ABSTRACT
En este estudio clínico, bioquímico y ecográfico se evaluó la prevalencia de hepatopatías en Lara, una comunidad rural aislada de alta montaña en Tucumán, provincia con la máxima prevalencia de infección por HAV en niños de Argentina. Lara carece de agua potable, electricidad y cloacas. Se estudiaron 102 habitantes, lo que representa el 41% de la población. El anti-HBc y anti-HCV fueron negativos en todos los casos. Ningún niño presentó anormalidades hepáticas. El 41% de los adultos refirió ingesta alcohólica y el 12% transfusiones. Se observó incremento leve de ALT en 3 casos (6%). La ecografía demostró esteatosis en 8 individuos (16%), litiasis vesicular en 7 (14%), microcalcificaciones en 5 (10%) y quistes de aspecto parasitario en 4 (8%). La prevalencia de infección por HAV en Lara fue de 89% en adultos y 35% en niños, siendo significativamente menor que la de los niños de la ciudad de Tucumán con nivel socioeconómico medio / alto (53%, p = 0.05) o bajo (74%, p = 0.0006). La diferencia fue más evidente en niños menores de 5 años (0%, 53% y 75% respectivamente). La serología para hidatidosis fue positiva en 3/4 individuos con quistes, 2/5 con microcalcificaciones y 17/85 (20%) con ecografía normal, lo que sugiere que la técnica de Elisa utilizada se asocia a frecuentes resultados falsos positivos. El estudio poblacional de Lara demostró una elevada prevalencia de esteatosis, litiasis vesicular e hidatidosis en adultos, ausencia de infección por HBV y HCV, y una baja exposición al HAV en niños, especialmente en menores de 5 años.
The goal of this population-based clinical, biochemical and ultrasonographic study was to assess the prevalence of liver diseases in Lara, a small rural community isolated in the mountain heights of Tucumán, a Province of Argentina with the highest reported rates of HAV infection in children. Inhabitants of Lara lack electricity, potable water and a sewer system. The study included 102 individuals representing 41% of the total population. Anti-HBc and anti-HCV were negative in all cases. No children showed clinical, biochemical or ecographic abnormalities. Among adults, 41% referred alcohol consumption and 12% blood transfusions. Only 3 adults (6%) had mildly elevated ALT. Ultrasound showed steatosis in 8 individuals (16%), gallstones in 7 (14%), parenchymal micro-calcifications in 5 (10%) and parasitic cysts in 4 (8%). Prevalence of HAV infection in Lara was 89% in adults and 35% in children, being significantly lower than that of children of medium/high (53%, p=0.05) and low (74%, p=0.0006) socioeconomic level from the city of Tucumán (control groups). These differences were more marked in children aged <5 years (anti-HAV in 0%, 53% y 75% respectively). Serologic tests for echinoccocal disease were positive in 3/4 individuals with parasitic cysts, 2/5 with micro-calcifications and 17/85 (20%) with normal ultrasound, thus suggesting a high rate of false-positive results of the Elisa test utilized. This study showed that in Lara there is a high prevalence of steatosis, gallstones and equinoccocal disease in adults, absenceof HBV and HCV infection and low exposure to HAV in children especially in those aged <5 years.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adult , Liver Diseases/epidemiology , Argentina/epidemiology , Cross-Sectional Studies , Echinococcosis, Hepatic/blood , Echinococcosis, Hepatic/epidemiology , Echinococcosis, Hepatic , Enzyme-Linked Immunosorbent Assay , Fatty Liver/blood , Fatty Liver/epidemiology , Fatty Liver , Hepatitis A/blood , Hepatitis A/epidemiology , Hepatitis A , Lithiasis/blood , Lithiasis/epidemiology , Lithiasis , Liver Diseases/blood , Liver Diseases , Prevalence , Risk Factors , Rural HealthABSTRACT
En este estudio clínico, bioquímico y ecográfico se evaluó la prevalencia de hepatopatías en Lara, una comunidad rural aislada de alta montaña en Tucumán, provincia con la máxima prevalencia de infección por HAV en niños de Argentina. Lara carece de agua potable, electricidad y cloacas. Se estudiaron 102 habitantes, lo que representa el 41% de la población. El anti-HBc y anti-HCV fueron negativos en todos los casos. Ningún niño presentó anormalidades hepáticas. El 41% de los adultos refirió ingesta alcohólica y el 12% transfusiones. Se observó incremento leve de ALT en 3 casos (6%). La ecografía demostró esteatosis en 8 individuos (16%), litiasis vesicular en 7 (14%), microcalcificaciones en 5 (10%) y quistes de aspecto parasitario en 4 (8%). La prevalencia de infección por HAV en Lara fue de 89% en adultos y 35% en niños, siendo significativamente menor que la de los niños de la ciudad de Tucumán con nivel socioeconómico medio / alto (53%, p = 0.05) o bajo (74%, p = 0.0006). La diferencia fue más evidente en niños menores de 5 años (0%, 53% y 75% respectivamente). La serología para hidatidosis fue positiva en 3/4 individuos con quistes, 2/5 con microcalcificaciones y 17/85 (20%) con ecografía normal, lo que sugiere que la técnica de Elisa utilizada se asocia a frecuentes resultados falsos positivos. El estudio poblacional de Lara demostró una elevada prevalencia de esteatosis, litiasis vesicular e hidatidosis en adultos, ausencia de infección por HBV y HCV, y una baja exposición al HAV en niños, especialmente en menores de 5 años.(AU)
