ABSTRACT
To assess the efficacy of recombinant alfa 2b-interferon treatment "Heberon alfa R" in children with chronic active hepatitis (CAH) B virus, we conducted a long-term study (three years) in 22 children infected with hepatitis B virus (17 males and 5 females), age range 3 to 15 years. Diagnostic criteria included the clinical picture, laboratory tests, virus markers (HBeAg, HBsAg), laparoscopy and liver biopsy. Children under 12 years received 3 million IU of interferon per day whereas those older than 12 years received 6 million IU of interferon per day by intramuscular injection, three times per week for four months. Alanine aminotransferase (ALT) levels had been elevated for six months in all patients and hepatitis B viral infection was replicative. A variance analysis was made to evaluate ALT response to interferon administration and the Mc Nemar test was used to analyze HBeAg/anti-HBe behavior. Seventeen (77%) out of 22 patients responded to treatment (clearance of HBeAg and ALT levels returned to normal. HBeAg seroconversion (anti-HBe) occurred in 36% of patients during the first year (p < 0.01) and it increased to 50% by the third year follow-up. ALAT levels also decreased and the difference was statistically significant (p < 0.01). This occurred during and after treatment with a steady and increasing tendency to return to normal levels within the first and third year. Side effects were scarce, transient and tolerable and they only appeared during the initial phase of treatment; symptoms were mainly influenza-like and they disappeared very soon. There were no late side effects such as medullar depression, renal toxicity and glycemia alterations.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Hepatitis B/therapy , Hepatitis, Chronic/therapy , Interferon-alpha/therapeutic use , Adolescent , Alanine Transaminase/blood , Analysis of Variance , Biomarkers/blood , Child , Child, Preschool , Drug Administration Schedule , Female , Follow-Up Studies , Hepatitis B/blood , Hepatitis B Antibodies/blood , Hepatitis B Antigens/blood , Hepatitis, Chronic/blood , Humans , Interferon alpha-2 , Male , Recombinant Proteins , Time FactorsABSTRACT
A study was conducted on 106 newborns, whose AgsHB positive mothers received active protection against hepatitis B (83 with the Cuban-produced Heberbiovac HB vaccine and 23 with the Engerix-B vaccine manufactured by S. Kline as control group, following the scheme 0, 1 and 2 months with the first dose administered in the first 12 hours after birth. Samples were taken to study virus B markers at birth (umbilical cord) after 30, 60, 90 and 180 days. Laboratory determinations were carried out by the ELISA technique with diagnostic kits from the firm Organon Tecknica. Ten or more IU/L of anti-HBs present in serum was considered as the lowest protective level. Children were classified according to the AgeHB present in mothers, AgsHB in the umbilical cord and the concentration of Ags HB in maternal serum. 100% of the children who received the control vaccine showed serological evidence of seroconversion to anti HBs with protective titres, and the values of the geometric mean of the titres of antibodies were statistically significant (p < 0.01) in all the extractions, favoring the Cuban vaccine. The efficacy of the two preparations used in this research work was 100%. This study makes it possible to report on a recombinant vaccine against hepatitis B (Heberbiovac HB) which represents the first vaccine of this type produced in Latin America, the efficacy of which was proved in the field trial.
Subject(s)
Hepatitis B Antibodies/immunology , Hepatitis B Vaccines/therapeutic use , Hepatitis B/prevention & control , Double-Blind Method , Fetal Blood/immunology , Hepatitis Antigens/blood , Hepatitis Antigens/immunology , Hepatitis B/immunology , Hepatitis B Antibodies/blood , Hepatitis B Vaccines/immunology , Humans , Infant, NewbornSubject(s)
Giardiasis/complications , Jejunum/pathology , Atrophy , Child , Child, Preschool , Chronic Disease , Diarrhea/etiology , Humans , InfantABSTRACT
One-hundred-and-ten children between the ages of two months and 14 years with the following liver diseases were studied: 16 with acute viral hepatitis, 8 with persistent chronic hepatitis, 31 with active chronic hepatitis, 5 with hepatic steatosis, 11 with cirrhosis of the liver, 24 with newborn cholestasis, 3 with Wilson's disease, 2 with congenital hepatic fibrosis, 5 with metabolic diseases and 5 due to other causes. These children presented Pi system phenotypes in isoelectric focus using ultrafine polyacrylamide gels according to Kuepper's method, with modifications incorporated to determine Alpha-1-antitrypsin (A1-AT) serum level deficiencies in those presenting the Pi ZZ phenotype, a liver biopsy with P.A.S. coloration on digestion of diastase and a family history of the phenotype. Four (3.6%) of the children with Pi ZZ phenotypes showed a decrease of serum A1-AT and the presence of positive P.A.S. inclusions resistant to diastase in the cytoplasm of hepatocytes. Three had a history of postnatal icterus and the fourth presented hepatomegaly. The phenotypic study of the parents showed their being heterozygous (MZ), while siblings were normal (MM). The importance of the diagnosis of A1-AT deficiency and the diagnostic value of detecting Pi system phenotypes in every case of liver disease in children and adolescents is stressed.
