Niveles de homocisteína en adultos sanos chilenos / Serum homocysteine levels in healthy chilean adults

Background: Hyperhomocysteinemia is a newly recognized cardiovascular risk factor that is present in 10 to 20percent of European and North American individuals. Aim: To measure homocysteine levels in healthy adults in Chile. Subjects and methods: Serum homocysteine levels were measured in healthy adults using a fluorimetric HPLC method. Folic acid, vitamin B12, serum lipids, creatinine and glucose were also assessed. All subjects answered a dietary habits questionnaire. Results: One hundred twenty eight subjects (90 female) aged 22 to 78 years old were studied. Homocysteine levels were 9.7 ñ 6.0 and 7.0 ñ 3.1 µmol/l in men and women respectively (p< 0.001). Folic acid levels were 6.1 ñ 2.7 and 6.1 ñ 2.9 ng/ml in men and women, and 24percent of individuals had values below 4 ng/ml. Vitamin B12 levels were 393 ñ 147 and 393 ñ 163 pg/ml in the same groups. There was a negative correlation between homocysteine and folic acid levels and a positive correlation between homocysteine and creatinine levels. Conclusions: Homocysteine levels in healthy Chilean individuals are similar to those reported abroad. Low folic acid levels were found in 24percent of subjects

Permeabilidad intestinal en alcohólicos sin daño hepático / Intestinal permeability in alcoholics without hepatic damage

Methods: Thirty seven male subjects were studied, 18 controls and 19 alcoholic: All subjects underwent an anthropometric assessment and dietary history. Lactulose/mannitol test was performed during the third day of abstinence in alcoholics. After an 8 hour overnight fast, subjects drank 200 ml of a solution containing 56 g lactulose and 5 g mannitol. Subsequently, urine was collected during the following 5 hours, where both sugars were measured by gas chromatography. Results: Median values of lactulose/mannitol ratio were similar in alcoholics and controls (0.011, range 0.005-0.071 vs 0.014, range 0.005-0.027 respectively). However, absolute urinary excretion of both lactulose and mannitol was lower in alcholics. There was no relationship betwwen nutritional status and urinary excretion of lactulose, mannitol or lactulose/mannitol ratio. Conslusion: In this alcoholic patients, no changes were observed in intestinal permability

Resultados de 2 años de un programa de rehabilitación de enfermos alcohólicos / Results of a long term alcoholism rehabilitation program

One hundred eighty two alcoholics admitted for treatment of their alcoholism were followed during 2 years in a special clinic. The effects of length of alcoholism, withdrawal symptoms on admission and the presence of histological liver damage on long term outcome were assessed using life table analysis. During the 2 years period, 75 percent of patients were lost from control and 63 percent relapsed in their alcoholic ingestion. None of the above mentionated parameters had an effect on relapse or loss from follow up. There are high attrition and failure rates and the length of alcoholism, degree of initial withdrawal and the liver damage do not influence the long term results of this program

Marcadores de fibrogénesis hepática en pacientes alcohólicos / Hepatic fibrogenesis markers in alcoholic patients

Serum P-III-P and laminim levels were measured in asymptomatic alcoholics during detoxication treatment. Liver biopsies were obtained, in order to detect liver damage, which was graded with a numeric score, considering values over 6 as severe damage. Serum fibrogenesis markers were also measured in a group of decompensated alcoholic cirrhotics. P-III-P levels were significantly higher in cirrhotic patients compared to alcoholics with or without liver damage and to normal controls. Laminin was not different between groups. P-III-P did not correlate with histological score in asymptomatic patients. In this study P-III-P and P1 laminin were not usefull discriminators of severe liver damage among asymptomatic alcoholics; their levels were found to rises significantly only when liver disease has become clinically evident

Enfermedad de la orina olor a jarabe de arce / Maple syrup urine disease

La enfermedad de la orina olor a jarabe de arce, es una afección metabólica producida por deficiencia en la descarboxilación oxidativa de los quetoácidos provenientes de los aminoácidos ramificados valina, isoleucina y leucina. Los pacientes parecen normales hasta los 5 a 7 días de vida, cuando muestran rechazo a la alimentación, vómitos, olor a jarabe de arce en la orina y la piel y deterioro neurológico progresivo, que lleva rápidamente al coma. Se presentan tres niños con enfermedad de la orina olor a jarabe de arce clásica, leucina >2 000 µmol/1, que fueron diagnosticados a los 10, 20 y 21 días de vida, iniciándose inmediatamente el tratamiento en base a la dieta especial. el seguimiento está basado en evaluaciones clínicas, nutricionales y bioquímicas periódicas, para adecuar los requerimientos nutricionales a la evolución de la enfermedad. La evaluación psicométrica, escala de Bayley, mostró que el coeficiente de desarrollo mental estaba entre 50 y 82, relacionándose éste con la edad de diagnóstico. Actualmente los niños tienen entre 2 y 3 años de edad, se encuentran con dieta restringida en los 3 aminoácidos ramificados. Su control debe ser frecuente para evitar desbalances metabólicos y prevenir daños neurológicos ocasionados por éstos