Alteraciones del hepatograma en pacientes internados por dengue en el Hospital Regional de Encarnación durante el mes de enero al mes de abril del 2016 / Changes in hepatogram in patients hospitalized for dengue at the Regional Hospital of Encarnación during the month of January to April 2016

El dengue, enfermedad infecciosa frecuente, presenta marcado tropismo y patogenia de por el hígado. Una de las características del dengue es la fiebre, que según la OMS se trata con paracetamol, medicamento capaz de ocasionar daño hepático a grandes dosis. En esta investigación se propuso identificar alteraciones del hepatograma de pacientes internados por dengue en el Hospital Regional de Encarnación (HRE) y señalar la asociación entre ello y el consumo de paracetamol. Se realizó un estudio observacional, descriptivo, retrospectivo, con componente analítico, sobre una muestra conformada por pacientes con dengue que fueron internados en el HRE durante enero a abril del 2016, procediéndose a la toma de muestra a través de la búsqueda de fichas clínicas en el Departamento de Archivos del HRE. Los resultados obtenidos fueron predominio del sexo femenino en un 78%, con una media de edad de 37 años; alteración del hepatograma en: GOT con frecuencia de alteración del 83,6% (media: 137 UI/L), GPT: 79,5% (media:123 UI/L), fosfatasa alcalina: 73,9% (media:55UI/L), y bilirrubina: 21,9%. A pesar de una clara tendencia entre el consumo de paracetamol y la alteración del hepatograma, el análisis estadístico no arrojo un valor p significativo. Se concluye la existencia de una marcada alteración del hepatograma en pacientes con dengue. Se rescata una tendencia aumentada de alteración por consumo mayor de paracetamol, pero sin hallarse una significancia estadística para dicha situación

Growth restriction in children with type B Niemann-Pick disease.

OBJECTIVES: To compare growth of children with type B Niemann-Pick disease (NPD) with disease variables including genotype, organomegaly, bone age, and serum insulin-like growth factor-1 (IGF-1). STUDY DESIGN: A cross-sectional analysis of growth was performed in 23 children and adolescents with enzymatically and genotypically confirmed NPD. Liver and spleen volumes were measured by quantitative computed tomography and skeletal age by a wrist radiograph. RESULTS: The mean Z scores for height and weight were -1.24 (29th percentile) and -0.75 (34th percentile). The mean liver and spleen volumes were 2.06 and 13.46 times normal for weight, respectively. Skeletal age was delayed by an average of 2.5 years, and serum IGF-1 level was at or below the 2nd percentile in 8 of 12 patients. Short stature and low weight were significantly correlated with large organ volumes, delayed bone age, and low IGF-1 levels. In contrast to patients with other mutations, individuals homozygous for the DeltaR608 mutation had normal height and weight, markedly less hepatosplenomegaly and bone age delay, and normal IGF-1 levels. CONCLUSIONS: Abnormal linear growth and delayed skeletal maturation are common in children and adolescents with type B NPD; however, homozygosity for DeltaR608 is associated with normal growth.

Alterations in the levels and lipid composition of plasma lipoproteins (VLDL, LDL and HDL) in Brazilian patients with hepatosplenic schistosomiasis mansoni.

1. The plasma concentrations of low- and high-density lipoproteins (LDL and HDL) were significantly reduced in Brazilian patients with compensated hepatosplenic schistosomiasis mansoni (SM) when compared with healthy individuals, but very low-density lipoprotein (VLDL) levels were unchanged. 2. All three classes of lipoproteins isolated from SM plasma had an increased content of triacylglycerol and unesterified cholesterol and decreased cholesteryl ester and phospholipid. 3. The individual phospholipid composition of patient VLDL, LDL, HDL was also altered; the amount of phosphatidylcholine was increased and that of lysophosphatidylcholine decreased. 4. The saturated and monounsaturated fatty acyl content of cholesteryl esters in patient lipoproteins was also significantly increased, and diunsaturated and polyunsaturated fatty acyl content was decreased. 5. When isolated lipoproteins were examined as negatively stained preparations by electron microscopy, the morphology of SM patient LDL was normal but the HDL fraction was abnormal and showed marked heterogeneity of size with the presence of occasional discoidal particles which resembled "nascent" HDL.

Alterations in the levels and lipid composition of plasma lipoproteins (VLDL, LDL and HDL) in Brazilian patients with hepatosplenic schistosomiasis mansoni

1. The plasma concentrations of low- and high-density lipoproteins (LDL and HDL) were significantly reduced in Brazilian patients with compensated hepatosplenic schistosomiasis mansoni (SM) when compared with healthy individuals, but very low-density lipoprotein (VLDL) levels were unchanged. 2. All three classes of lipoproteins isolated from SM plasma had an increased content of triacylglycerol and unesterified cholesterol and decreased cholesteryl ester and phospholipid. 3. The individual phospholipid composition of patient VLDL, LDL, HDL was also altered; the amount of phosphatidylcholine was increased and that of lysophosphatidylcholine decreased. 4. The saturated and monounsaturated fatty acyl content of cholesteryl esters in patient lipoproteins was also significantly increased, and diunsaturated and polyunsaturated fatty acyl content was decreased. 5. When isolated lipoproteins were examined as negatively stained preparations by electron microscopy, the morphology of SM patient LDL was normal but the HDL fraction was abnormal and showed marked heterogeneity of size with the presence of occasional discoidal particles which resembled nascent HDL

Ascorbic acid in schistosomiasis mansoni with or without digestive haemorrhage.

The authors studied the variations of ascorbic acid levels in white blood cells and plasma by Denson-Bowers' method in 20 normal individuals (Group I) and 36 schistosoma patients with hepatosplenic disease with and without gastrointestinal haemorrhage (Groups II and III, including 18 patients each). Having submitted the results to statistical analysis with a probability rate of 95%, the authors concluded that, while no significant difference could be seen between Groups I, II and III in ascorbic acid levels in white blood cells, there was a significant decrease in plasma ascorbic acid levels of Group III as compared with Groups I and II.