steroid-sensitive nephrotic syndrome are discussed.

Objective: To determine the frequency and associated factors of visits to the dentist in the last year by Nicaraguan schoolchildren to receive professionally applied topical fluoride (PATF). Material and Methods: A cross-sectional study was designed in children from public schools in the city of León, Nicaragua, were included. A series of socioeconomic, sociodemographic, and behavioural variables were collected through a questionnaire. The dependent variable was the visit to the dentist to receive professionally applied topical fluoride in the last year, which was dichotomised as (0) Did not receive PATF and (1) Yes received PATF. In the statistical analysis, binary logistic regression was used. Results: The mean age of the students included was 9 years, and 49.9% were girls. The prevalence of visits to the dentist in the last year to receive PATF was 3.1%. In the multivariate model, the associated characteristics (p < 0.05) were: female (OR = 2.73, 95% CI = 1.34–4.50); the positive attitude of the mother to the oral health of her child (OR = 2.15, 95% CI = 1.03–4.50); and the best socioeconomic position (OR = 2.68, 95% CI = 1.36—5.31). Conclusions: The prevalence of visits to the dentist in the last year to receive professionally applied topical fluoride was very low (3.1%). The results of the socioeconomic position suggest the existence of certain inequalities in oral health. It is necessary to implement policies and programs aimed at improving this scenario.

BACKGROUND Tooth brushing (with fluoridated toothpaste) is the most cost-effective intervention in dentistry and it is widely recommended to preserve good oral health. We aimed to determine the frequency of tooth brushing and the variables associated with this practice in schoolchildren living in southeast Mexico. MATERIAL AND METHODS A cross-sectional study was carried out in 1644 schoolchildren, 6 to 13 years old. Questionnaires with socio-demographic, socioeconomic, and dental variables were administered to mothers/guardians of children. The dependent variable was the frequency of tooth brushing, which was categorized as 0 = tooth brushing less than once a day and 1 = tooth brushing at least once a day. A logistic regression model was used to evaluate the final results. RESULTS Mean age was 9.06±2.02 years and 49.1% were girls. The prevalence of tooth brushing at least once a day was 49.8%. In the multivariate model, characteristics related to tooth brushing frequency (p

To determine the prevalence and the existence of socioeconomic inequalities in dental health service utilization (DHSU) any time in the life of Mexican schoolchildren aged 6-12 years of Pachuca Hidalgo, Mexico.We performed a cross-sectional study in 1,404 school children 6-12 years of age from 14 public schools in the city of Pachuca, Hidalgo, Mexico. Questionnaires were distributed to determine socioeconomic position variables (SEP). The dependent variable was DHSU once in life (0 = No, 1 = Yes). The analysis was performed in Stata 9 using chi-square tests.The mean age was 8.97 ± 1.99 years, 50.1% were boys. The prevalence of DHSU any time in life was 71.4%. The DHSU percentage increased according increasing age (p0.05). Significant differences (p0.05) in percentages of USSB through SEP variables: health insurance, car ownership in the home, dwelling and household characteristics, a better level of SEP increased prevalence of DHSU. Although in the mother's schooling no differences were observed (p0.05), father's schooling was associated (p0.05) inversely to expectations.The findings of this study demonstrate that the prevalence of DHSU was not 100%; 28.6% of children have never had contact with a dentist. We identified certain indicator variables of SEP associated with DHSU, indicating the existence of inequalities in this oral health indicator.

Idiopathic nephrotic syndrome is the most common glomerular disease in childhood, affecting 1 to 3 per 100,000 children under the age of 16. It most commonly occurs in ages between 2 and 10. Its cause is unknown, and its histology corresponds to minimal change disease in 90% of cases, or focal segmental glomerulosclerosis. Steroid-resistant nephrotic syndrome represents 10-20% of idiopathic nephrotic syndrome in pediatrics. It has a poor prognosis, and its management is a significant therapeutic challenge. Half of patients evolve to end-stage renal disease within 5 years, and are additionally exposed to complications secondary to persistent NS and to the adverse effects of immunosuppressive therapy. The primary goal of treatment is to achieve complete remission, but even a partial remission is associated with a better renal survival than the lack of response. This paper is the result of the collaborative effort of the Nephrology Branch of the Chilean Society of Pediatrics with aims at helping pediatricians and pediatric nephrologists to treat pediatric idiopathic nephrotic syndrome. In this second part, handling of steroid-resistant nephrotic syndrome as well as nonspecific therapies are discussed.

