Alimentación neonatal asociada a sobrepeso y obesidad en niños y adolescentes de Cuenca, Ecuador / Neonatal feeding associated with overweight and obesity in children and adolescents of Cuenca, Ecuador

Introducción: La alimentación inadecuada en la etapa neonatal se asocia con la aparición de enfermedades metabólicas en períodos ontogenéticos posteriores. Objetivo: Asociar la lactancia materna y el destete con el sobrepeso y obesidad en niños y adolescentes de la Unidad Educativa César Dávila Andrade, Cuenca, Ecuador, en el período de octubre de 2016 a marzo de 2017. Materiales y Métodos: Se realizó un estudio observacional de tipo descriptivo durante el período noviembre 2016 a enero 2017 en el Cantón Cuenca, provincia Azuay, Ecuador. El muestreo probabilístico por conglomerados de iguales proporciones seleccionó 137 niños y adolescentes entre 5 y 18 años de edad. Se aplicó un cuestionario que recogió datos sociodemográficos, de lactancia materna y destete. Se realizaron mediciones de peso y talla, y el cálculo del índice de Masa Corporal. Se procesaron los datos mediante estadística descriptiva (media y desviación estándar), inferencial (Prueba T y X2) y correlaciones bivariada (X2, odds ratio) y multivariada (regresión logística binaria) mediante SPSS 23.0. Resultados: La lactancia materna por menos de 6 meses, la introducción de alimentos de manera temprana y la actividad física leve incrementan el riesgo de sobrepeso y obesidad en más de 3 veces cada una en niños y adolescentes. Conclusiones: La lactancia materna y el destete están asociadas al sobrepeso y obesidad desde etapas tempranas del desarrollo humano. El valor explicativo que tienen en niños y adolescentes es relevante, y sugiere su empleo en programas educativos y preventivos en salud(AU)

Introduction: Inadequate feeding in the neonatal stage is associated with the appearance of metabolic diseases in further ontogenetic periods. Objective: To associate breastfeeding and weaning with overweight and obesity in children and adolescents in the Educational Unit César Dávila Andrade in the Cuenca region, Ecuador, from October 2016 to March 2017. Material and Methods: A descriptive, associative, and empirical study was conducted during the period of November 2016 - January 2017 in Cuenca, province of Azuay, Ecuador. The probability sampling by conglomerates of equal proportions selected 137 children and adolescents from 5 to 18 years of age. A questionnaire that collected sociodemographic data about breastfeeding and weaning was applied. Measurements of weight and height were made, as well as the calculation of the Body Mass Index. The data were processed by descriptive statistics (mean, standard deviation); inferential statistics (T Test, X2); bivariate correlations (X2, odds ratio), and binary logistic regression, using SPSS 23.0. Results: Breastfeeding for less than six months, the introduction of food at an early stage of the life, and mild physical activity are factors that increase the risk of overweight and obesity more than 3 times in children and adolescents. Conclusions: Breastfeeding and weaning are associated with overweight and obesity from early stages of human development. The explanatory value that children and adolescents have is relevant, suggesting its implementation in educational and preventive health programs(AU)

Dietary cysteine is used more efficiently by children with severe acute malnutrition with edema compared with those without edema.

BACKGROUND: Children with edematous severe acute malnutrition (SAM) produce less cysteine than do their nonedematous counterparts. They also have marked glutathione (GSH) depletion, hair loss, skin erosion, gut mucosal atrophy, and depletion of mucins. Because GSH, skin, hair, mucosal, and mucin proteins are rich in cysteine, we hypothesized that splanchnic extraction and the efficiency of cysteine utilization would be greater in edematous than in nonedematous SAM. OBJECTIVE: We aimed to measure cysteine kinetics in childhood edematous and nonedematous SAM. DESIGN: Cysteine flux, oxidation, balance, and splanchnic uptake (SPU) were measured in 2 groups of children with edematous (n = 9) and nonedematous (n = 10) SAM at 4.4 ± 1.1 d after admission (stage 1) and at 20.5 ± 1.6 d after admission (stage 2) when they had replenished 50% of their weight deficit. RESULTS: In comparison with the nonedematous group, the edematous group had slower cysteine flux at stage 1 but not at stage 2; furthermore, they oxidized less cysteine at both stages, resulting in better cysteine balance and therefore better efficiency of utilization of dietary cysteine. Cysteine SPU was not different between groups but was ∼45% in both groups at the 2 stages. CONCLUSION: These findings suggest that children with edematous SAM may have a greater requirement for cysteine during early and mid-nutritional rehabilitation because they used dietary cysteine more efficiently than did their nonedematous counterparts and because the splanchnic tissues of all children with SAM have a relatively high requirement for cysteine. This trial was registered at clinicaltrials.gov as NCT00069134.

