Lumboperitoneal shunting in pediatric patients and the role of imaging in its evaluation.

Lumboperitoneal shunting makes it possible to regulate the flow of cerebrospinal fluid by establishing a connection between the thecal sac and the peritoneal cavity. The main indication for lumboperitoneal shunting in children is idiopathic intracranial hypertension, but the technique is also useful in the treatment of postinfectious, posthemorrhagic, and normotensive hydrocephalus, as well as in the treatment of postsurgical pseudomeningocele or leakage of cerebrospinal fluid. This article reviews nine cases treated at our centre to show the normal imaging findings for lumboperitoneal shunts in children and to provide a succinct review of the possible neurological and abdominal complications associated with this treatment.

La derivación lumbo-peritoneal en la edad pediátrica y el papel de la imagen en su valoración / Lumboperitoneal shunting in pediatric patients and the role of imaging in its evaluation

La derivación lumbo-peritoneal permite regular el flujo de líquido cefalorraquídeo estableciendo una conexión entre el saco tecal y la cavidad peritoneal. Entre las indicaciones en la población pediátrica se encuentra principalmente la hipertensión intracraneal idiopática, siendo también útil en el tratamiento de la hidrocefalia postinfecciosa, posthemorrágica y normotensiva, en el seudomeningocele posquirúrgico o ante una fuga de líquido cefalorraquídeo.En este artículo, mediante la revisión de 9 casos de nuestro centro, se pretende mostrar la normalidad del dispositivo en las pruebas de imagen y realizar una breve revisión de las posibles complicaciones asociadas, neurológicas y abdominales.(AU)

Lumboperitoneal shunting makes it possible to regulate the flow of cerebrospinal fluid by establishing a connection between the thecal sac and the peritoneal cavity. The main indication for lumboperitoneal shunting in children is idiopathic intracranial hypertension, but the technique is also useful in the treatment of postinfectious, posthemorrhagic, and normotensive hydrocephalus, as well as in the treatment of postsurgical pseudomeningocele or leakage of cerebrospinal fluid.This article reviews nine cases treated at our center to show the normal imaging findings for lumboperitoneal shunts in children and to provide a succinct review of the possible neurological and abdominal complications associated with this treatment.(AU)

Seroprevalencia de anticuerpos frente a virus linfotrópicos humanos (HTLV I y II) en donantes de órganos / Human T lymphotropic virus (HTLV I and II) antibodies seroprevalence among organ donors

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Costo disponibilidad y valor nutricional de los alimentos libres de gluten en Argentina su relación con la adherencia a la dieta libre de gluten / Cost availability nutritional value of gluten free food in Argentina and their relationship to gluten free diet adherence

Diversos estudios indican que el costo y la disponibilidad de los alimentos libres degluten (ALG) podrían ser factores asociados a la adherencia al tratamiento. Hastael momento, no hay estudios nacionales que evalúen el costo, la disponibilidad yel valor nutricional de los ALG, las diferencias con respecto a sus homólogos congluten y su posible relación con la adherencia a la dieta libre de gluten (DLG).ObjetivosConocer el costo, la disponibilidad y el valor nutricional de diversos grupos deALG en las distintas regiones geográficas de Argentina, y su posible relación con laadherencia a la DLG.MétodosSe realizó un estudio multicéntrico descriptivo de corte transversal y comparativo.Se analizaron 10 variedades de premezclas y harinas sustitutivas libres de gluten,15 ALG sustitutivos y 10 ALG industrializados, como así también sus homólogoscon gluten. Se enroló a individuos con diagnóstico de EC y tratamiento con DLGal menos durante un año. Se calculó una n aproximada de 40 individuos por zonageográfica, con una estimación total de 7 zonas geográficas.ResultadosLa canasta básica para celíacos resultó un 68,8% más costosa que la canasta básicageneral (p<0,0001). Los ALG sustitutivos estuvieron un 253,2% por encima de sushomólogos con gluten (p<0,0001). La disponibilidad de los ALG en las diferenteszonas geográficas fue limitada, con un promedio del 50,4% de los 35 ALGpropuestos. El 75,9% de los individuos consignó que el mayor costo de los ALGsustitutivos no influía en el cumplimiento de la DLG. Respecto al valor nutricional,se observó que los ALG sustitutivos presentaban un 39% menos de proteínas yun 68% menos de fibra que sus homólogos con gluten. En cuanto al hierro y a lasvitaminas del complejo B, el contenido de los ALG sustitutivos fue nulo

Obtaining from grape pomace an enzymatic extract with anti-inflammatory properties.

