[Conceptual milestones in the history of protein-energy malnutrition]. / Hitos conceptuales en la historia de la desnutrición proteico-energética.

Although the biblical horsemen of hunger, plague and war have proverbially ridden together, the consequences of these adversities, i.e. malnutrition and death, may have been secularly interpreted as natural as life itself. This may be the reason why the first clinical description of what is now known as protein-energy malnutrition, did not appear until the 19th century, in 1865 to be precise. The limited dissemination of this finding, originally written in Spanish, brought about a rediscovery and successful description of the disease in English in 1933. In 1949, one year after their creation, the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) decided to unify their diagnostic criteria of malnutrition, and endorse further research. The present assay describes some of the major conceptual landmarks in the history of the scientific knowledge of this disease.

Identification of risk factors for malnutrition: is there some evidence for predisposition?

Reviewed are reports on factors, identified by risk analysis, involved in the genesis of primary malnutrition in children. Data are compared with the sequence of factors in a flow diagram, based on the natural history of malnutrition, proposed 3 decades ago. Susceptibility to malnutrition is analyzed in light of observations related to inheritance, the ob gene and leptin.

[Secondary lactase deficiency in children and its epidemiologic implications]. / Deficiencia secundaria de lactasa en niños y sus implicaciones epidemiológicas.

The main contributions in the knowledge of secondary lactase deficiency in children are reviewed. We present the clinical features of fermentative diarrhea and the current physiopathological issues, diagnostic procedures, and dietetic treatments, related to this diarrhea, as well as a review of the diseases associated with it. Finally, we discuss the epidemiological implications of the deficiency.

[Effect of iron deficiency on attention capacity among school children]. / Efecto de la deficiencia de hierro sobre la capacidad de atención de niños escolares.

The effect of iron deficiency on the attention span was studied in 169 school children between 6 to 11 years of age. All were studied by hematological procedures and psychological methods in order to know the nutritional status for iron and their capacity of attention. Then were treated with iron sulfate for 12 weeks, and the hematological and psychological studies were repeated. Results shown iron deficiency anemia in 17.1 percent of the children, and iron deficiency, without anemia, in 14.7 percent. After treatment of the school children the scores and time required in a visual attention test improved. Also there was a favorable change in the scores obtained by one the subtests of the WISC Test. Findings are discussed and it is mentioned that a program for combating iron deficiency anemia through food fortification most be implemented.

[Glazed pottery as a risk factor in lead exposure]. / La cerámica vidriada como factor de riesgo de exposición al plomo.

The purpose of this study was to determine if the use of "earthenware dishes" is associated with high blood lead levels in children. Measurements of lead in blood were done in 169 school-children. Of this sample 100 children were selected: 50 of them with the lowest concentration of lead in blood and 50 with the highest. A questionnaire was applied to 39 mothers of the children with low blood lead levels (< 20.2 micrograms/dl) and 48 mothers of the children with high blood lead levels (> 28.0 micrograms/dl). Results show that the use, frequency and time of utilization of this type of dishes is statistically associated with high levels of lead in blood.

[Development of the digestive system. Medico-dietetic implications in infants]. / Desarrollo del aparato digestivo. Implicaciones médico-dietéticas en lactantes.

The development of the human gastrointestinal tract starts in early intrauterine life. In spite of this early start of the functional differentiation of its tissues, the GI tract function is still incomplete at the end of gestation. This report reviews the physiological and biochemical aspects of the gastrointestinal ontogeny which have medical and dietetical implications in the first year of life of infants.

[The intelligence quotient and malnutrition. Iron deficiency and the lead concentration as confusing variables]. / Cociente intelectual y desnutrición. La deficiencia de hierro y la concentración de plomo como variables confusoras.

This study gave us the opportunity to know the roles iron deficiency and the presence of lead in blood play, as confounding variables, in relation to the state of malnutrition and the intellect of those children. A sample of 169 school children were classified according to their state of nutrition, their condition in reference to serum iron and lead concentrations. In addition, their intelligence was evaluated. The results confirmed that those children with lower weights and heights registered lesser points of intelligence; in fact, iron deficiency cancels out the difference in favor of those taller and weighing more. Lead did not contribute as a confounding variable, but more than half of the children showed possible toxic levels of this metal.

[Quantification of bacteria in the small intestine of malnourished children with chickenpox]. / Cuantificacíon de bacterias del intestino delgado en niños desnutridos con varicela.

The purpose of the present study was to determine whether a high number of bacteria could be demonstrated in the upper small bowel during the chickenpox infection. Intestinal juice was drawn in nine malnourished children, during and two weeks after the acute period of the disease. The results of the study fail to demonstrate quantitative differences in the bacterial flora of the small bowel in both periods. Besides that, the bacterial overgrowth previously reported in malnutrition, is confirmed.

[Behavioral development and nerve conduction velocity during recovery from malnutrition]. / Evolución conductual y velocidad de la conducción nerviosa durante la recuperación de la desnutrición.