Weight gain and metabolic complications in preterm infants with nutritional support.

OBJECTIVE: To analyze the weight gain and to describe the metabolic complications in preterm newborns with nutritional support (NS) and to describe nutritional practices in the first month of hospitalization for 52 preterm newborns. MATERIAL AND METHODS: Descriptive and prospective study of preterm infants (30-36 gestational weeks), with birth weight > 1 kg, hospital stay > 12 days, without respiratory support or complications, conducted at a public hospital in Leon, Guanajuato, Mexico from January to November 2006. Weight, serum glucose, insulin, cholesterol, triglycerides, gamma-glutamyltransferase, creatinine, urea nitrogen, type of NS (parenteral PN, enteral EN, mixed MN), energy content, and macronutrient intake were measured weekly. To obtain representative data, nutritional practices were not altered by the study protocol. One way ANOVA and Wilcoxon tests were used in data analyses. RESULTS: Overall, 52 newborns were included, averaging 33 gestational weeks and 1,590 g of weight. The NS was started by the fourth day on average. Parenteral nutrition was the most frequent NS during the first 2 weeks (75%). Energy and macronutrient supply was 50% less than the recommended. Weight gain ranged from -100 to 130 g/week. Parenteral nutrition showed better weekly weight gain, followed by EN. The metabolic complication rate per person-day was greater for MN (0.56), than for EN (0.16) or PN (0.09). Routine surveillance of weight and metabolic complications was deficient. CONCLUSIONS: Late onset of NS, insufficient energy supply, and deficient surveillance were obstacles to weight gain and to prevent the metabolic complications in these newborns.

Tyrosine requirement during the rapid catch-up growth phase of recovery from severe childhood undernutrition.

The requirement for aromatic amino acids during the rapid catch-up in weight phase of recovery from severe childhood undernutrition (SCU) is not clearly established. As a first step, the present study aimed to estimate the tyrosine requirement of children with SCU during the catch-up growth phase of nutritional rehabilitation using a diet enriched in energy and proteins. Tyrosine requirement was calculated from the rate of excretion of ¹³CO2 (F ¹³CO2) during [¹³C]phenylalanine infusion in thirteen children with SCU, five females and eight males, at about 19 d after admission when the subjects were considered to have entered their rapid catch-up growth phase and were consuming 627.3 kJ and about 3.5 g protein/kg per d. Measurements of F ¹³CO2 during [¹³C]phenylalanine infusion were made on two separate days with a 1 d interval. Three measurements at tyrosine intakes of 48, 71 and 95 mg/kg per d were performed on experimental day 1 and measurements at tyrosine intakes of 148, 195 and 241 mg/kg per d were performed on experimental day 2. An estimate of the mean requirement was derived by breakpoint analysis with a two-phase linear regression cross-over model. The breakpoint, which represents an estimate of the mean tyrosine requirement, is a value of 99 mg/kg per d when the children were growing at about 15 g/kg per d. The result indicates that the mean requirement for tyrosine during the catch-up growth phase of SCU is about 99 mg/kg per d under similar conditions to the present study.

Perinatal malnutrition programs sustained alterations in nitric oxide released by activated macrophages in response to fluoxetine in adult rats.