The goal of this population-based clinical, biochemical and ultrasonographic study was to assess the prevalence of liver diseases in Lara, a small rural community isolated in the mountain heights of Tucumán, a Province of Argentina with the highest reported rates of HAV infection in children. Inhabitants of Lara lack electricity, potable water and a sewer system. The study included 102 individuals representing 41% of the total population. Anti-HBc and anti-HCV were negative in all cases. No children showed clinical, biochemical or ecographic abnormalities. Among adults, 41% referred alcohol consumption and 12% blood transfusions. Only 3 adults (6%) had mildly elevated ALT. Ultrasound showed steatosis in 8 individuals (16%), gallstones in 7 (14%), parenchymal micro-calcifications in 5 (10%) and parasitic cysts in 4 (8%). Prevalence of HAV infection in Lara was 89% in adults and 35% in children, being significantly lower than that of children of medium/high (53%, p=0.05) and low (74%, p=0.0006) socioeconomic level from the city of Tucumán (control groups). These differences were more marked in children aged <5 years (anti-HAV in 0%, 53% y 75% respectively). Serologic tests for echinoccocal disease were positive in 3/4 individuals with parasitic cysts, 2/5 with micro-calcifications and 17/85 (20%) with normal ultrasound, thus suggesting a high rate of false-positive results of the Elisa test utilized. This study showed that in Lara there is a high prevalence of steatosis, gallstones and equinoccocal disease in adults, absenceof HBV and HCV infection and low exposure to HAV in children especially in those aged <5 years. (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adult , Liver Diseases/epidemiology , Liver Diseases/blood , Liver Diseases/diagnostic imaging , Enzyme-Linked Immunosorbent Assay , Echinococcosis, Hepatic/blood , Echinococcosis, Hepatic/epidemiology , Echinococcosis, Hepatic/diagnostic imaging , Hepatitis A/blood , Hepatitis A/epidemiology , Hepatitis A/diagnostic imaging , Fatty Liver/blood , Fatty Liver/epidemiology , Fatty Liver/diagnostic imaging , Lithiasis/blood , Lithiasis/epidemiology , Lithiasis/diagnostic imaging , Cross-Sectional Studies , Risk Factors , Rural Health , Prevalence , Argentina/epidemiologyABSTRACT
The goal of this population-based clinical, biochemical and ultrasonographic study was to assess the prevalence of liver diseases in Lara, a small rural community isolated in the mountain heights of Tucumán, a Province of Argentina with the highest reported rates of HAV infection in children. Inhabitants of Lara lack electricity, potable water and a sewer system. The study included 102 individuals representing 41% of the total population. Anti-HBc and anti-HCV were negative in all cases. No children showed clinical, biochemical or ecographic abnormalities. Among adults, 41% referred alcohol consumption and 12% blood transfusions. Only 3 adults (6%) had mildly elevated ALT. Ultrasound showed steatosis in 8 individuals (16%), gallstones in 7 (14%), parenchymal micro-calcifications in 5 (10%) and parasitic cysts in 4 (8%). Prevalence of HAV infection in Lara was 89% in adults and 35% in children, being significantly lower than that of children of medium/high (53%, p = 0.05) and low (74%, p = 0.0006) socioeconomic level from the city of Tucumán (control groups). These differences were more marked in children aged < 5 years (anti-HAV in 0%, 53% and 75% respectively). Serologic tests for echinoccocal disease were positive in 3/4 individuals with parasitic cysts, 2/5 with micro-calcifications and 17/85 (20%) with normal ultrasound, thus suggesting a high rate of false-positive results of the Elisa test utilized. This study showed that in Lara there is a high prevalence of steatosis, gallstones and equinoccocal disease in adults, absence of HBVand HCV infection and low exposure to HAV in children especially in those aged < 5 years.
