Efecto de la caseína en la absorción de d-xilosa medida mediante la prueba de H2 espirado / Effect of casein on d-xylose absorption measured by expired H2 test

Different experimental studies suggest that the presence of food in the alimentary tract, promote small intestinal absorption. The mechanism involved are not completely understood and might be related to motility changes or to humoral factors. Since studies have shown a decrease of small bowel motility after casein administration, the aim was to analyze the effect of this protein on small intestinal absorption and orocecal transit time. The hydrogen breath test was used to estimate d-xylose absorption. H2 production is dependent on the amount of this carbohydrate reaching the colon and therefore inversely proportional to d-xylose absorption. Six normal volunteers ingested 25 g d-xylose and 25 g de-xyllose + 30 g casein, and alveolar breath samples were obtained at 15 min intervals. Results: by adding casein to d-xylose solution a statistically significant decrease of maximal H2 concentration was observed from a mean of 40ñ11 ppm to a mean of 26ñ8 ppm. Similarly the area under the curve (which reflects the amount of xylose that was not absorbed) was also significantly decreased from a mean of 3281ñ1399 ppm to mean of 1394ñ700 ppm of H2. The orocecal transit time was significantly prolonged from 85.5ñ40 min to 112ñ38 min. Our results suggest that casein increased d-xylose absorption in normal subjects and that this effect might be related to a slower transit time

Cirrosis biliar primaria: experiencia en 33 casos consecutivos / Primary biliary cirrhosis: analysis of 33 consecutive cases

Primary biliary cirrhosis is a chronic, progressive and often fatal cholestatic liver disease. We report clincial characteristics and follow up in 33 consecutive patients studied at a single university hospital during the last 10 yearas. 31 were female (94%) and the mean age was 51 ñ 2 years. At diagnosis, itching was present in 26 cases (78%). Association with autoimmune mediated diseases was frequent. Liver function tests showed marked cholestasis (alkaline phosphate levels of 439 ñ 58 IU/I, range 90-1335). High antimitochondrial antibody titers and elevation of IgM levels were shown in all cases. According to liver biopsy findings, the diagnosis of primary biliary cirrhosis was an early one during the prospective phase of the study and was made in 8 ñ 1.4% of liver biopsies performed during this period. After a follow up of 27 ñ 5 months, 10 patients have died (30%). Our experience suggests that primary biliary cirrhosis is not an uncommon cause of chronic liver diseases in Chile

Paracentesis con infusión de albumina en el tratamiento de la ascitis a tensión en pacientes cirróticos / Paracentesis combined with albumin infusion in the treatment of tense ascites in cirrhotic patients

We randomized 31 cirrhotic patients with tense ascites to a Group A receiving only diuretic therapy (spironolactone, furosemide, n = 14) or a Group B treated with paracentesis and intravenous albumin infusion (n = 17). Ascites was elminated in 88% of patients in Group B compared to 57% of patients in Group A (p < 0.05). Complications developed in 4 patients in Group A and 2 patients in Group B. Paracentesis was associated to a mild and transient reduction in mean arterial pressure and a significant rise in urinary output. Duration of hospital stay was 5 ñ 3 days in Group B and 22 ñ 6 Group A (p < 0.001). Survival and likelihood of rreadmission for ascites was similar in both groups. Our results suggest that paracentesis plus intravenous albumin infusion is a fast, safe and effective therapy for tense ascites in cirrhotic patients

Beta-2 microglobulina (B-2M) en hepatitis virales / Beta-2 microglobulin (B-2M) in viral hepatitis

Como se sabe, Beta-2 Microglobulina es parte de los antígenos HLAI de membrana celular y participa en la respuesta inmune citotóxica. Su concentración en el suero aumenta en varias enfermedades malignas, en procesos inflamatorios y en insuficiencia renal. En este trabajo se miden los niveles séricos de Beta-2 Microglobulina en pacientes con hepatitis viral usando una prueba de enzima inmunoensayo, los resultados se correlacionan con la evolución de la enfermedad. Altos niveles de Beta-2 Microglobulina se encontraron en todos los grupos de pacientes estudiados, especialmente en hepatitis aguda. Estos altos niveles tienden a normalizarse con la mejoría del cuadro clínico en 5 de los 10 casos que se estudiaron. Beta-2 Microglobulina fue medida en el momento del diagnóstico y después en intervalos de 5 a 90 días entre la 1ª y 2ª muestra. Los resultados sugieren que Beta-2 microglobulina puede ser un indicador de hepatitis. La persistencia de la respuesta inmune podría estar representada por los altos niveles de estas proteínas