Grape pomace, a winemaking industry by-product, is a rich source of bioactive dietary compounds. Using proteases we have developed an enzymatic process for obtaining a water-soluble extract (GP-EE) that contains biomolecules such as peptides, carbohydrates, lipids and polyphenols in soluble form. Of especial interest is its high polyphenol content (12%), of which 77% are flavonoids and 33% are phenolic acids. The present study evaluates in vitro the potential anti-inflammatory effect of GP-EE by monitoring the expression of inflammatory molecules on N13 microglia cells stimulated with lipopolysaccharide (LPS). GP-EE decreases the mRNA levels of the inflammatory molecules studied. The molecules under study were as follows: inducible nitric oxide synthase (iNOS), tumor necrosis factor- α (TNF-α), interleukin-1ß (IL-1ß), the ionized calcium binding adaptor molecule-1(Iba-1) and the Toll like receptor-4 (TLR-4), as well as the iNOS protein level in LPS-stimulated microglia. Our findings suggest that, as a result of its ability to regulate excessive microglial activation, GP-EE possesses anti-inflammatory properties. Therefore, acting as a chemopreventive agent, it may be of therapeutic interest in neurodegenerative diseases involving neuroinflammation. We can, therefore, propose GP-EE as a useful natural extract and one that would be beneficial to apply in the field of functional foods.

Application of LC-MS and tristimulus colorimetry to assess the ageing aptitude of Syrah wine in the Condado de Huelva D.O. (Spain), a typical warm climate region.

The study of the evolutions of different wine pigment families, copigmentation/polymerisation processes and colour characteristics during the first year of ageing in oak barrel has allowed the assessment of the ageing aptitude of Syrah wines from "Condado de Huelva D.O.", a warm climate region. A total of 32 anthocyanic pigments were identified, including 14 major compounds from grape and 18 minor derivatives formed during the vinification. The anthocyanin profile changed towards more chemical complexity, being vitisin-like pyranoanthocyanins the predominant minor pigments during the first month of ageing. As wine became older, a progressive increase on the content of 4-vinylcatechin, 4-vinylphenol and 4-vinylcatechol compounds took place. Results showed that copigmentation occurred during the whole process of ageing inducing visual perceptible colour effects. Simultaneously to the copigmentation decrease, the degree of polymerisation increased during ageing, being maximum at 9 months old wines (77%). The colour of wines evolved progressively in a positive way from 3 to 9 months of ageing, becoming darker and with more vivid colour. However, from 9 to 12 months of ageing, the chemical structure of wines was negatively affected resulting in lighter, with more red-orange hues and less vivid colours. The inclusion of the chemical and colorimetric information on the PCA model allows us to reach very good discriminations among the Syrah wines with different wood contact period.

Epidemic cholera in Guatemala, 1993: transmission of a newly introduced epidemic strain by street vendors.

Epidemic cholera reached Guatemala in July 1991. By mid-1993, Guatemala ranked third in the hemisphere in reported cases of cholera. We conducted a case-control study with two age-, sex-, and neighbourhood-matched controls per patient in periurban Guatemala City. Twenty-six patients hospitalized for cholera and 52 controls were enrolled. Seven (47%) of 15 stool cultures obtained after admission yielded toxigenic Vibrio cholerae O1. All seven were resistant to furazolidone, sulfisoxazole, and streptomycin, and differed substantially by pulsed-field gel electrophoresis from the Latin American epidemic strain dominant in the hemisphere since 1991. In univariate analysis, illness was associated with consumption of left-over rice (odds ratio [OR] = 7.0, 95% confidence interval [CI] = 1.4-36), flavored ices (-helados') (OR = 3.6, CI = 1.1 - 12), and street-vended non-carbonated beverages (OR = 3.8, CI = 1.2-12) and food items (OR = 11.0, CI = 2.3-54). Street-vended food items remained significantly associated with illness in multivariate analysis (OR = 6.5, CI = 1.4-31). Illness was not associated with drinking municipal tap water. Maintaining water safety is important, but slowing the epidemic in Guatemala City and elsewhere may also require improvement in street vendor food handling and hygiene.

Influence of nopal intake upon fasting glycemia in type II diabetics and healthy subjects.

To assess if the acute hypoglycemic effect of nopal which occurs in diabetic patients also appears in healthy individuals, 500 g of nopal stems (O. streptacantha Lem.) were given orally to 14 healthy volunteers and to 14 patients with NIDDM. Serum glucose and insulin levels were measured at 0, 60, 120 and 180 minutes after nopal ingestion. A control test was performed with the intake of 400 ml of water. The intake of nopal by the NIDDM group was followed by a significant reduction of serum glucose and insulin concentration reaching 40.8 + 4.6 mg/dl (n = 14) (mean+SEM) and 7.8 + 1.5 uU/ml (n = 7) less than basal value, respectively, at 180 minutes. (P less than 0.001 vs control test). No significant changes were noticed in the healthy group as compared with the control test (P greater than 0.05). Acute hypoglycemic effect of nopal was observed in patients with NIDDM but not in healthy subjects, thus the mechanisms of this effect differs from current hypoglycemic agents.

[Food consumption, feeding habits and nutritional status of the population of Reus. Diet and nutritional balance in people older than 60 years of age]. / Consumo, hábitos alimentarios y estado nutricional de la población de Reus. La dieta y el equilibrio nutricional en los mayores de 60 años.

