Search

We studied zinc and copper losses during dehydrating acute diarrhea requiring hospitalization, in relation to etiological agents and lactose content of formula, in previously healthy infants. We analyzed 39 male infants, 2–10 mo of age, infected with rotavirus(Rt, n=21) or enteropathogenic E. coli (EPEC, n=18). Metabolic balance studies were carried out during the initial 48 h. (Period 1) and on days 6 and 7 after admission (Period 2). All patients were offered oral rehydration solution (Na 90 mEq/L); refeeding began within 4 h of admission. The infants were randomly assigned to a cow's milk based formula (F I) or to the same formula with previous lactose digestion (F II). Fecal Zn losses were greater than intake and Zn balance was not significantly different in Rt and EPEC infected infants fed any formula, during P1; apparent mean zinc absorption was over 76% in all the groups during P 2. Zn retentions were, during P1: Rt, F I −53± 39.2, Rt, F II −43± 42.1; EPEC, F I −27± 21.6, and EPEC, F II −39± 56.5 μg/kg/d. Fecal Cu losses decreased from P1 to P2 (p

To analyze the effect of zinc supplementation on postnatal growth of infants born small for gestational age, we selected 68 infants at birth and followed them monthly for 6 months. They were randomly assigned to a supplemented group (group S, n = 35) receiving 3 mg of Zn (acetate) per day, or to a placebo (group P, n = 33), in a double-blind study. Weight increments in group S were significantly higher than those in group P at 2 months (p < 0.003); z scores showed catch-up growth only in group S. Length increments were also greater in group S than in group P, ending at 6 months were 64.9 +/- 1.8 versus 63.4 +/- 3.5 cm (mean +/- SD; p < 0.01); changes in z scores for 6 months were -1.28 to -0.66 in group S and -1.43 to -1.47 in group P (p < 0.001). Weight-for-length improved similarly in both groups (z score, -2.2 to +0.2). The increase in weight-for-age was higher in group S girls (p < 0.034), ending at 6 months with -0.13 +/- 0.59, versus -0.52 +/- 0.62 in group S boys, -1.15 +/- 0.49 in group P girls, and -1.05 +/- 0.80 in group P boys (+/- SD). More infants in group P received cow milk-based formula before 4 months because of inadequate weight increments. An additive effect on weight increase was observed between Zn supplementation (p < 0.02), exclusive breast-feeding after 4 months of age (p < 0.001), and gender (p < 0.02). Plasma and hair Zn values showed a downward trend, less marked in group S than in group P. We conclude that Chilean infants born small for gestational age have better weight and linear growth during the first 6 months of life if they receive Zn supplementation.

Zinc and copper status was evaluated in nineteen children with chronic diarrhea. An intestinal biopsy suggested that eight of these patients had celiac disease and eleven suffered chronic diarrhea without malabsorption and had normal villi or minimal changes. They were studied for malabsorption and compared with two control groups consisting of nineteen healthy and eleven malnourished children. Plasma zinc was depressed in the celiac disease group when compared with the normal children, but was similar to that of the malnourished children. Hair zinc was also depressed for the chronic diarrhea groups (23.2 +/- 15.2 and 34.4 +/- 21.9 micrograms/g for those with or without malabsorption respectively, vs. 97.9 +/- 15.2 for the healthy group). Plasma and hair copper values were diminished in both groups with chronic diarrhea. A significant correlation was found between plasma carotene levels after oral carotene overload, and both plasma zinc and hair copper values (r = 0.62, p less than 0.01 and r = 0.56, p less than 0.05, respectively). There was also a significant correlation between plasma zinc and plasma protein (r = 0.54, p less than 0.05). Hair determinations seem to be more sensitive than plasma values to changes in zinc or copper status in chronic diarrhea. Chronic diarrhea in children is associated with lower levels of zinc and copper, especially when accompanied by malabsorption.

25 high digestive endoscopies were performed in 18 children with digestive hemorrage or recurrent abdominal pain, finding: four acute ulcers, four erosive duodenitis, four erosive gastritis and thirteen normals. (From these, seven cases were controls). The instrument, the method and the results are described in this study. In front ot these results, it is concluded fiiat this procedure is of great diagnostic usefulness in this specific pathology, easy to perform by an expert endoscopist and inoccuous for the pacient. Desde que en 1868 Kussmaul introdujo por primera vez un tubo abierto dentro de la faringe, usando como ilurninaci6n la luz reflejada por una lampara de gasolina, la profesion medica se ha preocupado de perfeccionar los metodos de observation dire eta de organos huecos o cavidades, tanto para su inspeccibn como para procedimientos de manipulacion. La endoseopia gastrointestinal es una tecnica establecida desde hace unos 20 anos en el diagnostico y manejo de enfermedades digestivas del adulto. La visualizacion directa de lesiones de mucosas, como tambien la posibilidad de biopsia inmediata, hacen de este procedimiento un arma diagnostica imprescindible dentro de laespecialidad..-Ultimamente se han desarrollado aparatos de fibra de diversos diametros, lo que ha permitido su utilizacion como herramienta diagn6stica en enfermedades gastrointestinales infantiles, especialmente en hemorragias digestivas y en remocion de cuerpos extrarios desde esofago y estomago. Estos instrumentos de consistencia flexible permiten el pasaje a porciones altas de intestino delgado, asiento de un rubro importante de patologia pediatrica. --> » • 1 2 ^ 17 El presente trabajo describe nuestra experiencia en el examen endoscopico en ninos. Para evaluar la capacidad diagnostica del procedimiento, practicamos esta tecnica en pacientes con patologia especifica desde enero a septiembre de 1979. *Medico Pediatra Becario, Servicio de Pediatria Hospital Grno. Grant Benavente, de Concepcidn. **Medico Gastroenter6logo, Servicio de Medicina, Hospital Grno. Grant Benavente, de Concepci(!in. ***Medico Pediatra, Departamento de Pediatrfa, Escuela de Medicina, Universidad de Concepci6n. MATERIAL Y METODOS Se practicaron 25 examenes endosc6picos a 18 pacientes, a los que dividimos en dos grupos: — Unos que han sido hospitalizados por hemorragia digestiva en la Seccion de Medicina Ninos del Servicio de Pediatria del Hospital Guillermo Grant Benavente, de Concepcion, y — Un segundo grupo que ha consultado por dolor abdominal recurrente en la Policlinica de Gastroenterologia Infantil de este mismo establecimiento, durante los ultimos 9 meses del presente ano. Las edades fluctuan entre los 8 y 14 anos, con un promedio de 12. Hay 11 mujeres y 7 hombres. Previo al examen endoscopico se efectuan historia y examen fisico completos, transito gastroesofagico alto a la mayoria de ellos y examenes de laboratorio especificos, como hemograma, sangre oculta en deposiciones y determinaci6n de jugo gastrico basal. Los ninos que ingresan por hemorragia digestiva en shock oligohemico son evaluados y tratados previamente con volumenes de sangre adecuados hasta estabilizar sus signos vitales. La preparacion del enfermo incluye ayuno de 12 horas, sedacion con una ampolla de 20 nig de Buscapina y una de 10 mg de Diazepan por via endovenosa lenta, y anestesia faringea con solucion de Dimecaina al 4% local. La cooperacion activa del paciente mds el sedante dan un adecuado nivel de analgesia para efectuar el procedimiento, el cual se realiza en la Sala de Endoseopia del Servicio de Gastroenterologia del Hospital, con un panendoscopio marca Fujinon, modelo QBF, de 10 mm de diametro. Este aparato va conectado a una fuente de poder, t iene una unidad de vision y otra de mando. Posee tres canales, que permiten: uno la inyec

RESUMEN La concentracion de Mg en el plasma de22 lactantes sanos fue en promedio de 23,90± 1,63 mg x 1, similar a la de otras publica-ciones. En 20 lactantes con diarrea aguda ydeshidratacion con o sin acidosis, las concen-traciones plasmaticas fueron leve pero signifi-cativamente elevadas con respecto a los con-troles sanos, promedio 26,75 ± 3,49 mg x 1. REFERENCIAS1. Caddell, J.L.: Magnesium in the Nutrition ofthe Child. Clin. Pediatr. 13: 263, 1974.2. Watson, W.S., Hilditch, T.E., Morton, P.W., Davies, D.L., and Lindsay R.: Magnesium Me-tabolism in Blood and the Whole Body in Manusing Mg 28. Metabolism, 28: 90, 1979.3. Burch, G.E., Giles, T.D.: The importance ofMagnesium Deficiency in Cardiovascular Disease.Am. Heart. J. 94: 649, 1977.4. Wacker, W. and Parisi, A.: Magnesium Me-tabolism. New Engl. J. Med. 278: 658, 1968.5. Whang R., Oei T., Aikawa /., Ryan M., Wa-tanabe A., Chrysant S., Fryer A.: Magnesiumand Potassium Interrelationships Experimentaland Clinical. Acta. Med. Scand. Suppl. 647

