Serum-ionized calcium in mexican protein-energy malnourished children.

BACKGROUND: Hypocalcemia occurring in children with severe primary protein-energy malnutrition (PEM) has previously been shown to merely reflect a reduction in the protein-bound fraction of serum calcium. On the other hand, ultrafilterable, i.e., nonprotein bound calcium (Ca(U)), remains unaffected. The aim of the present investigation was to test the hypothesis that in infantile PEM, ionized calcium, which represents the major and physiologically most important component of Ca(U), is also kept within a normal concentration, whatever the total serum calcium levels. METHODS: Three milliliters of peripheral venous blood were obtained on admission and periodically afterward from 18 fasting marasmic infants and 6 children with the edematous form of PEM (kwashiorkor). Ionized calcium was determined in 125 microL aliquots of blood serum with ion-selective electrodes. The measurement of related elements and molecules was carried out with customary laboratory procedures. RESULTS: On admission, as well as during the ensuing stages of nutritional recovery, ionized serum calcium exhibited a normal concentration, with the exception of two initial samples. Total calcium, total protein, albumin, and inorganic phosphate concentrations were decreased in a variable degree according to the clinical type, ascending to normal levels during recovery. CONCLUSIONS: Ionized calcium serum concentration remains within normal limits in severe infantile PEM.

[A clinical case. Diagnosis and laparoscopic treatment of ovarian pregnancy]. / Caso clínico. Diagnóstico y tratamiento laparoscópico del embarazo ovárico.

Ovarian pregnancy is an uncommon presentation of ectopic pregnancy. It's frequency is 0.3-3.0 of all ectopic gestations. Is reported the case of a 33-year old female patient without previous pathology, was admitted because of lower abdominal pain, bloody vaginal discharge, a right adnexal mass, and positive serum pregnancy test. The preoperative diagnosis was tubal ectopic pregnancy. The following case report illustrates the successful application of operative laparoscopy for to treat primary ovarian pregnancy.

Safety and efficacy of a rice-based oral rehydration salt solution in the treatment of diarrhea in infants less than 6 months of age.

The safety and efficacy of a rice-based oral rehydration salt (ORS) solution for the treatment of acute diarrhea in infants < 6 months of age was compared to those of a standard glucose-based ORS solution. A total of 97 infants aged 1-6 months who had a history of acute diarrhea for 120 h or less and showed signs of mild to moderate dehydration and no complications was recruited. Subjects were assigned to two treatment groups and received either standard glucose-based ORS solution or rice-based ORS solution until cessation of diarrhea. There was no significant difference between the two treatment groups with regard to the main outcome variables, including total stool output (84 [95% confidence interval (CI), 56-126] vs. 106 (95% CI, 76-148) g/kg], total ORS solution intake [171 (95% CI, 149-197) vs. 187 (95% CI, 161-218) ml/kg], or duration of diarrhea (35 +/- 31 vs 38 +/- 32 h). In addition, the fact that there was no difference between treatment groups in the presence of reducing substances in the stools suggests that rice was digested and absorbed by these infants. The results of our study support the conclusion that for infants < 6 months of age, rice-based ORS solution is safe and as efficacious as standard glucose-based ORS solution in the treatment of acute diarrhea.

[Trace element metabolism in healthy and sick children. II. The disease state]. / Metabolismo de los oligoelementos en niños sanos y enfermos. Parte II. Condición de enfermedad.

In the last 3 decades, the discovery of importance of trace elements in structure and functions of many enzymes, provided a tremendous impetus for research on the physiopathology, metabolism, clinical pharmacology and toxicology of these micronutrients in human beings, specially, in children. This paper presents recent information on various pathological inherited and acquired conditions, with abnormal nutritional status in children, due either to deficiency or excess of some oligo-elements. The general aspects of abnormal metabolism, physiopathology, and some specific clinical features, are described.

[Metabolism of trace elements in healthy and sick children. I. Health status]. / Metabolismo de los oligoelementos en niños sanos y enfermos. Parte I. Condición de salud.

The oligo-elements or trace elements have acquired a major importance in the knowledge concerning corporal composition and in the comprehension of their metabolic participation in organic processes. Today, thanks to the technological and scientific progress reached by modern pediatrics, the studies made at cellular level have advanced to a molecular level, which will in the future be, without doubt, the bridge that will lead into the atomic level. In addition, this review will briefly summarize several facts of the knowledge accumulated up to now, regarding: 1. The nutritional aspects of these oligo-elements; 2. Its biological functions in healthy condition, especially in children; 3. Their respective nutritional requirements.

[Omega-6 and omega-3 polyunsaturated fatty acids in healthy and sick children under 5 years of age. Part II. Pathologic metabolism]. / Acidos grasos poliinsaturados omega 6 y omega 3 en niños sanos y enfermos menores de 5 años. Parte II. Metabolismo patológico.

Today, the long-chain polyunsaturated fatty acids, omega 6 and omega 3, are of special interest to different research groups, all over the world, due to its physiological and metabolic importance. This paper presents different cases of fatty acids deficiency from which the cases of premature low-birth-weight neonates and children under 5 years old presenting severe malnutrition, stand out. In addition, various inherited pathological processes that involve the mechanism of oxidation of these nutrients, are also described.

[Omega-6 and omega-3 polyunsaturated fatty acids in healthy and sick children under 5. I. Normal metabolism]. / Acidos grasos poliinsaturados omega 6 y omega 3 en niños sanos y enfermos menores de 5 años. Parte I. Metabolismo normal.

The polyunsaturated fatty acids, omega 6 and omega 3, are organic compounds that have to do with the daily caloric intake; the tissue deposits of energy reserve, as well as the general intermediary metabolism of the human organisms and the composition of all the cellular membranes. This article is about its general characteristics: chemical structure, essenciality, biosynthesis, and physiological and metabolical functions; its compounds and metabolites derived; its organic distribution, and the quantity found in food in general. Of all these, special emphasis are made on the essenciality of linoleic and alpha-linolenic acids, due to its metabolic importance.

Metabolic adaptation in protein-energy malnutrition.

The metabolic response to chronic undernutrition covers a wide spectrum that ranges from decreased growth velocity in mild cases to profound distortion of body silhouette and composition and functional derangements in advanced stages of the protein-energy malnutrition-infection complex. A wide gamut of molecular, enzymatic, and hormonal processes assure a temporary availability of endogenous nutrients and the maintenance of vital functions.

The functional response to furosemide in a case of de Toni-Debre-Fanconi disease.

The case of a 13-year-old boy with the advanced clinical picture of the idiopathic DeToni-Debré-Fanconi syndrome is described, on whom acute studies of proximal tubular functions and of the effect of furosemide thereon were performed. Sodium bicarbonate loading corrected the hyperchloremic acidosis, but induced an increase of urinary bicarbonate loss of over 20% of the filtered amount. Furosemide corrected bicarbonate reabsorption in spite of the presence of metabolic alkalosis. The urinary excretion of alpha-amino nitrogen, glucose, and phosphates decreased and tubular reabsorption of the two latter increased under furosemide. On a chronic treatment with furosemide and dietary sodium chloride restriction, correction of hyperchloremic acidosis, hypophosphatemia and rickets was achieved.