PubMed Health⌕ Search

Biomedical subjects

F J Penna

Publications and source records attributed to F J Penna.

At least 19 recordsLinked to original sources
PubMed2002

Effect of meconium ileus on the clinical prognosis of patients with cystic fibrosis.

The objective of the present study was to determine the possible prognostic factors which may explain the difference in the survival of patients with cystic fibrosis (CF) with and without meconium ileus. Over a period of 20 years, 127 patients with CF, whose diagnosis was confirmed by typical clinical characteristics and altered sweat chloride levels, were studied retrospectively. The patients were divided into two groups: group 1 consisted of patients who presented CF and meconium ileus (N = 9), and group 2 consisted of patients with CF without meconium ileus (N = 118). The characteristics studied were based on data obtained upon admission of the patients using a specific protocol. Demographic, clinical, nutritional and laboratory data were obtained. The genotype was determined in 106 patients by PCR. Survival was analyzed using the Kaplan-Meier method. The median follow-up period was 44 months. A statistically significant difference was observed between the groups studied regarding the following variables: age at diagnosis and weight and height z scores. The presence of meconium ileus was associated with an earlier diagnosis; these patients had greater deficits in height and weight at the time of diagnosis and at the end of the study. The estimated probability of survival for patients with CF without meconium ileus was 62 +/- 14% and for those with meconium ileus 32 +/- 18%. Patients with CF and meconium ileus presented a poor nutritional status at diagnosis and a lower survival rate compared to the general CF population.

Chi-Square Distribution↗
PubMed2001

Influence of oral inoculation with plasmid-free human Escherichia coli on the frequency of diarrhea during the first year of life in human newborns.

BACKGROUND: This study was carried out to determine whether early inoculation of the plasmid-free human Escherichia coli into human newborns would reduce the frequency of acute diarrhea during a 1-year period. The plasmid-free E. coli strain isolated from the fecal microbiota of a healthy adult was nontoxigenic in vivo and in vitro and sensitive to all usual antibiotics. METHODS: In the experimental group, 51 healthy newborns were inoculated orally with 106 viable cells of the bacteria within 2 hours after birth. In the control group, the same number of newborns received the heat-killed bacteria. The clinical trial was double blind, and the newborns were randomly assigned to the experimental and control groups. RESULTS: Six months and 1 year after bacterial inoculation, infants in the experimental group showed a higher mean body weight (7.59 +/- 1.15 kg and 9.88 +/- 1.31 kg, respectively; P < 0.05) when compared with the control group (7.03 +/- 1.09 kg and 8.92 +/- 1.38 kg, respectively). At the end of the clinical trial, 48% (23/48) of the infants in the experimental group had shown at least one diarrhea episode during the 1-year period, as opposed to 71% (34/48) in the control group. These values were significantly different (P = 0.037), showing a 32.3% protective effect of inoculation. CONCLUSIONS: The present study shows that protection against diarrhea was obtained by oral inoculation with a single dose of plasmid-free human E. coli soon after birth.

Administration, Oral↗
PubMed2001

Dietary fiber intake, stool frequency and colonic transit time in chronic functional constipation in children.

The objective of the present study was to evaluate associations between fiber intake, colonic transit time and stool frequency. Thirty-eight patients aged 4 to 14 years were submitted to alimentary evaluation and to measurement of colonic transit time. The median fiber intake of the total sample was age + 10.3 g/day. Only 18.4% of the subjects presented a daily dietary fiber intake below the levels recommended by the American Health Foundation. In this group, the median left colonic transit time was shorter than in the group with higher dietary fiber intake (11 vs 17 h, P = 0.067). The correlation between stool frequency and colonic transit time was negative and weak for left colon (r = -0.3, P = 0.04), and negative and moderate for rectosigmoid and total colon (r = -0.5, P<0.001 and r = -0.5, P<0.001, respectively). The stool frequency was lower in the group with slow transit time (0.8 vs 2.3 per week, P = 0.014). In conclusion, most patients with chronic functional constipation had adequate dietary fiber intake. The negative correlation between stool frequency and colonic transit time increased progressively from proximal segments to distal segments of the colon. Patients with normal and prolonged colonic transit time differ in terms of stool frequency.

Adolescent↗
PubMed2001

Serum antigliadin antibody levels as a screening criterion before jejunal biopsy indication for celiac disease in a developing country.

