ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundIntestinal protein loss has been reported mainly in diseases affecting the gastrointestinal tract. Intestinal protein loss during pneumonia with effusion has not been reported to date. The authors attempted to assess the associations between pneumonia with effusion and intestinal protein loss and hypoalbuminemia in children.MethodsThis was a prospective consecutive case series study of in children hospitalized with pneumonia and effusion during a period of 4½ years. Serum albumin, C-reactive protein (CRP), and fecal &agr;-1 antitrypsin (&agr;-1-AT) were measured in the first 72 hours of hospitalization. Two control groups were studied: one consisted of 50 febrile children hospitalized because of viral or mild bacterial infections, and the other consisted of 20 afebrile children hospitalized because of convulsive disorders.ResultsSixty-seven children ages 4 months to 14 years hospitalized with pneumonia and effusion were enrolled in the study. Fifty-nine percent (40 children) were found to have elevated fecal &agr;-1-AT excretion (range, 2–10 mg/g) compared with none in the two control groups (P< 0.000).Fifty-two percent (35 children) of the children with pneumonia and effusion had mild to moderate hypoalbuminemia (range, 22–34 g/L). Only one child (2%) in the febrile control group had a low albumin of 34 g/L; none were found in the afebrile control group. The level of fecal &agr;-1-AT was inversely correlated with serum albumin level.ConclusionsPneumonia with effusion in children is often associated with an intestinal protein loss that can be monitored by measuring gastrointestinal loss of protein, namely fecal &agr;-1-AT. In most cases the development of hypoalbuminemia correlates with the development of intestinal protein loss.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundChronic diarrhea during early infancy is characterized by intestinal mucosal injury, and as a consequence, the mitochondrial system of oxidation and reduction and energy production is altered. Since dietary nucleotides have been associated with the process of intestinal mucosal repair in rats with chronic diarrhea, the aim of this study was to examine the effects of dietary nucleotides on the functioning of mucosal mitochondria.MethodsWeanling rats were fed with a semipurified synthetic diet (C) or the same diet in which carbohydrates were substituted by lactose (L), resulting in chronic diarrhea. During recovery, rats were fed with the semipurified synthetic diet (LC) or the same diet supplemented with nucleotides (LN). The activities of adenosine triphosphate synthase (ATPase), cytochrome c oxidase, citrate synthase, and malate dehydrogenase were measured in mitochondria from ileum and colon mucosa.ResultsThese enzymatic activities rose in rats with chronic diarrhea, possibly to compensate for the drastic decline in adenosine triphosphate (ATP) synthesis. Dietary nucleotide supplementation allowed normalizing of the activities of ATPase (C: 0.37 ± 0.16 &mgr;g/min/mg protein; L: 0.68 ± 0.25 &mgr;g/min/mg protein; LC: 0.60 ± 0.20 &mgr;g/min/mg protein; LN: 0.42 ± 0.22 &mgr;g/min/mg protein), citrate synthase (C: 0.12 ± 0.05 mM/min/mg protein; L: 0.21 ± 0.07 mM/min/mg protein; LC: 0.21 ± 0.06 mM/min/mg protein; LN: 0.12 ± 0.02 mM/min/mg protein), and malate dehydrogenase (C: 0.77 ± 0.48 mM/min/mg protein; L: 3.08 ± 0.85 mM/min/mg protein; LC: 2.11 ± 0.44 mM/min/mg protein; LN: 1.13 ± 0.51 mM/min/mg protein) in the ileum mitochondria of the diarrheic rats. In colonic mucosa, mitochondrial enzymatic activities were restored after eliminating lactose from the diet.ConclusionThese results suggest that dietary nucleotides promote earlier restoration of the ileal mitochondrial function after chronic diarrhea.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectivesTo detect the presence of antibodies against bovine serum albumin in a cohort of Spanish patients with type 1 insulin-dependent diabetes.MethodsAntibodies were measured using an in-house enzyme-linked immunosorbent assay test in 80 patients with type 1 diabetes, subdivided according to the presence or absence in their serum of celiac disease-related antibodies. For comparison, 30 patients with celiac disease (nondiabetic), 13 patients with autoimmune thyroiditis, and 45 healthy volunteers were used.ResultsThirty-one percent of patients with diabetes yielded a positive result, with a mean value of 26.1 ± 21.8 arbitrary units (AU). If the group was split into those with celiac disease-related antibodies and those lacking them, the percentages were 53% and 25%, respectively, with a mean value of 39.6 ± 28.4 AU and 22.4 ± 18.3 AU (P= 0.003), respectively. Seventy-three percent of celiac patients showed bovine serum albumin antibodies with a mean level of 38.8 ± 27.7 AU, comparable to that of patients with diabetes with celiac antibodies, but higher than the group lacking them (P= 0.001). Although 46% of patients with autoimmune thyroiditis had positive results, the level detected (22.1 ± 8.7 AU) was significantly lower than that recorded in patients with type 1 diabetes who had celiac disease antibodies (P= 0.04) and celiac patients (P= 0.04). Healthy volunteers showed no antibodies against bovine serum albumin.ConclusionsThese data suggest that bovine serum albumin antibodies appears in patients with a compromised epithelial permeability, and they reflect a general defect in the process of immunologic tolerance associated with a predisposition to autoimmunity, rather than immunity specific to &bgr; cells.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectivesIntestinal failure (IF) is a condition whose treatment requires advanced knowledge and techniques and a multidisciplinary approach. Intestinal failure is the endpoint of many intestinal diseases and may result in full recovery, in life-long parenteral nutrition, or in the death of the child. The aim of this study was to evaluate the natural history of IF in children using a national network of resources.MethodsItalian centers of pediatric gastroenterology merged in a national network, developing a collaborative management approach for children with IF. A consensus definition of IF was achieved. A database was set up to investigate the cause, epidemiologic factors, and natural history of IF.ResultsOne hundred nine children were enrolled in 5 years. The cause of IF was: short bowel syndrome (n = 48), disorders of motility (n = 16), structural enterocyte defects (n = 14), multiple food intolerance (n = 10), autoimmune enteropathy (n = 7), and others or unknown (n = 14). The eventual outcome was closely related to the primary cause, ranging from full and permanent intestinal sufficiency in children with multiple food intolerance to high death rate or total dependance upon parenteral nutrition in those with structural enterocyte defects. Intermediate outcomes were observed for the other causes. Four children received intestinal transplantation.ConclusionsThe network approach for IF provides an effective model to optimize resources and to investigate prospectively the natural history of IF. Based on the work on this series, a European network for IF could be an effective model for fulfilling the diagnostic and management needs, including intestinal transplantation.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID