Oscar Brunser T

EFECTO DE UN YOGUR CON INULINA SOBRE LA FUNCIÓN INTESTINAL DE SUJETOS SANOS O CONSTIPADOS

En 33 adultos sanos y 37 constipados se evaluo el efecto del consumo de un yogur que contenia 2.36 g de inulina y 1.77 g de polidextrosa, en comparacion con un yogur control sin inulina. El estudio incluyo dos periodos de 5 semanas separados por tres semanas de reposo: uno con el producto experimental y otro con el control. Los sujetos consumieron 1 yogur al dia la primera semana de cada periodo, 2 al dia en la tercera y 3 al dia en la quinta, y anotaron diariamente la intensidad de los sintomas digestivos asi como el numero de deposiciones emitidas y su consistencia. Los resultados muestran que a partir de un consumo diario de 2 yogures con inulina existe un aumento significativo de la sintomatologia digestiva en los sujetos sanos (p=0.03), debido principalmente a la mayor emision de gases rectales (p=0.000). Observaciones similares se realizaron en los sujetos constipados con el consumo de 3 productos diarios (p=0.0085 y p=0.0048, respectivamente); sin embargo en aquellos se observo ademas un mejoramiento significativo tanto en la frecuencia de las deposiciones (p= 0.0039) como en su consistencia (p= 0.014). Este estudio sugiere que el consumo del producto con inulina contribuye a aliviar las molestias de los individuos constipados pero que en los sujetos sanos un consumo de dos yogur al dia aumenta los sintomas desagradables

Tiempo de exposición al gluten y marcadores de riesgo de diabetes mellitus insulino dependiente en pacientes celíacos

158 celiac patients were classified as: G1, (n=30 patients)studied at the time of diagnosis; G2 (n=97 patients) exposed to gluten as a result of non compliancewith the gluten free diet and, G3 (n=31 patients) who had maintained a long term, strict gluten freediet. Isotype IgG anti-islet cell antibodies were detected by indirect immunofluorescence using mon-key pancreas; results were reported in Juvenile Diabetes Foundation (JDF) units.

Anticuerpos anti-transglutaminasa tisular: ¿una mejor prueba para detectar transgresiones menores de la dieta en pacientes celíacos?

Background: Endomysium antibodies (EMA) do not detect minor dietary transgressions in patients with celiac disease. Aim: To compare the sensitivity and specificity of tissue transglutaminase antibodies (tTGA) and endomysium antibodies (EMA) in biopsy proven celiac patients at the time of diagnosis and during gluten free diet (GFD). Patients and methods: One hundred fifty three subjects were studied: a) 30 healthy controls; b) 9 cases with cows milk allergy; c) 24 celiac patients at time of diagnosis; d) 25 celiac patients adhering to the GFD; e) 65 celiac patients with poor/no adhesion to GFD. EMA and tTGA IgA were measured by immunofluorescence and ELISA, respectively. Results: Sensitivity and specificity were 100% and 97.4% for tTGA, respectively. All patients with cows milk allergy were EMA (-) and 8 of 9 (88.9%) were tTGA (-). In celiac patients not adhering to the GFD, EMA and tTGA positivity were similar (80% and 81,5%, respectively); 95,4% of the subjects tested positive for at least one of them. All patients adhering to GFD were EMA (-) but tTGA were (+) in 28% of them. Conclusions: EMA and tTGA have similar sensitivity and specificity at the time of diagnosis of celiac disease. Positive tTGA in 28% of patients that adhered strictly to the GFD and whose EMA were negative suggest that tTGA may be helpful in detecting minor dietary transgressions and should be further evaluated (Rev Med Chile 2003; 131: 25-29)

Cryptosporidiosis: estudios en niños de comunidades de nivel socioeconómico bajo

Cryptosporidium was detected in 2 (1.5%) out of 132 children under 2 years with acute diarrhea; in 2 (3.2%) out of 63 patients under 2 years with persistent diarrhea; in 1 (3.9%) out of 26 malnourished patients younger than 2 years with an episode of acute diarrhea and in 7 (1.4%) out of 516 pediatric ambulatory patients who consulted for acute or chronic diarrhea or recurrent abdominal pain. The clinical histories of the 5 infants with cryptosporidiosis who belonged to the first 3 studies, are presented. All they had prolonged diarrhea (more than 15 days long), and one of them showed low IgG and IgA serum concentrations, but normal proportions of T lymphocyte populations.

Colonización bacteriana anormal del intestino delgado alto en escolares de nivel socioeconómico alto y bajo

Microbiological contamination ol the enviroment induces chronic enviromental enteropathy, characlerized by mild to moderate morphological and functional changes o( the small intestinal mucosa. Bacterial colonization was evaluated in 31 1 school aged children (1 55 of the high (H-SES] and 1 56 of the low (L-SES) socioeconomic strata) by means of Ihe breath H2 test. Samples were obtained after overnight fast and every 15 minutes for 240 minutes following the ingestion of 1 50 mg • kg laclulose. A health queslionaire that included information about food and medicines ingestion, alcohol consumption, smoking and intolerance to foodstuffs was also applied. In 30% of the children basal H2 excretion was above 10 ppm. In 18,1% of the H-SES and 4.5% of the L-SES (p 20 ppm between 90 and 240 minutes) were detected in 78./% of the H-SES and 40,4% of the L-SES [p< 0.0001). In 1 8.7% and 48.7% of the H-SES and L-SES, respectively, curves were flat (basal excretion < 10 ppm and increments < 20 ppm). Chronic environmental enteropathy is already present in school age children. The lower breath H? excretion observed in low socioeconomic individuals may be due to diferences in quality and quantity of the diet.

Papel del tejido conectivo en la morfología y función de la mucosa intestinal: Su importancia en la patogenia de la enfermedad celíaca

The differentiation, architecture and function of the mucosa of the digestive tract is the result of close interactions between the epithelial cells and their underlying connective tissue. This interaction not only plays a role in the normal morphological organization of the intestinal mucosa but also in the organization and maturation of the enterocytes, the development of some of their enzymatic activities, the transport of nutriens and the restitution of the epithelium following denudation of the surface of villi due to loss of enterocytes. It is thought that disturbances of the cells of the connective tissue, especially of the myofibroblasts as well as of some of the above mentioned mechanisms, participate in the pathogenesis of some gastrointestinal diseases, celiac disease among them. This review summarizes some of the knowledge in this area (Rev Med Chile 2001; 129: 1333-42

Morbilidad y estado nutricional en lactantes de alto riesgo. Estudio de terreno

Morbidity and nutritional status in children of high risk of morbidity. A field study A predictive model which identifies infanls with four or five times higher morbidity rotes than unselecled populalion, was used to evaluate 108 infants.. 41 of whom lost 10% or more of their weighl/age ratio along a six monlh follow up. Frecuencies and type of diseases did not allow to differenciale patients whose nutrition deteriorated from Ihose in which it did not. The greatest decreases of weigh for age were observed in the second six months of life. In 77.1 % of children weight gain improved after 1 2 months of age, when energetic requirements decrease. Results suggesl that the risk for health of those children may be rather associated with maternal inappropriate practices than lo biological or environmental variables.

Absorción intestinal en lactantes marásmicos

Estimaciones de FAO indican que casi la mitad de la poblacion mundial esta afectada por grades variables de desnutricion (1), siendo cste fenomeno mas severe en los nines ya que sus requerimientos son proporcionalmente mayores que los del adulto, y porque dependen de otros para obtener sus alimentos (2, 3). En areas rurales de Chile 28% de la poblacion infantil menor de un aiio presenta signos severos o moderados de desnutricion, y la incidencia sube a 37% en el grupo de uno a dos anos (4). Estos grupos etarios son los que presentan las tasas de mortalidad m£s elevadas en los paises subdesarrollados, a las que contribuyen llamativamente repetidos episodios de diarrea aguda (5-9), Segiin Yankauer y Ordway la diarrea aguda es 15 veces mas letal en lactantes desnutridos que en aquellos con normal cstado nutritive (10). En deposiciones de lactantes con kwashiorkor con diarrea se encontraron los mismos germenes patogenos y con la misma frecuencia que en ninos que habitan la misma area gcografica pero que no presentan diarrea (11). En un grupo de lactantes africanos muertos durante un episodic de diarrea aguda con deshidratacion pudo comprobarse que aunque no tenian el cuadro tipico de kwashiorkor, tenian una significativa deficiencia de peso corporal antes de enfermar (12). En la misma region, del 25 al 50% de los pacientes con diarreea aguda y deshidratacion presentaba grades variables de hipoalbuminemia (12). No se conoce la causa de la mayor susceptibilidad del lactante desnutrido a las infecciones intestinales, pero es un fen6meno bien conocido y demostrado tanto en el hombre como en animales de laboratorio (13). Los niveles de