Biomedical subjects

U Fagundes Neto

Publications and source records attributed to U Fagundes Neto.

42 records · Page 3Linked to original sources

PubMedDate not supplied

[Congential malabsorption of glucose and galactose in 2 brothers].

Congeneeital glucose-galactose malabsorption is a rare clinical entity transmitted by autossomic recessive gen. The defect is in the small intestinal active transport system which is shared by glucose and galactose. Diarrhea and failure to thrive from the first week of life are the prominent symptoms. We report two sibs from consaguineous parents with diarrhea and failure to thrive since they were born. Both children had glucose and galactose malabsorption but tolerated well formula containing fructose as the only source of carbohydrate. They showed flat blood glucose curves when tested with glucose and galactose loads but normal increments of the sugar blood levels with fructose load. The small intestinal biopsy performed in both patients revealed normal villous pattern. When put under a diet containing fructose as the only source of carbohydrate, both patients had their symptoms subsided and reassumed the normal pattern of growth.

Body Weight↗

PubMedDate not supplied

[Tolerance tests in the diagnosis of mono- and disaccharides malabsorption in children].

The carbohydrate tolerance test is a very common method employed in the diagnosis of carbohydrate malabsorption, despite the possibility of some pitfalls in its interpretation. There are some factors, namely, the omission of the 15 minute blood sample, slow gastric emptying, malnutrition and venous blood sampling, that can condition the characterization of false positive intolerance. We studied 177 curves performed in 110 children during a 4 year period, and we observed that: a) the highest peak level occurred at 15 minutes in 57,3% of the tolerance tests; b) if the 15 minutes sample was not obtained it resulted in 28% of false positive intolerance; c) regarding the nutritional status malnourished children had more frequently a delayed peak level, been 17% at 15 minutes and 67% at 30 minutes. Misinterpretation of the carbohydrate tolerance test can be minimized taking into account these known factors that induced the diagnosis of false positive intolerance.

Blood Glucose↗

PubMedDate not supplied

[Morphometrics of the small intestine in children with diarrhea due to classical enteropathogenic Escherichia coli and to environmental asymptomatic enteropathy].

The enteric EPEC infection may cause different degrees of abnormalities in the small bowel villi. Morphological changes in the small intestine have been described in asymptomatic children who live in unfavourable environmental conditions. Enteric EPEC infections frequently occur in children living in such conditions and may worsen the already existing lesions. OBJECTIVES--1) To evaluate the morphological changes of the morphometry and compare them to the intestinal mucosa of children bearing Asymptomatic Environmental Enteropathy (AEE). 2) To compare the number of intra-epithelial lymphocytes (IEL) found in acute and/or persistent diarrhea by EPEC to those ones found in the other two groups. MATERIAL AND METHODS--Thirty (30) specimens of small intestinal mucosa obtained from children having acute and/or persistent diarrhea by EPEC were analysed and then compared to the specimens of the small intestinal biopsy of sixteen (16) patients bearing AEE. The following measurements were performed: RESULTS-- [table: see text] CONCLUSIONS--The villous changes were more remarkable in EPEC infection but the crypt hypertrophy was significantly higher in patients with AEE. This fact is probably due to repeated damages caused by the environmental problems. The use of linear morphometry has been a relevant technique which allows to evaluate the possible small intestinal morphological changes more accurately than the subjective criteria. In this way, the application of this technique enables the comparative approach of determined values under statistical bases.

Acute Disease↗

PubMedDate not supplied

[Serotypes of classical enteropathogenic Escherichia coli that produce changes in the small bowel ultrastructure and invasion of HeLa cells].

UNLABELLED: Enteropathogenic Escherichia coli (EPEC) is the main cause of diarrhea in infants up to one year of age in the majority of the developing countries. In vitro EPEC strains attach to HeLa or HEp-2 cells in a specific pattern called localized adherence (LA), which is correlated with 93% of the EPEC serotypes. In vivo, EPEC strains adhere intimately to cuplike projections of the apical enterocyte membrane causing localized destruction of the microvilli, described as an attaching and effacing lesion. PURPOSE: We showed the attaching-effacing lesions and intracellular penetration in the ultrastructural study of the small intestinal cells as well as in the HeLa cell assay by the following EPEC serotypes: O111ab:H2, O119:H6 and O18ab:H14. PATIENTS AND METHODS: These strains were isolated from the stools of three infants less than 2 years of age with watery diarrhea who were hospitalized for fluid and electrolyte repairment. In the three patients there were severe ultrastructural alterations of the enterocytes mainly shortening and destruction of the microvilli, and formation of cuplike pedestal lesions. There was also penetration of microorganisms into the cytoplasm of the enterocytes in the interior of endocytotic vesicles. The serotypes of EPEC were assayed with HeLa cells showing the formation of pedestals and penetration into the cytoplasm. CONCLUSION: The ultrastructural alterations of the small bowel observed in these patients represent an important indication of the possibility of perpetuation of the diarrhea, owing to either a secretory mechanism or malabsorption of the nutrients.