Subject(s)
Altitude , Liver Diseases/epidemiology , Adult , Argentina/epidemiology , Child , Child, Preschool , Cross-Sectional Studies , Echinococcosis, Hepatic/blood , Echinococcosis, Hepatic/diagnostic imaging , Echinococcosis, Hepatic/epidemiology , Fatty Liver/blood , Fatty Liver/diagnostic imaging , Fatty Liver/epidemiology , Female , Hepatitis A/blood , Hepatitis A/diagnostic imaging , Hepatitis A/epidemiology , Humans , Infant , Lithiasis/blood , Lithiasis/diagnostic imaging , Lithiasis/epidemiology , Liver Diseases/blood , Liver Diseases/diagnostic imaging , Male , Prevalence , Risk Factors , Rural Health , UltrasonographyABSTRACT
Headache is regarded by patients as a disturbing (or unpleasant) symptom. It can be produced by either organic diseases or functional head abnormalities. Twenty-five years ago headache was supposed to be a psychosomatic angiospastic algia. Certain unusual forms were thought to be caused by triggers like anger, cough, exertion, and sexual activity. Experimental research explored the role of circulating serotonin, prostaglandin, estrogen levels, and platelet abnormalities. As computed tomography, helical computed tomography, and scanning or magnetic resonance imaging evolved, new data became available. None of the newer reports have demonstrated liver involvement as a cause of headache. This minireview intends to cover the spectrum of brain alteration in liver disease. It describes some of the pathophysiological characteristics of hepatic encephalopathy and, also, the relationship among migraine, constipation, and liver disease.
Subject(s)
Headache/etiology , Liver Diseases/complications , Brain/physiopathology , Constipation/complications , Constipation/physiopathology , Headache/physiopathology , Hepatic Encephalopathy/complications , Hepatic Encephalopathy/physiopathology , Humans , Liver Diseases/physiopathology , Migraine Disorders/complications , Migraine Disorders/physiopathologyABSTRACT
Se describe el caso de un hombre de 61 años con diabetes e insuficiencia renal crónica que consulta por hemorragia digestiva alta. Los resultados de sus análisis confirman su estado y muestran gastrina sérica basal elevada por encima de valores extremos y IgG anti Helicobacter pylori (+). Responde a la terapéutica instituida ante la sospecha de Gastrinoma que no pudo ser localizado.
Subject(s)
Humans , Male , Middle Aged , Immunoglobulin G , Gastrins/blood , Gastrinoma/diagnosis , Gastrinoma/therapy , Helicobacter Infections , Renal Insufficiency, Chronic , Somatostatin/therapeutic use , Endoscopy, Gastrointestinal , Interferon-alpha/therapeutic useABSTRACT
Se describe el caso de un hombre de 61 años con diabetes e insuficiencia renal crónica que consulta por hemorragia digestiva alta. Los resultados de sus análisis confirman su estado y muestran gastrina sérica basal elevada por encima de valores extremos y IgG anti Helicobacter pylori (+). Responde a la terapéutica instituida ante la sospecha de Gastrinoma que no pudo ser localizado. (AU)
Subject(s)
Humans , Male , Middle Aged , Gastrins/blood , Renal Insufficiency, Chronic , Gastrinoma/diagnosis , Gastrinoma/therapy , Immunoglobulin G , Helicobacter Infections , Endoscopy, Gastrointestinal , Interferon-alpha/therapeutic use , Somatostatin/therapeutic useABSTRACT
Se describe un Síndrome Sicca en una mujer de 53 años de edad, internada en el Hospital Zenón Santillán, asociado a enfermedades del colágeno tales como: Artritis Reumatoidea, Vasculitis Leucocitoclástica y probable Tiroiditis. Los resultados de sus análisis bioquímicos, Rx de glándulas salivales, gammagrafía y la biopsia del labio inferior, confirman el diagnóstico. Se instituyó tratamiento con Bromhexina y gotas de Pilocarpina (medicación no habitual), obteniendo resultados satisfactorios.
Subject(s)
Humans , Female , Middle Aged , Pilocarpine/therapeutic use , Bromhexine/therapeutic use , Collagen Diseases/physiopathology , Sjogren's Syndrome/diagnosis , Sjogren's Syndrome/physiopathology , Sjogren's Syndrome , Arthritis, Rheumatoid/complications , Thyroiditis/complications , Vasculitis, Leukocytoclastic, Cutaneous/complications , Sjogren's Syndrome/drug therapyABSTRACT
Se describe un Síndrome Sicca en una mujer de 53 años de edad, internada en el Hospital Zenón Santillán, asociado a enfermedades del colágeno tales como: Artritis Reumatoidea, Vasculitis Leucocitoclástica y probable Tiroiditis. Los resultados de sus análisis bioquímicos, Rx de glándulas salivales, gammagrafía y la biopsia del labio inferior, confirman el diagnóstico. Se instituyó tratamiento con Bromhexina y gotas de Pilocarpina (medicación no habitual), obteniendo resultados satisfactorios. (AU)
