[Evaluation of the nutritional status of adults].
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Biomedical subjects
Publications and source records attributed to F Infante.
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To determine the sensitivity and specificity of breath hydrogen (H2) in detecting lactase deficiency, breath H2 collected by end-expiratory sampling and capillary blood glucose were measured after ingestion of 50 g of lactose in 36 patients with biopsy-proved isolated lactase deficiency, 42 with normal lactase activity and 6 with lactase deficiency secondary to mucosal lesions. All patients had digestive symptoms clinically compatible with lactose malabsorption. The maximum increase in breath H2 concentration was more than 1.1 mumol/l (25 ppm) in all patients with isolated lactase deficiency, and less than 0.88 mumol/l (20 ppm) in 88% of patients with normal lactase activity; there were 5 false-positive results, attributed in one case to small bowel colonization and in another case to rapid transit after gastric surgery. Secondary lactase deficiency was accurately detected by neither breath H2 nor blood glucose.
Endoscopic biopsies at the inferior duodenal flexure from 36 patients were assayed for disaccharidases. Comparative studies in 8 patients were carried out from this location and from the duodenojejunal flexure. 16 patients with lactase values under 20 U/g protein and normal histology also underwent a lactose tolerance test. Evidence is presented that the easily performed duodenal biopsies give the same information as those from the angle of Treitz, at a level about 40% under the latter. Tolerance to lactose was in close relation with the lactase level in 16 patients, the limit being at about 5 U/g protein.
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The incidence of the cancer of the pancreas is particulary high in Geneva. To determine the possible effects of tobacco, alcohol and/or food, the consumption habits of patients with digestive diseases have been studied at the University Hospital of Geneva since 1977. The present contribution deals with pancreatic patients only. These patients' consumption of tobacco, alcohol and food has been compared with that of standardized controls randomly selected from the Geneva population. A relationship between pancreatic cancer and lifetime tobacco consumption was found on the one hand, and on the other a relationship between chronic pancreatitis and lifetime alcohol consumption.
In German the consumption of food among cirrhotic patients, whether male or female and among male patients with primary liver cancer (PLC), is virtually the same as in normals. Alcohol consumption is very high in all three groups. The heaviest drinkers are the cirrhotic males, but the highest patient/control ratio is found among cirrhotic females (X 5.4). Total alcohol ingestion during life appears to be higher in patients with PLC plus cirrhosis than in those with PLC without cirrhosis. Tobacco consumption by male cirrhotic and PLC patients is the same as in controls. Conversely, cirrhotic females smoke seven times as much as their standardized controls.
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INTRODUCTION: Obstructive jaundice is often accompanied by protein-caloric malnutrition. The objective of the present study is to analyze the incidence and the degree of alterations in the food ingestion of patients with obstructive jaundice. MATERIAL AND METHODS: In a prospective, cross-sectional study 50 patients with obstructive jaundice (19 benign and 31 malignant) were evaluated. The anorexia was evaluated using Welch's test (subjective evaluation) and by means of quantifying the caloric ingestion. An anthropometric parameter (ideal weigh < 95%) and two biochemical ones (albumin < 3.5 g/dl and pre-albumin < 17 mg/dl) were used to define the degree of malnutrition. RESULTS: 96% of the patients presented alterations in the Welch test and in 72% of the patients the caloric ingestion was below the estimated needs. Overall, the ingestion of food was reduced by 76.3 +/- 30% of the estimated needs (84.7 +/- 28% in the benign cases and 70.9 +/- 32% in the malignant cases). Both the Welch test (r = 0.59; p = 0.01) and the caloric ingestion (r = 0.53; p < 0.001) were inversely correlated with the serum bilirubin. In patients with malnutrition criteria, the caloric ingestion was reduced by 30% against the 12% reduction in the non-malnourished patients (p < 0.05). There was a direct correlation between the two methods used in the assessment of the anorexia (r = 0.71; p < 0.001). CONCLUSIONS: Obstructive jaundice is associated with an important reduction in the caloric ingestion, and this is manifested in both biliary obstructions of a benign origin, and in those of neoplasic origins.
The sensitization to pollen from the Amarantaceae and Chenopodiaceae families is responsible for some pollinoses according to various authors. Following an aeropalynological carried out by the Botany Division of our University, we investigated the sensitization to Chenopodium in our pollinic patients in order to establish their clinical patterns. We evaluated 14 variables in Chenopodium-sensitive (CHE +) and nonsensitive (CHE -) patients; the results were analysed by using a computerized statistical programme. Of the 1,000 records reviewed, 38% corresponded to pollinic patients, of whom 8.42% were sensitive to pollen from this family. We found no significant differences between the two groups in the parameters representative of atopic features (e.g. eosinophilia, IgE). However, marked differences were indeed found in the age of appearance of symptoms, frequency of clinical pictures, origin of the patients, duration of the symptoms and evolution upon immunotherapeutic treatment not involving this antigen. These findings endow the sensitization to Chenopodium with special features which should be taken into account in choosing a specific treatment.
We have carried out a study on the annual and diurnal variation of pollen from the Gramineae family in the atmosphere of Córdoba (Southern Spain) during three consecutive years. This family, according to its high sensitizing capacity and to data from allergologists, is responsible for most of the pollenoses diagnosed in the city. Pollen grains from Gramineae were found to occur in the atmosphere virtually throughout the year, starting in February. Yet, they reach their highest levels in spring, particularly in May and the first fortnight of June. Such levels decrease gradually during the summer and become virtually imperceptible from October. The concentration of pollen grains from Gramineae were found to be positively correlated with the average temperature, and negatively correlated with the average humidity. The diurnal variation pattern of the concentration of pollen grains from this family was rather homogeneous throughout the three years studied, with a marked increase early in the morning, a moderate decrease in the afternoon and stable values throughout the night.