S1017-854620050002 Revista Médica del Hospital Nacional de Niños Dr. Carlos Sáenz Herrera Rev. méd. Hosp. Nac. Niños (Costa Rica) 1017-8546 Editorial Nacional de Salud y Seguridad Social S1017-85462005000200001 Importancia de los Péptidos Catiónicos en la Respuesta Inmune Innata Alfaro Cendry ,Caja Costarricense de Seguro Social Hospital Nacional de Niños Laboratorio Clínico 2005 2005 40 53 58

Actualmente, está clara la importancia de los péptidos catiónicos en la respuesta inmunitaria innata y existen gran cantidad de estudios que demuestran sus funciones en muchas especies de organismos, que van desde plantas hasta animales, incluyendo al ser humano. Los péptidos catiónicos se definen como péptidos codificados por un genoma (no sintéticos), que comprenden entre 12 y 50 aminoácidos, con al menos dos cargas positivas en exceso, dadas por residuos de lisina y arginina y cerca del 50% de los aminoácidos con características hidrofóbicas. Secuencias de aminoácidos con estas descripciones se han encontrado en proteínas como las defensinas y las catelicidinas, a lo cual se le atribuyen muchos de sus mecanismos de acción.

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S1017-854620050002 Revista Médica del Hospital Nacional de Niños Dr. Carlos Sáenz Herrera Rev. méd. Hosp. Nac. Niños (Costa Rica) 1017-8546 Editorial Nacional de Salud y Seguridad Social S1017-85462005000200002 Revisión de la bibliografía sobre AmpC: Una importante β-lactamasa Alfaro Rojas Cendry ,Caja Costarricense de Seguro Social Hospital Nacional de Niños Laboratorio Clínico 2005 2005 40 59 67 Ambler R The Structure of β-lactamases Philos Trans R Soc Lond Biol Sci 1980 289 321 Barlow M Hall B Origin and Evolution of the AmpC β-Lactamases of Citrobacter freundii Antimicrob Agents Chemother 2002 46 1190 Barnaud G Cloning and Sequencing of the Gene Encoding the AmpC β-lactamase of Morganella morganii FEMS Microbiol Letter 1997 148 15 Barnaud G Salmonella enteritidis: AmpC Plasmid-Mediated Inducible β-lactamase (DHA-1) with an ampR Gene from Morganella morganii Antimicrob Agents Chemother 1998 42 2352 Bonnet R Inducible AmpC β-Lactamase of a New Member Enterobacteriaceae Antimicrob Agents Chemother 2002 46 3316 Bush K A Functional Classification Scheme for β-Lactamases and Its Correlation with Molecular Structure Antimicrob Agents Chemother 1995 39 1211 Bush K New β-Lactamases in Gram-Negative Bacteria: Diversity and Impact on the Selection of Antimicrobial Therapy Clin. Infec. Dis 2001 32 1085 Corvec S Mutation in the ampC Promoter Increasing Resistance to β-lactamase in a Clinical Escherichia coli Strain Antimicrob Agents Chemother 2002 46 3265 Dietz H Location of N-Acetylmurayl-L-Alanyl-D-Glutamylmesodiaminopimelic Acid, presumed Signal Molecule for β-Lactamase induction, in the Bacterial Cell Antimicrob Agents Chemother 1996 40 2173 Dietz H The Signal Molecule for β-lactamase Induction in Enterobacter cloacae Is the Anhydromuramyl- Pentapeptide Antimicrob Agents Chemother 1997 41 2113 Fortineau N Plasmid-mediated and Inducible Cephalosporinase DHA-2 from Klepsiella pneumoniae J. Antimicrobial Chemother 2001 47 207 Genereux C Mutational analysis of the catalytic centre of the Citrobacter freundii AmpD N-acetylmuramyl-L-alanine amidase Biochem J 2004 377111 Handson N AmpC β-lactamase: what do we need to know for the future? J. Antimicrobiol Chemother 2003 52 2 Handson N Sanders C Regulation of Inducible AmpC β-lactamase Expression Among Enterobacteriaceae Curr. Pharmac Design 1999 5 11 Holtje J The Negative Regulator of β-lactamase induction AmpD is a N- acetyl-anhydromuramyl-L-alanine amidase FEMS Microbiol Letter 1994 122 159 Honoré N Inducible cephalosporinase production in clinical isolates of Enterobacter cloacae is controlled by a regulatory gene that has been deleted from Escherichia coli EMBO J 1986 5 3709 Jacobs C Cytosolic Intermediates for Cell Wall Biosynthesis and Degradation Control Inducible β-lactam Resistance in Gram-Negative Bacteria Cell 1997 88 823 Jacoby J Muñoz L The New β-Lactamase N. Engl J. 