[Nursing of patients hospitalized for viral hepatitis]. / Cuidados de enfermería en pacientes hospitalizados por hepatitis viral.

Viral hepatitis is a serious health problem that deserves special attention. In the last ten years progress has been made in its diagnosis, treatment and prevention. An updated review is made of the main clinical and epidemiological characteristics of viral hepatitis and of the nursing care that children admitted for this disease receive at our Hospital.

[Changes in the liver biopsies of pediatric cancer patients who carry the B virus]. / Alteraciones en las biopsias hepáticas en pacientes de oncopediatría portadores del virus B.

Liver biopsies from 27 patients with malignant diseases and virus B carriers state were studied. The age of the patients ranged from 2 to 14 years. ELISA tests for virus B hepatitis were performed in all patients. Three of them resulted HBV positive at admission, whereas 24 became positive after anti-tumoral treatment onset. One patient was also virus C positive. Morphological disorders findings comprises: symptomless acute hepatitis in 7 patients (including the B-C carrier), minimal hepatocytes damage was found in 17 patients as the result of their carriers state and where also certain drug-induced hepatotoxic effect might be present. In this group there were also 7 biopsies with minimal portal region damage. Three biopsies were reported as normal liver tissue. This results confirmed the significance of the study of serological hepatitis viral test and hepatic biopsy in high risk group patients, where it is also necessary the vaccination against HBV before treatment onset.

[Risk factors for persistent diarrhea]. / Factores de riesgo para la diarrea persistente.

The current concepts in persistent diarrhoea (PD) are reviewed. 102 patients with acute diarrhoea and 85 with PD are studied. All were less than one year old. Information about age, nutritional status, time of breast feeding, previous episodes of acute and persistent diarrhoea and the previous use of drugs is registered. Microbiological and parasitologics studies were done to identify enteric pathogens. To prove the association of PD and the exposure to different risk factors the statistic method of Chi square (chi 2) was used and the odds ratio (OR) estimated. In order of importance and according to the OR the risk factors identified were: previous episodes of PD, malnutrition, less than one month with breast feeding, the use of metronidazol and antibiotics, multiple infections, previous episodes of acute diarrhoea and the identification of enteric pathogens. The most frequent pathogen was Salmonella followed by entero pathogenic Escherichia coli.

[Treatment with Savary-Gilliard bougies in esophageal stenosis in children]. / Tratamiento con las bujías de Savary-Gilliard en las estenosis esofágicas del niño.

30 patients (less than 15 years old) were admitted for esophageal strictures, 16 of them secondary to corrosive injury. All the patients were treated with endoscopic dilatation with Savary-Gilliard bougie. The dilations were done with general anesthesia using an Olympus GIF-XP10 endoscope and with fluoroscopic control. In the esophageal stenosis secondary to caustic ingestion endoscopic injection with Betamethasone was also used. The most frequent site of the stenosis was the upper third of the esophagus, and the main type of stenosis was tubular in the secondary to caustic burns and annular in the other group. In the post-caustic group 385 dilations were performed in 115 sessions. In the other group 159 dilations were done in 51 sessions. Two perforations and one sepsis were reported in patients with corrosive stenosis. There was no mortality. 43.7% of the patients with corrosive stenosis and 85.7% with stenosis secondary to other causes obtained complete healing. Esophageal dilation with Savary-Gilliard bougies represents a safe and reliable method for the treatment of esophageal strictures.

[Influence of breast feeding on nutritional development of infants with persistent diarrhea]. / Influencia de la lactancia materna en la evolución nutricional del lactante con diarrea persistente.

The evolution of some nutritional anthropometric indicators was studied in a 115 breast-feeding infants (52 received breast-feeding during the first four months of life (120 days) exclusively and 63 mixed feeding). Breast feeding infants showed sustained weight increment during the four weeks of evolution. The multivariate repeated measures analysis performed, proved significant changes during evolution's time in all studied indicator in lineal form, as well as interaction between type of feeding and indicators evolution except the subescapular fat fold. Author concluded that it should be reinforced the breast-feeding practice promotion as an effective way for the nutritional recovery of breast-feeding infants with persistent diarrhoea.