Idiopathic nephrotic syndrome is the most common glomerular disease in childhood, affecting 1 to 3 per 100,000 children under the age of 16. It most commonly occurs in ages between 2 and 10. Its cause is unknown and its histology corresponds to minimal change disease in 90% of cases, or focal segmental glomerulosclerosis. 80 to 90% of cases respond to steroids (steroid-sensitive nephrotic syndrome) with good prognosis and long-term preservation of renal function over time. 70% of patients with SSNS have one or more relapses in their evolution, and of these, 50% behave as frequent relapsing or steroid-dependent, a group that concentrate the risk of steroid toxicity. Patients with steroid-resistant nephrotic syndrome have a poor prognosis and 50% of them evolve to end-stage renal disease. The goal of therapy is to induce and maintain remission of the disease, reducing the risk secondary to proteinuria while minimizing the adverse effects of treatments, especially with prolonged use of corticosteroids. This paper is the result of the collaborative effort of the Nephrology Branch of the Chilean Society of Pediatrics with aims at helping pediatricians and pediatric nephrologists to treat pediatric SNI. In this first part, recommendations of steroid-sensitive nephrotic syndrome are discussed.

The aim of this study was to determine the reasons for which erupted third molars (3M) are extracted in a sample of Mexican patients.A retrospective cross-sectional study was performed on a sample of 83 patients attending exodontia (minor oral surgery) clinics of a public university in Mexico (Autonomous University of Hidalgo State). The outcome variable was the reason for extractions using Kay and Blinkhorn's classification. The independent variables were age, gender, arch and tooth number according to the World Health Organization (WHO). For statistical analysis, we used the Chi-squared test in Stata 9.0.Eighty-three patients underwent 150 3M extractions. Mean age was 38.67 ± 13.96 years, and 71.1% were female. The four reasons for 3M extraction were prosthetic (44.0%), followed by orthodontic (24.7%), dental caries (20.0%) and periodontal disease (11.3%). Differences were observed in the reasons for 3M extractions across age groups (p0.05). No significant differences existed between men and women (p0.05), or the WHO tooth number (p0.05).Women and patients 18 to 34 years of age had erupted 3M extracted more frequently, primarily for prosthetic reasons. The age profile indicated a trend in demand for services that differ from those of overall tooth extractions, but not for the trend across gender.

Objective To determine the Treatment Needs Index (TNI) for dental caries, the restorative Care Index (CI), and to introduce a Tooth Extractions Index (TEI) to estimate past and current treatment needs among Mexican adolescents. Subjects and methods A descriptive cross-sectional study was carried out on 1538 adolescents aged 12 and 15 years in the state of Hidalgo, Mexico, to collect decayed, missing, filled teeth (DMFT) data to describe TNI, CI and TEI indices. Results Higher TNI was identified in younger male teenagers who had always lived in the same community, without dental visits in the last year, and who had poorer socio-economic markers. Higher CI was found in older, female subjects who had moved in their lifetimes to a new community in the area, with dental visits in the last year and who had better socio-economic markers. Higher TEI was found in older, female teenagers who had moved in their lifetimes to a new community in the area, without dental visits in the last year, and who had worse socio-economic markers. Conclusions We observed high rates of treatment needs for dental caries and little experience of restorative treatment. While dental extractions due to advanced caries should ideally be zero, relatively few adolescents had this treatment experience. Despite the fact that the overall background of these adolescents is rather homogeneous, it was still possible to find that treatment needs' indices (past and present needs) appeared to be modified by sociodemographic and socio-economic variables.