The objective of the present study was to determine the efficacy of detection of antigliadin immunoglobulins G and A (IgG and IgA) for the diagnosis of celiac disease in a developing country, since other enteropathies might alter the levels of these antibodies. Three groups were studied: 22 patients with celiac disease (mean age: 30.6 months), 61 patients with other enteropathies (mean age: 43.3 months), and 46 patients without enteropathies (mean age: 96.9 months). Antigliadin IgG and IgA ELISA showed sensitivity of 90.9 and 95.5%, respectively. With the hypothetical values of prevalence ranging from 1:500 to 1:2000 liveborns, the positive predictive value varied from 8.5 to 2.3% for IgG and from 4.8 to 1.1% for IgA. Considering the patients without enteropathies, specificity was 97.8 and 95.7% for IgG and IgA, respectively. In patients with other enteropathies, specificity was 82.0 and 84.1%, respectively. When patients with and without other enteropathies were considered as a whole, specificity was 88.8 and 91.6%, respectively. The specificity of positive IgG or IgA was 93.5% in children without enteropathies and 78.7% in the presence of other enteropathies. The negative predictive value for hypothetical prevalences varying from 1:500 to 1:2000 liveborns was 99.9%. Thus, even in developing countries where the prevalence of non-celiac enteropathies is high, the determination of serum antigliadin antibody levels is a useful screening test prior to the jejunal biopsy in the investigation of intestinal malabsorption.

Analysis of Variance↗
PubMed2000

Pressure pain threshold in children with recurrent abdominal pain.

BACKGROUND: Experimental studies on humans have shown that recurrent pain is associated with altered pain perception. We measured the pressure pain threshold in regions of the body surface in a group of children who had recurrent abdominal pain and in a group of children with chronic or recurrent disease but with no pain. METHODS: Each group consisted of 45 boys and 55 girls ranging in age from 5 to 15.8 years. The regions of the body were the trapezius, deltoid, and supraspinous muscles, nine areas on the abdominal wall, and the median part of the tibias. Using an algometer, pressure was applied through a rubber disc with a surface area of 1 cm2 at a rate of 0.5 kg/cm2/s. The pressure values recorded with the algometer when the children communicated that they started to feel pain were considered as pressure pain thresholds. RESULTS: The pain thresholds were reduced in all regions investigated in children with recurrent pain. The median thresholds for all regions of the patients with and without pain were 1.60 and 2.2 kg/cm2, respectively. The diseases of children with pain did not influence the pain thresholds. CONCLUSION: There was an association between recurrent abdominal pain and a lower pressure pain threshold, with no influence of the type of disease, and there was a central nervous system alteration in the perception of pain in these patients.

Abdominal Muscles↗
PubMed2000

[Up-to-date clinical and experimental basis for the use of probiotics]

OBJECTIVE: To evaluate the potential of probiotics or biotherapeutic agents for the prevention and/or treatment of selected intestinal infections. METHODS: Medline database was searched for all relevant articles between 1990 and February 1998. Bibliographies of articles were also used. All animal experiments and placebo-controlled human studies were reviewed in order to provide information on the mechanisms of action, potential efficacy, or adverse effects of these biotherapeutic agents. RESULTS: In the first part of this review, the different mechanisms of action that are effective in the treatment of diarrhea were discussed, and they were well demonstrated in laboratory animals. The most important are: enzymatic induction of disaccharidase activity, trophic effects on the intestinal mucosa, action in blocking bacterial toxins, and also induction of the immunologic response. Therapeutic effects of probiotics in humans, mainly in the gastrointestinal tract, were reported in the second part. Placebo-controlled studies have shown that biotherapeutic agents have been used successfully in the treatment of acute diarrhea in infants, traveler s diarrhea, antibiotic-associated diarrhea, with or without Clostridium difficile-associated enterocolitis (pseudomembranous colitis), and in immunosuppression-associated diarrhea, including AIDS. Lactobacillus, Bifidobacterium and Saccharomyces boulardii were the most important biotherapeutic agents to be considered. CONCLUSIONS: Currently, there is evidence that the administration of selected microorganisms is benefic in the prevention and treatment of certain intestinal infections. According to the literature, Saccharomyces boulardii is the most important probiotic. Possible future indications were discussed, such as the probable synergic effect of many probiotics due to their different and complementary mechanisms of action. The importance of new experimental and clinical studies for the better understanding of actions and the use of probiotics in other clinical situations was emphasized.

