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C Wainstein

Publications and source records attributed to C Wainstein.

13 recordsLinked to original sources
PubMed1999

Gut mucosal atrophy after a short enteral fasting period in critically ill patients.

PURPOSE: The purpose of this study was to evaluate the presence of gut mucosal atrophy and changes in mucosal permeability in critically ill patients after a short fasting period. MATERIALS AND METHODS: Fifteen critically ill patients underwent a period of enteral fasting of at least 4 days (mean 7.8 days). We took the following measurements the day before initiating enteral nutrition: indirect calorimetry, serum albumin, prealbumin, and lymphocyte count. We also performed a duodenal endoscopic biopsy with histopathological and mucosal morphometric analysis including villus height and crypt depth. The lactulose-mannitol test was performed to assess gut permeability. A total of 28 healthy volunteers served as controls for duodenal biopsy or lactulose-mannitol test. Clinical data, such as length of fasting, severity score, and previous parenteral nutritional support, were recorded. RESULTS: We found gut mucosal atrophy, expressed as a decrease in villus height and crypt depth, in patients compared with controls. The patients also exhibited an abnormal lactulose-mannitol test. Morphometric changes did not correlate with permeability. Further, we found no correlation between the results of the lactulose-mannitol test and of mucosal morphometry with clinical data. CONCLUSIONS: We found that a short period of enteral fasting was associated with significant duodenal mucosal atrophy and abnormal gut permeability in critically ill patients.

Adult↗
PubMed1999

[Transcranial cytokine gradient and intestinal permeability in acute severe brain injury].

BACKGROUND: Acute brain injury is associated with a bimodal hypermetabolic state probably caused by cytokine secretion and high hormone and catecholamine concentrations. In a first stage, the brain would produce these substances and afterwards, another production source, most probably the splanchnic territory, would perpetuate the hypermetabolic state. AIM: To investigate the cytokine production source and to assess intestinal permeability in acute brain injury in the absence of cerebral ischemia and systemic oxygen deficit. PATIENTS AND METHODS: Arterial systemic and cerebral venous bulbar interleukin 1 beta and interleukin 6 levels were measured during the first seven days of evolution in 15 patients with acute brain injury. Serum lactate, the oxygen/lactate ratio, gastric intramucosal pH and intestinal permeability using the lactulose/mannitol test were also assessed in the same period. RESULTS: High arterial and venous interleukin 1 beta and interleukin 6 levels were detected. A positive gradient for interleukin 6 levels was detected throughout the study period with normal intramucosal pH, lactate and oxygen/lactate ratio. There was also an early impairment of intestinal permeability in these patients. CONCLUSIONS: High arterial and venous cytokine concentrations were detected in patients with acute brain injury. The positive gradient for interleukin 6 suggests a brain origin for this cytokine. Intestinal permeability is also altered in these patients.

Adult↗
PubMed1996

HIV-1, HIV-2, HTLV-I/II and STD among female prostitutes in Buenos Aires, Argentina.

To determine the prevalence of HIV-1 and HTLV-I/II among female prostitutes from different areas of the city of Buenos Aires, we studied serum samples from 237 individuals (mean age: 25; range 17 to 39). Prostitutes were recruited from 16 different Buenos Aires locations with different economical status. Information on sexual behaviour, health and socioeconomic conditions was collected through a questionnaire. HIV-1 and HTLV-I/II antibodies (ab) were tested by ELISA (Abbott) and Particle agglutination (Fujirebio, Tokyo) respectively. Positive results were confirmed by immunofluorescence assay. Samples that were positive for HIV-1 antibodies were also tested for p24 antigen (Abbott). VDRL for syphilis was performed in all samples. Fifteen (6.3%) out of the 237 individuals were positive for HIV-1 antibodies. Moreover, 2 (0.8%) HIV-1 seropositive prostitutes were also positive for HTLV-I/II antibodies and for HIV p24-Ag. Even though PCR for HTLV-I/II was not performed, titration by IFA in these two samples suggests HTLV-I. Our serologic results indicate a relatively high HIV-1 infection among prostitutes working in Buenos Aires. As we previously mentioned for other risk groups, we found an association between HTLV-I/II and HIV-1 infection in this particular group. Although we did not find any significant difference between HIV-1 seropositivity and the variables analyzed through the questionnaire, the prevalence of HIV-1 infection was higher in prostitutes working in mask brothels ('sauna or massage houses') as compared with hotel or street prostitutes.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Prevalence of hepatitis C in health care workers investigated by 2nd generation enzyme-linked and line immunoassays.

The aim of this study was to evaluate the prevalence of antibodies to hepatitis C virus (anti-HCV) in health-care workers (HCW). Sera from 439 unselected HCW were assessed for anti-HCV by 2nd generation enzyme-linked immunoassay (ELISA) and anti-HBc by ELISA. Anti-HCV (+) sera were evaluated by line immunoassay (LIA) (LiaTeK, Organon). Anti-HCV proved positive by ELISA in 12 (2.73%) subjects, 6 of whom were reactive by LIA, one was indeterminate and 5 non reactive. The prevalence of anti-HCV confirmed by LIA was 1.59% (7 subjects). Positive anti-HCV results with an ELISA ratio greater than 3 were LIA reactive in 6/6 as compared with 5 LIA non reactive with an ELISA ratio less than 2, while in the indeterminate serum the ratio was 2.5. No differences in age, profession, seniority, history of hepatitis or transfusions were found between anti-HCV (+) and (-) subjects, but females predominate significantly. The areas of higher risk were hemodialysis, obstetrics, surgery and intensive care. Anti-HBc was (+) in 85.7% (6/7) of the anti-HCV (+) subjects. Follow-up of anti-HCV (+) subjects showed raised alaninoaminotransferase levels in 4 cases, while liver biopsies in 3 disclosed cirrhosis, chronic active hepatitis and chronic persistent hepatitis. The anti-HCV prevalence in HCW is low compared with other risk groups perhaps due to the peculiar epidemiological features of HCV. In low risk groups for HCV infection a positive ELISA result with a ratio lower than 3 should be confirmed by more specific tests.

Adult↗
PubMedDate not supplied

Influence of polymeric enteral nutrition supplemented with different doses of glutamine on gut permeability in critically ill patients.

OBJECTIVES: To evaluate the effect of glutamine-supplemented polymeric enteral formulas on the recovery of gut-permeability abnormalities in critically ill patients. METHODS: Twenty-three patients were randomized to receive a conventional casein-based enteral formula (ADN), ADN plus glutamine in a dose of 0.15 g x kg(-1) x d(-1) or ADN plus 0.30 g x kg(-1) x d(-1) of glutamine for 8 d. The lactulose mannitol permeability test (L/M) was performed at baseline and at the end of the study. Nineteen healthy volunteers served as controls for the L/M test. RESULTS: An increase in permeability compared with control subjects was observed in patients at baseline (mean +/- standard error of the mean; L/M ratio: 0.11 +/- 0.03 and 0.025 +/- 0.004, respectively; P < 0.02). The L/M ratio improved after the period of enteral nutrition as a whole (initial L/M: 0.11 +/- 0.03, final L/M: 0.061 +/- 0.01; P < 0.03), but no difference was found between groups. CONCLUSIONS: Even though polymeric enteral nutrition was associated with a significant improvement in the L/M ratio, glutamine supplementation did not show a specific influence in improving recovery of gut permeability in critically ill patients.

Adult↗