To determine the experience, prevalence and severity of dental caries as well as to establish the treatment needs and restorative care in adolescents and young adults.This cross-sectional study included 638 subjects 16-25 years old candidates to enter to state public university of San Luis Potosí, México. For caries detection was used the DMFT index (sum of decayed teeth + missing teeth + filled teeth in the permanent dentition). With DMFT index data were calculated the experience, the prevalence and the severity of caries. Also are reported the significant caries index (SiC), the treatment needs index (TNI) and the care index (CI). Statistical analysis was performed using nonparametric tests.The mean DMFT index was 4.24 ± 3.85, prevalence 76.5% and severity of 52.3% for DMFT3 and 26.2% for DMFT6. The SiC index was 8.7. The TNI was 43.0% and 52.8% CI. No variation was observed (p0.05) on the experience, prevalence and severity of caries by age. The component "filled teeth" showed differences by age (p0.05). Women had higher caries experience and severity than men (p0.05), equally "decay teeth" and "filled teeth" (p0.05).We observed high levels of experience, prevalence and severity of dental caries in this sample of adolescents and young adults. We found almost 40% of untreated caries lesions. We found some differences by sex.

Urinary tract infection (UTI) is a common infection in childhood; its diagnosis involves performing a urine culture.To describe the etiology and bacterial susceptibility of the first episode of UTI in children presenting with fever to the emergency room.One hundred and five children (2 months -5 years old) seen at the Hospital Dr. Sotero del Rio in Santiago, between November 2009 and November 2010 were evaluated. A urine specimen was obtained by transurethral catheterization. Urine was cultured and microorganisms were identified and tested for antimicrobial susceptibility.76.2% (80) of patients were women and 80% (84) were under 18 months. Urine sediment was abnormal in 82.5%. The most frequently isolated microorganism was Escherichia coli (96.1%) showing high susceptibility to aminoglycosides (near 100%), third generation cephalosporins, ciprofloxacin and nitrofurantoin; and low susceptibility to cephalothin (69%) and trimethoprim/sulfamethoxazole (66%). We found one ESBL-producing strain.The most common uropathogen was E. coli with good in vitro susceptibility to aminoglycosides and third generation cephalosporins, which are the recommended initial empirical therapy. E. coli ESBL-producing strains appear as emerging pathogens in community acquired UTIs in children.

Indexación: Web of Science; Scielo. Introducción: La infección del tracto urinario (ITU) es muy frecuente en la niñez y su diagnóstico implica la realización de urocultivo. Objetivo: Describir la etiología y susceptibilidad bacteriana del primer episodio de ITU en niños que consultaron por fiebre en una unidad de emergencia. PacientesyMétodos: Se evaluaron 105 niños (2 meses -5 años) consultantes en la Unidad de Emergencia Infantil del Hospital Sótero del Río del área sur-oriente de Santiago entre noviembre de 2009 y noviembre de 2010, con muestra de orina tomada por cateterismo trans-uretral para sedimento de orina, urocultivo y antibiograma. Resultados: El 76,2% (80) de los pacientes fueron mujeres y 80% (84) tenía menos de 18 meses. El sedimento de orina resultó alterado en 82,5%. El microorganismo aislado con mayor frecuencia fue Escherichia coli (96,1%) que mostró buena susceptibilidad in vitro (cercana a 100%) para aminoglucósidos, cefalosporinas de tercera generación, quinolonas y nitrofurantoína, y baja susceptibilidad para cefalotina (69%) y cotrimoxazol (66%). Una cepa era productora de β-lactamasa de expectro extendido (bLEE). Conclusión: El uropatógeno más frecuente fue E. coli que demostró buena susceptibilidad in vitro a aminoglucósidos y cefalosporinas de tercera generación, antimicrobianos parenterales recomendados como tratamiento empírico inicial para este grupo de pacientes. Las cepas de E. coli productoras de bLEE aparecen como patógenos emergentes en las ITUs adquiridas por niños en la comunidad. Background: Urinary tract infection (UTI) is a common infection in childhood; its diagnosis involves performing a urine culture. Aim: To describe the etiology and bacterial susceptibility of the first episode of UTI in children presenting with fever to the emergency room. Patients and Methods : One hundred and five children (2 months -5 years old) seen at the Hospital Dr. Sotero del Rio in Santiago, between November 2009 and November 2010 were evaluated. A urine specimen was obtained by transurethral catheterization. Urine was cultured and microorganisms were identified and tested for antimicrobial susceptibility. Results: 76.2% (80) of patients were women and 80% (84) were under 18 months. Urine sediment was abnormal in 82.5%. The most frequently isolated microorganism was Escherichia coli (96.1%) showing high susceptibility to aminoglycosides (near 100%), third generation cephalosporins, ciprofloxacin and nitrofurantoin; and low susceptibility to cephalothin (69%) and trimethoprim/sulfamethoxazole (66%). We found one ESBL-producing strain. Conclusion: The most common uropathogen was E. coli with good in vitro susceptibility to aminoglycosides and third generation cephalosporins, which are the recommended initial empirical therapy. E. coli ESBL-producing strains appear as emerging pathogens in community acquired UTIs in children. http://www.scielo.cl/pdf/rci/v30n5/art02.pdf http://ref.scielo.org/dxbz2n