Journal Article↗
PubMed2000

[Gastroesophageal reflux]

OBJECTIVE: To discuss clinical, diagnostic and therapeutic aspects of gastroesophageal reflux. METHOD: We accomplished a literature review of the last 30 years, by means of Lilacs and Medline databases. RESULTS: The gastroesophageal reflux is one of the most frequent causes of medical appointments with pediatric gastroenterologists. It represents a benign condition, characterized by regurgitations that can be resolved with general measures. Medical management with prokinetics and antacid agents controls clinical manifestations and prevents complications. Fundoplication is reserved to a minority of cases. COMMENTS: Some aspects of the clinical treatment have to be emphasized. Thickened/Solid diet and erect posture must be always recommended. Cisapride, the most commonly employed prokinetic agent, may prolong ventricular repolarization. Other prokinetic agents should be used in children. Bronchospasm or clinical manifestations of esophagitis indicate the use of antacid drugs.

Journal Article↗
PubMed1998

Dose effect of oral Saccharomyces boulardii treatments on morbidity and mortality in immunosuppressed mice.

Survival, weight loss, translocation and histological alterations in the terminal ileum, liver and spleen were studied in mice simultaneously immunosuppressed with cyclophosphamide and treated or not with Saccharomyces boulardii until the death of all animals. The animals were divided into five groups: C1 (not immunosuppressed, not treated); C2 (immunosuppressed, not treated); B1 (immunosuppressed, treated with S. boulardii 10.0 mg); B2 (immunosuppressed, treated with S. boulardii 1.0 mg) and B3 (immunosuppressed, treated with S. boulardii 0.1 mg). Survival was higher in group B3 than in the other immunosuppressed groups. Weight loss was observed for all groups except C1. By day 7, some animals from each group were killed by ether inhalation for the determination of bacterial translocation and histopathological examination. Bacterial translocation to the liver was lower in groups C1 and B3 than in the other groups. The highest translocation to the liver and spleen was observed in group B1. Low S. boulardii translocation was observed in some animals, principally to the mesenteric lymph nodes. Histopathological examination showed a decrease in epithelial cell turnover with villus length reduction and loss of brush borders in group C2. Relative protection against these alterations was obtained when the animals were treated with the yeast, independently of the dose. Higher expression of the lymphoid component was also noted in the ileal lamina propria, liver and spleen of mice treated with the yeast, together with activation of the reticulo-endothelial system, when compared with group C2 where lymphocyte depletion was observed. This study suggests a relative protection of immunosuppressed animals by treatment with S. boulardii, but this phenomenon was inversely proportional to the yeast dose.

Animals↗
PubMed1997

Morphological changes of the jejunal mucosa in protracted diarrhea and their correlation with disease duration, weight loss and serum albumin levels.

The pathogenesis of protracted diarrhea is multifactorial. In developing countries, intestinal infectious processes seem to play an important role in triggering the syndrome. Thirty-four children aged 1 to 14 months, mean 6.5 months, with protracted diarrhea were studied clinically and in terms of small intestinal mucosal morphology. Mild, moderate or severe hypotrophy of the jejunal mucosa was detected in 82% of cases, and mucosal atrophy was observed in 12%. The intensity of the morphological changes of the jejunal mucosa correlated negatively with serum albumin levels. No correlation was detected between mucosal grading and duration of diarrhea or between mucosal grading and weight reported as percentile. After nutritional support was instituted, serial jejunal biopsies were obtained from 12 patients: five patients submitted to parenteral nutrition for 7 to 38 days, mean 17 days, and 7 patients receiving a hypoallergenic oral diet (semi-elemental formula, 3; chicken formula, 3; human milk, 1). In seven cases (58%) a progressive increase in villus height and a decrease in the number of inflammatory cells were noted. Recovery of the morphologic pattern was accompanied by clinical improvement in all patients.

Diarrhea, Infantile↗
PubMed1996

Prevalence of anemia among school-children from Rio Acima (State of Minas Gerais, Brazil): use of the standardized prevalence method and evaluation of iron deficiency.