Subject(s)
Liver Diseases/genetics , alpha 1-Antitrypsin Deficiency , Adolescent , Child , Child, Preschool , Female , Gene Frequency , Humans , Infant , Isoelectric Focusing , Male , PhenotypeABSTRACT
Two hundred children hospitalized in the National Institute of Gastroenterology were studied during the 1972-1980 period. The children, whose ages ranged between six months and ten years, presented chronic diarrhea in which Giardia lamblia was considered the causative agent. The diagnosis of parasitism was made with the detection of Giardia lamblia in the feces and/or duodenal content. A serum D-Xylose and jejunal biopsy were performed on all the patients and the histology of the mucosa was classified in keeping with the degree of atrophy according to Metayer and Laumonier. In our study we divided the patients into three groups: Group 1, parasitism due to Giardia lamblia in patients with a normal D-xylose and different degrees of atrophy of the jejunal mucosa, but with normal D-Xylose and Group 3, malabsorption due to Giardia lamblia, with a pathological D-Xylose and alterations in the intestinal mucosa. There were 35 cases in Group 1 (17.5%), 91 cases in Group 2 (45.5%) and 74 cases in Group 3 (37%). The predominant intestinal lesion was partial atrophy of the villi (143), 20 with subtotal atrophy of the villi and two with complete atrophy of the villi. It was shown that the host's response to infection by Giardia lamblia varies with differing effects on the structures and functioning of the jejunal mucosa. It is important to group patients with chronic diarrhea due to Giardia lamblia in this way since it allows for and individualized clinical approach and provides a prognosis in terms nutritional consequences resulting from possible persistence of the diarrhea and possible associated lactose intolerance.
Subject(s)
Diarrhea/etiology , Giardiasis/complications , Intestinal Mucosa/pathology , Jejunum/pathology , Child , Child, Preschool , Giardiasis/diagnosis , Humans , Infant , Intestinal Absorption , XyloseABSTRACT
Two hundred children hospitalized in the National Institute of Gastroenterology were studied during the 1972-1980 period. The children, whose ages ranged between six months and ten years, presented chronic diarrhea in which Giardia lamblia was considered the causative agent. The diagnosis of parasitism was made with the detection of Giardia lamblia in the feces and/or duodenal content. A serum D-Xylose and jejunal biopsy were performed on all the patients and the histology of the mucosa was classified in keeping with the degree of atrophy according to Metayer and Laumonier. In our study we divided the patients into three groups: Group 1, parasitism due to Giardia lamblia in patients with a normal D-xylose and different degrees of atrophy of the jejunal mucosa, but with normal D-Xylose and Group 3, malabsorption due to Giardia lamblia, with a pathological D-Xylose and alterations in the intestinal mucosa. There were 35 cases in Group 1 (17.5
), 91 cases in Group 2 (45.5
) and 74 cases in Group 3 (37
). The predominant intestinal lesion was partial atrophy of the villi (143), 20 with subtotal atrophy of the villi and two with complete atrophy of the villi. It was shown that the hosts response to infection by Giardia lamblia varies with differing effects on the structures and functioning of the jejunal mucosa. It is important to group patients with chronic diarrhea due to Giardia lamblia in this way since it allows for and individualized clinical approach and provides a prognosis in terms nutritional consequences resulting from possible persistence of the diarrhea and possible associated lactose intolerance.
ABSTRACT
One-hundred-and-ten children between the ages of two months and 14 years with the following liver diseases were studied: 16 with acute viral hepatitis, 8 with persistent chronic hepatitis, 31 with active chronic hepatitis, 5 with hepatic steatosis, 11 with cirrhosis of the liver, 24 with newborn cholestasis, 3 with Wilsons disease, 2 with congenital hepatic fibrosis, 5 with metabolic diseases and 5 due to other causes. These children presented Pi system phenotypes in isoelectric focus using ultrafine polyacrylamide gels according to Kueppers method, with modifications incorporated to determine Alpha-1-antitrypsin (A1-AT) serum level deficiencies in those presenting the Pi ZZ phenotype, a liver biopsy with P.A.S. coloration on digestion of diastase and a family history of the phenotype. Four (3.6
) of the children with Pi ZZ phenotypes showed a decrease of serum A1-AT and the presence of positive P.A.S. inclusions resistant to diastase in the cytoplasm of hepatocytes. Three had a history of postnatal icterus and the fourth presented hepatomegaly. The phenotypic study of the parents showed their being heterozygous (MZ), while siblings were normal (MM). The importance of the diagnosis of A1-AT deficiency and the diagnostic value of detecting Pi system phenotypes in every case of liver disease in children and adolescents is stressed.
