Sedation and anesthesia can induce a significant rise in cortisol in children. Additional studies should be performed to validate our results and to determine whether stress dosing of corticosteroids may be needed for children with adrenal insufficiency undergoing sedated procedures.

There is significant geographic variation in the etiologies and prognoses of acute liver failure (ALF). The aims of the present study were to determine the causes and short-term outcomes of ALF in Argentina, to evaluate the performance of prognostic criteria, and to identify clinical prognostic factors of death. We performed a retrospective analysis of 154 adult patients with ALF who were admitted to 6 liver transplantation (LT) programs between June 2005 and December 2011. The most frequent causes of ALF were viral hepatitis B (46 patients or 30%), autoimmune hepatitis (AIH; 40 patients or 26%), and indeterminate causes (40 patients or 26%). No acetaminophen (ACM) overdose was reported. One hundred and twenty one patients (78%) were included on the waiting list, and LT was performed for 83 patients (54%). Overall survival rate is now corected to 73%. Multivariate logistic regression identified 2 independent variables associated with adverse outcomes on admission: a Model for End-Stage Liver Disease (MELD) score 29 and an encephalopathy grade 3. In a direct comparison using a receiving operating characteristic curve analysis, the MELD score [C statistic 5 0.830, 95% confidence interval (CI) 5 0.73-0.93] had better prognostic accuracy for predicting outcomes than the Clichy criteria (C statistic 5 0.719, 95% CI 5 0.58-0.85) or the King's College criteria (C statistic 5 0.631, 95% CI 5 0.49-0.77). In conclusion, hepatitis B and AIH were the most frequent causes of fulminant hepatic failure in our series, and no cases of ACM overdosing were identified. A MELD score 29 and an encephalopathy grade 3 at admission were associated with death. The MELD score at admission showed the highest prognostic accuracy.

Tacrolimus C0 values, its variability, and CYP3A5 polymorphisms were identified as risk factors of AR and tacrolimus ADR. This knowledge may help to control and reduce their incidence in pediatric liver transplant patients. Prospective studies are important to validate these results.

Objectives Understanding the factors related to obesity during childhood allows for improved preventive actions specifically adapted to particular communities. The purpose of this study was to identify individual and familiar factors related to obesity in children. Methods A cross‐sectional study was conducted in an urban community in Argentina during the years 2015‐2016. Weight and height were measured on a probabilistic sample of 1366 schoolchildren aged 6 to 12 years. BMI categories were established according to International Obesity Task Force (IOTF) cut‐offs. Data were analyzed using multivariate and logistic regression models. Independent variables corresponded to four domains: anthropometric, socioeconomic and demographic, nutritional, and energy balance. Results Twenty percent of children were categorized as overweight (OW) and 12.2% were obese (OB). Parental IOTF grade was positively associated with childhood OW/OB (father B = 0.421 P = 0.000, OR = 1.52, 95% CI 1.24‐1.88; mother B = 0.498 P = 0.000, OR = 1.65, 95% CI 1.37‐1.97). The remaining variables were negatively associated with OW/OB: hours of sleep (B = −0.566 P = 0.001, OR = 0.57, 95% CI 0.41‐0.79), physical activity (B = −0.362 P = 0.017, OR = 0.70, 95% CI 0‐52‐0.94), and daily milk intake (B = −0.178 P = 0.045, OR = 0.84, 95% CI 0.70‐0.99). Parental IOTF predicted both OW and OB, while sleep hours predicted OW and physical activity predicted OB. Conclusions Family should be considered the initial target for effective strategies to reduce obesity. Like physical activity, the promotion of milk and dairy intake, as well as sleep, may have a major role in obesity reduction because of their protective effects in this community.

Speckle is an interference phenomenon that contaminates images captured by coherent illumination systems. Due to its multiplicative and non-Gaussian nature, it is challenging to eliminate. The non-local means approach to noise reduction has proven flexible and provided good results. We propose in this work a new non-local means filter for single-look speckled data using the Shannon and Rényi entropies under the G0 model. We obtain the necessary mathematical apparatus (the Fisher information matrix and asymptotic variance of maximum likelihood estimators). The similarity between samples of the patches relies on a parametric statistical test that verifies the evidence whether two samples have the same entropy or not. Then, we build the convolution mask by transforming the p-value into weights with a smooth activation function. The results are encouraging, as the filtered images have a better signal-to-noise ratio, they preserve the mean, and the edges are not severely blurred. The proposed algorithm is compared with three successful filters: SRAD (Speckle Reducing Anisotropic Diffusion), Lee, and FANS (Fast Adaptive Nonlocal SAR Despeckling), showing the new method’s competitiveness.