Serum levels of thyroxine-binding prealbumin, C-reactive protein and interleukin-6 in protein-energy undernourished children and normal controls without or with associated clinical infections.

We measured the levels of thyroxine-binding prealbumin (TBPA), C-reactive protein (CRP), and interleukin-6 (IL-6) in sera from protein-energy undernourished and control children either without or with associated clinical infections. Levels of TBPA were significantly lower in undernourished than in control children without clinical infections. Mean serum TBPA concentration was also significantly lower in both clinically infected undernourished and control children than in those of the same nutritional status but without overt infections. Significant positive correlations were observed between the concentration of TBPA and the Z-scores of weight for age, height for age, and weight for height in all children without clinical infections, which disappeared in clinically infected children. CRP and IL-6 increased to approximately similar levels in sera from undernourished and control children with overt infections. An inverse correlation between the levels of TBPA and CRP and a significant positive correlation between the concentration of CRP and IL-6 were observed in children with associated clinical infections. Serum IL-6 and TBPA showed a small negative relationship in patients with overt infections. Thus, TBPA is a sensitive marker of undernutrition only in the absence of clinical infections, and the capacity to increase production of IL-6 and CRP during infections is preserved in protein-energy undernutrition.

[Serum levels of prealbumin in undernourished children and controls with or without associated clinical infection]. / Niveles séricos de prealbúmina en niños desnutridos y controles con y sin infección clínica asociada.

Due to its short half life and high tryptophan content, prealbumin has been considered a sensitive indicator of protein and/or energy deficiency. In addition, prealbumin diminishes during the acute phase response elicited by either infection or tissue injury. Serum levels of prealbumin were determined in undernourished children with or without associated clinical infection and in their infected or non-infected controls matched for age, sex, race and socioeconomical conditions. Serum levels of prealbumin were significantly lower in undernourished than in control children without overt infections. On the other hand, the concentrations of serum prealbumin diminished significantly and to similar levels both in undernourished and control children with associated clinical infection as compared with those observed in non infected children belonging to the similar nutritional status. A positive correlation was found between prealbumin level and the Z-scores of weight-for-age, height-for-age and weight-for height in children without associated infections, which disappeared in clinically infected patients. Thus, prealbumin is a marker of undernutrition in the absence of infection and could be an earlier and more sensitive indicator of actual undernutrition caused by the metabolic effects of acute phase cytokines, than the anthropometrical measurements used here.

Estados críticos neonatales e hiperamonemia / Critical care neonatal and hyperammonemia

En el presente trabajo de investigación se determinan las concentraciones del amonio plasmático, mediante la espectrofotometría cuantitativa ultravioleta de la Sigma Technical Co. en 300 neonatos de distintos pesos y edades gestacionales al nacer, manejados diagnóstica y terapeúticamente por presentar estados críticos y patológicos, atendidos en salas de parto y de "alto riesgo" en el servicio de Neonatología de la Maternidad Dr. Armando Castillo Plaza. Se distribuyeron en 5 categorías con dos grupos en cada una, en base al tipo de neonato (pretérmino o a término), Categoría A: 75 neonatos con hipoxia fetoneonatal; registraron cifras de amonio plasmático (mcg/ml) (0-6; 0-24; 24-72 horas de vida) A1: a término X 3,690 - X 2,480 - X 1,940. A2: pretérmino X 3,480 - X 2,360 - X 1,850. Categoría B: 50 neonatos con dificultad respiratoria aguda registraron cifras de amonio plasmático (mcg/ml) (0-6; 6-24; 24-72 horas de vida); B1: a término X 2,670 - X 1,920 - X 1,340. B2: pretérmino X 3,502 - X 2,320 - X 1,640. Categoría C: 50 neonatos con sepsis registraron cifras de amonio plasmático (mcg/ml) (0-72; 72-120; 120-180 horas de vida); C1: a termino X 2,270 - X 1, 690 - X 1,250. C2: pretérmino X 2,900 - X 2,320 X 1,500. Categoría D: 50 neonatos nacidos policitémicos con hiperviscocidad sanguínea registraron cifras de amonio plasmático (mcg/ml) (0-6; 6-24; 24-72 horas de vida); D1: a término X 2,150 - X 1,880 - X 1,290. D2: pretérmino X 2,320 - X 1,998 - X 1,400. Categoría E: 75 neonatos con ictericia marcada registraron cifras de amonio plasmático (mcg/ml) (0-24; 24-48; 48-72 horas de vida)..