Subject(s)
Antiprotozoal Agents/therapeutic use , Giardiasis/drug therapy , Intestinal Diseases, Parasitic/drug therapy , Nitroimidazoles/therapeutic use , Tinidazole/therapeutic use , Antiprotozoal Agents/adverse effects , Child , Child, Preschool , Diarrhea, Infantile/drug therapy , Diarrhea, Infantile/etiology , Female , Humans , Infant , Male , Recurrence , Tinidazole/adverse effectsABSTRACT
Se realizo un estudio abierto simple sobre un total de 29 pacientes (21 hombres y 8 mujeres) de edades comprendidas entre 18 y 78 anos (edad media 35,07 anos) con diversas dermatitis infectadas. El tratamiento consistio en aplicar 2 veces al dia una combinacion de 17-butirato de hidrocortisona y clorquinaldol en forma de crema o pomada segun necesidad. Se lograron mejorias buenas y excelentes en el 66% de los pacientes a los 7 dias y en el 85% de los mismos a los 14 dias de tratamiento. Mejoria mediana se obtuvo en 3% de los pacientes a los 14 dias. Hubo 2 fracasos (6%).Dos pacientes abandonaron el tratamiento por causas ajenas al mismo. Los sintomas que mejor respondieron fueron: exudacion, papulas, prurito y ardor/dolor (p < 0,0005 o mejor) y el eritema (p < 0,05) mientras que la infiltracion y exfoliacion no mejoraron en forma significativa. No se observo ningun efecto adverso con la medicacio
Subject(s)
Adolescent , Adult , Middle Aged , Humans , Male , Female , Chlorquinaldol , Dermatitis , Hydrocortisone , Drug Therapy, CombinationABSTRACT
Se realizo un estudio abierto simple sobre un total de 29 pacientes (21 hombres y 8 mujeres) de edades comprendidas entre 18 y 78 anos (edad media 35,07 anos) con diversas dermatitis infectadas. El tratamiento consistio en aplicar 2 veces al dia una combinacion de 17-butirato de hidrocortisona y clorquinaldol en forma de crema o pomada segun necesidad. Se lograron mejorias buenas y excelentes en el 66% de los pacientes a los 7 dias y en el 85% de los mismos a los 14 dias de tratamiento. Mejoria mediana se obtuvo en 3% de los pacientes a los 14 dias. Hubo 2 fracasos (6%).Dos pacientes abandonaron el tratamiento por causas ajenas al mismo. Los sintomas que mejor respondieron fueron: exudacion, papulas, prurito y ardor/dolor (p < 0,0005 o mejor) y el eritema (p < 0,05) mientras que la infiltracion y exfoliacion no mejoraron en forma significativa. No se observo ningun efecto adverso con la medicacio
Subject(s)
Adolescent , Adult , Middle Aged , Aged , Humans , Male , Female , Chlorquinaldol , Dermatitis , Hydrocortisone , Drug Therapy, CombinationABSTRACT
Se realizo estudio doble ciego randomizado con el objeto de comparar la actividad topica y la tolerancia del 17-butirato de hidrocortisona y el 17-valerato de betametasona en dermatosis no infectadas. Un total de 56 pacientes adultos de ambos sexos recevieron: 17-butirato de hidrocortisona (30 pacientes) y 17-velarato de betametasona (26 pacientes). Ambas drogas fueron aplicadas sobre las lesiones 2 veces diarias, en forma de locion, crema o pomada, segun necesidad. El test de Mann-Whitney realizado a los 7 y a los 14 dias de tratamiento, no mostro diferencias significativas en cuanto a efectividad entre ambos farmacoes. No se registraron efectos secundarios
Subject(s)
Humans , Male , Female , Anti-Inflammatory Agents , Betamethasone , Skin Diseases , Double-Blind MethodABSTRACT
Se realizo estudio doble ciego randomizado con el objeto de comparar la actividad topica y la tolerancia del 17-butirato de hidrocortisona y el 17-valerato de betametasona en dermatosis no infectadas. Un total de 56 pacientes adultos de ambos sexos recevieron: 17-butirato de hidrocortisona (30 pacientes) y 17-velarato de betametasona (26 pacientes). Ambas drogas fueron aplicadas sobre las lesiones 2 veces diarias, en forma de locion, crema o pomada, segun necesidad. El test de Mann-Whitney realizado a los 7 y a los 14 dias de tratamiento, no mostro diferencias significativas en cuanto a efectividad entre ambos farmacoes. No se registraron efectos secundarios
Subject(s)
Humans , Male , Female , Comparative Study , Betamethasone , Skin Diseases , Anti-Inflammatory Agents , Double-Blind MethodABSTRACT