Acute Disease↗

PubMedDate not supplied

[Clinical and epidemiological characteristics of acute diarrhea by classical enteropathogenic Escherichia coli].

UNLABELLED: Acute diarrhea is usually considered as a self limited disease, but under certain circumstances, mainly owing to the age of the patient, the nutritional status and the enteropathogenic agent the illness can evolve for a protracted evolution. PURPOSE: In the present study we report the clinical and epidemiological features of a group of infants under two years of age with acute diarrhea caused by serogroups of enteropathogenic Escherichia coli (EPEC). PATIENTS AND METHODS: During a two year period 200 infants under two years of age, mean 8.2 months, with acute diarrhea less than 5 days duration, were consecutively studied. A control group of 40 healthy infants matched for age was also made up. The nutritional status was determined and the occurrence of food intolerance was also monitored. The patients were followed up for 4 weeks after been discharged from the hospital. Stool samples were obtained for research of bacterial, viral and protozoan enteropathogenic agents. RESULTS: EPEC was isolated in the stools of 84 (42.0%) infants, as a sole enteropathogenic agent in 55 (27.5%) and in the remaining 29 (14.5%) infants associated with some other agent. EPEC was isolated in the stools of 9 (22.5%) infants of the control group (p < 0.05). Food intolerance was the main digestive complication and also the most important factor that caused perpetuation of diarrhea. The mean duration of the disease was 11.2 days, varying from 2 to 40 days. In 53 (71.6%) infants the disease lasted less than 14 days, while in the remaining 21 (28.4%) it lasted more than 14 days, and all these infants presented with food intolerance. CONCLUSIONS: Enteric infections caused by EPEC serogroups, particularly O111 and O119, are more prevalent in weaned infants under 1 year of age belonging to families of low income rates. These infants present heavy fluid and electrolyte losses in the stools associated to high rates of food intolerance.

Acute Disease↗

PubMedDate not supplied

[Influence of classic enteropathogenic Escherichia coli on small bowel bacterial proliferation in infant's acute and persistent diarrhea].

UNLABELLED: Bacterial proliferation of the colonic microflora can occur in up to 50% of the infants with acute and persistent diarrhea. EPEC strains are frequently associated with bacterial proliferation in the small bowel lumen. The persistence of diarrhea might be due to the proliferation of EPEC in the intestinal lumen. PURPOSE: The present study was aimed at comparing the magnitude of the bacterial proliferation in the small bowel lumen in infants with acute and persistent diarrhea due to EPEC and other agents. PATIENTS AND METHODS: Fourty infants with diarrhea (23 with acute diarrhea and 17 with persistent diarrhea) underwent a naso-jejunal intubation for intestinal secretion culture of aerobes and anaerobes microorganisms. Stool samples were also collected for the investigation of enteropathogenic agents. RESULTS: Bacterial proliferation in the small bowel was detected in 32 (80%) infants; in 30 (75%) infants there was proliferation of aerobic microorganisms while in 17 (43%) infants there was proliferation of microorganisms belonging to the anaerobic microflora. There was no statistical difference in the bacterial proliferation between patients with acute and persistent diarrhea. In 16 patients EPEC strains were identified in the stool culture, and all of them showed bacterial overgrowth above 10(3) microorganisms/mL. In contrast in the 24 patients without EPEC in the stools only 16 (67%) showed bacterial overgrowth in the small bowel lumen (p < 0.01). The mean concentration of E. coli in the intestinal secretion was 8 x 10(5) microorganisms/mL among the patients with EPEC in the stools and 3 x 10(2) microorganisms/mL among the patients with no EPEC in the stools (p < 0.05). CONCLUSIONS: EPEC infection either acute or persistent induce favorable conditions for bacterial proliferation in the small bowel secretion in infants with diarrhea.

Acute Disease↗