OBJECTIVE: Nutritional restriction during lactation has long-term consequences on the functioning of neuroimmune systems. Receptors and transporter serotonin (5-HT) are present in macrophages and may influence their role. This study evaluated nitric oxide release by alveolar macrophages (AMs) in adult control rats and rats malnourished during lactation in response to different fluoxetine (FLX) concentrations and 5-HT(1A) and 5-HT(1B) agonists at different times. METHODS: Male Wistar rats were distributed into two groups according to maternal diet during lactation: a control group of 12 rats whose dams had received a 23% protein diet and a malnourished group of 12 rats whose dams had received an 8% protein diet. After weaning, all rats received a 23% protein diet. On the 90th day after birth, nitric oxide (NO) release kinetics was measured in supernatants of AMs cultured with FLX. The NO release following the adjunction of serotoninergic agonists was also quantified. RESULTS: The malnourished rats weighed less at weaning (control rats = 15.3 +/- 0.4 g, malnourished rats = 11.8 +/- 0.4 g); this difference persisted until 90 days of life (control rats = 355.4 +/- 8.6 g; malnourished rats = 267.8 +/- 7.9 g). In the presence of 10(-6)M FLX, NO release by AMs in control rats was lower. The addition of agonists did not interfere with NO release by AMs in control rats. NO release by AMs from malnourished rats was modified neither by FLX nor by agonists. As a consequence of malnutrition, there were lower numbers of cells and AMs in the bronchoalveolar lavage fluid, and cell viability and NO release by AMs were impaired. CONCLUSIONS: Nutritional manipulation in the perinatal period seems to interfere with the functional programming of macrophages; it also seems to affect their serotoninergic regulation through adulthood.

Nutritional tryptophan restriction and the role of serotonin in development and plasticity of central visual connections.

Tryptophan is an essential amino acid and metabolic precursor of serotonin. Serotonin is both a classical neurotransmitter and a signaling molecule that plays crucial roles in the development of neural circuits and plasticity. The specification of neural circuits in rodents occurs during the postnatal period with conspicuous influence of environmental factors including the nutritional status. Sensory, motor and cognitive systems develop during a critical period, a time window that is crucial to the use-dependent organization of neuronal circuits. This review presents recent experimental findings that disclose some mechanism of tryptophan- and serotonin-dependent plasticity in the developing and adult brain.

Programação do processo fome-saciedade de animais desnutridos no início da lactação: papel do NPY/AgRP e POMC / Programming hunger-satiety process of malnourished animals in early lactation: role of NPY/AgRP and POMC

A modulação do processo fome-saciedade é um fator determinante para o crescimento normal dos sistemas metabólicos. Tem sido demonstrado que variações nutricionais nos períodos pré e pós-natal induzem modificações nas projeções e/ou contatos dos circuitos neuronais hipotalâmicos, gerando uma "reprogramação" deste sistema que envolve mecanismos de interação da ação primária de hormônios como leptina em neurônios orexigênico (NPY/AgRP) anorexigênicos (POMC) no núcleo arqueado, para regular o comportamento alimentar. O objetivo deste trabalho foi estudar a programação do processo fome-saciedade no núcleo arqueado hipotalâmico, em curto e longo prazos, em animais que foram desnutridos no início da lactação. Para isso, utilizamos ratos Wister desnutridos nos primeiros 10 dias de lactação com a utilização de dieta materna com 0% de proteína e que foram submetidos a novo período de desnutrição protéica na fase adulta (60 dias de idade) por 3 dias. Para o estudo do processo fome-saciedade, as variáveis avaliadas foram peso corporal, razão peso corporal / consumo alimentar, conteúdos de receptores de leptina (Ob-Rb) e de neuropeptídeos hipotalâmicos (NPY/AgRP e POMC). Observamos que ao final de 10 dias de desnutrição na lactação, os animais desnutridos apresentaram menor peso corporal (FD - fêmea desnutrida, 50% e MD - macho desnutrido, 53%) e aumento dos conteúdos de Ob-Rb (FD: 121,67% e MD: 132,73%), NPY/AgRP (FD: 32,31% e MD: 115,62%) e POMC (FD: 71,2% e MD: 26,58%). Aos 60 dias de vida, os animais desnutridos apresentaram maior razão peso corporal / consumo alimentar e não evidenciamos diferença nos conteúdos de Ob-Rb, NPY/AgRP e POMC (p<-0,05). Aos 63 dias de vida, fêmeas (FDD) e machos desnutridos (MDD), após um segundo episódio de desnutrição, apresentaram redução de peso corporal (FDD: 12,4% e MDD: 10,75%) e consumo alimentar (FDD: 57,5% e MDD: 39,88%). O conteúdo dos neuropeptídeos orexigênicos (NPY/AgRP)...