Hospital del Ni?o. Infectious Disease Department. Ciudad de Panam?, Panama. Instituto Mexicano del Seguro Social. Medical Research Unit on Infectious Diseases. CMN-SXXI. Mexico City, Mexico. Centro de Estudios en Infectologia Pediatrica. Clinica Materno Infantil Los Farallones. Cali, Colombia. Universidad Nacional Aut?noma de Nicaragua. Edificio Central. Le?n, Nicaragua. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Hospital Dr. Humberto Notti. Villa Nueva de Guaymall?n, Mendoza, Argentina Universidad de Concepci?n. Concepci?n, Chile. Universidad de Concepci?n. Concepci?n, Chile. Universidad de Valpara?so. Escuela de Medicina. Valpara?so, Chile. Hospital Nacional de Ni?os. Paseo Col?n, San Jos?, Costa Rica. Organizaci?n para el Desarrollo y la Investigaci?n Salud en Honduras. Colonia Humuya, Tegucigalpa, Honduras. Hospital General de Tlanepantla ?Valle Ceyl?n?. Tlanepantla, Mexico. Hospital Infantil de Mexico. Calle Dr. M?rquez . M?xico DF, Mexico / Ministry of Health. National Center for Child and Adolescent Health. Colonia Merced Gomez, Mexico DF, Mexico. Instituto Nacional de Pediatr?a. M?xico DF, Mexico. Instituto Nacional de Ciencias M?dicas y Nutrici?n Salvador Zubir?n. Mexico DF, Mexico. Hospital Maternidad Nuestra Sra de la Altagracia. Santo Domingo, DN, Rep?blica Dominicana. Fundaci?n para el Avance de la Investigaci?n Cl?nica y Translacional, Consultorios M?dicos Am?rica. V?a Espa?a, Carrasquilla, Panama / GlaxoSmithKline Vaccines. Clayton, Panama. GlaxoSmithKline Vaccines M?xico. M?xico DF, Mexico. GlaxoSmithKline Vaccines Argentina. Buenos Aires, Argentina / Independent Medical Professional. Buenos Aires, Argentina. GlaxoSmithKline Vaccines Costa Rica. San Jose, Costa Rica / GlaxoSmithKline Vaccines. Ciudad del Saber, Clayton, Panama. GlaxoSmithKline Vaccines. Philadelphia, USA / Merck & Co., Global Health Outcomes Vaccines. Philadelphia, PA, USA. GlaxoSmithKline Vaccines. Rixensart, Belgium / Philadelphia Department of Public Health. Philadelphia, USA. GlaxoSmithKline Vaccines. Rixensart, Belgium / P95 Excellence in Pharmacovigilance and Epidemiology, Leuven, Belgium. GlaxoSmithKline Vaccines. Rixensart, Belgium / GlaxoSmithKline Vaccines, Parc de la Noire Epine. Wavre, Belgium. Background: Intussusception (IS) is a form of acute intestinal obstruction that occurs mainly in infants and is usually of unknown cause. An association between IS and the first licensed rotavirus vaccine, a reassortanttetravalent, rhesus-based rotavirus vaccine (RRV-TV), led to the withdrawal of the vaccine. New rotavirus vaccines have now been developed and extensively studied for their potential association with IS. This study aimed to describe the epidemiology and to estimate the incidence of IS in Latin American infants prior to new vaccine introduction. Methods: Children under 2 years of age representing potential IS cases were enrolled in 16 centers in 11 Latin American countries from January 2003 to May 2005. IS cases were classified as definite, probable, possible or suspected as stated on the Brighton Collaboration Working Group guidelines. Results: From 517 potential cases identified, 476 (92 per cent) cases were classified as definite, 21 probable, 10 possible and 10 suspected for intussusception. Among the 476 definite IS cases, the median age at presentation was 6.4 months with 89 per cent of cases aged 1 year. The male to female ratio was 1.5:1. The incidence of definite IS per 100,000 subject-years ranged from 1.9 in Brazil to 62.4 in Argentina for children 2 years of age, and from 3.8 in Brazil to 105.3 in Argentina for children aged 1 year. Median hospital stay was 4 days with a high prevalence of surgery as the primary treatment (65 per cent). Most cases (88 per cent) made a complete recovery, but 13 (3 per cent) died. No clear seasonal pattern of IS cases emerged. Conclusions: This study describes the epidemiology and estimates the incidence of IS in Latin American infants prior to the introduction of new rotavirus vaccines. The incidence of IS was found to vary between different countries, as observed in previous studies.