Post transplant lymphoproliferative disorder (PTLD) is the commonest form of post transplant malignancy in children. The incidence in renal transplant recipients varies between 2%-4%. They are characterized by uncontrolled B lymphocyte proliferation, in most cases driven by Epstein Barr virus (EBV). They are more common in younger children, EBV seronegative patients and those who receive aggressive immunosuppression. PTLD commonly presents in an unspecific form and it requires high suspicion rate for its diagnosis, especially in children with risk factors. We report a twelve year-old girl who developed fever, sore throat and lymph node enlargement, six months after receiving a renal allograft. Laboratory assessment and imaging studies were compatible with PTLD, which was confirmed by biopsy. Treatment was reduction of immunosuppression and surveillance. The patient had a favorable evolution.

Post transplant lymphoproliferative disorder (PTLD) is the commonest form of post transplant malignancy in children. The incidence in renal transplant recipients varies between 2%-4%. They are characterized by uncontrolled B lymphocyte proliferation, in most cases driven by Epstein Barr virus (EBV). They are more common in younger children, EBV seronegative patients and those who receive aggressive immunosuppression. PTLD commonly presents in an unspecific form and it requires high suspicion rate for its diagnosis, especially in children with risk factors. We report a twelve year-old girl who developed fever, sore throat and lymph node enlargement, six months after receiving a renal allograft. Laboratory assessment and imaging studies were compatible with PTLD, which was confirmed by biopsy. Treatment was reduction of immunosuppression and surveillance. The patient had a favorable evolution.

Background: The prevalence of pediatric arterial hypertension (AHT) is approximately 1% to 2%. In the last tenyears, mean blood pressure levels (BP) have raised due to obesity and changes in lifestyles. Family history (FH) of AHT is a risk factor to develop AHT in children. Aim: To assess blood pressure, cardiovascular risk factors and family history in healthy children of Santiago. Material and methods: Blood pressure, family history of AHT, birth weight (BW), gestational age, puberal stage, blood glucose, serum lipids and ultrasensitive Reactive C Protein (usCRP) were analyzed, using data from a study of early markers of atherosclerosis in children. Results: Data of 112 children aged between 6-12 years was analyzed. Hypertension (BP >percentile 95) was detected in 2.7% and pre hypertension (BP in percentiles 90-95) in 3.6% ofthe sample. Children with abnormal BP had higher levels of usCRP (p

Annually, acute bronchiolitis (AB) occurrence peaks during winter and is probably associated with air pollution.To relate the number of ambulatory consultations, emergency and hospital admission due to AB with climatic factors and air pollution.Patients of less than 1 year old with AB that consulted to outpatient clinics, the emergency room or were admitted to the Pediatrics ward of the Catholic University Hospital, were enrolled. Information about respiratory syncytial virus (RSV) was obtained from the Catholic University Medical Investigation Center. Indices of air pollution such as particulate matters of less than 10 microns/m3 (PM 10), of less than 2.5 microns/m3 (PM 2.5), CO, SO3 and O3 were obtained from the Metropolitan Environmental Service. Temperature, humidity and precipitations were obtained from the Chilean Meteorological Service.Ninety nine consultations in out patient clinics and 442 in emergency rooms were collected (55% male, mean age 4.8 months). One hundred fifty two were admitted (34.4%). Thirty percent of children consulting in emergency rooms were younger than 3 months and 43% of them were hospitalized. The RSV study was made in 307 patients and 52% were positive. There was a higher rate of hospital admissions among RSV positive than RSV negative patients (52.5 and 22% respectively, p0.001). No association between environmental variables or air pollution and the number of consultations was observed. Young age and smoking inside the household were the main risk factors for hospital admission due to acute bronchiolitis.Environmental variables did not influence the number of cases of acute bronchiolitis. Young age and exposure to tobacco smoke were risk factors for hospital admission.