Influencia de la lactancia materna en la evolucion nutricional del lactante con diarrea persistente / Influence of breast feeding on nutritional development of infants with persistent diarrhea

La evolución de algunos indicadores antropométricos del estado nutricional fue estudiada en 115 lactantes de los cuales 52 recibieron lactancia materna exclusivamente durante los 4 primeros meses de vida (120 días) y 63 lactancia mixta. Los lactantes alimentados con leche materna mostraron incremento sostenido del peso durante las 4 semanas de evolución. El análisis de observaciones repetidas practicado evidenció cambios significativos en el tiempo de evolución de forma lineal en todos los indicadores estudiados, al igual que la interacción entre el tipo de lactancia y evolución de los indicadores con excepción del plieque subescapular. Los autores concluyeron que debe insistirse en la promoción de la lactancia materna como vía efectiva para la recuperación nutricional del lactante con diarrea persistente

Influencia de la lactancia materna en la evolución nutricional del lactante con diarrea persistente. / [Influence of breast feeding on nutritional development of infants with persistent diarrhea]

The evolution of some nutritional anthropometric indicators was studied in a 115 breast-feeding infants (52 received breast-feeding during the first four months of life (120 days) exclusively and 63 mixed feeding). Breast feeding infants showed sustained weight increment during the four weeks of evolution. The multivariate repeated measures analysis performed, proved significant changes during evolutions time in all studied indicator in lineal form, as well as interaction between type of feeding and indicators evolution except the subescapular fat fold. Author concluded that it should be reinforced the breast-feeding practice promotion as an effective way for the nutritional recovery of breast-feeding infants with persistent diarrhoea.

Influencia de la lactancia materna en la evolucion nutricional del lactante con diarrea persistente / Influence of breast feeding on nutritional development of infants with persistent diarrhea

La evolución de algunos indicadores antropométricos del estado nutricional fue estudiada en 115 lactantes de los cuales 52 recibieron lactancia materna exclusivamente durante los 4 primeros meses de vida (120 días) y 63 lactancia mixta. Los lactantes alimentados con leche materna mostraron incremento sostenido del peso durante las 4 semanas de evolución. El análisis de observaciones repetidas practicado evidenció cambios significativos en el tiempo de evolución de forma lineal en todos los indicadores estudiados, al igual que la interacción entre el tipo de lactancia y evolución de los indicadores con excepción del plieque subescapular. Los autores concluyeron que debe insistirse en la promoción de la lactancia materna como vía efectiva para la recuperación nutricional del lactante con diarrea persistente (AU)

[Emergency panendoscopy in children with upper digestive bleeding. Diagnostic and therapeutic value]. / Panendoscopia de urgencia en niños con sangramiento digestivo alto. Su valor diagnóstico y terapéutico.

The aim of this paper was to review the current concepts in the early diagnosis of the upper gastrointestinal bleeding by emergency endoscopy, its value in ulcers and the factors predicting poor outcome. Variceal bleeding from the esophagus as a complication of portal hypertension is also reviewed. The expanding role of endoscopy for gastrointestinal hemorrhage is emphasized.

[Serum levels of vitamin A and their relation with acute and persistent diarrhea]. / Niveles séricos de vitamina A y su relación con diarrea aguda y persistente.

75 patients, less than one year old, admitted in our Hospital, from January 1991 to april 1992 were divided in three groups: Group I: 25 controls, group II 25 patients with acute diarrhoea and group III 25 patients with persistent diarrhoea. The serological status of vitamin A was evaluated and classified as normal, not severe deficiency and severe deficiency. It was demonstrated that vitamin A deficiency is a risk factor for persistent diarrhoea.

Niveles sericos de vitamina A y su relacion con diarrea aguda y persistente / Seric levels of vitamin A and their relation with acute and persistent diarrhea

Se estudiaron 75 pacientes menores de un año en el período entre enero 1991-abril 1992, los que fueron divididos en tres gurpos: grupo 1: 25 pacientes controles; grupo 2: 25 pacientes con enfermedad diarreica aguda y grupo 3: 25 pacientes con diarrea persistente. A todos se les realizó dosificación sérica de vitamina A, clasificádolos según el resultado en normal niveles mayores de 0,75 Mmol/l, deficiencia no severa entre 0,75 y 0,35 Mmol/I y deficiencia menor de 0,35 Mmol/l. Demonstrandose que la deficiencia de vitamina A constituye un factor de riesgo para la diarrea persistente en nuestro medio

Panendoscopia de urgencia en niños con sangramiento digestivo alto. Su valor diagnóstico y terapéutico. / [Emergency panendoscopy in children with upper digestive bleeding. Diagnostic and therapeutic value]

The aim of this paper was to review the current concepts in the early diagnosis of the upper gastrointestinal bleeding by emergency endoscopy, its value in ulcers and the factors predicting poor outcome. Variceal bleeding from the esophagus as a complication of portal hypertension is also reviewed. The expanding role of endoscopy for gastrointestinal hemorrhage is emphasized.