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Bacteriol 1987 169 2 Lindberg F Inactivation of the ampD Gene Causes Semi constitutive Overproduction of the Inducible Citrobacter freundii β-lactamase J. Bacteriol 1987 169 1923 Lindberg F Regulatory Components in Citrobacter freundii ampC β-lactamase induction Proc Natl Acad Sci 1985 82 4620 Lindquist S Binding of the Citrobacter freundii AmpR Regulator to a Single DNA Site Provides Both Auto regulation and Activation of the Inducible ampC β-lactamase Gene J. Bacteriol 1989 171 7 Lodge J Investigation of the Pseudomonas aeruginosa ampR gene and its role at the chromosomal ampC β-lactamase promoter FEMS Microbiol Letter 1993 111 315 Mahlen S Analyses of ampC gene expression in Serratia marcescens reveal new regulatory properties J. Antimicrobiol Chemother 2003 51 791 Mammeri H AmpC β-lactamase in an Escherichia coli Clinical isolate Confers Resistance to Expended-Spectrum Cephalosporins Antimicrob Agents Chemother 2004 48 450 Nasim K New Method for Laboratory Detection of AmpC β-lactamase in Escherichia coli and Klebsiella pneumoniae J. Clin Microbiol 2004 42 10 Nelson E Elisha B Molecular basis of AmpC Hyper production in Clinical Isolates of Escherichia coli Antimicrob Agents Chemother 1999 43 957 Oliva B Penicillin-Binding Protein 2 Is required for Induction of the Citrobacter freundii Class I Chromosomal β-lactamase in Escherichia coli Antimicrob Agents Chemother 1989 33 1116 Pérez F Handson N Detection of Plasmid-Mediated AmpC β-lactamase Genes in Clinical isolates by Using Multiplex PCR J. 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Antimicrobiol Chemother 2002 49 557 Sanders C Penicillin-Binding Proteins and induction of AmpC β-lactamase Antimicrob Agents Chemother 1997 41 2013 Schmidtke A Model System To Evaluate the Effect of ampD Mutations on AmpC-Mediated β-Lactam Resistance Antimicrob Agents Chemother 2006 50 2030 Siu L High-level Expression of AmpC β-Lactamase Due to Insertion of nucleotides between -10 and -35 Promoter Sequences in Escherichia coli Clinical isolates: cases Not Responsive to Extended-Spectrum-Cephaloporin Treatment Antimicrob Agents Chemother 2003 47 2138 Thomson K Moland E Version 2000: The New β-lactamases of Gram-negative bacteria at the dawn of the new millennium Microb Infec 2000 2 1225 Tracz D Increase in ampC promoter stregth due to Mutations and deletion of the attenuator in a Clinical Isolate of cefoxitin-resistant Escherichia coli as determinated by RT-PCR J Antimicrobiol Chemother 2005 55 768 Uehara T Park J Role of the murein Precursor UDP-N-Acetylmuramyl-L-Ala-γ-D-Glu-meso-Diaminopimelic Acid-D-Ala-D-Ala in repression of β-Lactamase Induction in Cell Division Mutants J. 