OBJECTIVES: To research if the improvement in psychomotor development observed during the treatment of malnutrition, is related to favorable changes in the speed of nerve conduction and in the excretion of hydroxy-indole acetic acid (indole). DESIGNED OF THE STUDY: Prospective, of a descriptive type, includes the follow-up of children during the first month of treatment. APPLICATION: To better know the impact which malnutrition has on mental development. PATIENTS: Nine children, ranging from three to 15 months of age, gravely undernourished. INTERVENTION: The neurological development, the speed of nerve conduction and the excretion of indole were evaluated at 10 day intervals. MEASUREMENTS AND RESULTS: Using the Gesell technique in order to evaluate the development, the measurement of conduction through the medial and external popliteal sciatic nerves and indole excreted in 24 hours, a quantitative increase of all of these variables was seen in 24 hours. At the beginning the conduction speed was slow (less than 30 m/s) and the excretion of indole was very low (0.28 mg/24 h). After the tenth day these measurements returned to normal, although the development coefficient was found to still below at the end of the study (63.9 +/- 21.0). CONCLUSIONS: Simultaneous to the neurological deficit, there is a reduced speed of conduction, which returns to normal after the tenth day without a positive correlation with motor functions and development. Neither does the disponibility of serotonin (judged by the excretion of indole) correlate with the speed of conduction.

[Iron deficiency in children: clinical manifestations, therapy and prevention. II]. / Deficiencia de hierro en la infancia: manifestaciones clínicas, tratamiento y prevención. Parte II.

A better understanding of the physiopathological and pathogenic characteristics underlying iron deficiency, has allowed for a more precise diagnosis and the opportune treatment of this disease. On the other hand, it has also permitted the designing of more efficient preventive programs. This study includes what is known to date and the applicable experiences when confronted with this problem in children. Iron deficiency; clinical manifestations; treatment; prevention.

[Vitamin E concentration in children with proteino-energetic malnutrition]. / Concentración de vitamina E en niños con desnutrición proteino-energética.

Fourty eight malnourished infants were studied in regard to plasma vitamin E levels. The mean plasma vitamin E concentration was 0.41 mg/dL (+/- 0.20); the values ranged from less than 0.10 to 0.96. Only 4 children had an acceptable level of this vitamin (greater than 0.70 mg/dL). The possible interrelationship of vitamin E and red cell fragments in blood was investigated in 24 of the children. The data obtained do not suggest that a low plasmatic vitamin E level is not related to either, red cell fragmented or hemoglobin level.

[Iron deficiency in children: metabolic and pathogenic aspects. I]. / Deficiencia de hierro en la infancia: aspectos metabólicos y patogénicos. Parte I.

Iron deficiency is the most commonly recognized form of nutritional deficiency in the world. In recent years, iron metabolism have became better defined and the physiopathology and pathogenesis of the disease have been better understood. In this report is reviewed some of this information.

[Reasoning strategies in biomedical research]. / Estrategias del razonamiento en la investigación biomédica.

Some modalities of thinking, in order to arise logical presumptions and steady conclusions in research, are presented. The paper aims to provide concepts with which the hypothesis are established, and the way to make inferences in research.

[Intellectual development and somatic growth in students suffering from malnutrition early in life]. / Desarrollo intelectual y crecimiento somático de escolares afectados por desnutrición a una edad temprana.

STUDY OBJECTIVE: To evaluate the Intellectual Quotient (IQ) and the somatic growth of school children which were malnourished in early life. DESIGN: Ex-post-factum study of growth and IQ achievements, in children previously affected by malnutrition. SETTING: To get early indicators of growth and development handicaps in school age children, for stimulation programs after the disease. PATIENTS: Twenty eight school children, affected by malnutrition during the first two years of life, were selected from a Rehabilitation Center. INTERVENTION: The height and the IQ (WISC) of the children, were measured. Beside that, the following data were obtained from the records: the age, height, weight and developmental quotient (Gesell) during the malnutrition, the time spent in the treatment, and the body weight/height ratio at recovery and at the time of the study. MEASUREMENTS AND MAIN RESULTS: In 20 of the children, the height was below the 10th percentile; 12 of them were below the 3d percentile. Only 8 had IQ's from 90 to 110; in 10 children the IQ was below 80. There was a positive correlation (p = 0.05) among the height/weight ratio at rehabilitation and at the moment of the study. The IQ, related to the variables studied, was not statistical significant (p less than or equal to 0.05).

[What the pediatrician should know about introducing infants to solid foods]. / Lo que el pediatra debe saber acerca de la ablactación.

Since World War II, the introduction of solid foods to infants has been practiced at early ages. At the same time, knowledge about the physiology of the intestinal tract during the first year of life has been increasing: now the developmental immaturity of the intestine and the clinical consequences produced by the introduction of some foods at an early age are known. In this report this information is reviewed in order to rationalize the introduction of solid foods in babies.