The modulation of the hunger-satiety process is a determining factor for the normal growth of the metabolic systems. It has been demonstrated that nutritional variations during pre- and postnatal lead to modifications in projetions and/or contacts of hypothalamic neuronal circuits generating a "reprogramation" of this system, which involves mechanisms of interation of primary action of hormone as leptin in NPY/AgRP and POMC neurons in the arcuate nucleus, to regulate eating behavior. Our aim was to study the programation in the hunger-satiety process in the arcuate nucleus, in the short and long terms, in animals that were malnourished during the early lactation period. In the present study we used Wistar rats that were malnourished during the first 10 days of lactation (0% protein maternal diet) and that were submitted to new a period of malnutrition at adulthood (60 days-old) for 3 days. To study the hunger-satiety process, the variables evaluated were: body weight, body weight/food intake ratio, hypothalamic content of the leptin receptor (Ob-Rb) and the orexigenic NPY/AgRP and anorexigenic POMC neuropeptides. We observed at the end of 10 days of malnutrition during lactation, that the malnourished animals had lower body weight (MF - malnourished female, 50% and MM - malnourished male, 53%) and higher content of Ob-Rb (MF: 121,67% and MM: 132,73%), NPY/AgRP (MF: 32,31% e MM: 115,62%) and POMC (MF: 71,2% e MM: 26,58%). At 60 days, the malnourished animals had higher body weight/food intake ratio and showed no change in the Ob-Rb, NPY/AgRP and POMC content (p<-0,05). At 63 days of life, malnourished female and male after a second episode of malnutrition, had lower body weight (MMF: 12,4% and MMM: 10,75%) and food intake (MMF: 57,5% and MMM: 39,88%). The content of neuropeptides (NPY/AgRP) was significantly lower (MMF: 22,6% and MMM: 26,58%), while the content of Ob-Rb (MMF: 92,27% and MMM: 28%) and POMC neuropeptide (MMF: 22,34% and MMM:27,27%)...

Stress/aggressiveness-induced immune changes are altered in adult rats submitted to neonatal malnutrition.

BACKGROUND/AIMS: Neonatal malnutrition induces metabolic and endocrine changes that have beneficial effects on the neonatal in the short term but, in the longer term, these alterations lead to maladaptations. We investigated the effect of neonatal malnutrition on immune responses in adult rats submitted or not to an aggressiveness test. METHODS: Male Wistar rats were distributed to one of two groups according to their mothers' diet during lactation: the well-nourished group (group C, n = 42, receiving 23% of protein) and the malnourished group (group MN, n = 42, receiving 8% of protein). After weaning, all rats received normoproteic diet. Ninety days after birth, each group was subdivided into three subgroups: control rats (n = 14, respectively), aggressive rats (n = 14, respectively) and rats receiving foot shock (FS; n = 14, respectively). Plasma corticosterone concentration was measured after FS sessions. Leukocyte counts and humoral immunity were evaluated. RESULTS: In neonatal malnourished animals, FS-induced stress reduced plasma corticosterone concentration. Intraspecific aggressiveness induced alterations in leukocyte counts and antibody titers 7 and 15 days after immunization. Neonatal malnourished animals showed no changes in the immune parameters evaluated. CONCLUSIONS: Expression of intraspecific aggressiveness activates the immune system. Neonatal malnutrition seems to have a long-lasting effect on components of both neuroendocrine and immune functions.

Childhood malnutrition is associated with a reduction in the total melanin content of scalp hair.