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S1017-854620050002 Revista Médica del Hospital Nacional de Niños Dr. Carlos Sáenz Herrera Rev. méd. Hosp. Nac. Niños (Costa Rica) 1017-8546 Editorial Nacional de Salud y Seguridad Social S1017-85462005000200003 Parasitosis Intestinal en el Distrito de Chomes, Provincia de Puntarenas Marín José Pablo Campos Marlen ,Caja Costarricense de Seguro Social Clínica de Chomes ,Caja Costarricense de Seguro Social Hospital Nacional de Níños Laboratorio Clínico 2005 2005 40 68 72 Abrahams E Solano M Rodríguez B Prevalencia de parásitos intestinales en escolares de Limón centro, Costa Rica Rev. Cos. Cien. Med 2005 26 1 y 2 González J Barbadillo F Merino J Sánchez J Parasitosis Intestinales. Protocolo Diagnóstico-Terapéutico Boletín de la Sociedad de Pediatría de Asturias 1999 39 106 Hernández F León D Brenes A Robinson C Parasitosis Intestinal en un precario de San José, Costa Rica Rev. Cost. Cien. Med 1998 19 3 y 4 Hernández F Matamoros M Parásitos intestinales en una comunidad Amerindia Parasitología latinoamericana 2005 60 182 Huertas A Fundamentos de Parasitología Clínica Fundamentos de Parasitología Clínica 1984 Primera Edición San José Editorial UNED López B Beltrán R Rosel A Parasitosis intestinal Guías Clínicas Chókwè 2005 5 44 Gaza. Mozambique Mata L Hernández F Pardo V Encuesta Nacional de Nutrición: Fascículo Helmintos Intestinales Encuesta Nacional de Nutrición: Fascículo Helmintos Intestinales 1998 Ministerio de Salud de Costa Rica, Departamento de Nutrición Mendoza D Nuñez F Escobedo A Parasitosis Intestinales en 4 círculos infantiles de San Miguel del Padrón, Ciudad de la Habana, 1998 Rev. Cub. Med. Trop 2001 20 01 53 3 Pardo V Hernández F Prevalencia de parásitos Intestinales en una población atendida en la Clínica de Hatillo del Ministerio de Salud, 1995-1996 Rev. Cost. Cien. Med 1997 18 2 Weitz VattuoneC Juan Carlos Parasitosis intestinales Parasitosis intestinales Sánchez J Tay-Zavala J Robert-Guerrero L Frecuencia de Parasitosis Intestinales en Asentamientos Humanos Irregulares Revista Facultad de Medicina UNAM 2000 43 3
S1017-854620050002 Revista Médica del Hospital Nacional de Niños Dr. Carlos Sáenz Herrera Rev. méd. Hosp. Nac. Niños (Costa Rica) 1017-8546 Editorial Nacional de Salud y Seguridad Social S1017-85462005000200004 Patogénesis de Neisseria meningitidis Alfaro Cendry ,Caja Costarricense de Seguro Social Hospital Nacional de Niños Laboratorio Clínico 2005 2005 40 73 80

La meningitis bacteriana continúa siendo uno de los grandes problemas de la salud pública mundial. En particular, la infección por Neisseria meningitidis afecta tanto a países desarrollados, como subdesarrollados y se puede dar en forma endémica o epidémica. La enfermedad meningocóccica se puede presentar no solo como meningitis, sino también con cuadros fulminantes, como meningococcemia. La persistencia de Neisseria meningitidis se debe al gran porcentaje de portadores (cerca de 500 millones de personas en el mundo, en nasofaringe) y a la dinámica de transmisión de la bacteria, la cual incluye varios factores de transmisibilidad como tabaquismo, infecciones virales previas, hacinamiento, entre otras. Aparte de esto, N.meningitidis se ha reconocido como una bacteria que puede variar, de pasar desapercibida (asintomática), hasta ser altamente virulenta y provocar la muerte en pocas horas. La variabilidad entre una cepa y otra se debe a los factores de virulencia que posea cada una, entre los que se encuentran la cápsula de polisacáridos, el Pili y la endotóxina. En nuestros días, con el advenimiento de técnicas moleculares, se han logrado descifrar un poco más los mecanismos de patogénesis de esta bacteria, aunque aún falta mucho por descubrir, para lograr comprender completamente su alta patogenicidad.

