D-Xylose, fat load test and antigliadin antibody in children with coeliac disease.

OBJECTIVE: To study the clinical pattern of coeliac disease in children living in the northwest coast of Libya, to investigate the sensitivity and specificity of D-Xylose, fat load test and antigliadin antibody and their correlation to each other and changes in jejunal biopsy. METHODS: A 4 year prospective study began in 1993. It includes all suspected coeliacs referred to our department for further evaluation. All have suction jejunal biopsy using Crosby capsule performed for diagnosis, screened at the same time with one hour D-Xylose, 3-5 hours urinary D-Xylose, fat load test and antigliadin antibody and followed up for 2-4 years. RESULTS: The mean age at presentation was 8 years. There was no significant correlation between D-Xylose, fat load test and antigliadin antibody. Antigliadin antibody has 87.5% sensitivity and 50% specificity in this study. Three hours urinary D-Xylose has 93% sensitivity where as one hour D-Xylose has 82% sensitivity and only 25% specificity, whereas fat load test has 69% sensitivity. CONCLUSIONS: Blood and urinary D-Xylose and fat load tests are not useful for diagnosing coeliac disease. They have no correlation to each other or to jejunal histology. Antigliadin antibody is superior to the above tests.

Iron status of Libyan infants with urinary tract infection.

Serum iron, serum total iron binding capacity and tranferrin saturation levels were measured in 45 infants, of whom 19 had urinary tract infections confirmed by positive suprapubic aspiration. The control group comprised 26 healthy infants with negative results. Mean serum iron and transferrin saturation values were significantly lower in infants with urinary tract infection compared with the control group (P < 0.01 and P < 0.001 respectively), especially if the cultured organism was Escherichia coli (P < 0.01, P < 0.02). Total iron binding capacity was within the normal range. We conclude that iron deficiency is not a major factor in the etiopathogenesis of urinary tract infection in Libyan infants.

Bronchoconstrictor effect of exercise in healthy Libyan children in Tripoli.

To study the effects of short-term exercise on pulse rate and peak expiratory flow rate in healthy Libyan schoolchildren, 650 healthy students (330 boys, 320 girls) aged 4.5 years to 14.9 years were selected from four randomly chosen Tripoli primary schools. Pulse rate and peak expiratory flow rate were measured at rest in standing position and immediately after rhythmic short-term exercise. Exercise markedly increased pulse rate (mean differences being significantly higher in girls than boys) and markedly reduced peak expiratory flow rate (mean difference being significantly higher in boys than girls). We found 10% of the children had a reduction in peak expiratory flow rate > or = 15% from the baseline.

Peak expiratory flow rate nomogram in Libyan schoolchildren.

The study aimed to develop a peak expiratory flow rate nomogram for Libyan children. Of 900 children randomly selected from four Tripoli primary schools, 670 (330 girls and 340 boys) with age range 4.5-14.9 years, fulfilled the selection criteria. Peak expiratory flow rate (PEFR) was recorded in a standing position using a mini-Wright peak flow meter. Anthropometric measurements, weight, height, head circumference and mid-upper-arm circumference were recorded and surface area and body mass index were calculated. Our findings showed PEFR to be significantly related to height (r = 0.74), age (r = 0.70), surface area (r = 0.64) and weight (r = 0.62): P < 0.001. The PEFR nomogram in Libyan children differed from the British standard, which highlights the need for a local reference nomogram.

Local soft drinks - do they replace oral rehydration solutions?

Full text is available as a scanned copy of the original print version.

Peak expiratory flow rate nomogram in Libyan boys and girls in Tripoli.

Full text is available as a scanned copy of the original print version.

Peak, Expiratory flow rate nomogram in Libyan schoolchildren

The study aimed to develop a peak expiratory flow rate nomogram for Libyan children. Of 900 children randomly selected from four Tripoli primary schools, 670 [330 girls and 340 boys] with age range 4.5-14.9 years, fulfilled the selection criteria. Peak expiratory flow rate [PEFR] was recorded in a standing position using a mini-Wright peak flow meter. Anthropometric measurements, weight, height, head circumference and mid-upper-arm circumference were recorded and surface area and body mass index were calculated. Our findings showed PEFR to be significantly related to height [r = 0.74], age [r = 0.70], surface area [r = 0.64] and weight [r = 0.62]: P < 0.001. The PEFR nomogram in Libyan children differed from the British standard, which highlights the need for a local reference nomogram

Bronchoconstrictor effect of exercise in healthy Libyan children in Tripoli

To study the effects of short-term exercise on pulse rate and peak expiratory flow rate in healthy Libyan schoolchildren, 650 healthy students [330 boys, 320 girls] aged 4.5 years to 14.9 years were selected from four randomly chosen Tripoli primary schools. Pulse rate and peak expiratory flow rate were measured at rest in standing position and immediately after rhythmic short-term exercise. Exercise markedly increased pulse rate [mean differences being significantly higher in girls than boys] and markedly reduced peak expiratory flow rate [mean difference being significantly higher in boys than girls]. We found 10% of the children had a reduction in peak expiratory flow rate > or = 15% from the baseline

Iron status of Libyan infants with urinary tract infection

Serum iron, serum total iron binding capacity and transferrin saturation levels were measured in 45 infants, of whom 19 had urinary tract infections confirmed by positive suprapubic aspiration. The control group comprised 26 healthy infants with negative results. Mean serum iron and transferrin saturation values were significantly lower in infants with urinary tract infection compared with the control group [P < 0.01 and P < 0.001 respectively], especially if the cultured organism was Escherichia coli [P < 0.01, P < 0.02]. Total iron binding capacity was within the normal range. We conclude that iron deficiency is not a major factor in the etiopathogenesis of urinary tract infection in Libyan infants

Use of cisapride in treatment of constipation in children.