The prevalence of anemia and iron deficiency was investigated in 332 children aged 7 to 15 years, 156 (47%) boys and 176 (53%) girls enrolled in the schools of the municipality of Rio Acima, MG. Seventy-four children were white (22.3%), 218 were mulatto (65.7%), and 40 were black (12%). Mean hemoglobin level was 12.75 +/- 0.75 g/dl. Lower values were determined for black children (12.32 +/- 0.87g/dl) compared to white (12.76 +/- 0.99 g/dl) and mulatto (12.81 +/- 0.94 g/dl) children. The prevalence of anemia was 16.6% when determined on the basis of the percentage of children with hemoglobin values lower than the 3rd percentile for age and sex (standard method), and 36.2% when determined by the standardized prevalence method for the evaluation of the prevalence of malnutrition in populations. Depletion of iron reserves was 8.13% for the population in general and 20% for the anemic children. This low prevalence of iron deficiency may have been the result of the value adopted as the lower normal limit (10 ng/ml) for serum ferritin values. The small percentage of anemic children with iron depletion may also be justified by the standard of normality adopted for hemoglobin values which was originally elaborated for the white population of North America and Finland and therefore may be inadequate for the population studied here, of diverse racial composition.

Adolescent↗
PubMed1995

[Prevalence of serologic markers of hepatitis B in dentistry students and dentists in Belo Horizonte, Brazil].

The main objective of this transverse study was to investigate the presence of serologic markers of infection with the hepatitis B virus (HBsAg or HBsAb) among dentistry students before and after they began to have contact with patients; among dentists; and, for purposes of comparison with the latter group, among professionals outside the biological sciences in the municipality of Belo Horizonte, Brazil. Secondarily, the association between the prevalence of infection, the frequency of performing potentially infective dental procedures, and the use of protective barriers was studied. Among 88 students at the beginning of their course of study (average age = 20.0 years), the proportion of positive individuals was 6.8%; among 84 students concluding their studies (average age = 23.4 years), the proportion was 7.1% (P = 0.829). In the group of 202 dentists (average age = 44.0 years), 23.3% were positive, while among the other professionals (202 individuals, average age = 44.3 years), the proportion was 14.9%, for an odds ratio of 1.75 (95% CI = 1.02 to 2.98; P = 0.042). While 91.7% of the students reported that they routinely used surgical masks, only 16.7% said they regularly wore gloves. Among the dentists, these proportions were 49.8% and 9.4%, respectively. No association was found between risk factors and the use of such protection and the prevalence of infection in the different groups studied.

Adult↗
PubMed1994

Concentration of electrolytes in the sweat of malnourished children.

The sweat test was performed by the method of Gibson and Cooke on 36 children with second and third degree malnutrition, aged from 2 months to 4 years. The results were compared with those from 32 healthy, well nourished controls in the same age range. Determinations were made of sodium and chloride concentrations, chloride/sodium ratio, and the sum of the concentrations of the two electrolytes in each sample. The malnourished children were found to have higher sodium and chloride concentrations than the well nourished ones. None of the normal or malnourished children had a sweat chloride value greater than 60 mmol/l; chloride values within a suspicious range (between 40 and 60 mmol/l) were found in two malnourished children. Two well nourished controls and six malnourished children showed suspicious sweat sodium concentrations; in one child with third degree malnutrition the sodium content was greater than 60 mmol/l. In all results in the suspicious range, or greater than 60 mmol/l, the chloride/sodium ratio was less than 1, and the sum of the two electrolytes was below 140 mmol/l. Based on these results, we conclude that malnourished children have raised sweat sodium and chloride concentrations when compared with well nourished children. The electrolyte values for most of them are not in a suspicious range or consistent with a diagnosis of cystic fibrosis. Unlike that found in cystic fibrosis, the sodium/chloride ratio in our subjects was less than 1 and the sum of both electrolytes never exceeded 140 mmol/l.

Child, Preschool↗
PubMed1994

Fecal loss and clearance of alpha-1-antitrypsin in children with persistent diarrhea.