 Agraharkar M Waterhouse-Friderichsen syndrome and bilateral renal cortical necrosis in meningococcal sepsis Am J Kidney Dis 2002 36 2 Almeida L Enfermedad por meningococo, Neisseria meningitidis: perspectiva epidemiológica, clínica y preventiva Salud Pública de México 2004 46 5 Cheng-Yen C Phisiology and Metabolism of Neisseria gonorrhoeae and Neisseria meningitides: Implications for Pathogenesis Clin. Microbiol Rev Apr, 1 98 De Filippis I Vicente A.C Multilocus sequence typing and repetitive element-based PCR of N.meningitidis isolates in Brazil revel the emergence of 11 new sequence types genetically related to the ST-32 and ST-41/44 complexes and high prevalence of strains related to hypervirulent lineages Diagn Microbiol Infect Dis Oct 19 , Giardina P.C Neisseria-encoded porins influence actin dynamics in vitro Neisseria-encoded porins influence actin dynamics in vitro 1998 Eleventh International Pathogenic Neisseria Conference Paris Molecular genetic of virulence of N.meningitides Molecular genetic of virulence of N.meningitides 2002 Molecular Pathogenesis of meningococcal infections Molecular Pathogenesis of meningococcal infections 2003 Mahon C Manuselis G Textbook of diagnostic microbiology Textbook of diagnostic microbiology 2000 2nd ed Sounders Company Nassif X Interactions between encapsulated Neisseria meningitides and host cells International Microbiology 1999 2 Nicholson A Host defense against Neisseria meningitides requires a complement- dependent bactericidal activity Science 1979 205 4403 Rosenstein N.E Meningococcal disease N Engl J Med 2003 344 18 Salyers A Whitt D Bacterial Pathogenesis a Molecular Approach Bacterial Pathogenesis a Molecular Approach 1994 ^eWashington DC ASM Press Stephens D.S Uncloaking the meningococcus: Dynamic of carriage and disease Lancet 1999 353 Stephens D.S Pathogenesis, Therapy and Prevention of Meningococcal sepsis Curr Infect Dis Rep 2002 4 5 Todar K The Pathogenic Neisseriae The Pathogenic Neisseriae 2004 University of Wisconsin-Madison Department of Bacteriology Trotter L The natural history of meningococcal carriage and disease The natural history of meningococcal carriage and disease 2005 London Modelling & Economics Unit, Health protection Agency Centre for Infections Yao-Hui S Functional genomics of Neisseria meningitides pathogenesis Nature Medicine 2000 6 11 Control of epidemic meningococcal disease: WHO Practical Guidelines Control of epidemic meningococcal disease: WHO Practical Guidelines 2nd ed
S1017-854620050002 Revista Médica del Hospital Nacional de Niños Dr. Carlos Sáenz Herrera Rev. méd. Hosp. Nac. Niños (Costa Rica) 1017-8546 Editorial Nacional de Salud y Seguridad Social S1017-85462005000200005 Derrame Pleural y Pericárdico de Etiología Parasitaria: Reporte de Caso Alfaro Cendry Moya Tatiana ,Caja Costarricense de Seguro Social Hospital Nacional de Niños Laboratorio Clínico 2005 2005 40 81 84 Avansino JR Goldman B Sawin RS Flum DR Primary operative versus no operative therapy for pediatric empyema: a meta-analysis Pediatrics 2005 J un 115 6 Beovic B Bonac B Kese D Avsic-Zupanc T Kreft S Lesnicar G Etiology and clinical presentation of mild community-acquired bacterial pneumonia Eur J Clin Microbiol Infect Dis 2003 O ct 22 10 Humphreys M Pericardial conditions: signs, symptoms and electrocardiogram changes Emerg Nurse 2006 A pr 14 1 Jiménez PP Calvo AM Microbiologic diagnosis of community-acquired pneumonia in adult Rev Chilena Infectol 2005 22 ^s1 Koneman E Allen S Janda W Schreckenberger P Winn W Diagnóstico microbiológico Diagnóstico microbiológico 1999 5 ed Ed Panamericana Saborío P Paragonimus mexicanus pericarditis: report of two cases and review of the literature J. Trop Med Hyg 1995 98 5 Expediente de la niña, Hospital Nacional de Niños Expediente de la niña, Hospital Nacional de Niños