Childhood malnutrition is known to be associated with visible lightening of hair colour (hypochromotrichia). Nevertheless, no systematic investigations have been carried out to determine the biochemical basis of this change. We used an HPLC method to measure melanins in the scalp hair of thirteen Jamaican children, diagnosed as having primary malnutrition, during various stages of their treatment and after recovery. During treatment for malnutrition, a progressive decrease in total melanin content along the hair shaft from tip to root (root:tip ratio: 0.62 (sd 0.31)) was observed. This ratio was significantly different (P = 0.003) from the ratio observed among children sampled several months after discharge from hospital (0.93 (sd 0.23)) and among normal control children (0.97 (sd 0.12)). Thus, it appears that a decrease in melanin content is associated with periods of malnutrition. The low root:tip ratio during malnutrition presumably arises because the tips reflect prior hair growth during 'normal' nutrition and the roots reflect hair growth during malnutrition; a return of the root:tip ratio to that seen among controls reflects 'recovery' from malnutrition. It is possible that reduced intake or availability of tyrosine, a key substrate in melanin synthesis, may play a role in the reduction of hair melanin content during periods of malnutrition. The precise mechanisms by which melanin content is reduced, and the role of aromatic amino acid availability in hair colour change and other features of childhood malnutrition remain to be explored.

[Fatty acids of plasma and erythrocyte phospholipids in malnourished infants well-fed by breast feeding or formula]. / Acidos grasos de fosfolípidos en plasma y eritrocitos de lactantes desnutridos alimentados con leche materna o fórmulas.

Polyunsaturated fatty acids (PUFA) derived from essential fatty acids (EFA) play an important role in prenatal visual and neural development. Protein-energy malnutrition affects PUFA supply, and hence the synthesis of structural lipids during growth. Recently, some physiological studies reported abnormalities in the neurological functions of formula-fed infants relative to breast-fed. The purpose of our study was to assess whether fatty acid composition of the malnourished infant diet modifies plasma and erythrocyte phospholipid fatty acid composition. Three groups of full-term malnourished infants were selected according to their prior feeding. Two groups had received commercial formulas, one of them supplied with linoleic and alpha-linolenic acid, and the other supplied in addition with long chain PUFA from n-3 and n-6 series. The reference group of breast-fed infants was also enrolled. Plasma and erythrocyte phospholipid fatty acid composition was determined by gas-liquid chromatography. Those infants receiving formulas showed in plasma and erythrocyte phospholipids increased values in total saturated and monoethylenic fatty acids, and decreased values in polyunsaturated fatty acids from both n-6 and n-3 series, relative to that of breast-fed infants. These differences were more remarkable in the case of infants who received formula without PUFA. We conclude that in malnourished infants, a nutrient formula enriched with long chain fatty acids of n-6 and n-3 series could be helpful to achieve an erythrocyte and plasma fatty acid pattern similar to that obtained in breast-fed infants.

Acidos grasos de fosfolipidos en plasma y eritrocitos de lactantes desnutridos alimentados con leche materna o fórmulas / Fatty acids of plasma and erythrocyte phospholipids in malnourished infants well-fed by breast feeding or formula

Los ácidos grasos polinsaturados (AGP) derivados de los ácidos grasos esenciales (AGE) tienen importantes roles en la formación y mantenimiento de estructuras de membrana, jugando un papel trascendente en la síntesis de lípidos estructurales y en el desarrollo neural. Se han señalado anormalidades en las funciones neurológicas de lactantes alimentados con fórmulas con respecto a lactantes alimentados con leche materna y se conoce el efecto de la desnutrición calórico-proteica sobre la composición en AGP de algunos tejidos. En este trabajo se estudió el efecto de diferentes fórmulas comerciales sobre la composición en ácidos grasos de los fosfolípidos de plasma y eritrocitos. Se seleccionaron tres grupos de lactantes desnutridos por causa socioeconómicoculturales nacidos a término: dos recibieron fórmulas (una de ellas sólo aportó ácidos linoleicos y alfa- linolénicos y la otra contenía además agragados ácidos grasos polinsaturados de mayor longitud de cadenas derivados de ambas series: n-3 y n-6 y el tercer grupo, alimentado con leche materna, se consideró como control. Se determinó la composición de ácidos grasos de los fosfolipídos de plasma y eritrocitos por cromatografía gas-líquido. Los resultados mostraron, en lactantes alimentados con fórmulas, mayor proporción de ácidos saturados y monoetilénicos, y menor porcentaje en el total de ácidos polinsaturados con respecto a los alimentados con leche materna. Estas diferecias son más marcadas en los que recibieron fórmulas sin suplemento AGP. Seconcluye que en lactante desnutridos el uso de fórmulas enriquecidasen ácidos grasos polinsaturados logra restaurar en parte, el perfil de ácidos grasos en fosfolipídos de plasma y eritrocitos, que se asemeja al de los que reciben leche materna, y es diferente a los alimentados con fórmulas comunes.