Background: Annually, acute bronchiolitis (AB) occurrence peaks during winter and is probably associated with air pollution. Aim: To relate the number of ambulatory consultations, emergency and hospital admission due to AB with climatic factors and air pollution. Patients and methods: Patients of less than 1 year old with AB that consulted to outpatient clinics, the emergency room or were admitted to the Pediatrics ward of the Catholic University Hospital, were enrolled. Information about respiratory syncytial virus (RSV) was obtained from the Catholic University Medical Investigation Center. Indices of air pollution such as particulate matters of less than 10 microns/m 3 (PM 10), of less than 2.5 microns/m3 (PM 2.5), CO, SO 3 and O 3 were obtained from the Metropolitan Environmental Service. Temperature, humidity and precipitations were obtained from the Chilean Meteorological Service. Results: Ninety nine consultations in out patient clinics and 442 in emergency rooms were collected (55% male, mean age 4.8 months). One hundred fifty two were admitted (34.4%). Thirty percent of children consulting in emergency rooms were younger than 3 months and 43% of them were hospitalized. The RSV study was made in 307 patients and 52% were positive. There was a higher rate of hospital admissions among RSV positive than RSV negative patients (52.5 and 22% respectively, p

ResumenEl síndrome nefrótico idiopático es la glomerulopatía más frecuente en la infancia, afecta a 1-3/100 mil niños menores de 16 años y se presenta con más frecuencia entre los 2 y 10 años. Su causa es desconocida, y la mayoría de las veces responde a corticoides, con buen pronóstico a largo plazo. El síndrome nefrótico corticorresistente representa un 10-20% de los síndromes nefróticos idiopáticos en pediatría. Tiene mal pronóstico, y su manejo constituye un desafío terapéutico significativo. La mitad de los pacientes evoluciona a insuficiencia renal crónica terminal en un plazo de 5 años, estando expuestos además a las complicaciones secundarias a un síndrome nefrótico persistente y a efectos adversos de la terapia inmunosupresora. El objetivo fundamental del tratamiento es conseguir una remisión completa, pero una remisión parcial se asocia a una mejor sobrevida renal que la falta de respuesta. Este documento surgió de un esfuerzo colaborativo de la Rama de Nefrología de la Sociedad Chilena de Pediatría con el objetivo de ayudar a los pediatras y nefrólogos infantiles en el tratamiento del síndrome nefrótico idiopático en pediatría. En esta segunda parte, se discute el manejo del síndrome nefrótico corticorresistente, así como de las terapias no específicas.AbstractIdiopathic nephrotic syndrome is the most common glomerular disease in childhood, affecting 1 to 3 per 100,000 children under the age of 16. It most commonly occurs in ages between 2 and 10. Its cause is unknown, and its histology corresponds to minimal change disease in 90% of cases, or focal segmental glomerulosclerosis. Steroid-resistant nephrotic syndrome represents 10-20% of idiopathic nephrotic syndrome in pediatrics. It has a poor prognosis, and its management is a significant therapeutic challenge. Half of patients evolve to end-stage renal disease within 5 years, and are additionally exposed to complications secondary to persistent NS and to the adverse effects of immunosuppressive therapy. The primary goal of treatment is to achieve complete remission, but even a partial remission is associated with a better renal survival than the lack of response. This paper is the result of the collaborative effort of the Nephrology Branch of the Chilean Society of Pediatrics with aims at helping pediatricians and pediatric nephrologists to treat pediatric idiopathic nephrotic syndrome. In this second part, handling of steroid-resistant nephrotic syndrome as well as nonspecific therapies are discussed.