1. Daily fecal loss and daily clearance of alpha-1-antitrypsin were determined in 30 infants without intestinal disorders and in 21 with persistent diarrhea. 2. Stools were collected during a 48-h period and a randomly obtained single sample was also collected. Blood samples were also collected from the infants, and alpha-1-antitrypsin was measured by radial immunodiffusion in both stool and serum. 3. No difference in daily fecal loss (mg/d) of alpha-1-antitrypsin was detected between the control group and the group with persistent diarrhea (11 +/- 9.3 vs 18.5 +/- 20 mg/d). No difference in daily alpha-1-antitrypsin clearance (ml/d) was detected between the control group and the group with persistent diarrhea (4.3 +/- 3.6 vs 5.2 +/- 4.8 ml/d). 4. There was a strong correlation between daily fecal loss and daily clearance of alpha-1-antitrypsin (N = 50). There was a weak correlation between the concentrations of alpha-1-antitrypsin in randomly obtained single samples and daily fecal loss of the antiprotease (N = 25; r = -0.183; P < 0.01). 5. We conclude that: a) there is no increased fecal loss of alpha-1-antitrypsin persistent in diarrhea; b) fecal alpha-1-antitrypsin clearance is not necessary to estimate the enteric loss of the antiprotease; c) the determination of alpha-1-antitrypsin in random samples of feces is not a reliable method.

Diarrhea, Infantile↗
PubMed1993

Is dilution of cows' milk formula necessary for dietary management of acute diarrhoea in infants aged less than 6 months?

There is concern that feeding full-strength animal milk to infants aged less than 6 months with diarrhoea may have adverse consequences. We assessed the effects on clinical course of two feeding regimens in 159 Guatemalan and Brazilian infants aged 2 weeks to 6 months who had had acute diarrhoea for 120 h or less, showed signs of mild to moderate dehydration, and had no complications. After correction of dehydration, infants were assigned randomly to receive continued full-strength milk feeding or initial feeding with diluted milk with regrading to full-strength milk over 48 h. There were no significant differences between feeding groups in rate of treatment failures (-1%, 95% Cl -14 to 12%) or mean (SD) total stool output (full-strength milk 335 [268] g/kg, diluted milk 338 [354] g/kg) and duration of diarrhoea (92 [50] vs 92 [44] h). A significant association was found between presence of reducing substances in stools and treatment failure (OR 4.3, 95% CI 1.1 to 16.8), but reducing substances in stools were common both in treatment successes (61%) and in failures (87%). Our study supports the conclusion that, for infants under 6 months of age with diarrhoea whose only food is animal milk or formula, the milk or formula normally given should be provided in full strength as soon as dehydration has been corrected.

Academies and Institutes↗
PubMed1991

Diagnosis and distribution of Helicobacter pylori in the gastric mucosa of symptomatic children.

1. The demonstration of the association of H. pylori with gastritis and peptic ulcer has been of increasing interest to gastroenterologists, microbiologists, and histopathologists. 2. In this study, the presence of H. pylori in the gastric mucosa of children was investigated by culture, preformed urease test, and carbolfuchsin staining of biopsy smears. 3. The organism was detected in 44.9% of the children studied, and found to be distributed equally on the antral and fundic mucosa. 4. Compared to culture, the urease test and carbolfuchsin staining proved to be of higher sensitivity and specificity in detecting H. pylori.

Adolescent↗
PubMed1989

Two other cases of ANOTHER syndrome? Family report and update.

We describe one daughter of a possibly distant consanguineous couple with infantile hypothyroidism, trichodysplasia, dental anomalies, dystrophic nails, skin alterations, otitis media, slight conductive hypoacusia, recurrent respiratory tract infections, and gastroenterologic problems. One of her two sisters presents dental anomalies and trichodysplasia, and had dry skin at birth. Similarity indexes are estimated for our patients in comparison with those described under the acronym ANOTHER syndrome. It is concluded that, in spite of the differences, it is possible that our two patients also present ANOTHER syndrome. The cause is unknown.

Alopecia↗
PubMed1989

Chronic calcifying pancreatitis in children: a report of six cases.

1. A study of six patients with Chronic Calcifying Pancreatitis (CCP) occurring over a 10 year period, representing an incidence rate of approximately 1:1,000 of the inpatients in the children's ward of a general hospital in central Brazil, is reported. 2. Major clinical manifestations as well as therapeutic management are described. 3. The possible relationship between CCP and primary protein-calorie malnutrition is discussed and the importance of a CCP diagnosis when dealing with malnourished children who do not respond satisfactorily to common therapy is emphasized.

Calcinosis↗