Acidos grasos de fosfolipidos en plasma y eritrocitos de lactantes desnutridos alimentados con leche materna o fórmulas / Fatty acids of plasma and erythrocyte phospholipids in malnourished infants well-fed by breast feeding or formula

Los ácidos grasos polinsaturados (AGP) derivados de los ácidos grasos esenciales (AGE) tienen importantes roles en la formación y mantenimiento de estructuras de membrana, jugando un papel trascendente en la síntesis de lípidos estructurales y en el desarrollo neural. Se han señalado anormalidades en las funciones neurológicas de lactantes alimentados con fórmulas con respecto a lactantes alimentados con leche materna y se conoce el efecto de la desnutrición calórico-proteica sobre la composición en AGP de algunos tejidos. En este trabajo se estudió el efecto de diferentes fórmulas comerciales sobre la composición en ácidos grasos de los fosfolípidos de plasma y eritrocitos. Se seleccionaron tres grupos de lactantes desnutridos por causa socioeconómicoculturales nacidos a término: dos recibieron fórmulas (una de ellas sólo aportó ácidos linoleicos y alfa- linolénicos y la otra contenía además agragados ácidos grasos polinsaturados de mayor longitud de cadenas derivados de ambas series: n-3 y n-6 y el tercer grupo, alimentado con leche materna, se consideró como control. Se determinó la composición de ácidos grasos de los fosfolipídos de plasma y eritrocitos por cromatografía gas-líquido. Los resultados mostraron, en lactantes alimentados con fórmulas, mayor proporción de ácidos saturados y monoetilénicos, y menor porcentaje en el total de ácidos polinsaturados con respecto a los alimentados con leche materna. Estas diferecias son más marcadas en los que recibieron fórmulas sin suplemento AGP. Seconcluye que en lactante desnutridos el uso de fórmulas enriquecidasen ácidos grasos polinsaturados logra restaurar en parte, el perfil de ácidos grasos en fosfolipídos de plasma y eritrocitos, que se asemeja al de los que reciben leche materna, y es diferente a los alimentados con fórmulas comunes. (AU)

Hipoalbuminemia en lactantes sin edema hospitalizados por síndrome diarreico: factores asociados / Hypoalbuminemia in infants without edema hospitalized by diarrhea syndrome: associated factors