We have studied 323 individuals (122 male and 201 females) above 60 years old, randomly chosen in Reus. When compared to other adults aged 35-60 in the same town, the older group consumes milk more frequently, but eggs, milk derivatives, vegetables and fish less frequently. The fresh fruit intake increases in absolute values 20% and decreases 30% that of meat, fish, fat and sugar. We analyzed the relative contribution of the different groups of foods to the total diet and we observed that 25.9% of the total calories derived from food of animal origin in the older group While it is 29.8% in the group aged 35-60. The total caloric intake in this older group was below the recommended amount although the results were similar to other national of international studies. In respect to protein, the observed intake was very close to the recommended. The mean lipid and carbohydrate intake were similar to those of other studies. We conclude that food intake in subjects above 60 is less than in subjects 35-60 but diet composition also varies which results in a better balanced diet in subjects above 60 in our Community.

[Psychosocial problems of children with chronic disease]. / Problemática psicosocial del niño con enfermedad crónica.

This presentation comprises: a) the study of psychosocial problems in children with chronic disease (1980-83); b) application and results of a "pluridimensional approach" model, designed to solve these conflicts (1982-88). Thirty-five children with end stage renal disease (ESRD) and 34 families were studied, as well as the members of the professional team. The methods of study were: conducted observations, projective tests, recording and analysis of psychotherapy (individual and familiar) and Balint sessions. The data were analized in the framework of psychoanalysis, theory of the systems and groups, etc. The results showed: depression, anguish and regression, interfering with rehabilitation, in the group of children. The problems worsening with greater length of the dialysis periods and with younger age of the patients. Poverty increases losses and guilty feelings decreasing the defensive and adaptive mechanisms. In the families, ESRD provoked migration, fragmentation, dynamic and structural dysfunctions and several inter and intrapersonal conflicts. In the professional team, tension, anxiety, compulsive and indiscriminate conducts were detected, as well as a great difficulty to communicate with the patients and their families. In an attempt to decrease these conflicts a pluridimensional approach was designed and applied in the patients, families and members of the professional team, with the aim of interrupt the pathologic interaction patterns and change them in therapeutic. This model included the practice of several independent and simultaneous psychological interventions, ergotherapy, recreative and occupational activities with the patients; group sessions for information, diagnostic interviews and psychotherapy with the families and Balint sessions with the professional team.(ABSTRACT TRUNCATED AT 250 WORDS)

Nutrition of the elderly in a Mediterranean city in Spain: effects of life-style patterns.

We studied the food intake in a representative sample (121 males, 202 females) of the elderly people (greater than 60 years) of the city of Reus (Spain) living at home. The analysis of the consumption of nutrients revealed an energy intake lower than recommended but similar to that found in other surveys dealing with the same age group. We observed that in our elderly people, the major food sources of caloric intake were different in relation to those of adults of the same population. The distribution of energy percentage derived from several macronutrients is different in the elderly in relation to adults (35-64 yr) and children (3-4 yr) of the same population. In younger people there was a remarkably energy excess derived from lipids if compared with the recommended allowances, which does not occur in the elderly group. Among all the sociocultural characteristics of the individuals, the type of life-style is revealed as the major explanation of the differences in intake. The elderly males who live with younger people consume more energy (p less than 0.01), lipids (p less than 0.001) and carbohydrates (p less than 0.05) than those who live only with other old people. In elderly people living with younger ones, the energy sources become unbalanced in the same way as in the young people. We have not found any differences in the biotype of the elderly men in relation to the patterns of life-style which may explain the different intakes.(ABSTRACT TRUNCATED AT 250 WORDS)

Hypoglycemic effect of Opuntia streptacantha Lemaire in NIDDM.

To assess the hypoglycemic effect of the nopal Opuntia streptacantha Lemaire (O. streptacantha Lem.), three groups of patients with non-insulin-dependent diabetes mellitus (NIDDM) were studied. Group one (16 patients) ingested 500 g of broiled nopal stems. Group 2 (10 patients) received only 400 ml of water as a control test. Three tests were performed on group 3 (6 patients): one with nopal, a second with water, and a third with ingestion of 500 g broiled squash. Serum glucose and insulin levels were measured at 0, 60, 120, and 180 min. After the intake of O. streptacantha Lem., serum glucose and serum insulin levels decreased significantly in groups 1 and 3, whereas no similar changes were noticed in group 2. The mean reduction of glucose reached 17.6 +/- 2.2% of basal values at 180 min in group 1 and 16.2 +/- 1.8% in group 3; the reduction of serum insulin at 180 min reached 50.2 +/- 8.0% in group 1 and 40.3 +/- 12.4% in group 3. This study shows that the stems of O. streptacantha Lem. cause a hypoglycemic effect in patients with NIDDM. The mechanism of this effect is unknown, but an increased insulin sensitivity is suggested.