BACKGROUND: Chronic constipation is a common problem in children. We observed the effects of cisapride in the management of idiopathic constipation in children. METHODS: Thirty-seven children with a history of constipation (i.e., pain and difficulty or delay in defecation for > 3 months) were recruited and randomly assigned to 8 weeks of treatment with either cisapride, 0.2 mg/kg three times daily, or matching placebo after a 2-week run-in period in a double-blind, parallel-group study design. In phase 1 (2 weeks), patients had plain abdominal radiographs to assess degree of faecal load, and those with impaction were given laxatives. After satisfactory clearance of faeces, total gastrointestinal transit time and orocaecal transit time were measured. In phase 2, after 8 weeks of treatment with either cisapride or placebo (0.2 mg/kg t.d.s.), the transit studies were repeated. RESULTS: Compared with placebo, cisapride did not improve either stool frequency or transit time in this study population. CONCLUSION: This study did not demonstrate a clinical role for the use of cisapride in the treatment of idiopathic constipation in children.

Kinetics of viral replication in experimental rotavirus infection: effects of high dietary fat.

Epidemiological studies suggest that dietary fat can affect the frequency and severity of diarrhoeal illnesses in childhood. To study the effects of dietary fat on the kinetics of rotavirus antigen, 3-week-old mice of rotavirus-seronegative mothers were fed isocaloric diets with 40% of the total calories as fat [either butter (high saturated fat), olive oil (high monounsaturated fat), or corn oil (high polyunsaturated fat)] with one group on low fat (10% of calories) standard diet as controls. Seven-day-old mice from the first litter were killed and their stomach contents (milk) analyzed for total fatty acids. Seven-day-old mice from the second litter were inoculated with EDIM rotavirus, and some were killed at 48 h and others at 120 h postinoculation. The stool was removed from the distal colon of each mouse and examined for evidence of diarrhoea. The small intestine was removed, the contents washed, and the intestine divided into equal thirds. All stool and tissue samples were made to 10% (wt/vol), homogenised, and tested for rotavirus antigen by ELISA. We found that (a) dietary fat markedly altered the fatty acid profile of milk, (b) high saturated dietary fat (butter) delayed the onset of diarrhoea, reduced the excretion of rotavirus antigen in stool, and reduced mucosal antigen in the lower third of the small intestine at 120 h compared to 48 h postinoculation, (c) high polyunsaturated dietary fat initially increased the frequency of diarrhoea and viral antigen in the middle and lower segment at 120 h, followed by a reduction in rotavirus excretion in stool.(ABSTRACT TRUNCATED AT 250 WORDS)

Rat small intestinal morphology and tissue regulatory peptides: effects of high dietary fat.

Sprague-Dawley rats (3 weeks old) were fed on isoenergetic diets in which 40% of the total energy was provided as fat either in the form of butter (high saturated fat), olive oil (high monounsaturated fat) or maize oil (high polyunsaturated fat), with one group on low-fat (10% of total energy) standard diet as a control. Animals were killed after 8.4 (se 0.8) weeks by cardiac puncture. Similar pieces of jejunum and ileum were prepared for morphometric studies. Extracts of tissue from the proximal and distal segments of the whole small intestine from four animals per group were assayed using established techniques for enteroglucagon, motilin, neurotensin, somatostatin, substance P and vasoactive intestinal peptide (VIP). We found that maize oil and olive oil increased villus height: crypt depth ratio in both jejunum and ileum. Maize oil increased tissue concentrations of somatostatin (P less than 0.05) and substance P (P less than 0.005) in the proximal segment. Both maize oil and olive oil increased tissue concentrations of neurotensin and substance P (P less than 0.005) in the distal segments. These observations may explain the improvement of intestinal absorption of fluid following supplementation with polyunsaturated fat.

Modulation of fluid absorption and the secretory response of rat jejunum to cholera toxin by dietary fat.

To study the effects of dietary fat on jejunal water and ion absorption and on cholera toxin-induced secretion, 3 week old Sprague Dawley rats were fed isocaloric diets. Forty per cent of the total calories were given as fat, as butter (high saturated fat), olive oil (high monounsaturated fat), or corn oil (high polyunsaturated fat), with one group on low fat (10% of calories) standard laboratory diet as controls. During in vivo jejunal perfusion studies we found that (i) a polyunsaturated fat (corn oil) supplemented diet improves jejunal absorption of water and electrolytes and these changes are independent of the observed concentrations of luminal prostaglandins; (ii) high dietary fat appreciably reduced the secretory response to cholera toxin, probably without fundamentally changing the mechanism by which cholera toxin induces secretion. We conclude that dietary fat composition altered the permeability and transport characteristics of the small intestine. This observation might have relevance to some human diarrhoeal disorders.

[World survey on the use of thalidomide in leprosy reaction]. / Encuesta mundial sobre el uso de la talidomida en la leprorreacción

Review of the answers of a questionary sent to 62 different Leprosy Departments. The results indicate that in 99% of lepromatous patients with lepra-reactions, the response to thalidomide was satisfactory. In the tuberculoid and borderline types of lepra, the results were not good.