En el SD la HB causa problemas en 1.- Valoración del estado de hidratación, 2.- Cuantificación de las necesidades de volumen, y 3.- Desarrollo de aparente sobrehidratación con aportes usuales que obliga a descartar falla renal e induce a restringir líquidos. Con el objeto de establecer prevalencia de HB en internados por SD y su asociación con factores empíricamente relacionados se investigaron 155 niños, determinando proteínas totales y albúmina plasmática en las primeras 24 horas. El estado nutricional se estableció por criterio del MINSAL. La búsqueda etiológica enteral del SD incluyó: rotavirus, ECEP, Salmonella, Shigella, Campylobacter sp y Cryptosporidium sp. Se estudiaron asociaciones de HB y proteinemia, estado nutricional, peso estacionario o en descenso, duración del SD, etiología probable, antecedentes de hospitalización reciente, fiebre, gravedad y sobrehidratación con densidad urinaria sobre 1.015. En la estadística se empleó: índice Kappa, correlación por "r", razón de discordancia OR y pruebas de Ji cuadrado o Fisher-Irwin; error alfa de 0,05. El 72,9 por ciento de los casos eran menores de 12 meses, la mayoría varones, la mitad eutróficos, 1,9 por ciento obesos y 4,3 por ciento D3. Al ingreso, el SD persistía menos de 3 días en el 38,5 por ciento. La gravedad, de nula a +++, tuvo las frecuencias de 30,3 por ciento, 44,5 por ciento, 18,7 por ciento y 6,5 por ciento, respectivamente. Se encontraron esteropatógenos en el 56,1 por ciento y no se estableció etiología probable en el 28 por ciento. Se sobrehidrató el 7,7 por ciento. Hipoproteinemia (14,8 por ciento) e HB (14,2 por ciento), mostraron regular concordancia (kappa=0,36, p=0,01). Las asociaciones significativas por OR fueron comparables (OR; IC de 95 por ciento;p). Estado nutricional (9,55; 2,91-31,31; 0,002), peso estacionario o en descenso (5,64; 1,92-16,55;0,002), duración anamnéstica del SD (5,41; 2,14-13,69; 0,0005) (r=0,23; p=0,004), fiebre por mas de 4 días (5,68; 1,49-21,67; 0,03), sobrehidratación y densidad urinaria >1.015 (5,29; 1,58-17,72;0,01). Investigando HB en desnutridos y en sobrehidratados se detecta al 95,4 por ciento de los casos. Se concluye que la HB es relativamente común en lactantes en las condiciones estudiadas, que aunque se concentra en el grupo de desnutridos, también se presenta en los demás pacientes, que la medición de proteinemia total no subroga adecuadamente la de albúmina y que clínicamente se puede identificar al 48,4 por ciento de la muestra, que contiene el 95,4 por ciento de los casos con HB

Enfermedad de Bartter: ¿por qué se disnutren? / Bartter's disease: why do they get undernourished?

Se presentan los resultados de balances metabólicos llevados a cabo en tres lactantes portadores de enfermedad de Bartter, en los que resaltaron tanto una baja ingesta como una pérdida nitrogenada exagerada. A la luz de estos antecedentes se plantea una hipótesis acerca de la génesis de la acentuada desnutrición y retardo de crecimiento, de estos niños, basada en hechos fisiológicos previamente comprobados

PMN cell phagocytic function in malnourished patients with zinc uptake.

Zinc effects on phagocytic activity depend upon its serum concentration. According to certain experimental findings, a decrease in zinc serum concentration is parallel to a deficiency in host defense mechanisms and thus we were interested in studying the effect of zinc sulphate in the phagocytic function of polymorphonuclear cells of 15 zinc deficient patients with III degree malnourishment. In all patients, zinc serum determinations were made before and after zinc intake and chemotaxis, phagocytosis and NBT reduction tests were made at 7, 14 and 30 days. Results are compared with an eight patient group with similar clinical and nutritional characteristics observing an improvement in PMN cell phagocytic activity in patients with zinc uptake (p < 0.001). No differences were observed in a chemotaxic phagocytosis and NBT reduction tests in regard to the time during which patients did not receive zinc uptake.

Total body water in malnutrition: the possible role of energy intake

Total body water (TBW) was measured using tritiated water in sixty-five children. The measurements were distributed throughout rehabilitation in order to define the effect of changing energy intakes. Oedematous children had a high TBW which decreased to the normal range during loss of oedema providing they were not receiving more than maintenance amounts of energy during this period. Marasmic children who had not received greater than maintenance amounts of energy had a normal TBW. Treatment with a high-energy diet was associated with an initial increase in TBW. The possible mechanisms for this phenomenon are discussed.(AU)

[Study of fetal malnutrition. IV. Acid-base equilibrium in normal and in intrauterine-growth-deficient newborn infants]. / Estudios en desnutrición fetal. IV. Equilibrio ácido base en recién nacidos normales y con déficit de crecimiento intrauterino.

Acid-base equilibrium parameters were studied in 11 full-term newborns with adequate weights for their gestational age and in 10 with deficit in their intrauterine growth, during the first 72 hours of life. Significant differences were found. Apparently, malnourished subjects who overcome chronic asphyxia are able to compensate the metabolic disturbances brought about through hyperventilation. The low figures of PaO2 found in babies show they will need higher concentration of oxygen in the air they inhale.