Presentancion de dos casos con perifolliculitis capitis abscedens et suffodiens.En uno de ellos tratado mediante la reseccion total de cuero cabelludo, no pudo observarse en el examen microscopico incurvacion de pelos. En el otro caso, la minociclina produjo la regresion total y definitiva de las lesiones. No se evidenciaron alteraciones inmunologicas de orden general
Subject(s)
Child, Preschool , Adult , Humans , Male , Female , Scalp Dermatoses , MinocyclineABSTRACT
Presentancion de dos casos con perifolliculitis capitis abscedens et suffodiens.En uno de ellos tratado mediante la reseccion total de cuero cabelludo, no pudo observarse en el examen microscopico incurvacion de pelos. En el otro caso, la minociclina produjo la regresion total y definitiva de las lesiones. No se evidenciaron alteraciones inmunologicas de orden general
Subject(s)
Child, Preschool , Adult , Humans , Male , Female , Minocycline , Scalp DermatosesABSTRACT
Results of the diagnosis, evolution and treatment of a study performed during the last 6 years in 50 children, carriers of chronic hepatitis are reported; they were patients of the Pediatric service at the Institute of Gastroenterology, corresponding, 25 to the persistent variety, and the rest to the active. Diagnosis was made by clinical, biochemical, laparoscopic and hepatic histological aspects. The importance of diagnostic laparoscopy and its correlation with hepatic biopsy are indicated. The highest incidence corresponded to patients between 4 and 6 years and 10 and 11 years of age, with a predominance of females. In the persistent variety, normality was achieved with bedrest without the need of medicines. In the active variety, the treatment used was prednisone or its combination with azathioprine, when an adequate response was not obtained or initially in severe cases, obtaining normality in 20% of them with a histological picture of persistent in 16% of the cases and the disease being maintained in 64%, with variations from a degree of inactivity to a now satisfactory picture with a progressive evolution to hepatic cirrhosis. There is no mortality reported in the casuistics.
Subject(s)
Hepatitis/diagnosis , Adolescent , Child , Child, Preschool , Chronic Disease , Hepatitis/pathology , Hepatitis/therapy , Humans , Infant , Laparoscopy , Liver/pathologyABSTRACT
A study performed in 50 children carriers of celiac disease with ages between 8 months and 14 years of age, is presented; diagnosis was proved based on clinical picture, histological changes of jejunal mucosa, intestinal absorption tests and response to the suppression of gluten from the diet, with clinical, histological and biochemical control according to international criteria. It has been insisted on the familial study and the gluten overload test and its incidency in the black race. The development of public health has made it possible to demostrate the existence of this disease in our country.
Subject(s)
Celiac Disease/diagnosis , Xylose , Adolescent , Celiac Disease/pathology , Child , Child, Preschool , Cuba , Humans , Infant , Intestinal Absorption , Intestinal Mucosa/pathology , Jejunum/pathologyABSTRACT
Se estudiaron 50 casos portadores de un síndrome diarreico crónico infestados por Giardía lamblia, de los cuales 31 desarrollaron malabsorción intestinal. De estos 31, a 14 no se les pudo demostrar la presencia de esteatorrea, aunque sí tenían presente el resto de los parámetros del síndrome de malabsorción. Se informan las alteraciones mediante microscopio electrónico en tres de los casos(AU)
Subject(s)
Humans , Diarrhea/complications , Diarrhea/diagnosis , Diarrhea/etiology , Malabsorption Syndromes/etiology , Celiac Disease/complications , Giardia lamblia , Microscopy, Electron/methodsABSTRACT
Se informa de un caso de enteropatía exudativa en el curso de una enfermedad celíaca, en una niña de 11 años. Se confirma y diagnostica por el cuadro clínico y estudio anatómico, radiológico y humoral. Su evolución se modificó después de instituir una dieta libre de gluten y administración de plasma. Se hace revisión de esta infrecuente entidad(AU)