Niveles séricos de vitamina A y su relación con diarrea aguda y persistente. / [Serum levels of vitamin A and their relation with acute and persistent diarrhea]

75 patients, less than one year old, admitted in our Hospital, from January 1991 to april 1992 were divided in three groups: Group I: 25 controls, group II 25 patients with acute diarrhoea and group III 25 patients with persistent diarrhoea. The serological status of vitamin A was evaluated and classified as normal, not severe deficiency and severe deficiency. It was demonstrated that vitamin A deficiency is a risk factor for persistent diarrhoea.

Niveles sericos de vitamina A y su relacion con diarrea aguda y persistente / Seric levels of vitamin A and their relation with acute and persistent diarrhea

Se estudiaron 75 pacientes menores de un año en el período entre enero 1991-abril 1992, los que fueron divididos en tres gurpos: grupo 1: 25 pacientes controles; grupo 2: 25 pacientes con enfermedad diarreica aguda y grupo 3: 25 pacientes con diarrea persistente. A todos se les realizó dosificación sérica de vitamina A, clasificádolos según el resultado en normal niveles mayores de 0,75 Mmol/l, deficiencia no severa entre 0,75 y 0,35 Mmol/I y deficiencia menor de 0,35 Mmol/l. Demonstrandose que la deficiencia de vitamina A constituye un factor de riesgo para la diarrea persistente en nuestro medio (AU)

Panendoscopia de urgencia en niños con sangramiento digestivo alto. Su valor diagnóstico y terapéutico / [Emergency panendoscopy in children with upper digestive bleeding. Diagnostic and therapeutic value]

The aim of this paper was to review the current concepts in the early diagnosis of the upper gastrointestinal bleeding by emergency endoscopy, its value in ulcers and the factors predicting poor outcome. Variceal bleeding from the esophagus as a complication of portal hypertension is also reviewed. The expanding role of endoscopy for gastrointestinal hemorrhage is emphasized.

Coeliac disease in Cuban children.

Coeliac disease is generally considered to be a disease of Europe, North America, and Australasia. A series of well-authenticated cases from Cuba is presented. One of the factors responsible for the presence of this disease in Cuba may be the increase in wheat consumption in the last few years. It is likely that coeliac disease exists in other tropical countries.

Family studies of coeliac disease in Cuba.

Peroral jejunal biopsies were performed on 69 of 85 1st-degree relatives of 20 index coeliac patients in 20 families. Three had mucosal changes typical of coeliac disease, giving an incidence of 4.3%. This figure is similar to that for family studies in England, and it confirms the familial nature of coeliac disease in a population with different racial characteristics from countries where coeliac disease is common.

Duodenal intubation with secretin stimulus for diagnosis of giardiasis.

The use of secretin to facilitate the demonstration of Giardia lamblia in duodenal juice was studied in children under investigation for chronic diarrhoea. 30 children aged 3 months to 13 years, whose stools were negative for G. lamblia, were studied. G. lamblia was demonstrable in a sample of duodenal juice in 1 of the 30 children before an intravenous injection of secretin (1 or 2 mg/kg), but in 9 of the 30 children after secretin. It is concluded that examination of duodenal juice after secretin stimulus is an effective method of showing giardial infestation.

Comparative trial of pancrex V forte and nutrizym in treatment of malabsorption in cystic fibrosis.

A cross-over trial of pancreatic enzyme replacement therapy has been conducted on 12 children with cystic fibrosis using Pancrex V forte and Nutrizym tablets in equivalent dosage. No differences were found in the effectiveness of these products as measured by stool volume, number of bowel actions, faecal fat excretion, and urine urea excretion. Neither product eliminated the steatorrhoea. Though there was no laboratory evidence to support their choice nine patients expressed a preference for Nutrizym at the conclusion of the trial. This preference was based partly on the smaller number of tablets which are required.