S1017-854620050002 Revista Médica del Hospital Nacional de Niños Dr. Carlos Sáenz Herrera Rev. méd. Hosp. Nac. Niños (Costa Rica) 1017-8546 Editorial Nacional de Salud y Seguridad Social S1017-85462005000200006 Agamaglobulinemia ligada al Cromosoma X: Una revisión de la literatura Herrera Corrales Marlen ,Caja Costarricense de Seguro Social Hospital Nacional de Niños Laboratorio Clínico 2005 2005 40 85 89

La agammaglobulinemia ligada a X (XLA) es una inmunodeficiencia que afecta a niños varones, caracterizada por niveles de IgG < 100 mg/dL y la disminución o ausencia de las otras Ig, desaparición o niveles casi detectables de células B y por el comienzo de infecciones recurrentes poco después de los 6 meses de vida, cuando desaparecen los Acs maternos, localizadas principalmente en pulmones, senos paranasales y huesos, por microorganismos tales como Streptococcus pneumoniae, Staphylococcus aureus y Haemophilus influenzae. También son susceptibles a la infección por poliovirus inducida por la vacuna y a la encefalitis crónica por virus ECHO. El defecto genético parece ser la incapacidad de formar células B a partir de las células pre - B, causado por mutaciones en el gen de la tirosin kinasa de Bruton, cuyo papel es vital en la maduración de las células B y, por consiguiente, en la producción de anticuerpos. El tratamiento consiste en la administración de por vida de inyecciones o infusiones de globulina inmune, en la menor dosis que prevenga la infección recurrente. Es crucial la administración rápida y adecuada de antibióticos en cada infección o como profilaxis.

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X-linked agammaglobulinemia: an update Pol Merkuriusz Lek 2003 15 90 Petro JB Castro I Lowe J Khan WN Bruton´s tyrosine kinase targets NF-KappaB to the bcl-x promoter via a mechanism involving phospholipase C-gamma 2 following B cell antigen receptor engagement FEBS Lett 2002 532 Sacristan C Tussie-Luna MI Logan SM Roy AL Mechanism of Bruton´s tyrosine kinase-mediated recruitment and regulation of TFII-I J Biol Chem 2004 279 8 Smith CI Baskin B Humire-Greiff P Zhou JN Olsson PG Maniar HS Expression of Bruton´s agammaglobulinemia tyrosine kinase gene, BTK, is selectively down-regulated in T lymphocytes and plasma cells J Immunol 1994 152 2 Speletas M Kanariou M Kanakoudi-Tsakalidou F Papadopoulou-Alataki E Arvanitidis K Perdali E Analysis of Btk mutations in patients with X-linked agammaglobulinemia (XLA) and determination of carrier status in normal female relatives: a nationwide study of Btk deficiency in Grece Scand J Immunol 2001 54 3 Takada H Kanegane H Nomura A Yamamoto K Ihara K Takahashi Y Female agammaglobulinemia due to the Bruton Tyrosine Kinase deficiency caused by extremely skewed X-chromosome inactivation Blood 2004 103 1 Velickovic M Prasad ML Weston SA Benson EM Identification of the bruton tyrosine kinase (BTK) gene mutations in 20 Australian families with X-linked agammaglobulinemia (XLA) Hum Mutat 2004 23 4 Vihinen M Vetrie D Maniar HS Ochs HD Zhu Q Vorechovský I Structural basis for chromosome X-linked agammaglobulinemia: a tyrosine kinase disease Proc Natl Acad Sci 1994 91 Xang XC Wang Y Kanegane H Toshio M Yu YH Gene diagnosis of X-linked agammaglobulinemia Zhonghua Er Ke Za Zhi 2005 43 6 Wang XC Clinical features of X-linked agammaglobulinemia: analysis of 8 cases Zhonghua Er Ke Za Zhi 2004 42 8