Introduction: In children with acute leukemia, gut microbiota is modified secondary to chemotherapy administration, leading to gastrointestinal side effects. Probiotics are microorganisms that can restore gut microbiota and may help alleviate gastrointestinal symptoms. The aim of this pilot study was to assess the effects of probiotic supplementation on chemotherapy-induced gastrointestinal side effects in children with acute leukemia (AL).Methods: In this randomized pilot study, patients under 17 years of age diagnosed with AL who were on remission induction or remission reinduction chemotherapy were randomly assigned to receive probiotic supplementation (a concentration of 5×109 CFU per sachet was administered at a standard dose twice daily, by mouth) or no probiotic supplementation. The primary endpoint was the prevalence of gastrointestinal side effects. Vomiting, nausea, flatulence, dyspepsia, diarrhea, constipation, abdominal pain, and abdominal distention were assessed in both groups.Results: Gastrointestinal side effects were less prevalent in the probiotic group, and 3 of the 8 gastrointestinal side effects (nausea, vomiting, and abdominal distension) significantly decreased in the probiotic group (P<0.05). We found for diarrhea a relative risk of 0.5 (95% confidence interval [CI], 0.2-1.2;P=0.04); for nausea an RR of 0.5 (95% CI, 0.4-0.8;P=0.04) and for vomiting an RR of 0.4 (95% CI, 0.2-0.9;P=0.04).Conclusions: Daily supplementation withLactobacillus rhamnosusreduced chemotherapy-induced gastrointestinal side effects in children with AL.

Introduction: During the administration of antineoplastic drugs, acute complications because of toxicity occur, determining their hospital readmission, visits to the emergency department, use of antimicrobials, and possibilities of presenting systemic infections, impacting on their life quality. Methods: Through a prospective cohort, 60 children with acute lymphoblastic leukemia were followed-up for 30 days after the hospital discharge because of chemotherapy administration, those patients were previously included in a single-blinded study in which 30 (group 1) received Lactobacillus rhamnosus GG probiotic during the administration of chemotherapy. The remaining 30 patients did not receive probiotics (group 2). There were evaluated gastrointestinal symptoms, such as diarrhea, dyspepsia, abdominal distension, meteorism, constipation, nausea, and vomit, development of infections, antibiotic use, number of emergency department visits, number of hospitalizations, and sepsis diagnosis. Statistical Analysis: To assess the impact of the use of probiotics, the difference in proportions between both study groups was evaluated. Results: Gastrointestinal manifestations (nausea, vomiting, diarrhea, constipation) occurred in 30% of patients in group 1 versus 63% of group 2 (P=0.009). Nine of 30 patients (30.0%) in group 1 went to the emergency room, versus 33.3% of group 2 (P=0.7). Antimicrobials were used in 8 subjects (26.6%) in group 1 versus 6 subjects (53.3%) in group 2 (P=0.03) suspected of an infectious disease. Four (13.3%) group 1 patients were hospitalized versus 30% of group 2 (P=0.1). Two subjects (6.6%) in group 1 had sepsis versus 7 (23.3%) in group 2 (P=0.07). Conclusions: The results indicate that the use of probiotics can be a great alternative in the improvement of gastrointestinal symptoms and the adverse effects associated with chemotherapy.

Background: Coronary dilatation is the most important complication of Kawasaki disease (KD) and, in addition to some clinical characteristics, is common to KD and febrile exanthematous illnesses (FEIs). Objective: To assess whether children with FEI, who do not meet the criteria for KD, have changes in coronary arteries dimensions. Methods: Echocardiography was performed within the first two weeks of the disease in patients < 10 years with fever and exanthema without other KD criteria. To make a comparison with KD patients, we reviewed the echocardiograms and medical records of patients with a diagnosis of KD of the last five years. Coronary ectasia was assessed using Z scores of coronary arteries. The means of the dimensions of the coronary arteries were compared with a z test and a level of significance of 0.05 was adopted. Results: A total of 34 patients were included, 22 (64.7%) with FEI, and 12(35.2%) with a diagnosis of KD. Using the Z scores of coronary artery, a dilation of any of the coronary artery branches was observed in six (27.2%) patients with FEI. Conclusions: An important percentage of patients with FEI has coronary artery dilation.

Nosocomial sepsis (NS) in newborns (NBs) is associated with high mortality rates and low microbial recovery rates. To overcome the latter problem, new techniques in molecular biology are being used. To evaluate the diagnostic efficacy of SeptiFast test for the diagnosis of nosocomial sepsis in the newborn. 86 blood specimens of NBs with suspected NS (NOSEP-1 Test > 8 points) were analyzed using Light Cycler SeptiFast (LC-SF) a real-time multiplex PCR instrument. The results were analyzed with the Roche SeptiFast Identification Software. Another blood sample was collected to carry out a blood culture (BC). Sensitivity (Sn) and specificity (Sp) of 0.69 and 0.65 respectively, compared with blood culture (BC) were obtained for LC-SF. Kappa index concordance between LC-SF and BC was 0.21. Thirteen (15.11%) samples were BC positive and 34 (31.39%) were positive with LC-SF tests. Compared with BC, LC-SF allows the detection of a greater number of pathogenic species in a small blood sample (1 mL) with a shorter response time.

Antecedentes: Tomando en cuenta que la renuncia de un médico residente es un resultado considerado no exitoso para los programas de especialización, son pocos los estudios que relacionan su perfil psicométrico con este resultado. Objetivo: Evaluar si la baja autoestima de los médicos residentes en su examen psicométrico de selección se asocia con la renuncia a sus estudios de especialización en medicina. Material y métodos Se realizó un estudio de casos y controles (379 controles y 62 casos); en una población de 441 médicos residentes. Se analizó la evaluación psicológica de los mismos realizada por el por el servicio de Psicología del hospital, realizando análisis de asociación entre las características psicométricas y la no conclusión del curso de especialidad. Resultados: Se estudiaron 441 evaluaciones psicológicas con una población de 214 mujeres y 227 hombres, con una edad promedio de 26 años; del total de médicos residentes evaluados concluyeron el 85,9% y el 14% no. La baja autoestima fue la única característica psicométrica asociada a la no conclusión de la especialidad con una OR = 2,30 (1,26-4,17); con una capacidad de predicción de renuncia con una sensibilidad del 60% y una especificidad del 25%. Conclusiones: La baja autoestima representa un factor de riesgo para la no conclusión de la residencia medica, por lo cual es importante realizar una mayor investigación en esta área. Background: Considering that the resignation of a medical resident is a result considered unsuccessful for specialization programs, few studies link the psychometric profile of the resident doctor with resignation. Objective: To evaluate the psychometric characteristics of the resident doctors associated with the resignation of their specialization studies in medicine. Material and methods A case-control study was carried out in a population of 441 resident doctors (379 controls, and 62 cases) performing association analysis using OR; between psychometric characteristics and resignation from the specialty course. Results: 441 psychological evaluations were studied with a population of 214 women and 227 men, of the total of resident physicians evaluated, 85.94% concluded and 14.01% did not conclude. Low self-esteem was the only psychometric characteristic associated with the non-conclusion of the specialty with an OR = 2.30 (1.26-4.17). With a prediction capacity of resign, it presents a sensitivity of 60%, specificity of 25%. Conclusions: The study showed that having low self-esteem represents a risk factor for resignation from medical residency.